Health-care reform catches a cold

What happened

President Obama’s health-care reform agenda hit a big obstacle this week, after the Congressional Budget Office estimated the 10-year cost of universal coverage at more than $1 trillion. The nonpartisan budget analysis concluded that the current version of a bill championed by Sens. Edward Kennedy and Chris Dodd would cost $1 trillion over 10 years to provide coverage for just 16 million of the estimated 47 million uninsured Americans. A more comprehensive bill from Sen. Max Baucus would cost $1.6 trillion. Baucus, vowing to get the price tag down to $1 trillion, put off releasing the bill, which damages its chances of getting passed before the summer recess. “Health-care reform is on life-support because the Senate can’t figure out how to pay for it,” said Rep. Jim Cooper (D-Tenn.), who has a separate bill in the House.

Obama said this week that he remained “very optimistic” that Congress would come up with a plan that is “revenue neutral” and does not add to federal deficits. Even $1 trillion, he said, can “be largely funded through reallocating dollars that are already in the health-care system, but that aren’t being spent well.” Obama reaffirmed his support for a robust government-run insurance option, saying the reform that’s needed goes beyond “just tinkering around the edges.”

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What the editorials said

The only thing more expensive than fixing health care, said the Los Angeles Times, would be not fixing health care. Our inefficient system already gobbles up 18 percent of America’s gross domestic product, and every year the cost balloons further. “If the trend continues, it will consume more than 30 percent of the economy in two decades.” Intertwined problems of cost, quality, and inadequate coverage feed on one another relentlessly. “The longer we wait to solve them, the more intractable they will become.”

Rushing reform, though, could lead to disaster, said Investor’s Business Daily. A responsible reform effort should include a bipartisan, blue-ribbon commission to think through all the options and unintended consequences, but Obama clearly thinks that if he doesn’t get some kind of reform now, he never will. “He acts as if he believes his political capital is dwindling so fast it will be gone by the end of this year.”

What the columnists said

The danger here is dithering, not rushing, said Froma Harrop in The Providence Journal. While Republicans are succeeding in frightening people about the cost, $1.6 trillion “is not an outlandish amount to spend on a decade’s worth of high-quality health care for all Americans.” It’s not that much more than the $964 billion George Bush committed to the Medicare drug benefit, which covered only one aspect of care for one group of people.

“Health-care reform is important,” said David Brooks in The New York Times, “but it is not worth bankrupting the country over.” Fortunately there’s an alternative bipartisan bill that would raise hundreds of billion by taxing employer-provided health benefits. Unions hate this idea and Obama slammed John McCain for proposing it during the campaign, but tax-free health benefits function as “a giant subsidy to the affluent” and encourage people to consume as much health care as possible.

Actually, we don’t need to worry about covering the so-called uninsured, said Larry Kudlow in National Review Online. Census Bureau statistics show that 20 million of the 47 million people without insurance are college kids or wealthy folks who choose not to pay for it. Another 11 million are already eligible for Medicaid but haven’t signed up, and 10 million aren’t even U.S. citizens. That leaves 10 million to 15 million people who are truly needy. Giving them vouchers to buy into our existing, high-quality health-care system would cost only about $25 billion a year. And it wouldn’t require “Canadian-European–style nationalization” and “massive tax increases.”

What next?

Mindful of how health-care battles hobbled the Clinton administration, Obama has largely stayed out of the fray, leaving Congress to hash out a plan, said Doyle McManus in the Los Angeles Times. But with so many competing proposals and none gaining traction, Obama will have no choice but to become fully involved and force all sides to make compromises. “They’ll pass something,” said one Republican strategist, “but it’s going to be ugly, and it’s going to take a whole lot of spin to make it look like a triumph.”