Health Care 12/16 – Are we done yet?

The soap opera of health care legislation continues, and I’m quite unhappy with the lack of progress.

Senate Democratic leaders abandoned the last vestige of a government health plan yesterday but pledged to move ahead on a sweeping health care overhaul, infuriating many liberals but pleasing President Obama, who said victory on his highest domestic priority was within sight.

Lawmakers, after getting another pep talk from Obama at the White House, said they would rather pass a weaker measure than go home empty-handed and miss a rare opportunity for a historic expansion of health care.

The bill would require that nearly all Americans buy health insurance and would provide government subsidies to those who can’t afford it on their own. The Senate is aiming to vote before Christmas, which would set up a round of conference meetings in January to forge a compromise bill with leaders in the House, which has already passed a measure.

The president, after meeting with Democratic senators, declared that America is on the “the precipice of an achievement that’s eluded Congresses and presidents for generations.’’

Senate leaders said they were giving up for now on the government-run insurance plan, the so-called public option, which many Democrats have sought as a means to pressure private health insurance companies into offering lower health care premiums. Several moderates had objected to the public option, including Senator Joseph Lieberman, a Connecticut independent who over the weekend also told Senate leaders he also opposed a Medicare buy-in for those 55 to 64, Democratic leaders’ last-ditch attempt to get something resembling the public plan.

Lieberman said he opposed the public option and the Medicare buy-in because he believes they could create a new burden for taxpayers. Without Lieberman’s support, the Democratic majority could not muster the 60 votes required to break a Republican filibuster.

“They’re not happy,’’ Senator Dick Durbin, Democrat of Illinois, said of liberals in the Senate Democratic caucus. “I’m not happy.’’ But, he said: “What remains is dramatic. We just don’t want to lose the opportunity, the once-in-a-lifetime opportunity.’’… [emphasis added]

Inserted from <Boston Globe>

Howard Dean appeared on Countdown to say that we should scrap the entire bill and start over, using reconciliation.

 

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Dean was incorrect, I think, about one point.  He said insurance companies would keep 27% of what they are paid.  If my understand is correct, the bill requires insurance companies to pay out 90% of their receipts in benefits.

Ron Wyden also appeared on Countdown to say that the best course is to pass this bill and improve it with future legislation.

 

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Ron appeared much more collected that he had the night before, having had time to think his position through.

I have no doubt that both Dean and Wyden were sincere.

Steny Hoyer thinks that the House will pass the Senate bill with few changes:

House Democrats can't always get what they want, Majority Leader Steny Hoyer told reporters today. But if they spin it right, he said, they just might find they got what they need.

Faced with a likely public option-free health care reform bill from the Senate, Hoyer said House Democrats will vote to move the reform process forward without government-run insurance included.

Much as his colleagues in the Senate Democratic leadership did last night, Hoyer said the political reality in the Senate means Democrats have to look past things like the public option to the "guts" of the bill itself.

"[Senate Majority Leader Harry] Reid does not have the votes for a public option, obviously," Hoyer said. "In a world of alternatives, you have to take what you can get."

Though they may have to sacrifice the public option in order to craft a reform package acceptable to the the fickle Senate Democratic coalition, Hoyer said House Democrats still reserve the right to tinker with the carefully-crafted Senate compromise, whatever it may be… [emphasis added]

Inserted from <TPM>

While I reserve the prerogative to change my mind after I know everything in the bill, I’m going to side with Wyden and Hoyer, with one reservation.  As angry as I feel over the LIEberman and a few DINOs have gutted the bill, what’s left is a foot in the door to real reform.  Reconciliation, started now, would take too long and last into campaign season, the worst time to pass major legislation.  This bill contains enough good things that I don’t want to give them up.  To come away empty handed would be the best possible gift we could give the GOP.  My reservation is that the mandate should be removed from the bill.  The rationale for the mandate was that it existed in a context to consumer choice.  With consumer choice removed, that rationale no longer exists.

On a positive note, The Senate will debate Bernie Sanders’ single-payer amendment today:

The Senate on Wednesday will debate for the first time in American history a proposal to create a single-payer, Medicare-for-all health care system.

"In my view, the single-payer approach is the only way we will ever have a cost-effective, comprehensive health care system in this country," said Sen. Bernie Sanders (I-Vt.), whose amendment will come before the Senate.

The Sanders Amendment would provide health care and dental coverage for every American, save money, and improve health care results.

"One of the reasons our current health care system is so expensive, so wasteful, so bureaucratic, so inefficient is that it is heavily dominated by private health insurance companies whose only goal in life is to make as much money as they can," Sanders said.

The 1,300 profit-making private insurance companies administer thousands of separate plans and waste about $400 billion a year on administrative costs, profiteering, high CEO compensation packages, and advertising. Health care providers spend another $210 billion on administrative costs, mostly to deal with insurance paperwork. 

As a result, the United States spends $7,129 per person on health care, almost double the amount spent by nearly any other industrialized country. Nevertheless, 46 million Americans lack health insurance, 100 million Americans cannot access dental care, and 60 million Americans do not have access to primary care.

Sanders acknowledged that his amendment would not pass. "As a result of the power of the insurance and pharmaceutical industries, this amendment will not pass or even get very many votes.  Nonetheless, given the view of millions of us that a single-payer approach is the only way this country will ever provide comprehensive, cost-effective health care to all its citizens, this is an important step forward… [emphasis added]

Inserted from <Common Dreams>

What makes this important is that the debate will help educate the public.  The strength of the arguments in favor compared to the weakness of the arguments against has never been exposed on the Senate floor.  In the end, whatever Congress passes this year, it is only a step toward the ultimate goal of universal, single-payer coverage for all.