Beyond Washington

The title to Andrew Sullivan’s post, “Tweaking healthcare: Look beyond Washington,” that highlights Aaron’s post from earlier today got me thinking. There’s another way in which we should be looking beyond Washington right now, and that pertains to the question “Was health reform worth it?”

That’s a question many bloggers, journalists, commentators, and pundits have been asking and answering in recent days. Jon Cohn had a post on it today, one that links to related posts by many others. They’re all principally about the political consequences of health reform, though some mention the benefits of reform for the budget or insuring the uninsured. That is, in large part, they reflect a Washington focus.

Let’s look beyond Washington. Doing so, we can recognize the most important benefit of health reform. It was, is, good for health. The principal way in which health reform is good for health is that it provides access to insurance for tens of millions of Americans. A secondary way is that it aims to increase the efficiency and quality of our health system through payment incentives and reduction of health care of low marginal value, in exchange for increasing provision of health care with high marginal value.

But let’s just take insuring the uninsured. Many, many, many, many, many, many studies using the best statistical techniques find that insurance is good for health. Aaron and I have written about them numerous times, so I won’t do a literature review in this post. (Follow the “many” links provided above.)

Given the importance of health reform for health, the interpretation of the question “Was health reform worth it?” in political terms, and only political terms, misses a lot. Even if health reform is responsible for a significant part of the mid-term’s outcome–and I don’t think it was–that it was worth it is not even a question in my mind. If one thinks that our health insurance system requires major reform, and I believe it does (who doesn’t?), then that’s the right thing to do. In fact, it was the right thing to do years ago.

Was health reform worth it? Looking beyond Washington and focusing on health, the answer is clearly “yes.” Even if the politics don’t justify it, the health of Americans does.

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