Sound and fury, signifying nothing
While the month of August clearly knocked the White House back on its heels, as Congressional town hall-style meetings exposed Americans’ unease with an overhaul, the uproar does not seem to have greatly altered public opinion or substantially weakened Democrats’ resolve.
Critical players in the health care industry remain at the negotiating table, meaning they are not out whipping up public or legislative opposition.
Despite tensions between moderate and liberal Democrats, there is broad agreement within the party over most of what a package would look like. Four of the five Congressional committees considering health care legislation have already passed bills. Each would require all Americans to have insurance and provide government subsidies for those who cannot afford it. Each would bar insurance companies from refusing coverage for pre-existing conditions; imposing lifetime caps on coverage; or dropping people when they get sick.
After all the ranting and rabble rousing by the shock jocks, nothing much has changed. The majority party is still in broad agreement that significant changes need to be made, and legislation is moving through committees. The President's address today will be an attempt to increase the momentum and win over support from confused or wavering moderates in congress and the public.
My bigger concern is that the legislation currently on the table is not really health care reform. It's health insurance reform. Now, health insurance reform is sorely needed, but, without more, it's not going to make a significant dent in the structural problems that lead to inefficient and uneven delivery of care and ever increasing costs. Assuming that we get universal coverage on the terms laid out in the current legislation, we are still going to need something like 50,000 additional primary care doctors by 2013. Without the competitive presence and concentrated bargaining power of a public plan, there is nothing to keep the cost of private insurance from increasing radically in response to all of the new legislative requirements on the insurers.
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