Wednesday, January 19, 2011

Health Care Repeal - Lies, Damned Lies, and Statistics

The CBO (congressional budget office) reports that the Affordable Care Act (ACA, or Obamacare) will save money over the next ten years. Closer inspection reveals, that the choice of time period and other assumptions matters crucially. Many costs don't kick in until four years from now (see WSJ article below). Supporters of the ACA should be cautious about justifying the ACA on the basis of economic savings.

If the Democrats have erred in too literal an interpretation of the CBO numbers, then Republicans have erred in too literal an interpretation of poll numbers. Many of those opposed to ACA wanted it to be bolder - to cover more people or to be a single payer system; they certainly would not want to repeal the ACA and return to the previous system (see article by Eugene Robinson below). Excluding the health care reform enthusiasts, the percentage of people opposed to the ACA drops to 37.5%.

As imperfect as the ACA is, at least the world's richest country is finally addressing the health needs of most of its citizens. In my opinion (students can feel to disagree), repealing ACA without replacing it with something better is unethical.

This July 14, 2008 clip from 60 minutes helps put a human face on the uninsured. It describes a program, Remote Area Medical, that was originally set up to provide health care to remote areas in developing nations. It has been adapted to help the uninsured and underinsured in the U.S.. Doctors, dentists, and optometrists volunteer for a weekend to treat as many patients as they can. During the 60 minutes episode, 920 people were treated in Nashville, TN - but 400 had to be turned away. The people lining up for service, as early as 7 hours before the gates opened, were predominantly working poor in middle life.;photovideo

Unfortunately, our country does not have unlimited recourses to devote to health care. ACA is just round one - revisions will be made. The ACA includes provisions that allow states to experiment with cost control measures. Perhaps one of those will work and will be expanded nation-wide. Perhaps a complete overhaul will someday be adopted including: medical savings accounts, catastrophic insurance, and tiered plans (with no tax deduction).

Matt Miller (see Washington Post link below)  challenges the Republicans to come up with a better plan:

 "If Republicans are serious, they have to accept that it's a national priority to make sure that every American has basic health coverage. Thirty million [newly covered people] isn't enough, of course, because the ranks of the uninsured still hover around 50 million. But since Democrats could only muster the will to cover 30 million, that's all we can expect the GOP to match as a measure of seriousness. (Though I'd be happy to see them shame Democrats with a plan to cover more).

The reason Obama should frame the debate this way is that there is no chance the Republican House will pass such a bill..."

Let us hope Matt Miller is being too partisan, and the two parties can work together over the next decade to craft a better, more efficient health care system for all citizens.

WSJ (1-19-2010) Health Care Repeal Won't Add to the Deficit

Washington Post (1-19-2011) Yes, repeal health-care reform -- on one condition
by Matt Miller

Washington Post (1-18-2011) Americans don't want health care repeal
by Eugene Robinson

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