Health policy analysts are at risk of neglecting the issue that will more profoundly influence health policy than all of those now absorbing their attention: whether tax increases form a major part of any program to curb future federal budget deficits.
The health reform debate is not about a fictional war between market-based health insurance and government regulation. It is about whether to provide adequate subsidies to cover the uninsured and whether to begin a process of leveraging change in the delivery and payment systems through which one-sixth of the U.S. economy is devoted to health care.
The health care reform discussion is beginning-at last!-to get real. On June 9, the Senate Health, Education, Labor, and Pensions Committee released a draft bill, and the Congressional Budget Office published an estimate that the bill would cost $1 trillion over 10 years and leave 35 million uninsured.