The health care reform package that passed the House of Representatives seems to satisfy the minimum requirements of morality. At least, it explicitly excludes the use of taxpayer dollars to pay for abortions.
It is at this point, that our critical engagement with the legislation must begin.
As citizens, we owe each other our best efforts at intelligent, informed, and charitable discussion of the legislation, the general situation of the country, the specific needs of regions, states and individuals - of what seems to have worked best, and where, and why - of what has failed, and why - of what seems destined to fail, and why.
What we need to exercise now is, in a word, prudence.
At the weekend, I will have some thoughts on what prudence is.
For now, let me ask a question about the cost of the package, one that a reader, Kevin from Texas, has helped me formulate:
Why 1.2 trillion dollars? As I understand the statistics, there are between 20 and 40 million Americans without health insurance at any given time.
This is between 7% and 12% of the population.
This means that somewhere between 93% and 88% of the population have some sort of health coverage at any given time.
The President of the United States told folks the package that passed the House would cover 96% of the population.
This, however, is only somewhere betwee 3% and 8% better than we are doing at present.
So, what I'd like to ask is: can we justify spending that kind of money for such marginal improvement?
As far as I understand matters, the folks who are at any given moment without health coverage are either, or some combination of, the following: just-graduated young people in search of employment; other people between jobs; people who, for whatever reason, are having a hard time finding a company that will sell them insurance.
Reforming the law to extend coverage past termination and to make policy portability possible would go a long way toward reducing the number of people in the second category.
Reforming the law to allow for the ready introduction of reasonable rules governing what is and is not a pre-existing condition, as well as what sorts of exclusions insurance providers can put on coverage, based on those conditions, would go a long way toward reducing the number of people in the 3rd category.
Very little, besides the recklessness of youth is keeping people in the first category from having coverage in the first place.
How much would legislative reform of the type I have articulated above really cost?
Indeed, both kinds of reform already enjoy broad bi-partisan support.
So, why not draft them, pass them, sign them, declare victory and go home?
There is another kind of reform that would drastically reduce the cost of actually providing health care (I mean running a doctor's office, a clinic, a hospital, etc.), which would presumably bring the price down, which would presumably reduce the cost of insurance coverage: malpractice tort reform.
Put a legislative cap on the size of malpractice awards, and doctors/medical institutions will not have to buy gargantuan malpractice insurance policies.
Granted: this last would mostly be an issue for state legislatures - but the Federal government could carrot-and-stick the states into action.
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