First there was Medicare for all 300 million of us. But that was a non-starter because private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it was too much like what they have up in Canada -- which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)There you have it. That portion I've highlighted in blue is addressed directly to me.
So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.
So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.
So the compromise that ended up in the House bill is to have a mere public option, open only to the 6 million Americans not otherwise covered. The Congressional Budget Office warns this shrunken public option will have no real bargaining leverage and would attract mainly people who need lots of medical care to begin with. So it will actually cost more than it saves.
But even the House's shrunken and costly little public option is too much for private insurers, Big Pharma, Republicans, and "centrists" in the Senate. So Harry Reid has proposed an even tinier public option, which states can decide not to offer their citizens. According to the CBO, it would attract no more than 4 million Americans.
It's a token public option, an ersatz public option, a fleeting gesture toward the idea of a public option, so small and desiccated as to be barely worth mentioning except for the fact that it still (gasp) contains the word "public."
And yet Joe Lieberman and Ben Nelson mumble darkly that they may not even vote to allow debate on the floor of the Senate about the bill if it contains this paltry public option. And Republicans predict a "holy war."
But what more can possibly be compromised? Take away the word "public?" Make it available to only twelve people?
Our private, for-profit health insurance system, designed to fatten the profits of private health insurers and Big Pharma, is about to be turned over to ... our private, for-profit health care system. Except that now private health insurers and Big Pharma will be getting some 30 million additional customers, paid for by the rest of us.
Upbeat policy wonks and political spinners who tend to see only portions of cups that are full will point out some good things: no pre-existing conditions, insurance exchanges, 30 million more Americans covered. But in reality, the cup is 90 percent empty. Most of us will remain stuck with little or no choice -- dependent on private insurers who care only about the bottom line, who deny our claims, who charge us more and more for co-payments and deductibles, who bury us in forms, who don't take our calls.
I'm still not giving up. I want every Senator who's not in the pocket of the private insurers or Big Pharma to introduce and vote for a "Ted Kennedy Medicare for All" amendment to whatever bill Reid takes to the floor. And if this fails, a "Ted Kennedy Real Public Option for All" amendment. Let every Senate Democratic who doesn't have the guts to vote for either of them be known and counted.
I'm rethinking my "better than nothing" stance, especially as we learn how long it will take for even these meager changes to be put in place. Would we be better to wait for a more liberal Congress after 2012 and start over? Most political analysts are saying that, without passing health care reform, Democrats are doomed to lose big time. So that doesn't seem an option.
Gloom.
Ralph
Anything's better than nothing. And revisiting a public option is always a "public option" in a Democracy. Why it could even bea campaign slogan for a future election!
ReplyDelete[As you can see, I'm having a 'hope' 'yes we can' day. They still come along occasionally.]
Please stay positive, Mickey. I feel like we're sinking in quicksand. The public option, even as weak as it is, won't even kick in until 2014 -- that's past the next presidential election.
ReplyDeleteAnd if they have to water it down further to get Lieberman, Landreau, Lincoln, and Nelson to make up the 60 to bring it to a vote, then it will be even less good.
Howard Dean says the choice is now between a bad bill and no bill -- either one is not good. So he's suggesting going back to the reconciliation route to passage. At least we could have a slightly better bill.
Anything is NOT better than nothing.
ReplyDeleteApply that logic to Iraq under Bush. If Bush had decided to invade with 10% fewer forces than he had initialled planned, would progressives have said, Anything is better than nothing?
If we support this cup that is 90% empty, that will be the only healthcare reform we will see in our lifetime. I think you can make a strong argument that those who truly care for healthcare reform should 'Just say No' to this horribly compromised legislation and hope that we can mobilize enough people to fight for legitimate reform.
Reich says (much more eloquently than I was capable of expressing) what I've been saying all along on this blog.
It's time for progressives to stand up and act like progressives. Why are we compromising just because we happened to vote for someone who seems addicted to compromising?
The failure to enact legitmate reform lies with the Democrats, in Congress and in the White House. Yes, the Republicans are obstructionists, but there werre enough elected Democrats to overcome that - if we had any leadership at all from anywhere. Even Pelosi caved in.
I think it's time to remove the rose-colored glasses. I love Obama as a person, but what has he wrought as a president? Has he shown any leadership for his party? He was the one who undercut helathcare reform by cutting deals tih Big Pharma, the AMA,and insurance companies. He allowed his man, Geitner, free reign and Geitner has clearly botched the stimulus plan(I remember an early quote from Chris Matthews - Geitner is a boy among men).
Is there any reason to believe he won't make the wrong decision in Afghanistan - where the only legitimate position is withdrawal?
You can't be a liberal or progressive and willingly embrace conservative, at best moderate, policy.
Walk the walk, or don't talk the talk.
richard
And one more thing.
ReplyDeleteThe situation became this dire because people who supported Obama didn't want to face the truth of what was happening. We wanted to pretend reform wasn't derailed. We wanted to believe. We wanted to hope.
If we'd all been vigilant early, and came out and pressed him to honor his campaign promises,if we showed the same ardor for our positions as the tea party crowd showed for theirs, instead of keeping our mouths shut and hoping the 'process' would work, there was something going on behind the scenes we didn't know about, surely we wouldn't be let dow - it may never have reached this sorry point.
richard