Some have likened the legislative process to making sausage. Understand this analogy was not meant to be flattering, but sometimes this process works better than you think...and people do like sausage. I think this is what is happening on Capitol Hill this week.
After leaving an intense, hastily called, late-night meeting (before its 2:30AM conclusion), I had a sleepless night before returning for another meeting with the same cast Saturday morning.
It was but one of many dramas occurring around the Capitol - in offices, in restaurants, in nooks and crannies - throughout most of the last 48 hours. It is ironic that my 15 months of intense work on health care, along with so many of my colleagues, comes down to this.
As I write this, despite the late meetings and sleepless nights, I am actually feeling good about where we are and what's going to happen.
I know that it is very hard for people outside of the Capitol to keep track of the developments that have occurred over these last few days, much less make sense of them. The fact is that the process here, for all of its frustrations and inefficiencies, is in fact working like it was designed to do. After more than a year of being in the middle of this drama, I am satisfied that a clear outline for fundamental reform for America's flawed health system is emerging. There is greater understanding inside and outside of government.
While we have the greatest health care in the world, the "greatness" is only available for some: those who can afford and navigate the system. For most Americans, however, our health care system is too expensive, the results uneven, too many are denied access, and the results for average Americans are mediocre. We get sick more often and longer, die sooner and pay far more for the privilege than most other countries that I hear opponents of reform vilify.
Our bill will expand access to over 30 million who currently do not have coverage. The insurance that everybody has will be better, eliminating some of the artificial dollar limits. Americans will no longer go bankrupt from medical costs. Over the next few years, insurance protections will be even stronger, the tyranny of being denied coverage for pre-existing conditions or being chained to a job for fear of losing your coverage will be eliminated.
Perhaps most important, we are on a path to save Medicare from collapse by empowering the government to study and then implement a system that rewards value, not just volume with tests and procedures. There will be new tools for the federal government to ensure equity and innovation that will put us on a path to save over a trillion dollars in the next 20 years. It puts us on a path to prevent Medicare from collapsing and eliminates the biggest fiscal threat to America's stability.
There is a certain amount of irony that the uniform Republican opposition actually made the bill worse. By following leader Boehner's admonition in March of '09 that his party should not be legislators, but communicators, they took themselves out of the game in the House and the Senate. True bipartisan legislation has a cushion that enables it to resist efforts from a small minority - and even a single member - to extract their pound of flesh and be granted special treatment. Across the board Republican opposition empowered every single member, for a bill that has come down to one or two votes, to have a moment in the sun. It gave them maximum leverage, and it would be surprising to not see people try and exercise it. On balance the fact that the legislation does so much good - controls cost, creates a new path and creates instant benefits for the American public - is remarkable.
It is also striking how the legislation, despite all the heated rhetoric from opponents (most of it wildly inaccurate), is quite moderate. It relies heavily on the private sector and existing insurance industry. While it does not make progress as fast or at a level as ambitious as I have fought for this year, it does have the key elements: access, cost containment, and insurance reform, which will put us on a path critical to our physical and economic health in the years ahead.
Tomorrow I will be voting on a bill that will be the fundamental foundation for health care results that are as good as what other countries have, and will put us miles ahead of what we have today. It will give Americans more coverage and rescue Medicare from collapse. At a time when the federal government provides $.50 of every dollar for health care, it's time that we exercise our full ability to make that money and that authority work for all Americans.
Follow Rep. Earl Blumenauer on Twitter: www.twitter.com/repblumenauer
There is NO excuse for standing by and doing nothing while even one of your countrymen dies for the lack of care.
In the end, there will be a finite number of people that die through the greed of their fellow citizens and a finite number of people responsible for those deaths.
Let them sleep well and wonder about the realities of their own karma and whatever lies beyond this frail human existence.
Unfortunately, though, like Obama and many other politicians, Blumenauer has apparently never heard of the Pentagon, or the Department of Defense, or anything about the monstrous bulk of budgetary waste that Congress rubber stamps yearly. If they knew about these things, they would refrain from saying such nonsensical things as healthcare consumes the largest part of our GNP, or our national budget, or accounts for the most rapidly growing portion of our deficit, and other similar gibberish.
One might find something to be hopeful about if the national defense culture were not both inordinately, monstrously wasteful; but also if there were just one, one sensible politician who would blow a very loud whistle about that monstrosity, and about the annual rubber stamping of its unruly budget.
That Blumenauer, Obama, et. al., don't seem to notice is a testament to just how bizarre and ignorant our ruling public servants have become. Our collective refusal to scream and parade with pitchforks about that monstrosity is an indication of just how cowed we ordinary citizens have become.
http://www.hr676.org/
Water should be free, since to charge for it is to make money from thirst.
Clothing companies should be nationalized, since they make money from the desire for modesty and protection from the elements.
