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How health reform will get done

By Dana Blankenhorn | March 1, 2010, 6:58 AM PST

There is a lot of confusion on this — much of it deliberate — so let’s describe briefly how health reform will actually happen, according to the Administration.

The House will pass the Senate plan.

House Speaker Nancy Pelosi has been cagey about the whip count., Soimetimes she says “:we will have the votes,” sometimes (as today) “we have the votes.”

The count is unclear because the House bill passed with a bare majority, and that only because of the Stupak Amendment, which keeps those who buy health coverage in the market from also buying abortion coverage.

Stupak is not in the Senate bill.

Only after the House votes do we get to the dreaded “reconciliation,” a process also used to let people keep buying into their employee plans after they leave a job. (The R in the so-called COBRA Act that allows this stands for reconciliation. It was passed in 1985, under President Reagan, with a Republican Senate.)

The idea is that the Senate will pass the 11 pages of amendments offered by President Obama at last week’s summit on a majority vote, in order to reconcile differences with what the House wants. The House will then pass the amendments and the President will sign both bills.

This is where it gets tricky. About 30 Democratic Senators have already said they want a public option in the reconciliation bill. This is not what the President proposed and exposes the fact that, in reconciliation, the whole bill is really re-opened.,

But many of Pelosi’s anticipated votes for the Senate package are based on the idea that reconciliation — a move toward their version of the bill — will follow quickly — and will deliver a bill they like. The Senate does not go to the bathroom quickly and Republicans have promised to use every procedural move at their command to stop it.

The result is uncertainty, the kind that puts the rest of the President’s agenda on hold and gives everyone that Perils of Pauline feeling. But what we’ve learned in the past 40 years, whether in the Bush tax cuts, the Clinton tax package, the Reagan program, or even the Nixon years, is that nothing important in Washington ever really happens without that feeling.

That tension is just the feeling of history being made.

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About Dana Blankenhorn

Dana Blankenhorn was a contributing editor for SmartPlanet from 2009 to 2010.

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Another Matter irt VA & MilRetiree Medical & Dental Systems

It is not free and neither is dental. Many times, there was a physical price paid deserving of the treatment, they retired, or other. They actually charge too but use an inordinate fee for service structure. They keep the prices hidden except when dealing with the insurance firms. Military retirees and vets get cheated as do the rest of the tax paying citizens (yes, retiree pay is taxed by the Fed and possibly by the state). Too much administration, little service, lack of efficiency and efficacy, plus costs that aren't commensurate with the level of service provided if provided at all.
Besides that do you know how many service organizations that exist that have to support the deserving vets and retirees? How many times must I insist that this is where a plausible effort to reform medicine should occur before the situation is addressed in the private sphere?

Posted by donnydo77@...

5th Mar 2010

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RE: How health reform will get done

If you want to see where Obama?s going, you have to watch this Brand New, Viral

OBAMACARE - YEAR IN REVIEW video: http://www.youtube.com/watch?v=6Rv7aW3NF7w

This Hilarious and Shocking Video provides a Fast-Paced Look at the No-Lie-Too-Big, Socialist Ideologues Who Now Run Our Country.

MUST?WATCH!?

Posted by CommieBlaster

1st Mar 2010

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RE: How health reform will get done

Classic case of the saying "I am from the government and I and here to help you." Special interests and lobbyists will make sure they get their payola and who pays? The average tax payer, not the wealthy - the wealthy can afford to pay politicians (less) to keep that from happening, not the poor - let's face it the poor need coverage but don't have the resources to pay for much if anything. Hmm, who is left? The average tax payer, no big PACs to represent them and a broad enough group so they can "redistribute" the people's hard earned income (not wealth) to big government health-care. Why is this? Well, because of one person one vote and no fiscal restraint. Budget? What Budget? Deficit, not a politicians concern. The government knows best how to spend other people's money; no need to clutter your head with trying to make ends meet, let the government do it for you. Only the little people have to live within their means, not big government. The big problem is any government program once in-acted is never repealed because some constituents in some politicians home benefit and it would cost the poor politician votes to do the responsible thing.

Posted by geoff@...

1st Mar 2010

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That really bad feeling.

Watching your car pull out of the driveway is not a comfortable feeling. But realizing that a criminal is driving it, and you don't know what is really going on, gives are REALLY bad feeling.

