Accept Health Reform and Fix It
Accept Health Reform and Fix It

Kathleen Sebelius fell on her sword last month and had to resign as head of Health and Human Services.

Her nominated successor is Sylvia Mathews Burwell, now head of Obama administration budget office. Burwell testified before Senate Health, Education, Labor, and Pensions Committee Thursday, and things look promising. 

She may be confirmed without a fight. It crossed my mind Sebelius did not resign during the open enrollment period because it would have left her slot empty. It would have been during the not only botched, but also vehemently opposed rollout of the Affordable Care Act. Possibly Congress would have refused to confirm any successor during the peak of the debacle.

Meanwhile, the success or failure of health care reform will be bigger and take longer than the enrollment rollout. The essential question is whether more people will get health insurance coverage and care, and whether the quality of that care will be better. 

In Massachusetts, which pioneered a similar health reform package, these questions have been answered. More are insured, and mortality rates are down, according to the study “Changes in Mortality After Massachusetts Health Care Reform.” The Harvard School of Public Health and The Urban Institute did the study. 

It compared the mortality rate (how many people die per 100,000 people) before and after the commonwealth passed health care reform in 2006. Deaths dropped 3 percent over those years.

Henry J. Aaron, senior fellow of economic studies at the Brookings Institution, wrote, “Although some opponents continue to call for repeal of the ACA, the law is here to stay. As long as Obama remains in office, he would surely veto any repeal law, and a veto override is inconceivable.” But it needs a number of technical fixes, and those will need politicians who accept that it is here to stay.

The secondary question is whether we will be able to cooperate enough politically to make it work. For now, this prospect looks as bad as the federal health exchange website on Oct. 1, 2013.

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