We Won Round One on Health Care

[babylonsister]

http://www.truthout.org/1228096


We Won Round One on Health Care
Monday 28 December 2009
by: Scott Galindez, t r u t h o u t | Op-Ed


There are widespread opinions out there on the Senate version of health care reform. I understand people's frustration with how "Traitor Joe" Lieberman and "Ben Arnold" Nelson held the Senate bill hostage. A robust public option would have been a great start to the real reforms needed to fix our broken health care system. Traitor Joe and Ben Arnold succeeded; there will not be a robust public option.

Many progressive groups have not given up on getting a public option this time around. Putting energy into pressuring Congress to come out of conference with the public option restored is a waste of valuable resources. One group goes as far as calling for the Democrats to call Lieberman's bluff and force him to filibuster the old-fashioned way by holding the floor for days. The problem with that is the need for 60 votes in the Senate has not gone away with the Christmas Eve passage of the Senate bill.

When the House and the Senate complete their next task and merge the two bills, the final version will go back to the Senate and the House for a final vote. While it is true that there can be no amendments and the final bill is not subject to debate, it is subject to one more cloture motion in the Senate. If the Senate doesn't reach 60 votes on that motion, they can't vote on final passage.

With the need for 60 votes in the Senate, the reality is the final bill coming out of conference will look a lot like the bill that passed the Senate. If the House version of the public option comes out of conference, I believe Traitor Joe and his 40 GOP Republican colleagues would kill the bill.

I know many groups are telling people that after conference there is only a need for 51 votes. They are wrong; I thought the same thing in August only to have many Congressional sources tell me I was wrong. Over the last few days, I confirmed the continued need for 60 votes with Senator Reid's office as well as Senators Levin and Feingold.

Many are saying it's better to just let the bill die and start over. I disagree, and here is why.

Access to the Same Options as Members of Congress

Does everyone remember cheering when many Democratic Party candidates for president called for allowing the American people to buy into the same insurance plans as members of Congress? Bill Bradley was the first; I seem to remember Howard Dean, John Edwards and John Kerry proposing the same thing. I know that it was in most of President Obama's stump speeches last year. It's in the Senate bill - well, not exactly.

Remember the confusion when most were reporting the public option was dead and Harry Reid unsuccessfully tried to deny that, saying there was still a public option in the bill? He wasn't referring to the Medicare expansion; he was referring to the compromise on the public option. It wouldn't be a total public option; private insurers, at least one of which would be a nonprofit, would offer national plans that would be administered by the same government agency that administers the federal employee health plan. That is what members of Congress have, so it is what President Obama and many past Democratic Party candidates campaigned on for the last decade.

It is not as good as the public option in the House bill, but it is better than what we have today.

Needed Reforms

* It will be illegal to deny people based on pre-existing conditions; that, in itself, is a major reform.
* There will a cap on out-of-pocket expenses.
* Small businesses will be able to buy from a national exchange, giving them increased buying power.
* A new benefit will allow workers to buy into a plan that will provide them a cash benefit if they become disabled and need in-home care.
* Access to Medicaid will be increased to people making 130 percent to 150 percent of the poverty level; the percentage will be worked out in conference.
* There will be limits on insurance company profits, requiring that 85 percent of revenues be spent on delivering health care.
* If insurance companies exceed those limits and more than 15 percent go to advertising, profit etc., they would have to pay rebates to those they insure.
* The Senate bill requires all insurers to fully cover federally recommended preventive health services, such as immunizations, colonoscopies and HIV testing.
* Insurers would not be allowed to rescind a policy for someone who gets sick.
* State and federal regulators would be required to review rate increases and determine if they are justified.

Let's face it, if this bill was the first offer and we were not teased by the "robust public option," we would all be ecstatic.

