I have been interested in the variety of responses from the talking heads, or, in this case, the writing heads. Most of this commentary comes from the left or center (the right seems to have gone off the deep end over this, claiming the fall of the Republic and other nonsense).
So here is some of that response.
Natural News: Health care reform bill dooms America to Pharma-dominated sickness and suffering:
Today the medical mafia struck another devastating blow to the health and freedom of all Americans. With the support of an inarguably corrupt Congress that has simply abandoned the real needs of the American people, the sick-care industry has locked in a high-profit scheme of disease and monopoly-priced pharmaceuticals in a nation that can ill afford either one.Read the rest.
And this Pharma-funded betrayal, it turns out, was led by the Democrats. Passed on a 219-212 vote that was only accomplished thanks to closed-door, last-minute secret meetings among the last holdouts, this new legislation puts America under the stranglehold of the medical mafia while doing absolutely nothing to address real health care reform. There is no mention in the bill, for example, of vitamin D for preventing cancer, or orthomolecular medicine for preventing degenerative disease. There's not even a word about protecting health freedom or ending the century of oppression that has been waged against naturopathic practitioners by the AMA, FDA and FTC.
The new legislation does, however, lock in billions of dollars in monopoly profits for the pharmaceutical companies -- the same companies who spent millions of dollars pushing for its passage and who depend on the continuation of sickness and disease for their future profits.
There's only one problem with this health care reform bill: It doesn't reform health care. It has almost nothing to do with health care at all, in fact: It's really more of an effort to expand a broken sick-care system. When faced with the problem that our sick-care system doesn't work, Congress somehow decided that fixing the problem merely involved expanding the failures to include everyone!
And you don't even get a choice in the matter, either. All Americans are now required to pay into a sick-care system of monopolized, pharmaceutical medicine even if they reject that failed system of medicine. So the healthy people who actually take responsibility for their health are financially penalized and forced to subsidize profits for drug companies!
What Is (and Isn't) in the Healthcare Bill: The House passed the legislation, but what does it actually do?:
5 Overblown Fears About Healthcare Reform:Here's a cursory look at what's in the legislation that the House of Representatives passed last night—and what didn't make the final cut. See a slide show of the 10 things that are (and aren't) in the healthcare bill.
1. Insurance for millions
Under the legislation, 32 million more people will have health insurance in 2019 than without the bill. That means that about 94 percent of all U.S. citizens will have insurance by the end of the decade. That still falls short of "universal coverage," but it's a significant increase from the 83 percent of American citizens who are covered today.
2. Coverage for people with pre-existing conditions
Right now, insurance companies can deny coverage to people with "pre-existing conditions," like cancer and heart disease, to name just two of many. The healthcare bill would ban this practice.
3. Help buying insurance
Lower-income Americans who can't afford to buy insurance will get help in one of two ways. The bill expands Medicaid, the free government plan for the poor and disabled, to anyone making up to about $15,000 a year. (About 16 million new people are expected to go into Medicaid or the Children's Health Insurance Program because of the bill.) Second, it would provide subsidies to people who aren't poor enough to qualify for Medicare but still struggle to afford insurance. Individuals making up to about $44,000 would qualify for some kind of subsidy. And for people who don't get insurance from their employers, they'd be able to shop for plans on new insurance exchanges.
4. Help for prescription drugs
Right off the bat, the bill will give seniors a $250 rebate to help pay for prescription drugs. Over the next decade, it also will get rid of the so-called doughnut hole (Medicare, thanks to quirks of past laws, helps cover seniors who spend either less than $2,700 or more than about $6,150 on prescription drugs, but nothing in the middle). To put it simply, seniors will get much more help paying for drugs.
5. Penalties for people who don't buy insurance and companies that don't offer it
The bill has what's called an "individual mandate," which means that most Americans, starting in 2014, must have insurance or face a penalty. The penalty would be $95 or 1 percent of income (whichever is greater) in 2014 and go up to $695 or 2.5 percent of income in 2016. The bill also includes an "employer mandate," which means that most businesses that don't offer insurance to their employees will face a penalty, too. Companies with fewer than 50 workers would be exempt.
6. No "public option"
Much of the debate in the past year was consumed by talk about the "public option," which was pushed by liberal Democrats who wanted the government to provide an alternative to private insurance plans. The House included it in its bill last fall, but the Senate, in order to get to 60 votes, did not. The final bill doesn't have the public option, either.
