The Healthcare Reform Bill Doesn't Help Me Practice Medicine

Robert Reich and others have noted that, compared with the impact that Medicare had on the lives of every senior in American, the current healthcare reform legislation will affect comparatively fewer Americans. Which is all well and good, but the bill does not help me be a better doctor.

Robert Reich's interpretation of healthcare reform’s significance is the most politically substantive I have seen — he contrasts the impact of Medicare, which “directly changed the life of every senior in America, giving them health security and dramatically reducing their rates of poverty,” with that of the current phase of healthcare reform by noting that “most Americans won’t be affected by Obama’s health care legislation.”

He goes on to say that “Most of us will continue to receive health insurance through our employers. (Only a comparatively small minority will be required to buy insurance who don’t want it, or be subsidized in order to afford it. Only a relatively few companies will be required to provide it who don’t now.)” This bill, says Reich, takes Richard Nixon’s idea of relying on prepaid, competing health plans and requiring employers to cover their employees and “takes it a step further by requiring all Americans to carry health insurance, and giving subsidies to those who need it.” Far from marking “a swing of the pendulum back toward the Great Society and the New Deal,” Reich instead insists this healthcare reform bill is “a very conservative piece of legislation, building on a Republican rather than a New Deal foundation.”

Which is all well and good, but the bill does not help me be a better doctor.

• The House vote supports conservatives more than liberals

• It ain't universal healthcare -- It's not Medicare for all

• It profits healthcare corporations who benefit when you, the consumer doesn't

• Although it modestly extends coverage and supports comparative effectiveness research, it does not make medicine more rational

Are we there yet? No, the proper incentives still are not aligned for truly effective healthcare reform.