Posted by dswanson2609

1st Mar 2010

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One can only hope that "will get done" is wishful thinking

What's under consideration will only make things worse and how is *mandating* people purchase insurance constitutional?

Posted by sullivanjc

1st Mar 2010

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Anyone like the curren t system?

If you're poor or old or a veteran you get all the government health care you want. "Get the government's hands off my Medicare" has to be one of the most hilarious political slogans of the last 20 years.

But if you're middle class, if you work hard and play by the rules, you can easily be priced out of the market. If you're a small businessman, or have to go into the individual market, forget it.

This is th system Republicans pretend to defend, although I admit they are intellectually honest in what they do want. They want the old and the poor tossed out too. Health care is a privilege, not a right. Which is an honest stand to take...if you are willing to tell your new constituency that your plan is to take away their health care.

Which no one admits.

Posted by DanaBlankenhorn

1st Mar 2010

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Anyone Like the current system

There are many who do benefit from the current system as patients. More benefit as a business that either provides supplies, the actual care or the insurance for health care.

Our congress critters have an excellent health coverage supplied by the government. Ex VP Cheney was reported to have been given excellent care to minimize his heart problems. I don't think this perk can be taken away from them without a huge ruckus.

There are those who have good coverage through their jobs; this also takes the urgency off of them even though more employers are passing more of the cost of premiums to their employees. The wake up call happens when you lose your job and the health care benefits that went with it. Of course, we have COBRA to allow ex employees to pay the premiums for a year.

The other group that gets hurt are those with "Pre-existing conditions". If you are an average employee and have a heart attack at 37 and lose your job later; then it is hard to get a health care policy due to that heart attack. Another job and another policy may ignor the previous heart attack, for now.

Then there are the people who have had severe health problems that result in tens of thousands of dollars of medical debt per year. It doesn't take much to have a catastrophic illness that can wipe out the insurance benefit, your savings and your future earnings.

The group that does like the current system is a shrinking population. Economic down turns can wipe out wealth and wipe out jobs.

The best reason for more public health care is that the larger the percentage of healthy people in a population the less impact epidemics have on the population. Health also allows people to be productive and also produces a healthier economy. Better health care will benefit everyone, bad health care is a higher cost due to loss of productivity.

Posted by sboverie

1st Mar 2010

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RE: How health reform will get done

Dana, and the rest of the liberals reading this,

I trust that your intentions are good in that you want good things
for the American people. However, I suspect that your vision is
clouded by compassion. No matter how much we "hope" that the
government will improve our standard of living it never does. No
experiment with socialism/communism has improved society.
Capitalism not only works, it benefits both the wealthy and the
impoverished. The majority of our economical problems are the
result of politicians implementing populist vote gathering programs
and political favoritism at the expense of the productive elements
of our society.

I suggest that you stop supporting progressive ideology and use your
forum to encourage entrepreneurship and self reliance rather than
pandering to those relying on a psychology of victimization. BTW,
life is not fair, nor equal, nor guaranteed comfortable. However,
freedom is wonderful.

Posted by Chasa

1st Mar 2010

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Chasa

I am not an ideologue. I believe in markets. And muddling through. I am for practical solutions to practical problems, like health care.

I favor encouraging entrepreneurship and self-reliance. I greatly favor freedom.

But freedom is not, as you zeem to think, a zero-sum game. Giving the opportunities of entrepreneurship and self-reliance to everyone is not relying on any psychology of victimization, not is it pandering.

I want our economy to be more efficient. And the way toward an efficient economy is making the best use possible of our human capital. All of it. Not just the rich kids, but everybody.

Liberals were forced to challenge their own assumptions after the 1960s, when their focus on specific groups tribalized them, and left them with rigid, simplistic slogans to the world's problems, solutions with no grounding in the reality of societal life.

I would submit that conservatives have run into the same problem. Examine your own assumptions. Stop seeking perfection. Stop with the tribalism -- the cult of Paul or of Palin or of Cheney.

Engage your principles against our real problems. Stop relying on a rigid ideology that failed, in the last decade, as thoroughly as communism did 20 years before. And for the same reason. Rigidity.

Posted by DanaBlankenhorn

1st Mar 2010

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The poor don't have it made

"If you're poor or old or a veteran you get all the government health care you want."

