By CARRIE BUDOFF BROWN & MEREDITH SHINER | 12/24/09 7:19 AM EST
Updated: 12/24/09 8:34 AM EST
After months of blown deadlines and political near-death experiences, a sweeping health care reform bill cleared the Senate Thursday on a party-line vote, putting President Barack Obama within reach of a domestic policy achievement that has eluded Democrats for decades.
With Vice President Joe Biden presiding over the session, Democrats gathered in the chamber before sunrise on the day before Christmas to cast a vote long in coming but in the end, hardly a surprise, a 60-39 tally that was the fourth time in as many days that Democrats proved they could muster the winning margin.
But this was the one that counted, the bookend to a House vote last month that puts Congress on record saying that Americans have the right to affordable health insurance, with plans that will cover 30 million Americans currently without it.
Senate Majority Leader Harry Reid (D-Nev.) said before the vote that Americans could wait no longer. “We certainly don’t have. . .the luxury of waiting. We may not completely cure this crisis today or tomorrow, but we must strive toward that progress.”
When Sen. Robert Byrd’s name was called, the ailing West Virginian said, “Mr. President, this is for my friend, Ted Kennedy – aye," a reference to the late Massachusetts senator who long fought for universal health care.
But Senate Republican leader Mitch McConnell (R-Ky.) vowed: “This fight isn’t over. My colleagues and I will work to stop this bill from becoming law. That’s the clear will of the American people — and we’re going to continue to fight on their behalf.”
The vote sets the stage for difficult House-Senate negotiations during which Democrats will be forced to settle differences that have lingered for months, and there is no guarantee a bill will pass in the end.
Sen. Joe Lieberman (I-Conn.), one of the last Democratic holdouts, once again made clear that his vote isn’t assured when the bill returns to the Senate. In the hallway outside the vote, he told his fellow moderate, Sen. Ben Nelson (D-Neb.), “Our work is not over.”
"Splitting the difference here could well break the 60 vote consensus," Lieberman said to reporters.
With momentum at their back, Democrats believe they can craft a compromise that, in broad strokes, would expand coverage through subsidies to help Americans buy insurance and allowing more people into the Medicaid program. The Senate plan includes a new national health insurance program overseen by the government but offered through private insurers.
It would prevent insurance companies from dropping patients who get sick and create a new legal requirement that all Americans must own health insurance – a provision already under growing attack from conservatives.
NOTE:
As always, the "devil will be in the details." It is difficult to conceive of how the House and Senate bills can be reconciled given that they are so different. Recall, the House bill contains a moderately aggressive "Public Option" while the Senate bill does not contain any Public Option at all.
Moreover the Senate bill has minimal provisions for cost containment. The most remarkable fact is that the Senate bill will force Americans to buy private health care coverage for the first time as a matter of law without providing any tough sanctions to prevent health insurance companies from excessively raising rates. After the Public Option was defeated in the Senate, health insurance company stocks soared in value indicating that the Senate bill is a financial bonanza for the private health insurance industry--a moral travesty that.
--Dr. J. P. Hubert
Showing posts with label Health Insurance Reform. Show all posts
Showing posts with label Health Insurance Reform. Show all posts
Thursday, December 24, 2009
Sunday, December 20, 2009
Deal on health bill is reached
By Shailagh Murray and Lori Montgomery
Washington Post
Sunday, December 20, 2009
Senate Democrats said Saturday that they had closed ranks in support of legislation to overhaul the nation's health-care system, ending months of internal division and clearing a path for quick Senate passage of President Obama's top domestic policy priority.
Majority Leader Harry M. Reid (D-Nev.) secured the pivotal 60th vote after acceding to the demands of Sen. Ben Nelson (D-Neb.) for tighter restrictions on insurance coverage for abortions, along with increased federal aid for his home state and breaks for favored health-care interests.
"Change is never easy, but change is what's necessary in America," Nelson said at a morning news conference, announcing his support as a snowstorm raged outside.
Speaking at the White House, Obama said it appears that a vote is certain on a bill that would provide coverage to more than 30 million uninsured Americans. "After a nearly century-long struggle, we are on the cusp of making health-care reform a reality," said Obama, who had dispatched senior administration officials to help lock down Nelson's support.
Republicans excoriated the bill as a threat to Medicare -- cuts to the program for the elderly would offset much of the cost -- and to the employer-based insurance system, which provides health coverage to most Americans.
"This bill is a monstrosity," said Minority Leader Mitch McConnell (R-Ky.). "This is not renaming the post office. Make no mistake -- this bill will reshape our nation and our lives."
GOP leaders, who have vowed to use every available tactic to keep the measure from advancing, invoked a rarely used Senate rule to require that the entire 383-page package of amendments introduced by Reid Saturday morning be read aloud on the floor, a process that consumed about seven hours.
