Tuesday, March 23, 2010

What's in a Win: The Significance of Reform

As we celebrate this momentous occasion, let's consider the profound impact that this legislation will have. Broadly speaking, the Congressional Budget Office reported that the new legislation will provide coverage for an additional 33 million Americans. On top of coverage expansion, here are the most important tangible provisions in the recent health care reform legislation package:
  1. An end to denying coverage based on pre-existing conditions.
  2. Prohibits insurance companies from dropping policies of sick people.
  3. Small business tax credits to help pay for premiums.
  4. Creation of high-risk pools for adults with pre-existing conditions.
  5. Medicare expanded to rural areas with less access.
  6. Rebates for seniors to cover the "donut hole" that limits medicine costs over $2700.
  7. Young adults can remain on their parents' plans until age 26.
  8. Lifetime and annual caps on insurance will be banned.
  9. Plans must cover preventive care as well, including checkups without copay.
  10. Transparency measures ensure overhead costs of companies are to be reported.
  11. All plans include an appeals process for coverage claims.
  12. Improves screening process to prevent fraud.
  13. New requirements for non-profit Blue Cross organizations to qualify to IRS tax benefits.
  14. Chain restaurants required to present nutrient content statements alongside items.
  15. Information provided by HHS on the web to help customers find optimal coverage.
  16. Tax credits created to incentivize research in new medical solutions.
On the policy side, it is clear that this is a pretty serious improvement for the American people. On the political side, the passage of this legislation might provide a well-needed boost to the Obama Administration, who is sitting on a 50% approval rating at the moment. A health care "bump" and an improved economy in the next 6 months might be just what it takes to defend Democratic majorities in the November midterm elections.

Some believe this legislation will go down in history as a major victory for the Democratic Party, the sort of win that is only achieved once in a generation. One conservative columnist, David Frum, felt that "Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s." Frum recognizes the virtually permanent nature of expanded entitlement programs, which is a point of discussion that has been floating around the pundisphere lately. Personally, I would love to see this program serve as a stepping stone toward a more centralized health care system (perhaps single-payer someday). For his entire analysis of how significant this reform was, you may read the rest of Frum's piece here.

My question to you, Lefties, is this:

Historically, how significant was the passing of health care reform?

*UPDATE* A University of Notre Dame College Democrats Co-President was quoted in today's Observer article on this issue. Please go offer him some supportive comments. The article will be read widely by students and alumni. Of course, please do this AFTER leaving us your thoughts in the comment thread here! :)

And now a moment of zen...


Tim Ryan said...

Did Frum happen to mention that all those "crushing defeats" in the 60's were part of Johnson's Great Society Program, which included the Civil Rights Act, the Economic Opportunity Act (War on Poverty), the Elementary and Secondary Education Act of 1965, Medicare, Medicaid, the National Endowments for the Arts and Humanities, the creation of a Department of Transportation, the Wilderness Act, and the Endangered Species Preservation Act? Way to be on the wrong side of history once again, Republicans.

ShamRockNRoll said...

This is clearly a very significant legislative win for the President and the Democratic Party. The mere fact that so many previous administrations have attempted to reform our healthcare system, and failed, is demonstrative of what a huge win this is.

The Republican party will be stuck defending why they want to kick kids off their parents' plans, reimpose pre-existing condition clauses, etc. This is a huge loss for them. This isn't to say the Democrats won't possibly face some midterm losses in tight races in swing districts as a result of this contentious issue. But it will be worth it. Sometimes you have to do the right thing even when it means losing seats.

Liberal critics of this bill claim that it should have been stronger. There should have been a public option, or full Medicare expansion, etc. They aren't wrong. The bill could have been stronger. The White House's strategy was flawed from the beginning by assuming good faith on the part of the GOP. However, those liberal critics who think we should have sacrificed this bill because it didn't go far enough quite frankly, need to grow up. Not getting this bill passed would have been electoral gold to the GOP, and shown the Democrats to be weak and ineffective, unable to deliver on campaign promises while maintaining one of the largest congressional majorities in decades.

Also, while I think we probably could have gotten a public option, we were not going to get a large Medicare expansion or other single payer option in this political climate. This country is still suffering from the Reagan Hangover. Incremental victories such as this will help bring us to a full paradigm shift that replaces the age of Reagan retrenchment with one that recognizes our moral obligations to our fellow citizens. When Americans begin to see how these changes benefit their lives, they will become more comfortable with the government addressing these societal ills on a grand scale.

Sara Bega said...

Yes, the bill could have been stronger. But I have trouble seeing this as anything but a win for America. Reform was crucial, and this bill accomplishes reform. Will this have an epic effect on our country akin to that of Social Security, Medicare, and Medicaid? I don't know. But such effects are now possible because of this reform. It is definitely historically significant! Yes we can.

Gregory said...

Tim Ryan: A higher % of Congressional Republicans voted for the 1964 Civil Rights Act than did Congressional Dems. So, nice try?

Henry: The bill has some good stuff, and it is obviously historic. I think there are some big problems however. It should've been funded more with a tax on employer-provided insurance or some sort of broad-based consumption tax (or broad based income tax, failing that). The tax on capital income will possibly hinder economic growth.

Generally, there should have been more provisions to push us towards high-deductible, catastrophic care. That's one of the only ways to control costs in a reasonable way. I'd actually even be able to stomach a single-payer plan if it enrolled everyone in high deductible plans. Rather than do this, the bill expands our current flawed system with it's low deductibles, high premiums, lack of cost consciousness, and spiraling costs.

I also would've much preferred a Stupak amendment. I understand that people would have to pay for their own abortion insurance under this plan, so its not so different from the status quo (though some people dispute this by pointing out the CHC funding). But why not just ban all abortion coverage from subsidized plans? It would've made the bill more popular among pro-lifers. And it's hard to fathom, from a moral or financial perspective, why anyone would need abortion insurance. If abortion is a big deal, shouldn't people be willing to pay for it out of pocket? We're not talking about a heart transplant or something else that might cost you tens of thousands of $. Buying insurance for something that would be a relatively low % of your income makes little sense usually. It's also weird to pay for something like that before you are even pregnant. You're basically encouraging yourself to make that choice before the choice even comes up. Abortion policy in the US is just plain weird.