Friday, December 18, 2009

The Progressive's Dilemma on Health Care

Progressives are in a quandary about the dismal state of the Senate’s proposed health care bill. Some, such as Paul Krugman in today’s NY Times column (here) urge passage under the premise that there are some good aspects in the bill, and even though it is flawed, we should take what we can get and use that as a basis for further reform and cost-cutting. Others, such as Senator Sanders and Keith Olbermann advocate defeat of the bill because it puts even more money in the pockets of the private insurance companies at the expense of the health of Americans.

We should pass this flawed bill and then resolve this dilemma by taking two additional actions. First, repeal the anti-trust exemption for the insurance companies that has created virtual monopolies in each state. As far as I know, the only two industries that have anti-trust exemptions are the health insurance companies and Major League Baseball. Why either of them needs this exemption is beyond understanding. While the now-dead “Medicare for All” approach would have been the best way to achieve competition, repeal of the anti-trust exemption will enable some competition and would tend to bring down premium prices.

The second action would be more difficult to get through Congress. If we must have “for-profit” insurance companies, let’s pass legislation limiting those profits. This is not unprecedented – we have had price controls in the past, and today certain segments of our economy (e.g. defense) have profit caps that are legislatively mandated. This will be a difficult sell, given that members of both parties in Congress receive significant contributions (i.e. “bribes”) from the insurance and pharmaceutical companies. But it would be worthwhile to bring such a proposal to a vote to see which members prefer to line their pockets, and which members vote for the health of their constituents.

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