The Obama administration has developed a health care financing reform package that is designed to front load costs to the nation, to consumers and to providers of health care services while back loading the benefits to patients. By this I mean the costs, both financial costs and costs in terms of loss of access to health care coverage, will be felt more or less immediately while the full benefits to these groups will not occur for at least four years.
Front loading costs and back loading benefits is something that is only done, in normal legislative processes, when you raise taxes, which this package will do. It will raise taxes directly on those making more than $250,000 per year. Beyond that, it will raise health care costs on almost everybody, eliminate coverage, in the short term, for tens of millions and will do so almost immediately.
It does this without imposing any real competition in the market place, making an efficient market, always improbable in health care finance, almost impossible. Not only does it not offer a public option for health insurance, it doesn’t do anything of significance to increase competition from other potential private sector providers.
It does give further economic advantages to the narrow cabal of health insurance providers. By doing so, it virtually assures these companies of an even larger percentage take from health care costs without their having to do anything of value to earn it.
I have read that there may be a last minute insertion of a public option plan into the bill. I have read that this may take the form of allowing individuals to enroll in Medicare without regard to the person’s age. If this is so, it would make a real difference in my opinion of the bill. However, I have also read that this is not so and that the votes to get this done, even if it were to be attempted, are not there. I have also read that the President opposes any public option, even if the votes are there, because he has promised the health insurance companies he will not allow it to happen in return for their allowing something to pass.
If the new law stays as it is currently proposed, I believe I am watching the suicide of the Democratic Party. The idea that the President and the Democratic controlled Congress would sell out the American people to the band of vultures and parasites that comprise the health insurance industry is unthinkable. It is unthinkable because the President, and the Congress, ran on the promise that they would fix the health care finance mess. For them to be so callously deceitful, by trying to foist this cynical mess on to us, speaks more eloquently than anything else they could say about the disrespect they feel for us, and the contempt they hold for us.
All that is very bad. However, what is far worse is the foolishness of it. People don’t particularly mind being led by scoundrels as long as the scoundrels are reasonably intelligent about things. The President and his Congress do not appear to be very artful or intelligent in the manner of their approach.
This bill is very bad in its opening years. The argument for it, that it somehow will be worth the suffering if we just all hang on until the end of the fourth year of its implementation, is specious. It is so bad in the opening years there will be no full implementation.
All the opposition to government involvement to health care financing has to do now is come up with something only slightly better than the horrid mess Obama has given us (assuming it passes). Using a combination of tax incentives and legal adjustments, it will not be hard to develop a “private sector” alternative that will be so much more attractive, especially in the initial years, than the proposed legislation. Democrats that survive the fall election will happily support a “market” alternative.
I am very sad to see this happen. I believe passing this law and claiming it means real health care finance reform will break the centuries old bond between the American people and the Democratic Party. The party is the oldest continuously operated political party in the world. Maybe it has lived so long it cannot remember that it is better to lose while standing for something than it is to pass something just so you can claim a victory.
It is said that failure to pass something that can be called health care reform, even if it is crap, will mean the end of the Obama Presidency. If what we have seen so far of Obama’s leadership is what we can look forward to, the end of it cannot come soon enough.