baucus

Sen. Max Baucus (D-Insurance Industry)

(And thank heaven for that.)

So Sen. Max Baucus’s Finance Committee has finally released a health care “reform” bill, months after every other committee charged with the task. (Or a “Chairman’s Mark” version of one, at least—i.e., something actually readable by laymen [pdf]).

The predictable result? It’s awful. Any Democrat who would vote for a bill that looks like this has absolutely no political sense whatsoever, much less policy sense, and should be drummed out of office on general principle.

Fortunately, most of them seem to realize that.

Fellow Finance Committee member Jay Rockefeller has already said there is “no way” he will vote for it. John Kerry says “it’s not going to be the bill we’re going to vote on.” Over on the House side of the Hill, yesterday a key committee took testimony again from former Cigna insurance executive Wendell Potter, who calls Baucus’s bill “an absolute gift to the industry”—and Nancy Pelosi called it “the Private Insurance Profit Perpetuation Act,” saying “we have no intention of doing that.”

Not a single Republican has signed on to support it, either—not even Grassley, Enzi, or Snowe, the hand-picked members of Baucus’s “gang of six.” Senate minority leader Mitch McConnell is still demagoguing the issue, claiming “The American people want health care reform—not with more government, but with less. They don’t want a new government-run system; they want us to repair the system we’ve got.” McConnell is lying, of course. Poll after poll demonstrates that substantial majorities of Americans want the choice of a public option—and for that matter, so do substantial majorities of doctors. Damn straight I, personally, would prefer not to put my money into the hands of the parasitical insurance industry.

Baucus’s bill would leave me no choice, though. It includes no public option; instead it suggests a feeble “co-op” alternative, which has been tried in Wisconsin with (at best) limited effectiveness and which offers no serious prospect of competing with large private insurers. What the bill does, mainly, is forces Americans into a captive market for those private insurers. There are no mandates for employers, only individuals.

And what we’d be forced to buy is, not to mince words, junk coverage that is neither “quality” nor “affordable,” contrary to Baucus’s rhetoric. Copays of 30% or more? Seriously? The New Republic examines the details and links to a memo [pdf] the committee drew up estimating the costs citizens would bear. A family of four earning $66k (roughly the national median household income) would have average health care costs (premiums and “cost sharing” combined) of $12,800, or 19.4% of gross income. A single adult earning $32k (again, roughly the median) would have costs of $5,600, or 17.3% of gross income. And those are just the average costs, not the maximums to which people could be exposed. Based on CBO models, the actuarial value of the coverage (i.e., the portion of costs an insurer actually has to cover) could be as low as 66%.

Speaking of the CBO… its cost projections for the overall reform proposal(s) are being used by anti-reform demagogues to stand in the way of getting anything done. Sen. Kent Conrad (part of Baucus’s “gang of six”) has arranged to have those projections cover a 20-year time horizon, rather than the usual ten, the better to inflate the perceived costs. This, despite the fact that the scrupulously careful CBOs’ conservative projections have consistently overestimated government health-care costs and underestimated savings in the past, judging by its Medicare forecasts. (Yes, it really is possible to save money by reducing fraud and abuse.)

Baucus’s pretext about seeking bipartisanship is beyond ridiculous at this point. His dithering and delay and compromise hasn’t won over a single Republican; it only gave them a chance to ramp up their (incoherent but angry) rhetorical war against reform. In reality Baucus’s approach was all about pleasing the lobbyists who have inflated his campaign coffers so handsomely. This is a bill designed to guarantee profits for the insurance industry. (Otherwise known as “the bastards who caused this mess.”)

As I said, no self-respecting Democrat should vote for a bill that looks like this. Because even if one or two Republicans do eventually cross over… the Dems unequivocally own this bill in the public mind. All the credit—or blame—will fall to them. What’s most important, therefore, is that whatever passes actually work, not stick it to the average middle class citizen.

How many Dem votes is it worth losing to pick up a Republican vote? NONE. How many voters is it worth pissing off to please industry donors? The answer is the same, and for the same reason. That’s what it means to have a majority. You don’t let the opposition dictate the terms (the GOP damn sure never did), and you don’t pander to lobbyists rather than the public interest… because in either case, there’s no one to blame but yourselves, and the voting public can and will recognize that.

(Yet the DSCC is doing public fundraising right now. Ain’t that a hoot?)

It’s on the Dems to do the right thing here. Give us a public plan, one that anyone can opt into, one that will genuinely expand coverage and reduce costs. Nothing less is worth considering.

