Healthcare’s complexities get in way of the message
The Nov. 9 editorial “A green light for attacking Obamacare” offers an informative look at the politics of healthcare reform. The fact that the complexities of the issues involved do not lend themselves to neat sound bites is a terrible problem. It means the fact that 100% of the increased cost of an expanded Medicaid program is borne by the federal government through 2016 and not by the states is lost on the public. It also means that the more subtle implications of reform will be even more difficult to communicate to the wider population.
Further reform of our healthcare system is necessary because of the faulty foundations of the current system. Insurance coverage for all is one of the key elements if we are to maintain a private healthcare system that we can all afford and that delivers measurably high-quality care. The idea of nearly universal coverage is important for the population, of course, but it is also good for healthcare providers and the underlying economics. It can help avoid distorted pricing, cost-shifting and bad-debt stress on the safety net providers. It also moves us toward accountable care and, ultimately, to a point where healthcare inflation is more easily controlled.
But all of this takes a lot of explaining, and if we are not even getting to first base with ensuring coverage for the near-poor through Medicaid expansion, then it is rather discouraging.
Kevin Mowll Executive director Resource Initiative & Society for Education (RISE)
Santa Cruz, Calif.