Health Care Vote Tomorrow Night

Tomorrow night the Senate is supposed to vote on whether it will take up the health care bill released this week. They need 60 votes, and it’s a big question mark whether they will get 60 votes.

The Senate bill is somewhere between “not what we wanted” and “better than nothing.” It pulls back a bit on the House bill’s draconian abortion restrictions, but it adds a “national plans” provision that would allow insurance companies to sell policies without regard for state consumer protections.

Conservatives and the insurance companies love the national insurance idea. The insurance companies could all set up shop in Texas and sell cheap junk policies to healthy young people in any state. Most of the young folks likely would pay premiums for quite some time before they make a claim and realize their policies are a ripoff and their insurance doesn’t cover whatever it is they have. Big profits to be made. But if enough healthy young people drop out of the state insurance pools, the not-so-young and not-so-healthy will be paying higher premiums.

The public option will be available only to people who can’t get insurance any other way, and because it will attract a less-than-young and healthy (hereafter abbreviated Y & H) risk pool it is expected to actually be more expensive than private insurance. Robert Reich explains.

The Senate bill has a state “opt out” provision that many leftie bloggers don’t like. I think that if there have to be compromises (and why is that true?) this is one of the less onerous ones. If the public option were to be more robust, and go into effect sooner, I think it would actually hurt conservative state-level politicians in the long run to opt out. As it is, I’m not sure it will make a whole lot of difference to many people.

Many of the provisions of the bill won’t go into effect until 2014. I think this is a colossally stupid move on the part of the Democrats. I know Reid put that in to make the bill cheaper. But it will give the Right plenty of time to spread more “death panel” stories to scare the public with. If they manage to take back the House or Senate in 2010 or 2012, expect them to try to kill the legislation before it goes into effect.

Jon Walker at FireDogLake explains these and other issues with the bill. At the Washington Post, Ezra Klein explains the actuarial values thing. He also explains what parts of the bill go into effect before 2014. The New York Times presents the major provisions of the Senate and House bills side by side.

Between now and then, expect to hear all kinds of rumors and speculation about how senators Baucus, Landrieu and Lincoln will vote. Michael Tomasky argues that obstructing the health care bill would be bad for their political careers in the long run, even if they might take a hit from their conservative constituents in the short run.

As I’ve written many times over the recent months, the political paradox is this, at least for Nelson, Landrieu and Lincoln. As individual senators from red states where Obama has lower approval ratings, they would be rewarded in the short-term by blocking reform. But as members of the larger group of Democrats who represent states where Republicans tend to win statewide elections, a collective party failure is far more likely to hurt them in the long run than it is to hurt safe, blue-state Democrats.

If they’re really thinking long term, they should want reform to succeed. And oh yes, there’s this, too: the fact that they represent poor-ish states (especially Lincoln and Landrieu), where many families are uninsured and would benefit from being able to purchase insurance with a decent federal subsidy. This should make them want a bill.

Emphasis on should. We’ll know more soon.

Yes, I guess we will.

9 thoughts on “Health Care Vote Tomorrow Night

  1. So, wait, because i’m healthy and have a job they’re just going to force the small family-owned restaurant where I work to offer an insurance policy that will take even more money out of my already minuscule paychecks? That’s helping me how?

    On second thought I live in a red state w/ a Republican governor who’ll probably opt out (my Democratic representative voted against the bill). That will just leave me where I am today, uninsured. Whew!

    Should I be trying to develop a pre-existing condition now to avoid the rush?

  2. The health-care issue with which Congress should have dealt was, and is, why the United States has the worst health-care system in the developed world and why Americans pay twice the Western average to maintain that system and what fundamental changes are needed to make the system better serve us.

