Healthcare

Current healthcare legislation: Bad medicine for Hispanics

As a Hispanic American, I have watched with amazement as President Obama and his team have communicated one message on health care to the mainstream media and have sent a very different and conflicting message to left-leaning Hispanic groups.  During his speech to Congress, the President said, “illegal immigrants would not be covered.”  At a recent Hispanic gathering; however, the President’s message was clear that the issue of undocumented workers needed to be resolved.  So, if immigration reform passes next year allowing undocumented individuals to become legal, this policy change could potentially add an extra 12 million individuals to the health care government program, which has not been calculated into the cost of either the House or Senate bills.  These unanticipated costs would add to the trillions of dollars that will likely be spent by the government, which is exactly what the American people fear.  It is time for the President to be straightforward with the Hispanic community and the American people.

Like all Americans, health care is an incredibly important issue for the Hispanic community.  Surprisingly, a recent poll by Latino Decisions showed that health care is the top issue for Hispanics voters surpassing the economy and immigration reform and including strong support for the public option.  These findings make it even more essential that Hispanics understand the true costs of the so-called “reforms” being debated in Congress. I am concerned that the Hispanic community is unaware of the details in the health care legislation and in turn, Hispanics, especially in urban areas, will be the losers.  While liberal congressional members have promised that the health care reform legislation is the fix-it-all wonder drug for providing insurance and affordable health care for minority communities, the outcome is pushing more individuals into the broken Medicaid program, less funds directed towards urban hospitals that disproportionately serve minority communities and cuts in Medicare Advantage that greatly impact Hispanic seniors.

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Effective reform must consider needs of speciality care physicians in addition to patients and primary care providers

Late last week, the American Urological Association, along with other groups in the surgical community, issued a statement calling for the U.S. Senate to consider changes to its healthcare reform legislation, the Patient Protection Affordable Care Act of 2009.

While we agree there is a need for substantial healthcare reform, it cannot be at the expense of physicians’ ability to provide quality care. Reform efforts should not unthinkingly sacrifice the care provided by specialists day in, day out,  in collaboration with primary care providers. High quality specialty care is an integral part of our current system and seems to have been taken for granted in some of the proposals that Congress is considering. Access to healthcare is a major issue for patients in this country and the AUA, like the rest of organized medicine, supports universal access to insurance to allow greater access.  However, legislative reforms that fail to consider the organizational capacity of our healthcare system to absorb these patients, and in particular, the capacity of all healthcare professionals, including specialists, to meet the needs of these patients,  will fall far short of their laudable goals.

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Stopping Stupak in the Senate (Sen. Kirsten Gillibrand)

As you know, last week the U.S. Senate began debate on our version of the health insurance reform legislation. As I wrote a few weeks ago, the fact that we have gotten this far is monumental but the fight is not over. The debate has already been fierce and I'm extremely disappointed that one of my fellow Democratic colleagues is introducing a measure similar to the House's Stupak-Pitts amendment. I was proud that the bill brought to the Senate did not have this provision in it, but the opponents of choice are fighting hard to get it put back in and I am prepared to fight this effort.

And I'm going to need your help. Please join me in signing Emily's LIST's Stop Stupak petition here.

It's important that we set the record straight about some grave misinformation being spread about what the Senate bill means for women and reproductive rights.

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The Big Question: Is reconciliation an idle threat or next step?

Some of the nation's top political commentators, legislators and intellectuals offer some insight into the biggest question burning up the blogosphere today.

Today's question:

Is the Democratic leadership's threat to use reconciliation on healthcare reform a politically viable option or an idle threat?

Sen. Johnny Isakson (R-Ga.) said:

Reconciliation is simply a maneuver for Democrats to force their terribly flawed, outrageously expensive, government-run healthcare system on an American public that doesn't want it. It's hard to believes the citizens of this country will stand for that kind of behavior.

Craig Newmark, founder of Craigslist and a Pundits Blog contributor said:

We need Senators and Representatives to vote their conscience and give Americans a break via health care reform. A lot of people are suffering out here, thousands more every day.

