Second Thoughts on HCR

I have spent the past several days reading and thinking about health care reform, specifically the bill that will soon pass the Senate. My initial thoughts, as I posted, were that the bill ought to be stripped of the individual mandate or killed. And while I still believe the mandate without a public backstop is bad politics and even worse policy, I have come around on my thinking on the overall package of reform.

Quite simply, moments of major change only happen infrequently. We are in one of those times right now, and if health care reform were to die now we might not have another bite of the apple for several years. Over that time period hundreds of thousands (millions?) of people will die for lack of care. Countless others will be denied medically necessary treatment, thus diminishing their quality of life. Still others will not even be able to purchase insurance due to pre-existing conditions.

To turn our backs on health care reform now would allow the perfect to be the enemy of the good. And aside from placing ideals before action, we’d be doing untold harm to many of our fellow citizens. It would be immoral to fail to support health care reform, plain and simple.

But let us be perfectly clear, this is a flawed bill. It fails to adequately address the cost curve. It does not have a public backstop, nor provide adequate competition for what is a largely oligopolistic insurance market. What it does provide, though, outweighs these shortcomings. Millions of people will now have access to health insurance and medical care. And by enacting this reform now, we make it easier to address the bill’s shortcomings in future years.

With that said, I am still only cautiously optimistic. Much work needs to be done to reconcile the bill passed by the House and that soon to be passed in the Senate. There are still points along the way where a renegade member(s) in either chamber could derail this historic opportunity.


5 thoughts on “Second Thoughts on HCR

  1. Something I’ve been wondering about this bill:

    There is supposedly something that will prevent insurance from denying coverage to individuals with pre-existing conditions, but there are supposedly no rules about the prices insurance companies can charge.

    Does this mean that if I have a pre-existing condition I can be charged an impossibly high rate and then be fined because I can’t afford a policy due to my condition?

    If so, this bill will have only made the current system worse. Before I just couldn’t get health insurance on the private market (only through a group policy). In the future, it sounds like not only will I still not have access to the individual market for health insurance, but I will also get fined for not being able to afford a policy.

  2. John-
    Under the Senate bill, insurance companies would not be allowed to either deny coverage or charge higher premiums for pre-existing conditions. Plus, for those who do not qualify for Medicaid (up to 133% of the Federal Poverty Level), there are subsidies for those earning up to 400% of the FPL.

  3. The thing I don’t get. The cost of (really) covering a number of people who can’t afford coverage or get coverage today is forcing every American to buy private insurance. (as if the industry will ever back repeal)

    How is this not more expensive than just expanding Medicaid? Or providing catastrophic care coverage?

    As for the premiums issue, doesn’t that just mean insurance companies will just raise everyone’s premiums, I mean what are people going to do leave the market or go to a public option? Oh wait.

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