Bob Herbert has it this morning:
This new health reform fever isn't about coming for you (or even Grandma, or the dog), but for your (healthy) sons and daughters.
Forget about a crackdown on price-gouging drug companies and predatory insurance firms. That’s not happening. With the public pretty well confused about what is going on, we’re headed — at best — toward changes that will result in a lot more people getting covered, but that will not control exploding health care costs and will leave industry leaders feeling like they’ve hit the jackpot.
...
Insurance companies are delighted with the way “reform” is unfolding. Think of it: The government is planning to require most uninsured Americans to buy health coverage. Millions of young and healthy individuals will be herded into the industry’s welcoming arms. This is the population the insurers drool over.
This additional business — a gold mine — will more than offset the cost of important new regulations that, among other things, will prevent insurers from denying coverage to applicants with pre-existing conditions or imposing lifetime limits on benefits. Poor people will either be funneled into Medicaid, which will have its eligibility ceiling raised, or will receive a government subsidy to help with the purchase of private insurance.
If the oldest and sickest are on Medicare, and the poorest are on Medicaid, and the young and the healthy are required to purchase private insurance without the option of a competing government-run plan — well, that’s reform the insurance companies can believe in.
Well, maybe not
your sons and daughters, being that you've (hopefully) successfully launched them from the nest and they're insured, privately, through the benevolence of their employers for their hard-earned work. Chiropractic treatments covered too.
I jest. Really, it's other people's healthy young adult children (think working middle class) who will be brought into the system, just as privatizing Social Security would enhance the revenue of junior financial planners across the land via an artificial injection of capital into more 401(k)'s for everyone.
I'm guessing the healthy young uninsured (remember "keep your government choices off my body" ?) are sitting out this "debate", perhaps under 25 or even 30 nowadays, living in multigenerational homes, under- or unemployed, hit hard by the lack of building and skilled trades. Not college student material really, beyond a year or 2 at a tech college, these young adults aren't covered by extended family health insurance plans, but physically, they don't need medical treatment yet, beyond over-the-counter meds perhaps, as their bodies naturally fight back to homeostasis. (And wash your hands for that swine flu epidemic!)
Those young people, it seems for now, will again be asked to continue to keep this dirty pool afloat. Those who generally aren't responsible for the spiraling healthcare costs because statistically -- except for accidents -- they are demographically healthier* than the rest of the population, and tend to treat conservatively.
Herbert:
And then there are the drug companies. A couple of months ago the Obama administration made a secret and extremely troubling deal with the drug industry’s lobbying arm, the Pharmaceutical Research and Manufacturers of America. The lobby agreed to contribute $80 billion in savings over 10 years and to sponsor a multimillion-dollar ad campaign in support of health care reform.
The White House, for its part, agreed not to seek additional savings from the drug companies over those 10 years. This resulted in big grins and high fives at the drug lobby. The White House was rolled. The deal meant that the government’s ability to use its enormous purchasing power to negotiate lower drug prices was off the table.
The $80 billion in savings (in the form of discounts) would apply only to a certain category of Medicare recipients — those who fall into a gap in their drug coverage known as the doughnut hole — and only to brand-name drugs. (Drug industry lobbyists probably chuckled, knowing that some patients would switch from generic drugs to the more expensive brand names in order to get the industry-sponsored discounts.)
To get a sense of how sweet a deal this is for the drug industry, compare its offer of $8 billion in savings a year over 10 years with its annual profits of $300 billion a year. Robert Reich, who served as labor secretary in the Clinton administration, wrote that the deal struck by the Obama White House was very similar to the “deal George W. Bush struck in getting the Medicare drug benefit, and it’s proven a bonanza for the drug industry.”
The bonanza to come would be even larger, he said, “given all the Boomers who will be enrolling in Medicare over the next decade.”
Credit Herbert for honestly summing up this stinko mess. Krugman in a column weeks ago (is it me or does he seem ... angry lately?) snorted that it was the kids "gaming the system" by not purchasing health insurance until later years, when they actually
needed it, who ought to be punished through the mandatory nature of the beast. Nevermind that the undocumented, the poor, the elderly, the pregnant of any income group, would actually be further subsidized by those who currently pay out of pocket when/if medical care is needed, and again, treat
conservatively and practice preventative maintenance.
There
are lifestyle choices -- not to be mandated, but to be voluntarily
chosen -- that can eliminate prescriptions and procedures, and I wish somewhere in this "debate" we might keep mentioning that having good healthcare insurance does not equal having good health, as if the magic elixir of "being covered" somehow means you are then amongst the healthiest. Were it only so.
The old phrase is "your health is your wealth", though too many seem to think of it merely as a commodity, another: "You get what you pay for." Personally, I think it's that easy passivity in surrendering life's freedoms and individual choices, trading off for a quick betterment, that's killing us out here.
But back to Herbert. He's hit upon something in today's column, though he might only have been advocating for the now-eliminated public option.
While it is undoubtedly important to bring as many people as possible under the umbrella of health coverage, the way it is being done now does not address what President Obama and so many other advocates have said is a crucial component of reform — bringing the ever-spiraling costs of health care under control. Those costs, we’re told, are hamstringing the U.S. economy, making us less competitive globally and driving up the budget deficit.
Giving consumers the choice of an efficient, nonprofit, government-run insurance plan would have moved us toward real cost control, but that option has gone a-glimmering. The public deserves better. The drug companies, the insurance industry and the rest of the corporate high-rollers have their tentacles all over this so-called reform effort, squeezing it for all it’s worth.
Meanwhile, the public — struggling with the worst economic downturn since the 1930s — is looking on with great anxiety and confusion. If the drug companies and the insurance industry are smiling, it can only mean that the public interest is being left behind.
Wait for a better cure, I say, before committing to this unhealthy mess in these hard times. That's me speaking, not Mr. Herbert.
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*As I understand it, this swine flu operates against the numbers here, meaning something about the fighting back defense built into the immune systems of young people, actually further cripples the body's defenses. More young Mexicans, in traditionally healthy age groups, have died. Which is why we'll all be watching the numbers, and the system's response, come winter here.
