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COLUMNISTS
TODAY'S STORIES
12.11.2008
Universal Coverage: Full Speed Ahead

I'll have more to say on Max Baucus's health care announcement tonight or tomorrow.  (Boy, did I pick the wrong day to spend out of the office reporting!) Quickly, though, I want to highlight one key development.

In the full paper, Baucus says it will take three to four years before we'd get to universal coverage. But that doesn't mean he wants to delay working on a bill. Here's what Carol Guthrie, spokesperson for the Democratic staff at the Finance Committee, just told me:

Senator Baucus would like to move a comprehensive reform bill in 2009. He’ll work with his colleagues on a precise timeline, however, for movement of legislation and implementation of reform. In the “Call to Action,” the reforms he envisions would be phased in over a period of years--some immediate, to help many uninsured Americans get some coverage right away, and some over two or three years, as insurance market reforms take effect and a marketplace can be created where folks can easily compare and buy a plan that works for them.

Translation: He'll get working on a bill early in the year, as reported here previously. Whether that means passing something in the first few months or later on depends entirely on how the politics of this issue shapes up.

Again, if you care about universal coverage, this is good news. Kevin Drum thinks there's an 80 percent likelihood we'll get universal coverage by summer's end. That sounds rather optimistic to me, but I agree the odds are looking better and better.

P.S. If you can't wait a few hours for your fix of health care coverage, I recommend Ezra Klein's postings here and here. Steve Benen has more thoughts here

--Jonathan Cohn 

Posted: Wednesday, November 12, 2008 5:16 PM with 6 comment(s)

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bdgreen said:

I'm excited about this. Hillary was right about mandates; they've worked in Massachusetts, and they're a critical part of getting people to buy insurance before they're sick. Premiums won't be affordable unless they're paid by sick and healthy alike. Now, while he's in a reneging mood, if Obama could just find a way to drop his support for corn-based ethanol...

November 12, 2008 5:57 PM

Doug75225 said:

Alright, let me get this straight: universal health coverage for old people is set to run out of money in 9 years (according to the Medicare trustees).  And there's not a whole lot of room to cut costs; physicians are already refusing to take new Medicare patients because remuneration is so low.

So by all means, let's extend this bankrupt program to the rest of the country at large. I just have one question: Does a nine-trillion dollar debt left to our children really scare no one??

We have two choices: either limit accessibility, or ration care. The "free" health care of other Western democracies uses the latter to keep costs down. Are the American people ready to let Grandma wait 3-4 months to get her broken hip fixed??

November 13, 2008 2:22 AM

bsemple said:

We will be talking about health care reform as long as we leave private insurance in the mix. Subsidies and mandates that leave our tower of Babel of public and private insurers in place just make an exorbitantly expensive and bureaucratic  "system" of funding health care more costly and complex. Some of us will remain uninsured, underinsurance will increase, and costs will escalate. Single-payer financing will cover 100% of us, people won't be facing financial ruin due to health care expenses, and overall health care spending can be less. Let's just do it.

November 13, 2008 2:28 AM

propositionjoe said:

Doug:

I respectfully disagree with your argument. First, I don't think the choices you present are actual binaries. The fact is that we ration care by limiting accessibility right now. Rationing care is an inevitability in a world of finite doctors, machines, procedures, and money. We ration by price everyday. Second, your last point suggests that Europeans are doomed to death and suffering by their nationalized systems. Life spans seem to suggest otherwise. American men live to be about 73 and American women make it to 79. British men make it to 74 and British women make it to 79. French men make it to 74 and French women make it to 82. The numbers are about the same throughout Western Europe. Life spans are only suggestive, of course. But your post suggested that elderly Europeans live in dire agony as their broken bones knit unevenly on bathroom floors across the Continent. I'm guessing that might be a tad overstated. In short, I think it's wrong to suggest that rationing is an unwanted outcome of reform. Our current system already rations in ways that exclude millions of people from necessary care, and nationalized systems that ration in other ways have not destroyed the health of the populations that they serve.

November 13, 2008 5:14 AM

micjimenez said:

As a long-time resident of Sweden, let me assure Doug and others that "long lines" are not an inevitable consequence of universal health (there is no wait for services in the U.S. now?!). It's about HOW you implement it. The U.S. is in the "fortunate" position of being able to take the best from already existing systems and creating a new being of its own. Learn from the mistakes of others!!!  

November 13, 2008 7:15 AM

hmseil01 said:

Here we go again with the misconceptions. To bdgreen, the Massachusetts mandate plan is complicated, and adds layers of bureaucracy. It will not be able to control costs in future because the insurers are still profiting for performing an unnecesssary role. Why are we paying entities that do not provide care?  And to Doug75225, please do some research on wait-times in single payer countries. No one waits for urgent care.  Patients may wait for non-urgent care if hospitals or regions lack physicians or capacity.  In Canads, wait-times are posted on provincial Ministry of Health web sites.  Are we so transparent?  How long do our uninsured wait?

As Sen Baucus has said, his bill has not been written yet, nor has it been costed out. You can bet the cost projections will be more than a single payer plan because multi insurers will still have their hands in our pockets.

November 13, 2008 11:51 AM