Saturday, January 23, 2010

Distrust of Non-Reform Healthcare Reform

According to the local paper I delivered this morning, 60% of Plymouth, Mass. voters turned out to vote on Tuesday. Republican Scott Brown won in every precinct in town. What is going on here?

Aside from specifics relating to the particular candidates and campaigns, part of what is going on is that financially strapped blue-collar workers don’t trust Democrats not to waste their money. They are afraid that government will overtax them, then give the money away to everyone from investment bankers to illegal immigrants. And what they will get for working hard every day is a continuation of wages too low to keep a roof over their heads and no affordable healthcare when they are sick, in spite of big chunks of their paychecks being sent to insurance companies every week.

When it comes to the healthcare reform bill that just died, it no longer included a real public option that would be available to everybody, whether currently insured or not. It was going to insure some portion of the currently uninsured, which sounded to many like one more instance of taking money they couldn’t afford to lose and handing it to somebody else, while improving their own very real problems not at all. People who already have insurance but can’t afford to go to the doctor when they‘re sick, balked at that. People who have opted out of insurance because their experience is that it costs an arm and a leg and doesn’t cover their health costs anyway, don’t want to be required to purchase it. Insuring the uninsured doesn’t solve much if the insured can’t afford medical care. Mainly it puts more money in the pockets of the insurance companies that are already robbing everybody.

One remedy is to get rid of health insurance firms entirely by instituting national healthcare. This would be cheaper than our current system, and might actually provide healthcare to the less than wealthy. The other remedy is to make the insurance companies compete with a real public option that is available to all and actually provides healthcare. Then insurance companies would have to provide actual healthcare at an affordable rate or fold.

Whether the now defunct healthcare bill would have actually cost or saved money in the long run is hard to pin down with any accuracy. What is clear is that most didn’t think there was much in it that was going to help them enough to be worth the probable costs. That the bill is now being pared down to a few clearly helpful essentials, such as disallowing the elimination of coverage on the basis of previous conditions, may be a good thing.

A better thing will be when we pass a bill with a real public option for all. If we have to put that off for a few months to focus on regulating our seriously off-kilter financial system, then regulate away, because the system is a mess, and we need to save the economy from it. We’ll still need real healthcare reform in the end, but this wasn’t it, so if it’s dead, OK. Whether we can convince distrustful voters to support a real reform bill when we propose one remains to be seen, but it will be an easier sell than a toothless jury-rigged mess. Democrats do still have a strong majority, even if not a filibuster-proof one, so it is still up to us to come up with real solutions.

[Note: I am a Democrat, and I voted for Coakley. However, the bill that just died had already lost its teeth, so we’d better come up with a better one next time. How about if we don’t let the insurance companies write it?]