The State of the Health Reform Debate

I am back from a great vacation in Orlando with the family, during which I dropped further out of the health policy ‘debate’ than I have been since the Spring of 2009. I followed favorite blogs, commentators and news sources via twitter, mostly taking in the big picture while waiting in line at Theme Parks. My conclusion is that we are having the same discussions over and over again. This may be obvious to others, but only came into full relief for me when I pulled back a bit from the fray and decided that I was not going to answer anything I read with a post, no matter what.  After a full year of health reform discussion, then a full year of repeal and replace talk, the release of a variety of long term fiscal plans from different groups with health policy aspects, the release of the Ryan budget, and then the President’s response, we are here on health reform:

  • We say that we need to do something about health care cost inflation
  • We are opposed to any policy that might actually have a chance of working

There is very little actual health policy debate going on, just people talking past one another. We are in need of a political compromise on how to expand insurance coverage so that we can then try and address health care costs. We will never take on the hard work of addressing health care costs so long as any reform plan is that of one party or the other. That is because the last step of any successful cost reduction policy will be that someone will get less care than they would have, and/or a provider will get paid less than they would have, as compared to the status quo. This will be dreadfully hard. It is much easier to say the other side’s ‘hard things’ are impossible while my ‘hard things’ will work no problem than it is to develop a compromise plan. If there is no breaking of the health reform log jam over the next several weeks as part of some sort of wide ranging fiscal compromise, the 2012 election is just going to be fought out along the lines of ‘I am not as bad as the other guy.’ Depressing.

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