While it is still difficult to predict the final outcome, momentum for passing health care reform has slowed. Republicans have launched their typical misinformation campaign to scare voters. They continue to confuse the fact that the real changes are over how insurance coverage is handled. This is not a “government takeover of health care” or anything resembling “socialized medicine.” It certainly does not help matters when Republican politicians make uninformed and dishonest statements such as claiming reforming health care coverage is comparable to placing health care under FEMA as Bobby Jindal does today in The Wall Street Journal.
Besides the endless number of dishonest Republican claims, there are also real concerns about the complexity of the plan and the cost. First Read points out a major problem in passing health care reform:
One of the bigger, but more under-reported, sea changes in American politics is how any kind of tax increase — whether in war or peace, good economic times or bad ones — has become absolutely unacceptable. After all, Ronald Reagan raised taxes. So did every modern American president involved in war, until George W. Bush. But not anymore. Indeed, as one of us pointed out on Nightly News last night, only 29% (or 157) of the 535 and House members and senators serving in Congress were around the last time — 1993! — the federal government raised taxes, and that was on gasoline. Think about that for a moment: Congress hasn’t really had a TOUGH vote in 16 years, if one defines a “TOUGH” vote as the government asking for a financial sacrifice from the American people. This is the political climate that President Obama faces in trying to pay for health reform. Republicans and some Democrats are opposed to a tax on the wealthy, and unions and Obama’s political strategists are against taxing health benefits.
While I am generally not a fan of big government programs and opposed HillaryCare, the situation with health care coverage has deteriorated to the point where government action is necessary. This is also something which costs money despite the claims of the Obama administration that health care reform can largely pay for itself. It costs money to provide coverage to those who cannot afford it, increase the delivery of preventive care, and improve health care information technology. We will not see the savings from improved preventive care and information technology for many years.
As I’ve noted before, reforming health care coverage is something which benefits everyone, not only the near one hundred million who are currently uninsured or under-insured. Having a society in which nearly everyone has health care coverage and nobody has to fear losing coverage due to developing a serious illness, losing a job, or desiring to change jobs is worthwhile but we must be willing to pay for it.
The chances of raising enough money to both achieve these goals and avoid the types of restrictions on care which Americans would not want to see imposed is greatest if the money for this can be raised by a broad based tax as opposed to pretending we can get all the money by taxing the rich alone. Unfortunatley this probably is not politically feasible as there would be protest over a tax increase on the middle class, even if it would be largely offset over time by both lower insurance premiums and ultimately lower costs from a more efficient health care system.
Earlier in the year polls did show that voters were willing to accept a tax increase to pay for health care reform. We are not seeing as many support this now. Some of this is for unavoidable reasons, such as belt tightening during a time of economic crisis and due to the scare tactics of the right wing. This is also due to a missed opportunity by Barack Obama to show true leadership.
If Obama had proposed a health reform plan and honestly discussed both the costs and benefits, he might have received support for the taxes needed to pay for this. Obama has done an excellent job of receiving support from groups which opposed health care reform in the past such as the American Medical Association. He could have further demonstrated a willingness to respond to the crisis by going beyond traditional partisan concerns by taking an even stronger position on malpractice reform. While Republicans do greatly exaggerate the role of malpractice on health care costs, the fact remains that reducing costs on defensive medicine does remain one of the easier ways to reduce costs without negatively impacting quality or patient choice.