In what will certainly be the news of the day, the Senate Finance Committee Chairman, Max Baucus (D-MT), released his version of the national health care reform bill.
Although there are many interesting provisions in the Baucus Bill, including a requirement that individuals have health insurance coverage, the establishment of a health care exchange, proposed reforms for the private insurance system including not allowing exclusions for preexisting coverage, and expansion of the Medicaid program for the poor, I want to focus on three parts that trouble me that directly deal with current employee benefits law.
First, the plan does not adopt a public option for health care. Instead, it establishes state-based cooperatives to compete with private health plans. I think this a huge mistake and such coops will be a failure from the start. For the best explanation as to why, here is former Labor Secretary Robert Reich explaining why the public option is so superior to co-ops.
Perhaps even more disappointing from my perspective is that the Baucus Bill does not require employers to provide coverage to workers, like some of the House counterpart bills. Instead, employers with more than 50 workers who do not offer coverage will have to reimburse the government for each full-time employee receiving a health care affordability tax credit in the exchange starting in 2013.
Two thoughts on this one. One, there is no reason to limit this to employers with 50 employers with more. That is the cutoff currently for the Family and Medical Leave Act, and it has left a huge number of workers without leave protection. Similarly, this arbitrary cut-off will continue to leave millions of workers at smaller employers without health coverage. As long as we are going to stick with our unique employer-provided coverage, we should make sure all employees can get coverage through their employers. The only other options is for these people to qualify through some other government program like Medicare, Medicaid, or Social Security. Yet, those programs do not provide the necessary and timely health treatment that many employees need.
Second, why does this not start until 2013? Assuming the bill passes in 2010, why should a vast number of workers suffer at these larger companies without healthcare? Or put at little more forcefully, how many employees will die in those three years from that delay in providing coverage.
Needless to say, I sure hope that these two provisions are not in the health care reform bill that President Obama eventually signs into law.
The text of the bill, America’s Healthy Future Act of 2009, is available here.
I was pleased to see Senator Baucus drop the public option from the Senate Finance Bill. The public option is a potential deal breaker, so proponents of getting a bill passed this fall should welcome Baucus’ compromise.
Leaving aside the legislative reasons for dropping the public option, allowing the federal government to get in the business of insurance is the backdoor way to single-payer health care. Its most ardent proponents insist that a public option is necessary for competition. As if the government would compete on an equal footing. Private insurance companies have to turn a profit. A government insurer would not. Private insurance companies must monitor for fraud. Fraud and abuse are congenital defects of government programs. The American people are right to reject the Democratic nostrum that a new entitlement program will save the taxpayers money.
The public option represents an attempt to reorient the relationship between Americans and their health care. The Lewin Group estimated that the public option will push 118 million Americans off of private insurance and into the lap of the government. It’s not difficult to see why. If a public option passes, employers will have no reason to provide health insurance to their employees because the government can do it for them, and for less money. As more people cycle off private insurance, insurance companies will leave the health insurance market because it is no longer profitable. Illinois Representative Jan Schakowsky even let the mask slip earlier this year .
The most vocal supporters of the public option simultaneously insist that it is absolutely necessary and not a radical change. But if the goal was simply expanding coverage, House Democrats would propose a tax credit for uninsureds to purchase private insurance (similar to the way members of Congress get their health insurance).
President Obama often says that if he could start from scratch, he would favor single-payer health care. For a president who likes to think he can remake so much of American society in his image, I take him at his word.
Dear Matthew, I would consider any information from the Lewin group like to be heavily slanted toward health insurers. Large insurers are certainly not in favor of a public option since it would be a major competitor for them. Consider for example that Lewin is owned by Ingenix and that Ingenix is a subsidiary of United Health, one of the largest health insurers.
Another factor to consider is that a public health plan, means nothing more than that a public or non-profit co-op provider could be an option when the health exchanges take effect in 2013. It might mean that Medica, a United Health Care Company, would compete with a non-profit provider such as Health Partners. As an independent voter, I want to have as many health care options available to me as possible. I also believe there is a place for non-profit organizations in health care since I believe health care is a right. Non-profits don’t have to use any money for profits and they can make more of my premium dollars work for direct provision of health care services.
Well, anyway I have some of these questions on my mind about for-profit insurance and health care. I think that the foundation of my concern is really doubting whether the for-profit model is the right one to use for health care. This is especially true for me when I see my relatives in Canada with national health care. They like some features of our county, but are afraid of even considering moving here because they’ve heard so many health care horror stories. Our health care related bankruptcy just doesn’t happen up there. Here it is a major reason for about 60% of personal bankruptcies.