Necessary but not sufficient

Ezra Klein today reports in the Los Angeles Times on positive developments on the path to universal health coverage in the U.S. Several of these developments were new to me, so I'm grateful to learn about them. And thanks to my Canadian friend Sol, who I know would like to see the U.S. come to its senses, for pointing me to the article.

I do think we need universal coverage, but I don't think it's enough to solve the mess that is health care in the U.S. It won't solve our problems with quality of care, disparities, or cost-containment, though as Klein points out, cost-shifting would be reduced as the uninsured will no longer be forced to delay basic care and obtain it from emergency rooms.

I'm a little skeptical of some state efforts, such as Massachusetts' new requirement that everyone be covered, an initiative sponsored by Republican governor Mitt Romney. Under the new law, many state residents won't be able to afford coverage, or at least meaningful coverage, according to Physicians for a National Health Plan. It does, though, help the insurers expand their market. Cost containment? Unlikely; the plan sounds like another form of cost-shifting to me. And on a national level? We shall see. The insurance industry, who are promoting their own (lousy) plan for expanding coverage (see my previous post, under 'Expanding Coverage'), were powerful enough to deep-six - abruptly and completely - our efforts at single-payer health care, led in the early '90s by the Clintons.

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