But Republicans were running out of options in their quest to derail the overhaul. Securing Nelson's support allows Reid to maneuver the legislation through a complex parliamentary minefield without obstruction. A bloc of 60 votes is the exact number required to choke off the filibuster, the Senate minority's primary source of power, and the GOP's best hope of defeating the bill.
Unless the GOP yields and the vote comes sooner, the bill is expected to pass in a final Senate vote at 7 p.m. on Christmas Eve. Negotiations to merge the bill with the House version would begin early next month.
Many liberals, however, were bitterly disappointed with the bargains Reid struck to win support from moderates in his caucus, any member of which could demand alterations in exchange for his or her support.
Democratic leaders dropped a government insurance option and the idea of expanding Medicare to younger Americans. Reid also omitted language that would have eliminated the federal antitrust exemption for health insurers -- another nonstarter for Nelson
(Editor's emphasis).
Savings forecast
Congressional budget analysts reported Saturday that the revised package would not worsen the nation's fiscal situation, as GOP critics have warned. The analysts said the updated Senate bill would spend $871 billion over the next decade to extend coverage to the uninsured by dramatically expanding Medicaid and by offering federal subsidies to those who lack affordable coverage through employers.
Editor's NOTE:
As always, the "devil will be in the details." Without a public option or some other powerful incentive which forces the health insurance industry to stop excessive rate increases, there will be no way to control costs or to make certain that people will be able to afford the private coverage which is mandated. Moreover, the industry has four years in which to continue the despicable practice of refusing to cover adult patients with pre-existing medical conditions. Even in 2014 there is no guarantee that premiums for those with pre-existing conditions will be affordable. Worse yet, the purported increased medicaid coverage the bill envisions is the very worst of all reimbursement schemes available for medical providers. The fact that medicare reimbursements will be decreased rather than increased is also self-defeating as medicare reimbursements are already too low.
The current iteration of the Senate bill does nothing to eliminate the wasted dollars which the private insurance industry now spends on excessive corporate salaries/bonuses/benefits or the dollars which accrue to stockholders of publicly traded health insurance companies. Those proceeds should be payed to providers of actual health care.
It remains unclear how the Senate and House bills which differ so markedly can be reconciled in conference. It appears that the health insurance and pharmaceutical industries have managed through extensive lobbying efforts to secure their morally illicit monopolies.
--Dr. J. P. Hubert
Washington Post
Sunday, December 20, 2009
Senate Democrats said Saturday that they had closed ranks in support of legislation to overhaul the nation's health-care system, ending months of internal division and clearing a path for quick Senate passage of President Obama's top domestic policy priority.
Majority Leader Harry M. Reid (D-Nev.) secured the pivotal 60th vote after acceding to the demands of Sen. Ben Nelson (D-Neb.) for tighter restrictions on insurance coverage for abortions, along with increased federal aid for his home state and breaks for favored health-care interests.
"Change is never easy, but change is what's necessary in America," Nelson said at a morning news conference, announcing his support as a snowstorm raged outside.
Speaking at the White House, Obama said it appears that a vote is certain on a bill that would provide coverage to more than 30 million uninsured Americans. "After a nearly century-long struggle, we are on the cusp of making health-care reform a reality," said Obama, who had dispatched senior administration officials to help lock down Nelson's support.
Republicans excoriated the bill as a threat to Medicare -- cuts to the program for the elderly would offset much of the cost -- and to the employer-based insurance system, which provides health coverage to most Americans.
"This bill is a monstrosity," said Minority Leader Mitch McConnell (R-Ky.). "This is not renaming the post office. Make no mistake -- this bill will reshape our nation and our lives."
GOP leaders, who have vowed to use every available tactic to keep the measure from advancing, invoked a rarely used Senate rule to require that the entire 383-page package of amendments introduced by Reid Saturday morning be read aloud on the floor, a process that consumed about seven hours.
But Republicans were running out of options in their quest to derail the overhaul. Securing Nelson's support allows Reid to maneuver the legislation through a complex parliamentary minefield without obstruction. A bloc of 60 votes is the exact number required to choke off the filibuster, the Senate minority's primary source of power, and the GOP's best hope of defeating the bill.
Unless the GOP yields and the vote comes sooner, the bill is expected to pass in a final Senate vote at 7 p.m. on Christmas Eve. Negotiations to merge the bill with the House version would begin early next month.
Many liberals, however, were bitterly disappointed with the bargains Reid struck to win support from moderates in his caucus, any member of which could demand alterations in exchange for his or her support.
Democratic leaders dropped a government insurance option and the idea of expanding Medicare to younger Americans. Reid also omitted language that would have eliminated the federal antitrust exemption for health insurers -- another nonstarter for Nelson
(Editor's emphasis).
Savings forecast
Congressional budget analysts reported Saturday that the revised package would not worsen the nation's fiscal situation, as GOP critics have warned. The analysts said the updated Senate bill would spend $871 billion over the next decade to extend coverage to the uninsured by dramatically expanding Medicaid and by offering federal subsidies to those who lack affordable coverage through employers.
