The chairman of the Senate Finance Committee, Democrat Max Baucus, is circulating what he calls a bipartisan proposal for health care reform. The proposal contains neither a public option (not even "triggers,") nor a government-run insurance plan to compete with private insurers. Baucus refuses to support the public option even though a majority of constituents from his state of Montana say they approve of the public option idea, while a majority disapprove of Baucus' actions on health care reform, and a majority of Americans support the choice of a public option.
Additionally, Republicans like Charles Grassley are unlikely to support even this woefully watered down proposal. If Republicans are refusing to vote no on reform regardless of what the final health care bill contains (Republican Senator Jim Inhofe says he is going to vote no without reading or knowing what the bill includes,) why does Baucus continue to compromise reform into total meaninglessness? The Republicans insist on throwing chronic tantrums and have made it clear they're not interested in compromise, so one can only conclude Baucus is tossing out the public option -- triggers and all -- because of demands from the private health care industry with perhaps some other Centrist Democrats serving as proxies for private industry wish lists.
Baucus's proposal will cost between $850 billion and $900 billion, which he plans to pay for by taxing insurance companies on their most expensive policies. "The hope is that employers would buy cheaper, less generous coverage for employees, thereby reducing the overuse of medical services," according to the New York Times. This means employers will provide less health care coverage for their employees, who will then have to pay for their health care out-of-pocket, which effectively passes the cost for Baucus's plan to hardworking men and women.
In July, former health care executive Wendell Potter told me about these kinds of "consumer-driven plans," a euphemistic term for shifting the financial burden from insurance company to consumer. Potter explained that these plans feature high deductibles and are really just another way for the insurance companies to make money from the suffering of their consumers. Baucus isn't proposing a reform solution that will benefit a majority of Americans in his latest proposal. He's literally shifting the burden from the insurance companies to employers, and ultimately employees. Baucus is actually maximizing the suffering of a majority of Americans.
California Lieutenant Governor John Garamendi told the Associated Press in 2005 when he was serving as the state's insurance commissioner, the movement toward consumer-driven coverage will eventually result in a "death spiral" for managed care plans. Unlike "death panels," "death spirals" are the real deal. Garamendi explained that this will happen as consumer-driven plans "cherry-pick" the youngest, healthiest and richest customers while forcing managed care plans to charge more to cover the sickest patients. The result, he predicted, will be more uninsured people.
"In other words," Potter explains, "a high-deductible plan might be exactly what you're looking for if you don't really need decent insurance now and can afford to shell out thousands of dollars of your own money in the event you get hit by a bus. The rest of us, however, might want to steer clear of this sort of plan -- if we had the choice."
Baucus attempts to address the financial worries of Americans by including another section in the proposal where poor people receive assistance from the government in order to pay for their insurance. People with incomes from 300 percent to 400 percent of the poverty level (up to $88,200 for a family of four) would generally not have to pay more than 13 percent of their income in premiums. Currently, 37 percent of low-income people and 22 percent of middle income people with private coverage spend more than 10 percent of their household income on health care, compared with 8 percent of high-income people.
Baucus's proposal is a government subsidization of the private insurance industry. Nothing in his "solution" controls cost or regulates the insurance industry. In fact, coverage under Baucus's plan would be less extensive than the most modest of three levels envisioned in a bill approved by three House committees. Poor people pay taxes into a system in which the government then cuts them checks to purchase insurance on the private market. It's more expensive for average citizens, and it's a boon for the private health care industry.
In the past six years, nearly one-fourth of every dime raised by Baucus and his political action committee has come from groups and individuals associated with drug companies, insurers, hospitals, medical supply firms, health service companies and other health professionals. These donations total about $3.4 million, or $1,500 a day, every day, from January 2003 through 2008, according to the Billings Gazette.
Baucus would have to be insane to drain the pockets of his most generous campaign contributors. So it's no surprise that this proposal -- rather than placing the onus of reform on the private healthcare industry -- places the burden on the shoulders of average, hardworking men and women. It's not surprising, but it sure is evil.
Cross-posted from Allison Kilkenny's blog. Also available on Facebook and Twitter.