Ezra Klein is satisfied with the Senate bill.
"Insurance companies win," Markos Moulitsas tweeted last night. "Time to kill this monstrosity coming out of the Senate."
This was, for progressives, a frustrating vote. But the flip side of it being morally unconscionable for Joe Lieberman to put the bill at risk over something as small as Medicare buy-in for 3-or-so million people is that the absence of Medicare buy-in -- and of the weak public plan -- is not reason enough to oppose the bill, either.
Klein's argument seems to be:
- If we need more money for subsidies, we can later throw more money at the system,
- If costs aren't held down, then there'll be a better argument for a public option in the future.
My take is that it's unconscionable to force people to buy a product from a private insurer that enjoys sanctioned monopoly status. It'd be like forcing everyone to attend baseball games, but instead of watching the Yankees, they were forced to watch the Kansas City Royals. Or Washington Nationals. It would effectively be a tax -- and a huge one -- paid directly to a private industry.
Without any mechanisms to control costs, this is yet another bailout for yet another reviled industry. Subsidies? Insurance companies are free to raise their rates to absorb that cash. More money for subsidies? More rate increases, as well as more national debt. Don't expect Lieberman and his ilk to care. They're in it for their industry pals.
If you want a similar model, watch how universities increase tuition to absorb increased financial aid opportunities. And since the Senate and its industry-bought Senators won't allow insurance premium caps or an end to the insurance industry's anti-trust exemption (much less a public option to compete against them), there is nothing keeping those companies from jacking up rates to screw people. In fact, that's been their modus operandi for years.
Provisions prohibiting rescissions are fine and dandy, and fairly non-controversial, but they are toothless. The legislation allows rescissions based on "fraud" and "willful misrepresentation". I'm still not sure what that means, but if the insurance company doesn't want to pay for your expensive care, seems they can assert those clauses and refuse to pay. Then what? You have to fight for coverage, get lawyers, hit the courts, hope you survive long enough to resolve the issue. Looks a lot like the status quo, doesn't it? Indeed, insurance companies already cite fraud or misrepresentation as the excuses for rescissions.
The insurance industry began 2009 fearing genuine reform that would force them to become responsible corporate citizens, and they are exiting it on the cusp of a dramatic government-sanctioned windfall. It pays to be an industry that's too big to fail.
Strip out the mandate, and the rest of the bill is palatable. It's not reform, but it's progress in the right direction. And you can still go back and tinker with it at a later time. Whether this passes or not, any further reforms will still need new legislation. And any new legislation will be just as furiously opposed as this one was. It's not like the opponents of health care are motivated by reason. They are motivated by the health insurance industry's bottom line. Nothing we do with this current bill will change that.