Details of Harry Ried’s latest compromise are still emerging, but the broad outlines are fairly clear. One yardstick for measuring the results is this passage from the 2008 Democratic platform:
Ensuring quality, affordable health care for every single American is essential to children’s education, workers’ productivity and businesses’ competitiveness. We believe that covering all is not just a moral imperative, but is necessary to making our health system workable and affordable. (Emphasis added.)
Here’s what the latest Senate version of health care “reform” likely will entail:
Universal coverage for all Americans and legal residents? No. That’s not achievable with the current system. At best, ten years from now, perhaps 94 percent will be covered. That leaves 18 to 20 million out in the cold — and ten of thousands will die because of that decision by President Obama and Congressional Democrats.
Prohibitions on reprehensible health insurance industry practices such as denial of coverage for existing health problems, rescissions, annual and ultimate caps, and higher premiums for older and sicker people? Yes — eventually. Whether this can be policed effectively is something I doubt.
Subsidies for those who cannot afford private insurance on their own? Yes — but whether the subsidies will be high enough to really help people is not yet known. And the subsidies might be delivered through tax credits, which would require paying the full price of the policy up front. That would be a hardship for some, an impossibility for most. There would be humiliating means tests; Americans might have to sell their belongings and swear a pauper’s oath to obtain the subsidy.
A government run insurance plan — the so-called public option — that, by not charging prices that generate profits, would compete with for profit health insurers and drive down prices? No. At least not in any form that would have a discernible economic impact. Joe Lieberman and his fellow reactionaries have seen to that.
A requirement that everyone purchase health insurance? Yes — and the stiff fines for not complying will be collected by the Internal Revenue Service. This mandate provides private health insurance companies with tens of millions of new customers, most of them healthy and not in immediate need of health insurance.
A buy-in to Medicare for the age 55 to 64 cohort? Possibly. It’s shaping up that way, but the details that have emerged thus far are not encouraging. Here’s Talking Points Memo’s initial summation:
That buy-in option would initially be made available to uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized—people will have to pay in without federal premium assistance—and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.
All this preserves the private health insurance industry — the industry whose mere existence is the problem — and makes it richer. Costs will rise because of the hideous complexity of administering the scheme. Congressional Democrats and the White House may call this reform. I call it a tragedy.