The headline is inspired by this column by Eugene Robinson in the Washington Post. He’s spot-on in his rationale for why the Democrats efforts, perhaps a little too ugly, were right. Thousands of people go bankrupt every year trying to pay doctors and hospitals. The Democrats had an opportunity to change it, and they took advantage.
As I type the Senate has passed the final procedural hurdle, a 60-39 vote for cloture. Tomorrow morning at 7:00 a.m. the bill will come for a final vote. A simple majority rules.
If you read the comments section of this blog you’ll see some visceral (and personal) reactions to the health care bill which both Sen. Blanche Lincoln and Sen. Mark Pryor voted for. Fair enough. Everyone’s entitled to their opinion, and this site is meant to be a forum for thinking and opinion sharing.
By now, you know my view on this. I think this bill, while not perfect, goes a very long way in correcting some of the truly awful things in our health care system. Over time, as people understand the benefits of the bill, I believe they will respond favorably. History will see this as landmark legislation even though it will be tinkered with as time goes by.
While there are changes that need to be made (and both political extremes are making a lot of noise about it), the bill as it is written does some very good things. The provision that now prohibits insurance companies from turning people away because they have a pre-existing condition is a game-changer. It will positively and profoundly impact the lives of millions.
At the same time, the bill helps middle and low income working families, including small business owners and employees, procure affordable private insurance. It creates competitive exchanges where health insurance companies will bid on their business, and it provides more than $100 million in subsidies and tax credits.
The median household income in Arkansas is around $41,000. For residents in that income bracket the costs savings are enormous. Currently, if you live in that income bracket your health care exposure is anywhere from 49% – 73% of annual income. Under the Senate bill that exposure would decrease to 18% – 21% of annual income. It’s not ideal, but it’s substantially better.
This bill drives costs down for seniors. Currently, health insurance companies charge seniors upwards of eleven-times the average cost for care. This bill reduces costs to three-times the cost of care. Again, it’s not perfect, but it was enough of an improvement to obtain the support of the AARP, the nation’s largest advocacy group for seniors.
By virtue of the individual mandate, insurance companies will be provided with 30 million new customers without the hassle of having to compete with a government-run public option. It is no wonder stock prices of the largest health insurance companies in America have soared in recent days. At the same time, there are cost-control measures, including requiring insurance companies to spend 85 percent of their premium income on care, and an excise tax on Cadillac plans aimed at driving premium costs down.
As Ernie Dumas noted in The Leader, Medicaid will be expanded in Arkansas to potentially cover 170,000 residents who have never had coverage. Despite what the advertisements on television say, the costs for this will be absorbed by the federal government from 2013 – 2016 in full, and then at 91% of total costs to the state from thereon. Any suggestion that this will bankrupt our state is misleading. The federal government is able to pick up the tab by reducing inefficiencies and wasteful spending.
The Congressional Budget Office opines that the Senate bill will reduce the deficit by $132 billion over ten years. Critics of the bill don’t like the CBO’s accounting methods. I’m not an economist or an accountant, so there’s little I can say either way. I know that the CBO is mandated to provide “objective and impartial” analysis on the cost of legislation. Furthermore, CBO reports contain no policy recommendations. With that in mind, I am willing to give their analysis the benefit of the doubt.
I am aware of concerns about CBO estimates generally (and this relates to process much more than politics). As a reader notes, Megan McArdle of The Atlantic has been diligent in critiquing the review process. She’s adamantly opposed to this bill, as she noted on her blog, but her analysis of the speculative nature of these efforts is something to consider broadly.
If there is a moral aspect to this debate it is this: to what degree was this simply the right thing to do? That degree will vary, I realize. Cast in those terms, my conclusion is this: citizens should have, as a right, affordable health insurance that allows for doctor care and choice, affordable medications, and relief from fear and anxiety over how the bills will be paid. (If you don’t believe that fear is real, you should have attended the free health clinic in Little Rock a few weeks ago.)
If one thing is certain today it is that the cost of inaction is too high.