This Bill has to be compared to the current Status-Quo, not to some other Bill that cannot pass!

[FrenchieCat]

If you compare this bill to what happens if a bill doesn't pass, then you will see the good in the present Senate Bill.

Realists who must vote like Sen. Franken, Sanders, Harkin, Boxer, and Rep. Wiener, all understand that this bill is way superior to the Status Quo. That case can be made of those who do not have a vote, but understand the economics or the importance of the impending disaster that the current status Quo leaves us with; Folks like Krugman and Mrs. Kennedy.

Those who are comparing what we have ready to go to what we could have had but didn't have the votes for, are going to be unhappy with this bill, not because it isn't an improvement over what we have, but because it isn't as much as they wanted.

In otherwords, it is easy to see the glass 1/2 full or 1/2 empty depending on where you sit.

Of course, Folks like the Teabaggers, the Republican congresspeople prefer the status quo, period.

Bottomline is that this bill can and will be improved on, because at least there is a bill as a foundation to get other improvements in it, and those can be made through the reconciliation process dealing with budgetary matters needing only 51 votes.

The same cannot be said about the status quo; because no bill means nothing to build on; nothing at all.

That's the reality.

What’s In The Manager’s Amendment
By: David Dayen Saturday December 19, 2009 9:38 am


So I’m frantically trying to read the manager’s amendment (turn on CSPAN-2 and you can follow along yourself) and all the supplementary information that’s out there on just what’s now in this health care bill, and here’s what I’ve got so far:


• The CBO score is out. The top line numbers? The bill costs $871 billion and would save the federal government $132 billion over the next ten years. The changes in the manager’s amendment amounted to a net $2 billion dollar savings. The bill would cover 31 million people and leave 23 million uninsured by 2019.

• On the abortion issue: states could prohibit abortion coverage in the exchange if they passed a law. This basically punts the Stupak issue to the states, and if the exchanges expand over time as expected, essentially end abortion services coverage in states that pass a law. This becomes a huge culture war battle in states for years and years to come. Good for pro- and anti-abortion groups’ fundraising coffers, bad for women.

• The CLASS Act, the federally managed, voluntary long-term care program, is still in the bill. Lieberman may have mentioned it on Face The Nation, but he didn’t kill it.

• The public option is replaced with the OPM-managed multi-state plans in the exchanges. Not all of them have to be non-profits; in fact, only one of them has to be.

• The individual mandate penalty actually looks a little higher here, although it’s phased in over time. It would be the “greater of a flat dollar amount per person or a percentage of the individual’s income,” up to 2% by 2015.

• Apparently Nebraska and maybe a few other states get more money for Medicaid funding. I can’t get entirely worked up over a legislator securing more money for poor people in their own state. It beats kickback deals for local defense contractors of developers. I think Paul Wellstone would have done no less.

• Small business tax credits to purchase insurance have been expanded by $12 billion and phase in immediately, and are eligible to companies that pay higher wages. Every bill in Congress has to include small business tax credits, it’s the law.

• The medical loss ratio, which was floated to be at 90%, had to be dropped down because of a nakedly political act by the CBO, which said that a 90% MLR would have amounted to nationalizing the insurance industry. So the MLR is now 85/80%, but that apparently does not include the money insurers get through risk adjustment, which means that in practice it’s actually higher.

• They’ve banned pre-existing conditions for children immediately, starting in 2010.

• There are new insurance regulations, including the ability to ban insurance companies from the exchange if they raise their rates above a certain amount. And if an insurer denies a claim, there will be an independent board to which customers can appeal. The design of that board is crucial.

• The nationwide plans, which could have gutted state-level insurance regulations, have been dropped. This is a good thing.

• There are $1.25 billion in new resources for community health centers in the bill, totaling $10 billion overall (there’s $14 billion in the House bill). I’ve written about community health centers before, which could provide a base of low or no-cost primary coverage for all low-income Americans in communities throughout the country. I actually think this is the best thing in the bill. Bernie Sanders is actually talking about this now on CSPAN. He says that 10,000 more communities will have access to community health centers with this legislation.

