The horizon is not so far as we can see, but as far as we can imagine

Bankruptcies Due to Healthcare Costs up to 60%

And even more damningly, 75% of those had health insurance. This is up from 50% of bankruptcies just a few years ago.

Meanwhile, in Washington, Single Payor healthcare, which would end this, is “off the table” and a public insurance “option” is under attack, and even if it gets into the final plan, will probably be so crippled by restrictions that it is no better than private insurance.

Current proposals seem to center around the “car inssurance model”, which is to say, you will be forced to buy insurance.  Yes, there will be some subsidies, but do you trust them to be sufficient?  I don’t, and if you do, well, I have a bridge to nowhere you should consider buying.

Health insurance costs are crippling America.  GM and Chrysler probably wouldn’t have gone bankrupt if there had been single payor universal healthcare, for example.  People are forced to stay in jobs they hate, and not move into jobs they would prefer to do (and thus be better at) because they need to keep their insurance.  This directly reduces productivity, decreases the number of new businesses created (since creating a business will leave you uninsured) and reduces innovation.   Countries with universal healthcare pay, on average, 1/3rd less per capita than Americans.  That additional money can be used for other purposes: like good internet, or high speed trains, drug benefits or an industrial policy.  Americans, instead, spend more and get worse health care on virtually every metric.  You don’t live as long, you’re not as healthy, and when you get sick it destroys your finances, often for life.

Here’s my prediction: whatever health care “reform” you get from Obama and this Congress is going to be a half-hearted piece of suck, because it won’t sufficiently (or at all) cut out the private insurance companies.  The public option, if it exists, will be a crippled piece of crap, won’t work well, and will be used to discredit the idea that the government can provide health care cheaper than the private sector.

If the goal was to make a system which worked, the US would simply either copy a system which does work (Germany’s or France’s, say) or it would just extend Medicare to everyone, and allow private insurers to do top-up insurance.  Oh, and it would allow Medicare to negotiate with drug companies, and to choose its own formulary.

Instead, what will happen, is a program which amounts to a massive forced subsidy of the private insurance industry.

None of this should be a surprise.  Obama never promised anything better during the campaign, and since he has a record of not even living up to his campaign promises, why would you expect this to be any better?

[h/t Americablog]


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  1. Ian, is there even a ghost of a chance that the inequitable 2005 Bankruptcy “Reform” Bill could be repealed?

  2. Ian Welsh

    Short answer: highly, highly doubt it. They couldn’t even get through a bill to allow judges to modify mortgages.

  3. gan1

    —The public option, if it exists, will be a crippled piece of crap, won’t work well, and will be used to discredit the idea that the government can provide health care cheaper than the private sector.

    I agree 100% with the above and this will unfortunately poison the well for a long time against a single payor system.
    I look for the proposed solution to little more than semantics. The uninsured will be shifted to the status terribly-insured. They will pay a disproportionately high price for the care they recieve. (either with premiums/high deductibles, or lower wages/worsened work conditions, “blamed” on the governments actions/interfence in the free market.

    I would look for choices available with medicare (re; MD choice etc) to be restricted somehow.

    I hope I am wrong!

  4. gtash

    I too must agree with your analysis, Ian. And with gan1’s remark that the whole outcome will be held-up as an example intended to discredit government. And you know what else? I think this is entirely intended by Obama. I simply do think he was or is sincere in pursuing healthcare for all. He is pursuing “health-insurance access” for all, and not doing that very well either.

  5. Ian, I think Obama’s petrified about the prospect of alienating his powerful neo-liberal supporters. He’s doing a pretty mean balancing act – trying to keep his coalition of progressives and Tom Freidman types together. This is the first time the neo-liberals (e.g. the Joe Kleins, Freidmans, etc.) are actually standing up to an Israeli Goverment for something resembling a just settlement with the Palestinians. If Obama could build on this hopeful dynamic, maybe, just maybe, our blood-sucking Military/Security Establishment could finally be tamed. The other Barbarian Horde is the prospect of depression. In your many missives on the Agonist, you predicted that this would all end in tears. Even I despair here, the “Gangs of New York” remain arrogant and unrepentant. Can he get meaningful numbers of neo-liberals on board to establish needed regulatory reform? It seems that Summers and Geithner are playing for time, and engaging in obfuscation.

    Perhaps Obama’s new Hispanic Supreme Court Justice signals that he’s at work building a coalition of Blacks, Hispanics and true progressives that can thrive and rule without groveling to feculent and destructive neo-whatever dogma.

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