Thoughts on what next for health policy

Mostly if you read my blog and columns you have heard it before. A few emailed and asked. Briefly:

• Repeal is like the dog actually catching the car. System unsustainable before PPACA, will be again if repeal. Still not sustainable with PPACA without much more heavy lifting to address cost inflation. If you repeal, then you need a plan for how to start over. The Republicans don't have an actual plan to do anything, just ones designed to argue against something. Insurance across state lines is a great slogan, but not a consequential policy. Malpractice reform, I am for it because the system is a total mess, but it is not a cost savings panacea (though will reduce spending some).
  
• Keep in mind the numbers 218 (votes needed in the House) and 60 (votes needed in the Senate) and 1 (President that must sign). The repeal talk is fantasy and/or political theater. Maybe House should just pass one sentence repeal bill, Pres can veto and then they can get down to business. Rs can say we tried but the scary President vetoed, the Pres can say I prevented the scary Rs from repealing. Whatever. So long as they get down to business.
  
• Here are some tweaks within PPACA framework moving toward Republicans I suggested before the Feb. summit. Perhaps they can have a cross-Congress compromise. In policy terms it is there and always has been.
  
• Here is what I wrote about Deficit Commission, and the next (obvious in policy terms) step to address health care costs.