Wednesday, September 16, 2009

Breaking Down Baucus' Useless Bill

Not entirely fair in the headline here, Baucus' proposal released today does do some good things, including subsidizing individuals at up to 300% of the poverty level to purchase insurance out of regulated health insurance exchanges.  The trouble is that in a failed effort to be "bipartison," the bill failed on the kind of cost control measures that American health care desperately needs.  It contains no public option, and institutes fees on the most expensive insurance plans, a set of fees that will be shifted to consumers.  Instead of a public option, Baucus opted for coops.

The Baucus bill instead would create of a series of private health insurance cooperatives, which Baucus and other centrist Democrats say could offer the same protections as a new government plan.
This kind of language dominates media reports on the topic and has dominated the conversation on coops ever since the idea surfaced, but the question I've always asked is "how are we going to create these things?"  The answer in the Baucus proposal, it turns out, is that we're not.  Baucus sets aside money for loans and grants for the creation of coops by anyone who wishes to, but does not actually create anything.  I don't know if anyone has actually done any studies as to why there are few health care coops, it could be start up costs, in which case the Baucus proposal would effectively lead to their creation, or it could just be that they aren't viable in the insurance market, in which case we're just throwing away money to create some things that won't be able to last past the public investment to starting them anyway.  I think the coop idea is rediculous anyway, but its not obvious that the Baucus proposal even leads to the existence of more coops.  Why the media has put so much emphasis on the Finance Committee is beyond me, it lead to a crap proposal that isn't going to get any Republican votes anyway.  I'm frankly not convinced that the finance committee will even pass this, and I would be just fine if they didn't.

Side note-The New York Times has a pretty good feature on the Baucus proposal.  To summarize, nobody likes it, liberals hate it because it doesn't have a public option, and conservatives hate it because they claim its "too much government."  A great idea we've had here, put pressure on Baucus to create a "bipartison bill," and then be surprised when everybody hates what he proposes.  Its time everyone recognize that no Republican will support any health care reform that reaches beyond ending recessions and pre-existing conditions.