Thursday, December 10, 2009
So it's come down to this. Republicans and some Democrats wouldn't vote for a government-run health plan that competed with private insurers -- though it would enjoy no special taxpayer subsidies. That's socialism.
But as a compromise, they may agree to push aside the so-called public option and instead let people ages 55 to 64 buy into Medicare, which is both government-run and taxpayer-supported. That's not socialism.
If you say so.
This is really a variation of Medicare-for-all, the proposal set forth eons ago to simply expand Medicare, the federal plan for the elderly and disabled, to the uninsured. That was never a bad idea.
Replacing the government-lite public option with more Medicare, the most socialized element of our medical system, would be a fitting climax to what has been a certifiably insane debate over Washington's proper role in health care. Conservatives who've been hyperventilating over Democratic proposals to trim some of the waste in Medicare can't suddenly hiss the "s" word at the program they've demanded not be touched.
Or maybe they can. Consistency has not been their strong suit.
For example, several Senate Republicans opposed to the public option have been simultaneously pushing a bill to legalize prescription drug imports from Canada. In other words, they don't want the United States government managing Americans' health care, but it's OK if the Canadian government does. As we all know, medicines are cheaper in Canada because Ottawa extracts price concessions from the pharmaceutical companies.
The most ambidextrous of the bunch is Sen. Charles Grassley of Iowa. He has staunchly opposed the public option, twittering last May: "Public option (backdoor to Canada health system). Scares me."
More germane to the bill that would permit re-importation of pills from Canada -- and more curious -- is Grassley's 2007 vote against a measure that would have let Washington negotiate drug prices for Medicare.
"Private competition works," Grassley said at the time. "The government has very little experience and a dismal track record figuring out what to pay for drugs." He obviously didn't mean the Canadian government.
Other Republican senators in favor of having Ottawa bargain down drug prices on behalf of their American constituents include Arizona's John McCain and Maine's Olympia Snowe. Both oppose the public option as government interference in American health care.
In their semi-defense, do note that McCain and Snowe supported the bill to let the federal government negotiate Medicare drug prices. We'll take principle wherever we can find it.
The new plan to drop the public option and instead expand Medicare puts fans of ideological labeling off balance. An understandably confused CBS interviewer asked Howard Dean how he felt about his beloved public-option idea being scuttled. The former Vermont governor and Democrats' point-man on health care said the following things:
"Medicare is a government-run, single-payer plan. ... You don't have to reinvent another bureaucracy to do it." And, "This is what should have been done in the first place."
Could the fight over health care end as a comic opera with most everyone happy?
Insurance company stocks immediately rose on the news that the Senate may have found an alternative to the public option. The private insurers clearly believe that the public option would have succeeded in forcing them to curb their premiums. (And we can thus assume it would have saved money for taxpayers and employers.)
The insurance industry may free its captive lawmakers to vote for health care legislation that liberals also like. And those who've been throwing around the "s" word may now back the more socialistic alternative of a bigger Medicare.
Whatever you want to call this health care reform, that's fine with me.
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