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Tag Archives: healthcare

            President Obama has always been very clear on what he wants to see in healthcare reform: 1.) ensure that all Americans have insurance that will provide them with the care they need. 2.) Make reform deficit neutral.  And 3.) bring down the costs of healthcare expenditures for families, businesses, and the government in the long term.  Being a pragmatist, Obama has remained open to different methods of accomplishing these goals.  If the answer lay in a single payer system, he would probably support that; if the answer required as little government intervention as possible, that would be acceptable to him also.

            However, there came a point at which universal healthcare has turned into “incremental” healthcare—out of concern for fiscally conservative Democrats and Republicans.  But now, each passing week that the Senate Finance Committee cannot come up with an outline for a new system is time in which town hall protestors, Fox News commentators, and the general dynamics of next year’s midterm elections may prevent reform from occurring at all.

            Obama has given the Finance Committee negotiators until September 15 to come up with a bipartisan bill, at which point he presumably will press for action without the Republicans.  While I worry that imposing such a deadline may alienate any GOP senators who are thinking of supporting reform, there comes a point at which thoughtful deliberation turns into purposeful obstruction.  There is no point in watering down reform in order to meet Republicans at some imaginary middle point where they will say, “Okay, that’s good enough for us.”

            That point probably lies somewhere to the right of insurance cooperatives—a proposal that the small-state senators in charge of the negotiations have proposed in lieu of a public option.  Critics on the left say that co-ops will be too small to be effective competition and will have to negotiate rates with healthcare provides like private insurers.  Critics on the right, like Sen. Jon Kyl (Ariz.) are calling co-ops a “Trojan horse” that are just disguising a planned government takeover of healthcare.

            If GOP senators feel that even a concept as weak as a cooperative is too much government intervention, then I think that it is time to pull the plug on bipartisanship and return to the public option commitment.  The public plan is a compromise that liberals made after a single payer system was taken off the table.  What exactly have conservatives compromised?  The fact that they seem not to be willing to support anything other than the status quo is hardly a commitment to improving the healthcare system.

            To be fair, some Republicans are taking the reform effort seriously.  Sen. Olympia Snowe (Maine) was the only Republican on the Finance Committee not to draw a line in the sand in opposing a public option.  Like the president, she remains open-minded on the means to the overall end of accomplishing the three key goals.  Sens. Susan Collins of Maine and George Voinovich of Ohio may also be open to the Democrats’ plan.

            Realistically, the Democrats have 60 senators; they do not have 60 votes, however—meaning support from GOP moderates is key.  But in looking at the record of the current Congress, the most important votes were taken with almost solid Republican opposition: the Lilly Ledbetter Fair Pay Act in January, the stimulus package in February, and Sonia Sotomayor’s confirmation in August.  Although I don’t believe in the helpfulness of drawing strict lines, President Obama should seriously enforce the September 15 deadline.  Otherwise, he may not have another opportunity to build momentum to pass this crucial legislation.

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            This is a bit of a stretch for me—mostly a geographical stretch—but I thought this story was too quirky to pass up.

            Cory Gardner, a Republican state representative in Colorado who is planning to challenge freshman Democratic Rep. Betsy Markey, is bashing Markey for not holding health care town halls in her district over the August recess (she is on an overseas trip to Israel).

            Rather than let his criticism simmer, though, he decided to designate himself de facto congressman for the district and hold his own meetings on healthcare (his website has a press release posted entitled “Look who is not afraid of holding town halls”).

            And the fact that Gardner is stomping on her turf is not even the kicker: not only did he invite her to what is essentially a campaign debate over healthcare, but he sent the letter on his “Cory Gardner for Congress” stationery, revealing his not-so-innocent intention to take her job.

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            So, here’s the recap.  Gardner accuses Markey of not representing her district’s needs.  Gardner proceeds to play the role of pretend congressman in advance of an election for which he’s not even the official challenger.  Then, Gardner blasts Markey for not accepting his invitation to debate him (in a campaign she is under no obligation to participate in)—even though he is trying to portray the event as a favor to her in being able to listen to her constituents.

            It’s going to be a looong fifteen months until the midterm elections.

            Some fundamental questions about the nature of the democratic process have revealed themselves over the course of the healthcare debate.  For example, how does one reform the system, as President Obama wishes to do, while still telling people that they can maintain the medical and insurance networks that they have now?  Or, why are lawmakers holding town hall meetings now to receive either affirmation or criticism from the public—after the key decisions have already been made?

            Or, why is a group of senators that represents 3 percent of the population crafting 20 percent of the healthcare bill?  That is the question The Washington Post addressed last week in looking at the Gang of Six on the Senate Finance Committee—Max Baucus (Mont.), Charles Grassley (Iowa), Kent Conrad (N.D.), Olympia Snowe (Maine), Jeff Bingaman (N.M.), and Mike Enzi (Wyo.)—who are tasked with finding a way to pay for the new system.  The potential problem is that these folks—while attempting to inject moderation between coastal liberals who yearn for a single-payer system and southern conservatives who seem perfectly satisfied with the status quo—really have the interests of a totally unrepresentative sample of the American public in mind.

         Is this fair?

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         Let’s have a little history lesson here.  James Madison, who drafted the Virginia Plan prior to the Constitutional Convention as a broad outline of an effective national government, wanted to limit the influence of states on the types of responsibilities that would fall to the federal government in three ways: 1). He wanted the House of Representatives to elect senators (a “dilution” to pick the wise and stable men who would act as a check on the tumultuous lower chamber).  This was scrapped relatively early and relatively unanimously by people who thought that—our republic representing both the people and the states—the state legislatures should be the most appropriate electors of senators.

         2.) He wanted a federal veto on state laws that, by either being bad or volatile or just plain improper, would be overridden by the national government.  He more or less got this, though not explicitly, in the form of the supremacy clause and the fact that federal courts can declare state laws as violating federal statutes.

         3.) Madison wanted proportional representation in both houses of Congress.  This was crucial, and it took him several weeks of vocal opposition to come to terms with the fact that this would not happen.  Small states threatened to walk out and one delegate from Delaware took Madison aside to tell him that if small states could not have their interests represented equally in at least one chamber, they would have to find comfort in foreign hands.  A counter-proposal by the small states called the New Jersey Plan was never seriously considered (even small states recognized that the national government needed to be stronger; consequently the only real difference between the two plans was a unicameral vs. bicameral legislature), but it was leverage the smaller states used to make their concerns heard.

            It’s not that Madison did not respect the concern about a “tyranny of the majority.” He just felt that small states’ fears were misplaced.  He asked, what could Pennsylvania, Massachusetts, and Virginia possibly have in common that would cause them to ally against the smaller states?  In his mind, divisions would be regional—North v. South.  That was where differences in economy, lifestyle, ethnicity, and, of course, slavery would arise.  Naturally, he was correct.

          Fast forwarding one hundred years or so, we can thank the composition of the Senate, for better or for worse, for the shape the nation began to take.  As Manifest Destiny took hold in the 19th century, our continent was still inhabited by the French, Spanish, and British.  What was to keep American settlers loyal as they headed west, far from the seat of the federal government—or any government for that matter?  It was the incentive that they would receive outsize influence in the Senate should they decide to apply for statehood once the population reached a sufficient size.

         The bottom line is that the way the Senate is structured is the same double-edged sword that the Founders anticipated.  Is it fair now?  No.  Was it fair then? No.  Has the Senate augmented its own importance and magnified its own dysfunctions since 1789?  Absolutely.  Is there a fix?  Only if small state senators use their disproportionate power for the greater good—that is to say, they realize that they are the beneficiaries of a two hundred year old compromise and cannot fairly impose the beliefs of a small minority on the majority.

            There is nothing un-American about people who are opposed to the healthcare reform legislation.  They have a right to be skeptical about how their current coverage will be affected, what the cost of reform will be, and whether they will still get needed treatment.  I realize that.

            What IS un-American about healthcare opponents is, I believe, summed up in these two sets of video clips.  Here is footage from Sen. Claire McCaskill’s (D-Mo.) town hall today.  These types of events are less about persuading members of Congress or the general public toward a particular direction on the legislation and more about allowing people who feel that they have no other way of being heard to air their opinions to a captive audience.

            But this is not democracy—it’s more state-of-nature than civilization.  Whoever has the loudest voice or the biggest sign is in control.  Yes, everyone has the right to say what they want, but everyone acknowledges that there are limits to how you say things.  People can swear, just not over certain mediums at certain times.  Articles can be written about people, they just cannot be libelous.  And, of course, there is Oliver Wendell Holmes’s famous statement about yelling “fire” in a crowded theater.

            Kudos to Sen. McCaskill for standing her ground, for not walking away, and for not giving up on her constituents.  The worst experience for any customer service representative is being shouted at by a client who is definitely in the wrong.  It doesn’t help that these people are using phrases like “socialism” and “death panels” that trigger a rabid response from the crowd, yet no one fully comprehends what they mean.

            The second un-American aspect of the anti-healthcare crowd is the subject of this video.  Simply put: why can we not provide regular doctor-patient care for all of our citizens at an affordable price?

 

            The answer is money.  Insurance companies and drug companies spend a lot of it to tell us, in essence, how they must continue to make ungodly profits in order for our healthcare to be as good as it is.  It’s a form of blackmail: saying, “You think we take you on a ride now?  Just wait and see how bad it will be once we’re out of the picture.”  And members of Congress apparently see no harm in the correlation between money and influence.  Witness Rep. Loretta Sanchez (D-Calif.) when confronted on the amount of campaign contributions she received from the healthcare industry, morphing her response from “that’s impossible”; to “that’s not a lot” of money; to hey, they should be giving that money to “people who have more direct control” of legislation.

            People can oppose this legislation, President Obama, and vague notions of socialism all they want.  But if money and misinformation are causing people to turn a blind eye to millions of uninsured and underinsured Americans, then this continued resistance to our healthcare crisis is wholly un-American.

           Madam Speaker, I rise in opposition to HR 3200, the so-called healthcare reform bill.

            It is clear that this bill will ( raise taxes / kill jobs / kill puppies ).  This bill, which the Democrat majority hopes will move us toward ( socialism / fascism / homosexualism ), is just an effort to make the government take over ( your health / your house / your dreams ).  The Democratic agenda has failed us thus far.  When we look at the record stimulus passed earlier this year, I ask you, ( Where are the jobs? / Where is the money? / Where is the beef? )

            What my colleagues on the other side of the aisle need to understand is that Republicans represent ( small businesses / middle-class families / the insurance conglomerates that finance our campaigns ).  They say that we have no solution. Our party does have a solution: ( cut taxes / cut taxes and increase spending / cut taxes, increase spending, and blame any problems on the Clinton administration ).

            This health care bill will do one thing only, and that is to enlarge our country’s ( debt / bureaucracy / prostate ).  Democrats say that universal healthcare will cost one trillion dollars.  One trillion!  That is enough to buy ( three F-22s / one unnecessary war in the Middle East / every single member of Congress and their staffs ).

            My constituents don’t want a government takeover of healthcare.  They don’t want us to turn into ( Canada / Europe / Nazi Germany, circa 1939 ).  But that’s right around the corner, folks.  I urge my colleagues to vote against this bill, because it is ( too much, too soon / too little, too late / too big to fail ).