Home > healthcare, jonathan rauch, national journal > The Senate Bill, only for those who don’t like the status quo

The Senate Bill, only for those who don’t like the status quo

No one who has examined our current healthcare delivery and finance system believes it is worth preserving. Jonathan Rauch, in National Journal magazine, makes the case for passing the Senate Bill, which despite its flaws, is much better than nothing.

Moreover, after reform is enacted, the taboo on taxing employer-provided health benefits will be shattered once and for all. From then on the question will be how much to tax, not whether. A door that had been welded shut will have been pried open. The country will be able to have a new kind of discussion, one in which the tying of health insurance to employment — which is insane, when you think about it — is no longer sacrosanct.


As health costs rise, more employer-provided health plans become taxable, giving employers an incentive to find cheaper plans. As employer-provided plans grow less generous, more employees have an incentive to take a tax credit and shop around, and, as premiums rise, more qualify to do so. Little by little, insurance coverage shifts toward an individual-based, consumer-driven market. And the faster health insurance costs rise, the faster the transition happens. The disease triggers its own antibodies.

Again, no guarantees. The transition would be very gradual, and political blowback could easily disrupt it. But the point is that the reform contains a pathway to sanity. No one can say that about the status quo.

I’m hoping President Obama makes the case for passing reform during tonight’s State of the Union Address. The principle for all Americans having access to health insurance will be set. Improvements can be made later; if this fails now we’re stuck with nothing for a very. long. time.

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