Thursday, December 17, 2009

Reform hanging on by a thread...

Listen to the chorus coming from both proponents and opponents. It seems that everyone senses that the health care overhaul package is skating on very, very (!) thin ice and the rhetorical jousts coming from both sides appear to be trying to do one thing - push the bill off the balance beam over to the desired side.

Former Democratic National Committee Chair Howard Dean stated, after the collapse of the age 55-64 Medicare buy-in option designed to appease Connecticut Senator Joe Lieberman: “This is essentially the collapse of health care reform in the United States Senate.” Nebraska Senator Ben Nelson is refusing to sign the bill without strong anti-abortion language and others are similarly acting as though their vote is the only one that counts. With the balance of yays and nays so tight, each vote is actually that important.

Meanwhile, Majority Leader Harry Reid is expressing confidence that the bill will pass while the President is tweeting that the Senate is "on the precipice of a historic decision."

We ought not forget though that even with the increasingly watered down version that is emerging, there are some significant changes coming (assuming the bill gets to a vote and survives). These include: Medicaid program expansion, movement toward outcomes-based (or at leased influenced) reimbursement for providers, consistent removal of the pre-existing condition clause and the inclusion of some 30+ million Americans who today do not have comprehensive health care coverage.

So... depending upon whether you are a glass-is-half-full or glass-is-half-empty kind of person (i.e., liberal leaning or conservative leaning), you may be getting ready to declare victory for having passed the most comprehensive health reform package in history... or having defeated the most ambitious health reform package in history by successfully diluting down all of its ill effects.

I guess it all depends on how you look at it.

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