Health Care Reform, If You Want It!

We got a health care reform bill passed yesterday. A vote of 14-9 passed it. Only one Republican voted for it, Sen. Olympia Snowe of Maine, and I'm certain that she just lost any chance she had for getting re-elected.

President Barack Obama said that passage of legislation by a key Senate Committee is "a critical milestone" toward getting a health care overhaul this year but "now is not the time to pat ourselves on the back" and he's right. This bill is kind of a compromise (middle-of-the-road) and does not have the public option that so many of his supporters on the left were really hoping for. That's cool though... this is the way Washington works and he is going to learn that, just as the idealistic Bill Clinton learned.

The right-wing said that if he didn't get this health care initiative passed, it would mean the end of his presidency... in that he would no longer be seen as an effective leader. Well, I guess they can put away the shovels, caskets, and hang-up their black suits. President Obama maybe on his way to doing what six presidents before him tried and failed to do... overhaul the health care system, as we have known it.

President Obama praised Sen. Olympia Snowe for her political courage in voting to approve the bill. The Maine lawmaker said she was laying aside misgivings for now and voting to advance the bill, a sweeping $829 billon, 10-year health care remake that would help most Americans get coverage without creating a new government insurance plan. "When history calls, history calls" said Snowe.

Finance Committee Chairman Max Baucus (D-Montana), called his bill "a common sense, balanced solution." A distance runner, Baucus has endured months of marathon meetings to get this far and it's not the finish line. Health care legislation is expected to be on the senate floor the week after next, said a spokesman for Majority Leader Harry Reid of Nevada. But, it won't be the Baucus bill. Reid will combine the finance version with a more liberal proposal from the Health Committee with unpredictable results. Baucus said in an interview with The Associated Press after the vote that he hopes his bill survives the merger process without major changes.

Baucus said, "The bottom line here is we need a final bill, a merged bill that gets 60 votes" Baucus said. Our goal is to pass health care reform, not just talk about it." The vote in the Finance Committee was 14-9, with Snowe joining all 13 Democrats in support. In a sign of the long political battles ahead, every other Republican voted against it. (Was anybody surprised by this?)

The ultimate fate of the legislation hinges on how lawmakers decide dozens of unresolved issues, from letting government sell insurance to abortion coverage. Even some senators who voted for the Baucus bill said they have concerns it will deliver on providing access to affordable coverage for all. As Snowe made clear, "My vote today is my vote today. It doesn't forecast what my vote will be tomorrow."

For the first time, the Baucus plan would require most Americans to purchase insurance and it also aims to hold down spiraling medical costs over the long-term. Questions persist about whether it would truly provide access to affordable coverage, particularly for self-employed people with solid middle class incomes. I'm not so sure that urging people to purchase insurance is really the solution here. This still puts more money into the pockets of the insurance companies and doesn't help the poor guy who couldn't afford insurance to begin with because it was so high. Still, I'll hold that thought and my peace until this is further elaborated.

The Finance Committee's top Republican, Chuck Grassley of Iowa, gave voice to the GOP's concerns about the bill, saying it was "...moving on a slippery slope to more and more government control of health care. There's a lot in this bill that's just a consensus which needs to be done but, there are other provisions of this bill that raise a lot of questions. Contending the legislation would mean higher costs for Americans."

The committee approval marked a personal victory for Baucus. Four other congressional committees finished their work before August and for months, all eyes had been on the finance panel, whose moderate make up most closely resembles the Senate as a whole.

One of the biggest unanswered questions is whether the legislation would slow punishing increases in the nation's health care costs, particularly for the majority who now have coverage through employers. The insurance industry insists it would shift new costs onto those who have coverage. This is the problem I have with what I see now... this just looks like these guys are making an end run around real reform and finding a slick way to continue business as usual. This is why I don't feel particularly good about the bill as it stands right now.

Baucus' bill includes consumer protections such as limits on co-pays and deductibles and relies on federal subsidies to help lower-income families purchase coverage. Insurance companies would have to take all comers and people could shop for insurance within new state market places called "exchanges".

Medicaid would be expanded and, although employers wouldn't be required to cover their workers, they'd have to pay a penalty for each employee who sought insurance with government subsidies. The bill is paid for by cuts to Medicare providers and new taxes on insurance companies and others.

Unlike the other health care bills in Congress, Baucus' would not allow the government to sell insurance in competition with private companies, a divisive element sought by liberals. Last minute changes made subsidies more generous and softened the penalties for those who don't comply with a proposed new mandate for everyone to buy insurance. The latter change drew the ire of the health insurance industry, which said that without a strong and enforceable requirement, not enough people would get insured and premiums would jump for everyone else. This is one step forward and two steps backwards, if you ask me.

Confusing? Yes, it's confusing. I, like you, don't know what all of this means and I'm pretty sure before it's all over, this bill will look nothing like anything I've written about here. You know what? The shame of this is, all of the senators and representatives arguing over this are insured. I'm betting that they all have pretty good insurance too and, if anybody in their family gets sick, they can take care of it with their own money alone.

They don't know and they have no concept of what it feels like to be somebody who has to put their house up for a second mortgage to pay the hospital bills for a sick loved one or for themselves. They don't feel the pain I felt last year, when I considered putting my mother, who was in the terminal stage of colon cancer, on my insurance plan so that she could undergo a radical new kind of cancer treatment being developed at my place of employment that might have saved her life. They don't know what it's like to not be insured at all and to live in fear of getting sick because they have absolutely no way to pay for medical attention. They don't know and that's why they can come up with the solution of just buying more insurance. That's why the people that run the insurance companies can talk about hitting people already covered and already paying ridiculous premiums as it is with more costs.

See, if they knew and even more importantly, if they cared, then there wouldn't be a need for any of the discussions I've written about in the paragraphs above. A public option and the notion of universal health care wouldn't sound so frightening and spoken as though it's anti-American. It would be the only discussion we'd be having and it would be the right thing!

Still, I applaud the present administration for getting the ball rolling and to getting people to talking about true health care reform because for so long, nothing has been done... nothing at all. As my mother would always say, something always beats nothing.