WASHINGTON, D.C. - Some readers may notice on C-SPAN that obstructionism is in play on the floor of the U.S. Senate this weekend.
Meanwhile, rising health care costs are crippling the economy, squeezing middle class families' budgets, and making health care unattainable for a growing number of Americans. More than 14,000 people lose their coverage every day. We know that as the number of unemployed goes up, the number of uninsured goes up as well. Most of these individuals are not eligible for Medicaid or Medicare. They are exposed and vulnerable, without access to any health care services.
Approximately 46 million Americans went without insurance in 2008 - a figure expected to rise in 2009 due to the recession - causing an estimated 45,000 premature deaths this year alone (pdf). Over the next decade, the cost of private health insurance is expected to double.
Once the current diversionary antics are finished on the floor, the Senate leadership hopes to pass a health care reform bill by its own self-imposed Christmas deadline. This comes after months of debates, town hall meetings, countless revisions and ongoing confusion.
Is the Senate bill still worth passing in the Senate? Most Republicans, on the right, and many Democrats, on the left, say it's not worth passing. Not me. I guess I'm "going rogue" today. I think the Senate should pass this bill. Here's why...
Those of you that know me might protest, "Hold on, Pam! You are a die hard Public Option advocate. The Senate bill does not contain a public option. How can you say that you want the Senate to pass such a bill?"
Yes, it's true that the Senate bill is different from the House bill that passed last month and I much prefer the House bill. The House bill contains a bedrock costs-saving measure called a Public Option. The Senate bill does not include the Public Option that I believe is critical to reform. I firmly believe in the Public Option as the only true road to reform.
Nonetheless, the Senate bill contains many cost-saving measures and protections, even though it stops short of actually reforming the "system."
I'm of the opinion today that, at this point in the process, it might not be wise to 'throw the Senate's baby out with the bath water.' Especially when we can achieve agreement on many of the other impressive and worthwhile features before heading to the January conference between the House and Senate. The items that both bodies already agreed on will surely be included in the final product that comes out of conference. Other items, such as the Public Option, can still be considered and will still be on the table then.
For now, let's take what we can get. The more we agree on before conference, the better.
The man that led the effort in the Senate, Sen. Harry Reid said on Saturday, "We knew from the beginning that we had to have a bill that saved lives, saved money and saved Medicare. This bill does that. This bill will do so many good things for so many people."
The Senate bill would stop insurers from standing between patients and their doctors. Insurance companies would no longer be able deny coverage because of pre-existing conditions. The insurance industry would be unable to continue to rescind coverage or impose lifetime limits on care.
The Senate bill, like the House bill, also ends insurer discrimination against women - who currently pay as much as 48% more for coverage than men - and gives women access to reimbursed preventive services without cost sharing, copays or deductibles.
It would lower insurance premiums for everyone by an average of 8.4 percent, provide subsidies for people who cannot afford insurance and represents the largest single expansion of Medicaid since its inception.
The Senate bill makes health care more affordable for many struggling senior citizens. lt makes a commitment to close the so-called doughnut hole that adversely harmed 3.4 million seniors enrolled in Medicare Part D in 2008.
The bill would expand coverage to many millions of Americans who currently have none. According to the Congressional Budget Office (CBO), the bill covers 31 million currently uninsured Americans, extending coverage to 98 percent of legal residents.
All individuals and families with incomes at or below 133% of the federal poverty level will be eligible for Medicaid. Others with higher incomes may also be eligible for Medicaid, depending on rules that vary by state.
Many millions of Americans that will not be eligible for Medicaid, will be eligible, under the Senate bill, for subsidies. Subsidies are only available for people purchasing coverage on their own in the Exchange (not through an employer). The subsidies will make huge differences in many lives.
For example, a family of 4 that has a combined income of $80,000 will have 51% of its combined health insurance premium subsidized by the government, under the Senate Bill. That family of 4 will receive a check (subsidy) from the government for $7,521 with which to buy insurance.
Obviously, at income levels lower than $80,000 per year, the Senate bill subsidy increases and reaches 100% for many of the currently uninsured. Young people starting out in their careers or attending college are likely to not have to pay for insurance under this bill.
Though not nearly as effective as a Public Option plan would be to bring down costs, the Senate bill does have a number of provisions to contain costs.
According to the CBO, the amount that subsidized individuals would pay for insurance coverage "would be roughly 56 percent to 59 percent lower on average than the nongroup premiums charged under current law."
The Senate bill also saves us from the looming disaster of Medicare by extending the trust fund for nine years. Without this measure, analysts say the fund will become insolvent in 2017.
The bill will lower the deficit by $127 billion over the next decade and by $650 billion during the decade after that, according to the CBO.
Perhaps most substantially, a "CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years -- with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019."
