Socialism is the Least of our Worries; Health Care Reform Part Three

I think this article by Robert Reich is a very good summary of some of the problems with the sausage-making now going on in Congress. Congress and Obama hoped to avoid the industry opposition that the Clinton effort ran into. So they have been making deals with industry players, and some of those deals are obstacles to the goals of real reform. The concessions to the pharma industry particularly bother me. Any reform that doesn’t let Medicare negotiate directly for lower drug prices… well, it would be crazy to exclude that. That’s a Bush-league move, and I mean that literally.

I have been holding out hope that the final bill will resolve some of these issues, but there’s no denying that trying to please all the stakeholders is creating problems.

And then there’s the ongoing debate on how to pay for it. I think Obama’s pledge not to raise taxes on the middle class has always been a problem; there are just too many things to fix in our country to think we’re not all going to have to chip in and pay a little more. But I’d probably make a spectacularly unsuccessful political advisor. One thing to watch is a possible tax on health insurance companies. If I’m not mistaken, that sounds like the “provider tax” we have here in Minnesota. It’s extremely unpopular with physicians, hospitals, and health plans, but it has provided a stable source of funding for MinnesotaCare, one of our best public health programs.

Another issue that we’re hearing a lot about here in Minnesota is Medicare reimbursement. The system currently doesn’t do enough to reward quality over quantity, and it reimburses inefficient regions better than more efficient regions, such as the upper Midwest. Obama was going around talking about these regional differences in early July; I haven’t heard much about it lately, and that’s unfortunate. Without finding efficiencies, without changing the way some docs and regions practice, we will continue to have unsustainable increases in costs.

I’ve always supported the idea of getting the ball rolling on health care reform and refine it as it goes. But I very much want the best legislation possible, and the pressure is on the pro-reform lawmakers to deliver it.