Reform or Insurance Regulation?
Did I hear you ask, “So Dad, what do you think of the new Health Care Bill passage?” I’m glad you asked. First let’s start with my rant/opinion/knee-jerk reaction.
First, let’s be clear, this is not health care reform. This is largely health insurance regulation. There is little here that reforms the health care system. There is nothing about malpractice liability, pharmaceutical pass-throughs, Medicare fraud, intermediary administration oversight, emergency room abuse, nursing shortages, hospital malfeasance, medical training or consumer education. It’s all about regulating the big bad insurance companies. Ironically, the bill does not ensure that every American has health care, it tries to ensure that every American has health insurance – that we all are customers (willing or unwilling) of those same demonized insurance companies.
It does nothing to address the cost of health care. That is – why health care cost so much to begin with. I don’t mean why do insurance premiums go up – I mean why does the price charged for an X-ray go up? Insurance premiums go up because health costs go up. The bill is addressing issues from the consumer end of the equation (users, insurance, coverage loopholes) rather than from the provider end of the equation (technology, supply and demand, profitability).
The difference between “care” and “coverage” is vast. You can have all the insurance in the world, but if there are not adequate facilities and professionals at your disposal, what good is it? If there are no doctors or hospitals willing to accept your particular insurance carrier’s product, then you are out of luck. It’s true that many 1st world countries have national health care programs. It’s also true that they have huge service backlogs and inferior care. Just having an insurance card in your wallet won’t necessarily get you the care you need.
Where did the votes come from? Conviction or Duress?
Second, it is quite clear that members of Congress are not voting their conscience; they are voting under duress, under pressure, under coercion and under the influence of backroom deals (e.g., Nebraska and Florida). According to the Rasmussen Reports national telephone poll, taken Friday and Saturday nights, 41% of likely voters favored the health care plan. Fifty-four percent (54%) were opposed. Given that we theoretically have a constitutional representative form of government, one might expect that 54% of Congress would also oppose the bill. That doesn’t seem to be the way it turned out. A scant 50.8% voted in favor. Hardly a mandate.
It is difficult to believe that there wasn’t a single Republican (not all Republicans are conservative, you know) that saw plausible value in this bill. It’s also astounding to see how many democrats jumped the fence (just two weeks ago, Speaker Pelosi admitted she did not have the votes to pass the bill). The notion of party loyalty/arm-twisting flying in the face of personal judgment is very disheartening.
Can we do better?
Third, as a taxpayer and voter, I resent that this bill has been crammed down my throat. It seems quite clear that those in power set a goal to pass a “health care” bill. Not necessarily to pass the best possible health care bill, or the most sensible health care bill, or the most cost effective health care bill – but just to pass a bill. I have no doubt that the health care system in this country needs miles and miles of improvement, but that is not reason enough to pass whatever bastardized bill can somehow squeak through Congress. There is no reason that this bulk of change had to be passed in a single ostensibly comprehensive bill other than to enable its proponents to say, “There, we did it.”
In the next post – let’s look at some of the particulars.