Wednesday, December 23, 2009


Those of you who follow this site, or who have heard me speak on air or at  public functions, know that I support the Public Option (actually, I support a single-payer system, but that's for another day). You also know that I think if our gourmet health care deal included the Public Option what we've ended up with is the health care version of Hamburger Helper. But I support what Senator Reid and Speaker Pelosi have pushed through thus far.

Still, I want to make it clear that while I will support what I think will eventually make it out of committee I'm not naive about what's in the health care bills presented by the House of Representatives and the U.S. Senate. Much of it is not pretty, and down right stinks.  Here's why.

There is absolutely no doubt that what we're looking at is health care legislation that perpetuates a broken system. It will continue a system that costs 50% more than any other nation in the world, while delivering far less in terms of health outcomes. This is what good lobbying (see Aetna), political extremism (see Sen. Jim Demint), and unethical elected officials (see Sen. Joe Lieberman) will get you in America.

So, let me get this out of the way: The health care bill is a windfall for the insurance and pharmaceutical industry. It insures price-fixing and price gauging long into the future. The Senate health care bill maintains the status quo in the following ways.

* REGULATORY SUBSIDY: The anti-trust exemption for the health care insurance industry, which allows the industry to create oligarchic market structures throughout the country, was maintained in the Senate health care bill. This undermines competition and guarantees price-fixing.

You can thank Senators Joe Lieberman (I-Connecticut) and Ben Nelson (D-Nebraska) and the Republican Party for this.

* NO HONEST BROKER: There is no government, or public, option available to keep this oligarchic industry from price-fixing and organizing the market to suit their needs (I'm still not convinced about the health exchanges). With no honest broker to provide a legitimate alternative to the health care insurance industry (like public universities provide an alternative to private universities) prices will continue to climb.

Again, you can thank Senators Joe Lieberman and Ben Nelson and the Republican Party for this.

* NO PRICE COMPETITION: Incredibly, Congress turned down an amendment that would have allowed imported drugs (from Canada, no less) to compete with price-rigged drugs sold here in the United States. The amendment was defeated.

There was bi-partisan stupidity on this one.

Still, in spite of all this I support what's coming down the health care pike (assuming the Conference Committee doesn't go nuts, or something). Here's why.

1. As I tell my students, good legislation is a process, not a moment. We need to see this legislation as the first step on a long path. Social Security, Civil Rights, the Women's Movement, and Medicare - all involving long hard fought pieces of legislation - took decades, and even more than a century (in the case of Civil Rights and the Women's Movement) to get right. Think about Medicare. At first it covered only hospital visits. Then regular doctor visits. Then medicines were included. In many respects we're still working on Medicare.

Rome wasn't built in a day. A good health care system won't be either.

2. This is what seals the deal for me. We need to support the health care plan currently making its way through Congress (even without a public option) for one simple reason: The Republican Party is using health care to defeat President Obama.

Republicans could care less about helping ordinary Americans who have no health insurance. They're after political power. If they can kill the health care bill they believe they can wound President Obama politically. This, they believe, will help them win more seats in 2010 and, in their minds, the presidency in 2012. They know they can't run on their record, their past, or their failed ideology. So dragging President Obama down is their goal.

This is not governing. It's petty, vindicative, and childish.

3. There are some very good elements that need to be supported. No drops/denials for pre-existing conditions ... a $10 billion increase in funding for the health centers (thank you Sen. Bernie Sanders) ... expanded access to high quality primary health care for millions ... mental health counseling ... dental care ... more/stiffer regulations ... etc. There are too many to list.

The point is, significant progress is being made.

4. We need to keep in mind that if we do absolutely nothing health care costs are going to continue rising anyways. This country will go broke if we do nothing. Check this out.

Simply put, if we have to suffer through increased costs (and they will continue to rise because we've legislated market competition out of the market), we might as well as get something in return.

Now, some of you might have noticed that above I make it clear that costs and prices will continue to rise with the current piece of legislation too. This is true. Some of you may have also noticed that the health insurance industry has promised to raise rates so they can blame it on the health care legislation. This is probably true too.

What's clear though is that "out of pocket" expenses will not rise as quickly because of provisions in the bill. Sure, I don't like the fact that some union health plans will be taxed. But I do like that the industry must now dedicate 85% of their premiums to health care, instead of the current 68-70%.

Again, this is a process, not a moment. We need to support the President on this.

- Mark

1 comment:

freshjiva. said...

Here's an idea:

1) Get government out of healthcare. I mean, completely.
2) Get corporate lobbyists out of Washington. I mean, completely.
3) Allow private insurance companies, medical product manufacturers, biotech and drug companies to compete head to head.
4) Let the free market drive prices down and enhance quality.

Cost control, in every market sector, is made possible only under free market competition without coercive legislation and subsidies from the federal government, and without corporate interests running the legislative process. The only purpose of government under the Constitution is to enforce integrity of the markets, not subsidization nor coercive regulation.

Both Republicans and Democrats have let us down. We need to end this welfare + warfare state, and return to our Constitutional Republic.