House puts forth heath bill that is the minimuim of acceptability, so the Senate can undermine it

[Political Heretic]

and then the House-Senate conference can deliver a bill that is far below anything the american public should tolerate.

That's called politics as usual. That's not a jab on Obama, hence I didn't say anything about "change." But it certainly is exactly what the President has consistently indicated that he deplores: politics as usual.

So forget the blame, whose at fault and all that good stuff. Let's have a thread about how the hell we break this cycle? How do you think we break this cycle when far too many Democrats in Washington are just as complicit in politics-as-usual as Republicans are? What are the steps you would suggest to break this cycle and how optimistic are you that the cycle can even be broken?

[cdsilv]

1. Another 'throw the bums out' movement, like in '94?

...as I recall, the dems ended up losing in '94 due to the check kiting scandal - I remember hearing loud and clear - "throw the bums out".

We need that again, to tell them ALL that if they don't do this right, they'll be voted out...

[lumberjack_jeff]

2. Do we know who from the senate will be on the reconciliation committee?

[babylonsister]

3. Got a link, or are you just guessing? nt

[Political Heretic]

4. I am not guessing.

The link to the house bill is out there. I've read it.

The analysis of the senate action is in no way a "guess." It's not a guess to review the historical pattern. It's actually irrational and inappropriate to ignore historical precedent when it is very one sided. And the clear precedent is that the Senate waters down and "slows down" almost everything the House sends its way. Some even argue that this is the Senates main "function."

[babylonsister]

6. Are you talking about the markup?

Sounds very common to me. I'm not sweating anything until both sides of the aisle come to a workable plan. Maybe that won't happen, maybe it will. I'd rather not have anything if a public option isn't involved. I'm hoping in the end we'll all be pleasantly surprised. Of course, that will never happen either!

http://www.alternet.org/blogs/peek/house_health_care_bill_races_to_markup_/#141316

House Health Care Bill Races to Markup
Posted by David Waldman, Daily Kos on July 14, 2009 at 3:00 PM.

The House "tri-committee" health care bill, introduced earlier today, is already set for markup in the committees beginning on Thursday.

Take note here: The "tradition," at least on most committees, is to give two days' notice between introduction of a bill and a markup on it. But committee rules, typically, require only one day. It's interesting to note, then, that they've chosen to go with the rules rather than tradition. That'll engender some Republican resentment, to be sure.

But here's the thing: I think it's realistically the case that there's nowhere for Republican votes to move as a result of this resentment. In other words, the Republicans have pretty much redlined their opposition meters, so in some respects, it's no longer worth giving deference to their feelings in this, since the deference is never returned in kind.

It's hard to disagree with that thinking. Might even be useful in the Senate, though it certainly runs counter to the way things have normally worked there.

Then again, so did the record-breaking pace of cloture voting in the last Congress. Doesn't feel a great deal like that's changing in this Congress, either.

[TheBigotBasher]

17. I do have to agree with you.

The House has delivered consistently. Even on the Stimulus, it delivered.

The Senate may as well be Republican. In fact it would have been better if they were. They have already broken key tax promises (make work pay). The Stimulus package it produced was more expensive but delivered less stimulus.

It is hard to justify what is produced from the Senate of Harry Reid. He says do not let the good be the enemy of the perfect. I say do not let the crap be the product of compromise.

[ThomCat]

5. A link to the entire bill was posted earlier

And some of us have been reading it and commenting on it for half the day already.

http://energycommerce.house.gov/Press_111/20090714/aahca.pdf

Here is a partial review, given the length. More following as we dig through the entire text.
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8528296&mesg_id=8528553

[babylonsister]

7. Thanks, but I've been checking out some

opinions myself:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6068091&mesg_id=6068091
House Bill Looks Good So Far.

http://voices.washingtonpost.com/ezra-klein/2009/07/the_house_releases_its_health-.html?hpid=news-col-blog
'On first glance, it looks good.'

