The Senate's version of health care reform is becoming a "cave-in" to the medical and insurance industries, writes Robert Reich in Talking Points Memo today. The one reform that would actually cover almost everyone, a Medicare-like voluntary option in competition with private insurance, is falling off the table. Only a ferocious effort by the White House can put it back.
On the campaign trail, Barack Obama pushed a compromise -- a universal
health plan that would include a "public insurance option" resembling
Medicare, which individual members of the public and their families
could choose if they wished. This Medicare-like option would at least
be able to negotiate low rates and impose some discipline on private
But now the Medicare-like option is being taken off
the table. Insurance and drug companies have thrown their weight around
the Senate. And, sadly, the White House -- eager to get a bill enacted
in 2009 rather than risk it during the mid-term election year of 2010
-- is signaling it's open to other approaches.
Those other approaches, he says, would fragment a public option into regional or even state-level plans. "In other words, the putative 'public plan' would be broken into little
pieces, none of which could exert much bargaining leverage on Big
Pharma and Big Insurance. These pieces would also be so decentralized
that the drug companies and private insurers could easily bully (or
bribe) regional third-party administrators.
What Reich doesn't note is that the Senate itself is considering an even worse choice: Letting private insurers, the companies that overcharge, exclude and deny patients treatment in the name of profit, keep the whole field to themselves.
Mandatory purchases of private insurance policies without offering a
public alternative to the private market is nothing other than a
bailout for HMOs -- whose greed, waste and indifference to our health have created the current mess.
Reich holds out a faint hope at the end:
It's still possible that the House could come up with a real
Medicare-like public option and that Senate Dems could pass it under a
reconciliation bill needing just 51 votes. But it won't happen without
a great deal of pressure from the White House and the public. Big
Pharma, Big Insurance, and the rest of Big Med are pushing hard in the
opposite direction. And Democrats are now giving away the store. As
things are now going, we'll end up with a universal health-care bill
this year that politicians, including our President, will claim as a
big step forward when it's really a step sideways.
Given that insurers and the hospital lobby are already reneging on their promise to voluntarily cut costs and not even apologizing for it, they feel flush with enough power to back down both President Obama and Congress.
Obama surprised his opponents in the primary and the general election with his power to offer voters a new vision. Now, with no help from Congress and too many crises, he'll be tempted to let health reform slide. If he takes a pause to hear what the public really wants, and how it feels about profit insurance companies and HMOs, we think he can muster a fight.