Saturday, March 20, 2010

"Can You Give Me More Details About This Bill?"

In the comment section of my last post regular commenter, friend of this blog, family member and rational conservative one L bill wrote the following:

A coworker turned to me last week and said "next week they vote on whether the gov't takes over 20% of the economy." I asked if he was talking about healthcare (I already knew the answer) and he said "yeah". So my next question was what they were voting on. He gave me a general answer, so I clarified that I wanted to know more specifics about the bill. He said he couldn't tell me anything because he haddn't made time to read [more specifics about] the bill.

I feel like this sums up 95% of Americans... either Republican or Democrat. They latch on to the1 or 2 talking points that are easy and ignore the rest... and if that 20% figure is accurate, then it seems like there's a problem.

I know you are better read than my coworker, but I only see the general outrage in most of your blog posts. Can you give me more details about this bill, JBW? It doesn't need to be in this comments section. I know it's a lot of information.
As I began to answer I had the thought that some other readers might have the same question about tomorrows vote so I decided to make it a post instead. That number is actually closer to 16% (1/6 of our economy already goes toward health care and that number has been rising for decades). I haven't gone into any great specifics about the legislation thus far because frankly they've only just finished crafting it, and even if it passes both houses of congress certain aspects will be changed again in committee after that before it reaches President Obama's desk. Some things I can tell you:
  • It will cover 95% of Americans.
  • Almost everyone will be required to participate (that's the only way it will work to cover that many people).
  • Consumer safeguards will include no denial of coverage for preexisting conditions including children, no higher premiums for women, no lifetime dollar limits on policies for those with serious illnesses, parents can keep their kids on their policies until age 26 and starting out there will be a high risk pool for the uninsured.
  • It expands the federal-state Medicaid insurance program for the poor.
  • It closes the "doughnut hole" coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830.
  • Businesses are not required to offer coverage and instead employers are charged a fee if the government subsidizes their workers' coverage; businesses with 50 or fewer workers are exempt from this fee.
  • Tax credits are provided for purchasing insurance.
  • Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges which would offer the same kind of purchasing power that employees of big companies benefit from.
  • This will not be a government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress.
  • No health plan would be required to offer coverage for abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. And no, your grandmother will not be executed for being too old either.
As I've said before, this bill is far from perfect. I personally would have liked to see a single-payer system instituted but that idea was scrapped some time last year. I would also like to see some of the proposals put forth by Republicans (although not wholly owned by them) like tort reform, malpractice reform, increased fraud investigation and purchasing coverage across state lines included as well. Hopefully some of these ideas will find their way into the final legislation as it's instituted and refined over the next several years.

The nonpartisan Congressional Budget Office estimates that reform will cost $940 billion over ten years whilst trimming federal deficits by an estimated $138 billion over that same time period, and studies have shown that increased preventative care will further defray current costs. To put those numbers in perspective, we've already spent over $970 billion in Iraq and Afghanistan and that cost is estimated to climb to between two and three trillion by the time we leave those countries, if ever. We spend more than twice as much on health care per capita than any other Western industrialized nation and our overall level of care is mediocre by comparison. Yes, the United States has the best health care system in the world but it has become increasingly obvious that only the financially well off are able to take full advantage of it; the rest of America is forced to incur what are often crippling lifetime debts in order to do so.

Presidents have talked about reforming our health care system since Teddy Roosevelt was in office and as every administration since has failed to do so Americans' insurance premiums and costs have continued to increase while coverage and levels of care have similarly decreased. I honestly don't know if Obama's reforms will solve these problems (nobody does, although most of the provisions sound pretty good to me) but I do know that our current path is entirely unsustainable financially and has been for quite some time. Doing nothing for decades has clearly not worked. I for one am ready to try something else. I hope this was what you were looking for, one L.


Leslie Parsley said...

Wow: thank you for capsulizing this. It even helps us libs.

Oso said...

Firedoglake sums it up pretty well:


Oso said...

We desperately need access to affordable healthcare. This bill does nothing towards that goal, it finishes the job of privatizing a basic human right without regulation.

JBW said...

No worries, Leslie. It helps me keep it all straight by writing it out like this.

JBW said...

Baby steps, Oso. The system can't be changed all at once but this is a good start. Subsequent legislation can improve on what we will hopefully soon have. I council pragmatic realism on that point. Moving too far to the left won't get us anywhere right now. I like Dennis Kucinich but I'm not counting on him to make any real progress in Washington.

Only a conservative moderate like Obama can do that in our present political climate. Patience my friend, the changes are coming.

Anonymous said...

I think it's interesting that you consider me a rational conservative and your boy Barack as a conservative moderate. I'm not saying you're right or wrong; but interesting indeed!

Thanks, JBW. This is exactly the kind of info I was wanting. It just so happens that we were on a plane with TV's tonight. I spent most of the flight readig the tickers between Fox News, CNN and CNBC. CNBC listed many of the same attributes that you did.

I think it sounds like a pretty reasonable step. I know a lot of my southern brethren will be/are pissed about any part of their paycheck possibly subsidizing healthcare for the unemployed, but to them I show the bird. I plan to read as much of the bill as I can in the coming days, but I think it sounds like a great start.

The quicker they can close the donut-hole, the better. My mom kind of loop-holed herself through it this year, but I know she won't always be so lucky. Here's hoping this system works and that my mom can see that it does benefit her.

JBW said...

No worries one L, but I might suggest reading summaries of the bill from trusted sources rather than the bill itself. It's a long one.