Health­care’s com­plex­i­ties get in way of the mes­sage

Modern Healthcare - - COMMENT -

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.

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