Wednesday, September 23, 2009

Missing the point on health care

Good news is lawmakers are converging on a health care bill. Bad news is they seem to have completely forgotten why we need a health care bill to begin with. Let's review, shall we? Health care costs are going up. They are going up so fast that if the present trend continues the country will be bankrupt in a few years. So we need health care reform to bring costs down so the country doesn't go broke. Doesn't seem too hard to understand, right? And yet Congress seems ready to pass a health care bill that will make costs go up, not down.

I am at an utter loss to find an adjective that is up to the task of describing this situation. "Incompetent" just doesn't begin to do it justice. How could someone as smart as Barack Obama have let this situation spin so wildly out of control?


Don Geddis said...

There are numerous, unfortunately somewhat contradictory, goals for health care reform. Which is part of the reason that it's been such a hard sell.

A primary one was containing costs. That's not the only one. But even if it were, one could imagine a tradeoff that would limiting future growth in costs, but only with significant upfront costs.

In addition, there's a (compassionate?) desire to cover the uninsured. That's clearly not about saving costs (and is a source of a good chunk of the additional spending in the bills being considered).

There are other (more minor?) goals as well. It would be nice to deal with rescission, adverse selection, preexisting conditions, etc. And it's a shame that health insurance is tied to employment; that often makes changing jobs very difficult, if you current have some medical condition.

Anyway, different aspects of these reform goals appeal to different people. It's not much of a surprise to me that the current proposals are projected to increase costs, instead of decrease them.

Ron said...

> A primary one was containing costs. That's not the only one.

That's true, but it dominates all the others. If the U.S. is bankrupt -- which it could be soon if we don't do *something* -- everything else will be moot. That's the reason for the urgency. That's why (the rhetoric went) we have to do this *now* and not next year.

BTW, a lot of the "compassionate" goals were originally sold as cost-cutting measures. The argument was the uninsured get care now, but they get it through emergency rooms, which is the least efficient way to deliver care. If we cover everyone, the argument went, costs would go down.

At *best* this is a bait-and-switch.