Tuesday, December 15, 2009

A Health Care Reform Post From Mount Olympus

A report from the health care reform wars. By me.

I have been following the debate over the idea that people 55 to 64 could buy into something like Medicare with great interest. Mostly I knew it could not be a real thing because it so suddenly dropped from the skies, late in the process, and because it's everything the Republicans hate (and we are ALL bipartisan now).

On the other hand, getting that group out of the private insurance markets would make the companies swoon in excitement and have even more caviar-on-gold-leaves parties on their yachts. The average costs of health care rise with age, so if the market could get rid of people over 55 altogether, without being told to cut the average premium, they could get even richer. "They" being the shareholders in the companies, ultimately, though also some groups who work in health care.

On the third hand, letting only the 55-64 group into a public program would guarantee that the costs of that program would remain pretty high, and that would make the public option look bad. Because of those higher-than-average risk levels. So perhaps the Republicans should have wanted it so that they could take the whole program down later.

All that is irrelevant now that Joe Lieberman has torpedoed the idea. We are left with a smaller reform proposal, still containing useful things, still helping some people, but not the kind of thing that would be inscribed in future history books. Except perhaps as an example in political science texts: How a party which governed the country and had majorities in the House and the Senate was finally taken down by one single jowly guy.

If I sat on some other planet I'd be settling down with a few barrels of pop corn to watch this all. It's pretty incredibly hilarious for those who have no cow in the game. With a bit of sarcastic cynicism it still is, because the debate takes place in a country where money buys votes and where the industries threatened by any proposed reforms are the ones who are paying the politicians, where the average person does not vote at all and where lots of voters vote on such populist principles as being scared of foreigners and blacks and gays and "vaginas". Shooting your own toes, that's what a lot of this boils down to.

And we will have no insurance coverage for that.