Health Reform: If Everyone Is Happy, Nothing Is Getting Done

There is a buzz building in the traditional media and in some DC Democratic circles about how we should just accept the fact that we are not going to get a bigger health care reform bill passed, and should just agree to accept the things that the insurance industry has already said they are willing to give us. The insurers say they are willing to give us doing away with coverage denial for pre-existing conditions, for example, or not charging sick people high rates. Let's just take what we can get, some Democrats are saying, declare victory, and go home.

This line of thinking reminds me of a piece of legislation that all you non-health care wonks out there probably have never heard of: the Kennedy-Kassebaum Act of 1996. This bipartisan bill passed the Senate 98-0 and the House 421-2. Its stated aims were to protect health insurance coverage for workers and their families when they change or lose jobs, and to limit to the pre-existing conditions denial problem. It was all policy the insurance industry agreed to, and the bill passed with a lot of fanfare. There was a very nice bipartisan bill signing ceremony (which I attended) on the South Lawn of the White House. Pundits were delighted.

There was only one problem with it, which you may have noticed if you think about it: it didn't actually do anything to solve our health care problems, even the ones it was specially intended to solve. People still lose their health insurance when they lose their job. Insurance companies still deny people with pre-existing conditions. And the problems of our health care system get steadily worse year after year.

You see, the insurance companies are really good at writing loopholes for themselves, especially if you announce in advance that you will only pass what they agree to.

Look, this should be obvious, but apparently it's not: when some big piece of our economy is really messed up, but some major corporate interest is making lots and lots of money off the system, if that corporate interest doesn't object to the "reform" being proposed, whatever legislation being proposed will not solve the actual problem. The 98-0 votes that folks like David Broder love and extol, the bipartisan bill signing ceremonies that thrill the hell out of everyone in DC - they don't actually solve or resolve anything important.