Why wait till 2013?
Because that was the only way to minimize the cost of the bill in order to pass it (rescinded tax cuts will be a big boon), and it is the time needed to set up the programs, including a PO and the exchange, without screwing it up (which if went wrong because it was being rushed, would give fodder
to Republicans)
It is impossible to put this kind of infrastructure in place on short notice without causing tremendous disruption to our health care system. I know because I have lived through four years of disruption caused by an attempt to consolidate behavioral health services, previously administered by seventeen agencies, into a single, privatized system under a single statewide entity. After three years of chaos, the state fired the insurance company managing the services. We are now starting over with another. Billing and claims systems don't work. Most providers have not yet been paid for their services.
Granted, I am convinced that for-profit insurance is unethical. Nevertheless, the arrangement might conceivably have worked more effectively if we had allowed sufficient start up time.
We cannot afford a national health care reform debacle.....it makes sense to allow the federal government time to put functional systems in place.
http://www.dailykos.com/story/2009/10/20/795135/-Why-is-the-Health-Reform-Start-Date-2013 If the House bill becomes law, it would become illegal in 2010 for insurance companies to rescind existing health insurance policies to avoid paying for an enrollee's health needs. Funding for community health centers and preventive services would also increase, and a health benefits advisory committee would be established that would come up with an "essential benefits" baseline that must be part of any insurance package offered in a health insurance exchange.
Under the bill approved by the Senate Health, Education, Labor and Pensions Committee, discrimination against consumers with pre-existing medical conditions would become illegal upon the bill's signing, as would capping lifetime insurance coverage.
http://www.cleveland.com/medical/index.ssf/2009/09/health_care_reform_bills_inclu.html"I understand that the politically safe move would be to kick the can further down the road -- to defer reform one more year, or one more election, or one more term. But that is not what the moment calls for. That's not what we came here to do. We did not come here to fear the future. We came here to shape it. I still believe we can act even when it's hard." - Pres. Barack Obama
And even if some want perfection or nothing.....
Saying you want stuff and you want it as you'd imagine it is what's easy,
getting anything meaningful passed in the current political climate
is what is difficult.
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