Monday, November 27, 2006

Side-Stepping Comprehensive Health Care Reform

Journal Sentinel business columnist John Torinus took on health care reform over the weekend, concluding that the private sector is best suited to lower costs and expand coverage.

I'm not going to take the time here to rehash all of the research that questions the usefulness of consumer driven health care -- which Torinus advocates-- or the data that demonstrates consolidating payers is the best route to go for lowering costs and expanding coverage. I've already citied these figures in more posts than I can count. For those who are interested, a few of those posts are here, here, here, and here.

But what makes Torinus' column worth mentioning is the manner in which he side-steps comprehensive health care reform (which he dubs "public sector" solutions). Here's the key passage:
Besides ducking the real issue, expect a din from the left for a government takeover. Let's shift the payments from businesses and individuals to the government, À la Medicare, Medicaid and BadgerCare.

Translation: Let's shift the unbearable costs where they are less visible - to the taxpayers. That's us, by the way.

Torinus' claim that "public sector" solutions amount to transferring cost from businesses and individuals to taxpayers (i.e., businesses and individuals) is ridiculous, but it's not new. This is a line that's been used before by the those on the right to dismiss fundamental health care reform, and it's a line that will undoubtedly be used more as the health care reform debate ramps up in the next few years.

First off, out of the three comprehensive health care proposals currently before the state legislature in Wisconsin (here, here, and here), only one (and the one that seems least likely to pass) would shift cost to public revenue (the last of the three links). The other two use the same funding structure -- that is, an employment-based one -- that's currently in place.

This leads into the second point, which is that comprehensive health care reform -- as opposed to the piecemeal "consumer driven" approach proposed by Torinus and others -- is not about transferring cost, but lowering cost. Torinus completely ignores the actual arguments behind consolidating payers in the system, and instead pretends comprehensive reform amounts to simply creating a new way to pay for our current inefficient and expensive (and privatized) health care structure.

Not once does Torinus challenge or even mention the argument that consolidating payers would decrease administrative costs and increase the purchasing power of payers in the system.

In short, what Torinus doesn't say is more concerning than what he does say. Let's hope this doesn't characterize the health care reform debate that's about to bust wide open in this country. It's too important of a debate to sell any ideas short.


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