Health Reformation

Our View: While Last Week's Vote Signals Health Insurance Reform's Passage, Much Still Depends On How The Senate And House Reconcile Significant Differences

December 28, 2009

With last Thursday's vote in the U.S. Senate, health care reform is headed for final passage, although perhaps not for weeks yet. While there are significant differences to be ironed out between the Senate and House, the final version is likely to be neither the robust shake-up that progressives sought nor the ruinous assault on personal freedoms that conservatives have decried.

Instead, what Congress is going to produce is a bill that will ensure that millions of Americans who lack insurance now (or are at risk of losing coverage) will soon have it. By any standard, that is a major accomplishment - if only because it represents such a monumental shift from years of Washington's denying there was even a problem to a willingness to find a solution.

Today, there are at least 43.6 million Americans without health care insurance of any kind. It is a number that has been growing for years as health care has grown increasingly unaffordable not only for individuals but also for small businesses who employ them. These are people who often end up getting medical treatment in the most expensive and inefficient way possible, the hospital emergency room, and their families generally live just one health crisis away from financial ruin.

We are a nation with the most expensive health care system but far from the most effective one. By most any common measure from longevity to infant mortality, the U.S. lags shockingly behind much of the rest of the industrialized world.

Whatever legislation emerges from House and Senate negotiations will not fully solve this by any means. Most disappointing is that not all Americans will end up being insured - although an estimated 95 percent will.

Yet it seems almost miraculous that such a substantial measure has emerged at all given the complexity of the issue, the entrenched partisanship in Washington and the ridiculousness of the often-wholly-unrelated public debate. In a nation that so loves its Medicare benefits, did Congress really have to get tied up in knots over the possibility of some people buying their health insurance from a government entity? Over access to abortion?

Sadly, listing all these moments of embarrassing absurdity (particularly in the Senate where it apparently now takes 60 votes to agree on the time of day) would take more space than is available on this page. Suffice to say that the nation can only be grateful that nobody has to rely on Congress for medical care or else it would be along the lines of: "The doctor will see you just as soon as these 2,000 pages are read aloud in an empty room."

Yet with such a fragile coalition in the Senate, many of the most controversial elements of insurance reform - nationwide insurance policies managed by the federal Office of Personnel Management instead of a public option, for instance - are almost certain to adhere to that chamber's position.

The best possible bill, however, would require compromise from both bodies. The Senate's version may have more cost-control (and sets up a more realistic path toward reducing Medicare spending), but the House's would be more helpful to low-income families and is tougher on drug companies.

Will any resulting health care law actually improve public health? Yes, this seems certain, according to independent analyses. It's also bound to reduce the total cost of health care simply by expanding the insurance rolls and thereby enabling greater access to check-ups, prescription drugs and other preventive measures.

Clearly, more could have been done - to both expand access to care and hold down costs - and will have to be accomplished in the future. The health care bill is not a cure so much as one form of therapy, but not an insignificant one.

Readers respond

The Senate bill is a complete betrayal of the promise of real reform - they should call it the "Health Insurance Corporation and Pharmaceutical Corporation Profit Protection Act of 2009."

Real reform must include a public option with price controls - the promise of this is what got President Obama and the Democrats in Congress elected.

Without a legitimate public option, available to all Americans, the absolute best the Democrats can hope for is to be voted out of office in their next election.

Personally, I'm checking prices on pitchforks and torches.

AC

All I'm gonna say is there is no way I'm gonna purchase this health insurance for myself the way President Obama wants. I dont care if the law does pass! I'm extremely upset the idiot cant see what he is about to seriously screw up! Hey, you ever heard the old saying you can lead a horse to water but you can't make it drink? Well, this is one horse you ain't gonna have enough power to make drink! This is a fact!

JWC

What a joke. Senators being bought with billions of our money.Democratic leaders saying, "So what, that's how Congress works." No tort reform because they're all lawyers. Taxes going up, premiums going up, no jobs!

God Bless America, Merry Christmas, or to all you liberals a nondenominational Happy Holidays.

DWM

This is not health care reform bill. This is a power struggle of Democrats vs. Republicans, with citizens the losers.

No way that dumping 30 million more into care pot without adding facilities and doctors can work.

Frank25

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