Big Change in a Small Bill
Healthcare reform is once again on our minds. It is moving onto the front burner again as reports come out as to costs actually moving beyond the trillion dollars price point that was so important to President Obama. Limitations of the coverage, delays in implementation, and the specter of premium costs increasing by 30 - 50% as corporate health plans renew in January, are all bubbling back into the new media, and even occasionally into mainstream media.
The left of Harry Reid and Nancy Pelosi is looking at heavy losses come November. Harry Reid is likely looking to be yet another casualty of the bad economy as his predicted unemployment looms. President Obama is trying to throw everything he can against the wall to see if anything sticks. It's looking like the wall is coated in Teflon. Cap & Trade is stalled. Financial Reform is in the midst of a bruising battle. The Obama trial balloon of Immigration Reform was shot down by a riled public and SB1070 in Arizona. You would have thought that he would have looked at GWB's experience there and kicked it down the road a bit.
TPP has attended some Tea Parties, and some town halls over the past few weeks. The foundation of most of the frustration felt in the country sits squarely on the health care reform bill. A good illustration of the anger comes from a self-described pro-choice feminist. She quotes a popular slogan among the pro-choicers that the government should "keep their laws off of my uterus." She explains that principle extends to the rest of her body as well. By extension, that stand can be applied to the rest of the human race as well. "Keep your laws off of my body" is a much better bumper sticker than "Repeal & Replace".
Repeal & Replace is still the bumper sticker of the moment though. We've heard all of the calls for repeal. What exactly are we to replace it with? Most agree that the current system is in need of improvement. Costs are going up far outpacing inflation. There is the situation faced by the uninsured who would like to be insured. The dilemma of pre-existing conditions needs to be addressed.
Floating around is "The Small Bill" ( http://smallbill.org/ ). Read it. It is seven points outlined on one page. It is not 2400 pages crammed with backroom dealmaking, bribes, exceptions and accounting tricks. It is understandable, not legalese gobbledygook. It provides solutions targeted at specific problems, not a reinvention of the wheel. They are all, as we like to say at TPP "common sense" proposals that actually address the problems within the healthcare system that the American voter is concerned with. This is not to say there might not be challenges or disagreement in implementing these ideas, but they provide an excellent jumping off place.
It's origins are nebulous. Jeffrey Anderson and Tevi Troy, associated with the Weekly Standard, claim to have had an early grasp of what is being promoted in this package. TPP has promoted many of these very ideas as early as 2008. These are solutions that are viewed favorably by most Republicans and a fair share of Democrats as well. It could be the basis of a truly bi-partisan supported bill that could become a popular healthcare reform package.
We'll do the short summation. We do recommend that you read the original. The Small Bill provides for allowing purchase of insurance across state lines as a cost cutting measure. It offers lower premiums for healthier lifestyles. It matches the tax incentives given to employer-based health insurance plans to the self-insured or non-insured, again making health insurance more affordable. It proposes no cuts to Medicare.
It provides for issuance of block grants to the states to more efficiently manage the uninsured. This would provided additional funding to cut down on emergency rooms visits for routine health problems. TPP thought this an intelligent approach in our look at Healthy San Francisco ( http://blog.thomaspaineproject.org/2009/08/01/a-suggestion-on-healthcare-reform.aspx), which reallocates local and state spending for emergency room visits into focusing on prevention and maintenance health care.
It also promotes block grants to the states to create insurance pools for those with pre-existing conditions along the lines of state coverage for flood or earthquake insurance - going where the private sector cannot. We promoted this idea last October ( http://blog.thomaspaineproject.org/2009/10/23/heathcare-reform-revisited.aspx ).
It minimizes the economic effects of medical providers practicing "defensive medicine" for fear of frivolous malpractice lawsuits. It embraces several ideas from the current healthcare plan (electronic records, small and non-group markets, and opening the medical field to alternative disciplines such as homeopathic medicine).
The Congressional Budget Office comparison between the standing healthcare reform package and the Small Bill puts the cost of the Senate passed bill at 2.5 trillion dollars in the 10 years from full implementation (2014) through 2023. The cost of the Small Bill for the same period is 180 billion dollars. It does not project deficit spending. It projects that for every 20 billion dollars spent, the Senate bill would provide insurance for an additional 260,000 people. For the same amount the Small Bill covers an 1.1 million people.
Common Sense Dictates
TPP is not going to claim unlimited support for the Small Bill. The only information available about it is coming from those who are actively promoting it. It does nothing to address the underpayment of the Medicare and Medicaid to healthcare providers which skews the whole system to overcharge to make up the difference. It does little to address catastrophic health care coverage that would appeal to younger healthy persons who do not need many of the bells and whistles of the typical healthcare plan. No government program ever lives down to it's budget projections. Still $180 billion versus $2.5 trillion is a sizable difference. A nearly 4 to 1 difference in the amount of newly insured people also sparks attention. The ideas that are presented in the Small Bill are common sense, targeted, and workable within the framework of our existing system. The Senate bill signed into law is none of the above. Should the Republicans run and win on "Repeal & Replace", we find the Small Bill to be a sound alternative to the Senate bill. We find it to be a common sense place to start in a real reform of our health care system, in a manner acceptable to a wide majority of Americans. We always try to be on the side of Common Sense.
