Shooting the Easter Bunny

After a holly-jolly 17-day break, Congress will reconvene next week and begin to merge the two houses’ versions of healthcare reform into a single bill – the most important one to cross their desks in my lifetime.  Certainly no legislator or private citizen should thoughtlessly toe the party line on every issue.  But I am deeply troubled, and admittedly somewhat puzzled, by the number of left-wingers who actually oppose this legislation.  Arianna Huffington called it “reform in name only.”  Keith Olbermann kicked it up a notch, calling the plan “immoral” and “a betrayal of the people who elected you.” called for “progressives” to “block this bill.”  Howard Dean believes it would “do more harm than good.”  What unholy Bizarro-Rove entity is behind the curtains directing this show?  Have they all forgotten the historical context, the dark depths from which we so recently emerged?

Whatever the final version of the bill looks like, it will be far from perfect.  Almost all of its supporters, including Obama, have acknowledged that.  The public option will not make the cut, which truly is a shame.  But that’s merely a kick to the nuts; the reform has not been castrated.  It will guarantee healthcare for the 14% of working Americans whose employers do not offer plans, yet who do not qualify for any government programs like Medicare or Medicaid.  Alone, this could be considered a gift to the insurance companies.  But along with enabling those 30,000,000 new customers to purchase policies, the bill will impose strong regulations on the industry.  Insurers will be forced to accept millions of customers who they previously turned away because a pre-existing condition, or some other red flag identifying them as “high-risk,” made them unprofitable to cover.  These are the people most in need of coverage – fifty of them die every day for lack of it.

A provision in the House bill would require insurance companies to spend at least 85% (80% in the Senate bill) of the revenue from premiums on actual healthcare (as opposed to overhead and executive bonuses).  In the language of the industry, that expense is called “medical loss ratio,” as if the cost of providing the goods and services that customers pay for, that the industry exists to provide, were equivalent to flushing money down the toilet.  No one really knows what these ratios currently are, but the testimony of a former consigliere turned conscionable rat is revealing:

“To win the favor of powerful [Wall Street] analysts, for-profit insurers must prove … that the portion of the premium going to medical costs is falling.  I have seen one insurer’s stock price fall 20 percent or more in a single day after executives disclosed that the company had to spend a slightly higher percentage of premiums on medical claims during the quarter than it did during a previous period. The smoking gun was the company’s first-quarter medical loss ratio, which had increased from 77.9 percent to 79.4 percent a year later.”

Could this be part of the reason for our ever-rising healthcare costs?  Requiring all insurance companies to a) reveal their medical loss ratio, and b) issue partial refunds to their policyholders if it’s not above a set floor level, sounds to me like real reform.

Passage of the bill would also cause a huge ($196 billion the first year) redistribution of income from the excessively wealthy to the working U.S. citizens too poor to afford a policy without assistance.  In essence, it finally recognizes (even in the absence of a public option) that access to medical care is a basic right of people in a civilized society – not a luxury for those who can afford it at whatever price the invisible hand comes to rest on.  What could be more consistent with the liberal ideology?

The final bill will almost certainly exhibit the inevitable influence of lobbyists and special interests.  It will yield to the vehement minority on abortion.  But what this group of Democrats and Independents are doing, fighting something good because it’s not good enough, is so anti-rational it makes my head hurt.  It’s like shooting the Easter Bunny for not being Santa Claus.


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