The Big Surprise in the House Bill
Published May 14, 2009 @ 09:26PM PT
The AP has scored quite the coup, releasing details on the health care bill that’s being worked on in the House. I’m really glad they did because it’s got quite a number of surprises! You’re not going to believe it, but… uh… well… hrm… well, you see… OK fine, there’s absolutely nothing surprising about the details that have leaked. Nada.
By the way, we can say “House bill” rather than “House bills” because the committee chairs with jurisdiction – Henry Waxman for Energy & Commerce, Charlie Rangel for Ways & Means, and George Miller for Education, Labor & Pensions – have already agreed to work on a unified bill, bypassing the normal process of having three separate bills that need to be reconciled. This streamlined process makes the pledge that those three, Speaker Pelosi, Majority Leader Hoyer, the President, and the Vice President made at the White House to have a bill on the floor of the House by July 31 not just possible but likely.
But it’s clear that expediency isn’t the only reason for the unified bill. There’s just not enough disagreement between where the House leaders wants to go and where the President wants to go to warrant a long, drawn-out process in the House. There’s also probably not much disagreement between the chairpersons themselves – Rep. Rangel is the only one in that group who has been a diehard single-payer supporter and professedly still is, but he had no problem endorsing Hillary Clinton’s health care plan a year and a half ago, despite it being virtually identical to what the AP says is currently being considered.
If you’ve been following health care at all, you can probably recite along with the AP’s findings:
- “allowing [those happy with their insurance] to keep their coverage"
- “an insurance purchasing pool called an ‘exchange’” for individuals and small businesses to buy into
- the government will be involved “setting insurance rules and providing financial help to low- and middle-income families” – up to 400% of the poverty line, according to the AP
- “employers, government and individuals share responsibility,” meaning mandates
- “stricter consumer protections” on insurance, meaning no pre-existing conditions, lifetime maximum benefit, stratified individual ratings, etc.
- “a government insurance program to compete with private companies. It would be financed by premium payments, not taxpayer dollars.”
Yeah, we’ve seen this movie, folks. This is what we’ve been talking about since the presidential primary season. There’s no news here. The only detail that’s not immediately familiar is the AP’s claim that only small business with 10 employees or fewer would be able to purchase coverage through the Exchange when it starts up, and other businesses will get that option eventually. Other than that tiny detail, I could have written this article without benefit of a leaked document. You probably could have, too.
So come to think of it, having watched Congress for years, the big surprise is that there is so little difference of opinion. The stars (pun intended) are aligned.
(Photo credit: White House.gov)
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Comments (28)
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Tim has been an online organizer and blogger on health care policy for the Obama for America campaign (during the primaries) and currently for the Committee of Interns and Residents/SEIU Healthcare, a labor union for intern and resident doctors. Views expressed here are Tim's, and don't represent the positions of CIR or SEIU.
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Tim, while I am glad to see the preservation of personal liberty, I am somewhat nervous that this is not universal enough. I am afraid there will be a stigma attached still to obtaining government financed health care. Even if people receive the health care They need, is there assurance here that They will not lose their home paying a massive hospital bill? Will there be enough of a customer base to support the government side? Will there be enough of a customer base to support the private side? Will there be an absolute guarantee that whichever option a person goes with, that They will receive the care They need without going belly up financially?
Posted by Charlie Reed on 05/15/2009 @ 04:35AM PT
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The AP does mention that the amount people would pay for medical care would be capped, as it is now for private insurance plans. I encourage you to click on the link and take a look at the story.
Posted by Timothy Foley on 05/15/2009 @ 05:27AM PT
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If the so called public option does not use tax dollars but charges the people wanting government health care this appears less desirable. I don't consider that a public option I want single payer where everyone pays taxes into one large pool of money. Then the government pays the doctors and hospitals.
Go here http://bit.ly/single_payer
Posted by Liberal Democratic Party Of The United States on 05/16/2009 @ 07:36PM PT
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How would this public health insurance program be funded by premium payments and not tax dollars if the government (i.e.,taxpayers) are subsidizing low and middle income families? And are those subsidies going to the public program or to the private for-profit health plans? And why go thru all these convolutions just to keep the for-profit plans in business when we would save so much money by changing to a single payer system?
Posted by Christine Adams on 05/15/2009 @ 05:18AM PT
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Suffice to say, we have the AP summarizing a document no one else has seen. I encourage you to click on the link and take a look at the story.
