Watching the Debate and Vote on Health Care

As I watched the debate last night preceding the historic vote on health care reform in the House of Representatives, I played a game: I substituted social security every time one of the Republicans said health care, thereby giving me a chance to step back in time to 1935 to catch a soundbite from the historic Social Security debate. I gained a new respect for those courageous legislative pioneers of 75 years ago who set the stage for Sunday night's vote.


And when the dust settles, the loud clamor against health care reform will fade into the background quickly. No one is going to succeed in challenging the constitutionality of the process. Are you kidding? Congress can pass any bill any way it wants to. It is one of the co-equal branches of government. But the Republicans would know that if they read the US Constitution. The Courts will have nothing to say about "the process" used. That is clearly the prerogative of the Congress as set forth in the Constitution. Nor will any other attempts to roll back the vote be anything but a waste of energy.


I regret the R's chose to roll the dice this way. I wish they had been willing to do as Repubs have done in the past: compromise on the issue so they could go home and tell their constituents they "won" something for them. Soon, it will be evident to all Americans, including the Repubs, that the minority party does not wish to advance the American cause; they just want to govern for the sake of perpetuating their position in power. So sad.


Watch for the growth in an Independent Party movement if the two major parties do not learn how to govern together. We are not far from such a victory and that may be the best thing for America. It will get us back on a track closer to what the Founding Fathers had in mind. They did not have the current "process" in mind, that is, where one party says "NO" and the other says, "I guess we got to do this without you." That's not representative democracy. In a true representative republic, the two sides are expected to work together for the good of all.

Where is the reason?

Martha Coakley is a fundamentally flawed candidate. The latest gaffe has her criticizing her opponent for shaking hands outside Fenway Park. Not even the rankest of amateurs would make that mistake. Not even Sarah Palin would make that kind of mistake. Regrettably, the Democrats will lose this seat.

What does it mean for the current debate on health care reform?

The people want health care reform. The Republicans in Washington want health care reform. (Yes, that is not a typo. The Rs really do want health care reform; they just don't want to tell you that -- ever.) The people, however, are being told by the Republicans that the current bill in conference is the wrong one. And that is too bad...because now –with the loss of Martha Coakley in MA— a bill may not pass with the coverage of the original and the regulatory structure needed to make it work.

Make no mistake about it: the Rs want this bill. They want it to pass without their vote so they can campaign against it and complain about it for at least a full decade. The Democrats have to have the stomach to see this through one way or the other, even if it costs them seats. The Rs never wanted Social Security; the Rs never wanted Medicare for the elderly. The Rs, indeed, never want any basic reform that "promotes the general welfare" of the people. They want the Democrats to vote such measures through so they can sit back and yell "no" from the back bench where they are most comfortable. If we reach the day where the yelled "no" carries the day, well.....I hope we never reach that day.

No one, I repeat NO ONE wants to repeal Social Security; no one wants to repeal Medicare. We did not become a socialist state when they passed in 1935 and 1965, respectively, and we will not become a socialist state when health care reform is passed into law this year …or whenever. I just want reason to prevail. Is that too much to ask?

GOP Shoe Does Not Fit Anymore

If the Republicans win the current debate to decide whether or not America will begin the process of reforming health care costs, coverage and delivery, every one of us will lose.

And we will lose something far more precious than rejection of one major reform initiative. We will have handed control of our government to one very influential special interest group: the health insurance companies. The NRA will be proud of their success.

President Truman urged the Congress to pass legislation covering all Americans with basic health care. That was 60 years ago. In 1972, the first speech I wrote for a U.S. Senator focused on the need for health care reform. That was 37 years ago. In 1993, President Bill Clinton urged Congress to move forward finally on health care reform, and again, the insurance industry rejected it flatly. Each time they succeeded by buying the votes they needed to gain total loyalty from a minority that could be counted on to defeat any and all efforts to move forward on the issue.

