The Indy Star (and lots of others) are reporting that the Senate has passed a health care bill. It still needs to be reconciled with the House bill. In all likelihood, the final product will look more like the Senate bill. The liberal Democrats and the Blue Dog Democrats are like a dysfunctional couple. The person who wants the relationship least has the most power. The Blue Dogs are the most satisfied with the status quo and, therefore, have enormous leverage. This is Joe Lieberman and Ben Nelson’s bill. The Republicans have chosen not to have a role in shaping the policy because they would rather have the health care bill as a campaign issue than help craft its contours. Any Senate Republicans who chose to break ranks would have a lot of power to demand changes of various kinds and would, at the same time, reduce the leverage of Lieberman and Nelson.
I’m torn. The status quo is broken. As a nation, we spend an average of $7,200 per person per year on health care compared to about $3,600 in countries with health care models that are “too expensive.” We spend 16% of our GDP compared to much less in other countries. Our pricing system is opaque. We will provide charity care when people show up at the emergency room with critical, expensive health problems; but there is no real process for treating people earlier in their illnesses when outcomes could be better and cost less. There is every incentive for someone facing a ruinous health care bill to try to cast blame on someone else and litigate in efforts to get their bill paid rather than lose their house or file bankruptcy.
On the other hand, the “fiscal conservatives” have seemingly opposed most of the measures that could be expected to contain costs. There is no public option to hold the profit-motive of insurers in check. There is no provision for the government to negotiate rates with pharmaceutical companies.
What I fear is a forced transfer of wealth from the public to insurers with no reduction in health care costs or improvement in treatment or outcomes, just another one of Taibbi’s great vampire squids wrapped around the face of humanity.
Still, I get the sense that the Senate bill is essentially as good as it’s going to get. It’s either that or the status quo. Which is preferable?
not only were republicans unwilling to help shape the final bill, they were determined to filibuster any bill. (they were even willing to filibuster funding for the troops in order to delay the health care bill.) this threat forced the democrats to appease the likes of lieberman and nelson to get them on-board. no filibuster threat == very different bill.
as it is, the bill has important reforms, like banning insurers from denying coverage based on pre-existing conditions. i’ll take that over the status quo.
Kind of hard to help shape anything in a meeting you can’t get in to.
I read the article on Yahoo about the Senate passage of the health care bill and setting aside the actual ins and outs of the bill, the thing that bothered me the most was the fact that some senators votes were essentially bought by giving them incentives for their state. I know this is a fairly common practice in politics, but come on. Let’s vote on the bill based on the conscience of what’s best for the American people and not just the people in one locality. This is, after all, a federal bill. Also the fact that the final vote being done on Christmas Eve when people have other things on their minds and most likely have the mentality of “Let’s just get this over with…” just goes to show how broken our political system is on all fronts and both sides of the political aisle.
I have to think there’s the potential to write a five page bill that would do something unarguably good for health care in this country – maybe not fix everything, but just do SOMETHING good.
Wouldn’t a series of such bills be better than a 2000+ page Frankenstein’s monster that no one has ever read?
I think this bill is awful. Health insurance stock shot up after details of this bill was released…that should give you a clue as to who and what really benefits from this. They still will be able to deny coverage in a sense; I do not see the ability to set price controls so they will essentially price people out of the market. It is going to put extreme economic strain on individuals who do have some health issues. A single payer system is needed to keep the health insurance prices in check or they need to have stricter regulation of the private health insurance industry like the Netherlands. Why is everyone concerned about protecting the health insurance industry; it is an industry based on benefiting from someones misfortune and it makes a lot of money.
Every single piece of social legislation passed began as a highly unsatisfactory series of compromises–go back and look at the first versions of Social Security and Medicare, for example. The initial passage of inadequate legislation nevertheless broke an ideological and political logjam, and enabled subsequent Congresses to amend/improve the measures. I’m not happy either–and I agree with the previous comment that our government is seriously broken–but I don’t think there is any doubt that this bill, however flawed, should pass.
The length of the bill doesn’t bother me. Reading isn’t that hard, and they’ve been working on this thing for months. And I’m guessing if any Republican Senator had said they were inclined to vote for cloture, their ticket would have been punched for any meeting they cared to attend. This also would have minimized the need for logrolling. Nobody is going to give a rat’s ass about reimbursing Nebraska’s Medicaid program if Ben Nelson’s vote isn’t necessary to override a Republican filibuster.
Doug –
The length of the bill doesn’t bother you?
