Reasons Not To Kill The Senate Bill
Reasons Not To Kill The Senate Bill
Over at Firedoglake, Jane Hamsher outlines 10 reasons to kill the Senate health care bill. The comprehensive list relies on the competent work of FDL’s team of health care bloggers and some of the critique is not without merit; other points are overstated. For instance, the claim that “many will be forced to buy poor-quality insurance they can’t afford to use,” is a bit baffling. The newly uninsured would have access to a minimum benefits package that is far more comprehensive than the available options in the individual market. Two-thirds of these “forced” Americans would pay less for more substantive coverage, not more. And the poorest Americans would have their out-of-pocket costs capped.
Hamsher claims that the bill “allows insurance companies to charge people who are older 300% more than others.” This is true, but it’s a massive improvement from the status quo, which allows insurers to charge older people as much a 11 times more for equivalent coverage. The 3:1 ratio may be excessive but it also recognizes that older people use more care than younger people and permits insurers to attract younger applicants with lower rates. Finally, the argument that “the cost of medical care will continue to rise,” also misses the point. National health expenditures will naturally increase, but under the Senate bill, they will raise at a slower rate.
On the whole, Hamsher is right to argue that the Senate bill is a deeply flawed piece of legislation which, as Paul Krugman observes, “we’ll spend years if not decades fixing it.” In fact, “with few exceptions, sweeping initiatives in the U.S. system start small, are often flawed, and then are expanded, sometimes improved, sometimes not.” Medicare began as smaller program that was expanded to cover “hospice benefits, mammograms and pap smears to detect cancer, and most recently, under the Republicans, prescription drugs.”
Fixing something that’s broken is better than not having anything to fix. Buying a fixer-up home is more appealing than remaining homeless for the next 10 to 20 years. In time, you’ll be able afford to change the tile in the bathroom or fix the leaky roof patch, but for the time being you’ll have a place to sleep, eat, and keep warm. A newer house would have caused less problems, but it — like the Senate health care bill — was simply out of reach.
The top 10 list isn’t reason to kill the bill, it’s reason to improve it in the years to come. After all, the choice isn’t between passing this bill or a better bill — it’s between passing this bill or nothing at all. Seen in this context, the Senate health care bill provides an adequate foundation for transforming the system in the years to come.
Here is a graphic representation of the choice lawmakers face:
34 Responses to “Reasons Not To Kill The Senate Bill”
Register
RSSLogin
Wonk Room Tweets
Topic Cloud
ArchivesBlog RollAbout Wonk RoomContact Us
Donate
missing from the analysis
Mandate:
with HCR
Number of uninsured people required to buy crappy insurance 100%
without HCR
Number of uninsured people required to buy crappy insurance 0%
At least this should be mentioned in the HCR debate.
December 21st, 2009 at 6:51 pm“For instance, the claim that “many will be forced to buy poor-quality insurance they can’t afford to use,” is a bit baffling. The newly uninsured would have access to a minimum benefits package that is far more comprehensive than the available options in the individual market”
It is in the article. Read better.
December 21st, 2009 at 7:09 pmEven if Jesus came down and sprinkled holy water on a copy of the healthcare bill, the Republicans will vote against it. The facts don’t matter to them. They are just one big freakshow. Everyone likes a freakshow until you get tired of it and move on down the road.
December 21st, 2009 at 7:59 pmAmerica with Single-Payer
Universal, Comprehensive Coverage
Only such coverage ensures access where
everyone is in and no one is out, avoids a two-class system, and minimizes expenses (administrative, negotiating drug prices, etc.)
No out-of-pocket payments
Co-payments and deductibles are barriers to access, administratively unwieldy, and unnecessary for cost containment
A single insurance plan in each region, administered by a public or quasi-public agency
Global operating budgets for hospitals, nursing homes, allowed group and staff model HMOs and other providers with separate allocation of capital funds
Free Choice of Providers
Patients should be free to seek care from any licensed health care provider, without financial incentives or penalties
Public Accountability, Not Corporate Dictates
December 21st, 2009 at 8:28 pmMarket mechanisms principally empower employers and insurance bureaucrats pursuing narrow financial interests
Ban on For-Profit Health Care Providers
Profit seeking inevitably distorts care and diverts resources from patients to investors
hey Wang,
WTF are you talking about? Did you know 100% of Canadians are required to pay taxes so that they can be enrolled in the health care system?
You want to fix the system so that the mandated insurance isn’t crappy? Give people a stake in the system. If it sucks but people have to buy it, then there will be pressure to change the law. But if everyone’s shut out, the system will never get fixed.
December 21st, 2009 at 8:41 pmJoe,
December 21st, 2009 at 9:01 pmStop trying to be reasonable, dammit! Folks like Richard don’t really care about anything but punishing the insurance companies, so they’re going to be against anything that isn’t single-payer, facts be damned.
