Shrewd Politics or Good Health Care--Vision Care?

"It’s shrewd politics, but is it good policy?" That's the question asked on the op-ed page of the Columbus Dispatch regarding Secretary of Health and Human Service Kathleen Sebelius's new policy. "Administration officials make three arguments. First, the president has emphasized that the act is a federal-state partnership; delegating these choices to states reflects that. Second, basing a state’s essential health benefits on its existing insurance plans would minimize disruption. And finally, priorities vary by states. 'Coverage that works in Florida may not work in Nebraska,' said Sebelius. To which, there are reasonable objections. Medicare is national. The uniformity allows economies of scale. If Medicare, hypothetically, varied by state, its already huge costs almost certainly would be higher. The advantages of using existing plans also may be exaggerated, because the act mandates that some benefits not routinely included in most plans — eye care and dentistry for children, and mental health and substance abuse — be covered." Read more.