Health Care: The Elevator Pitch

by Nate Silver
FiveThirtyEight.com

I've written several thousand words about health care over the past 48 hours, and tens of thousands of words over the past six months. Some of those words have been a bit, uh, confrontational. So let's try this approach instead. This is my summation -- my elevator pitch for passing health care reform:

Ben Nelson and Blanche Lincoln are probably willing to sign off on $900 billion in public subsidies so that poor and sick people can have better access to health care. Is there really no way we can make this work for us?

To anticipate several of the objections to this:

But it's not real reform! You're right: the bill is not "real reform" in the sense of something that fundamentally alters the structure of the current, predominately private, predominately employer-based insurance system. The only solutions that I'm aware of that might do that are single payer and Wyden-Bennett, either of which I'd prefer to what's on the table now -- but neither of which are liable to be politically viable any time soon. By the way, I don't think a bill with a public option would constitute fundamental reform either -- it would be better, but it's still tinkering around the edges of a flawed system.

But it doesn't control costs! No, the bill is not particularly great, or even particularly good, when it comes to cost control -- especially without the public option. But, it is liable to help at the margins. According to CMS, the Senate's bill would increase total health care spending nominally -- by about 0.7 percent. However, in so doing, it would cover about 10 percent more people than the status quo does -- so this represents something like a 9 percent efficiency gain. Now, those estimates were made before the public option was removed, which was expected to reduce the bill's tab by about $25 billion, or about 3 percent of the total outlay. Wipe out the public option, and you reduce the efficiency gain further, to somewhere in the mid-high single digits. It's not great, but it's something. It certainly doesn't make the problem worse.

(More here.)

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