Health care Rx doesnÂ’t need haste

The health care bill that garnered enough votes in the Senate Saturday to move on to debate on the Senate floor still faces multiple challenges, and rightfully so. There is much in the bill that makes us uneasy, not least of which are the estimated costs over the long term.

Senate Democrats and the Obama administration should take their time trying to resolve the conflicts creating those obstacles rather than attempting to steamroll a bill through Congress that might cause more serious problems.

Most apparent of the obstacles is the public option — a government-run insurance program that would compete with private insurance providers. Some of the senators whose votes were key to moving the bill forward Saturday say they are still reluctant to support a public option. One of them, independent Joe Lieberman of Connecticut, has said the bill will face filibuster if it includes a public option. Conversely, some liberal Democrats say they will do all they can to kill the bill if it doesn’t have a public option.

How Senate Majority Leader Harry Reid deals with this conundrum will be a key test of his leadership abilities. One possibility, raised after Saturday’s vote, is to revisit the so-called trigger for a public option. The trigger would authorize a government insurance plan to be created only if private insurers fail to meet various benchmarks for coverage and cost containment. We continue to believe that is a sound alternative, since it would give private insurers real incentives to meet those benchmarks.

But the public option isn’t the only obstacle to final passage of the Senate bill. Cost remains a major point of dispute.

The official cost estimate is $848 billion over the next decade, but Republicans vehemently dispute that figure. They point out that it relies on nearly all of the revenue-raising measures being put in place as early as next year, while benefits wouldn’t begin until 2014.  Also, the measure relies on significant cuts in Medicare payments to doctors that almost no one believes will materialize. Even the Congressional Budget Office that produced the cost estimate suggested it is based on premises that are highly subject to change.

The Senate must come up with a less-fictitious cost estimate, and more realistic proposals to pay for it.

There are many more disputed provisions in this massive bill. No doubt more will appear as legions of people from both parties delve deeper into the 2,000-plus pages of this bill — a monumental amount of paper that all but guarantees something unexpected or overlooked is hidden in the dense text.

That’s why we believe Reid, Obama and others should take their time in trying to resolve the numerous conflicts related to the bill.

Health care reform remains imperative because the current system, with its mushrooming costs, is unsustainable. But a rushed-through bill with little-known provisions and unforeseen consequences could end up being worse than no legislation at all.


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