And now, Republicans stand on the threshold of defeating the current health care reform legislation supported by President Obama and a majority of the Congress. In addition to serving the interest of the insurance companies, the GOP opposition will hand a major defeat to President Obama ...and they live for that.

Why not use the reconciliation process to circumvent the opposition? That’s the question I am asked often. It might be done. Remember, only items in the bill that affect budget numbers – spending issues or tax revenues can be considered in reconciliation but that would include much of the bill. Excluded would be all of the oversight and regulatory provisions in the current bill.

Remember this: It was the Republicans who set up this process of passing legislation through reconciliation without the risk of a filibuster. And now that they are in the minority, they rue the day they thought of this mischief.

Until 1996, reconciliation was limited solely to deficit reduction, but that year the Republican majority adopted a precedent to apply reconciliation to any legislation affecting the budget, even legislation that would increase the deficit.

Under Bush 43, Congress used reconciliation to enact three major tax cuts. Efforts to use reconciliation to open the Arctic National Wildlife Refuge to oil drilling failed. That’s right – oil drilling! Thankfully, the idea did not pass.

They were in the majority and they were dedicated to perverting the reconciliation process to pass any and all bills they wanted. So much for the Senate rules. So much for respecting the views of the minority.

And they paid no heed to the warnings that the day would come when the Democrats would be kin the majority and use they same rule against them. Now they have the audacity, the unmitigated gall, to say the Democrats should not use the reconciliation process to pass one of the most important bills of our time.

Make no mistake: They represent the insurance companies; they do not represent the interest of their constituents. Is this the form of government the “tea baggers” support? Maybe they don’t understand a representative democracy as defined by our Constitution. (Maybe they ought to read the Constitution.)

Why health care reform WILL become law this year

As the debate on health care reform approaches the day of final reckoning in the Congress, health insurance companies continue to increase their premiums -- even for federal employees -- in double digits. Last week, I heard from a federal employee whose agency announced proudly that it had been able to negotiate a lower rate with BCBS Carefirst of the National Capital Area. Now, instead of a 25 percent increase in premiums for 2010, federal employees under the plan would only pay an increase of 9.5 percent. Mind you, our nation's inflation rate has been less than 2 percent for the past year. Gall? No. Nerve? No. There is another name for it.


Health insurance companies have for the past 20 years imposed ever increasing premiums on a public that generally has paid little attention because they don't pay the premiums, "my agency (or my company) pays them." Of course, you and I know that is not true. Indeed we all pay. Because products and services for all other sectors of our economy must go up to feed the appetite of the health insurance industry....and sooner or later, those goods and services become non competitive with those produced by others, e.g., Mexicans, Chinese, Koreans, etc. And jobs go overseas to produce those things we need.


Meanwhile, back home, we just continue to complain about it all and keep on paying the higher and higher premiums which have nothing to do with the laws of supply and demand. They have everything to do with .....greed. Republicans who want to protect such a system are either ignorant of how the capitalist system works or are intentionally turning a blind eye to the problem. I choose to think they are ignorant rather than intentionally acquiescing to those who keep their campaign coffers full.


And so, to the health insurance companies, work with your government, get costs under control, because if you don't, to paraphrase the words of Arnold Schwarzenegger, "The government will be back." Would you like me to tell you what comes next IF the current version of health care reform doesn't pass? I didn't think so.


Thank you for your attention. You may now return to counting the deposits your health insurance company will make in the bank today.

A Perfect Health Care Reform Bill???

Congress will never achieve the perfect bill in seeking to enact true health care reform for the benefit of all Americans. But that will be OK.

Indeed, that will be just fine.

When the 1787 Constitutional Convention was in its last day, and still there remained deep divides among the delegates Benjamin Franklin penned these words and, too weak to actually deliver the speech, asked fellow Pennsylvanian James Wilson to deliver his words. Here are selected lines from his speech:

"Mr. President –

I confess that there are several parts of this constitution which I do not at present approve, but I am not sure I shall never approve them: For having lived long, I have experienced many instances of being obliged by better information, or fuller consideration, to change opinions even on important subjects, which I once thought right, but found to be otherwise. ..

