The end game of the health reform bill in the Senate, with furious
bargaining inside the Democratic Party, looks a lot like moving out of
a house you’ve lived in for 20 years: As the moving truck pulls up,
stuff you thought you couldn’t live without ends up in the trash.

By the end of the day, or the week, the weakened and worn-down
public health insurance option will probably be in the garbage bin, deemed
too far-gone (like Grandma’s tarnished silverplate) to be keep fighting
for. Women’s right to insurance coverage for abortions may be tossed. *Update: amendment tabled* 
States’ right to regulate insurance benefits may be slashed. States’
rights to even opt out of poorly regulated "national" insurance plans
may be lost to appease Sen. Olympia Snowe.

Some of what’s staying in the plan is near-junk: Pharmaceutical
companies will give seniors some discounts, but keep their right to
charge Americans more than citizens of any other developed country for
their drugs. A small step toward regulating out-of-control health
insurance premiums sounds good, but may or may not produce any results.

A decent thing that might be added is opening Medicare to people
over 55, as long as they pay their way. Even that is a boon to
insurance companies, who don’t have to worry about covering sicker,
older folks.

The sum of the wrangling in the Senate is to make life better for
private insurance companies. Since current private health insurance
plans will be "grandfathered," allowed to keep operating for many
years, insurers can use the next few years to jack up prices, dump
employer plans that are less profitable and rake in the dough–no doubt
while falsely blaming reform for their greed. If they are allowed to
sell "national" health plans, unregulated by the states where they’re
sold, insurers can use their marketing ploys to attract the healthiest
customers, dumping the rest on states and the subsidized plans.

Then, when costs  go up, the same insurance companies can declare
reform a failure and demand even more "freedom" to sell policies that
look cheaper but cover too little, bankrupting families if anyone get
seriously ill.

Does that mean reform will be worse than what we have now? It’s
still hard to say no. At least many more people will be covered, with
the help of tax subsidies. But letting private insurance companies that
answer only to Wall Street keep controlling our health care is nobody’s
idea of a good or fiscally responsible thing. It just puts taxpayers on
the hook for whatever insurers want to charge. 

The trash bin is being far too carelessly used.