Cautious pols choke healthcare reform to death

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To paraphrase Joseph Conrad: Healthcare reform, it dead.

I know, the reform effort continues to move forward, but the goal has shifted from transforming the system to tweaking it, from expanding access and improving care to creating a bureaucratic maze that sort of looks like universal coverage but that protects the very people who have made such a mess of things in the first place.

Real reform — otherwise known as single-payer — was never on the table. The politics, everyone agrees, made it impossible. Of course, the politics — otherwise know as the conventional wisdom — is self-perpetuating.

But even without single-payer, we had a chance to make major changes in the system that would have forced the insurance companies to play ball — a public option that would have competed for customers.

Already, the group of six has tossed aside the idea of a government-run insurance plan that would compete with private insurers, which the president supports but Republicans said was a deal-breaker.

Instead, they are proposing a network of private, nonprofit cooperatives.

The public option was no panacea — but with requirements in place preventing the insurance companies from gaming the system as they do now (they would not be able to deny coverage for a pre-existing condition, cap payments or kick people off their rolls), it would have made a huge impact on the way the healthcare system runs.

Howard Dean, the former Vermont governor and a physician, told Rachel Maddow last night that the bill that latest proposal “is insurance reform but it‘s not health reform.”

It‘s not going to—what it will do, I assume there is guaranteed issue and so forth in there, and if that‘s true, if the guaranteed issue is in there and community rating, then it‘s insurance reform.

It‘s not going to do anything to curb expenses. It‘s not going to change the health care system. It‘s not going to insure anybody extra. That‘s what I call the fake public option.

He continued:

This bill is going to cost a lot of money and isn‘t going to do anything if this compromise, this so-called compromise is true. This compromise does nothing except it will reform insurance. That‘s a good thing to do, but they ought to strip the money out of it because we reformed insurance like this in Vermont 15 years ago. It‘s a fine thing to do, but it doesn‘t insure more people.

There is this sense now that it is more important to get something — anything — done and that it have some Republican support. That kind of thinking is similar to one of the great failed football strategies — the late-game use of the so-called prevent defense, which is all about caution, all about playing not to lose (which is not the same thing as playing to win).

What we are witnessing is a Democratic majority more concerned about the insurance lobby and its campaign cash while also being able to share the blame in case their reforms fail to function as advertised, rather than going hard at the end zone — which would require an aggressive reconstruction of the healthcare system in the United States.

Author: hankkalet

Hank Kalet is a poet and freelance journalist. He is the economic needs reporter for NJ Spotlight, teaches journalism at Rutgers University and writing at Middlesex County College and Brookdale Community College. He writes a semi-monthly column for the Progressive Populist. He is a lifelong fan of the New York Mets and New York Knicks, drinks too much coffee and attends as many Bruce Springsteen concerts as his meager finances will allow. He lives in South Brunswick with his wife Annie. View all posts by hankkalet