At least it’s moving forward. Not sprinting — more like clumsy, halting steps against a punishing headwind — but national health care reform finally has left the gate, with proposals in both houses of Congress and a plan actually passing a Senate committee last week.
The right plan? Probably not. The Congres-sional Budget Office says the proposals discussed so far would not meet the cost-saving requirement that President Barack Obama has set and must stand by.
Yet the right elements of reform are on the table, including consumer choice, a government alternative to private insurance, gap coverage for people between jobs and the right to purchase coverage regardless of existing medical conditions.
Obama must not follow in the footsteps of Theodore Roosevelt, Harry Truman, Richard Nixon, Jimmy Carter and Bill Clinton in failing at health care reform. His reputation might survive, but the United States economy would not. This country must catch up with the rest of the industrialized world and reverse the growing number of Americans lacking coverage, now some 47 million — 7 million in California.
As much as Americans need universal coverage, the main focus must be cost containment. The United States can’t continue to compete economically when it’s spending 17 percent of its gross domestic product on health care, vastly more than nations that offer far more complete coverage.
Nor can Americans continue to prosper if health care costs keep growing at twice the rate of inflation.
Workers are now paying $1,600 more a year on premiums for family coverage than they did 10 years ago. The rate of increase is four times higher than the increase in worker earnings. At the same time, employers increasingly strain under insurance costs and understandably try to shift ever more of the burden to workers. The system of employer-based health insurance that covered the vast majority of Americans in the last century is disintegrating.
Much of the American health care dollar goes to the middleman — private insurers. The federal Medicare program is flawed in many ways, but its overhead is a fraction of the amount private insurers take. This is why a public option has to be part of the reform package.
The economic and personal imperatives for reform overlap.
Even people of means quickly become vulnerable when they lose health coverage. Medical catastrophe is the No. 1 cause of personal bankruptcy. It has fed the foreclosure crisis as well, since savings and investments that might otherwise keep up mortgage payments are quickly sucked away by a cancer diagnosis.
And who doesn’t know someone who hates his or her job but can’t leave for fear of being without health coverage? How many more risk-taking entrepreneurs might enrich our economy if people knew they could find reliable, affordable health insurance for themselves and their families?
These are the facts members of Congress need to keep in mind as they struggle with what might appear to be hopeless conflicts over reform. Now that there’s movement, the president has to engage more fully in the debate as well.
This effort can’t fail. Nothing less than the future of the American economy is at stake.