The Scientific Activist

It’s been a rocky ride this year, getting heath care bills passed in the House and the Senate. It’s been just over a month since the Senate passed its bill in a dramatic Christmas Eve vote (and much longer since the House passed its version), but the fate of health care reform still appears as uncertain as ever. In particular, a surprising political setback in Massachusetts has made the already difficult Senate an almost impossibly hostile environment for reform.

The most obvious solution is for the House to pass the Senate bill without hesitation; however, House Speaker Nancy Pelosi has already said this is unlikely to happen. On the positive side, it looks like Democrats in the House and Senate may be close to brokering a deal allowing reform to pass. But, if this fails–and maybe even instead of pursuing this strategy–the House should do its best to pass the Senate bill.

So, what’s the hold up? Well, liberal Democrats are understandably reluctant to support the highly watered-down Senate bill. But, the House version isn’t all that different. There’s also some weird resistance to some largely irrelevant abortion provisions, but that should really be a non-issue.

Here’s the deal. There’s not going to be a public option, at least not for now. And, please trust me that it pains me greatly to say this, as I have been a major proponent of the public option and single-payer/universal health care systems in general. But, that’s the political reality, and there’s no getting around it. The kind of sweeping health care reform that many of us envisioned for this year hasn’t materialized, but that doesn’t mean that we should scrap the whole thing now. There’s still plenty to like in the Senate health care bill.

There are a variety of problems inherent in America’s market-based health care system. A true solution will require a comprehensive overhaul, but the Senate bill at least addresses some of the most pressing ones. There are three provisions in particular that even on their own would be worth investing a major effort in passing. Firstly, the bill prevents insurers from denying coverage based on preexisting medical conditions. This common industry practice has caused untold strife for so many, and this provision would be a major step forward. Secondly, the bill eliminates lifetime limits on insurance coverage–another bane for people with chronic medical conditions. And, finally, the bill enacts various subsidies and tax breaks to help individuals afford coverage–a benefit that speaks for itself. For more, check out analyses here, here, here, and here.

It’s been somewhat painful watching the political process at work this year as health care reform worked its way through Congress. We saw the Democrats make compromise after compromise, and the Republicans still refused to offer any support–instead stubbornly opposing even the most meager reforms. But, if you thought this was tough, it’s likely to only be worse in the near future. The political climate this year–as bad as it’s been–was unusually favorable. Still, we saw how badly health care industry lobbying money could influence the course of the debate. And, you thought that was bad? Last week’s unusual and disturbing Supreme Court decision in Citizens United v. FEC has the potential to make these the good old days, as destructive corporate influence in politics will only increase.

In short, now is the time for health care reform. Not next year, not next month, not even tomorrow. Today. Now. So, please, contact your Representative in Congress and tell him or her that you want him/her to commit to passing the Senate health care bill in the house–and then to convincing his/her peers to do the same.

Click here to look up your member of Congress. You can then either write a message using that site, or Google your Representative’s contact info and then call or email to make your voice heard. The Supreme Court may have opened the floodgates for unfettered corporate influence in politics, but hopefully we can show that good old fashioned democracy still has a role to play.

Comments

  1. #1 republicanblack
    January 25, 2010

    Bringing up abortion in the health debate is only there to cause fights and division to keep us from getting what needs to be done, done.Though I am a pro-life advocate, I support the health care reform and the law should remain as is, where there is no fed funding of abortion. I saw this article that really challenged my believes on abortion and how the current law is consistent with the constitution and faith. As a conservative it challenged me to rethink how I view abortion. It’s not too shocking, but it definitely was a good read, check it out

    http://keironjackman.wordpress.com/2010/01/25/abortion-religion-politics/

  2. #2 Alan Kellogg
    January 26, 2010

    The government pays for my health care (SSI recipient). The government does not pay the full cost of my health care (something about forcing health care providers to bring their fees down, which ignores what it actually costs health care providers to provide the care they do). So the costs not covered by the government gets passed on to you, the private citizen.

    Even worse, the government insists on paperwork. Which paperwork adds to the cost of providing me with health care. As a result costs are driven up and you get to pay those extra costs. Which leads us to this question…

    The public option; good in theory, but what about practice?

  3. #3 Paul Browne
    January 26, 2010

    I tend to agree that the Senate bill would be better than nothing, though I’m far from happy about the lack of a public option and the possibility (probability?) that the ban of federal will make obtaining a safe and legal abortion more difficult and more expensive.

    Incidentently this post on Pompe disease by Drugmonkey provides yet another example of the problems that can follow when insurance companies have too much say in when they will pay out. Reform is certainly needed.

    http://scienceblogs.com/drugmonkey/2010/01/extraordinary_measures_pompe_d.php#more

  4. #4 Nick Anthis
    January 26, 2010

    Alan,

    Based on my experience with nationalized health care in the UK, a robust public option, at least, could simplify our health care experiences considerably. See here for more.

