At the end of last year I posted my thoughts on the Health Care Debate and in summary said that I supported the idea that something needed to be done and some of the specifics I was in support of. I also reminded all of us that just because two bills had been passed by the houses of Congress did not mean that a final bill was a certainty. Once two separate bills are passed, it usually goes to a conference committee made up of both members of the House and Senate where a final bill is negotiated and taken back to both bodies for a simple up or down vote.
Well the Democratic leadership in both houses have decided to forego this formality and instead what is referred to as legislative ping-pong. Essentially, both houses will continue to amend their bills until they are identical. This avoids the need for a conference as the identical bills can be sent to President Obama presumably for his signature. Normally, I would not have a problem with this approach, but the way the Democrats are actually conducting these negotiations is completely out of the public eye. The democratic leaders are going to the White House for sessions with the President’s key advisors in a manner that completely shuts off the discussion from public scrutiny. The only updates that the public gets are the reports of what comes out of the people involved in the negotiations. With this approach, I cannot support the President who had promised to make government more transparent. This essentially hides the legislative process from the public and I believe sets a bad precedent for the future. Republicans have tried to make some hay out of this, but obviously, this whole story is taking a back seat to the tragedy that occurred in Haiti this week.
That being said, as I write this, it appears a deal has been reached on one of the key roadblocks to the bill – funding mechanisms. Organized labor was supporting the House bill as it funded the program through increased taxes on the wealthy, where the Senate bill taxed high end health care plans, many times referred to as “Cadillac plans.” Today, organized labor apparently agreed to the excise tax on high end health care plans in exchange for the limits being raised.
What remains unclear is where the negotiations are on other key points of dispute such as the Stupak Amendment, which deals with whether tax dollars would go to fund abortions under the plan. Once again the Stupak Amendment which prohibits such spending is in the House bill while it is not in the Senate bill. I will continue to try and monitor these updates, but like I said, the way the negotiations are being conducted, it becomes difficult to get information.
As for the Republicans, they continue to sit back and unanimously oppose the bill. There have been attempts to get one of the Maine Senators to come aboard, but so far, they have refused. The Republicans seem content to allow this bill to pass so that they can run against it. However, I must ask, “If you truly care about the future of your country and a bill which you think is absolutely horrible is about to be passed, why are you going to let it pass for hopeful political gain?” That my friends is how a politician thinks. They have no concern for the future generation, only the future election. I believe the Republicans dropped the ball on this health care debate last summer. Republicans pride themselves in being devoted to the free market and allowing the market to fix problems. It is for that reason that they despise government involvement in business and economics even when the practices of the business are such that they take advantage of the average consumer.
Last summer, Senate Finance Chair Max Baucus (D-MT) proposed the idea of having health care reform be done by developing non-profit cooperatives which people could buy their insurance from. The idea was that the government would give an infusion of money to start the co-ops, but that they would then run themselves. The government might even provide stipends to low income people to pay the premiums or tax breaks to middle income people. However, the government itself would not be in the business of running any sort of health insurance plan. It would be the perfect way to inject some much needed competition into the health insurance industry and it would do it in a way that would force the for-profit companies to rethink the way they operate in only making decisions based on stock prices and bottom lines. When I heard the idea, I thought it was brilliant. It allowed the government to provide a sense of accountability in the industry without becoming directly involved while letting America’s free market approach ultimately fix some of the inequities.
So what happened? Eventually, Senate Majority Leader Harry Reid decided to take health care over for himself rather than have it go through the Finance Committee like it should. Probably because Senator Baucus is too moderate and liberals ridiculed the co-op idea as not going far enough and the plan was dropped. But for a month, it was a real possibility. Supposed Senate Republicans had recognized the long term value in such a plan and had decided to get behind it. Other moderate democrats like Ben Nelson & Evan Bayh certainly would have supported it as well. Once a few moderate democrats jumped on board it could have started a wave of support that could have really picked up steam and you would have had a truly bi-partisan effort in trying to reform health care. An opportunity missed on the Republican politicians. And why? Because they did not want to hand President Obama his prized piece of legislation on a silver platter because they know he would have benefited most
It was once said to me that “Politicians make decisions based on the next election while Statesmen make decisions based on the next generation.” As I watch the polls, this health care debate may be weighing in the Republicans favor politically for the mid-terms, but I can’t help but think, why are there so many politicians in the Republican party – the party I’ve called my home? Yet, right now, there seems to be statesmen in the Democratic party as they are voting on legislation that they believe will help the next generation even if it costs them this November. Even if you disagree with their politics, that is courage and conviction you have to admire, and for some (not all), it makes them a statesman in my book.