7. No traditional Medicare cuts
Seniors won't see cuts to their regular Medicare benefits. Those who have Medicare Advantage, however, may see some changes. Medicare Advantage plans, which are paid for by the government but administered by private companies, offer extra benefits like eye care and dental visits. These plans, on average, cost the government about 15 percent more per person than regular Medicare. In an effort to cut spending, the bill gradually cuts the amount the government will give private insurers to offer Medicare Advantage, which may lead to insurers dropping benefits or dropping out altogether.
8. Higher taxes for the wealthy
To help pay its $940 billion price, the bill raises certain taxes on individuals making more than $200,000 a year and couples making over $250,000. For example, the Medicare payroll tax would rise (for these individuals), as would taxes on some investments.
9. Cutting the deficit
Even though Republicans say the bill is too expensive and spends wastefully, the Congressional Budget Office says that it will actually help cut the deficit, by more than $130 billion in its first 10 years and more than a trillion in the second 10 years. That said, the CBO admits that there's considerable uncertainty in its estimates.
10. Making healthcare cheaper
The cost of healthcare for Americans (and the amount the government spends on healthcare) has been rising for more than a while now. The bill has several ideas for "controlling costs," including experiments to pay hospitals and doctors a lump sum for treating a particular patient, rather than paying them for every single test and procedure they provide. There are also programs in the bill to bring medicine into the digital age. Experts say these ideas could be game-changing, but it's too early to tell if they'll actually work.
Here are a few of the most overblown concerns:Read the whole article.The government will take over one sixth of the economy. That would be alarming if it were true. But government involvement in healthcare will increase gradually over time and remain modest, especially since there's no "public option" in the current plan that would set up a government-run insurer. If you have doubts, consider the attitude of professional investors, who would stand to lose a lot if the government took over healthcare. They don't exactly seem worried. Shares of health insurers like Aetna, UnitedHealth, Wellpoint, and Cigna—subject to the strongest new rules under reform—have outperformed the stock market over the past year. The pharmaceutical and hospital industries also are considered winners because there will be millions of new customers who suddenly have insurance that can pay for treatment. That led the entire stock market higher the day after reform passed. In fact, it's hard to identify any part of the private-sector healthcare industry that stands to lose under reform.
The federal debt will explode. It might, but not because of healthcare reform. The Congressional Budget Office—which is probably the most reliable, nonpartisan number-crunching outfit in Washington—says the reforms will reduce government deficits by $143 billion through 2019, thanks to new taxes and fees and cost savings in government healthcare programs like Medicare. But opponents of the bill and powerful lobbying groups like the U.S. Chamber of Commerce say otherwise, and they seem to have had a stronger influence on public opinion than CBO's methodical analysis. A recent poll by the Kaiser Family Foundation, for example, found that 55 percent of Americans mistakenly believe the CBO has said the healthcare legislation will add to the deficit. Only 15 percent know that CBO has said the opposite.
[See 21 things we're learning to live without.]
Doctors will revolt. Doctors don't like the current system, in which insurance companies call the shots. But instead of sweeping reform and more government involvement, they prefer gradual reform that puts more control in the hands of … doctors. In one recent survey, nearly one third of physicians said they'd consider leaving medicine if reform passes, which it now has. Doctors worry that the new rules will cut into their incomes—which may happen, eventually. But it's implausible that thousand of doctors who have dedicated years to a complex profession will simply quit. What will they do? Become accountants? Open a Subway franchise? Besides, with millions of new patients seeking care, the demand for doctors will actually rise, not decline. And if cost controls discourage the docs who are in it to get rich, maybe that will help bring costs down for everybody else. Meanwhile, the American Medical Association and dozens of other physicians' lobbying groups will continue to look out for doctors' interests in Washington.
Businesses will suffer. The new rules will impose fees on businesses with more than 50 employees if their workers receive government subsidies to buy insurance in lieu of employer-provided coverage. Business groups complain that this could stunt economic growth and slow hiring. But businesses are more resourceful than that. It's true that many companies will have to absorb additional costs, which they do every year anyway when health insurance premiums go up. But well-run companies excel at solving problems. That's what makes them successful. Smart entrepreneurs salivate at the chance to outcompete bigger firms that can't manage challenges like this. And companies already pass on the rising costs of healthcare to their employees; there's no reason to expect that will change if they can't manage costs some other way. There's also an outside chance that the new insurance exchanges will make life easier for small businesses, as intended, by giving their workers a way to buy coverage at rates comparable to what big companies are able to negotiate.
[See 8 sneaky ways to raise taxes.]
