No More Gloom and Doom: We’re Getting Health Insurance Reform.

Health insurance was never going to happen in one bill, and
it’s really starting to bother me that many progressives thought it could
happen. Relax, and stop the doom and gloom nonsense. 

You should be rejoicing.

The political naiveté of a
large portion of the progressive side of the political debate is troubling, and it's time for
Uncle Miltie to smack you in the head with a dose of reality.

I don’t know if you’ve noticed, but we were inundated
with right wing politics from January 1981 to this past January. That’s 28 years of the right
wing having far too much influence in the country. That’s nearly three decades
of living in a country run by people who see the price of everything and the value of
nothing. Three decades of leaders with a mindset that favors the snake oil
salesman concept of economy and which stifles innovation. The United States used to be a
can-do country, but we became a “can’t do” country under the Republican
leadership. And that culminated in the appointment of George W Bush, twice, and
the most corrupt six years of government in US history.

That’s three decades of having their ideology pounded into voters’
psyches. A lot of the basic ideas
these phony “conservatives” pushed are now part of the mainstream, whether we
like it or not.

Suffice it to say, you don’t change the collective behavior
of 300 million people in one election. 
If you expected the entire political landscape to change because we
elected a moderate black president and 60 Democrats, then I hope Santa really does bring you that Ferrari in a couple of weeks.

It’s an absolute miracle that we are getting so much health
insurance reform in one bill. Even without the “public option,” it’s amazing to
consider how much is in there.

From this day forward, insurance companies will
no longer be able to operate as they have for many years. They will no longer
be allowed to turn you down for any reason when you apply for insurance. They
will no longer be able to drop you unless you don’t pay. They will no longer be
able to refuse to pay for a valid medical procedure, and they will no longer be
able to veto yours and your doctor’s medical decisions.  And your cheapskate employer has to make
insurance available to you under most circumstances, and pay at least 2/3 of
the premium costs.  In addition to that,
those who work for businesses too small to be expected to bear the costs of
health insurance, and who make too little money to be expected to pay the full
premium, will receive a subsidy from a trust fund so that they, too, can buy
insurance. Far more people will be eligible for Medicaid, as well.

The health insurance “cartel” is pretty much history with
this bill. They will no longer have an antitrust exemption, and they will be
forced to compete in the marketplace. They will no longer be able to carve out
portions of the country and run them as though they were the Gambino crime
family and the product was drugs.  States
will have to allow multiple insurance companies to operate in each state or
region, and each will have to offer several levels of coverage. Your employer
will no longer negotiate a plan for your workplace; they will offer you a
cafeteria-style selection sheet, and you will be able to choose which plan you
want to pay for.  

That’s all without that magical “public option,” folks. Even without the public option, at least 35-40 million currently uninsured people will now have insurance. And yet, I have heard more than one self-described "progressive" suggest scrapping the entire bill if it doesn't have a "robust public option." It makes me wonder if they get the fact that the root word for progressive is "progress." Is it really "progress" to scrap coverage for 35-40 million people and keep the status quo, because it doesn't cover 47-50 million?

I’ve always been puzzled as to why some progressives are so
enamored with the phrase “robust public option,” anyway. It’s a phrase without any actual meaning, if you want
to get right down to it. I broached the following question many months ago; how much
of the rest of the reform package would we be willing to give up in order to
get a public option? The response was relative silence from the crowd, except for
demands for a public option, or else. In other words, while Blue Dogs are
willing to kill coverage for about 36 million people for one principle,
progressives seem willing to do the same, just for a different principle.Why are we better again?

Creating or expanding the public health insurance system is
an absolute necessity, to be sure. Private insurance has demonstrated that they cannot and will not cover 100% of the American people, and if we're to get a handle on costs in this country, we'll have to make sure all bills are paid. But to get bogged down with a phrase like “public
option” to the point that we can’t see the forest for the trees, is just plain
crazy.Not only that, but a public option health insurance system is not a guaranteed winner; what if it fails? The public option is not a panacea; stop treating it as such.

Now, about the Senate. I know you won't believe me, but the Senate, of all bodies, may have stumbled upon something much better than a public option; certainly better than the watered down public option in the House bill. (Which is still better than nothing, by the way; whatever is passed will have to go through significant tweaking.)

I can’t tell you how many plaintive e-mails I’ve received from
progressive groups in the last few days, distressed over the Senate’s likely
dropping of the public option, in favor of an alternative. Have you sat down and read about the
alternative? If you can read the
details of the alternative and not giggle with glee, then you're not thinking. 

The plan, as it’s being reported, would replace the "public option" with something mirroring the same plan government employees
receive. It would be created by private companies (think Fannie Mae and Freddie Mac), but it would
be administered by the Office of Management and Budget. That's already not a horrible alternative. If you know anything about the federal employees insurance system, they don't deal with most of the bullshit the rest of us do.

But more intriguing still is the other part of this alternative plan, which would allow people as young
as 55 to buy into Medicare. The age 55 is significant as hell, really. How old is the largest chunk of the Baby Boomer population? It's estimated that as many as 20 million people would be eligible to buy into Medicare under this, and that would include many who are currently carrying private insurance. But most importantly, it opens the door to an expansion of Medicare.

Such a move will go a long way toward controlling costs and creating competition. The OMB portion of the plan will force private insurers to compete, and it will create a model for controlling costs. But with Medicare being opened up to those over 55, how long do you think it will be before people under 55 start clamoring for a piece of that? 

Politically speaking, it's a stroke of absolute genius as well. It's a combination of private and public, with the public portion being Medicare. We know the Republicans will never go for it, but are Blue Dogs going to vote against an "expansion of Medicare," a program they've been praising for months?

Keep in mind, folks; not many of the countries we’d like to
emulate actually have ONLY a single-payer system. Most have a hybrid, which is
what we could be creating here.

Don’t look now, but the Blue Dogs just gave
us an “in” to an eventual single-payer plan.

But either way, be progressives. Make progress. Just don’t
expect it all to come in one big bite. All useful reform comes in a trickle; it’s
rare when major reform comes all at once, because people naturally fear change. Be patient and realize we have a lot
of hearts and minds to change.  Universal
health insurance is the goal; let’s not lose sight of that.  

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