‘Whatever happened to Saturday night?” asked the poet. Most Americans, we hope, had more diverting business than staying up near unto the witching hour to watch Nancy Pelosi’s Democrats vote to make meatloaf of the insurance business and a good chunk of the overall health-care system with it. Saturday night’s alright for party politics, but the hangover is inescapable. Let’s hope the Senate is more sober.
Never mind the $1.3 trillion needed to fund this thing, say the Democrats, there is hope and change afoot, and the changes are these: Under Pelosi’s plan, Americans will be required to purchase D.C.–approved insurance, whether they want it or prefer something else. If your existing insurance fails to meet the Pelosi standard, then — poofpoof! — it isn’t insurance. If you don’t buy Pelosi-approved insurance, you will be fined and, if it comes to it, jailed. Businesses over a certain size likewise will be forced to buy insurance for their employees, with similar punishments for failure to comply. In some cases the government will pay Americans to buy insurance and in some cases the government will sell them insurance itself through the “public option” — a government-run insurance company. (Yes, because they’re doing such a bang-up job with AIG and the banks.) Doing all this, explained Rep. John Dingell of Michigan, “offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it.”
Here Dingell dangles over a gap in the bill’s logic: Taking over the insurance industry is not going to provide Americans with access to health care. Access to health insurance is not the same thing as access to health care. The Democrats’ bill contains special favors for the ever-rapacious trial lawyers, who keep Democrats’ campaign coffers full, and nothing but punishment for the doctors, hospitals, medical-device manufacturers, and pharmaceutical researchers who — let’s not forget — are the ones who actually deliver real health-care services. The conflation of health insurance and health care is not trivial: Ask those Canadians and Europeans flocking to U.S. clinics what the promise of “access” is worth when there are fewer and shabbier services to be accessed. (Ever wonder why America has so many of India’s best doctors, and Europe’s?)
The great achievement promised by this trillion-dollar folly is to raise Americans’ rate of health-insurance coverage from 83 percent to 96 percent. That’s not exactly landing on the moon — you’d think you’d get more for a trillion bucks. But what is really odd is this: Insurance, as we know it, ceases to exist under this plan. The health-reform bill is an assault on our liberties and pocketbooks, but it’s also an assault on the English language: Insurance is, by definition, an agreement in which one party pays a fee to another party in exchange for the promise of a payment in the event of a future misfortune. Insurance is a way to hedge against the risk of things that might happen in the future but have not happened yet and may not happen at all. Insurance companies determine how much insurance will cost by taking those risks into consideration. But the Democrats’ bill forbids insurance companies to take into account preexisting conditions, and thereby converts insurance into something else, for which we do not yet have a name: It’s something that does not consider events in the future, but in the past — and you cannot insure against something that already has happened. As we have previously observed, the Democrats are turning insurance into a product that no rational person would buy and then forcing everybody to buy it.
Making metaphysical mincemeat of the word “insurance” is no accident: It is the heart of the matter. As Rep. Barney Frank of Massachusetts helpfully pointed out to his liberal constituents, the “public option” — the government-run insurance program — is a very capacious Trojan horse for fully socialized health care, i.e. “single payer.” Under the Pelosi plan the government: 1) forces everybody to buy insurance; 2) crushes the private-insurance industry with new taxes and regulations; 3) creates incentives for employers to dump as many workers as possible into the “public option”; and 4) ensures that it remains more or less impossible for individuals and families to economically purchase their own insurance, rather than rely upon their employers or the government. Should this bill become law, the middle class would be shunted into something that looks like a hybrid of Medicare and Medicaid. There are bits of good news: Americans will not be forced to subsidize abortions, at least not very directly, and 39 Democrats joined all but one Republican in opposing the bill — a fact that moderate-minded Senate Democrats should keep in mind. Unfortunately, Senator Reid has decided to forgo the counsel of moderation and instead forwarded the more radical Senate bill, one based on a “public option” scheme. Senator Lieberman already has declared that he will vote against such a bill, and other Senate Democrats share his reservations. The House has acted irresponsibly in approving this legislation, and it falls to the Senate to fulfill its historical role as a force for moderation. But in the dark of a Saturday night, with trillions of dollars on the table, who knows what Congress will be tempted to?