By Marc Seltzer; originally published on March 13, 2010 at care2.com.
For all the smoke and mirrors, all the outrageous claims, and all the frustration about what is not in the Democrat’s health care reform legislation, the fundamental impact of the proposed reform is very simple. The Senate bill, soon to be voted on by the House, uses public funds to insure Americans who do not have insurance. (Making sense of the polling, from the Washington Post)
In providing for universal coverage, it satisfies President Obama’s preeminent campaign goal — one he has not walked away from despite profound economic turmoil and deep political resistance.
It is amazing that the debate over such a simple idea took so long and involved so many distractions.
Republicans do not want to spend public funds to insure the uninsured — plain and simple. Though they do not say it so clearly, instead, hiding behind claims that the deficit, the recession, and public opinion polls are the reason that the bill is wrong for America.
Smoke and mirrors. (Krugman dispels some myths)
President Obama seeks to add an entitlement, consistent with contemporary democratic principles of capitalism with a social safety net. Republicans, consistent with principles of individual effort and individual reward, seek to resist it.
What is more puzzling is why the left is so fractured in its desire for reform. There has not been a serious proposal for an open-enrollment public option or for single payer public insurance on the table since the beginning. This is not to say that the United States wont move towards public insurance or public medicine in the long run. But with only a subsidy and insurance regulation on the table, the left’s threats to undermine President Obama’s universal coverage program because it does not do away with the for profit medical system makes little sense.
What would make sense is to take a longer range view: To believe that universal coverage is an important step in the direction of providing good care for all; to trust that reforms included in this legislation can be used to regulate for-profit insurance practices to eliminate exclusions and rescissions which kept people who wanted insurance from receiving it; and to recognize that a variety of reasonable cost-containment measures will be used to slow the growth of health care inflation.
I have written often about deficits and debt, reform of fee for service medicine and changing financial incentives in health care. And I think this legislation is serious medicine for the problems we have in these respects. And I have spoken with Canadians and Europeans who love their publicly funding health care systems. And I still think that this legislation is a serious attempt to insure that all Americans can receive adequate health care. If I were like most supporters of this health care reform, I would say that this legislation is poor, for one reason or another, and then suggest that it was the best we could get under the circumstances. But this legislation is powerful, historic and designed to solve the problems we face. So why, complain?
Pass the bill.
March 19, 2010 Update: Paul Krugman sounding more positive, as well, in the New York Times.