Monday, October 26, 2009

Unhealthy care reform

I was going to title this post something about Yin-Yang, but decided against it because neither of those opposing principles is bad, it's just a question of when either is to be preferred as a source of action.

And this is a case of good news/bad news; to be more specific, a sort of good news plus a reminder of bad news.

The sort of good news is that the version of the health care bill to be considered by the Senate will include a public option, albeit with an opt-out provision.
The "opt out" proposal would set up a national insurance plan with government seed money and be run by a private, not-for-profit board. Under the proposal, states would have to prove they can provide comparable coverage in order to exit out of the federal plan.
States would have until 2014 to opt out.

As I said on Saturday, I think an opt-out provision is
overall a bad idea but I don't know that I'd consider it a deal-breaker because I'm confident that any state that did try to opt out would find significant pushback from within its own borders and frankly it's hard to see what the benefit would be to the state to not participate.
Unfortunately, the public option offered is a pretty weak one, as it would
negotiate rates with providers just like private insurance companies do, presumably keeping premiums on a level playing field with the private industry,
which makes it difficult to see what the advantage to consumers is of having it. Still, the fact that the provision is there at all is good news in that it sharply increases the chances of it being in what the Senate ultimately passes, which in turn clearly increases the chances of a decent public option being part of whatever final bill comes out of a Senate-House conference. Bottom line is that whatever comes out at the end (I was tempted to say "of" the end) will fall far short of what should be done - but the possibility of having something worth passing is still alive.

The bad news is the reminder the Los Angeles Times brings us today, the reminder that a "bill worth passing" may still be not worth passing:
[T]he oft-vilified health insurance industry is on the verge of seeing a plan enacted that largely protects its financial interests. ...

[T]here is broad agreement that the final plan will, for the first time, require Americans to buy health coverage, with taxpayer subsidies for millions who cannot afford it.

For the health insurance industry, that means millions of new paying customers. What's more, there are likely to be no limits on what insurers can charge, while at the same time the plan is expected to limit competition from any new national government insurance plan that lawmakers create.
In short, taxpayer-guaranteed profits to an industry which will have guaranteed customers, continue to lack significant competition, and still be free from anti-trust regulations.
[I]n Washington, many marvel that lawmakers have not wrung more from an industry that, surveys show, is held in low regard by the public.

"The industry is really in no position to be making demands," said Celinda Lake, a longtime Democratic pollster.
Bullshit, and you know it, Ms. Lake. Because what it is in a position to do is spread a lot of money around on both lobbyists and lawmakers. And that is making demands of precisely the sort too many legislators will heed.

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