Health reform is one of the hottest topics on the federal docket right now, and as to be expected, the range of opinions and proposals on how to do it right further intensifies the debate. And who could forget the $1 trillion price tag from the Congressional Budget Office?

The cost is spread out over 10 years, but in our present economic state, it’s not easy to think about spending $1 trillion dollars, even for the best of causes.

According to a special edition update from NCOA (National Council on Aging), “lawmakers are working to draft and pass bills in both the House and Senate before the House adjourns on July 31 and the Senate adjourns on August 7 for the August recess.”  A tall order, given the aforementioned range of opinions and proposals, but there seems to be overwhelming support from President Obama for at least taking a step forward. Fiscal crisis or not, the continual sharp increases in health care costs – both for providers and patients – will slowly (or maybe not so slowly) erode any economic stability we acquire.

NCOA’s update gives a thorough and extensive analysis of the legislative process that the numerous bills must go through, along with the provisions that their organization is most focused on as the process moves forward. Of note:

“The Affordable Health Choices Act includes provisions from Senator Ted Kennedy’s CLASS Act (S. 697), which would create a new, voluntary national insurance program with a cash benefit to help individuals remain in their communities if the time comes when they need assistance with activities of daily living (see NCOA’s summary).

S. 434, the Empowered at Home Act, introduced by Senators John Kerry (D-MA) and Grassley, to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes.

Project 2020 (S. 1257), introduced by Senators Maria Cantwell (D-WA) and Debbie Stabenow (D-MI),would provide funding through Medicare and Medicaid savings for aging network initiatives on evidence-based health promotion and disease prevention, single-point-of-entry information and referral for long-term services and supports, and nursing home diversion programs.

Senator Jeff Bingaman (D-NM) and a coalition of groups are working to include provisions from the Senator’s bill, the Medicare Financial Stability for Beneficiaries Act (S. 1185).  The bill would significantly improve both the Medicare Part D Low-Income Subsidy (LIS) and Medicare Savings Programs (MSP).”

I understand the need to “do something” about our health care system. I agree that it’s a complicated and expensive undertaking, no matter how you do it. I know that there are many, many pieces to this puzzle, and just as many players. But here’s my beef: Why isn’t there more discussion around managing Medicare fraud? The headline from an MSNBC.com article in 2007 (almost ancient history at this point) shouted “Blatant Medicare Fraud Costs Taxpayers Billions” and there have been a plethora of stories in recent months of fraud rings exposed in Houston, Detroit, and Miami.

A Washington Post article published on June 25^th indicates that the Justice Department, the FBI, and the Department of Health & Human Services are taking this issue seriously.

According to the article, Attorney General Eric H. Holder Jr. said, “We will strike back against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising health-care costs.”

I would think we could shave a nice chunk off that $1 trillion price tag if we weren’t losing billions of dollars to fraudulent providers preying on vulnerable elders… and regardless of the cost savings, it is the right thing to do.

What are your thoughts about the health care reform debate? What issue(s) do you think are absolutely crucial to making reform a reality?

- Michelle Seitzer