Sick and Wrong
"How Washington is screwing up health care reform – and why it may take a revolt to fix it"
He describes 5 ways Congress "gut the measure until there was nothing left:"
Step One: Aim Low
Heading into the health care debate, there was only ever one genuinely dangerous idea out there, and that was a single-payer system. Used by every single developed country outside the United States (with the partial exceptions of Holland and Switzerland, which offer limited and highly regulated private-insurance options), single-payer allows doctors and hospitals to bill and be reimbursed by a single government entity. In America, the system would eliminate private insurance, while allowing doctors to continue operating privately.
In the real world, nothing except a single-payer system makes any sense. There are currently more than 1,300 private insurers in this country, forcing doctors to fill out different forms and follow different reimbursement procedures for each and every one. This drowns medical facilities in idiotic paperwork and jacks up prices: Nearly a third of all health care costs in America are associated with wasteful administration. Fully $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system — more than enough to pay for the whole goddamned thing, if anyone had the balls to stand up and say so.
Step Two: Gut The Public Option
Simply by removing the profit motive, the government plan would be cheaper than private insurance. "The goal here was to offer the rock-bottom price, the Walmart price, so that people could buy insurance practically at cost," says one Senate aide.However, legislators, concerned that providers might not be paid enough, upped the amount they would be reimbursed:
In one fell swoop, the public plan went from being significantly cheaper than private insurance to costing, well, "about the same as what we have now," as one Senate aide puts it.
Step Three: Pack It With Loopholes
A real mess here, from drug companies being permitted to hold patents on their drugs for 12 years (so, no generics during the time), to removing a consumer's choice to opt out of their paltry employer-based healthcare benefit (e.g. Wal-Mart's).
Step Four: Provide No Leadership
Taibbi paraphrases former labor secretary Robert Reich (Reich writes about healthcare at length on his own blog):
There were now so many competing ideas about how to pay for the plan and what kind of mandates to include that even after the five bills are completed, Congress will not be much closer to reform than it was at the beginning. "The president has got to go in there and give it coherence," Reich concluded.In this section, Taibbi revels a depressing statistic, via Dr. Steffie Woolhandler:
Three-quarters of all people who file for bankruptcy because of medical reasons have insurance when they get sick — and they're bankrupted anyway.
Step Five: Blow The Math
If it's not done right, it's going to cost:
Without a real public option to drive down costs, the federal support to make sure everyone gets coverage is going to get very expensive very fast," says Behan, the aide to Sen. Sanders.
There's no consolidated bill yet. Since this piece was written, the fifth and final committee, the Senate Finance Committee chaired by Senator Max Baucus, released an outline of their proposal. It's the only one of the five (3 House, 2 Senate) not to recommend a public option. Baucus' plan instead proposed the watered-down "nonprofit insurance cooperatives."
I'm getting the sense that what's going to pass as reform won't be the simplified, cost-contained prospect reformers want.