The Healthcare Bill: Why So Complex?

I saw two interesting panel discussions about the omnibus House healthcare bill on CNBC yesterday morning.

On one, a former FDA official, a representative for the bio-pharma sector, and former HHS secretary Tommy Thompson discussed how European pharma companies stopped producing innovative medicines a few years after imposition of universal healthcare programs in various countries. Their point was that, with government-imposed cost controls, pharma companies had less profit with which to fund innovative drugs, and little prospect of recovering any such investments, at a profit, by selling such new products to the same cost-conscious European country healthcare systems.

On the other, several industry executives and, I believe, at least one Congressional member, discussed the inadvisability of attempting to force through, hurriedly, such a complicated, voluminous and incomprehensible bill.

One noted the sudden fears rising among already-insured Americans who suspect that this bill will change what they have, and not for the better. Another mentioned a now generally-agreed brief list of legislatable fixes which, if implemented, would likely resolve more than 75% of the coverage and cost-containment issues now being debated, without redesigning the entire US healthcare system.

In response, the Hispanic co-anchor Carlos Q objected that sometimes big, broad programs are necessary to accomplish big tasks, such as Social Security in the 1930s and Medicare in the 1960s.

Two panel members immediately criticized Carlos for misunderstanding the current situation and needlessly complex, lengthy bill.

I have an additional criticism of the rather unintelligent, clueless CNBC co-anchor. It's a really simple one, but, never the less, one that escaped him.

Social Security and Medicare are both programs which offered benefits to individuals which had not existed before. That is, public pensions and medical care were not changed due to those two programs, but were provided by government for the first time because of them.

Universal healthcare bills are essentially and radically different. They, for the most part, promise not new coverage or benefits, but simply changed benefits.

Sure, perhaps 8-10MM new, poor, currently-uninsured will be served. But for the 250MM+ Americans who already have health insurance and access to good medical care of their choosing, life will change.

If it didn't, why the complicated bill? It's easy enough to just legislate tax credits or vouchers for government-offered or private health insurance without touching the rest of the system.

No, people are appropriately wary that such a large, unreadable, lengthy bill must be full of changes and traps which, if seen clearly in a 10-page or less bill, would provoke a terrible firestorm of voter fury and rejection.

Several of the panel members noted that if Wonderboy made progress on only one or two aspects of healthcare in his first term, e.g., interstate insurance availability, removal of mandates in policies, tax credits and vouchers for health insurance or no tax preference for anyone on the matter, and tort reform, people would credit him with real progress and accomplishment.

But, as they noted, fear is what you get when you deliberately pass a bill so long and complex that the average American knows the resulting administration of said law will subject them to a new, horrible nightmare.

This time, it won't be about retirement benefits, or old-age healthcare. It's going to be about every aspect of their most private family choices involving health and medicine.