Wrapping Your Head Around the Health Bill

New York Times, Economix: Wrapping Your Head Around the Health Bill

On Tuesday, President Obama signed into law H.R. 3590 — the Patient Protection and Affordable Care Act [both pdf's]. …

…What is one to make of these bills? Are they, as the president put it, a major step in the right direction, even if not the final chapter of American health reform? Or are they, as their critics have it, a government takeover of health care that deprives Americans of their freedom?

A problem with any such legislation is that it is hard to grasp in its entirety. In the original version, H.R. 3590 as passed by the Senate on Dec. 24, 2009, ran to some 2,400 pages, although with a very large font, triple spacing and huge left and right margins.

With normal margins the document probably would shrink to about 500 pages or so. But even in that form, the Senate bill would be a major opus and a remedy against insomnia for all but the truly dedicated reader.

To appreciate what the legislators crafting the bill tried to accomplish, anyone truly interested in this reform bill might start at the beginning, with Senator Max Baucus’s “Call to Action: Health Reform 2009” [pdf].

This 89-page, eminently readable white paper was composed by the senator’s staff of health policy analysts under the leadership of Liz Fowler, Ph.D. The paper draws extensively on a huge array of first-class research papers produced over the years by the health-services research community. It is a well-structured catalog of problems identified in that literature and on the mind of Senator Baucus and his staff members.

“Call to Action: Health Reform 2009” became the springboard for the bill that eventually emerged in the Senate (H.R. 3590), although that bill was the product of many political compromises and would hardly have been called the ideal envisioned by policy wonks.

As to the Senate bill itself, I would recommend to readers a summary of that bill, prepared by the Congressional Research Service. The Congressional Research Service is a bipartisan research arm of Congress.

This 24-page summary of H.R. 3590 is written in plain English. It can give any reader who actually cares to know what is in the bill a good grasp of its contents.

A similarly readable summary of H.R. 4872, the reconciliation bill passed by the House and now being debated in the Senate, can be found here [pdf]. That summary also is written in plain English, rather than the legalese of formal bills, although it should be kept in mind that the bill is merely a set of proposed amendments to H.R. 3590, the Senate bill.

I go to such length about the bills that will constitute United States Health Reform 2010 and to provide Web links to them in the belief that the time has passed for concerned citizens to let themselves be informed solely by pundits of various ideological stripes. Citizens should read at least the accessible summaries of the bills to become truly familiar with them. Think of them as a reading assignment in college. …