The Big Picture
I don’t really have anything insightful to add to Hendrik Hertzberg’s most recent post, but this is certainly worth repeating:
Maybe (though the odds are long) the Reid compromise will make it to the President’s desk. Maybe “opt-out” will become “opt-in,” shifting the onus onto liberals at the state level by making P.O. nonparticipation the default. Maybe we’ll end up with some Olympia Snowe-approved, blank-shooting “trigger” or a lot of powerless “co-ops,” which would have about as much chance against the private-insurance behemoths as the pretzel-wagon guy on the sidewalk in front of my office has of displacing McDonald’s.
Or maybe there won’t be anything at all that can be plausibly described as a public option. But that doesn’t mean health-insurance reform won’t be worth doing even without one. The resulting “system” will be a nightmare, of course, but it won’t be as bad as the current nightmare. Once another twenty or thirty or forty million people are covered, however crappily, the issue will no longer be whether they should have coverage. It will be how to make coverage better and more efficient and more humane and, for society, less expensive in relation to outcomes. [Emphasis mine]
I’m not particularly optimistic about the health care bills under consideration; I don’t think they’ll do much to bend the cost curve, nor will they do much to control costs for families, and I don’t think we’ll see a terrible amount of reform within the insurance industry. That said, if a bill is passed, it will do a tremendous amount of good for a lot of people. What’s more, these reforms will finally give us the space to craft a far more rational health care system than what we have.