Howard Dean Must Face Zero Risk of Becoming Uninsured
There’s been lots of talk on the blogosphere over the last couple of days about whether Senate Democrats should continue to support health reform without a public option or just kill the bill and start over or resort to reconciliation, as Howard Dean has suggested. Some claim that the Senate bill will do more harm than good without a public option or Medicare buy-in.
I find that claim astonishing and assume that people making it must have pretty good health security with good coverage today and little fear that they’ll lose that coverage if they get sick or lose/change their job. Clearly, the health reform bills are not perfect, and the Senate bill in particular has much room for improvement. We support a public option and are disappointed that the Senate is unlikely to pass one, but have always held that the public option is not more important than guaranteeing access to affordable, comprehensive coverage for all. It’s possible to accomplish the latter without the former, as Uwe Reinhardt points out, other countries have done.
As others have pointed out, even the flawed health reform bills on the table will provide the most meaningful social justice reforms for low- and moderate-income Americans in 40 years. Here’s the big picture: a progressively financed system of comprehensive care that is accessible not only through a job and is affordable at every income level will enable many more families in poverty to attain middle-class income and assets. Unlike food, shelter, transportation, and education, the cost of needed health care varies wildly across otherwise similarly situated families. A family with serious chronic condition, illness or injury may need hundreds of thousands of dollars in care in a year, while one with routine preventive and primary care needs may need relatively little.
There are no shortage of provisions in national health reform that will greatly benefit Texans and that we could not pass on a state level anytime in the foreseeable future, including a prohibition on discrimination based on pre-existing conditions and expanding Medicaid to all people living in poverty, just to name two.
Nothing that emerges from a legislative process is ever perfect, and the Senate process in particular moderates legislation and forces compromises. But moving forward in the Senate is the best alternative. Getting the strongest bill possible out of the Senate, out of the conference committee, and signed by the president is just the first step in health reform. As the legislation progresses, we’ll continue to point out how it can be improved. And once it is passed, we’ll continue to work with everyone else who wanted more from reform by advocating for strong implementation of the bill, and over the years ahead, improvements that get us closer and closer to ideal health reforms.