Thursday, September 17, 2009

Yes, I'm Going to Pile On Max Baucus and Kent Conrad Too

Prior to day's piece, I've written six pieces about health care this year. More of them have been critical than not. I've attacked specific elements of reform bills. I've attacked whole reform bills as intellectually dishonest attempts to defund Medicare and exposing the Republicans as the only people actually advocating rationing. I've posted frank criticisms of many of the core 'religious' elements to arguments about free market health care. I've even proposed my own national health care bill. Clearly, I feel fairly strongly about the issue.

I've not been a fan of the Senate Finance Committee bill for some time. One of the early pieces I wrote critiquing the reform process was in reference to the original Senate bill as it left Teddy Kennedy's committee. I was already less than completely happy with it.

Well, Senators Max Baucus and Kent Conrad have gone and come up with something even worse. Dr. Ron Chusid of Liberal Values pointed out key problems with the Finance Committee bill back in early August and suggested it might actually be worse than no reform at all. As Bob Cesca and RJ Eskow both write on Huffington Post, the final Finance Committee bill is possibly even worse. Ryan Grim writes that the Baucus bill is already facing signficant resistance among Democratic senators and most of the Democrats in the House.

I'm going to pile on too. I'm not going to rehash every point that Cesca and Eskow make, except to say that I agree with their view of many aspects of the bill. It has the potential to do considerable economic damage to American business, seniors, and the working class. A provision to tax 'Caddillac' insurance benefits will double the burden already laid on older consumers by a fee scale that allows older customers to be charged as much as five times as much as younger consumers... a fee scale that completely wipes out the benefits provided by eliminating restrictions against and fees for consumers with pre-existing conditions. 'Health reform', if the Baucus bill passes, could actually end up making it more expensive for the average American to purchase insurance. At the same time, the individual mandate has not been dropped. The public option, of course, is gone.

The real damage done by the Baucus bill is in a provision that chop-blocks what would otherwise be the best provision in the bill before the bill even leaves Committee. Instead of a public option, the bill would empower health consumers to form their own co-ops to insure their own health care costs. I've more than once admitted to a strain of a certain kind of socialism, and that part of me certainly likes the idea of health insurance co-ops having the power to compete aggressively with the private insurance market. It would give many ordinary Americans an alternative to private insurance that could actually be superior to a government run plan. Conservatives have understood just how powerful co-ops could be in lowering health care costs and empowering health care consumers. That's why Ed Morrissey took the time to rail against them on Hot Air. Legitimately empowered health insurance cooperatives would be a very serious competitor for the insurance industry.

The trouble is that the Baucus bill kills co-ops before they get started. While allowing consumers to form cooperatives to cover their health care costs, it specifically denies those cooperatives collective bargaining power over fees. So the insurance companies would enjoy a huge advantage in competition, while the co-ops would be hampered in their ability to provide quality coverage at an affordable cost. When the single best part of the bill is so badly crippled by its own language, it becomes difficult to support the bill at all.

Baucus and Conrad become the real villains of this affair. Baucus has written a bill that gives the insurance companies everything they have asked for in order not to oppose reform. Yet the bill does not include enough comprehensive reform of the system to justify the concessions. If the bill contained a public option, a robust subsidy for those who cannot afford insruance but do not qualify for Medicaid, or a robust strengthening and widening of Medicaid to cover those unable to otherwise comply with the individual mandate then one could argue that the concessions might be worth it. Instead there is no public option, the subsidy is depressingly shallow, and the Medicaid benefits made available for those unable to otherwise comply with the mandate has been described as 'Medicaid lite.' When one considers how inferior Medicaid already is, this is simply unconscionable.

While Republicans have lied about the threat of any reform, Baucus has completely castrated reform in the hopes of winning Republican support. He has utterly failed to do so. Not one of the three Republicans in the 'Gang of Six' has signed on to the Baucus bill, not even Olympia Snowe... who is arguably more liberal than Baucus. Despite this, Baucus claims a belief that the bill will pick up support from Republicans on the Senate floor. I don't know what motivates this fount of optimism. Perhaps it is the same kind of 'we hope it is true therefore it must be true' thinking that impelled the Bush Administration to tell us all how easy the Iraq war would be.

Max Baucus needs to be run out of the Senate. He needs to be challenged by an aggressive liberal primary opponent who makes health care reform and the Baucus bill the central issue of the primary campaign. With this bill, with his lack of regard for the needs of the country, he has single-handedly stepped up to the plate for the role of scapegoat if this round of reform fails. If his excrable brand of 'reform' passes, he's clearly the man to blame.

Either way, we all need to make sure he becomes the face of Republican resistance to reform. It's what he has chosen to become in his quest for 'bi-partisanship.'

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