Reform bill doesn't cut it

As with virtually any senator, Utah's Orrin Hatch can at times be given to hyperbole. But when he said, in prepared remarks given on the Senate floor Tuesday, "Only Washington could try to sell a promise like this with a straight face," we doubt too many astute observers would disagree.

The subject was health-care reform. The Senate Finance Committee had just voted 14-9, with only one Republican (Maine's Olympia Snowe) joining the majority, to approve a major bill. But then this version, one of many in both the House and Senate, will be, as Hatch said, rewritten "behind closed doors in the dark corners of the Capitol and the White House" before a final version is brought to both houses for a vote.

It should be beyond question that the nation's health-care system needs reform. Health-care costs are rising at rates that far exceed inflation, and the current economic crisis has either raised premiums and lowered benefits or completely stripped Americans of their coverage. Meanwhile, through the years, the system has evolved in such a way that little, if any, true competition exists. Costs are hidden and removed a step from the insured. Americans spend more as a percentage of gross domestic product (18 percent) than virtually any other industrialized nation. They already spend more out of pocket and in taxes for health care than most countries with socialized medicine.

But the answer to that is not to increase taxpayer spending on health coverage. It is to introduce and somehow enhance competition among providers while eliminating insurance rules that place some people in dire circumstances through no fault of their own.

Once you eliminate pre-existing conditions, however, you must require all Americans to obtain insurance; otherwise, some people will wait until they are sick to acquire coverage, and private insurers would have to raise premiums considerably on everyone else.

All of that will require a carefully crafted piece of legislation. Frankly, the bill that emerged from the Senate Finance Committee doesn't cut it. Nor will anything that comes out of Washington. This is a job for states.

The version approved Tuesday would tax people with so-called "Cadillac" insurance policies, and it would make cuts to the Medicare Advantage program. Both moves would stifle, not enhance, competition. Many Democrats, including the president, are still pushing for a broader public option that would compete with private insurers for business. This subsidized version also would skew, and perhaps eventually kill, competition.

The best type of reform would be one that sets parameters and allows states to reach those goals however they see fit.

Much was made this week of a report by America's Health Insurance Plans, which said the bill would more than double the cost of insurance to the average family within 10 years. Democrats quickly attacked that as a self-serving bit of propaganda.

Sure, the industry does have an interest in keeping itself as profitable as possible. But its claims are no less fantastic than those from Congress that health reform will cost nothing while solving the nation's health-care woes.