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After Reform

One in six Americans at some point during this year will go without health insurance.  Most of them at any  given point in time do not need it.

One in ten working Americans are without gainful employment right now. Every one of them wants a job . . . right now.

That as much as anything explains Tuesday’s Senate special election result in Massachusetts, the only state in the union that has a health insurance plan similar to ones passed in the House and Senate last year. Were voters there rejecting their own system? Not according to every poll that asks the question. The Bay State has the lowest uninsured rate in the nation; local residents have learned to participate in the insurance exchange set up under its plan (passed under a Republican governor); and people seem to like it.

So any commentary that seeks to make health care reform the scapegoat for voters choosing Scott Brown, an obscure state senator, over an aloof attorney general Martha Coakley, is off the mark.

Massachusetts hasn’t solved its health care problem. Its costs are still rising at an unsustainable pace, suggesting the reforms in the national legislation won’t solve that problem either.

But moving beyond the insuring-the-uninsured has made cost control the central issue in that state, which it should be. Lower cost care will be better care, a fact that has been lost in the current debate. Reform as defined by the House and Senate bills has largely been about including everyone in a dysfunctional system that delivers poor quality care.

Reformers ultimately need to refocus the debate on the policy prescriptions that are needed to improve the quality of care and lower its cost. But to get to that point, they need to move beyond the question of universal coverage, as they did in Massachusetts.

Therefore, the Democrats who control Congress should do whatever is necessary to pass something that achieves that end. If it means getting the House to adopt the Senate bill, which is terribly flawed in many respects, especially in its embrace of schemes like taxing high-cost plans that falsely claim the magic of the market can hold down costs, so be it.

As numerous commentators pointed out this morning, both the House and Senate bills are centrist plans designed to win bipartisan support. Passage of either would require constant tinkering year after year to amend its flaws. Both rejected universal schemes that would eliminate employer-provided care: the left-backed single-payer plan or the everyone-buy-their-own plan proposed by Sen. Ron Wyden of Oregon, either of which makes more sense than the Rube Goldberg machine apparatus preferred by centrists.

So, given the political dynamic facing the Democratic leadership this morning, the best option is to have the House pass the Senate bill. And when the dust settles, probably after the next election, certainly after the economy has improved, the tinkering can begin.

This post first appeared on GoozNews.

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Adam
Guest

I think that the Americans must still be thankful to God for the health care facilities which they are getting in this situation of economic cruch. It is far better than other countries in Africa and Asia.

Peter
Guest
Peter

“The systems in French and Germany are far less dependent on public financing that health care spending in the US and yet they cover more people at less cost.”
Margaret, whose pockets do you want to take it out of to get more coverage at less cost? If you want it to come from insurance companies, device makers, hospitals and docs, tell me how your going to get that through the Senate and Congress.

Greg
Guest
Greg

Boy! It seems that a lot more on the right, besides Nate, really could use a valium.

Margaret
Guest
Margaret

“Both rejected universal schemes that would eliminate employer-provided care: the left-backed single-payer plan or the everyone-buy-their-own plan proposed by Sen. Ron Wyden of Oregon, either of which makes more sense than the Rube Goldberg machine apparatus preferred by centrists.” The whole idea behind the exchanges was to continue dependence on employer-provided insurance and try to come up with something for “everyone else”. What we need is a system where everyone has the same level of physical and financial security. In short, we need a universal health care. Why doesn’t the left focus on universality instead of public funding. They never… Read more »

MD as HELL
Guest
MD as HELL

Give everyone their money back. This show has been cancelled. Everyone should get their money back from managed care, too. It is a ripoff. If you don’t have a contract that spells out what is covered and what is not, then you do not have insurance of any kind. All you have is hot air.
All you on Medicare had better make alternate arrangements. Your program is too expensive and will be cut, either by the Democrats or the Chinese.

Holt sucks
Guest
Holt sucks

“As numerous commentators pointed out this morning, both the House and Senate bills are centrist plans designed to win bipartisan support.”
What?

Cartesian
Guest
Cartesian

Hello, in order to improve the image of chemistry (medicines…) in the world, what could help health care by motivating more the people to take some medicines, you can find something about a petition which could interest you in the top right-hand corner at the following address: http://eternal-cartesian.blogspot.com/ . Sincerely for a better world

Robert
Guest

“One in six Americans at some point during this year will go without health insurance. Most of them at any given point in time do not need it.”
Are you joking? Americans don’t need health insurance at any given point in time?