Monday, March 22, 2010

Historic Health Care Reform -- A First Step Accomplished

Last night Congress passed a historic health care reform bill. It will go a long way to provide Americans with access to affordable health care coverage. It is something that Presidents and Congresses have been trying to enact for early 100 years.  Theodore Roosevelt proposed one of the earliest versions, but couldn't get it passed.  Richard Nixon suggested something akin to medicare for all, but the time was not right.  Bill Clinton worked on a bill, but it did not pass.  

The current bill, is not a perfect bill. Unfortunately, it got voted in on a party line vote.  That is unfortunate, but not surprising because the current party system has become increasingly polarized.  The Republican Party, in which I grew up and cast my first political votes, no longer exists.  The party that embraced a Nelson Rockefeller and a Tom McCall no longer exists.  There was once a liberal wing of the Republican Party that mirrored the conservative wing of the Democratic Party, but that is long gone. There is a conservative/moderate wing in the Democratic Party, which is why the fight for Health Care Reform has largely been fought within that Party.

As for the imperfections of the bill.  Well, many Americans wanted a public option, but that was squeezed out in the Senate. At the same time, in a time of economic uncertainty, many Americans are concerned about costs.  While some of that was covered here, not all of it was -- and thus work must be done.

What it does do is this:

  • End the practice of recision, wherein health insurance companies can cancel your insurance should you need to use it.
  • Prohibit the use of pre-existing conditions to discriminate against applicants for insurance.
  • Provides for a regulated exchange program for insurance to be purchased (this will be phased in by 2014, because it takes time to set up the infrastructure)
  • It allows families to continue covering their children to age 26
  • Ends caps on life-time use of benefits
  • You won't lose insurance coverage when moving or changing jobs -- or work for a small business. 
  • Requires all Americans to purchase health insurance.  Now, this is unpopular in some quarters, but the only way to end discriminatory practices is to include everyone in the pool.  
  • And there is much more.

Because the Senate filibuster practices prevents the Senate from taking up a revised, compromise bill, the House voted last night 219-212 (with no Republicans concurring -- not even the Republican voting last time) with the Senate Bill. It also passed a set of fixes that will improve the Senate Bill. This is the way Congress is set up to work. Both parties have used this process in the past. Now, the Senate will take up the fixes but need only a majority not a supermajority to pass it.

So,  what does it not do?  Well, it doesn't really address the way that medicine is delivered in the United States.  So, further legislation needs to tackle some of the causes of increased costs, such as:

  • Ending fee for service, by which doctors and hospitals make their money by the number of procedures performed.  A better model would be that of places like the Cleveland Clinic and the Mayo Clinic, where the medical personnel are on salary.
  • Tort Reform.  This has actually been a demand from the Republicans,and the President has embraced it.  So, this is something that a bi-partisan effort could be made to improve the current legislation.
Now, last night I heard the Republicans continually chant a mantra about heeding the will of the American people.  The problem is that the people are not of one mind, and in fact seem evenly split on the issue.  Some, on the left, don't like the legislation because they wanted a public option, or better yet, a single-payer system.  Some simply don't understand what is happening -- due in large part to conflicting use of data. 

My suggestion is that we take this framework, this foundation, and then begin to make it better by addressing the issues of cost.  My own insurance costs have sky rocketed.  I have less coverage than before, at increasingly higher costs.  Because I don't work for a large corporation, my options are fewer and more expensive.  When I do use medical care (or the family does), the insurance company decides whether to cover it.  We have a high deductible, HSA plan, but as I've watched the way they pay for things, it appears they do everything they can to not fulfill the deductible.  I'd like more options, but they are few.

I am pleased by this decision.  But, I know that this is not the end of the story. 

An update: In reading the NY Times op-ed this morning, I note that they're take seems to echo mine.  So, I encourage you to take a look at it, by clicking here.   

 

5 comments:

Rial Hamann said...

I was up late last night. I watched the 3 major partisian votes and was sickened. I like to think of myself as a rational independent. It really is too bad that the Republican party did not allow 1 vote in opposition to their party wishes. I fear that we may have finally come to politics by mob and club rule...

Ace said...

We have come to government by corporation rule. Which, in a way, is club rule.

Anonymous said...

Do you mean club as in group? I guess you mean weapon. I wish we could have done a one payer. What is it, 12 states are now charging unconstitutional? It's hard to argue that the government shouldn't compel the purchase of a product vs a tax.

This might prove educational. David Mc

Anonymous said...

Bipartisan.. opposition..lol.
What it means:

Taxes.. lots and lots of taxes.
Most cuts happen immediately, to make the costs work, but the benefits are YEARS away.
It means the government is now involved in health care.. how have the other ventures worked out in say mortgage lending?
It means the Dems are DONE in November.. (see 2008 anti-Bush backlash)r

commentbug said...

free health care, long waits, will see.

http://www.commentbug.com