Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.
At a low moment of the Second World War, a breathless young aide barged in on Winston Churchill to report some bad news. Showing the aplomb one fully achieves only within the pages of one’s own memoir, Churchill quotes himself responding: “I’ve heard worse.” That’s the resilience Democrats need.
Treatment readers already know that many health policy experts across the political spectrum support House passage of the Senate bill, with an accompanying fix of the bills various shortcomings through the reconciliation process. Like Paul Krugman, Jonathan Cohn, Ezra Klein, and Jacob Hacker, Tim Jost and I very much agree that this is the best approach.
Yesterday, Tim and I crafted a simple letter (shown below), which we emailed other health policy experts we know. Some are progressives who identify with a single-payer approach. Others are more politically moderate economists, sociologists, and political scientists. Still others identify with organized labor, medicine, or public health.
Within several hours, many outstanding scholars, activists, and practitioners signed on. Signers include Henry Aaron, David Cutler, Jon Gruber, Theda Skocpol, Paul Starr, and many others, including Anna Burger, Secretary-Treasurer of SEIU.
Some people we contacted could not sign on, but reported that they are seeking the same goal through more private means. Virtually no one we contacted disagreed with this letter on either political or policy grounds. Our letter represents a broad consensus of those supporting health care reform.
We are so close to enacting a historic reform. Now is the time for calm and resolute Congressional action. The Massachusetts election was a setback. Democrats still have large majorities in both the Senate and the House. We’ve heard worse. It’s time to act.
Watching CSPAN-2 over the weekend, I was mesmerized by a succession of Senators lambasting the Senate's health reform bill--especially its reliance on Medicaid.
One says that the program is too stingy. He recounts a heartrending tale of seriously-ill Texas children going without needed care because pediatric specialists would not take low Medicaid reimbursement rates. Another notes disparities in neonatal mortality between Medicaid and private insurance patients. "Care delayed is care denied," he intoned to great effect. A third laments that poor people will be consigned to the "medical Gulag" of Medicaid. A fourth suggests that the only reason poor people are made eligible for Medicaid rather than for private coverage is to make the CBO numbers look better. A fifth--worried about the impact on state budgets--notes that Utah Medicaid covers nonworking parents only up to 48 percent of the poverty line. (He didn't seem to notice that such painful state policies are really arguments in favor of the Senate bill.) A sixth drew liberally from an unflattering Washington Post account of the Mayo Clinic's low proportion of Medicaid patients, and its reticence to serve Medicare primary care patients.
Many of these charges are standard fare from single-payer advocates and other progressives unhappy with the Senate bill. It’s a little odd coming from a succession of pasty white guy conservatives. It's odder when one considers what is left unsaid. For all the talk of the perils and indignities of Medicaid expansion, not much is said about the third tier of American medical care: that provided to the uninsured.
