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Paring back health care isn't as easy as it sounds

Associated Press Modified: January 22, 2010 at 10:17 am •  Published: January 21, 2010


WASHINGTON (AP) — Trimming back the 2,000-page, trillion-dollar Democratic health care bills to the parts that average Americans understand and like may not be as simple as it sounds.

A complete ban on insurance companies denying coverage to people with medical problems would be out of the question. Forget about guaranteed health insurance for all Americans — it costs too much. Still, Congress might be able to produce legislation that takes some rough edges off today's coverage problems and makes progress in controlling costs.

That is if Democrats and Republicans can call a truce.

Republicans, who for months have been urging "commonsense" alternatives to the Democrats' sweeping overhaul plan, may still be unwilling to help pass anything that lets President Barack Obama claim an election-year victory. They will have 41 votes in the Senate to block it once Massachusetts' Scott Brown is seated.

Yet the U.S. health care system is unlikely to heal itself. The number of uninsured will rise above 50 million unless government steps in, while ballooning costs could leave Americans turning 65 with a bare-bones government health care program for the elderlly.

"The problems that exist in our health care system are real problems," said Sen. Jeff Bingaman, a moderate Democrat who has worked to find compromise with Republicans. "It would be unfortunate if we were to just set aside significant health care reforms."

Obama has suggested shifting the focus to popular proposals like banning denial of coverage to those with medical problems. That particular fix is unlikely because it would encourage people to put off getting insurance until they are sick, driving up premiums for everybody else.

"In health care, everything fits together," said Sen. Jay Rockefeller, a Democrat, "It's very hard to say we can cut this out and do that." Banning pre-existing medial condition denials would have to go hand-in-hand with coverage for all.

Still, some limitations on health insurance companies are feasible, said Mark McClellan, who served as a health care official for President George W. Bush.

"There is a starting point," McClellan said. "There is a way to do something meaningful without going to requirements for coverage and trillion-dollar subsidies."

On McClellan's short list would be a ban on denial of coverage to children with medical problems, forbidding insurers from canceling the policies of people who get sick, and limiting in some way what the companies may spend on overhead and profits instead of direct medical care.

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