The Empire Strikes Back!

pay or die…

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Originally published in New Ground 110, January — February, 2007. The degree to which these recommendations (essentially a preview of Obamacare) provoked opposition from the wealthy should have been a clue as to the reaction to Obamacare. Obamacare’s coverage of lower-income persons was partially subsidized by taxes on the very well off, clearly adding fuel to the fire.

by Bob Roman

As this issue of New Ground goes to the printer, the final meeting of the Adequate Health Care Task Force will be happening. As reported in New Ground 109, the Task Force will be recommending to the Illinois legislature a health insurance scheme that resembles the plan recently passed in Massachusetts. A minority report advocating a “single-payer” (that is to say state run) insurance plan will also be submitted. In New Ground 109, I speculated that the insurance industry would present its own minority report. And indeed, 5 members (all appointed by Republicans) of the Task Force are submitting such a dissent.

This dissent is the opening shot in a campaign to prevent the legislature from doing much of anything on the issue of health care. Some of this involves whining about process: about how the Task Force went about its work, about how the interpretation of facts and assumptions made by the Task Force’s consultant (Navigant) didn’t fit with the libertarian dogma of the dissidents. You’ll be hearing more of this, as “unfair” is such an easy charge to toss at your opponents, especially if it’s a half-truth.

But the essence of the dissidents’ complaint is: “the plan advanced by the Adequate Health Care Task Force will, if implemented, increase health care costs, reduce consumer choice of health care coverage, have a negative effect on the quality of health care provided to the citizens of Illinois and restrain job growth.” Some of this, particularly “consumer choice” and “job growth”, are symptoms of libertarian dogma.

If this minority is ideological and self-serving, don’t assume they are also, therefore, stupid. In fact, some of the criticisms they make of the majority report are dead on, and others are plausible enough to scare skittish legislators. Among the latter, one example is the charge that the system proposed by the majority report would violate the federal Employee Retirement Income Securities Act (ERISA) that regulates employee benefit plans. In order to achieve uniformity across the states, ERISA preempts state laws. Maryland’s recent health care law aimed more or less at Wal-Mart was struck down by the courts using ERISA. Even if it does not apply in this case, proponents of the majority report had best get Attorney General Madigan on board as reassurance, at least.

More to the point are the dissidents’ complaints regarding the lack of cost containment measures and complaints (and questions) about just who is going to pay for this system. Employers will be expected to pay about $1.5 billion. Since this is money not necessarily going to the insurance industry, to any good libertarian it’s obviously a burden and a waste. But there are also some 3 to 3.5 billion dollars in expenses (and more as those numbers do not include start up expenses) that are not funded by the majority report. Unfunded mandates have become common in the past quarter century and typical under the Blagojevich Administration, but they should make you very afraid.

These dissidents can’t simply say “no”, not in the face of so much heart-breaking testimony collected by the Task Force. But they are mostly content with restating elements of the insurance industry’s proposal to the Task Force. To be fair, this was not the worst proposal to the Task Force. It might cover up to 28% of the presently uninsured (some of the other proposals covered fewer), and if you have sufficient income so that you could save or invest, you might do well enough provided you’re not especially sick. It represents an attempt to address the anguish of those denied access to health care (or bankrupted by it) while preserving the primacy of the financial industry. (Insurers are not in business to cover your butt against misadventure. They are in business to make money by investing your premium payments.)

That the other Republican appointees to the Task Force did not join this dissent suggests these dissidents just don’t get it. Health care is not just another commodity; it is a basic human right, not a reward for being the biggest rat in the race.