Health reform is moving along

One by one, the obstacles to a once-unimaginable overhaul of the nation’s $2.5 trillion health care system are tumbling by the wayside.

The Senate’s deliberation this weekend over its prescription for expanding health insurance coverage to most Americans represents, as President Obama noted, another milestone on the road to health-care reform.

Despite the entrenched and increasingly shrill opposition from congressional Republicans to any and all comprehensive reform, there is growing reason to hold out hope for success.

In predicting on behalf of the GOP that the coming Senate debate will be “a holy war,” veteran Sen. Orrin G. Hatch (R., Utah) appears to ignore what most Americans understand about the critical need for reform.

As long as 47 million people remain uninsured, as long as health insurers are able to deny coverage at their whim, and as long as the upward spiral of health spending remains at unsustainable levels, both U.S. citizens’ well-being and the nation’s economic prospects will be under threat.

Indeed, drug makers and insurers are busy raising prices in anticipation of reform — proof-positive that further delay and obstruction will only boost costs and leave more people on the rolls of the uninsured.

With a House plan already approved, the unveiling of the Senate proposal on Thursday by Majority Leader Harry Reid (D., Nev.) moved Congress closer than ever to getting many of the details right.

The goal is to deliver on the promise of near-universal health coverage, but the plan has to be affordable and realistic.
With its Affordable Health Care for America Act, the House hit the first mark but fell far short on affordability. Left unchanged, that approach might sound the death knell for health reform this year — since opposition in Democratic ranks primarily comes from moderates who rightly fear that reform won’t bend the health-care cost curve downward.

While the Senate’s plan isn’t perfect, its Patient Protection and Affordable Care Act does a better job of controlling costs, backstopping Medicare health insurance for retirees, and avoiding the abortion controversy.

The Senate plan does suffer from the same accounting gimmick that masks doctors’ costs under Medicare, leaving that issue for another day. But it would reduce costs — even trimming the federal deficit over time — by delaying until 2014 the launch of health insurance subsidies for low-income individuals to purchase insurance.

The Senate also would set up an advisory board to limit Medicare costs, a potent cost-control tool hailed by congressional watchdogs. At the same time, the Senate smartly boosts revenue for Medicare with a hike on the payroll tax paid by high earners.

Both House and Senate plans have more bullet points in common than not, including the smart move to provide new competition for private insurers through a Medicare-style health plan for working-age Americans.

Reid has achieved his goal of a bill that “will save lives, save money, and save Medicare.”