|Democrats Ponder Health-Care Suicide
by Robert Parry
IF DEMOCRATS ENACT something like the health-care bill emerging from
the Senate Finance Committee, they may call it a legislative victory
and it may keep the campaign donations flowing from the insurance
industry, but the Democrats would surely infuriate millions of
Indeed, it seems like some Democrats, such as Sens. Max Baucus and
Kent Conrad, have lost themselves so much in the inside-Washington
reeds of legislating a convoluted compromise acceptable to the
insurers, that they are inviting an angry backlash from average
The danger for Democrats is that this industry-friendly legislation
would impose new burdens on citizens, including government fines for
failing to sign up for a health-insurance plan, without guarantees
that the coverage won’t be almost as crappy and expensive as it is
now. The bill rejects a public option that would put competitive
pressure on private insurers.
Plus, key elements of the bill, like the so-called shopping
“exchanges,” aren’t to take effect until 2013, meaning that Americans
will have watched this messy process unfold for months and then be
told that the current system, which has cruelly pushed millions of
sick people into bankruptcy, will get four more years to bankrupt more
By contrast, Medicare, the single-payer health system for senior
citizens, was signed into law on July 30, 1965, and took effect on
July 1, 1966, less than a year later.
The Senate Finance Committee bill also is so complicated that few
citizens can possibly understand it or how it might affect them.
Instead of straightening out the health-insurance maze, the bill makes
it trickier to navigate.
While dumping the relatively straightforward public option, which
President Barack Obama favors and which is in the four other
committee-approved health-care bills in Congress, the Finance
Committee bill offers “non-profit, member-run” co-ops for individuals
and “small group markets.”
The co-op notion is a populist-sounding alternative favored by the
insurance industry because a co-op’s organizational difficulties and
relatively small size would make it easy to compete against, much as
small food co-ops can be overwhelmed by the pricing advantages that
favor large grocery store chains.
The other glaring problem for co-ops is that most Americans,
especially small-business people, are extremely busy already. They
don’t want to take part in running an insurance company; they simply
want to get health insurance at a reasonable price.
Nor do most Americans want to puzzle their way through Baucus’s
hodge-podge of private insurers, government subsidies, emergency
waivers, penalties for non-compliance, etc., etc. If Americans lose a
job or fall on hard times, they don’t want to go hat in hand to some
government bureaucrat and have to lay out their financial problems to
get some special favor.
What Americans Want
What Americans want is affordable health coverage provided in as
simple a package as possible.
That was the finding of a New York Times/CBS News poll which
discovered widespread confusion about the health proposals taking
shape in Congress, but more than 2-1 support for a public option to
compete with private insurers -- 65 percent for a public option, 26
percent against and 9 percent no opinion.
After all, one of the attractions of the public option is its relative
simplicity and cost-effectiveness. It could piggyback on the existing
Medicare bureaucracy and thus get started quickly and cheaply.
According to congressional budget analysts, it is the only plan that
offers significant cost savings.
Cost savings would not only help reduce the federal deficit but they
would mean that more Americans would get the health care they need
without going broke. In other words, it would save lives, reduce
housing foreclosures, and protect families now being ripped apart by
brutal financial pressures.
Yet, despite this common sense – and broad voter support for the
public option – the Senate Finance Committee rejected the idea.
Chairman Baucus conceded that the concept was appealing, but he joined
other conservative Democrats in voting no, claiming a public option
couldn’t clear the 60-vote hurdle to stop a Republican filibuster.
So, instead of trying to rally the votes – or using the
“reconciliation process” that allows a simple majority to enact
legislation having budget implications – Baucus kept on cobbling
together a nearly incomprehensible construct of tax credits, income
formulas, fees and other mumbo-jumbo.
This modified Baucus bill is in line to win final committee approval
this week. According to Washington’s “conventional wisdom,” it will
then become the vehicle for action by the full Senate, where
Democratic leaders have been ambivalent about a public option.
Some observers feel the best chance for the public option to survive
may be with a trigger mechanism that would permit it in some parts of
the country sometime in the future if private industry doesn’t offer
The trigger idea has been floated by Sen. Olympia Snowe of Maine, the
only Republican on the Finance Committee who has indicated even a
faint desire to vote for comprehensive health-care reform. However,
the trigger would push even this limited public option to some point
after 2013, when the insurance “exchanges” are finally scheduled to
Yet, if a trigger proposal is needed to win over some votes and beat a
filibuster, another approach could be a “reverse trigger,” one that
would put the public option in place immediately but set up a trigger
that would stop the public option from signing up new clients if
private insurers cut rates by 25 percent and scored a 90 percent
approval rating from customers.
Even then, the "reverse-trigger" public option would stay in place,
serving the Americans who had already signed up and ready to resume
taking clients if private insurers slide back into their old ways of
excessive executive compensation, bloated bureaucracies and huge
By moving up the timetable of reform to “as soon as possible” and
putting immediate pressure on the insurance industry for real savings
– in other words, letting voters see real benefits in 2010, not making
them wait until 2013 – the Democrats could show they're on the side of
the people and rack up electoral gains in 2010 and 2012.
However, if the Democrats insist on trading the common good for the
favors of special interests, all the industry campaign donations in
the world may not be enough to save them.