I'm a long time lurker new to posting here, and I don't see how to post this as a quick hit, but this is going to be rather long anyway so maybe it's better to post the following as part of a diary.
I found a couple of links at Seminal.FiredogLake.com that are highly enlightening. The first points out the deficiencies in the House bill favored by speaker Nancy Pelosi.
A recent Harvard study estimated that nearly 45,000 deaths annually are due to lack of insurance. The question that needs to be addressed here, is how much this figure is likely to be reduced during the "band-aid" period before the exchange and the PO are operative? It is a question I can raise, but cannot answer accurately at this point. It's clear from the bill that the uninsured entering the risk pool will be able to buy private insurance at a cost no greater than 125% of the rate being offered by the insurance companies to individuals. For someone losing employment and work-related coverage, the cost of individual insurance, apart from the 25% increase, would be a great financial burden. People already seriously ill, will do all they can to get the insurance, since those in the risk pools can't be denied insurance due to preexisting conditions. However, those who are healthy won't have a mandate forcing them to buy insurance until the exchange is available in 2013. So they may well risk not having coverage. If they do take the risk, and get sick, they can always get coverage, but the bill doesn't provide for immediate entry into the pool for the sick, and as far I can tell at this point, there will be a wait of up to 6 months before they get in, a wait that can well be fatal, or that can greatly exacerbate the severity of their illness, and the prognosis for recovery.
So, realistically, we have to ask how many people will actually sign up for the high risk pool. Right now there are 47,000,000 people without insurance. Roughly 0.1% of them die every year. CBO estimates that 36 million of the 47 million will eventually be covered once the exchange is established. But how many will enter the high risk pool and be covered before the exchange is established? I'm going to conjecture that because of the absence of a mandate, the paperwork involved in applying, and the cost, absent subsidies of individual private insurance, we are likely to see no more than 1/3 of the uninsured get insurance before 2013. This is admittedly a guess, and if anyone has a more reasonable conjecture about the percentage involved, I'd be interested to see it. But, using the 1/3 guesstimate, roughly 31,000,000 will still be uninsured in the band-aid period. That period will be at least 3 full years and may also involve part of 2013, depending on how quickly the exchange can be established in that year. Assuming the exchange might be ready halfway through 2013, there would then be 3.5 years in the band-aid period. At the beginning, it will take time for people to enroll in the high risk pool and get insurance, so less than 1/3 of the uninsured will be covered. At the end of the period, many more than 1/3 may be covered. I have no easy way to estimate these details, so I'll use 1/3 covered and 31,000,000 uninsured as an average for the whole 3.5 year band-aid period. Since roughly, 0.1% of the uninsured die every year due to lack of insurance, I estimate that this legislation, over the whole band-aid period leaves 108,500 to die from lack of insurance. An amount equal to thirty-six (36) 9/11 tragedies. Is this a price we can afford to pay in order to make the reform bill deficit neutral over the period 2010-2019? This is a central question that legislators who claim to care about the well-being of the American people have to address before they pass this bill.
There's a lot more to the article, so I can't post all of it here, but read it in full. If you still think it's better to pass a bad bill than nothing at all, consider the price and whether or not it's worth the continuation of mass suffering and death.
The second link deals with Florida representative Alan Grayson's support of the weak bill that Pelosi wants passed. The writer of the article calls him disingenuous, and after reading it, I am hard pressed to disagree.
Alan and I agree that nearly 45,000 Americans die every year because they lack health insurance. But Alan never says that the House bill he supports, as currently written will save only roughly 14,000 of those lives annually between now and 2013, and only 34,000 per year even when the House reform is in full swing after 2015, and that according to CBO forecasts it will never reduce the annual death toll to less than 11,000.
Alan doesn't say ... that in the 3+ years of the band-aid period there will be 85 Americans dying every day, and even when the bill is fully implemented, there will still be 30 Americans dying every day due to lack of insurance. This bill that Alan Grayson is so quick to support will not eliminate the problem of dying Americans due to lack of health insurance in the next 3+ years. Nor will it do that even in the 7 years after that, or ever, according to CBO forecasts.
In response to a comment Grayson made about uninsured citizens of Connecticut, the writer of the article states:
The population of Connecticut is roughly 3.5 million. Roughly 10%, or 350,000 are uninsured. Of these, about 350 will die each year due to lack of insurance without any reform. If the House bill passes, then in the Band-aid period, 241 people will still die, and when the reform is in full swing, 86 Americans from Connecticut each year will still die. So Alan is way off, unless his statement is taken to apply to a ten year period, then there will be hundreds and hundreds saved, but also even more hundreds and hundreds will die, needlessly, because of the House's failure to legislate an end to these deaths.
A more general evaluation of Democratic behavior on health care reform comes next:
The Republicans do need to stop lying. Listening to them is often like listening to a fairy tale, and what is even more irritating is that Republicans seem to have elevated lying to a fundamental principle of politics, as if they had all internalized Plato's doctrine of the noble lie, and forgotten how dependent the health of American Democracy is on at least a modicum of honesty when faced with reality. Unfortunately, the Democrats and Mr. Grayson himself are often less than scrupulous when it comes to stretching the truth. We have seen that in the "bait-and-switch" campaign for a public option-led health care reform. And we see it now in the Democrats celebration of the House's very flawed proposed bill, as a milestone accomplishment, when, in fact, it is largely a sell-out to the insurance industry that doesn't eliminate deaths, bankruptcies, and foreclosures due to health insurance, and also does almost nothing to contain costs, while it provides the insurance companies with a huge expansion of their revenue. The Democrats celebration of this bill is nothing but spin - in the older more direct vernacular, it is nothing but a lie.
Finally:
The House bill won't produce universal health insurance. Even after the band-aid period is over, it will leave 11,000,000 Americans uninsured. The health plan for them will be "if you get sick, die quickly."
As far as "affordable" is concerned, what is "affordable" will be defined by a Congress which is already far more concerned about deficit neutrality, then they are about universal health care. Also, the health care subsidies provided in the bill, are not tied by the legislation to inflation in private insurance premiums. So, as the years pass, this bill will provide mandates for individuals to buy insurance, but subsidies that are inadequate to fund private sector premiums. This situation may even exist in 2013, since the lack of price controls in the bill almost guarantees that by the time the exchange is operative, insurance premiums will have risen 40-50% over today's prices.
As far as "comprehensive" is concerned. It is doubtful that the bill will cover abortion in the public plan. Also, since the public plan will have to compete on a level playing field with private insurance plans, it is doubtful that the public plan will be able to cover more than the private plans and also compete successfully with them.
So, it appears that the House bill will produce neither universal, nor affordable, nor comprehensive coverage for all Americans. The attempts of Alan Grayson and the House Democrats to over-sell Nancy Pelosi's bill are both foolish and counter-productive. Some people may be fooled into thinking that this bill is the major accomplishment they say it is. This evening KO was certainly very accepting of Alan's interpretation, as Ed Schultz was last week. But by today, Ed was asking some tough questions of guests on his show about the bill. He clearly has already begun to question the Democrats "happy talk" about it. If the bill or even a weaker one passes, the happy talk won't last long, and the insistence that the health care reform, while far from perfect, is a great accomplishment of Democrats and progressives will give way to the continued reality of deaths, bankruptcies, foreclosures and rising insurance and medical costs. In the end the public will blame the Democrats for this sad excuse of a reform bill, not praise them.
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