Thursday, March 4, 2010

Now or never?

In a matter of weeks, we will know whether significant reform of the nation’s health-care system will pass in Congress. With their ability to stop filibusters in the Senate eliminated by the recent Massachusetts election, President Obama and the Democrats in Congress faced a decision: scrap everything they had done on health care over the past year, or use a filibuster-exempt process known as reconciliation. There really was no decision to be made. Reconciliation is the only option, because Republicans have never and will never negotiate in good faith on health care. If, at the beginning of the reform process, Obama had offered legislation that was an exact replica of what the GOP is now touting as its “plan,” the Republicans would have been unanimously against it, solely because it was proposed by Obama. They have no interest in real health-care reform, offering only piecemeal approaches that would likely do little to make health care significantly more affordable or cover very many of those currently without insurance. Nevertheless, Obama has offered to include several of the GOP proposals in the final health-care bill. Republicans, of course, are not satisfied. And, of course, their idea for how health-care reform should proceed is for Obama and the Democrats to totally kill every bit of what they've done to this point and start over, start over, start over, start over. Why did I just type "start over" four times. Because that's how the Republicans sound, like a broken record. Apparently, they received a script from GOP headquarters telling them that anytime they are asked a question about health-care reform, their reply must be, like a trained parrot, to squawk, “START OVER!" If the Democrats did agree to start anew, does anyone really believe that Republicans would engage in good-faith negotiations on health care? Of course not. They would do as little as possible, as slowly as possible, while filibustering each and every item that showed any sign that it might hurt the big insurance companies. And the Republicans still may get their wish. Democratic unity is a non-entity. There are a lot of Democrats in Congress who are clearly more interested in their re-election prospects than pondering whether the reform bill would be good for their constituents. There's no doubt that they are facing an angry electorate. It's not surprising, considering that the economy is still struggling to rebound, and that Republicans have spent the past year spreading misinformation and outright lies about the health-care measures, including false claims about abortion funding and the “death panels.” But at some point, people who claim to be leaders have to have the courage to cast unpopular votes, if they believe those votes are in the best interest of the people they represent. The key objections raised by opponents of real health-care reform are the cost of such an effort and the government involvement. Well, doing nothing clearly isn't working in terms of controlling costs, and if not the government, who is going to put a stop to the mess that exists today? I'm pretty sure that insurance companies and drug-makers aren't going to cut us all a break out of the goodness of their hearts.

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Blogger Ellipses said...

It would be great to see an exposition of terms and procedure in your paper on the procedural issues that are going to be acted out in the coming weeks...

For example, the bill itself won't be passed through reconciliation, as I understand it... the House will simply vote to pass the Senate's bill, but with the promise from the Senate to use reconciliation to add back House-favored points.

Reconciliation is used to reconcile policy with budgetary demands. Some argue that this is too narrow of an opening to do anything "big" like creating a public option... However, I'd like to see that tested, since a public option, and all of HCR, really, is predicated upon budgetary issues.

Also, in the coming weeks, I am sure you will be hearing a lot about "going nuclear" or "the nuclear option" in regard to reconciliation. This is simply inaccurate. The "nuclear option" was coined by Trent Lott in 2005 referring to the possibility of changing the senate filibuster rules. Reconciliation existed then as a budgetary tool (as it does now) and no Senate rules would need changed for a reconciliation bill to be passed congruent with the HCR bill. In short, the nuclear option was to blow up the senate rules, reconciliation IS in the senate rules.

March 4, 2010 at 12:58 PM  
Anonymous Anonymous said...

We get it Brant. Obama and Democrats = good.
Republicans = bad.
Now, about that Charlie Rangel thing.

March 4, 2010 at 3:34 PM  
Blogger Brant said...

I don't think all Republicans are bad, or Democrats good. In fact, I haven't been all that impressed with the Obama presidency thus far. And Charlie Rangel is a slimy politician. That's hardly news in D.C. But it has been duly reported in our paper.

March 4, 2010 at 4:01 PM  
Anonymous Anonymous said...

kinda unloaded the dump truck here with not much basis, huh? only with lots of accusations and assumptions do you reach any kind of conclusions. journalism, at its best NOT!

March 4, 2010 at 6:32 PM  
Anonymous x anonymous said...

I watched Bill Maher on Larry King the other night. His words have never rang more true.

If you think this bill doesn't line the pockets of the insurance compaines, big pharm, doctors and the Govt you are mistaken.

March 4, 2010 at 9:52 PM  
Blogger Brant said...

To the anonymous poster, let me clear something up. This blog is a different animal than what we put on the front page or a news page of the newspaper. It's not news, it's opinion, like what is found on the editorial page. I have my opinion, you have yours, and it's actually better if we don't agree. ;-)

March 5, 2010 at 6:37 AM  
Anonymous Anonymous said...

Brant, good for you on your response to the anonymous poster. The blog is your opinion and while I more often than not don't agree with you, that's what makes the world go 'round. And even though I seldom agree, your opinions always make me think - a compliment to the manner in which you present them.

March 5, 2010 at 9:22 AM  
Blogger Brant said...

I appreciate the kind words. With the blog, I really try to serve as a conversation starter, and it really is boring if we agree on everything, You're absolutely correct in the statement that differing opinions make things more interesting.

March 5, 2010 at 10:15 AM  
Anonymous Anonymous said...

Show of hands for benevolent dictatorship?

March 5, 2010 at 2:50 PM  
Anonymous x anonymous said...

you mean in favor of the one that we have had since 1913ish?