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8 Responses to “The Baucus bill looks to be DOA”
  1. And here’s the latest on the reactions to this abomination of a bill (just on the Finance Committee itself!):

    Ron Wyden objects that the costs it imposes on people aren’t affordable (no kidding), and moreover that everyone (including those with employer coverage) should be allowed to opt in to the “exchanges”;

    …Maria Cantwell has joined Rockefeller in saying flatly that she won’t vote for a bill without a public option;

    …and Rockefeller has added to that criticism by pointing out that the improved regulations (about preexisting conditions, rescission, etc., that everybody supposedly agrees about) don’t even apply to large companies that self-insure, which happen to provide the coverage to (wait for it…) 46% of Americans.

    And yet, much of the mainstream punditocracy is still trying to push the meme that this bill will somehow be the basis for the final reform… apparently on the premise that if a proposal’s so bad that everybody hates it (except, umm, industry lobbyists, but don’t look at the man behind the curtain), why that must mean that it’s just the kind of “compromise” that’s bound to pass!

  2. Thanks for the link. What Schroeder describes sounds like Nirvana to me.

    Even people I know who have “good” employer-provided coverage will talk about how they routinely (routinely!) put off doctor visits as long as possible because of the onerous out-of-pocket “cost sharing.” (Not to mention the long waits, uneven customer service, and general bureaucratic hassles.) Nor does anything in the private coverage this “reform” would force everyone into do the slightest thing to change any of that.

    So—to just pay my taxes (I do that anyway), and have my health care covered automatically? ‘Tis a consummation devoutly to be wished. It absolutely boggles my mind that a significant number of Americans polled claim to be “happy” with their current private coverage. “The devil you know”?…

    (Of course, the very first commenter on Schroeder’s post repeats the shibboleth that the problem is regulatory “interference” in “the market,” rather than the business model propagated by private insurers. A later one sets things straight, though, pointing out insightfully that “every piece of data I’ve ever seen about attempting to create market pressure by passing cost onto the consumer indicates that we humans are terrible risk assessors and make profoundly bad choices when asked to do those cost-benefit trade-offs ourselves. … A free marketeer who values the informational power of markets… should understand that betting on the future of your health is a gamble where we all get the best odds if we all go in together.”)

  3. And as for the sort of system you’ll want to aim for: here’s Karl Schroeder’s blog entry on the subject, the first of a series:

    http://www.kschroeder.com/weblog/archive/2009/09/17/what-canadian-health-care-is-really-like-1.-my

  4. Just looking at this…

    Letting companies charge people over 55 as much as five times the premiums of younger people? Seriously?

    …is enough to make me question the political and ethical wisdom of anyone who’d seriously propose this as part of any legislative package on health care on either side of the Border.

  5. Here’s a “modest proposal” I ran across that might help strip some of the demagoguery out of this debate (not to mention the concern trolling over making it “bipartisan”)…

    “…pass health care reform, but only for Democrats. If it’s so bad and evil then it’ll only be Democrats that suffer, only old Democrats that get snuffed out, not Republicans or supposed Independents.

    I dare conservatives to put their money where their ass is – since that’s what they talk out of most of the time anyway – and support health care reform for Democrats only.

    While we’re at it, we can ban Republicans from Medicare and Social Security, since they hate those socialist programs as well. Costs for all three programs will immediately drop by half, something conservatives can hang their hat on, and they won’t have to be a part of evil socialism or suffer at the hands of their cruel, democratically elected oppressors who want to kill all the old people.

    We’ll all see how how that works out for the GOP over the next couple of decades…”

  6. RAB says:

    I’m reluctant to get my hopes up based on anything Jay Rockefeller says — and I had such great hopes for the guy when he first took office! Still, maybe this is the issue where he’ll turn out to be consistent and trustworthy when it really counts.

  7. Well, Jay Rockefeller sent an open letter to his colleagues today explaining in detail just what’s wrong with the “co-op” idea… and then met personally with Obama and left making very encouraging statements about how they were “united” in their goals. So that’s all to the good.

    (Not that I’m a huge fan of Rockefeller, especially after he sold everyone out on the FISA “reform” bill last year, but he has made health care one of his big career issues, and I think he takes it seriously.)

    Honestly, at this point I’m skeptical that Baucus ever intended the actual bill to be taken seriously. (Letting companies charge people over 55 as much as five times the premiums of younger people? Seriously?) I’m thinking perhaps the real deliverable to his donors was the delay itself, giving opponents time to try to shift the debate. Whether that strategy worked or backfired, I suppose, remains to be seen (and that’s why we should all contact our own Senators)… but the widespread response today does seem to bode well.

  8. RAB says:

    I just hope this doesn’t turn into some kind of feint by the administration — i.e., that they now expect progressives will be more likely to accept another bill that falls short of the needed action because “at least it isn’t as bad as the Baucus bill.” The co-op idea may be off the table for a while thanks to this immediate negative response…just as the the trial balloon of “triggers” was shot down pretty decisively last week…but you can’t rule out the possibility that one or both of these ideas might yet make a comeback under a different name, or that the lobbyists have yet another dodge waiting in the pipeline.

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