Health Care Reform - almost a done deal? DONE

[Ivan Seeking]

It appears that the House will vote on Sunday; I think on the Reconciliation Act of 2010.
http://www.rules.house.gov/bills_details.aspx?NewsID=4606

Then it goes back to the Senate. However, as I understand this, the President can sign the bill passed by the House making it law until the Senate votes on the changes.

I still haven't figured out the ins and outs of the Deem and Pass [known dysphemistically as Demon Pass] maneuver, but it seems the Dems have a path to get this done.

 

[calculusrocks]

The Slaughter option (deem and pass) means that they pass a rule instead of a vote based on Yeas or Nays. It changes the rules of the house so that the House acts as though the bill passed with a vote of Yeas or Nays. This will undoubtedly draw a constitutional challenge if tried.

If they had the votes, they would have done an up/down vote by now.

ADD: http://en.wikipedia.org/wiki/Self-executing_rule

 

[calculusrocks]

Reconciliation is only for budget bills.

http://en.wikipedia.org/wiki/Reconciliation_(United_States_Congress)

That will draw a Constitutional challenge as well, because its a health coverage bill.

 

[Ivan Seeking]

Apparently this provides cover for Dems up for election who would not normally support the bill for fear of voter backlash.

As I understand it, aspects of the bill not relating to budget issues were deleted.

 

[calculusrocks]

That is the theory, that it'll provide cover for the Democrats. Barack Obama has said that this is not the case and that the American people will judge the Slaughter solution as a vote for or against health care in a recent http://video.foxnews.com/v/4113350/fox-news-exclusive-president-obama/?loomia_ow=t0:s0:a16:g2:r5:c0.037577:b31982604:z6".

 

[calculusrocks]

Apparently this provides cover for Dems up for election who would not normally support the bill for fear of voter backlash.

As I understand it, aspects of the bill not relating to budget issues were deleted.

Well, the democrat argument is that health coverage will save money on the budget, so it is a budget item. I see it as a rationalization in order to gain power over the insurance industry, which is about 1/6 of the total economy. I'll qualify that as an educated opinion.

 

[Ivan Seeking]

Imo, what is important is that this passes. Let the chips fall where they may. Most people actually support a good part of what's in the bill but they just don't know it. The Dems are betting that once people understand what was passed, more than not, the rest will be forgotten.

We have to do something about the cost and state of health care. If we don't do this now, no one will touch it again for a very long time. There is no more time to wait. Things can always be amended later.

Don't let the perfect be the enemy of the good.

 

[Ivan Seeking]

As far as legal challenges, I'll leave that up to the lawyers. The Republicans have used this technique 70% of the times it was used.

 

[turbo]

Don't let the perfect be the enemy of the good.

The GOP is pulling out all the stops to kill this bill. Pass it now, with all of its warts, and fix it incrementally. The CBO has already said that the bill will reduce the deficit over time and add 32 million uninsured people to our health-care system.

 

[calculusrocks]

As you know, I'm on the other side of this issue. I profoundly believe in property rights, and this bill will be the first time in history where the government is allowed to force citizens to buy a product. That is flatly unconstitutional, and I see much of the problems in America as direct results of our progressive deviation of small constitutional government. There are a lot of ways to reform health care without giving up our individual liberties.

 

[calculusrocks]

The GOP is pulling out all the stops to kill this bill. Pass it now, with all of its warts, and fix it incrementally. The CBO has already said that the bill will reduce the deficit over time and add 32 million uninsured people to our health-care system.

The current CBO estimate is preliminary. The CBO scored it without seeing the bill yet. It's a little odd/troubling to me that the CBO comes out with the estimate on a bill that isn't even written yet.

http://www.humanevents.com/article.php?id=36091

 

[turbo]

As you know, I'm on the other side of this issue. I profoundly believe in property rights, and this bill will be the first time in history where the government is allowed to force citizens to buy a product. That is flatly unconstitutional, and I see much of the problems in America as direct results of our progressive deviation of small constitutional government. There are a lot of ways to reform health care without giving up our individual liberties.

You want poor people to keep their individual "liberty" to have no access to preventative care, and rely on ER visits for emergent care when it is (often) too late to hope for positive outcomes, that drive up costs for all of us? Why?

