I've heard it suggested that Scott Brown's election last night to the US Senate may bring about a new compromise on health reform. There is speculation in the NYT
http://bit.ly/8jFTPd about a compromise that could bring Olympia Snowe back into the fold, or perhaps some effort that could bring both Snowe
and Brown over to the reform camp. Presumably, Brown has to tack to the left to be elected again in Massachusetts, in less than two years.
But I don't see a compromise happening any time soon. Currently, no Republicans support the reform bills before Congress, and there is little evidence to suggest that the GOP will suddenly get religion.
Brown has suggested that states should be left to do health reform as they see fit. Snowe wants limited and perhaps no additional Federal involvement in the health system after reform. Neither of these positions can bring about reform of our system. Health reform in the US has to be predicated on one major change: everyone has to participate in the health system, at least at a minimum level. Without this change, "reform" isn't reform at all. Call me a pessimist, but I don't see this happening without increased Federal involvement.
If health reform fails to reach nearly every US resident in every market, the private suppliers of high cost health care interventions will continue to carve up markets, charge whatever they want, invent new "interventions" that have little chance of improving health, and over-treat unwitting patients with aggressive and unnecessary care. The "suppliers" I am referring to include (but are not limited to) pharmaceutical and medical device manufacturers, hospital systems and many medical specialists. It doesn't hurt that many patients want unlimited access to new medical technologies, whether they can improve health or not. All of the incentives are pointed in the same direction: toward newer and more expensive health care.
The suppliers of health care thrive on high cost and high tech interventions, interventions that are oversold to the American public. While some patients need new and expensive technologies, not all of us do. We are suffering from a technology binge in every corner of the US health system. Americans spend 16 cents of every dollar on health care, and the suppliers of high cost care won't mind if we spend 20 cents or more in a few short years.
As if on cue, Pfizer and Merck stocks rose on news that Brown had won the election
http://bit.ly/6J07tO . Investors went to Pharma "on hopes for more concessions to be made to health care legislation." Concessions to Pharma? Is this what voters meant when they said they wanted more compromise?
I just don't see Brown or Snowe coming over to a health reform package that has any teeth. If a bill survives, it won't be strong enough to achieve anything meaningful. We should expect premiums for a healthy adult to rise well past $1,000 per month in a few years. That's what it will take to fund our voracious appetites for high cost health care.
