Wednesday, November 18, 2009

Well, all right, now !!

The Senate health care reform bill that Harry Ried has unveiled sounds promising. It is the result of merging to two senate bills and includes the following:

1. 94% of Americans would have health care insurance.

2. As vetted by the nonpartisan Congressional Budget Office, it would cost $849 billion, while lowering the deficit by $127 billion, over the next decade.

3. It would have a public option plan with an opt-out provision for the states.

4. It would prohibit federal funds being used for abortion (as is the law now); but, unlike the Senate Finance Committee bill, the insurance exchange from which one could choose a private insurance plan would have to offer at least one plan that offered abortion coverage and one that did not.

5. It is also expected to result in at least $1 trillion in cost savings within the health care system.

6. It has a tax on the expensive, "Cadillac" insurance plans.

7. And of course. like all the bills, it eliminates preexisting conditions and the possibility of losing your insurance due to illness or changing jobs.

This sounds to me like a winnable bill. It includes the essentials, it saves money, it comes in at a lower cost that some, and is more "universal" than some.

I'd vote for it in a minute.

Ralph

6 comments:

  1. Senator Orrin Hatch has declared that "it's going to be a holy war."

    Let's hope the American people see this as a holy war against their interests and their desperate need for health care reform. How can anyone with a straight face claim that Republicans are offering any serious counter-proposal?

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  2. Ralph, I feel a bit like the kid pointing out the emperor has no clothing on. Did you watch Keith Olberman? Listen to Rep Weiner from NY? There is a lot in this bill which is pretty bad. Start with the fact the public option(which won't kick in for 4,5 years) is more expensive than private insurance. And yes, it covers pre-existing conditions, but doesn't put a limit on what insurance companies can charge you. Which means, they can effectively price you out of insurance if you have a pre-existing condition. Also, because insurance companies can now sell 'nationwide' they can sell you a policy from a state that doesn't have any consumer protections. It also, I believe, does not allow consumers to buy drugs from Canada, or insure the right to cheap generic drugs. And while Big Pharma has agreed to 'forego' $8 billion in price increases(and onoy increase drug prices $10 billion a year), the cost of drugs ahs already risen 9% this year, which means they effectiveloy bumped their prices up beyond what they normally would have in anticipation of 'saving' consumers money. You can make an argument there are more things in this bill to appease conservatives than progressives.
    richard

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  3. Richard -- I agree there is a lot in the bill not to like. But what's your alternative that could actually get passed by Congress at this time?

    Would you rather have no reform?

    If this is defeated, we would then get a better bill. It would probably be much worse, making even more concessions to conservatives to get their votes.

    If progressives hold out for a better bill, it will simply defeat it for a long time to come -- until the makeup of the Congress changes dramatically. And if it is defeated, Congress will likely only become more conservative in the 2010 elections,not more progressive.

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  4. Correction: In my post just above, the third paragraph actually was meant to begin as a question:

    "If this is defeated, would we then get a better bill?" -- which I answered in the negative, that it would probably be much worse.

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  5. I think Obama doomed this bill by compromisiing from the start. Yes, I think it's better than no bill at all, but not much better. I think the net effect is going to be minimal in terms of personal costs and quality of care.

    I think his obsession with getting Olympia Snow ruined any chance the Dems had to pass legitimate healthcare reform. I forget the term offhand, but I would be perfectly happy with the procedure that would've rammed through a much better bill on a simple majority vote. There was a point in time where that could've been accomplished. Obama's steadfast refusal to consider that option because he wanted the illusion of bipartisanship doomed healthcare reform to the sorry state it is in now.

    Have you ever read Peter Singhe's work on systems theory? He makes the point that systems fail to deliver what it is they claim to value because too often they begin by compromising first. He said when you hold out for what you value it forces the other side to come closer to your original desires.

    Obama began - began - by kowtowing to the conservatives and the healthcare industry. He had no place to go but down. What have the republicans given up that's apparent in this bill? Tort reform? Did the AMA or Big Pharma give up anything? Not really. Insurance companies? I don't see what they lose here. In fact, they're better off being able to sell nationwide policies where they can't be held to consumer protection standards.

    The conservatives didn't get malpractice reform.But you know what? I would have preferred to have given them malpractice caps instead of a public option that has been totally eviscerated - and still won't be supported by conservatives. I would've given up the type of pre-existing condition coverage that allows insurance companies to price those policies beyond the reach of patients with such conditions, and instead fought to allow people to buy drugs from Canada, and capped doctor fees(like they do at the Mayo Clinic, where everyone is on salary).

    Obama had a great opportunity to lead the healthcare debate. And he failed. He utterly failed to be a leader.

    Not only is this not a progressive plan. It's hard to make a claim it's a liberal reform.

    Public Option was my main goal. We get a 'public' option that the CBO says, and Dems admit, will be more expensive than policies offered by insurance companies.That is no choice at all.

    I have a personal interest here. My insurance rates have doubled in 2 years. I had to take out a high deductible plan in order to find affordable insurance. Which means, I am paying, between payments and deductibles 17% of my inicome for healthcare. Do you have any idea how burdensome that is? 17%. Of my gross income. 21% of my after tax income.

    And I'm in the low middle income bracket, and can't afford to own a house.

    Nothing in this bill changes that. Nothing in this bill gives me any relief. Nothing in this bill improves my healthcare costs. And I'm not sure it imiproves my healthcare.

    So tell me again, as a progressive, why I should support this bill?

    Yes, I will, because there is no other alternative.

    But supporters overstate the case by saying the alternative is 'worse'. The alternative is simply not that different.

    Oh well, here's hoping he can do a better job with Afghanistan.
    richard

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  6. Richard, I don't disagree with anything you say. I want the same things. I wanted single payer. I wanted a robust public option that would actually save money. I am disappointed that Obama began his negotiating with what should have been the fall-back position. I am concerned that this bill won't really save money, and then the Repubs will say, "see, it didn't work."

    I hate it that they have offered nothing, given up nothing, and still want to hold it up. Now the latest is they are saying they need 6 weeks to debate the bill. Why? They already know they're going to vote against it.

    But you know what? Obama is who we elected, and this seems to be what we get. As much as I wanted more, I still respect the man and his vision. I'm reading David Plouffe's book about the campaign, and I have a better understanding of how Obama looks at the bigger picture and the longer range view than anyone else.

    I don't know what all went into his thinking about strategy and what seems like lack of leadership. One thing may be that he was avoiding at all costs the Clinton mistake of directing it out of the White House. Maybe it would have gone nowhere in Congress, if he did.

    Let's face it. There are not the votes necessary for a really progressive bill. I wish there were.

    So, although this is not the bill I wanted, I do think it is far better than nothing. If it did nothing but offer near universal coverage, no preexisting conditions, and no cancellations -- that would be a major step forward.

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