Among the many things not to like about the current health care reform proposals, IMHO, are the provisions that public funds will be used to subsidize the purchase of private insurance. I would propose that any public funds be used strictly to provide public health insurance, so that we can be assured that our tax dollars do not end up in the pockets of health insurance company CEO's and shareholders instead of being used to provide actual health care for those who need it.
In addition, providing public funds for private health insurance may actually be a step backwards in the fight for reproductive rights, because in order to make good on the pledge that this bill will not reverse a long-standing policies prohibiting the use of federal funds for abortions, it is likely that any health insurance legislation coming out of this process will also prohibit subsidized health insurance policies from covering abortion procedures. I would imagine that at least some private insurance policies would drop abortion benefits in order to qualify for subsidies.
Under the major proposals, those making less than 133% of poverty would be covered by Medicaid, which is a public plan and already prohibits funding for abortions. No issue there.
But for those making between 133% and 400% of poverty (up to $88,000/year for a family of four), there would be subsidies provided to assist with the cost of obtaining health insurance. Those subsidies would be available for both private health insurance and any "public option" that survives the legislative process. By most estimates, the vast majority of these subsidies will go towards the purchase of insurance on the private market. As there is no requirement that the private options be nonprofit, we can then guarantee that at least some of our tax dollars will in fact end up in the pockets of insurance industry CEO's and shareholders. That only is enough for me to oppose it.
But the sticky-wicket is the abortion issue. How can the federal government avoid paying for abortions, if it's subsidizing the purchase of insurance that provides them?
Directing these subsidies to the private sector could become a real budget-buster. The bills all include a requirement that everyone buy health insurance, while including no limits on how much they'll have to pay for it. Those who complain about this potential screwing of the American people are told that, "oh, but there'll be subsidies to make sure that it will be affordable".
Well, the subsidies are in fact defined in terms of "affordability" with anything above 12% of your total income being considered unaffordable. But if there are no limits on premiums, then the federal government will be on the hook for an unlimited amount above and beyond those affordability limits. Given the profiteering that already exists in the insurance industry, as well as other provisions in the bill that will surely raise costs from insurance companies such as not being able to deny people for pre-existing conditions, who knows how high those premiums, and thus the federal subsidies, will go? The sky's truly the limit.
Again, I do want everyone to be covered. I just don't think that we should be contemplating paying private insurance companies to do it. Why not just focus our public funds on our public plan, as do know with Medicare, Medicaid, and the VA, and as nearly every other country does. "Privatizing" universal health care is a recipe for disaster, whether it be in terms of affordability, quality of care, or federal budgetary issues.
UPDATE from HuffPost h/t to Davis X Machina in the comments: Maine Sen. Olympia Snowe addressed some of these issues in a meeting Tuesday with business representatives and lobbyists from her state Robert Bixby, executive director of the Concord Coalition; Clifford Mohr, president of Group Dynamic Inc.; Greg Dugal, executive director of the Maine Innkeepers Association; Tarren Bragdon, CEO of the Maine Heritage Policy Center; Dean Powers, director of the Maine Small Business Coalition; Richard Grotton, CEO of the Maine Restaurant Association; David Spellman, President of the Pratt Financial Group; and several other lobbyists.
She quizzed the bunch on what they thought of the proposal to mandate that individuals purchase health insurance. She added that she was considering requiring business with more than 50 employees to pay 100 percent of the cost of subsidies for their employees' health insurance.
Small business representatives told Snowe that they were opposed to any mandates that came without a public option and that such an alternative was desperately needed for small business, which can't afford the rising cost of health insurance for their employees. The costs make them unable to compete on a level playing field with bigger companies, which can use their size to leverage lower prices. Lobbyists representing larger corporations took the opposite position.
The heart of the Finance Committee's bill, Snowe said, is regulation that would force health insurers to offer, at an affordable price, a minimum standard of coverage -- a so-called "bronze" plan.