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Healthcare Dust Settling

In the aftermath of President Obama signing the healthcare bill, I've been thinking about the healthcare debate.  Most of the discussion has been about non-issues (death panels) or things that most people agree on (don't mix up abortion policy with this healthcare plan -- stick to the Hyde Amendment).  Congresspeople dismiss the projections of their own Congressional Budget Office but can't point out where the analysis is wrong.  They just don't agree.

I think that Obama made a big mistake in leaving healthcare to Congress for 2009.  Congress is completely ineffective due to the polarized nature of politics.  There is very little compromise and very little bi-partisanship.  This has spiraled out of control since the early 1990s.

Since Obama didn't take charge of this at the beginning, he (and now we) are left with a bill that is far from perfect.  It's got a lot of the right ideas (everyone gets coverage regardless of pre-existing conditions, everyone needs to buy insurance so we can cover those who have pre-existing conditions, etc.).  But, it is overly complicated and has a long implementation period.  Things won't really change until 2014, after the next Presidential election (smart for Obama!). 

I wish that Obama had kept the US plan to be a scaled up version of the Massachusetts plan.  I've bought insurance for my family under this plan.  It was well organized and easy.  I was done in an hour.  Most of the time I spent was checking to make sure that our doctors were part of the plan I wanted.  The same private insurers are available in the market as before.  In fact, you don't hear anyone in MA complain about MA healthcare.  Even Mitt Romney likes it.  He should, it was his doing.  Romney thinks that each state should do what Massachusetts does.  The problem is that most states won't, leaving 10s of millions of people uninsured.

The MA plan hasn't broken the bank.  The latest numbers I've seen say that the state's contribution is 0.4% of the state budget.  And yet, one of our gubernatorial candidates says that it's bankrupting the state.  And, he's the current state Treasurer.  Guess math isn't his strong suit.

Romney figured this out:

Central to the plan was Romney’s recognition that uninsured individuals were costing the state and federal government money because they showed up in emergency rooms for non-emergency care. If they had health insurance, Romney concluded, those government payments to hospitals could be applied to paying to cover the uninsured.

“We said, let’s take the money that the federal government is giving us and that we’re taking from our own state coffers that we use to give to hospitals to give out free care,’ ” Romney says. “Instead, let’s use that money to help low-income people purchase their own private market-based insurance.”

I wish our new federal plan was closer to this simple idea.  Instead, Democrats in Congress overreached.  Some Congresspeople demanded that their states be paid off in order to secure their votes.  The Republicans encouraged irrational opposition irrespective of facts.  And, our debate turned into the Hatfields vs. the McCoys.  Opponents don't even know for sure why they hate the bill (or, their reasons are based on legend and not facts).  But, they know they hate it.

I hope that Obama leads with a heavier hand going forward.  He needs to control the debate and get Congress to follow in line.  He needs to keep reaching out to Republicans and let them decide if they want to collborate with him or stay as the party of No.  And, if he's smart, he'll adopt a couple of Republican-led issues as his own, as Clinton did with welfare reform.

And, let's hold all the news media and talking heads to some strict fact checking.  I appreciated the artilcle about Romney that I linked to before.  He rightly took credit for cracking the code on MA healthcare.  He pointed out where the Democratic legislature went against his wishes on some of the details.  But, he's willing to acknowledge that overall it's a good bill.  Sounds pretty darn bipartisan and reasonable to me.


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