The Senate Prepares to Keep America from Joining the Rest of the Civilized World

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A report today in the Washington Post indicates that, with the announced support of Nebraska Senator Ben Nelson, there are now enough votes to pass the Senate's version of a health care reform bill. If the bill is passed, the next step will be reconciliation with legislation that came out of the House in November, which promises to be interesting, to say the least.

HR 3962, the House's Affordable Health Care for America Act, is summarized as follows:

... It seeks to expand health care coverage to the approximately 40 million Americans who are currently uninsured by lowering the cost of health care and making the system more efficient. To that end, it includes a new government-run insurance plan (a.k.a. a public option) to compete with the private companies, a requirement that all Americans have health insurance, a ban on denying coverage because of a pre-existing condition and, to pay for it all, a surtax on individuals with incomes above $500,000.

The Senate version, however, is a different beast entirely.  Not only does it lack a public option, but it places even greater coverage restrictions on abortion procedures - which, despite whatever one's personal feelings might be, are perfectly legal - and mandates the purchase of coverage from private insurers.  Former Vermont governor, presidential candidate and Chairman of the Democratic National Committee Howard Dean eviscerated the bill in column last Thursday:

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.

Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage. The bill was supposed to give Americans choices about what kind of system they wanted to enroll in. Instead, it fines Americans if they do not sign up with an insurance company, which may take up to 30 percent of your premium dollars and spend it on CEO salaries - in the range of $20 million a year - and on return on equity for the company's shareholders. Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.

From the very beginning of this debate, progressives have argued that a public option or a Medicare buy-in would restore competition and hold the private health insurance industry accountable. Progressives understood that a public plan would give Americans real choices about what kind of system they wanted to be in and how they wanted to spend their money. Yet Washington has decided, once again, that the American people cannot be trusted to choose for themselves. Your money goes to insurers, whether or not you want it to.
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I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.

I agree with Dr. Dean; the Senate bill is a giveaway to the insurance industry that does little to fundamentally alter the health insurance landscape.  And let's be entirely clear about whose fault this is: blame for this debacle should be placed not only on Senate Majority Leader Harry Reid, but President Obama, as well.

It was Senator Reid's decision to use rules for advancing this bill that require 60 votes to end debate, as opposed to a simple 51-vote majority, which he could have done, and which would have made people like Ben Nelson and Joe Lieberman - who have gutted this legislation - irrelevant.  The president, meanwhile, has failed to lead in this entire process, declaring in September that he would like to see a public option included, but then backing away from this stance mere weeks later, leaving Mr. Reid and the American people out on a limb while taking care to distance himself from any political fallout.

To be sure, real reform is not dead, but it will take unwavering leadership from the House of Representatives, and a full-court press on the White House to make it happen.  This isn't about passing a bill before Christmas so Mr. Obama can cross an item off of his to-do list; it's about helping real people, making our country stronger, and standing with the rest of the civilized world.  (See map above.)