The argument, as presented by Senator Harkin, that the current health care bill is a foundation that we can build upon is gaining some traction of late.
The basic theme is that the bill moves us towards universal health care, that somehow, this the legislation as it stands (and is likely to exist when negotiations are complete) will be a step towards even better reform in the future, that it will be the foundation upon which we can build out a better system.
I believe the opposite is the case. Rather than moving our view of health care towards a universal and individual right, the bill as it stands moves insurance for health care wholly and fully into the private sector. It enshrines the insurance companies as the entities that control health care in our society, and by doing so, will make it even harder to get anything like a PO or single payer or expanded medicare down the road. And by placing sole responsibility for providing health care in the private sector, given our nation's history for the last few decades, it will actually make further regulatory reform even more difficult.
The bill as it stands places the insurance companies on the level of the financial institutions; this bill will make them Too Big To Fail, no matter how poorly they preform their new "societal duties". As it stands, this bill would permanently enshrine the insurance companies as the mechanism to control and regulate health care in our nation, just as the financial industry now controls and regulates the coin of our realm.
Once they have been enshrined in that role, and knowing that if they go down, we all go down, they'll make the assumption, as the banking industry did, that they can take undue risks, because they know that they'll be propped up and bailed out if they fail.
At the end of the day, right now, the health insurance companies make sure that they can at least pay out a certain percentage of their contractual obligations. Yes, their policies of denial of care, or recension, of effectively prescribing care based on cost are vile at best, but if they can't pay at least some portion of the majority of the claims, they go under.
If, however, they are enshrined in the pantheon of Too Big To Fail, they'll take riskier investments. Oh, I'm sure that they'll justify it to themselves - they'll embrace statistical algorithms like those that led to the bundling of toxic assets; they'll say that they need to expand horizontally to increase income to pay medical costs, but eventually, they'll crash, just like the financial industry has. In effect, it will become the true unholy union of the financial sector, the health sector, and the government.
And when they do crash, they'll know that We The People will be forced to bail them out, no matter how bad a job they're doing. And because they'll be so entrenched, because they'll have so much money and Washington power behind them, because they'll have the bucks to sell us on how vital they are to our society, we'll do it. And the cost of doing it will be that we'll be even less healthy and live shorter, harder lives.
Now, I realize that some folks hope for more regulation down the road that will cap deductibles and premiums, and generally ensure that insurance equates to availability of care regardless of financial situation. That the flaws in the current legislation can be fixed. But look at the financial sector. Once they were effectively given control and regulation of the coin of the realm, look at what they did with it. Again and again during the last decades. And regulation has weakened, not been strengthened, in that sector.
Furthermore, once the insurance companies are given that much more power and influx of wealth, they'll have that many more resources at their disposal to maintain their position. They'll use even more of the money that we pay them buy ad time to convince us of what a great job they're doing and to lobby bribe our legislators in order to ensure that there never is real regulatory reform.
A true foundation would have been something that actually gave us material to work with. A weak PO could have been expanded. A limited medicare buy-in could have been built upon. But simply giving complete control to the insurance companies does not give us the basis for improvement. Rather, it only serves to empower the insurance companies, to give them more pull, to cement their position as the gatekeepers of our well being. In other words, the foundation for permanent control of our very health by monopolistic, private, for-profit corporations is being laid. The foundation that is not being laid is one that we can build a true, modern health care system upon.
In the end, people need to remember that corporations exist for exactly one reason: to make money for their shareholders. Nothing more. And when there is actual competition, when we aren't talking about monopolies that control life and death matters for all Americans, this can be a good and healthy thing. But in the case of health care, especially when there is no competition, and said corporations are exempt from anti-trust laws, the best way that they can create profits is to increase costs and decrease care. Once it is the law of the land that we pay for their services, and with no competition against them, it will be well neigh impossible to break their hold on their position.