Drawing the Lines

November 28, 2012 at 11:42 am | Posted in Congress, Economy, Obama Administration, Politics, Taxes | Leave a comment
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The bombardment has already started, and will intensify until, as the year ends, either a solution to the “debt crisis” will emerge—or our fearless leaders will kick the can down the road. Again.

There are actually three sides to the discussion. One side believes that the need to eliminate the national debt has been overhyped. After all, they say, people have been crying for decades that the sky has been falling. But it hasn’t, and it isn’t. People, regardless of nationality, have been falling over themselves trying to lend us money, with the result that the interest rate on our national debt is at an all-time low. (There are many other arguments for not worrying so much…but I understand that one, and agree with it.) What we need to do is worry about improving the economy as a whole; if we can do that, the national debt will take care of itself.

The other sides are mostly debt hawks, and they have framed the discussion in terms of reducing/eliminating the national debt, with the health of the general economy at a lower priority.

One group (let’s call them conservatives for short) has an economic philosophy akin to the European Austerity policy. They believe we can’t afford social programs, we need to spend more money on the military, and we must reduce taxes. They say that cutting social programs (especially entitlement programs) will save the money we need to reduce the deficit. They say that by reducing taxes we will induce business and wealthy individuals to create more jobs, thus raising more revenue to further reduce the deficit.

But look what Austerity has brought the Europeans: their economies are in decline, and their people are rioting or striking because they’re not getting a fair return on the time and energy they spend working. They’re not creating jobs. They’re not increasing revenue. They are imposing poverty on their populations.

Another group (yes, we’ll call them liberals) believes differently. They’d like to increase taxes on the very rich. The increases won’t make a bit of difference to the lifestyles of these people, nor cause them to fire people. The proposed increases would apply only to the income over $250,000. The liberals would like to eliminate certain tax breaks treasured by big businesses and wealthy individuals, like the oil depletion allowance. They’d like to eliminate tax breaks that help pay for corporate jets, and tax loopholes that encourage businesses to make as much of their money as possible overseas and avoid taxes here. Liberals say that by increasing taxes on the very wealthy and eliminating tax breaks and loopholes we’ll increase revenue we can apply to the national debt.

They’re probably right. But both groups are forgetting that the best way to reduce the national debt is to create jobs. We need to invest in physical infrastructure, like roads, bridges, power grids, and buildings. Those physical projects will create thousands and thousands of jobs, most of which can only be done here. The workers who get those jobs will pay taxes and buy products, creating more revenue for the government and more demand for products, thus even more jobs. Employers will hire, but only if there is more demand for their products and services.

The federal government needs to invest in the states. Money for education will help our workers compete in an ever more challenging workplace—and provide jobs for teachers. Money for public safety will reduce crime rates and improve state and local responses to disasters—and provide jobs for police officers, firefighters, and disaster relief workers. Those are only a couple of examples of areas where federal investment can provide programs, equipment, and jobs to improve our lives. And the workers who get these new jobs will pay taxes and buy products, creating more government revenue and more demand for products and services.

The top priority is not the national debt: it’s the economy. The conservatives and the liberals need to work together, to find compromises that will get the job done. You need to pass this message to your friends and let your elected representatives know how you feel. They need to stop “standing on principle” and start governing: the country is at stake.

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Debt Ceiling? What Debt Ceiling?

July 2, 2011 at 6:18 pm | Posted in Congress, Economy, Politics | 4 Comments
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People are going into panic mode—again. We are rapidly approaching the debt limit imposed by legislation and, people say, if we reach that limit the country will default. Defaulting would indeed be a catastrophe for the U.S. and world economies. It would result in a deep recession here and probably across the world. Yet President Obama still leads from the rear, and the Democrats in Congress do little. The Republicans in Congress mulishly refuse to consider increasing revenue, while insisting that we cut spending with a blunt axe before they’ll vote to raise the debt limit even if it sends us into default.

But we don’t need to default. When we reach the debt limit President Obama could thumb his nose at Congress and just keep spending the money to pay the country’s obligations, like Government bonds, Social Security and Medicare payments, subsidies for school lunches, and all that stuff.

President Obama could ignore the debt ceiling and keep spending, because the legislation that imposes the limit is… well, unconstitutional. Section 4 of the 14th Amendment to the Constitution says, “The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions and bounties for services in suppressing insurrection or rebellion, shall not be questioned.”