Editor's NOTE:
As always, the "devil will be in the details." Without a public option or some other powerful incentive which forces the health insurance industry to stop excessive rate increases, there will be no way to control costs or to make certain that people will be able to afford the private coverage which is mandated. Moreover, the industry has four years in which to continue the despicable practice of refusing to cover adult patients with pre-existing medical conditions. Even in 2014 there is no guarantee that premiums for those with pre-existing conditions will be affordable. Worse yet, the purported increased medicaid coverage the bill envisions is the very worst of all reimbursement schemes available for medical providers. The fact that medicare reimbursements will be decreased rather than increased is also self-defeating as medicare reimbursements are already too low.
The current iteration of the Senate bill does nothing to eliminate the wasted dollars which the private insurance industry now spends on excessive corporate salaries/bonuses/benefits or the dollars which accrue to stockholders of publicly traded health insurance companies. Those proceeds should be payed to providers of actual health care.
It remains unclear how the Senate and House bills which differ so markedly can be reconciled in conference. It appears that the health insurance and pharmaceutical industries have managed through extensive lobbying efforts to secure their morally illicit monopolies.
--Dr. J. P. Hubert
Saturday, December 19, 2009
White House as Helpless Victim on Healthcare
By Glenn Greenwald
December 16, 2009 "Salon" -- Of all the posts I wrote this year, the one that produced the most vociferious email backlash -- easily -- was this one from August, which examined substantial evidence showing that, contrary to Obama's occasional public statements in support of a public option, the White House clearly intended from the start that the final health care reform bill would contain no such provision and was actively and privately participating in efforts to shape a final bill without it. From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House -- hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama's campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN). Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn't pass it. The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party -- rather than the GOP -- will continue to be the prime recipient of industry largesse.
As was painfully predictable all along, the final bill will not have any form of public option, nor will it include the wildly popular expansion of Medicare coverage. Obama supporters are eager to depict the White House as nothing more than a helpless victim in all of this -- the President so deeply wanted a more progressive bill but was sadly thwarted in his noble efforts by those inhumane, corrupt Congressional "centrists." Right. The evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives. The administration is getting the bill which they, more or less, wanted from the start -- the one that is a huge boon to the health insurance and pharmaceutical industry. And kudos to Russ Feingold for saying so:
Sen. Russ Feingold (D-Wis.), among the most vocal supporters of the public option, said it would be unfair to blame Lieberman for its apparent demise. Feingold said that responsibility ultimately rests with President Barack Obama and he could have insisted on a higher standard for the legislation.
"This bill appears to be legislation that the president wanted in the first place, so I don't think focusing it on Lieberman really hits the truth," said Feingold. "I think they could have been higher. I certainly think a stronger bill would have been better in every respect."
Let's repeat that: "This bill appears to be legislation that the president wanted in the first place." Indeed it does. There are rational, practical reasons why that might be so. If you're interested in preserving and expanding political power, then, all other things being equal, it's better to have the pharmaceutical and health insurance industry on your side than opposed to you. Or perhaps they calculated from the start that this was the best bill they could get. The wisdom of that rationale can be debated, but depicting Obama as the impotent progressive victim here of recalcitrant, corrupt centrists is really too much to bear.
Yet numerous Obama defenders -- such as Matt Yglesias, Ezra Klein and Steve Benen -- have been insisting that there is just nothing the White House could have done and all of this shows that our political system is tragically "ungovernable." After all, Congress is a separate branch of government, Obama doesn't have a vote, and 60 votes are needed to do anything. How is it his fault if centrist Senators won't support what he wants to do? Apparently, this is the type of conversation we're to believe takes place in the Oval Office:
The President: I really want a public option and Medicare buy-in. What can we do to get it?
Rahm Emanuel: Unfortunately, nothing. We can just sit by and hope, but you're not in Congress any more and you don't have a vote. They're a separate branch of government and we have to respect that.
The President: So we have no role to play in what the Democratic Congress does?
Emanuel: No. Members of Congress make up their own minds and there's just nothing we can do to influence or pressure them.
The President: Gosh, that's too bad. Let's just keep our fingers crossed and see what happens then.
In an ideal world, Congress would be -- and should be -- an autonomous branch of government, exercising judgment independent of the White House's influence, but that's not the world we live in. Does anyone actually believe that Rahm Emanuel (who built his career on industry support for the Party and jamming "centrist" bills through Congress with the support of Blue Dogs) and Barack Obama (who attached himself to Joe Lieberman when arriving in the Senate, repeatedly proved himself receptive to "centrist" compromises, had a campaign funded by corporate interests, and is now the leader of a vast funding and political infrastructure) were the helpless victims of those same forces? Engineering these sorts of "centrist," industry-serving compromises has been the modus operandi of both Obama and, especially, Emanuel.
