Wednesday, December 16, 2009

Don't Give Up On Health Care Now

I am extremely disillusioned with the shape the healthcare bill has taken, but I'm not willing to say it shouldn't pass and/or we should start over. I'll let Kevin Drum speak for me. He makes a compelling argument for seeing this bill through.
With the public option now out of the healthcare bill, is it still worth passing? Regular readers will be unsurprised that I think the answer is pretty firmly yes—and that liberals who now want to pick up their toys and hand reform its sixth defeat in the past century need to wake up and smell the decaf. Politics sucks. It always has. But the bill in front of us—messy, incomplete, and replete with bribes to every interest group imaginable—is still well worth passing.
Six defeats. Think about that. More from Kevin:
When big legislative efforts go down in flames, they almost never spring back onto the calendar anytime soon — and that's especially true when big healthcare bills fail. It didn't happen in 1936, it didn't happen in 1949, it didn't happen in 1974, and it didn't happen in 1995. What makes anyone think it will happen in 2010?
Drum also makes the point that if healthcare reform dies this year, it dies for a good long time, and Republicans know it. And even though it's not the bill we wanted, it's a good start. Via Ezra Klein:
"This is a good bill," Sen. Sherrod Brown said on Countdown last night. "Not a great bill, but a good bill." That's about right. But the other piece to remember is that more than it's a good bill, it's a good start. With $900 billion in subsidies already in place, it's easier to add another hundred billion later, if we need it, than it would be to pass $1 trillion in subsidies in 2011. With the exchanges built and private insurers unable to hold down costs, it's easier to argue for adding a strong public option to the market than it was before we'd tried regulation and a new competitive structure. With 95 percent of the country covered, it's easier to go the final 5 percent. And with a health-care reform bill actually passed, it's easier to convince legislators that passing such bills is possible.
Here's some other things we'll be getting:
  • Insurers have to take all comers. They can't turn you down for a preexisting condition or cut you off after you get sick.

  • Community rating. Within a few broad classes, everyone gets charged the same amount for insurance.

  • Individual mandate. I know a lot of liberals hate this, but how is it different from a tax? And its purpose is sound: it keeps the insurance pool broad and insurance rates down.

  • A significant expansion of Medicaid.

  • Subsidies for low and middle income workers that keeps premium costs under 10% of income.

  • Limits on ER charges to low-income uninsured emergency patients.

  • Caps on out-of-pocket expenses.

  • A broad range of cost-containment measures.

  • A dedicated revenue stream to support all this.
  • Drum is right. This is still a huge achievement, one that will benefit tens of millions of people in very concrete ways and will do it without expanding our long-term deficit. And he also points out "this is more than Bill Clinton ever did, more than Teddy Kennedy did, more than LBJ did, more than Truman did, and more than FDR did."

    Don't throw in the towel now.


    abi said...

    I'm more than discouraged about this so-called "reform," Kathy. Reform would mean we were changing the fundamental structure of the system, but we're not. This plan reinforces the inefficient and expensive for-profit, multi-payer system we've always had, and doesn't even allow for a weak public option to compete with it, never mind a robust one.

    But it does offer regulation, albeit weak regulation. I disagree with some of the regulation Drum points out - for example, I believe the senate version allows for yearly caps - but until the dust settles and an actual bill is written, it's hard to tell. And I'm still unclear about what the Medicare cuts involve.

    At this point, I'm feeling pretty well beaten down on health care. All I ask of our in-the-pockets-of-the-lobbyists Democrats is that they call the bill what it is - health insurance regulation, and weak regulation at that - and not pretend that it's reform.

    Kathy said...

    Hi Abi, I agree with you completely, this bill is health insurance regulation, but it will provide subsidies to help people buy insurance and it will cover millions of people who wouldn't have had health care otherwise.

    It's not what I wanted either, but the system is so rigged in Washington that it's the best we can hope for at this time. I'm just trying to stay focused on the goal: Insuring the uninsured (or at least a majority of the uninsured). Living in Michigan where jobs and insurance are scarce commodities these days, I know several people who will benefit from this bill - flawed as it is.

    (Hope all is well with you and your family. The auto woes caught up with my husband and he lost his job a couple of months ago.)

    abi said...

    Kathy, I'm sorry to hear about your husband. I hope he's keeping his spirits up, and finds work soon. I wish you and your family all the best in 2010...

    And yes, you're right about the Senate bill - it will help some people. But it's disheartening to think that this was the best we could come up with.

    Kathy said...

    Abi, I'm sorry, I should have asked how your job search was going. Did you find anything? There's not much demand for 50-60 year old workers in our area, but my husband is hoping that he might be able to land a long-term contract position.

    Sigh...I seem to be saying "something is better than nothing" quite a bit lately. :-(

    You need to get back to blogging so the world can keep in touch with you, although you probably have had too much of most of the world if you're like me.

    All the best to you and your wife in 2010 too.

    abi said...

    Thanks for asking. Yes, I did find a job, but at a salary level I was making 10 years ago. And all the hours I'm required to work is pretty much why I haven't posted anything on the blog.

    I'm not really complaining, tho. I know how lucky I am to have found a job at all. Like you say - better than nothing. ;-)