By Leonard Rodberg
Progressives worry that, if Obama’s health reform plan (hereafter called the “Plan”) fails to pass, a latter-day right-wing Gingrich movement will take over the Congress in 2010 and the White House in 2012. What I have not heard, but what I am increasingly coming to believe, is that, if the Plan passes in any of its current forms, things will go just as badly for him! Why is that?
The general reason is that the Plan is a DOG. It is a terrible, complex plan that will accomplish almost nothing. Relatively few people will benefit from it, while everyone who has to use health care will continue to experience the mess that is, and will continue to be, the American health care system. And, because of the new requirements built into the Plan, health care finance will become even more complex and confusing.
1. The large majority of people, who receive their insurance from their employer, will see no benefit whatsoever from the Plan. Most will, in fact, find their premiums rising as new requirements imposed by the Plan (e.g., the elimination of lifetime limits) raise the cost of insurance. And, of course, to their undoubted surprise, most of them will not have access to the public option, even if there is one.
2. Most provisions of the Plan will not become effective until 2013. This gives four years for Republicans to criticize the Plan, including (1) its use of cuts in Medicare reimbursements and Medicare Advantage premiums as principal sources of funding, (2) its lack of any real or believable mechanism for containing costs, and (3) its bureaucratic complexity.
3. The taxes on high-cost insurance plans, the other principal source of funding, will cause those who now have good insurance (called, pejoratively, “Cadillac” plans) to find these plans heavily taxed and their employers given a strong incentive to cut back on their benefits. Instead of reducing underinsurance, this part of the Plan will increase it! (And the rest of the plan does little about underinsurance at all.)
4. During the four years of waiting for the Plan to take effect, costs will continue to rise. By the time the Plan takes effect, costs are likely to be at least 25% greater than now. Even more people will find insurance and health care unaffordable. People will ask “What was health reform about?” The disillusionment will be great.
5. The complexity of the plan, including (1) federal rules regarding what kinds of employer-based insurance plans are “qualified,” (2) new income tax forms that will be needed to implement the individual mandate, and (3) the process of determining income eligibility for everyone, will all lend themselves to criticism and even ridicule.
Is there a way out? Not, in my view, as long as Obama sticks with this worthless and unworkable Plan. Only if we were to adopt a much simpler plan that would benefit everyone — a Medicare for All plan — would he be seen as actually addressing the problem and really offering a workable solution. Short of that, he, and all of us, are in real trouble.
(Leonard Rodberg, Ph.D. is Professor and Chair, Urban Studies Department, Queens College/CUNY.)
By Don McCanne, MD
“If we don’t pass this…”
You hear that phrase in almost every speech made in support of the “Plan” – the reform proposal of President Obama and the Democrats in Congress. It has the implicit threat that if the Plan is not passed, we will be condemned to continue to live with the deteriorating health care mess that we now have. If we do pass the Plan, we will be condemned to live with the deteriorating health care mess that we will have – the mess that Professor Rodberg so adeptly describes.
With all of the rhetoric about choice, why should we be limited to these two options? Neither one is acceptable!
We cannot leave things the way they are. Yet we cannot allow this awful legislation to pass. We may have to have a lockdown of Congress until they get it right, but, if that’s what it takes, let’s do it!