kenberg, on Mar 20 2010, 06:01 PM, said:
I don't know if this is going to work or not. I think some claims for it have been more along the line of wishes rather than of fact. Counting revenue from a tax that is to be implemented eight years from now seems to me to be very very optimistic. But I do think that Democrats will be seriously motivated to make it work. Contrary to some ways of thinking, I think that failure is always an option. But it would be very ugly.
Failure is always an option. But before health care reform passed the system was headed toward certain failure. When faced with a choice in bridge, I prefer the approach that might succeed over the one that is certain to fail.
The bill that our country adopted contains quite a number of cost control measures proposed by experts of all political persuasions. Only if those measures turn out to be
counter-productive (and that surely won't be the case -- anyone can see that with a quick reading) will we be worse off than we were.
On the other hand, we will now have 32 million uninsured people brought into the US health care system. This will unleash a pent-up demand that will increase costs in the short term, and congress has reallocated some funds (taking some bankers off the public teat, for example) to cover those costs. In the long term, though, bringing those people in will help rein in costs for the rest of us.
For starters (as the republicans often point out) many folks without insurance can find emergency rooms that will treat them anyway. The cost of that treatment is
already borne by those of us who do have health insurance. Furthermore, using emergency rooms in this manner is a tremendously expensive way to deliver health care. Now 32 million people will start contributing toward paying those costs, and they will also be able to get care in a more cost-effective way.
Speaking for the republicans, Lamar Alexander argues that these gains will be more than offset because some people today -- whether through pride or ignorance -- die without going to an emergency room to obtain the care they need. Now those people will be brought into the system, increasing costs.
I've not seen any hard numbers that support Alexander's position on this, but suppose he is correct? I still want to bring those folks into the system, and I would not want to be running for office on a platform of excluding them.
While passing this health care reform was necessary, it is far from sufficient. We definitely need to chip away at the huge amount of money wasted on undignified and largely unwanted contraptions attached to folks near the end of life. There are also some savings to be obtained by more aggressive tort reform. And -- maybe somewhere down the road -- the US can gain the efficiencies of the single-payer system that luke warm and many others want.
The growth of wisdom may be gauged exactly by the diminution of ill temper. — Friedrich Nietzsche
The infliction of cruelty with a good conscience is a delight to moralists — that is why they invented hell. — Bertrand Russell