Monday, July 20, 2009

Taxing The Wealthy To Keep The Rest Of Us Healthy & Other Notes On Reform

If you don't believe that health care is as much a right as education, clean air and voting, then move along because there's nothing for you to see here.

But if you're with me and have managed to keep up with the health-care reform lollapalooza going on in Washington without getting whiplash, then you might agree with the following conclusion: Out of all the smoke will come a reform law by year's end that will include some sort of public option.

The law will be a good start on reducing the ranks of the tens of millions Americans who have no insurance or are underinsured. It will banish the ghosts of HillaryCare, the 1993 reform disaster. But it will fall short of being the kind of comprehensive reform that is desperately needed.

As things now stand, a bill that is the consensus work of three committees -- an accomplishment in itself -- has been introduced in the House that would mandate certain cost cutting, primarily in Medicare, and include a progressive tax on the richest
Americans to attain the goal of dramatically reducing the number of uninsured. (The American Medical Association, in a politically shrewd move, has endorsed the House bill, but there are bound to be many strings attached to that endorsement.)

The cost of ObamaCare: $1 trillion over the next decade, according to the nonpartisan Congressional Budget Office. Or $1.5 trillion if you're Newt Gingrich.

Meanwhile, over in the Senate two committees also are working on legislation, one closely resembling the House bill. and the other a watered-down version.

Per usual, reform votes have been along strictly partisan lines with Republicans predictably fuming about dunning the rich even though the surtax for people making in excess of 500,000 large a year would be more or less comparable to the gas-guzzler tax on a BMW 7-series luxocruiser.

Spoketh House Minority Leader John Boehner: "During a deep economic recession, it is criminal malpractice for Democrats to push a government takeover of health care . . . that will destroy more American jobs."

It really is mindblowing that the GOP base is increasingly made up of white guys who
drive pickup trucks with gun racks and Confederate flag stickers, yet the party elders -- as have their forebears for decades -- rush to the defense of those picked-on rich people whose wealth continues to grow disproportionately when compared to the party's own Bubbas.

The biggest of the big lies told by Boehner and his ilk, as well as the pharmaceutical, insurance and for-profit hospital interests that bankroll them, is that if Obama and the Democrats get their way, health care will be rationed. As in, like, socialist countries such as Russia and China.

"Rationing" is a dirty word if ever there was one, but
dirty pool on the part of the antis since nothing that President Obama or his congressional surrogates have uttered or proposed includes rationing in any way, shape or form.

What would happen is that a public option would give
individuals a choice. Imagine that! If enough people opted for the public option then private insurers might have to become competitive.

What dog? We are, of course, talking about c-o-s-t-s.

No reform plan will succeed if it doesn't include incentives to keep down costs, and a key to doing that is giving primary-care doctors a greater role in keeping their patients healthy.

There is, however, a shortage of these physicians because Medicare, Medicaid and private insurers don't pay enough for the work they perform.

That's right, it will cost more to level this particular part of the playing field, but the payoff could be ginormous.

Don't look now, but a consensus aspect of the Democrats' reform agenda looks suspiciously like Republican presidential wannabe Mitt Romney's greatest success as governor of Massachusetts. That was a sweeping reform of the way health insurance was marketed that sailed through the legislature with the support of Democrats whipped on by Senator Ted Kennedy.

Like the House Democrats' plan, virtually all Massachusetts residents must have health insurance or pay a penalty.

So-called "exchanges" are the central mechanism through which coverage has been extended and costs restrained. Under these exchanges, individuals get access to group coverage from private insurers, with subsidies for low earners.

The results have been impressive: Just 2.7 percent of Bay State residents are now uninsured -- the lowest of any state -– against 15 per cent nationally. Costs, which overran the program early on are now on budget and no private insurers have been driven into the sea.

Should this give congressional Republicans pause. You betcha. But will it? Nah.

The key component in the health-care system is nurses, but they have been utterly absent from the reform debate.

This is because they are poorly organized or not organized at all, are at the mercy of rapacious hospitals and health-care companies, and their advocacy groups are
laughably inept. Just ask this nurse.

Obama nails it when he says health-care reform is essential to a healthy economy. But with the Republicans throwing up obstacles that have more to do with trying to limit the Democratic hegemony , might we assume that they're against a healthy economy?

No and yes. Even the most cold-hearted Republican must be able to see the pain and suffering the recession has caused when they venture outside the beltway, be it homelessness or closed auto dealerships. But government involvement in health care is anathema to the GOP even if Medicare and Medicaid have been major ingredients in the glue that has kept American society together for the last 40 years.

As noted here, very few of us (myself included) will be
healthy enough in old age that we won't need healthcare or be able to pay for it after we retire.

That, when the lollapalooza plays out and all is said and done, is why there will be new reforms in the new year.



John said...

The draft House Bill (H.R. 3200)looks pretty good. Time for those who believe in universal coverage to get behind it and push.

bjalder26 said...

Obama Care claims to be like CommonwealthCare, but that's kinda like putting wings on a boat, and talking about how plane-like it is.