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Rep. Joe Sestak

Rep. Joe Sestak

Posted: October 18, 2009 06:12 PM

The Baucus Bill: Right Step, Wrong Direction

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The health care reform bill passed by the Senate Finance Committee chaired by Sen. Max Baucus is not the reform we need and is not the reform we promised the American people. In its current state, the bill reinforces health insurance monopolies, does not provide access to affordable care for all Americans, and does not present a full and honest accounting of its costs. While I am encouraged that the Finance Committee has moved forward, I hope our Congressional leaders will embrace the legislation passed in my committee (Education and Labor) in the House that better controls cost, expands coverage, and improves care.

The Senate Finance committee is the last of five Congressional committees to advance a health care plan. It is the only one that lacks a public health insurance option.

The public option is crucial if we want to introduce competition and bring down costs. The current health insurance industry is highly monopolized, with a small group of insurers exercising an almost "cartel" like power to dictate prices and continually raise premiums and fees on American families. Nationwide, an astounding 94% of insurance markets meet Department of Justice criteria for being "non-competitive." In Pennsylvania, two insurance companies control 70% of the market; one company has 74% of all the insurance plans in Southeast Pennsylvania.

A public option will guarantee competition and, as it will not be subsidized by the government and will operate on a fair playing field, it will use market forces to bring down prices and raise the quality of care. As the Senate moves forward, it must incorporate a public option.

Our goal is to provide affordable care to all Americans, but the Baucus plan will leave about 16 million of the approximately 40 million uninsured Americans without coverage. The bill does not do enough to assist working families, and it even leaves out an additional two million people from the requirement to have insurance because they would not be able to afford it.

One flaw in the bill actually discourages businesses from hiring low-income workers. Instead of requiring employers to provide insurance, businesses that do not provide insurance have to pay a penalty if at least one of their employees needs federal assistance to purchase insurance. These employees would traditionally be lower income, working class individuals. This approach, though appealing to the business community, would establish a serious disincentive for companies to hire workers from larger or single-income families. This is a regrettable and unintended consequence that clearly has to be fixed.

Though the Senate bill may appear less costly than its House counterpart, the numbers do not tell the full story. The Senate Finance bill, unlike the House bill, ignores an impending 20% cut to Medicare doctors' payments that will occur as a result of current law and threatens seniors' access to their caregivers. The House bill confronts this issue and puts in place a long-term solution, while Senate Finance just kicks the can two years down the road in order to save costs now.

The Baucus bill also disguises cost by using Medicaid expansion to shift too much of the burden to the states. Medicaid will be a crucial component of any substantial health care reform, but it should not be used to make the cost of this reform seem less expensive, especially when many states are coping with budget deficits.

Funding of the plan also relies on an excise tax on higher cost or "Cadillac" insurance plans -- those costing more than $8,000 for individuals or $21,000 for families. Unfortunately, because this tax is pegged to overall consumer price inflation and not skyrocketing health costs, within the decade it will begin to hit "Chevy" insurance plans as well. We cannot pay for health care reform by making health insurance more expensive for working families.

Symbolically, the passage of the Senate Finance Committee bill is a big step -- every committee asked to produce legislation has done so -- and comprehensive health care reform is closer to passage than it has been in decades. Now, as we begin to meld various bills and proposals, let us not forget that the goal here is good governance, not political gamesmanship. The Baucus bill, in areas, creates perhaps as many problems as it solves. The House version does a better job of meeting the President's goals and should be the focus of our efforts. It is the meaningful, effective reform we promised, and owe, the American people.

Rep. Joe Sestak (PA-7) is a member of the Health, Employment, Labor and Pensions Subcommittee on the Education and Labor Committee. He is a Democratic candidate for U.S. Senate.

Follow Rep. Joe Sestak on Twitter: www.twitter.com/Sestak2010

 
 
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12:13 PM on 10/20/2009
Yes, Congressman, the public option is crucial and will guarantee competition. But what you're forgetting is the nature of that competition. Big insurance companies comprising the "cartel" have effectively quashed competition in their own industry to create near-monopolies in most healthcare markets. They’ve expertly beaten competitors who've been much fiercer than any pubic option could ever be. They've defeated competitors with impunity and ruthless efficiency.

To date, Big Insurance has flexed a relatively small degree of its massive lobbying muscle. Yet look at how Congress has all but rolled over. Committees have dismantled or eliminated critical components of healthcare reform. The insurance cartel's complete dominance over the legislative process is further proof of their unmitigated power. Compared to that power, the public option as competition will be brushed aside by the insurance companies like a gnat off an elephant's butt.