Socalized medicine is on the way. In the Kaiser poll, 41 percent of respondents said they believe the new law would require people who already get insurance through their employer to change their coverage. But most people who already have health coverage won't have to change anything, unless they want to. The new rules will have the most direct impact on people who don't have coverage, or who don't get it through an employer. Those who fear the advent of "socialized medicine" mainly seem to worry that the current set of reforms is just Phase 1, to be followed by bigger changes that will replace doctors with bureaucrats and render individual patients even more powerless than they are now. This is supposed to happen despite the likelihood that the Democrats who supported reform will lose seats in the November elections, while Republicans who opposed reform will gain seats. It seems much more likely that after surviving the battles of the last year, the current for-profit healthcare industry will be with us for the foreseeable future.
Calorie Counts on Restaurant Menus as Part of Health Reform:
Coming to chain restaurants nationwide, courtesy of Congress (or at least 219 House Democrats): calorie counts on menus and menu boards. Health reform legislation passed yesterday includes provisions to require restaurants with more than 20 outlets to post calorie information for all of their regular menu items.
Whether the move, which some cities have already instituted, will actually work to change purchases or reduce waistlines is still a matter of debate. A working paper released in January by the Stanford Graduate School of Business looked at Starbucks. It found that the calorie posting mandated in New York City was linked with a 6 percent reduction in calories per transaction—though beverage purchases weren't affected. A study conducted by the New York City Department of Health and Mental Hygiene also found an impact; it said that people who saw the posted calories and used the information in their purchasing decisions "consumed 152 fewer calories at hamburger chains and 73 fewer calories at sandwich shops compared with everyone else," wrote USA Today. (It's worth noting that it was the city government that mandated the calorie postings in New York.)
Read the whole article.
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From Reason, I'll Tax the Insurance That You Lack:
As I've mentioned before, one of the main factors that soured the insurance companies on President Obama’s health care plan was the mismatch between the cost of medical coverage and the size of the penalties for failing to buy it. If the government cannot conscript enough young, healthy policyholders to subsidize care for people with pre-existing conditions, rates will shoot up, encouraging more of the healthier customers to drop coverage, which will cause rates to rise further still, and so on. As Peter Suderman put it in January, "Go through a couple iterations of this, and fairly quickly you have a very small, very sick, and very, very expensive insurance pool." Washington Post columnist Charles Lane, a supporter of ObamaCare, is worried about just such an "adverse selection" spiral, and it’s not hard to see why.
Under the bill Obama is about to sign, the penalty for failing to buy medical insurance is initially $95 or up to 1 percent of income, whichever is greater; it rises to $695 or 2.5 percent of income by 2016. In 2009, according to an industry-sponsored survey (PDF), coverage for a single person in the individual market cost an average of about $3,000. For a young, healthy person making $30,000 a year, paying the penalty ($750) will be much cheaper than buying insurance he already has decided he does not want. In fact, the gap between the penalty and the cost of insurance will be larger than these numbers indicate because premiums will be pushed up by new minimum coverage standards and by regulations requiring insurers to accept people with pre-existing conditions and charge them the same rates as everyone else. Furthermore, because those new rules mean that people can safely wait until they get sick to buy coverage, the young and healthy may be even less inclined to comply with the individual mandate.
Read more.
This is good, and presents many of my own arguments, only better, so I am posting the whole article. From The Progressive, Victory for a Mediocre Health Care Bill:
In lobbying for the health care reform bill, Barack Obama liked to say, “Don’t let the perfect be the enemy of the good.” But what he really meant was, “Don’t let the perfect be the enemy of the mediocre.”
Because the passage of the health reform bill is not nearly as good as it should be.
There’s no public option.
There’s no federal rate commission on insurance industry pay hikes.
There’s no removal of the anti-trust exemption for health insurers.And most of the benefits don’t kick in until 2014, which is bad morals and bad politics. It leaves people to suffer needlessly, and it gives the Republicans an opportunity to rollback health care reform before most people have had an opportunity to enjoy its full fruits.
For instance, insurance companies can still discriminate against adults with preexisting conditions until the year 2014. If you’re sick now, and you’re over 21, you’re going to have try to hang on for three years and three quarters.
I don’t call that compassion—or reform.
Another example: The bill will expand Medicaid coverage to single poor adults for the first time—a really good thing--but that won’t happen until 2014, either. (And the ceiling is 133% of the poverty line, not 150%, as in the original House bill.)
So if you’re single and poor, you’ve got to hang on, too.
There are some other really nasty parts to this bill, as Physicians for a National Health Program have outlined.
“Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform,” the group says.
Meanwhile, the consumer may still get socked. “ Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill,” the group says. “Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.”
And hospitals with a lot of public patients will face steep cuts. “The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions.”
Then, of course, is the assault on abortion rights in the bill, which Obama will make even worse with an Executive Order he is writing on the subject to try to mollify the pro-life crowd.