 

[Ivan Seeking]

The current CBO estimate is preliminary. The CBO scored it without seeing the bill yet. It's a little odd/troubling to me that the CBO comes out with the estimate on a bill that isn't even written yet.

http://www.humanevents.com/article.php?id=36091

Bull
http://www.cbo.gov/

Uh, your link is dated March 1st.

 

[calculusrocks]

“Although CBO completed a preliminary review of legislative language prior to its release, the agency has not thoroughly examined the reconciliation proposal to verify its consistency with the previous draft. This estimate is therefore preliminary, pending a review of the language of the reconciliation proposal, as well as further review and refinement of the budgetary projections.” (CBO Director Doug Elmendorf, Letter To Rep. Nancy Pelosi, 3/18/10, P.1)

The letter is from the CBO to the Speaker of the House. You be the judge.

 

[calculusrocks]

The reconciliation hasn't happened yet, so it can't be officially scored. Thus its preliminary.

 

[calculusrocks]

Oh wait, it's been updated. They do have an official score today.

UPDATE (12:30 EDT): The Congressional Budget Office has released the official score. You can read that here.

They did not before. It's an article that's been kept up to date.

 

[MotoH]

Do Illegals get health care benefits also?

Can you just walk into a hospital now and say "treat me?" Or do we get a card?

 

[BoomBoom]

... this bill will be the first time in history where the government is allowed to force citizens to buy a product.

My state government requires I purchase auto insurance...so maybe not the 1st time.

Besides, was it not the republicans that originally proposed the idea of an insurance mandate during the Clinton era? ...and now they are calling it unconstitutional?
http://www.npr.org/templates/story/story.php?storyId=123670612"
I honestly don't see how they can keep their stories straight sometimes...talk about "Flip-Flopping".

 

[BoomBoom]

Do Illegals get health care benefits also?

Yes, I believe people in prisons get splendid healthcare!

 

[calculusrocks]

My state government requires I purchase auto insurance...so maybe not the 1st time.

Besides, was it not the republicans that originally proposed the idea of an insurance mandate during the Clinton era? ...and now they are calling it unconstitutional?
http://www.npr.org/templates/story/story.php?storyId=123670612"
I honestly don't see how they can keep their stories straight sometimes...talk about "Flip-Flopping".

You are not forced to buy auto-insurance any more than you are forced to drive on public roads.

It's not republicans calling it unconstitutional. You guys have to understand that constitutional challenges originate from citizens.

 

[BoomBoom]

You are not forced to buy auto-insurance any more than you are forced to drive on public roads.

If I do not, then I can get a hefty fine...the same as with the health insurance mandate. So neither one is being "forced" to buy a product, just installing a penalty if you don't.

 

[calculusrocks]

If I do not, then I can get a hefty fine...the same as with the health insurance mandate. So neither one is being "forced" to buy a product, just installing a penalty if you don't.

Like I said before, there is no law requiring you to get auto insurance. You can simply choose not to drive. Auto insurance is required in case you injure someone else. It's a faulty analogy. Even if the analogy wasn't faulty, your conclusion is faulty. The conclusion wouldn't be that neither one forces you to buy a produce. The conclusion would be that both forces you to buy a product. But, you are not forced to buy auto insurance.

 

[Ivan Seeking]

To me, this is just another example of the fact that the free market is not the end-all solution to all problems. We have a free-market healthcare system now and it is clear that what we're doing isn't working. From dropped coverage upon illness, to denied coverage for pre-existing conditions, skyrocketing administrative costs in place of patient care costs, runaway patient costs, the looming costs of medicare and medicaid, and the 30 million+ people who have no coverage at all, in painfully real terms for many Americans, what we have now is barely more than a bad joke.

 

[calculusrocks]

We do not have a free market solution in health care right now. There are a lot of boundaries inhibiting competition. Not the least of which is the ban on buying insurance across state lines, inhibiting choice.

ADD: Choice drives down cost, because of competition.

 

[hamster143]

Do Illegals get health care benefits also?

Can you just walk into a hospital now and say "treat me?" Or do we get a card?

Illegals always could do that. I'm not sure how this is going to work in the new bill. I'm pretty sure that illegals can't get federal subsidies for healthcare. Therefore they are probably also exempt from the mandate.

