Down the River

That's us and health care reform. It looks as though one thing the Democrats have learned from the Bush administration is to be blatant about screwing America. The reports are too depressing to comment on, so this is going to be more of a link dump than anything.

First, it seems the Obama team wants to save the insurance industry's profits at all costs -- with us bearing the cost. This report from John Aravosis summarizes information from several posts. Via McJoan at DailyKOS, quoting an AP story:

WASHINGTON — A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.

The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.

As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.

Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."

So the section of the law that forbids coverage limits actually allows them.

Jane Hamsher rips into Harry Reid on this one -- it's at his door:

People are asking who put this in the bill. The only person who could put this in the bill is Harry Reid. As Majority Leader, Reid alone is responsible for combining the bills that came from the Senate Finance Committee and the Senate HELP Committee into the bill that went to the floor of the Senate. But neither of those bills had a lifetime limit on benefits. That was manufactured solely by Reid–in violation of the promise made repeatedly by President Obama.

Not that Obama's going to feel bound by that any more than Reid does. Digby has a comment on that:

President Obama has not really done much of anything to advance this health care bill except to tell everyone they ned to get along. But two specific goals that he personally promised were that nobody should lose what they have and that nobody should ever have to go broke just because they got sick. He should at least care about those two principles enough to insist that this is fixed before he signs the bill. It's really not too much to ask.

One thing that Obama doesn't seem to have learned in Chicago politics is that you have to deliver. That's what keeps our mayors in office -- they produce. He hasn't quite managed that part of it.

Ezra Klein has a short piece that everyone is starting from, for good reason:

This, however, obscures the choice that's being made. The tradeoff here is slightly higher premiums for everyone versus total financial ruin for the people who absolutely need help the most. Politically, choosing "everyone" rather than "people with cancer" makes sense, because the first group has more votes than the second. But on a policy level, it's nuts. Health-care insurance literally exists to protect us from the worst-case scenarios. This provision says that the Senate bill will protect everyone but the truly worst-case scenarios. If you assume that people support the basic concept of health-care insurance, then they don't, or shouldn't, support this. Emphasis added.

That's one thing that seems to have gotten lost in the debate, probably because the insurance industry doesn't really worry about it any more -- insurers are all about maximizing profits, just like banks and auto makers. (Auto makers have a problem with it because they actually have to produce something, unlike banks and insurers.)

McJoan lays out very clearly the rationale -- and the necessity -- for a public option:

This provision is a deal-breaker, and now that it's been exposed will undoubtedly be removed in the manager's amendment. But it's a great example of the larger problem in our system. This is just one of the reasons why those of us who have been arguing so hard for so long for a public option continue to do so. Because the power of the providers in this system is so strong, because it's had its thumb on the scale in this process from the get-go. Because there has to be a counter to the private system if reforms are actually going to work. The only counter that has ever proven to really work in this country is competition, and the only entity big enough to provide adequate competition is the government.

This got more complex than I had expected, so I'm going to leave this part of the health care commentary here. There may be more on other aspects.