First there was supposed to be Medicare for all 300 million of us. But that was a nonstarter because private insurers and Big Pharma wouldn’t hear of it, and Republicans and Blue Dog Democrats thought it was too socialistic—much like what they have in Canada, which, by the way, cost Canadians only 10% of their GDP and covers every Canadian. Our current system of private for-profit insurers costs 16% of our GDP and leaves out 45 million people. Yet life expectancy is longer in Canada than in the United States, and the infant mortality rate is lower. (Nair, Karim, Nyers).
Nonetheless, the compromise was to give all Americans the option of buying into a Medicare-like plan that competed with private insurers. Fully 70% of Americans polled supported the idea. Such a plan, open to all Americans, would have the scale and authority to negotiate lower prices with drug companies and other providers and to force private insurers to provide better service at lower cost. It is no surprise that private insurers and Big Pharma wouldn’t hear of it and Republicans and Blue Dog Democrats thought it would be too socialistic. So the compromise was to give the public option only to Americans who wouldn’t be covered either by their employers or Medicaid; peg their coverage to Medicare rates. But private insurers and … well, you know the rest.
When it passed, the much-compromised House bill had a meager public option, open only to 6 million Americans not otherwise covered. But even the House’s shrunken and costly public option was too much for private insurers, Big Pharma, and Republicans. So Harry Reid proposed state-run cooperatives, which states can decide not to offer their citizens—and that passed.
However, now that the Republicans have gained a precious seat in Massachusetts, people (led chiefly by the media) are predicting the death of health reform, and panicky Democrats are following suit. They’re no longer filibuster-proof in the Senate, and unless the Senate version is accepted as is, the Senate would have to accept the changes. Last week, even President Obama conceded everything except a few measures that would curb the private insurers’ most egregious practices.
This means that our private, for-profit health insurance system, designed to fatten the profits of private health insurers and Big Pharma, is about to be returned to…our private, for-profit health care system.
So healthcare costs will double within the decade. And 45 million Americans still won’t have access; 42,000 of them will die each year. Plus, all of us will remain dependent on private insurers who care only about the bottom line, who deny our claims, who charge us more and more for copayments and deductibles, who bury us in forms, and who don’t take our calls—unless a miracle happens and a good many of our legislators grow both a spine and a conscience!
Nair C, Karim R, Nyers C. (1992). Health care and health status. A Canada-United States statistical comparison. Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d’information sur la santé. 4(2):175–83.