Wednesday, December 09, 2009

Public Option Stripped from Healthcare Reform Bill


I have mixed feelings about this.... It's not what most Progressives wanted to see, yet I expected something like this would happen. In order to garner enough support in the Senate, I knew the legislation would have to be watered down even more than it already had been.

The new approach would basically leave private insurance companies (yes the ones that have been gouging and defrauding the American people for all these years) in charge of healthcare at all levels. The Fox has been put in charge of guarding the Hen House. And tonight, the Fox (the insurance industry) is laughing its ass off all the way to the bank. Why? Because this is a giant corporate giveaway.... like none other. Millions of Americans will be pushed onto private insurance rolls, strengthening the bottom line for the insurance industry.

Harry Reid (one of the worst Senate Majority leaders in modern history) wants to give us the illusion that what is left is still very much a "public option".

Essentially, this plan will allow the insurance industry to collude... to artificially set prices higher, etc, so that the industry could continue to make the same killing (pun intended) profiting from cutting corners on Healthcare that it does today. It will be very difficult to get any real competition under this plan. I am not arguing that it can't be done....apparently the new system will rely on a not-for-profit program...so it's possible. But I am pointing out that it will be difficult. The likelihood of success has gone down significantly in my opinion. Because the private insurance industry is going to naturally act in its own monetary interests....not in the interest of public health. I don't trust can't trust this industry to act in my best interests and compete effectively against itself. And with this approach, there is no real threat of consequences that would effectively deter insurance companies from trying to create workarounds and returning to some of the same abusive practices that they engaged in before.

This plan basically replaces the Public Option with a co-op. I believed that a combination public option/co-op could have been a workable compromise... but this is a much bigger scale down... a capitulation in a sense.

Perhaps the most interesting twist in all of this is the fact that Senators want OPM to run the new program. For those not familiar with OPM.... this is an organization that can't even handle its core mission very well, let alone a new complex program. Essentially OPM isn't all that good at running OPM. This agency has been underfunded and understaffed for years. That was the second red flag for me (the first came with word that the public option as it was structured before was dropped from consideration, and Harry Reid was refusing to make a statement).

Despite all of this, I hope the new plan will work as intended. This is probably the best that Obama and the Democrats could have accomplished under the circumstances. And perhaps it will could be something to build on later. If you think about this in the context of incrementalism... this is a pretty impressive accomplishment.

So despite my grumblings, I have to give the legislation a thumbs up.

Still learning more about everything that is in the new plan.

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7 comments:

Liberal Arts Dude said...

Hi AI

I've been watching the Ed Show on MSNBC and following the blogs like Open Left and Firedoglake on the public option. Needless to say I am not happy. It is sad to see the day the insurance companies won out over the interests of people. It is sadder to see the very low influence of the Progressive movement on mainstream politics. Progressives can't push healthcare reform on its terms at a historical moment with Democratic majorities in the Executive branch and both houses of Congress. I'm just bummed out about all of this.

Cosmic Navel Lint said...

Speaking as some who comes from a country, the UK, where all healthcare is free-at-the-point-of-need, regardless of a patient's medical needs or illness, I still struggle with the concept of the richest country in the world, the US, even considering the prospect of denying healthcare to approx. 40-45 million of its people.

Mind you, in our country, proper healthcare for all is considered an essential service and a societal responsibility, and not, as it appears to be in the US, merely a Lobbyist-driven business where profits come before people's needs.

I wrote this piece, the link below, trying to capture the quandary in which the US finds itself with regards to healthcare:

Scenes from the US healthcare debate

If the public option is now truly dead for US citizens, then it's another sad story in the canon of US healthcare.

The Angry Independent said...

LAD,

With enough safeguards, this may work. But it is difficult to see, from a structural standpoint (with the inherent conflicts of interests that come with this kind of setup) just how they will be able to accomplish the same end without a genuine public plan.

