The Consequences of “No” (New Eng Jour Med)

[pinto]

The Consequences of “No”

November 18th, 2009
Arthur L. Kellermann, M.D., M.P.H., and Lawrence S. Lewin, M.B.A.

In the next few weeks, Congress will determine the fate of health care reform. An early and important objective of the Obama administration, reform once carried an air of inevitability. But a spirited anti-reform effort and concerns about the legislation’s cost have raised doubts about its prospects.

Congressional Republicans are united in opposition to the current reform bills. Although the Democrats hold commanding majorities in both chambers, they also face defections from within their ranks. The House bill passed with a razor-thin majority; Senate action is far from certain. Articles about reform have largely focused on various implications of the House and Senate bills. But if history is a guide, equal scrutiny should be given to another legislative possibility — a “no” vote that preserves the status quo.

Recently, a committee of the Institute of Medicine (IOM) analyzed the current trajectory of our health care system. It studied the dynamics driving downward trends in insurance coverage and examined the health consequences of the lack of insurance for individual adults, children, and communities. The committee’s report, released earlier this year, built on and updated the work of a previous IOM committee that issued six reports on this topic between 2001 and 2004. Collectively, the reports of these committees (which we chaired) paint a compelling picture of the harmful health and financial effects of the status quo — not only for people without coverage but also for people who have health insurance.

Health care costs and coverage are tightly intertwined. For more than four decades, health care costs have grown faster than our national economy. As a result, health care consumes a steadily growing share of federal and state budgets and the budgets of American families. Relentless cost growth threatens employer-sponsored insurance, undermines publicly funded programs such as Medicare and Medicaid, and renders individual insurance policies inadequate or unaffordable.

<more at>

http://healthcarereform.nejm.org/?p=2360&query=TOC

Source Information

From the Emory School of Medicine, Atlanta (A.L.K.); and Chevy Chase, MD (L.S.L.).
Dr. Kellermann cochaired the IOM Committee on the Consequences of Uninsurance from 2001 to 2004;
Mr. Lewin chaired the IOM Committee on Health Insurance Status and Its Consequences from 2008 to 2009.

[TexasObserver]

1. Recommend

[BrklynLiberal]

2. Appears to be working out perfectly for Big Pharma and the insurance companies....

No doubt their profit forecasts are rising as steadily as the cost of health care.

[TexasObserver]

3. I suppose that if we get anything, some citizens will be helped.

At least that's what I read here.

I fear, however, that we've traded the chance at real health care reform for a system which only adds to the control the health care/health insurance/pharmaceutical oligarchy already has in place.

We need universal care, not universal insurance. We need a safety net, not a steel trap.

[yurbud]

4. kick