That means we can’t question whether any debt legally incurred by the government is valid (must be paid). It must be paid, and that’s all there is to it. But establishing a debt ceiling casts doubt on whether existing debt will be paid, because the government borrows money to pay its debts: bonds, Social Security and so on. It means that the debt ceiling law is unconstitutional, and the President can ignore it.

That’s not just my opinion. It’s the opinion of several noted Constitutional lawyers, Congressmen, and other Serious People. The option has been raised to President Obama himself at a news conference, and he did not rule it out. It could happen, and while I hope it’s not necessary, it’s a lot better than defaulting.

Raising the debt ceiling (or ignoring it) would give the politicians a chance to get off their ideological high horses, negotiate a budget in good faith, and get the country moving toward financial stability. Will they take the chance? That’s up to you. Write and tell them what you think.

Unemployment Compensation vs. the Bush Tax Cuts

November 20, 2010 at 11:31 am | Posted in Congress, Economy, Politics | 2 Comments
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Thursday evening the House of Representatives defeated a bill that would have extended unemployment benefits. It would have cost $33 billion next year, but would have added thousands of jobs, pumped $1.90 per budget dollar into the economy, and allowed the unemployed to live with at least some dignity while they’re looking for a job. It would have been a net gain for the economy and a humane thing to do.

Many of those who voted against the bill are also opposed to the Democratic plan to let the tax cuts for the very wealthy expire, while keeping the tax cuts for the middle class. That plan would provide $700 billion in revenue that could be used for aid to states, tax credits for job creation—and unemployment compensation. Everybody, including the very wealthy, would still get a tax break, because the first $250,000 of income would be taxed at the lower rate.

By the way, the argument that letting the tax cuts for the very wealthy expire would hurt small businesses is complete and utter nonsense. Less than 2% of small businesses would be subject to the tax increase. More than 98% would continue to get the middle class tax break we now enjoy.

Also nonsense is the argument that ending the tax cuts for the very wealthy would slow economic growth. Tax cuts lower government revenue and raise government debt; higher government debt leads to higher interest rates, which restrain growth.

According to the Congressional Budget Office (CBO), extending the Bush tax cuts would have little effect on the economy, increasing the GDP by only 10 – 40 cents per dollar. The very rich don’t spend as much of their income as lower income people do, so extending the Bush tax cuts only for the wealthiest 2% would be even less stimulative than extending all of the tax cuts. The CBO said that extending tax cuts would have the least value of the eleven economic stimulus policies it studied. A combination of direct aid to states, tax credits for job creation, and extended unemployment compensation would have three times the effect of extending the Bush tax cuts. Extending unemployment compensation alone would add as many as 600,000 jobs and boost economic output by as much as $1.90 per budget dollar. That’s because people will spend the money right away. For necessities. And for Christmas.

Republicans and Blue Dog Democrats who claim to be deficit hawks say we can’t afford to spend $33 billion to help the unemployed, even though it would add hundreds of thousands of jobs and put nearly $2 per budget dollar into our struggling economy. Nor do they want the government to have the $700 billion in extra revenue that would result from ending the Bush tax cuts for the very rich, even though the revenue could be used reduce the deficit or stimulate the economy.

Please write your elected representatives and tell them you want unemployment compensation extended. And tell them you want to let the Bush tax cuts for the very wealthy expire. That will help the economy and reduce the deficit. Pretty good deal, huh?

It’s Over; the Democrats lost. Why? What’s Next?

November 4, 2010 at 1:48 pm | Posted in Congress, Economy, Obama Administration, Politics, Uncategorized | Leave a comment
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Stop me if you’ve heard this one: “Unprecedented Republican sweep.” OK. Democrats, Progressives, and Liberals lost. The Republicans gained control of the House, and made gains in the Senate.

Why? Let’s look at some numbers. Republican leaders, who surely read the exit polls, say the message is clear: “Repeal healthcare reform!” But according to those exit polls, only 18% say healthcare reform is the top issue. 48% want to repeal it. 47% said keep or expand healthcare. Doesn’t sound like a mandate to me.

House Minority Leader (and presumptive Speaker) John Boehner says the “loud message” from the voters is “Cut spending!” Well, 39% say that cutting the deficit should be Congress’ top priority—but 37% say the government should spend more, to create jobs. 39% to 37%: another non-mandate.

It’s interesting to note that most of the voters in this election cycle were older, blue-collar white men from the South and Midwest. Those areas are not the twinkling stars of our economy, folks, and those voters are suffering.

