At this point in the process its hard for me to judge just how successful the result of HCR is going to be. There has been a great deal of talk about the value of the public option and about the subsidy levels in the bill. Well generally there has been a lot of talk about a lot of things. As we approach the point where the bill heads to floor i have to wonder how good the end product is going to be.
I think that the end point of this is really not going to feel like a victory. Even if we succeed in getting the Public Option linked to medicare and in opt out form it looks like it will only be available to a small percentage of out population. Obama himself has said that it would only be open to 5 percent of the populace. Dont misperceive me, im very happy that we are getting some form of public option even if it is a fourth tiered compromise version of it. this just has the feeling that when we look back on it the result and any victories will feel rather hollow.
When this is all over are the American people going to be in a position where they can say that nobody goes broke in this country because of health care costs? No. Will we be in a position to say that we can say that nobody dies because they couldnt afford to see the doctor? I dont think we will. Will workers have the freedom to take risks and leave jobs with out the worry that they wont have health coverage? no again. werent these some of the bedrock reasons for reform? At the end of the day things may be better but they will be far far from good. This is one way of saying that President Obama will not be the last president to deal with this issue. He may even have to deal with it again in a potential second term.
Ezra Klien had a post today that helps illuminate why this is all feeling dissatisfying.
Among the many implicit precepts directing health-care reform are the following:
(1) The employer-based system doesn't work, either to assure coverage or control cost.
(2) The employer-based system must be preserved.
(3) A strong public option would offer consumers lower premiums and attract a lot of customers.
(4) A strong public option cannot be included because private insurers cannot effectively compete with it.
(5) Among the worst economic distortions of the system is the fact that employers choose insurance for their employees, and thus employees don't really understand the cost of coverage.
(6) The exchange cannot initially be open to employees, and may never be opened to employees, because they might leave employer-based insurance in order to shop for their own policies more aggressively.
Probably most sad of all is the idea that we really couldnt have expected better from our political system. Raise your hand if your fairly surprised that the public option wasnt kicked to the curb entirely at this point? (raises hand). We started from a position where 40% of the senate was against everything. 40% of them were not only useless but actively opposed to making the lives of the american people better. Its probably safe to say that another 10 percent are so corporate owned that anything beyond an empty hollow of reform is anathema to them. Then there is joe lieberman. looking at that what chance does total reform have?
The result is at most a baby step towards the goals that progressives strive towards, the elimination of bankruptcy due to medical bills, the ability to see a doctor when you need or want to, the freedom from dread of losing health coverage. So people must continue the fight. Continue the battle for an America where the citizens enjoy the best health care in the world as opposed to an America where the rich enjoy the best health care in the world.
but who knows maybe my view is too cynical.