A long article in the NY Review of Books entitled straightforwardly "The Money Fighting Health Care Reform" tells in some detail this depressing tale. Suffice it to say, millions upon millions of dollars were marshaled by big insurance and big pharm, mostly, both against various proposed provisions of the bill and for the reelection campaigns of key players. Although the article is careful to detail the positive aspects of the legislation--end of discrimination for preexisting conditions or catastrophic illness or health status, subsidies for 30 million uninsured, and more precedents that take us a long way--the pity of it is, the bill could have been a lot better. The list of provisions that were thrown out: public option, reimportation of drugs, collective Medicare buying of drugs, closure of the "doughnut hole" in current Medicare drug coverage, speeding up of "biologic" drugs to market, and more.
Plus, White House strategy, which put the entire process of writing the bill and moving it through to the legislative branch was faulty. It avoided the White House-centric process that sunk the Clinton bill, but it went too far the other way. That's why it's a year later, and the country has no bill . . . and what it's actually likely to get is wimpy.
It goes without saying that had we gotten anything close to what Obama said he supported during the campaign, we would be getting something that actually resembles a true reform bill. As it is, what we've got here is something crafted by the entities that require reformation! This is nuts, but given our present system of legalized bribery of legislators, what could we really expect?
I have reluctantly, very reluctantly, come to the conclusion that some bill on healthcare reform is better than no bill at all. But I'm not happy. Not in the least.