There is something we can agree on.
I actually see little benefit to prolonging the debate. We have passed the point where those opposing the bills are actually trying to make improvements. Rather, they are simply trying to prevent any action using every delaying technique and argument they can muster. This is evident in the various made up issues such as the entire discussion concerning section 1233 of HR3200, the advance planning provisions being characterized as the basis for death panels. The cynicism behind such claims is setting new lows even by Congressional standards, especially in a context where many of those joining the chorus have previously proposed similar changes to Medicare.
For this reason, I hope both the House and the Senate force votes quickly following the summer recess and then begin focusing on the mid-term elections. The biggest threat to this schedule is not the Republicans, but Nancy Pelosi who could decide to push for a bill that will not pass in the Senate. Between now and then, I hope the administration focuses essentially all of its efforts on Iraq/Afghanistan, the budget, and the economy along with implementation of whatever health bill passes. These are the items that will drive the vote in 2010.
In 2010, it may be less important for the Democrats to retain a super majority in the Senate than it is for the Democrats to strengthen their position in swing-state legislatures. That is where redistricting decisions will be made following the 2010 census.
Left is bailing on any changes to public option in Osamacare:http://www.foxnews.com/politics/2009...h-care-option/
Medicare was originally passed as a single payer system. In fact, private carriers have been administering payments since the day the program was created. There were a variety of provisions concerning what services were covered and which were not. Over time, the number of services covered has been generally expanded. There were many limitations in the original bill to protect current providers. In some cases, these provisions spurred the creation of entire abusive industries. This included abuses in nursing homes, laboratory services, and dialysis services among others. Over time controls were implemented to curb these abuses.
Stealth change is hard to sustain in our system of government. Presidents have tried to rewrite laws through regulatory changes (GWB tried pretty hard) but have generally found their powers limited by Congress and political change. Legislators have proposed amendments to redefine existing programs but generally find that only incremental changes are possible in the short term and that in the long term someone else assumes power. All of this gives us a government that is more pragmatic than ideological. It tends to be hated by all ideological purists from either end of the spectrum, and tolerated by everyone else. Personally, I think that sounds like the hallmark of democracy and I like it.
Nonetheless, I disagree with your original statement; I happen to think that just passing "something" in this case is an invitation to insurance and pharmaceutical companies to lock-in behind the scenes deals before anyone but the lobbyists really understands what is being agreed to.
This is an elephant that needs to be eaten one bite at a time. It is lack of discipline that has kept genuine reform from passing for many decades, not lack of worthiness of the cause. The last thing this country needs is "fake" reform--that would be a far worse injustice than no reform, IMO.
For me, numbers 1, 4, and 6 are the core requirements for health insurance reform. Number 2, effective cost control, will only happen if number 1 happens first in my opinion. I hope that number 7 will happen over time to help US business compete more effectively in the global economy.
- Coverage of all Americans
- Effective cost control
- High quality coordinated care.
- Choice of insurance plans, doctors, and hospitals along with the ability to buy additional insurance coverage
- Fair funding requiring all Americans to contribute to the cost of services
- Reasonable dispute resolution to replace the current malpractice system
- Economic revitalization from removing health insurance as a responsibility of employers.
I believe, as do many of those most strongly opposing any legislation, that if health insurance reform is not passed this year it will not be addressed again in any substantive fashion for at least 10-15 years. I believe the one bite at a time approach is an open invitation to the profiteers.
Congressional looney left bailing on osamacare without public option. Great news, perhaps this socialized crap will fail totally.
If a significant reduction in cherry-picking and a significant improvement in portability were made in the next 3 to 5 years, that would be substance enough to improve many, many lives for real, and lay solid groundwork for, or even make progress on, other changes you've outlined (with which I generally agree).
If the Democrats insist on passing big legislation that frightens people (whether their fears are well-founded or not is totally irrelevant, by the way), there WILL be a third party in 2012, and I'll be in it--not because I don't want health care reform, but because I think lawmakers are being selfish and arrogant and stupid. Government can't take that kind of legislative power for itself without the agreement of its citizenry; even though we are a representative democracy, our representatives have to have a certain respect for the voice and will of the people when legislation cuts right to the core of life, liberty, the pursuit of happiness, and the ownership of property.
I've said it before, and I'm not afraid to say it again--when and if the time comes for single-payer national health insurance, that will be a day I am a very happy person--single-payer done right makes complete sense to me, and I try to articulate its benefits clearly in every health-care conversation I have in person, but that may not be what happens. The point is to make peoples' lives better.
I daresay if incremental, common-sense reforms had been started during the Clinton administration, we'd be far closer to meeting most of the goals you've listed above today. But no--arrogance and greed and behind-the-scenes dealmaking blew it up then, and those same factors (and some of the same people!!!) are going to blow it up again. It is absolutely, positively infuriating.