Wednesday's heated House Ways and Means Committee hearing may provide a glimpse into the battles ahead in health reform as Congress works toward a June deadline.
Tension across party lines was high, patience was thin and outbursts were common among the committee members.
Expert witness Uwe Reinhardt, an economics professor at Princeton University, said reform will come down to whether healthcare is viewed as a moral right.
"I do not discern a shared common ethos around healthcare," he said of Americans. But, he warned, "If you treat healthcare like a social good - like elementary education, for example - then it is unavoidable that the government must administer it."
In other words, the private market can't and won't be focused on social good. It is, by design, meant to focus on profit. Half-way attempts at social good will only eventually buckle, he said, as risk pools shrink and healthy people shy away from purchasing insurance.
Reinhardt, who is an immigrant, said he can't understand why some Americans decry government-run healthcare when that is what the nation has chosen to use for its veterans.
Kenneth Sperling, global health management leader at Hewitt Associates and the only expert out of five who represented Republican views on the panel, testified on behalf of the National Coalition on Benefits. He said reform must include measures to strengthen employer-based care, and noted that employer-based care is leading the way in bringing down healthcare costs through focus on preventative care.
Much of the debate hinged on whether public plans would undercut and threaten the private market. Linda Blumberg, principal research associate at the Urban Institute - who said her comments represent her opinion rather than that of the Institute - said, "we're not really seeing true competition in private insurance markets."
U.S. Rep. Kevin Brady (R-Tex.) said the public is justifiably hesitant to trust a government-run shadow plan. "Medicare is not a good model. It's rampant with fraud and doesn't always provide quality of care," he said.
House Ways and Means Health Subcommittee Chairman Pete Stark (D-Calif.), who helped lead the hearing, said, "Consumers trying to navigate the marketplace find insurers who are unwilling to provide coverage, unclear about the cost of insurance and sneaky about what care is covered. We can't fix this market without having a public health insurance plan that will compete with the private insurers to stabilize the marketplace and give consumers an option that isn't wholly profit-driven."
Photo by -Andrew- and obtained under Creative Commons license.