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Health Care Reform Goes Into Extra Innings

By on July 25, 2013

hospital costsIn spite of Obama’s victory at the polls, and the Supreme Court’s decision to let the Affordable Care Act stand, it is becoming clear that the Affordable Care Act 0f 2010 is still under seige. Obama has postponed the employer mandate taking effect for a year. This is not a big deal according to Professor Ezekiel Emanuel of the University of Pennsylvania. However opponents of reform are jumping on it  as a sure sign of failure. The House of Representatives  has again passed a repeal of the whole act which goes nowhere in the Senate again either. Who is this supposed to please? Action in Congress continues also to whittle away at the bill, changing definitions. blocking funding, harrassing supporting groups e.g. actions to redefine the term full-time employee so that firms like Walmart can scale back workers’ hours to avoid providing them with health care benefits.

Worse news, opinion polls still show the public as badly divided on the reform act, still uninformed and confused. The Obama PAC has recently started airing infomercials trying to sell the changes once  again to the public. These rea reminiscent of the Harry and Louise ads used by opponents to torpedo the health care reforms of the Clinton era. There is a real danger in government by polling. We would never have ended slavery, given women the vote or started social security if we had relied solely on public opinion polls to guide us. Sometimes you just have to do the right thing.

socialismReports show doctors who have generally been supportive of reforms as more confused. Only 16 states are expanding Medicaid and 24 have decided not to get involved, letting the formation of local insurance exchanges up to the federal government. This is to be regretted because some of the early evidence shows  that where exchanges have been set up, as in New York,  insurances companies bidding for contracts have brought down prices significantly. This may be in the form of reimbursements to providers and hospitals, but there is plentiful evidence of extreme variation in pricing by providers.  And as we have already seen, price does not necessarily mean quality. Many providers not like this as it means less money to go to lobbyists trying to block reform in the congressional coatrooms.

$It will be a genuine catastrophe if the desirability of reform becomes a real issue in the election of 2014. Opponents pick apart the current plan as flawed, but offer nothing in exchange. We cannot afford that. It would be a repeat of the Clinton Era and guarantee that the matter would come back again in the future in even worse shape. Health care costs  are a genuine threat to the stability of the US economy.  If we do not get a grip on the cost of health care coverage for working Americans, we are headed for a far worse financial crisis than the Great Recession of 2008.

The public needs to realize this is not American Idol we are talking about but our real future. This is not more news as entertainment.  Attaching health insurance to employment may have seemed like a great idea in 1946, but now it has just become a giant headache. Changing the failing American system will take some doing and some time. Not addressing the problem at this late date is unthinkable.

But politics these days is no longer a thinking man’s game. The thinkers seem to be in the showers right now and the Health Reform game is going into extra innings with a lot of chuckleheads taking the field. I would advise the fans to keep their seats and pay attention to what follows. You have more at stake than you know.

 

Tom Godfrey

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