Doing nothing isn’t a valid health-care option

Doing nothing isn’t a valid health-care option

OK, here’s the plan: Require employers to provide health care insurance for their employees, provide federal subsidies for the poor, create health clinics and a network of committees to set industry standards, guarantee basic coverage regardless of pre-existing conditions and coordinate insurance for the self-employed.

Sounds very much like what’s being denigrated as Obamacare and painted as one step short of radical socialism.

But what the first paragraph actually describes is President Richard Nixon’s 1974 health care reform bill. The irony is that it was killed by Republicans who thought it was too radical and Democrats who didn’t think it went far enough,

Lessons to be learned

There are a number of lessons to be taken from the failure by Congress to pass health care reform 35 years ago. One is that stridency on both sides can kill anything that those in the middle are working toward (think the abortion funding issue seized on by Republicans and some Blue Dog Democrats and the refusal to give ground on the need for a public option by some Democrats).

The abortion issue is a red herring. Some abortions are already funded with tax-subsidized payments. Many employer-provided health insurance plans cover abortions, and those plans are paid for with tax-exempt money. Anyone with a Health Savings Account has access to tax-free money that could be used to pay for an abortion. The primary difference is that those benefits are available to the solidly middle class or upper middle class health care subscriber; under comprehensive health care reform, the benefit would work its way down the socio-economic ladder.

As to the public option, it is difficult to follow the reasoning of people who say government can’t do anything right, yet argue that if government is allowed to make a public option available to companies and individuals, private insurers will be driven out of business. They’ll be driven out only if they can’t compete, that is only if they can’t provide coverage at a lower price. And lowering the cost of health coverage is one of the primary goals of reform.

High cost of doing nothing

For all the talk about how America can’t afford the various reform plans that have been presented to Congress, the obvious is ignored: America can’t afford anything less than fundamental reform. The kind of tweaking that opponents are bringing to the table now will not cut it.

America cannot afford health care costs that continue to rise at rates double that of inflation, growing every year as a larger share of the GNP. American companies cannot compete in a world market place in which they are paying for health insurance for their own workers and subsidizing the health care of the uninsured because hospitals pass along a portion of their unpaid bills to their paying customers. Even companies not involved in world trade find themselves providing health care for their workers, and paying toward care for people who work at companies that don’t cover their employees.

If the public option is a killer, delay its implementation. Set cost-reduction targets for health care providers and insurance carriers. If they are met, fine. If not, roll out the public option.

Dynamics of change

A half century has shown that health care reform is far easier to defeat than to pass. And that’s not surprising because change sounds good during a political campaign, but the closer change gets, the more people are inclined to feel they would be better off with the devil they known than the devil they don’t know. “I’m happy with the coverage I have now,“ more and more people are saying these days. But the coverage they have now is unsustainable. Health care coverage for an average family today is about $13,000 a year, with the employer and employee sharing the cost to varying degrees. Without fundamental reform, that cost will rise to about $25,000 over the next decade. How many companies can afford that burden? How many families that may now be paying 10 or 20 percent of that $13,000 will be able to pay 30 or 50 percent of that $25,000?

The health care bill passed by the House last Saturday isn’t perfect. The Senate version, likewise, is flawed. But unless both houses of Congress are able to work out a meaningful compromise, the politicians on the fringes will win, the lobbyists and special interests will win, and the rest of America will lose.