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Health care reform bottom line

2010 March 10
by Ian Welsh

So, there’s a push on for a vote, now that Massa has been forced out and the kneecappers have made clear what happens to progressives who won’t play ball on HCR.

The bottom line is that health care reform is a giveaway to special interests, funded by cuts from Medicare and forcing people to buy insurance or pay or a fine.  There’s some decent stuff in it, but less than folks think (for example, old folks can be charged multiple times what young folks are).

I’m still opposed.  I don’t think the good outweighs the bad.  This is not a case of “we can get better if it fails”, this is a case of “this is worse than nothing.”

9 Responses
  1. zot23 permalink
    March 10, 2010

    I would like to see an up or down vote on PO before this shindig winds down, just to know who stands where. If a decent PO or medicare buy in is passed, I’d be OK with passing the bill. If it fails, I’d start making calls to kill the overall bill and start again. In my mind, the mandate always must have been counterbalanced with cost controls or a PO type addition, without that it’s just a massive bailout in reform’s clothing.

  2. March 10, 2010

    To me, the bottom line is that it makes insurance companies more involved in the financing of health care, when they should be less involved. The alternative of real regulation doesn’t seem to have occurred to Congress, and I’d be suspicious if it had.

  3. David H permalink
    March 10, 2010

    If they want me to believe they’re not simply shoveling money in the pockets of insurance companies they’ll revoke their anti-trust exemption. Otherwise all talk of competition is empty rhetoric proving they aren’t interested in reform, only in looking like they are reforming.

  4. March 11, 2010

    &, if the Senate bill passes unmodified, there will be carnage on the Democratic side of the House, come next November.

  5. March 11, 2010

    I’m still opposed. I don’t think the good outweighs the bad. This is not a case of “we can get better if it fails”, this is a case of “this is worse than nothing.”

    I’m glad at least that you’re not under the illusion that “we can get better if it fails”, but if we can’t get better if it fails, then why is inertia better than passing the bill?

    At least people who think that killing this bill somehow leaves the single-payer door open have a stated justification for wanting to kill the bill. Do you believe that this inertia doesn’t lead to catastrophe?

  6. Ian Welsh permalink
    March 11, 2010

    You quoted my reasoning.

  7. March 11, 2010

    I find it difficult to believe that you don’t know what I was asking that you would provide a circular answer.

    I haven’t seen you or anyone else explain how it is that this bill is worse than doing nothing—except, from some people (not you), that it may preclude single-payer in the future by some form of physical exclusion principle or something. Is it just that the mandates are inherently wrong, and avoiding them is worth the ongoing implosion? Is there an actual economic case for doing nothing over this bill?

    In all of the hubbub about the bill, I haven’t seen anyone make it—it’s no accident that almost all the left-wing opposition to the bill comes from people saying that there’ll be something better in the offing.

    (Clearly, there’s an obvious case for doing single-payer over this bill. Like there’s an obvious case for me having chocolate cake right now. But I don’t have any chocolate cake at the moment.)

  8. Ian Welsh permalink
    March 11, 2010

    I believe that forcing people to buy shitty health insurance without adequate health insurance regulation is worse than nothing at all. The fact that the anti-trust exemption is not being repealed should tell you what you need to know.

    Jon Walker at FDL has done the nitty gritty detail work on this, I’m not inclined to recreate it or do a post on it since no one is paying me to do so and since I don’t believe such a post would make a difference one way or the other.

    This bill is not worth passing. It will do more harm than good. It is as likely to accelerate the effective collapse of the medical system in the US as it is to delay that collapse, and if it delays the collapse it will do so very marginally.

    Bottom line: at very best it is an extremely marginal improvement. (I don’t believe in the best interpretation of any bill in Congress, and I think anyone who does is a fool. Thousands of lobbyists have spent billions of dollars making the sure the bill works for their clients.) At worst, well, it will drive up costs even faster than they are now.

    And I know, from years of experience, that my errors are almost always on the upside. If I think it’s marginally worse than nothing, I think if I’m wrong, it’s far more likely that it’s worse than I think it is, not better.

    We’ll see.

    I have no idea if it’s going to be passed or not, but I do know that what I think is irrelevant to the process at this point, so I’m not going to sweat it.

    Thank God I live in a country with single payer.

  9. March 12, 2010

    Fair enough; your prognosis is that it will likely accelerate cost increases, in the average case. It’s one prognosis among many, it may be right. My own belief that it should pass is not based on the immediate/direct policy outcome anyway.

    I should point out that in a universe subject to entropy, doomsayers have an easier time being right in general than pathological optimists.

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