And finally this:

http://webstar.postbulletin.com/agrinews/335397460497913.bsp
House's health care reform bill contains big changes
Tuesday, July 14, 2009
By Jean Caspers-Simmet
Agri News staff writer


OELWEIN, Iowa -- The U.S. House's draft bill for heath care reform creates shared responsibility among individuals, employers and government to provide all Americans with affordable coverage of essential health benefits, said U.S. Rep. Bruce Braley.

The bill would protect current coverage allowing individuals to keep the insurance they have if they like it and preserve choice of doctors, hospitals and health plans, Braley said during a town hall meeting in Oelwein last week.

It creates a Health Insurance Exchange, a system that allows private and public options to be available for employers and individuals to choose what health insurance options make the most sense for them, Braley said.

The Health Insurance Exchange sets and enforces insurance reforms and consumer protections and administers affordability credits to help low and middle-income individuals and families purchase insurance.

There is a public health insurance option which creates a new choice in many areas of the country which are dominated by just one or two private insurers today.

Insurance firms won't be able to engage in discriminatory practices that enable them to refuse to sell or renew policies today due to an individual's health status, Braley said. They can no longer exclude coverage for pre-existing conditions. The bill prohibits lifetime and annual limits on benefits, and it limits the ability of insurance companies to charge higher rates due to health status, gender or other factors. Premiums can vary based only on age, geography and family size.

Plans offered in the Health Insurance Exchange must provide essential services including hospitalization, outpatient services, physician services, prescription drugs, rehabilitation, mental health and substance abuse, and prevention and wellness programs. There must be dental, vision and hearing for children under 21. A basic plan must have 70 percent of the actuarial value of all these benefits.

The House draft bill provides sliding scale affordability credits to low- and moderate-income individuals and families. It caps annual out-of-pocket spending to prevent bankruptcies from medical expenses, Braley said. Individuals and families with incomes below 133 percent of the federal poverty level will be eligible for an expanded and improved Medicaid program, and the expansion will be federally financed.

Senior citizens and people with disabilities will benefit from provisions that fill "the doughnut hole" over time in the Medicare Part D drug program, eliminate cost-sharing for preventive services, improve the low-income subsidy programs in Medicare, fix physician payments and make other program improvements.

Braley has worked on legislation to make sure resources exist to assist senior citizens as they age, keep them healthy and allow them to stay in their homes and communities.

The draft bill modernizes and improves Medicare, improves payment accuracy and eliminates overpayments, prevents waste, fraud and abuse, and simplifies administration.

The House draft bill includes Braley's "plain language" provision that requires insurance documents to be clear, concise, easy-to-read, and follow plain language principles.

[Political Heretic]

9. Youre missing the damn point.

It's not about whether you think its "good" and I think its "marginally good" (i.e. the bare minimum I'd be willing to accept) - the point is that, if history is any indication, once it gets through the Senate and conference, it will be well below the standard of "marginally good" I'd be willing to accept.

That's the historical precedent on policy bill movement between house and senate.

[babylonsister]

12. And you are trying to discourage anyone from thinking there might

be something positive passed. If history was any indication, this bill wouldn't be up for a vote to begin with.

[ThomCat]

18. If there was something positive in there I'd be the first person cheering.

I'm seriously disabled and dirt poor. I'm one of the people who's going to need this bill the most.

But I'm not wearing blinders, looking to cherry pick good information to make this look better than it is. If it's a pile of stinking manure I think we all need to know it in advance.

I know that Obama has pinned his hopes on this as his big progressive accomplishment, so his big fans are going to do anything to paint this as progressive even if it's totally not. Make it a success even if it's all just faith and smoke and mirrors. But I like to live in the real world where it's not about how popular someone is or how much he's loved, but what politicians are really doing and how that affects people's lives.

So look at what politician are really doing in this bill, and how it will really affect the millions of poor people who will depend on it. It looks like it's modeled on the Massachusetts plan. Have you taken a look at that?

Look at this and see which parts were clearly written by lobbyists, and which parts were clearly fought for and won by Kennedy's side. You can tell in a lot of sections whose interests won out. But look through this bill yourself with an eye towards reality, not popularity.

