Why I want Obama's health care reform to pass

You can't please everyone. As we approach the historical vote for health care reform, it seems like not everyone is really happy; some less so than others. But that's just the nature of the beast. In my perfect little liberal world, the United States would catch up to most other industrialized nations and use a single-payer system. I think a public option would have been a good thing. But even with the bill in its current state, it does a lot of very important things – it extends health care coverage to millions of people while reducing costs. The bill remains controversial, however, so I wanted to articulate why I personally think this is a vital piece of legislation, despite any shortcomings I may feel it has.

First, however, it's worth addressing the falsehoods that have been spread in order to defeat this bill. In the tech world, when companies spread misinformation about their competitors, it's called FUDfear, uncertainty and doubt. The most common line I hear is that the bill amounts to a "complete government takeover" of the health care industry. But it's utter nonsense. A government-run single-payer system has never even been considered – to our detriment, in my opinion – and the public option, whose self-explanatory title belies the FUD spread that we would be forced to rely on the government for health insurance, has been removed from the bill. What the bill does do, however, is give the government more regulatory control over the insurance industry. We don't seem to mind the government regulating our food quality or air safety – heck, we could save billions if food companies were not forced to comply with FDA standards, but we might not be eating very safe food either.

It's also commonly asserted that the bill will increase taxes and run us into debt. I do find it ironic that most of the people complaining about deficit spending didn't seem to mind Ronald Reagan or George W. Bush each doubling our national debt during their presidencies. The non-partisan Congressional Budget Office estimates that the bill will save us over $130 billion over ten years. That's not a ton of money over a decade, but it's certainly not in the red, and it's quite disingenuous to suggest that the bill will be a tax burden when tax relief is a central part of the bill. But most importantly the bill will expand coverage to 30+ million people while saving the government money. If if costs remained neutral, the expanded coverage would be worth it.


So what does this health care bill actually do? It prevents insurers from denying care through rescission, which is when you get cancer and they root through your application and drop you because you forgot to mention that case of acne you had, or because you wrote "okay" in the space where it said "do not write in this space".

It also prevents insurance companies from denying coverage due to pre-existing conditions or charging higher premiums due to health history, gender, or occupation. This is common-sense regulation that is done in better-off countries like Sweden, in which the government provides tight regulations over the sale of private insurance. Right now, many families are unable to find affordable health care coverage – if they can get it at all – because one or more family members has a pre-existing condition.

It will provide subsidies for millions of people to buy insurance, and expand medicaid coverage to people lower on the poverty line. Altogether, over 30 million people will have at least a minimum level of coverage they currently lack.

A la Canada, the federal government will now be able to negotiate with pharmaceutical companies to control prescription costs for people using medicare.

Most importantly, it will create a national health insurance exchange, which is sort of like how you can use Lending Tree to get banks to compete for your business by using a third party to bargain on your behalf. The national exchange will have a bargaining power that individual consumers lack, and unlike the regular insurance market, insurance companies will be required to meet a minimum level of coverage. This preserves – even increases – competition and consumer choice and should, at least in theory, placate the "free market" ideologists while taking important measures to protect consumers from denial of care or inadequate care. Ezra Klein elaborates:

The Health Insurance Exchange combines the benefits of choice that are theoretically available on the individual market with the bargaining power and scale that's generally accessible only in large employers (and the exchange will, in theory, have more bargaining power than even the largest employers, as it will have a much larger base of customers). You also have a space to test out innovative ideas that might make the market better, like Sen. Jay Rockefeller's (D-W.Va.) insurance rating agency, or the public insurance option. You can standardize billing and payment methods and force the adoption of electronic medical records.

Much of the opposition to this bill is rooted in confusion, partisan ideology and fear-mongering. When we look at what this bill actually does, any sensible person can see how important it really is. It's not a sweeping overhaul of the heath care system, but it institutes many changes that we desperately need to dramatically expand coverage and reduce costs while protecting consumer choice. Why should this not be done? Why is this not vital, and urgent? 

p.s. – Many conservatives have put forth the notion that we should remove regulations that prevent insurance companies from selling across state lines. That's a bad idea, for one simple reason: insurance companies would be able to pool in a state that was most favorable to their bottom line, with no protections in place for a minimum standard of coverage, and no one in the other 49 states would have any say in the matter. The national exchange provides the requisite free-market boon while federal oversight ensures a minimum standard of care for all consumers.


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