Health care: Devil in the details

Inter Lake editorial

Not to the degree of President Barack Obama, of course, Sen. Max Baucus can also admirably and effectively explain problems with the American health-care system to his constituents. However, Obama and Baucus both have a much harder time explaining how the reforms offered up so far would actually improve the system.

The rate of health-care cost increases is 'straining everything," Baucus told the Inter Lake editorial board last week. Health care is increasing large and small business payroll costs, and it is increasing state and federal spending, all at unsustainable rates. The spiraling cost increases along with growing numbers of baby-boomer beneficiaries will put the federal Medicaid system in the red within eight years.

Sen. Baucus is right. And that's why there is general agreement that some kind of reform is necessary for the health-care system. The problem for the reform proposals that Democrats have been pitching is that that they are exceedingly broad and complex.

The fierce opposition that Democrats have encountered at town-hall meetings in the past couple of weeks is largely driven by the bills that have been generated from Nancy Pelosi's House of Representatives.

Interestingly, Obama repeatedly referred to the legislation "that Max is working on" at Friday's town hall meeting in Belgrade.

And Baucus concedes that the House legislation hasn't been helpful for his bipartisan panel's more protracted and deliberative approach in developing legislation.

"Because there is no single bill, it gives the opponents a field day, and it gives the proponents nothing to defend," he said.

Baucus seems sincere in attempting to effectively address the most pressing reform priorities, specifically the goal of reducing the rate of inflation in health care. But the headwinds he and Obama are encountering is driven by very real and legitimate concerns.

"No bureaucracy or insurance person will decide if you get health care," Baucus told us.

And to great applause in Belgrade, Obama said, "I don't want government bureaucrats meddling in your health care, but I also don't want insurance company bureaucrats meddling in your health care."

Trouble is, the House legislation has fueled precisely those fears.

Rasmussen polling this week found that support for "the plan" that has been offered up so far has fallen to a new low of just 42 percent. More significantly, 44 percent of respondents strongly oppose it.

And that's mainly because of Congressional Budget Office projections that the reforms will produce higher costs and deficits as well as a perception that "public option" provisions will incrementally drive the private insurance sector out of business, to be replaced by an evolving federal health-care leviathan.

Most Americans do not view government, particularly the federal government, as being a model for thrifty management and efficiency in delivering services. They think of Amtrak. They think of the post office. They think of Medicaid.

So if Max Baucus and President Obama want to pass reforms that can win the support of at least a majority of Americans, the final proposals had better look a lot different and a lot more effective than what the public has seen so far.