I really like the graphic on this one.
December 21st, 2009 at 10:35 pmThis being the “Wonk Room” and all, shouldn’t it be explained where these numbers came from? Which version of the bill do these numbers reflect?
December 21st, 2009 at 10:54 pm@richar wang
Because we all know, that is much better to be completely without insurance, than to have some insurance. For some people, this insurance that they will get, can mean the difference between medical bankruptcy or not. Even with the “crappy” insurance.
December 22nd, 2009 at 2:24 amNo, it isn’t in the article. You try reading better.
December 22nd, 2009 at 2:47 amLOL please link to or cite the data for that graphic
December 22nd, 2009 at 6:28 amWhen you say that this bill is better than nothing, you are being insincere.
Those who oppose the bill do so because they know the Senate can get something much better through the reconciliation process. It’s not they they want nothing.
They want something better. This bill may be better than nothing, but it is just a band aid and will leave many people unable to afford insurance and with horrible plans, with enormous deductibles.
Yes, it’s better than nothing, but not nearly as good as it could be
December 22nd, 2009 at 9:11 amHenry
The public option can not be implemented with use of reconciliation, neither can a medicare buy-in. Don’t know if those are what you were referring to. Me=Single-payer.
December 22nd, 2009 at 10:36 amI see you’ve drank the koolaide.
December 22nd, 2009 at 10:39 amThanks for the information graphic — well done.
December 22nd, 2009 at 10:54 amAs painful as ‘no bill’ might be, maybe that’s what it would take to get people out into the streets. In a couple years health costs will be so high that there will be no choice but a public option for all.
December 22nd, 2009 at 11:28 amWhy DO republicans care so much about what they think a long haired liberal like Jesus would have thought?
December 22nd, 2009 at 11:42 amWhere are the columns for
1) Cash-strapped citizens fined for not being able to afford insurance.
2) Health insurers’ customer base increased due to gov’t mandate that citizens buy their product.
3) Pass-through gov’t subsidies designed to “assist” poor citizens that actually go directly to health insurers.
BTW, love the deficit reduction graphic–sure, I can reduce any deficit so long as I start taxing you five years before I give you any benefits.
December 22nd, 2009 at 1:28 pmSeems like NOT passing the gift to INSURANCE HEALTH REFORM bill is best. This insult to ‘trusting’, expectant Americans which got more insulting each end result every time Congress ‘fixed’ it. Consider the turmoil caused by not passing anything. Outrage would likely force Congress without too much delay to institute what most Americans surely want. EVERYBODY in without all the discrimination divisions. Too young, not old enough. Women special needs. The poor. Middle income. The rich. Forced insurance on most without it, mostly the young and healthy. Income too much, not enough. Employer insurance opposed to Government. Taxed ‘Cadillac’ policies. Small Business. Big Business. All resulting in PREMIUMS all over the place. Passing this current Health Reform bill likely would delay fixing it right. Human, if not Congress’ nature enters in. It’s done, so be it, move on. Until after this arduous battle for something at least blows over, when soon the deficiencies erupt forcing representatives of complaining discriminated divisions to again tackle reform. Bit by bit fixes you say will be ongoing in Congress? Starting at what bottom line? Single Payer? Public Option? Medicare starting at 55? Or where we are? INSURANCE INDUSTRY profits and premiums tinkered with.
December 22nd, 2009 at 1:49 pmThis chart is an ad, not an unbiased analysis.
Of course, they leave off the costs reductions a public option would have given, which were much more significant than the current plan. The costs of dropping the public option to buy Lieberman are far more than the benefits of passing the bill without it.
As for the “results”, the cost of insuring the uninsured comes directly from the Treasury to the tune of $1 trillion. The reduction in premium for those at 150% poverty level, shown here as $3000, comes straight from taxpayer provided subsidies to those who qualify. The result is still a monthly premium of $900, pretty steep for a family making less than $3k per month before taxes. The subsidy is absorbed by private insurance, another example of taxpayers feeding corporations.
The analysis also does not factor in the mandates driving up demand while supply is limited to the oligopoly insurance companies. Basic econ says that will drive premiums up, absorbing the subsidies and resulting in taxpayers paying more in taxes (more likely in public debt) and paying much higher premiums.
The end of pre-existing clauses is worthy but again will drive up premiums.
Without a public option, there is no downward pressure on premiums whereas this bill provides mandates, subsidies and ensures those with pre-existing conditions, all of which will drive insurers to raise premiums at a more dramatic rate than our current double-digit inflation.
Finally, pushing back doomsday for Medicare is great, but 9 years is hardly worth crowing about. Competing bills had pushed it back to 2054, practically an eternity in the world of politics.