“It’s the economy, Stupid!” Some voters wrongly blamed the Obama administration for the sullen economy, but more of them blamed Bush II, and even more blamed Wall Street. The last two groups had it right: the economy was sliding into the tank when Obama took office; the TARP package was started under Bush but passed under Obama. (After they helped pass it the Republicans repudiated it.) The Obama administration successfully bailed out the U.S. auto industry (American made cars are selling better than foreign cars and the automakers are healthy again), and bailed out the financial sector as well. (We, the taxpayers are making a profit on the bailouts, by the way.) The Obama administration passed financial regulation and consumer-friendly credit card laws that will help prevent problems in the future. And they did it over the anguished screams of Republicans—and constant Republican obstructionism.

The avalanche of money from the big-money crowd both at home and abroad is another reason the Democrats lost so many seats, but I’ve already commented on that and will do so again elsewhere. In the main it was the poor economy that bashed the Democrats, even though it’s not their fault.

But the Democrats could have done a lot better on November 2. They simply did not get their message across to the voters, or motivate the voters to go to the polls. During the first two years of his administration President Obama should have exercised the charismatic leadership that got him the job. He, Harry Reid, and Nancy Pelosi should have imposed better discipline on the Democrats in the Congress, should have been less anxious to be “bipartisan,” and should have used the bully pulpit to counter Republican arguments.

What’s going to happen in the next two years? I had lunch yesterday with a friend who had the most likely answer I’ve heard: nothing. Nothing will happen. The House will pass legislation that nobody really likes, after endless hours of wrangling, and between endless hours of hearings and endless investigations of Democrats that will turn up virtually nothing. The Senate will sit on any legislation the House manages to pass. If the Congress actually passes something on the Republican agenda (like the repeal of healthcare reform or the privatization of Social Security) Obama will veto it.

Doing nothing puts us on the road to disaster. If you don’t go forward you will go backward. It’s a law of nature as immutable as the law of gravity. The Democrats—from Obama on down—must get their act together. Get your agenda straight, Democrats! Negotiate among yourselves, but come to an agreement—and stick to it! Work together. Don’t bother to try to work with the Republicans: they’ve said time and time again that they won’t compromise. You still have power, Democrats. Use it.

Or the United States of America will end up being a Third World country.

Don’t let John die

November 30, 2009 at 1:16 pm | Posted in Congress, Healthcare, Obama Administration, Politics | 1 Comment
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Recently The New York Times published an Op-Ed piece by Nicholas Kristof, titled Are we going to let John die? It’s the story of a man who will die soon—because he can’t get healthcare.

A friend wrote me and said he didn’t understand why John is having problems with his healthcare, that he doesn’t think our healthcare system is broken, that he doesn’t think the healthcare reform bills would do anything for John, and that he doesn’t want the government stepping in and spending lots of money.

This is my response.

Here’s why is John having problems with his healthcare:

  • Because of his condition he is unable to work.
  • Because he is unable to work he lost his health insurance.
  • His wife’s insurance company won’t cover him because he has a pre-existing condition—and neither will any other insurance companies.
  • Emergency rooms can’t do much for him. They can give him a pain pill, but they can’t treat the condition. And he’s gone to the ER so often that one hospital told him not to come back until he gets insurance.
  • In August he qualified for Medicaid, but the payment rates are so low in Oregon that he can’t find a doctor who will do the operation he needs.

The healthcare reform bills would help John in a couple of ways. Both bills would make insurance companies take him on despite his pre-existing condition. The House bill (and probably the Senate bill) would prohibit his insurance company from dropping him because he lost his job. And a strong public option would reduce premium costs by making health insurance companies compete.

If our healthcare system isn’t broken, how could John’s problem be solved?

He’s going to die. He’s going to die because he doesn’t have health insurance, or the money to pay for the healthcare that would save his life. He is one of the roughly forty-eight thousand people who die each year because they are underinsured or uninsured.

Healthcare reform is expensive, sure. Yet the Congressional Budget Office says that both the House and Senate bills will more than meet President Obama’s requirement that they “not add a dime to the deficit.” They will actually reduce the deficit. Can we afford healthcare reform? Yes.

But healthcare reform is not simply a financial issue. It’s a moral issue. We have the ability, so it is immoral and unethical to evade our responsibility to care for those who cannot care for themselves. It would be nice if friends, relatives, churches, and social organizations could take care of the problem. But they can’t. It is simply too big, too complex, and too expensive for that. Who is left?

