The roots of politics run deep in health-care reform debate

The roots of politics run deep in health-care reform debate

The script for health-care reform was written last summer, not by President Barack Obama or any Democratic congressional leader, but by U.S. Sen. Jim DeMint, R-S.C., who said, “If we’re able to stop Obama on [health care reform], it will be his Waterloo. It will break him ...”

At the time, other Republicans, including Minority Leader Mitch McConnell, said he was more interested in getting “the right kind of health care for America,” but the party’s unified refusal to compromise on health-care reform in the six months since DeMint’s declaration belie that.

Republicans have made it clear that they will not give health-care reform an up-or-down vote by a majority of the Senate, requiring Democrats to muster the 60 votes needed to defeat a filibuster.

Less-than-artful compromise

In an attempt to get those 60 votes, Senate Majority Leader Harry Reid, D-Nev., has made so many compromises to Blue Dog Democrats and to erratic demands of Independent Joe Lieberman of Connecticut, that the bill is a shadow of its former self. Still, not a single Republican has broken ranks.

The bill has been watered down to the point that some Democrats are flirting with the idea of letting it die. They should not kid themselves that if this bill dies, they’ll get another chance. History shows that when health-care reform measures have been beaten down in the past, they have lain dormant for 10 or 15 years.

In fewer than 10 years, the $13,000 that Americans (or the companies that employ them) pay for health insurance today will be $25,000. How many individuals or companies will be able to afford that? Five years from now, hundreds of thousands of Americans who for any reason lose their insurance — perhaps because they lost their jobs — will not be able to get insurance because of their pre-existing conditions. They will run up bills that they are unable to pay and be forced into bankruptcy. The loss from their unpaid bills will be passed along to an ever increasing smaller number of insured Americans.

It is a vicious cycle that cannot be sustained.

A brief summary

As it stands, the legislation would extend coverage to millions who lack it, ban insurance company practices such as denying coverage because of pre-existing conditions and slow the rise in medical spending nationwide. It would require most Americans to purchase insurance, and it includes hundreds of billions of dollars in subsidies to help lower- and middle-class families afford it.

But it will not force fiscal discipline on the insurance companies – or, by extension, the health care providers — that a public option would have. At the very least, the threat of a public option, tied to cost containment goals should have survived the chopping up of this bill. It simply makes no sense that those who maintain that government is incapable of doing anything efficiently would fear a government administered competitor to the health insurance industry.

Nonetheless, it now falls on Obama to make the public case for reform and on Reid to enforce the kind of partisan discipline that Republicans have gotten from their leadership.

Senators of both parties have had more than enough time to read (or have their staffs read) the legislation. That’s one of the things they are paid to do.

They’re also paid — handsomely and with excellent benefits — to work. If they have to work four days next week (Christmas is a national holiday) and return the Monday afterward, that is not too much for the American people to expect.

This bill is certainly not a perfect answer to what ails a health-care system that continues to grow in cost at two or three times the rate of inflation. But it is better than pretending that a little tweaking here or there is all that’s needed.

The bill is less sweeping today than what was proposed by President Richard Nixon in 1974. Passing it today and improving it tomorrow is hardly a radical idea.

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