Leave aside the lack of a public option and the fact that the weak exchanges are probably unworkable. And, for now, let’s ignore the poorly designed regulator framework and the huge give away to PhRMA. (I know, big stuff to leave aside). Let’s just look at Baucus’s bill from 10,000 feet.
For starters, being “covered” under Baucus’s reform really is no guaranty of financial security. The yearly cap on out-of-pocket expenses for a family is $11,900 (and that is not counting the cost of premiums, which could be double that). How many middle income families have the financial reserves to take that kind of hit if a spouse needs serious medical treatments over the course of a few years? This bill would reduce–but will not end–one of the greatest shames in our nation. That of “under-insured” Americans forced into medical bankruptcy.
The other major problem is that there is no major reduction in the number of uninsured until 2014. It will be roughly 44 months after the bill is signed before we start seeing a noticeable reduction in the number of uninsured. There is not one but two elections before anything really gets started. Looking closely at the new CBO report, it won’t be until 2014 or 2015 that we start seeing a serious reduction in the number of uninsured.
Even after the bill is in full swing, around 2015, the number of uninsured who will be “covered” is only 27-29 million. Even after reform is fully implemented their will still be 24-25 million people in this country without health insurance, a full 9% of our population. Ignoring undocumented immigrants you are still talking about 17 million Americans without health insurance. This bill will not produce universal health care. It will not even produce near universal health care. After this bill goes into effect we will need another almost equally massive reform effort if we want to get to universal health coverage.
Just to give you a comparison, let’s look at Switzerland (the second to last major industrialized nation to adopt universal health care). In 1994, the Swiss decided to reform their health care system partly because roughly 4% of the country was without health insurance. This number of 4% was considered to be unacceptable by the Swiss. I hope that sinks in. Baucus’s bill would hopefully get us to a place five years from now where we have 9% of people in our country without health insurance. That is still dramatically worse than where Switzerland was before it decided to undertake serious health care reform.
Even if Baucus’s bill works as hoped, we would still have the dramatically more of our people uninsured than any industrialized nation. We will still have the cruelest, least fair, most wasteful, and most expensive health care system of any rich nation. It will only get us to a place that any European nation would consider shockingly unacceptable.
Would Baucus’s bill be an improvement on the currently awful state our health care system? Yes, but starting from a terrible place is no excuse for aiming incredibly low. The nicest thing I could say about it, is that Baucus’s bill will improve the grade of our nation’s health care coverage from a F to a D-. We will still be the absolute bottom of the class compared to all other rich nations. Let’s not try to pretend that this is anything short of an awful bill that would still leave us with a terrible health insurance system. This is not change we can believe, this is the change than I might have expected from a President Mitt Romney.