It's Not Over Until It's Over

Who wins and who loses in the health care debate?

When sweeping new health care reform is finally signed into law by President Obama (I'm guessing mid-February), how sweeping will this bill be and who wins and losses as a result?

For the record, I'm definitely in favor of all Americans having access to quality health care under the new bill. It was and still is the primary reason for initiating health care reform. Rich or poor, employed or unemployed, health care, like food, should be available to all. There is no reason why anybody should be denied this basic life essential. If you're sick or hurt, you should be able to receive medical care, regardless of your circumstances.

Okay, I'll get off my soapbox and continue the discussion on whether or not this will truly be the sweeping reform originally intended. The answer is no, but then again when has any major legislative reform achieved the idealistic goals intended?

The "public option" of health care was a real sticking point and has since morphed into discussions on how to manage a general insurance exchange system designed to offer affordable health care coverage for the estimated 50 million Americans currently uninsured.

Another real sticking point of employer responsibility to provide coverage or pay a $750 per employee excise tax once again fueled debate in early January when it was discovered that labor unions in the construction industry lobbied to have a provisional amendment added to the Senate version requiring all businesses with fewer than 50 workers to provide coverage or pay the penalty. Labor union lobbyists contested that nonunion construction businesses not required to provide health care benefits would have an unfair competitive advantage.

The Senate's earlier versions exempted those small businesses from being penalized if they failed to provide insurance coverage. The provision added would exempt construction businesses with fewer than five employees.What's really ludicrous about the provision is that it exempts all businesses with fewer than 50 employees from penalties in every industry except construction.

This is only one of many behind-the-scenes debates which will significantly impact the business landscape in this country. This particular 'minor provisional amendment' is not about forcing contractors to provide health insurance coverage to their employees, but rather singling out one specific industry. I don't know if it will make it to the final draft, but if it's the right thing to do than do it across the board with all industry segments.

So, while the final health care reform legislation will be far from perfect, hopefully it will provide more positives than negatives for all Americans. And, with final passage, hopefully Congress and the Obama administration can then move on to jobs creation and surface transportation legislation.