If the fight over health care reform has proven anything, it's just how broken our system has become -- from the crippling influence of money on our politics to the way the modern misuse of the filibuster has taken away the power of the duly elected majority and handed it to a handful of bought-and-paid-for senators (yes, I'm talking about you Joe Lieberman).
This disturbing and destructive state of affairs has created a country that is, in the words of Tom Friedman, "only able to produce 'suboptimal' responses to its biggest problems."
And that's where we find ourselves on health care as we head towards the legislative end game. The big optimal solutions have all been gutted -- and we are left to pick through the patchwork of suboptimal ones.
What makes this exercise harder is that the details seem to change form more frequently than the characters in Twilight. At the moment, and while we are waiting for the latest CBO score, "the whole town," as Mike Allen puts it, "is talking about a proposal that few have seen, and none understand."
One by one, Congressional leaders who said they would not support a bill without a public option have come to the conclusion that, on second (or third or fourth) thought, they actually will. Leaving aside what this does to the already tattered trust the public has in their representatives, is a progressively watered-down public option preferable to a Medicare expansion combined with a national non-profit insurance plan similar to the one offered to federal employees, regulated by the Office of Personnel Management?
Bernie Sanders, one of the leading advocates of the public option, is now arguing that these proposals combined "may be stronger than the very weak public options that both the House and the Senate have already passed."
Jacob Hacker, the godfather of the original public option concept, also approves of the proposed expansion of Medicare, calling it an "enormous positive development."
Of course, expanding Medicare by allowing those 55 to 64 to buy into the program won't be subsidized for the first three years and therefore may end up being prohibitively expensive, especially if it ends up being an expansion of Medicare not tied to Medicare rates.
Amidst the tea leaf reading and jockeying for political position (at least among Democrats; Republicans are united in their commitment to kill reform) it's important not to lose track of the things that absolutely have to be included in any health care bill for it to deliver reform in more than name only.
It has to expand access to include as many of the 46 million uninsured Americans as possible. Both the House version and the current incarnation of the Senate bill go a long way to meeting this goal.
It has to create competition and reduce costs. In the end, it doesn't matter if this is accomplished by creating a government-run non-profit insurance provider (the so-called "public option") or by adopting a national privately run system that is heavily regulated by the federal government, and allowing those 55 to 64 the "option" of buying into the Medicare program. It's not the label we give these that matters, it's the end result: competition and cost reduction. The current bill mandates that most Americans get insurance coverage, creating 30 million new customers for the insurance industry. These new customers have to have options -- especially less expensive options -- or this will be a massive windfall for insurance companies.
The best way to provide more choices for consumers is through the latest incarnation of Sen. Ron Wyden's Free Choice Act, which he is offering as an amendment to the health care bill. The provision would give employees the ability to choose their own insurance plans within the insurance exchange -- instead of having to accept the plan chosen by their employer, as is the case in the bill Harry Reid brought to the floor of the Senate.
To qualify as real reform, the bill also needs to give Congress the ability to negotiate with the drug companies over Medicare prescription drug prices. The White House cut a deal with PhRMA taking away this ability to negotiate. That agreement is still part of the Senate bill but not part of the House bill -- and should not survive the conference process.
And, knowing how quickly things can get slipped into bills, or carved out of bills, in the dark of night, we have to ensure that the positive elements of the current bill don't suddenly vanish -- especially the provisions that keep insurance companies from denying people coverage on the basis of pre-existing conditions or dropping customers when they actually become sick.
If the final bill contains all these elements, it will be a suboptimal solution worth supporting.
Then we can move on to the business of fixing our broken system, so we can get back to being a country able to produce optimal responses to our biggest problems.
Follow Arianna Huffington on Twitter: www.twitter.com/ariannahuff
If the 'gov't' were really interested in 'fixing' the system, they would address the causes driving up the cost of healthcare.
1 - The Rx industry (which collects 30%+ of every dollar health insurance companies collect). Big pharma spends only 10% of their revenue on R&D and a full 50% on advertising!!! The U.S. public ultimately pays for this advertising.
2 - The AMA, which limits the number of docs entering the market place to limit competition.
3 - Mega hospital conglomerates own most PPO networks, collecting 15% to 20% of EVERY dollar paid to ins.cos. Insurers are very good at predicting the incidence of claims; but need the medical service costs guarantees the PPOs provide to budget for claims.
