To serve as a counter to the more widely publicized positive analysis of the proposed health care bill from Max Baucus, here is a round-up of the negative appraisals that (mostly) progressives have given of that proposal:
It won't lower the price of health insurance premiums. Ezra Klein:
None of the bills, on their own, really do all that much to control costs.
Some people will get worse coverage as a result: The New York Times (emphasis mine):
Mr. Baucus's plan, expected to cost $850 billion to $900 billion over 10 years, would tax insurance companies on their most expensive health care policies. The hope is that employers would buy cheaper, less generous coverage for employees, thereby reducing the overuse of medical services.
The minimum plan insurance companies would be required to give the uninsured covers less than 70% of medical costs: The New York Times, again:
To compare health plans, experts often focus on the percentage of medical expenses paid by insurance, on average, for a given population. This figure ranges from 70 percent to 95 percent under the House bill's options, but it would be less than 70 percent under Mr. Baucus's proposal.
It can't expand into something bigger and better: Again, Ezra Klein:
The main disappointment is that insofar as you see the bill as a vehicle for moving us towards a better, more efficient, less costly system, there are some problems. In particular, this bill seems to block off a lot of its own possible points of expansion. The health insurance exchanges are limited to the state level, and appear to split the individual and small-group markets apart from each other. There's no mention of a possible expansion toward larger employers, either. Similarly, the co-op plan is an interesting policy proposal, but unlike a public insurance option, it's difficult to imagine it growing into anything significantly stronger than what's outlined in the paper.
People would be fined if they don't purchase private health insurance: Daily Kos:
[I]t requires all Americans adults under the age of 65 to buy health insurance in the private sector, fining those who don't up to $3,800 per family.
Companies that don't offer health insurance would be fined less than individuals without health insurance: Marcy Wheeler:
Total amount a corporation with more than 50 employees would pay in fine if it did not offer health insurance: $400 per employee
It would make hiring women, minorities and low-income workers more expensive than other workers: Matthew Yglesias:
While an employer responsibility requirement is an essential component of health care reform, a proposal included in the new health reform package that Senator Max Baucus unveiled this weekend would have serious consequences, particularly for low-income and minority workers and women.
Basically the way Baucus has done this, hiring certain classes of workers-typically people from the most vulnerable social classes-would be costlier than hiring other kinds of workers. This is no good. It's pretty distant from the core health reform issues we've been debating, but congress really needs to change this before we have a real vote on the Senate floor.
It would gut state-level regulation of the health care industry. dday:
Interstate Sale of Insurance. Starting in 2015, states may form "health care choice compacts" to allow for the purchase of non-group health insurance across state lines. Such compacts may exist between two or more states. Once compacts have been formed, insurers would be allowed to sell policies in any state participating in the compact. Insurers selling policies through a compact would only be subject to the laws and regulations of the state where the policy is written or issued.
This is something that conservatives have been begging to do for years. Even the most outgunned conservative on a talking head debate can vomit up "let people take their insurance across state lines to increase competition!" It sounds reasonable. But there's a very good reason why it would quickly turn into a nightmare, and you can see it in the examples of Delaware and South Dakota.
Both of those states have essentially no regulations on credit card companies. When legislation passed allowing banks to issue credit cards across state lines, some states started wildly deregulating their credit card markets in a race to the bottom. South Dakota and Delaware won. And now practically all credit cards are issued from those two states.
It won't change the political dynamic. If a bill passes without a public option, then it means that, even with wide Democratic majorities and a Democratic in the White House, progressives have once again been defeated, while a large corporate lobby has once again succeeded. As Paul Kurgman notes, it also reinforces the ideological status quo, at least rhetorically:
Let me add a sort of larger point: aside from the essentially circular political arguments - centrist Democrats insisting that the public option must be dropped to get the votes of centrist Democrats - the argument against the public option boils down to the fact that it's bad because it is, horrors, a government program. And sooner or later Democrats have to take a stand against Reaganism - against the presumption that if the government does it, it's bad.
"All of the protest letters in the world don't add up to much if you don't finally stand up and vote No on something the President and Nancy want," Weiner said. "There is clearly a sense that progressives in Congress are easily rolled."
"If the Congressional left can't pass even something as modest as a watered down public option, then frankly I don't think anyone is going to take the left very seriously later on in this Congress," Weiner continued. "When Blue Dogs talk, there are fewer of them but they have more influence than when progressives talk."
It will be very difficult to change this pattern at any point during the Obama administration after such a major setback on health care.
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