Is House-Passed Reform Bill Better than Nothing?
Is H.R. 3962, the Affordable Health Care for America Act passed recently by the House of Representatives, better than nothing? It’s clearly a far cry from the type of affordable, quality, universal health care found in every other rich country. Here’s a sampling of opinion from some who have followed the twists and turns of this continuing struggle.
Rose Ann DeMoro, California Nurses Association: What’s in the bill? This is a good overview:
Dr. Steffie Woolhandler, Harvard prof and primary care doctor: “We’re debating whether to give aspirin or Tylenol to a patient with breast cancer. We need to start over”:
(The first part of this interview with Amy Goodman is about veterans who died because of lack of health insurance. Woolhandler’s analysis of the House bill begins with Amy’s question, “How does this fit into the bigger picture . . .?”
Marcia Angell, M. D.: Worse than nothing
Jonathan Cohn. The New Republic: Better than nothing
(My opinion: DeMoro, Woolhandler and Angell make it clear that the House bill would be a partial, stopgap measure at best. I think Cohn has an overly rosy view of what this bill could accomplish. For instance, he notes that people with pre-existing conditions would “finally have the ability of get insurance,” but fails to mention that insurance companies could charge them up to 40% more for the same coverage than people without such conditions. He fails to note that nothing in the bill restricts how often and how much the insurance companies can continue to raise premiums. So if they keep rising 10-12% a year, it might not be long before people with pre-existing conditions will again be without insurance – not directly because of their conditions but because they can’t afford the premiums, even with subsidies. He also is uncritical of the public plan which, if it survives at all, is designed to be small and noncompetitive – the Congressional Budget Office says it is unlikely to cover more than 3% of the population, and might even cost more than the private options.
However, I cannot agree with Angell that the House bill is “worse than nothing.” Warts and all, it would still subsidize health insurance for a lot of people who don’t have it now — at least for awhile, until their subsidies lag so far behind skyrocketing insurance premiums that they lose it again. This alone, in my opinion, makes the bill “better than nothing.” This might be an academic question for those of us who have insurance, as I’m sure DeMoro, Woolhandler, Angell and Cohn do, but it might be a matter of life or death for some who don’t. Literally: a recent Harvard study estimated that 45,000 Americans die each year for lack of health insurance. I haven’t heard of any uninsured people who think this bill is “worse than nothing.”
Further complicating the picture, especially for women, is the bill’s restriction on coverage for abortions. On the other hand, millions of uninsured women would be able to get subsidized insurance, beginning in 2013 (until the system collapses into crisis again, probably in the near term). The bill also promises to eliminate gender-based premium disparities. So is it “better than nothing” or “worse than nothing” for women? Here’s more on that:
Adele Stan: How Catholic bishops threw the health care debate into turmoil with anti-abortion maneuver