If Reform Fails

This editorial from The New York Times, is a part of a comprehensive examination of the debate over health care reform. You can read all of these editorials at: nytimes.com.

As the fierce debate on President Obama’s plan for health care reform comes to a head, Americans should be thinking carefully about what happens if Congress fails to enact legislation.

Are they really satisfied with the status quo? And is the status quo really sustainable?

Here are some basic facts Americans need to know as Congress decides whether to approve comprehensive reform or continue with what we have:

HOW REFORM WOULD WORK: Let’s be clear, the changes Mr. Obama and Democratic leaders in Congress are proposing are significant. But, despite what the critics charge, this is not a government takeover. And the program is not only fully paid for, it should actually reduce the deficit over the next two decades.

Under the new system, all people would be required to have health insurance or pay a penalty. If you are poor or middle class you would also get significant help through Medicaid coverage or tax credits to pay the premiums.

The legislation would create exchanges on which small businesses and people who buy their own coverage directly from insurers could choose from an array of private plans that would compete for their business. It would also require insurance companies to accept all applicants, even those with a pre-existing condition. And it would make a start at reforming the medical care system to improve quality and lower costs.

46 MILLION AND RISING: If nothing is done, the number of uninsured people — 46 million in 2008 — is sure to spike upward as rising medical costs and soaring premiums make policies less affordable and employers continue to drop coverage to save money.

The Congressional Budget Office projects 54 million uninsured people in 2019; the actuary for the federal government’s Centers for Medicare and Medicaid Services projects 57 million.

It should be no surprise that people without insurance often postpone needed care, and many get much sicker as a result. That is morally unsustainable. It is also fiscally unsustainable for safety net hospitals — which foist much of the cost on the American taxpayer when the uninsured end up in the emergency room. As the number of uninsured rises, that bill will rise.

The Senate’s reform bill would reduce the number of uninsured by an estimated 31 million in 2019. The Republicans’ paltry proposals would cut the number by only three million.

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