• Increased debt forgiveness for medical students to work at community health centers.

• The “doctor’s fix” was removed (probably to improve the CBO score) and will be dealt with in separate legislation.

• There’s an increase to the payroll tax for high-income Americans to pay for the bill. Before the increase was 0.5% for individuals with income above $200,000 and for families with income above $250,000; now it’s 0.9%.

• They traded the Botax for a Boehner tax; there’s now a 10% excise tax on indoor tanning.

http://news.firedoglake.com/2009/12/19/whats-in-the-managers-amendment/

[monmouth]

1. Much like a Christmas tree; with just the lights on it isn't much, but once

all the other goodies are put on, welllll..where did that come from????? Whew..

[depakid]

2. That's a false assertion- a more effective bill could pass, but the administration and Congress

lack the political will and fortitude to use the appropriate procedure to get it done.

By pandering and acceding to the corrupt and ideological of the party- they've proven themselves weak- if not inept- and that WILL effect every single piece of controversial legislation coming down the pipeline for the next three years. In other words- you will all be repeatedly sold down the river.

And- I don't say this lightly- that process (wherein the administration is repeatedly walked on and disrespected, has a pretty decent chance of ensuring that Obama is a one term president, provided that Republicans nominate an ostensibly competent and moderate candidate in 2010.

[FrenchieCat]

11. Much speculation, and a refusal to acknowledge that political reality is reality.....

You speak of what the political will currently is, and you are correct....

but the problem remains, doesn't it?

In otherwords, you are not addressing the issue with solutions,
only speculating on a future based on assertions that you are deriving
from not very much but more speculations.

And yet, you somehow fool yourself into believing that your analysis is a solution?
To what exactly? :shrug:

[depakid]

21. Here's the political reality- 50+ 1 would have done this more effectively

without the weak kneed pandering. The rest is a bunch of excuses (and will be rightly perceived by the electorate as such):

The Byrd rule states that legislation is unfit for reconciliation if it "produces changes in outlays or revenue which are merely incidental to the non-budgetary components of the provision." I asked Jim Horney, a budget expert at the Center for Budget and Policy Priorities, how you define "merely incidental." And what, exactly, is a "provision"?

He sighed. A provision, he said, is "not defined anywhere. It goes well below a title or section of a bill and even below a paragraph. But exactly what it is nobody knows." And the Senate rules offer no more clarity on the definition of "merely incidental." Asked if anyone had developed an accepted meaning, Horney seemed almost apologetic. "No," he said. "Absolutely not."

The matter is not simply academic: The Byrd rule allows senators to challenge the acceptability of any provision (undefined) of a reconciliation bill based on whether or not its effect on government revenues is "merely incidental" (undefined). Thus, if you enter reconciliation with a health-reform bill, it's not clear what's left after each and every provision -- however that is defined -- is challenged and a certain number of them are deleted altogether: the tax portions, certainly. And the government subsidies. But is regulating insurers "merely incidental" to government revenues? How about reforming hospital delivery systems? How about incentives for preventive treatment? Or the construction of a public plan? An individual mandate?

It's hard to say. The ultimate decision is left up to the Senate parliamentarian, whose rulings are unpredictable.]i] Under George W. Bush, Republicans managed to ram tax cuts, oil drilling, trade authority, and much else through reconciliation. But they were as often disappointed: The GOP leaders fired two successive Senate parliamentarians whose Byrd rule rulings angered them.

http://www.prospect.org/cs/articles?article=the_fifty_vote_senate

With the constant banter about how the various bills effect the budget (and save money- reducing the deficit) this should be obvious. All that's lacking here is political fortitude.

[BeyondGeography]

24. Votes are what's lacking; isn't that clear by now?

:banghead:

[DJ13]

3. If we just close our eyes and pretend, why its a fine bill?

[FrenchieCat]

6. 80-85% Medical loss ratio from the current 65% is a great big improvement!

