Map of life expectancy at birth from Global Education Project.

Monday, March 15, 2010

Pronouncement ex cathedra

After deep deliberation, I say unto you my Representative Michael Capuano, pass the damn bill.

It clears three high hurdles that can get us to a better place from which true goodness can be attained:

1) It imposes nationwide regulation on health insurance that incorporates the essential principles of community rating, minimum standard benefits, and guaranteed issue. No, we don't quite get community rating, but we get an endorsement of the principle, and we get closer;

2) It expands subsidies for low and moderate income people and makes insurance more affordable for more of them. No, it doesn't go far enough, but we get an endorsement of the principle, and we get closer;

3) It contains a nod toward expanded comparative effectiveness research and some small scale experiments in the reorganization of services and financing, and the rationalization of allocation. No, it doesn't actually go anywhere, but we get an endorsement of the principle, and it will help us get closer some day.

4) Update: I forgot to mention (nearly) universal participation, also absolutely essential.

Best of all, it will be a victory over Big Insurance and Big Pharma, and it will be a proof of principle that something can get done which is at least intended to be a blow for democracy and justice.

And Rep. Capuano, if it doesn't pass, there won't be enough Democrats in Congress in 2011 to do anything at all; and you don't even want to try to imagine who might be president in 2013. Vote yes, or be a tool.


roger said...

IMHO, as we sometimes say, a federal law requiring all citizens (residents? who exactly are we talking about?) to buy insurance from a private company is, or would be so declared by an honest supreme court, unconstitutional and a very dangerous precedent.

Cervantes said...

Well I don't know about that Roger. All drivers have to buy insurance; buildings have to be up to code, which requires that you buy stuff from private manufacturers and tradespeople. There are many costly impositions the state puts on its citizens and often non-citizen residents. As you know, I much prefer that this be done through progressive taxation and a public single payer -- we don't need the insurance companies, and I'm agin 'em, but I don't think it's unconstitutional.

That's not to say you have to like it.

kathy a. said...

oh, i'm not happy with supporting the ins. co's, either. but the thrust of the thing is to share responsibility broadly and include everyone, and also to impose regulations -- and, as i understand it, subsidize those who cannot otherwise afford insurance. steps in the right direction.

this is as important as roads and fire departments, isn't it?

Cervantes said...

To summarize my rationale, which I might not have made sufficiently clear in the post, I think this gets us to a place where it's easier to get to an even better place. Ergo, a yes vote is called for.

No, I won't be content with this outcome, not at all. But defeating it will be worse than passing it.

roger said...

i am in favor of taxes and roads and police and firemen. i also think that we will come to regret another mass transfer of public money to private interests (insurance), in the same way many are waking up to the huge giveaway to the big financial players (AIG, GS, BofA et al.).

i am not optimistic about making it better later.

C. Corax said...

You saying Capuano is hedging?

As long as there are meaningful, no-loophole controls on the insurers, I'll reluctantly support the bill.

Cervantes said...

RM -- No, I don't like that part either. What I'm saying is, we can fix it, but not if we don't get this far.

CC -- Yes, he is still officially undecided. It has to do with the disproportionate share payments to Cambridge Health Alliance and Boston Medical Center. A parochial concern.