At bottom, the bill was needless complicated. A much simpler approach would have been to offer Medicare for all who want it, a position that 65 percent of the American people favored. But no, Obama left the private insurance industry with a corner on the market.
The sadness is, Obama and the Democrats had the power to push through a much better bill. And the rhetoric and the muscle he summoned toward the end could have been used just as effectively for such a bill, rather than the final inferior product.
Despite all the attacks about socialism coming from the right, Obama’s health care reform bill wasn’t socialistic enough. Hell, it wasn’t even New Deal enough.
“Don't believe anyone who says Obama's health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal,” Robert Reich notes. “Obama's health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation.” (To be fair, Reich believes passage of the bill is a “very big deal” in political terms, though, since it advances the argument for a positive role for government.)
Yes, Barack Obama deserves some credit.
Yes, he finally woke up to the fact that bipartisanship is a myth.
And yes, he pushed hard for this bill at the end, though it took Nancy Pelosi to stiffen his spine.
But he should have woken up earlier. And he should have pushed harder for a better bill.
Not a perfect one. But not a mediocre one, either.
From The Christian Science Monitor, New healthcare bill pros and cons: It expands benefits now, cuts them later The new healthcare bill expands the federal budget's commitment through 2019, then decreases it for the following decade.
Read the rest.The good news: The combined package would reduce the deficit by slightly more over the next ten years ($143 billion) than previously estimated ($138 billion). And nothing has changed about the projected increase in insurance coverage. CBO still expects that the legislation would increase the number of people with health coverage by 32 million in 2019.
The interesting news: A few months ago, CBO invented a particularly useful measure of the federal government’s commitment to health care. This measure combines federal spending on health care and federal tax subsidies for health care. If you view many tax subsidies as close equivalents to spending (as I do), this is a very important metric. It would indicate, for example, that if you increase health spending, but decrease tax subsidies by the same amount, that the federal commitment to health care is not increasing, even though both spending and taxes would be rising. I think that’s a useful way to look at things.
So how does the legislative package line up on this measure?
CBO estimated that H.R. 3590, as passed by the Senate, would increase the federal budgetary commitment to health care over the 2010–2019 period; the net increase in that commitment would be about $210 billion over that 10-year period. The combined effect of enacting H.R. 3590 and the reconciliation proposal would be to increase that commitment by about $390 billion over 10 years. Thus, the incremental effect of the reconciliation proposal (if H.R. 3590 had been enacted) would be to increase the federal budgetary commitment to health care by about $180 billion over the 2010–2019 period.
In subsequent years, the effects of the provisions of the two bills combined that would tend to decrease the federal budgetary commitment to health care would grow faster than the effects of the provisions that would increase it. As a result, CBO expects that enacting both proposals would generate a reduction in the federal budgetary commitment to health care during the decade following the 10-year budget window—which is the same conclusion that CBO reached about H.R. 3590, as passed by the Senate.
In short, the reconciliation package increases the federal commitment to health care over the next decade (e.g., by rolling back the excise tax on expensive insurance plans that’s in the Senate bill) but then brings it down in the future (e.g., by ramping up the excise tax beyond the ten year window).
From a budget point of view, the basic structure of the legislative package is thus: Expand the commitment to health care in the next decade, pay for that expansion using other revenue sources, and then reduce the overall health commitment in later years.
Finally, over at Huffington Post, The Coming Republican Campaign For Medicare Buy-In:
Step one of health care reform has passed. Republicans vow to campaign on repealing it, which means that from now until the election they will use all of their communication channels to tell the public about all the problems with the health care bill. This is an opportunity. We have to tell the public that the answer to the problems the Republicans describe is not repeal; it is Medicare Buy-In, leading to Medicare-For-All.
Like the Iraq War there are facts and there are Republican lies. Over time facts catch up with lies. In spite of what the Republicans had most of the country believing, over time the public came to understand that Iraq did not attack us on 9/11. Over time the public came to understand that Iraq was not preparing to attack us with nukes.
And just as with Iraq, over time the public will come to understand that Republicans have lied to them about health care. There are no "death panels." There is no "government takeover." Etc. Over time the public will become comfortable with the reform that has passed and it will become unthinkable to go back.
The coming Republican campaign to turn the public against items in the legislation should be answered by saying this is why we now need to add a Medicare Buy-In before it takes effect. As Republicans proceed with their campaign to knock down the legislation we must make the solution a choice between going back to the bad old ways, and adding Medicare Buy-In.
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Good information. Thanks, Bill. I must say that I definately think passage of the bill is a great good thing. The benefits vastly outweigh the bad. And, having quasi-universal health care in place advances the likelihood of it being improved as opposed to our nation continuing to not try to care for all its people.
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