Reform Doesn't End With the President's Signature

FDR has a legacy as a great reformer, but let's not forget that Social Security was weakened to get it through Congress, and then reformed over the years to make it a better program. Advocates for universal health care need to continue to fight until every American has full health care coverage. There are short-term fights that can be waged right away: How about eliminating the three-year exemption on pre-existing conditions? Let's make it an election-year issue to make the law outlawing denial of coverage based on pre-existing conditions go into effect immediately instead of in 2014. Expanding access to Medicare to younger Americans would be a powerful election-year tool; let's make Republicans come out on the record against that without the ability to hide behind other parts of a larger bill.

I understand everyone's frustration, but let's get strategic and accept this as a first-round win, and continue to fight until the American people get what we deserve: universal health care delivering as good an outcome at as good a cost as other industrialized countries. Until someone proves me wrong, I believe that means single payer.

[MNDemNY]

1. Bullshit tripe.

[inna]

12. +1

The only "we" who won is parasitic insurance industry and Pharma. And corrupt politicians, of course.

"We" the peasants were thrown a few crumbs, just sufficient for distraction while yet another upward redistribution of wealth is taking place.

[dflprincess]

26. We're not even getting crumbs

we peasants are going to get the tax bill to pay for "reform" that still doesn't give us access to care.

[HuckleB]

2. Good piece.

Thorough, accurate, logical, and based in reality. That's where we must be to move forward.

[Vincardog]

3. Right ya are it is BS. I love all the "reality impaired" folks saying trillions for Parasitic Corp

are a good thing. This abortion of a bill institutionalizes the parasitic private corporations.

[Name removed]

4. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Cha]

5. Kick for this..

"I understand everyone's frustration, but let's get strategic and accept this as a first-round win, and continue to fight until the American people get what we deserve: universal health care delivering as good an outcome at as good a cost as other industrialized countries. Until someone proves me wrong, I believe that means single payer."

[Undercurrent]

6. Good post!

Putting our energies into both the short term attainable improvements, and the long term improvements is the productive path to take. Progress is never easy or perfect or fast. I wish it were, but I don't live in a Wishville.


"FDR has a legacy as a great reformer, but let's not forget that Social Security was weakened to get it through Congress, and then reformed over the years to make it a better program. Advocates for universal health care need to continue to fight until every American has full health care coverage. There are short-term fights that can be waged right away: How about eliminating the three-year exemption on pre-existing conditions? Let's make it an election-year issue to make the law outlawing denial of coverage based on pre-existing conditions go into effect immediately instead of in 2014. Expanding access to Medicare to younger Americans would be a powerful election-year tool; let's make Republicans come out on the record against that without the ability to hide behind other parts of a larger bill."

[freddie mertz]

7. Who is this "we" you refer to, Kemosabe? nt.

[babylonsister]

8. Okay, not you. nt

[freddie mertz]

20. And not the American people. Not yet anyway.

I think it is premature to crow over the bill, which is why I keep sending e-mails and making calls trying to improve it.

Wish we had your help too, but you seem to be satisfied with the present legislation.

[Bodhi BloodWave]

42. you speak for the american people? n/t

[lamp_shade]

9. A good read. Thanks for posting.

[angee_is_mad]

10. Thanks Sister

Keep bringing it.

[rudy23]

11. Any argument that begins with "Let's face it"... should be as suspect as the "Come on" argument

"You know you would've liked this bill if you'd never been teased with the public option----I mean, come on!"

[RoyGBiv]

13. That's your rebuttal?

Picking on a popular transitory idiom occurring almost at the end of the piece as though it were the entire basis of the argument is your response?

Really?

[rudy23]

17. I mean, really. I was kind of teasing.

But the bolded part that did happen to begin with "Let's face it" didn't seem to present any other basis for the conclusion that followed, other than "let's face it."

[RoyGBiv]

18. Fair enough n/t

[RoyGBiv]

14. Yes, we did ...

I've momentarily lost the article in a list of articles I've gathered for more thorough reading over the last few days, but a recent on that was exactly on point noted that the bill currently winding its way through Congress does something rather important that few are really focusing on. It establishes the institutional framework required before any of the more grandiose levels of reform (the stuff we really want) can even be attempted. It's one thing to say we want single-payer health care. It's quite another to put that system into place.

The framework established by this bill will make that eventual goal easier.

