The flawed and circular logic of fixing it later
Remember the tag line? “Eat some now, Save some for Later.” Seems that is like the health care argument - we need to pass something now - and “fix it” - later. Sometimes there is a dose of “incrementalism” tossed in (I debunked that here) but always deferring improvements until “later.”
Tactics and Strategy
I understand the part about deferring the tactical improvements until later - should we insure everyone or just 60% of uninsured Americans. When should we stop denial of pre-existing conditions? 2014, 2013 or now? Should the tax rate be XX% or YY%? I understand that not everyone will get 100% of what they want.
But there is the strategic objective - How do we get true, real, effective reform. Do we maintain the current delivery method? Continue to use the same players expecting them to somehow act differently? Do we introduce true competition or rely on some level of self-policing. Self-policing that can lead to collusion like we have seen in the past. In the end, the profit motive is still present and will drive the decisions of those who deliver coverage.
The question to ask is does the tactical success achieve contribute to the strategic objective.
In this case - it doesn’t. I wonder this effort simply amounts to making a safer cigarette. Different ingredients, same result.
The path forward
Why are true progressives pissed? Well, first off this is an insurance regulation bill that favors insurance companies - not Health Care reform. We keep employer based Health Care, add people to Insurance company rolls who don’t have an employer, do the insurers a favor by having the government assume the risk of high risk people, all being told that we will “fix it” later.
Later isn’t going to happen anytime soon. We do not see a path forward.
What legislator will have the stomach for a health care fight, anytime soon? Really - as I have said before - some bill would pass - looks like the Senate Bill is the bill that will pass. It is 2010. What is on the horizon? Well, war, immigration, economy, trade, 2010 elections, transition to a new Congress in 2011, a Presidential race in 2012. Oh, after the Presidential race results are in, midway through a second Obama term or a first G- NO- P term, the Health Care system that was passed in 2010 will start to be in effect assuming it is not undone.
Bottom line - a bill will be passed in 2010 and effects won’t be seen or felt for many years after that.
What does the Senate bill do? At a high level
Though it includes some positive subsidies and regulatory tweaks, the bill creates few mechanisms to halt premium increases, bust insurance monopolies and end price discrimination — and it includes no public insurance option.
Extending coverage to 31 Million Americans is really about language.
Worst of all, it doesn’t actually extend “new coverage” to 30 million more Americans. Through the “individual mandate,” it simply makes people criminals if they don’t buy expensive insurance from the private corporations that helped create the health care crisis in the first place.
Speaking of no change - when those millions of Americans are delivered on a silver platter to insurance Insurance Companies why would they want to change the system - anyone thought about this?
Because of the requirement that the uninsured buy health insurance from private insurance companies, the insurance companies will almost certainly grow more powerful as they add tens of millions of people onto their rolls, employ more people and increase their profits and lobbying power. Health insurance companies will be even better poised to combat any proposed modifications to this bill, other than those they want.
Um yeah. No public option, enshrines the current system into law. Makes insurance companies a bigger force than before. More money and influence. With out a public option there is no check on the system.
No, we need the best possible bill now because later isn’t coming anytime soon.
Time to light up my safer cigarette.
Related posts:
We do need to get it right or a reasonable facsimile of it
Now
While you have your safe ciggie I’ll be putting some clean coal in some stockings