Since I've written occasionally about the current health care reform efforts here, I feel as if I should say something now that a bill has passed the House. To be honest, though, I'm having a bit of trouble getting my thoughts in order, although I do feel the need to vent. Readers who aren't in the mood for my political opinions can skip this one.
Here goes: first off, it's rather hard for me to get past my anger at being told (repeatedly, by both the President and members of Congress) that this bill will "bend the cost curve" and on top of that, actually reduce the deficit. This is, in this case, such a transparent lie that it indicates actual contempt for their audience on the part of those repeating it. We can start with history and general principles: I have yet to hear of a state or federal health care system in this country that has not ended up costing hugely more than it was ever slated to.
I can get more specific in this case, though, since the entire bill was carefully structured to show a spurious deficit reduction (in order for it to be pushed through the budget reconciliation process, without which it could not have passed at all). Costs are pushed out past the Congressional Budget Office's ten-year time horizon, offloaded onto the states (whose Attorneys-General are now frantically trying to figure out what to do), or just blatantly left out. In the last category is the "doc fix", the adjustment to Medicare reimbursement rates that had to be dropped from the current bill in order to hocus the CBO numbers. The firm understanding between the interested parties is that the House will quietly pass that in the near future when not so many people are paying attention, and damn the numbers anyway. As I said above, "contempt" is the word that keeps coming to mind.
To my mind, this bill will indeed manage to provide health insurance to a portion of those now uninsured, but at a ferocious cost. And to that point, I was unhappy with the amount of money the Bush administration spent, but had I only known what was coming, I would have enjoyed the fiscal restraint while I could. I believe that we're spending entirely too much money that we don't have, and not getting that much in return for it (other than lots of warm, heartfelt favors to friendly constituencies that can be expected to support the current administration).
And here's my last point: my own industry's trade association, PhRMA, believes itself to be in that last category. Whether you felt like it or not, if you work in the drug industry, you spent a lot of money to help get this bill passed. I haven't heard the details of the quid pro quo deals for our business, but no doubt there are some nice ones hidden in the recesses of the bill (or just outside it, like the doc fix). My worry, though, is that dealing with the government on this level is like dealing with a hungry bear. Sooner than we think, the costs of this bill will kick in. At that point, I predict that we will find ourselves in yet another Health Care Crisis, having failed to bend any cost curves whatsoever. Then the bear will turn its head to us again, but this time, with a new look in its eyes.