[babylonsister]

15. Maybe this one?

Health Care Bills "Making Private Insurers Unnecessary"

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x100016

:hi:

[IndianaGreen]

16. Who is 'we'?

It sure as hell wasn't the working class.

Health Care Excise Tax = A Big Middle Class Tax Increase

Revised December 17, 2009

JCT data shows excise tax in the Senate bill would strike at the heart of the middle class

Health care legislation under consideration in the U.S. Senate would raise $149 billion over ten years by imposing a 40 percent excise tax above certain thresholds on insurance company health plans and self-insured plans offered by companies to their workers. This tax would have a dramatic effect on those plans forcing steep reductions in benefits, shifting of costs to workers and a significant increase in taxes on millions of middle-class families.

Contrary to claims by proponents that it will affect only “Cadillac” health plans, like those enjoyed by Goldman Sachs executives, according to Joint Committee on Taxation(i) data the excise tax will:

• Affect 19 percent of workers with employer-sponsored health coverage in 2016.
• Affect nearly 25 million households(ii) in 2019, including one-fifth of middle-class households making between $50,000 and $75,000.
• Affect about 25 percent of health plans by 2019.
• Cost affected households an additional $7,500 in taxes on average between 2013 and 2019, or more than $1,000 a year.
• In 2019, cost affected taxpayers who are millionaires an extra $2,600 in taxes and those making between $50,000 to $75,000 an extra $1,100 in taxes, but the wealthy taxpayers’ income will be at least 13 to 20 times greater.
• Be a tax increase of 0.1 percent of income for those households affected that make more than $1 million a year and be a tax increase of 1.4 percent for those households affected that make $50,000 to $75,000.

The JCT assumes that 82.5 percent of the revenue raised from the tax will be generated by increased wages to make up for health benefits cuts and increased cost sharing. However, most employers say they will not increase workers’ wages in response:

• Only 9 percent of human resource executives in a recent Towers-Perrin survey said if health care reform reduced their benefit costs would they increase salary or direct compensation; 78 percent said they would retain the savings in the business as profit.
• Just 16 percent of health plan sponsors in a recent Mercer survey said they would convert any health care cost savings into higher pay for their workers.

http://www.healthcarevoices.org/pages/impact-of-the-excise-tax-on-the-middle-class

[chimpymustgo]

35. We, the people LOST. Insurance, Pharma leeches WON.

[jenmito]

19. K&R. I agree-we (who aren't purists) won this round. n/t

[rudy23]

21. I'm glad we can count on you to be part of the push to shift from private to public insurance

once the framework for that is laid down by this bill. We'll count on all who supported this bill for those reasons to be vocal proponents against the privatization of things like schools, social security, etc.

[jenmito]

23. I'm glad you're glad.

[rudy23]

24. Good.

[niceypoo]

33. Purist?

If you arent happy that EVERYTHING we wanted was compromised out if the bill, you are a, 'purist?' Remember how the Baucus bill that passed congress was going to, 'get fixed in the senate?' What happened with that? The senate bill was handed to Lieberman and ended up far to the right of the Baucus bill. At every step the bill was frogmarched further and further to the right. This makes you happy? Lipstick meet pig.

Purist? Pleeeeze!!

[Bluenorthwest]

36. Why do you feel the need to label those you do not agree with?

What is your objective in doing so?

[becxx]

22. Many with pre-existing conditions did not win

I have a pre-existing condition and it looks to me like the Senate bill would not help me. In fact, I'm guessing it will make things worse. In my state, those of us with pre-existing conditions can get insurance from a special pool that charges 25% above market prices for a policy. Also, in my state, all health insurance providers must operate on a non-profit basis--and that has kept the insurance companies better than average although not perfect by any means. Now, under the Senate bill it looks like the sellers of heatlh care rationing will be coming into our state to sell their pathetic wares on a for-profit basis.

Under the Senate bill, insurance companies can charge four times as much to older insureds. As a result. I'll probably end up with a lousy, Class D policy that basically turns me over to the dogs for care.