December 22nd, 2009 at 2:31 pmWhat seems to be lacking here is an understanding that this is not a bill that can wait for years and years more of “improvement.” People are dying now because they have no insurance. Hard working people are losing their homes and going into bankruptcy to afford healthcare. We need a public option. Reducing the amount of the uninsured is meaningless if you are one of the 23 million people who will still have no insurance when this “reform” bill is passed. There is no rule that states “congress must approve a mediocre bill in order to work on improving it over many many years” Yes, that is the way it has been done in the past, usually based on special interests mattering more to congress than the people who voted for them. Just because this is the way it has been done in the past does not mean we should continue to allow our congress to practice this way when 23 million human lives are at stake.
December 22nd, 2009 at 4:41 pmI saw nothing in the healthcare bill allowing Medicare to negotiate prices for drugs for Medicare Part D. It should have scrapped the Republican Part D privatizing legislation and added drugs to regular Medicare with the price negotiation language.
December 22nd, 2009 at 4:48 pmSomeone please explain to me why no one will discuss Medicare for all citizens. It is the least expensive and most comprehensive method of true healthcare reform.
The current Senate bill is a travesty.
If “the best we can do” is the current Senate Health Care bill and the previous massive bailout of Wall Street, Senators should be removed and replaced by honorable and competent people like Senator Bernie Sanders.
You noticed that health insurance stocks went up with the passage of the Senate healthcare bill. Have you noticed the financial stocks rising in anticipation of the touted “reform of financial regulation?”
I have watched the Republicans dismantle every protection for average working people put in place from FDR on and hoped that a Democrat President, Senate, and House would reverse the trend. Instead they are obviously bought and paid for by the people FDR was proud to call his enemies.
We should have known since this President prefers to emulate Ronald Reagan rather than FDR and JFK.
For the perennially impoverished, even subsidized health care coverage will be trumped by costs of housing and food. For those with pre-existings, the promise of coverage is heartening.
December 22nd, 2009 at 7:22 pmAs for “better” coverage, this remains to be seen.
http://www.cspan.org/Watch/Media/2009/12/19/HP/A/27526/Sen+Bernie+Sanders+IVT+Press+Briefing.aspx
This is one the BEST reasons to support the bill….just don’t let Lieberman know that we like it…
14,000 total Community Health Clinics
December 22nd, 2009 at 7:27 pmExpand CHC capabilities to match VHA
45,000,000 people served
$$$$$ to attract 20,000 more primary care physicians
Drugs at VHA prices
Dental care
Patient billing scaled to income
Why is the Majority of People against the Senate Bill? When there was a mandate with Public Option the polls was about 60+ and -30+ then they removed the Public Option keep the Mandate and the polls reversed….Damm facts hurt. It’s about the Public Option stupid.
December 22nd, 2009 at 9:21 pmThe twisting of information in this is amusing, or would be, if the effects of such positive spin were not so tragic:
1/2) Many “uninsured” people will continue to *voluntarily* not buy in to the insurance business. Maybe they realize that insurance companies are there to make money (much like casinos); maybe they don’t want to support a system that causes health care costs to go up. Many families are stretched to the limit of their own budgets, regardless of whether health care costs them an extra $13k/yr or $10k/yr. It’s still too much, and for what net effect? The fact of the matter is that people have, since time immemorial, somehow managed to survive without regularly giving money to corporations just so that some day they might not have to pay *as much* for possible health problems.
3/4) Real “reform” would be simple legislation prohibiting companies from discriminating against people like this. You don’t need to bundle in a country-wide spending package (with what constitutional mandate, again?) to get this done.
5) The real reason I just had to write something in response to this post. In both cases, the deficit continues to rise. It’s not like subsidized health care is going to “save us so much money!”. There are two ways for the “deficit” to be reduced: more taxes of the citizens of this country and less federal spending. Given that there’s clearly more federal spending going on in this bill, that needs to be balanced by … more and more taxes. Oh well, maybe we’ll just take out some loans from the banks we just “bailed out”. Or make our kids pay for it.
6) Similar to 5: Medicare (yay! You see the government take that money out of your paycheck, too!) is still insolvent – we’re delaying the inevitable. There’s a Despair.com poster that says: “Contractors: If you can’t be part of the solution, there’s good money to be made in prolonging the problem.” Sticking our head in the sand isn’t going to help here. Another 9 years until the thing simply falls apart under it’s own incompetence and ill conception?
This is an extension of the welfare state; the entitlement state. Everyone pays for it.
I’ll leave you with a quote from Mussolini: “Fascism should more appropriately be called Corporatism because it is a merger of state and corporate power.”
December 23rd, 2009 at 8:26 am$13,100 now verses $10,133 subsidized.
December 23rd, 2009 at 11:57 amWhere does that subsidy come from and how much is it?