Even if the bill that couldn't pass had it up 5-10% more.

15-20% is a large improvement.

[grytpype]

4. Well I see the leftbaggers have voted this down already

[FrenchieCat]

7. Pounced on it as soon as I hit "Post Message".

It's actually funny to see how rabid they are in their attempts to squash all debate....
cause debate is never good at getting to the real truth....or so they think!

[glen123098]

5. Is it better than the status quo to

Have an individual mandate which taxes people because they cannot afford to buy private insurance? I think not.

[FrenchieCat]

9. It penalizes those who will not be insured.....because when they break their arm,

and come in for urgent care, they will have indeed paid for it,
as opposed to being on the government dole, where we all have to pay for their
broken arm.

[glen123098]

12. What about someone who makes 12 dollars an hour and has no work provided insurance?

Like my brother. Is he gonna have to pay an extra tax because he cannot afford healthcare?

[FrenchieCat]

16. He will pay, not a tax, but a penalty. This penalty is there

so that when he is in need of health care, he will not be forced to go to the county hospital and die. I think the fact that there will be low income clinics that are well funded which will help your brother, more than the way the system is set up now.

[Cleobulus]

26. So he's being penalized for being poor, why should he pay a penalty for being poor? n/t

[Laelth]

8. The status quo is better because it will ALLOW for states to address this issue themselves.

Passing the bill will prevent state action on this issue. California will probably pass single payer on its own in 2011. All they need is a Democratic Governor. The legislature has already passed the bill. Schwarzenegger vetoed it. Once California has single-payer, most (if not all) states will follow suit.

It's likely that if we pass a new law now, the new law will preempt single-payer, i.e. the Federal law will preempt state law and prevent states from enacting a single-payer system.

THIS is what the health insurance companies fear. THIS is what brought them to the bargaining table. THIS is why they are not fighting Obama's tepid reforms, and THIS is why it is extremely important that we do not pass any health insurance reform bill this year.

Let's not settle for a bail-out of the health insurance industry. Let's insist on the eradication of it. In all likelihood, California will lead the way in 2011 ... if we can just give them time.

Canada got its single-payer system one province at a time, and it looks like that's the only way it can happen in the United States.

I don't think the Federal Government is capable of reforming the system right now. If this bill is the best the Federal Government can do, then the Federal Government should do nothing. It's time to let the states try.

Kill the bill.

Forcing people to buy insurance is no more the answer to a failed health care system than forcing people to buy houses is the solution to homelessness.

:dem:

-Laelth

[FrenchieCat]

10. Sure....you are waiting for single payer health in California........

and for it to spread throughout the land.....
good luck with that.
They can't even pay for Medicaid as it is!

[Laelth]

22. Three states have applied for ERISA waivers to enact single-payer systems.

It doesn't have to be California.

But if this bill passes, no state will be allowed to pass a single-payer system. In fact, that appears to be the principal purpose of the bill.

If that's what you want, fine. Please be honest enough to admit it.

:dem:

-Laelth

[dflprincess]

31. In addition this bill allows the insurance companies to sell across state lines

It won't be long before they all head for the state with the least regulation which they will use as a base to sell their shoddy (and bound to get worse) products.

That worked out so well for us when the credit card companies all moved to South Dakota with its lax usury laws.

If they didn't think they could pass meaningful reform they should have just left the issue alone instead foisting this scam on it. However, I think this Insurance Profit Protection Act was the bill Obama and his DLC pals wanted all along. They don't care if we can actually get health care or not as along as we keep writing those premium checks - and I'm sure they'll be well rewarded by for this by their corporate masters.

[Ildem09]

13. Bleh

Considering that HR 676 would have scored at 1.2 Trillion for 10 years and would have covered everyone for everything. I think the real problem gets down to not what is possible, because any sane person would see that it would be a great deal. however the issue lies in the fact that there is private money involved in politics. there needs to be NO PRIVATE MONEY of any kind in politics. implement a 3 dollar per person fee on IRS forms and dole out money for campaigns from that corporations or special interests cannot be involved at all in politics.

