From the August 2009 issue of Ceridian Connection.

According to the National Business Group on Health (NBGH), each of the proposed bills, as well as the White House, would support a new national program aimed at disease prevention and wellness. The NBGH favors changing the IRS definition of qualified medical expense for purposes of tax deductions to include health and wellness expenses.

Other bills would provide for a special employer tax credit for costs of employee wellness programs, establish a national wellness research strategy at the national Institutes of Health (NIH), tax sugar-sweetened beverages, require insurers and employer plans to provide incentives for wellness programs, and factor tobacco use into federal subsidies.

In addition to these areas of general agreement, there is also broad support on Capitol Hill to improve Medicare funding practices, expand Medicaid and State Children's Health Insurance Program (SCHIP) to reach more low income families, put greater focus on primary care and health information technology such as electronic medical records and crack down on fraud in public health programs.

Four consensus issues	SPACE	Four roadblocks to reform
Insurance market reform	SPACE	Financing healthcare reform
Creation of a health insurance exchange	SPACE	Saving for out-of-pocket health costs: FSAs in the spotlight
Subsidies for lower income households	SPACE	Public plan option in the health insurance exchange
Support for wellness and prevention	SPACE	Employer mandate

To be sure, legislation that addressed only these areas of agreement would represent reform -- and improvement -- of America's healthcare system.

The challenge, however, is that as Congress makes progress in addressing each of the areas of general agreement, new issues arise that prove far more contentious. So far, these issues have become huge obstacles to reaching final agreement.