Thursday, December 10, 2009

Senate Healthcare Bill Changing--Still Bad

Senate Democrats have begun to alter their healthcare bill in the hopes of getting the support of 60 Senators to move past filibuster threats. I'll wait on the incomparable Keith Hennessey's detailed analysis (not up on his site yet) and the CBO scoring of the bill to go completely right wing nutjob on it, but there is enough coming out for me to already have some questions.

Firstly--the Senate's dropping of a "Public Option" (theirs was a watered down one already, with healthcare "cooperatives" subbing for a straight up Public Option) is interesting--I imagine Reid didn't have the 60 votes with it in there--otherwise, he wouldn't have scrapped it. That said--the House bill is vastly different. The conference committee to reconcile whatever comes out of the Senate (if anything), with the House bill is going to be bloody among Democrats.

But as for the changes to the Senate legislation, there are two biggies. First, instead of the cooperatives, the Feds would set up two private, but national health care plans modeled after the Federal Employees Health Benefits Program (FEHBP), in which presumably, the insured would pay a portion of their premium and the federal government would pay a portion (probably the lion's share). Also presumably, the amount one pays in premiums would somehow be tied to one's economic conditions.

The second big change in this plan is to allow individuals as young as 55 to "buy in" to Medicare--the federally funded program for healthcare for Seniors.

In each case--what we see at work is the triumph of "universal coverage" over "controlling costs". And this must be what Republicans and conservatives use to defeat the plan ultimately.

I'll leave it again up to CBO to help us determine the number of uninsured that this will take off the streets, but I don't believe it will be substantial. What will happen though is a huge increase in the number of people on medicare (how were you going to pay for this all again Senate Dems? Reductions in medicare, right? Whoops--not with millions of new people in the system!), and a huge increase in the number of people in federally sponsored insurance plans. Put another way, the Federal Government will gain additional coercive power to set prices and compensation levels for those their programs. Doctors and hospitals will have little choice but to swallow hard and accept the Feds mandates--and then pass the costs along to everyone else with private health insurance (i.e--YOUR costs go up). Additionally, YOUR costs will go up in the form of the taxes you will pay to fund the government's share of the FEHBP-like programs AND the increased number of people within the Medicare system.

Is there ANYTHING good in the changes the Senate is making? I think so, and it would be worthwhile to figure out how to sustain it--and that is, the decision to extend Medicare eligibility to those older than 55 would make insurance available to a group of people particularly vulnerable to the "pre-existing condition" stigma. That is, if you get laid off, fired, etc at 57 years of age--and you then re-enter the work force--you are far more likely (I am guessing here) to be denied coverage by your new-employer due to pre-existing conditions than if you had lost your job as a 34 year old (see this post for the horrors of aging). I see the Feds as the "insurer of last resort" in this case, and as long as we as a society are repelled by the notion of someone being denied insurance because of pre-existing conditions, this seems like a worthwhile step.

Stay tuned for more and better analysis as greater understanding of the bill's changes come available.

1 comment:

Anonymous said...


You thought it was "The Hammer" weighing in, didn't you?

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