Housing industry should be nationalized- since to charge people for shelter is making money from their need for protetion from others and the elements.
How has society prospered for centuries under such cruelty?!
It was how we got to be a wealthy nation. The greedy profit before all theory doesn't work, that was business 101. I offer as proof the mess your ilk has made of our economy.
1) How a company can possibly price insurance coverage with no coverage limits?
2) By using an incredibly low penalty for non-coverage ($95 or 1% of income, rising to max of 2.5% of income) and eliminating pre-exisiting conditions, what's to prevent rationale people from dropping coverage, paying the penalty, picking up coverage when needed, and then dropping it again? What effect will this have on bending the cost curve? How has this worked out in MA, under "Romney-Care"?
3) How does this "legislation" remove the tie between job and health insurance? Only two ways exist to do that a) make employer provided health benefits fully taxable b) or, make all health expenditures fully tax deductible. Where in this "sausage" is that done?
4) Where is the Constitutional authority and the legal precedent for the federal individual mandate? When has the Fed government ever been able to compel private citizens to engage in commerce with each other? How will this stand up to SCOTUS scrutiny? When it doesn't, how will those lost income streams be replaced?
That's where the downward pressure on the premiums is going to come from.
2017 for small group and individual plans.
I'm glad you pointed this out, but a lot can change in 7 years, including the majority in Congress. What was the justification for delay in implementation?
Health insurance is not the main cost driver in health care costs, but the health care industry is the "villian" being used to push through more government control of 17% of the economy.
Isn't the suggested profit roof 20%
Anyone who believes that "4-5%" is part of the reason this country is so messed up.
3.47 Billions were lavished (over 6 million per elected official) on members of congress last year alone to influence votes on a myriad of issues. How can this have had no effect, and if it was in fact ineffectual, why does the money increase every year? I sincerely doubt there is no return on this corporate investment, otherwise it would cease.
"No man can serve two masters". When push comes to shove, who do you serve? The ones that voted you in to office? Or the ones that provide the funds to get you re-elected? Did you vote your conscience? Did you vote for the good of your constituents? Or did you vote for the interest that paid the most for that vote? Until this issue is addressed, every single decision made by congress is under a cloud of suspicion, and deservedly so.
Well congress? What say ye?
This is paid for by mandatory fees!
Good thing for a Decent Republican to scare people with!
Will banking "reform" run the same course?
Wow god forbid.
The ignorance and outright stupidity in this country is unbelievable and maddening.
Why must I be made to pay for others needs? It's one thing to ask me for charity, it's quite another to stick the government's gun to my head and steal it from me.
Tell me, where does the money come from to pay for an infinite desire for health care in a world of finite resources? How will those resources be allocated, and by whom?
Right now, a severly hampered market attempts to do that by the price mechanism.
Will it be "fairer" when nameless, faceless unaccountable bureaucrats do the rationing?
The U.S. has a for-profit health care system. The pre-existing condition practice was not allowed to happen for the good health of our citizens. It was for profit, period. The fact that is was allowed to exists for many years says where the common good fits relative to the profit of a few. All the politicians were enablers of this practice.
Rep. Blumenauer is an example of the good guy who somehow can't take that big step for actual reform. He talks about how the bill does good things, but actually fixing the system somehow can't be reached. Maybe it can't, but at least speak the truth and make the effort.
The truth is for-profit corporate motivation is in direct opposition to good health policy. Europe, Australia, Canada know this. Their health insurance system for basic coverage is not-for-profit. Not government run only, but all are not-for-profit. Highly regulated and single payer, the systems costs for 8% to 11% of the GNP of the country. The for-profit system in U.S. is 17% and going up. It is about community and being smart.
John - what would happen to the cost of hazard insurance on homes if anyone could buy insurance after their home burned down?
Yes, this is one of the Fundamental misconceptions...
Americans!
Decent Health Care is coming, within 24 hours, even to those who don't deserve it.
That's change I can believe in.
Interesting choice of words. Continuing down the current path will undoubtedly lead us to the day when government bureaucrats decide who deserves it and who doesn't.
Welcome to the end of the Rule of Law and the dawn of the Rule of the State.
We the people are represented according to established democratic principles.
Our Representatives legislate and the Health care Insurance Industry are supposed to abide just as the people are supposed to abide.
Is that a problem for U?
And don't try to fool me with some irrelevant and lurid reference to the Constitution...
What do you think we would be getting if the GOPers were in control.
Only choice and competition will ever serve to bend the health care cost curve; government price controls and heavy regualtion will never do that (indeed, they will do quite the opposite)
I would really like something better however, and I hope we all keep fighting for it. Public option would be about like a turkey sandwich, and single payor would be fine dining.
What we would be getting if the GOP were in control is more excuses trying to justify our crappy health insurance system based on free market arguments -- like there is any free market in healht care.