Unemployed in Michigan

Joe Biden apparently can make the difference in the upcoming battle to pass health reform, which will be critical for helping the economy recover and improving the unemployment rate.  According to an MSNBC report, he has the power to overrule decisions that will be made during Reconciliation.   When Republicans object to a part of the bill, the Senate parliamentarian can decide to throw that part, but Joe Biden can overrule that decision.   Will the Democrats have the guts to pass health care reform in this manner?  They should, because you can bet the Republicans would not hesitate to do so if the shoe were on the other foot.  They have always viewed politics as an offensive war against the opposition, not as a way to help the American people.  To get anything done, the Democrats should fight them on their own terms.

Today the President met with Republican and Democratic leaders to discuss health care reform.  In general, Republicans most often said (1) the American people don’t like the bill (2) “we need to start over” by throwing out the current bill and (3) it is a government takeover of health care.  To me it sounded as if they were reciting the lines that were dictated to them by a central party.  It was clear the Republicans did not come to the Summit to try to help, but to obstruct.  Quite a few Democrats talked about a large pool that would help reduce costs.  This sounds a lot like the public option.  The current Senate bill does not contain a public option, but the house bill does. President Obama seemed just plain fed up with the Party of No and endorsed passing the bill on reconciliation.  So there is still hope for a good health care bill that will help the poor and unemployed.

These are my notes from viewing the meeting on cspan.org. Of the seven hour meeting, I watched the first half hour, but missed the next hour. I have tried to be objective and just report what I heard.  Republican comments are shown in italics.

Introduction

Republicans began by saying they want to start at the beginning by throwing out all of the work that has already been done.  Their main concern seems to be their perception that the bills would raise taxes, even though the Congressional Budget Office says the bills would not raise taxes!  Democrats agree that insurance denials because of pre-existing conditions should be eliminated. Republicans believe insurance companies should be able to drop people if they have pre-existing conditions.  Democrats and Republicans disagree on how to accomplish any reform.  Republicans think the bill should be put aside and just tackle small things one at a time, because the country just cannot afford the additional taxes caused by this bill.   Both parties seem to agree that people should be able to buy insurance plans from other states, although this does not seem to create much in the way of savings on the health care dollar.

Insurance Reform

President Obama asked Kathleen Sibelius, who had been an insurance commissioner, to speak about the problems of moving forward with health care reform.  She stated that the insurance market generally fails people (Am Med Assn study) by not providing choice, providing poor benefits, punitive plans based on your health conditions, and high costs.  High risk pools, provided by many states, are very expensive, because it costs more money to treat the sickest people.  The state pools do not work very well.  Insurance commisioners oppose private health plans, because there are no protections (ins co. can kick people out of hospitals early).  There should be choices for consumers, and insurance companies should be regulated by how much is being spent on salaries and health care.  Transparency would allow regulation.  Pools, like those in an Exchange (contained in the current bills) would allow this kind of regulation and ability to understand where money is being spent.    Republican Eric Cantor spoke next, but he started by speaking about the bill in general.  In no way did he address her comments. Again, he said the bill should be set aside and start over.  Obama then made the point that insurance is a very complicated activity.  For example, we use the FDA to protect consumers so that new drugs are not just used without first being tested.  The insurance exchange would provide this same level of protection by allowing an equal playing field for insurance companies.  In addition, a very large pool for those do not have insurance (e.g. high risk people or those who cannot afford anything else) would allow the risk to be spread among a very large number of people.  It would have the effect of allowing lower rates for all.  Companies would not have to drop people for pre-existing conditions, because the effect of that person would not be the same without that large pool.  Eric Cantor’s then restated the Republican mantra that it was that we just can’t afford it, and the government should not force people to be part of something they don’t want.  Obama answered this by stating that no one will be forced to be part of it.   

Republican Mike Enzi started by saying that seniors are upset because so much money will be taken from Medicare.  He also said republicans had made very little input on the current bill (see response from Tom Harkin next).  He wants to include Health Savings Accounts, which can be very helpful to younger workers.  He agrees that an exchange is a good idea.  Democrat Tom Harkin stated that there had been two committees and many meetings, with over a hundred Republican amendments.  9 out of 10 changes are also in the House bill.  He made the point that you can’t make small changes to the industry, because you need to have everyone in the large pool to get the cost benefits.  In Massachusetts, premiums dropped 40% after implementing a comprehensive public insurance plan.  His last point was to compare segregation with health care insurance, where sick people are discriminated against because of their health status.  Therefore he does not believe in having separate pools, but one large pool.