Politicians, regatrdless of what they say, are far more corruptible and inherently have greater conflicts of interest than does industry. Politicians bear little accountability. Except in cases of outright embezzlement, they seldom are brought to justice over THEIR actions, no matter how self-serving their actions are proven to be. Amazingly, most unscrupulous legislators even get re-elected.
While one can sue an private cos. for damages, can one really sue the gov't or its agencies for damages?
However in all fairness he had a heart attack and everything was taken care of. Good! he owed nothing when he left the hospital and all is meds was free. Good! Great ! Fantastic! Not Really! he has been on a waiting list for over 5 years now for a knee replacement as he continues to get bumped for younger more work able individuals. HE told me that he requested a cost analysis of his stay and got the figures. Taking in to account 50% of his check was taked for years and the cost of his surgery and the rationing of his care he has paid nearly 20 x times what he would have paid in the us. and would have gotten the replacement without waiting! So much for government run health Care!
there will be no single payer plan. the only way to fix our mess as agreed by almost anyone with a brain, but because of the lobbyists, because of the mobsters single payer has been branded "socialist" ... and the sheep bleat "we can't have socialism".. they don't want the old people to be killed by the government... the brainless being led by the bought..
so just stop it now...
Washington, go on your Christmas break. Go home. You have done NOTHING for America... We will be better if you all just stay home and stop meddling. I would look forward to the next election, except there is no one who can help our corrupt system.
In my world one goes to jail for corruption.
As long as there is money in the picture in politics our system will not be fixed.
Seems like the capitol can not get it right since the beginning of time.
We are sick and tired of tax this tax that! Washington needs more money they add another tax.
What are they doing with our money??????
Elected officials sure know how to steal the publics money. Now is the time to pay us back!!!!!
AND THE FEDS WENT AFTER BERNIE MADOFF FOR STEALING OPM!
WHEN ARE THE FEDS GOING TO GO AFTER THE CORRUPTED ELETED OFFICIALS IN WASHINGTON?
The Democrats have no choice but to deliver the goods. They must deliver soon enough for prospective voters to feel, touch, and taste what the Democrats have wrought. This is the only way for the Democrats to counter the deceptions and lies of their enemies, the Republicans and the Insurance Industry.
If they fail to deliver in such a way, the Republicans will rebound in Congress and reap vengence surpreme.
The only chance Democrats have is to rebuke the corporations and embrace medi-care for all. They must do it quick enough for the people to try it, and embrace it. Once the people adopt it, they will go to the polls and vote to keep it.
The only crack in the logic of this strategy is the existence of golden umbrellas for Congressmen, and massive campaign contributions from the rich class and from corporations.
The solutions to those problems are:
1. A 10 year ban on Congressmen , White House and Congressional Staff from taking employment from Corporations who lobbied them.
2. A progressive tax on campaign contributions to reflect the true cost those contributions have on our country.
Remember the entire Western world, including USA, has a manageable healthcare system run by doctors and hospitals. Yes, healthcare-on-demand is and should be over. Beyond true medical care, the family will have to care for their own relatives; instead dumping their 'near and dear' ones on a healthcare system to be taken care-of by "the system"- akin to the educational system.
Let's face it. Each one of us is responsible for the high cost of public services we receive from "the System" and the decline in our own social values; because we have failed in our own next-of-kin social network.
I.N.S.U.R.A.N.C.E. .....Insurance is the problem, not the solution. What the hell is so damned difficult in understanding this? Every industrialized, civilized nation has health CARE for ALL their citizens. Only America has to take something that is simple and make it complicated.
The only real, sane way of delivering health care to all Americans is by single payer - period. The present insurance tied system is so intertwined with business, insurance, medical supply companies, medical employees, teachers, and doctors, that is is impossible to separate one without disrupting all the others. They're like parasites that live on the sick who have no power to help themselves.
We don't need a band aid to fix a system that requires major surgery. We need to kill the beast it has become. Lost in all this administrative bureaucratic BS is the real reason we need change - to keep people from becoming patients in the first place. If ever the old saying that an ounce of prevention is worth a pound of cure it's, now in this screwed up mess we call a health care delivery system. Single payer will accomplish what all the complicated intertwined morass can not - institute a preventive medicine establishment that hold s down illness, gives more and better care, and puts an end to exploding casts. Where do we go from here?
It's important not to spread misinformation
here...start with Switzerland
http://en.wikipedia.org/wiki/Healthcare_in_Switzerland