The Senate Finance Committee continued debate on its healthcare reform bill today, voting down two amendments to add a public plan to the bill. But, that’s okay, because this bill should not be passed anyway. If liberal Democrats manage to find the courage to match their rhetoric, they will not vote for the bill on the floor until not only a public option is added, but also needed revisions are made.
The Finance Committee version of the bill, America’s Healthy Future Act, also known as the Baucus bill, after committee chairman Max Baucus, is far from perfect, and far from simple, wrapped in layers upon layers of legalese that contain more benefits for insurance companies than for the American people. There are highlights.
For one, there is a mandate that all people in the country purchase health insurance. This is essential to any healthcare reform designed to lower costs, as the healthy will subsidize the ill. Why is it okay to force people who don’t need healthcare to purchase it? Because unless a healthy person dies suddenly and unexpectedly, they will need healthcare eventually, and the time they spent buying into the system beforehand reduces their costs. Also, sickness and injury cannot be predicted. The healthy can enter the ranks of the unhealthy in an instant.
What may not work in this mandate are the penalties for non-participation. The Baucus bill prescribes a yearly penalty of up to $950 for individuals and $3,800 a year for families who remain uncovered. The idea of punishing a person for doing nothing creates an uneasy feeling, as it feels like an invasion of a person’s liberty. But, in the case of an insurance mandate, where lives will be saved because everyone participates in making the system strong, levying penalties on those who refuse to participate is appropriate. It’s the final numbers that need to be worked out.
There is also a requirement that insurance companies provide coverage to all individuals regardless of their health status. This is another essential element to any healthcare reform, as denial of coverage is among the most cruel and inhuman behaviors that an insurance company can engage in. The details behind this provision remain murky, however. Insurance companies deny coverage to their customers, and their potential customers, in order to increase profits. Their initial reaction in being forced to provide coverage, as seen in individual states that have mandated coverage laws, is to raise the cost of premiums across the board to cover the healthcare of those they would normally not cover.
Hard numbers on the cost of premiums to an individual purchaser or a business are hard to come by, but expect there to be much wrangling within Congress and the lobbying industry over the final dollar figures of this provision. Also, expect the insurance companies to find friends in Congress to rig the numbers so they actually increase their profits because of this provision. Cynical? Yes. But unless realistic caps are placed on the cost of premiums, this provision has the potential to increase the cost of healthcare in the United States rather than rein it in.
Another murky area is that of the non-profit healthcare cooperatives that people would be able to purchase plans from. Supposedly, these co-ops will offer plans at cheaper rates than that charged by for-profit corporations, but it remains to be seen how these co-ops would be staffed, or how they would negotiate with health providers. Will they just pop up out of thin air? How many people will need to purchase plans before they have the clout to confer real savings on members? What happens if a co-op goes bust?
Currently, healthcare cooperatives are little more than an idea, proposed to placate opponents of including a public plan in any healthcare reform. There is an inspiration for the idea, Group Health, that operates in the northwestern United States, but no one in the debate seemed to care about co-ops until the public option began to go down in flames. It is purely a stop-gap proposal designed as a response to the despicable right-wing tactics that have destroyed honest debate since the summer. As such, it should be held in the same regard as anything else that is a knee-jerk response to fear, hate, and bigotry.
As for the public option, two amendments were introduced before the Finance Committee today, by Senators John D. Rockefeller IV and Chuck Schumer, and both were defeated. The general feeling among those in the committee is that any bill with a public option, while it would find the support of more than 50 Senators on the floor, would not be able to pass the threshold of 60 necessary to end debate, thus inviting the Republicans to filibuster the bill to death.
Baucus and the other Democrats on his committee that killed the two versions of the public option today are taking a mighty gamble. They are betting that party solidarity on the floor of the Senate will overcome the ideologies of liberal Democrats and push the bill to passage regardless of its content. He, rightly, is taking for granted any Republican support. The only GOP senator who could vote for healthcare reform is Maine’s Olympia Snowe, and her vote at this point is a pick ’em. If the bill gets even a little blue, she’s gone. As for the rest of the Republicans, they are not concerned at all with passing healthcare reform. Their aim is to deny President Obama any legislative victory at all, so there is nothing in any Democratic bill, regardless of actual content, that they could vote for in the Senate. So that leaves the Democrats with essentially sole responsibility for passing the bill, depending on how the wind is blowing in Maine on any given day.
But, there is no guarantee that the Democratic caucus will maintain its solidarity in the face of the Baucus bill. A public option is far from a peripheral proposal to liberals and progressives. Most regard it as just as essential as any other important provision of healthcare reform. Any bill that does not have the option to buy into a public plan is a bill not worth passing to those who feel this way.
Additionally, polling indicates that a majority of Americans support including a public option in healthcare reform. A recent poll released by the New York Times and CBS News asked the question “Would you favor or oppose the government offering everyone a government-administered health insurance plan like Medicare that would compete with private health insurance?” 65% of respondents favored such a plan, while only 26% opposed. If that poll is an accurate measure of opinion in this country regarding the public option, then woe be to any Senator or Representative that opposes it.
The key piece of wording in that question is “government-administered health insurance plan like Medicare...” That simple bit encapsulates in simple terms all that has been wrong with the debate on healthcare. Medicare is a hugely popular program in this country. There is little doubt that a public plan within healthcare reform would amount to much more than an extension of Medicare to those under the age of 65. But, the debate was allowed to twist this idea in so many different directions this summer that there were actually protestors who thought that Medicare was a private plan that the government was targeting for termination.
But when presented honestly and simply, as it is in that question, there is little reason to doubt or regard the public option with suspicion, and thus it finds broad support.
So if the public supports a public option so strongly, it is baffling that there is even a bill being considered at all that has no provision for government-run insurance within it. There will be plenty of Democratic senators who come to the same conclusion, and there is every reason to believe that Senator Baucus miscalculated when he decided he could thread the needle on the floor with his plan.
A strong public option is what the bill requires, and it is what the country demands. The health insurance industry in this country is morally bankrupt and indefensible. The ideologies that allow human suffering to serve as the basis for a profit-making enterprise kill tens of thousands of people a year. Removing profit from the equation, by forcing insurance companies to compete with a government plan, is not only fair, it is right.
When Ron Paul stands on the floor of the House and says, “No one has a right to medical care,” he is saying that empathy for the suffering is wrong. He, along with so many others, is saying that a person’s suffering, their very survivability, their worth on this planet has a dollar value, and that if they cannot meet that value, then they deserve to die.
This is why we have a government. This is why we have a civilization, so that we can all cooperate in making sure that needless death and suffering is prevented. The public option is that important. It is affirmation that we are a species blessed among the rest of the animals, that these big brains evolution bestowed on us have separated us from the savagery of the jungle.