Speed isn't the enemy of reforms

They say speed kills, but nothing will kill America faster than foot-dragging on health reform. The country is traveling head-long toward fiscal and systemic oblivion under current conditions, yet our leaders are bogged by endless discussions about which countermeasures to endorse.

President Barack Obama, in a meeting in Cleveland on Thursday, drew laughter in noting that reforming health care has been talked about since the Truman administration. While this might be a great punchline, it's nothing to joke about. What other policy takes a half-century to debate?

Talk about a filibuster.

Stalling for another day, week or month to consider revisions to the health care reforms now before Congress only brings America that much closer to an ugly end: more citizens lacking heath insurance, more bankruptcies due to medical expenses, more social safety nets disintegrating.

Time is immaterial. The metrics of importance are cost containment and universal coverage — in that precise order. State and federal initiatives for the latter have been easily enacted, like the much ballyhooed policies in Maine and Massachusetts, only to be eventually victimized by the former.

They've toppled under their cost. That's the story of Maine's Dirigo Health, which six years into its existence has fewer than 9,400 enrollees, a far cry from universal coverage. Its revenue never supported its operations, a fundamental flaw in an otherwise laudable, but far too grandiose, policy notion. 

Only this year, with a new tax on private health insurance claims promising $38 million in revenue, may Dirigo find the fiscal sustainability it's never had. Or, if Congress acts, it could find itself moot. 

In Massachusetts, a trailblazing first-in-the-nation program of mandated health insurance coverage has been a rousing success. The state has a mere 2.6 percent rate of uninsured, best in the country. (Maine by comparison is about 10 percent.)

Yet the cost monster has arrived. According to USA Today, the price of this near-universal coverage to taxpayers has been an additional $600 to $700 million per year. Then, the recession's double impact — lower tax revenue and the increased utilization of public insurance — has thrown the Bay State's budget into turmoil.

So much so, in fact, that Massachusetts officials are attacking the oft-blamed villain of health care in response: reforming "fee-for-service" payments to medical providers, which would ostensibly remove any financial incentive to provide lavish, excessive or unnecessary tests or treatments.

This avenue is keenly eyed by Obama administration officials for savings, under dispute by some doctors who essentially say, gripe all you want about wasteful tests, but Americans are living longer, healthier and altogether better for their money. The system is expensive, yes, but it produces results.

Nobody should argue that. What Americans want out of health care isn't a cheaper system, just one where costs aren't blatantly crippling. That's the real reform. Expanding insurance coverage — the second act of this play — is just that, an expansion, not a reform.

There are 47 million Americans now without health insurance that could be covered tomorrow, by instituting a hodge-podge of new subsidies and loosened eligibility requirements for Medicaid or Medicare.

Of course, this is where speed would kill, because costs would remain unaddressed. That cannot happen again. One thing states, acting as the policy laboratories for Washington, have proven is that true health care reform is not possible without bending the cost curve.

How do we do this? Unpopular ideas. Taxes on the rich, draconian efficiency committees and complex analyses of physician quality and outcomes, for example. Or, not so unpopular ones, like a public health insurance option that injects some competition and leverage into health care markets that could desperately use it.

We know what reform requires. The ideas are here. The will is here. The need is here.

The time is now.

editorialboard@sunjournal.com

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Comments

 's picture

There is no good reason why

There is no good reason why our tax dollars should be used to fund abortions or to give free healthcare to illegal aliens. While I believe we need major health reform, IMO, those two elements must get removed from ObamaCare.

RAYMOND FRECHETTE's picture

One thing for sure is that

One thing for sure is that we all insist that the President and the members of Congress have to use the same plan they give us and that they do away with all the special care they now enjoy at Walter Reed and other special hospitals. Let them go to the back of the line as we do.

 's picture

They have already said they

They have already said they wouldn't give up their plan.

 's picture

Well that's too bad, because

Well that's too bad, because all government folks should be the first to convert off from their overly expensive Cadillac plans... but we know the unions/PACs won't allow that to happen...just ask MSEA-SEIU in Augusta.

RAYMOND FRECHETTE's picture

Maybe what we need is less

Maybe what we need is less government inteference instead of more. To tax the rich is smoke and mirror tactics as the rich never have nor will ever pay these taxes. Their lobbyists and accountants will find a way around them. Forcing citizens to carry insurance would help, but do we necessarrily want government to do this? Maybe the draconian measure of not providing care until one pays for it would work best. Those of us who are old enough to remember debtor's prisons remember that time in jail usually got the deadbeats to pay.

The unfortunate truth is that there are no easy answers, quick fixes, or magic bullets to this problem. Starting with taking most non-narcotic pharmaceuticals off the prescription only list and making them availble over the counter would bring those costs down to a reasonable level. Tort reform where doctors can make an informed decision without a battery of tests to back themselves up against potential lawsuits would help. Simpler insurance forms where doctors and hospitals would not need such a large staff to collect their dues from insurance companies would help. Giving the stockholders of companies the power to control their board of directors and the foolishly high bonus arrangements that these boards give out would certainly help.

The last thing we want is a government run plan. This is proved by every country that has one. Look at our neighbor to the North; why do you think the people of Quebec sued their government successfully to be able to bypass their so called "free" government insurance service and buy private insurance so they can enjoy what we take for granted.

Face it, those genuinely poor are now covered by Medicaid; the rest of us can and should buy insurance. Anthem has high deductible plans at affordable prices. All that is needed is a plan similar to an assigned risk plan for motorists that would guarantee acceptance to those with existing conditions.

 's picture

So speed isn't the issue?

So speed isn't the issue? Well it sure did create a major problem with the stimulous package. Members in congress voted on it without having time to read it. Obama has all the democrates to prevent a republican fillinuster so you can't blame the Republicans for slowing down a vote. Making small business pay their disproportionat amount for this is yet another nail in this economy. The masiah has lost his mind yet again.

 's picture

We want to change "health

We want to change "health care", but we want to leave many aspects of our life alone. We want to have a portion of our population paying for everyone's medical care. We want to continue to permit people to spend their precious few dollars on booze, chips n' dip, hamburgers and hot dogs, but we exact no financial "down payment' from them to cover the inevitable medical care that looms in front of them as the result of this self-destructive behavior and life choices.

Things work better when participants in any activity have some of their "skin in the game." (We are finding out all about this concept with all the liar loans and financed mortgaged loan down payments, aren't we?) Want the chips? Pay a tax that helps pay for all of the "free" healthcare you are going to need. Don't want to exercise (as in walk around the block)? Pay into the fund.

I doubt that Obamacare is designed to do more than soak the rich and create huge masses of Federal employee union members. Until Americans, all Americans, are willing to put some skin in the game, "free" healthcare isn't going to work.

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