The left has come unhinged over health reform.
Make that dangerously unhinged.
The Senate bill would extend coverage to more than 30 million
Americans who would otherwise be uninsured—and provides $900 billion
in government subsidies to get there. It would crack down on the most
abusive practices of the insurance industry. No longer would insurers
be allowed to refuse to cover individuals with pre-existing
conditions, charge them more because of poorer health, or cancel their
policies once they get sick. People who lose their jobs, or their
insurance, would have a place to turn for coverage through the new
insurance exchanges. For the first time, childless adults living in
poverty would be guaranteed health care through Medicaid.
MSNBC’s Keith Olbermann calls this a “hollow shell of a bill” and
warns President Obama of the “distinct possibility” of a primary
challenge in 2012. Former Democratic National Committee Chairman
Howard Dean calls it a “bigger bailout for the insurance industry than
AIG” and “not worth passing in its present form.” Blogger Markos
Moulitsas tweets, “Time to kill this monstrosity coming out of the
The fundamental problem, they argue, is the Senate’s failure to
include a public option—a government-run insurance plan to compete
alongside private companies in the insurance exchanges. Without such a
public option, they contend, there will be no discipline on insurers
to control premium prices—even as individuals are required by the new
mandate to buy insurance they won’t be able to afford.
This dire assessment assumes all sorts of failures—of the
marketplace, of regulation—that I don’t consider inevitable. It
invests the public option with more magical power to affect premium
costs than I think is warranted. But let’s assume the critics on the
left are correct, and that insurers are only pretending to be unhappy
with the Senate bill in order to lure lawmakers into passing it—at
which point (actually, in 2014) they’ll be able to pounce on millions
of new customers.
What do you imagine would happen if premiums turned out to be
unaffordable—even with hundreds of billions of dollars in subsidies?
Would Congress enforce the mandate for individuals to buy insurance,
or ease it? Would Congress keep subsidies at the same level, or make
them more generous? Would Congress play nice with insurers, or add a
public option? History teaches that, once in place, entitlement
programs tend to become more generous, not less. The approach to
programs that do not work as intended is to lubricate their operations
as Congress does best—by spending more money. This is a cause for
concern about the Senate bill, but not among liberals.
Those who denounce the Senate plan imagine that President Obama
and fellow Democrats possess political muscle to achieve something
more. They don’t. If health reform does not get done soon, its moment
will be gone for years. Congressional Democrats are likely to be in a
weaker position after 2010.
And Americans, particularly poorer Americans and those without
insurance, will be far worse off with the status quo, which is what
will result if liberals succeed in their effort to kill the Senate
bill. That would be the real monstrosity.
Ruth Marcus’ e-mail address is email@example.com.