besides long wait times for needed surgeries and lack of permission to have them performed?
The idea of some reform to the health care system is not
per se bad. However, the entire approach of this Congress and Administration is hell-bent on taking care of special constituencies (Both voting blocks, and business sector lobbies) under the banner of 'Reform' when the provisions they put into the bill are foreseeably going to make matters worse, and quickly.
I'll just leave aside the entire question of whether this is even in the Federal lane at all, after all Medicare and MedicAid, TriCare, VA, involvement in the management-union process through Federal regulation of collective bargaining all pretty much prove it's futile to take a do-or-die position on that, appealing as it may be to rugged individualists everywhere. However, there are a ton of other legal and practical turds in the punchbowl:
1. Lack of insurance portability/interstate sales: Unlike, say, car insurance, every State has a death grip on health insurance in its own bounds. You can call it a States' rights issue (Which to some extent it is), but it is tremendously inefficient economically. A lot of people benefit from this inefficiency, including the State governments, both personally for important players and institutionally for revenue generation reasons. The people who pay the premiums, however, are definitely NOT benefitting from the arrangement, but are paying the full price for this interference with a free market. The 'Reform' does nothing to fix this entrenched problem.
2. Malpractice insurance/Tort reform: Lawyers will tell you this is totally overblown, and can support it by proving that despite the publicity garnered by a few outrageous cases, the total of malpractice awards does not amount to a Hell of a lot in the big picture. This is actually true, but it's looking at only one surface of a multi-faceted problem. There are huge macroeconomic effects that the Bar totally ignores in this defense of its profession, including the overhead of pervasive, overlapping, and expensive malpractice insurance, and the effect of the theat of legal action rather than concern for the patient in care, testing and risk decision-making. The 'Reform' act does nothing to fix this, either.
3. Cost: Only an idiot or a Democrat would come up with a program that would have to pull in taxes for ten years in order to provide services for six years, and declare it would be solvent through the following ten years and therefore was a fiscally stable and supportable program forever.
4. Forced purchase of insurance: Huge question about where the Hell they can find any authority to do that one. Congress has the power to tax, in support of a specified power of the Federal government (Generally the plenary powers, like commerce and national defense), and it has been stretched to extraordinary lengths in the past, but how they pulled this one out of their collective asses is a mystery to everyone but true-Blue Democrats, who basically believe the Federal government has unlimited autocratic powers of social engineering (As long as it is pursuing programs with which they agree, of course). It would actually be far more legitimate and legally acceptable to establish a pseudo-public option bare bones plan than this (I.e., something akin to auto insurance risk pools, where States compel you to have insurance but prevent bad-but-licences drivers from being frozen out by the auto insurers - this would be a last ditch fallback, available after a citizen proved that he or she had reasonably tried and been denied equivalent commercial health coverage, and like auto insurance risk pool would not be free, though for the truly poor the State MedicAid could roll over into it).
5. Secrecy: There are lots of nuggets buried in the House and Senate bills, it is not clear which ones will survive the conference process and go into a final bill (And, since it's all being done in secret, there is no public trust in the process) it's just too early to say on that. However, issues liek the Lousiana Purchase and the Cornhusker Bribe are big issues in their own right, if they survive, as is the abortion funding and lack of citizenship verification in the variants.
