Monday, November 9, 2009

Healthcare Reform Update

This past Saturday the U. S. House of Representatives finally passed their massive healthcare plan by a very close vote of 220 to 215, with only one Republican supporting it and 39 conservative Democrats voting against the plan. It is now the U. S. Senate's turn to come up with a bill their chamber can approve. President Obama has for many months been hoping he can sign into law before the end of the year a final bill approved by the Congress, but it's very possible the legislative process will drag into January or February, given the strident opposition and filibustering opportunities available to the Republicans in the Senate.

I mentioned in my post on Healthcare Reform in June that I was confident reform legislation would be approved by Congress and signed into law by the end of the year. I'm still confident, but possibly I may have been a little too optimistic on the timing. I also mentioned in June that I was hopeful the legislation would be the product of genuine bipartisan debate and consensus. Unfortunately it's clear this didn't happen. Looked at narrowly, the approval in the House was a victory for President Obama and the Democratic leadership and a loss for Republicans. However, the result in my opinion was not in the best interest of the American people. A bipartisan bill incorporating the best ideas of Democrats, Republicans, as well as Independents, in a more balanced manner would have been much better.

In fact, the bill could most probably have been significantly improved if it also took into account some of the best features of the health care systems employed in several of the other advanced democracies in Europe and Asia, as covered in Frontline's recent TV presentation, "Sick Around the World." Primary among those countries, as I perceived it, were Japan, Taiwan, the U. K., the Scandinavian countries, Germany and Switzerland. Taiwan used this very approach in effectively reforming their apparently very successful system. Some of the main features highlighted in their broad survey were a generally high degree of patient satisfaction with the systems, good quality care, no medical bills for patients, no bankruptcies of patients resulting from high medical bills, limited and improving waiting times for patients, and much lower administrative costs to operate their systems. In the U. S. administrative costs reportedly were about 16% of total healthcare costs versus an average of about 5-6% in these other countries.

Clearly, huge savings in healthcare costs could be achieved if we could learn from the experiences of these other countries and follow their leads in substantially reducing administrative expenses. Has this been seriously explored by politicians and medical experts advising them? Or have both groups essentially been dissuaded by the private sector healthcare industry and their lobbyists?

It's not too late, but I'm not optimistic about a good bill coming out of the Senate within a reasonable timeframe. I'm afraid serious ideological differences, as well as motivation by Republican leaders to do what they can to deter President Obama from achieving a major legislative victory on a high priority issue, will make it unlikely the Senate will come up with a sensible, pragmatic and bipartisan result that best serves the great majority of the American people. Another obstacle will be the impact of expected campaign contributions for the approaching congressional elections. I hope I'm wrong and that these points can be overcome.

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