Showing posts with label Stupak Amendment. Show all posts
Showing posts with label Stupak Amendment. Show all posts
Thursday, January 14, 2010
Friday, December 25, 2009
The Health Care Debate – Perfect v. Good
Ever since the health care debate started this past summer, I have been trying to figure out how to express my thoughts on this controversial topic. Part of my hesitancy to post was due to my own uncertainty concerning the proposals and part was due to the fact that I was struggling on how to express my thoughts in a concise cohesive fashion. As I have researched it; listened to the talking heads; listened to the common man and even listened to health professionals, I have come to the conclusion that the topic is too confusing to even be summed up in one post, let alone in the 15 second sound bites that you hear on the evening news.
That made me think of something I heard recently from some of the democrats who were calling for compromise regarding the health care bill. They said that you can’t let the perfect be the enemy of the good. In other words, just because something is not perfect does not mean it shouldn’t be pursued. Rather if it is still good and better than the alternative of doing nothing, then indeed, it is worth pursuing even if it may not be the ideal. I am sort of viewing my post along those lines. This is not going to be a perfectly thought out position, nor is it going to be some treatise on the bill. Rather, here are some general thoughts about health care in general and how they relate to the proposed bills.
First of all, something needs to be done. Nothing makes me more frustrated in the health care debate than to hear conservatives say things such as “If it’s not broke, don’t fix it.” This insinuates that the current system works. For the average American who has a good health care plan through their employer, yes it does work and the people who make that comment are generally (if not always) in that category. Unfortunately, the number of people in that category continues to shrink.
As an attorney in practice for myself, I am thankful that my wife’s work provides coverage for us (at a cost), but frankly, there are many times my wife Jen and I look at each other and say to one another, “what are we paying this for?” Everything health related that we do use seems to either not be covered (like chiropractic care or medical massage both of which Jen requires for her bad shoulder) or if it is covered, they come with such large co-pays that we wonder if we would actually save money by not paying for the insurance and just paying the service as we need it. The only thing that prevents us from doing so is the chance at some major medical need arising where we would need the coverage. I hear other people saying similar things regarding coverage and co-pays. All this means to me that he current cost of health care has gotten too far out of control. Along those lines something clearly needs to be done.
Second, just because the Senate passed a bill on Christmas Eve does not mean that passage of the bill is a certainty. They are MANY differences between the House and Senate versions and for those of you who need some brushing up on your Government 101, the bill will now go into conference between the two chambers to try and hash out a deal. If a compromise is reached (and I emphasize IF), the bill then goes back to both chambers for a simple up or down vote. No more amendments are allowed once it comes out of conference.
You will now be hearing a lot in the news about the conference that will be meeting between the House and Senate to try and work out the differences. For instance, one of the major hurdles is abortion and the so-called Stupak amendment. Congressman Stupak (D-MI) offered an amendment to the House version of the bill that would prohibit federal dollars from being spent to cover abortions. The amendment passed in the House and therefore was added to the bill. It was largely believed that many moderate house democrats, like Congressman Stupak, were unwilling to vote for the bill as a whole if the amendment was not added. A similar amendment was introduced in the Senate by Senator Ben Nelson (D-NE) but it was never added and therefore is not part of the Senate bill.
Another major difference between the bills is the existence of a public option. The House bill provides for a government insurance option that people would be able to purchase based on income level. At certain income levels, it would become an entitlement. The Senate bill does not provide for such an option. Instead it mandates everyone carry insurance and provides some tax credits and some public funding to make it affordable for people to buy policies from private insurers. Whether the conference can come to some resolution on these and many other differences will decide the ultimate fate of the health care bill.
Thirdly, like I said above something needs to be done and I think that the bills that have been proposed are a step in the right direction. First of all, both bills require insurance companies to accept applicants with pre-existing conditions and not disqualify them from coverage. Additionally, they require coverage for certain preventative screenings which will actually cut long term health care costs if problems are detected earlier. These are things that have been sorely needed for some time now.
Along these lines, I hope that it will make health insurance companies think more about their customers than their shareholders as has been the case in the last several decades. Another line that conservatives spout that makes me cringe is when they decry “government run health care” as meaning the decision about someone’s health will not be made by the patient and the doctor but by some government bureaucrat. The problem with this argument is that it assumes the current system allows for medical decisions to be made by the doctor and patient when in fact it is made by some insurance company bureaucrat. So what’s really the difference? At least the government bureaucrat won’t be answering to next quarter’s profit and loss statement and what that will do to stock prices.
