Health
Care Reform Update: One Iowan's Musings on the Messy Senate Health Insurance Expansion Bill

Like progressives everywhere, I was furious about the loss of the public option and the Medicare buy-in for those 55-64 years old. “Kill the bill” was my first reaction, or at least get rid of the individual mandates.

That first night it was hard to sleep. One vivid nightmare made me sit right up in bed. In my dream, we had killed the bill, hoping to bring it back in a few years. But I was horrified when I remembered that killing the bill meant unnecessary suffering for a low income acquaintance of mine with no insurance and in immediate, desperate need of health care services. With no dependent children, she is not currently eligible for Medicaid, but she would have had coverage under the bill we had killed. I vowed not to let my anger make me forget about millions of low income Americans the “bad” Senate bill would help.

It is true there are many good things in the Senate bill. And to appease progressives outraged by the loss of the public option, more good things have been added in. Again, I trust Howard Dean more than anyone else on this issue, and you can watch this clip of his interview with Nora O’Donnell about improvements to the bill over the last week. 

(Speaking of trust, I don’t know about you, but what’s up with President Obama? It sounds like Senator Russ Feingold, Howard Dean, and Joe Lieberman concur that President Obama made no effort on behalf of the public option. I think he’s been stringing progressives along this whole time. And don’t get me started on Afghanistan.)

The Senate bill may be good for low income people, but it is not good for the middle class or the taxpayers, who are going to be paying more for insurance and more in taxes than with a public option in the bill. Howard Dean, well known for his “tell it like it is” prescience, predicts that this Senate health insurance expansion bill will lead to thirty years of battles with the private insurance industry over excessive costs. It is worth reading the transcript or watching the video of Dr. Dean's Dec. 20, 2009 appearance on Meet the Press.  

Although middle class (and wealthy) Americans could benefit from insurance reforms, like getting rid of pre-existing conditions and preventing insurers from dropping policy-holders when they get sick, those reforms will only work if there is a way to enforce them. I fear the Senate bill is weak on regulation.

I’ve been trying to console myself by thinking about the Medicare drug bill. I opposed that bill because it was a fiscally irresponsible transfer of wealth from the public (as individual purchasers of medicine and as taxpayers) to the pharmaceutical industry. But it did lead to a drug benefit in Medicare, which is a good thing. Even without cost controls and with little help for the middle class, many people will benefit from the Senate health insurance expansion bill, just like many people benefit from Medicare Part D.

The Republican Party is a different species of elephant when they are in the majority, like when they passed Medicare Part D. Since the Republicans were in the majority, the Medicare Part D bill only needed 51 votes to pass, not the 60 required now that Democrats are in the majority. (Is that in the Senate rules, do you think, that only Republicans can filibuster?) And with fiscally irresponsible Republicans in control, there was no effort to pay for their $900 billion (over ten years) gift to the drug companies; it was just added to our national debt. The Senate health insurance expansion bill costs roughly the same, but the fiscally conservative Democrats actually have spending cuts and some tax increases to pay for their bill.

I enjoy reading Froma Harrop, and in her column this week she also compares these two bills. In addition, she wonders if Joe Lieberman is about to pull a “Billy Tauzin.” Representative Tauzin wrote the Medicare drug bill forbidding the government from negotiating with drug companies to get the best prices for Medicare recipients. After selling out his country and the taxpayers, Tauzin took a $2.5 million a year job with the big pharmaceutical lobby. Could Joe Lieberman be looking for a similar reward for his efforts to transfer public money to the private insurance industry?

Finally, following up on my post last week on reforming the filibuster, Paul Krugman thinks it’s a good idea, too!

My advice to Blog for Iowa readers: Call your Senators and Representative about what you do or do not want in the health care reform bill. Even if the public option is dead, pretend you are a conservative Democratic Senator or Joe Lieberman, throw a fit, and demand they cater to your whims. Maybe then they’ll spice up this mess to make it more palatable to the American people.

Alta
Price is a physician practicing Pathology in Davenport, Iowa. One of
the original Deaniacs, she stays involved with Democracy for America,
Iowa, and the Quad Cities. She advocates for quality, affordable health
care for all, primarily as a volunteer with Progressive Action for the
Common Good (Health Care Reform Issue Forum).  Watch for Dr. Price's Health Care Reform Update every Tuesday here on Blog for Iowa.  E-Mail Alta Price