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Bob Cesca

Bob Cesca

Posted: September 9, 2009 05:14 PM

The Most Nightmarish Health Care Reform Bill Ever


Yesterday, Senator Max Baucus (D-MT) finally released a proposal for his committee's health care reform bill -- the framework for the eventual Senate Finance Committee legislation.

Predictably, the Baucus Plan is totally nightmarish. Naked on the subway while being accosted by prostitutes that resemble Chuck Grassley nightmarish. I've been writing about the terrible possibility of such a bill for several weeks, but now it's actually beginning to take shape.

But first, because he's not the most famous or likely political villain, here's some background.

Baucus controls the Finance Committee, which has jurisdiction over any legislation that revolves around Social Security, Medicare, Medicaid and health care in general. So the senator, as chairman, enjoys a remarkable degree of power considering that he only represents 960,000 people in Montana, one of the most sparsely populated states in the Union. And I'm fairly certain that if polled most Americans would say that Max Baucus is the guy who played Thurston Howell on Gilligan's Island.

While the Baucus Plan would impose the usual syllabus of regulations on the health insurance industry, it also includes an individual mandate, making it compulsory for everyone to buy a health insurance plan. I get the idea: mandates are an important step to controlling costs and achieving a universal health care, but mandates should be accompanied by a public health insurance option in order to serve as an "option of good conscience" -- an escape hatch for those of us who have moral objections to being forced under penalty of law to finance the corrupt insurance cartels.

And the Baucus Plan doesn't offer a public insurance option.

So you're basically screwed if you have moral objections to being forced by the government to hand over a chunk of your monthly income to the same corporate criminals who heretofore have engaged in practices that can accurately be defined as death panel-ish: canceling the policies as soon as you get sick, denying claims, refusing to pay for life-saving procedures, or, as we read about this week, randomly hiking the premiums for 114,000 Michigan residents by around 30 percent effective immediately. If you happen to object to financing such corporate practices (past or present), there's no public option waiting for you in the Baucus Plan.

Instead, you would have to buy a private insurance policy or be penalized by the federal government like so:

Penalties for failing to get insurance would start at $750 a year for individuals and $1,500 for families. Households making more than three times the federal poverty level -- about $66,000 for a family of four -- would face the maximum fines. For families, it would be $3,800, and for individuals, $950.

Let me repeat this another way. Max Baucus wants to force us to hand over billions of dollars in free cash to the private health insurance cartels and if we refuse, we'll be fined thousands of dollars if we object to paying these mafia-style tributes to Baucus' dons.

The public option, however, would create an escape hatch for those of us who find such a law to be unconscionable. (The public option would also significantly reduce the overall cost of health care reform and it would foster a more competitive atmosphere in which people with private insurance policies would benefit. See also my list of 10 things about the public option.)

Instead of being coerced under penalty of law to pay our monthly premiums to Aetna, CIGNA, Wellpoint or UnitedHealth, those of us without an employer-based policy could buy affordable, portable and reliable insurance offered by We The People. An inexpensive policy based on a Medicare framework that doesn't finance CEO bonuses and multi-million dollar golden parachutes. A policy whereby 96 cents of every dollar pays for actual medical care rather than junkets, lobbying and other varieties of corporate masturbation we've been unwittingly financing for too long.

You might be asking yourself, though, Why does Thurston Howell want to create such an enormous and compulsory handout to the private insurance cartels?

The short answer is that Baucus receives around $1500 a day from the health care lobby and PACs and he needs to keep his financiers wallowing in their own filth. But a more specific answer can be defined by who wrote the Baucus Plan.

Funny story. Baucus and his staff forgot to delete the name of the author of the plan from the Acrobat version of the document. Whoops!

In the Properties dialogue box of the PDF, in the "author" slot, the name Liz Fowler appears. Fowler is a Baucus staffer who was with the senator in the early part of this decade but left to take a breather in the private sector and only returned to Capitol Hill last year. During her time in the private sector, can you guess where Fowler worked?

She was the VP for Public Policy and External Affairs at WellPoint, the health insurance parent company of Blue Cross. And while Fowler was an executive at Wellpoint, there was this unfortunate but all too typical incident:

Blue Cross of California [parent company: Wellpoint] "routinely" violated state law when it canceled individual health insurance coverage after policyholders got pregnant or sick, making no attempt to determine whether they did anything to merit such "harsh" treatment, according to a state investigation of practices that appear to be industrywide. [...]

As a result of its unprecedented investigation, the Department of Managed Health Care on Thursday said that it had fined Blue Cross $1 million -- an amount immediately criticized by canceled policyholders and consumer advocates as too small to matter to an insurer whose parent company, WellPoint Inc., earned $3.1 billion in profit last year on revenue of $57 billion.


Incidentally, Wellpoint is still doing this to its customers.

And so a former executive of a company that was penalized for rescinding the policies of sick people was tasked by Max Baucus with writing potentially the most powerful health care reform proposal to be crapped out of the Senate. No wonder it contains individual mandates but no public option. It's a proposal that snares us all and makes us, in effect, government mandated prisoners of the health insurance industry.

People of all political stripes are fond of repeating lately that the public option isn't the entirety of health care reform. It might not be the only item on the list, but it's surely the most important. It's the glue that holds the entire thing together. Mandates are important in terms of covering everyone and consequently controlling health care costs, but without a public option, a bill with mandates is unacceptable to anyone with a brain and some basic morality.

There's really no way around this. But if Congress drops the mandates, then the bill would fail to effectively control costs and it certainly wouldn't achieve universal (or near-universal) coverage. As such the bill would be mostly a failure.

What's worse is that if anything similar to the Baucus Plan passes -- that is, anything with mandates but no public option -- we will have worked for months, years and decades for health care reform legislation only to achieve a bill that literally forces us to pay the enemy.

Have you thrown up into your own mouth yet?

The Baucus Plan or similar legislation runs so contrary to the core values of most of the netroots and progressive base of the Democratic Party that it would touch off an internal revolt unlike anything we've seen to date. I suspect many independents and some Republicans (the ones who aren't fixing to swipe Charlie Cheswick's cigarettes) would also have a thing or two to say about it as well. The whole thing would be a disaster of epic proportions for the White House and the Democratic Party. And then say howdy to President Mitt Romney and Vice President Liz Cheney.

And yes, it's arguably worse than passing nothing. We might still be uninsured or underinsured, but at least right now we don't have to pay the crooks who will always find cruel and unusual ways to screw us.

The Baucus Plan cannot be passed into law. But regardless of whether it has any legs, healthcare reform must include a robust public option without strings. Without it, the insurance-industrial-congressional complex only strengthens its chokehold on an already asphyxiated system, and extricating ourselves will be nearly impossible.

This is it, folks. The public option must become law.

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