So now what?
So, setting aside whether or not one supports the public option or other counter-proposals for a moment, and just looking at the healthcare reform measures taking place right now, the question becomes – if there is no public option, and if current employer-based benefits are not taxed, then what on earth can we expect from the reforms? At this point it looks like maybe we can expect a mandate to have health insurance and to have businesses provide health insurance. This seems like a pretty bad step to take all by its lonesome.
For one, this may make some people purchase health insurance who are too “wealthy” to get on Medicare Medicaid, but who are also “poor” enough to make buying health insurance an either/or sort of decision. As in, I can buy health insurance or I can make a payment on my house; or, I can buy health insurance or I can buy food for my kids. A lot of these people will be employed by a very small business, or self-employed. They will ostensibly be middle class, but depending on cost-of-living and other factors that may or may not be true. Likely having to purchase insurance (or face fines and penalties) will end up benefiting insurance companies a great deal – most of whom operate as near-monopolies in many communities – but will hurt citizens and other industries. And I’m not at all sure that such a gutless reform will do anything to lower overall costs.
So what can we expect from reforms? And at how much cost? If a public option does not make it to the final bill, how satisfying would an expansion of Medicare and Medicaid be? At what point does the public plan just become Medicare Medicaid, or vice-versa? (And why do we need both, anyways?) And would liberals ever warm to a more conservative approach like the Wyden bill if the public plan in its current form doesn’t make it off the ground?