  5. #5 Susan VP
    January 26, 2010

    I’m not sure that the pre-existing conditions ban is still on the table. Check out http://www.americablog.com/2010/01/did-someone-just-chuck-pre-existing.html

    Specifically: “The only reason to specify that children under the age of 19 won’t be denied coverage is because you plan on letting everyone 19 and over BE denied coverage for pre-existing conditions.”

  6. #6 MikeB
    January 26, 2010

    Nick – your op-ed for the Star seems to have disappeared – any chance of posting it ?

  7. #7 Nick Anthis
    January 26, 2010

    MikeB: You’re right; it is gone. I don’t have the full text with me now, but I’ll post it later.

    Susan: My understanding is that the ban on coverage denial for children goes into effect immediately, whereas the coverage denial ban for everyone else goes into effect in 2014–hence the differentiation of the two.

  8. #8 OleanderTea
    January 26, 2010

    Even worse, the government insists on paperwork.

    Alan, if you think the government requires a lot of paperwork from providers, you should see what private insurers require. Worse, you should see how many channels a “private insurance” claim goes through before it pays. The days of submitting a claim to MongoInsurance, Inc., having it price based on a fee schedule, and be sent back with a check are LONG gone.

    Which is part of the problem of the health care debate. Most Americans who have private insurance don’t know the labrynthine routes claims take to “pay” and how it affects costs. And they won’t know, either, because it’s boring and will never, ever, be a news story.

  9. #9 Moby
    January 27, 2010

    No question that healthcare reform is a necessity. The inequities are enormous, the paperwork is daunting, the pre-existing conditions exclusions are unacceptable, etc.

    But healthcare cannot be dealt with in isolation within the maelstrom of all the other inequities, bad decisions, obstructionism, cultural challenges, governmental intrusions, violations of the Constitution, and special treatment of the legislative branch.

    Multi-trillion dollar deficits make further deficits impossible to swallow. Government blunders, likewise. Patronage, likewise. WE JUST CANNOT TRUST OUR GOVERNMENT TO DO ANYTHING RIGHT.

  10. #10 Nick Anthis
    January 28, 2010

    I have now uploaded my Star-Telegram op-ed onto my blog here and edited the links within the original post accordingly.

  11. #11 Chuck
    February 2, 2010

    We need to pass the senate bill now. http://proudprog.blogspot.com/

    If we don’t pass the senate bill, then healthcare will die. No Democratic President will take it up for a generation. We know a Republican President won’t.

  12. #12 Brian G.
    February 16, 2010

    I too would love to see a real public option in the US. I really thought it would happen too. I was fooled, and frankly, I’m still pretty angry about it.

    I’ve been pretty fortunate, for the last 5 years I had a well-paying IT job that made me, for the first time ever, very financially comfortable. But that’s over now – two months ago, the company I worked for closed an entire facility and put 400 or so people back into the job market, in an agricultural community of less than 40,000 people. Even if I move, it is highly likely in this economic climate that I will be unemployed for some time. One of my friends just hit the one-year mark. Another has been working on and off, less than part time, for almost two years now. The point being: my story isn’t unique. Unemployment is insane right now, and it is highly likely that it will continue to be insane for at least a year or two – possibly longer.

    Moreover, I grew up in a poor family, and all of my friends were (and for the most part, still are) poor folks. Most of them struggle to pay the bills. Some struggle to pay *some* of the bills, and just toss the rest of them in the trash.

    The problem is, federally mandated health care with penalties for noncompliance but without a public option is just utter madness. COBRA is stupidly expensive, only available for a short time, and disappears as soon as you miss a single payment – oh, and it’s only available for a specific class of people. And there’s no guarantee any other coverage will be any better – or even available. I am simply not willing to take the risk that poor folks (like pretty much everyone I know) will “probably” not have to pay a fine based on their “hardship” circumstances. This is negative progress. It creates a huge bureaucracy charged with enforcing health care coverage but DOESN’T ACTUALLY PROVIDE HEALTH CARE TO ANYONE AT ALL.

    Sorry. This really strikes a nerve right now. To think that a year ago we were inducting a Democratic president and Democrat majority Congress, and the end result of that is a bill that will put me in a significantly poorer position than I was to begin with just makes me want to curl up in a ball and cry.

    Especially considering the fact that the buzz coming out of DC these days is that preexisting conditions are back on the table, it’s unconscionable to pass a bill that mandates everyone have coverage, but provides no public option. That, for lack of a better term, is a poor tax.

    And not a single bit of that criticism addresses the fact that poor folks probably couldn’t afford to pay their deductibles anyway, so mandated healthcare (sans public option) is going to be a losing proposition for them.

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