If you like Michael Lind's essays, his latest in Salon
is a real treat. It's about Obama and populism.
One line that caught my eye was this one which, while not directly addressing the Senate bill's excise tax, is applicable to it:
... a purely budgetary solution of cutting spending without delivery-system reform will merely provide Americans with smaller amounts of excessively costly care ...
Cutting spending is the goal of the Senate bill's excise tax.
There hasn't been any serious attention to delivery-system reform with the health care legislation. Yes, there is reform about who gets in, and who pays, but the actual system of doctors, hospitals, and drugs is pretty much left alone to operate as it always has.
"Yes, there is reform about who gets in, and who pays, but the actual system of doctors, hospitals, and drugs is pretty much left alone to operate as it always has."
Well, that's because while it's easy to attack insurers for the rent-seeking parasites they are, attacking actual providers is frowned upon. Some people are willing to agree that to really cut costs and get rid of unnecessary care and dangerous care, we need to fundamentally alter the industrial organization of medicine.
But there's a lot of people out there who either don't understand or disagree. Like the single-payer advocate who also intones that nobody should come between him and his doctor, which is a presciption for exploding health care costs.