I hear a lot of people talking about "public option" and various other ways to keep the insurance companies in the loop, and I know that few of them seem to realize that the very concept of keeping the private insurance companies mandatory and the public optional was dreamed up in order to keep quality healthcare unaffordable for most Americans, keep profit margins high and keep the government insulated from the responsibility of ensuring healthcare was of acceptable quality.
The result has been a real nightmare of terrible healthcare and unaffordable prices for millions of Americans who have been in positions where they had the need to go to the doctor or hospital. Preserving that system can't be done, its pretty clear, BUT some are determined to prolong our agony in the worst possible way. They aren't interested in ever giving us affordable, quality insurance, don't fool yourselves, it can't happen without huge amounts of money that is not forthcoming. What they do want to do is DELAY CHANGE by any mens possible. Thats what "public option" is all about, that multiyear delay, while our nation is looted.
What we have now isn't working. When an MRI that costs $98 in Japan or $200 for the national plans or nonprofit private insurance companies (the patients never see those bills) in Europe costs $3000 in the US, something is wrong!
A big part of that huge cost is the commission charged by the insurance broker, and the 30%-50% "overhead" tacked on by the costs associated with insurance companies and billing. This means that so little eventually gets allocated for care that the care keeps getting worse and worse.
Lets look at what would be required in order to make public option or mandatory insurance affordable and represent good quality health care. First thing, we would need MUCH larger subsidies than have been discussed. At least ten times larger. That would cut into the military budget or future banking bailouts. Or require substantial raising of the marginal tax rate to pre-Reagan levels, So it won't happen. What choice is left? Single payer.
The bill as it currently stands is not going to leave us with any affordable "options" that work for people who have any kind of chronic illness. Its going to mean premiums co-pays and uncovered costs that are so high that those who are forced to buy insurance won't be able to afford to do it, so they will have no choice but to simply be fined. The sick are going to fall off the edge into the abyss. They wont have a way to make it work. They will end up uninsured and in huge debt, like they do now, but with the additional burden of years of untreated illness.
Sure this gets the government off the hook for responsibility for their care, but we are going to be creating an entire generation of Americans who not only can't get healthcare, they will be permanently in debt with no way out, and wont be able to rent or buy homes, get credit of any kind, or even probably travel. (unless they want to pay cash for everything)
We have reason to worry about the working class's future. An overlooked but very important reason for the vanishing security for the middle class is simple, we haven't been investing what we need to, in education.
Technology increases productivity, and creates quite a few good jobs, somewhere to, to manage it- However, the fact is that it does more things better and better at a very rapid rate is alwys catching up with people in the workplace, and our choices are either learn more or accept permanent unemployment.
As a mature economy, we increasingly have millions of people with a very expensive cost of living who don't have the skills to get the jobs that ARE being created. Thats one of the reasons we dont have any other choice than single payer at this point.
If we deny that imperative, we are going to be dooming hundreds of millions of Americans to healthcare that is so bad, that it will shorten their life spans, and fail to treat chronic illness, crippling them in the job market.
America is already the worst nation to be chronically ill in. Another few years of this terrible HMO style healthcare we are already sick from will create serious problems for us in the international arena - we won't be able to compete.
If this is our intent, then, this country is not America, its something else. But it seems to be the politicians intent to shirk their responsibility and cover up the very serious consequences of their actions.
If you still feel hopeful about that bait that is being offered, the so called public option, do some reading about their closest equivalent, the state high risk pools.
They are insurance plans that can't throw you out of you get sick. BUT, they are EXPENSIVE, so expensive they are out of reach for most of the people who need them, THEY LOSE MONEY LIKE CRAZY and they are not meant to suddenly become affordable to those who can't afford them- and they also are going under, the states can't afford to maintain them, just like the Feds will be forced to do- Theats their plan and everybody knows it. (The signs are all there that its going to be PROFOUNDLY limited in scope - For example, what about the poor middle class people who suddenly find themselves in the hospital with crappy insurance or no insurance but had a modest - but above the cutoff- income the year before?) That won't happen. These public options have been tried in state after state AND THEY NEVER HAVE WORKED.. Why? because they run into the roadblock of out of control medical costs and they are limited in what they can do BY their option-ness.
without forcing a complete restructuring of the system or spending far more than would ever be available, I think that the goal of whoever made that decision seems to be, in the context of what most of us realize now, really evil.
That secret, backroom decision to take the known working solution off the table, and try to substitute, (using a great deal of deception) something else, was NOT an innocent, well meaning attempt to build a bipartisan reform, as the Obama administration is still trying to represent itself as having meant. If they wanted quality and affordability, they would have said "this is the most acceptable, and only affordable way to do this, its the only way that will work." THEN they would have succeeded.
But thats not what they have done at all.
How have this administration and the bulk of the political establishment inside the Washington bloatway done this without more of an outcry? I suspect its by somebody, somebody with huge amounts of money to spend, seeding the blogosphere with massive numbers of fake, paid advocates of first, their candidacy and then, their health care related positions.
I think that given the HUGE stakes involved, the fact that Americans are dying in huge numbers because of the failure of Washington to act decisively to bring healthcare in the US up to international standards of performance, and the lack of candor on the fact that the public option could not be profitable, and indeed, had a built in self-destruct mechanism, we have to ask ourselves, HOW have they managed to get away with their secret deals at the beginning derailing affordability? How did they get this really terrible bill so far without being called to task for it?
It reminds me of that movie, Murder on the Orient Express, in its shared culpability, except instead of victim who clearly deserves their fate, people who comprise this nation are being destroyed by a thousand cuts, delivered separately, but collectively by all of the perpetrators. Its a war on the American people.
This was not an effort to bring about affordable quality healthcare. If you look at what they have DONE and not what they say, so far what we have really seen is an all out, bipartisan effort to STOP the real reform we need from happening.
Single payer WOULD be accepted by both left and right, AS PREFERABLE TO THE ALTERNATIVE, NOT SOLVING THE PROBLEM ACCEPTABLY AT ALL.
Do we have a real, or a sham democracy? This issue is the test, where the rubber meets the road.