Wednesday, March 17, 2010

Yes, the Health Care Bill

Today, Nice Guy Eddie, over at "In My Humble Opinion," jotted out a post on "The Health Care Bill." I started to write a reply, over there, and my comments started to run long, so I decided to turn it into a full-blown posting here:

Those opposing the health care "reform" bill from, broadly speaking, the left are right about it. They aren't opposing the bill out of some blind idealism, as is so often suggested; they're opposing it for very particular reasons, ones they've been articulating in their public remarks on it. In a nutshell, they're against it because it isn't reform. It isn't anything even close to reform. It's a corporate welfare bill, and nothing more. Eddie and some others who've been commenting on it lately have, in my view, missed this entirely, and seem to be functioning under the misimpression that this is, instead, a reform bill. It isn't. It isn't some sort of improvement in the present mess that can be improved even more at some indeterminate point in the future, as it is so often presented. If it was, I’d be supporting it myself. I'm a liberal, but I'm also a pragmatist. The perfect should never be made the enemy of the good, and that isn't how the liberals have approached the current bill.

For all those grating screams of "socialism" from the right, this is, in fact, a conservative Republican bill, written, at various stages, by insurance company lobbyists, pawned off by conservative Republicans as their own, and eventually adopted by Obama as his own (causing all the Republicans to jump ship). That lineage is important, because the bill's conceptual failing is rooted in it.

Eddie asks if the insurance companies make a profit from this and answer "Yes, I'm sure they'll find a way to. They always do." They don't have "find a way," though; the health care bill is the way. Corporate welfare. The bill sets up a corrupt triangle of money. It gives tens-of-billions in government subsidies to low-income people, who, at the point of the government gun, must spend it on private insurance companies, who then route a portion of it into the pockets of politicians in order to keep any positive changes off the table in the future.

Rather than improving anything, the bill makes everything worse. The "public option" was, theoretically, at least, a means of curbing costs by offering serious competition with the private insurers. Without it, there’s absolutely nothing to curb costs. Health care costs rise at many times the rate of inflation every year, and all this bill does is force people into that ever-costlier system on the blind hope that, if more people sign up, costs will go down, because there are more people in the risk pools. This is a "market based" approach, otherwise known as "wishful thinking," the kind we expect to pay off now, though it never has in the past.

The insurers are legally allowed, under the bill, to collude and fix prices. The noxious Slavery Provision forces people to buy private insurance or face a new tax penalty. I can't afford a new tax penalty any more than I can afford private insurance, but that's all the bill offers for someone in my predicament.

Contrary to the false claims of its supporters, this bill does not fix the problem of pre-existing conditions. Companies that continue to refuse to sign up people based on them can, after a lengthy procedure, be fined only $100/day, while those companies that do sign them up, having been barred from charging the individuals whatever exorbitant premium they want, can just raise everyone else’s rates an unlimited amount to make up for the difference, as long as they don't say that's why they're doing it. They're also allowed to continue rescinding policies based on fraud or misrepresentation, entirely defined by them. That's been, for some years, now, their major pretext for rescinding coverage for those who become ill, and, with the current health bill in place as law, we'll simply see the industry miraculously uncover an astonishing epidemic of fraud among those with pre-existing conditions. Another way of getting around it included in the bill: selling those with such conditions only minimal policies.

The bill isn't some "necessary first step" toward reform; it's a huge leap away from reform, and will make it much harder, if not outright impossible, for any real reform to be enacted in the future, because the insurance companies have been given, effectively, a government stipend for their bribery of legislators. The bill doesn't bring us closer to reform--it takes us much further away.

Those among the Democrats who are pushing this seem to have completely lost their minds. They seem totally blind to the mess this monstrosity can create. They don't even demonstrate any rudimentary self-survival instincts--it's very bad politics for the Democrats to pass the bill. It doesn't, in my view, provide for the possibility of any short-term gains--the polling has made it pretty clear that people don't want the bill in its present form. Public reaction is likely to fall somewhere between indifference and outright hostility. Once the bill goes into effect, some years down the road, the Democrats certainly won't be able to bullshit people anymore. They'll be slaughtered at the polls for the mess they’ve made of this--it's why Rahm Emanuel only wanted it to kick in after what he hopes will be the Obama's reelection.

The future, under this bill, is one of premiums that continue to rise for those with insurance, people without the money to buy private insurance being left with even less money, a health insurance industry with federal subsidies, making it even more invincible, and the feds funding, in effect, the campaigns of the politicians the industry chooses to purchase, a job our wonderful Supreme Court has just made a lot easier. It's a bad bill--it needs to die.



"Niceguy" Eddie said...

Glad to know I could lend you some inspiration. I repsectfullly disagree, but all of your points ARE valid and good. No question about that.

Couple of other questions though:

1) If this was such a sweet deal for the insurance companies, why are the Republicans and the Right still fighting it tooth and nail? Are you suiggesting THEY'RE the ones on the public's side?

2) You say you can't afford more taxes and you can't afford insurances. Well... Do you really think that you're going to get yourself, or anyone else covered for free? Even single payer would hit your taxes. You KNOW this. You get nothing for free. Everyone has to put in. Do you deny this?

2a) Curious: Where is your income, relative to the range where there are subsidies? The truly broke are already covered by medicaid, so the sudsidy has to kick in at heigher than what will put you there. I'll admit I really don't know - but that's why I'm asking: You seem pretty up-to-speed on these things.

