{ "id": "R40517", "type": "CRS Report", "typeId": "REPORTS", "number": "R40517", "active": false, "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department", "versions": [ { "source": "EveryCRSReport.com", "id": 351969, "date": "2009-08-31", "retrieved": "2016-04-07T02:18:57.114356", "title": "Health Care Reform: An Introduction", "summary": "Health care reform is a major issue in the 111th Congress, driven by growing concern about millions of people without insurance coverage, continual increases in cost and spending, and quality shortcomings. Commonly cited figures indicate that more than 45 million people have no insurance, which can limit their access to care and ability to pay for the care they receive. Costs are rising for nearly everyone, and the country now likely spends over $2.5 trillion, more than 17% of gross domestic product (GDP), on health care services and products, far more than other industrialized countries. For all this spending, the country scores but average or somewhat worse on many indicators of health care quality, and many may not get appropriate standards of care.\nThese concerns raise significant challenges. Each is more complex than might first appear, which increases the difficulty of finding solutions. For example, by one statistical measure, far more than 45 million people face the risk of being uninsured for short time periods, yet by another, substantially fewer have no insurance for long periods. Insurance coverage and access to health care are not the same, and it is possible to have one without the other. Having coverage does not ensure that one can pay for care, nor does it always shield one from significant financial loss in the case of serious illness. Similarly, high levels of spending may be partly attributable to the country\u2019s wealth, while rising costs, though difficult for many, may primarily mean that less money is available for other things.\nSolutions to these concerns may conflict with one another. For example, expanding coverage to most of the uninsured would likely drive up costs (as more people seek care) and expand public budgets (since additional public subsidies would be required). Cutting costs may threaten initiatives to improve quality. Other challenges include addressing the interests of stakeholders that have substantial investments in present arrangements and the unease some people have about moving from an imperfect but known system to something that is potentially better but untried. How much reform might cost and how to pay for it is also an issue.\nHealth care reform proposals rekindle debate over perennial issues in American health care policy. These include whether insurance should be public or private; whether employment-based insurance should be strengthened, weakened, or left alone; what role states might play; and whether Medicaid should be folded into new insurance arrangements. Whether changes to Medicare should occur at the same time is also being considered. Concerns about coverage, cost and spending, and quality are likely to be addressed within the context of these issues.\nThe committees of jurisdiction for health care have prepared comprehensive reform proposals. The Senate HELP Committee approved a measure on July 15 (Affordable Health Choices Act), whereas H.R. 3200, a coordinated measure by three House committees (Education and Labor, Ways and Means, and Energy and Commerce), was approved by the first two committees with some variations on July 17 and by Energy and Commerce on July 31. The Senate Finance Committee has no draft available to the public, though it has released policy option documents and many of its debates have been publicized. More than a dozen other comprehensive bills have also been introduced.\nThis report does not discuss or even try to identify all of the concerns about health care in the United States that are prompting calls for reform. Other concerns may also be important, at least to some, and will likely contribute to the complexity of the reform debate. The report may be updated to include other health care reform issues as the debate in Congress unfolds.", "type": "CRS Report", "typeId": "REPORTS", "active": false, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R40517", "sha1": "db084cfd47d7b6ff9d1b4fa0a1b61cdc30b8d81c", "filename": "files/20090831_R40517_db084cfd47d7b6ff9d1b4fa0a1b61cdc30b8d81c.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R40517", "sha1": "93d2a0072fd185a42b2a2a63a43221485f34b58e", "filename": "files/20090831_R40517_93d2a0072fd185a42b2a2a63a43221485f34b58e.pdf", "images": null } ], "topics": [] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc689458/", "id": "R40517_2009Jul29", "date": "2009-07-29", "retrieved": "2015-08-03T15:06:47", "title": "Health Care Reform: An Introduction", "summary": "This report provides an introduction to health care reform. It focuses on the three predominant concerns just mentioned--coverage, cost and spending, and quality--and some of the legislative issues within which they likely will be debated, including the scope of reform (particularly whether Medicare and Medicaid should be included); the choice between public and private coverage; whether employment-based insurance should be strengthened, weakened, or left alone; and what role states might play.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20090729_R40517_b49a8b2619af751266af25286944a6e98cfa18ba.pdf" }, { "format": "HTML", "filename": "files/20090729_R40517_b49a8b2619af751266af25286944a6e98cfa18ba.html" } ], "topics": [ { "source": "LIV", "id": "Health", "name": "Health" }, { "source": "LIV", "id": "Health policy", "name": "Health policy" }, { "source": "LIV", "id": "Medicine", "name": "Medicine" }, { "source": "LCSH", "id": "Diseases.", "name": "Diseases." } ] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc818229/", "id": "R40517_2009Jun30", "date": "2009-06-30", "retrieved": "2016-03-19T13:57:26", "title": "Health Care Reform: An Introduction", "summary": null, "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20090630_R40517_e1e59c7be56d50052e67e708d9814d0b83d48fae.pdf" }, { "format": "HTML", "filename": "files/20090630_R40517_e1e59c7be56d50052e67e708d9814d0b83d48fae.html" } ], "topics": [] }, { "source": "University of North Texas Libraries Government Documents Department", "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc700705/", "id": "R40517_2009Apr14", "date": "2009-04-14", "retrieved": "2015-08-27T16:20:31", "title": "Health Care Reform: An Introduction", "summary": "This report provides an introduction to health care reform. It focuses on three predominant concerns--coverage, cost and spending, and quality--and some of the legislative issues within which they likely will be debated--the scope of reform (particularly whether Medicare and Medicaid should be included); the choice between public and private coverage; whether employment-based insurance should be strengthened, weakened, or left alone; and what role states might play.", "type": "CRS Report", "typeId": "REPORT", "active": false, "formats": [ { "format": "PDF", "filename": "files/20090414_R40517_e83812db706e5ea4ca5381dabb2a3ee1851da0f5.pdf" }, { "format": "HTML", "filename": "files/20090414_R40517_e83812db706e5ea4ca5381dabb2a3ee1851da0f5.html" } ], "topics": [ { "source": "LIV", "id": "Medical care", "name": "Medical care" }, { "source": "LIV", "id": "Health care reform", "name": "Health care reform" }, { "source": "LIV", "id": "Access to health care", "name": "Access to health care" }, { "source": "LIV", "id": "Health policy", "name": "Health policy" } ] } ], "topics": [ "Domestic Social Policy", "Health Policy" ] }