How can things change when Congress is so overwhelmingly influenced by the insurance lobby? The money, staff, and resources that Congress people so gladly accept from the industry is the real problem. Until Representatives and Senators escape the cartel's clutches, nothing like real progress toward healthcare reform can be made.

With regard to your own campaign, will you go on record now to state exactly how you will oppose the health insurance industry's anti-reform efforts? How about a firm commitment now to not hire current or former insurance industry executives or lobbyists as staff or advisors? And to decline all current and future campaign contributions from such sources?
07:41 PM on 10/19/2009
Good analysis.

The Senate is and always has been more corrupt and for the plutocracy than the House.

It was designed that way as a comprise to states.

Notice how the most anti people senators are from the states with the least people.
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JackWhistle
02:49 PM on 10/19/2009
Admiral, I have been an independent for 5 years now. By my view both parties have been.. overzealous.. in their pursuit of conservative voters while leaving us libs/prog out to dry. I switched to Democrat this year because you gave me hope that we could actually have representation in congress. JSYK, You are the first politician I ever donated to sir.
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ibsteve2u
Someone who cares - to his unending regret
02:07 PM on 10/19/2009
Know how much I trust the insurance corporations?

Were I in need of continuous medical care, I would use four or five proxy servers before I posted comments against their monopoly and their REAL "death panels" lest they figure out my identity and...accidentally...lose my paperwork.

lolll...does that tell you?

Or does my belief that they routinely violate doctor/patient confidentiality and reveal patient medical conditions - particularly if those conditions promise to be debilitating eventually - to those corporations who purchase group plans from them - which the latter corporations may...unintentionally...allow to influence promotion and retention decisions suggest anything?
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deminmo
just looking for answers
12:51 PM on 10/19/2009
There is not reform in any bill if the insurance companies
are not forced to compete for customers, are regulated on
costs of policy, and restricted on dropping people from
insurance they already have or apply for, because of a pre-
existing condition. Call it "Public Option" or whatever, just
make health care affordable for everyone and available before
thousands more die because of lack of health insurance!
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11:44 AM on 10/19/2009
Admiral, sir. Could you please post some of the places where these cooperatives are working. Where they're working at lowering the Heath care premiums, providing some type of leverage strong enough to influence Health insurance monopolies and drug prices. I live in Seattle, Washington, which has had vast experiences with cooperatives in general and the several articles in our local fish wrappers (Seattle Times, Seattle PI) have said they don't work. In fact there was this very experienced co op dude on TV that said cooperatives in the Heath care field have been tried in Seattle had sorry results, of course unless you're a Health insurance company.
11:31 AM on 10/19/2009
Time is here for all progressives, regardless of party affiliation to get behind the idea of the public option. Congressman Anthony Weiner has a webpetition for those in support of the public option.
http://countdowntohealthcare.com/
Please support the Public Option, we need it desparately to counteract the greed and outright "thievery" by for-profit health un-insurers!
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ariveria
07:33 PM on 10/19/2009
this is not a fight for progressives. this is a fight for patriotic americans.

the right has shown whatever they are the patriot does not apply to them.

"a lie repeated often enough becomes the truth"
glenn beck
information czar fox news
the view 5/20/09
11:16 AM on 10/19/2009
Agree with Joe -- he's pointing out a disturbing feature of the entire Obama agenda, which is to push for ineffective policies that cost lots of money -- the Porkulus, Cap'n Tax, now health insurer enrichment.
11:13 AM on 10/19/2009
You get a POS from people that are a POS.
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drricklippin
physician-activist-poet
10:20 AM on 10/19/2009
Rep Joe Sestak from my state of PA is demonstrating courage here - a rare commodity in DC

Now our new young President has to rise to his own historic moral moment and insist on a public option.

I believe he will.

