Health Care reform moves ahead

by: Blue Girl

Wed Nov 12, 2008 at 09:53:32 AM CST

| More

"My door is open and I seek partners with 'can do' spirits and open minds," Mr. Baucus wrote in an introduction to his 89-page plan. "I believe -- very strongly -- that every American has a right to high-quality health care...and I believe Americans cannot wait any longer."

Like Mr. Obama, he proposes a national marketplace that he dubs the Health Insurance Exchange, in which individuals and small businesses could buy coverage, with subsidies based on income. Private insurers and a new Medicare-like public program would compete through the exchange to offer coverage.

Wingnuts, of course, protest that the plans offered by Democrats give government too heavy a hand in the design and delivery of health coverage.  They are, of course, mysteriously silent when bean counters at for-profit insurance companies deny lifesaving procedures to people who pay their premiums and then run afoul of the company by actually getting sick and needing to use their coverage.

Under the plan laid out by Baucus, most employers would be required to offer health coverage to their employees.  Those not offering coverage would be required to pay into a pool fund, the amount based on the size of the company and it's annual revenues.    Small employers that offer coverage would receive a tax credit, the size of which would be based on the same metric:  company size and annual revenue.  

The plan doesn't say how large or small companies would have to be to fall under these rules or qualify for the credit. It also doesn't provide a cost estimate, and a Baucus aide declined to give one. The plans proposed by Sens. Obama and Clinton were each estimated to cost about $100 billion a year, not accounting for savings they hoped to generate through new efficiencies in health-care delivery.

Mr. Baucus, too, proposes a slate of ideas for reducing costs and improving quality. Many of these ideas enjoy bipartisan support.

The document reflects Mr. Baucus's thinking, but an aide said the senator hopes to begin building bipartisan support for it immediately. He hopes to begin with meetings next week with leaders in both parties of his Finance Committee and the Senate Health, Education, Labor and Pensions Committee. Sen. Edward Kennedy (D., Mass), chairman of the HELP Committee, is expected to play a major role.

Republicans tend to favor a "free market" approach to the health care conundrum, in spite of the fact that patients are not "customers" and "free market" solutions to problems in our health care system are elusive.  Health care is simply not suited to being solved by free market solutions.  Remember during the campaign John McCain proposed a solution that he himself would not have been eligible to participate in.  Fortunately, Democrats are in charge and the republicans aren't, so the odds of reform that helps citizens instead of corporations are fairly good.

Rounding out the Baucus plan are proposals to expand SCHIP and Medicaid, and a provision that would allow people 55 to 64 to pay a premium and buy into Medicare.  Also, insurance companies would be prohibited from charging higher premiums or denying coverage based on pre-existing conditions, an obstacle now faced by people seeking coverage on their own.  

Insurance companies have indicated that they might be willing to go along with these new rules if their bottom lines are protected by a mandate that all Americans carry insurance.  

I am not particularly sympathetic to the plight of insurance companies.  But a couple of decades in health care has radicalized me on this topic.  In my professional life, I saw a lot of people suffer needlessly because insurance companies denied care, or refused to pay for name brand medicines that were more effective and had fewer side effects and offered better quality of life for the patient.

If it were up to me, it would be against the law for insurance companies to operate as for-profit entities.  But it isn't up to me, so I will take what I can get and keep fighting for more until I either get it, or shuffle off this mortal coil.

One thing I will not do is let the perfect be the enemy of the good.