Prescription for health-care disaster: Sticking with status quo

Jan 25 2010 - 10:24am

I took a little stroll down memory lane last week. Back to the glorious days of June.

Polls then showed an American public that acknowledged its health-care system was broken and wanted Congress to do something about it.

"Americans generally see government involvement in health care in a positive light, and most support it," CBS News reported on the findings of its own poll.

The numbers boded well for an overhaul: 72 percent of Americans supported a public option to compete with private insurers; 64 percent thought government should guarantee health insurance for all Americans; 61 percent thought rising health care costs presented a serious threat to the economy.

Now here we are in a January fog. Months of wrangling in the House and Senate may be doomed because inept Democrats in Massachusetts allowed their senatorial race to spin out of control and political realities now dictate that 60 votes, not a simple majority, are needed to get a bill through the Senate.

Broad support for health-care reform only six months ago has given way to mostly irrational fears -- happily fanned by special interests and Republican politicians -- and the mistaken notion that our health-care system isn't in such bad shape after all.

But let's talk about what will happen if health-care reform doesn't pass.

The number of uninsured, currently at 46 million, will continue to grow. People without access to regular medical care will be less healthy. Taxpayers will pick up the cost in charity care when the ailing end up in the emergency room.

Families will remain paralyzed by the costs of medical coverage and the insecurity of the insurance market. People will forgo entrepreneurial ventures and postpone retirement, clinging to the security of employer health plans.

Insurance companies will still deny people affordable coverage because of pre-existing conditions. They will even rescind the policies of some patients who become sick.

An ever-growing proportion of our nation's spending will be eaten up by medical care. It currently consumes almost one-fifth of the nation's economy. Health care costs will make the deficit worse and our companies less competitive in a global marketplace.

We will continue to spend more on health care than any nation in the world, while achieving poorer results.

The thing about health care is, it can't be handled piecemeal. Congress can't bar health insurers from turning away people with pre-existing conditions (a universally popular idea) without getting healthy customers in the insurance pool. But how do you do that without the much less popular steps of mandates and subsidies?

The health care reform bills in the House and Senate vastly expand access to insurance, they stop insurers from turning away patients because of pre-existing conditions, they help small businesses buy policies for their employees, and they create the potential for vastly expanded choices for businesses and individuals. They also contain carrot-and-stick incentives for eliminating mistakes and driving down the cost of medical procedures.

The plan shaping up isn't perfect, but it is quite good. And it can be made better.

Republicans and some Democrats are saying we should go back to the drawing board and design something simpler and less controversial. Good luck with that.

If health-care reform crashes now, it'll be radioactive for decades. And the next plan, if and when there is one, will be more timid. Harry Truman reached for single-payer health care and didn't get it, and every reform attempt since has seen a lower bar.

Not so long ago, Americans broadly supported health care reform. Experts of all political stripes still agree that the status quo doesn't work.

But if Congress does nothing, health care will grow increasingly expensive, inaccessible and wasteful.

See you in the emergency room, everybody?

Barbara Shelly is a member of the Kansas City Star editorial board. Readers may write to her at: Kansas City Star, 1729 Grand Blvd., Kansas City, Mo. 64108-1413, or by e-mail at bshelly@kcstar.com.

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