Posted on 12/22/2009 12:59:27 PM PST by ConjunctionJunction
The Senate’s dramatic vote on health care reform early Monday morning was a bittersweet moment for those who have been fighting to increase competition and accountability for private health plans.
On the one hand, the vote moved the United States a major step closer to joining the company of other affluent democracies and ensuring every American is guaranteed affordable, quality health care. After nearly a century of defeated attempts, we stand on the threshold of historic changes that will provide major new subsidies for health insurance, impose new requirements on insurers and create a new means — the so-called exchanges — through which individuals and small employers can gain access to the same sorts of group health plans that workers at large companies take for granted.
On the other hand, the Senate bill fails to include a public health insurance option to provide an affordable, secure alternative to private insurance. This gaping hole in the bill would have greatly pained me even if the opposition had not been led by my home-state Sen. Joe Lieberman (I-Conn.). As the thinker most associated with the idea, I have long argued that the public option was the best hope for creating accountability for insurers, holding down premiums and ensuring Americans had access to a plan that didn’t deny needed care or shift costs onto them. Now, thanks to Lieberman, the institutional dysfunction that is the Senate filibuster and hundreds of millions in medical industry spending, the public option that a strong majority of Americans consistently supported is gone — in this round.
But while the public option is gone, it has not been forgotten. To compensate for its loss, Senate Majority Leader Harry Reid’s manager’s amendment puts a series of stronger regulatory checks on the insurance industry. The manager’s amendment sets a floor on the number of premium dollars insurers must spend on care and requires insurers to issue rebates to policyholders if they do not live up to this standard — a strong new regulatory check on insurer behavior.
And, for the first time, the federal government will require insurers to disclose many of their claims-payment policies and related practices, allowing consumers to understand more about the insurance products they are buying than ever before.
All of these steps represent a good beginning — but only a beginning. The gaping hole left by the removal of the public option must be filled, at least partially before the final bill is passed and more fully every year thereafter.
Several critical provisions in the House bill would help to fill this hole. The House bill offers Americans living at 250 percent of poverty or below (about $55,000 for a family of four) far greater affordability protections than does the Senate bill, and it expands Medicaid to individuals with incomes of roughly $16,000. Both provisions are central to ensuring health care is affordable and available to all Americans, not simply those with means. Both are also central to making morally and politically acceptable the requirement that Americans have coverage.
The House bill also has far stronger employer responsibility requirements than does the Senate bill. Although many of these will be hard to incorporate into the final legislation, House leaders and the president should insist on making the employer requirements apply to part-time workers and on strengthening insurance regulations on large employment-based plans.
Finally, and perhaps most important, Congress must ensure that the federal government does not leave reform dependent on the capacity and will of state governments. The best way to do this is to move away from the near-exclusive emphasis on state regulation in the Senate bill toward the stronger federal regulations in the House bill.
I understand why the many advocates and citizens who fought with me for a stronger bill are angry. But I urge them to harness their anger to make it better — now and every year from now. We should start by insisting that House leaders and the president strengthen the legislation prior to final passage rather than simply accept the weaker Senate bill. As delicate as the compromises were that allowed Senate Democratic leaders to break a GOP filibuster, they are not so delicate that the bill cannot be constructively changed between now and passage, especially on issues that were not at the heart of the Senate battle.
Once a bill is enacted, we must demand more steps to provide immediate relief to Americans before the exchanges are operational nearly a half-decade from now. And we must fight to revive the public option to deliver on reform’s promise of cost control and accountability for insurers.
We have a once-in-a-generation moment to pass reform, and we must seize it. But what we pass must be understood as only a step — an important but ultimately incomplete step — toward the goals that the inspiring campaign for the public option embodied.
Jacob S. Hacker is professor of political science at Yale University.
http://www.cnsnews.com/news/article/52716
Read the history of the NAZIs “ENABLING ACT” of 1933.
Where is the mega-barf alert?
The Senate bill just passed does none of the things this clown says it does, none.
As in a typcial fashion with communists, they never admit defeat, but rather the put a happy face on a political disaster. That is why this communist scum is trying to find a way to say that the bill is good for him and his communist ilks. It is not. This bill is the worst ever political disaster for the democrats.
Where is the mega-barf alert?
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Oops! I forgot that. And now I can’t edit it.
Mods? Help, please?
What do you think those 1000 odd fill in the blanks by the faceless bureaucracy in the bill are for?
The bill is first and foremost a reparations bill, and secondly Rev Wright’s plan for whitey. All these Black Liberation Theology kooks think alike.
There are more private firearms in the U.S. than citizens. One sector that has thrived in the recession is the manufacture and sales of guns and ammo. The founders anticipated tyranny and provided a counterbalance.
"Show me just what Mohammed brought that was new, and there you will find only things evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelogus
I must have missed the Barf Alert and the “Liar, Liar, Pants on Fire” warning.
Thisi s nothing but an attempt by the Communists to take over our government. They have added illegal “Senate Rules” such no further bill can be introduced to overturn this medical industry takeover. That’s right. No Senator may introduce any bill that voerturns this bill.
This is a move by a dictatorship and an overthrow of the US government!
“No Senator may introduce any bill that voerturns this bill.”
If that’s the case, a conservative senate can vote in a rule to execute all democrat senators. It’s stupid crap which brings me to your second point: This is a move by a dictatorship...
That’s spot on. This is an attempt to establish a dictatorship by the communist rats. Trouble is, they don’t the people, balls or guns to enforce it. There’s serious payback coming soon. We’re seeing the beginning of the end of leftist rat party in America, and the rise of a new patriotic movement that will crush them.
All you leftist professors, eco-fascists, politicians and bureaucrats had best be making arrangements NOW for your one-way ticket to North Korea and safety amongst your Nazi and communist bretheren.
“patriotic movement that will crush them”
Count me in!
Hmmm, wonder if Harry is taking his revenge on the companies by driving them out of the medical insurance business?
Of course, he could be trying to corner the public: if the private companies walk away, people will be prodded to clamor for "single payer".
Which is a game the Rats have been playing since Hillarycare failed -- by letting the insurance industry into ownership of medical practices and hospitals, for instance, which was previously prohibited by law. Screw everything up, and create a "constituency" for single-payer Sovietcare.
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