Swirling Health Care Stories

Posting links to new health care articles could tie up most of my time every day. This day, however, produced a cornucopia of conflicting perspectives, likely to be regularly revisited over the next few months. Have a look.

David Sirota, who previously championed Sen. Karen Keiser's statist health care reform in a Seattle Times op-ed, bootstraps his experience with letting his health insurance lapse to an scathing indictment of the whole health insurance system, which he then conflates with terrorism and natural disasters.

We now not only have to be afraid of Al Qaeda and hurricanes and evildoers, but also of the health insurance companies that we are customers of - and executives from these companies still have the nerve to go before Congress and publicly wonder why so many people hate their guts.

Read the whole, understated piece to get an idea of where some of these guys are coming from. And read this other Sirota piece that shows where they're going: to state capitols like ours. He links to a recent poll in Wisconsin, where a massive payroll-tax-based state-run plan passed one house of the legislature.

More than two thirds of the state says it would be better for the health care solution to come from states, rather than from the federal government - a major rejection of those who say progressives should focus their health care activism only on D.C.

He's right about this: Voters want change and they're more apt to support reforms that emerge from state legislatures, which connect more closely with local voters.

Fortunately, today's news also brings signs of responsible legislative efforts, plans that expand choice and rely more on the marketplace than the state bureaucracy. Here are a few.

From the Heartland Institute, a piece from Grace-Marie Turner on the Healthy Indiana Plan, which has expanded health insurance coverage to thousands.

The Atlanta Journal-Constitution reports on how Georgia is using information technology to increase consumer awareness of health care costs and quality.

MinnPost.com reports on efforts in Minnesota to take a broader view of competition, one that ties access to information to an expanded understanding of the market.

Here are the three things that we think must occur for meaningful reform:

• The development of an information system that supports decisions based on value.

• Payment reform based on "total cost of care."

• Governance structures that set the ground rules for a functional market, but don't over-regulate.

It's a debate that's going to continue for a long while. And business groups like ours will continue to engage on behalf of reform efforts that emphasize quality, access, cost control, and choice - components of a responsible market-based system. Because today's news also brings further detail on the pitfalls of state-based system.

Here's another Grace-Marie Turner piece on the flawed Massachusetts experiment.

osts are still a problem for the Massachusetts plan. The state government now estimates its annual spending on the new program for the uninsured may exceed its budget by nearly $150 million.

And a bleak look at what's going on in California.