WASHINGTON (AP) -- The drive to remake the nation's health care system suffered yet another setback in Congress on Thursday when a pivotal group of House Democrats demanded changes in legislation the leadership was drafting on a fast track.
The emerging bill ''lacks a number of elements essential to preserving what works and fixing what is broken,'' 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote party leaders. To win their support, they said, any legislation would need to be much more aggressive in reining in health care costs as well as in addressing a disparity in Medicare payments they said adversely affects rural providers.
A group of the moderates met into early evening with House Speaker Nancy Pelosi and Majority Leader Steny Hoyer and arranged to sit down with committee chairmen on Friday to go over proposed changes. Officials said the public release of the bill, originally set for Friday, would occur no earlier than Monday.
It was the second setback in three days for President Barack Obama's top domestic priority, although it was unclear whether it would amount to anything more than a brief delay for a bill of enormous complexity and controversy.
There was upheaval earlier in the week in the Senate, where the Democratic leadership is intent on scuttling a proposed tax on health care benefits that has long been key to attempts at a bipartisan compromise. At the same time, Senate Majority Leader Harry Reid and others went out of their way during the day to emphasize eagerness for Republican support.
Of course if they scrap the tax on employee benefits they will follow the Rangel method and increase income taxes.
From the Times:
Paying for the roughly $1 trillion, 10-year cost of the health care legislation is arguably the biggest hurdle confronting lawmakers and the White House as they pursue President Obama’s top policy goal of extending health coverage to all Americans and curtailing the steep rise in the cost of medical care.
Senate negotiators had been eyeing a tax on some employer-provided health benefits but shifted course this week after the Senate majority leader, Harry Reid of Nevada, and other top Democrats voiced opposition. The House speaker, Nancy Pelosi of California, said Thursday that the House bill would not tax those benefits.
Instead, the House Ways and Means Committee was said to be nearing agreement on an income tax surcharge of 2 percent or more on Americans with the highest incomes — those earning more than $250,000. The surtax would rise for those earning $500,000 and rise again for those earning more than $1 million.
At the same time, aides said that the House was moving away from other ideas, including a proposed sales tax on sodas and other sugary drinks and a new payroll tax of 0.3 percent to be paid by employees and employers.
The White House has not expressed a position on the surtax, but lawmakers said they had heard no objections so far.
No doubt the President has said nothing, one of the greatest weakness's of this Presidency is Obama's seeming indifference to legislation and the bill writing process. This is no surprise considering he voted present as often as possible and spent his 2 years in the Senate running for the Presidency. Of course the President's declining polls is playing a role in this new resistance as his approval rating is now at 51%:
It is time for real healthcare reform. There is a related post at http://iamsoannoyed.com/?page_id=588
ReplyDeleteOMG, here it is we will never get what heathcare we need. Get rid of the insurance all together, they have caused all these problems. tehn after they are gone, set a base rate for everything, why doctors can charge so much for so little is wrong. And for the final straw, just give everyone the same dam benifits, not one person should have better benifits than another, all people are equal so why shouldt we all have equal heathcare.
ReplyDeleteI truly beleave if we dont gfix these major issues like healthcare in the next few years we will never fix them, and we will become the dying nation USA. We can not let these major issues go, globla warmming heathcare drug war, green jobs and fuel. It all will become a thing of the past and the USA will be no more. We best wakje the hell up today, there isnt any time left to change things.
The time is now!
Unfortunately its not that easy, medicine is a service and a business in this country, unless you change this, you cannot free premium benefits for everyone.
ReplyDeleteTo make this change, the gov would have to provide medical education, tort reform would be required, insurance companies would be more or less eliminated, more doctors would need to be trained, the entire payscale of the medical profession would need to be changed; doctors in France make ~55k a year, nurses in the US easily make more than this. Doctors in countries with universal healthcare also work far fewer hours than US doctors, hence the need for MANY more doctors.
...and these are just the things I can think of off the top of my head.
BTW why aren't you complaining about the amount of money auto mechanics charge? I pay more to take my car to the mechanic than I do to go to the doctor and mechanics require no post high school education. What I'm trying to say is, blaming rising health costs on doctors and their "ridiculous" salaries is not where you want to go. Sure docs make good money, more than most Americans, but most Americans do not spend 12-15 years of their life in higher education and since medical students are some of the brightest young Americans, their opportunity cost of attending medical school and residency is easily a million dollars. The real reasons for absurd healthcare costs are; UNHEALTHY AMERICAN LIFESTYLES, insurance and pharmaceutical industry profits, and lawyers.
anonymous 1,
ReplyDeletein an odd way I agree with you. If we can block this nonsense in the next year it will never happen.
