Oh, Never Mind

Incredibly, it seems the poetically ironic election of a Republican senator from Massachusetts has left many politicians with the idea they can just stop talking about health care reform. “We’re not on health care now,” Harry Reid, the Senate majority leader from Nevada, said after the election.

That may have happened when “Hillarycare” – the Clinton administration’s ill-fated stab at tackling the problem of uninsured Americans – went down in flames in 1994, but it simply cannot happen in 2010. The problems have grown exponentially since then, and it is too late for the Emily Litella – “Oh. Never mind.” – approach.

The plan that 60 Senate Democrats came up with was deeply flawed by special deals and deserved much of the criticism it received. Maybe it even deserves the deathblow struck by the election of Scott Brown to fill Edward Kennedy’s former seat in the Senate. But Brown, as a state senator, voted for Mitt Romney’s universal insurance mandate that has extended coverage to 98 percent of the Massachusetts population, and he endorses universal health insurance for all Americans.

The message of his election may not truly be opposition to reform. It may be opposition to a plan that would be a windfall for states like Arkansas at the expense of states like Massachusetts. It was another Massachusetts politician, Tip O’Neill, who famously declared that “all politics is local.”

That Arkansas as a whole would benefit did not, of course, make the Senate bill a good one. But the election of Scott Brown does not change the fact that the current system is broken, and recognizing its fundamental problems does not a bleeding-heart liberal make.

 • More than 10 percent of American citizens are uninsured at any given time, and at least twice that many have been uninsured at some point in the past two years.

 • Because we are not a society that will allow the uninsured to suffer and die untreated, the cost of providing medical care to the uninsured is shifted to taxpayers and insured Americans.

• Managed care – that is, discounted contracts between insurance companies and their preferred providers – squeezed a lot of fat out of the system when it replaced the old 80-20 point-of-service system three decades ago, but it has had the perverse long-term effect of rendering traditional market forces impotent. The free market does not work when consumers have no idea how much a product or service costs. Insured patients need not even ask how much a trip to the doctor costs and certainly have no incentive to shop around.

Americans pay much more for health outcomes that are no better than other developed countries. Even if we don’t want to adopt the same solutions, we must acknowledge that the countries that get more for less are the ones that took the bull by the horns and came up with a system that works for them. 

The Republicans won one in Massachusetts, but a single political victory does nothing to solve the fundamental problem. As more Americans fall into the ranks of the uninsured and the rest see more and more of their incomes going to health insurance premiums, will they blame the party that said no to everything? Or will they blame the party that could have done something alone but failed?

Back to the drawing board, Congress. There are some problems that you can’t ignore away.