Open Threads

I know people have been asking about a “short read” on the current state of HCR that can be used for the 85% of the population (all of our non-BJ-reading friends, family, neighbors & carpool drivers) who haven’t had the time or interest to follow the ongoing soap opera. The NYTimes editorial “If Reform Fails” seems like a pretty good start. (Read the whole thing, at the link.)

As the fierce debate on President Obama’s plan for health care reform comes to a head, Americans should be thinking carefully about what happens if Congress fails to enact legislation. Are they really satisfied with the status quo? And is the status quo really sustainable?
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HOW REFORM WOULD WORK: … Under the new system, all people would be required to have health insurance or pay a penalty. If you are poor or middle class you would also get significant help through Medicaid coverage or tax credits to pay the premiums.
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The legislation would create exchanges on which small businesses and people who buy their own coverage directly from insurers could choose from an array of private plans that would compete for their business. It would also require insurance companies to accept all applicants, even those with a pre-existing condition. And it would make a start at reforming the medical care system to improve quality and lower costs.
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46 MILLION AND RISING: If nothing is done, the number of uninsured people — 46 million in 2008 — is sure to spike upward as rising medical costs and soaring premiums make policies less affordable and employers continue to drop coverage to save money.
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It should be no surprise that people without insurance often postpone needed care, and many get much sicker as a result. That is morally unsustainable. It is also fiscally unsustainable for safety net hospitals — which foist much of the cost on the American taxpayer when the uninsured end up in the emergency room. As the number of uninsured rises, that bill will rise.
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The Senate’s reform bill would reduce the number of uninsured by an estimated 31 million in 2019. The Republicans’ paltry proposals would cut the number by only three million.
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BUT I HAVE INSURANCE: While most Americans have insurance, many pay exorbitant rates because they have no bargaining power with insurers. That includes many of the tens of millions who buy their own insurance — the unemployed, the self-employed, and those whose employers do not offer insurance…
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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 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.
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I’M JUST WORRIED ABOUT COSTS: You should be. The cost of medical care is rising far faster than wages or inflation… 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.
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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.
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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.
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Any change as big as this is bound to cause anxiety. Republicans have happily fanned those fears with talk of “dangerous experiments” on the “best health care system in the world.” The fact is that the health care system is broken for far too many Americans. And the country cannot afford the status quo.

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And now we return y’all to our regular late-weekend-night listening pleasure…

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(This would’ve been taped a few years after I heard Ms. Griffith introduce this song, during a performance at a midwestern university, talking about her first experience touring the bars of Norway doing “American cowboy music”. As a Texan, she was… impressed… by the Norwegians’ barroom standards: “We came through Oslo three times [over the course of several weeks] on that tour, and every time they’d have the stage built up a li’l bit higher, but no matter how high it got they could *still* toss the drunks up there with the band! Guys’d finish their bottle and just toss it away, not even lookin’ where it was gonna land… shuuuure, we do that in Texas, but we alus LOOK before we throw, ’cause it’s only polite to know who you’re threatening to brain!… “

Early Morning Open ThreadPost + Comments (61)