“If, as reported, the Democrats have dropped the public option, they have abandoned any attempt to improve the health care in the United States in favor of increasing health-care insurance profits. This is good for the economy, as ever more jobs will be created in medical claims processing. Also, delivering 40 million new (taxpayer subsidized) premium-payers to the insurance companies to pretend to cover the currently uninsured will certainly drive up health insurance stocks. But nothing in the bill will actually improve heath care nor lower the cost of what passes for healthcare in the US. The war is over, the people lost.”
I must say that I strongly disagree with this sentiment. First and foremost, it presupposes that adding 40 MILLION PEOPLE to the world of the insured is somehow barely worth doing. All these folks can go see a doctor, and not just whoever is on duty at the emergency room. And, presumably, won’t be financially ruined for doing so. And, presumably, will go sooner, when the treatment course will be both cheaper and more effective. Look no further than breast cancer diagnostic stage and outcome in african american women stratified by socioeconomic standing for a hint at what this could really mean. Answer: a lot. A shit-ton. Just this is (potentially) a giant cost container if you can convince people to use it and find sufficient primary care doctors to handle them.
Then, you’ve got the public/private government plans: extending tightly regulated but still for-profit plans like those offered to government employees. This is your mid-level cost container. These are big pools of folks…public option light with a prettier name. Garden-variety people will see the cost benefits that a large pool can bring. Also for the good.
Forgetting all that, though, you still have the (supposed) Medicare buy-in for individuals over 55; this is the biggest deal by far, and, if actually enacted, marks genuine progressive progress in this country. For the first time, you’ll have actual consumers comparing prices of the dread government care and that provided through private insurers. Worth noting that these same 55-and-ups vote. A lot. This is potentially a game changer. It’s a lot simpler to revisit the law and roll the eligible age for buy-in to 45, then 35, then everybody that might want it than it is to announce that on Jan 1, 2010, we’ll be having a single-payer plan in these United States, as much as many on the left would like to believe otherwise. This plan, much more that what remained of the late but not terribly lamented public option, has the potential to completely rewrite how we deal with healthcare in this country. Seriously. Because people will finally know what the costs are and what it means to be part of a negotiated, nationwide cost structure. And this information will begin to trickle down. Think of it as healthcare Reaganomics…
Best of all, though: This version appears to have the votes for passage. You could (potentially) convince Pelosi to ping-pong this thing straight to Obama’s desk before Jan. 1. Not saying that’s going to happen, but it could. But, by all means, go on like this outcome is a giant failure, not worth doing in the first place, and a deep disappointment to boot. Nothing gets us to President Palin more quickly.
Lemkin 