Monday, March 22, 2010

House Passes Healthcare Reform Meaure 219-212; Reaction

The House of Representatives has passed a measure to reform the US healthcare and insurance industries.  The strictly partisan vote was 219-212.

Although I am generally pleased with the measure, I have a few concerns.

First, even though the Congressional Budget Office predicts that the measure will save money during the next ten years, the CBO cannot project too far into the future. Thus, the ultimate costs are not known. Congress must combine this with cost-saving features. Repealing some aspects of the Bush tax cuts and winding down the two wars will help some, but other cuts probably must take place.

Second, the abortion executive order is quite disturbing. It is one thing to deny coverage of abortion services for persons in public health plans. It is a completely different proposition to mandate that everyone have health insurance or face legal sanctions, provide subsidies for poor people (which is the equitable thing to do), but then restrict the availability of abortion services for poor women who buy the mandated coverage. Although I doubt that the Supreme Court would find this unconstitutional, it is a highly disturbing aspect of the reform package.

Third, I am upset with the lack of a public plan.  The public plan would have provided the strongest path for health insurance cost containment.  The Republicans favored simply handing people money (tax credits) to purchase insurance, which would have probably driven up costs. The Democrats promised not to do this, but this essentially what they have done with their version of a market solution.

Finally, the so-called healthcare debates have been awful. The White House was mercurial and evasive on the subject at times, which lengthened the process and led to uncertainty among supporters.  The rightwing distorted reality and fomented loud, angry and often wrongheaded opposition. It has been quite unpleasant.

Nevertheless, this is historic legislation.  Having anxiety about the process and the future does not mean that this is the wrong decision. Many great moments are filled with uncertainty.  I believe that this is one of those moments.


Matt P. said...

Good lord Darren. You need to let this CBO stuff go. Especially if you are going to say the rightwing distorted reality in the same post. I mean it is laughable.

The CBO is not some sort of God. It only answers the questions put to it and if the questions are manipulated the answer comes out a certain way. The budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. Even the first 10 years are demonstrably false. This is pretty much an objective fact not subjective opinion.

When a bill collects revenue for 10 years but only spends for the last 6 years you call that revenue neutral as does the CBO based on the bill's structure. That isn't reality though. There are multiple other issues as well over the first 10 years but this example is the most egregious and easiest to understand.

Darren Lenard Hutchinson said...

Matt: You see what you want to see. My post says that the CBO cannot predict things accurately into the future. It was listed as a "problem" I have with the measure. Apparently, YOU need to let go.

Matt P. said...

I read this: "First, even though the Congressional Budget Office predicts that the measure will save money during the next ten years, the CBO cannot project too far into the future. Thus, the ultimate costs are not known."

In the context of your earlier post on first 10 years versus second 10 years. If you are just claiming even the first 10 years are murky at best then I stand down.

Darren Lenard Hutchinson said...

If you agree that the ultimate costs are unknown, then please drop it. Time is precious.

LETICIA said...

Darren, I wouldn't go so far as to say this is historic legislation, unless of course you mean historically bad. This may be harsh, but this is like if the KKK was in charge of implementing the Civil Rights Act. The insurance companies in many aspects of the bill are expected to basically regulate themselves, or the states are left to put a regulatory body in place, which obviously isn't a given.
This bill is a sellout in so many ways, and I'd like to know why anyone thinks they'll go back and "fix it later" when this is the best we could get with majorities in the House and Senate, plus a Democrat in the White House.

Darren Lenard Hutchinson said...

Leticia: I think we are on the same page with respect to many of the criticisms. I believe, however, that after all of the conflict, this is probably the best we could attain. Social Security was not perfect either (e.g., it excluded domestic workers and agricultural workers which harmed blacks). We have to keep pushing for new policies. No one piece of legislation has ever had all of the answers - not even the Civil Rights Act of 1964.

Matt P. said...

Leticia your points are very valid and go back to an argument that started my love/hate relationship with Darren. :-)

This is mere Kabuki or rearranging the deck chairs. The main beneficiaries will be the large insurance companies and a small percentage of the population that was getting healthcare anyway. I suspect trial attorneys will make out also. Just a suspicion at this juncture.

This is the best the Democratic Party could do with historic levels of control and good will.

Darren Lenard Hutchinson said...

With crazy mobs inside and outside of Congress - yes, this is the best. I recognize the limitations of government and the weakenesses of this legislationn. In fact, the ENTIRE POST discusses my concerns with the legislation. But selective reading seems to be a new source of entertainment around here.

Matt P. said...

You are right Darren. It would be impossible for the Democrats to admit that the legislation was very unpopular and go back and try and craft something that could be supported by a portion of the Republicans.

My take on this is that during the greatest economic crisis of a generation they have wasted a year on this. The next 7 months will be spent STILL trying to sell this (Obama goes on tour next week I believe). Then, the Dems will lose badly in November and another year will be spent battling over ways to alter it or repeal it.

A giant waste of time. Although time is precious as you say...the truth is more precious.

Matt P. said...

I should add that the arguments over it will certainly continue through the next presidential election cycle. My post above makes it seem like the House alone could repeal it.

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