RLB
Categories: Social Policy, Healthcare
Tags: healthcare reform political leadership
Read the Small Bill and it makes sense. It also looks like most of the stuff that's been said on the subject here. I like the block grant approach that would allow communities to deal with the uninsured in ways they develop themselves, for their own residents. Your example of Healthy San Francisco - it might not work in a lot of communities, but it works for them. We need what works.
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This makes more sense, and could cut down on ER visits, but does nothing about Medicare / Medicaid not paying or underpaying for services. Without taking care of that the system will still have to overcharge insured patients to make up the difference. We should start with Medicare / Medicaid reform.
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Bring on the catastrophic insurance! I've been saying that from my first post. I don't need most of what I have in my health plan. I pay out a lot of money when all I usually do is get a phuysical every year. It would be way cheaper for me to just pay for tye physical and have insurance that is only for hospital stays or serious injury. A lot of people feel the same way.
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It certainly seems more efficient and practical than the actual plan that Obama signed, but the devil is always in the details. It may be one page now in principle, but ionce you put the "how it's done" in and flesh out the details, it will get up to that thousand page mumbo jumbo. Congress doesn't know how to act without micro-managing everything. Still, if it gets brought up, I can support this.
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I'm with Angela. If we don't deal with the fundamental imbalance of Medicare payments to the actual costs of services, all the rest of this is just window dressing. It might help bring down some costs or make insurance a little more available to those who need it, but the system is still screwed up as long ad the 50% of annual costs that the health care system generates are underpaid by government programs.
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Well, you have to start with an outline of a plan. Yeah it will grow to use a few reams of paper, but at least it's a plan. Obama didn't even start with that much. I say let's explore this plan as a possible replacement. I sure don't like what we have.
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I don't know why everyone is so down on the health care reform. Really the world hasn't ended. It lowers costs, reigns in the insurance companies, get coverage for pre-existing conditions and adds 30 million people onto the insurance rolls. It is not a bad plan. It is not socialism. It is not taking over your lives. It's a piece of legislation that brings some order and expectations to the health care industry.
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It isn't a disaster - yet. The new taxes haven't kicked in yet, costs haven't been passed onto subscribers yet, and no benefits will kick in til 2014. Come January, all of those pre-existing conditions that can't be denied coverage will be let in. Private health insurance will need to cover the cost of those people eating up more money than putting in, and that comes from you and me. Look at your paystub in the next few months. There will be a new deduction for the health reform program. It might only be $5, but that's how my Social Security deduction started out. Now it's more than my income tax withholding. Soon fewer and fewer people will opt to keep private insurance as it gets more expensive. Then Obama answers the need by getting single-payer in to fill the gap left by insurance companies that can no longer provide affordable insurance. It's long range thinking but this plan winds up there no matter the route taken.
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I thought that you conservatives weren't doom and gloomers. You can't tell by a lot of these posts. The Obama plan is not what was enacted. What was enacted was whatever they could cobble together to pass by whatever means necessary. The Obama plan was single-payer. I happen to agree that single-payer is the best possible option. Single-payer isn't even a page. It is a word. Conservatives may disagree with the concept of single-payer but no one can look at the bill that President Obama signed into law and claim it was his plan. It is a bad idea but for a completely different set of reasons than is argued here.
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I'll agree that it's not Obama's plan. Once he got the blowback on single-payer, it became really obvious that he didn't care what passed as long as he had something to sign. He abandoned his principles and he abandoned the fight. What emerged was what happens when you allow Congress to act without leadership. Or in the case of Nancy Pelosi, crazy leadership. Harry Reid did his job by pimping out his version of the bill. Nice job falling on your sword Harry. Enjoy your retirement. This tangle of corruption and kickbacks really needs to go away. The ideas presented here look reasonable and cost efficient. I'd like to see it put forward in November.
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Grant, it almost sounds like you're disappointed that Obama didn't get his plan. I know that can't be right.
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God no! I was just pointing out that the bis O's leadership skills need a lot of work. I like this small bill. It sounds a lot like what we've been hearing here for a long time.
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The Small Bill is one of several plans being promoted by the conservative bloc. They are all pretty similar to this, but outside of conservative news media, they can't get any publicity. It will be good to have some sort of spokesman emerge who can not only rip apart Obamacare, but who can present these ideas and be heard.
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This I can understand. That's more thanI can say about Obamacare. I don't agree with everthing in this bill, but at least I understand it. What I understand, I can suggest changes on. I think this gives us something to work with. It sure beats having to pass a bill to find out what's in it.
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Is there something wrong with having a health care. plan. I think this would greatly help us in terms of paying our medical bills. Some are opposing health care for they think that this only benefit only few people. If that's the case health care reform is really needed to change this kind of system.
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Especially since the job problem, has been fixed. According to what Obama said. Come January, the Bush tax cuts go away, and the Obamacare nightmare begins. A double wammy. This is why I feel, Obama doesn't really care, that he wins. He has screwed us up so much. There might not be much, that can be done.
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