A few final thoughts on all the Health Reform things

First, I want to harken back to one of my previous posts. The bills I do not think address a key matter, and that is migrants under the Compact of Free Association (COFA). The Compact allows us to use certain Pacific islands for military purposes (many of which were U.S. trust territories, and which we used for military bases and nuclear tests back in the day). As a result, citizens of these countries can migrate freely into the U.S. It is as if they are granted automatic permanent residency status.

However, as part of welfare reform in the 1990s, they cannot receive federal aid. Instead, to cover things up, there is a block grant that is woefully insufficient. These are often sick individuals, and those from bombed out areas often can have radiation related disorders. However, states often bear the brunt of this, and yes, my old state, Hawaii, has a disproportionate amount of these individuals.


I am hopeful that as markup occurs on this bill that pushes towards including Compact Migrants in the more federalized Medicaid program, and includes them in the exchanges and subsidies.


Second, I wanted to show off some graphics/flowcharts. Thanks to Ezra Klein.


(NB: You will probably need to open the post to really see the graphics in their full glory).


Shockingly the Republicans have had some scare tactics. Here's the chart of the House Democrats plans:

It does look a bit scary.


However, Jon Cohn and company made a lovely graph as well. It represents our current system.

It is even more messed up and scary.


But more frightening is House Republican's graph:







What the hell do they want? Consumer directed health care? The RAND Insurance Experiment discredited that, saying people stopped using the cheaper services, and saw detrimental effects to their health.


All told, these charts represent some fundamental truth. Health care is big and scary. And it will always be messy. The question is does all the messiness produce outcomes we want.