The House passed health care reform on Saturday night. I know it’s a big deal. I know it’s the furthest we’ve gotten in, well, ever. I suppose we should celebrate.
I don’t want to be a downer – I really don’t. But I can’t believe it’s been this hard. I can’t believe people are talking about how hard it’s still going to be. Listening to the rhetoric from the minority party, you would think President Obama was trying to make communism look like socialism. It would be funny if it weren’t so sad.
How far has the Right (and the Left) moved to the right? Bear with me as I take you into the past.
A president sends a “Special Message” to Congress. He’s proposing comprehensive health care reform. Here are his words:
Without adequate health care, no one can make full use of his or her talents and opportunities. It is thus just as important that economic, racial and social barriers not stand in the way of good health care as it is to eliminate those barriers to a good education and a good job.
Today the need is even more pressing because of the higher costs of medical care. Efforts to control medical costs under the New Economic Policy have been Inept with encouraging success, sharply reducing the rate of inflation for health care. Nevertheless, the overall cost of health care has still risen by more than 20 percent in the last two and one-half years, so that more and more Americans face staggering bills when they receive medical help today.
Guy makes a good point. What does he want to do?
Upon adoption of appropriate Federal and State legislation, the Comprehensive Health Insurance Plan would offer to every American the same broad and balanced health protection through one of three major programs:
[1]--Employee Health Insurance, covering most Americans and offered at their place of employment, with the cost to be shared by the employer and employee on a basis which would prevent excessive burdens on either;
How would that work?
Every employer would be required to offer all full-time employees the Comprehensive Health Insurance Plan. Additional benefits could then be added by mutual agreement. The insurance plan would be jointly financed, with employers paying 65 percent of the premium for the first three years of the plan, and 75 percent thereafter. Employees would pay the balance of the premiums. Temporary Federal subsidies would be used to ease the initial burden on employers who face significant cost increases.
Now that’s a powerful employer mandate. I see no small business exclusion. That’s way more than anyone is pushing right now. Radical!
[2]--An improved Medicare Plan, covering those 65 and over and offered through a Medicare system that is modified to include additional, needed benefits.
So this president wants to strengthen Medicare. Fair enough. I’m listening. What’s the last part?
[3]--Assisted Health Insurance, covering low-income persons, and persons who would be ineligible for the other two programs, with Federal and State government paying those costs beyond the means of the individual who is insured;
But how would this fancy Assisted Insurance work?
The program of Assisted Health Insurance is designed to cover everyone not offered coverage under Employee Health Insurance or Medicare, including the unemployed, the disabled, the self-employed, and those with low incomes. In addition, persons with higher incomes could also obtain Assisted Health Insurance if they cannot otherwise get coverage at reasonable rates. Included in this latter group might be persons whose health status or type of work puts them in high-risk insurance categories.
Assisted Health Insurance would thus fill many of the gaps in our present health insurance system and would ensure that for the first time in our Nation's history, all Americans would have financial access to health protection regardless of income or circumstances.
A principal feature of Assisted Health Insurance is that it relates premiums and out-of-pocket expenses to the income of the person or family enrolled. Working families with incomes of up to [a certain amount], for instance, would pay no premiums at all. Deductibles, co-insurance, and maximum liability would all be pegged to income levels.
Anything else?
There would be no exclusions of coverage based on the nature of the illness. For example, a person with heart disease would qualify for benefits as would a person with kidney disease.
And how would you make sure that happens?
The States would approve specific plans, oversee rates, ensure adequate disclosure, require an annual audit and take other appropriate measures. For health care providers, the States would assure fair reimbursement for physician services, drugs and institutional services, including a prospective reimbursement system for hospitals.
That’s… a massive amount of government regulation. This guy loves his government oversight and intervention. Moreover, he doesn’t seem to want to leave anything to the free market system.
OK, so we have lots of people getting insurance from their employer. People over 65 get strengthened Medicare. The rest would get subsidies to buy private insurance. No one could be denied insurance because of prior conditions. States would closely regulate insurance and reimbursement. This sounds awfully familiar; the conservatives must have hated him.
Who was this communist?
Can we stop pretending this is government run amok? Can we stop pretending this is unprecedented? Can we stop pretending that every cry of socialism, of communism, of fascism is reasonable? Please?
President Obama has proposed a plan that is slightly to the right of President Nixon. It’s a remarkably moderate incremental sort of reform that a reasonable conservative should recognize as his or her own.
I don’t think this reform is enough, and I won’t stop saying so. There are plenty of rational reasons to criticize it. But it’s not nearly as radical as some are pretending it is. They should stop.
Read more about health care policy and get your questions answered at Rational Arguments.
Follow Aaron E. Carroll on Twitter: www.twitter.com/DSYGAaron
Marcia Angell, M.D.: Is the House Health Care Bill Better than Nothing?
The House Health bill just throws good money after the bad. And because costs will keep rising, there is now a danger that people will conclude reform is impossible, when in reality, we still haven't really tried.
Eric Tang: Anh "Joseph" Cao: The Surprises Are Just Beginning
The improbable victory of Joseph Cao gave Republicans something to gloat about in the wake of its November defeats. But Republicans may soon learn that they're getting more than they bargained for.
Lord Weidenfeld of Chelsea: 20th Anniversary of the Fall of the Wall
In the future much of the world's power -- however uncomfortable the word may still sound for Germans -- will emanate from Germany, where it is strongly rooted.
Nancy L. Cohen: 10 Reasons Why the Stupak-Pitts Amendment Has to Go
Even if some Democrats who voted for the amendment did so because of deep convictions, the main thrust of the measure is to condemn women for being sexually active.
NEJM -- Nonpayment for Performance? Medicare's New Reimbursement Rule
Obama Wants Medicare Reimbursement Rates Out of Congressional ...
Obama and health care: Miles to go
White House Spent 'Weeks' Courting Lone GOP Vote on Health Care Bill
Would Senator Joe Lieberman chose Iraq War death over Health Care life?