The 2009 national healthcare debate: funding and cost control

Healthcare Debate

Summer '09: The National Healthcare Debate

Funding Disputes

Obama and others in his administration (and/or in the Democratic Party) had developed a somewhat complex and unclear plan for paying for the proposed healthcare bill that involved certain increased taxes and a rearranging of federal spending, including making cuts to Medicare. Many speakers at the town hall meetings and in later online posts interpreted the plan as a simple way to "spread the wealth around," forcing people who already had adequate health coverage to pay more for the same service in order to pay for the other people that would be required to purchase insurance if the healthcare bill was passed. This is essentially what the debate over the funding sources boiled down to: whether the bill's provisions would be funded by the government in some way that did not place an extra burden on middle- and upper-class tax payers (primarily middle), or if it would do exactly that by developing a system of wage-based contributions for a national mandatory health care program. Some very heated though less prolonged debate also centered on the issue of Medicare cuts, with reassurances that the health care plan would adequately cover any loss in service due to the Medicare cuts dismissed out of hand by many.

Oversight

There has also been considerable debate regarding exactly who will be overseeing the program. There was considerable talk of "death panels," a deliberately fear-invoking image of a bunch of suit-wearing individuals determining when it was time for a person to die rather than continue to receive expensive medical care. The thought of panels of government bureaucrats overseeing every aspect of care, including end-of-life care, was horrific to many people, and a major source of anger and opposition to the bill. Proponents of the bill, however, insisted that the doctor and patient would still determine health care plans, and that the government's role would purely be in ensuring adequate funding in order to cover the vast majority of currently uninsured Americans. The reconciliation of these two views is still long in coming.