Battered and bruised, with Senator Kennedy fighting his health battles at home and Sentor Mikulski in a cast from a badly broken ankle, the Senate Health, Education, Labor and Pensions (HELP) subcommittee limped over the finish line with Senator Dodd firmly holding onto a health care reform bill. On the floor of the Senate on Friday evening Dodd, the patrician son of a Senator and Ambassador, showed his bloodlines by excoriating his fellow Senators, including Democrats for planning to take their summer break while millions of Americans who need health care wait anxiously for bills to be reconciled and passed.
So what flavor were we left with when the “sausage making” process was complete? If you have the patience to “wonk” through our brief summary of what the Senate HELP committee produced you will see what they have in mind. And it’s not bad. But first, watch this video. The early part is a gratuitous praise of Dodd, although he deserves it. But wait for the vote to understand how hard it is to get populist legislation done. All–all–the Republicans voted against this bill. You can see from the expressions on the faces of everyone from Senator Enzi to Senator Alexander to Senator Hatch how dismayed they are that they were not able to come through and prevent health care reform. They failed to come through for their lords and masters, the health insurance, hospital and pharmaceutical industry lobbies.
They are, frankly, a pathetic sight and a blot on our form of government. What must those around the world think, those who have already committed in their own countries to the idea that government is “of the people, by the people and for the people.” What do they think of our supposed “dedication to freedom and democracy?” For these Neocons, who did not help but only tried to derail the process, Senator Dodd was too kind by a factor of a thousand. There was a day when men like Teddy Roosevelt would have suggested that they be taken out and horse whipped–for their arrogance, pride and greed!
Before anyone comes to their defense, remember that these supposedly “wise” men helped and supported Bush and Cheney to send 150,000 men to attack a country when our General Staff objected and said that what was needed, if it was needed, could have been done with a flight of 19 Stealth bombers simultaneously. Instead, in a typically botched plan by an ex-AWOL who never should have been President and a Yale drop-out Vice President we ended up losing 4,500 American lives, 30,000 more mutilated, and destroyed a country. We permitted anarchy to take over and it killed hundreds of thousands more.
We permitted the looting of that society’s main historical treasures, housed in one of the world’s most sacred repositories of ancient artifacts. We cost the Iraqis billions in oil revenues, trillions in reconstruction costs and–already–almost ten years of agonizing civil strife. This was done with the support of the same Neocon Republicans who, while willing to spend $3.5 trillion on that fiasco, and never even blink, are unwilling to vote for this bill, or even try to make it better, which Republicans at one time would have done. Of course the costs of the Iraq war are not over. There will be more added to the $3 trillion and the total $11 trillion Neocon, Double-Bush+ Reagan, Republican national debt levied on the people. Yet they have the nerve to fight against $600 billion for universal health care. Our money, not theirs. They want our money to go to health insurance industry CEOs.
Look at these men, all millionaires, all who have enriched themselves and their families on the government payroll. Look at the expessions on the faces of the Republicans. All of them clearly upset, because you will now have guaranteed health care. Whenever you wonder whether you are ascribing motives to people who merely have a more libertarian or fiscally conservative approach than you, remember those expressions. Those are expressions of defeat–because the People won, and corporations lost. For now.
Our summary of the bill follows, but if you are brave, and/or impatient, you can go directly to: http://help.senate.gov/Maj_press/2009_07_15_b.pdf and read a 22-page summary, longer than ours.
The Affordable Health Choices Act of 2009
So, to begin with, the first part says that you can’t be denied, that rates cannot go above a certain standard that all companies must adhere to and that there cannot be limits on benefits either by year or for the lifetime of the policy. Dependents can stay on the plan until they are 26 years of age. Pre-existing conditions were dealt with this bill right out of the box. Health insurance companies can’t look turn you down for a pre-existing condition and they can’t deny you care for one after you have the policy.
