Sen. Kay Hagan was in an upbeat mood yesterday afternoon talking about health care reform, as who wouldn't be after a visit to the beautiful SAS headquarters in Cary. Indeed, with all that's gone wrong with America, I recommend that everyone make time to see the SAS campus and be reminded that there remain people in this country -- even some business people -- who are capable of doing a thing very, very well. SAS is in the software business, of course. But Hagan was there to underscore the fact that SAS does health-care delivery right well too.
The line she was trying to draw from SAS, with its in-house health care staff and plethora of wellness programs, to health care reform on a national level is more boolean than direct. But there is such a line, and it's this --
* SAS provides a "medical home" for its 5,000 employees as a platform for their health care -- and for their very good health results.
* A "medical home" is precisely the thing that most Americans don't have, either because their health care coverage is by an insurance company (not a home, surely, that anyone wants to live in) or because they have no coverage at all. So we're "treated" a lot -- too much, in fact -- but in very inefficient ways that don't add up even to good care, let alone cost-efficent care.
In short, Hagan was arguing that the way our health care delivery is organized -- with rootless patients wandering in a field of providers and insurers -- is at the root of America's dysfunction, which she summed up nicely as: "We spend way too much money in this country on health care with no better outcome" [than other countries that spend far less].
I was a little startled today to read that Hagan's comments meant that she was backing off the idea of a public option as part of health care reform and is about to jump on a phony coop approach. I didn't hear her say that at all. What I did hear was an argument that health care reform has got to bring costs down over time ... that the public option in the bill that the Senate HELP Committee produced, with her support, would help to do that ... and that she's willing to look at any alternative plan that the Senate Finance Committee produces, if it ever produces one, to control costs.
That the Senate Finance Committee is talking about coops isn't news. Nor should it be news that a junior senator from North Carolina is willing to consider what that committee proposes as well as what her own committee has proposed and "hopefully merge two bills together so we can have health care reform."
Since the Senate Finance Committee has thus far produced nothing, not even a sketch of how health care coops would be started or how they'd be run, nobody can say whether they'd be any good or not, any more than we can say that the fictional "death panels" were a mistake, since -- again -- they don't exist.
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