Why Reforming Health Care Can Help Heal The Economy & Other Ailments

The two biggest lies being told by opponents of President Obama's health-care reform plan is that it will be financed entirely on the backs of the rich and that the depths of a protracted recession is no time to go forward with such a bold and expensive initiative.

If you believe, as I and a majority of Americans do, that health care is a right and not a privilege, then the first lie is easy to answer and the second only somewhat more difficult.

If you believe that getting adequate care when illness or disease strikes should continue to be predicated on your ability to pay and don't care that several million children remain uninsured even after the S-CHIP program was expanded by raising the federal cigarette tax (cough, cough), then kindly take your curmudgeonly self elsewhere.

As it is, half of the $634 billion cost projected over a 10-year period for the Obama plan would come from raising taxes on the rich, which translates into about $7,500 more from everyone making in excess of $500,000 a year, or approximately one-tenth of the cost of a new BMW 7-series luxocruiser.

The other half would come from a key component of reform: Squeezing much of the waste out of the health-care system. This includes subsidies for private plans that participate in Medicare, exorbitant payments to drug companies, hospitals and other health-care facilities and rooting out the billing fraud that is all too pervasive among big hospital chains.

With so much in need of repairing as the recession enters its 15th month, an argument can be made that this is no time to tackle the task of insuring 46 million Americans, providing adequate care to others who are underinsured and reining in the waste and fraud that is at the heart of a maddeningly complicated and dysfunctional system that spends much more per capita than other industrialized nations.

Yet America's gravely ill health-care system is the greatest threat to social stability and fixing it will go a long way to begin to heal a very sick economy.

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In 1993 when Hillary Clinton pitched her disastrous reform plan there was neither the will nor the way. Fast forward 15 years and a lot has changed -- and very little.

While out-of-control health-care costs and a recession have had a clarifying effect for the many Americans who now support some form of universal coverage, the huge pharmaceutical and insurance companies want to keep costs high because they profit from the very waste that undermines the system.

Their lobbying groups are more or less making nice with the Obama administration, but their "commitment" to reform is only skin deep. When you read the fine print of the insurance industry lobby group's policy brochure it is obvious that it wants the government to assume the cost of treating the sickest -- which is to say the most expensive -- people while offering their own watered-down policies with no cap on premiums.

Reform, my ass.

As a reporter, I covered the Clinton reform initiative full time in 1993 but had forgotten that there is a key difference in what she proposed and what Obama wants to do.

ClintonCare, as it was called, was not a government takeover of health care but rather a handover to HMOs that would provide managed care.

In retrospect, that was a recipe for more pain and suffering. This is because for HMOs, "managing" care has been more about denying care, and almost everyone has a personal tale of woe or knows someone who could not get treatment for the flimsiest of reasons. Meanwhile, costs have continued to spiral out of control despite the supposed efficiencies of HMOs.

The Obama plan, to the extent that it has been delineated, will be a hybrid system in which private plans coexist with a greatly expanded but temporary federal role -- if 10 or 20 years can be called temporary.

The devil, of course, is in the details, mostly notably what the role of employers will be. While providing a general framework, the White House is leaving most of those details to Congress, which is exactly what Clinton did not do.

I myself favor a middle ground, although I do not doubt that the president will step in if a Democratic congressional majority more or less receptive to reform dithers in the face of crisis and caves in to special interests and the Republican opposition, which is stuck on the false notion that government needs to butt out of insuring people because that would be anticompetitive. Anyone who believes there is true competition now needs to have their meds upgraded.

Only a fool would predict that elements of real health-care change will be in place by year's end. But failure is not an option.

Paintings by Jose R. Perez. More here.