IN WASHINGTON, "healthcare reform" has degenerated into a sick joke.
At this point, only spinners who've succumbed to their own vertigo could use the word "robust" to describe the public option in the healthcare bill that the House of Representatives passed on November 7, 2009.
"A main argument was that a public plan would save people money," the New York Times has noted. But the insurance industry--claiming to want a level playing field--has gotten the Obama administration to bulldoze the plan. "After House Democratic leaders unveiled their health care bill [on October 29], the Congressional Budget Office said the public plan would cost more than private plans and only 6 million people would sign up."
At its best, "the public option" was a weak remedy for the disastrous ailments of the healthcare system in the United States. But whatever virtues the public option may have offered were stripped from the bill en route to the House floor. Another last-minute concession to conservative Democrats was the addition of tight restrictions on coverage for abortion.
What remains is a Rube Goldberg contraption that will launch this country into a new phase of healthcare apartheid.
People who scrape together enough money to buy health insurance will discover that they're riding in the back of the nation's healthcare bus. The most "affordable" policies will be the ones with the highest deductibles and the worst coverage.
We're hearing that large numbers of lower-income Americans will be provided with Medicaid coverage in the next decade. Translation: If funding holds up, they'll get to hang onto a bottom rung of the healthcare ladder. Many will not be able to get the medical help they need, from primary care providers or specialists.
Not long ago we were told that the Obama administration was aiming for a public option that could provide coverage to one out of every four Americans. Now the figure is around one out of every fifty.
Not long ago the idea was that taxpayer-funded subsidies were to be used only for the public option. But now the entire concept has been hijacked by and for the private insurance industry. As House Speaker Nancy Pelosi (DCA) put it on October 8, private insurance companies "are going to get 50 million new consumers, many of them subsidized by the taxpayers."
Pelosi was making the argument that the least the insurance industry could do in return would be to accept a higher level of taxation. But her comment was a telling...