The task of the House-Senate conference committee on health care reform will not be an easy one. Yes, the legislation passed by each chamber have many provisions in common. But where they tend to differ are on some of the thorniest, most controversial issues. Whether there will be a government-run health plan and how to pay for health care reform are but two of the items needing to be worked through. One issue on which finding common ground will be especially difficult concerns abortions.

Most of the media and blog coverage of the abortion issue (including my own) have focused on the political aspects: will the more restrictive House language survive the conference committee or will the slightly less restrictive Senate version be a part of the final health care reform bill? And will liberals pass health care reform legislation that includes any additional restrictions on the procedure?

The folks at ReportingOnHealth.org, a project of The California Endowment Health Journalism Fellowships and the USC Annenberg School for Communication, asked a more interesting question: what would the likely compromises concerning abortion coverage currently being considered by lawmakers mean in the real world? How would the compromises work in practice? They invited me to offer a post on the topic and, for those interested, the post is available on their site.

ReportingOnHealth.org is aimed at helping journalists gain a better understanding of health care issues. The result is a host of meaningful insights for the general public as well. It’s a site well worth regularly checking.

Speaking of sites with interesting perspectives and enabling my descent into the world of punditry, there’s also HealthLeaders Media. They consistently offer an objective, reasoned view of the health care reform debate and provide perspectives from varied viewpoints. They are also one of the few news organizations offering regular podcasts on health care reform. My interview with Les Masterson focused on how health care reform might impact the industry.

On AARP’s website they have what is called a “Doughnut Hole Calculator” which has been designed for the 2010 Plan to avoid falling into a gap for Medicare Part D coverage.  It’s a four step tool that is very useful for saving you money on your health insurance quotes.

The Doughnut Hole Calculator is easy to use.  First, gather your medications and drug plan cards and go onto AARP’s website.  Enter the name of each drug, dosage, and how often you take it.  Then you can view a chart to determine if you are going to hit the “doughnut hole” for Medicare Part D.  The calculator will give you a list of alternative drugs that are similar to the prescribed drugs but they can dramatically reduce expenses and stretch your AARP Medicare supplements coverage.  They supply a form letter you can print out and show your doctor to ensure the drugs will suit your needs.

You can learn more about avoiding a gap in your Medicare coverage on AARP’s website.  You can also read and share experiences with the Doughnut Hole Calculator to see what other people are dealing with.  There is an online community available to members which many find extremely valuable.

In America, the majority of people have health insurance coverage through their employer. Of all residents in the United States, it is estimated that 60 percent are covered by their employer’s health plan, 27 percent are covered by government funded health insurance programs, and the other 13 percent are left to find their own coverage. While this may not seem to be all that big a deal, if you or a member of your family is considered by the insurance companies to be ‘high risk’ then you may find it near impossible to get quality health care coverage.

The reason is simple: money. Health insurance companies will not offer coverage to those who are high risk and may have a pre-existing condition because they know that the person will more than likely spend a good deal of money on medical expenses. On the other hand, if a person is low risk, then it stands to reason that they will not require much medical attention and that means more dollars to the insurance company’s bottom line. So if you are high risk, what can you do?

Depending on the state in which you live, it may be possible for you to qualify for coverage under what is known as a high-risk pool. These are typically state run programs and are reserved for those who cannot obtain coverage from a private insurance company. But just because it is state run don’t expect to pay less. People who are categorized in the high-risk pool will normally pay out much more than they would if they were able to get coverage from a private insurer.

There are presently 34 states that have such programs though many are considered to be poorly run and the coverage’s are not always the best. Many states cite poor organization and underfunding to be the main reasons as to the ineffectiveness of such programs. However, if you fall in the high-risk category and can’t get adequate health care coverage elsewhere, it may be your only option.