Dr. Rick Lippin
Southamprton ,Pa
10:13 AM on 10/19/2009
From what I have been reading about the process going on between Reid, Baucus and Dodd, I think there will be a public option in the final bill. However, it will be made palatable for ALL 60 Democrats. That is how we avoid a filibuster. For example, in Kent Conrad's state, Cooperatives may be set up. They have a good history of making coooperatives work. In other states, the legislatures will be able to vote to "opt-out" of the federal public option. In other states, a "trigger" mechanism will allow a public option if certain metrics are not agreed to (perhaps in Maine). For most of the country and especially in the states with large populations, a robust public option will be adopted. The Federal government will run it. That is how you get to 60 votes. It may not be perfect. But we need to understand that even when a bill is passed and signed by the President, it will need to be tweaked. And we will probably need a Health Care Reform Bill #2 down the road. By establishing a public option, we will show the whole country how we can make health care work. This is how we will get to single payer - we will evolve there. Because insurance companies won't be able to compete as "for profit" entities any more and many will just "opt-out" of health insurance and go into another line of work where they can maximize their greed.
10:28 AM on 10/19/2009
The starting point to effective health insurance reform is establishment of a public insurance option. If triggers or opt-outs get everybody on board, at least we have a point from which to start. Opt-outs still give the voters of a particular state a direct voice in opting back into a public option if they so chose (or the inevitable negative market pressures will prompt it eventually if they do not). I dont find anything specifically wrong with the trigger concept. Often just the threat of regulation can push corporations in the right direction....look how fast some of the TARP funds got repaid when there was serious talk of salary caps for execs. We just have to make sure that the Baucus/Obama plan never makes it past that committe...the most insidious parts of that bill are the provisions that close any posibility of ever changing anything thereafter (especially at the state level) and ensure that the health insurance industry is further insulated from any attempts at regulation. I applaud all members of the house that are standing firm and demanding that there be a full public option, and therefore, meaningful reform in the final bill.
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TrekBear
03:23 PM on 10/19/2009
States like Texas would never vote to opt back into a public option - that's just how self-destructive we are!

Either the Texas Legislature would prevent it from coming to a vote or the die-hard so-called conservatives would vote against their best interests.
10:47 AM on 10/19/2009
Going along with weak-kneed politicians is not the way to avoid a filibuster. Although I didn't care for his Vietnam War stance, former Pres. Johnson set the proper example for getting legislation passed. President Obama and Congressional colleagues of the aforementioned weak-kneed can remind them that their electoral prospects can or can't be enhanced with the support of the party, that legislation they would want in the future has or hasn't a better chance with support from more colleagues and whatever other measures that former President Johnson used that you and I may or may not be aware of can also be brought to bear. In addition a good health care bill can be passed without having to go the route of the fillibuster problem so that 51 votes does the job.
10:01 AM on 10/19/2009
Joe, you have my vote to unseat the current Senator--Arlen Specter. A Public Option with the parameters as you have discussed is essential for working Americans.

http://eye-on-washington.blogspot.com
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jmpurser
See My micro-bio
09:25 AM on 10/19/2009
A public option will guarantee competition and, as it will not be subsidized by the government and will operate on a fair playing field, it will use market forces to bring down prices and raise the quality of care."

I see this assertion made over and over again by fans of the "robust public option". What's your proof? Given that the "public option" will by design only accept 5% of Americans at MOST how is that going to "guarantee competition"? And if "Competition" is going to magically cause an industry that produces NOTHING RELATED TO HEALTH CARE to suddenly become an economic benefit why haven't GENERATIONS of competition done so already?

Your faith is touching but I prefer fairy tales to be limited to sleepy children while people in charge of the ship of state pay more attention to reality.

If you want the benefits of REAL health care reform then you need to suck it up and deliver REAL HEALTH CARE REFORM like Single Payer. Corporate welfare will not get you there.

And BTW you can't make a "Right Step, Wrong Direction". I hope for the sake of the people of Pennsylvania that your thinking isn't always that muddy.
11:02 AM on 10/19/2009
While I agree with you that a good single-payer system is a better means of providing health care to all, a good public option also can. Please notice that I had to add to both alternatives mentioned the adjective "good". A title such as "single-payer" or "public option" sounds fine but quality is in the nitty-gritty of the legislation. What's been presented -- all the alternatives from the House and the Senate -- are not written in stone. They all must be reconciled into one final Bill that will be voted into law. We can conceivably have a public option that permits anyone who so chooses to join. We still can have a single-payer system since the Health Insurance Industry chose to oppose even a public option. Let's remember, the Public Option idea was only created as a sop for the Health Insurance Industry, Big Pharma and the Hospitals.
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usna73
We are all in this together
08:45 AM on 10/19/2009
Well done Admiral. While I can't be on the front line for you in the Senate race next year( I reside in a neighboring state), I promise to work hard to help elect you POTUS in 2016. I hope to retire that year, so I'll be glad to tow the line.

"Take heed in your manner of speaking
That the language ye use may be sound,
In the list of the words you are choosing
"Impossible" may not be found."
08:42 AM on 10/19/2009
Rep. Sestak thanks for posting here, we(family) have become a huge fan of yours from watching you on the political talk shows even though we are not from PA.

great article, clear and concise for any lay person to read and understand.

as someone else commented you are preaching to the choir here, every chance you get on the media circuit please address and explain what you have done here, half of the country simply doesn't understand what is stake here...they have been mislead, misguided and manipulated.

looking forward to to your upcoming Senatorial WIN!