In my final post of this year, I want to say that my heart is with rebellious progressives but my head is telling me that a health care bill must be passed, even if it has no public option. As I have said in past posts, the Senate version would expand eligibility of Medicare to millions of low income workers.
Let me mention one more reason (this year) for hoping we will get passage of health care reform: the employer mandate that will certainly be in a final bill. Employers will be required to either provide health insurance or pay into a fund. This “play or pay” provision was the core of the Nixon plan as well as the Clinton plan.
Although there is a justifiable amount of angst about driving millions of people into the arms of the insurance industry because of a mandate for everyone to purchase insurance, with the expansion of Medicaid and the employer mandate, we don’t know how many individuals will be faced with purchasing insurance on their own. I do find it interesting that there was little outrage – that I can remember at least – when somewhere around 40 million people over 65 were driven into the arms of the insurance and the pharmaceutical industries as a result of passage of Medicare Part D.
Let’s face it, when the final bill is passed and signed, our (us activists) work will just begin. We have to organize and take on the insurance and pharmaceutical lobbies. It is obvious theyhad to power to stop health care reform in its tracks and were, therefore, bought off by the Obama Administration and Congress.
Have a happy holiday season!
I have noticed that the news commentators are comparing the current health care reform process as very similar to making sausage. This is a good comparison and it goes on every year with Medicare. Before we extend Medicare to more Americans we need to fix some basic problems with the Medicare budget proceess.
The Congress has been playing politics with Medicare every December for years, with everything up in the air until the last minute. For instance, until the recent vote on the budget for armaments (which included a provision related to Medicare), Medicare was scheduled for a 22% cut on this Jan. 1st. As it is, payments to providers will remain at the 2009 level. Needless to say a 22% cut would have caused many providers and hospitals to shut down. The lobbyist for hospitals, doctors, therapists etc have been working to stop this cut for months/years. But what about next year, will it be another round of playing politics with Medicare?
The Medicare budget is controlled by the Congress and those that influence Congress. Obama has mentioned the possibility of forming another entity to oversee the Medicare budget instead of Congress. A Medicare regulatory body would be able to set reimbursement rates and yearly changes to control costs. Medicare is a large percentage of healthcare now and will grow as 79 million people age into the program. There are about 40 million people on Medicare now. The Federal Employees health insurance program is not controlled by Congress, maybe that program would be a better choice for expansion to all Americans.
We all need to pay close attention to the Congressional process in Jan. because all will be decided then. My impression is that anything can be subtracted or added to this bill in the final days. It is like a court case where you meet the day before the trial date to come up with a settlement under the pressure of the deadline.
In the meantime, we need to continue to pressure in every way that we can to get the best healthcare reform possible.