James Fallows on why this moment matters

For now, the significance of the vote is moving the United States FROM a system in which people can assume they will have health coverage IF they are old enough (Medicare), poor enough (Medicaid), fortunate enough (working for an employer that offers coverage, or able themselves to bear expenses), or in some other way specially positioned (veterans; elected officials)… TOWARD a system in which people can assume they will have health-care coverage. Period.

Anthony Hecht is The Stranger's Chief Technology Officer. He owns no monkeys.

13 replies on “What He Said”

  1. And they will have it without the choice of a public option. Wonder how high the insurance stocks are going to climb Monday morning after the opening bell?

  2. @1 – A question for you that’s been raised in other threads: if this is going to be such a boon to the insurance industry, why are they spending millions to defeat it? If it’s going to make them so rich, wouldn’t they support it?

  3. I sure wish I could assume that I’d have actual health care instead of health care coverage. That unheralded distinction is the whole reason I’m deeply unenthusiastic about this entire stupid mess. Why are we trying to create “reform” that will only recruit everyone into participating in a system that’s known to be broken?

    @2, the bill’s going to change the status quo and some provisions will undoubtedly cost insurers a lot of money. The requirement that they not simply drop coverage for expensive patients alone will sting, and so it’s entirely expected that they’d fight it. Unfortunately, that doesn’t necessarily equate to quality health care, especially not for the vast majority of people who don’t actually need multiple extremely expensive procedures.

  4. @2: I dunno, I’m giving #1 more credit. It’s not ideal by any means. I think the insurance companies don’t want it because, despite the fact it won’t fix our problem, they can make way more money with the status quo.

    After this, they won’t be able to exclude preexisting conditions, drop your coverage when you actually need to use it, dump college kids off their parents’ plans when they turn 24, bar small businesses from access, etc. etc. They also want to kill any suggestion Americans – not just the rich, healthy ones that line their pockets – should have access to basic health care.

    So it’s still a painful pill for insurance bailout fatcats even if it’s not quite a lethal one.

  5. @3, @4 – Yes, exactly. I completely agree that the bill has numerous flaws, some pretty big, my problem is with the argument that it will massively benefit the insurance companies bottom lines, with no explanation of why if that’s the case, they seem so dead-set against it. This bill will make it harder for them to make massive profits, for the reasons you both cite. It forces them to cover people they don’t want to cover. People it’s not profitable to cover.

  6. @2, millions? Yes but do you know how much the CEO’s of the insurance companies made last year in bonus’ alone? What they spent to “fight” it is nothing but pocket change.. yes, pocket change. They do prefer the status quo but if their must be change make sure you buy and pay for the President who will sign this paltry “reform” bill into law.

    And you realize their stock has increased in value the past few months by 28% right? And those mandates will easily counter any loses they may have to suffer with taking on people they normally would have dropped.

    Yep, change we can believe in!!

  7. @7 – Okay, for the sake of argument, let’s concede that this bill will increase insurance company profits. Is that it? Does that mean it has no good effects? I completely agree that a public option is what we really need, but despite its flaws, I think this bill is a good start, and creates many much-needed reforms and does more good than harm. You seem to be saying that it does this one kind of harmโ€”it gives money to private corporationsโ€”and that alone is enough to make it more harm than good. I don’t see it that way.

  8. Anthony, I’m a huge supporter of this bill, even with it’s flaws. I’ve heard that it can be improved upon later. Does that mean a future addition of a public option to the exchanges is possible?

  9. “…TOWARD a system in which people can assume they will have health-care coverage.”

    NO! It’s moving us toward a system in which people can assume they will BE FORCED TO BUY MEDICAL INSURANCE! Not the same thing AT ALL!

    I’m w/ Cato @10 – anyone who thinks Congress is going to gradually improve the bad parts of this bill hasn’t been paying attention to what’s been going on in DC the last 30 years. All the evidence indicates it’s only going to get worse.

  10. @8, 10:

    I agree too, but you also need to think about the ideological significance of the bill. Before this, it has been the position of the Democratic party that all Americans have the right to basic health care. After this, it is the law of the United States that they have that right.

    The problem is that the bill doesn’t make good on that right. It makes it easier; it breaks down some of the barriers that keep that dream from becoming reality. But it won’t realize the dream of efficient, equitable, and dignified basic health care for every single American – not by a long shot.

    Let’s remember the Brown v. Board of Education or Civil Rights Act of 1957 – also filibustered and protested ad nauseum by mindless, short-sighted idiots on the Republican side. It too did little to ensure right to the vote, employment and public services for all Americans. But it made it law that we wanted to do so.

    We’re arguing this might be the Brown v. Board of Education of healthcare. I’m not arguing this is what I wanted.

    PS. The Senate health care reform bill was just gaveled in by the House, 219-212.

  11. @9 – Sure, anything is possible. To me, the key is exactly what Fallows’ quote says – that this bill establishes a new idea that all Americans deserve affordable healthcare. Once that idea becomes ingrained, further reforms and provisions are likely to be enacted. That’s the way it happened with Social Security and most other social programs. You establish the idea that it’s a right, and then you build on it.

    @11 – Yes, you’ll have to buy it. In all cases, in all countries that mandate coverage, the citizens have to buy it, either directly or through taxes. The difference here is that you’ll have to buy it from private companies. A big flaw, yes, but this “having to buy” thing is a red herring. You have to buy car insurance too.

    @12 has it right. History shows that these kinds of massive changes don’t happen all at once. You establish the principle by making often unpalatable compromises, and then the principle becomes established, and you make more significant reforms.

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