So President Obama, the Democrats, and, yes, the American people got their much-awaited Christmas gift–healthcare insurance reform. Oh, sure, the Senate bill has to be reconciled with the House bill, but I’ll bet you my weekly copy of JAMA that’s a no brainer.
So now (or next Monday when the world returns to work) we can expect a slew of criticism and predictions of doom from people unhappy with the bill as passed. I want to head off some of this at the pass by saying this: No, the bill is not perfect. No, the bill will not reform the healthcare system. No, the bill will not save billions of dollars and reduce the amount of GDP (currently at 17 percent) that our country spends on healthcare.
But, as a wise friend once told me, perfect is the enemy of good.
The reality is that the Senate bill is a first step on a very long journey to contain our out-of-control health system. There will be many more such steps before we even get close to stuffing this evil genie back into the bottle. Why? Because we have allowed our system to become the kudzu of our culture. For those who aren’t of Southern roots, kudzu is an evil vine that grows about a mile a day and, left unchecked, can smother a small town within a month. Health care in the United States is pretty much the same. I’ve often compared it to a closed toothpaste tube: you squeeze out some savings at one end and they just pop up somewhere else.
Plus, as with any huge system, once you start messing with it there will be unexpected results. For instance, when Massachusetts required that all its residents have health insurance, it didn’t expect the significant shortage in primary care physicians that resulted as millions of newly insured people rushed to the doctor’s office. Expect similar unintended consequences as we begin manipulating our current healthcare system.
In the meantime, though, we have the first, all important step.
On the plus side, the Senate bill (and, likely, any reconciled bill):
- Mandates healthcare coverage for most Americans and provides subsidies/low-cost options for such coverage to people who can’t afford to purchase health insurance at full cost
- Prohibits health insurance companies from discriminating on the basis of preexisting conditions (see my blog about this)
- Prevents health insurance companies from cancelling your coverage when you get sick
These are just the headlines. I’ve been reading the excellent summary of the bill that the Kaiser Family Foundation provides and, in upcoming blog posts, will be addressing several of the less publicized components of the plan.
For now, though, I’m opening my bottle of champagne early.