Indeed, we've seen before what the White House can do -- and does do -- when they actually care about pressuring members of Congress to support something they genuinely want passed. When FDL and other liberal blogs led an effort to defeat Obama's war funding bill back in June, the White House became desperate for votes, and here is what they apparently did (though they deny it):
The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won't get help with reelection and will be cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said Friday. "We're not going to help you. You'll never hear from us again," Woolsey said the White House is telling freshmen.
That's what the White House can do when they actually care about pressuring someone to vote the way they want. Why didn't they do any of that to the "centrists" who were supposedly obstructing what they wanted on health care? Why didn't they tell Blanche Lincoln -- in a desperate fight for her political life -- that she would "never hear from them again," and would lose DNC and other Democratic institutional support, if she filibustered the public option? Why haven't they threatened to remove Joe Lieberman's cherished Homeland Security Chairmanship if he's been sabotaging the President's agenda? Why hasn't the President been rhetorically pressuring Senators to support the public option and Medicare buy-in, or taking any of the other steps outlined here by Adam Green? There's no guarantee that it would have worked -- Obama is not omnipotent and he can't always control Congressional outcomes -- but the lack of any such efforts is extremely telling about what the White House really wanted here.
Independent of the reasonable debate over whether this bill is a marginal improvement over the status quo, there are truly horrible elements to it. Two of the most popular provisions (both of which, not coincidentally, were highly adverse to industry interests) -- the public option and Medicare expansion -- are stripped out (a new Washington Post/ABC poll out today shows that the public favors expansion of Medicare to age 55 by a 30-point margin). What remains is a politically distastrous and highly coercive "mandate" gift to the health insurance industry, described perfectly by Digby:
Obama can say that you're getting a lot, but also saying that it "covers everyone," as if there's a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don't get it from their employer. I guess you can call that progressive, but that doesn't make it so. In fact, mandating that all people pay money to a private interest isn't even conservative, free market or otherwise. It's some kind of weird corporatism that's very hard to square with the common good philosophy that Democrats supposedly espouse.
Nobody's "getting covered" here. After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won't make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn't or didn't want to write. Indeed, it actually looks like the worst caricature of liberals: taking people's money against their will, saying it's for their own good --- and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don't miss the money as much when they never see it.
In essence, this re-inforces all of the worst dynamics of Washington. The insurance industry gets the biggest bonanza imaginable in the form of tens of millions of coerced new customers without any competition or other price controls. Progressive opinion-makers, as always, signaled that they can and should be ignored (don't worry about us -- we're announcing in advance that we'll support whatever you feed us no matter how little it contains of what we want and will never exercise raw political power to get what we want; make sure those other people are happy but ignore us). Most of this was negotiated and effectuated in complete secrecy, in the sleazy sewers populated by lobbyists, industry insiders, and their wholly-owned pawns in the Congress. And highly unpopular, industry-serving legislation is passed off as "centrist," the noblest Beltway value.
Looked at from the narrow lens of health care policy, there is a reasonable debate to be had among reform advocates over whether this bill is a net benefit or a net harm. But the idea that the White House did what it could to ensure the inclusion of progressive provisions -- or that they were powerless to do anything about it -- is absurd on its face. Whatever else is true, the overwhelming evidence points to exactly what Sen. Feingold said yesterday: "This bill appears to be legislation that the president wanted in the first place." (editor's emphasis throughout)
December 16, 2009 "Salon" -- Of all the posts I wrote this year, the one that produced the most vociferious email backlash -- easily -- was this one from August, which examined substantial evidence showing that, contrary to Obama's occasional public statements in support of a public option, the White House clearly intended from the start that the final health care reform bill would contain no such provision and was actively and privately participating in efforts to shape a final bill without it. From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House -- hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama's campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN). Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn't pass it. The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party -- rather than the GOP -- will continue to be the prime recipient of industry largesse.
As was painfully predictable all along, the final bill will not have any form of public option, nor will it include the wildly popular expansion of Medicare coverage. Obama supporters are eager to depict the White House as nothing more than a helpless victim in all of this -- the President so deeply wanted a more progressive bill but was sadly thwarted in his noble efforts by those inhumane, corrupt Congressional "centrists." Right. The evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives. The administration is getting the bill which they, more or less, wanted from the start -- the one that is a huge boon to the health insurance and pharmaceutical industry. And kudos to Russ Feingold for saying so:
Sen. Russ Feingold (D-Wis.), among the most vocal supporters of the public option, said it would be unfair to blame Lieberman for its apparent demise. Feingold said that responsibility ultimately rests with President Barack Obama and he could have insisted on a higher standard for the legislation.
"This bill appears to be legislation that the president wanted in the first place, so I don't think focusing it on Lieberman really hits the truth," said Feingold. "I think they could have been higher. I certainly think a stronger bill would have been better in every respect."