It is therefore that the older I grow, the more apt I am to doubt my own judgment, and to pay more respect to the judgment of others. Most men indeed as well as most sects, think themselves in possession of all truth, and that wherever others differ from them it is so far error.

...I agree to this Constitution with all its faults, if they are such; because I think a general Government necessary for us…

…I doubt, too, whether any other Convention we can obtain, may be able to make a better Constitution. For when you assemble a number of men to have the advantage of their joint wisdom, you inevitably assemble with those men, all their prejudices, their passions, their errors of opinion, their local interests, and their selfish views. From such an assembly can a perfect production be expected?

…It, therefore, astonishes me, Sir, to find this system approaching so near to perfection as it does; and I think it will astonish our enemies, who are waiting with confidence to hear that our councils are confounded like those of the Builders of Babel; and that our States are on the point of separation, only to meet hereafter for the purpose of cutting one another's throats.

Thus I consent, Sir, to this Constitution because I expect no better, and because I am not sure, that it is not the best…"

It is my hope that at least one representative in Congress will rise this fall to repeat Mr. Franklin’s words for the benefit of all his colleagues…and that each will bear Mr. Franklin’s words in mind as he casts a vote in favor of health care reform.

"Cut the deficit, cut my taxes, but don't spend less."

It now appears the Obama health care proposal is being watered down even as you and I sit in front of our computers. It appears Congress will exempt about 83% of small businesses from compliance with the new law. I’m sure those 83% of small businesses will, in the spirit of true altruism, offer health coverage to their employees anyway, aren’t you?

In the end, the new law may not offer much reform....but maybe that's what Americans think they want right now. It seems government can't get our attention until disaster strikes us and then government has 15 minutes to straighten out the problem or we dump 'em.

Is this a great country or what!

The NYTimes/CBS poll soon to be released, perhaps today, will say:

"Most Americans continue to want the federal government to focus on reducing the budget deficit rather than spending money to stimulate the national economy... Yet at the same time, most oppose some proposed solution for decreasing it."

"Fifty-six percent of respondents said that they were not willing to pay more in taxes in order to reduce the deficit, and nearly as many said they were not willing for the government to provide fewer services in areas such as health care, education and defense spending."

Think about our recent history on health care reform. When the Clinton team proposed it, all the stakeholders opposed it and it went down in quick defeat. If the Obama effort at true reform goes down with a watered down version of virtually no changes, that will be another setback. And the Republicans want nothing but the status quo because the “free market will solve everything.”

In the meantime, the American people are seeing their health insurance premiums increase in double digits every year while inflation is an anemic 1.5% to 3%. What sort of civic mindedness thinks that’s a better state of affairs than we would get with the Obama plan?

I don’t know about you but I would gladly pay more in taxes if it would result in bringing my insurance increases down to ….oh, say….8-9% annually (which is itself outrageous).

I fear we are reaching a state of national mindset that will not allow anyone or any institution to govern effectively. It was a great republic at one time. Now it's just overweight and selfish...and demanding more and more for less and less.

Health Care Reform is a Complex Issue

Opponents of the current health care reform legislation are attempting to boil it down to language that will support their efforts to enlist others in working to defeat the bill. And they don't care if they exaggerate or get it totally wrong; they’ve got to kill this thing. Right now, the bill in question is HR 3200. It is 1,018 pages, not the 1,800 pages frequently claimed in e-mails circulating on the Internet. And most critics will be quick to claim members of Congress have not read the bill. A comment on that in a moment.

BTW, HR 3200 is not the only bill working its way through Congress. There are three bills being considered by House committees and at least two in the Senate. The Senate is not as far along as the House but we are a long way from setting language in concrete. You wouldn’t know that from the scaremongers who are using the draft to claim every evil known to man is about to be visited upon us.

