Subscribe to Common Dreams News Updates
Most Popular This Week
Popular content
Today's Top News
Signed, Sealed, but Not Delivered: Six Big Flaws Need Fixing to Make New Law Meaningful Health Care Reform
This health care reform bill passed late last night and soon to be signed into law is a seriously flawed piece of legislation, for it fails to achieve the goals of real health care reform. Now that it is essentially the law of the land, the country needs to work diligently at the federal and state levels to correct many of the most egregious problems with the legislation before the reform package fully goes into effect in 2014. The six main areas that need to be fixed are: cost control, enforcement, individual mandate, abortion, competition, and immigration.
1) Lack of Real Cost Control
This bill does not create real cost control and will not bring down premiums for most Americans. Congress and state legislatures need to adopt real cost control measures like: drug re-importation, Medicare direct drug price negotiation, a public insurance option, Medicare buy-in, or a central provider reimbursement negotiator (all-payer system). These changes would save the government and regular Americans hundreds of billions of dollars over the next decade.
The bill also needs to provide a better pathway for states to opt-out of this bill so they can experiment with better health care models that could truly bring down cost.
2) Dangerously Weak Enforcement
There are some good new regulations, but regulations are only as good as the strength of the agency tasked to enforce them. This bill is dangerously lacking in this area, leaving enforcement mainly up to the same state insurance commissioners that now often lack the will, funding, or power to hold the private insurance companies honest. Only a national exchange and a federal insurance commissioner would have the power to make sure the new regulations are more than over-hyped window dressing.
3) Individual Mandate
The individual mandate, which uses the IRS to force people to buy a product from a poorly regulated, private industry, is an affront to the American people. The policy is not needed, and must be corrected before it has a chance to go into effect. People must be offered the choice of a public alternative, or the individual mandate must be repealed. Alternatives like a back premium payment system could achieve a similar policy goal to an individual mandate without a massive expansion of the IRS or government coercion.
4) Abortion
This bill is a massive rollback of a woman’s right to choose. It would take away the abortion coverage of millions of Americans. The system of exchanges and affordability tax credits could easily be modified to ensure federal funds are not used to pay for abortions, while still not taking away the ability of women and small businesses to buy insurance packages that cover abortion. Having an individual mandate that forces women to buy insurance, but also a law that prevents them from getting insurance that covers a legal medical procedure, is a disgusting abuse of women’s rights.
5) Lack of Health Insurance Competition
The bill will do almost nothing to address the problem of lack of competition in the health insurance market. Repealing the anti-trust exemption and adding a public option would be two big steps toward solving the problem. Creating an all-payer system would make it easier for new insurers to enter new markets. Requiring a standardized insurance package, instead of a confusing set of choices based on actuarial value, would allow Americans to do real apples-to-apples comparison shopping. Finally, adding much stronger risk adjustment mechanisms would force insurance companies to compete on quality instead of on avoiding the sickest Americans.
6) Immigration
Under this almost-law, undocumented immigrants would not be allowed to buy insurance on the new exchanges, even if they are willing to pay the full cost of the insurance with their own money. This policy is not only cruel and immoral, but fiscally irresponsible. The more undocumented immigrants that pay for their own health care, the more taxpayers save by not being forced to pick up the cost of undocumented immigrants’ uncompensated care when they use the emergency rooms.
The White House and Democratic leaders have made many promises about health care reform throughout this long and winding process—from guaranteeing affordable, quality care for everyone to pledging tougher regulation of the medical industrial complex that created this broken system in the first place. If the majority party wants to honestly deliver on these promises—not to mention if they want to remain in the majority—then a concerted and immediate effort is required to prove that this week’s legislation is truly the first step toward reform, and not the last.
26 Comments so far
Show AllI'm glad the bill passed but am not celebrating. It's so half-assed compared to universal single payer.
The insurance industry would love the "federal insurance commissioner" that Walker recommends. It is far more cost effective for the insurance industry to pay the US Congress to render a single enforcer impotent compared to attempting the same in each state.
Obamacare's individual mandate will give insurance companies enough additional revenue to render impotent all regulations, irrespective of the source or enforcer.
I wish this author elaborated on some points. What is "all-payer"?
Typical democrat.
"Go as far as you can see and when you get there you can see farther" (Chinese proverb). The Health Care Reform legislation just passed is a baby step. Movement has been accomplished without deconstruction. Congratulations all. Now lets get on with other pressing matters facing this Country as it moves to fulfill the rhetoric of "life Liberty and the pursuit of Happiness".
like real health care reform
instead of a huge give away to the health care insurance companies
U.S. Stocks Rise as Drug Shares Rally After House OKs Overhaul
By Rita Nazareth
March 22 (Bloomberg) -- U.S. stocks gained, erasing an early decline, as drugmakers rallied after the House of Representatives passed an overhaul of the industry.
