The Goal of Health Care Reform
by Nathan Empsall, Wed Dec 23, 2009 at 11:52:24 AM EST
There's absolutely no question that the health care bill is a gigantic boondoggle for the health insurance agencies. Millions of Americans are being forced to become new customers yet the agencies aren't being forced to lower costs. I get that - I'm just not sure it's the most important thing about this bill.
Desmoinesdem told us yesterday about a piece from MarketWatch in a post called, "MarketWatch: Health care reform good news for insurance industry". Her persuasive piece reminded me of a high school friend of mine who has taken to routinely posting health insurance stock prices on Facebook. Arianna Huffington compared arguments for the bill to the debate surrounding No Child Left Behind, calling it "Leave No Special Interest Behind." All these arguments were most famously summed up by Dr. Howard Dean when he called the bill "a bigger bailout for the insurance industry than AIG".
Here at MyDD, Desmoinesdem and Jerome are arguing against the bill in its current form, and Charles says he leans that way too. I disagree, and Jonathan seems to as well. This blog is a microcosm of the larger party, where we see Bill Clinton, Barack Obama, sixty percent of the U.S. Senate, Paul Krugman, Vickie Kennedy, and the inventor of the public option, Professor Jacob Hacker, squaring off against Dr. Dean (update: I should point out that Dr. Dean has walked back his comments), the bulk of the Netroots (including Markos, Jerome, Arianna, and Jane Hamsher), and many leading House progressives.
The health care debate between the left reminds me of the climate debate between scientists and conservative economists. "How much will addressing climate change cost?" is not the right question to ask. Instead we should ask, "How much will addressing climate change cost vis-à-vis not addressing it?" When it comes to health care, the question to ask is not, "Will this bill hammer the insurance companies?" The question we need to ask is, "What's more important, screwing the insurance companies, or lowering the deficit, bringing insurance to 30 million more Americans, and forcing coverage of pre-existing conditions?"
Joe Biden says one should never question another person's motives. We all have our priorities, and most of them are admirable - but for me, expanding insurance now is the top health care priority, and though I would have put financial regulations and clean energy first to gain political capital for a better bill, the inferior bill is nonetheless worth it. As Jonathan said, "This bill isn't perfect, but it may be the best chance at reforming the system that there will be for a long, long time."
I'm not going to compare this bill to what it could be; I'm going to compare it to what we have now. It sucks, but it sucks less than what we're used to. Covering 30 million more Americans for less than the cost of the Iraq war, all while lowering the deficit, is worth a Ben Nelson boondoggle and an insurance company give-away. It may taste bitter, but hey, the caffeine is worth the bitterness each morning, and this is no different. And just as you can put sugar in your coffee even after you've drank half the cup, we can improve this new system in future years.
It's an argument you've heard before but I stick with it: Every time we blow it on covering more Americans, it's decades before we get to try again, only to blow it again. We HAVE to pass this bill if we're going to increase insurance coverage in this country. Cost containment, however, is a different story. Washington seems to be capable only of fixing what's right in front of them, never taking a long-term view. Well, health care costs are becoming a more and more immediate issue every day. There is no way this country can sustain itself with health care costs eating up more than 20% of the GDP, which is we're rapidly headed. If we don't address insurance now, we may never address it. If we don't address cost containment or the for-profit model now, we will definitely return to it in a relatively short amount of time. And when this bill succeeds in its limited aims, we'll have an even stronger case for the public option than we do now.
Here's what Roger Hickey said at the Huffington Post:
In 1964, when the civil rights movement was trying to pass the Civil Rights bill, southern Senators succeeded in watering down provisions to guarantee voting rights, citing states' rights. Martin Luther King and the movement he led took what they could win in that historic bill, but knowing that political change would never occur (and elected officials would never respect the rights of black communities) unless people had the right to vote. So the movement went to the grass roots all over the South... On March 7, 1965, a voting rights march was met with violence on the Pettus Bridge. And on August 10, Congress passed the Voting Rights Act of 1965... Our movement should see this health care act as just one step toward real health reform.
This bill may improve in conference, and even if it doesn't, I still feel that this is our best chance to insure 30 million of our brothers and sisters, and all profits aside, save some lives. Let's do it.
The Institute of Medicine's methodology says 22,000 people died in 2006 because they didn't have health-care coverage. A recent Harvard study found the number nearer to 45,000. Since we talk about the costs of health-care reform over a 10-year period, may as well talk about the lives saved that way, too. And we're looking, easily, at more than a hundred thousand lives, to say nothing of the people who will be spared bankruptcy, chronic pain, unnecessary impairment, unnecessary caretaking, bereavement, loss of wages, painful surgeries, and so on...
On its own terms, the bill is the most important social policy achievement since the Great Society. It will save a lot of lives and prevent a lot of suffering. But moving forward, it also makes future improvements and expansions easier. A lot of the hard work of health-care reform -- in particular, the money for subsidies -- will finish this year. If reformers want to come back for the public option or more subsidies in a future year, they won't be doing it atop a $900 billion price tag that's being battered by tea parties and industry and everyone else. This bill doesn't have all the good stuff it should have, but reformers can stand atop what good stuff it does have and focus their energies on what good stuff is left to achieve.