[ThomCat]

11. You missed the two biggest changes

mandates that people buy insurance. And the cap on shared costs for the basic (cheapest) plan is $5000 per year.

So every poor person is the US will be required to buy an insurance plan, and who can afford to use the insurance if it will cost you $5000 out of pocket. This is access to insurance, but not necessarily access to health care, which was one of the big worries from the beginning. :(

Then there is the supposedly "Stong" regulation of the insurance industry is sabotaged a number of ways.

1. The federal agency has almost no enforcement power of it's own. It is directed in the bill to go to state agencies and work with them for enforcement.

2. The bill repeatedly requires that nothing in the bill supersedes any state law, which means the insurance industry can still game the state laws to get around anything this new agency tries to do, and in many states this is not a problem.

3. The regulation administered by this agency come from a panel of experts, most of whom will come the insurance, pharma, and health care industry and lobbys.

Please read the bill, and knowing that lobbyists had a large hand in it, and that Bauccus favored them through the finance committee, be just a little skeptical for once. This is no time to be blithely optimistic just for the sake of being optimistic.

[Political Heretic]

13. I'm sorry but your way, waaay off on this one part:

The bill also includes big subsidies for persons up to 400% of poverty level, so its not quite the case that it will cost you 5000$ out of pocket to buy a plan. The bill currently also includes what appears to be a somewhat solid public options.

Still reading and figuring out the details, but if you aren't reading the actual text I'd highly recommend doing that first and reading commentary second.

[ThomCat]

16. Read the text of the bill.

That $5,000 is the dollar amount LISTED IN THE BILL as the cap on "cost sharing" for the basic plan. So that is in the language of the bill as the amount insurance companies can charge for co-pays and deductibles.

That subsidy is for the premiums. So you can get the premium cheaply, but you're going to get hit with the "cost sharing."

[Political Heretic]

19. That's an annual cap, not a one time - its not talking about someone paying a 5k deductible

I think... I'm sorry I'm not an expert on this, I'm just reading too...

[ThomCat]

21. I know it's an anual cap.

But that cap is the maximum amount they can charge in one year in the combination of 1 time deductible and accumulated co-pays. For anyone with a disability (like me) who uses their health care on a constant basis, we're going to hit the cap. Insurance companies are going to make sure of that.

That's how they are going to be making their money. So how many people can afford to pay an extra $5,000 per year just to use their insurance?

Given that the goal here was to make this "competative" with commercial insurance, it's a good bet that the deductible will be in the same range as similar commercial insurance. Individual insurance for someone like my typically has a one time deductible of $2-3,000 per year before insurance kicks in. So figure half of that $5,000 is likely to be deductible, and half in co-pays. That is still out of reach for poor people.

[Occulus]

8. How do we break the cycle?

Publicly funded elections and an out-and-out ban on corporate donations to any Federal electoral campaign.

We might want to ban corporate lobbyists while we're at it, and if at all possible, strip corporations of their personhood.

[Political Heretic]

10. None of that is going to happen, so I don't consider it an answer.

Of if you insistent that is is going to happen or is at least possible, tell me how.

[Occulus]

14. How about this, then:

None of those things are going to happen, yet they are the only remedies for the current situation.

The fact that those actions are the only remedies may be the exact reason why it'll never happen.

[Political Heretic]

20. I don't know what to say to that.

[Egalitariat]

15. We're getting a bunch of bills passed that have the right names, but don't really

do anything.

1. American Recovery and Reinvestment Act of 2009 - or "the Stimulus"
2. American Clean Energy and Security Act of 2009 - or "the Climate Bill"
3. America's Affordable Health Choice Act of 2009 - or "the Health Care Bill"

The names are all cute. And they'll sound great when President Obama gives the SOTU in February.

But we're not really getting anything, and it looks like our leaders are happy to get the cheery PR that comes from the cute bill names.

It reminds me of a bill from a few years ago. No Child Left Behind. Cute name; played well in the SOTU.

[robinlynne]

22. Noone who has received ANY money from the health industry should be allowed to vote!

[blindpig]

23. It's a dog & pony show