This author follows with some good reform proposals of her own.Conservative rhetoric notwithstanding, the House bill is not a "government takeover." I wish it were. Instead, it enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)
Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?
First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.
On Saturday, November 8 the Democrat Congress gave us a corporate driven healthcare bill which amounts to nothing more than a de facto bailout of the healthcare insurance companies. The carnival conducted by the Democrats, masquerading as a debate around healthcare, demonstrates conclusively how craven are Barack Obama and the Congressional Democrats....
Here we have a health care bill which will not only drive up insurance costs but will not even permit the government to negotiate with pharmaceutical companies, thereby driving up pharmaceutical costs as well! The Congressional Budget Office (CBO) estimates that only 2% of Americans will be able to participate in this plan while 33% of Americans will remain either uninsured or underinsured. The bill even was stripped of the Kucinich amendment which would have permitted states to develop their own single-payer options. Americans will now be forced to buy health care plans from private insurance corporations. Forced!
Even a little arithmetic indicates what a horror show this nasty piece of legislation creates. Imagine a family at roughly 300% of poverty -- around $55,000 a year. It will cost them in the neighborhood of $15,000 in taxes, $14,000 in mortgage or rent; close to $20,000 on childcare and they'll need around $7,000 for food. That puts them in debt already! Now they will be forced to buy health care -- forced! Under penalty of law! Even with government subsidies they will still be in debt! (There is not enough money in the bill to subsidize all the people who will need it). Now imagine a medical catastrophe. Even if caps are eliminated this family will be deeper in debt as the insurance companies increase their profits!
But wait! It gets better – worse if you please. The Congressional Budget Office also explained that one of the other reasons why so few people would be able to buy into this plan is that it "would typically have premiums that are somewhat higher than the average premiums for the private plans." Yes, you read that correctly: "premiums that are somewhat higher".
What about those people who don't get coverage through their jobs or who have their health insurance dropped at work because there will now be an incentive to dump benefits? History already provides us the answer to that question. Most of the adults who tried to buy insurance on the open market never bought a plan because they could not afford it or they could not find a plan that met their needs. Now the prices will be higher! What a choice: buy insurance coverage or pay a penalty of hundreds or even thousands of dollars per family if they decide to forgo insurance....
The Senate version of health care reform is even more draconian than the House version but the real hero of this tragedy, Joe Lieberman, promises to join a Republican filibuster! The independent senator from Connecticut, hated by liberal Democrats may yet save us! The senator told "Fox News Sunday" today that Democrats can certainly count him in the "no" column if they keep in a government-backed insurance plan. "If the public option is in there as a matter of conscience, I will not allow this bill to come to a final vote," signaling as he has before that he would back a Republican filibuster -- which Democrats need 60 votes to break....
We may not like Joe Lieberman and Max Baucus but ironically we may be in their debt if they join the filibuster to block this anti-working class, corporate welfare legislation.
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