So those are some of my thoughts for now. I’ll try and be better about posting as the bills go through conference. As for my next post, since I still consider myself a Republican, I’ll post where I think they went wrong in the long term on this health care debate – so keep checking in.
That made me think of something I heard recently from some of the democrats who were calling for compromise regarding the health care bill. They said that you can’t let the perfect be the enemy of the good. In other words, just because something is not perfect does not mean it shouldn’t be pursued. Rather if it is still good and better than the alternative of doing nothing, then indeed, it is worth pursuing even if it may not be the ideal. I am sort of viewing my post along those lines. This is not going to be a perfectly thought out position, nor is it going to be some treatise on the bill. Rather, here are some general thoughts about health care in general and how they relate to the proposed bills.
First of all, something needs to be done. Nothing makes me more frustrated in the health care debate than to hear conservatives say things such as “If it’s not broke, don’t fix it.” This insinuates that the current system works. For the average American who has a good health care plan through their employer, yes it does work and the people who make that comment are generally (if not always) in that category. Unfortunately, the number of people in that category continues to shrink.
As an attorney in practice for myself, I am thankful that my wife’s work provides coverage for us (at a cost), but frankly, there are many times my wife Jen and I look at each other and say to one another, “what are we paying this for?” Everything health related that we do use seems to either not be covered (like chiropractic care or medical massage both of which Jen requires for her bad shoulder) or if it is covered, they come with such large co-pays that we wonder if we would actually save money by not paying for the insurance and just paying the service as we need it. The only thing that prevents us from doing so is the chance at some major medical need arising where we would need the coverage. I hear other people saying similar things regarding coverage and co-pays. All this means to me that he current cost of health care has gotten too far out of control. Along those lines something clearly needs to be done.
Second, just because the Senate passed a bill on Christmas Eve does not mean that passage of the bill is a certainty. They are MANY differences between the House and Senate versions and for those of you who need some brushing up on your Government 101, the bill will now go into conference between the two chambers to try and hash out a deal. If a compromise is reached (and I emphasize IF), the bill then goes back to both chambers for a simple up or down vote. No more amendments are allowed once it comes out of conference.
You will now be hearing a lot in the news about the conference that will be meeting between the House and Senate to try and work out the differences. For instance, one of the major hurdles is abortion and the so-called Stupak amendment. Congressman Stupak (D-MI) offered an amendment to the House version of the bill that would prohibit federal dollars from being spent to cover abortions. The amendment passed in the House and therefore was added to the bill. It was largely believed that many moderate house democrats, like Congressman Stupak, were unwilling to vote for the bill as a whole if the amendment was not added. A similar amendment was introduced in the Senate by Senator Ben Nelson (D-NE) but it was never added and therefore is not part of the Senate bill.
Another major difference between the bills is the existence of a public option. The House bill provides for a government insurance option that people would be able to purchase based on income level. At certain income levels, it would become an entitlement. The Senate bill does not provide for such an option. Instead it mandates everyone carry insurance and provides some tax credits and some public funding to make it affordable for people to buy policies from private insurers. Whether the conference can come to some resolution on these and many other differences will decide the ultimate fate of the health care bill.
Thirdly, like I said above something needs to be done and I think that the bills that have been proposed are a step in the right direction. First of all, both bills require insurance companies to accept applicants with pre-existing conditions and not disqualify them from coverage. Additionally, they require coverage for certain preventative screenings which will actually cut long term health care costs if problems are detected earlier. These are things that have been sorely needed for some time now.
Along these lines, I hope that it will make health insurance companies think more about their customers than their shareholders as has been the case in the last several decades. Another line that conservatives spout that makes me cringe is when they decry “government run health care” as meaning the decision about someone’s health will not be made by the patient and the doctor but by some government bureaucrat. The problem with this argument is that it assumes the current system allows for medical decisions to be made by the doctor and patient when in fact it is made by some insurance company bureaucrat. So what’s really the difference? At least the government bureaucrat won’t be answering to next quarter’s profit and loss statement and what that will do to stock prices.
So those are some of my thoughts for now. I’ll try and be better about posting as the bills go through conference. As for my next post, since I still consider myself a Republican, I’ll post where I think they went wrong in the long term on this health care debate – so keep checking in.
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