An Idiot's Guide to Health Care Reform

As the September showdown over health care reform approaches, it's easy to get lost in the summer haze of town hall scream fests and liberal freak-outs and hand-wringing about euthanizing grandmas and Sarah Palin's impressionist position on facts. Let's get back to basics and answer three big questions.

1) What will the health care bill do?
2) Why do we need reform?
3) How would the law affect you?



1) What will the health care bill do?
Alec MacGillis, writing in the Washington Post, has an excellent "health care cheat sheet" that breaks down the reform proposals in crystal clear language. It's a great touchstone as we move through the next few months. It explains how health reform is about two things -- 1) Covering more people; 2) Lowering costs -- how the bills try to do accomplish both, and whether experts think they'll be successful. I suggest you read the whole thing here. If you'd like a preview, here's a great explanation of why cost control is so hard to do:

What is unclear is if the proposals would achieve long-term savings. Reformers tout a new federal effort to determine, with the help of computerized records, the "comparative effectiveness" of treatments. But they say this effort would not take cost into account or issue firm guidelines over what to cover -- assurances made, in part, to avoid upsetting providers and patients groups. End-of-life care eats up a huge slice of spending, but the proposals do little to address this directly. And the clause in the House bill about providing Medicare reimbursements to doctors for counsel on end-of-life questions originated in an earlier proposal backed by Republican senators.

2) Why do we need reform?
It's well-recited that health care costs consume 16 percent of the economy and pose an exponentially rising burden on government outlays. Why are government costs projected to explode in the next new decades? Calculated Risk answers that question with some alarming graphs.

Here are two graphs that illustrate the dramatic swaying of the US population from the late baby boom to the middle of this century. Check out the Over 80 crowd.

OK so what if folks are getting much older? Life is a blessing, after all. So true. But life is also really expensive, and for the most part, the more life you live, the more expensive your health care. Take a look at this last graph on expenses for Americans older than 65 and under 65. This gives you a good idea about why fiscal hawks are nervous about our older population exploding with static revenue sources from the under-65 crowd.

3) How would the law affect you?
This sounds like it should be really complicated. But Nick Beaudrot makes it look really easy with this miraculously clear flowchart, based on a Chris Hayes lecture.