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HEALTH REFORM: Stimulus Eases Short-Term Crisis, But No Substitute for Comprehensive Reform
The stimulus package, signed into law on Tuesday, provided a "down payment" on comprehensive health reform by funding two initiatives, health information technology and comparative effectiveness research, that stand to create jobs and lay the foundation for a high-quality, efficient delivery system.
To prevent states deep in the red from shedding hundreds of thousands from their Medicaid rolls, the stimulus allocated billions to the program. For workers who've lost their jobs—and hence their insurance—since September 2008, the stimulus provides a 65 percent subsidy for COBRA premiums. Those provisions will help many people. But it won't fill in the health coverage gaps for everyone. Noam Levey in the LA Times takes a look at who the stimulus helps and who it doesn't.
Several provisions once included in earlier versions of the legislation were not included in the final package. COBRA subsidies were limited to workers who lost their jobs after September 2008, a controversial move given that the recession was already underway for months by then. The final bill did not open Medicaid coverage to additional unemployed workers (previous versions of the bill would have allowed unemployed workers who were not eligible for or who could not afford COBRA to enroll in Medicaid). And it struck a provision that would have allowed workers over age 55 to remain on COBRA until they became eligible for Medicare.
Though the COBRA premium subsidies and additional funds for Medicaid will blunt the immediate crisis by preventing many from losing insurance, the comprehensive reforms needed to extend coverage to all Americans and address our system's cost and quality issues are still as necessary as ever.
The National Journal's health experts blog has a variety of views on how effective the health provisions in the stimulus will be in spurring economic recovery and getting the newly jobless/uninsured through hard times.
The federal deficit
What do you believe about the federal deficit?
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Do you believe a balanced federal budget or a federal surplus is more prudent than a federal deficit? Consider this: All six depressions in U.S. history began with a series of federal surpluses:
1817-1821: U. S. Federal Debt reduced 29%. Depression began 1819.
1823-1836: U. S. Federal Debt reduced 99%. Depression began 1837.
1852-1857: U. S. Federal Debt reduced 59%. Depression began 1857.
1867-1873: U. S. Federal Debt reduced 27%. Depression began 1873.
1880-1893: U. S. Federal Debt reduced 57%. Depression began 1893.
1920-1930: U. S. Federal Debt reduced 36%. Depression began 1929.
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Do you believe federal deficits cause recessions? Consider this: There have been 9 recessions in the past 50 years. All began with reductions in federal deficit growth and all recoveries coincided with increases in deficit growth.
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Do you believe large deficits are an unsustainable burden? Consider this: In 1971, the federal government ended the last vestiges of the gold standard. The purpose: To give itself the unlimited ability to create money. Therefore, the government can service any size debt. No debt is an unsustainable burden for the federal government.
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Do you believe federal deficits cause inflation? Consider this: Every period of significant price growth since 1969 has been associated with rising energy costs. Not one of these inflationary periods was associated with federal deficit growth.
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Do you believe federal deficits crowd out lending funds? Consider this: The government borrows to support deficit spending. So money lent to the government immediately returns to the economy for further lending. Deficits add lending money to the economy, which is why deficit spending stimulates the economy.
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Do you believe our children and grandchildren will pay for today’s deficits? Consider this: There is no historical relationship between tax rates and deficits. Tax rates are based solely on political considerations. Generally, Democrats raise tax rates and Republicans lower them, irrespective of deficits. Unless tax rates are raised and the government runs a surplus, our children and grandchildren cannot pay for today’s deficits.
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Given these facts, what do you believe?
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Rodger Malcolm Mitchell
rmmadvertising@yahoo.com
www.rodgermitchell.com
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