Coming Through At Last

The NY Times editorial board finally comes through with some truth about HCR, and they finally address where the Republicans have been able to do the most damage: people who are already insured, and people scared of debt.

BUT I LIKE MY INSURANCE: Most Americans get their insurance through large companies, with large group bargaining power. While they complain about premiums and paperwork, most seem satisfied with their coverage.

For them the real fear is what happens if they lose their jobs or decide to change jobs. Will they be shut out of coverage because of a pre-existing condition or forced to pay high rates to buy their own insurance?

For this group, the real advantage of reform is security. If they get laid off, decide to be self-employed or switch to a smaller employer that offers no insurance, they will still be guaranteed coverage — even if they are a cancer survivor or have heart trouble or any other pre-existing condition. And they will be able to buy insurance on the exchanges.

I’M JUST WORRIED ABOUT COSTS: You should be. The cost of medical care is rising far faster than wages or inflation. And despite all of the talk about reform “bending the curve,” no one is yet sure how to do that.

Many reforms that people instinctively believe should cut costs — computerization of medical records, paying doctors for quality not quantity of services, and prevention programs to promote healthy living and head off costly illnesses — cannot yet be shown to lower costs.

Pending reform legislation, specifically the Senate bill, would launch an array of pilot projects to test reforms in delivering and paying for care. It would also create a special board to accelerate the adoption of anything that seemed to work. That seems a reasonable way to go and a lot better than standing by as costs continue to spiral out of control. The Republicans’ proposals — including their call to cap malpractice awards — would make only a small dent in the problem.

WHAT ABOUT THE DEFICIT?: Republican critics of health care reform have done an especially good job of frightening Americans with their talk of bankrupting the Treasury. The truth of the matter is that the pending reform legislation has been designed to generate enough revenue and savings to more than offset the substantial cost of expanding Medicaid and providing subsidies to the middle class.

The Congressional Budget Office estimated that the Senate bill would reduce deficits over the first 10 years by $132 billion and even more in the second decade.

What critics certainly do not talk about is what happens to the deficit if Medicare costs continue their relentless rise. That is something that should keep Americans up at night.

The pending reforms would cut the growth in Medicare spending per beneficiary in half — from 4 percent a year to 2 percent — by demanding productivity savings from Medicare providers and cutting unjustified subsidies to the private plans in Medicare.

There is some skepticism that Congress will stick to its guns if health care providers say they cannot survive on the reduced rations. But Congress has stood by most previous Medicare cuts (physicians excepted) and should have its spine stiffened by new pay-go rules requiring that any Medicare increases be offset by other savings or taxes.

If reform is defeated, it seems likely that most of the proposed experiments designed to cut costs — first within Medicare and then throughout the rest of the health care system — will die as well. The legislation needs to be passed to establish a structure to force continuing improvement over the years. That is the best chance of restraining soaring medical costs that threaten the solvency of families, businesses and the federal government. 

And while this has been true all along about the Dems' HCR bill, it's the Village itself that has allowed the Republicans to direct the "debate" by allowing them to lie repeatedly and scare millions of Americans into believing this is a "socialist takeover of healthcare".   The simple fact of the matter is that doing nothing is not an option right now.

But the really angering part is this is what the Village should have been saying about HCR since last year.  Instead the Village is printing an editorial on how there's all this misinformation out there when they're the ones responsible for failing to challenge the misinformation in the first place over the last year.

I only hope it's enough.