The Baucus Health Care Reform Bill
Wednesday, 23 September 2009
WIN A FREE ELDERBLOG: If you don't have a blog and wish you did, see Monday's post on how to win a free Typepad account for a year. The deadline for the contest is Friday 25 September.
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
Wow! I am really impressed that they're reaching out to elder bloggers. I guess the squeaky wheels do get some oil & perhaps more will be coming. All of you are to be commended for your hard work. Thank you very much. Dee
Posted by: Dee | Wednesday, 23 September 2009 at 04:40 AM
Ronni, I found your post very interesting. Just hope many of the American readers make the effort and sign up with their government representatives and support this reform. The bill doesn't have to be perfect; it just has to be a start. I've been the beneficiary of universal health care system for nearly 30 years and, let me assure you, things change. What is excluded today might be included tomorrow, and it is an iterative process. Main thing, affordable care for everyone...
Posted by: lilalia | Wednesday, 23 September 2009 at 05:05 AM
A few nights ago we were talking with two friends who run a small furniture store and are over 60. They are paying 19,000 for a policy with a 2500.00 deductible.
Heard an NPR story about people over 55 losing jobs at a higher rate than the rest of the population. The show didn't mention that employees losing jobs at that age are going to have a hard time getting any insurance in the individual market. Seems to me that lowering the age for Medicare would help these people get jobs. Other friends with a good sized business of 30 employees say they still can't get a group policy because they are mostly older workers. They are paying half the cost of whatever policy their people can get. One employee, healthy at 40, just can't get coverage.
It has become absurd in the extreme. I am afraid that my husband and I will not be able to afford any coverage when we hit 60 and will have 5 scary years waiting to be on Medicare.
We've just returned from France where people are amazed that this is such an issue here. People who don't travel don't realize how far behind Europe we actually are. We were driving a lovely car that got 60 mpg which you can't buy here. Kids can go to college. Trains cross the countryside. The roads are excellent. No one goes bankrupt if they are ill.
It was depressing.
Posted by: zuleme | Wednesday, 23 September 2009 at 05:23 AM
I, too, am pleased as punch that the aides had the sense to reach out to you. Thanks for this explanation of the bill and how this whole thing works. I will follow your directions on contacts to be made. Having lived in France for 25 years, I echo what Zuleme said above. And the health care there was excellent.
Posted by: Alexandra | Wednesday, 23 September 2009 at 06:33 AM
Israel, too, has outstanding coverage and stellar medical professionals and state-of-the-art services and technologies. We in the USA w horrific "coverage" are not paying the income tax percentage rates that citizens in countries with great health care we cite are paying.
That said, Ronni, what a thrill that your/our voice was heard among the others "testifying." And good for the hosts with brains to invite the bloggers.
To find the email addresses of your senators and congresspersons: Contact Elected Reps.
Posted by: tamar | Wednesday, 23 September 2009 at 06:48 AM
Thanks, Ronni, for all you do on TGB, and for including my blog and others on the conference call. I notice that Birds on a Wire has had several visitors from the US Senate in the last 24 hours, thanks to the conference call. I'm sure they're reading blog comments, which means our readers' voices are being heard through the blogs.
Posted by: Paula | Wednesday, 23 September 2009 at 07:35 AM
I was never contacted, Ronni. I assume it's because having a difficult time hearing on the phone eliminated me. I am so glad you set this up because this is the kind of thing that gets the attention of our representatives. I think I will take time to e-mail mine ofter with your subject in the heading. Thank you for continuing to push for this.
Posted by: Darlene | Wednesday, 23 September 2009 at 07:44 AM
Ronni, of your many useful posts over the years, this one is the finest. It's validating to learn that Senator Reid and others in Congress are listening to older, thoughtful voices.
Feeling a little played-out on pushing for single payer for years, I needed this nudge to keep on keeping on. Thanks for your efforts.
Posted by: naomi dagen bloom | Wednesday, 23 September 2009 at 07:47 AM
Thank you for this!
Posted by: Claire Jean | Wednesday, 23 September 2009 at 07:48 AM
I just did it. I emailed my senators, Harkin and Grassley, (both of whom have very significant roles in this issue) my rep., Latham, and Pelosi and Reid. I feel good that I finally did this. Thanks for making it so easy. Your hint about the subject line/first line of the message really helped. And WOW, I'm impressed that your (and our) voices are heard. Thanks so much, Ronni.
Posted by: Tarzana | Wednesday, 23 September 2009 at 08:13 AM
I just want to say that, having been privileged to take part in this call, I was in awe of how my sister bloggers pushed the staffers
Nancy kept insisting that they listen to her experience with how insurance companies have gamed the system to deny patients needed care under HMOs. Paula was calmly determined to learn all she could -- and Ronni wanted to know how we could influence the outcome. (George -- sorry -- I didn't hear you.)
They know they have fires out here in the real world, set by people who don't trust profit-seeking corporations to make choices about our health care. As much as some people fear the government, many of us fear insurance companies that don't have to compete with a public option even more. As Ronni says, this is the time to make ourselves heard.
