The shell game of health care reform

Well, I promised Leticia last week that I would get my own post up here about the town hall meeting with my Congressman, Democrat Joe Courtney, on September 2nd.

I was fortunate enough to get in, arriving at about 5:40 for the 6:30 meeting, one of the last people allowed into the 519-capacity auditorium. The place was packed, and as they wouldn't allow standees, I found an empty seat near a man formerly of my parish, whom I was happy to sit next to.

I had a copy of the House bill on my laptop for reference if necessary, but I quickly realized that this would be impractical and jotted down my questions for Rep. Courtney. Unfortunately, the mic at the podium wasn't working properly, so the moderators would hold the clip-on mic for questioners then race down to the front so Joe could answer.

There were loud protests when the first announcement was made that the school needed us to be done by 8:30, so we were on a limited time frame. (I wonder what other event was planned there that evening?)

Anyway, the crowd, from my estimation was a little more evenly spread pro/con than was evident from the people milling about outside. Yes, it was a bit raucous at times, but most people at least tried to be respectful to let others ask their question, and when emotion did overtake, many cries of "Let him speak" did carry sway. (I'll note that the only person who did have to be escorted out was a heckler in support of the bill who continually yelled over others' criticism of the bill and the congressman.)

Not surprisingly, I wasn't satisfied with the answers that Joe gave. He continually found ways to make general statements that didn't address people's particular critiques or questions (especially regarding how this can be paid for). He stated about four times that he himself does not participate in the Congressional health care plan, a principled stance he plans to continue until everyone has access to the same care. (Hey, for all my disagreements with Mr. Courtney, I can respect that. However, that answer only goes so far, especially when people wanted to know how other members of Congress could vote for this legislation without being held to its consequences.)

I did not get to ask my questions, though not for lack of holding up my hand the entire time.

So here are a few of my questions and concerns:

1. President Obama has gone on a crusade to quash myths about the health care plan in Congress. He claims that one such fabrication is that abortion would not be covered by tax payer dollars. Mr. Courtney also made that claim on his local radio appearance two weeks ago delineating a system of payment credits and sequestering of funds, citing the Capps Amendment, which passed on July 30th. However, the Capps Amendment only makes those delineations in the section on the private Health Insurance Exchange, whereas the section on the public option only states that the public option shall provide abortions for which public funds are allowed and shall not be prevented or prohibited from covering abortions for which federal funds are not allowed. Nope, no disconnect here.

2. As I read through the text of the bill (I had 16 hours to kill when I missed my flight at O'Hare) I was struck by the amount of authority that the Congress would essentially be ceding--in our name-- to the Administration. By this plan, the rules that govern the health care of every man, woman and child in the United States would be determined by the Secretary of Health and Human Services. That means that the decisions that most intimately affect everyone would henceforth be political. Every presidential election from now until the end of the Republic would be about what's in "my health care." Not the economy, not national security, not education. Don't like your health care plan? Wait four years and elect a new president.

For all those in support of this legislation, I can't help but wonder if they would have given this much authority to President Bush?

3. My congressman has very clearly read the bill (another point for which I have to give him at least that credit). However, many members of Congress had not until recently, and it's not certain that they all have read it yet. This bill would restructure one sixth of the American economy, and if President Obama and Speaker Pelosi had their way, this bill would have been passed a month ago before Congress went on August recess, before the American people could have read the bill. Is this responsible?

4. Courtney side-stepped another question about the path to single-payer health care by stating that this bill is not single payer health care and that such a plan would have zero chance of passing now. Yet that is not the concern here, Joe. We can see that it doesn't yet create a single-payer mandate, but Barney Franks is on record admitting that if we are to get to a single-payer structure, the public option is the best way to get there.

Then, after hearing President Obama's campaign speech before both houses tonight, another thought crossed my mind. He said that the public option would have to be self-sufficient, operating only on the premiums it collects. And then I got to thinking, if the public option is for those who cannot get health care because they either have pre-existing conditions or they cannot afford it, how will they be able to afford the premiums on the public option unless it is taxpayer subsidized? (Let that sink in, then, and see question 1 above.)

And if the Health Insurance Exchange will impose rules on private companies that forbid them from denying coverage or dropping people, why would the public option be necessary at all? A cheaper alternative? How then, will it stay viable as a system if it is collecting lower premiums?

Obama made it clear that everyone will have to purchase (or in the case of employers, provide) health insurance or they will be taxed. Two questions: 1. If an individual decides not to buy health insurance and is fined/taxed, does that tax automatically enroll him in the public option or does he still have to buy insurance now on top of that? 2. If a company drops insurance benefits for employees and is fined/taxed, will the fine be much greater than the premiums it currently pays? Otherwise, any business owner will be calculating the premium amount and administrative costs; suffering the tax and letting all the employees get dumped into the public option might be a wise business decision. (Is this the ultimate goal? Is the public option the mechanism for eventually getting everyone into a single infrastructure of health care?)

Keep watching the shell. This game isn't over yet.