HOW EXCHANGE WILL WORK

The health insurance exchange allows people to choose from a menu of health insurance options. It includes mostly private options, but these private vendors are more regulated than the current ones. It will also include a public option similar to Medicare but for people under 65 years old.

The mandates for employers say either the employer must provide health insurance or pay a tax, which the government will use toward insurance.

The mandates for individuals require each person to have health insurance or pay a tax. If the government determines an individual IS unable to afford insurance even with subsidies, that individual is exempt.

by Erin Wiltgen

chh@heraldsun.com; 918-1035

CHAPEL HILL — Local experts outlined the basics of the health care reform debate in a panel discussion held Monday night at the UNC School of Medicine.

The forum, initiated by different student groups within the School of Medicine, consisted of a short briefing on the health care debate followed by a question and answer session.

“It’s vitally important for the medical students to understand what’s going on in the current health care environment,” said Tim Carey, a professor of medicine and one of the four doctors on the panel. “Plus more generally we all need to talk about what’s going on with health care as a society.”

Jonathan Oberlander, an associate professor in the School of Medicine and the Gillings School of Global Public Health, started the discussion with a 10-minute lecture on health care reform. He discussed how the U.S. health care system is mixed, with both the private sector and the government having a primary role. Even with both these venues, however, 47 million people still fall through the cracks and don’t have health insurance, he said.

In his presentation, Oberlander outlined the basic points in the bills approved by four of the five congressional committees devoted to health care reform. The House of Representative committees have approved legislation that expands Medicaid for low-income people; institutes a health insurance exchange; includes subsidies in the form of tax credits to help buy insurance; and a series of mandates for employers and individuals alike.

The Senate plans, Oberlander said, won’t include the public option that the House puts in the health insurance exchange, will offer fewer subsidies and benefits, and will be less liberal in general.

After the presentation, audience members asked the panel questions on specific aspects of the health care reform debate.

Brian Goldstein, chief of staff at UNC Hospitals and one of the doctors on the panel, said the questions not only demonstrated the interest in health care reform but a need to clear up confusion: “I think it’s hard but important to cut through all the noise in the health care debate and really get down to the nuts and bolts of what’s really being proposed and what might happen.”