So the Senate voted early this morning to end debate on their version of a health care bill. Why it was done in the middle of the night is a mystery. After eight months of raucous debate, it wasn't going to slip by unnoticed like those secret pay raises Congress gives itself.
Remember, this doesn't mean the bill has passed the Senate. There will be another few votes on procedural issues this week and then the final vote for passage on - another mystery - Christmas Eve. It's a done deal, they say, but given the obstructionism of the Republicans and the wavering of some Democrats, I don't trust passage until I see it.
Senate Republicans voted en masse against the bill. It is difficult to believe that there is not a single elected Republican who believes we don't need better health care. But many, if not most, hate this bill. Senator John McCain said in no uncertain terms on Fox News Sunday,
"We will fight until the last vote. We owe that to our constituents, because...we must do everything. We must look back and say, 'We did everything we can to prevent this terrible mistake from taking place.'"
A lot was lost from health care in the Senate negotiations – a public option; Medicare buy-in for uninsured people age 55-64; millions of federal dollars for Medicaid that should be shared by all states going to just Nebraska, the last of which Senate Leader Harry Reid called “compromise.” Phooey.
Some of the compromises are stunning in their stupidity. For example, a tax on cosmetic surgery has been replaced with a tax on tanning beds. Those cosmetic surgeons must have a better lobby than tanning bed enterprises since no sane person can make the case for cosmetic surgery over tanning.
Although most of the health care bill will not go into effect for three or four years (another outrage; Medicare went into effect 11 months after the bill was signed), insurers will be prohibited immediately from denying coverage to children with pre-existing conditions. Adults are not included until 2014. (How many will die between now and then for lack of coverage?)
On the up side, according to Vice President Joe Biden's Sunday Op-Ed in The New York Times:
”Insurance companies will no longer be able to...drop coverage when people get sick. Charging exorbitant premiums based on sex, age or health status will be outlawed. Annual and lifetime caps on benefits will be history. Those who already have insurance will be able to keep it...”
The bill includes a mandate for coverage and Americans who fail to purchase it would pay a penalty of $750 or two percent of their household income, whichever is higher. This would be fine if there were a guarantee of affordable coverage which there is not. Health care under this bill has been left in the hands of private insurers with no one to compete with but themselves - as it is now.
An additional 30 million people, it is said, would be insured under this plan leaving about 21 million still uninsured.
The bill is so far from what every developed country in the world has that it seems almost useless. It could have been so simple: expand Medicare to everyone. The needed bureaucracy is already in place, most of the kinks have long-since been worked out and it would create a risk pool of the entire population decreasing costs across the board. But our elected officials are venal and weak – that is the only explanation for their intransigence and heartlessness.
Nevertheless, I support the bill and do so because it – along with the House bill with which it must be merged – is a framework, a starting place, a beginning toward healthcare for everyone. It will be many years before that can be fully achieved, but with the legislation in place, health care cannot, as it was in the Clinton administration and seven times before that, be dropped into a black hole for another generation.
At The Elder Storytelling Place today, Mark Sherman: What Were They Saying?