Now that the dust has settled, however, a hard look at the legislation that prompted all the fuss suggests that, far from ‘fixing our broken health care system,’ it merely reproduces some of its worst features.

The bill does nothing to lessen the grip of the private insurance industry on our health care system. It won’t bring exploding health care costs under control. It does little to change the shameful disparities in access to treatment in a society that treats medical care as a commodity to be bought and sold, rather than as something all of us need and deserve.

What it will do is require everybody to buy health insurance, with federal subsidies for those who can’t afford the premiums on their own. The price tag of these subsidies is $447 billion over the next ten years. That’s money that could have gone to pay directly for medical treatment but which will, instead, wind up in the pockets of the insurance industry - one more corporate bailout at taxpayers’ expense.

To help pay for it, public hospitals that treat the uninsured will have their federal funding slashed by $36 billion. Eight years down the road, union health plans and other job-based health insurance will be slapped with a 40% ‘excise tax.’ Protests from organized labor succeeded in getting this tax modified somewhat, but not eliminated from the bill.

The bill does expand eligibility for Medicaid, the federal health care program for the poor. And it is supposed to make it harder for insurance companies to deny legitimate claims or refuse to cover ‘high-risk’ patients. Insurance industry lobbyists, who actually helped draft the bill, swallowed these reforms in part because they’ll get 30 million new customers out of the deal, and in part because over the years the industry has proved adept at evading every government attempt at regulation.