Understanding reform doesn’t come from handicapping it
Here’s something you won’t learn from reading headlines or obsessively watching text crawl across the bottom of the TV screen: Health care reform isn’t a horse race.
It doesn’t turn on what the latest key member of Congress said this morning or the latest poll by an influential industry group.
It moves slower than a horse race and slower than a 24-hour news cycle. Understanding it requires more than sound bites.
On Saturday, it lurched forward again when the House narrowly approved a reform bill, 220 to 215. That was a milestone, but it wasn’t health care reform’s make-or-break moment.
Next up is the Senate, which will move toward a debate after the nonpartisan Congressional Budget Office “scores,” or estimates, the cost of the Senate reform bill.
That CBO evaluation probably will come this week. It won’t be the make-or-break moment, either.
One constant thus far has been the horse race analogies — the premature declarations of success or failure. During raucous town hall meetings last summer, we learned that health care reform was dead. That report, like the influence of the town hall meetings, was greatly exaggerated.
This fall, we were told that the so-called public option is a marker of “real reform.” If it weren’t included, there would be no real change — even though millions more Americans might get insurance coverage.
We later learned that the public option was dead; it wasn’t. A public option is included in the recently approved House bill and the soon-to-be-debated Senate bill.
Now, we’re breathlessly informed that Sen. Joseph Lieberman, I-Conn., won’t vote to begin debate on the Senate bill. No wait, he’s changed his mind; he’ll vote to begin debate, but if a public option is included, he won’t vote to prevent a filibuster.
All of this fills air time and causes furious typing on political blogs, but it doesn’t help anyone understand the complex and far-reaching issues raised by reform.
This raucous sideshow won’t end anytime soon. There are important differences between the House and Senate reform bills; the differences probably will grow as still more deals are cut. Will it be the public option by a nose or state opt-outs going away?
Players in the health care industry worry greatly about such things, as well they should. Health care is a $2.5 trillion-a-year business. Slight changes in the final wording can mean millions of dollars in revenue or losses.
But all the focus on differences obscures much larger areas of agreement. Both the House and Senate have bills that would provide near-universal coverage for the first time. More than 95 percent of American citizens would be insured. Now, 17 percent of the population is uninsured; millions more face financial catastrophe if they get seriously ill.
All the bills under consideration would require that insurance benefits are sufficient to cover at least 65 percent of the cost of serious illness or injury. Health coverage couldn’t be canceled if people got sick. It couldn’t be capped if treatment were expensive.
All the bills would establish markets in which private companies compete for customers. All would create nonprofit plans to compete against for-profit insurance companies.
Few Americans understand complex health policy issues; few can understand implications of the breathless reports on the news. What’s important is that the nation finally is seriously addressing a crisis that has been building for decades. The real winners are ordinary Americans.
I really have nothing to say but just wanted to officially post something before Lisa12.
Amazing to me how quickly the republicans forget their own debacle. A ten year, on etrillion dollar real shot at making health care work for the people? What a bargain! It was the republicans who blindly followed George Bush over a cliff in declaring war on Iraq for a reason no one to this day knows. Total cost: approximately 700 billion or about 100 billion a year. Spend it over there or spend it here, at least we know that humanity will be served with the health care matter.
This was written to the Clarion Ledger ( Jackson , MS ) by one of our General Surgery residents at the University Medical Center . I don’t think he could’ve illustrated this more perfectly!!
Dear Sirs:
During my last night’s shift in the ER, I had the pleasure of evaluating a patient with a shiny new gold tooth, multiple elaborate tattoos, a very expensive brand of tennis=2 0shoes and a new cellular telephone equipped with her favorite R&B tune for a ring tone. Glancing over the chart, one could not help noticing her payer status: Medicaid. She smokes more than one costly pack of cigarettes every day and, somehow, still has money to buy beer. And our Congress expects me to pay for this woman’s health care? Our nation’s health care crisis is not a shortage of quality hospitals, doctors or nurses. It is a crisis of culture — a culture in which it is perfectly acceptable to spend money on vices while refusing to take care of one’s self or, heaven forbid, purchase health insurance. It is a culture that thinks “I can do whatever I want to because someone else will always take care of me”. Life is really not that hard. Most of us reap what we sow.
Don’t you agree?
STARNER JONES, MD
Jackson, MS
> Few Americans understand complex health policy issues
And few newspaper editorial writers understand simple economic issues. This bill will provide a new entitlement for people who do not work, a substantial reduction in cost for those in their 50s and 60s, and yet another burden on those of us who work every day to pay for all these goodies. The more you tax work, the less interested people will be in working, and the more moochers you’ll have on your free insurance plan. Great plan. Have another donut, gentlemen.
The health insurance regulation currently being kicked around is not an end in itself. It is a median step (the first step was health insurance, the second step was Medicare). The current mess is merely one more step in an ongoing process.
Boo!
So San Fran Nan has found a way to cover the 7 Million un-insurded Californians that her broke state can pay for. Get the other 49 States to pay for it. This in nothing more than Responsible States being asked to pay for States that want to give everything away for free.
And I can’t express how glad I am to hear this Ed Board proclaim they have all the knowledge and understanding. We wait holding our breath to be told how to think.
The real problem is that Americans subsidize medical care for the rich while millions of poor taxpaying Americans go without medical care. This type of thing goes on in other areas but in the medical arts it can be deadly. Estimates range from 18,000 to 44,000 dead yearly from not being allowed medical care needed to survive. None of these people were denied because medical care offered no hope they just could not pay. In the United States a country that claims people have a right to life corporations impose harm on millions of Americans and expect the government or the victim to pay the cost of said harm. This applies to toxic pollution, alcohol, tobacco, diet, firearms, accidents related to work, and many other areas of the law. Why should these victims of corporate and government laziness and greed have to suffer losses to include their lives? I say make the guilty pay for harms done seller beware.
Mr. Harris must not have noticed the 39% of House Democrats or the 58% of Senate Democrats who also voted to follow W. over that cliff, and I’m guessing that the $74 TRILLION in unfunded mandates for which Medicare is already on the hook (another all-time government “bargain”) has also escaped his attention.
A few observations - Your exposing the fickle conduct of ill-behaved children that are our representatives; insurance is a funny word when provided by the same organ that is facing $100 trillion in existing obligations with all of the clarity of Mr. McGoo and bravery of Chamberline; decrees to insurance companies (read fascism) about who will be covered & how much they will get will insure many…insurance companies become new organs of the state. For all of the uncertainty SLPD laments over a few hundred masters to get their act together [in a timely and predictable mannner], you’d think they’d see that predicting weather 100+ years out is something of a joke.