Where did you get that idea? Do a little research - the only people who are guaranteed care are those who show up at the emergency room with a life-threatening illness or injury. If your condition is deemed not critical, you can be denied care.

Try googleing Medicaid and Medicare, you'll find out those programs provide limited benefits, are extremely complicated, and don't cover all the poor and elderly - or even come close.

Posted by Greenknight_z

2nd Mar 2010

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RE: How health reform will get done

Washington is truly out of touch with the concerns of the American people. Obama is the second President to tell us health care reform is our greatest concern. If he asked, the American people would be glad to tell him jobs and the economy tops our list.

In the 60s America was the richest country in the world, there were uninsured among us but it was not an issue.

Now the world?s biggest debtor nation, with 10% unemployment, expresses concern for 46 million uninsured and declares federal authority and responsibility 200+ years after the constitution was adopted.

WAKE UP! . The Federal takeover of health care is about assuring the fiscal health of insurance companies, big pharmaceuticals and medical providers and only incidentally about the poor uninsured. Private insurance is shrinking because of recession, unemployment and baby boomers retiring and that means less profit and less money to cost shift and subsidize the health care of the uninsured. 30 MILLION NEW HEALTH INSURANCE POLICIES. (I am already receiving unsolicited snail mail ads from Blue Cross ? Blue Shield.)

With all the sincerity of a soap opera, Obama complains how the Supreme Court?s campaign reform decision will remove all restraint on the influence of corporate special interest. Meanwhile he presses forward on health care and Cap and Trade, despite polls the majority of citizens do not want either. If politicians will not acknowledge the will of the people, what does it matter if corporations control newspaper chains and broadcast networks? The health care debate is a perfect example of special corporate interests pulling the strings.

And the governments solution is require everyone buy insurance. Why didn?t the poor uninsured think of that? Is it because Ma and Pa cannot just print more money and must balance a checkbook? Of course there will be subsidies for the poor, but the only sustainable transfer of wealth is full employment!

What if the Federal Government had spent the bailout money rebuilding the nations crumbling infra structure instead of subsidizing corporations and banks that were too big to fail? Would providing people wages in return for work, enabling them to purchase, health care and other necessities be a better use of government funds?

Posted by Repeal

2nd Mar 2010

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RE: How health reform will get done

MANDATING PURCHASE OF HEALTH POLICIES IS UNCONSTITUTIONAL

The Federal Government does not have the authority to tell us how to spend after tax dollars! US Senators and Congressmen who propose this over reach more than the British Redcoats! Why should we the people respect law makers who will not be constrained by laws already on the books

Where does after tax (my) money start if the Federal Government can tell me what goods and services I must purchase? Will government be requiring I buy a new car and TV next? According to the Congressional Budget Office, the Federal Government has never required Americans to purchase any good or service as a condition of lawful residence in the United States.

Do you believe in a Federal Government small enough to fit in the Constitution?
Representative John Shadegg (R-AZ) has re-introduced The Enumerated Powers Act EPA - HR 450. EPA would require Congress to reference the specific clauses of the U.S. Constitution that grant them the power to enact laws and take other congressional actions.
Join the campaign at: http://www.downsizedc.org/etp/campaigns/87

Posted by Repeal

2nd Mar 2010

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RE: How health reform will get done

