Monday, November 09, 2009

 

Health Care Reform (?)

Concerns:

(A) I still worry that once the sausage making is done in the Senate, we'll end up with something that mandates health insurance purchase, gives health insurers every excuse to increase insurance prices and does nothing to ensure real competition to make sure price increases don't happen.

This will be the "compromise" that ensures "bipartisan support" -- except it won't. Holy Joe and the GOoPers (how's that for a band-name) will still filibuster, a few Dems. won't vote for the final bill (including 1 or 2 liberals because it will be a piece of crap bill). Thus in 2010, the GOP will be able to campaign that "the Dems. pushed through a partisan bill, facing bipartisan opposition, that even some liberal Senators didn't support -- and this bill has made your health care more expensive, etc., rather than better", etc., etc. (c.f. all my earlier posts on how problems with health care reform will affect support for Dems and progressive legislation). Of course, the so-called liberal media is always gaga for "compromises", so they'll support the bill -- which will give the GOP more leverage with it's "even the liberal media" arguments (as well as help cement the linkage between liberalism and wanking in the public's eye).

(B) Perhaps the Stupak amendment will be a wake-up call to an issue many Dems (including myself) tend to ignore but looms large in public concerns about health care reform: government run health care will indeed set-up a minimum standard for health care (because in order for private insurers to survive, they will need to do better than the minimum). However, the free market tends to sink to the lowest bar possible. Thus, whatever services are not provided by government health care will, with the exception of a few token services that private insurers will provide to gain market share with "value added" products, will not be provided by private insurers ... even if they provide such services now, private insurers may not continue to provide such services after they have to "cut costs to satisfy new regulatory requirements" (vide supra).

In fact, private insurers have already pulled this trick. Remember in the 1990s where there was a lot of talk about un-necessary procedures and the winds of health care reform under Clinton started blowing? Well, private insurers used this as an opportunity to start denying claims -- and it got so bad you could be in an ER for respiratory distress and your insurer would deny the claim of a chest X-ray! (happened to me)

We (I myself have argued this) argue that adding a public option, etc., will not affect those who already have insurance, but lot of fear that those with health insurance will be affected negatively by health care reform is based on what has happened previously with even attempts at reform. Dems. now are starting to realize this with the Stupak amendment -- if government subsidized health insurance won't cover abortions, why will private insurers do so? -- but it's a general issue.

If health insurance reform will result in those currently with health insurance having their coverage reduced to the point where it is just above the minimal insurance provided via a public option or some similar mechanism, then many of us who do have health insurance will be very unlikely to support it. And, the way sausage making works, you can bet that whatever government run health insurance comes out of said sausage making will be pretty horrid (because "to have robust health insurance subsidized by the government would cost too much money" the wankers will say).

So what will ensure that those of us who are lucky enough to have health insurance currently won't see our quality of health care plummet with health insurance reform?

(C) Small businesses -- health insurance is an issue that turns glibertarian would-be small-businessmen concerned about taxes and regulations killing their nascent businesses into commie pinko moonbat small-businessmen who cannot afford to provide health coverage for their employees but who need to hire employees to grow and who thus realize that the best thing government can do for them is not to get out of the way as they previously thought but rather to provide everyone with socialized medicine.

Unfortunately, the house bill mandates that employers provide employees with health insurance. Health care reform is a winning issue for Democrats because it is a wonderful example for glibertarian chamber of commerce types of how the progressive agenda and big government would actually help said chamber of commerce types. Unfortunately, the mandates, etc., of even the House bill will just re-enforce every fear Joe and Jane Shopkeeper have about "big gummint". And the Senate is, by design, even more out of touch with Main Street than is the House.

In general, I think the Dems are, as usual, shooting themselves in the foot by trying to have a "compromise" health care reform package. We need to have a public health care system in this country -- why not just provide one and let it grow until we get teh socialized medicine? Instead the Dems are crafting an overly complicated bill with a series of compromises that will satisfy no-one and that will backfire, both in terms of providing health coverage to people and politically.

What is up with the Democratic party? At a time when the GOP is in a tailspin, the Dems. still are busy with duck fondling that they can't even take advantage of the situation and pass popular legislation? Instead they have to make a bunch of sausage that will just make everyone sick? What's up with that?

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