Who are the real obstacles to overhauling the American health care system?
If you say Republicans, you're wrong. There aren't enough of them left in Congress to affect the outcome of pending health care legislation.
No, the real obstacles to effective and affordable health care for all Americans are ...Democrats! Not all of them. Just the "moderate" or corporate Dems who oppose single payer or even the possibility of a government-backed public option insurance plan.
The Associated Press says that the two factions are on a "collision course" when it comes to health care reform:
"The disagreements underscore steep challenges ahead as Congress rushes to meet Obama's goal of passing a health care overhaul that keeps down costs and extends coverage to 50 million uninsured Americans."
Single payer advocates, who want to take the profit out of health insurance, are skeptical of the public option. As long as the private insurers are still in business, they say, a government-backed insurance program is likely to attract the least healthy Americans, thereby driving the cost of the program up.
According to Helen Redmond, that's what happens when you mix private and public insurance programs. She quotes the founders of Physicians for a National Health Program on the impact of private insurance impact on Medicare:
"A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage."
Single payer advocates, says Redmond, also object to a public option for other reasons. Among them:
- It doesn’t make health care a human right that can never be taken away.
- The system would continue to have multiple payers and therefore the complexity and gaps in coverage that are inevitable when there are numerous bureaucracies to navigate.
Speaking of the public option, Robert Reich reports that the moderate Maine Republican Olympia Snow has convinced some Dems, including Oregon's Ron Wyden, to sign on to a plan concocted by "Big Pharma and Big Insurance" for the public plan to "kick in years from now," but only if the private health care industry fails "to bring down healthcare costs... ."
Reich says that " 'years from now' in legislative terms means never."