Choice?

"Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices." President Barack Obama, September 9, 2009, Remarks by the President to a Joint Session of Congress on Health Care.

So here we are at the beginning of autumn and Congress has yet to pass health care reform. To make matters worse the legislation that we’ve been given is the Baucus Bill. While there are numerous problems with the bill I want to center on only two elements: weak, poorly funded health care cooperatives and the lack of a public option.

First, the problems with the provisions relating to health care cooperatives. While I strongly support their creation, which I’ve mentioned previously, the details in this bill will handicap the new co-ops. According to the bill the start-up capital would only be $6 billion, which would be spread among the new co-ops. That’s far too little investment to create the type of co-ops that can challenge the private insurers. Add to this the co-ops will be limited in their scope. Ezra Klein with the Washington Post reports that rather than being able to contract with large employers the co-ops would be limited to contracting only with "small groups and individual markets." Another major flaw in the cooperative provision is that it fails to give the co-ops special pricing power. While they can band together to increase their purchasing power they’re restricted from setting national payment rates. To challenge the big boys these co-ops need this power. As Klein put it, "The insurance industry is, in other words, being protected from not just public competition, but co-op competition." Finally, even if the above flaws are fixed there needs to be a restriction placed on these co-ops that would prevent them from some day demutualizing into private corporations as some co-ops have done in the past.

Second, the Baucus Bill lacks a public option. The poorly funded co-ops, as they would be set up by the Baucus Bill, simply would not be able to reign in the abuses of the private insurers. If we’re not going to properly fund and empower the co-ops where that they’re able to challenge the private insurance companies then why not create a strong public option that could have a real effect on the private insurers?

Let me make my position clear. It’s my belief that quality, affordable health care is a fundamental human right. A sure way to guarantee this right would be through a Single-Payer system operating within a network of private practitioners and community-based, non-profit clinics/ hospitals. But we know that no matter what legislation comes out of Congress this year it will not include this. So whatever legislation that we do get must have the ability to restrict the power of the private insurers and to provide access to quality health care to those who currently don’t. This means that we need legislation that includes either a strong public option or well-funded and powerful health-care cooperatives.

One last comment. I can’t help but wonder why couldn’t a bill include both a strong public option and well-funded, powerful co-ops? What would prevent such a combination? The President said that this legislation will include "quality, affordable choices." Then I say that Congress should give the American people exactly that. Give us the ability to choose either well-funded co-ops with real power or a strong public insurance.

Faith and Economic Democracy

Back in July of this year Bill Moyers sat down with three leading theologians on his PBS show to discuss the role of faith and social justice. One of his guests was Gary Dorrien, who is the Reinhold Niebuhr Professor of Social Ethics at Union Theological Seminary and Professor of Religion at Columbia University. He’s the author of 13 books and numerous articles. As I mentioned in a prior post Professor Dorrien is also a strong advocate of economic democracy.

In the Bill Moyers production Dorrien stated,

“That's why I'm for economic democracy, because I think that economic democracy is essentially an attempt to sort of hold down, serve as a kind of a break on human greed and will to power, which are virtually universal, so I'm not talking about anything that requires some kind of idealistic idea about human nature, or what we're capable of, or the like. My main argument for it is the same that Niebuhr, that Reinhold Niebuhr had about democracy. You know, the human capacity for goodness makes democracy possible, but it's precisely the human capacity for evil that makes democracy utterly necessary. There are two sort of fundamental stories or ideas about a just society, what it could be, that have been operative in US American history virtually from the beginning, and that are always there. And that one is the idea of providing unrestricted liberty to acquire wealth.

And there's a politics that goes with that. You want to hold down government. You want to hold - even democracy is not really necessarily a good word, in that conception. And then in the other idea, it's that you want to attain as much through a democracy as you can, over society's major institutions.

You can interpret virtually every decade of U.S. American history by the way these two different sort of conceptions of what a just society would be, end up conflicting with each other, sometimes modifying each other, sometimes changing each other.”

I highly recommend to this episode. You can download the episode’s transcript as well as view the show at the PBS web site.