Let's repeat that: "This bill appears to be legislation that the president wanted in the first place." Indeed it does. There are rational, practical reasons why that might be so. If you're interested in preserving and expanding political power, then, all other things being equal, it's better to have the pharmaceutical and health insurance industry on your side than opposed to you. Or perhaps they calculated from the start that this was the best bill they could get. The wisdom of that rationale can be debated, but depicting Obama as the impotent progressive victim here of recalcitrant, corrupt centrists is really too much to bear.
Yet numerous Obama defenders -- such as Matt Yglesias, Ezra Klein and Steve Benen -- have been insisting that there is just nothing the White House could have done and all of this shows that our political system is tragically "ungovernable." After all, Congress is a separate branch of government, Obama doesn't have a vote, and 60 votes are needed to do anything. How is it his fault if centrist Senators won't support what he wants to do? Apparently, this is the type of conversation we're to believe takes place in the Oval Office:
The President: I really want a public option and Medicare buy-in. What can we do to get it?
Rahm Emanuel: Unfortunately, nothing. We can just sit by and hope, but you're not in Congress any more and you don't have a vote. They're a separate branch of government and we have to respect that.
The President: So we have no role to play in what the Democratic Congress does?
Emanuel: No. Members of Congress make up their own minds and there's just nothing we can do to influence or pressure them.
The President: Gosh, that's too bad. Let's just keep our fingers crossed and see what happens then.
In an ideal world, Congress would be -- and should be -- an autonomous branch of government, exercising judgment independent of the White House's influence, but that's not the world we live in. Does anyone actually believe that Rahm Emanuel (who built his career on industry support for the Party and jamming "centrist" bills through Congress with the support of Blue Dogs) and Barack Obama (who attached himself to Joe Lieberman when arriving in the Senate, repeatedly proved himself receptive to "centrist" compromises, had a campaign funded by corporate interests, and is now the leader of a vast funding and political infrastructure) were the helpless victims of those same forces? Engineering these sorts of "centrist," industry-serving compromises has been the modus operandi of both Obama and, especially, Emanuel.
Indeed, we've seen before what the White House can do -- and does do -- when they actually care about pressuring members of Congress to support something they genuinely want passed. When FDL and other liberal blogs led an effort to defeat Obama's war funding bill back in June, the White House became desperate for votes, and here is what they apparently did (though they deny it):
The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won't get help with reelection and will be cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said Friday. "We're not going to help you. You'll never hear from us again," Woolsey said the White House is telling freshmen.
That's what the White House can do when they actually care about pressuring someone to vote the way they want. Why didn't they do any of that to the "centrists" who were supposedly obstructing what they wanted on health care? Why didn't they tell Blanche Lincoln -- in a desperate fight for her political life -- that she would "never hear from them again," and would lose DNC and other Democratic institutional support, if she filibustered the public option? Why haven't they threatened to remove Joe Lieberman's cherished Homeland Security Chairmanship if he's been sabotaging the President's agenda? Why hasn't the President been rhetorically pressuring Senators to support the public option and Medicare buy-in, or taking any of the other steps outlined here by Adam Green? There's no guarantee that it would have worked -- Obama is not omnipotent and he can't always control Congressional outcomes -- but the lack of any such efforts is extremely telling about what the White House really wanted here.
Independent of the reasonable debate over whether this bill is a marginal improvement over the status quo, there are truly horrible elements to it. Two of the most popular provisions (both of which, not coincidentally, were highly adverse to industry interests) -- the public option and Medicare expansion -- are stripped out (a new Washington Post/ABC poll out today shows that the public favors expansion of Medicare to age 55 by a 30-point margin). What remains is a politically distastrous and highly coercive "mandate" gift to the health insurance industry, described perfectly by Digby:
Obama can say that you're getting a lot, but also saying that it "covers everyone," as if there's a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don't get it from their employer. I guess you can call that progressive, but that doesn't make it so. In fact, mandating that all people pay money to a private interest isn't even conservative, free market or otherwise. It's some kind of weird corporatism that's very hard to square with the common good philosophy that Democrats supposedly espouse.
Nobody's "getting covered" here. After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won't make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn't or didn't want to write. Indeed, it actually looks like the worst caricature of liberals: taking people's money against their will, saying it's for their own good --- and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don't miss the money as much when they never see it.
In essence, this re-inforces all of the worst dynamics of Washington. The insurance industry gets the biggest bonanza imaginable in the form of tens of millions of coerced new customers without any competition or other price controls. Progressive opinion-makers, as always, signaled that they can and should be ignored (don't worry about us -- we're announcing in advance that we'll support whatever you feed us no matter how little it contains of what we want and will never exercise raw political power to get what we want; make sure those other people are happy but ignore us). Most of this was negotiated and effectuated in complete secrecy, in the sleazy sewers populated by lobbyists, industry insiders, and their wholly-owned pawns in the Congress. And highly unpopular, industry-serving legislation is passed off as "centrist," the noblest Beltway value.
