Thursday, October 08, 2009

Health care reform shorts: what if it got done?

Ezra Klein, Washington Post policy wonk extraordinaire, posts today Meet the New Health-Care System, Not That Different From the Old Health-Care System. He's referring to Max Baucus' version of a bill that may be on its way out of committee, that may then form some part of the basis of a Senate bill, that may then be merged with a House bill, that then might finally become the law. That is, we're still a long way from done here, but he's assessing a strong possibility.

And this one certainly meets one of President Obama's criteria; if you like what you have, you'll be able to keep it (so long as your employer offers the same health insurance).

The verdict? It will look a lot like our old health-care system.

Unless you're uninsured, or on the individual market, this bill is not expected to affect you. CBO estimates that 29 million Americans who would've otherwise been uninsured will be covered. ...But most people will never notice it. ... Which is only to say that this is not the end. ...most of the systemic problems will remain unsolved.

I'm old enough to have been raised on the mid-twentieth century historian Richard Hofstader's observations of U.S. society. He became somewhat cranky in the tumultuous '60s, but his earlier work probably influenced my picture of the outlines of our democracy. This Hofstader dictum seems relevant to Klein's summary.

When one considers American history as a whole, it is hard to think of any very long period in which it could be said that the country has been consistently well governed. And yet its political system is, on the whole, a resilient and well-seasoned one, and on the strength of its history one must assume that it can summon enough talent and good will to cope with its afflictions. To cope with them -- but not, I think, to master them in any thoroughly decisive or admirable fashion. The nation seems to slouch onward into its uncertain future like some huge inarticulate beast, too much attainted by wounds and ailments to be robust, but too strong and resourceful to succumb.

from Hofstader's Reflections on Violence in the United States, via Matt Yglesias

The struggle over whether health care reform can be achieved seems more and more a struggle over whether our "democratic" institutions retain the ability to both answer to majority opinion and accomplish anything at all. We'll see.


primerica insurance said...

So basically you're saying that the current bill is not bringing up nowhere near enough change for the system?

Sorry if I misunderstood. Had a long day.

janinsanfran said...

Lorne: yes -- I'm saying that the way our government works, the current health reform can do no more than make some changes around the edges. As it is developing,it looks like it will cover --SOME -- but not all, of the 45 million uninsured, restrain but not fix the problems created by profit-seeking parts of medical delivery (especially insurers). and do little to control rising costs.

And yet it will be progress. These failures are intrinsic to our system of government, for better and worse.

Darlene said...

We lurch from one crisis to the next and from the left to the right with regularity.

Congress makes bad laws, then they have to correct them. They never seem to see the unintended consequences looming down the road.

By the time they get through adding amendments to this reform bill so it will pass, there won't be enough left of real reform to wonder why we all bothered.

primerica insurance said...

JaninSanfran: thanks for responding. What I never like about any reforms is that instead of real debate among professionals that have something to say on the topic and among those that will be affected the most by the reform (read: the people), the struggle/battle becomes just a political theatre with one or the other side collection political points, claiming their "victory". Instead of deciding on what the best solution is, the particular solutions are labelled as too leftist, too rightist, too socialist, too liberal, too whatever. How sad is that?

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