The health care reform bill passed the Senate on Monday morning, and is close to becoming law. The Democrats, by their numbers, have simply silenced any effective debate on the measure.
The poorer among us will be covered by an expansion of Medicaid. Funding for Medicaid is provided jointly by the Federal government and the states. As a result, most states will be mandated to support the cost of a broader Medicaid program. However, Senator Nelson of Nebraska got, as part of the price for his support of the measure, that the Feds would pay Nebraska’s increased Medicaid costs so the state wouldn’t have to. Meanwhile, with New York State going broke even without new Medicaid mandates, our esteemed senators, loyal Democrats that they are, didn’t get us one thin dime. (Senator Nelson also insisted that the Federal government not pay for abortions through insurance subsidies, but that’s within the realm of reasonable politics.)
The rest of us will have to purchase insurance for ourselves or get it through our employment. Those who don’t will have to pay a penalty tax. Given that insurers won’t be able to decline coverage for pre-existing conditions, or adjust rates to the age of the insured to properly reflect the actual risk, insurance will become very expensive. New York has similar rules as part of state law, so insurance is already expensive here, but premiums are expected to rise still further.
As a result, insurance will be so expensive that most ordinary people won’t be able to afford it without help. So the Federal government will subsidize part or all of the cost.
Meanwhile, the government will also define what constitutes an ‘acceptable’ health insurance policy. As a result, when the cost of medical care goes up (as it certainly will, because there are no direct measures to contain costs), Federal regulators will respond by identifying ‘appropriate’ treatments that will be covered by ‘acceptable’ insurance policies. And expensive treatments will be limited or made unavailable as a result. The government may also institute a rule, similar to current Medicare, that a doctor who takes insurance money may not contract independently with patients for treatments that insurance won’t cover.
Yes, insurance companies will remain, and they will ‘compete’ for your business. But with the benefits to be provided set by government, and the actuarial performance set by government, they won’t be able to compete on the actual attributes of their insurance.
So what we end up with is government control of the health care system, just like socialized medicine. But instead of the government paying directly for health care, the control is accomplished through regulation of insurance, which everyone is required to buy.
And there’s nothing I can do about it. I could write my Senators and Congressman, but they’re true loyal Democrats, totally in favor of the plan. They didn’t even try to wheedle some extra benefits for their home state like Senator Nelson.
I should save my breath to cool my porridge.