One more thing I'm curious about is how this bill deals with older immigrants. Right now, noncitizens over 65 can't get Medicare (can't even buy it for the first 5 years in the country), and most private health insurance companies refuse to insure them. (The one insurance company I know of that does, Kaiser, charges a premium of $1000/month.) It would seem unfair to mandate those to have insurance, unless something is changed in their access to healthcare.

BTW, as of this moment, Intrade gives the health care deal a 78% chance of passing. Big improvement from January (right after the Mass elections, they saw a 20-25% chance.)

 

[calculusrocks]

I'll post more on that point later. I don't want to be dismissive about it.

 

[hamster143]

People keep conflating two very different issues. (And our president isn't helping, unfortunately.)

One issue is that the whole health care system is badly screwed up. Lots of people can't get insurance because of preexisting conditions, no one is sure that his insurance company isn't going to drop him at the first sign of trouble, any transaction involving money requires negotiating (because there's no universal schedule of fees that applies to everyone), neither doctors nor patients know a priori whether their health insurance is going to cover any given procedure ... That can be addressed partially by the existing bill, which is a big step in the right direction, but, ideally, to fix that, we need a single-payer system.

A whole different issue is cost of health care. Sure, it is driven partially by the administrative overhead in the current system, but the primary cause is the severe shortage of doctors, thanks to the AMA cartel lobby (which, as recently as 1995, was screaming about the impending surplus and demanding to limit residency spots - just as healthcare costs were taking off). The AMA cartel is fully committed to the idea of providing every medical student with a $200,000+ job by the time he or she is 35, and ensuring his salary and job security till he's 70. Why wouldn't they be? Obviously, patients have very different priorities, but no one listens to them.

Other smaller issues behind the high cost of health care are the lack of central authority that decides which tests can or cannot be made; stringent patent laws that limit availability of generic drugs; lack of nationwide medical malpractice tort limits.

All these things are completely tangential to the subject of universal mandated healthcare.

 

[WhoWee]

The GOP is pulling out all the stops to kill this bill. Pass it now, with all of its warts, and fix it incrementally. The CBO has already said that the bill will reduce the deficit over time and add 32 million uninsured people to our health-care system.

I believe the period of time they are looking at is 10 years.
http://www.reuters.com/article/idUSTRE61O4NV20100319

Unfortunately, it's my understanding, this 10 year period includes 10 years of taxes and only 6 years of health care - take a closer look.

 

[dilletante]

Dow Jones Newswires | Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company's health-care costs by more than $100 million in the first year alone.

In a letter Thursday to House Speaker Nancy Pelosi (D-Calif.) and House Republican Leader John Boehner of Ohio, Caterpillar urged lawmakers to vote against the plan "because of the substantial cost burdens it would place on our shareholders, employees and retirees."

Caterpillar, the world's largest construction machinery manufacturer by sales, said it's particularly opposed to provisions in the bill that would expand Medicare taxes and mandate insurance coverage. The legislation would require nearly all companies to provide health insurance for their employees or face large fines.

The Peoria-based company said these provisions would increase its insurance costs by at least 20 percent, or more than $100 million, just in the first year of the health-care overhaul program.

"We can ill-afford cost increases that place us at a disadvantage versus our global competitors," said the letter signed by Gregory Folley, vice president and chief human resources officer of Caterpillar. "We are disappointed that efforts at reform have not addressed the cost concerns we've raised throughout the year."

Business executives have long complained that the options offered for covering 32 million uninsured Americans would result in higher insurance costs for those employers that already provide coverage. Opponents have stepped up their attacks in recent days as the House moves closer toward a vote on the Senate version of the health-care legislation.

A letter Thursday to President Barack Obama and members of Congress signed by more than 130 economists predicted the legislation would discourage companies from hiring more workers and would cause reduced hours and wages for those already employed.

Caterpillar noted that the company supports efforts to increase the quality and the value of health care for patients as well as lower costs for employer-sponsored insurance coverage.

"Unfortunately, neither the current legislation in the House and Senate, nor the president's proposal, meets these goals," the letter said.

 

[Ivan Seeking]

Dow Jones Newswires | Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company's health-care costs by more than $100 million in the first year alone.

Two problems with your post: First, please do not quote the entire story as that is a copyright violation. Next, you need to provide a link.