We can’t afford not to reform our healthcare system! We must do the right thing and make healthcare available to everybody.

The Republicans, Joe Lieberman, and the Blue Dog Democrats are doing everything they can do to keep the status quo. I don’t suppose most of them want John to die, or would simply let him die. But apparently they would rather see John die than lose the contributions they get from the health insurance companies. And most Republicans simply want to see President Obama fail because they think it will be to their political advantage—but that’s another discussion.

We won in the House, and we cannot let healthcare reform be emasculated or defeated in the Senate. Write or call your senators—both of them—and tell them that, like most of the people in your state, you want real health reform, including a strong public option. They’ll listen, because you have something the health insurance companies don’t have: the vote.

House passes major healthcare reform bill: Cheers from the left, boos from the right

November 8, 2009 at 1:09 pm | Posted in Congress, Healthcare, Obama Administration, Politics | 1 Comment
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It was no big surprise. Saturday evening the House passed its healthcare reform bill—certainly the most important healthcare legislation to be passed since Medicare. The sad part is the number of Democrats who voted against it. My representative did. Despite letters and phone calls from his district (23% of the non-elderly residents of Mr. McIntyre’s district are uninsured) Mr. McIntyre voted the way his real constituents—the health insurance industry—wanted him to vote. He voted no.

But the bill passed, and most of us are cheering and rolling up our sleeves in preparation for the Senate debate. Of course there are those who oppose this legislation, and some of them responded to the email I sent around last night. For example, my son the Conservative (oh, where did I go wrong?) wrote:

“He’s going to vote against it? Good! You’re right, I should call him and congratulate him for taking the right stance. This healthcare reform bill, as I understand it, is a fiscal abortion. It is time for our government to stop spending money like mad!! Obama has TRIPLED(!!!) our national debt in less than a year! Enough with entitlements! How about we work for and earn what get?”

I should perhaps tell you that my son Peter has three children of his own, plus two stepchildren. One of Peter’s kids is in the U.S. Marines, and is to be deployed this Spring to Afghanistan. Another is a Senior at SUNY New Paltz, majoring in Theater Arts. Another, just over a year old, is the family comedian. And Peter’s two step-daughters are in elementary school.

The following is my response (with minor edits):

“If you think the bill is a fiscal abortion you don’t know what it says.  It will actually reduce the National Debt!

 “When you say that President Obama has tripled the national debt, you forget that Bush left office with the economy going over a cliff and two hugely expensive wars eating us up.  The Bush administration rammed a fiscal stimulus package through, but it was completely unmonitored, and we will probably never know how the money was actually spent.

“The Obama administration fiscal stimulus had more teeth in it (although not nearly enough) and has brought the economy back from the brink.  The package didn’t go far enough, according to many economists, but the economy is showing signs of recovery.  Unfortunately employment has not recovered, and according to the administration, job creation is now the economic priority. It should be.

“Think about this:  suppose I were to get some debilitating disease and need nursing home care.  Without Medicare I’d literally have to beggar myself to get that care, and if the disease lasted more than a few months you’d have to help too:  Sell your house, trade in your vehicles on clunkers, and tell Abby, Emily, and Fred to forget about college.  Would you do that?  I hope not.

 “‘Work for what we earn and get’ is a good idea, as is the idea of helping your needy family members. In today’s world the government must step in because few us have the financial strength to provide the help that may be necessary. The “family” has to be a lot bigger to make it possible to support the members.  Things like Social Security, Medicare, Medicaid, and the VA are supporting your needy family members, and that’s good.   Helping our needy family members across the nation is the right thing to do.  Did you read my blog?  45,000 Americans died last year because they were uninsured or underinsured.  Is that right?  I don’t think so.

 “Can you rely on the private sector?  Well…no.  Between 2000 and 2007 health insurance company profits rose by about 400%.  The cost of healthcare caused over a million bankruptcies last year; over 1.5 million people lost their homes.  Is that right?  I don’t think so.

 “Healthcare reform is not just a financial or philosophical issue.  It is those, but it is also a moral issue.  Yesterday’s House vote was a mighty victory on both fronts, and I celebrate it with my mind and my spirit.

 “Our next challenge is the Senate, and I hope you’ll become an enthusiastic supporter of healthcare reform.  After all, it’s in your own interest!”

