By Fester:
Ian Welsh has the outline of the Senate Finance Committee�s health insurance plan. The shorter version of the short version is that it sucks. Here is the short version of the plan:
1) Lower the medicaid coverage rate from 150% to 100% of the Federal poverty line, 133% for kids and pregnant women (once you have the baby, too bad for you)2) Subsidies stop at 300% of the poverty line (was 400%)
3) No Public Option mentioned
4) Insurance exchanges at the State level
5) Must buy insurance unless it costs more than 15% of your income
6) A fine if you don�t buy insurance unless you�re below the Federal poverty line
For the most part, as Walker discusses, this is actually identical to or slightly worse than the plan put forward by America�s Health Insurance Plans (AHIP). Yes, worse than the insurance industry�s plan. Remarkable. Baucus is really earning his campaign donations these days�. Without a public option, the insurance companies will have no check on their prices, let alone pressure to actually reduce them. Because people will be forced to buy bad insurance, they�ll hate the plan, and because �reform� has been passed, we�ll have to wait another 10 or 12 years for another shot....
Tim at Balloon Juice is very curious why Obama is not actively selling a strong public option proposal.
Watching Democrats try to fix health care I see a photo negative of the Bush years. Here is an issue with obvious urgency. Setting aside our shameful infant mortality rate, uninsured rate and other statistics, medical bills are by far the leading cause of personal bankruptcies. Insurer misconducy wrecks lives every day in every city in America. The right options are obvious and relatively few in number. Huge majorities support doing the right thing.
Even self-interest is similarly one sided. Remember how much Republicans invested in realigning the destroying Social Security? Imagine if they had an issue that would realign the country in their favor and instead of huge majorities violently hating it, most Americans strongly supported what they wanted to do. Republican strategists would give two of their first three kids for a shot at an issue with this much going for it....
I hear that Obama supports the public option. That would mean more if it felt even a little more urgent than his idea that we should have a college football playoff series.
Belaboring the obvious, people who care about what they�re doing normally enter negotiations with some firm goal in mind. Most would agree that it is moronic to make negotiating itself the point.
Many others, including Steve have noted that if a major and effective health financing reform bill passed with either a pathway to de facto single payer for baseline care or at least a strong public option, major fundraising avenues will be closed off to some of the current veto points in the Senate and the House. I think that is part of the problem with the Democrats.
However, I would like to get a little more cynical for a moment. What if healthcare reform is to Democrats what abortion and anti-feminism is to Republicans in that both are seem by significant portions of their respective bases as high salience issues that are best served by never fully addressing? Gotta keep the activists in line and ready to donate and phone bank for two more incremental steps in the 'right' direction instead of attempting to systemically change the constraints of power and the political process.
Tim is right that an effective public plan option would be a system changer that would effectively tilt the political playing field to Democrats for at least a generation or two in much the same way that Social Security and Medicare are high salience, high effectiveness boundary conditions for Democrats to lean on. However the Democrats who would benefit from these changes are not neccessarily the Democrats who are currently in power or more importantly, currently occupying critical blocking positions. So reform that can shave off several points of GDP on health expenditures, improve coverage and re-align US politics is not a winning solution for the key set of stakeholders; instead their winning solution is to do just enough to avoid overwhelming political costs and pressure.
Nicely put about about our Dem "stakeholders," but it could be put even more pointedly: it's a salient issue for poor people and middle-class people who worry about health care, but not for rich elite Dems who actually run the party. Their health insurance is rock-solid by virtue of their economic position, so they worry about it less.
ReplyDeleteIt strikes me that you have no politicians and especially no Democrats with a real and I mean real fire in their belly for the health care issue and I think you'd need this to kick ass and get a proper system in place - I suspect you'll end up with a dog's-breakfast kind of sinkhole which won't be evident immediately. The fact that millions aren't in the street in DC, having been tweeted or whatever to get there means, I think, other than on phone polls, voter complacency. Nothing new about that in a busy modern society that's the same all over the West.
ReplyDeleteRe: leadership, Obama never breaks a sweat and from up here in the North the guy, charming and articulate though he maybe, seems to have no issue he'd fight in hell to get done, other than, of course, getting funding for his Afghanistan war and hiding pictures. Flexing his muscle on war funds number simply indicated to cynical old me that he is in "must get a second term mode" already so can't be vulnerable to any donkey's are weak comments from elephants.
Sort of disappointing, but he's still better than McCain/Palin, least on the small things.
>> ...major fundraising avenues will be closed off to some of the current veto points in the Senate and the House.
ReplyDeletePardon my caffeine deficiency, but... What does this mean?