If not the case, we need the leadership to do what it takes.

Dean Baker, Co-Director of the Center for Economic and Policy Research, said:

This one requires political insight beyond my capacities, however there is an obvious point to be made. If the use of reconciliation really is an idle threat, then an awful lot of people around DC look really stupid right now since, they made such a big point of pushing for the inclusion of health care under reconciliation last spring. If there is no conceivable scenario under which reconciliation will be used to get health care passed, then maybe the political insiders who were pushing it last spring should look for a new line of work. They wasted a lot of people's time and energy when they obviously didn't have a clue as to what they were talking about.

A.B. Stoddard, associate editor of The Hill, said:

Reconciliation is used for legislation that saves or spends money, which is why it was used to pass President George W. Bush's tax cuts in 2001. Anyone in the Democratic leadership will admit privately that though it remains on the table it would be nearly impossible to pass a bill the Democrats could defend using the reconciliation procedure. Since any of the insurance reforms and consumer protections that remain the most popular part of the bill would be subject to a point of order and would likely be thrown out, Democrats would end up with a massive subsidy bill that cuts Medicare but doesn't reform the health care delivery system. Democrats know that to end up with a conference-bill that can get signed into law they are likely better off with a product now that wins over 60 votes and appeals to conservatives. 

John F. McManus, president of The John Birch Society, said:

It seems to me that the Democratic leadership will do whatever it takes to enact some sort of healthcare program beyond the truly gargantuan ones (in cost and bureaucratic management) already in place. My surmise is that, if allowed to do so, they will resort to the time-tested and despicable process known as "get something on the books; we'll fix it later."  The "fixing" that might come later would bring the measure up to their ill-conceived standards, the plateaus that in time will help us to duplicate what Cubans endure. The real solution for any American who gives a hoot about the U.S. Constitution and the freedom of the American people is to bar the government from having anything to do with healthcare.  Does anyone see "health" or "medicine" in the Constitution?  I don't!

Bill Press, host of the Bill Press Show, said:

I certainly hope the use of reconciliation to pass a strong health care reform bill is more than just an idle threat. With zero help from Republicans, Democrats are closer to passing health care reform than they've ever been. Harry Reid must not let two or three so-called Democrats, who oppose the public plan option, scuttle the whole bill. If Leader Reid can't get 60 votes, he should not hesitate to invoke reconciliation.

John Feehery, Pundits Blog contributor, said:

It's a real threat, but should Reid follow through with that threat, it will be dangerous for him politically. Nevadans are not happy with where Reid is taking the healthcare debate (and the country), and a bill that employs reconciliation would be significantly to the left of where Reid's constituents are. So, if Reid decides to go that route, he may lose his seat as a consequence. That is why he is trying to thread a needle and pass a bill without going the reconciliation route. 

Justin Raimondo, editorial director of Antiwar.com, said:

I see no reason to consider it politically unviable. If that's the only way they can pass it, then it seems likely they will.

Michael J. Wilson, national director of Americans for Democratic Action (ADA), said:

It can’t be an idle threat – it has to be a promise.  While President Obama has been fighting for health care reform – as have many Democratic Senators -- Senators McConnell, Kyl, and DeMint have proven that there is great solidarity among those opposed to health care reform in their opposition to make it the President’s Waterloo (their term, not mine). Senator Reid has three options; work with the Senate to pass the best bill possible through regular procedures, garner 60 votes to end the filibuster, or utilize reconciliation in order to keep faith with the American people.  Call it a threat or call it a promise, but the finish line is within sight.  To show acquiesce to those who are not in the majority and let them determine the outcome of health care for the rest of us would be criminal.  Sen. Reid has to keep reconciliation in his breast pocket and willing to use it if necessary.  If only to keep the promise.

