Friday, August 12, 2011

Book Out Next Week

My book, Balancing the Budget is a Progressive Priority will be out next week via Amazon Kindle. At the heart of the book are my suggested next steps for health care reform, because there is no hope of a balanced budget without a means of dealing with health care costs. The 10 year deficit reduction needs as far as the work of the super committee goes is only a part of the story. In the "out years" the impact of health care costs absent more reform are unimaginable. So, if you want a balanced budget ever again, you need a health reform plan.

Everyone is buzzing today about the 11th Circuit Court of Appeals ruling that the individual mandate in the ACA is unconstitutional, but severable, meaning the remainder of the law could remain even if the mandate is invalidated. There are a variety of policy remedies that could be used to try and reduce adverse selection in the absence of an individual mandate. In policy terms, all would not be lost, and the mandate is quite weak in any event. Politically, I think it is a different story.

The Supreme Court will now almost certainly hear the case, and perhaps rule next Summer just as the Presidential campaign hits full boil. The "losing side" be it President Obama and the Democratss or the Republican party will receive quite a political blow.

I don't believe there is any perfect health system and certainly no perfect health reform plan. What our country most needs is a way forward in health reform that provides both "sides" with some credit, and most importantly, which makes both sides responsible for the next, harder steps in addressing health care costs. Currently, every health policy study, finding or news items is first and foremost the next salvo in a political war that is being waged over the ACA. We have no hope of doing the hardest things in health reform as long as it remains politically toxic.

Democrats do not want to see their major policy achievement lose a key aspect, and Republicans, if they are smart will realize they do not have a coherent health reform plan and that they need one if they are serious about achieving a balanced budget some day.

Both sides have an incentive to remove the uncertainty that a Presidential-year court ruling on the mandate might bring and strike a deal. The book suggests the outlines of such a deal that would have at its heart guaranteed, catastrophic insurance that would render the individual mandate unneeded, and render the court cases moving toward the Supreme Court, irrelevant.

More next week.

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