Winners and Losers of the House Health-Care Reform Bill

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Following in the Senate's footsteps, leaders in the House of Representatives revealed late last week their plan for what the bill debated on the floor will look like. Like any major piece of legislation, there are things that people will both love and hate. Let's dive right in and see who could be the big winners and losers.

The bill fails to stop cuts to Medicare doctors.

  • Winners: The government and you, indirectly.
  • Losers: Doctors, obviously, but also you, indirectly. If doctors are being paid less, they either won't take Medicare patients, or they'll require higher payments from those with private insurance to make up the difference.

The government-sponsored public plan is alive and well.

  • Winners: People demanding an alternative choice.
  • Losers: Health insurers like UnitedHealth Group (NYSE: UNH) and Aetna will face additional competition, but it might not be that bad. The Congressional Budget Office estimates that the public plan would have premiums slightly higher than those of private insurers.

A pathway to generic biologic drugs includes 12 years of exclusivity.

  • Winners: Biotech companies such as Biogen Idec and Amgen (Nasdaq: AMGN), as well as pharmaceutical companies with biologics, such as Eli Lilly's and Bristol-Myers Squibb's Erbitux, will enjoy a longer exclusivity than the five years afforded to small-molecule drugs.
  • Losers: Generic-drug makers like Teva Pharmaceutical (Nasdaq: TEVA), hybrids like Novartis (NYSE: NVS), and even pharmaceutical companies like Merck (NYSE: MRK) have planned to enter the market once Congress gives the Food and Drug Administration direction on how to approve the knockoffs. Unfortunately, they'll have to wait a little longer before getting their shot at some of the blockbusters.

The bill contains a 2.5% tax on medical devices.

  • Winners: The government. We've got to pay for this thing somehow.
  • Losers: Medical device makers like Boston Scientific (NYSE: BSX) and Medtronic (NYSE: MDT), but possibly the public, if those taxes are also passed along to the end consumer.

Keep in mind that there's still a long way to go. The final bill still needs to be passed by the full House, and then reconciled with the Senate bill, which will likely contain some different provisions. That last step could lead to a health-care stalemate.

What's your favorite or least favorite provision? How do you think this will affect your investments? Sound off in our comments section below.

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Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. UnitedHealth is a pick of the Motley Fool Stock Advisor and Inside Value newsletters. Novartis is a Global Gains selection. The Fool owns shares of UnitedHealth and Medtronic and wrote puts on Medtronic. The Fool has a disclosure policy.

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On November 02, 2009, at 4:21 PM, wnlong wrote:

    How about the effects of this bill on low profit per employee industries industries such as casual dining, and certain sectors of retail (Home Depot / WalMart).

    I have heard estimates of up to a $2,500 per employee expense associated with this bill for employers. For many companies in many industries $2,500 per employee is enough to force them out of business or generate massive inflation.

    I think that there are many more industries to be worried about as 'losers' than just those in the health care circle.

  • Report this Comment On November 02, 2009, at 4:51 PM, chapramsey wrote:

    I get so excited when I think that the government is going to takeover our healthcare....especially when I see what a good job they've done with social security, medicare, medicaid, etc.....

  • Report this Comment On November 02, 2009, at 5:23 PM, Dannysea wrote:

    Remember fellow readers, the WH has stated this is only 3 1/2% of the changes they have in mind.

  • Report this Comment On November 02, 2009, at 6:01 PM, showmegw wrote:

    I am part of a small business that recieved word Friday that our group health insurance premiums have been increased by over 50%. The rationale is that because the size of our group shrunk due to layoffs the premiums would have to be increased. The company cannot afford to do it. I have existing heart conditions and three adopted grand children. Needless to say I need a Public Option, but guess what it isn't here and may never be because of all the political wrangling and greed.

  • Report this Comment On November 02, 2009, at 6:05 PM, pacella wrote:

    I don't understand the objection to universal health care. Every modern country in the world has it. Why are people so convinced that the U.S. can't afford it. This constant harping of a "government take-over" is balony. The government may not always do it right, but at least we can put pressure on them at the voting booth. Talking to an insurance company is like talking to the wall. I'm retired and have medicare. It works beautifully, ask anyone who has it. Ask anyone that has veteran's benifits All government run. The insurance companies are making fools of all these people who believe all the crap that they spread

  • Report this Comment On November 02, 2009, at 6:40 PM, scruff101 wrote:

    I recieved notice from SLE A few weeks ago that my Retirement insurance was increasing from $400 to $1300 per-month because they can not afford to pay any of it .I have checked on cost with several insurance companies with little sucess.as we get older insurance companies just do not want you! The only hope we have is the Public Option.