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Industry funded report is more of the same false attacks on real health care reform (Sen. Tom Harkin)

Yesterday the health insurance industry released yet another report that claims insurance premiums will rise under the Senate hearth reform bill,  the Patient Protection and Affordable Care Act.  This study’s “findings”  are far from the truth.  In fact, the findings go against reports from the non-partisan, independent Congressional Budget Office (CBO), which show that the bill will save average Americans money by creating more competition in the health insurance industry and cracking down on waste, fraud and abuse.  In fact, just yesterday a new analysis showed that our legislation will result in significant savings of 14 to 20 percent for Americans purchasing coverage on their own.  In my home state of Iowa, individual will save from $148 to $355 annually and Iowa families will save between $960 to $1,177 on their health insurance premiums.

And lower costs are just the start.  The bill will also ensure that Americans will no longer be denied coverage because of pre-existing conditions and will no longer be subject to gender rating or rate hikes because of health history.  At the same time, the measure will extend coverage to an additional 31 million Americans, which will save lives.

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A Day of Action!

We called for a day of action to stop the Stupak abortion ban and that's exactly what we got! Like me, hundreds of activists from across the country flooded the U.S. Capitol today with one mission in mind -- to pass health care reform and to ensure that the anti-choice abortion ban, known as the Stupak amendment, is not part of the health care reform bill.

I was blown away by the energy of the standing-room-only crowd of more than 1,000 advocates at our noontime Stop Stupak Event on the Hill. Pro-choice American women of every age and geographic background and some pro-choice men, too -- thank goodness for them -- made it clear that health reform that robs women of access to reproductive health care is not health care reform at all. The power of our movement was palpable.

Planned Parenthood representatives from 30 states were there. Seeing all of our supporters and our many coalition partners (too many to list here) in one room was awe-inspiring.

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Should Americans be allowed to spend their own money to save their own lives? Rationing in the Senate and House health care bills

Although there has been much discussion of the Medicare cuts in the Senate and House heath care bills, little notice has been taken of provisions in both that would effectively empower the Health and Human Services Department to deny senior citizens the right they currently have to add their own money on top of the government Medicare contribution in order to get insurance less likely to ration health care.  In practice, this means limiting older Americans’ ability to spend their own money to save their own lives.

Both Section 3209 of the Senate’s Reid Substitute and Section 1175 of the bill passed by the House indirectly amend the section in existing law that allows private fee-for-service Medicare Advantage (MA) plans to set their premiums without interference by the Centers for Medicare and Medicaid Services (CMS) to add, “Nothing in this section shall be construed as requiring the Secretary to accept any or every bid submitted by an MA organization under this subsection.” This allows CMS, at its absolute and unlimited discretion,  to refuse to allow private-fee-for-service plans that charge premiums adequate to avoid rationing treatment to be offered– or, literally, allows CMS to ban private-fee-for-service plans (or any other MA plans) altogether, without having to base its decision on any statutory or regulatory standard.

Similarly, both bills, instead of allowing American consumers themselves to balance benefit and cost in choosing what health plans to be purchased in the new insurance exchange that would be set up (nationally under the House bill, and separately in each state under the Senate bill ) would authorize the exchange to exclude plans offered by insurers deemed to have a “pattern or practice of excessive or unjustified premium increases”– terms completely undefined by the bill and thus left to the unfettered discretion of the exchange to interpret and apply.

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The Big Question: Will 'Louisiana Purchase' amendment backfire?

Some of the nation's top political commentators, legislators and intellectuals offer some insight into the biggest question burning up the blogosphere today.

Today's question:

Republicans seized on an addition to the Senate healthcare bill that provides $100 million in extra Medicare subsidies for "certain states recovering from a major disaster," as pork designed to win the vote of Sen. Mary Landrieu (D-La.).

Will Democrats pay a political price for this amendment or will memories of Hurricane Katrina prevent a widespread backlash?

Glenn Reynolds, the Instapundit blogger, said:

"Every election is an advance auction of stolen goods." This is just dividing the loot.  It should remind people that the more power and money they give to the government, the more power and money will be spent in the purchase of . . . yet more power and money for the government.

Bill Press, host of the Bill Press Show, said:

Nobody will remember this well-deserved Medicare subsidy, and nobody can prove it "bought" Sen. Landrieu's vote. Republicans are just looking for anything to distract the American people from the fact that they voted, en bloc, for the status quo and for leaving insurance companies in charge.