Looked at from the narrow lens of health care policy, there is a reasonable debate to be had among reform advocates over whether this bill is a net benefit or a net harm. But the idea that the White House did what it could to ensure the inclusion of progressive provisions -- or that they were powerless to do anything about it -- is absurd on its face. Whatever else is true, the overwhelming evidence points to exactly what Sen. Feingold said yesterday: "This bill appears to be legislation that the president wanted in the first place." (editor's emphasis throughout)
Monday, November 30, 2009
Medicare in Crisis: The Devastating Impacts of a Corporate Health Care Bill
Editor's NOTE:
I share Mr. Cooke's concerns re: the competing Senate and House Health Care bills. Both appear more or less to be reform "in name only" which benefit health insurance companies at the expense of the Middle class and working poor. Medicaid rates of reimbursement are already unconscionably low and Medicare reimbursement rates have either been frozen or have failed to keep pace with inflation for over a decade.
As a retired physician and surgeon who has worked in the nightmare that is "for-profit" health care, I favor universal single payer coverage for all Americans. If health insurance companies were eliminated entirely, provider's could be paid reasonable rates of reimbursement for services including increases tied to the rate of inflation (for more see THIS...) Given the fact that Congress is currently "owned" by elite special interests, such an option appears extremely unlikely any time soon. While the current situation is deplorable, I fear the passage of a health insurance industry "reform" bill in the current climate--would be far worse.
--Dr. J. P. Hubert
By Shamus Cooke
Global Research,
November 27, 2009
Wading through the endless debate over health care has exhausted the patience of most Americans — the zigzags, obscure language, and long-winded discussion is inherently repulsive.
But now the dust is starting to settle, and the Congressional vision for health care in the U.S. is emerging. Instead of being “progressive,” it will amount to a massive, corporate-inspired attack on American workers, the elderly, and the poor.
After months of confusion and delay, Congress has shipwrecked the popular energy over health care onto the jagged rock of corporate interests. More spectacularly, health care “reform” is being used as an opportunity to greatly advance corporate influence over social spheres long-dedicated to the working-class — seemingly harmless provisions carry with them enormous implications.
These devils hide in the details of the competing health care bills in Congress; both contain debilitating right-wing policies hidden within a progressive shell. Obama is indeed acting as the agent of change, to the great benefit of the U.S. corporate elite.
And although the final bill has yet to be crafted, there exists general agreements as to what the end version will look like. Americans will be forced to buy shoddy corporate insurance with no limit to the cost, no guarantee of quality, with large premiums and other tricks to further gouge consumers. If a public option emerges in the final bill — by no means a guarantee — it will be shrunken enough to insure very few people (2 percent of the U.S. population).
But it gets worse. How this health care “reform” will be paid for has implications that dwarf the above atrocities.
For example, the Democrats were determined to pass a health care bill that “will not add one cent to the deficit.” And they have succeeded: the House and Senate health care bills both plan to reduce the deficit by over $100 billion. But a second-grader could do the math here: more service does not equal less cost — a truism that dominates the for-profit health care industry.
So how does the government plan to save billions of dollars as they “help” millions of people?
The two biggest cost saving schemes are the most damaging. The first is the enormous attack on Medicare. Since its inception, the corporate elite wanted this program struck down. Now they have their man for the job — a Republican could never get away with such obvious treachery.
The Congressional Budget Office estimates that the Senate version of health care would cut $404 billion from Medicare and Medicaid; the house version would cut $570 billion. The final cut could be much more. Obama made the ridiculous claim that only “wasteful” parts of Medicare would be cut. The truth is far different.
One way that both Congressional health care bills will gut Medicare is referred to as “forced productivity gains” — cost saving measures essentially; trimming the fat.
What are these savings? The most mentioned device — by politicians and media alike — is the reduction of “wasteful tests” and procedures that doctors routinely perform, an idea that the health care mega-corporations love. It will save them billions, while having catastrophic effects on the health care of millions of people.
For example, the recent announcement that women will now be persuaded to cut back on screenings for breast cancer and cervical cancer have caused an uproar nationwide: people are correctly making the connection behind Congress’ “forced productivity gains” and the new “recommendations” that will be used by insurance companies to justify cutting these services, both of which will boost profits. The general agreement behind rationing health care in this way will be an attack on not only Medicare, but serve as the backbone of any health care bill passed, negatively effecting everyone unable to afford luxury health care.
Another piece of Medicare that’s being trimmed is Medicare Advantage, a favorite program of the elderly because of its comprehensive services. Premiums for this program are already rising drastically in anticipation of the health care bill’s passage, considered by Congress to be “wasteful.” Without this program, Medicare will be greatly devalued and be more appropriately named: “band-aides for seniors.”