Republican Dave Camp  said Americans should not be forced to buy insurance they can’t afford.  The health care bill should be scrapped.  The President stated that in the Republican bill, if you are in a high risk pool because you can’t afford another, then the premiums would be very high because of all the sick people there.  This would not be a useful tool, because there was not enough money to pay for them.  He reiterated Kathleen Sibelius’s points about state high risk pools. 

Democrat Jay Rockefeller said that states cannot do it better, as the Republicans would have us believe.  His case in point is that states allow insurance companies to kick people off their plans. Insurance companies are not restrained by antitrust laws, and their only goal is to make money, not to provide health care.  “It is a rapacious industry that does what it wants”.  Again, we need to have a big pool.  He suggested as others have, we need to mandate that insurance companies are spending 80% of revenues on patient care expenditures.

Republican Marsha Blackburn spoke about purchasing insurance across state lines.  She is for it, because many people in her state are near state lines.  She said this would not be available until 2016 by the current bill.  The President responded saying he supports intrastate insurance availability.  But this would not help the problem of there not being one large pool, from which there will be real cost savings.  But if there was a national exchange, then these health plans could be available.  We are doing this now but only on a limited, local basis (i.e. from one insurance company).   Marsha seemed  to not understand his point and said people should instead be allowed to go outside of the state to seek insurance.  The President noted having an exchange is the the same thing.

Deficit

The Vice President noted there is a lot of waste in Medicare spending and health care costs have gone way up.  35c on every health care dollar is being spent by the federal government on Medicare and Medicaid.  The costs are rising exponentially, but the bills will both cut cost growth significantly as confirmed by the Congressional Budget Office.  He said that many of the savings will be put back into health care.  Medicare Advantage was supposed to be more efficient, because private companies would run these plans.  

Republican Paul Ryan said the bill does not control costs.  It will not reduce the deficit.  It takes money out of Medicare to pay for the new health care plan.  He said millions of seniors who have Medicare Advantage, which is working well, now will lose this insurance.  The cost for the system to absorb their health care will increase the deficit.  He said the chief actuary stated the deficit will increase and feels the CBO is unrealistic in their findings.  The government should not be in control of health care.  We need to start over, because the current bill will not work.  The President responded that the money taken out of Medicare for Medicare Advantage would be ($500 billion) would be used to close the donut hole (a prescription insurance fee) and would create savings.  He said he has seen no study showing the Medicare Advantage is really working well.   Republican John McCain said that 800,000 Floridians would not get their Medicare Advantage cut by the bill, and this is unfair to everyone else.  The President agreed.  Tom Coburn said we just need to make sure the benefits for Medicare Advantage are being applied more effectively.  Democrat Xavier Becerra then said the Republican doubts of the CBO findings is unrealistic, since they are all we have to make these judgements about the bills.  Republican Chuck Grassley said both bills cause more taxes on small businesses, and this hurts the economy.  He said the bill is creating an unconstitutional mandate for Americans to buy something (i.e. health insurance).    So much money is going to Medicaid, but doctors routinely refuse to treat Medicaid patients.  President Obama then stated that we need to have courage to make changes such as getting rid of Medicare Advantage.  Medicare Advantage is making a lot of profits for the insurance companies, and it is not a good use of health care dollars.  Democrat Kent Conrad indicated something must be done about finding savings in Medicare, because it is known that it will go broke in 8 years.   He said 5% of Medicare recipients use most of the money spent by Medicare, and we must do something about the problem of caring for these sick folks. 

Republican John Boehner said the American people want the bill to be scrapped.  Medicare and Social Security are going broke.  Government takeover of health care is wrong.  We should not raise taxes.  We should improve Medicare instead of creating a new entitlement program.  It will drive up the cost of unemployment.  Employers will dump their employees from their insurance plans, and they will then go to the exchange.  He also said the bill allows for taxpayer funded abortions.  President Obama sharply answered these comments by saying that these talking points were well known and all not true, but there is no time in this discussion to address them once again.  Democrat Jim Cooper noted that talk is cheap, but republicans who had supported bills in the past did not vote for them.  The republicans passed a huge medicare bill in the last administration, and it has increased the deficit significantly.  Republican John McCain said that Medicare Malpractice reform should be included in the bill, as it works well in Texas.  He also said reconciliation has never been used to pass a bill like this.  President Obama retorted that Americans want a vote to move forward.  Malpractice reform would not gain much in savings.  Democrat Dick Durbin confirmed this by quoting the CBO findings.  He went on to say the bill would incentivize states to reduce medical errors, and that alone would help in this area.  In fact, malpractice claims have actually significantly decreased in recent years.  But the republicans are focusing on this insignificant issue instead of trying to provide health care to most Americans.

