If you’re a liberal or progressive or whatever, chances are you fall into one of two camps today when it comes to health care reform. Either you’re in this camp (with Ezra Klein):
It’s difficult to conclude that these things slip backwards rather than marching forwards. The $900 billion for people who need help, the regulations on insurers and the exchanges that will force them to compete, the structure that will make health care nearly universal and the trends that suggest more people — and more politically powerful people — will be entering the new system as employer-based health care erodes — it all makes this look even more like the sort of program that will take root and be made better, as opposed to the sort of common opportunity people should feel comfortable rejecting. It doesn’t feel like that now. But then, it rarely does.
Or you’re in this camp (with Howard Dean):
If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers’ monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.
Nate Silver has 20 questions for people in Howard Dean’s camp.
Update: Nate Silver offers his elevator pitch for health care reform.
December 16, 2009 at 9:51 pm
I’m in the former camp because I think this bill will declare the goal of the US federal government to be universal healthcare coverage. If private insurers continue to raise rates the way they have been, it will no longer just be the problem of individual employers and employees; it will be the problem of the US federal government, and that means that the problem will be tackled one way or another – and as we see with any proposed cuts to Medicare, once instituted, taking away a benefit is extremely difficult (which is as it should be).
I think very likely the US will end up with a single-payer system because that’s the only way to control costs; that or a system of highly-regulated nonprofit insurers like Switzerland. There just isn’t room for profit in a system where costs are already so high. For-profit insurers have not shown an ability to keep costs down, quite the reverse.
Universal coverage. $100 billion a year in redistributive subsidies. If it has to start off as a boondoggle for private insurers then so be it.
My big concern is not with the bill. It’s with the spotlight the bill has put on the process of policy-making in this country. You have one party dedicated to obstruction at all costs, and the other party held hostage to marginal opinions in the Senate despite holding a comfortable majority. You have astroturf activism becoming increasingly organized and effective. This does not bode well for the future whether the Democrats retain control of Congress or not.
December 17, 2009 at 9:58 am
Nate must live in a very, very tall building.
December 17, 2009 at 11:22 am
Hah. I think the elevator pitch is the stuff in italics at the beginning …
December 17, 2009 at 3:19 pm
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December 17, 2009 at 7:27 pm
Kos had a pretty good response to Nate Silver’s 20 questions: http://www.dailykos.com/storyonly/2009/12/16/815402/-20-answers
I’m not totally convinced by every point, and still think the bill is worth passing, but it’s worth a read for the insight into why some people think it is not.
December 17, 2009 at 7:36 pm
The Kos response mainly inspired me to insult him on Twitter. The idea that the bill could be scrapped and then return bigger, stronger, and better through reconciliation is for the deluded or idiotic.