We have seen a number of new health care proposals--many I recently cited in a post.
My old friend and health care policy mentor, Henry Simmons, who is President of the National Coalition on Health Care, recently released a statement on President Bush's health care proposal.
One of the key points he made is that any health reform proposal must be comprehensive and able to slow the growth in health care costs, "What America needs is a comprehensive approach to health care reform--a package of policies to assure health coverage to all Americans, slow the rate of increase in costs, and improve the quality and safety to care."
None of the health reform proposals currently on the table--not just the President's--deal in any substantive way with making the actual cost of health care more affordable.
That problem was brought home this past week when the new Massachusetts health plan regulator announced that the individual cost of the mandated base plan would average $380 per person per month. It was originally estimated to cost $200 per person per month when the bill passed the legislature last year.
The lesson is simple--you can mandate universal coverage but what difference does it make to do that if consumers and their government can't afford the price?
It may be that America is ready to take only an incremental step in health reform by expanding current public and private health plans.
But any of those expansions will only set up an imperative to finally find a way to deal with health care cost--and the related issues of quality.
Incremental reform will end up forcing comprehensive reform in the years that follow it because the lesson of Massachusetts will only repeat itself.
Doing comprehensive reform in the first place may the right way to do it.
But politically, incremental reform targeted on expanding access, that later creates the unavoidable imperative to deal with the cost of care, may be the only practical route.