  • Report this Comment On November 02, 2009, at 7:13 PM, danteps wrote:

    We are all losers if universal healthcare becomes a reality. What makes America the greatest nation on Earth was our previous sense of self reliance, hard work and dedication.

    Now we are a nation that expects bailouts, handouts and a government to take care of us. The founding fathers would roll over in their graves if they witnessed what this formerly great nation has become.

    Keynes, FDR and LBJ put this nation on a path of self destruction and bankruptcy. Nearly every entitlement program should cease. So many of us are tired of paying for our fellow citizens choices.

    Smoke cigarettes, do drugs, don't exercise, drink alcohol, overweight? Let's pay for your health care.

    Can't afford your house? Let's pay for your downpayment or if you are about to foreclose, we'll pick up the tab.

    Can't afford your car? We have cash for your clunker.

    Can't manage risk and are a bank about to go under? We'll bail you out.

    Can't build cars people want to buy? We'll bail you out.

    Looking for a place where capitalism exists. Please advise.

  • Report this Comment On November 02, 2009, at 8:07 PM, yldhawg wrote:

    danteps,

    I hope that neither you nor any of your family ever have a catastrophic illness. No matter how self reliant, dedicated, or hard you have worked, when the bills exceed your maximum insurance coverage you are left cold. The life of your loved one is on the loosing side of the monitary balance because of this great nation's health care system.

  • Report this Comment On November 02, 2009, at 9:43 PM, xetn wrote:

    The only losers will be the citizens, who will end up paying through the nose for this boondoggle and receive less services in the process. Health care is a scarce resource and will be even more scarce when the government runs it. I will be much worse, because government cannot run anything efficiently; it always costs more while producing less. Does anyone believe the Post Office would still be around without the monopoly over 1st class mail? No, UPS and/or FEDX or someone else would be providing this service better and more cost-effectively.

  • Report this Comment On November 02, 2009, at 9:49 PM, danteps wrote:

    They have done a wonderful job with Amtrak. Or maybe Social Security.

    No wait . . . our government has squandered away billions withe these programs.

  • Report this Comment On November 02, 2009, at 10:47 PM, holisticfool wrote:

    Our health care system is just that, a system. It is designed to be expensive because of the need to generate maximum profits. Other governments can provide universal care at much lower costs than this government could. The FDA does whatever is necessary to block the use of drugs which cannot be patented.

    Commission E in Germany will establish treatment protocols using alternative medications that cost a fraction of what patented medicines costs in this country, and most have no side effects. Some of these medicines date from ancient Greece and Rome.

    There is an area in Central China that is very low in soil selenium. The Chinese government applied this minor element to soil and crops and added it to fertilizer and table salt. The result was a huge drop-off in the incidence of their worst infectious diseases. You won't read about this in our papers.

    In China and other Asian nations there is wide use of traditional medicines that have been used for treating diseases there for thousands of years.

    This country has the most expensive health care in the world, and, according to WHO we are thirty-seventh in the quality of that care, just below Morrocco.

    All we have to do is decide to offer the best medical care at the lowest possible cost. That is not what we are doing now. We need, first, to take down the walls that keep us from using many of the proven medicines that are in very long term use in other countries. This would begin to reverse the dollar flow that presently takes money from the working people and their employers and directs it to certain entities that really haven't earned it..

    If anyone reading this is willing to venture away from his/her training, simply Google the following: Vitamin D3 flu, selenium cancer, olive leaf viral diseases, garlic heart disease. That would be good for starters.

  • Report this Comment On November 02, 2009, at 11:41 PM, holisticfool wrote:

    The business I was running when I retired, employed seventy hard-working souls. Health insurance that we paid for cost us between $250 and $300 bucks a month per employee.

    This was a $20,000 a month bite out of profit, or about a quarter Million a year. Since the work was of a physical nature, Worker's Comp was also outrageously expensive, as was all the rest of our coverage.WC insurance is expensive because it is basically health care with a lot of extras that add to the cost.