Posted by Timothy Foley on 05/15/2009 @ 05:28AM PT
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Everybody needs to watch Obama talking about health care, and forward this video far and wide. A travesty is being foisted upon the American people.
http://www.youtube.com/watch?v=dxEbA-cZfhk&feature=channel%20.
Posted by Carla Rautenberg on 05/15/2009 @ 06:16AM PT
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Carla, I agree! Isaw Obama on TV last night, saying that NO form of single payer would be in the plan. He'd been saying that, if you wanted to keep your insurance, you could, but if you wanted to join an expanded Medicare-type plan, you also could.
Now he says that would be TOO difficult. He's been giving in, on other issues (torture prosecutions, etc), presumably to prevent a very ugly fight on single-payer, so I've been giving him a 'Hail Mary', but this is unacceptable. What has he been saving all the political capital for, after all?
If they start w/a non'mandatory single-payer system (medicare) and, over time, people see it works, more & more citizens will join it, and, like Charlie Reed said, on here, about it putting insurance companies out of business, 'Tough, that's business'. Let them make money off something besides human misery. We have to get a single-payer option on there first, though.
Posted by Roger Choate on 05/15/2009 @ 02:54PM PT
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Yep. That's the same clip I saw last night. Obama says it'd be 'too hard' to do single-payer. 'Too hard'? Boo hoo! What does he think we elected him for? No one said it'd be easy.
Posted by Roger Choate on 05/15/2009 @ 03:44PM PT
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Tim, after reading the AP article I realize this is pretty much the Romney plan, with a few changes to allow dems to exclude Him from any credit. Same lack of liberty, Everyone is mandated to get coverage. Same choice of private or public coverage, kudos. To the insurers complaining it will drive Them out of business I say tough, that's business. I like the annual cap on expenses. That should save a families' finances. I like that the republicans are trying to preserve personal liberty, but frankly I doubt the democrats will show much bipartisanship. they don't need to.
Posted by Charlie Reed on 05/15/2009 @ 10:55AM PT
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I agree, Charlie, about the insurance companies. Let them make their money off something besides human misery.
Posted by Roger Choate on 05/15/2009 @ 02:58PM PT
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Everybody--Diane Rehm stated today in her weekly news roundup, that this Monday, May 18, she is going to devote an hour of her show to Single Payer!
Tell everyone you know to listen! The time has not yet been published on the web site, but my guess is it will be at 10:00 a.m. Eastern daylight. If not, then it would be at 11:00 a.m.
Listen and call in at 1-800-433-8850 or email the show at drshow@wamu.org. PASS THIS ON!
Last Monday, Diane's guest host Steve Roberts led a pathetic show on so-called health care reform.
She said today that she was "inundated" with calls and emails from Americans who are demanding that single payer be put on the table.
I was one of those people. This is the email I sent:
Dear Ms. Rehm,
Over the years, I have had great respect for your even-handed way of interacting with both your guests and your callers, even though your narrow choice of largely establishment "talking heads" has often disappointed.
Today, however, marked a new low for the Diane Rehm show. In the first hour of the show, purportedly covering "Health Care," your guest host, Steve Roberts, was not well briefed in the subject matter, and he allowed his guests to make many inaccurate and misleading statements.
Both Mr. Roberts and the guests toed the corporate party line, with the exception of a very brief telephone segment with Russell Mokhiber of Single Payer Action.
Please. This is a topic of the utmost importance to every American. We need you to do better. Much better. When the Senate Finance committee and the President take something off the table, that's exactly the time for the Diane Rehm show to put it ON the table, with a vengeance. Come on!
Sincerely,
Carla Rautenberg
A very disappointed listener in Cleveland, Ohio.
Posted by Carla Rautenberg on 05/15/2009 @ 04:16PM PT
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You mean keep the health care system that the insurance companies and the drug companies and the pharmacies apepar happy with.
Please sign this petition to pressure one of the biggest pharmacy chains to get us the single payer we want. Each person who signs this petition in effect votes for single payer health care.
Go here
http://bit.ly/single_payer
which will take you to the petition at change.org
In a country where companies control the process, make your complain with one of these companies by pressuring them for what we want.
Thank you.
Liberal Democrat.
Posted by Liberal Democratic Party Of The United States on 05/15/2009 @ 04:21PM PT
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A mandate to purchase health insurance is no surprise. Any reform that leaves a large segment of the population insured will fail. The costs of caring for the insured (however ineffectively) will be passed unto the insured and drive up rates.