Finally, The Senate health care bill attacks Medicare by reducing payments to doctors by 25 percent. If doctors receive such a drastic reduction in pay, they will simply refuse to see Medicare or Medicaid patients; people will thus be insured only on paper. The newly insured Medicaid patients under any new congressional bill will be sorely disappointed.
Once Medicare is undermined in the above ways, the corporate sponsored right-wing will make a very convincing argument that “Medicare doesn’t work”, leading to future cuts that will further destroy the program.
The second hidden disaster in financing a congressional health care bill is the tax on so-called “gold-plated” or “Cadillac” health insurance policies that some employers offer their workers. This tax is supposedly meant to apply to the health care policies that “elite” employees receive.
And while there should exist no complaints about taxing corporations, the motives behind this particular tax are intentionally deceiving. As it turns out, many, if not most workers in unions will be included in this tax, which, under the Senate version, will include any plan worth more than $8,000 for individuals and $21,000 for families. Hardly elite, considering the still-soaring costs for health care.
If this provision were to pass — and it’s very popular in Congress — the immediate reaction would be very predictable: employers would immediately drop their health care plans, forcing workers into the now-forced purchasing of inadequate health care. This is why unions oppose such a plan. California Democrat Pete Stark agrees: “Employers and insurers will reduce their benefits to avoid paying the proposed tax.”
Workers fortunate to have union contracts will be heavily pressured to concede their plans, which in the past they’ve sacrificed wage-increases to keep. Ultimately, employers will have a new excuse not to provide health care to workers.
Obama again used his superb intelligence to totally obscure the issue in support of the tax:
“I do think that giving a disincentive to insurance companies to offer Cadillac plans that don’t make people healthier is part of the way that we’re going to bring down health care costs for everybody over the long term.” Translation: he supports taxing the health care of union workers.
Overall, a compromise bill between the Senate and House versions will create utter disaster for the working-class. It will not signal a progressive “step in the right direction,” as many liberals claim. At minimum, it will be a step backward, though more likely such a bill will be an enormous regression, to a time where health care was the exclusive privilege of the wealthy.
The right-wing attacks on “Obamacare” — along with the media’s lack of questioning — have shielded the Democrats from any serious debate about the above questions, including many other concerns unmentioned here.
The trash legislation that Congress is producing is the direct consequence of the Democratic Party being dominated by giant corporations — in this case the health care industry. The two-party system is the political system of the corporate elite, who switch party affiliations when they find it convenient; many of them throw equal money at both parties.
A crucial prop in this broken political system needs to be removed and organized under its own strength. If the unions took their support from the Democrats, organized their members and resources into a new political party, and aggressively pushed reforms that benefited the majority of working-class Americans, U.S. democracy would be tremendously strengthened. Medicare could not only be saved, but expanded to everyone from birth to death and be considered a fundamental human right.
I share Mr. Cooke's concerns re: the competing Senate and House Health Care bills. Both appear more or less to be reform "in name only" which benefit health insurance companies at the expense of the Middle class and working poor. Medicaid rates of reimbursement are already unconscionably low and Medicare reimbursement rates have either been frozen or have failed to keep pace with inflation for over a decade.
As a retired physician and surgeon who has worked in the nightmare that is "for-profit" health care, I favor universal single payer coverage for all Americans. If health insurance companies were eliminated entirely, provider's could be paid reasonable rates of reimbursement for services including increases tied to the rate of inflation (for more see THIS...) Given the fact that Congress is currently "owned" by elite special interests, such an option appears extremely unlikely any time soon. While the current situation is deplorable, I fear the passage of a health insurance industry "reform" bill in the current climate--would be far worse.
--Dr. J. P. Hubert
By Shamus Cooke
Global Research,
November 27, 2009
Wading through the endless debate over health care has exhausted the patience of most Americans — the zigzags, obscure language, and long-winded discussion is inherently repulsive.
But now the dust is starting to settle, and the Congressional vision for health care in the U.S. is emerging. Instead of being “progressive,” it will amount to a massive, corporate-inspired attack on American workers, the elderly, and the poor.
After months of confusion and delay, Congress has shipwrecked the popular energy over health care onto the jagged rock of corporate interests. More spectacularly, health care “reform” is being used as an opportunity to greatly advance corporate influence over social spheres long-dedicated to the working-class — seemingly harmless provisions carry with them enormous implications.
These devils hide in the details of the competing health care bills in Congress; both contain debilitating right-wing policies hidden within a progressive shell. Obama is indeed acting as the agent of change, to the great benefit of the U.S. corporate elite.
And although the final bill has yet to be crafted, there exists general agreements as to what the end version will look like. Americans will be forced to buy shoddy corporate insurance with no limit to the cost, no guarantee of quality, with large premiums and other tricks to further gouge consumers. If a public option emerges in the final bill — by no means a guarantee — it will be shrunken enough to insure very few people (2 percent of the U.S. population).
