Ron Brownstein has written a long and somewhat wonkish assessment of the health care reform bill currently being debated in the Senate. Long story short, the bill's chief purpose is to cut skyrocketing health care costs by moving the system away from a fee-for-service template and toward a fee-for-outcomes template.
Republicans outside elected office like the bill, but wish it had as many sticks as carrots to encourage better coordination of care among providers. And malpractice reform. But since Republicans have decided to not play ball with the White House and the Democratic majority, there's no one at the table lobbying for the latter.
Like a lot of liberals, I've tended to view the success or failure of the bill almost solely in terms of the survival of the public option, but the article points out that a state-sponsored insurance plan "would affect who writes the checks in the medical system, but not what the checks are written to pay for." It raises the question of the relationship between universal coverage and cost containment, and the priorities of the two.
Apparently, President Obama is rather smitten with the article, and Rahm Emanuel has made it required reading for the White House staff.
Campaigning for universal coverage is sexy in that social justice kind of way. But the HCR bill detailed by Brownstein's article isn't a bit sexy. It's the government using its regulatory and reimbursement power to encourage a set of best practices that are designed to make health care less expensive and the nation's citizens healthier.
And that's OK. In fact, that's probably the best we can expect from people at the pinnacle of power in 21st century America.
It's the difference between Amos's passion and Joseph's prudence. So long as the prudent are seeking to achieve the aims of the passionate, we ought not denigrate reform just for lacking sex appeal.

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