Our current system of financing health care is dependant on employer based coverage. The threat of its collapse is the main driver of reform. Policy makers and legislators in Washington are claiming that the employer-sponsored segment of the private insurance market is working quite well for us and reform should include policies to expand this market - already subsidized through the tax system - with additional taxpayer subsidies required to pay for private plans, whether through tax credits or tax deductions.
In short, while Washington is bending over backwards to maintain its dysfunctional, fragmented, multi-payer, health care financing system in the name of choice, it is simultaneously dismantling any semblance of a "free market" to ensure a privileged position for private insurance companies who would prefer a captive market minus a public option. (Which is why they want the monopsony power of the public option watered down.)
Before we adopt reform based on the private insurance model, we should think about what that means. Amongst the great multitude of problems, we would be adopting a system that allows businessmen to intrude between the patient and the physician and take away with them whatever money they can. That doesn't seem wise when we could have our own public program that is designed to provide the best care for all of us with the resources that we have... Obama's public option is necessary to the viability of the impending watered-down reform.
Also, much has been made of preventative medicine. Nonetheless, even if people lose weight, lower their blood pressure, lower their cholesterol count, quit smoking, drinking etc., there is nothing to ensure the resulting savings won't be pocketed as profits by health insurace companies unless the companies are decoupled from their shareholders and Wall Street.
Posted by Martin Bring on 05/16/2009 @ 12:27PM PT
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Stupid spell check! I changed my uninsured to insured. Damn..
First paragraph should read:
A mandate to purchase health insurance is no surprise. Any reform that leaves a large segment of the population uninsured will fail. The costs of caring for the uninsured (however ineffectively) will be passed unto the insured and drive up rates.
Posted by Martin Bring on 05/16/2009 @ 12:35PM PT
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@Martin Bring... You say "Amongst the great multitude of problems, we would be adopting a system that allows businessmen to intrude between the patient and the physician and take away with them whatever money they can." Martin, that is exactly what we have now! All of us who have insurance are actually under-insured because the insurance can deny care at will. And they do!
You go on to say "That doesn't seem wise when we could have our own public program that is designed to provide the best care for all of us with the resources that we have..."
YES. That would be universal, single payer, cradle to grave, national health insurance. EINO (everybody in, nobody out.)
Forget Obama's "public option" nonsense. It will increase costs, and make an already outrageously fragmented system more so.
Only single payer will improve quality AND reduce costs. Conservatives never seem to complain about socialized highways, or socialized police departments. But they place social insurance in a whole difference category. And they're wrong to do so.
Listen to NPR's Diane Rehm show on Monday, May 18 to have a doctor explain it all to you.
Posted by Carla Rautenberg on 05/16/2009 @ 01:20PM PT
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I concur... I am a proponent of single payer.
Note, I say, "Obama's public option is necessary to the viability of the impending watered-down reform."
I will try and watch the Diane Rehm show on Monday. :)
I've arrived at a point in my advocacy for single payer to where I feel its merits are self-evident. Now I spend most my energies on critical analysis of Obama's public option and the Max Baucus' Circus.
Posted by Martin Bring on 05/16/2009 @ 02:44PM PT
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You are ignoring one very important fact. All people are endowed at birth with the right to choose. You have no right to force "everyone in"
Posted by Charlie Reed on 05/16/2009 @ 04:22PM PT
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No one was speaking of rights. Rather a proposition.
IF a large segment of the population is uninsured, THEN current attempts at health care reform will fail.
I have a right to choose so long as my choice does not negatively affect others.
If I drive a car, I am required by law to carry liability insurance.
At present, if I choose not to purchase health insurance and then need surgery I cannot afford, the costs are passed on to others. I am not helping to defer the social costs of health care. I am not assuming my share of liability for the costs incurred by others.
Posted by Martin Bring on 05/16/2009 @ 07:16PM PT
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a public option that is not funded by taxpayer dollars is NOT a public option. taxpayers who pay private insurers to administrate plans for federal employees while they themselves cannot afford insurance is taxation without representation. if obama thinks he will get away with this fraudulent action he is sorely mistaken.
the progressive support that helped usher him into the white house is slowly evaporating. the 47 million uninsured did not vote for obama because they thought he would give them an opportunity to buy health insurance at inflated prices.
charlie, even if you had the right to keep your present coverage, do you think obama's ideas on the public portion are good? would you be satisfied with that? don't you think a public option should be a real choice for people, a public choice, not a here's a bunch of private insurers you can pick through, and you're on your own paying for 'em? this public option is nothing more than a "stocked" pool for the insurance companies. if my public option has to be paid for with premiums only, then schumer's insurance should be too as well as all the other good folk who have coverage at the taxpayer's expense. this is a travesty.
