So far, health care reform nothing but words

Luis Fábregas
| Monday, March 18, 2013, 10:29 a.m.

Let's forget for a minute about Beyonce's not-so-live national anthem performance at this week's inauguration ceremony. Forget, too, about the first lady's bangs and Sasha Obama's big yawn during her father's inaugural speech.

Let's talk about the part of President Obama's speech that few people apparently noticed. Five minutes into his address at the U.S. Capitol, the president mentioned health care.

“We, the people, still believe that every citizen deserves a basic measure of security and dignity,” Obama said. “We must make the hard choices to reduce the cost of health care and the size of our deficit.”

With those words, Obama touched on what could be one of the most crucial challenges of his second term: implementing the much-debated Affordable Care Act. The law, often referred to as Obamacare, weathered an unpleasant showdown in the Supreme Court with a narrow 5-4 victory.

The law's most controversial component — requiring most Americans to carry health insurance or face a penalty — takes effect in about 11 months. A lot needs to happen before that, including the creation of online health insurance marketplaces to allow people to sign up for insurance.

Expect a lot of action in coming months, and a lot of headaches. Though some of the law's provisions are in effect, the marketplaces are anything but done. Pennsylvania is among 28 states that rejected creating its own marketplace, until recently known as exchanges.

Gov. Tom Corbett, a Republican, said it would be irresponsible to put state residents on the hook for the millions of dollars it would cost. The federal government has about eight months to put these systems in place. Can you hear the clock ticking?

Obama never directly addressed the health care law in his speech. He mentioned Medicare and Medicaid fleetingly, to remind us that “they free us to take the risks that make this country great.”

Obama's speech didn't exactly require an in-depth analysis on health care. He had me at “the cost of health care.”

There was no need for him to remind us that we spend trillions every year on health care and manage to have one of the most ineffective systems in the world.

There was no need to remind us that we can no longer afford a health care system that rewards quantity, not quality. There was no need to remind us that we have a health care system that thrives on treating the sick instead of emphasizing prevention. There was no need to remind us that it's a system that lacks transparency and it's almost impossible to find out how much a simple lab test might cost.

More than words from the president, what we need is action. If our health care system remains unchanged by the time he leaves office in 2017, can his health care law truly be considered successful?

If prices of other products grew as fast as health care since World War II, we'd be paying $48 for a gallon of milk and $55 for a dozen eggs, according to the Institute of Medicine.

It sounds absurd until you realize that the bleeding of health care dollars — as the Tribune-Review showed last year with its “Code Green: Bleeding Dollars” investigative series (read online at — is even more absurd. And it's going to take more than just a powerful speech to fix the problem.

Luis Fábregas is a staff writer for Trib Total Media. Contact him at 412 -320-7998 or

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