Many years ago, Markos was a dude like you and me. At parties, once everyone was all liquored up, folks would listen to him. It is the same way with me. Once everyone has a few, they will listen to anyone. That was then. Now, Markos has an audience of hundredss of thousands, if not millions. Markos has grown with his audience. He has tailored his rants. He makes thoughtful arguments that some of the best columnists in the world don't or can't make.
Markos makes an excellent case for giving the Senate a big fat raspberry.
(Raspberry at 2:19)
Ezra Klein takes me to task for my opposition to the mandate, pointing out that Switzerland, among other systems, have mandates that require citizens to purchase health insurance from private insurers. It's true. They do. Those countries also have strict regulatory regimes that heavily regulate those insurance companies. In Switzerland, for example, insurance companies cannot profit from the essential benefits plan everyone must purchase. That's kind of an important detail missing from the Senate's monstrosity of a bill. In addition, Switzerland also strictly regulates the price of medicines and medical devices -- something this Senate has explicitly refused to allow.
Give me those kinds of restrictions to the Senate bill, and I'll rethink my opposition.
Then there's Nate Silver and his 20 questions For Bill Killers, which I'll happily answer:
- Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?
The assumption here is that this bill is the only option on the table. The House still has a say in the matter. And really, the point of reform isn't to shovel taxpayer dollars to the insurance companies, it's to expand care and lower costs. I'm not willing to surrender on costs.
2. Would a bill that contained $50 billion in additional subsidies for people making less than 250% of poverty be acceptable?
This betrays a simplistic view of liberals, as if our answer is to merely shovel money at a problem. What we're looking for is good policy, which in this case, would also be good politics. So no, throwing money at the insurance companies doesn't change a thing. The insurance industry would simply absorb the new subsidies just like universities have raised tuition to shovel up any increases in financial aid.
3. Where is the evidence that the plan, as constructed, would substantially increase insurance industry profit margins, particularly when it is funded in part via a tax on insurers?
Where is the evidence that insurance companies would rig the system to extract record profits? I don't know. Perhaps the last decade or two might provide the answer.
4. Why are some of the same people who are criticizing the bill's lack of cost control also criticizing the inclusion of the excise tax, which is one of the few cost control mechanisms to have survived the process?
Because it is a measure that would disproportionately affect blue collar workers in high-risk jobs, or workers that have given concessions on wages to preserve good benefits packages. Limit that provision to people making over X amount (say, $100K/year), and I wouldn't have a problem with it.
5. Why are some of the same people who are criticizing the bill's lack of cost control also criticizing the inclusion of the individual mandate, which is key to controlling premiums in the individual market?
Because without premium caps or a public-run competitive option, there is no incentive for them to lower their premiums. They have a monopoly, and monopolies aren't in the business of unilaterally reducing their prices. There are two ways to force them to do so -- government regulation or market competition. The former is out, and the latter is inadequate.
6. Would concerns about the political downside to the individual mandate in fact substantially be altered if a public plan were included among the choices? Might not the Republican talking point become: "forcing you to buy government-run insurance?"
If you start worrying about Republican talking points, you've lost the game. They're accusing Democrats of trying to kill grandma. They're not going to back off because a talking point isn't 100 percent accurate. 2010 will be the year of the "commie socialist Democrats", no matter what health care reform bill is passed.
In any case, Republicans have tried to destroy socialist programs such as Medicare and Social Security for years. If people like a program, there's nothing the GOP can do about it.
Please read more of his thoughts. I think that Markos has done an excellent job at summarizing the thoughts of those of us who are trying to get behind this bill. There are some good things in this bill. Unfortunately, I feel that supporting this bill is like buying a car without the engine. There simply ain't much there.