So after a very long absence from blogging about healthcare reform, I'm finally back. Been really busy lately, but here's the main reason I wasn't blogging about healthcare - disgust.
The whole "reform" effort got so badly hijacked by special interests that it no longer resembled anything like real reform. So I thought I'd let the subject lie fallow for a while before weighing in again. Here's what I think:
1. Maybe passing something was better than nothing, just so Congress doesn't decide that trying to reform healthcare is political suicide. That would close down any chance of change completely.
2. The reform has some merit, but a whole lot of "unintended consequence" potential. I like the supposed cessation of throwing people off for pre-existing conditions, but without control of costs, does this have any meaning? "Yes, Mrs. Jones, we have to accept you onto our program. It'll just cost you $11,542.76 per month. Welcome."
3. Like a few other problems on this planet, a lot of smart people know what needs to be done, but the political status quo is too entrenched for anything to change. We all know that the incentives in medicine stink and many players are taking advantage of a completely corrupt system in which the game is to capture as many dollars from Medicare payouts as possible. That's the whole rationale behind much of what goes on. Until that's fixed - I'm not holding my breath - not much else will change.
I still consider an entire meltdown of the healthcare system to be entirely possible. If one large insurer gets into trouble (remember AIG in the finance industry?), the whole system collapses. If one large payer defaults, all major hospital chains go bankrupt if they can't collect. And then? The federal government will have "no choice" but to bail out the system. Will it be reformed as a result? If you think that, you haven't been following finance reform.
As Tom Friedman put it recently, "The tooth fairy is dead."