One Sec Tech

Cited: Forbes

On November 7, the House of Representatives passed the health care reform bill by a vote of 220-215 that includes the government run insurance plan aimed at expanding coverage for 36 million people. The question we need to ask now is the kind of debate will there be in the wake of this House vote.

The lone Republican voting in favor was Louisiana Rep. Joseph Cao. The measure is expected to cost $1.1 trillion over the next 10 years, but to be fully offset by increasing taxes on the wealthy, cost savings in Medicare and other provisions.

It is a historic vote–never before has the chamber passed such sweeping health care legislation–but not the historic vote that would send the bill to President Obama for his signature. The Senate must still vote on its own version of health care reform. If that passes, the two chambers would have to sort out their differences, producing a final bill to be voted on. That whole process could take months.

In the coming weeks, a crucial debate surrounds health care reform: Will the process resemble that of the economic stimulus bill, a $787 billion measure passed in February with no Republican support? Or will it more closely resemble the push to pass climate change legislation, another overhaul effort (estimated price tag: $864 billion over 10 years) the House passed in June with just eight Republican votes, and which has an uncertain fate in the Senate?

These three very different legislative efforts, all priorities of the Obama administration, are more similar than it might appear. On their own, each of the measures cost more than the entire $455 billion federal deficit for fiscal year 2008, a record until Uncle Sam went $1.4 trillion in the red during FY2009.

Their effectiveness is also questionable. It’s not clear whether health care reform will actually curb rising health care costs; in fact, it’s largely paid for by raising taxes. The stimulus bill seems to have contributed to overall economic output, but the 10.2% national unemployment rate shows that it’s not having the fully desired effect. According to the Congressional Budget Office (CBO), climate change legislation could dampen families’ purchasing power an average of $455 each year between 2012 and 2050. What that means is uncertain, but it doesn’t sound promising.

If health care reform passes, Democrats will tout it, like the stimulus bill, as a major accomplishment. But if it throws a wrench in the health insurance industry, or if the unemployment rate continues to rise, Republicans will be able to cite during the 2010 and 2012 elections two examples of Democratic boondoggles. And like climate change legislation, health care reform would overhaul a major sector of the economy. Success would be transformative for the economy; failure, disastrous.

Nonetheless, it’s a gamble Democrats are willing to take. The House’s health care reform bill would mandate that most U.S. citizens have health insurance and expand Medicaid. It would set up exchanges so that people who don’t have employer-based insurance could get subsidized insurance from the government. While the House’s plan would dramatically expand coverage, it would still leave about 18 million Americans uninsured, according to the CBO.

Heading into Saturday’s vote, the biggest problem for Democrats was rounding up party members who were concerned that government subsidies would pay for abortions and that illegal immigrants might be eligible for insurance through the exchanges. However, another divisive issue remains: cost.

The CBO says the House bill, though fully paid for, would reduce the federal deficit by $109 billion during the next decade. That’s peanuts for Uncle Sam–the deficit for last year alone was about 13 times that amount. CBO Director Doug Elmendorf says the bill would create “slight” budget reductions in the following decade, with a caveat: “Those estimates are all subject to substantial uncertainty.”

Now, all eyes turn to the Senate, where Democrat leaders are combining two competing bills. Senators are considering levying taxes of as much as 40% on “gold-plated” insurance plans, which typically have low costs and high premiums to pay for their version of reform. The action in the House Saturday may give health care overhaul some momentum in the Senate.

Meanwhile, expect the lobbying efforts to heat up. Although the AARP, American Medical Association, and the AFL-CIO are among the powerful groups that supported the House bill, its opponents included organizations just as influential, like the U.S. Chamber of Commerce and America’s Health Insurance Plans.

It gets trickier in the Senate: Unions, which often have negotiated for their members to have some of those gold-plated plans, don’t like the idea of taxing them. And if Congress doesn’t prevent a previously scheduled reduction in Medicare reimbursement rates for physicians (at a cost of cost $210 billion), the AMA could drop its support altogether.

After the president visited Capitol Hill for some pre-vote arm-twisting on 7 November he said, “Now’s the time to finish the job.” Now the White House will get more involved with process. And the president these words many times before the final vote.

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My Take: I think they should put this health care bill to a public vote! I for one would vote no on any reduction in Medicare benefits. One of the things that Pres. Obama is planning on reducing to help pay for everybody else’s healthcare. People who use Medicare as it is don’t get much!

It’s not like Medicare recipients need the use of a Destin City Florida plastic surgeon like many rich people do. However, some of them may need a Tallahassee hair loss surgeon but they usually say, “Oh well,” and go on about their business.

However, Medicare recipients do need medical equipment that sometimes is not covered. If Pres. Obama succeeds in cutting Medicare, someone who has Alzheimer’s and needs Aricept may not get it. The same goes with someone with a heart condition that needs Celebrex. Both of these drugs are expensive and people on Medicare cannot afford them by themselves. Even if someone on Medicare needing something as simple as bladder scanning to diagnose a bladder problem may not be able to get it if they reduce Medicare coverage.

Yes, I am very opinionated on this subject. I am disabled and I have Medicare. Some things that everybody can afford because they have medical coverage, such as specific eyewear, hearing aids and dental care, are barely or not covered at all by Medicare and they went to reduce the coverage of Medicare.

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