Health Care Reform is not a Done Deal. What Can be Done Now?

[laughingliberal]

So, I am a 100% supporter of single payer/strong public option reform. But, it does seem obvious that we will not get that. Not only do we still have the Blue Cross Dogs sitting in the Senate still prepared to filibuster it, but I firmly believe the administration is committed to keeping it out of the bill.

That said, the bills are going to conference between the House and the Senate. It is likely to be mostly a sham conference, a formality designed to kill what's left of the House bill and leave the Senate bill intact. There is a very small window to fight for elements of the House bill that could improve the situation. I believe, as much as I hate this, that tying up all our energy in pushing for the House to force the PO into the final bill will neglect some of the portions of their bill which could make it into the final bill. Here are 2 areas I think we need to let our reps know we want to see changed from the Senate version to the House version:

1) Fight for the House version of funding. We will all be better off if the House plan to tax the wealthy to raise the revenue needed is kept and the plan to hit the union workers with the tax on
'Cadillac Plans' is scrapped. First, this keeps some of the financial burden off the working and middle classes and it will keep the unions on board for 2010 with their GOTV efforts and
financial support. Keeping the House version here is one way to make this bill more progressive, less regressive.

2) Fight to keep the community ratings model from the House bill over the Senate bill. The House bill allows only a 2x multiplier the insurance companies can use to figure premium costs. The
Senate bill allows a 3x multiplier. Lowering the multiplier they are allowed to use for community rating will help clip the wings of the insurance corporations perhaps almost as well as
forcing them to compete with the weakened public option.

3) Fight to keep the House definition of small business. The Senate version exempts employers with a payroll of $500,000 from the employer mandate. That will cover only about 20
employers in the nation who do not already provided benefits to their employees. The House bill will exempt much fewer employers and capture more benefits for employees. I had
hoped and I know many of you had, also, to move away from an employer based system that keeps Americans enslaved to their jobs. But, if we must keep this system we need more
employers in the pool.

In addition to these, look for the loopholes the Senate bill contains for health insurance corporations that the House bill does not contain. Push to have them removed.

It is still iffy that the House can even get these changes made to the Senate bill. Remember, the White House will be pressuring the progressive caucus to cave and pass the Senate bill as is. Fighting for the PO to be included will divide our resources for a fight I don't think we can win. Fighting to get the House version of the above issues into the final bill will go a long way to making it more what we want and it is, outside possibility, doable. President Obama's team really wants this passed in time for him to trumpet it in SOTU. It does not look as if he is, necessarily, going to get that. Perhaps we have some savvy House members who can offer to get it to him by then if they get these concessions?

[WeDidIt]

1. The final version will be qbout 95% the Senate version.

Sorry, cold hard fact. Nothing anybody does or says is going to alter that outcome.

Don't like it? Work to get a Progressive Senate because the current Senate is conservative.

[laughingliberal]

2. Every party has a pooper....

on edit: I think my post acknowledged that reality. I think it doesn't hurt to make sure the 5% that is from the House is the correct 5%.

[WeDidIt]

3. ABSOLUTELY

We sure as hell don't want the 5% coming from the House version to be the Stupak Amendment, for example.

[laughingliberal]

4. Correct nt

[juno jones]

5. If community clinics are gonna become our public option...

Wanna REALLY support community clinics as our backdoor to better things?

Then give them TEETH!

Make sure that equal resources are alloted at every level. Community clinics should do everything in house that a normal clinic does, and any referrals should be subject to the same sliding fee scale. Make those clinics 100% percent UncleSamgovt owned and not extensions of the 'faith-based' octopus that is attempting to eat out public education. Fight against any exclusions of gay partners, and any exclusions for women, or discrimination account of age. Make sure the poverty level as measured in this country is brought up to a standard that guarantees a basic income in this country including protections for the worker and make medicare requirements nationally reflect that standard.

We need to start shaping the community clinics NOW, sending a message to our congresspeople that blatant discrepancies in care based on income are not going to fly, especially as more and more middle class are forced to use these clinics due to the sliding scale and medicare assistance. We need to jump now before the spin, before the hands go out for the funding. We need to keep this from becoming a faith-based morass like education is becoming. We need to do this for us.

No ghettoization of treatment! No double-standard two-tier system! I don't wish the experiences I've had with bottom-tier health care on any of you, so lets make it better for all building a strong support for a future universal system of care. I think all reasonable people no matter their take on the bill can agree that we can work together to insure fair treatment for all. The next life you save may be your own.

[laughingliberal]

6. These are protections we could try to push for. I agree about bottom tier health care.

Many of my patients through the years have been relegated to the bottom tier. It is a horror for them and a horror for those trying to help them. If we've been shut down on public option we need to put some energy into pushing some improvements we might get BEFORE this bill is passed into law. Will be a lot harder to improve once it's passed.

[clear eye]

9. Important. The push is on to degrade public Medicare to Medicaid

so that it never again will be a rallying cry for single-payer. People have no idea how bad that can get.

[andym]

7. Remove the anti-trust exemption of the insurers

If the idea of the exchange is to foster competition to get better rates and service, then the anti-trust exemption is a significant barrier that needs to be removed. The House bill repeals the anti-trust exemption.

[laughingliberal]

8. That's another thing we could try to get included.

I hope there are some advocacy groups looking at some, possibly, achievable improvements we can make to the Senate bill before it gets passed. And, as always, we can write to our Reps and Senators. I think it will be more productive to look at issues like this than continuing to push single payer at this point.