"This is quite a system. What do you call it?"
by isamuel, Thu Dec 10, 2009 at 12:21:01 PM EST
The Senate seems set to kill off the public option in exchange for a package of compromises on other issues. This is going to cause understandable heartburn among progressives, but do we really think that a member of Congress should vote against the whole bill if it's this compromise or nothing?
How would such a Congressperson explain that decision to one of her constituents? Consider:
Jane: So, Congresswoman, what's going to happen with health care in this country?
Rep.: Well, Jane, I've got good news and bad news.
Jane: Uh oh. Better start with the bad news.
Rep.: The bad news is, the health care bill isn't going to pass because I've decided to vote against it. And I'm the critical swing vote.
Jane: Oh, no. Really?
Rep.: Yes. You see, I'm just not convinced that it's a good bill. For example, what do you do?
Jane: I'm a cashier at the local Wal-mart.
Rep.: And do you have a family?
Jane: Yes. I'm raising two kids by myself.
Rep.: Must be hard. Do you have health insurance?
Jane: No, I don't. See, my employer doesn't offer it, but I can't afford to buy it. An individual plan is incredibly expensive. I was looking forward to health care reform because I thought it would have changed that. Wasn't it supposed to give me access to a health insurance exchange where everyone paid the same price?
Rep.: Well, yes and no.
Jane: Yes and no?
Rep.: I don't know how much you make, but it's quite possible you wouldn't have been on the exchange.
Jane: Oh, that doesn't sound too good. Maybe this bill was bad after all. Why wouldn't I?
Rep.: You might have gotten health care for free.
Jane: For free?
Rep.: Sure. The bill had a big expansion of Medicaid benefits so that if you're a working person without much money, you might have had access to government health insurance. No charge.
Jane: I thought the bill didn't have a public option.
Rep.: Oh, it didn't. That's why I voted against it.
Jane: But you just said I might have gotten free government health insurance.
Rep.: Right. But if you made more money, you might have lost it! Once you weren't eligible for Medicaid, you'd have to buy private insurance.
Jane: Yikes. Or what?
Rep.: Or you pay a fine.
Jane: That seems unfair. The government requires me to buy something and doesn't even give me any help?
Rep.: Oh, no, you would have gotten big help paying for it. Major subsidy.
Jane: Oh. Well, still, even with a subsidy, we all know how much insurance plans cost.
Rep.: Actually, they would have cost a lot less. Remember, everyone would have been paying the same price, and insurance companies would have been required to spend 90% of the money on health care.
Jane: I see. So you voted against this because there was no public option?
Rep.: Absolutely. It's just unfair to make someone buy something they can't afford.
Jane: And the public plan would have been free?
Rep.: No. It would have been financed through premiums.
Jane: So I would have had to buy health insurance anyway.
Rep.: You bet. That's how we get universal coverage.
Jane: But the public plan would have cost less because it would have been financed by the government, right?
Rep.: No way! It's a level playing field. That's why I was so excited to vote for it.
Jane: What does that mean?
Rep.: Basically, the public plan would have had to compete on the same terms as every other health insurance company, and be financed entirely through premiums you paid.
Jane: So why is it better?
Rep.: Because making you give money to health insurance companies is bad.
Jane: Oh, right. Because they can deny me coverage based on pre-existing conditions and charge me more because I'm a woman. That does sound bad, truthfully.
Rep.: Actually, the bill I'm voting against would have outlawed that. People couldn't be denied coverage because of pre-existing conditions anymore.
Jane: This is a lot to take in.
Rep.: You ready for the good news?
Jane: I could use some.
Rep.: The good news is, now that health care didn't pass, you don't have to buy insurance!
Jane: I don't?
Rep.: Nope. You can keep living just like you have been---with no insurance at all.
Jane: That's the good news?
Rep.: Absolutely. Wouldn't it have been awful to be forced to buy health insurance? I mean, those awful insurance companies.
Jane: But I want health insurance. That's the point! Where am I going to get it now?
Rep.: From a health insurance company.
Jane: You said giving money to health insurance companies was bad.
Rep.: Oh, the worst.
Jane: Do I get any help paying for it?
Jane: Can they deny me coverage because of a pre-existing condition?
Jane: Can they charge me more because I'm a woman?
Jane: And lifetime caps?
Rep.: I'd read the fine print.
Jane: This is quite a system.
Rep.: I'll say.
Jane: What do you call it?
Rep.: From now on? Liberalism.