From a business perspective I see no benefit to the passage of this bill. Regardless of the political hype it is evident that it will increase the cost of healthcare, e.g. how else will those previously denied healthcare coverage receive economical care other than to spread the cost across all consumers.

From a personal perspective see the first paragraph of my response.

I think there's huge and obvious benefit from the bill, employers often can't see the wood for the trees, there will be cost but not as much as they believe. And it will stop many in the workforce from worrying themselves to death over the costs of healthcare, enabling them to be far more productive (which is the key - last time I checked the cost of labour is the highest factor in running a business, so getting the most for that cost is the key requirement).

Nick is very astute, even though I suspect, not part of our American health insurance system, by his english. Don imagine the possibilities. Currently, our hospitals and health care providers are extremely inefficient. Many uninsured Americans (from job loss or pre-existing conditions) are still treated. Most times payments are made slowly or not at all. Many hospital and physicians' receivables are financed costing some providers 10% or more, when they do get paid.

More money into the system allows for higher salaries, and more positions can be made available. Most preventative care today, can be performed by qualified RN's and LPN's under a physician's supervision. If we adopt clinics or team care where multiple specialties treat the entire person at one facility, we can increase quality and reduce costs at the same time.

Administrative systems can be stream-lined as well. Uniform on-boarding, forms, coding, with secure patient and pharmacy records available to patients and providers at the touch of a button. Imagine a system were adverse reactions to medications can be reported to a health care clearing house. Dangerous side effects can be recorded and announced to the medical community instantly.

Improving care, saving lives, affordable access for all. Isn't that what our goals should be?

Bruce Silver
Employers RX LLC
http://employers-Rx.com

Some of those are legitimate improvements Bruce. They do not involve bankrupting the country, creating larger government, creating a government funded health option or adding to the federal bureaucracy.

As to requiring insurance compqanies to cover pre-existing conditions you may forget the HIPAA exclusions currently in place. Further, requiring any and all pre-existing coverage will once again raise costs for all others. Additionally isn't requiring pre-existing coverage much like requiring insurance companies to cover repeat offender drunk drivers ? If these individuals went into a common pool where their group covered the risk of all who have been excluded for pre-existing conditions then perhaps the solution could be further discussed. As long as it wasn't run by an already bloated federal government.

I always scratch my head over the access issue as well. In the US even the uninsured have access to care already.

Kate, yours is quite a good question. I don't believe the lack of attention on CNN on a particular date is indicative of the feelings of much of the nation, however.

I am bewildered by the comments about the impact of the bill passed by the House and the one scheduled for debate by the Senate. It will be interesting to see what emerges from the Senate; however, it remains possible the Senate will be unable to act. Sen. Reid is still at least two votes and perhaps four short of the 60 required for cloture.

I've read the 1900 page House bill and the more than 2000 page Senate proposal, and they will be disastrous for small and midsized business in America. One of the challenges is that there are some decent principles underlying the bill and most of them sound really good on their own. Eliminating pre-existing condition exclusions for individuals is consistent with provisions adopted in HIPAA. While it will have a one-time huge effect, that isn't a game changer and merits adoption. Requiring insurance for all is noble, if it can be done for the indigent without bankrupting whatever means is used to support it. I'm still not convinced it can be done, particularly if illegal aliens are not covered. I would not envy the hospital that turns away a dying patient because he is an illegal without mandated health insurance.

Once again, however, Congress demonstrates that it doesn't understand the risk sharing and risk transfer elements of insurance. Here are three aspects of the current plans that should be of significant concern for businesses:

1. Private insurance, according to two recent studies, pays a 28% premium in order for hospitals to offset the insufficient reimbursements of Medicare and Medicaid. This is greater than the 15% premium needed to offset the costs of the uninsured. You want to reduce private insurance premiums, raise the reimbursement levels of existing government medical benefit programs.

2. There are several tax increases in each bill that would impact businesses. Taken in the aggregate, they will approximate an added 8% tax burden on businesses offering insurance and up to 13% for LLCs. There are also taxes on medical devices that will increase the costs to hospitals and clinics that will almost certainly be passed along to endline consumers. This isn't consistent with the mission to slow the pace of cost increases.

3. The benefit levels required by each of the bills are not specified, so anyone who suggests costs will be lower has no basis for that calculation. Even the nonpartisan CBO quietly concedes it is making estimates based on guesses.

4. The Senate proposal has a provision that will tax benefit plans that are seen as too rich. In other words, if an employer wants to provide a better plan than Congress defines, that company will be penalized for taking better care of its employees. This cannot but have a chilling effect on greater benefit compensation.

5. Neither bill directly addresses two core issues: the costs of care and medical quality. Over 200,000 people die in the US annually as a result of preventable medical error, one of the highest rates in the world. Bruce is correct that this needs more attention.

Finally, but not in the list above since it didn't fit the business theme, the Senate bill includes a provision that would direct $100 million to the Louisiana fishing industry. President Obama has repeatedly stated he will veto any bill with pork provisions included. This is going to be a test many will hope is not noticed.

We need reform, but this isn't the right way to go about it.

It was the "u" in "labour" that give it away, right? It's true I'm not American, but the principles are the same.

If employers are getting bad value from health insurance, they only have themselves to blame, healthcare in the US is amongst the most expensive in the world, in terms of $ per head spent in the system.

Yet as David states, many more die in the US as % of population due to treatable ailments.

The idea that privatised health is good for anybody, is frankly a little worrying. People get better healthcare in Cuba, which provides all treatment on the state.

If it's the cost that worries employers so much, then sensible employers should be voting for a completely state-funded and administered healthcare system, and not for the profits of an inefficient greedy system like the one in place at the moment.

Is anyone seriously trying to tell me that the costs of selling and administering (and making profits on) health insurance are somehow a benefit to the nations health? Or to the employers who foot the bill for it?

If the money went round the insurance companies and straight into healthcare, on a free for all basis, you'd still save money...

Is the guy working on the shop floor any less entitled to health care for him and his family, because he didn't have the connections to become CEO (and please don't tell me CEO's are chosen on merit, the evidence significantly suggests otherwise)?