I’ll Pass on the Party Hats and Whistles, Thanks

As of last night, the House of Representatives has passed sweeping health care reform. The deed is done. Not really, of course; the bill must go yet again to the Senate, where—despite the euphoria of Democrats—passage is not assured. And if it does, the issue still won’t be settled; several states are planning to fight against the law in court. But the vote is seen by a key moment for both sides, with leaders of both arrogantly claiming to tell us that real Americans are on their side. We’ll see who is right over the course of the next several months and the next election cycle. I suspect that in this, as just about every other issue and election over the past several years, the divide is passionate but pretty even.

(I’m relieved that, whatever the outcome, the Democrats did not resort to the “Deem and pass scheme.” Even had I wholeheartedly endorsed the bill, it would be a tragic betrayal of our values if our leaders were to circumvent the essential democratic process with some procedural chicanery.)

I’m decidedly ambivalent about the whole issue. I’d hoped to write a series of posts exploring the issue in depth while the issue was hot, but other demands and priorities prevented that. Perhaps I’ll still get around to it in the not-too-distant future. Suffice it for now to say that I do strongly believe we need serious health care reform. I support the idea of some form of universal health care, though I find some merits and would be willing to give a chance to some form of a “consumer-driven” system. I hope that the bill accomplishes what its supporters claim. But there are many troubling aspects to this bill that I fear may come back to haunt us.

The Right has been rabid in their denunciations, as can be expected with virtually any Democratic effort. But if you put aside the reflexive cries of slippery slopes, socialism, totalitarianism, and the bungling nature of government, there are some substantive issues. The costs of the bill and the potential to balloon the debt if everything does not go precisely as planned is something which does trouble me. And while I do see the logic of requiring everyone to be in the risk pool by having insurance, I do think that there is a legitimate issue regarding the constitutionality and the ethics of requiring everyone to own insurance simply for existing.

It isn’t just the conservatives who are concerned. In the today’s email message from Rabbi Michael Lerner’s Network of Spiritual Progressives, there was many caveats in the praise for the victory

it’s also ok to acknowledge that this bill does not represent most of what we really want. It is the biggest give-away to the private insurance companies in decades, forcing 30 million people to buy health insurance whether or not they want it without putting any significant price controls in place, so the insurance companies get a huge new group of health insurance purchasers and can (and will) raise their prices just as they have done in outrageous ways in the past decade.

Ralph Nader, dismissed the bill in the New York Times as “a major political symbol wrapped around a shredded substance…It is a remnant even of its own initially compromised self. Chris Hedges referred to it today in Truthdig as “a bill that will do nothing to ameliorate the suffering of many Americans, will force tens of millions of people to fork over a lot of money for a defective product and, in the end, will add to the ranks of our uninsured.”

I suspect that the Democrats have used up their only opportunity to fix health care. I don’t think there will be the chance to revise things over the next few years; after labor that difficult, what you see is what you get. I guess we can only hope that their gamble pays off.

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4 Responses to “I’ll Pass on the Party Hats and Whistles, Thanks”

  1. Enna Says:

    Great post, Derek. I think there are a lot of concerns with the bill, but to me, I kind of think it was a necessary first step – forcing through some form of health care reform, just so that in 8 – 10 years we can see that in fact, we are not all socialists now, and the world didn’t end. And then we can try tweaking it a little more again.

    I often heard the argument during debate that you couldn’t require insurance companies to insure everyone (getting rid of their ability to deny based on pre-existing conditions) without requiring everyone to get insurance. There seems to be a lot of logic in that. But I think it requires a third leg to stand on: you can’t require everyone to get insurance without an affordable option. For so many people a few hundred dollars a month is simply not affordable. Period. As far as I know, this bill didn’t include any expansion of medicaid, and so I worry about those that make too much for government care, but not enough for private premiums…

    A friend posted this on her face book page – http://www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_508315.html#s75147 – it gives the top 18 ways that this bill will affect people. Some of them – inability to deny coverage, inability to drop coverage, are important reforms, in my mind. I’m still feeling hopeful about this one…

  2. Tristin Says:

    Great points, Derek. I also agree with Enna right now; knowing that change is normally a game of momentum, the most important thing is to get the ball rolling and break through the restrictive norms in place today.

    The bill clearly has its weaknesses, and the potential for failure is massive, but my opinion is that nothing could be worse than the old system in place right now. 30 million uninsured and financially destitute Americans likely agree with me. The fortunate thing about being in the middle class is that when you are getting screwed by a law it is very difficult for government and corporations to ignore you. Either the law will be fixed or the private sector will find a solution to attract your business.

    Thanks again for the sober discussion!

  3. Julie Says:

    Thanks for this post. I very often don’t agree with your liberal stance, but you (hopefully) know that I like to hear your side. With all the bashing on one side and praises on the other, I felt like it was just a huge party-line piece of legislation. I know you don’t exactly prefer to call yourself a democrat, but I like to see when my more conservative view and your liberal view actually meet in the middle.

  4. Erik Says:

    One reason healthcare bills are often so high is that Hospitals and doctors must over compensate for their losses from treating the uninsured and under insured patients. If someone does not have insurance, they often just wait till the condition worsens and ultimately go to the emergency room. Of coarse, if someone is uninsured then the likelihood of them being able to afford the bill is quite low. These means that hospitals are loosing money from the uninsured and the rest of society has to pay for it. Furthermore, the biggest reason for bankruptcy in the US is medical dept. When people declare bankruptcy the hospitals need to compensate for the loss, so they charge others more. What I am getting at is that when people are uninsured (or under insured), it costs the rest of society money via higher prices at the hospital. The insurance mandate would make it so the hospitals will not need to charge more to some to overcompensate for unpaid bills by the uninsured and the under insured.

    The insured (and the uninsured who can afford the bills) pay for a portion of the uninsured and under insured’s health bills. At least the healthcare bill (theoretically) will make it so people can afford health insurance and won’t have to rely on the emergency room, which is incredibly expensive, to get treated.

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