3) You say this doesn't force the insurance co's to cover you, that there's that whole $100 dollar a day fee provision. I knwo about ithat, and I AGREE that this is complete BS... but it's also TEMPORARY. That ends after four years, no? (Yes, IDKY they put that in either. It's BS, to be sure, but it DOES end at some point.)

Bottom line, if the costs were just going to skywrocket, and the insurance companies could just charge whatever they want and rake it in, they'd have ordered their congressional whores to support it by now. Either their angling for MORE or it's not as sweet a deal as you're making it out to be.

I still say this is a necessary first step. Get everyone covered - that means both ACCEPTED and PAYING - and THEN we'll see what things REALLY cost. Only then can we have reform because only then will we know where we really are. Right know we don't even have a MARKET. (So all the "market forces" arguments you get are BS.) At least now we'll have THAT MUCH. I'm not satisfied with that, and I don't believe anyone [on the left] is. But getting everyone IN the system, will increase popular support for TRUE reform, especialy if prices skyrocket as you suggest they will. (Personally, I'm still not convinced that they will.)

And I don't disagree with any of your criticisms of the bill. Nor Michael Moorse's, nor Keith Olbermann's nor Dennis Kuccinich's. I only disagree with the conclusion that this makes things worse. Not in a macro sense anyway. I'm a 'progressive.' And I still see this as 'progress.' Christ, it's an embarassingly small baby-step, but I just can't see it as corporate welfare. Either these comapnies are up to the task of financing helath care or they're not. And they may have to FAIL in a BIG WAY before the public realizes this.

Thanks for the PLUG in any case. I always look forward to reading your comments and posts, as I always find them to be well thought out and well informed. It's refresshing to disagree occasionally with someone who has SOME IDEA what they're talking about!

classicliberal2 said...

As I said over on your blog, the insurance industry wrote the bill currently under consideration. Specifically, the vice-president of Wellpoint. It was a clone of a Republican proposal also authored by industry lobbyists. The industries' current #1 whore in congress (the biggest recipient of industry largesse) is Sen. Max Baucus, who is supporting the legislation and allowed the aforementioned Wellpoint VP to write it. Joe Lieberman is the Senator From AETNA, and helped insure there would be no public option. The Obama himself was purchased with $20 million in campaign contributions from the health-care industry. It's why he, among other things, flip-flopped on the question of the Slavery Provision. Health care industry contributions shifted to the Democrats in the last election cycle. Sensing the emergence of the issues, the industry was ensuring things would go its way. That's why Harry & Louise were dragged out of the closet in support of the bill this time. You said that if the bill was such a boon to them, they'd have ordered their whores in congress to support it. They have. That's how we've gotten where we are.

The spotty industry opposition we've seen isn't to the entire bill, which is, in fact, corporate welfare. It's directed at certain provisions. For example, the industry wanted jail-time as a penalty for those who didn't buy insurance; the bill itself only provides for a tax penalty. This was why the industry crafted that phony "study" toward the end of last year, using creative math to demonstrate that a weak penalty would cause everyone's premiums to rise. As another example, the industry spent a bloody fortune getting the public option stripped out of the bill. As yet another example, the industry has recently been funneling huge amounts of money into the "Blue Dog" right-wing Democrats (Google it), the very people who have made a mockery of the reform effort.

The Republicans definitely aren't on the side of the public. It's just that they've gotten the hind-tit on health industry funding (for perhaps the first time in history). They wrote the original version of what became this bill. In the last year, they have adopted, as a matter of party policy, obstruction (and demonization) of everything Obama and the Democrats try. What they've been suggesting, as alternatives to the bill is a "reform" package that is even more industry-friendly (I think you even mentioned some of its provisions in your original post). The industry is always angling for more.

My current situation is that I'm broke, unemployed for more than a year, and the only reason I'm not living in a cardboard box just now is because of the kindness and support of others (something I'm hoping is about to change). I am an artist who has spent a lot of my life trying to make it as an entrepreneur. A measure of my level of success: At no point in the decades of my adult life have I made enough to afford insurance, and I have more than one of those dreaded pre-existing conditions.

My last regular job, however, did pay enough that I could have afforded insurance under either a single-payer or "public option," because they'd be far less expensive than private insurance.

classicliberal2 said...

Part 2, because I always run long...

The more-holey-than-the-pope bar on pre-existing conditions in the Senate bill doesn't even begin until four years after the bill's passage (except for children--it begins for them almost immediately).

I still maintain it's delusional to think this bill provides any basis for real reform at all in the future. It in fact closes almost every avenue for ever making it happen (until things completely fall apart). It isn't that I don't see a serious argument for that--I don't see any argument at all for that anywhere. The corrupt triangle of money will keep the gravy-train running until it runs right off the rails. Passing this monstrosity erects a barrier to real reform that will make the Berlin Wall at its worst look like a minor thicket by comparison.

Kevin Kelley said...

Based on your analysis, would you believe that there will be no benefits from this legislation?

In my opinion, things haven't been working out so great with the current system, and this bill may not represent the "true" reform, but I think it's minor tweaking may offer something in the future, and if things need changing, legislation could be worked out keeping the things that work while eliminating the parts that don't work...

Kevin Kelley said...

I would have to say that I agree with much of what you write, but I guess I am too much of an idealist!

Maybe with the passage of an industry bill, the pendulum will swing in the opposite direction when things go wrong, leading to real reform...

classicliberal2 said...

"Based on your analysis, would you believe that there will be no benefits from this legislation?"

I went ahead and made a full-blown post of my reply to this, Kevin.