Thursday, December 17, 2009

Where is health care reform heading? (Updated 12/19 below)

I'd like to personally chastise the people of Connecticut for electing Joe Lieberman as their US senator, allowing him to gum up the works on health care reform and to generally be a gadfly to the Democrats he claims to be affiliated with. Lieberman is an dullard who seems to enjoy being swayed by both sides as the potential 60th Democratic vote on any issue. Some people are just idiots, but what can you say about a state that sends such a man to Congress?

Meanwhile, Sen. Bernie Sanders of Vermont introduced an amendment yesterday that would extend Medicare benefits to all Americans, effectively bringing a single-payer system to the US, as the good people of Canada, the UK, Australia and elsewhere already have. This is the route that I would like reform to take. However, even though the amendment had no chance of passing, a Republican senator asked that the 787-page proposal be read aloud in its entirety, something rare in a house of Congress, where big bills are often considered. This was clearly a move to slow down the whole health care debate and Sanders eventually withdrew his amendment -- which presumably delighted the Senate clerks who otherwise would be reading it for some ten hours.

And now, in today's Washington Post, Howard Dean -- former DNC chairman and presidential candidate -- writes that the current Senate health care proposal, stripped of a public option and a Medicare buy-in, would "do more harm than good to the future of America." Oh boy. What is a committed liberal to make of all this?

Update (12/19): Paul Krugman, writing in yesterday's New York Times, advocates passage of the current health care bill before the Senate, no matter how flawed it might be.

At its core, the bill would do two things. First, it would prohibit discrimination by insurance companies on the basis of medical condition or history: Americans could no longer be denied health insurance because of a pre-existing condition, or have their insurance canceled when they get sick. Second, the bill would provide substantial financial aid to those who don’t get insurance through their employers, as well as tax breaks for small employers that do provide insurance.

All of this would be paid for in large part with the first serious effort ever to rein in rising health care costs.

The result would be a huge increase in the availability and affordability of health insurance, with more than 30 million Americans gaining coverage, and premiums for lower-income and lower-middle-income Americans falling dramatically.
Krugman goes on to write: "Look, I understand the anger here: supporting this weakened bill feels like giving in to blackmail — because it is." But an imperfect bill is better than no bill, the Nobel Prize-winner reasons, noting that Democrats failed to compromise on the issue with President Nixon and that President Clinton wouldn't compromise with moderate Republicans in Congress and, on both occasions, the outcome was no reform at all.

The final peg of Krugman's rationale is that social programs have often started as imperfect bills that get fixed along the way, with Social Security a prime example. So, he says, let's get it done. And I agree.


Eric Bradley said...

Follow the empirical evidence. Being committed to an abstract ideal of health reform with little regard for the concrete problems its application creates is a sure sign of ideology.

Just because some on the left are wary of the proposed legislation doesn't make them traitors to the cause. In Dean's case, he's afraid that the proposed reform will further empower insurers; before we call him a sellout, shouldn't we find out IF HE'S RIGHT? If he is, isn't it good that he's speaking up?

Or what about the other Democrats who are afraid that the entire thing will just inflate costs, create an unnecessary bureaucracy, and lower the overall standard of health care in this country? If they're right, they're not traitors to the left - they're heroes. And if they're wrong, at least they were trying to PROTECT vulnerable Americans, even if they were misguided.

James said...

Is anyone questioning Lieberman's competency? In September he proposed expanding Medicare to 55 and after the Dem leadership agreed last week, he now not only opposes expanision, but he says he will fillibuster!

How is anyone taking him seriously at this point? Either he is completely owned by the insurance companies in Hartford or he is mentally incompetent. Either way, he should not be a US Senator.

And can you believe that a few years ago he was the Dem VP nominee!

N.starluna said...

If there was real concern about the costs, then they would not have gotten rid of the public option or the Medicare buy in. The individual mandate coupled with the prohibition of pre-existing coverage exclusions and similar rules will only increase costs. If we are not going to go in the single payer direction, there needs to be a mechanism to increase real competition within the insurance industry. Or we need to put people into large pools with enough leverage to bargain with the insurers.

I do not believe Lieberman has an ideological bone in his body. I think he is a media whore.

James said...

Costs are totally going up, just like they have in MA after we passed our plan a few years ago. The very fact this bill eliminates pre-existing conditions is going to require insurance companies to charge more to the healthy in order to pay for the sick.

The subsidies in the MA plan are only for the very poor and middle income folks who are seeing their salaries decrease and health care costs rise, don't get any relief.

Unless someone can tell me otheriwse, I think this national plan is replicating the MA model. If this is the case, then I cannot support the bill. Without a strong public option, the insurance companies will soak the middle class.

And while I'm on the subject, why don't we just scrap this entire bill and introduce a bill that simply allows anyone at any age to buy into Medicare? I came to really like the idea of early buy-in and now feel we missed a window to actually get a framework for single payer.