Armstrong Williams, Pundits Blog contributor, said:

Its cash-and-carry time on the hill. Desperate to pass Obama’s signature health care proposal, the Democrats are funneling money to key centrist Democrats, whose votes are needed to pass healthcare reform. 

Most of the country calls this bribery. In D.C., the preferred term is “walking around money.” Semantics aside, here’s the jig: the Democrats need every Democratic senator, plus two independents that caucus with them, to ensure that the healthcare bill is filibuster-proof. In order to ensure that they get those votes, they’re now handing out bribes ... er, um ... “walking around money” to those Senators who might oppose the bill.

Exhibit A: Centrist Sen. Mary Landrieu (D-La.) recently declared she would vote for the Senate's first procedural motion on healthcare reform. Just 24-hours prior, the Democrats inserted an amendment into the bill providing for $100 million in extra Medicare subsidies for "certain states recovering from a major disaster." Landrieu's state of Louisiana, of course, was hit by Hurricane Katrina, thus making it a shoe-in for the extra pork. As if there were any doubt as to the intended recipient, the amendment clearly states that only Louisiana is entitled to the extra cash. In a press release, the GOP criticized her vote as the "new Louisiana Purchase." Otherwise stated, Sen. Landrieu was bribed. I can understand if she supports the healthcare proposal because she feels tax hikes and Medicare cuts are an acceptable price to pay for near-universal healthcare. I cannot accept that she is supporting a bill that may bankrupt the country in exchange for an unapologetic bribe.

Peter Fenn, Pundits Blog contributor, said:

So, let me get this straight -- the Republicans want to bring up their incompetence and mismanagement of Katrina and complain about help to that devastated area? Hmmm, bring it on.

Justin Raimondo, editorial director of Antiwar.com, said:

A corrupt Louisiana politician? Who would've thought?!

The public is realistic -- i.e. completely cynical -- when it comes to the behavior of politicians. They expect this -- and are rarely disappointed.

There will be a backlash, but not against the "Louisiana Purchase," specifically, but against the healthcare "reform" bill in general if and when it becomes law. Because they will then discover that they've been "reformed" out of their private health insurance plans, confronted with a tax hike, and coerced into buying into a government-mandated healthcare plan that they may not want, or need.

Dean Baker, co-director of the Center for Economic and Policy Research, said:

The cost is equal to 0.003 percent of the budget or 100 soldiers in Afghanistan for a year. There are bigger political handouts than this, with less justification, every day of the week. If the Democrats pay a price for this it would only be because the media is even more incompetent and/or corrupt than is generally recognized.

Bernie Quigley, Pundits Blog contributor, said:

It is a disgrace. It is this kind of malfeasance, manipulation and criminal contempt for the citizenry that is leading states with vitality and life force to take their own initiatives.

A.B. Stoddard, associate editor of The Hill, said:

No one wants to know how sausage is made, for this very reason. And this isn't new. There are likely more concessions we know nothing about. But Sen. Mary Landrieu (D-La.) isn't wrong to fight for money for the very broke state of Louisiana and she isn't wrong to make a trade in exchange for her support on a procedural vote. Senate Majority Leader Harry Reid made his own deal to help his state cover the Medicaid expansion included in health care reform that are so unpopular with governors across the country. The states simply cannot afford to shoulder more Medicaid costs.

Michelle D. Bernard, president and CEO of the Independent Women's Forum, said:

The American public is so used to hearing examples of wasteful spending and the corrupt use of earmarks that the mini-scandal over the purchase of Senator Landrieu is likely to elicit little more than yawns. The public's opinion of Congress -- which boasts approval ratings of less than 30% -- could hardly be lower.

Yet, if the Democrats are unlikely to pay the price for this instance of vote buying, they are likely to pay a price for ramming through a health care package that few Americans say they want. A poll of women (who are generally assumed to be more sympathetic to an expanded role in health care) showed that two thirds of women would be less likely to support a candidate who supported moving people from private to government run care.