[janx]

14. Frenchie, people were hoping for more. Obama campaigned and

pushed for more, but the insurance companies and some senators wouldn't allow that.
So it's an improvement in that it regulates the insurance companies, but it's not the health care reform that many were expecting.

C'est la vie. :hug:

[Ildem09]

15. your comment

assumes that the cheerleaders are not blinded by their love of the person over the policy. I love Obama hes a good guy. his policies are lackluster. I have the ability to differentiate. I don't think they want to. they want you to have to buy into the Cult of personality

[FrenchieCat]

18. The name calling needs to stop.

I'm a cheerleader for A better America, and don't you forget it.

As for a "cult"; the American voters voted, and you lost.
get.over.it.

[Ildem09]

20. Jesus

I voted for the man too. you don't seem to understand my point... about separating the person from the policy

[Name removed]

23. Deleted message

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

[niceypoo]

28. "you lost so get.over.it."

Childish

[bigwillq]

27. So does yours, Frenchie.

Another hypocritical post. :puke:

[FrenchieCat]

17. I agree. I don't consider it the best that we could have done,

only the best that we can do.

I'm not estatic.....
but again, I'm seeing that there can be improvements,
and that is the area that I will be pushing for....
in particular in the area that can be "fixed" via budgetary reconciliation....
as a budget has to be passed every year.

Of course the CBO cannot predict the savings of some of the cost saving items that are included
in this legislation but cannot be counted in the way the CBO scores, as they are conservative in what they do. Hopefully, these cost saving measures will be generate funds that can then better revise the new system that will be in place.

Again and again, health reformers believe they have identified ways to save money through more efficient delivery of care. So why can't we count on those savings to budget the coming expansion of health care for Americans or lower cost growth?

It is not as if various steps to contain health care costs won't yield positive results. Electronic health records and promoting comparative cost effectiveness are only two examples that could yield benefits. Providing rapid access to patient centered care, greater use of primary prevention, efforts to reduce re-admissions to hospitals soon after discharge, and better identification of low-quality and high-quality hospitals — all these are sensible steps.

But much to the chagrin of the members of Congress looking for ways to reduce costs, the Congressional Budget Office often "scores" these potential improvements in health care as generating moderate or no saving. That makes it harder for the President and the Congress to finance larger health subsidies or tackle our long-term deficit.
http://www.pgpf.org/newsroom/tgwd/34/

[treestar]

19. Rec'd

That is so true.

[jeanpalmer]

25. It maintains the status quo

of a high cost health care system. It reallocates the costs from some people to others (mainly from the old and unhealthy to the young and healthy) but maintains the high cost structure and extends it to still more victims. It has to, because nothing fundamental in terms of cost control is being done. Providers will still run up bills, we'll still have that extra cost layer of insurance bureaucracy, and there's no negotiating of drug prices. Per person cost in the US will remain far above what it should be.

What the Democrats have managed to do is redirect your focus from real healthcare reform to tinkering and cost reallocation. They've made this bill so complex that each little issue becomes a major item, even though none of them significantly reduces the overall cost of healthcare. They've basically distracted you from the main goal of making healthcare significantly less expensive and affordable for all.

When they bring the cost of health care down fome $7000 per person to something affordable, then we'll have real health care reform.

This bill will lock in the old insurance system with some small variations. That's not something we want to do. It will preempt any chance of getting a better system sveral years down the road. There's no reason to pass it now. It won't take effect for four years. Why the rush, except to save the asses of a unprincipled bought off politicians who are willing to accept anything and call it change?

[gardenista]

29. Rec

Wow, I don't know what's happened to this place.

Good post.

[HughMoran]

30. Excellent and very informative post - thanks.

Lots of good stuff there - I'm actually kind of sad thinking that progressives won't fight to have the pre-existing condition provision removed immediately for adults too. I hate to think some may cut off our nose to spite our faces - just because they didn't get everything they wanted :(