Looking back over the past year of health-care legislation, I would make the following observations:
• The Obama Administration made remarkable progress on health information technology, prevention and wellness and health-care quality in the February 2009, stimulus legislation.
• Although the House and Senate health-care reform bills were not bipartisan and some of the compromises were not particularly good ones, I am pleased that the Senate discarded the public option, the logic for which was never compelling.
• Relative to what the bills attempted to accomplish, the goal of enabling universal health insurance would be achieved. However, there are some structural flaws in the design of the insurance systems that, if not corrected, will put our country at serious financial risk.
• Structural health-care payment and delivery reform could avoid a financial crisis, but it is not clear that any level of government has the political will to tackle these issues, and they were addressed in these bills. Raising taxes to fund health insurance will cripple the economy, and cutting Medicare payments in our existing flawed system will simply drive doctors and other providers out of the system, which will create shortages. At this stage, it is unclear how we will create universal insurance that is affordable and financially sustainable.
• I commend Senators Harkin and Dodd and their colleagues for some excellent work on prevention and wellness. I also believe that the foundation has been laid for supporting more community health centers, a vital tool for health care delivery. Nevertheless, the good pieces of the legislation are relatively under-developed nuggets, not full-blown health care transformation solutions.
Politically, this legislation went as far as Congress could probably go, but much remains to be done.
Certainly one quick way to fix the health care system is to compare apples to apples. It is my understanding that the U.S. and Europe calculate infant mortality differently and in a way that skews comparisons in favor of the old world.
In the U.S., an infant is counted as "dead" if they die in the first 24 hours. In Europe, they are not counted as "dead" if they die within the first 72 hours. I guess they're just in limbo. This makes infant mortality, which is one of the important components of health care measures, seem higher in the U.S. than in Europe; creating the misconception that our health care ranks lower.
If you're going to compare systems to justify a major overhaul of our health care, then we should get the figures right.