Wednesday, March 24, 2010

On the Political Event of the Week


So the United States Congress passed legislation regarding health insurance, and the President signed it into law Tuesday. You may have heard something about this.

Perhaps you've read a post or two, on this very blog, on the subject of these reforms.

This will be a brief response. It is complicated, and it takes some time for me to sort through what I am learning about this.

In the New York Times, David Leonhardt wrote yesterday that we are seeing the "biggest attack on economic inequality since inequality began rising more than three decades ago." This is something I would like to see, something that is possible to do. I'm not so sure we have earned this praise yet.

What has not changed is that Reaganaut laissez-faire capitalism, and its pumped up global scion, neoliberalism, are still linked in the American imagination to the idea of liberty. This is the major political achievement of the Reagan revolution.

The idea that human beings can use government to pool resources and distribute services in an equitable way is still held as suspect. A socialist enquiry into these matters is still widely feared without being understood. It is still true, to paraphrase Dom Helder Camara, that if one asks about the system of production and distribution itself, you get labeled as the worst thing in the world.

Herein lies the difficulty in getting a national health program. We could, if we had the will, take what has been done in so many industrial nations and improve on it, establishing something effective and providing oversight to keep it running well. Yet we can't even vote on it in our legislature; nay, we cannot even have a serious discussion about it, at a policy level.

So we have this bill instead, which will now have to go back to the House for another vote.

The Obama Administration promises that, because of the bill he signed yesterday, insurance companies will have to behave more decently toward their customers. No more dropping us when we get sick, no more refusal to cover us because of pre-existing conditions, and improvements such as free preventative care. There are unproven and uncertain promises that the legislation will keep costs down and control prices binding on consumers and businesses. It modifies a competitive and private market, and then obligates us as citizens to buy products from these same private insurance companies. The requirement helps the Administration's boast that it has "expanded" coverage to Americans who don't have it (read, are now forced to buy it), and generates a bonanza of new business for an industry that is already massively wealthy and has been most untrustworthy.

These improvements are better than nothing. I do not believe, however, that "better than nothing" is the best we can do. Sadly, it may be the best that our unworthy political system can do, where only two badly corrupted political parties are permitted to govern.

The vanishing middle class will not be totally protected from financial ruin if they become ill: despite spending a chunk of their income buying mandated private insurance, there will still be co-pays and deductibles.

At a time when the Supreme Court has ruled that corporations have the same free-speech rights as people, and can spend unlimited amounts of money to dominate media with their political messages, the insurance industry stands to gain, some say, $447 billion in public subsidies (helping poor people buy the mandated insurance). I will not only be paying the industry for my family's premiums, I will also be paying them in taxes so as to increase their power.

Safety-net hospitals take a hit in the legislation, which is going to hit the percentage of Americans who will remain uninsured.

This plan follows the Massachusetts model, where health costs have continued to rise.

Despite the congratulatory media analysis of Obama's achievement, this is not the kind of reform he promised in his campaign. In some aspects, it is a total reversal.

I cannot find any basis for the belief that the profit motive is a decent engine for controlling costs and delivering health care universally. If it can be done in the free market, why isn't it? If it can be done in the public sector, why don't we?

Physicians For a National Health Program has more.


[Photo: A sight we should not have to see in our country: a free health clinic organized by a non-profit organization because we, as a society, cannot muster the will to do so.]

1 comment:

Pam said...

I read today that the company insurance plans already in force will be grandfathered in under the new plan, meaning they will still be able to cap limits, etc.

I also read somewhere that, currently, we don't have enough doctors to be primary care physicians for the masses. Perhaps that will change in the future, but it does take time to become a physician.

As for what I DO like in the new plan is the ban on denying coverage for children with pre-existing conditions and the no cap on lifetime benefits.

I've also read that even with the new legislation healthcare costs will continue to rise.

Confusing and disheartening.