All the polls are showing, consistently, that Americans do not like the health care bill.
And can you really blame them? It's certainly the worst example of hideous sausage-making I've ever personally witnessed. It's still, mostly, a bill worth passing if you're just talking about policy. But we're NOT just talking about policy here. And when you consider the policy AND the politics, I've got to say at this point I don't think it makes sense to try to pass the existing bill... (follow me after the jump)
There are a couple things about health care reform that people understand immediately, and at a visceral level. Things that would be good policy AND good politics. And they're very simple.
First, the things that (if I understand correctly) need to be passed through the normal Senate procedure:
- No more discriminating by insurance companies about pre-existing conditions. This has to be paired with an insurance mandate, so people can't easily game the system.
- No more rescission of coverage until and unless intentional fraud has been proven in court.
Good luck getting the public on board with republicans who try to block a bill consisting almost solely of those provisions!
Now, the things that we'll probably need to pass through reconciliation:
- Set up national health care exchanges, Massachusetts style, so people can buy insurance individually if they need to.
- Subsidies. We need these to go along with the mandate, and we need them because it's the moral thing to do anyway.
- Major Medicare expansion. The Public Option was always just a poorly-defined pathetic substitute for this, and it confused the issue. So, make it simple: One of the plans available through the Exchange is Medicare. Reimbursements for providers from patients enrolled under expanded Medicare would be pegged at, say, "normal" medicare rates plus 5%. Or maybe 10%. Whatever.
... And that's it.
Simple plan. Easy to understand. Not a giant behemoth of a bill that's going to scare the crap out of people.