I share Ron's concerns noted below about what may finally emerge from the reform debate. While there's been an awful lot already given away, the House version does contain some significant improvements to the existing system. This is from earlier today:
The House of Representatives, by a vote of 220-215, passed
a landmark health care reform bill last night. The tight margin
follows a Saturday morning Capitol Hill appearance by President Obama
and a major concession by Democrats on abortion rights.
The
approved House version includes a public option, individual and
business mandates, subsidies for insurance premiums, bans private
insurers from discriminating against those with pre-existing
conditions, and lowers the federal deficit in the out years by over
$100B.
The president and Speaker Pelosi deserve some major
props. They've accomplished what no other administration, Republican
or Democratic, was able to; a comprehensive reform of the nations
health care system. But, along the way, Democrats made some significant concessions that may or may not have been actually required. Ezra Klein had written recently:
For the real liberals, the public
option was already a compromise from single-payer. For the slightly
less radical folks, the public option that's barred from partnering
with Medicare to maximize the government's buying power was a
compromise down from a Medicare-like insurance plan. For the folks even
less radical than that, the public option that states can reject is a
compromise from the public option that would be available to
Mississippi's residents and Vermont's residents alike. A liberal person
in a conservative state will not be allowed to choose the insurance
option they prefer, nor will an apolitical person who simply doesn't
trust private insurers.
Speaking
of compromises, also adopted yesterday was the Stupak/Pitts amendment.
The amendment, passed with a 240-194 margin, prohibits the public
option insurance function from paying for abortions (except to save the
life of the mother, or in cases of rape or incest) and
prohibiting the use of federal subsidy money to purchase private
insurance to cover an abortion.
The Stupak Amendment may be the perfect metaphor for this very long health care debate and the amount of compromise. In
an effort to woo conservative House members who had argued a public
option was nothing more than a government takeover of insurance and
would lead to faceless federal bureaucrats making the insured's private
health care decisions, Democrats added an amendment that mandates
faceless federal bureaucrats make private health care decisions.
Jay
ReplyDeleteI disagree that the bill they produced can be called "a comprehensive reform of the nations health care system". It reformed very little!
Well, it's not single payer, which I favor. But I would argue a plan that includes previously unavailable provisions like a public option, mandates, some (albeit not enough) restrictions on private insurance practices, and provides subsidies for lower incomes is "reforming."
ReplyDeleteThe concern I have is that the House version will be insufficient to "fix" the problems with health care cost and quality.
I never really thought that any comprehensive reform would be possible at this time. The special interests are just too firmly entrenched. Real reform can only occur when the current system implodes - I'm guessing within the next two years. The danger of a health reform bill now that really does very little for most Americans is that the Democrats will be blamed when it does implode. The best thing now for the Democrats politically is for the bill to be filibustered in the Senate. I also think that is the quickest path to "real comprehensive reform".
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