The Health Care Bills

I have not studied the bills in-depth, so I may easily change my mind. But first, I think we need to pass a bill. And what we pass is not going to effectively address the big elephant in the room, costs. But it is going to do some good stuff, including giving access to most of those people who cannot get insurance and eliminating preexisting conditions as a basis for denial. By doing so, premiums are going to rise. You add riskier people to the pool. The public option question at this point is only about the small percentage of people who will not be able to get insurance. Who are these going to be anyway? If we have an exchange where these people can choose the coverage they want, how important is a government-run program? So liberals, get over it. The right wing focus on the public option is stupid, but it is not that important. In the long run, we are going to have to return to look at the single payer option anyway when we finally get around to addressing costs. Continuing to link health insurance to employment is not the future. You can look at any other wealthy democracy to see this. And Medicare needs to be independent from Congress to eliminate special interests from blocking reform. Ultimately we need to do things like eliminate fees for services payments. If Medicare shows that it can deal with costs in a more innovative and effective way, then you have an argument for Medicare Part E (for everyone). I happen to think exchanges that give people choices are a better way to go, but that is partly an empirical question to which we do not know the answer. And you could always have both, a basic Medicare program along with exchanges for Medicare supplemental insurance. What happens in the future is dependent on what has happened in the past and what is happening now. We need to get a health care reform bill passed now. But knowing the Senate works, you have to be skeptical. After all, the Senate managed to keep blacks from exercising their civil rights in the south, including voting, for 100 years after the Civil War. One of the most effective methods was the registration test, graded by local board members so that no black could pass. Or having to have a sponsor to register. Let's also realize that many of the provisions do not go into effect until 2013. The debate about costs needs to continue. Holding out for the perfect plan now is less likely to result in healthy reform in the long run.

Addendum: For the fiscal year 2008, Medicare cost per enrollee was over $11,000. According to the Kaiser Family Foundation, cost per enrollee was $7439 in 2004. The fair amount for someone who is not subsidized by the government is cost per enrollee. No insurance company profits to figure in. So, instead of creating a whole new agency, why not let those who cannot get insurance sign up for Medicare and pay the premium? I would like to give them some different options.