Wednesday, January 20, 2010

Separating The Specifics From The Goal Of Health Care Reform

It is surprising that Democratic pundits do not separate the specific bills in Congress from the goal of health care reform.

Most of the public in Massachusetts and in the US support reform. They do not support the Senate or House bills before Congress.

For many reasons, the electorate does not see the two proposed laws as positive reform. The public sees special favors, unrealistic cost savings estimates, uncertain cost savings promises without assurances and few if any benefits to their own health care.

Passage of a health care law derived from a compromise of the two bills will not change that perception.

The two biggest benefits cited was the prohibition against using a pre-existing condition to deny health insurance coverage and coverage for the uninsured. The public understood that to make that happen all Congress needed to pass was a simple law making it illegal to use pre-existing conditions and an increase in the coverage of either Medicare or Medicaid for the uninsured. There was no need for deals, pork, promises about uncertain future outcomes, etc.

The bills are icebergs. Most of their provisions and future effects were not above water and visible to the public. The public was suspicious and angry about the special favors for select groups.

The Democrats do not seem to be able to separate their need to pass health care reform law from the quality of the law they want to pass. They are willing to pass a bad law because it is called health care reform. The public is not so enamored of the title and instead wants substantive, useful, helpful, positive change passed. Unfortunately, the President assured a Democratic loss of Senate control and that the bill as is would not pass when he sent signals (deal with the unions, etc) that he was willing to agree to almost anything to get a law called health care reform passed.
The above is my comment to Ezra Klein's post "Political courage" on The Washington Post.

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