What Is "Reform?"
Earlier this year, the Obama administration expanded the Children's Health Insurance Program to cover 4 million more children. That was a good bill and a significant achievement. But it was not "health-care reform." It was a health-coverage expansion.
It's a useful difference. There are certain policies under consideration right now that could significantly change how the health-care system functions. A tax on employer benefits, for instance, that begins to reduce the primacy of employer-sponsored health coverage. A public plan that's accessible to all Americans. A Health Insurance Exchange that's open to everyone and can offer an alternative to both the employer and the individual markets. An individual mandate creates the expectation of universal coverage and a mechanism for achieving it.
But if those elements -- and maybe a few others I'm forgetting -- are stripped from the final legislation or significantly weakened, then the bill will not be a reform of our health-care system. It will be a coverage expansion. It might make certain improvements to the current system through insurance market regulations and delivery system changes. That might be, on balance, a hefty improvement against the status quo. But it will not be health-care reform. It will not change the fundamental dynamics of our current system. It might even strengthen them.
Photo credit: Marvin Joseph -- The Washington Post Photo.
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