It's true that I firmly believe that the Public Option is the only real way to bring down health care costs in any significant way for the long-term. The Public Option can exert market pressure by increasing quality of care, increasing patient choice and decreasing costs all at the same time. The Public Option offers opportunities for citizens to buy into a plan, as an option, whereby corporate bureaucrats are kept from dictating what health care services Americans can receive.
Only by offering a government-run plan that is not in the business of profiteering will we ever be able to remove the 25 to 30% overhead that currently is siphoned off by the insurance industry. We've already done this with Medicare. Since we know from experience that Medicare can administrate a program while only steering 5 to 8% of its revenues into overhead, it's tragic to require Americans with limited resources to pay homage to the insurance industry by watching up to 30% of their premiums be kept by insurance corporations. The concept of expanding Medicare for all, or offering a government-run program as an option in the Exchange, is the most sustainable, economical and just method to approach health care reform.
Overall, it's a bad thing that the Public Option is not in the Senate bill. I, for one, will continue to promote the Public Option. I'll stand with Dr. Howard Dean until the job is done, no matter how long it takes.
For now, I nevertheless want the Senate to go on and pass its bill.
The Senate plan may be painfully slow to implement and the bill's measures will be essentially incomplete in any attempt to actually reform a system. Without the cost savings offered by the Public Option, the Senate's programs may in fact be unsustainable over the long-term, but - this is a start.
And, besides, we haven't heard the last of the bill from the House. Over there, the Public Option is still very much alive. The "conference" between the House and Senate is likely to occur in January. It's still possible that a Public Option will survive conference.
The Senate bill does in fact reach out to save the lives of those whose lives are in jeopardy. So many of our neighbors, people we know and most we don't, are dying and suffering all around us. Millions of lives depend on our ability to take action.
So, for now, let's just keep this ball moving forward.
Right now, in America, if you are a child without insurance, if you're seriously ill and end up in the hospital, you are 60 percent more likely to die than the sick child in the next room who has insurance.
As we all focus on the health reform debate, let's remember that more people of all ages are struggling with health care bills than ever before. Many are choosing to die rather than seek readily available, but cost prohibitive, cures.
The tragic nature of those unnecessary life-shortening choices is unconscionable.
We don't live in a third-world country. We have the technology already. We have the trained professionals in our communities.
We already have the cures for these routine diseases and disorders. These are cures that the insured can access right now in our country but these same cures and treatment remain out-of-reach for the 50 million Americans that are uninsured and the additional 100 million Americans that are under-uninsured.
Let's get something done for them.
We must stop the suffering.
For more information, handy charts and tools with which to understand the Senate and House bills, see the helpful links below. These are really the best resources I've found for getting to the heart of matter and understanding the facts:
Thanks so much for sharing this article. This was very informative to both my wife and I in terms of how this bill would affect us. A half a loaf is better than no loaf at all. And you can build on half a loaf---it gives you a platform to build on. Ted Kennedy regretted that he turned down Nixon's offer of employer-mandated health insurance proposal, as it was half a loaf. He thought he could get the whole loaf, but here we are 27 years later getting half a loaf.
Marty, it was even worse than that! It's actually been 37 years since Senator Kennedy and President Nixon didn't get that health care plan. 37 years went by!
I think if the Senate Bill aw currently written, passes it is a disaster for Democrats. There's a reason that healthcare stocks are at a 52 year high. This is nothing more than a boondoggle for insurance companies. Once again, corporations win and the people lose. I can't believe it took 60 Democrats to write this terrible bill. What a shame.
Yes but we have what we have - and it's what we have to work with.
Agree with Pam that we need to get something done for the children, the seniors, and those struggling in this economy.
Let's not lost sight of the fact that people are dying. I wish the bill was better. BUT I am thankful that there is a bill in the Senate. I am grateful.
Now, for the argument against the Senate bill.
I have enormous respect for three organizations that have been in the forefront of health care reform.
First, Kaiser Family Foundation for the solid information that it collects and distributes.
Secondly, Dr. Howard Dean and Democracy for America for their 100% support of the Public Option. Dr. Dean is the perfect spokesman for the effort.
And, lastly, FireDogLake Action and Jane Hamsher have really stepped to the front to lead netroots and grassroots efforts to fight for the Public Option.
I am in complete agreement with Howard Dean and DFA - and Jane Hamsher and FDL Action - that the Public Option is the only sustainable way for health care costs, quality and access to improve for Americans.
Though I am glad that the Senate will pass their bill this week, I am not giving up on the Public Option. In fairness to those I respect that are fighting hard for the Public Option, I'm copying a recent e-mail from Jane here in its entirety, followed by the most recent statement by Dr. Dean.
And, now this from Howard Dean: