Congress Makes Strides Toward Health Care Reform, Working Families Hopeful
By Tom Chamberlain of Portland, Oregon. Tom is the president of the Oregon AFL-CIO.
Congress took two major steps this week which should leave working people in Oregon and across the country optimistic about the future of our nation’s health care system.
Over half of respondents to a recent AFL-CIO survey of both union members and non-union workers said that they could not obtain the health care they need at a price they can afford. Of respondents who do have health care, a full quarter reported forgoing basic health care services; among the uninsured that number rose to three-fourths. Over 96% of those surveyed, including the insured, say that given the current economic crisis health care reform is urgent.
Against that backdrop both the U.S. House and Senate have taken up the health care reform debate again, and are considering various ways to reform the system. Two proposals that would help working families gained momentum this week.
The House – A Single Bill to Tackle Reform
The House has brought three committees together to create one comprehensive health care reform bill. Representatives Blumenauer and Wu each serve on committees that have been drafting the House’s America’s Affordable Health Choices Act. On Tuesday the committees introduced their bill and immediately gained the support of groups across the country, including the AFL-CIO. I couldn’t say it any more succinctly than national AFL-CIO President John Sweeney – “this legislation offers the real promise of improving quality, increasing access and reducing costs, all at the same time.”
The House bill not only addresses the policy issues addressed in the Senate HELP committee bill including the crucial insurance exchange and public option, and insurance industry regulations (continue reading for details on the HELP bill), it also:
- Creates a set of essential benefits that any insurance plan operating within the exchange must include (Oregon’s HB 2009 reform includes similar language) so that everyone receives quality care for the money they spend on insurance;
- Caps annual out-of-pocket medical spending so that fewer families face bankruptcy each year due to medical expenses; and
- Ensures that employers who are doing the right thing by providing health insurance for their workers stay competitive by (1)assisting small employers with insurance costs and (2)charging a fee for bad-players who choose not to offer insurance to their workers.
The revenue generated through the bad-player fee, along with a small surcharge for high-income individuals making over $280,000 a year and couples making over $350,000, will help low-income families and working people afford health care through sliding-scale subsidies. Everyone including high income individuals and families will also save money though this plan because the small surcharge will be less than the savings generated by insuring more people.
This comprehensive reform builds on the reform that was passed during the legislative session through HBs 2009 and 2116, and ensures that Oregonians have options, can access quality care and save money on their health care costs.
The Senate – A Progressive Policy Bill Moves Forward
The Senate has split the task of health care reform between the Health, Education, Labor and Pensions Committee (HELP), on which Senator Jeff Merkley serves, and the Finance Committee, of which Senator Ron Wyden is a member.
The HELP Committee proposal, the Affordable Health Choices Act, will accomplish three important pieces of reform:
- create options by allowing everyone to choose to either keep their current health insurance or find a new plan, including a public option;
- ensure small businesses can afford health insurance for their workers by creating a health insurance exchange like the legislature in Oregon created; and
- control costs by making primary and preventative care more attainable, stopping the practice of denying coverage or raising rates for preexisting conditions, age, and other factors, and increasing the number of paying, insured patients in our health care system.
On Wednesday, just one day after major reform was introduced in the House, the Affordable Health Choices Act passed out of the HELP Committee, moving it one step closer to passage and bringing working Americans one step closer to affordable, accessible health care options.
Together, these reform bills could create the health care overhaul that working people – from our lowest income workers to upper-middle income earners and everyone in between – need to keep afloat and still receive the care they need.
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July 17, 2009
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Jul 17, '09
Tom, you better have a firm talk with Ron Wyden. He is uniting with the Repugs to delay a health care bill. It's time for Ron to start paying attention to his constituency and less time with his buddies in the Republican party.
http://tpmdc.talkingpointsmemo.com/2009/07/citing-cbo-directors-statements-senate-centrists-urge-slower-pace-for-health-care-reform.php?ref=fpa
Jul 17, '09
Both dont sound too promising. But if i had to choose the Senate one would be hte better. AS far as the House one, everyone needs to be taxed for this not just "the rich". Yeah a progressive tax , but really just lumping all the costs on one group is pretty infantile.
Jul 17, '09
I just have a hard time believing that government truly has the ability to offer healthcare affordably, efficiently, and without layers of bureaucracy and red tape.
Jul 17, '09
It's time for somebody to challenge Wyden in next year's Democratic primary. What an utter disappointment.
Jul 17, '09
Ron Wyden is selling us out again:
http://tpmdc.talkingpointsmemo.com/2009/07/citing-cbo-directors-statements-senate-centrists-urge-slower-pace-for-health-care-reform.php?ref=fpa
Call Wyden's office and tell him if he doesn't support the house version of health care you won't vote for him in his next primary and then call Steve Novick and tell him to challenge Wyden.
Jul 17, '09
Hard to imagine Ron Wyden choosing to align himself with the likes of Lieberman and Nelson to block health care reform. If big Pharma and the the Health Insurance lobby can get to him, who's next?
10:41 a.m.
Jul 17, '09
"AS far as the House one, everyone needs to be taxed for this not just "the rich". Yeah a progressive tax , but really just lumping all the costs on one group is pretty infantile."
Lumping all the benefits on one group, as "the rich" have enjoyed for the last 30 years, was pretty infantile. Restoring the balance, adult.
Jul 17, '09
Ron Wyden is proving to be a real snake in the grass traitor to this effort. He speaks out of both sides of his mouth. He wants to put this effort out of reach of the budget reconciliation act so that the Blue Dogs can filibuster this and a purely corporate bill gets passed. Delay, delay, delay.. signs on with Lieberman, Nelson, Snow, and Collins...
It's time for a march on Washington, and a demand that Congress not recess until this is done.
Jul 17, '09
"Lumping all the benefits on one group, as "the rich" have enjoyed for the last 30 years, was pretty infantile. Restoring the balance, adult."
This isnt a tit-fot -tat playground game. This is the future of health care in the USA Me? I want single payer. I liked the NHS in SCotland and think it would work just fine here. BUt everyone pays in..not just the well off. To get any sort of good public option ( i hate that phrase) everyone is going to have to contribute. Passing the buck on to the other guy has to stop. We do need some adults in Congress agreed.
Jul 17, '09
"I just have a hard time believing that government truly has the ability to offer healthcare affordably, efficiently, and without layers of bureaucracy and red tape."
In which case we should demand that our elected representatives stop using the healthcare benefits they so enjoy as members of Congress and start paying $1,000-$2,000 a month for crappy, private, for-profit health insurance.
Jul 17, '09
I need to ask Tom Chamberlain why the Oregon AFL-CIO is aligning itself with a senator who is so clearly aligning himself with Republican delaying tactics and with the corporate insurance interests in this effort. If he needs more time, he can simply forgo the Aug. recess and earn his pay. And while he's at it, Wyden can forgo his tax payer provided health insurance until such time as the people who pay for his govt. provided coverage can have some of their own.
Jul 17, '09
Talk about snake in the grass---where is Congress going with the push to tax health care benefits? One week it is dead and the next week it creeps back in the news.
I support a single payer system, but who knows if we are ever going to get there. Not going the whole nine yards and taxing me and my union brothers and sisters who have worked hard to negotiate better health benefits feels more like a punch in the gut than decent reform.
11:46 a.m.
Jul 17, '09
As you have laid it out, I agree, the legislative pieces are coming together for a good health care bill. However, it could become a great health care bill if organized labor (yes, you) would be a bit more flexible on the issue of taxing health care benefits. To my thinking, four issues are important here: inadequate financing, insufficient cost control incentives, labor mobility for economic growth, and basic fairness. Unions are on the wrong side of each.
Inadequate financing: the proposals mostly call for $1 trillion in financing. Most proposals rely upon about half coming from new taxes on the wealthy and half from Medicare savings. I fine with the new taxes, but the Medicare savings are a shame, a shell game. We need the Medicare savings to keep Medicare financially viable. And no, as stated previously on another blog thread, we are probably not going to get the savings from defense budget cuts. We could get those funds from taxing health benefits.
Insufficient cost control incentives: This is the case that Congressional Budget Office Director Elmendorf made in Senate testimony yesterday. He’s right. Not only do we not get needed funds to support the program, but with a tax-free benefit consumers are given an incentive to consume more health care benefits than they would if such benefits were taxed.
Labor mobility for economic growth: Unlike Wyden’s proposal, all the currently viable proposals continue the link between employment and health care benefits. This is not good. It traps some workers in their current jobs and puts a drag on the dynamism of our economy as some workers are reluctant to change jobs.
Basic fairness: It is not fair for those with few health care benefits to be subsidizing through the tax break the greater health care benefits of others. The playing field needs to be leveled.
I’m a Democrat. I am usually proud of the Democratic coalition. I’m now a bit peeved at the organized labor wing of the party for high jacking health care reform for their own self interests (which I understand) rather than the public interest.
Jul 17, '09
Ron Wyden and the Obstructionist Gang of Six: (Take Note Oregon AFL-CIO) http://www.dailykos.com/storyonly/2009/7/17/754585/-Gang-of-Six-Moderates-Tries-to-Slow-Healthcare-Reform
Here are some more statistics [pdf] to consider for Senators Nelson, Landrieu, Wyden, Snowe, and Collins.
Here's what it means for those specific Senators:
Jul 17, '09
The insurance industry and big pharma have been cultivating Ron Wyden (and others on the Finance Committee) for years in anticipation of this fight. It looks like their investment is now paying off:
(from 07-16-09 Democracy Now! interview with former Cigna PR flack Wendell Potter)
I have called Wyden's office until I'm blue in the face. At this point I would support a Steve Novick challenge to Wyden in his next primary. We need real leadership from our Senators, not corrupt slaves to corporate donors.
Jul 17, '09
just have a hard time believing that government truly has the ability to offer healthcare affordably, efficiently, and without layers of bureaucracy and red tape.
and yet they are very efficient at killing hundreds of thousands of innocent people and running up the deficit with their overblown "defense" budget
Jul 17, '09
One of the key problems with both the House and Senate bills (and the concept of "universal" health care in general) is that the bills assume mandating insurance will significantly reduce the number of uninsured thus creating savings, as stated in Tom Chamberlain's column. This assumption is pure fantasy...any significant reduction in the uninsured will come at the cost of excessively bureaucratic government enforcement.
According to the NCHC 18% of the US population under 65 is without health coverage. Compare this to rates of non-compliance for other mandatory programs that are subject to government enforcement and penalty: - auto insurance: 14.6% non-compliance - federal income tax: 14.7% n-c - state of Hawaii employer health insurance: 10% n-c
The examples above demonstrate that any mandatory "universal" health bill will generate a voluntary compliance rate of 90% at best. Compliance beyond that will come only at the cost of excessively bureaucratic government enforcement. Those who do submit to being forced to purchase health insurance will use more health services – whether needed or not – thus increasing overall health spending, putting stress on supply/access of health care, while not making a dent in quality.
So much for "the real promise of improving quality, increasing access and reducing costs, all at the same time.”
Jul 17, '09
In yesteday's testimony to Congress by Director Doug Elmendorf of the CBO (Congressional Budget Office) he called the savings to the health care system Obama is touting is nothing but an illusion.
Then throw in the fact that small business owners with a payroll of just $400,000 (basically 5-8 employees) will be hit with charge of 8% of payroll, and you have a jobs killing/layoff bill in the making. If I have to pay an additional $32,000 for health care, I'm going to have to fire an employee just to make sure the business survivies for the other employees to keep their jobs.
Raising taxes on business when national unemployment is 10% = Idiotic liberalism!
What's being discussed isn't progressive, its thuggish!
Jul 17, '09
Once again, the Dalai Bama has succeeded in shifting the "debate" to right vs. far right. "Public option" was a sellout from the start, and a compromised public option will realize the right-wing dream of "starving the beast" through raising costs and reducing efficiency during a depressed economy. Naomi Klein wrote all about what's happening in Shock Doctrine, but DP liberals don't read anything to the left of Webster Tarpley.
Jul 17, '09
The relationships between Ron Wyden, his largest campaign contributors (Health care interests) and the voters who elected him sounds to me like a CONFLICT OF INTEREST.
Jul 17, '09
Ron Wyden is doing this? WYDEN????
Time to get out the phone banks. And if we don't have a public option passed in time for the August recess, we'll need to have a presence at any Wyden appearances in Oregon during said recess, to make our feelings known.
Holy %$&*. I'd have expected this from Gordon Smith, or Lieberman, or some Democrat from a state that usually hates Democrats...but not from one of ours! What the heck is he thinking?
Jul 17, '09
Once again, the Dalai Bama has succeeded in shifting the "debate" to right vs. far right. "Public option" was a sellout from the start, and a compromised public option will realize the right-wing dream of "starving the beast" through raising costs and reducing efficiency during a depressed economy"
Corerect Wrench. If we do get the "public option" these creeps will make damn sure its a terrible shambles on purpose. It has to be Single Payer or nothing.
Jul 17, '09
WHat's with Ron Wyden's shenanigans? See the posting by Bill R up-thread, or the link HERE.
2:12 p.m.
Jul 17, '09
FWIW, Terry Gross had an excellent overview of where things stand on Fresh Air yesterday with Jonathan Cohn, author of Sick.
4:10 p.m.
Jul 17, '09
Wyden is wrong on his current approach to health care, but let's not forget: when the Rs were in power, he came up with a plan that had a chance, and would have been very good. but times changed, and he needs to move forward with the rest of the country.
2nd, on so many other issues, Wyden is a great Senator. how many Senators can even define "net neutrality"? (can you?) yet he's a leader on this. he was one of the few to vote against the war in 2003. and recently, after the Oregon NG shipped to Kuwait and my son reported a potential issue, a FB note to Josh Kardon became several phone calls with Wyden's staffer, communications with the 41st's brass and some solid answers & information.
so let's push Wyden in the right direction on health care (public option si) but as far as trashing him in general, that's absolutely uncalled for and wrong-headed. perspective, gang: it's a good thing.
4:46 p.m.
Jul 17, '09
I agree with t.a.. And Ron's not wrong in wanting health care reform to include an focus on cost control, although probably the best way to do that is to have a public option that uses best evidence to identify the most cost-effective treatments for certain conditions and that pays for those and either does not pay, or requires hefty co-pays for, treatments that are more expensive but no less effective than cheaper alternatives. (Did ya see David Leonhardt's piece in the Times last week? http://www.nytimes.com/2009/07/08/business/economy/08leonhardt.html) Ron is neither traitor nor fraud nor captive of special interests. And I think he gets full credit for the great state of Rhode Island deciding to follow Oregon's lead and tax capital gains at the same rate as ordinary income - who else on the national scene has been talking up that idea?
5:33 p.m.
Jul 17, '09
It's interesting to read Bill R., who a little more than year ago, was showering verbal abuse on any one wouldn't run Sen. Clinton out of the party. Differences of opinion must be very, very hard for Bill R. to take.
Jul 17, '09
I want to clarify something that has come up in a few comments to Tom's post (I work for the Oregon AFL-CIO) so that this debate doesn't veer too far off topic -
This post was submitted before the letter from Senator Wyden, et al, was circulated. We agree with Senator Wyden on many issues, but on health care we believe that the time for reform is now.
As Tom stated in his post, high quality health care reform has gathered momentum on the heals of this week events and we believe that if Congress doesn't act now we risk losing that momentum and waiting another ten years to see real reform. Delay will deter reform.
While we respect Oregon's senior Senator and look forward to working with him on many issues, we do not, by noting his involvement in health care reform, endorse all of his opinions on what that reform should look like.
Jul 17, '09
Elana: "...health care reform has gathered momentum on the heals of this week events and we believe that if Congress doesn't act now we risk losing that momentum and waiting another ten years to see real reform. Delay will deter reform."
Exactly correct, this is a rush job, but why? Why rush approval for an unread 1300 page bill that is so hot off the press that the CBO can't yet put a final number on it??
The President and the Dems have gone into frantic mode this week because they know as Obama's approval ratings continue to slide deeper into negative territory, voters are growing increasingly wary about a public health option and the inevitable associated tax hike for the middle class.
Jul 17, '09
Together, these reform bills could create the health care overhaul that working people – from our lowest income workers to upper-middle income earners and everyone in between – need to keep afloat and still receive the care they need.
Did you not see the CBO numbers? The ship has sprung a leak and we're still anchored.
Over 96% of those surveyed, including the insured, say that given the current economic crisis health care reform is urgent.
Did you mention the tax increase to get there?
Jul 18, '09
I am on board with the two ideas, the one suggested by the President Obama: Based on a new report that details how much waste and inefficiency there is in medicare, how best practices are not always used, how many billions of dollars could be saved, the independent groups of doctors and medical experts to oversee long-term cost saving measures every year force congress to make sure that they are acting on these recommendations to bend the cost curve each and every year. The other idea echoed by New York Times;
"Meanwhile, it will be important to get some guaranteed fast savings from the health care industries by cutting and reallocating hundreds of billions of dollars from projected spending on Medicare and Medicaid...Just to be sure, Congress ought to establish a fail-safe mechanism that could impose additional cuts after a few years if savings are less than projected." I agree that In the near-term, this type of accountability will ensure that health reform legislation is fiscally responsible and fully financed. In the long-term, it will make certain that our health system, especially Medicare, is sustainable for generations to come. Please visit http://www.newamerica.net/blog/new-health-dialogue/2009/health-reform-finding-trigger-points-controlling-costs-13089 for further details. Thank You !
Jul 18, '09
As we can see, the runaway premiums led to collapse in the middle class and housing market / financial market. In that case, top priority should be to restore the struggling middle class. Consumer confidence might be the most crucial element and boost in hiring process as we experienced in recent years. In case the health care reform provides the general public with peace of mind, the rising mental stress or illness caused by financial instability may bend the curve surprisingly, in combination with kicking out the 'keep eating habit' to forget the deep-seated instability and apprehension, I guess. 'Work or Break' health system with no brake or safety system might be one of the biggest hidden causes of mental stress, obesity or overweight threatening the overall economy, I cautiously suppose.
Jul 19, '09