Will Health Care Reform Make You Healthier?

Maybe a bit. But not by much. Indeed, the main impact of health-care reform on health may be that if it could contain costs, we'd have money to spend on things that actually do make us healthier. That, at least, is the thesis of an article I wrote for The American Prospect. An excerpt:

Amy and Lane are the sort of entrepreneurs politicians mythologize. Folks who stepped out of the safety of corporate employment, identified a market niche, and filled it. The couple owns a small broadband Internet-access provider in Northeastern Iowa. The work they do matters: A remote corner of a rural state depends on them for connectivity and competitiveness. And they are going bankrupt.

Their finances have not failed because their business has flagged. Nor were they victimized by Wall Street's collapse. Rather, their woes began 17 years ago, long before there was a Google to access or there were download speeds to compare. When Lane was 21 years old, he was diagnosed with cancer. The treatments were vicious: Doctors took a lung, a leg bone, and part of a hip while fighting the disease. But they were successful. Now he is cancer-free. The disease still haunts his life, however: In particular, it haunts his finances. Health insurance consumes 40 percent of the family's income. They have no retirement savings. Loan officers casually mention bankruptcy, a word that breaks Amy's heart. "This is not who we are," she said. "We have done everything we were supposed to do."

Health-care reform, at least as discussed in Washington, is designed to help families like Amy and Lane. Indeed, if their plight sounds straight out of a political speech, that's because it is. Barack Obama told their story in May 2007, when he unveiled his health-care plan at the University of Iowa. This was the situation he chose in order to illustrate the problem he meant to solve. But read it closely. Amy and Lane are not facing a health problem. They are facing a health-financing problem. Reform will make them more economically secure. It will not necessarily make them any healthier.

This is frequently elided in the health-reform debate. Obama's campaign Web page sold his health-reform proposal as "A Plan for a Healthy America." Sen. Ron Wyden calls his bill "The Healthy Americans Act." But for a clearer account of what health reform is really about, consider the congressional committees that have primary jurisdiction over it. In the House, it is the Energy and Commerce Committee. In the Senate, it is the Finance Committee, rather than the Committee on Health, Education, Labor, and Pensions. In both cases, the money committee commands the issue. After all, this is fundamentally an issue of money.

Whole thing here. What do you think?