Friday, September 18, 2009

Health Care Update

Paul Krugman had it about right: the Baucus bill is inadequate as it stands, but it can be improved enough to make it worthwhile.

To paraphrase him, three improvements are needed:
1) The employer mandate section is hopeless, penalizing employers for the number of employees getting subsidies to help pay for their insurance. This needs to be replaced with a simple "pay or play" provision--either employers pay in for group insurance, or pay into a pool to help their employees get it.

2) There is not enough money in the bill for subsidies for the poor to get insurance--the result would leave the society far short of universal coverage.

3) The provisions to increase competition on insurance--the co-ops--are inadequate. I believe they would help in some rural areas, but for the typical urban dweller, a public option is needed.

If these don't come up, or if it goes in the demagogic other direction, focusing on political culture wars about abortion, illegal immigrants, and malpractice insurance, the bill will die. And should. There will be another, though...

Updates from the Peanut Gallery

The new figures from the Lewin Group, an independent study group (though sponsored by United Healthcare) are that about 20 million Americans would take up a public option--as it came out of the House committees, i.e., after the provisions which would give it the same mandated discounts medicare enjoys. This down from 100 million; it's a good balance between truly providing competition and crowding out the private insurers (which most people don't want).

Finally, I just finished reading a long, incisive piece in The Atlantic by David Goldhill (called "What Washington Doesn't Get About Health Care--Here's How to Fix It" on the cover, but titled "How American Health Care Killed My Father" at the head of the article). Basically, he calls for the elimination of "comprehensive" health insurance (including for Medicare!) and scares the beejesus out of the reader. Not even single-payer could save us, and none of what's on the table would do much. Don't read it, even though it's packed with accurate information--his subtitle should be something like "Save America $1.6 million and Kill Yourself--Today!" It's that depressing.

Don't Blame Sen. Bingaman
Our Senator Jeff Bingaman should not be tarred with the Baucus brush (Bauchanalia?), though he was one of the infamous Gang of Six (along with "Coops" Conrad, "Frosty" Snowe. "Crass" Grassley, and Enzi "Face"). Bingaman was the well-meaning orthodox liberal in the group, trying to uphold progressive values, though not always succeeding. He has not endorsed the Baucus formulation as it stands, though commending the effort, and has announced he will support the public option in an amendment to be proposed before the full Committee (where it may well pass).

Here is his statement on the release of the Baucus draft.

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