Monday, March 22, 2010

It Ain't Over Yet

The unusual Sunday proceedings by the House of Representatives was a long,drawn out affair, but in the end the Democrats prevailed and voted for health care reform. The drama was high throughout the day because it appears that right up to the last moment it wasn't really a given that Speaker Nancy Pelosi had the votes to pass the bill. It was a grim reminder that making legislative sausage is sometimes very difficult and very ugly.

And what did we get after all the high drama? Certainly not an ideal bill, or even one that, as it stands, will help many people. And the reason for that is clear enough to even the center-left editorial board of the Los Angeles Times, although I'm not so certain that this editorial consciously set out what the bill is all about.

The House vote Sunday to send a comprehensive healthcare reform bill to President Obama's desk put the United States on a path toward universal health insurance, a goal that had eluded reformers since then-presidential candidate Teddy Roosevelt called for all workers to have coverage in 1912. It may prove to be the signal accomplishment of Obama's administration, even though the controversy surrounding it threatens to end his party's majority in Congress. Rarely has such a good thing for Americans been perceived by so many as a threat to their livelihood and liberty. [Emphasis added]

The new bill isn't about universal health care access, which is what the nation needs, it's about universal health insurance. The two concepts are not the same, and aren't really connected in this context except tangentially. Under this bill, private, for-profit insurance companies will provide the coverage, but without any firm control over the prices consumers will have to pay, especially for policies covering pre-existing conditions. It will be the insurance industry which will decide what treatment is acceptable for any given condition, with its eyes ever on the bottom line. Anthem Blue Cross will decide whether you get to see a specialist and then decide whether to pay for the treatment recommended. About the only thing the government will do is make certain any federal funding involved in the low-income policies won't be spent on abortions.

The bill is a boon for the money-making insurance industry, but for the consumer, eh, not so much. Still, as the editorial points out, it's a start.

We hope Congress keeps the reform moving forward, not backward. Although the measure attempts to improve the efficiency and quality of care, lawmakers will need to do more to restrain costs and provide more options for low-priced coverage. Nevertheless, the bill takes a big step toward solving the problems threatening the U.S. healthcare system. The path to a sustainable healthcare system is long and complex; Sunday's vote was a good start.

Will this be enough to dilute the call to roust Democrats in November? Maybe. It all depends on whether the economy picks up enough steam to put people back to work. It will also depend on whether the Democrats are strong enough to consider and pass a bill which adds the public option to the mix as the next step. That will at least encourage the liberal wing of the party to roll back their promises to sit this election out as a protest.



Anonymous Paula said...

Good point, Diane, as you say, this is only the first step toward real reform. Now the tough stuff begins, and it's not going to make everyone happy. In fact, many of those who fervently backed HCR may balk when they see how it impacts their own lives, at least temporarily. Still, all things said, I'd rather live in a country that's trying to make it easier for people to lead healthy, productive lives, than one that makes it easier for the few who control health care delivery to build their fortunes on the backs of the sick and injured.
I've written a big thank you note on Birds on a Wire blog to you and others who have helped get us to this point in history.

9:27 AM  

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