Merck & Co. and Pfizer Inc. climbed more than 1.7 percent to help lead health-care companies to the biggest gain among 10 groups in the Standard & Poor’s 500 Index after the House approved legislation that will ensure tens of millions of uninsured Americans will get medical coverage. Boeing Co. advanced more than 2 percent to lead gains in the Dow Jones Industrial Average on analyst upgrades.
======
Health-care stocks jumped more than 1.1 percent as a group and contributed to more than 40 percent of the S&P 500’s move, according to Bloomberg data. Tenet Healthcare Corp. had the biggest gain in the S&P 500, surging 6 percent to $6.10. Pfizer and Merck rose at least 1.8 percent.
House Democrats approved a Senate bill passed in December and then voted 220-211 to pass a measure that would amend the Senate legislation to fix provisions they don’t like. The Senate must also pass this second bill. The two bills together will cost $940 billion over 10 years and cover 32 million uninsured Americans, the Congressional Budget Office estimated.
‘Overhang’ Removed
The approval of the legislation will remove a significant “overhang” from the industry and will be viewed positively, Credit Suisse Group AG analyst Ralph Giacobbe wrote in a note today. Health-care companies will have higher valuations as investors “rotate” back into the stocks, analyst Charles Boorady at Citigroup Inc. said in a note.
========
http://www.bloomberg.com/apps/news?pid=20601087&sid=a_I5KjWeBKRE&pos=2
The bill does way with pre-existing conditions, cancellations, and lifetime limits. That's enough for me to support it.
Don't f*ck it up. We've come this far. Take it and run.
WRONG WRONG WRONG
the insurance companies can set the premiums to what ever they want
true there can be no more pre-existing conditions, cancellations, and lifetime limits
BUT
the same thing as a cancellation can be done by raising the premiums
to beyond the reach of even bill gates
so this bill dose nothing for the people
it's just a huge give away to the insurance companies
"Aside from that, Mrs. Lincoln, how was the play?"
Amen. Thanks.
Let's see just how many jack assed Republicans make any effort to affect any of these changes.
The only Republican mantra during this whole debate was tort reform. Great - lets keep the over 200,000 who die each year dying because of medical malpractice and unclean medical care in the United States.
The key to Democrats(I vote third party so it dosen't matter to me) winning in November is affecting the changes that will make this health care bill a real reform bill. The Republican 'party of no' will continue to do nothing but whine.
Here's a peek at the fine print. It appears that we will have a Federal Health Care Choice Commissioner to decide if your "choices" are approved for reimbursement. Alternatives will disappear.
To those who think this is a good first step: think No Child Left Behind
UH, NCLB was a BUSH era unfunded mandated mistake, nightmare.
So what? The purpose of NCLB was to destroy public schools. The purpose of this legislation is to provide a bailout of the health insurance and pharmaceutical industries. The end result will be the same.
I can't say I am glad the bill passed because I don't like the individual mandate and there nothing in it to control costs. Health insurance is now similar to auto insurance.
But there must be something to it or why would the corporate backed and funded bogus tea party members call black congressman n.....s and a republican congressman yell baby killer at Bart Stupak right on the house floor during the vote. House members are now protecting the cowardly republican's identity who won't stand up for his own remark.
Republican congressional leaders left the floor while democrats were on the floor during the vote process, republican congressman were going out during the vote and egging on tea party members to yell and scream, and they offered up a motion to kill the bill. They did everything they could to try to stop this bill.
So my point is there must be something good in the bill for the American people or else why are the republicans using every foul tactic in the book, including the n word.
This is the same type of attack the republicans used in the Florida presidential election in 2000 for junior Bush. Only this time it didn't quite work.
They are not done yet. Law suits are next to follow, and the supreme court still has enough conservative votes to strike down the legislation.
comment moved to Chris Hedges article
Published on Monday, March 22, 2010 by TruthDig.com
The Health Care Hindenburg Has Landed
by Chris Hedges
Rep. Dennis Kucinich's decision to vote "yes" in Sunday's House action on the health care bill, although he had sworn to oppose the legislation unless the And so he signed on to a bill that will do nothing to ameliorate the suffering of many Americans, will force tens of millions of people to fork over a lot of money for a defective product and, in the end, will add to the ranks of our uninsured.
The claims made by the proponents of the bill are the usual deceptive corporate advertising. The bill will not expand coverage to 30 million uninsured, especially since government subsidies will not take effect until 2014. Families who cannot pay the high premiums, deductibles and co-payments, estimated to be between 15 and 18 percent of most family incomes, will have to default, increasing the number of uninsured. Insurance companies can unilaterally raise prices without ceilings or caps and monopolize local markets to shut out competitors. The $1.055 trillion spent over the next decade will add new layers of bureaucratic red tape to what is an unmanageable and ultimately unsustainable system.
The mendacity of the Democratic leadership in the face of this reality is staggering. Howard Dean, who is a doctor, said recently: "This is a vote about one thing: Are you for the insurance companies or are you for the American people?" Here is a man who once championed the public option and now has sold his soul. What is the point in supporting him or any of the other Democrats? How much more craven can they get?
