One of the arguments frequently made by proponents of the Senate health insurance bill is that we need to pass it so we can fix it later. I have a simple question: how do we do that?
If we couldn't get a good health care bill in 2009, which started with an enormously popular president, and ended with us having large majorities in both houses of Congress, how are we going to get a better one, any time soon? Why would anyone think that the Congress that couldn't get it right in the first place will be able to fix what it couldn't get right in the first place? And given that we are undoubtedly going to lose seats in both houses of Congress, this year, when exactly are we expected to get it right? Next year? Next decade?
To me, the Senate bill has too many serious flaws. I've previously explained them, but I'll repeat some of the larger ones:
A mandate with no public option, which is nothing more than corporate welfare.
An anti-trust exemption, which will allow collusion to neutralize any positive impact of any exchange, even a national one. But there's no national exchange, anyway.
The excise tax. Health care costs will continue to rise, even if not quite as quickly. And more and more people will find their plans cross the threshold, as the so-called Cadillac tax begins to look more and more like a K-car tax. Bob Herbert addressed this most clearly.
No repeal of ERISA Section 514, which means it still will be difficult and deadly even to sue for denial of treatment. And given that the insurers will be required to cover people with pre-existing conditions, they certainly will have an even greater incentive to deny treatment to those whose pre-existing conditions require expensive treatment. That the insurers can't kick people off their plans while the lawsuits are slogging their ways through the legal labyrinths is irrelevent, because even though the victims of denial of treatment still will have insurance, they also still won't be getting the treatments they need. And for some, that will mean they will die.
Couple the mandate with denial of treatment, and you will have people forced to pay for plans that won't help them. They will be forced to throw away money for nothing. And for some, that will mean they will die.
Nelson. Reproductive rights. Overton Window. The Democratic Party being the agent of regression.
The public option remains popular, while the current plan is increasingly unpopular. Even single payer or a Medicare expansion was consistently popular, when polled. There are so many problems with the Senate bill, and House members have every reason to be worried about both the policy and the politics of passing it.
At the risk of repeating myself, there is another way. Just passing the Senate bill would be a disaster. Reconciliation could remove some or all of the bad aspects, and it could add some good new aspects, such as the popular public option. And reimportation of medicines. And the ability of HHS to negotiate better prices on medicines.
But getting back to the original point, it's again worth asking: if Congress can't get it right, in the first place, why is there any reason to believe it will fix it, later?