I don't blog about this very much, because I don't understand it very well.
I know there are several bills and versions out there; I just don't know what they do or how they differ.
I know there's such a thing as a "single payer system" which is essentially "socialized health care". In essence, it's a single universal health care system where everybody is under the same "plan", kind of like Medicare, but involving everyone. I also know this is not what Obama proposes.
I know there's such a thing as the "public plan option" which is what Obama is proposing. Essentially, this is a government-run insurance plan (again, like Medicare or what congressmen have) that anyone can opt into. It will cover people who are presently uninsured and essentially compete with private insurance plans. But of course, because it is the government, it can provide better services at lower costs (the government has more bargaining power). And I believe most of the proposals on the table are some varience of the "public plan" option.
Some say that the public plan approach is a stepping stone to a "single payer system". That's fine with me.
But the main reason I have a problem getting my arms around health care reform is that I just don't know the lingo, as this helpful post from Exra Klein made salient:
There are two things that people might be talking about when they bring up the cost of health-care reform. One is "national health expenditures." That's the amount of money we spend as a country, in both the private and public sectors, on health care. The other is "public health expenditures," which is the amount of money the government — and thus taxpayers — spend on health-care programs like Medicare and Medicaid.
These two measures do not always point in the same direction. A single-payer system could cut national health expenditures by 10 percent while increasing public expenditures by trillions of dollars. In that scenario, national health expenditures would fall, but public health expenditures would rise, because we would be paying through taxes rather than premiums. Conversely, a scenario in which we ditch or weaken the public plan might mean that public health expenditures are lower because less money is being routed through government, but national health expenditures are higher, because you're missing out on a potential source of cost savings.
Another piece that confuses people is the difference between "paying" for health-care reform and "saving money" through health-care reform. Imagine that the final health-care bill costs $1 trillion but spends all that money on subsidies and doesn't change the system at all. That bill could be "paid for" through a tax that raises $1 trillion, or by cutting defense spending by the same. But it wouldn't save money. Conversely, imagine a health-care bill that cost $1 trillion but unravels the employer-based market and substantially reforms Medicare: That bill might save trillions in the long term by cutting national health expenditures, but unless someone found $1 trillion up front, it wouldn't be "paid for."
The goal of health-care reform — at least on the cost side — should be to save money on national health expenditures. Saving money in the long run is a lot more important than deficit neutrality in the short run. And the total level of health-care spending is a lot more important than what percentage of it is public.
I think I follow.
One thing I do know is that there really is no excuse in the 21st century for not having digitized and easily transportable electronic medical records. I understand there is a huge upfront cost to having hospitals and doctors' offices convert to digital, but it is something that needs to be done. So much of health care costs is due to administrative expenses, and the way to save money on national health expenditures is to lessen those expenses.