A Health Care Reform Update

This is Ezra Klein take on the plus and minuses of the Senate’s version of the Patient Protection and Affordable Care Act. Otherwise known as imperfect health-care reform. A few other voices have chimed in striking the it is not perfect, though it is progress: Pandagon has a particularly nicely written post –  If it’s one or the other. BlueOregon does the pluses and minuses ( tons of links) and with a final “it’s still a substantial improvement on the status quo”. The Kaiser Foundation has a piece up that uses a concrete example that some may find worth printing out to explain how the PPAC will affect an average family, The Senate Bill Saves Families Money

Let’s imagine it’s 2016 and you are an administrative assistant, a garage mechanic or perhaps trying your hand at consulting for the first time. You’re married, just turned 40 and have two kids to feed on a household income of around $50,000. You want to buy health insurance, but can’t get it through an employer. How much will it cost? And how much–or how little–protection will it provide?

If reform doesn’t pass, according to Gruber’s figures, the average premium for the non-group market–that is, the market for people buying coverage on their own–will be around $12,000 a year. Right off the bat, you’re spending a fifth of your income on health insurance.

[   ]…So what happens if reform does pass? For starters–and this is no small thing–the insurance company will have to sell you a policy, no matter what pre-existing conditions your family brings to the table. And you’ll know from the start that the policy will cover basic services because the government will be defining a basic benefits package. That package is going to include a broader range of services than the typical non-group policy would without reform. So when your doctor recommends a standard test or procedure, you won’t have to panic it falls into some hidden policy loophole.

But what will that coverage cost? The basic premium is roughly the same, according to Gruber’s calculations that he extrapolated from official Congressional Budget Office estimates. But that $50,000 income means you’re also eligible for federal subsidies. Large federal subsidies. In fact, the government will cover about two-thirds of the price, so that you’re left owing just $3,600.

This chart may also be helpful,

Click here for a larger version of Health Care Cost Projections.

Glenn Greenwald is correct to a large degree (Jane Hamsher is also even though some of her interpretations of the parts of the bill are incorrect) that the PPAC is in some ways a gift to corporate America. What Greenwald describes as a triangulation between Clinton-DNC centrism, the government and corporate insurers/health-care providers. This is not an issue to be minimized, but it is something that needs work and elections, not blown fuses. Democrats, for those that remember directly or from history had a pretty good track record from FDR to the early nineties when we had the so-called Republican Revolution. In other words, the paleo-neocons( starting with Nixon, Kissinger) had a long way to go get their agenda into play. Genuine progressive government for the common good was never likely to happen with the election of one president or a simple majority in the Senate. I’m not an eternal optimist or a pessimist, I’m a pragmatist that does not believe in giving up, ever. I can understand why conservatives continue to contribute nothing to the national discourse, but vitriol – Republican strategist Matalin slurs health reform advocates as ‘health care jihadists.’ ( any thing that pisses off rabid ideologues like Matalin cannot be all bad), but there is no reason to think that progressive Democrats cannot actually pick up seats, Kamikaze Democrats?

I see a meme developing among conservative-ish opponents of healthcare reform:

Megan McArdle: “Democrats are on a political suicide mission; I’m not a particularly accurate prognosticator, but I think this makes it very likely that in 2010 they will lost several seats in the Senate — enough to make it damn hard to pass any more of their signature legislation — and will lose the house outright.”

Sean Trende: “I don’t think they’re close to finding their Grail.  I think the better analogy is probably that they’re close to their Moby Dick. And we all know what happens to Captain Ahab once he finally harpoons his white whale.”

Ross Douthat: “Public opinion has turned dramatically against the bill, and every swing-state Democrat who votes for it is courting political suicide.”

Everyone gets pissed at people getting something they do not deserve – AIG, Bank of America, etc – and the PPAC is not what Obama campaigned on ( though literally millions of Americans lives will be saved), but come election day 2010 the issue will be jobs, jobs and jobs. Bush and Republicans were that giant flushing sound for American jobs for eight years. So if I read the meme correctly from the Right, some centrist Democrats didn’t undo the mess they made in eight years, in two years, vote the corrupt bunglers back in to do some real damage. While some on the liberal spectrum think progressives should stay home in 2010 and let the expert flushers back in because the shiny new bicycle was not shiny enough.

I just noticed a post by Nate Silver regarding the Senate’s bill and corporatism, Insurance Stocks Rise on News of Health Care Deal; What’s It Mean?

The bottom line is that, by the stock market’s estimation, the private health care industry appears as though it will benefit if the Senate enacts its plan. But the benefit — about $16 billion in discounted cashflows — is small as compared to the total magnitude of the program, and likely reflects an increase in the size of their customer base rather than any anticipation of higher profit margins.

update: Senator Obama did campaign on the public-option. The one thing that stood out in my memory was Obama’s promise to make drug companies price their drugs competitively. The Senate bill (which just passed as I write this) does not address the drug pricing issue. As Ezra points out Obama would have done better in terms of consoling liberals if he had not denied he campaigned on the issue and simply said that there was no way a public option would pass the Senate and pleaded the realities of compromise.