Health Care Reform Without Cost Control

Like others, I am watching the House of Representatives debate the health care reform bill. One way to pay for the bill, or at least to ease the burden of watching, would be to tax cliches spoken on the House floor.

The health system in the United States needs lots of reform. What it is getting this week is highly selective. The Congress will make it easier for many persons with prior conditions to obtain insurance, and ensure that plans cover more, and more people are covered. These and many other provisions in the bill are important elements of any reform package.

What is generally missing is anything that will seriously control costs. Indeed, many provisions will predictably drive costs up, as expanded coverage will expand the demand for expensive services and products. When the AMA, the hospitals and PhRMA are lobbying for the bill, it isn't because of humanitarian urges.

This is the big gap, the big failure of nerve, in the health care debate. Americans will continue to pay about double the share of GDP on health care as do most high income countries, without getting better outcomes for patients.

At this point, the Fox News crusade against the bill, the antics of the Tea Party and the Sarah Palin wing of the Republican party, and the ugly campaigning by the Chamber of Commerce have created a political environment where the bill pretty much has to pass, or the Democrats might as well give up trying to govern. They have to deliver something, and this apparently is about all they can do right now. So a lot of people are rooting for a fairly disappointing bill -- expectations being so low these days.