But it gets worse. How this health care “reform” will be paid for has implications that dwarf the above atrocities.
For example, the Democrats were determined to pass a health care bill that “will not add one cent to the deficit.” And they have succeeded: the House and Senate health care bills both plan to reduce the deficit by over $100 billion. But a second-grader could do the math here: more service does not equal less cost — a truism that dominates the for-profit health care industry.
So how does the government plan to save billions of dollars as they “help” millions of people?
The two biggest cost saving schemes are the most damaging. The first is the enormous attack on Medicare. Since its inception, the corporate elite wanted this program struck down. Now they have their man for the job — a Republican could never get away with such obvious treachery.
The Congressional Budget Office estimates that the Senate version of health care would cut $404 billion from Medicare and Medicaid; the house version would cut $570 billion. The final cut could be much more. Obama made the ridiculous claim that only “wasteful” parts of Medicare would be cut. The truth is far different.
One way that both Congressional health care bills will gut Medicare is referred to as “forced productivity gains” — cost saving measures essentially; trimming the fat.
What are these savings? The most mentioned device — by politicians and media alike — is the reduction of “wasteful tests” and procedures that doctors routinely perform, an idea that the health care mega-corporations love. It will save them billions, while having catastrophic effects on the health care of millions of people.
For example, the recent announcement that women will now be persuaded to cut back on screenings for breast cancer and cervical cancer have caused an uproar nationwide: people are correctly making the connection behind Congress’ “forced productivity gains” and the new “recommendations” that will be used by insurance companies to justify cutting these services, both of which will boost profits. The general agreement behind rationing health care in this way will be an attack on not only Medicare, but serve as the backbone of any health care bill passed, negatively effecting everyone unable to afford luxury health care.
Another piece of Medicare that’s being trimmed is Medicare Advantage, a favorite program of the elderly because of its comprehensive services. Premiums for this program are already rising drastically in anticipation of the health care bill’s passage, considered by Congress to be “wasteful.” Without this program, Medicare will be greatly devalued and be more appropriately named: “band-aides for seniors.”
Finally, The Senate health care bill attacks Medicare by reducing payments to doctors by 25 percent. If doctors receive such a drastic reduction in pay, they will simply refuse to see Medicare or Medicaid patients; people will thus be insured only on paper. The newly insured Medicaid patients under any new congressional bill will be sorely disappointed.
Once Medicare is undermined in the above ways, the corporate sponsored right-wing will make a very convincing argument that “Medicare doesn’t work”, leading to future cuts that will further destroy the program.
The second hidden disaster in financing a congressional health care bill is the tax on so-called “gold-plated” or “Cadillac” health insurance policies that some employers offer their workers. This tax is supposedly meant to apply to the health care policies that “elite” employees receive.
And while there should exist no complaints about taxing corporations, the motives behind this particular tax are intentionally deceiving. As it turns out, many, if not most workers in unions will be included in this tax, which, under the Senate version, will include any plan worth more than $8,000 for individuals and $21,000 for families. Hardly elite, considering the still-soaring costs for health care.
If this provision were to pass — and it’s very popular in Congress — the immediate reaction would be very predictable: employers would immediately drop their health care plans, forcing workers into the now-forced purchasing of inadequate health care. This is why unions oppose such a plan. California Democrat Pete Stark agrees: “Employers and insurers will reduce their benefits to avoid paying the proposed tax.”
Workers fortunate to have union contracts will be heavily pressured to concede their plans, which in the past they’ve sacrificed wage-increases to keep. Ultimately, employers will have a new excuse not to provide health care to workers.
Obama again used his superb intelligence to totally obscure the issue in support of the tax:
“I do think that giving a disincentive to insurance companies to offer Cadillac plans that don’t make people healthier is part of the way that we’re going to bring down health care costs for everybody over the long term.” Translation: he supports taxing the health care of union workers.
Overall, a compromise bill between the Senate and House versions will create utter disaster for the working-class. It will not signal a progressive “step in the right direction,” as many liberals claim. At minimum, it will be a step backward, though more likely such a bill will be an enormous regression, to a time where health care was the exclusive privilege of the wealthy.
The right-wing attacks on “Obamacare” — along with the media’s lack of questioning — have shielded the Democrats from any serious debate about the above questions, including many other concerns unmentioned here.
The trash legislation that Congress is producing is the direct consequence of the Democratic Party being dominated by giant corporations — in this case the health care industry. The two-party system is the political system of the corporate elite, who switch party affiliations when they find it convenient; many of them throw equal money at both parties.
A crucial prop in this broken political system needs to be removed and organized under its own strength. If the unions took their support from the Democrats, organized their members and resources into a new political party, and aggressively pushed reforms that benefited the majority of working-class Americans, U.S. democracy would be tremendously strengthened. Medicare could not only be saved, but expanded to everyone from birth to death and be considered a fundamental human right.
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