Do We Want Healthcare Reform, or Do We Want Health?

According to a press release issued by the Kaiser Family Foundation, a solid majority of the American people (61%) continue to believe that health reform is more important than ever given the country’s economic problems; sizeable majorities support key elements of reform currently being debated such as employer mandates (69%), individual mandates (71%), and a public plan option (65-67% depending on wording).

However, as seen in previous polls less than half of the public (41%) say they are willing to pay more for health reform, with a similar number supporting changing the tax treatment of employer based health insurance (40%), one of the major revenue raisers being discussed. Overall opinion, according to the release, remains highly moveable, with support for many elements of reform susceptible to arguments pro and con and often moving by as much as 40 percentage points when arguments are tested.

These poll results speak volumes about the complexity and the emotions of this issue. Sure, everyone can agree on the conceptual issues of access, affordability and quality, but when it comes to the harder questions of figuring out who will pay, and for how much, there is still a tremendous amount of disagreement. Special interest groups are now closing ranks to protect their piece of the healthcare pie.

More casual supporters of the concept are likely to cast a skeptical eye on healthcare reform efforts after they read about today’s announcement from the Congressional Budget Office that said the Senate Health, Education, Labor and Pensions Committee health reform legislation would cost the government an estimated $1 trillion over the next 10 years while reducing the number of uninsured U.S. residents by about one-third, or 16 million people.

This has sent the powerful tax-writing House of Representatives Ways and Means Committee looking for more money and their Chairman Charles Rangel, D-N.Y. aims to have proposals by Friday to help pay the trillion dollar tab.

According to a Reuters report, among the proposals Rep. Rangel is expected to announce by Friday are cuts to private plans that operate in the Medicare Advantage health program for seniors. Rep. Rangel also said the panel was weighing the “depth” of the subsidies that low-income people might get under any health reform legislation.

I am still confused about why this discussion centers so much on buying health insurance coverage instead of the real issue which is providing opportunities for Americans to achieve better health. Would it really cost a trillion dollars to make us all healthier and less dependent on expensive medical treatments? Isn’t that what we are really trying to do here? If we just focus on devising ways to pay for care once we get sick – mostly because of lifestyle choices – we had better have a lot of money to throw at this problem and the last time I checked, we didn’t.

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