The Future of U.S. Health Care Reform - What Might Fail; What Might Work

Abstract

The world has watched with fascination as the United States enters its second year of trying to reform its health care industry. The Herculean effort has come down to a case study in the institutional peculiarities of the United States Senate. What began as a pretty good idea from the Obama Administration survived intact through the House of Representatives, but as it has wended its way through the Senate sausage mill it has transformed into something unrecognizable and unwieldy. A plan whose primary purpose was to accord over 40 million currently uninsured people access to affordable health care has turned into a mandate on the nation to buy policies from private insurers, at prices set by those insurers that are exempt from US antitrust laws, to be paid for in part with taxpayer dollars, that may still be unaffordable to a large number of that 40 million. Even a “public option” – a government-run health insurance alternative to private policies – that would have insured no more than a relatively small number of people, with a policy that no doubt would have offered far less than privately-offered policies, was jettisoned at the behest of just one senator.