People are increasingly coming to realize that the Democrats' health care proposals would mean higher insurance prices for most families, higher taxes, more government debt, and big cuts to Medicare; in other words, it's a big political loser. Democrats can be certain that Republicans will work to tar opponents as tax-and-spend, big government liberals for supporting this massive expansion of government's role in health care. And with the facts supporting the allegations, it's a charge that's likely to stick.

John F. McManus, president of The John Birch Society, said:

Democrats won't pay a political price for the "bribe" given to Sen. Landrieu because the Republicans, who might exact such a price, are equally guilty of padding legislation with their own earmarks. The process of looting the taxpayers with special payments for virtually everything under the sun is the problem. If constitutional law and good sense ever return to Capitol Hill, the process will cease. At that point, the increasingly beleaguered American taxpayer will breathe a sigh of relief.

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The Republican plan to block healthcare reform (Sen. Jeff Merkley)

Last night, we took a huge step forward towards passing health care reform. Senate Majority Leader Harry Reid unveiled details of the Patient Protection and Affordable Care Act and the CBO score stating that the bill will reduce the budget deficit by $127 billion dollars over the first 10 years and provide coverage to tens of millions of Americans who are currently uninsured.

Last night, we took a huge step forward towards passing health care reform. Senate Majority Leader Harry Reid unveiled details of the Patient Protection and Affordable Care Act and the CBO score stating that the bill will reduce the budget deficit by $127 billion dollars over the first 10 years and provide coverage to tens of millions of Americans who are currently uninsured.

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The Big Question: Who loses if GOP filibusters Senate healthcare bill?

The nation's top political commentators, legislators and intellectuals offer some insight into the biggest question burning up the blogosphere today.

Today's question:

If Republicans successfully filibuster the Democrats' healthcare reform bill, who loses politically? Will Republicans be labeled obstructions or will Democrats be labeled ineffective?

Rep. Danny Davis (D-Ill.) said:

The people lose.  They lose politically, they lose economically, they lose socially and most of all, they lose in quality of life and health.

Ronald Goldfarb, Pundits Blog contributer, said:

Both. And the American public will be fleeced by the moneyed lobbyists.

Rob Richie, executive director of FairVote, said:

The big loser will be the filibuster itself. Republicans are pushing use of the filibuster to an unseemly extreme, while some Democrats are clearly taking advantage of it to shake down the leadership for pet concerns in exchange for a key votes.

As public perception of Congress sinks, senators may finally wake up to the fact they are demeaning the institution -- we have gone to more filibusters in six months than in the entire 19th century. Any success in killing health care based on the filibuster could be the final straw that breaks the filibuster camel's back. By simple majority rule, the Senate might then redefine the filibuster so that it encourages more deliberation, but does not undercut the accountability that comes with final votes on passage being based on majority rule

Armstrong Williams, Pundits Blog contributer, said:

The healthcare reform bill is one of the most sweeping pieces of legislation to come from the Democratic Party in decades. Thus, its failure—which seems increasingly imminent— will be historic. With moderate Democrats joining Sen. Lieberman in threatening to filibuster the bill, it is hard to see how the Democrats will garner the 60 votes needed to break a filibuster.

The major bone of contention is the public option, which would effectively create a government takeover of the health care industry. The Republicans have taken ownership of this issue by stressing how the public option would drive private insurers from the market. For good reason, no one trusts the government to run an industry that is equivalent to one-sixth of American gross domestic product. With little to show for their $787 billion bailout, the electorate is increasingly hesitant to support a bill that could bankrupt the country. In a close legislative battle, people will opt for the status quo. A Republican filibuster will maintain the status quo, and thus seem the most palatable option.

Meanwhile, the administration will look increasingly unable to make progress on any of their legislative agenda. On all fronts, the Democrats are looking incompetent. Americans are no longer so sure about Obama’s ability to
repair the economy, heal the rifts that divide this country, or even to accomplish a smattering of his professed political goals. The inevitable failure of the healthcare bill will be just one more signpost in this administration’s winding road of legislative failures.

