In the early morning of Christmas Eve, the United States Senate passed its version of the health care reform bill. Despite being touted as the Senate’s early Christmas gift to the American people, progressives like me stand incredibly disappointed and frustrated with the watered-down bill. While I recognize that there is an inherent struggle between idealism and reality in any political battle, this bill fails in any sort of substantive and comprehensive reform. So here is my basic progressive primer on the Senate’s health care bill, including what to hate and who to blame.

While many debate the actual number of people it would affect, progressives should make no mistake — the public option is vital. While Speaker of the House Nancy Pelosi (D-Calif.) and the House Democrats were able to secure a public option in their version of the bill, Senate Democrats were not. The public option provision would create a government alternative health care plan to private insurance companies, allowing the government to negotiate payments with doctors and hospitals.

The health care system cannot be fixed if Congress allows it to stay in the private sector alone. In order to make health care actually affordable, a public option is necessary to break the monopoly insurance companies have, force competition and finally make insurance companies responsible to the people. Some contend that private companies cannot compete with public institutions. This is simply not true — they coexist and compete in multiple sectors. The Post Office must compete against FedEx and public schools exist with private ones. Many other countries have private-public health systems as well, including France, which was ranked first for its health care system by the World Health Organization.

Though it hasn’t received the amount of attention the public option has, there is another key element to health care reform: the anti-trust exemption for health insurance companies. The McCarran-Ferguson Act of 1945 allows for health insurance companies to receive exemptions from the federal anti-trust laws that apply to most businesses. This allows for the insurance companies to collaborate and essentially set prices at any rate they see fit. Because of this exemption, insurance companies indulge in practices like bid rigging and market allocation, all of which reduce competition and increase prices for the consumer. While the repeal of the McCarran-Ferguson Act may seem like a simple no-brainer, it was evidently overlooked by the Senate, which was not able to fit it into the bill.

We can thank the Republican Party for not allowing the public option or the repeal of the anti-trust exemption in the Senate health care bill. Not a single member of the Grand Opposition Party supported the Senate bill and few made genuine attempts at reform. It is quite clear that the Republican Party stands firmly against the general welfare of the American people’s health care. While standing in stubborn opposition to almost every idea proposed by Democratic Party leadership, they must have lacked the time to be able to propose any ideas of their own. Despite American health care being ranked 37th by the World Health Organization, Republicans held ignorantly that America “had the best health care in the world.” I cannot stress enough how at fault this party is. The only people it truly represents are corporate insurance companies, insurance lobbyists and the radical fringe right that now controls the party.

But the Grinches who really stole health care reform were Senators Joe Lieberman (ID–Conn.) and Ben Nelson (D–Neb.). While standing as the last holdouts for their votes on health care reform, these two senators were effectively able to hold health care hostage and ruin Christmas in Grinch-like fashion. Lieberman said that he wouldn’t support a public option or an expansion of Medicare — despite supporting the idea previously — and even threatened to filibuster with the Senate Republicans. Ben Nelson expressed similar concerns but got even more bang for his buck with his “Cornhusker Kickback,” a deal that gives the entire state of Nebraska a permanent exemption from its share of Medicaid taxes.

The public option and the repeal of the McCarran-Ferguson Act are necessary for real health care reform in America. These provisions were not able to make it into the bill because of Joe Lieberman, Ben Nelson and the entirety of the Republican Party. As the conference committee approaches, progressives need to remain strong in their convictions. While lawmaking is a profession of compromise, diluting a bill until it isn’t strong enough to make the changes necessary is a mark of bad government.

Will Butler is an LSA freshman.

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