Final Stretch On Health Care: The Middle Class Losers, and A Public Option After All?
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After a frequently cantankerous year of deliberations and debate, the Democrats are posed to move forward Sunday by voting on health insurance reform. On this, as well as much other legislation, the Republicans appear ready to continue their year-long legislative obstructionism.
Anticipating that all Republicans will vote against the bill, CNN is keeping a sampling tally of 100 House Democrats, which is less than half of the necessary 216 votes needed for passage. Speaker Pelosi is on the record as saying that she will not call the vote before she has the votes for passage.
The proposed legislation meets the 3 bedrock principles President Obama stipulated were necessary for his signature: reduced costs, guaranteed choice, and ensuring quality care for all. Today, speaking at George Mason University, President Obama framed the debate as about a system "that works better for the insurance companies than it does for the American people."
Speaker Pelosi outlined 18 key provisions in the pending legislation. The first one is key to the health and well-being of our work force, and when implemented, will assist small businesses with tax credits of 35%, increasing to 50% in 2014, to provide employee health insurance. This is really meaningful because small businesses employ just over half of all private sector employees.
As the only industrialized nation that doesn’t provide health care for its citizens as a human right, our employer-based health insurance system originated during World War II when health benefits were offered as a way of attracting scarce labor. That was the era when 40-year careers with the same company, culminating in a gold watch, were pretty common.
Of course, now it's common for workers to change jobs 7 to 10 times throughout their working careers, so the fear of losing health insurance keeps some unhappy workers in their jobs, while placing many laid off workers in health and financial jeopardy. Baby boomers in particular have been highly mobile, moving from employer to employer, and now face higher premiums due to age, if they are insurable. Succeeding generations exhibit just as much job mobility, as businesses require greater staffing flexibility to meet the continuously changing competitive demands of the global marketplace. The absence of affordable, portable insurance is a drag on the American economy for both employers and employees. Escalating health insurance costs place American employers and the American economy at a competitive disadvantage against other industrial nations that provide affordable health care for their workers.
This past week, many progressives were bitterly disappointed and vehemently outraged with the standard bearer of single-payer Medicare-for-All, Rep. Dennis Kucinich, appeared to capitulate to the proposed health care legislation, announcing that he would vote “Yes” on the health insurance reform legislation. Nonetheless, he vowed to continue to work for states rights to implement single-payer systems.
And his work is particularly important to the middle-class, which, according to a recent report by the Robert Wood Foundation, is losing health care at a faster rate than the poor, who have the Medicaid safety net; “the number of middle-income earners who obtained health insurance from their employers dropped by 3 million people from 2000 to 2008.”
Now, Rep. Alan Grayson of Florida has taken the banner of increasing competition to make health care more affordable through the public option. He has introduced a simple, 4 page bill, HR 4789, the Public Option Act, that would allow anyone, regardless of age, to buy into Medicare. He is petitioning Speaker Pelosi to call for a vote on the bill.
Such a move would invigorate the American work force with a renewed dynamism through affordable, portable health insurance and help all workers with job mobility, reduce pressures on employers to forego salary increases in order to pay for employees’ continuously increasing insurance premiums, and provide another choice to Americans evaluate and select new health insurance options, further fulfilling one of President Obama's bedrock principles of health insurance reform.
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Comments
Lord Knows We Need Reform!
Hi Chip! Even though I preferred Single Payer Health Care, which really, a 2-year-old kid could've understood, I am glad some kind of reform passed. Still wish it was something to punish insurance companies, not enrich them even more. If the stoopid All-American GOP Teabaggers would have half a brain they could see Single Payer would be the best system to have but they're such fearmongers who wallow in GOP propaganda.
Fear
Fear is a terrible motivator, but that is all the right wingers and the media have. They do not know how to use enlightened self-interest or any other positive motivaton. Its pretty sad and all it does is serve the interests of the few.
Backlash Starts
Already the backlash is starting, with Republicans predicting big losses for Dems in 2010, and beyond. Republican Minority Leader Boehner was clearly stoking that fear during his speech last night as he called for electoral retribution, and today Rush Limbaugh is calling for "hounding Democrats out of office...safe district or not, they are going to be exposed, and hassled, and chased from office...we need to defeat these bastards. We need to wipe them out." So Limbaugh is acting as the Republican agent provocateur, and he is doing it in such a way that he appeals to the basest (in)human instincts. Nonetheless, it is sort of fun to tune in and listen to him sputter and spit as he goes all apopletic.
But other conservatives, like David Frum in his commentary column on CNN, are more sanguine. Frum wrote that Republican Rep. Rep. Paul Ryan (WI):
...repeatedly complained that the Obama plan would "dump" people out of employer-provided care into the exchanges. He said that as if it were a bad thing.