There are severe problems with the Senate bill and that is the reason the national nurses' association is not supporting it.

Frankly, if that Senate bill is passed into law without substantial changes, I promise I will never vote Democrat again. And I have been a Dem voter for my entire life.

Obama's handling of the health care bill is especially troubling to me. Unless he manages to turn this around, I will be considering him the Dem Benedict Arnold of all time.

[johnaries]

28. Actually,

"States will have flexibility to establish basic health plans for non-Medicaid,
lower-income individuals; states may also seek waivers to explore other reform options; and
states may form compacts with other states to permit cross-state sale of health insurance."

So, if your State has a better program, they can get a waiver.

[becxx]

31. I am not lower but middle income

And this Senate bill will be devastating for me. I may end up in terrible condition because of this Senate bill. I am just sickened by the Senate bill.

[burning rain]

25. For the comparison to Social Security to be valid...

Social Security would have had to begun as a program that forced people to invest in the stock market to secure their retirement. It's unfortunate that people keep recycling that failed talking point.

[johnaries]

29. Participation was still mandatory, which a lot of people hated.

[johnaries]

27. K&R. It may not be a "great" start, but it is a very good start!

[becxx]

30. I have to disagree

I think Senate bill is so bad many of us, including myself, are far better off without it. I am just sick about the Senate bill and the impact it may have on me--a person with a pre-existing condition. In my state, the status quo is much better than this Senate bill.

[EndElectoral]

32. Boy ,this is depressing. We've in fact won nothing.

[BlueIdaho]

34. Its time to change America.

While the Senate bill is not my ideal - its better than the status quo so I say its time to pass a bill and move America forward.

[natrat]

37. what a load of shit, as usual

[Orsino]

38. A Pyrrhic victory, but a victory.

Despite Congress' herculean effort to do absolutely nothing, some reform slipped through that seems likely to benefit a lot of people.

Still waiting for a final bill before eating my words. x(

[ima_sinnic]

39. "we"? another protesteth-too-much "blame" of Lieberman & Nelson

--but I guess a bill for the sake of a bill is "success."

ask me (and the rest of the U.S.) how WE feel about it after we get our IRS-enforced bills for a worthless product that will only be the beginning of (unregulated) payment for any kind of health care.

But the leeches are happy; they have a guaranteed lifetime supply of blood, actually enough blood for a million lifetimes, but they always have to do everything in excess--"enough" is never enough--they're happy for now, but leeches are never satisfied; their greed is boundless. This is a "start," all right--they'll figure out how to get the rest out of us, don't worry, and apparently many here will cheer that.

[TheKentuckian]

40. What a bunch of bullshit!

This is worst than about any worst case scenario. There isn't even serious market based reform in here and the entire house of cards is built directly off of all the most failed parts of the broken system we have now.

This is profitcare. Please stop trying to snow the American people that Baucus II: Electric Boogaloo is something we would otherwise love, we despised it this summer and those with any intellectual honesty would continue to but in the mad dash for crumbs many that formerly despised the abomination are pretending it is a dream come true and anyone that disagrees is leftbagging purist.

This bill sucks snd it's not just that it lacks a public program but because it fails to realy get tough on big insurance, it utterly lacks enforcement, how stupidly it is funded from a political and fairness standpoint, the restrictive scope, and because it makes the risk pools as small as possible.

[Better Believe It]

41. So what did we win? Oh .... the insurance industry and big Pharma won!

"While it is true that there can be no amendments and the final bill is not subject to debate, it is subject to one more cloture motion in the Senate. If the Senate doesn't reach 60 votes on that motion, they can't vote on final passage".

Well, if you're not voting cloture to end a debate or a make believe Republican filibuster what are Senators voting to end?

And the writers contention that 60 votes are needed to pass the Leiberman Health Insurance Industry and Big Pharma Protection Act is absolutely wrong! Only 50 votes plus Vice-President Biden are needed to pass legislation in the Senate.

And Senator Reid can either require opponents to filibuster on the Senate floor or he can simply bypass a filibuster easily with a simple parliamentary move called the "nuclear option".