Apparently, the Republican win in the Massachusetts special election five days ago has altered the balance of power enough to place in jeopardy passage of any health reform bill. As I predicted 10 months ago, the bloated omnibus bills which emerged from the House and the Senate have something in it for everyone – that is, every legislator can find something in the bill they don’t like. When public opinion – so strong in favor of reform just 15 months ago – seems to shift, politicians go running for cover.
All possible ways through this dilemma seem to lead to inaction or failure. Once again the majority of the people in the USA have demonstrated that, when offered the chance to expand the number of people covered by health insurance, they are not really interested. GW Bush’s “Let them eat cake” comment sums up the attitude very well: “…people have access to health care in America. After all, you just go to an emergency room.” (July 10, 2007, in Cleveland) If you’ve ever been to an emergency room with a minor complaint, you understand the absurdity of that statement.
And, apparently, the majority are also not interested in slowing the relentless rate of rise in health care costs, which go up annually at more than twice the rate of other expenses. People see that rise when their insurance coverage goes up annually.
Or maybe I’m wrong. Maybe people do want to do something about those things, but don’t understand the solutions contained in the House and Senate bills. I mean, who has time to read over 3,000 pages of legislation? Or even a 10 or 20 page summary of it. What we need, I think, is Ross Perot, with his folksy charm and his hand-drawn charts showing just how bad the Federal deficit is, and then promising to roll up his sleeves, and look under the hood to fix that pesky Guvmint.
I say, once we’ve got the hood up on those health care bills, let’s just start taking the parts out one by one, and selling them off at auction. For instance, put forward HIRA – the Health Insurance Reform Act of 2010. Put those bullet points on the table, and see if people actually want to support legislation through which:
- Insurance companies will no longer be able to engage in discriminatory practices that enable them to refuse to sell or renew policies today due to an individual’s health status.
- Insurance companies can no longer exclude coverage of treatments for pre-existing health conditions.
- Prohibits lifetime and annual limits on benefits.
- Limits the ability of insurance companies to charge higher rates due to health status, gender, or other factors.
- Premiums can vary based only on age (no more than 2:1), geography and family size.
And which requires insurance companies to:
• Spend at least 85% of revenues on actual medical costs,
• Cover young adults on their parents’ policies through age 26,
• Eliminate pre-existing condition exclusions,
• Protect treatments for children with deformities;
- implement new programs to protect retiree health
- enact administrative simplification
All of these bullet points, by the way, are from legislation passed by the House, and replicated for the most part in the Senate bill. However, I’ve changed the wording from their official press release to render the ideas into actual American English, as distinct from the bureaucratic gibberish produced in DC. Think we can get agreement on these things?
What about setting a minimum benefits package all insurers must provide? “The basic package will include preventive services with no cost-sharing, mental health services, oral health and vision for children, and caps on the amount of money a person or family spends on covered services in a year.” Again, language drawn directly from the summary of the House bill.
How about a bill to sponsor a series of cost and payment reductions in Medicare, through a series of “pilot projects”, which, if they pan out, could be implemented by the agency which pays for over 30% of all US health care, and would also probably be adopted even sooner by those private insurance carriers who fund another 50%? This set of projects is already in legislative form, within the Senate bill.
Finally, why not use the already existing Federal Employees Health Benefits Board to vet insurance plans which meet the above requirements, and, instead of making them available to just Federal employees and retirees, open them up to any one or any small business who wants to buy them? This is the basic concept of the mysterious “Insurance Exchanges”, contained in both version of the bills already passed.
A little legislative creativity and courage is needed to go this route, so I doubt we’ll see it happen. But I can at least dream that the bills might be broken up, put back on the docket, and given a chance to be voted on by those who will be seeking re-election this fall. If they vote against any of these reforms, then I’d like to hear them explain that to their constituents.