Saturday, December 19, 2009

Four Reasons to Support Health Reform Bill, and Six Reasons Not To

Ours is not to reason why, but to do or die.

Alfred, Lord Tennyson, 1809-1892

The Tennyson quote might also apply to Democrats as they rush to pass a Senate Health Reform bill before Christmas. Their main reason seems to be: this historic opportunity will never come again. Besides, the Senators don't want to go home during the Christmas break and face withering criticism from constituents, only 32% of whom support the current bill, according to national polls. These senators do not want to go through another Tea Party revolt, like they experienced during their August break.

I like better the reasons David Brooks gives for supporting and opposing the bill. In his December 17 New York Times column, “The Hardest Call," Brooks gives four reasons why to support the bill and six reasons why not.

Four Reasons to Support Bill

ONE, it would provide insurance for 30 million more Americans.

TWO, it takes the deficit seriously with serious Medicare cuts and serious, even whopping, tax increases.

THREE, it contains a million little ideas and dozens of gradual programs for cutting costs.

FOUR, if it fails, Obama will fail, and health costs will strangle the nation.

Six Reasons to Oppose Bill

ONE, it will not fundamentally reform health care.

TWO, it will cause national health spending to increase faster.

THREE, it is politically unsustainable because it increase demand without increasing supply of doctors.

FOUR, you can’t regulate 17% of the economy without adverse consequences.

FIVE, it will slow innovation.

SIX, it will not control costs.

Brooks conclusion: “If I were a senator forced to vote today, I would vote no. Unless you get the fundamental incentives right, the politics will be terrible forever and ever.

3 comments:

Michael Kirsch, M.D. said...

Hi Richard, I saw David Brooks on Jim Leher's PBS News Hours discussing his column. He pointed out what many of us fear. 'Reforming' on top of a rotted system only deepens the hole. As you point out, without fundamental restructuring, we are building a new attic on a crumbling foundation. I'm sure that many well meaning folks are torn as to whether they want the current HCR effort to succeed or fail. Personally, at this point I am leaning against it. How about you? www.MDWhistleblower.blogspot.com

Richard L. Reece, MD said...

Yes, I lean against it mostly because it has no cost controls, too many mandates, and no market-driven incentives, such as encouraging more HSAs with high deductibles, which have been proved to reduce costs and the uninsured among employed people.

Richard L. Reece, MD said...

Yes, I lean against it mostly because it has no cost controls, too many mandates, and no market-driven incentives, such as encouraging more HSAs with high deductibles, which have been proved to reduce costs and the uninsured among employed people.