Will Congress Really HELP on Health Care?

Posted on July 6, 2009

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Congress goes back to work this week. Lawmakers have a lot on their plates in the coming weeks and, of course, health care reform is high on the agenda. There’s so much work to do that, according to a Wall Street Journal article, leaders in both the House and Senate “are keeping lawmakers in Washington for five-day workweeks in July.”

A five-day workweek. The horror.

But I digress.

The health care reform debate will surely grow louder as lawmakers work to get a bill to President Obama by the fall. One of several draft pieces of legislation working its way through the halls of Congress is a bill that is coming out of the Senate Committee on Health, Education, Labor, and Pensions (otherwise known as HELP). The first version of the committee’s bill came in for much criticism when the Congressional Budget Office (CBO) estimated that the bill would cost over $1 trillion and provide far fewer people with health insurance than had been expected. Over the weekend, the CBO released a significantly lower cost estimate for a new draft version of the bill. (For more on the estimate, see this post from the Director of the CBO. Paul Krugman also has a column about the new bill in today’s New York Times).Is HELP for health care on the way?

Whatever the eventual price tag of a health reform bill – be it $500 billion, $1 trillion, or something else – as a nation, we continue to avoid the fundamental issue, namely that what needs to be reformed in the U.S. are our expectations of the health care system. At the end of the day, all of us will have to pay a lot more – whether as employers, employees, or taxpayers – unless we find a way to rein in overall spending.

One of the challenges in controlling spending is that economic realities don’t necessarily match up well with what most of us think we want from our health care system. A recent column in Governing Magazine makes some very blunt points about the economics of health care – for example: “from the standpoint of the expense to the entire medical care system, from cradle to grave, prevention does not save money except in certain cases….” (Kris Dunn has a blog post on BenefitsBuzz discussing the column).

What the U.S. needs to figure out is how to make people healthier while spending less on health care. Until we succeed in figuring that out, billions (or maybe trillions) of dollars will continue to be spent on health care and, one way or another, all of us will be stuck with the bill.