NEWS & LETTERS, October - November 2009
Healthcare 'reform'
Flint, Mich.--Real objections to the two major healthcare bills before the U.S. Congress are lost in the noise from the right wing about "death panels" and "rationing."
HR 3200, which has three somewhat different versions, and the bill proposed by Senate Finance Committee Chairman Max Baucus, are variations on the same idea: individuals and employers are required to buy health insurance or be penalized if they don't. The major difference is that the Senate plan does not have the "public option" of the House bill which would allow individuals and employers to buy insurance from a government plan. Both have penalties for not buying insurance: 2.5% of adjusted gross income in the House plan, and a flat charge of $750 to $1,500 in the Senate.
In either case, paying the penalty does not mean that you have health insurance, only that you would not go to jail. There would still be a substantial number of people not able to afford health insurance but who will be penalized. This could amount to 20 million people according to Healthcare-Now.
A family of four with 35-year-old parents earning $30,000 per year would be forced onto Medicaid by the Senate bill. For people above the Medicaid level there would be tax credits available, a form of subsidy that would be worthless to an unemployed person. A 35-year-old single person earning $30,000 per year would have to pay premiums after the tax credit between $2,000 to $3,000 per year under either plan.
The 1976 Hyde Amendment has prohibited the use of federal funds for abortion. It is unclear whether abortion would be covered under either plan, since federal funds are not directly involved except through tax credits. Any real healthcare reform would repeal the Hyde Amendment, since more people will be forced onto Medicaid, which does use federal funds. Republican senators are proposing amendments that would require private health plans to cover abortion only as a special rider that would more explicitly prohibit use of federal funds.
There is a real need for healthcare reform. The Institute of Medicine of the National Academies calculated in 2002 that 18,000 people die per year in the U.S. from lack of health insurance. The number of uninsured in the U.S. was 46.3 million in 2008. The number of uninsured is growing, in part as a result of the loss of relatively well-paying jobs that provided health insurance.
Proponents of the House plan with the public option, and even proponents of the Senate plan, speak of being "realistic" and "incremental reform." There is nothing realistic about plans that at best cut the number of uninsured only in half and either put people in jail or force them to buy health insurance they cannot afford. There is no reason to think that either plan would lead to a single-payer system. The only immediate reform worthy of the name would be a single-payer system that covered everyone and all medical procedures, including abortion.
--Dan B.
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