Comprehensive Health Care Reform Not Very Comprehensive

Once upon a time it looked like Congress and the White House would deliver meaningful, comprehensive health care reform to the American people. They certainly started down that path. The talk was of “bending the cost curve.” And of tackling issues like medical malpractice. There was even promises being made of moving toward comparative effectiveness programs and away from the costly fee-for-service provider reimbursement model of today.

Those were the days, but they’re over now. Whether as a result of the August Town Hall ruckuses, lawmaker’s ignorance, or general cynicism, those ideas are pretty much a thing of the past. Yes, there are modest efforts in the current Congressional bills to control costs. But to call them modest is kind. Politicians and pundits. will claim that what’s moving through Congress will make health care coverage more affordable and relieve the burden of medical costs on American families, but few actually believe it.

Over the past few months, the focus of health care reform has shifted to health insurance reform. And while some changes in the way health care coverage is marketed and administered are necessary, those changes will do little if anything to bring down the cost of care. On the contrary, some of the proposals being considered will, it is generally accepted, increase insurance premiums.

This shift by lawmakers from comprehensive health care reform to simply addressing marketing and distribution reform is, to say the least, disappointing. It also shows the challenge in accomplishing major change in Washington. The partisan divide is deep and cynical. The extremes within each party are in ascendancy, making compromise – the life-blood of the legislative process – all but impossible.

So instead of passing real reform, changes to the system that would restrain medical cost increases, the goal seems to have shifted to passing something – passing anything – on which the “health care reform” label can be hung. The result will do little to increase the affordability of insurance coverage or to restrain medical cost inflation. Lawmakers choose to ignore this reality – and to distract attention from it by keeping the focus on whether Congress will create a publicly run plan to compete with private carriers.

Yes, health care reform is hard while taking on the insurance companies is easy. And, as I’ve mentioned, there are some industry practices that need reforming. Given the political realities in Washington it may be that health insurance reform is all that lawmakers are capable of delivering any time soon. 

The shame of it all is that the current health care system is unable to meet America’s needs. The status quo, most objective observers from across the political spectrum agree, is unacceptable. America is the only developed nation in which medical costs bankrupts families. The cost of medical care is overwhelming state governments, threatening their ability to deliver other necessary services. Medical cost inflation is outpacing growth in wages and general inflation, resulting in increasing numbers of families and businesses being priced out of health care coverage.

Meaningful, comprehensive health care reform is critically needed. It’s what the American people desire. But Congress and the White House seem unable to deliver. The fault is not solely with the Democrats nor solely with the Republicans. This is a bi-partisan failure. And hiding behind health insurance reform won’t change that reality.