My congratulations to the U.S. Senate and particularly the Democrats for passing healthcare reform legislation. The House and Senate must reconcile their differing bills but hopefully that will occur rapidly.
Is this imperfect legislation? You bet it is. For the left, the Senate bill has no public option. Liberals fear that insurance companies will continue to rake in the profits with insufficient cost controls and competition, particularly now that 30 million more Americans will need insurance. Conservatives fear that the legislation will give rise to another government bureaucracy and entitlement program and lead to greater deficits. All of these concerns have some legitimacy but the alternative was that this great country would continue to limp along without universal or near universal healthcare for its citizens and that the current healthcare system, which almost all consider inadequate, would remain in effect with no end in sight.
I truly believe that twenty years from now most Americans will view this healthcare reform as having been the right and the smart thing to do and wonder why so many opposed it so vigorously.
Yes, there will be bumps in the road and perhaps worse. Costs need to be contained. But the notion that a country as wealthy, developed and powerful as the United States should still have a healthcare system that has excluded so many from being able to afford decent healthcare and limited so many more through exclusions such as pre-existing conditions is absurd. Today there are still naysayers when it comes to Social Security and Medicare but very few. Yes, Social Security has expanded far beyond the original conception but most recognize its significance in providing a safety net for senior citizens and having a stabilizing impact on the economy. And yes, Medicare costs need to be controlled but few dispute that the program has been a life saver for countless older Americans who otherwise would have quickly deteriorated in health. Has each of these programs somewhat reallocated wealth among Americans? Yes. But what community — be it a family, a tribe, a religious organization or a polity — doesn’t reallocate wealth to at least some extent to best serve the collective interests of that community? I don’t know of any.
Will this society have to make some choices as we move forward as to the allocation of healthcare dollars and the availability of medical procedures? I should think so. Critics rant about death panels but how is the allocation of healthcare dollars handled under the present system, for no one should delude him or herself into believing that we don’t currently limit access to certain medical procedures. In the present system those with wealth can select any treatment, even if it means going overseas, but those without the means either can’t afford costly procedures, or find themselves at the mercy of insurance company bureaucrats who decide which medical procedures are necessary and appropriate, or must find charities to support them. Talk of death panels is nothing but a scare tactic. But there will be a need for effective public policy that defines the allocation of scarce medical resources just as today there are policies governing kidney and other organ transplant processes because of their scarcity.
There is always room for improvement and we are likely to see changes in this legislation not only before it is finally promulgated but also before its major provisions go into effect in 2014.