Again, does no one understand that these great social benefits cost money. That being said, just how does our system of 15 minutes with your drug providing doctor,not that we don't need or use them to great benefit or need, will handle let's see, 30million with the DEms, 3 million with Reps. None of this matters if you cannot get an appt. with the Doctor! We don't have the infrastructure to handle thew people.
How about another way to tackle this. How about going to the people with a plan to EDUCATE enough of the proposed need for Doctors and nurses, caregivers, etc. first, or in conjunction with the TAX that WILL be levied on the populous, (I prefer a 1% sales tax the first year of the plan), to offer any Highschool student to have a contarct with the GOV., that says "We will pay for your tuition, books and length of education, to go to work in the HEALTH sector, until your GRANT is paid back." In other words we will Contract with you to work in the HEALTH sector your education was paid for.
Thjis would take up to FOUR years to completely implement. As these four years are being implemented, the NEW NEighborhood cliinics are being built,(JOBS), the providers needed are being trained,(EDUCATION), and the people will be taken care of as they should be,(HEALTH CARE IN IT"S REAL FORM), is being implemented. NOT HEALTH INSURANCE, which IS a GIVEAWAY to the insurance industry,(ie. HEALTH PAY!. Look Folks, NO doubt that it SEEMS socialist, but WE ARE A SOCIAL SOCIETY, regardless of your political outlook. The Biggest scare at the Moment is the PROJECTED $750 a month to be paid by thge individual. That IS a HUGE amount out of the budget! If you have Company benefits, great. If you don't JUST TRY TAKING $750 out of my retirement pay @ $19,450 a YEAR! (I'M NOT ON MEDICARE)There is no overtime for me to make this up. The ONLY fair way is NATIONWIDE. The only Healthy way is to include EVERYBODY!
Many people say other countries do health care. They 'all' get health care. Not 30 million, not 3million, but all of them. This is How youu do it folks. Include all or it's a waste of time. Want to find out why the proposal in Congress is what it is? FOLLOW THE MONEY> INSURANCE COMPANIES LOBBY! FOLLOW THE MONEY> PHARMACEUITICAL COMPANIES LOBBY!
To make this work we all have to pay and the fairest way is....

Posted by Solution1

2nd Mar 2010

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"Single Payer" is inevitable

As the Federal and state governments continue to meddle in the marketplace, it is inevitable that the current system, such as it is, will crash. My guess is less than 10 years. Fewer and fewer will be able to afford the premiums and quit. We'll actually get to learn what "too big to fail" really means. When it all comes crashing down, the helpless masses will beg for the Federal government to rescue them.

Of course, that's always been the plan of the progressives, knowing that American's would never ordinarily support the idea of a socialist system.

Of course, for a few years this might actually work well, at least for me. After my mortgage, my largest monthly expense is health insurance. Hopefully in a few years I'll be rid of the mortgage. If health care becomes "free", I'll be able to mostly retire years early since it won't be worthwhile to work, given the inevitable levels of taxation we all will be facing.

Unfortunately, there will be tens-of-millions of others like me who come to the same conclusion.

In short, we'll eventually become Greece, where nearly everyone is either on the dole or government pension, and nearly half of the real economy is driven underground. The other difference is that there will be nobody to bail us out.

Posted by JohnMcGrew@...

3rd Mar 2010

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Repeal

How interesting to see you now want strictly limited government.
Where were you when the deficit exploded and we went to war on lies?

I know where you were, and so do you. You were for it.

So please don't give any of us lectures about the Constitution. I'm
tired of your sanctimony, your Paul to Damascus moment, your trips
and dramas.

I want America to be competitive, and that starts with changing our
health care system so we don't spend 17% of GDP covering just 80% of
us, but instead spend closer to the 12% of our economic competitors
covering all of us.

You have no answer to that. And your former answers caused our
present difficulties.

I'm certain you will deny it utterly, but I don't believe you.

Posted by DanaBlankenhorn

4th Mar 2010

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JohnMcGrew@..

Bad satire. Canada spends 12% of GDP and covers everyone. We spend 17%
and miss a large proportion.

I have another post that describes what real reform consists of, but
curiously no one has seen fit to comment as of this writing.

Posted by DanaBlankenhorn

4th Mar 2010

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Dana, you don't know $#$%, and even less about me.

$100 to your favorite charity if you can find anywhere on the Internet (and I've been on it for at least as long as you have been) where I've been a fan of deficit spending under Bush I or II. If you try at all, you'll find plenty of criticism of profligate spending of every administration and Congress.

But you won't bother. You're lazy and you can't deal with anything that falls outside of the liberal-progressive narrative that says that anyone who disagrees with you must be a brainless fascist zombie. It spares you having to answer any point I make, which you know you can't without Ad hominem vapidness.

Posted by JohnMcGrew@...

4th Mar 2010

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Stop Talking About MilVet & Retiree Medicine, It's A False Impression

I've indicated this before and you still say false things about it. This provides a false impression. Please stop. It is where medical reform should begin. How can you even continue with open ended and unqualified statements that make it appear that everything veterans need is provided in a snap? Far from the truth. Personal experience, research, and others that have to be subject to it.

Posted by donnydo77@...

5th Mar 2010

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Another Matter irt VA & MilRetiree Medical & Dental Systems

Posted by donnydo77@...

5th Mar 2010

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