Health Care is Not Done

I’m not at all surprised to learn that the deficit commissions Medicare deliberations have been dominated by conservatives but what is distressing from Brian Beutler’s reporting is one of the reasons — health care fatigue:

“[B]asically you’ve got some Dems saying they don’t want to jump back in the [health care reform] pool, so you’ve mainly got Republicans swimming in there on their own,” says one source familiar with the commission’s proceedings.

“[Senate Finance Committee Chair Max] Baucus has kind of come in and basically said, ‘we’ve just done health care,’” a second source tells TPM. The sentiment echoes that of other Democratic commissioners. “We’ve done health care, we can’t do much more.”

As Rambo says the reality is that “nothing is over” is when it comes to reforming the American health care system. The Affordable Care Act extends much-needed insurance coverage to the uninsured. It will be financially beneficially to most women and lower-income people regardless of their current insurance status. It will somewhat reduce the long-term deficit and somewhat reduce the rate of increase of health care costs. And it contains a large number of initiatives that hold at least some promise for making the American health care system a better value proposition. But on the latter-two points, the ACA doesn’t do nearly enough to get us where we need to be and won’t fulfill its promise unless legislators keep working at it.


Meanwhile, I think the real issues are obscured by continuing conservative obsession with repealing the Affordable Care Act. In a big-picture sense, what ACA is doing is transitioning American health care for the 64-and-under set into a means-tested voucher program. Meanwhile, the big conservative proposal is to transition American health care for the 65-and-over set into a means-tested voucher program. That doesn’t necessarily strike me as an unbridgeable chasm of principle. What if all Americans, regardless of age, got their health care through a means-tested voucher program that included a public option?