The e-mail I received listed 31 so-called “egregious acts of government intervention in our lives” if health care reform passes. Here’s the first one:

Pg 22 of the HC Bill MANDATES the Govt will audit books of ALL EMPLOYERS THAT SELF-INSURE!!

Not true. It actually says “The Commissioner…shall conduct a study of the large group insured and self-insured employer health care markets.” [Underline added by Ben]

Several criteria are listed for the study but the one that troubles most opponents is the one:

(C) The financial solvency and capital reserve levels of employers that self-insure by employer size.

In other words, the new Commissioner will be required to conduct a study of the solvency of self-insured employers and provide recommendations to Congress on how to make the program work better.

Because the study will take a look at the "solvency and capital reserve levels" of employers, the author of the scare e-mail interprets that to mean the government will audit your books. That's not what the language says...but, wait a minute, isn't it true that government already has the authority to audits the tax returns of businesses, and individuals?

The next item in the e-mail says:

Pg 30 Sec 123 of HC bill - THERE WILL

BE A GOVT COMMITTEE that decides what treatments/benefits you get

Not true. Language in the bill actually says there will be a public/private advisory committee established to recommend covered benefits.

The proposal says there will be 26 members appointed by the President and Congress to serve on this advisory panel…and more than government will be represented on it. Here is the actual language of the bill:

(1) PARTICIPATION- The membership of the Health Benefits Advisory Committee shall at least reflect providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies. and at least one practicing physician or other health professional and an expert on children’s health and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee.

Does that sound like "a Government Committee will decide your benefits?" Hardly. The advisory committee even includes "consumer representatives" and -- note the last line -- "so that no single sector unduly influences the recommendations of such Committee." That doesn’t sound very malevolent to me.

The person who wrote the e-mail I received attempted to cite 29 additional provisions of the new proposal that convinced him there should be no law passed to address health care reform. His exaggerations undermine his argument for as soon as they are exposed for the exaggerations they are, and in some cases, outright falsehoods, his argument is dismissed. But his hard-line ultra right wing view is shared by many members of Congress who think it best that America not address health care reform.

Finally, don't let anyone get away with telling you Members of Congress don't read the bills they pass into law. When it comes to important landmark legislation such as health care reform, every member will read every word. Most of them will read and re-read the most important sections of the bill many times.

Those who don't want health care reform to pass claim members have not read the bill because THEY DO NOT WANT YOU TO READ THE BILL. They want you to think the task is too daunting and you should be happy they are reading and interpreting it for you.

At some point, we must stop listening to those who only want to scare us, and start listening to those who want to genuinely lead us.

Change is coming. The status quo of our health care delivery system is untenable. Of course, there are those who don't want any change. I say to them, take a look around you.

Collection boxes for US Mail are going away. They will soon be relics of our past because Americans have adopted new forms of communication.

Cars will soon be run on energy other than fossil fuels because the supply of fossil fuels is finite and will soon disappear altogether. And our cars will be made of material that doesn't break in a crash, only bends.

In our lifetimes, most of our electricity will be generated by means other than fossil fuels.

Change is part of who we are. Change is not something we should be afraid of.

We have 47 million (or more) Americans who don't have any health care coverage. It is costing us an arm and a leg to take care of them in Emergency Rooms across this nation. We can't continue to do so. Our hospitals and other aspects of our healthcare delivery system are suffering.

In addition, you and I and others who have health insurance, have seen our premiums soar annually in double digits for the past 25 years (that's my own experience) and even the rates we pay, exorbitant as they are, are unrelated to the true cost of health care. That true cost, which most of us never see, impacts us all and robs our nation of precious resources that could be used to help us achieve higher productivity.

President Obama is trying to do something very difficult. He needs the help of a lot of people. Mostly he needs citizens to have a little faith in him, and believe he has our nation's best interest at heart...because he does.