It's true: senators who firmly believe health care reform will land us in the soup have gotten in backwards. Is this a result of their inability to pay attention, or is it simply a political decision to oppose health care reform, no matter what? Probably a mix. Between venality and not paying attention, many centrist-in-quotes senators have joined the right in betraying all of us.
Paul Krugman sees real economic dangers in their actions. If we don't have health reform, we're going to have enormous deficits.
Long-term fiscal projections for the United States paint a grim picture. Unless there are major policy changes, expenditure will consistently grow faster than revenue, eventually leading to a debt crisis.
What’s behind these projections? An aging population, which will raise the cost of Social Security, is part of the story. But the main driver of future deficits is the ever-rising cost of Medicare and Medicaid. If health care costs rise in the future as they have in the past, fiscal catastrophe awaits.
You might think, given this picture, that extending coverage to those who would otherwise be uninsured would exacerbate the problem. But you’d be wrong...
How so? Because enlarging the pool of insured to include younger, healthier people adds revenue. And because the proposed legislation includes reforms of Medicare and Medicaid, the two programs which are costing the most.
The health care economists I respect are seriously impressed by the cost-control measures in the Senate bill, which include efforts to improve incentives for cost-effective care, the use of medical research to guide doctors toward treatments that actually work, and more. This is “the best effort anyone has made,” says Jonathan Gruber of the Massachusetts Institute of Technology. A letter signed by 23 prominent health care experts — including Mark McClellan, who headed Medicare under the Bush administration — declares that the bill’s cost-control measures “will reduce long-term deficits.”
The fact that we’re seeing the first really serious attempt to control health care costs as part of a bill that tries to cover the uninsured seems to confirm what would-be reformers have been saying for years: The path to cost control runs through universality.
Today, the theme of this blog seems to be, "They're not listening." That's undoubtedly true of many members of the Senate. The only thing we don't know is how much of that is sheer bull-headedness and how much is a result of their ties to lobbyists for whom the bankruptcy of America isn't a problem as long as their own revenues keep pouring in.