Coverage

The President said that most Americans should receive health insurance coverage.  Everyone should be allowed to be in a large pool and subsidize those who could not afford it.  But there is a difference in the two bills of how many people would be covered. 

Republican John Barrasso said that Americans believe their health care costs will go up and quality go down.  Further, putting 15 million people on Medicaid will not ensure their care, because doctors will refuse to treat them – doctors do not make enough money on Medicaid patients.  We need to start over.   The President answered saying that the people who will benefit are not like congressmen, who can well afford their health insurance, but are working people who can barely afford to live.  Barasso had nothing to say to this.  Democrat Henry Waxman reiterated that we need a very large pool so that costs for the sick can be contained and absorbed by the premiums being paid by the healthy.  After all, that is what insurance is for.  Everyone needs to be in the pool.  The deficit would not be affected.

Republican Peter Roskam said people in his district are very disappointed.  He objected to funding the uninsured via Medicaid, which is not working well. 

The President said no one has yet addressed the difference in coverage between the two bills.  Very poor people are now on Medicaid.  He said those who need it the most are working people who make too much to be on Medicaid but cannot afford any insurance.  Expanding Medicaid is thus a good idea.

Democrat Chris Dodd said republicans think those who don’t have insurance are just not working hard enough.  He noted that everyone else is paying for those uninsured people who show up in the Emergency room to have to have medical care at some point in the future.  Everyone’s taxes and insurance premiums go up, because these higher priced bills need to be paid by someone.  Thus these people must be covered in order to help reduce overall health care costs.

Republican Joe Barton said that free markets are to be used for allowing choices.  The government should not regulate in order to provide competition.  He went on to say that allowing purchasing insurance across state lines will help to reduce premiums. 

Democrat Ron Wyden noted republicans have said they want incremental coverage instead of the big bill, but he noted incremental reform usually costs more. 

Republican Mitch McConnell said that Americans don’t like the bill and they don’t want it to pass on reconciliation.  We should start over.  The President stated that when people understand the bill, they overwhelmingly support it.  Polls are important, but you need to understand what questions were asked.

John Dingell stated that starting from scratch is just partisan, bogus talk.  We need to do something about the impending disaster of doing nothing about the health care system.  He asked “why people are upset at making  a decision based on a democratic majority of 51 votes?” 

Speaker Pelosi came out in favor of the public option.  She also stated there is no public funding of abortion, and there is no reduction of Medicare benefits for seniors in the current bill, in defiance of republican statements above.  She indicated that the republican bill would not get rid of pre-existing conditions.

The President summarized by addressing many of the republican points above.  He noted that the Exchange would be a free market and not a government takeover.  But it would allow people to easily choose a plan that is best for them.   He said employers would have to pay a fine if they dumped their employees, because that is just part of their responsibility to their employees.  Many of the ideas already in the bill came from republicans, but some of those same ideas have since been attacked by republicans.  On reconciliation, the President believes that the American people want a bill to be passed.  “We cannot have another year-long debate on this”.

It should now be clear to Americans that Republican leaders are cowards who are only out for themselves.  They are backing away from Obama’s offer of a bipartisan meeting (see article) to resolve differences on healthcare legislation.  They are afraid to meet with him again after their meeting with him in Baltimore.  He destroyed their every point, and they do not want the American people to continue to see how inept they really are (note how Fox News did not report on that meeting).  After all, what do they have to be afraid of if they really have any good ideas?  The only ideas they have put forward are already in the bills (see article search for BOEHNER:’)!   Their demand to “start over” seems ridiculous – why are they afraid to attack him on actual points in the proposed legislation?  The answer could be (a) they do not understand the bills as proposed (b) they are too lazy to read them or (c) they know they will lose votes when people see their real intentions.  I will give them the benefit of the doubt and assume they fear losing votes in the coming elections.  It is becoming more clear what selfish losers these Republican obstructionists really are.  My guess is their strategy is to force Obama to pass healthcare on reconciliation so that in the 2012 election campaigns they can say that the Democrats did not listen to their (nonexistent) ideas on healthcare. 

It should also be obvious by now that Republicans do not care about the wishes of the voters.  Their goal is to push their own narrow agenda despite what most people want or need.  With them it is just a game to see how many people they can sucker into believing that theirs is the way to a self-centered “prosperity” by witholding help from those who need it.  Unfortunately there are some naive people who fall for this, forgetting that conservates led us into this recession.

