Congress is bought and paid for. Our representatives don't represent us at all.
I have grown dismayed this morning by the myriad reports throughout the entire press (irrespective of actual media, whether broadcast or print) regarding the Obama administration backing off a "public option" being a part of any health care reform. In fact, I am quite upset about it, yelling like a right-wing bozo does at a town hall meeting, in the general direction of my television, and even at my wife, about the stupidity of this, in between grimacing while grinding my teeth into dust in anger.
If the insurance companies pull this off it will be the final demonstration that any meaningful democracy in America is dead. We are no longer "governed." Instead, we are being ruled over by people we cannot identify by name or face. We don't know who they are, but they make the decisions about what they will or will not allow us, "We the People," to see and to hear, and what rights we have, no matter what we might vote for or against. At least in a monarchy or a dictatorship the subjects know who to blame for the decisions that affect their lives. Here we have no clue who the heck the people actually are who are pulling all the strings, but they seem to be pulling them quite effectively whether Democrats or Republicans are in power. The only difference is that, if the Democrats actually did control Congress, with maybe 75 Senate votes rather than a mere 60 that requires the opposition to peel away only a single vote to defeat any progressive initiative, then "We the People" might have some say. But not today, evidently. And I harbor growing doubts that we would have any say even then.
That bit of paranoia (is it paranoia when they really ARE out to get you?) aside, I would like to give you my take on where health care reform stands today, with the "public option" hanging by a very tenuous thread. If the "public option" is jettisoned, health care reform will have the following features and really nothing more.
1. A mandate that insurance companies cease some of their more despicable practices, like denial of coverage for pre-existing conditions and scouring patient records for any inadvertent omission a policyholder might have made in his or her initial application for insurance in order to cancel a policy as soon as the policyholder becomes sick or injured.
2. A series of "health insurance cooperatives" organized at the state or regional level that would permit individuals to purchase health insurance at group rates.
3. Ensuring universal coverage through a legal mandate requiring all businesses to cover their employees and that all Americans purchase health insurance, either through their employers or privately.
4. Federal subsidies to help small businesses and economically disadvantaged individuals purchase the mandated coverage.
As far as I can see (and if any of you out there see it differently, please let me and the rest of our readership know), that's it. And this is a recipe for absolute and total disaster.
The health insurance companies will use feature #1 above as justification to significantly raise the already exorbitant premiums they charge. This will place a huge burden on employers who still provide health coverage for their employees, who will either have to carry this additional expense, increase paycheck withholding, and/or change their plan offerings to policies that offer less coverage combined with massively increased co-pays. The Obama administration will be blamed for this.
Regarding provision #2, the health insurance cooperatives (A.K.A. "Hillarycare"), the only thing this accomplishes is to allow people to join health insurance groups, similar to those that cover employees of corporations, and thus obtain care at rates lower than would be charged for individual coverage. Most people, however, don't understand how that really works. Where an employee might only have a couple hundred dollars withheld from his or her paycheck, this is only a small percentage of the actual health insurance premium that is paid for his or her coverage. The employer pays for at least half, and more commonly 3/4ths or 5/6ths, of the cost.
But the ENTIRE cost has to be borne by the policyholder when purchasing from one of these cooperatives. For a family policy, this would come to somewhere between $500 and $600 (and in some places more) out of EVERY BI-WEEKLY PAYCHECK. And for those that are not covered by their employers, this will be the least expensive option available. And cost of this coverage will surely rise, and rise HUGELY, because of the inability of insurance companies to so dishonestly limit their "medical losses" by denial of care for pre-existing conditions and canceling policies once policyholders actually get hurt or sick.
But consider this little hand-grenade: Because there is no provision (at least of which I am aware) to control costs, either of health insurance premiums or the actual cost of the medical care itself, in any way, the Federal subsidies mentioned in #4 will skyrocket very rapidly, putting an unsustainable burden on our Federal budget. What is in this bill to stop insurance companies from continuing their patient gouging? Indeed, this bill seems to ENCOURAGE it, as if any such encouragement is necessary when it comes to the insurance companies' need to overcome their reluctance to take our money. The private insurors will have a totally captive customer base and access to the U.S. Treasury. It would be a very tasty outcome for them.
But note that, aside from denial of coverage for those of us with pre-existing conditions, there is nothing in this bill that might leave us individuals with more money in our pockets or any increased availability of health care itself. It would not just be a disaster for American health care, or for the Federal budget, but also for the Obama administration and congressional Democrats. Remember, Barack Obama will need to stand for re-election in 2012, and House members and a third of Senators in 2010. If the currently likely bill passes, WE DEMOCRATS will LEGITIMATELY take the justifiable blame for it.
(There is a sliver of hope, however, that the House will pass a measure WITH the public option, the Senate will pass a different plan without one, the public option will be retained in the reconciliation bill, and then the reconciliation bill will pass with the necessary fifty votes plus Biden. If this is the strategy, it is a very clever one and I hope it succeeds.)
I will, however, STRIDENTLY oppose any plan without the public option. Such a plan will be WORSE than nothing. I hope that Barack Obama, despite his rhetorical vacillating and his spokespeople's evasiveness, will veto any such measure, and then beat the Republicans (AND "Blue Dogs" during the primaries) about the head and body with the resulting failure. I am quite certain that the vast majority of Americans support genuine health care reform and will vote on that single issue alone on election day.
Private health insurance needs to go. Period.
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