Then, if “reading isn’t that hard”, I suggest that you hold off on expressing further opinions about the bill until you have the chance to read it in its entirety (and of course, consult all the cross references, and decode the language that can take up to a page to refer to a single state) and come to a profound understanding of its provisions and their likely impacts.
Of course, you’ll also need to read the result of the conference committee in the same way, and compare that to the original House and Senate bills.
I’m sure the process will allow plenty of time for that. After all, it “isn’t that hard”, and the process is so marked in its transparency and allowance for mature consideration.
It’s not my job. I didn’t campaign for that job. And I read plenty of legislation; far more, I’m willing to bet, than the hordes of people who piss and moan about our government on general principle.
The “it’s too long” argument is too simple. We could write a three page health care bill ala Paulson and the bailout, that wouldn’t make it any better. “Insure everyone, use agricultural subsidies to pay for it.” Simple.
When the founder of the Daily Kos and other top liberal bloggers think this bill is horrible and does not do what Obama campaigned on. Then this is an issue for the Democrats….These people helped the Democrats get elected and well basically got lied to.
This bill was shoved through and not a good bill at all and if you think different Doug…then you are not as smart as thought you were.
When a minority of 40 (to 45 counting the Blue Dogs) can hold the majority of (about 55 without Blue Dogs) 60 hostage for 3 months, that indicates the Senate’s filibuster system is overly collegial. Debate it for 3 or 4 weeks maximum, then vote for or against it, without resorting to political stalling tactics.
“Good” is a relative term. The relevant metrics are: 1) whether a better bill was possible to pass; and 2) whether this bill is better than the status quo.
“Possible” is also a relative term. In the given context, with DC controlled by statists and a minority party that is unable to enunciate market-based reform, then more statism is a likely conclusion.
It’s easy to make the case that a high degree of statism has led us into the status quo– and it takes a lot of faith and ignorance to believe that incrementally more statism is going to help, on net. The public seems to understand that better than the politicians; I guess we’ll see how it plays out in 2010 and 2012 (assuming they can resolve the Senate and House bills).
Given that I have no hope that any of these measures will improve things directly, the only hopes I have here are that:
1.) this makes thing obviously (vs. subtly) worse– so that those who want to foist this on us will pay a large political penalty; and
2.) the resulting increases in premiums will speed the move by consumers/insurers toward true/catastrophic health insurance– the real problem/solution in health care/insurance.
We have a government that works for the people for a change. They’re not statists. They’re doing what needs to be done. Simple as that.
A lot in our health care system needs to be fixed. Thus the length of the Senate bill. Big deal.
Premiums are increasing like crazy every year anyway, so there’s no sense being upset because you think premiums might increase.
I suggest we all hope that the bill will be improved upon in the coming weeks.
It’s time to open our hearts as well as our stinking wallets and do what’s right. And don’t start complaining about your taxes being too high, either. Unless your typing your messages on a library computer, my guess is that you’ve done pretty well for yourself over the last ten years.
Now, it’s time to help those who are suffering.
I know too many people who have no health insurance and for no other reason than that they have a pre-existing condition, or have lost their jobs.
It’s time to quit belly aching about taxes, length of the bill, statist governments, and on and on and get this thing fixed.
That’s the right thing to do.
Charlie sez: “We have a government that works for the people for a change.”
If by that you mean UAW members, SEIU members, and Federal employees you are correct. If you’re talking about the un-insured, this bill left about 19 million of them out, and of the ones it covers, they won’t be having their “life saved” (as leadership would have you believe) until 2014’ish. You don’t need a 2000 page crap sandwich bill to insure the “supposed” 30 million dying souls. With the stroke of a pen, they ALL could have been covered with Medicare, another grand socialist entitlement failure, but at least one that is already in place for God’s sake.
If you know people that are suffering, why haven’t you shared your wealth with them yet? Write them a check from YOUR checkbook, not mine.
This bill has nothing to do with “health care”. It’s about health insurance premiums and who is going to pay for them. Like any other commodity, insurance is something you buy. Much like Doug mentions above, reading legislation isn’t his job, and paying for my neighbors health insurance policy is not MY job.
You don’t have a right to health insurance or a right to healthcare. You have a right to freedom, at least you used to.
I would agree with Tim Zank that the bill passed is more about insurance than health care. But insurance is the main issue.. Insurance reform is a gigantic step.Health care is very good for those who have access through the front door. The bill that has just passed seems a far cry what the Democrats advertised, and I was initially very disappointed at what has been accomplished,but the emphasis will now be on what has been passed ,and how to improve it, rather than what shouldn’t be passed,and whether it’s ‘socialism’.