Posted by Lauren Serven on 05/16/2009 @ 05:06PM PT
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i thought those of you disgusted with the travesty of this health care"debate" would find this of interest
http://www.blackagendareport.com/?q=content/obama’s-health-care-charade
Posted by Lauren Serven on 05/16/2009 @ 05:26PM PT
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There are too few doctors and medical facilities to take care of the health care needs of Americans. This pay to play mentality must end. Everyone should have affordable access to health care. And with employers completely dropping health insurance coverage for their workers, it is more important then ever that something be done.
Those earning minimum wage would not even take home enough money to pay for a good health insurance family plan.
There needs to be a balanced approach that preserves private health insurance while providing a safety net for those that do not or can't afford it. Either way, we are paying for this now.
Posted by Bill Woosley on 05/16/2009 @ 07:26PM PT
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All people have the right to have no insurance at all if They dare. This is not about saving money. I am willing to pay the taxes to help the less fortunate. There is a pretty good chance I will be among the publicly insured. That does not give Me the right to force others to give up their liberty.
Posted by Charlie Reed on 05/17/2009 @ 04:43AM PT
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Then there's the old saying:
If you haven't got your health, you haven't got anything.
I value my liberty as much as anyone. But it must be weighted against my personal and social responsiblilities. I would not think a single payer system of financing health care should infringe too much on my liberties as such a sytem would free me of the worry of becoming uninsured and reduce my costs as well. In short, like many other public goods, I think it would be a bargain.
Posted by Martin Bring on 05/17/2009 @ 07:49AM PT
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This is exactly what Ben Franklin was talking about when He spoke of the danger of giving up a bit of liberty for security, in this case financial security. This is only one example of the erosion of freedom in this country.
Posted by Charlie Reed on 05/18/2009 @ 04:03AM PT
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I believe that Ben Franklin was referring to things like the Patriot Act when he issued that dictum.
Here's another quote:
The Road to Serfdom
By Friedrich A. Hayek
Quote from the condensed version as it appeared in the April 1945 edition of Reader's Digest
There is no reason why, in a society which has reached the general level of wealth ours has, (the certainty of a given minimum of sustenance) should not be guaranteed to all without endangering general freedom; that is: some minimum of food, shelter and clothing, sufficient to preserve health. Nor is there any reason why the state should not help to organize a comprehensive system of social insurance in providing for those common hazards of life against which few can make adequate provision.
"The Road to Serfdom," the work of Nobel Laureate F. A. Hayek, has been one of the most influential books of the last century. It has been an inspiration to those who are opposed to socialism and who support free markets and libertarianism.
And yet, Hayek has no objection to people organizing, as a matter of expediency, comprehensive systems of social insurance that rely on state taxes for their support rather than markets. Think of Social Security, Medicare, Medicaid. (I would do away with the latter two and replace them with Single Payer)
Posted by Martin Bring on 05/18/2009 @ 12:04PM PT
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@Charlie Reed: you are perfectly free not to drive on any highways or city streets that We, the People financed together through our tax dollars. No one is forcing you to call our socialized Police or Fire Depts. for help. Our public libraries do not reach out and pull you in the door. And I'm sure once we have Medicare-for-All, no one will force you to go the doctor.
You can always try find another country that doesn't cover all of its citizens for medical care as a birthright--perhaps Rwanda or Saudi Arabia? I'm not sure. But good luck to you!
Posted by Carla Rautenberg on 05/18/2009 @ 04:39AM PT
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Carla, I understand that I will be free to go to a doctor or not. The questions are can I pick the the insurer? Can I pick the doctor? Can I pick the hospital? In all the cases You name above, I can choose. Also once again I must say, I have no problem helping pay for those less fortunate. I will very likely participate Myself. Liberty is a far more important issue though, and it must be protected fiercely from all attempts at dilution.
Posted by Charlie Reed on 05/18/2009 @ 06:33AM PT
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Carla, I also am not willing to accept forever the idea that people of other nations should not have access to decent health care. On a practical sense I know it is not yet feasible, but We need to extend this to all people, not just Americans.
Posted by Charlie Reed on 05/18/2009 @ 08:01AM PT
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