Sublime Compromise to Achieve a Pyrrhic Victory on Healthcare Reform

I predict that the “public option” in healthcare reform will be a completely useless Rube Goldberg concoction in order to please and displease everyone simultaneously. However no one on the left or right should fear it because it will never come into existence even if it written and passed into law.

The public plan that will emerge from the joint conference committee between representatives of the U.S. House, the U.S. Senate and the Obama Administration will be completely unrecognizable to anyone on the left, right, center, or even to the health insurance industry. It will only be a possibility to an infinitesimally small number of individuals on state-run health insurance exchanges that all the states can “opt out” from even creating and would only be permitted in those that “opt in” on the further occurrence of a set of statistically rare “trigger” conditions all being met simultaneously – something close to the probability of winning the lottery or being struck by lightening.

I alluded to this ineffectual outcome months ago in some of my prior TMV posts. Perhaps we may adopt some of Switzerland’s health insurance policies that provide universal coverage through strong public regulations and a mandate that all citizens purchase a minimal national insurance policy from one of the dozens of private health insurance companies. We might expand Medicare and Medicaid a bit to fill in some other gaps. We will likely get some comprehensive patient bill of rights passed to protect cancellations or denials of coverages by private health insurers. We will probably get most of these reforms in place in 2010 to stop the endless fear-mongering in time for the Midterm elections. But a public option was dead on arrival with the Obama Administration.

I would hope that most reasonable and astute Congressional Democrats and Republicans see the eventual “public option” language thrown into the final Health Reform Bill as just more “mandatory useless fluff” to get a compromise bill passed. But the rest of the healthcare reform measures should be passed as worthwhile first steps in a much-longer process of carefully modifying 16% of our nation’s economy over the next decade.

I know some on the left will be greatly disappointed with the final results. Well they must simply grow up and accept the limitations of our political system designed in the 18th Century. Some on the right will be disappointed that any healthcare reforms were passed but they can be comforted in knowing that it may be a pyrrhic victory for Democrats. Furthermore a large number of U.S. citizens will not have any meaningful health insurance except for an expensive high-deductible catastrophic-only policy they must purchase from some private health insurance company. Global competitive pressures on U.S. businesses will ensure that most employees will eventually have the same meaningless health insurance policies as well.

These minor policy disappointments will pale in comparison to the steady decline of the United States vis-à-vis all its economic, political and military competitors around the globe. Our ossified political system is only designed to meet the short-term needs of its wealthiest campaign contributors, who are just as clueless as our political class and many in the U.S. electorate in acknowledging our relentless national decline until it is too late to shift course.

Marc Pascal