Marketplace Scratch Pad

Health care under the tree

Scott Jagow Dec 21, 2009

Ho, ho, ho. The Senate will most likely stuff a health care bill down the chimney by Christmas. Is it a gift to the American people? Or a bag of coal?

Of course, the opinions are wide-ranging, and we’ll get to those shortly. But first, the facts.

The public health insurance option that’s in the House bill is out of the Senate bill. The individual mandate is in both, meaning for the first time in US history, every American would be required to purchase health insurance. Those who don’t would be financially penalized. Other elements of the Senate bill:

Insurers cannot deny coverage based on pre-existing medical conditions.

People who don’t get coverage through work can buy insurance through “exchanges.”

Tax credits for lower income people who get their insurance through an exchange.

Employers that offer health benefits must pay 60% of the cost. The employee portion of the premium cannot exceed 9.8%.

Paying for the plan: Taxes on “Cadillac” health insurance, fees on drug companies and insurers and an increase in the Medicare payroll tax for individuals making more than $200,000 and couples making more than $250,000. Those taxes would start next year, while most of the benefits of the plan wouldn’t take effect until 2014.

Ezra Klein writes for the Washington Post that if you go back and look at President Obama’s campaign promise, this bill is pretty close to the mark:

… there are, to be sure, some differences. The public option did not survive the Senate. The individual mandate, which Obama campaigned against, was added after key members of Congress and the administration realized that the plan wouldn’t function in its absence. Drug reimportation was defeated, and a vague effort to have government pick up some catastrophic costs was never really mentioned.

But the basic structure of the proposal is remarkably similar.

But the Wall Street Journal would like to see the bill shredded into a million tiny pieces:

The rushed, secretive way that a bill this destructive and unpopular is being forced on the country shows that “reform” has devolved into the raw exercise of political power for the single purpose of permanently expanding the American entitlement state. An increasing roll of leaders in health care and business are looking on aghast at a bill that is so large and convoluted that no one can truly understand it, as Finance Chairman Max Baucus admitted on the floor last week. The only goal is to ram it into law while the political window is still open, and clean up the mess later…

This is all of a piece with the hubris of an Administration that thinks it can substitute government planning for market forces in determining where the $33 trillion the U.S. will spend on medicine over the next decade should go.

New York Times’ liberal economist Paul Krugman says this:

It’s a seriously flawed bill, we’ll spend years if not decades fixing it, but it’s nonetheless a huge step forward.

In other words, doing something is better than doing nothing. You agree or disagree?

See also:

Comparing the House and Senate bills (LA Times)

What does the Senate health care bill do? (Reuters)

Profiles: How might health reform affect you from PBS NewsHour.

Why I still believe in this bill (from an ardent support of the now-vanquished public option).

Ten reasons to kill the Senate bill.

Why the Supreme Court should strike down the individual mandate from Business Insider.

Health care winners and losers (Washington Post).

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