I post these words—Peter’s and mine—with his permission, and because I hope they will reassure those of you who are on the left and perhaps even change some minds on the right. Please, dear readers, think about it.

Oh, by the way…

October 10, 2009 at 7:58 am | Posted in Congress, Healthcare, Obama Administration, Politics | Leave a comment
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I used Congress.org to write emails to my elected representatives on healthcare reform, and I’ve reproduced the emails below. I strongly urge you to send similar letters (but for best results, don’t copy mine). If you prefer, phone your reps: ask for the staffer who handles healthcare reform and leave a message. Or, write a letter. But do it, please: putting pressure on these people, showing them that public opinion is strong on this issue, is the best way to get the job done.

President Obama

When you ran for President you promised us a strong healthcare reform package with a robust public option. Like most Americans, I know we need that package badly: it’s important that we get it, and I care little about the politics and processes. I want it done. Now.

I worked on your campaign and voted for you, but I’ve been disappointed in your lack of aggressive leadership on this issue. Mr. President, the country relies on your strong leadership to get a bill—like the ones in the House—passed in Congress and signed into law.

Please: get it done!

Representative McIntyre

Healthcare reform will soon come to a vote in the House. It is a critical issue. Like most Americans, I want to see a bill that reins in the health insurance companies, makes them compete with each other, and includes a strong public option. We can do this, as every other industrialized nation does, and failure to do it would result in financial disaster for individuals, and for the nation.

Remember, Mr. McIntyre, it is the people who vote, not the corporations. And the people care about this issue. Like the people of North Carolina, you must support real, robust healthcare reform. Get it done!

Senator Kay Hagan

Healthcare reform will soon come to a vote in the Senate. It is a critical issue. Like most Americans, I want to see a bill that reins in the health insurance companies, makes them compete with each other, and includes a strong public option. We can do this, as every other industrialized nation does, and failure to do it would result in financial disaster for individuals, and for the nation.

Remember, Ms. Hagan, it is the people who vote, not the corporations. And the people care about this issue. Like the people of North Carolina, you must support real, robust healthcare reform. Get it done!

Senator Richard Burr

Healthcare reform will soon come to a vote in the Senate. It is a critical issue. Like most Americans, I want to see a bill that reins in the health insurance companies, makes them compete with each other, and includes a strong public option. We can do this, as every other industrialized nation does, and failure to do it would result in financial disaster for individuals, and for the nation.

Mr. Burr, you have voted against virtually every piece of legislation since January. That’s childish, and it’s not what you were elected to do. Remember: it is the people who vote, not the corporations. And the people care about this issue. Like the people of North Carolina, you must support real, robust healthcare reform. Get it done!

Make it happen

October 9, 2009 at 6:57 am | Posted in Congress, Healthcare, Politics | Leave a comment
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It’s a matter of life and death. Literally. 45,000 Americans died last year because they didn’t have health insurance. Many of them couldn’t afford it: premiums have been rising four times faster than wages.

Even if you don’t die from lack of health insurance you’re going to suffer: the cost of healthcare causes well over a million bankruptcies a year, and causes 1.5 million Americans to lose their homes each year.

Meanwhile, mergers and acquisitions resulted in a situation where there is little or no competition in most markets. Health insurance company profits rose more than 400% between 2000 and 2007. Premiums increased, coverage decreased, and it became harder and harder to get claims paid.

Quite simply, the problem is that the health insurance companies are not competing with each other. They’re ripping you off. They’re ripping your employer off. They’re acting like…a cartel. The result is pain, death, and financial ruin for individuals and problems for the economy.

It has to stop, and it has to stop now. It is a matter of public safety, like defense against attacks by other countries and terrorists, from criminals, and from natural disasters. Without real healthcare reform we are unsafe, and the longer we wait for reform the less safe we are.

Extending coverage to everybody is complex, but like every other industrialized nation we can do it. It will be expensive—but we can reduce the cost of healthcare by getting rid of inefficiencies, fraud, and misuse of resources. We can reduce the cost of healthcare by reducing the cost of health insurance: by regulating the insurance companies instead of subsidizing them, and most important, making them compete with each other.

Making the insurance companies compete is easier than you think. We need to set up a national health insurance exchange that would allow people (and employers) to choose among many companies competing on a level playing field. We need to add a new player to that field: a Medicare-like plan that would be available as another choice to everybody, that would be self-supporting like all the other insurance companies, but that would be run by the same people who bring you Medicare.