March 5, 2010 at 7:34 PM  
Blogger Dawn Keller said...

You might want to check out Paul Ryan, the ranking Republican member on the House Budget Committee. He's one of the few that have come up with a very detailed plan ... not just to deal with health care, but also Social Security, balancing the budget. Just by what you've blogged about in the past, I have a feeling you might like his ideas Brant.

March 8, 2010 at 9:59 AM  
Blogger MJ said...


From what I've heard about Ryan's plan, he intends to hand out vouchers to seniors so they can buy their own health insurance. That might stem the increase of government debt, but it also leaves seniors holding the bag as health care costs continue to rise.

March 8, 2010 at 11:38 AM  
Blogger Ellipses said...

Is this what we are talking about?

They aren't "bad" ideas... but there isn't much in the way of predictive data here. For example, "Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs."

That's fabulous and all... but a couple things jump out. One, how did he arrive at these particular dollar amounts? The per capita expenditures on health care in America in on the order of 7 grand per year... So, you'd be getting a tax credit to buy health insurance and it wouldn't really do a whole lot to offset that total cost to an individual or a family. Also, how many of the 30-45 million uninsured Americans actually have a tax bill due that is greater than or equal to the value of the tax credit? I mean, buy a house, donate some stuff to charity, have student loans, throw in a couple kids and viola! Your tax bill gets small really quick. Already, we have people moaning about "some people" who get a tax refund bigger than the amount of taxes they actually paid... Cutting individual taxes is not a bottomless source of revenue for solving problems...

He has other suggestions, too, that deserve attention... but no estimation of what the impact would be on prices, quality, or accessibility. On the other hand, we have a CBO estimate on the Senate Bill, the House Bill, and we have facts and figures out the wazoo from every other industrialized nation on earth that pays considerably less than us for equal or greater quality of care...

I'm not saying we should NOT do the things Ryan is suggesting... but I AM saying we shouldn't ONLY do those things. I doubt they'd have the impact that we need, now.

March 8, 2010 at 1:35 PM  
Anonymous Anonymous said...

No matter the idea, the very first step is to get everyone under coverage. Then you tweak as is necessary. Republicans talk about costs. What are the costs of 10s of millions of people who will lose their coverage in five or six years if we do nothing. This is not a perfect bill but it's better than waiting for a health care system to go through a financial melt down.

March 8, 2010 at 11:22 PM  
Blogger Greg said...

I took my 2 boys to the doctor for their annual check-ups. They needed shots for school, but otherwise healthy. When I went to check out, I was told my co-pay was $20 per child. My employer pays around $1500 a month for my health family's health care. That's $18,000 a year for myself, wife and 2 healthy boys.

Are you frigging kidding me....

The problem is the extraordinary costs related to health care industry.
Where is all the money going?

Why aren't there limits on attorney costs for health care and negligent law suits?

Why don't people eat right, to help prevent disease? We are supposed to eat 5 fresh fruit and vegetables a day.

Why does the medical profession frown upon taking vitamins?

Because the whole medical profession is one big, monstrous, money grubbing machine that preys upon life threatening diseases to fuel their thirst for more money. It’s a business, just like any other business, but the only difference is, human lives are on the line.

If the body is fed its daily nutritional needs, it will live a long happy life.

Our bodies are also armed with disease fighting properties that fight off attacks.

So the three answers are: individual awareness (including healthy consumption of the right foods and supplements), controlling extraordinary health expenditures (including senseless and endless testing), and controlling ridiculous (uncapped) legal litigation.

It’s like a pie in the sky with too many fingers in grandma’s hot apple pie.

March 9, 2010 at 9:50 AM  
Blogger Ellipses said...

Effects of Paul Ryan's tax plan:

March 10, 2010 at 3:00 PM  
Anonymous Anonymous said...

Greg, your comments about cost containment are on target. That is not the issue with the present discussion by the Democrats. Their focus is all about health insurance premiums. It says nothing about curbing health care costs. Perhaps that is left to Michelle Obama and her programs for obesity.

One other problem you don't address and that is the makeup of costs lost on Medicare patients. Since Medicare only covers about 80% of the cost of care, costs for other patients need to be artificially inflated to cover costs. We have heard recent rants about how insurance premiums are rising. If the insurance companies are being asked to cover costs that providers can't cover for Medicare patients, then it should be no mystery why premiums are higher.

Remember that profit margins of health insurance providers are #87 on the business sector list. Before ranting about the insurance companies, the first 86 (with higher profit margins) need to be taken down a notch first.

March 10, 2010 at 9:46 PM  
Blogger Ellipses said...

Tupperware has a profit margin of about 7.5%... nobody cares because nobody dies if they can't afford to fart-lock their casserole.

Here's a fabulous bit about insurance company profits that somewhat addresses the thing you mentioned... it's by some dude, I guess :-)

March 11, 2010 at 6:35 AM  
Anonymous Anonymous said...

Well, the good news of yesterday is that March 18 is no longer a deadline to take a vote. That means the Speaker is having a hard time rounding up the votes. If it can get further pushed back until the recess, and House members go home to take an earful, the chances of the present plans being implemented are getting very close to zero.

And, this is not to say "no" to reform, rather "no" to the massive government control under the present plans on the table. Reform does not mean government control. We need reform badly, not government control.

March 12, 2010 at 9:58 AM  
Blogger Brant said...

If you'd like to deal with reality, rather than right-wing hysteria, check this out:

March 12, 2010 at 10:33 AM  

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