Wouldn’t it be nice if someone introduced a three page bill which extended Medicare to everybody? (Take a lesson from the enemy, Henry Paulson. Scare everybody and then introduce a three page bill.)
December 23rd, 2009 at 12:08 pmthenk you
December 23rd, 2009 at 12:20 pmThe main reasons to pass the bill:
1)It shows the public that the Democrats can actually, you know, govern with the majorities the voters gave them. The Republicans haven’t really done much of that since the 1980’s. Restore trust that positive things can be accomplished, even though this bill is probably about a 5 on a scale of a 1 to 10 of what it could’ve/should’ve been.
2) If this bill goes, down the Dems probably get slaughtered in 2010 and Obama faces a tougher 2 years trying to get anything substantive done….try getting 60 votes in the Senate to do anything when you only have 57 Senators. Then even if he wins reelection in 2012, this issue will not be revisited any time soon.
3)The Dems will own this issue in the coming years and it makes future improvements/reforms more likely if the public trusts that party to do the best they can, rather than just obstruct. The public never trusted Bush and the GOP to do the right thing on Social Security reform, because of the party’s track record on domestic public safety net issues. Just like they’d never trust the GOP on any kind of significant health care reform. Once again those who oppose reform are on the wrong side of history.
4) This “purity” test that the progressive blogosphere is putting the party through via the votes for the public option and medicare buy-in in this bill is not far from what the GOP base is doing with the Teabaggers. If you want to govern with huge majorities, you have to understand that a small but significant part of that majority is going to be out of step with the mainstream of the party on a few issues. Keep in mind if the Dems only had 59 Senators right now and not 60, this bill would be scary bad if it even got to the floor. Imagine Specter remained in the GOP. He’d have to vote against it because of the primary challenge. So that would leave them scrambling to win the votes of Snowe or Collins and still holding onto Lieberman and Nelson. It’d be a shell of what it is now. And my guess is the GOP would filibuster it.
There are some good reforms in there as pointed out above in this post. It’s a decent bill, not a great bill….certainly nowhere near a perfect bill. I see this as a first step. Frankly as long as the vast majority of people seem oblivious to the fact that their health insurance really costs $13K/year right now and not the $3K or so they are paying through their employer, many of these major reforms will be unpopular or at best people won’t care either way and will wonder about why all the time was spent on the issue. I guarantee you the minute people had to start paying $13K a year 90% of the country would favor a Single Payer system. That’s what is so laughable about the GOP’s arguments about keeping government out of health care. Government subsidies are a big part of it now. It props up the current employer-based health insurance model.
December 23rd, 2009 at 2:49 pmImproved title: “Reason to Kill the Senate Bill”…23 million remains uninsured with reform!
December 23rd, 2009 at 6:08 pmIf we’re all forced to buy health insurance, what will hold down premiums? I have health insurance but I like the having the freedom of not having health insurance if I so choose.
December 25th, 2009 at 1:29 pmTo #31
December 27th, 2009 at 12:43 pmNo they wont ! Everybody else that pays taxes will pay for them ! What good is it if the peoples vote (for or against)has no effect? Do we give up our privacy while under the “Government controled system” ? Hmmmm ? You guessed it LOL.
As if to say they don’t already! Bill of rights ? Constitution ? Our lives will be controled with Government control. To think Our “Insolvent government” can accually run something and make a profit should sign up on the “new plan” for reform of health care. Once evey 5 years have yer head checked! Do we need a new plan ? Yeppers! We do.
Someone said something about “CAPS” on costs.Wouldn’t that be a novel idea! If it’s so great why did the Dead (TED) Kennedy exclude the house & congress ( Politicians in general)? I made the wrong career choice !
Can anyone tell me where the governemnt got the money to “Bail out Wall St.”? What system got raped ? Why wasn’t there any “Conditions” on each Companies that got bailed out ? So much for the 8th Commandment, Thou “SHALL” not steal.
Where did the Trillions go ?
No need for transparentcy in government, it’s evident what’s goin’ on !
(mail will not be published) but (required)?????
To #32
Nobody’s forcing us into it , so far. If you know you dont like the taste of the **** sandwich, dont bite into it ! We all still have a choice .
December 27th, 2009 at 1:26 pmYou pay taxes , right ? Directly out of your paycheck,Right? In the conception of income taxes, “taxes” were totally voluntary, now it’s Mandatory. We don’t have a choice !
Government Control, Ain’t it a “B”.
Shut up and pay the taxes ! Watch our governemnt bungle it. What comes after trillions ? Ask your great great great great grandchildren !I think they’ll say something like , we’ll never get that one paid off anyway ! Why even think about it?
How about Term Limits for politicians ? Vote for NO incumbant! No more “lifers”/”Blood suckers” !