4 Thoughts on Health Insurance Reform

Notice I never call it health care reform? That’s because it isn’t. Very little of what is being discussed will change what happens between you and your doctor beyond how (and how much) he* gets paid.

As I see it, there are 5 points of view on the bill currently being rammed through the Senate:

1. It goes too far. This point of view has a problem with anything that might be called “socialized”. They are barely able to tolerate the idea that their tax dollars go towards schools where the people who will eventually sack their groceries attend; subsidies for buying insurance is way out! Let them get jobs that have decent benefits!

2. It does some important things, even if it’s a little too liberal. Hey, at least it’s making those lazy bastards buy insurance so they can go to a doctor instead of just sneezing their germs on me! In other words, it’s better than a lot of things and the bad things can be fixed later. Some people I generally respect hold this position.

3. It does some important things, even if it’s a little too conservative. Or, the Ezra Klein position. Hey, we’ll take out that Stupak thing in conference or something. At least there is some money set aside for subsidies to help people afford the overpriced and underfeatured health plans they will soon be forced to purchase. In other words, it’s better than a lot of things and the bad things can be fixed later. Huh, where have I heard that before?

4. It does almost nothing — except give favors to Big Insurance and Big Pharma. Or, the Howard Dean position. Progressives didn’t get anything they wanted or needed out of this bill. No public option. Pre-existing conditions can still be used to set rates. Corporations are still in charge, and because we are legally obligated to do business with them — that’s what mandatory coverage or “the coverage mandate” is about — there is no incentive for them to chance their ways.

In short, two points of view say “It’s better than nothing, and far better than it could have been,” and two points of view say “This is worse than nothing and should be scrapped.” While I appreciate where the others are coming from, I generally hold to view 4. What we wanted and needed was a short laundry list that included getting rid of abusive practices such as use of pre-existing conditions for coverage or pricing, rescission, and constantly rising prices, maybe 10 pages of law. What we appear to have is a legal requirement to bend over and take it, a law so long that the Republicans are threatening to make them read the whole thing out loud in open session.

And nobody is talking about not just the elephant in the room, but a veritable zoo: obesity rates raising the amount we spend on health care; baby boomers who will soon be on Medicare; obscene insurance company profits; a looming shortage of primary care physicians and experienced nurses to assist them.

* Um Yeah, that’s right, I said “he.” Not “he or she”, not “she.” Politically correct horsehockey aside, odds are very good your doctor is a dude. Don’t like it? Encourage women in your life to go to medical school. Just don’t get them any books on the subject like House of God. I can’t find the book that made me decide I wanted no part of medical school on Amazon, but this looks like similar content.