Yes, run by the government. Run by the people who are supposed to defend the country from attacks by foreign countries and by terrorists, who are supposed to leap in to lead the recovery from natural disasters, who provide medical care for wounded veterans, and who provide pensions and medical insurance to millions of Americans who are over 65 through Social Security and Medicare. That’s what government is supposed to do, and providing a self-supporting plan for anybody who wants it is a logical extension of what government already does.

There are healthcare reform bills in Congress that do, or could be amended to do these things. But there is opposition. Not surprisingly, much of that opposition comes from the health insurance companies, who spent something like a billion dollars a day during August, lobbying against reform and financing “grass roots” opposition to reform.

In Congress some of the opposition comes from the Republicans, who have voted en masse against almost every piece of legislation since January, simply because we have a Democratic president. Some of the opposition comes from “Blue Dog” Democrats who are in the pockets of the health insurance companies, or have problems with the proposed legislation.

Lobbying the Republicans is useless. They have said they’ll vote against the healthcare reform bills no matter what is in them. But there are plenty of senators and representatives who are Democrats or independents. They are the ones who will pass a bill. It is up to us—to you and to me—to see that they pass a good bill. A bill that reins in the insurance companies and makes them compete. A bill that offers a robust public option (the Medicare-like plan I talked about above). A bill that extends coverage to as many people as is humanly possible.

Please…call, write, or email your senators, your representative, and our president. Tell them you want a strong healthcare reform bill—with a robust public option—that will extend coverage and reduce healthcare premiums.

You can’t afford not to.

Healthcare reform: A defining issue

August 28, 2009 at 1:47 pm | Posted in Congress, Healthcare, Politics | 2 Comments
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There is something seriously wrong in America. According to the U.S. Census Bureau, 45.7 million Americans had no health insurance for the entire year in 2007. CNN reports that Families USA did a study and found that 86.7 million people were uninsured at some point during 2007 and 2008, three-quarters of them for more than six months. That’s one third of Americans under 65.

We are the richest country in the world. And we are the only industrialized country in the world that doesn’t provide high quality healthcare to all of its residents.

Most of you think of yourselves as having a pretty good moral character. You know I’m not a Bible thumper, but I remember an injunction somewhere about being openhanded toward your brothers and toward the poor and needy in your land.

Can you stand by while one third of Americans under 65 get substandard healthcare, have to choose between medicines and food, or file for bankruptcy because of exorbitant medical bills? I can’t.

Some people don’t have health insurance because they don’t think they need it. One of these days they’ll wake up with a backbreaking load of debt, and realize that they should have planned ahead–and then they’ll go bankrupt. Even if you think they deserve it (I don’t) remember: their problems are costing the rest of us money in higher premiums and taxes.

Others don’t have health insurance because they don’t make enough money to both eat and pay the premiums. If they have jobs their employers can’t afford to give them health benefits because the premiums have skyrocketed in the last few years, doubling, tripling, even quadrupling over the course of a year or two. Still others don’t have jobs. They live hand to mouth, depending on the charity of friends and family—or perfect strangers, and they get little healthcare. What they get is usually from hospital emergency departments—a very expensive way to get healthcare.

Do I need to tell you who pays for the bad debts and the indigent patients? You and I do, because the cost of care for people who can’t pay is reflected in hospital rates, and those rates are reflected in the insurance premiums we pay.

Well, we’re the richest country on the planet, right? But healthcare costs are going up, up, up…faster than wages, faster than inflation. According to the Kaiser Family Foundation, spending on health care is projected to be 17.6% of the U.S. gross domestic product (GDP) in 2009. That’s $8,000 per U.S resident. It has consistently grown faster than the economy overall, and by 2018, it will be at more than 20% of the GDP, which is $13,100 per resident! (In 1970 it was about $356 per resident.)

You probably didn’t notice that healthcare is taking $8,000 out of your pocket this year, because only some of the money is health insurance premiums you pay. Some is health insurance premiums your employer pays, and some of it is taxes. But one way or another you’re paying it.

Can we afford it? No. Not as individuals, not as a country. Our healthcare system is broken and needs to be fixed.

President Obama has proposed a solution. The Congress is working on it. Perhaps the most complete and (for now) the most stable solution is a bill under consideration by the House Ways and Means committee, HR 3200.