I ask questions better than I can answer them,but that’s how solutions get started. A question I would ask is : how much should a family of 4 be expected to pay for health care insurance? Insurance is the front door ticket into the system. The median salary is this country is still below $50,000 a year, so how much a month should a family of 4 be reasonably expected to pay,keeping in mind that half make below $50,000.
I would hope down-to-earth questions like these will result in more meaningful answers to what the next steps in legislation are. I would doubt we start over at this point ,and I have confidence that the Senate and House bills will be combined.It’s not even an issue exactly how that is done and what is compromised away. We go on from here.
Doug,
Inspired. Take away a type of corporate socialism and replace it with a type of human socialism. I love it. The net result would be no more socialism than we have today.
Not sure if this is fair or not,but according to the news I watched and listened to, the reason Republicans didn’t take part in the health care debate in a ‘constructive way’was that they wanted only to take out items that Democrats had included ,such as consumer and patient protections such as any kind of public option which would have set up government-private competition. They had little interest in adding anything( except maybe tort reform and tax cuts to certain ones). Tort reform( I use the term without really understanding it) may be be helpful but not as the first item of business,and as the only principle reform.But experts should respond to that ,and not politicians.
Im kind of a mind after this debate that ‘free market’ and people seeing themselves as ‘consumers’ or ‘patients’ is mutually exclusive.Free market as seen today needs to feed itself by its own rules and there cannot be any open negotiation or the free market risks being destroyed.Quite a beast we created,or let create itself.
Charlie, they’re statists by definition: they look to the State for a very wide variety of (supposed) solutions. I’m a free market guy– supported by a (very) limited but strong government. I come to that position through considerable study, on the basis of ethics and prudential considerations. Hopefully, we all come to our views on political economy and public policy through study and reflection– and hold them with appropriate humility. In any case, you and those in Congress should be proud of your views; just own them for what they are.
To echo a comment that followed: it might look more like “working for the people” if they didn’t bow to those in labor unions to protect their “fat-cat”, upper-middle class, fringe benefits. Favorable treatment for some, at the expense of many, can never effectively look like it’s for “the people”. I know unions are used to pursuing a selfish legislative agenda, but hopefully they don’t compound that unfortunate stance with blindness to what they’re accomplishing for (largely their) good and for (largely our) ill.
Premia will have a secular increase with the new regulations– and then resume their previous, govt-enhanced rate of increase. This makes things worse and pretends to make things better– both worth getting upset about.
How many pages is the senate bill in the Congressional Record?
Eric, you know not what you say:
“I know unions are used to pursuing a selfish legislative agenda, but hopefully they don’t compound that unfortunate stance with blindness to what they’re accomplishing for (largely their) good and for (largely our) ill.”
After the required reading assignment of the page below, I hope you are enjoying a nice long week end.
http://www.aflcio.org/joinaunion/union101.cfm
Here is a great example of modern day union activity from a couple days ago. Unions are so far astray from their originl intended purpose it is comical.
http://online.wsj.com/article/SB10001424052748703478704574612341241120838.html
I hope the damned thing gets passed. It won’t be an improvement over anything. Indeed, it appears to me merely more *crony capitalism*, which is ironic coming from Democrats.
I’m sick of the ‘free market’ and ‘capitalism’ (two things our health care system is not) taking the blame for all of the failings, without a whole lot of credit for what works. Very well. Make it 100% socialized, and get the pretense of capitalism out of the way. Let’s see how that works out, and we can get to the business of assigning blame more properly.
When the Republicans passed without any funding whatsoever, No Child Left Behind, that was the final melding of free market talk with unfunded socialism. No party can turn 180 degrees on a dime like the Republicans! Poor President Obama..the unfairness of it all! To paraphase Mike Kole above,lets try pure socialism for a chance so at least we know what it is, and it isnt.
( When I ride the 200 mph trains in France and eat my gourmet meal with absolute stablity,that frames my view of French socialism)
Charlie,
The website does a nice job in laying out the benefits of being in a (labor market) cartel. Not surprisingly, additional monopoly power is typically a good thing for suppliers (whether of product, services, or labor). And interest groups are fond of using the government to establish and extend that power. But the link says nothing about their legislative agenda…
Having a great week, thanks! You and yours as well, I hope…