The only good news is that health care stocks and bonuses for the heads of these corporations are shooting upward. Chalk this up as yet another victory for our feudal overlords and a defeat for the serfs.
This bill is not about fiscal responsibility or the common good. The bill is about increasing corporate profit at taxpayer expense. It is the health care industry's version of the Wall Street bailout. It lavishes hundreds of billions in government subsidies on insurance and drug companies. The some 3,000 health care lobbyists in Washington, whose dirty little hands are all over the bill, have once more betrayed the American people for money. The bill is another example of why change will never come from within the Democratic Party. The party is owned and managed by corporations. The five largest private health insurers and their trade group, America's Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world's biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of 2009. The Washington Post reported that up to 30 members of Congress from both parties who hold key committee memberships have major investments in health care companies totaling between $11 million and $27 million. President Barack Obama's director of health care policy, who will not discuss single payer as an option, has served on the boards of several health care corporations. And as salaries for most Americans have stagnated or declined during the past decade, health insurance profits have risen by 480 percent.
Obama and the congressional leadership have consciously shut out advocates of single payer from the debate. The press, including papers such as The New York Times, treats single payer as a fringe movement. The television networks rarely mention it. And yet between 45 and 60 percent of doctors favor single payer. Between 40 and 62 percent of the American people, including 80 percent of registered Democrats, want universal, single-payer not-for-profit health care for all Americans. The ability of the corporations to discredit and silence voices that represent at least half of the population is another sad testament to the power of our corporate state to frame all discussions.
Change will come only by building movements that stand in fierce and uncompromising opposition to the Democrats and the Republicans. If they can herd Kucinich and John Conyers, the sponsors of House Resolution 676, a bill that would create a publicly funded National Health Program by eliminating private health insurers, onto the House floor to vote for this corporate theft, what is the point in pretending there is any room left for us in the party? And why should we waste our time with gutless liberal groups such as Moveon.org, which felt the need to collect more than $1 million to pressure House Democrats who had voted "no" on the original bill to recant? What was this purportedly anti-war group doing anyway serving as an obsequious recruiting arm of the Obama election campaign? The longer we tie ourselves to the Democrats and these bankrupt liberal organizations the more ridiculous and impotent we appear.
"I'm ready to listen to the White House, if the White House is ready to listen to the concerns about putting a public option in this bill," the old Kucinich said on the "Democracy Now!" radio and television program before he flipped. "I mean, they can do that. You know, they're still cutting last-minute deals. Put the public option back in. Make it a robust public option. Give the people a chance to really negotiate rates with the insurance companies ... from the standpoint of having a public option. But don't just tell the people that you're going to call this health care reform, when you're giving insurance companies an even more powerful monopoly status in our economy."
Is this the editorial we who will speak out and demand real reform? Because it sure will not come from our politicians. We, the public will have to take it in and absorb the inadequacy of this excuse for real reform and howl before any of our buffaloed Congress will pick up even an echo of it. Do any of them have a sense of what they have left out, how much they were extorted and how mad the public will be--five or six years from now when it falls apart?
tammons: apres moi, le deluge! What do these moral midgets in Congress and the White House care about how mad the public will be 5 or 6 years from now? Meantime they get the adulation of their local constituencies for the Louisiana Purchases or the Nebraska bacon they brought home by "negotiating" their votes. Besides its easier to face the wrath of public anger in a half-decade than that of Rahm Emanuel today.
I admit I didn't read the contents of this guy's article. I can't read his shit anymore... and it just keeps coming and coming.
The title was shit enough.
I mean, it sounds like he's saying all the old engine needs is a little earl and some attention.
Instead of--corporate power runs our Congress.
Which given those circumstances, what sense does it make to try get something--anything--out of that kind of political system and call it healthcare reform? Doing so might indicate that the political system works--but for whom?
What this guy and Hamsher at FDL are doing is providing a way for the elite (the "whom") and those in power to again narrowly focus people's energies and attention on anything but the the real problem:
Our Congress is controlled by corporate power.
The only way to "fix" that is to challenge that power based on a moral definition of human worth (ala singlepayer).
F - Fony
D - Deceptive
L - Ludicrous
So much for the 13th Amendment to the US Constitution - we have been sold to Big Insurance Corporations. The Democrats have put us right where the Republicans wanted us - at polar opposites from Universal Single Payer.
This is the minimalist collection of grievances.
The more robust attack is over at the Physicians for National Health Plan site.
I hate to say this, but I can remember the expectations when the Americans with Disabilities Act was passed. How certain all those who had fought for this bill were that a new shining day had dawned for American with disabilities. There were some =real teeth= in the act about matters of "accessibility" and equal opportunity for employment.
The percentage of disABLED persons employed now is about the same as it was before the Act. In legal actions brought by PWDs against companies blatantly practicing discrimination, my guess is less than 5% have been won by disabled persons.
Trylon
7. Substantial civil disobedience to force a Congress and President that have just massively betrayed public trust to weaken any part of this gift to insurance grifters.