My Thoughts on Health Care, Part III

What You Need To Know: A Summary For You Lazy Asses

·         I had previously written that I would not support a health insurance bill that had an individual mandate to buy or have health insurance but not provide a public option to go with it.  Lo and behold, that’s what we have in the Senate bill.

·         What troubles me is that, much like the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, this bill appears to provide benefits and make peoples’ lives better, but comes with all kinds of conditions and poison pills that actually set back my ideological and policy goals.

·         If I were a Senator, I would vote Yes on cloture just to get the process moving and get this bill out of the Senate and into conference with the much better House bill.

·         On the question of whether I will actually support the final bill if it’s mostly similar to the Senate bill, as it most likely will be, I am as yet undecided.  My decision will largely hinge on whether I feel the final product will be a real step forward or will be yet another looks-like-a-step-forward-but-really-is-a-step-backward piece of crap like the prescription drug law was.

Back in September I wrote that I could not support a health care bill that would impose individual mandates to have health insurance without providing a government-run public option of some kind.  After a tense standoff with an anti-public option Gang of Four consisting of Senators Joe Lieberman (ID-Conn.), Ben Nelson (D-Neb.), Mary Landrieu (D-La.) and Blanche Lincoln (D-Ark.), the public option in the Senate bill was removed and replaced with a three-part concession to liberals.  The first two parts, a triggered public option and an Office of Personnel Management-overseen mini-exchange of private plans, were largely useless and negligible, but the third part, an actual Medicare buy-in for uninsured 55-64 year olds, was better than what we hoped for – remember, the Medicare buy-in was the best type of public option, as I explained in Part I.

 

Well, as with so many things that are too good, this one turned out to be not true.  Senator Lieberman, who has by now become a de facto Emperor Palpatine, single-handedly seized control of the Senate and had the Medicare buy-in removed, leaving us liberals with… nothing.  No public option or other major expansion in government health insurance in the Senate bill.  That’s unfortunate, as I have stated previously that “I refuse to support any bill that has an individual mandate without a public option.”

 

So now, the question for me is, given the lack of public option or other government health insurance alternative in the Senate bill, and given my previous statement, do I support it or not?

 

I’m approaching this question as a person who, like most Democrats in Congress, opposed the 2003 Medicare Prescription Drug, Improvement, and Modernization Act.  I mapped out my line of thought here (emphasis not in original post):

 

I was thinking about the Medicare prescription drug legislation of 2003 and how most Democrats voted against it, but the few that voted for it were denounced by the left as centrist sell-outs.

 

That legislation provided government subsidies for prescription drugs for Medicare recipients for the first time, so ostensibly it was a step forward, right?  But the left opposed it because it was a step backwards ideologically (the benefit was only available through private plans, so it transferred power from the government to the private industry) and financially (it undermined Medicare’s finances).  In so opposing it, they would have denied prescription drug coverage, however subpar, for millions of seniors.

 

Now we have to look directly at the fact that, at least at face value, this bill, even with no PO and Medicare buy-in, still would subsidize health insurance for millions of people who won’t, don’t, and/or can’t get it right now, as well as enact some badly needed reforms.  At the same time, by locking in a captive market it’s a huge piece of corporate welfare.

 

So, on balance, does this move us forward or backward?  I’m very conflicted on the answer to that question right now.  I loathe so much about the bill, but at the end of the day I can’t deny the possibility that this bill could make life easier for so many people.  We just have to try and figure out if those near-term gains would result in bigger setbacks further down the road.

 

To expand on this, the Medicare prescription drug law provided subsidies for prescription drugs to seniors for the first time, BUT:

 

  1. It did so through private insurance companies
  2. It was not paid for
  3. It had no kind of cost control (most notably, it had a provision preventing the government from bargaining for lower prices)
  4. By giving all the power to drug and insurance companies and no power to government it consolidated the profit-motivated drug and insurance companies’ control over health care and, thus, our lives.  So while it may have appeared to be a step forward, my estimation was that in fact it was a poison pill that would set us back.

 

Now with this Senate health insurance bill, it’s largely looking like the same kind of deal.  People will get subsidies for health insurance – yay! – BUT:

 

  1. It will do so only through private insurance companies
  2. It will be paid for, thank goodness
  3. It has little cost control (most notably, no public option or any other kind of institution exerting downward pressure on costs, prices and rates)
  4. Again, it gives all the power not to our democratically-elected and accountable government, but rather to the same profit-motivated drug and insurance companies that have put and kept us in this mess to begin with and the same ones that make money off of people’s suffering and dying. (Even worse, where the prescription drug benefit was voluntary, this is NOT and you will be forced by law to have/buy private insurance as long as you’re alive and in America.)

So, much like the Medicare drug law, it appears to be a step forward, but it could actually be a poison pill-laced step backwards.  If so, how can I in good conscience oppose the Medicare drug law but support this bill?

 

If I were a Senator, I would vote Yes on cloture just to get the process moving and get this bill out of the Senate and into conference with the much better House bill.

 

However, on the questions of final passage on this bill, and on cloture and final passage on the final bill assuming it will be mostly similar to the Senate bill (and it most likely will be), I am as yet undecided.  My decision will largely hinge on whether the final product will be a real step forward or yet another looks-like-a-step-forward-but-really-is-a-step-backward piece of crap like the prescription drug law was.  To properly make that judgment, I will have to compare the Senate health insurance bill and the status quo with the prescription drug law and its status quo.

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