Nothing lasts forever … not even health care reform compromises. The Congressional Budget Office is expected to come out with its analysis of the latest proposal – replacing a the creation of a new government-run health plan (the controversial “public option”) with a program in which Americans 55-64 could buy Medicare coverage. However, it’s looking like even if the CBO determines the idea makes financial sense, the votes to go forward with the proposal there doesn’t seem to be enough votes around for it to move forward. Which means the public option remains the big make-or-break element of health care reform in the Senate.

Only a few days ago, along with the idea of empowering the Office of Personnel Management to organize a coverage program, the Medicare buy-in compromise  seemed to be the solution to breaking the public option impasse. Now the idea seems to be losing steam.

First, doctors and hospital groups came out in opposition to the Medicare buy-in compromise, with the Washington Post reporting them as claiming the approach “would be financially untenable and would jeopardize access to health-care services for millions of Americans.”  The medical and hospital groups are concerned, according to the Washington Post, “because the program pays providers at much lower rates than private insurers, and because older Americans are the greatest consumers of health-care services.”

And then two conservative members of the Democratic caucus have indicated their disapproval of the Medicare buy-in. According to the Associated Press, Senator Joe Lieberman, who had originally sounded open to the idea, now considers it “a bad deal for taxpayers and the deficit.” And the AP quotes Senator Ben Nelson as saying “I’m concerned that it’s the forerunner of single-payer, maybe even more directly than the public option.”

So while, as the Washington Post and others are reporting, the President Barack Obama and many Democrats are praising the compromise, the fact is, the Democrat’s need 100 percent buy-in by their caucus to pass any bill. (Yes, it’s possible Senators Olympia Snowe and Susan Collins might cross party lines and vote for a bill, but it’s hard to see how these Republican Senators could support any legislation conservative Democrats like Senators Lieberman and Nelson could not).

Democrats are trying to dodge a nasty choice: dropping the public option from health care reform. Liberals have made inclusion of a public option their litmus test for meaningful reform. As the liberal blog Daily Kos put it this past summer, the public option is the compromise progressives are willing to make between a single payer system and the status quo.

In the end, however, liberals will need to decide whether the absence of a public option is enough to get them to walk away from reform. Because there does not seem to be any way they will obtain 60 votes in the Senate for a bill that includes a new government-run health plan. My guess? Liberals will complain bitterly, but ultimately vote for a bill without a public option. Health care reform has been on their agenda for decades and they have moved the issue further through Congress  than ever before. To abandon it now would set back health care reform for at least a decade if not longer. Failure would hand Republicans a huge stick to use against them in the 2010 elections.

Passing reform, even reform liberals perceive as too weak, provides a foundation for future efforts. This might seem like a hollow victory for many progressives, but it would be a victory for them nonetheless. And I just don’t see them trading even a hollow victory for a hard defeat.

In a recent report from the Commonwealth Fund, which is a private organization with a focus on healthcare, it was found that women are more apt to forgo medical visits and struggle with health care as opposed to men. The information was ascertained from data that the Commonwealth Fund gathered in 2007 and showed some staggering statistics.

According to the report, 70 percent of women younger than age 65 reported one or more of the following problems:

• Medical bills and or medical debt issues.
• Trouble accessing necessary health care due to cost.
• Poor medical insurance or none at all.

While the numbers were still high for the men they did come in a full 10 percent lower than the women in relation to the problems listed and saw 60 percent display one or more of the problems. Additionally, the report showed that women were more likely than men to skip preventative procedures such as annual cancer screenings because of the extreme cost.

The results were troubling to many experts as they showed that the problems with women and men not having adequate medical insurance coverage or struggling to pay for medical procedures and tests started well before the recession in which the US now finds itself in. This is a double whammy for women as they typically earn less income than men but need more health care.

The Commonwealth Fund drew its data from 2,616 adults surveyed in 2007 all over the age of 19. While the survey has a margin of error of two percentage points, the numbers simply don’t lie. America it seems, is having a problem with getting adequate health care and being able to afford necessary treatments; especially America’s women.