It looks like we are moving toward the passage of historic healthcare legislation. What this means for us now and for our future remains to be seen, but the fact that this is getting done after so many decades of trying should be celebrated if and when it happens. The arguments against this bill have in large part keep us stuck in place in terms of providing affordable healthcare to as many citizens as possible. In effect, our inability to make big and important changes and govern ourselves is tied up in how we aren’t able to rationally address this central life and death issue. Ezra Klein is the expert we turn to for insight on healthcare reform. He has linked a must read article from the Common Wealth Fund titled “The Costs of Failure: Economic Consequences of Failure to Enact Nixon, Carter, and Clinton Health Reforms.” Here is an excerpt from that article:

Ever-higher health spending has directly contributed to stagnating incomes and rising health insurance premiums for middle-class families and workers. Commonwealth Fund analysis has shown that premiums have risen from 11 percent of family income in 1999 to 18 percent in 2009. If current trends continue, average family premiums will reach 24 percent of median income by 2020.

Rising health care costs–and the subsequent rise in health insurance premiums–have fueled an increase in the number of Americans without insurance over the past three decades. Nearly 50 million Americans are expected to be uninsured in 2010. Cost growth also has placed enormous pressure on employers’ ability to provide comprehensive benefits, leading many to shift to less generous policies or drop coverage altogether. Employees of small businesses, which are much less likely to offer coverage, are at particularly high risk.

It is difficult to estimate with precision what would have happened had proposed reforms been enacted. Still, it is instructive to consider where we would be today if those efforts had succeeded. Each included provisions designed to provide health insurance coverage for all.5 Each set out regulatory restraints on the growth in provider payment or insurance premiums, or both. All had significant mechanisms to control costs, including changing provider payment, increasing competition in the insurance market, and controlling the growth in private insurance premiums.

Exhibit 1 shows the growth in national health expenditures as a percentage of GDP and what we would have spent as a nation if effective measures to slow the growth in health expenditures by 1.5 percentage points a year had been adopted in 1975, 1980, and 1995. In 1960, we spent 5.2 percent of GDP on health care, compared with the 3.8 percent of GDP median rate in all major industrialized nations. Today, we spend 17.7 percent—nearly twice the rate of 9 percent that is devoted to health care in other industrialized countries.