    A major part of our production was exported. In this global economy were found ourselves at a terrible disadvantage competing with companies based in other countries, countries that subsidized or provided their health care.

    The way health care has been handled in this country has harmed our people far more than most of us realize. It is one of the major reasons why manufacturing jobs have gone elsewhere.

    Now we are supposed to believe that our government is going to fix health care. Our government is what broke it.

  • Report this Comment On November 03, 2009, at 3:09 PM, Digray wrote:

    I find it amazing that people readily bash the US Postal Service which can deliver a letter from Seattle, Washington to Tacoma, Washington for 44 cents while the same letter sent FedEx costs $12.77. Maybe we should privatize the US Postal Service and charge $12.77 for a letter.

    Generally speaking, US Government agencies provide a great service when you consider the limited resources typically provided. Sure you can find instances of waste, but you can find waste in any organization.

    One thing is for sure. You won’t find any managers in the US Postal Service, or any other government agency, making multi million dollar salaries. Talk about waste!

  • Report this Comment On November 04, 2009, at 1:21 PM, RinqueRat wrote:

    Wow! I can't believe some of the comments posted here.

    I'm glad to have Medicare, too, but it would cost us (the taxpayers) a lot less if the approx. $90 BILLION per year in Medicare fraud were eliminated.

    Yes, you can send a letter coast-to-coast for $0.44, but it takes DAYS to get there.

    Most veterans would rather suffer in silence than be subject to the VA hospital system, it's so bad.

    The WHO health-care ratings are based on inconsistent data; they're not comparing apples to apples, but rather apples to pineapples to beans to grapes. How many patients are flocking to Morocco for health care?

    Other countries may provide "universal" health care at a lower price, but as is always true, you get what you pay for. Canada and the U.K. are not used as bad examples for no reason, after all.

    While it may be comforting to think that we can pressure the government thru the ballot box, I don't think you can point to a single example of that tactic working. Private industries are always more responsive because if they're not, you can take your business elsewhere. If the government is the single payer for health care - their avowed intention - then where can you turn?

    The number of fees, fines, punitive costs and direct and indirect taxes included in the bill will cost the consumer dearly; the cost of the services themselves have already been estimated to be MORE than the cost of private coverage now. Plus, administrative and operating costs over the next ten years will add some 10 TRILLION dollars to the national debt - with no way to pay it off.

    There are over a HUNDRED new agencies, boards, bureaus and commissions called for in the bill - a completely unwarranted expansion of government that will be next to impossible to deal with.

    If this is what you want your healthcare to be, please consider moving somewhere it exists already and leave our best-in-the-world care alone!

    Wait - how does this affect us as investors? Well, if you've got pharma or med insurance or med care corp's in your portfolio - and keep them - you'll likely take a bath. If we go to a single-payer government-based system, maybe it will be profitable to go for T-bills and savings bonds... if the gov issues any, and you can get them, and they carry an attractive rate.

    I'm not optimistic.

  • Report this Comment On November 04, 2009, at 6:56 PM, holisticfool wrote:

    RinqueRat,

    I'm not saying that I would favor a health-care system controlled by our government. THAT'S WHAT WE HAVE RIGHT NOW. If it were not for the government we would have access to cures that are kept from us under policies that have been in effect for decades. I cured myself of an "incurable" disease by going against the system.

    There are cracks in the wall that have appeared just in the last month or so. The American Heart Association said that garlic was good for artery health, and an eye-doctor friend of mine told me that in his field, they are actually admitting that lutein supplementation slows the development of cataracts and macular degeneration. Just think, if this information had been common knowledge a few years ago, we would have had fewer bypass operations and fewer blind people. Garlic supplements have been shown to reduce hypertension, cholesterol, platelet aggregation and LDL oxidation. That knowledge could lead to a multi-billion dollar reduction in drug company profits and a big cut in your insurance bill. Our government will see that it doesn't happen. What do you think that the lobbyists carry in their briefcases?

    You have all been conditioned to think that if it doesn't come from a guy/gal in a white jacket, it is quackery and will probably kill you. I jumped out of that box about ten years ago. Oh yes, cinnamon for diabetes.

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