Thursday, December 17, 2009

My Views on Health Care Reform

I've had quite a few people asking me how I feel about the direction that health care reform has taken since Lieberman outright screwed any chance for a public option or expansion of medicare. While I am in the middle of several time consuming job related deadlines, let me just say a few words which I am sure fellow progressives might not like to hear.

First, the term dissappointment best characterizes my feelings about the current health care reform proposals in the House and Senate. The House has a public option, but is weak on other cost control mechanisms and imposes undue restrictions on womens' privacy rights. The Senate bill has no public option, but does contain a variety of other measures that reduce health care costs. The big dissapointment for me is that, when all is said and done, there will be no public option and no expanded Medicare. At this point, that's a fact and there's nothing that can be done about it.

Secondly, the term "perplexed" best characterized by reaction to Howard Dean's call to kill the bill and start anew. The following statements by Kevin Drum at Mother Jones is illustrative of my curiosity towards Dean's position.

Here's what I want to know: which one of us is living in dreamland? If you don't like the Senate bill, fine. Don't support it. But in what universe will healthcare reform get revived anytime soon if it dies this year? 2010? With the legislative plate already jammed, healthcare reform probably polling in the mid 30s, and midterms coming up? 2011? After Republicans have gained a bunch of seats in both the House and Senate thanks to public disgust with Democratic disarray? 2012? A presidential election year? 2013? 2014?

Well said. What's more, anyone ever involved in things like NGO work or politics will always say that "sometimes small wins matter". Again, Kevin Drum:

But if it passes, here's what we get:
  • Insurers have to take all comers. They can't turn you down for a preexisting condition or cut you off after you get sick.
  • Community rating. Within a few broad classes, everyone gets charged the same amount for insurance.
  • Individual mandate. I know a lot of liberals hate this, but how is it different from a tax? And its purpose is sound: it keeps the insurance pool broad and insurance rates down.
  • A significant expansion of Medicaid.
  • Subsidies for low and middle income workers that keeps premium costs under 10% of income.
  • Limits on ER charges to low-income uninsured emergency patients.
  • Caps on out-of-pocket expenses.
  • A broad range of cost-containment measures.
  • A dedicated revenue stream to support all this.
As you read this post, you may know that I spent considerable energies here on Twitter and Facebook, trying to help energize the push for public option. But, I am never one to say that the best way to go down is to go down swinging. At heart, I am a pragmatist and know when tactical retreats are needed. AND RIGHT NOW, A TACTICAL RETREAT IS NEEDED.

What we have is a health care bill that is an utter mess, but better than nothing. In the short run, we no longer have the choice between public option or no public option. Our choice is between failing to pass some needed health care reform measures and hoping to solidify progressive majorities in the next Congress, versus killing health care legislation and...well then what?

I know some of you reading this have worked with me tweeting and retweeting health care stats and calls to action. And we should continue to do this. But, we also need to know what realistic options we have at this moment. Taking Dean's course of action is not one of them. Instead, lets get this needed reform passed, regroup, and focus on getting progressives in Congress in 2010. Then we can give a single-payer a serious push and expect to at least get something akin to a public option.

As an additional note: I think this petition is still worth signing. I still believe we need to make it clear that we object to having the public option sidelined. http://is.gd/5rzwR

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