Congressman Dennis Kucinich (photo at right) says he won’t vote for President Obama’s health care reform bill because it gives too much to the insurance industry and gets too little in return. He has a point.

I am sure that the President is motivated by the many stories he has heard – including his own mother’s – of desperately ill Americans who were not adequately covered by health insurance. His overriding goal is to get coverage for the millions of uninsured.

The Senate bill that the House is being asked to rubber stamp extends coverage to about 30 million people who now have no health insurance. But the cost may be too high.

The bill forces all Americans to buy health coverage, sending millions of new customers to the insurance companies. And it provides subsidies for those who cannot afford to pay the premiums. To Kucinich – and to me – that’s a huge taxpayer bailout of the private insurers. The President proposes to raise the bailout money in part by slashing Medicare Advantage, which many older Americans depend on for their prescription medicines and other health care benefits. You can bet the old folks will have something to say about that in the November elections.

And the bill doesn’t seem to have adequate safeguards against soaring health insurance premiums. The “competition” it mandates is severely limited. For example, if you are covered by your employer’s health insurance progam you can’t opt out and buy your own coverage even if it would be cheaper.

The bill’s supporters claim it will force insurers to end such abuses as denial of coverage for people with a pre-existing condition and make the companies spend most of the money they take in on customer care instead of salaries and other overhead expenses. But insurance insiders warn that the companies will find ways to get around such restrictions, and I tend to believe them.

Most of all, Kucinich objects to the bill’s barriers against states developing single-payer “Medicare for All” programs. He wants Congress to waive existing federal restrictions and to address federal laws that might be interpreted as supporting insurance company suits against states that provide more extensive coverage than is currently proposed by the President.

That would open the door to development of government-run health care programs state by state, following the example of Canada, where national health care evolved after the province of Saskatchewan started the ball rolling.

Several American states already have health care programs of their own, and some go farther than the proposed federal law in various areas. I wonder how the President’s plan would affect those states. Would they have to trim their programs to fit the federal mold?

The President and his allies should try to address Kucinich’s concerns. One way to win him over might be including a “public option” – opening Medicare enrollment to Americans under 65, for example – in the reconciliation process. There’s a growing movement in the House and Senate for that.

If everyone had the opportunity to join Medicare as an alternative to buying private insurance, there would be real competition in the marketplace, and that would act as a restraint on premiums. To those who argue that it would bankrupt America to open up Medicare, the response is simple: Make sure that the new customers pay their fair share for coverage. That way there would be no cost to the taxpayer.