Wednesday, July 29, 2009

Simplicity

I keep wondering why the new health care bill keeps getting more and more complicated. First 1,200 pages long, then 2,000 pages long. And "no one has read it" except talk radio hosts who tell us that they found communism and socialism and totalitarianism deep inside it, even as they describe amendments offered by conservatives. Every think tank with a budget office throws out different figures.

Then I realize this is what happens when you try to please everyone.

Public Option? Sure, but only if everyone has to buy insurance, because insurance companies are scared of competing with big ineffiecient government. And even then only if we keep the payments of the young and healthy high enough to offset the payments of the sick people we could bilk the government for under the current system. And even then only if everyone looking for the public option is exposed to competing private plans in the health exchange. And then only if we remove the tax breaks to employers who pay into private insurance to employees so we can give tax breaks to people who don't pay taxes so they can afford whatever it is we're selling. Because after all this, we aren't sure anymore. Ditto a national non-profit co-op. Oh, and under this plan, still, not everyone is covered.

I wonder if this strategy is designed to make us want the single-payer system back.

Which is what I wish was still on the table. Write one up over break, submit it to committee and see if stands of falls. After that? Public option. Everyone can chose to be a part of a single payer government system. Write that up over break, submit it if single-payer falls, and work on that one. After that? National co-op. After that, massive tax breaks for regional private non-profit co-ops. And so forth. No thousand amendments. No bending over backwards because you think the GOP or the milquetoast Dems will vote for your legislation given enough amendments (they'll gut your bill, overcomplicate it, then vote it down while calling supporters communist totalitarians).

I'm just getting tired of the big comprehensive bills. They are political and policy losers, and the sooner we understand that, the more we can get done.


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1 comment:

Dante said...

"Sure, but only if everyone has to buy insurance, because insurance companies are scared of competing with big ineffiecient government."

The public option isn't nearly as scary as what will happen to the private options. Right now private insurers choose what packages they offer and price them according to expected risk. When the government starts choosing what packages private insurers can offer, it won't be based on cost. And don't fool yourself into thinking it will be based on our well-being either. Packages will be based on political favor. But don't worry, you can be grandfathered into your current package for 1 year* before being thrown to the lobbyists with the most cash. And blocking insurers from denying pre-existing conditions? Didn't we just ride the financial sector's ass for applying normal risk models to high risk customers? Why is it now ok to do the same thing here? That won't end well.

If Congress were willing to offer a public option and leave the private options alone (which I believe you are suggesting as Step 2 below), this bill might actually be popular. And it might even have some support among Republicans since that would be Romneycare in a nutshell. Right now there a lot of people are afraid because there is a lot to be afraid of.

* I know it's really "5 years" but that's only as long as nothing in your policy changes and politicians know damn well insurance premiums are adjusted yearly.