If you're keeping score on how our elected representatives, laden with private sector campaign contributions and quid pro quo expectations, are playing out the contest for health care reform, here is this week's outlook on whether any visible change might happen in your lifetime:
The Senate finance committee has entirely dropped the public health coverage option -- the heart of any meaningful change for premium-trampled citizens -- from that body's ever-shrinking health care reform initiative, and senators are balking and barking at the price of what remains: $1.6 trillion, according to the Congressional Budget Office, for a mixture of private insurance requirements, expanded Medicaid, and insurance "co-ops" where government bows out of the underwriting of affordable coverage. The CBO fiscal estimate represents an overrun of more than a half-trillion dollars above the $950 billion President Obama has been talking about, and now he and his advisors are hunkering down to try to find ways to shave more and more boldness from the administration's proposals. Can you hear the cutting edges being filed off of the word "change?"
Meanwhile, Congress (Congressional Dems, actually) yesterday revealed their own health care bill, which retains the public coverage option, offering a government-run health plan that would compete with private insurance companies and would limit what doctors could charge patients. According to the New York Times, the Congressional bill would also create a new federal agency to oversee health care, headed by a presidentially-appointed "Health Choices Commissioner." The bill would require all Americans to have health insurance, it would forbid many of the maneuvers insurers now use to deny coverage or hike rates to sick subscribers, and it would expand Medicaid coverage and payments to doctors and undo a major cut in Medicare payments to physicians. Dems claim the bill would cover 95 percent of Americans. They offer no estimate of what it would cost (it looks as if Congressional Dems, learning from the Senate experience, want to stall going to the CBO for numbers until they build as much public support as they can) or how they will pay for it.
Meanwhile, back in the Senate, the Senate health and labor committee is proceeding at a sedated snail's pace along strictly party lines on a mountain of 388 amendments to the already-weak Senate draft health care bill. 364 of the amendments are from Republicans, and most are hypocritically obstructive (example: an amendment requiring advance proof of savings before any health care legislation can be approved). Postures are struck. Diatribes are traded. The Washington Post quotes Sen. Judd Gregg (R-NH) snapping at Sen. Barbara Mikulski (D-MD) about "debt on the back of America" and "a wish and a prayer." Mikulski hisses back that she didn't simply write the bill "while I was getting a manicure." Two-hour lunches are taken. As of Thursday, June 18, the committee's count was 5 amendments argued and voted upon, 383 to go. According to the Post, at this rate it will take the committee five weeks to bluster its way through this sorry bill -- and that is if the senators eliminate their summer recess.
And back in Congress (is this travelogue turning you in circles?), Repubs, in their outraged opposition to Congressional Dems' plan, are achieving new levels of amnesic chutzpah. According to the Times, for instance, Rep. John Boehner (R-OH) condemned the bill as a "reckless" increase in government power and spending, and he predicted a dire scenario of federal bureaucrats bullying millions of hapless policyholders. (Uh, Rep. Boehner, where have you been during these decades of corporate health insurers both bullying and price-gouging Americans? And where were you during the past eight years of radically unchecked excesses in government power and spending? Do Signing Statements, FISA, Iraq, and torture ring a bell?) And the president of the Blue Cross and Blue Shield Association called the Dems' plan "a recipe for disaster.” (Well, to be fair, disaster is a realm in which he has some expertise.)
Similarly, on the Senate side, the most strident objections suggest major lapses in brain function. My favorite is the claim, voiced by some Democrats(!), that a government health plan, with its greater leverage for discounts and cost savings, would be unfair competition for business. Hello? The purpose of health care is not to foster the profitability of business. The purpose of health care is to provide the best possible care for the most people in the most cost-effective manner. If government-backed health care achieves this better than private profit-based health care -- and the experience of virtually the entire industrialized world tells us that it does -- then it is the private sector that has to adjust to this hard truth of the marketplace. Since when does the most efficient delivery system for health care -- public coverage -- not count as part of the invisible hand?
To be sure, $1.6 trillion for the Senate plan is a whole lot of money. And so was Obama's optimistically advertised price of $950 billion.
But $680 billion is also a lot of money. That's the amount that Republicans and most Democrats have cumulatively assented to spend to date on the catastrophic war in Iraq, with nary a peep in its first few years about fiscal discipline or frugality.
So is $100 billion, the amount spent annually by we health insurance policyholders on the redundant administrative costs of a throng of profit-making private insurers when a single-payer public system would eliminate this audible flushing of our hard-earned dollars.
And so is $400 million, the amount spent on TV advertising alone by the two major candidates in the 2008 presidential election -- a sum that reflects not the public interest, not publicly-driven dollars, but sheer cash that the candidates were able to extract from largely private donors who have a vested interest in certain eventual policy outcomes.
Did we witness waves of proposed bills and amendments and new federal policies to rein in these crazed and destructive expenditures? Did we see processions of outraged Senatorial and Congressional speeches and traded barbs? Did we hear sustained and widespread shrieks for accountability?
As I mentioned a couple of entries ago about Toni Morrison's warning to American voters, there is only so much of this injustice we can blame on an un-heroic President Barack Obama. The rest of the blame lies with us. For tolerating it.
Partway around the world right now, hundreds of thousands of citizens in a brutal theocracy are taking their lives in their hands in a demand for fairer government. Their courage, ironically, is being loudly cheered by the fickle and corrupt moneychangers who pass for legislators on our side of the Atlantic.
So what will it take for us to actually get up and move toward reclaiming our own government?
Comments