Two posts today: this, the first, is about the US health reform agenda (the next will be on the Lib Dems’ health policy announcements and the need for drugs. The two are not connected.)

A caucus around Baucus?
The Economist offers an update on the proposed plan from Senator Max Baucus, head of that body’s finance committee.

Baucus has not moved on President Obama’s option of a public insurance option (which will please the extant US insurers), proposing instead an expansion of Medicaid (the insurance for the poorest Americans – apart from those who can afford no coverage) and ‘refundable tax credits’.

The Economist observes that the assumptions used to make the Baucus plan revenue-reducing are heroic ones: that doctors will accept a 25% reduction in payments from Medicare in 2011.

It also quotes Senator Judd Gregg’s quip that “claims of deficit-neutrality is dependent on Congress’ willingness to follow through on painful cuts they have been unwilling to follow through on in the past”.

President Obama did five morning TV show appearances on Sunday to push the health reform agenda. Tonight, he appears on The Late Show With David Letterman.

Political momentum is what is needed here. The Obama administration’s bizarre decision to allow the anti-reform movement to gather such momentum has obviously been recognised for the serious mistake it was, permitting former Republican governor and vice-presidential candidate Sarah Palin’s lies about government death panels to get halfway round the world before the rebuttal got its boots on.

The political momentum will probably be dissipated by the events of the G20 in Pittsburgh. Economic meltdown trumps healthcare reform for news editors. Healthcare reform is a long slog.

But the importance of fixing the US healthcare cost-inflation remains paramount to longer-term economic recovery. Not only for the USA. But that is where it will make most impact.

I was heartened to read this piece from one of my favourite authors in today’s Independent.

Smart Americans have got it already. The very talented Paul Hipp put together this video – N.B. sound required - which tells the story of where the US healthcare system ranks in the WHO rating, and gave me the title quote for today’s blog, a line from Lou Reed’s classic Velvet Underground song ‘Femme Fatale’ – “you’re number 37 – have a look”.

As it stands today, US healthcare is a femme fatale: great-looking; sweet to the rich; and inevitably high-maintenance until she becomes downright bad news.