Based on the 2008 report, Caterpillar had $51 Billion in revenues with $2.4 Billion in capital expenditures. $100 million represents a 4% increase in expenditures. It was also a record year for profit.
http://www.cat.com/cda/files/2096799/7/Caterpillar 2008 Annual Report - electronic only.pdf

 

[calculusrocks]

America's health insurance market is not a free market. In fact, it is heavily regulated and controlled by gov't. The most recent bill simply expands these regulations and subsidies, and potentially create a single-payer system. Here is an article about it in http://www.forbes.com/2009/07/28/health-care-reform-obama-opinions-columnists-shikha-dalmia.html" .

 

[mheslep]

This is a ten year trillion dollar disaster. The mandate, and perhaps the 'deeming' non- vote are probably unconstitutional. There are far better ways on the table to reform.

 

[mheslep]

To me, this is just another example of the fact that the free market is not the end-all solution to all problems. We have a free-market healthcare system now

Clearly not. We should actually try a free-market system.

• The government already funds about 50% of every dollar spent in the US health system via Medicare, Medicaid and other programs.
• If you live in Washington state, you are not free to buy perhaps cheaper medical coverage from a company in my state.
• The federal employer-medical tax exemption makes only employer based coverage feasible, meaning most people are hidden from actual costs of the medical care.
• US Tort law allows spurious and trivial malpractice suits.

and it is clear that what we're doing isn't working. From dropped coverage upon illness, to denied coverage for pre-existing conditions, skyrocketing administrative costs in place of patient care costs, runaway patient costs, the looming costs of medicare and medicaid, and the 30 million+ people who have no coverage at all, in painfully real terms for many Americans, what we have now is barely more than a bad joke.

Yes, that doesn't mean this disaster of bill is any way close to being a workable remedy that doesn't make things worse. If one recognizes that Medicare and Medicaid government created plans are broken, it seems to me more scepticism of federally based solutions is the logical course, not of market solutions, and are surely not a recommendation for huge all-in bets on more federal health care plans.

 

[mheslep]

If I do not, then I can get a hefty fine...the same as with the health insurance mandate. So neither one is being "forced" to buy a product, just installing a penalty if you don't.

Like I said before, there is no law requiring you to get auto insurance. You can simply choose not to drive. Auto insurance is required in case you injure someone else. It's a faulty analogy. Even if the analogy wasn't faulty, your conclusion is faulty. The conclusion wouldn't be that neither one forces you to buy a produce. The conclusion would be that both forces you to buy a product. But, you are not forced to buy auto insurance.

The salient difference is the many states have the power to mandate insurance if they choose; the US constitution grants no such power to the federal government without some squinty eyed look at the commerce clause to interpret as meanin ... the federal government can do any dam thing it pleases, anywhere, absent conflict w/ the first five or so amendments.

 

[turbo]

This is a ten year trillion dollar disaster. The mandate, and perhaps the 'deeming' non- vote are probably unconstitutional. There are far better ways on the table to reform.

The problem is that the GOP is adamant and unified in demanding that there be NO reform. The constant harping of "start over" is very tedious, since it is tantamount to saying "not in this generation". The GOP (apart from Sen. Snowe (R-ME)) refused to participate in the crafting of the bill, then complained that they were "shut out" of the process. The problem is that there are plenty of air-heads who watched the obstructionism unfolding, but failed to understand it and actually believe the complaints.

We need health-insurance reform ASAP. And we need to address reforms in health-care, too, though reining in systemic abuses by the insurance companies should be job #1. I am medically disabled, and I have health insurance only because my wife works for a decent company that provides comprehensive health insurance (medical, dental, and eye care) for all employees. If her company were to fail, neither of us would be able to get health insurance under the present system because both of us have pre-existing conditions. If one of us should come down with cancer, experience organ failure, or other debilitating condition, we would be ruined financially. Nobody should lose their life-savings and their homes just because they got sick. The US is the last "modern" country to allow the assets of its citizens to be stripped by catastrophic illness. Thanks, insurance companies.

BTW, in an effort to purge "ineligible" persons from coverage, Anthem required my wife's employer to audit its employees, so that I had to contact my town office and send the insurance company a copy of our marriage certificate (35+ years ago) to prove that we are married. I hope that the town clerk and the justice of the peace spelled everything just right in case Anthem has another round of recissions planned.