While previous reform efforts reffered to providing universal coverage as a moral issue, President Barack Obama is instead focusing on reigning in the burgeoning cost of care.
- Today's Papers
It sounds to me that he is doing both. From the press conference:
This is not just about the 47 million Americans who don't have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid.
It is hard not to make health care an issue without talking about the moral component. Concern about not having care, being sick, and so forth is not just about money. But, given the times and that it is also about money, it is pragmatic and sound to focus on that aspect too. I do think we can focus on it too much -- for many it is first and foremost a moral issue, even if (at least in the short term) it is expensive.
On the cost issue, this by Peter Orszag, directer of Office of Management and Budget is interesting:
In part because legislation under consideration already includes substantial savings in Medicare over the next decade, CBO found modest additional medium-term savings from this proposal -- $2 billion over 10 years. The point of the proposal, however, was never to generate savings over the next decade. (Indeed, under the Administration’s approach, the IMAC system would not even begin to make recommendations until 2015.) Instead, the goal is to provide a mechanism for improving quality of care for beneficiaries and reducing costs over the long term. In other words, in the terminology of our belt-and-suspenders approach to a fiscally responsible health reform, the IMAC is a game changer not a scoreable offset.
More from TPM. Again note the "improving quality of care" with costs as a "long term" goal. It might even be said that it is a secondary, if still very important one.