More relevantly: Do Republicans write a one-sentence bill declaring that the whole thing is repealed? Will they vote to reopen the "doughnut" hole for prescription drugs for seniors? To allow health insurers to deny coverage to people with pre-existing conditions? To kick millions of people off Medicaid?
It's unimaginable, impossible.
A pragmatist, Frum doesn't stop at hand-wringing, but forges ahead into more analysis of the health care industry. And that's where it gets really interesting, because there are a few areas of real commonality between his viewpoint, and what many progressive Democrats say. Here's one example:
Yet free-market economists from Milton Friedman onward have identified employer-provided care as the original sin of American health care. Employers choose different policies for employees than those employees would choose for themselves. The cost is concealed.
Wages are depressed without employees understanding why. The day when every employee in America gets his or her insurance through an exchange will be a good day for market economics. It's true that the exchanges are subsidized. So is employer-provided care, to the tune of almost $200 billion a year.
But Frum's reasonable, pragmatic recognition of how employer-based health insurance undermines individual health and wealth, the bottom lines of businesses and the nation's competitiveness then quickly turns to criticism of the bill by turning to the failed "free market" philosophy.
We should call for reducing regulation of the policies sold inside the health care exchanges. The Democrats' plans require every policy sold within the exchanges to meet certain strict conditions.
Imagine those darn Democrats wanting to regulate that insurance companies don't ripoff or under-insure their customers! And after the way the insurance companies have been so humane, responsible, customer friendly and cost effective in the past. Who wouldn't want to be sick and weak, trying to focus on regaining health, without the stress of worrying that they will be treated fairly by their insurer?
Which again, isn't to relegate everything Frum writes to the trash bin.
Conservatives have whipped themselves into spasms of outrage and despair that block all strategic thinking.
Or almost all. The vitriolic talking heads on conservative talk radio and shock TV have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination.
When Rush Limbaugh said that he wanted Obama to fail, he was intelligently explaining his own interests. What he omitted to say -- but what is equally true -- is that he also wants Republicans to fail.
After all, as Frum points out: "If Republicans succeed -- if they govern successfully in office and negotiate attractive compromises out of office -- Rush's listeners get less angry. And if they are less angry, they listen to the radio less and hear fewer ads for Sleep Number beds."
At least Frum nailed that, too.
Corporate Spending Didn't Prevail
Hi Joanaroo, The corporate health industries spent over a $1 million per day to lobby against the bill, so this is a huge and very costly defeat for them. And, although I personally agree with you that single-payer, Medicare for all is more moral, and could be more cost effective, this legislation does constrain the amount of money that insurers can spend on administrative costs to 15-20%, down from approximately 30%.
Although this bill is lengthy and complicated (and therefore, could have unanticipated results) it does offer some positives, like insurance applications not being rejected for "preexisting conditions." That's only one insurance company's list (Pacifica). Looking at the list, it seems apparent that many uninsured people would not qualify to buy health insurance from Pacifica without the bill's outlawing denying insurance because of preexisting conditions. And that's just one provision of the bill that provides benefits to all Americans, regardless of their political beliefs.
Once the President signs the bill on Tuesday, other changes that take effect immediately to benefit Americans include: insurers can't drop patients when they get sick, free preventative care, no caps on lifetime benefits (your treatment doesn't end regardless of cost), and young adults can be covered on their parents policy until age 26.
Time to support our Democratic leaders
Now that the Democrats, for the most part have stepped up to the plate and put their jobs on the line to provide Americans health care reform, it is a beginning. They will now need our support more than ever, until America realizes they have Americans best interest at heart. It is also important not to put too much blame on the few Democrats that did not vote yes. They need our support also for other bills down the road.
True most people are not satisfied with this bill and that is understandable but they needed to pass something, anything, to build on to improve our Country.
Anyone that wants to see this country improved will vote for the party that is not afraid to pass legislation, not the party of obstructionist.
This bill is a good start for good things to come. Yes We Can, And will.
Chip, Don't Get Me Wrong, But....
Hi Chip! I do agree that it's great something was passed to help the uninsured-something that we really needed. I would've preferred the Euro-Canadian type system, but this is a start. But now the brain dead like Tom Corbett, PA's Attorney General filed a lawsuit against the bill before Pres. Obama had a chance to stretch his bum after sitting and signing it. I heard his and the other poor states with these lawsuits will lose them. What's your take on this?
Supremacy Clause
Hi Joanaroo, In view of the Supremacy Clause, I think the states filing lawsuits to attempt to overturn the Patient Protection and Affordability Act are wasting their taxpayers' money. Sore losermen. I'm looking forward to them defending why they are opposed to the benefits of the health insurance bill, which is not to say that I don't think that single-payer, Medicare for All is a better solution.