---

In print | Published November 12, 2009 — Updated November 17, 2009 19:54

The health care reform debate took a significant step forward on Capitol Hill Saturday as the House of Representatives approved the Affordable Healthcare for America Act. The bill passed the House by a slim margin of 220 to 215; just a single Republican representative, Ahn Cao (La.), voted for the plan, while 39 Democrats voted against it.
For college students, it is patently easy to remain detached from the discussion. So even though it is practically impossible to provide a comprehensive yet brief summation of the various viewpoints (the House bill that just got passed is 1,990-plus pages long, after all), there are certainly salient points that warrant further elucidation.

What was recently passed in the House
The bill that was passed in the House centers on providing health care to nearly all Americans. One main provision of that objective is the public option that provides an alternative that anyone can opt into. What this means is that the federal government will create, pay for and operate a system of health insurance that will stand as an alternative to the many private insurers in America.

Currently, there are about 47 million Americans living without health insurance, according to CNN. A major contribution to this problem is the ever-increasing premiums that private insurers charge.

The government-run public option could cover anyone, regardless of their health, so that President Obama’s goal of achieving health care for every American — universal health care — can be realized. As the New York Times reports, if the House bill were to be enacted into law, health care would be extended to 36 million of the currently uninsured.
Liberals had initially pushed for single-payer health insurance, but the Obama administration made it clear that it wanted to rely on competition to provide health insurance. The difference between the two is that a single-payer system would require that the government finances all of the nation’s health care services; the delivery and operation of medical services could be handled by the government itself or contracted to private organizations. (In fact, Medicare is an example of single-payer health care, albeit for a restricted demographic.) The public option approved by the House simply offers another choice for Americans to decide on.

There are several other key aspects of the House bill that deserve highlighting. Foremost is the fact that the bill requires most Americans to obtain health insurance. If not, penalties will be levied: either a fine of 2.5 percent of adjusted gross income or five years of jail for the illegally uninsured. Employers with payrolls of more than $500,000 (which accounts for just 14 percent of America’s businesses, according to the House’s website) are also required to provide health coverage for all employers or face a fine of up to 8 percent of the payroll. It is easy to see where an affordable public option comes into play for individuals and employers.

The House bill also provides for the creation of two new institutions: a “national exchange” where people living on up to 150 percent of the poverty level can purchase health coverage through federal subsidies, and the piloting of nonprofit cooperatives that are paid for and run by its members to provide health insurance as yet another alternative to private insurers.

There are two more points that warrant consideration before examining arguments against the House bill. First, Obama says that insurers will no longer be able to discriminate based on pre-existing conditions, a source of much anxiety for the afflicted masses. Second, the reforms will be paid for from a variety of sources, not least of which is the health care surtax levied upon the wealthiest 0.3 percent of Americans (individuals earning more than $500,000 and couples earning more than $1 million). Obama has said that “hundreds of billions of dollars” can also be found in savings in the federal budget.

What opponents of the bill are saying
It would be incorrect to say that only Republicans are against the bill. While it is true that the Republicans have a long-documented aversion to the public option, there are plenty of Democrats who worry about the costliness and incomplete nature of the House bill. To be sure, many of the arguments lodged against the House bill hold significant merit.

The worry about the public option is that it may be lacking in quality. House minority leader John Boehner (R- Oh.) points to your local DMV and post office as prime examples of government inefficiency. And while the public option is indeed optional, detractors worry that employers will opt out of presumably better private insurance plans for the less expensive public plan.

Conservative resistance to the public option is also founded on ideological grounds. Conservatives claim that the mandatory health insurance provision represents a step towards total governmental takeover of the health care system, which would mean a level of interference that many in the Republican Party are highly opposed to. They call instead for specific, targeted reforms.

It is important to emphasize again that opposition to the bill is coming from all sides. One major concern is the costliness of the affair. The states, in particular, are unsure on how they will fund the reforms. “We can’t afford expansion [of health care],” said Toby Douglas, chief deputy director of health care programs in California. Carol Steckel, commissioner of Alabama’s Medicaid agency, assents: “[We’re] not real sure how we’re [even] going to get through tomorrow.”

Though estimates of how much money the plan could save range from $175 billion to $1.8 trillion over ten years, the fact of the matter is that in the short-term, the states would find it difficult to create enough budget space to accommodate the new plan.

The most pressing objection to the bill, on top of all these concerns, is its apparently incomplete nature. Representative Dennis Kucinich (D- Oh.) bemoans the fact that the House bill is far too diluted a reform and “[i]n the end, this is the insurance companies getting carte blanche and the Congress giving up its power to insurance companies.”

In fact, nobody suggests that the bill is perfect.

If anything, the Democrats are tripping over themselves in emphasizing that this bill is simply one step forward; America should pass the bill now and smooth over the rough edges later, as we did with Social Security and Medicare.

“Our plan is not perfect, but it is a good start toward providing affordable health care to all Americans,” Representative Peter DeFazio (D-Or.) said. Bill Clinton echoed the sentiment: “It is not important to be perfect here [at this juncture].” The mentality is that the reform movement needs a strong push to sustain momentum before the revising, as it were, of the law commences. Whether that sentiment is valid is, clearly, still very much up for debate. It is now up to the Senate to make a decision on health care, and a palatable compromise between the two houses of Congress must be reached before Obama can sign off on anything. Senate Majority Leader Harry Reid (D- Nev.) hopes to bring a version of the health care bill to the floor next week; expect the Senate’s version to differ from the House’s current bill.

What this means for us as college students
A thousand words in, and the health care bill still may seem very separate from the daily grind of college life. The House bill — and whatever incarnation the Senate ends up debating — does have, however, very real implications for our demographic.

Given that the health care reform will end up fining those who are uninsured (whether the amount is exactly as written in the House bill is doubtful) and that about 71 percent of four-year private nonprofit institutions require health insurance of all students (Swarthmore is one of them), the effects of a public option will be very direct.

Currently college students have fewer problems getting health insurance because they are generally healthy and private insurance companies make money on them.

Once we get out of college we have the option of not buying health insurance, which has a good chance of being cheaper than paying premiums every month.

But under the new plan, we would be required to have health insurance. For society, it is important that young people have health insurance to level the playing field and keep costs down. While we may dislike this now, in the long run we will feel the positive effects of everyone being required to have health insurance.

---

« RETURN TO OPINIONS

« PREV ARTICLE | NEXT ARTICLE »