"HEALTH REFORM IS A RISK WORTH TAKING"
While the Washington Post has been tracking to the right recently, it has this morning come out with an important editorial endorsement of HCR which should sway many fence-sitters in the Village.
The Post bemoans the lack of cost controls and doubts the ability of Congress to enforce spending cuts. But in spite of those reservations it points out that the vote now is between the bill and the status quo which is unacceptable.
Also the Post says that the bill contains many seeds of reform which can make the health system much better in the future.
The Post doubts the excise tax or Medicare cuts will ever really take effect:
As the health-care debate unfolded, however, those goals increasingly were pushed aside in favor of expanding access. One of the chief mechanisms to rein in costs, the excise tax on high-value insurance plans, is not scheduled to take effect until 2018, long after Mr. Obama will have left office. More worrisome: Will it take effect at all -- or will a future Congress balk, once the benefits of health reform are in place? Likewise with promised cuts in Medicare spending: Will they be implemented or, as with perpetually delayed cuts in reimbursement rates for physicians, will they be postponed once they start to pinch? The package of fixes unveiled by the House on Thursday revealed yet one more promise of virtue postponed: It pumps up subsidies at the start, to make insurance more affordable (and mollify liberals in the short run) -- but in later years has the subsidies growing more slowly than previously budgeted, allowing for boasts of deficit reduction.
Yes, the Congressional Budget Office scores the latest measure as reducing the deficit, particularly in its second decade. But the CBO's rules require it to accept that Congress will do what it says it is going to do. Experience suggests that is not always the case -- especially with powerful constituencies such as seniors and health-care providers pressuring lawmakers. Meanwhile, the revenue lost from the reduced and postponed excise tax will be made up with a new Medicare payroll tax on wealthy taxpayers' unearned income. If Medicare taxes are spent on what Mr. Obama terms "the largest middle-class tax cut for health care in history," where will he find revenue to save Medicare itself?
So moving ahead with health reform is fraught with risk. The question is whether the measure carves out enough of a toehold on cost containment to justify that risk. We think it does. And this is the second chief selling point: The measure contains important seeds of reform.
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