Keep in mind, the earlier "public option" was never going to be a full fledged public plan. Right wing branding attaching negatives to the "public option" has been so good that they even convinced some Progressives that it was going to be a complete government run program. But that was never going to be the case. The public option was basically going to be a government managed plan using mostly private sector service providers. Not that much of a difference in terms of structure from what they are proposing now. The difference w/ a public option would have been real competition, more oversight, stronger consequences for providers, stronger requirements for providers...with the government demanding certain things on your behalf...backing you up so to speak...and the government negotiating prices to keep costs under control...and offering coverage and more options for those at the very bottom who can't afford insurance (not sure what this plan offers for those at the bottom of socio-economic ladder).

Dumping the public option in the form it was packaged in was inevitable under the circumstances. And from a branding standpoint, getting rid of the "public option" may not have been an altogether bad move... It's just that the Dems waited too late to do it. The Republicans (beating the Dems in the media/PR game again as I predicted) were successfully able to run a campaign that turned the "public option" into a bad term for the American consumer, particularly for Conservatives and Independents. The Dems should have scrapped the terminology much sooner...or should have avoided the new confusing terms altogether...and simply branded their proposal as an expansion of Medicare. Those same Conservatives and Independents either use Medicare (a gov't managed program) or they know someone who does.... so the branding problem would have likely been taken care of from the beginning, avoiding this last few months of pure nonsense...(which has led to HCR being watered down numerous times).

Progressive strategists who surround Obama and Dems in Congress seem to be clueless about thinking ahead to take into account what the Right is going to do....anticipating their moves and developing appropriate policy approaches and tactics. They should be able to stay a step or two ahead of these folks at this point. The playbook of Right wing conservative strategists should be well known and understood by now... the bulk of it hasn't changed in the last decade.

But yes, I have the same sense of demoralization and fatigue as I watch all of this play out. I pretty much told the tale of this back in the Summer. It's playing out even closer than I thought to what I had anticipated.

The Angry Independent said...

Cosmic,

I envy the programs and systems of gov't in Europe (generally speaking).

Europe and Canada simply have a different social contract with its people...and have a different idea of what's important. Their priorities are fundamentally different. In the U.S., corporate interests, private sector profits, and special interests (powerful lobbyists & elites) are assigned a higher priority than the welfare of ordinary people. It has been this way for many years...through much of the 20th century (minus New Deal policies).

Europe and Canada made a decision that they would invest in people...in their human capital... because it is a good investment.

The U.S. seems to think that it can neglect the welfare of its people...avoid investing in its human resources (education, healthcare, safety, child welfare, college access, job training, food insecurity, homelessness, social services, wellness, labor rights, economic security, etc etc) and remain on top in the world...and that's not going to happen.

At some point under this system, even the military industrial complex.... the beast that eats so much of our nations resources...will begin to suffer....for example... Fewer qualified folks available to fight with the new age technology, fewer people healthy enough to recruit (there was just a report on this a few weeks ago), fewer tax dollars available to feed the beast... because your economy isn't growing properly because the nations human capital has been neglected for so long, etc....

Cosmic Navel Lint said...

Damned fine and lucidly put points Sir!

And by extension, in terms of the covenant between a government and its people, i.e. 'the social contract', what incentive is there for any individual to invest his/her personal collateral into a society which doesn't, by default, do likewise in them?

It's easy to see how the cracks are built in to the US system: it's all very well the rote placing of your hand on your heart, as a schoolchild, and pledging allegiance to the flag - but on too much recent evidence, the flag aint keeping its side of the deal.

Roderick said...

AI, if you hadn't noticed there is no cohesion in the Democratic Party much a less cohesive message.

But what ticks me off is how gleeful the conservative Democrats seem having killed off the public option.

*sigh*

But I lay most of the failure of this bill at the feet of Obama because he has not put any political capital into this debate and what he doesn't understand is that if the Republicans postpone passage of this reform until it dies that they will be further emboldened to challenge him after they win some seats in November 2010.

Cosmic Navel Lint said...

Thought you guys might like this Jacob Weisberg article from Slate:

Are Republicans Serious About Fixing Health Care? No, and here's the proof.