Tuesday, March 23, 2010

The Healthcare Bill: What’s Going to Really Happen?

There has been so much confusion with this Healthcare Bill not only because the contents, like the abortion language, are not clear but also the way it was passed was “unconventional” to say the least. I will try to explain what I know and will give you my personal opinion about the bill and how it was passed.
Some Facts: The bill passed 219-212, the magic number being 216, without any Republicans voting for it. What also passed was the compromises that will be added onto the Healthcare bill after they go to the Senate and are voted on, however if these “compromises” have to do with the budget in some way it falls under reconciliation and therefore senators can’t filibuster them. I believe we talked about the filibuster on this blog before, but I’ll refresh your memory: It’s when a senator decides to disrupt the Senate by declaring his filibuster and then talking at the Senate for hours (sometimes) until a vote for cloture is called for. They can end the filibuster with 60 votes and if they don’t have them that “kills the bill”. As was also mentioned before, Democrats don’t have 60 votes in the Senate anymore with Scott Brown’s victory in Massachusetts, so they decided to go around this rule. How did they do that? The House passed the Senate’s healthcare bill instead of the two bills by the House and Senate being reconciled (which means almost “merged”; the House and Senate duke it out to see what goes into the final bill essentially). But, because the House doesn’t entirely like the Senate’s bill they want to make amendments to it which are the “compromises” I mentioned at the beginning of this paragraph. This is part of the complication; it’s hard to understand why they passed a bill they didn’t like? Why are they allowed to circumvent the rules of the Senate or House? Why can they be sneaky and go around Democratic processes our Founders wanted, like debate? Why? Because they wanted the bill passed NOW. Time was a major constraint and the Republicans winning an extra seat in the Senate didn’t help much. To pass anything they already had was their option or to scrap the bill altogether and start over (which I would have liked) which would politically look bad for Obama.
What does the bill do: Well, that’s hard to ascertain because many things are “projected” and we won’t know what’s certain until many years in the future. According to the CBO (Congressional Budget Office), this plan will cut deficits by 1 trillion dollars in the second decade. Personally, I don’t understand how that’s possible but I’ll address my qualms later. Remember this is projected not certain. It creates “health exchanges” which make it cheaper to buy insurance, Medicaid will be expanded, It creates new taxes for health insurers and higher income families, and you are required to buy health insurance. An important clarification is that of the abortion situation: NO GOVERNMENT MONEY WILL BE GIVEN FOR ABORTIONS. If people want abortion coverage they pay for it with their private funds and this was also clarified by an executive order issued by Obama.
My contentions with the Bill: First of all, I was unnerved with the way it was passed. No Republicans voted for the Senate Bill in the Senate and no Republicans voted for the Senate bill in the House. There is some talk of their proposed amendments making it into the bill, but as of now we don’t know that for sure. So, basically this bill had NO bipartisan support. In my opinion, on legislation this big and sweeping bipartisan support is needed to legitimize it and also just make it better and more likeable. I like using this example, in the Supreme Court for big cases they much rather have a 9-0 decision than a 5-4 decision because it shows the strength behind their argument. It’s the same with healthcare. I just feel throughout the process Republicans were being ignored because they (democrats) thought they could ignore them. When they had to deal with them, as in after Scott Brown was elected, they still went around them by passing law in an unconventional manner without the thought process that usually is present.
That brings me to my second point; they totally disregarded the rules and ideals of our country. Someone on C-SPAN made a really great point, he asked if they can pass bills like this why do we usually do it the longer way? I think the answer is the longer way makes the bill better in the long run. You are able to fit more ideas/opinions in and really compromise. The founders wanted bills to take a long time because they wanted us to think about what we’re doing. And I think knowingly going around this deliberate process is wrong and the end product turns out being mediocre at best. That’s what I think we have; a mediocre healthcare bill that doesn’t really address cost very well and that could have been worked on longer.
My third point is the contents of the bill don’t fully make sense to me. I think the cost issue is still a problem. I bet the government health insurance will cost more than private insurance because maybe they’ll have to pay doctors more or they have to pay for it because Medicare doesn't cover it, or something like that, so it has to cost more. This is just my opinion, but it seems plausible. Also, how exactly are we paying for this? They stipulate cutting Medicare will pay for a lot of it but they’re also using that money to expand Medicaid, subsidies, etc. so that doesn’t exactly makes sense. They’re obviously going to raise taxes which I think is unnecessary for a bill that doesn’t do much and in an economy that’s not too healthy right now. I believe TORT reform is in the amendments to the bill and should be (which would subjugate insurance companies to ant-trust law and therefore make competition). But, that would have helped in the first place and maybe we wouldn’t need this whole government run thing.
One thing I like about the bill is that it doesn’t let insurance companies drop you for pre-existing conditions. That’s just cruel and also that’s the reason people have health insurance in the first place. That should have been made a law much earlier. Another thing I find beneficial but have some dissonance with is that people must have health insurance. I like this idea because if everyone has to buy it the price goes down (supply and demand) however I also feel the government shouldn’t make you buy something you don’t want (for whatever reason). If it’s a “right”, then shouldn’t we be able to choose if we want it or not?
All in all, I was just disappointed and disheartened to see this bill get passed in this way and the quality of the content. I think there could have been more bipartisan support for the bill and they could have passed the bill in the intended way: with thoughtful debate. Also, I think the bill isn’t that great and doesn’t cover the main reasons why people wanted a healthcare bill in the first place. I suppose it’s fine for now, but once the taxes and costs and deficit’s rise I think we’ll be sorry we passed it. We’ll just have to see what happens.
Further reading:
(text of the Healthcare Bill)

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