    But while you and I fret, fume and flail about right vs left, red vs blue, Repub vs Dem, within the incestuous Halls of the Legislatures it’s all about which politicians will enjoy the privilege of representing the interests of the rich. As the bill stands now, we will be thrown a few crumbs to keep us quiet, and the health-care industry will realize millions of new customers, a sharp increase in profits and revenues, all paid for out of our taxes. The health-care industry will get richer, politicians who made it possible will enjoy concomitant status elevation among their colleagues, and you and I?

  3. Sigyn — I believe the opt-out provision is only for the public option. If your state opts out you and your employer will still have to abide by whatever the final bill provides. The difference would be that all of your choices of insurers will be private for-profit companies.

  4. THis is unbelievable. It is so bad that I would say, no way. It has gone of the line of ‘better than nothing’ into ‘no way jose’ . If Obama is truly smart, maybe he planned for this to fall completely on its face and then come in with a single payer system that will work. Yea, I did just come in from another planet or just trying to keep a small modicum of faith in my country. How could we ….. up so much in 8 years.

  5. “If Obama is truly smart, maybe he planned for this to fall completely on its face and then come in with a single payer system that will work.”

    Unfortunately, the issue is not what works, but what might pass Congress.

  6. Dyedinthewoll said….” It is so bad that I would say, no way. It has gone of the line of ‘better than nothing’ into ‘no way jose’ .”

    There’s a lot to dislike in this bill, and I guess you agree with the Republicans who demand perfection – a health care solution should satisfy everyone, not cost any money, and be no longer than a page and a half and be easy for a 7-year-old to understand. Look at what the bill WILL acomplish: Provide for a mandate – nearly everyone MUST have insurance (with a few exceptions) provide for subsidies for those who need it — insure about 30 million uninsured, raising the percent of insured to about 96%, reduce the deficit, do away with ‘pre-existing condition’ clauses that allow insurance companies to leave some policy holders on the curb to die. The House version will do away with the anti-trust exemption.

    Blow it off and 40,000 Americans per year will die needlessly for lack of medical care. That’s the Harvard estimate, not mine. The odds for a better bill don’t improve with time. Ask Bill Clinton. He took a crack at reform 12 years ago. Can we wait that long again? We will likely lose seats in the 2010. Nobody is predicting we will have a better chance after 2012.

    Politics is not about perfect solutions. It’s about trends – trends for the better or trends for the worse. This reform trends to the BETTER. Will the detractors please tell me how NO bill – with the suffering and death that entails – is better than an imperfect bill. OR tell me how no bill improves the chances of a stronger bill before a half million needless deaths happen. OR explain to me what principle is worth a half million lives you will so casually sacrifice.

  7. maha,
    The only thing that will pass through Congress is, respectfully, a stool.
    They taste, they digest, they argue, and, in the end, it’s the food critics in The Senate who get to do their review. And, as usual, the restaurant across the street is paying them a Hell of a lot more to give the health care legislation a bad review.

    So after digesting the Stupid-Spitt’s amandement, and maybe actually rejecting it, The Senators will do whatever they can to enrich the companies in the health care industry, limit access to people, while mazimizing profits, thus turning a dream into a funtional nightmare.

    So, as usual, the only thing that actually passes Congress’s digestive system comes out as a PIECE OF SHIT!

  8. Doug Hughes, “Will the detractors please tell me how NO bill – with the suffering and death that entails – is better than an imperfect bill.

    Most of the things you talk about will not happen till 2013, yet we start paying for it right away. By then, we could have had single payer in place for at least 2 years and it would cost NO MORE MONEY than is in the system now. When we already spend 2X what every other developed country pays, is the answer really more money? Is that going to be the ‘uniquely American way’ forever? People are fearing change because they are still too comfortable with the present. That will change in 1-2 years and single payer will look better. If the reforms all took place next year, I could support your idea of ‘better than nothing.” This reform is ‘a PIECE OF SHIT’ and ‘no way jose’ will stand right now. Lives lost are not going to change for 2-3 years what ever happens with this bill. WHen this one fails, the country will be in worse shape and possibly unable to minimally care for the uninsured.

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