As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Monday, August 03, 2009

The Single Payer Vote

I think it's great that single payer will get a vote on the House floor. It's important to set a marker for the future and separate friends from enemies (although, it being a free vote, you'll have more support than probably exists - see the Employee Free Choice Act free votes in 2007-2008). But this line troubles me:

In another part of the deal, the House bill would allow the federal government to negotiate prescription drug prices and use the savings to lower insurance premiums in the health exchanges that would be established in the bill, according to a copy of the agreement obtained by The Hill.

Another provision calls for finding additional savings through other methods by simplifying Medicare and Medicaid administrative costs.

The cuts sought by the Blue Dogs would remain in place unless the drug negotiation and other initiatives yield savings. But any savings would be used to lower premiums.

I believe that negotiations on drug prices will yield savings. So this could work out fine. But there's a strong implication there that the single payer vote was traded in exchange for keeping the Blue Dog-Waxman deal intact. That would be a mistake and a shame, with real-world implications for the middle class and the poor. We'll know when Nancy Pelosi merges the bills, at any rate.

Given the reality of this vote, the biggest thing single payer advocates could get out of it is a full analysis of HR 676 from the Congressional Budget Office. Incredibly, despite the amount of sponsors and the fact that it's been around for years, there has been no CBO analysis of the bill yet, and I think that a score showing that single payer would cost less than the Rube Goldberg plan under discussion and cover more people definitively would be fairly powerful and useful. In a perfect world we would pay a portion of taxes and get insurance coverage, period, end sentence. It appears we're going the route of unwinding an inefficient system slowly. The more information gleaned about the better option, the faster that unraveling can take place.

But if subsidies are more meager as a result of getting a vote, I'm against punishing those who can't afford insurance for the sake of symbol. Especially when Democrats are trying to foreground a message of taking on the insurance companies. Lawmakers are in broad agreement on regulating the insurance market and providing subsidies to those who can't afford insurance. Those also happen to be the two most popular and tangible elements of any bill. They shouldn't be messed with.

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