Monday, March 23, 2009

NoLimits.org Updates: COULD CONGRESS VOTE ON HEALTH CARE THIS FALL?

From the NoLimits Newsletter
"More than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and almost 50 percent say they're "very" or "extremely" worried about the issue."

Harris Interactive/Health Day poll, reported by USNews March 18, 2009

The bottom line on health care is clear - and it's not pretty: the cost of health insurance has doubled since 2000, leaving more Americans to join the uninsured; while even those with health insurance worry about costs and coverage. Rising health care costs endanger our families' wellbeing; burden state budgets; and make it even harder for American manufacturers to compete.

That's why it's good news that we are starting to hear about a vote on health care as early as this fall. According to the Washington Post, House Democrats, in consultation with the White House, "will give Republicans until September to reach a compromise" on a health care reform bill.

The House leadership plans to include health care reform in their budget proposal, or budget reconciliation. According to congressional rules that means it requires a majority vote, but cannot be filibustered. The Senate will probably use a different procedure; whatever they decide, the goal of this strategy is to ensure that health care reform does get a vote this year.

So watch for the discussion of health care in the budget next week (and beyond!) And if you hear some talking heads on television complain that putting health care reform in the - budget reconciliation is somehow unfair - remind them that it will still require a majority vote. Isn't that what democracy is about?

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2 comments:

Tom Slockett said...

Congressman David Loebsack (IA) is on the side of the angels in co-sponsoring HR 676, equitable single payer health care (Medicare) for all. Congressional Democratic Leaders who abandoned single payer at the beginning of the health care by debate adopting what should be, at best, a reluctantly agreed upon compromise--and only then if absolutely necessary--should reconsider and get behind HR 676. They know the dangers which have already been articulated. The rationale is that, by compromising at the beginning, lines won't be drawn, and tempers won't flair. The resulting camaraderie will result in so much good will that those who have stopped the measure dead in it's tracks since Harry Truman first proposed it, will be so filled with gladness that they will denounce their loyalty to big insurance companies with campaign contribution treasure troves and accede to a single payer public option they have so long opposed without so much as a whimper. The danger is, having thrown the backbone of the effort for equitable comprehensive health care for all to the dogs, the proposal will be made vulnerable to the wolves in sheep's clothing who are ready to do whatever is required to defeat the measure, they hope, for many years to come. Consider the very real possibility that the dangers recognized are much greater than any advantage that could possibly be gained by deluding ourselves that the more comfortable approach of throwing in the towel at the outset will work. The towel thrown in is not set in stone and can and will be sullied much more than it already is.

Maybe one of the reasons we can't get universal health care in the US is it really isn't the top priority for a majority or even a large plurality, in part because a majority have coverage. Other things seem more pressing: opposing the Patriot Act, torture, jobs, peace, and justice. Yet 50 million without a safety net is not unlike a kind of biological warfare, a game of biological roulette waged on 50 million with increasingly high odds of death for those not covered and have medical conditions, or are homeless, living in poverty, or aging. For some of them, it's as bad as losing freedom or detention, and in some cases not unlike torture. There is a need to educate people who do have health care to make it a priority for universal coverage equal to that enjoyed by Congress, and at no cost, a requirement of anyone we support, even if it is not necessarily one of our top few priorities. We cannot allow to be acceptable the situation in which people are helpless to avoid being held hostage to health care options decided by employers or individual states. Why should one person's children have different health care than another just because they work at different addresses? It is completely predictable that states, given the ability to do so, will try to entice corporations into economic development within their boundaries by bidding down the quality of health care that a prospective company will be required to pay, while threatening the voters with the loss of jobs if they don't accede.

Democratic Leaders in Congress make all the arguments for single payer, then declare single payer to be anathema. Rather, they say, an amorphous, fungible concept they call "the public option" should be the goal, alongside insurance driven private health care. This strategy of co-opting the rationale for single payer while empowering those who oppose it by contending that the logical conclusions that follow are not valid reasons for single payer, is precisely to what I object. This approach seriously undermines the possibility of having a single payer "public option", as well. The Republicans are already strongly stating that the public option can not be allowed to be an advantage over the "non public option" because that will mean government is unfairly competing with private industry. They don't have to argue against single-payer because Democrats won't even allow it to be discussed on the floor of the congress.

Tom Slockett

Tom Slockett said...

The Congressional Leadership taking single payer "off the table" is analogous to the terrible mistake of Dick Gephardt and the Democrats when they took the invasion of Iraq "off the table" so the Democrats could get elected. The result was George Bush got elected and our government snubbed it's nose at International Law. The unthinkable, horrifying consequences are still unfolding before our sad eyes. Compromising at the beginning of a negotiation will get us nowhere. The "Swift Boat Ads" will attack whatever options are put forward with equal force, just fill in the blanks, no matter how weakened the position is at the outset. The weaker it is, the greater the danger that they will succeed.

During the Vietnam war, anti-war leaders warned that our "liberal friends" could serve as the greatest obstacle to success. I fear that this process of taking single-payer off the table will not work. It is too clever by half and will result in a seriously compromised health insurance plan instead of equitable universal health care for all. Medicare is the best existing model in the U.S. to provide the most coverage for the least cost. Health care should be like public education. If you want more expensive care you should be able to get it if you pay for it. But what is available to all should be perfectly adequate and unsurpassed anywhere in the world. By compromising at the outset, we will have precluded the possibility of reaching these laudable goals.

I do not underestimate the difficulty of taking this approach. Taking single payer off the table is the position of the Congressional Democrats who are in charge of the process. The Republicans are thrilled that they have done this. But, seeing weakness, they attack and marginalize the "public option" all the more ferociously. Could the Democratic Leaders be making a mistake? Were they right to adopt the comfortable position of taking Iraq "off the table"? I appeal to Congressional Democratic Leaders and anyone who has accepted their decision to reconsider and re-prioritize the factors in that decision. Democratic Leaders and the public can have a much greater ability to affect a positive outcome by arguing the uncomfortable case for single-payer than by taking the course of providing reassurance that there is no need to move from the comfortable position of "public option" conventional wisdom. The fight for single payer is also the fight for the strongest possible public option.

Tom Slockett