the US healthcare bill

Everyone agrees that the health bill approved by the Senate finance committee last week is a flawed bill. Nonetheless, argues Financial Times columnist Clive Crook, “the bill is a breakthrough” and Barack Obama is right to call it a “critical milestone”.

Nobody actually likes the measure. A muddle of awkward compromises, it has something to offend everyone. …. Yet this is the furthest a bill to guarantee access to health insurance in the US has ever come. …. An entitlement that other rich countries have long taken for granted is finally within reach. ….

If this bill or something like it becomes law, Mr Obama’s prospects will revive, and he will have an indelible achievement to his name.

Why indelible? Because this dispensation will never be reversed. The country will decide it cannot live without it. Medicare, the publicly funded health programme for the elderly, is grossly inefficient and costs far too much, but ending it is unthinkable. The promise of access to affordable health insurance, once made, will never be renounced.

Clive Crook, “Passing a bill is just a start for healthcare”, Financial Times, 19 October 2009.

The Senate bill does nothing to address the high costs of health care; indeed, increased costs are inevitable because wider access to health insurance does not come cheaply. The US is a wealthy nation so, one might argue, can easily afford an increase in waste and inefficiency as a politically necessary price to pay for a long overdue reform. Eventually, as health costs rise even more, there will be pressure to reduce costs by moving to a single-payer system or, at the very least, to tight regulation of basic health insurance policies along the lines of the Swiss system. On the Swiss system, see this post by Jason Shafrin, a young healthcare economist based in California.


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