Unemployment funds are now in peril as conservative forces are gaining ground again.  Once again the party of No has succeeded in appealing to the selfish interests of the people by fearmongering.  The Supreme court, now loaded with Bush conservatives, has decided that it was a mistake to let a president be elected by the people.  Instead they have ensured that future elections can be controlled by corporations.  No longer will we be able to elect a president with personal small donations via the internet, as Obama was elected. The much richer corporations will forever have the advantage and continue to air TV commercials that promote their interests alone.  Not only are future unemployment funds in jeopardy, but it is also the last chance for health care reform, as the insurance giants will make sure that republicans continue to be elected and oppose future health care reform.  The last chance is now.

With the loss of Ted Kennedy’s seat to a republican senator, Republicans will surely filibuster any health care bill.  It is the last chance for a bill that can benefit the poor and unemployed.  Democrats need to push through a bill without fear of a filibuster and pass a bill in reconciliation.

Both Republicans and Democrats opposed Social Security reforms with similar complaints of big government taking over, high taxes, etc.  This is nothing new, and does anyone really think anyone actually wants to get rid of Social Security now (aside from the few individuals who have enough for retirement without it)?

In Michigan, with its almost 16% unemployment, the health insurance companies are one of the few employers that are actually hiring.  Does anyone think that bailing out the banks was a bad idea?  Well one idea for a health care bill will be sort of like bailing out the insurance companies, who are the least who need help!

Congress might propose a public option which would not take effect until it was shown that there were savings for the American people.  This is the scenario they are talking about:  There would be no public option at first, or maybe never.  Everyone would continue to buy insurance from insurance companies, using public funds for those who can not afford it (i.e. the 45 million now uninsured).   So the insurance companies will suddenly have 45 million new subscribers that we are paying for with our taxes!  So what is the trigger?  That means if someone decides the insurance companies are not providing enough savings for our tax money, then government would resort to a public option, which would be a program (like Medicare) that would cover the 45 million uninsured. 

So what is the problem with the Trigger Option?  The short answer is it will probably never happen.  Insurance companies love this idea, because they will be able to reap a huge bonus from our tax dollars.  But who will decide whether the savings are there, and how long will it take?  The devil will be in the fine print of the bill.  It just doesn’t make sense anyway, because we already know that health care costs are spiralling out of control.  I have not heard of anything in any of the bills that would control health care costs for those of us who have insurance now.  The only proposal so far is the public option, which would be a government-run company that would compete with the huge insurers.  So things will continue on the path they are on now, the only difference being that insurance companies will reap even larger profits due to the large number of new subscribers funded by public money.  Good luck in pulling that trigger.

The Republican party had its roots in the anti-federalists of the American Revolution.  They did not want a strong federal government, because they had just gotten free of an overbearing King.  George Washington knew better than anyone how difficult it was to win a war with a poorly funded army, and to go forward as a country they needed a strong federal government.  I find it hard to see any similarities between modern Republican politicians and people like Thomas Jefferson, an anti-federalist who became the first populist president.  My opinion is that today people become conservative for selfish motives, although many delude themselves into thinking their reasons are virtuous.  I am not alone: Senator Grayson thinks the Republicans should be renamed the Selfish Party. Some are unapologetic about their base motives and will stop at nothing to get what they want including violence and murder.  It is my opinion that many of the rest derive secret pleasure in those heinous acts (let that teach those liberals).  Uncaring and unsharing, they want only what is best for themselves.   That will be their downfall in the end, as all civilizations were built on providing aid to their people and not by witholding it.

We may be witnessing that end, with Republicans at an all time low.  Although the Republicans had an efficient political machine during the last 20 years, it was obviously fueled by greed, corruption (remember the Abramoff scandal), money, and the illusion of prosperity.  At the beginning of that time Ronald Reagan was elected on promises of ”trickle down” riches and good old fashioned self reliance.  George Bush continued that tradition with his tax rebate bribe that helped get him elected in 2004.  He tried it again in 2008, but it was too late – all credibility had been lost.  Reagonomics’ final gift to us was the market crash of 2008 and this Great Recession.  The party he gave new life to is now in shambles.  Imploding after the elections of 2006/2008 and the market crash, it has no leader and has lost its way.  Ludicrously, its official direction under Michael Steele is to become the “hip hop” party, but unofficially it is being led by rabble rousing racists and hate mongers.  Everyone else seems to have jumped ship.  Many left the party after seeing Bush drag this country down for eight years.  But why hasn’t a leader come forward to unite the Republicans?  Perhaps no one wants to step forward, because they are afraid of the crazies.  Or maybe they just don’t have the right ideas for this economy and are waiting until it gets better.  A fair weather party?