You have chosen the lowest possible poll for Obama's approval ratings. Gallup and Quinnipac both have him at 57, and CNN at 61. His numbers will go down as the recession drags on, and rise again when recovery sets in. It always does, irrespective of politics. Cherry picking data is bad form.
ReplyDeleteI agree with the statement that American lifestyles play a huge role. The three leading causes of death in the U.S. are smoking, alcohol, and obesity- all lifestyle choices, and all preventable. As an active, non-smoking, fit American who drinks with great moderation, I really don't feel like subsidizing other peoples' laziness and poor decision making.
At the same time, the system is decidedly broken. There is no reason for healthcare costs to have doubled in the past seven years even as profits skyrocketed, other than healthcare is essentially a non-optional service, and insurers can get away with it. It is a need, not a want.
There are unexplored market solutions to this crisis (and it is a crisis). There should be costs and benefits associated with health decisions over which individuals have control. Taxes should be a federal tax placed on non-food such as cigarettes, alcohol, candy, soda, food dyes, and so forth. This would have the dual effect of somehwat depressing demand for some health services, while simultaneously partially funding a public insurance program. However, conservatives would rail against these taxes, however sensical.
Similarly, discrimination laws should be revised to allow insurers to apply higher premiums to specific, narrowly defined, verifiable health choices to individuals in group programs. This value would be taxed separately at a higher rate, the revenue from which would also go to fund a public program. The public program could also levy greater fees on these lifestyle based issues. This type of system would restore a greater sense of individual responsibility for lifestyle, and provide a market incentive for elective health. Of course, the liberals will halt all such efforts as "discriminatory", even as they pertain to individual choice.
A good healthcare system will incentivise good choices and preventative care. The insurance system should provide a sensible safety net against the devastating economic consequences of disease and catastrophe. It should not enable waste and irresponsibility.
Sadly, I have no faith that either the markets our politicians have what it takes to fix this broken system. There are no compromising, creative politicians left.
Responding to various comments:
ReplyDelete"...why doctors can charge so much for so little is wrong."
Yes...only important people like athletes, celebrity politicians and Hollywood starlets should be making the big money. Everyone else, from Nurses and burger flippers, to janitors and physicians, should make pretty much the same amount of money. ...Makes sense to me!
Question: how much should a doctor charge? Who should decide what is appropriate or "wrong"?
Another question: Why don't we cut everyone who has an income of > $50K down to about half of what they are currently making? That would make just about everything cheaper.
Next question: Do you nave any idea how much of a doctor's "charge" is related to overhead and government mandated regulation?
Some perspective for the brilliant, open-minded progressives in the house: http://tr.im/rqdS
"...just give everyone the same dam benifits, not one person should have better benifits than another"
Yeah, give prisoners and homeless drug junkies the same benefits as high achievers and hardworking taxpayers...brilliant.
"...their opportunity cost of attending medical school and residency is easily a million dollars."
Great point.
"You have chosen the lowest possible poll for Obama's approval ratings. Gallup and Quinnipac..."
The numbers are trending down. That's the real story. Also, Rasmussen polls LIKELY voters. Gallup doesn't focus on likely voters.
"...healthcare is essentially a non-optional service, and insurers can get away with it. It is a need, not a want."
Food is non-optional, but market solutions have made it plentiful and abundant.
Please disabuse yourself of the notion that health care in America is delivered by the free market. Currently, about 50% of all health care dollars are filtered through the government. As long as the government is running health care it will be expensive, relatively scarce and relatively poor in quality.
"There are unexplored market solutions to this crisis...Taxes..."
Encouraging the use of HSAs would be a market-based solution. Taxes, whether you like 'em or love 'em, are NOT a market-based solution.
It is amusing that when Repulicans vote with the Democrats (as the media thinks the Republicans should) the media praises the Repulicans as "bipartisan". But when Democrats vote with the Reublicans (which the media thinks never should happen) the media labels the Democrats "blue dogs". The media seems to think that bipartisanship is good only when it is the Republicans that are doing the compromising.
ReplyDeleteHere, the media could have reported that a bipartisan efort has slowed down this legislation for further study. But, no, they instead label Democrats voting their concience to side with the Republicans as "blue dogs".