Health Care Reform

Government is poised to become king of the hill in America's vast health care system, with or without President Barack Obama's planned redo, according to an economic report released Thursday.

"The Chronicle's editorial support of the House version of health reform ("High cost of politics," Editorial, Dec. 22) ignores one critical flaw - a shortcoming that could result in billions of Medicare dollars being shifted from California to other states without congressional oversight."

How much can people afford to pay for health care?

That question is at the heart of the current debate in Congress about a health care overhaul. Yet there is not a firm consensus among lawmakers, economists and health policy experts—and that is complicating efforts to come up with a common approach.

The Union-Tribune editorial board recently conducted a roundtable discussion on key issues in the U.S. health care reform debate with five local hospital and insurance executives: Bill Hammett, president, San Diego Association of Health Underwriters; Ed Martinez, CEO of San Ysidro Health Center; Michael Murphy, president/chief executive officer of Sharp HealthCare; Kathleen Sellick, president/CEO of Rady Children's Hospital; and Chris Van Gorder, president and CEO of Scripps Health. This is the first in a series of condensed, edited excerpts of some of their observations:

As part of health care reform legislation, Congress is addressing regional variations in the cost and intensity of care at hospitals in different parts of the country. Recent research shows significant differences in the level and cost of care provided in various geographic regions. Legislators are considering changing Medicare reimbursements to help even things out and to save money.

If Congress makes history and puts a bill on President Barack Obama's desk by Christmas, how long before the uninsured get medical coverage?

If you said three years or more, you'd be right. Yet many people don't realize that to keep costs down, lawmakers made compromises that might not appeal to consumers.