The House Bill Is "Worse Than Nothing"? Really?

[babylonsister]

http://www.tnr.com/blog/the-house-bill-worse-nothing-really


The House Bill Is "Worse Than Nothing"? Really?
Jonathan Cohn


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Angell is a well-known advocate for single-payer health care: If it were up to her, she'd simply expand Medicare to cover everybody. This is not, of course, the kind of health care reform we're going to get this year. Instead, we will--if we are lucky--get something that looks like the bill that passed the House of Representatives on Saturday night.

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Perhaps Angell and those who agree with her that this would be a constructive failure--that eventually growing frustration with our health care system will help us elect even more progressives and pass more ambitious reforms. Well, maybe. But that's an awfully big chance to take. Progressives said the same thing when the Clinton health care plan failed and, before that, when efforts to pass universal coverage under President Richard Nixon collapsed. If anything, the conversation about health care reform has drifted the opposite direction over that span of time. You could plausibly claim that the reforms on the table today are more or less what moderate Republicans were proposing under Clinton, just as the Clinton reforms were not that far removed from what Nixon himself wanted in the early 70s.

And what would happen in the meantime? According to the Congressional Budget Office, the House bill would mean about 36 milion people get health insurance, reducing the number of uninsured by around two-thirds. People who had pre-existing medication conditions would, finally, have the ability to get insurance just like the employees of large companies do. The insurance would not always be as generous as it should be, but the government would prohibit lifetime caps, place some limits on out-of-pocket spending, and establish a basic benefits package that makes sure all policies cover a broad range of services.

The studies--which, I know, Angell has seen--suggests millions of people die or go bankrupt every year because they can't afford to pay their medical bills. Countless more suffer. The House bill wouldn't stop such hardship altogether. But it would reduce it significantly--arguably, by as much as any single piece of domestic legislation since the Great Society. Surely that qualifies as something more than "a few improvements around the edges."

The House bill would do many other things, too, familiar to the readers of this space--from the creation of a public plan to the creation of pilot programs that would begin to change the way we deliver medical care. And while it wouldn't do nearly enough to make health care less expensive--the drug industry, among others, remains a source of untapped savings--the House bill certainly wouldn't cause the cost of medicine to go up even more quickly. If anything, it'll cause the cost to go up a bit more slowly.

As I've argued repeatedly, the House bill is not close to perfect. Neither is its Senate counterpart. But we don't pass perfect laws in the U.S. We pass imperfect ones and then do our very best to improve them over time.

It happened that way with Social Security and Medicare. It can happen that way with comprehensive health care reform, too. But only if we do something, rather than nothing.