Wondering what happens if healthcare reform doesn’t pass?

At this point no one knows what the future of healthcare reform is. On the one hand, the President seems as committed as ever to passing a bill, however imperfect, and preferably soon; on the other hand, the President’s advisers insist that reform “can wait a while,” which surely represents the death knell for any meaningful bill. Either way, the price of not acting is pretty high.

The Urban Institute and the Centers for Medicare and Medicaid Services have run some numbers on what healthcare in America will look like by the end of this decade if the status quo is maintained. (And make no mistake, the Republicans obstructing the bill in Congress prefer the status quo to any reform proposals currently on the table. If they take back either House of Congress in 2010, or the presidency in 2012, healthcare reform will be completely and utterly dead.) Their findings, and more, are discussed at length in an excellent piece by David Wessel in, of all places, The Wall Street Journal. Here’s what they project:

- The percentage of national GDP (a.k.a. national wealth) spent on healthcare will jump from 17.3 percent in 2009 to 19.3 percent in 2019. So that’s an extra two dollars for every hundred spent that we, as a society, will be spending on healthcare within the next ten years. In case those numbers need to be driven home, think of however much you spend on healthcare now. Then add to that amount $2 for every $100 you earn.
- The percentage of uninsured people will rise from 18.4 percent to 20.1 percent of the population. Yes, one in five citizens of the wealthiest, most powerful country in the history of the world will be without health insurance, and most of that increase will come from middle-class adults, not poor people or children (or seniors).
- That’s because the poor (especially children) and seniors have public options (familiar phrase, eh?) like Medicaid and Medicare. The percentage of poor people and children receiving public healthcare will rise from 16.5 to 18.3 percent. Even more frightening – the total amount the federal government spends on Medicare and Medicaid combined will increase from about $725 billion to $950 billion by 2014. That’s a 30 percent increase in less than five years, and we, the taxpayers, will be on the hook for that. Remember that Republicans hate voting for taxes, so that extra $225 billion or so will likely just be added to the deficit if the GOP controls Congress and/or the White House. (Also remember that that increase is only between now and 2014; it will keep going up, probably at faster rates, after 2014 if the status quo is maintained.)

I don’t need to tell you, Dear Reader, that the reform proposals put forward by the Democrats in Congress (take your pick between either House’s version, since either one is preferable to the scenario I’ve just outlined above) would bring down the rapidly rising cost of healthcare, cover somewhere between 60 and 70 percent of the uninsured (click that link and then select "Coverage"), and reduce the federal deficit by over $100 billion (click on "Cost" and then "Net decrease in the Deficit") over the next decade. No, I doubt I need to tell you any of those things, but someone sure as hell needs to tell the Democrats in Congress.

Ezra Klein has a great piece in his blog (which I recommend everybody read on a daily basis) on how the problem lies not with the Democrats’ ability to pass healthcare reform – reconciliation, overcoming a filibuster, etc. – but with their will to do it. I’ll let Ezra have the last word on this one, since he’s better at this than I am:

If 51 Democratic senators and 218 Democratic congresspeople are dead-serious about passing a bill, they can, and will, pass a bill. ... Democrats can pass this if they want to. The project now is not learning the Senate rules but steeling Democratic spines. … This is the closest this country has ever gotten to passing a universal health-care bill, and a critical mass of congressional Democrats have chosen this as the moment to freeze up. They need to be slapped back to reality.

Let the slapping begin.