Put the Celebration on Hold

Okay, so it's not a done deal yet, but by this time tomorrow, no doubt, people in the United States will be led to believe that their House of Representatives has gifted them with health care reform. Well, it's not time to pop open that bottle of bubbly just yet, and toast to the passage of health care reform just yet. There is at least one element of the proposal that needs fixing, regardless of how the House votes, and it must happen a.s.a.p.

In his pep talk to the House today, President Obama kept stressing how his bill makes coverage more affordable to uninsured working families by giving them "tax credits." The notion of tax credits is not a new one. You may recall another president, George W. Bush, was also fond of the idea of tax credits. Bush was also fond of privatizing social security. Both are bad ideas, and both essentially constitute a dream deferred.

And, as for deferred, think of a tax credit as a rebate. One lays out the cash to buy something, and then submits the appropriate paperwork et voila, the check is in the mail. A fine idea except when a part-time legal secretary finds herself facing a stack of bills on her desk, a refrigerator with a container of milk and some stale bread, and a gas tank on empty, it might be hard for her to get excited by a tax credit. Who would expect her to jump up and down for joy knowing that, based on her annual salary, she now has to shell out an additional $200 a month for health insurance on top of $200 for car insurance, a big chunk of her paycheck. Salary, after all, is meaningless unless one factors in cost of living expenses.

The same applies to small business owners who are struggling to make payroll every week. Tax credits would need to be healthy ones, indeed, to offset the added out of pocket expense of having to insure their workforce.

More importantly, those who will be exempted from having to meet the mandate to buy into an insurance plan, the poor, are the ones most in need of genuine health reform, yet they are the ones who will be shut out of the process. While their numbers may be small in comparison with the overall numbers of those uninsured who will soon have to cover themselves, the demands on county emergency rooms won't go away as long as we have a private insurance system. Presuming that this health care reform measure passes, Congress must act swiftly to mitigate against this by expanding Medicare.

Those who argue that the mandate to buy insurance won't go into effect for another four years also presume that the hemorrhaging of our financial markets, and biblical losses many Americans have had to endure over the last few years will just evaporate, and disappear. Well, it doesn't work that way. This is a specious argument, and we're living in the days of endangered specious.

And, those Democratic leaders in the House who are prepared to make last minute deals with the devil to ensure passage of their legislation need to be reminded that Rep. Stupak's more stringent restictions on abortion really boil down to an assault on working women, and the insertion of privilege into the debate. This is unseemly for a party that purports to defend and serve the underprivileged, and the disenfranchised.

Ultimately, private insurance companies are destined to go the way of the dinosaur, and history will record those who worked to make that happen because it is they who are working for the public good.

Let me be clear. This bill must pass even if it's only to keep insurers from denying people based on pre-existing conditions, but Congress must also prepare to roll up its sleeves and get to work to reshape it so that it best reflects, and articulates the needs of the poor, and the working poor.

People need to worry more about the spread of complacency than the spread of swine flu because complacency kills many more people. The time to celebrate will come when every child born in this country has the same chance up at bat, and the only government mandate will be to ensure the best medical care for each and every one of us regardless of our ability to pay.