| The challenge of healthcare reform is perhaps the toughest one facing the 111th United States Congress. When it comes to Obama's agenda -- not economic recovery, but the things that he's always planned on doing -- healthcare reform is certainly the number one priority. But it's easier said than done.
I want to make something clear right off the bat: I'm not here to try and argue against universal healthcare or a public option. I am not opposed to that on principle. I had the good fortune of listening to Rep. Jan Schakowsky (D-Illinois) speak on this subject recently. She said, "We are the only industrialized Western nation that regards healthcare as a privilege and not a right." That really struck me. It's obvious to anyone that the current healthcare system is majorly screwed up, and damn the insurance companies, we need to make some major changes.
We can all agree on that much, but we can't agree on how to go about it. The easiest part, it seems to me, is to expand the options that people have when it comes to picking a health insurance company. People should absolutely be able to buy health insurance across state lines, rather than being forced to pick one of two preposterously overpriced options in the state. Any bill that is passed must include such a provision. For that matter, why, in this day and age, are health insurance companies still exempt from anti-trust laws? That needs to be changed.
So that's the easy part. The harder parts to pass are (a) the health insurance mandate, (b) the creation of a government-run health insurance option, and, hardest of all, (c) paying for it.
Those are the parts I have a harder time supporting. First of all, the mandate. This whole idea really bothers me. It's not a uniquely Democratic idea; Mitt Romney's plan also includes a national mandate. But I feel very uneasy about it, to be honest. Correct me if I'm wrong, but wasn't that one of the differences between Obama and Hillary Clinton in the Democratic presidential primary season a year-and-a-half ago? Unless I'm mistaken, he was against the mandate then and she was for it. I guess he changed his mind. I still haven't. This isn't like driving a car, where the government can force you to get insurance to use their roads. This is the government trying to force you to get insurance so long as you're alive. I'm not saying it's a bad thing to have health insurance -- that'd be stupid. But I really don't like the mandate idea.
Then there's the public option. Again, I'm not against the idea in theory. As a matter of fact, I really do like the idea of having a public option compete with the private insurance companies to drive insurance prices down. But the reality is less pretty than the theory, I fear. Make no mistake, I loathe the health insurance companies. But if and when private insurers decrease their prices to compete with a public plan, they most likely will hike premiums, hurting still more people -- just because they are that terrible.
"So what?" some say. "Switch to the public option then."
There's where the biggest problem lies: Paying for it. The CBO's report from earlier this month said that if only 3 million people switch to the public plan over the course of a decade, it will enlarge the national debt by $1.042 trillion from 2010 to 2019, with the effect on the deficit increasing every year. That's an incredible amount of money, and we're already facing record deficits. I supported the stimulus package because of the unusual economic situation, but generally I am more conservative on fiscal issues. In particular I am a deficit hawk. I strongly oppose spending on things we can't afford, except in certain circumstances, and this is not one of those circumstances. Healthcare is a big problem, but it is not a national emergency or a war or economic crisis. I'm all for reform, and I genuinely want major changes to our deeply flawed healthcare system. But when it comes to unsustainable levels of spending that will eventually result in America failing to pay off the interest on the national debt...well, that's something I just can't get behind.
I do want as many people as possible to afford health insurance, but the more people who sign on to the public plan, the closer we go towards fiscal ruin. CBO's estimate of 3 million is almost certainly too small. Small businesses with less than 10 employees employ 12.3 million Americans. For these small businesses, together with numerous other slightly larger small businesses with payrolls of less than $250,000 ($500,000 under the Blue Dogs' compromise plan), the tax exemption will make it advantageous to switch to the public plan. So right off the bat, that's way more than 3 million people switching, and that's not even counting people who simply want to switch their plan because it's cheaper. It will not make financial sense for any of these businesses to continue providing private health insurance to their employees under the mandate, so more and more businesses and people switch and more and more debt piles up on the backs of the taxpayers.
And tax revenue still won't be able to keep up with the costs, again leading us to financial ruin.
I don't want to look like I'm just taking this position to be obstinate; I'm not trolling here. There are a lot of genuine problems with this healthcare reform proposal -- problems that the Blue Dogs' compromise does not alleviate. And I'm just looking for someone to give me an honest explanation of how this is going to work.
A couple of weeks ago, Reps. Rush Holt (D-NJ) and Leonard Lance (R-NJ) wrote dueling editorials in The Star-Ledger on this very subject.
Rep. Holt wrote in favor of the liberal proposal, and while his editorial was certainly engaging, I felt that it glossed over the problems of the proposal (as might be expected in an op-ed). Ultimately, I thought Rep. Holt made the case for major reforms to the healthcare system, but he did not really make the case for these changes specifically. And that's not really an effective editorial, in my opinion...most everyone agrees that the current system is broken.
You can see Rep. Holt's editorial here: http://holt.house.gov/list/spe...
Rep. Lance, on the other hand, advocated the "Medical Rights and Reform Act," a centrist alternative to the Democratic proposal. (An aside, if I may: How refreshing to see an actual alternative being provided by the Party of No.) Lance writes that this plan would not raise taxes, add to the federal debt, or jeopardize employer-provided insurance. He describes the provisions of the bill as well.
You can see Rep. Lance's editorial here:
http://lance.house.gov/index.c...
So here's what I want to see in the comments:
1. Am I right or wrong to be worried about this proposal? Won't it be unsustainably expensive for our federal government?
2. What do you think about the centrist alternative Rep. Lance was advocating in The Star-Ledger?
Talk to me. |