I pretty much agree with that bill, partly because it puts needed constraints on the health insurance companies, and fosters competition. But the insurance companies don’t want healthcare reform; they’re fighting back by putting out a lot of misinformation, using scare tactics and phony “grass roots” organizations to disrupt the civil dialog we should be having, and lobbying members of Congress by reminding them of the large contributions they got from the healthcare industry.

Opponents of healthcare reform make some strange claims. They claim the bill would provide health insurance for illegal aliens. It would not, and they know it: The bill specifically excludes anybody who is in the U.S illegally from receiving federal dollars for health care.

Another canard is that the bill provides for “death panels” that would decide who gets end-of-life care and who does not. That is totally untrue. Medicare would be required to pay for counseling sessions between patients and their own physicians to discuss the options for life-sustaining treatments and end-of-life care, and to encourage patients to make the decisions in advance.

The decisions may be recorded in a “living will” or “advance care directive,” and everybody ought to have one. If you don’t have one, illness or accident could force you or your family to make critical decisions under the worst possible circumstances. Yet the bill doesn’t force people to plan ahead; it allows them to do so, with or without the (free) expert advice of their physicians.

And there are other misrepresentations of what is in the bill. My Representative came up with a list of goodies that he said must be put into the bill before he would vote for it. He implies that they’re not there, but every provision he talks about is already there! (My letter to the editor on this subject is published below this article.)

The opponents of healthcare want you to vote based on fear and ignorance. I’m not going to go over all the myths and outright lies that are circulating, but if somebody tells you indignantly that he’s opposed to healthcare reform because it does something he hates or because it doesn’t do something it should…take a look at the bill. If you’d like to read it for yourself, the text is here, on the House Ways and Means Committee web site, which also contains a lot of discussion and analysis done by committee staffers (who watch each other like hawks).

Choice and Coverage

Perhaps the most important thing about the bill is that it provides choice. You may keep your current providers (doctors, hospitals, etc.) or choose new ones. In fact you’ll have a wider choice of providers than you do now, because the bill requires insurance companies to increase the sizes of their networks.

You choose your own health insurance company. Keep the one you have, if you wish, or shop around for the best deal. A caveat here: if you have healthcare insurance through your employer, you may not be able to switch unless you lose your job or change jobs.

But if you’re an individual or a small employer you can use the Insurance Exchange established by the bill. This exchange makes it easier to compare plans and prices—thus fostering competition, so that you can make a choice among competing companies.

One of the choices would be a government-run healthcare plan something like Medicare. Particularly important if you live in a part of the country where there are few insurers, it will be financed only by its premiums and subject to the same restrictions as private insurance plans. It will compete for your health insurance dollar—but you are the one who makes the choice.

But no matter how you get your insurance, they can’t drop you because you get sick, refuse coverage because of preexisting conditions, or impose annual or lifetime maximums.

The bill establishes an advisory committee chaired by the Surgeon General and composed of practitioners and other healthcare providers. This committee will come up with a basic package of healthcare benefits that must be in every plan, including preventative service (available with no cost-sharing) mental health services, and oral and vision services for children.

The costs—and paying the costs

In addition to specifying minimum benefits, the package will put a cap on the amount of money a person or a family must pay for services in the basic package over a year. But there are other ways that the bill will minimize the costs of healthcare.

Medicare reform will modernize Medicare to reward efficient healthcare providers, and to reduce (and eventually eliminate) the “doughnut hole” in supplemental prescription plans. It will enhance subsidies to low-income patients, reduce subsidies to Medicare Advantage plans, and improve the accuracy of payments made to other providers. In addition the bill provides for additional controls to reduce fraud and abuse, and will reduce and simplify the paperwork required of healthcare providers.

The public option program will follow similar procedures to make it an effective and efficient provider of health insurance services. And the competition from the public option program will encourage private insurance companies to be more efficient and lower their premiums to meet the competition.

But the bill provides for insuring virtually every legal resident of the United States, and that’s not cheap. The non-partisan Congressional Budget Office estimates the cost of the bill at $1.042 trillion.

The Congressional Budget Office estimates that the savings coming from the provisions of the bill will cover about half of that. The rest will come from a revenue package that will raise your taxes—if your adjusted gross income is more than $350,000 a year. If, like most of us, you make a whole lot less than that, you will see no tax increase at all.

Competing Philosophies

If we ignore the lies and misrepresentations, the arguments against healthcare reform, or at least against this bill, seem to center about the contention that government should not and cannot run healthcare programs. We’re told that the reform amounts to a government takeover of healthcare, and that it’s socialized medicine.

