No Bill Is Better Than A Bad Bill?

Commentary By Ron Beasley

I have have said that a bad health care bill is worse than no bill at all.  Dr Marcia Angell agrees:

Conservative rhetoric notwithstanding, the House bill is not a
"government takeover." I wish it were. Instead, it enshrines and
subsidizes the "takeover" by the investor-owned insurance industry that
occurred after the failure of the Clinton reform effort in 1994. To be
sure, the bill has a few good provisions (expansion of Medicaid, for
example), but they are marginal. It also provides for some regulation
of the industry (no denial of coverage because of pre-existing
conditions, for example), but since it doesn't regulate premiums, the
industry can respond to any regulation that threatens its profits by
simply raising its rates. The bill also does very little to curb the
perverse incentives that lead doctors to over-treat the well-insured.
And quite apart from its content, the bill is so complicated and
convoluted that it would take a staggering apparatus to administer it
and try to enforce its regulations.

None of the current bills do anything to fix the systemic problems in the current health care system.  Ezra Klein disagrees with both Dr Angell and me.

Failure does not breed success. Obama's defeat will not mean that
more ambitious reforms have "a better chance of trying again." It will
mean that less ambitious reformers have a better chance of trying next time.

Conversely, success does breed success. Medicare and Medicaid began
as fairly limited programs. Medicaid was pretty much limited to
extremely poor children and their caregivers. Medicare didn't cover
prescription drugs, or individuals with disabilities, or home health
services.

But once the programs were passed into law, they were slowly and
continually improved. They became more expansive, with Medicaid growing
to cover not only poor families but also poor adults, and the federal
government giving states the option, and matching dollars, to include
more people under the program's umbrella. Medicare was charged with
covering people with long-term disabilities, and it was eventually
strengthened with a drug benefit, more preventive coverage, the option
of supplementary plans and much more.

This is a convincing argument except I remain convinced that we don't have time for the slow and continued improvement that Ezra talks about.  The health care system is going to implode very soon - perhaps within the next two years.  There will be nothing in any bill passed this year that will help avoid that implosion.  If an inadequate Democratic health care bill passes the likelihood is that  it will be blamed for the implosion.  The best case scenario for the Democrats is a bill, even a bad one, being filibustered in the Senate.