By David Hoskins
Newspaper headlines, radio talk show hosts and cable news commentators have all spent the better part of the last month warning the Obama administration of a possible repeat of the 1993 failed Clinton health care proposal. Senate Majority Leader Harry Reid bolstered this sentiment when he announced that the Senate would not vote on the bill before the August recess as President Obama had initially requested.
Indeed, many of the key ingredients of the 1993 health care debacle appear to be in play once again. Democrats have advanced a complicated bill that falls far short of universal coverage. Intraparty squabbling, this time between the Democratic leadership and its right-wing “Blue Dog” faction, has hindered attempts to bring the bill to a full vote in Congress. Big insurance companies, the Republican Party, and the corporate media have all lined up to defeat any public option to cover the uninsured.
Democratic health plan critically flawed
One Senate and two House committees have passed a health reform plan. The Senate Finance Committee and the House Energy and Commerce Committee have yet to vote on the measure. The Finance Committee’s refusal to take up the measure has prevented the bill from reaching the full Senate floor before the August break.
House Energy and Commerce Committee Chairman Henry Waxman publicly threatened to circumvent his own committee and bring the bill before the full House over the objections of Blue Dog Democrats who have threatened to kill the bill in committee.
A big part of the problem in obtaining meaningful health reform is that the Democratic plan, even if it ultimately passes, fails to provide the real reform workers need and deserve. The plan is complex, and politicians on both sides of the debate have admitted that even they fail to fully understand it.
The details that have emerged indicate a plan full of giveaways to the pharmaceutical and health insurance industries with little guarantee of quality coverage for those who need it.
According to the Congressional Budget Office, the plan would establish a mandate to purchase health insurance, expand Medicaid eligibility, regulate private policies, set up insurance exchanges to provide subsidies to certain individuals and families, and offer a “public plan” option through those exchanges. The CBO estimates that it would take seven years to reduce the number of uninsured individuals to 17 million.
Even that estimate may be overly optimistic. The plan reinforces the problems of the existing system. The main difference is that the proposed plan finally delivers the insurance companies what they really want—a captive market—by placing the burden of health insurance on the individual with a mandate to purchase it. Physicians for a National Health Program points out that the plan does not limit how much insurers can charge for premiums, deductibles, or co-pays.
The public option so widely touted by the plan’s supporters is expected to affect just 10 percent of the population. Those covered by an employer-sponsored plan are prohibited from accessing the public option. After it is established, the so-called public option will receive no government funding.
In time, the public plan is likely to be pushed out of the market altogether as private insurers cherry pick young healthy patients. Sick and older patients would be forced into the public plan, driving up costs disproportionately and making the plan unsustainable over time.
As if that were not enough, the version that passed the Senate health panel insulates biotech companies from generic competition for 12 years after their drugs go to market. This would ensure an extraordinary price tag for the groundbreaking biologic drugs used to fight life-threatening diseases such as cancer.
Right wing refuses any reform
The right wing has united to defeat the Democratic plan, even with all its shortcomings and windfalls for pharmaceutical and private insurance companies. The reasoning behind this intransigence is simple. Corporate health profiteers and their conservative ideologues fear any sort of competition with a public insurance system, regardless of how miniscule the public option is or how uneven the playing field.
Minnesota Rep. Michelle Bachman, a rabid rightwing Republican, recently said as much on the House floor in July 20 comments picked up by C-SPAN. Bachman stated: “Approximately 114 million Americans are expected to leave private health insurance. Why? Their employers will drop the insurance because the taxpayer-subsidized plan will be 30 to 40 percent cheaper. This action will collapse the private health insurance market, and then the Federal Government will own the health provider game.”
Bachman’s claims are not substantiated by the evidence. Neither the CBO nor the reform plan’s most ardent sponsors expect anywhere near 114 million people to flock to the severely restricted public option. However, the comments reveal that the right wing is fully aware of the inefficiency and inequities inherent in the private insurance system. This awareness has fueled the attempt to block even minor health reform at all costs.
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