Justin Raimondo, editorial director of Antiwar.com, said:

A filibuster would undoubtedly make the Republicans out to be the party of "obstructionists," but then again some things need to be obstructed. I think the underlying unpopularity of healthcare "reform" -- do we really need yet another major entitlement program in the midst of a recession? -- will neutralize the "obstructionist" charge.

And of course the Democrats do have a majority, albeit one that may not be sufficient to overcome a filibuster. Most Americans don't understand arcane Senate rules, however, and so voters will be left wonder: How come the Democrats can't seem to get it together?

I think the momentum for the healthcare "reform" bill is largely gone, and the focus is rapidly shifting. People want to know when the jobs will start coming back, and aren't all that concerned with plunging into largely unknown territory with a multi-thousand page heathcare measure.

Herb London, president of the Hudson Institute, said:

As I see it the country will engage in a collective sigh of relief if Republicans along with nervous nelly Democrats can deep six this bill. Sentiment has been running heavily against it and the races in New Jersey and Virginia have put on the fence Dems in an awkward position. The vote should be close but there are too many controversial dimensions of this bill for passage.

A.B. Stoddard, associate editor for The Hill, said:

A successful Republican filibuster of health care reform would alter the political fortunes of the Democratic party, not the Republican party. The public is split down the middle in support and opposition to reform, with majorities believing that costs will go up as a result of reform and that quality of care isn't likely to improve. Independents are moving out of the Democratic coalition and are now supporting Republicans out of concerns that the Obama administration has expanded government and deficits to unprecedented and dangerous levels. No matter what the health care reform bill looks like the GOP would claim they had stopped an imminent disaster because the Democrats wanted to go too far and that their bill would have done far more harm than good. Would they succeed in stopping reform Republicans would paint the Democrats as beholden to liberal special interests like pro-choice advocates, incapable of governing and unable to deliver on promises. I think independents will believe them.

Rep. Raul Grijalva (D-Ariz.), co-chair of the Congressional Progressive Caucus, said:

If Republicans kill health care reform with a filibuster, the voters will hold them accountable. It’s hardly a matter of personal opinion what will happen next. Polls show that a public option is popular nationwide, including with political independents, and if Republicans are really heartless enough to smother it in the cradle, they’ll face a backlash they’re not prepared for.

John F. McManus, president of The John Birch Society, said:

If Republicans filibuster the Senate version of the healthcare bill, the biggest winner will be the American people. If the filibuster fails, the biggest winner will be the state-of-mind Marxists who want government to control everything.

As for the political fallout should the filibuster succeed, the Republicans will receive angry responses from people who think it's government's role to take care of everyone. And the Democrats, who are losing support for many other reasons, will lick their wounds while insisting, with customary unfounded name-calling, that un-American right-wing loonies are too powerful. To those who want government healthcare and lots of other government paternalism, I say, "Check out Cuba to see what more than 50 years of such 'care' has accomplished."

Michael J. Wilson, national director of Americans for Democratic Action (ADA), said:

That decision is really up to the American voters. Of COURSE the Republicans are obstructionists (every single Republican in the House – save one – has already voted against health care reform. Isn’t that the definition of groupthink?) But the GOP is gambling that they won’t pay a political price for that intransigence. And if they are able to pick off a GOP-leaning Democrat like Joe Lieberman (who really preferred John McCain for president) of COURSE it will make the Democrats seem ineffective. The institutional problem is that rewarding that kind of behavior is like giving in to a child who is having a tantrum. The symbolic threat that Sen. Minority Leader McConnell will hold his breath until he turns blue is laughable unless he wins. Then the joke is on the American voters.

Bill Press, host of the Bill Press Show, said:

For Republicans to filibuster healthcare reform legislation would be more than short-sighted. It would be suicidal. They are setting themselves up for failure in 2010 and 2012 as the party that opposed Social Security, Medicare, and now, universal healtcare. Thanks to John Boehner and Mitch McConnell, the Republican Party has become the Party of No and the Party of Don't Care.

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