A Bad Bill Is Worse Than No Bill At All - Part II
Commentary By Ron Beasley
A few days ago I wrote A Bad Bill Is Worse Than No Bill At All.
I remain convinced that there was never any possibility of a health care reform bill that actually reformed anything. Obama just wants a bill - he really doesn't care what's in it. This is not only wrong but politically stupid, more about that later. As lawmakers do they just want it to look like they did something without pissing off any of their sugar daddies. They first thing that made any possibility of meaningful reform impossible was the concentration on the insurance side while ignoring The Medical Industrial Complex. The reality is the only way to reduce costs is to do one of the things that the insurance industry is criticized for doing - not approving procedures, tests and medications that don't have any real value to the patient.
Well a bad bill with a few good points is just what we got. Just as expected this bill sorta goes after the insurance industry without "reforming" any of the other problems. As a result the US health care system will continue to implode and the vast majority of Americans will see their health care deteriorate. This is bad for the country and bad for the Democrats politically if not in 2010 then certainly by 2012. The bill not only doesn't remedy but actually forces one of the main things wrong with both our health care system and our economy - employer based health insurance. It does nothing to curb the unnecessary and often harmful medical procedures that drive up health care costs. This should not be a surprise. In a corporatocracy lawmakers can't go against too many of their sugar daddies if the expect to be reelected.
Lee Stranahan points out that there was one brave vote yesterday - Dennis Kucinich.
There were plenty of cowardly votes in the House last night but there was only one truly brave one. The unsung hero of the night was Ohio Representative Dennis Kucinich. Despite enormous pressure to support H.R. 3962, Rep. Kucinich did the right thing and voted 'no'. Unlike the Blue Dog votes against the bill, he did it for all the right reasons.
In a principled and practical statement, Rep. Kucinich said what a growing number of progressives have realized as we've watched real health care reform be compromised again and again.
During the debate, when the interests of insurance companies would have been effectively challenged, that challenge was turned back. The "robust public option" which would have offered a modicum of competition to a monopolistic industry was whittled down from an initial potential enrollment of 129 million Americans to 6 million. An amendment which would have protected the rights of states to pursue single-payer health care was stripped from the bill at the request of the Administration. Looking ahead, we cringe at the prospect of even greater favors for insurance companies.
But even Kucinich is only addressing the insurance industry and not the Medical Industrial Complex.
As bad as the House bill is whatever can be passed in the Senate will be even worse. The best thing that can happen now to insure real health care reform in the future would be for any bill to be stopped in the Senate. This would also be best for the US economy and the long term political success of the Democrats because a bad bill will eventually hurt them more politically than no bill at all.
IF employer and individual mandates survive unmolested the results may not be as predictable as we think.
I have favored uncoupling employment from health insurance ever since the idea surfaced, of all places, in the policy thicket of George W. Bush. It never saw the political light of day, but along with his immigration reform efforts it was one of the few Bush propositions I liked.
The original reason for employee health care insurance was to be a job benefit to attract employees from competitors and retain them longer. As time passed, union negotiators seized on them as their birthright, pushing with every negotiation to squeeze them to be better and more paid for by management, which meantime enjoyed the tax-favored status of corporate group plans thanks to the political influence of the insurance industry.
Ultimately group insurance premiums outrun individual policy premiums by definition, and the contrast becomes sharper with the employer's portion both tax advantaged and hidden from beneficiaries.
Some provisions of the legislation, however, eat away at this construct, including a surcharge on deluxe plans (either via the TPA or the sponsoring company) which will make group plans more expensive (therefor more realistically priced). And if ALL employers over a certain size are mandated to furnish health insurance, group insurance will no longer be a competitive advantage in the labor pool.
So employer mandates plus the other caps and subsidies mean an end to "job lock" which frees employees who want to leave jobs without fear of losing a vital "benefit." Asshole bosses have more to lose if subordinates are not shackled by health insurance. Ambitious people (like my son-in-law) can start businesses without fear of losing health care until they get past those risky opening years.
Posted by: John Ballard | November 08, 2009 at 02:20 PM