Monday, October 12, 2009

Bill Nelson's Health Reform Dyslexia

Merely to satisfy one Republican and the handful of Blue Dog Democrats left in the Senate who are not nuzzling too deep in the hog's trough of health insurance campaign contributions, over the past couple of weeks two compromise ideas have been floating around Washington, presumably to satisfy the 70 percent of Americans who want a public health insurance option while making it possible for politicians to claim otherwise when they're confronted with the remaining 30 percent.

One path to compromise is the so-called "trigger" option. Under this, there would be no hope of universal health reform for years to come, under the best of circumstances, and probably never.
The other is the so-called "opt-out" option -- everybody gets it, unless they're stupid enough to elect a state government that "opts out."

Today, Florida Senator Bill Nelson was asked which he prefers. His answer suggests he has a bad case of Health Reform Dyslexia. He got it exactly upside down and inside out:
[T]o argue that a trigger is preferable to the opt-out seems entirely wrong. With the latter, there would be a national public plan that gives consumers a choice. With the prior, there would be no public option at all until some arbitrary point in the future, when private insurers have failed by some arbitrary measurement.

Or put another way, with the opt-out, it's possible that some states would refuse to let residents have a choice between competing public and private plans. With the trigger, it's definite that everyone would be denied a choice between competing public and private plans for some indefinite period of time.

This bears repeating: Congress on a number of occasions has enacted a half-step toward reforming something and then added a "trigger" to mollify reform advocates. In no case has the trigger ever been pulled. The legislative "trigger" is merely a congressional slight-of-hand to make you think you can have it both ways.

The "opt-out" alternative isn't problem-free, either. It looks too much like the Missouri Compromise, enacted to satisfy both abolitionists and slave holders. The criticism, in those antebellum days, came down to a fundamental point of fairness, justice, and equality: either everyone really is created equal, or they're not; latitudes and state boundaries should have nothing to do with it.

So, too, with health reform. Either everyone in America should be entitled to quality medical care, or not. Allowing Mississippi, Florida, Texas, and such -- basically, the old Confederacy -- to "opt out" not only invites terrible inequality, it will endanger the rest of the nation's population when the next epidemic comes along.

Germs and viruses have no respect for state boundaries or political preferences. The opt-out option makes no more sense than does providing police and fire protection only to those who can buy it.

Neither "compromise" is reasonable. Both should be rejected in favor of true health reform -- a strong public option. But if we have to have one of them, Florida's own Bill Nelson has it exactly wrong: the trigger would deprive all Americans of a basic freedom. Only the "opt-out" compromise gives all Americans a true choice.


life insurance Canada said...

I really liked your article, just want to add my opinion about opt-out public. I prefer this option to all others. Give everyone the right wing ideologues running the asshat nations a possibility to show the courage of their convictions.

Anonymous said...

This should be on the front page of every newspaper in America —in large bold letters. This was a "letter to the editor" in August 29th Jackson , MS newspaper.
Dear Sirs:

"During my last night's shift in the ER, I had the pleasure of evaluating a patient with a shiny new gold tooth, multiple elaborate tattoos, a very expensive brand of tennis shoes and a new cellular telephone equipped with her favorite R&B tune for a ringtone. Glancing over the chart, one could not help noticing her payer status: Medicaid. She smokes more than one costly pack of cigarettes every day and, somehow, still has money to buy beer.

And our Congress expects me to pay for this woman's health care? Our nation's health care crisis is not a shortage of quality hospitals, doctors or nurses. It is a crisis of culture — a culture in which it is perfectly acceptable to spend money on vices while refusing to take care of one's self or, heaven forbid, purchase health insurance. A culture that thinks "I can do whatever I want to because someone else will always take care of me". Life is really not that hard. Most of us reap what w e sow.

Don't you agree?

Jackson , MS

What about providing gold teeth for those who really really neeeeeed them ?