Posted by: janinsanfran | Wednesday, 23 September 2009 at 08:36 AM
Government run health care – the so-called “public option” - presents serious challenges for us. The private sector and competitive market forces are the best means to meeting health care needs. Watch this video from the U.S. Chamber http://www.friendsoftheuschamber.com/media/
Posted by: Audrey | Wednesday, 23 September 2009 at 09:04 AM
Could you explain what it is that the private sector and competitive market forces of the insurance industry have done for our health care needs lately or, for that matter, over the last hundred years or so?
Posted by: Jessie Landis | Wednesday, 23 September 2009 at 09:22 AM
Ronni, thank you again for including me on the call. And for your rational, easy to understand description of the process and the updates.
I have another update. Reuters just released a story that the Republicans are pushing to slow this process down: http://www.reuters.com/article/newsOne/idUSTRE58J18320090923
This cannot happen. And, I disagree with Audrey's comments above. The private sector has failed its members, the people it covers, and the citizens of the US miserably. Here is a recent story that emphasizes why we need a public option: a 40 year old went to the emergency room with Ventricular Fibrillation (an extra heart beat that is NOT conducive with life). She had emergency surgery and will live (a mother of 3 young children). Her insurer, a national managed care company, denied the claim as medically unnecessary leaving her with over hundred thousand in bills.
Audrey: is this the coverage you want? for yourself? your children?
Public option is a necessity. I of course am pushing for Medicare for all. Contact your congressional representatives, especially Republicans. We can make this happen
Posted by: NancyB | Wednesday, 23 September 2009 at 09:25 AM
Absolutely fascinating.......thank you so very much for all of this. We will make this happen with your help.
Posted by: Mage B | Wednesday, 23 September 2009 at 10:44 AM
Our Congress woman, Carol Shea-Porter supports Medicare For All, the only logical solution.
Great! And we voted for her.
Posted by: zuleme | Wednesday, 23 September 2009 at 11:05 AM
Good to have comment by anonymous Audrey with no attribution to her name. Reminds me never to forget (as though I could) opinions 180 degree polar opposite of my own. Can't help wonder which lobby employs Audrey...
Posted by: tamar | Wednesday, 23 September 2009 at 11:43 AM
Keep the good fight going.
Push and act as if there is no finish line.
Medicare for all.
Posted by: doctafill | Wednesday, 23 September 2009 at 12:12 PM
Thanks, Ronni, for this great info. Just e-mailed all the appropriate players...Guess we now hope for the best!
Posted by: Nana | Wednesday, 23 September 2009 at 01:00 PM
Finally, voices are being heard thanks to your continued efforts, Ronni. Thanks, also, to those who participated in that phone conference. Guess I should see if my Skype is operative and maybe get in my two dollars worth sometime.
I'll tell you this, the local HMO groups are knocking themselves out offering all sorts of freebie programs and handing out all sorts of multi-page resource books, especially for "seniors." They're including all this not only for their members, but seem to be really pushing the same for non-subscribers now. Isn't that a coincidence in timing with all that's going on with health care right now. There are increased free classes, too, for all -- various type exercise programs, disease information and anything else you can think of within the health category. I've never known of so many offerings from them in our community.
How many of these offerings will continue if inaction on health care change occurs, or if significant health care changes are not made this year?
I had occasion to make an inquiry of one HMO representative yesterday. I noted to her in passing that should I take the class we were discussing that I wanted her to know in advance I would not be changing my insurance provider (I have Medicare.) She became instantly defensive. I know a sales promotion when I see it, but I didn't say that to her.
You know where some of the money for this probably comes from is that extra money the HMO receives from Medicare (over and above what Medicare normally pays.) That larger payment is given the HMO for those patients who sign over their Medicare and join the HMO. Data has shown the HMO takes in considerably more than what's normally spent on regular Medicare patients Of course the HMO then has an incentive to cut the Medicare patients expenses, and not always in patient beneficial ways.
Many such patients don't realize they're getting short changed from needed service in the name of insurer profit. Some health care service professionals dedicated to their patient's best interests have been known to recommend to the patient they switch back to Medicare in order to receive the service they need and deserve.
I think we really need to hold our Congresspersons feet to the fire on health care reform, especially and including those dedicated to slowing the process in an effort to defeat it, or who obstinately refuse to acknowledge the large number of their constituents who oppose their Congressperson's position. That's part of what I'm doing since the latter is true in my situation.
My Rep. holds phone conferences, speaks with a few of those participants who generally seem only to reflect his position -- isn't that a surprise. I've been invited to participate -- that means listen in -- but have yet to be asked to have a speaking participation allowing me to ask him a question. I consider the experience an attempt to brainwash me, so have quit participating. I just call his office as they suggest if you can't be available for the conference call and leave my message with his Aide.
I'm probably butting my head against a stone wall, but I keep pressing him, my Republican Representative. Naturally, he's toeing his Parties political line and I think that's all the more reason to keep after him not only privately, but especially through much more public forums. I'm trying to do that, too, with local newspapers.
(The Rep., David Drier, was a strong force in the previous Congress and was a power behind the recall of our previous Calif. governor and putting Arnold Schwarzenegger in office.)
Posted by: joared | Thursday, 24 September 2009 at 03:46 AM
Yes!....I emailed Reid & Pelosi...Thanks for all this great information....
Posted by: Judy W | Thursday, 24 September 2009 at 08:05 PM