Thursday, December 24, 2009

Reform Rx - Change, Yes We Will

The bills have passed. We did not get everything we desired and need to understand and accept for the present that the conference committee on the combined bill will be a compromising committee. What we have today is largely what we will see in the bill that will pass both the House and Senate and be health care reform...for now.

One perspective to view health care reform from is the historical development of Social Security. The original legislation in 1935 had many coverage gaps and was a far weaker program than it is today. Significant amendments to the act in 1939 and 1950 (when it became much more universal) along with the constant attention to improving the program's effectiveness to the present day are a result of expanding on Franklin Roosevelt's vision.

The public option, the dissolution of the insurance cartel, and single payer are not sacrificed forever.

Monday, December 21, 2009

Reform Rx: Stock Tip

No comment nor investment advice on this sad state of affairs reported by Huffington Post:

The rise in stock prices has been particularly striking in the period since Sen. Joe Lieberman (I-Conn.) said on October 27 that he would filibuster a Senate health care reform bill if it included a public option - a threat that caused Senate leaders to cave without much of a fight. Here's a quick breakdown of major health insurance company stock performance from
Oct. 27 to Friday's market close:

Coventry Health Care, Inc. is up 31.6 percent;
CIGNA Corp. is up 29.1 percent;
Aetna Inc. is up 27.1 percent;
WellPoint, Inc. is up 26.6 percent;
UnitedHealth Group Inc. is up 20.5 percent;
And Humana Inc. is up 13.6 percent.

By comparsion, the Dow Jones Industrial Average is only up 2.3 percent during that time; the NASDAQ Composite is up a (relatively) paltry 1.4 percent.

Thanks Joe. (CT-I*)
* Insurance Party

Reform Rx: Collins goes to 7-11

An excerpt from Senator Susan Collins’ statement on deciding to vote against health care reform:

It is unfair that Republicans were allowed to offer only seven amendments to a bill that affects every single citizen and one-sixth of our nation's economy.

Unfair? Seven? Of course it depends on what Senator Collins is counting to make her "it is unfair" point I counted twenty-four (24) significant amendments or amending motions with the following eleven (11) offered by Republicans. Collins math lesson: 11 out of 24 = 45%, not bad for having 40% of the seats. By the way, many of us in Maine think that Susan Collin has been unfair to us in regard to fighting for our health care needs.

Here are the seven, I mean eleven Republican offerings (Source Slate):

Republican Sen. Kay Bailey Hutchison's motion to delay taxes used to pay for the bill until the bill is actually implemented. Set aside Dec. 16, 56-41.

Republican Sen. Mike Crapo's motion to strip the bill of any provisions that will result in a tax increase for individuals earning less than $200,000 or families earning less than $250,000. The obvious point of this amendment was to embarrass President Obama for violating his promise that health care wouldn't impose taxes on this group (which, for the most part, it won't). Failed Dec. 15, 45-54.

Republican Sen. John McCain's motion to send the bill back to the finance committee so it can extend to all Medicare Advantage beneficiaries the special deal Democratic Sen. Bill Nelson won for his Florida constituents. Score one for McCain: This amendment shines a spotlight on a cheesy political bargain. Nelson, after trying unsuccessfully in the finance committee to "grandfather" (i.e., maintain for existing beneficiaries) benefit levels for all current Medicare Advantage recipients, got a narrower provision inserted providing relief to Medicare Advantage recipients living in certain "local areas" as determined by a complex formula that fits South Florida like a glove. McCain is in effect saying: Hey pal, share the wealth! Can you blame him? The motion failed Dec. 8, 42-57.

Republican Sen. Judd Gregg's amendment (2942) requiring Medicare savings to be used to "save Medicare." Gregg is the author of a Dec. 1 letter to fellow Republicans offering parliamentary tips on how to obstruct health reform. So don't waste too much attention on this. Failed Dec. 7, 43-56.

Republican Sen. John Ensign's amendment (2927) limiting contingency fees to malpractice lawyers to one-third of any awards of $150,000 or less and one-quarter of any awards of more than $150,000. Not an entirely terrible idea. Failed Dec. 6, 32-66.

Republican Mike Johanns' motion to strip from the health reform bill $42 billion in cuts to home health care agencies. Failed Dec. 5, 41-53.

Republican Sen. John Thune's amendment (2901) removing Community Living Assistance Services and Supports (CLASS), a proposed new voluntary program for nursing-home and other long-term care insurance, from the bill. Failed Dec. 4, 51-47. (This amendment required 60 votes to pass.)

Republican Sen. Orrin Hatch's motion to strip the bill of cuts to the privately administered Medicare Advantage program. Failed Dec. 4, 41-57.

Republican Sen. John McCain's motion to strip the bill of Medicare cuts. McCain proposed more than twice as many Medicare cuts to fund his own health plan during the 2008 election. McCain is unbelievably touchy about this! His amendment failed Dec. 3, 42-58.

Republican Sen. Lisa Murkowski's amendment (2836) barring the U.S. Preventive Task Force from being used to deny coverage for anything. Failed Dec. 3, 41-59.

Republican Sen. David Vitter's amendment (2808) amending Mikulski's amendment (see below) to prevent the United States Preventive Task Force from restricting mammograms, which it can't do anyway. (Vitter is a well-known feminist.) Passed by unanimous consent Dec. 2.

Friday, December 4, 2009

Reform Rx – End Results Count Most

Senator Barbara Mikulski’s amendment to the Senate’s health care bill to promote and expand preventive healthcare for women passed yesterday on a 61 to 39 vote.

The amendment is in part a political reaction to the controversy that arose over the U.S. Preventive Services Task Force’s updated guidelines regarding mammograms for women in their 40s. The conservative fear machine spun the Task Force report into an ugly specter of rationing. Both Senators Snowe and Collins voted with the Democrats on the amendment which received a great deal of coverage similar to that from Health Leaders Media:

The amendment, which calls for coverage of screening procedures, such as mammographies and Pap smears, would also cover cervical cancer, postpartum depression, heart disease and diabetes. The amendment received some bipartisan support with three Republicans—Sen. Olympia Snowe (ME), Sen. Susan Collins (ME), and David Vitter (LA)—voting for it.

We can expect Senators Snowe and Collins to vote for several amendments during the course of the debate on issues on which they are routinely lauded as moderates. Amendment debates and occasional supportive votes on all of these matters may create an impression of moderation but in the end, voting for final legislation that contains substantive health care reform with a robust public option is the vote that counts.

That final vote needs to be where we focus considerable effort to influence our Senators to a greater degree than the insurance industry. What we do not want is Senators Snowe and Collins to earn moderate accolades for voting on a bunch of amendments and then voting down the final bill because of cost, government control, or public option opposition. We cannot afford to be cheated in the end with their explanation of “I worked so hard to improve the bill but the gosh darn Democrats just made it impossible in the end to support in good conscience because of blah, blah, blah...”

And we also must avoid a watered down bill that is not substantive or carrying a robust public option because Senators Snowe and Collins traded a few amendment votes along the way in exchange for the watering down of other key provisions. Those means would not justify the ends.