This legislation establishes in each state, or in some cases in a region of states, an Affordable Health Benefit Gateway. That government operation will oversee the development of a pool of health insurance policies that will be made available according to the rules mentioned above, i.e., that everyone can take a look at them, select one, and not be turned down or kicked off. This system of Gateways was based on exactly the same procedure that the government employees use, including Congress people and Senators, to select their health care. In addition to all the competing private plans, there will be a fall-back plan, or perhaps one that could be selected first, which will be a government plan. The goal is to make the government plan a standard of service and affordability. The Gateways must be established within 60 days of the enactment of the legislation, so this is why Dodd is so interested in having Senators work through the recess…to get things going. The Gateways will control and point people to affordable health care plans.
Each Gateway will offer a a so-called Community Health Insurance Option. That is the public option. It will be operated in a procedure borrowing much from Medicare and will be administered by a non-profit organization, under contract, as is now done by Medicare. To insure that everyone has insurance, there will be subsidies. Information on income will decide what kind of subsidy you receive. As an example, (with no reference to real numbers) if you are a low-income person, only 200 percent above the poverty level, you will receive some kind of subsidy. At 300% above poverty there may be another. At some point, now it is set at 400% above poverty, ($88,000 household income) any subsidy stops and you pay for your private health care…or…you can opt for the public option. If you are at the under 200% above poverty level (again just an example) you would have Medicaid, which will probably be improved. But it looks as if the government is saying, whether you think you are invincible or not…you will have health care for your good and that of others in society, just as we mandate auto insurance.
As far as employers are concerned, those with 25 or fewer employees are exempt from everything, period. They can participate or not, but the individual is still responsible to have health care. Employers with 50 or fewer employees who pay 60% or more of the employees health care will get tax credit. People who are self-employed and otherwise have no subsidy can apply for a subsidy on part of their premiums as a small business. The law basically says to individuals you must have some kind of health care. By establishing a penalty of $750 for the year in which you did not have health care, the government is saying…we’ll give you enough subsidies to cover your insurance, even if you have a hardship situation. If you can afford it…and we’re making it as affordable as possible…you need to get some kind of health care. This only works if everyone acts responsibly. Employers with over 25 employees who do not share 60% of health care costs will now pay an annual one-time fee of $750 per employee per year, which might not seem like much, but it shows that everyone is sharing in the responsibilty.
Only U.S. citizens are eligible for this plan. Those individuals on SCHIPS may decide to move off it onto a private or government plan. Remember, they would have some subsidies. But they can stay on SCHIPS if they like, for their children. But no family can receive more than one subsidy. You choose one plan or another.
In the areas of wellness and delivery of services, there are potentially huge discounts for corporations and individuals who establish or participate in wellness and prevention programs. The number and quality of medical school, nursing and some medical specialty subsidies and educational offers have been expanded. Almost every aspect of medical delivery is expanded and improved, from loan repayment programs for doctors to to opportunities for nurses to run nurse-based regional clinics. There is a program for expanded access to dental care and dental facilities in many areas. There is expanded training in many areas and expanded educational loan programs for under served positions, such as nurses.
If you analyze the complete plan, it is much more of a long-term agenda than a short-term cost cutter. It is an integrated system of health care delivery. If totally realized, it could become not only the best in the world, but perhaps the best thing about being an American citizen. And it seems very likely that it will eventually cost less than we pay right now. Why don’t we know that? Democrats don’t want to promise it, because, while it is pretty clear simply from the current costs and costs of similar programs elsewhere, it can’t be proved easily. Economists are saying it, however. One reason you don’t hear that it may cost less is that the health care lobby–still going strong–nothing is settled–has made it the battle costs based on our currently inflated private care. And of course they continue to try to defeat this or stall it with irrelevant, non-issues like government bureaucrats and rationing. But you hear nothing about the outrageous salaries and benefits and profits, all coming to them right out of your pocket.
Now, if you can, take ten minutes to hear a guy who is on your side.