Wednesday, 23 September 2009
The Baucus Health Care Reform Bill
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UPDATE AT 12 NOON Senator Reid's office just contacted me with this link to a new document from the White House outlining how health care reform will affect Medicare and elders. It is laid out well, clearly written and easy to read.
A few days ago, aides to Senator Majority Leader Harry Reid reached out to me to discuss the health reform bill from the Senate Finance Committee headed by Senator Max Baucus. On Monday, I had an enlightening telephone conversation with the aides and yesterday, there was a conference call with Reid's office including several other elderbloggers.
We got some good explanations, particularly on how the bill would affect Medicare beneficiaries, and the aides got an earful from us about our concerns.
The Finance Committee bill (which you can read here pdf) creates NO Medicare benefit cuts for elders. It includes a 50 percent discount on generic drugs for people who fall into the donut hole of Part D (the prescription drug coverage), a free annual physical is added to benefits along with such preventive screenings as mammograms and colonoscopies.
During the conference call, Nancy Belle, who blogs at The Tempered Optimist, made an impassioned plea to Senator Reid's aides to include bone density screenings for Medicare beneficiaries. About four hours later, an email arrived from Reid's office announcing that Senator Blanche Lincoln had added an amendment to the Baucus bill to improve access to bone density tests. You would almost think she had been listening in on our call.
The bill also eliminates the currently mandated 21 percent decrease in physician payments scheduled to take effect in 2010.
One of the nitpicky items that has been confusing me is the discussion of co-ops, which substitute in the Baucus bill for a public option. I couldn't work out what they are in relation to “exchanges” that are also talked about.
In case you're confused too, co-ops are a type of coverage available in exchanges that would be set up by states and regions - one among other choices from private insurers. I still don't like co-ops and support a public option which is included in the HELP bill from the House, and Senator Jay Rockefeller has submitted an amendment to the Baucus bill for a public option to replace co-ops.
Actually, there are nearly 600 amendments from the 99 senators. Many that have been accepted to include in the bill for debate are posted online here [pdf] as modifications.
The Baucus bill is, as Jan Adams of Happening Here noted, a cheapskate bill and I don't like most of it. But there some good points and do keep in mind that there is a long way to go before a final bill reaches all of Congress and it will change dramatically during that time – for better or worse.
What I most appreciate from the aides we spoke with is an explanation of how health care reform will move through Congress. With this information it will be easier to follow the news of the bill since the media is not often clear about what's going on.
The Baucus bill is now in what's called “mark up” in the Senate. All the items in the bill and all the amendments are being considered and the aides say the final, full bill will be ready by Friday or Monday. (Changes, additions, subtractions)
The bill then goes to the Senate floor. It will take about two weeks for that debate (more changes, additions, subtractions) and then the final vote. Meanwhile, the same process is going on in the House to combine those three reform bills for a final vote.
When each house of Congress has passed a bill, those two must somehow be combined and we can expect all kinds of floor speeches and media appearances from Congress members denouncing one another.
When there is a single bill, Congress votes up or down. There are more complexities than what I've explained, but that's the general idea. There is an good graphic at The New York Times showing the process of the health reform bills.
As has been widely publicized, there are six insurance industry and big pharma lobbyists for every Congress member, all working hard to convince Congress (along with contributions to election campaign funds) to retain and even increase their profit margins. I asked Senator Reid's aides what we the people could possibly do, against that multi-million dollar force, to make ourselves heard, to get Congress to consider our needs and opinions over those of big business.
Their answer is to keep contacting our representatives by phone, email and postal mail. Our messages are read and they are tracked. One of the aides said she had just spoken with a member of Minnesota Senator Amy Klobucher's staff who had received more than 18,000 letters so far about the Senate health care reform bill.
To help make it easier for all those aides counting up the letters from us, I suggest that when you email, you include in the subject line the topic and your position. Something like “No co-ops – we must have a public option."
It is also important to contact House Leader Nancy Pelosi and Senate Leader Harry Reid. They are shepherding the bills through their respective houses and should hear from us too.
Senator Reid's aides, who are in frequent contact with aides to other senators, believe it is a reasonable goal to have a reform bill passed by the end of the year. We all know it won't be perfect, but if something is passed, it is a start and we will have broken a 50-year stalemate during which everyone talked about health care reform and nothing ever happened.
Contact your senators and representative here.
You might also check out the blogs of other elders who were on the conference call with Senator Reid's aides:
George Phenix of Blog of Ages
Nancy Belle of The Tempered Optimist
Paula of Birds on a Wire
Jan Adams of Happening Here
At The Elder Storytelling Place today, Johna Ferguson: The Loves of My Life