The House Bill Is "Worse Than Nothing"? Really?

[babylonsister]

http://www.tnr.com/blog/the-house-bill-worse-nothing-really


The House Bill Is "Worse Than Nothing"? Really?
Jonathan Cohn


snip//

Angell is a well-known advocate for single-payer health care: If it were up to her, she'd simply expand Medicare to cover everybody. This is not, of course, the kind of health care reform we're going to get this year. Instead, we will--if we are lucky--get something that looks like the bill that passed the House of Representatives on Saturday night.

snip//

Perhaps Angell and those who agree with her that this would be a constructive failure--that eventually growing frustration with our health care system will help us elect even more progressives and pass more ambitious reforms. Well, maybe. But that's an awfully big chance to take. Progressives said the same thing when the Clinton health care plan failed and, before that, when efforts to pass universal coverage under President Richard Nixon collapsed. If anything, the conversation about health care reform has drifted the opposite direction over that span of time. You could plausibly claim that the reforms on the table today are more or less what moderate Republicans were proposing under Clinton, just as the Clinton reforms were not that far removed from what Nixon himself wanted in the early 70s.

And what would happen in the meantime? According to the Congressional Budget Office, the House bill would mean about 36 milion people get health insurance, reducing the number of uninsured by around two-thirds. People who had pre-existing medication conditions would, finally, have the ability to get insurance just like the employees of large companies do. The insurance would not always be as generous as it should be, but the government would prohibit lifetime caps, place some limits on out-of-pocket spending, and establish a basic benefits package that makes sure all policies cover a broad range of services.

The studies--which, I know, Angell has seen--suggests millions of people die or go bankrupt every year because they can't afford to pay their medical bills. Countless more suffer. The House bill wouldn't stop such hardship altogether. But it would reduce it significantly--arguably, by as much as any single piece of domestic legislation since the Great Society. Surely that qualifies as something more than "a few improvements around the edges."

The House bill would do many other things, too, familiar to the readers of this space--from the creation of a public plan to the creation of pilot programs that would begin to change the way we deliver medical care. And while it wouldn't do nearly enough to make health care less expensive--the drug industry, among others, remains a source of untapped savings--the House bill certainly wouldn't cause the cost of medicine to go up even more quickly. If anything, it'll cause the cost to go up a bit more slowly.

As I've argued repeatedly, the House bill is not close to perfect. Neither is its Senate counterpart. But we don't pass perfect laws in the U.S. We pass imperfect ones and then do our very best to improve them over time.

It happened that way with Social Security and Medicare. It can happen that way with comprehensive health care reform, too. But only if we do something, rather than nothing.

[Aramchek]

1. Obama will sign HCR with a Public Option into law. And the People will always remember him for it.

[babylonsister]

11. From your lips. Lots of drama to go, for both factions of DU!

:fistbump:

[ShortnFiery]

17. They'll remember him as a lackluster - centrist President who only served ONE TERM. n/t

[dionysus]

19. we know that's what you want, but that's not gonna happen.

[kestrel91316]

2. How does that saying go, something about the perfect being

the enemy of the good??

Half a loaf is always better than none, and right now too many cupboards haven't even a crumb.

[Cha]

3. Thanks, I feel like I'm..

er, we're a part of history in the making like when Social Security was just getting started and it's going to be so helpful to me next year!

Thank Goodness for those with Vision.

[FrenchieCat]

4. Naw, let's do nothing! We'll show those Insurance Companies a thing or two!

What, the Insurance companies don't want any stinkin' bill passed
and would love for this bill to stall and not pass?

[Laelth]

5. It is worse than nothing. California will pass single-payer in 2011.

All they need is a Democratic Governor. The legislature has already passed the bill. Schwarzenegger vetoed it. Once California has single-payer, most (if not all) states will follow suit.

It's likely that if we pass a new law now, the new law will preempt single-payer, i.e. the Federal law will preempt state law and prevent states from enacting a single-payer system.

THIS is what the health insurance companies fear. THIS is what brought them to the bargaining table. THIS is why they are not fighting Obama's tepid reforms, and THIS is why it is extremely important that we do not pass any health insurance reform bill this year.

Let's not settle for a bail-out of the health insurance industry. Let's insist on the eradication of it. In all likelihood, California will lead the way in 2011 ... if we can just give them time.

:dem:

-Laelth

[babylonsister]

8. If, if, if. CA is primarily liberal. The whole country isn't. nt

[rockymountaindem]

15. Yes, but if California enacts single-payer, that will be a serious blow to private insurers

because of the massive size of the California population and economy. It would also potentially demonstrate the benefits of single-payer to the rest of the country. That is, after all, how single-payer gained a foothold in Canada with its adoption in Saskatchewan.

[Cha]

10. No, it's not and so many respectable people agree.

[rhiannon55]

6. Very well put

He makes some excellent points.

[FourScore]

7. I agree wholeheartedly. n/t k/r

[Window]

9. K/R. n/t

[Cha]

12. Another

kick for prosperity~

[babylonsister]

13. Where are all those 'cooler heads' that think the whole HCR is bunk?

We should wait? yadayadayada? Nothing?

Got nothing to add? Say? Dispute?

[Armstead]

18. Why bother?

Some of us think we're screwing the pooch with this, and further entrenching an inherently bad system by further embedding the private insurers, and forcing people to buy overpriced private insurance while having a weak useless "public option."

I acknowledge there are some good things in the proposals. However, there are also poison pills.

Personally, I think if Obama and Congress were not planning to make any meaningful structural changes (either single payer or at least a strong voluntary Medicare for all who want it) then they should have kept a tighter focus on the useful and modest aspects (like no denial for pre existing conditions) rather than this Rube Goldberg contraption.

But those who feel otherwise are equally entrenched in the belief that anything is fine as long as it's called reform and comes from the Democrats.

We go back and forth in full Democratic Primary mode substituting personal insults for reasoned debate or civil disagreement, and we alienate each other in the process.

Ultimately, the Congress and Obama will do what they do, and time will tell whether it turns out to be historic and wonderful or meaningless or destructive.

[geek tragedy]

14. The important thing to keep in mind is that the "it's worse than doing nothing"

people have virtually no pull on Capitol Hill. None. So, while they may be aggravating in the noise they make, they're ultimately irrelevant and therefore harmless.

[dionysus]

20. but they can sure throw a good tantrum on teh interwebs.

[geek tragedy]

22. As I said, they're good at aggravating.

Notsomuch at achieving policy goals.

[ShortnFiery]

16. Yes, really! Have you read all the "Grandfather Clauses?" It's WORSE than nothing. n/t

[TwilightGardener]

21. I assume that anyone who feels that it's worse than nothing either has the luxury of

current insurance coverage, or is perfectly healthy and insurable, and therefore can wait for the perfect bill. Those for whom the bill was intended--people with no access to insurance or who have pre-existing conditions, actually want it to pass.

[SpartanDem]

23. History has proven the wait for something better crowd wrong

you all see these people saying that it will only take a couple more years, when it's taken a decade or more us to attempt reform again after it fails.