Sunday, November 8, 2009

Health care in States crosses huge hurdle

It's kind of hard to believe but more than a hundred years after health care reform was first proposed by Theodore Roosevelt -- TR! -- the US House of Representatives passed a proposal for overhauling the medical system, one more ambitious than what President Obama proposed in his landmark speech to Congress barely two months ago and also even more broad than "Hillarycare" which never even came to a final vote before the Gingrich revolt in 1994. The vote last night was close; 220-215 (219 Democrats and 1 Republican for, 39 Democrats and 206 Republicans against). The GOP well as pro-life Dems did get one major concession -- they got through a provision that tightens the 1975 Hyde Amendment (which prohibits federal funding of abortions) further.

The most important provisions have been the two humps that has bedeviled lawmakers for years -- first getting rid of the anti-trust exemption that ensures virtual oligopolies in 34 states (even though there are dozens of companies who would gladly want to compete as they can for federal employees and drastically drive down premiums were it not for the loophole); and second, the rule allowing denial of coverage for a pre-existing health condition and also permitting cancellation of a policy for a condition one didn't even know about when applying for a policy. No other country would tolerate either of these, even for supplemental insurance over and above the state plan.
The bill will have to be reconciled with whatever comes out of the Senate (certainly less sweeping, about $300 billion less over ten years) but approval in principle is still a major victory for Obama after months of "teabagging" (a misappropriation of a lewd sexual act) and even comparisons of universal health coverage to the Holocaust (which prompted Elie Weisel, the famous survivor of the massacre, to write a very angry response on his Twitter account this week). Not to mention using babies, live babies, as props on the House floor saying such things as "our babies don't want a government run plan." I don't recall their being asked if they want to die, though.

It still seems amazing that every industrialized democracy other than the US has figured out a way to pool the wealth when it comes to health care. As I've mentioned previously, some have had complete takeover, such as with the NHS in the UK. Even there private competition exists and all three major parties there have offered, under certain circumstances, to have the government pay to "go private" if the wait for certain procedures gets too long. This is something Canada should stop fearing and also approve, provided that the private clinics generally outside the loop only first take patients who are not entitled to our health care system at all.
Other countries strictly regulate the health care markets to ensure every can affordably access the system. Then there is Canada, which as noted before is basically Medicare for all but needs more than tinkering to ensure its survival especially with an aging population.
The battle is far from over; but the fact a vast majority of Americans support at least a broad outline of reforms similar to what Obama and most other Democrats have advocated will put pressure on the Republicans to offer something should they ever regain control of Congress -- getting rid of reforms barely a year after they were passed will create an uproar that will make the teabagging / birthers / KKK protests seem tame by comparison.
A major item that will have to be in the "reconciliation" bill would have to be portability. Firstly, across across state lines. Second, being able to continue to be able to buy into a company plan after one leaves an employer within certain time limits with the of course much lower premiums than under an individual plan (this is actually the law, an act written by two former Senators -- Republican Nancy Kassebaum and Democrat the late Edward Kennedy -- but never enforced due to the powerful health care lobby). Just these two would drive down premiums enough to get about half of the uninsured covered again; and cut down the length of the current bill by at least two-thirds (from over 2000 pages to around 600).
Admittedly, Obama should have stuck to his prior guns and demanded the right of Americans to buy into the public service plan. But at least there is a start.

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