I disagree. Governments the world over run single-payer healthcare systems, and despite the occasional horror stories, their citizens get healthcare that’s just as good as ours. (You want horror stories? There are plenty of those about our system too!) Other countries also pay less than we do, and that tells me there’s something wrong…with our system.

I would be in favor of a single-payer system—eventually—but it’s not on the table now, and there are some very good reasons. Implementing a single-payer system would cause chaos in a healthcare system that is so complex, with so many interrelated pieces, that I doubt if anybody understands it. What the president has proposed, and what HR 3200 implements, is a system that includes a public option, but that keeps the private insurance companies and providers that characterize our system.

It keeps them, but restricts what they can do. The people who run the companies that make up the healthcare system don’t care about the patients who depend on them. They care about their boards of directors and their stockholders. As they should.

But in their single-minded pursuit of profits they are running roughshod over the rest of us, and one of the functions of government is to protect the public from the tyranny of private power. We, the people, can control the government; we cannot control the big corporations.

As individuals, of course, we have little say in what government does. But we have a weapon the big corporations do not have: the vote. Believe me, our elected representatives (and their appointees) know that, even though they usually act as though we’re impotent.

As individuals we are nearly impotent, but if we join together—if we write, phone, email our legislators and members of the administration—they will get the idea, and they will act accordingly.

I hope my position is clear: we need healthcare reform, and we need it now. The bill written by the House Ways and Means committee is far from perfect, but it is a very good start. We need to pass that bill, and once it’s passed we can worry about changes and improvements.

I urge you in the strongest terms to tell your legislators and the committee members how you feel. It is important, folks. This is a defining issue.

Let’s get the job done!

A letter to The Editor of The Robesonian

August 28, 2009 at 1:45 pm | Posted in Congress, Healthcare, Politics | Leave a comment
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It seems that Congressman McIntyre opposes the Healthcare Reform bill.

But when he claims the bill provides benefits to illegal aliens he is either misinformed or misrepresenting the facts: the bill explicitly prohibits illegal aliens from getting Federal dollars for health care.

When Mr. McIntyre puts the cost of the bill at $1.6 trillion and claims it will put the country in debt he is, again, either misinformed or misrepresenting the facts: the Congressional Budget Office says that cost savings, coupled with the revenue package in the bill (which affects only families with incomes of more than $350,000) will fully finance the $1.042 trillion cost.

According to The Robesonian Mr. McIntyre suggested that any bill reforming the healthcare system should allow people to choose their own doctors, allow people to keep or change their insurance plan without being penalized for preexisting conditions, avoid penalizing or putting more mandates on small business, and avoid bankrupting the system with economic irresponsibility.

Doesn’t Mr. McIntyre know that the bill already does these things? It provides for an individual’s right to choose a doctor. It provides for wider insurance networks, thus making more doctors available to choose from. It provides that individuals may keep their plans or choose another, and requires insurance companies to provide coverage regardless of preexisting conditions.

Small businesses? Isn’t Mr. McIntyre aware that 76% of all businesses, the smallest, are exempt from the employer responsibility requirements?

Mr. McIntyre says he is concerned that Medicare reimbursements be “proper,” and set to attract doctors to rural areas. The bill does exactly that, eliminating a planned 21% cut in physician fees planned for next year, and increasing reimbursement for primary care services. In addition, it extends protections for rural providers—already in the law—to ensure continuing access to healthcare in rural areas like ours.

Mr. McIntyre says he is worried about the bill cutting benefits to seniors. But it has provisions that extend and improve benefits to seniors, like the eventual elimination of the “doughnut hole” that traps seniors into increased payments for medication, improve the Medicare low-income subsidy plans, and enhance nursing home transparency and accountability.

Mr. McIntyre, everything you say you want in the bill is already there! And despite what you say, the bill explicitly prohibits illegals from getting coverage! Are you trying to scare us, are you misinformed, or are you simply ignorant?

Mr. McIntyre, you say we’re going too fast with healthcare reform, that members of congress ought to have more time to read the bill. Where were you during the five-hour congressional briefing session where the bill was fully discussed?

We’re not going too fast. We’re going too slow. Mr. McIntyre, the voters of this district recognize the urgent need for healthcare reform. We want you to go back to Washington and get the job done!

—Barney Bornn, Lumberton

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