Piece-meal Health Care Reform? Experts: Get Real

Brian Buetler continues his fine reporting for Talking Points Memo with the response of health care experts to the idea of re-working the reform effort by passing it one piece at a time.

One of the main problems is that some of health care reform's least popular elements are essential to its effectiveness. For instance to guarantee that sick people can get coverage, healthy people have to be part of the insurance pool to spread the risk and keep insurance premiums from skyrocketing.

"The idea of scaled back reform, and particularly of doing insurance reforms by themselves, is a fantasy," says Richard Kirsch, director of the reform campaign Health Care for America Now. "The public wants to stop insurance companies from denying coverage for pre-existing conditions. You can't do that without a mandate; you can't do a mandate without subsidizing coverage; you can't subsidize coverage without Medicare savings and new revenues. The public wants to end medical bankruptcies - but to do that you need to provide affordable coverage to people and you need to mandate decent insurance benefits and put a ban on annual and lifetime caps. Doing all that requires setting up exchanges and subsidizing coverage." Likewise, covering millions of uninsured Americans--many of whom can't afford insurance on their own costs money. And that means taxes.

The "break it up" plan, in other words, could create a patchwork of reforms that don't amount to a working health care system. And that's distinct from the piecemeal plan's political problem: Passing several, individual regulatory reform bills means asking the Senate to act on several bills--the same Senate that, thanks to Republican filibusters, often takes weeks to pass non-controversial legislation. Asking the Senate to pass several bills could mean dragging the health care reform fight on for months. And nobody knows which, if any of them, would pass.

--Ballard Burgher