Sunday, December 27, 2009

The Good Things the Senate Health Care Bill Does

It's easy to get confused about the health care debate, what with both extremes going to extremes to take it down, and the folks in the middle who are actually trying to solve problems not really articulating the depth and breadth of what they're doing. Even your faithful correspondent here at the anticontrarian blog gets a bit confused here and there.

So mad props to Jonathan Chait at The New Republic for laying it out, debunking some myths, and putting the whole thing in the context of the present fiasco we call Health Care in America.

A few choice quotes:
The salient fact, though, is that the United States currently has, among advanced countries, a uniquely horrible system—twice as costly as the OECD average while producing mediocre results and denying care to millions.
Health reform solves the affordability problem by subsidizing insurance coverage, or expanding Medicaid, for low- and moderate-income families. And it solves the pre-existing condition problem by setting up a marketplace, called an exchange, where insurers must sell policies to anybody, at one price, and cover all basic services. In order to prevent people from going uninsured until they get sick, it also requires everybody to purchase insurance, except in limited hardship cases.
Employer-sponsored health insurance is tax-deductible, while wages are, of course, taxed. This means an additional dollar of health care benefits costs less than an additional dollar in wages—an anomaly that has contributed to runaway health care costs. Taxing high cost plans, which do not produce better health outcomes, will give employers a strong incentive to shop for cheaper plans. Either way, the government would collect revenue—either directly through the excise tax, or (better still) indirectly when employees start getting less compensation in the form of tax-free health care, and more in the form of taxable wages.
Small pockets of high-quality, low-cost care, like the Mayo Clinic, exist throughout the country, but most doctors and hospitals have not embraced the methods that produce this efficiency. Health reform contains a number of pilot programs to encourage more efficient care—such as penalizing hospitals with high infection rates, an easily-preventable failure that causes 20,000 deaths a year, or various provisions to reimburse Medicare providers based on results rather than the number of procedures used. Numerous other experiments abound in the bill.
The sum total effect of this legislation is fairly simple. It would redirect a large chunk of the money sloshing around the health care system away from ineffective treatments and toward providing care for the uninsured. On top of that, it would prod the system, in dozens of ways large and small, to adopt cutting edge methods.

I'll spare you all the laundry list of things I'd've liked to see in the bill that aren't there. But anyone who tells you that this bill doesn't do any good is lying, misinformed, or both. To those on the right, this ain't socialism, and even if it was, our most successful health care system here in America, Medicare, is a single-payer system. Just about everybody who's got it thinks it's just great, and you maybe ought to take that into consideration before you keep spouting off about government encroachment on health care. To those on the left, you maybe didn't get everything you wanted this Christmas, but love it or hate it, politics is the art of the possible, and the one thing that was not acceptable was a continuation of the status quo. I'm not fully satisfied either, but the solution is not to take your bat and your ball and go home, thinking that somehow it'll work out better next go 'round. The solution is to keep up the pressure on lawmakers and to keep making the argument that the more Progressive our health care system is, the better the outcomes will be for everybody. That you're probably right should make it easier on you.

I know it was rough in the Bush years, but just cuz Obama got elected doesn't mean the whole game magically changed.

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