In yet another round of ever present “face time” on health care, Obama today delivers a stern message to his was-and-still-almost-is supermajority Congress…. put it to a vote. In this seemingly simple demand, the entire PR stage show of the “health care summit” is laid bare. If Obama cannot achieve his desired goal to lay the groundwork for a single payer health system, he’s not going to allow his failure, alongside his supermajority Congress, to be a victory for the GOP in November.
How does he accomplish this? Quite simple. Stage the summit to show bipartisan cooperation. Throw a few of their ideas in that still do not cure the ideological opposition to the proposed “cure”, ask for a vote that is guaranteed to fail, and voila…. a shrug of the shoulders and out comes the midterms talking points – “it’s not our fault”.
It goes something like this….
We felt health care should be a bipartisan endeavor, therefore we have gone the extra mile to work across the aisle with the GOP. We’ve included the best of their ideas, and they still voted against the bill. It is obvious that the GOP is the “party of no”. They lied to you about the facts in order to gain political power when what they prefer to do is nothing about the rising costs of health care.
Almost sounds sane, yes? That’s what they’re counting on. The appearance of a sane appeal, and a short memory on facts.
Speaking of fact, the media will glide silently over that pesky detail that the Democrats… holding a supermajority… never needed GOP approval for health care. They will be content to be fed another bone to pick with their favorite scapegoat, those evil and radical conservatives. The Dems? The know not to spoil the butter for their bread. They much prefer to blame the GOP rather than point fingers at their own moderate Bluedog Dems.
Another fact the media will gloss over is the *reason* for the continued conservative and GOP opposition to the bill… even with the token incorporated ideas. There’s no *health care costs* reform. Instead, we are being sold health care *insurance* reform as a solution to rising costs of medical supplies, advanced state of the art equipment, drugs and services.
Now, some also believe that we should, instead of doing what I’m proposing, pursue a piecemeal approach to health insurance reform, where we tinker around the edges of this challenge for the next few years. Even those who acknowledge the problem of the uninsured say we just can’t afford to help them right now — which is why the Republican proposal only covers 3 million uninsured Americans while we cover over 31 million.
That’s no freudian slip. Obama has spent his eternal campaign confusing health care costs with insurance reform. And he’s been adept at blinding the O’faithful with the spotlights behind the greek columns, selling the nation a bill of goods. He misses the point that government price fixing of premiums – an action that is illegal in the private sector – is a dangerously inadequate answer for what ails America’s health system… the baseline, break even costs of those who provide medical care.
Instead, Obama suggests capping consumer price for a Cadillac at $25,000, when the car costs $25,000 to manufacture and market. This doesn’t address the mitigating factors that lead to that $25,000 cost to the manufacturer and dealership networks. Nor does it allow for R&D to improve the product line.
But what happens when it costs $30,000 to build and sell that Cadillac because Congress, in their infinite stupidity, decides to add new regulations, taxes and/or costs onto the manufacturer and dealers? Obama would still only be able to pay $25,000 price tag in order to call it a “solution”, and let the loss be absorbed by those providing the product.
This is exactly why many ill-informed believe Obama’s “solution” contains costs. If their purchase price doesn’t rise, it’s “cost containment”… at least until there are no more “Cadillac” manufacturers and dealers, and they’re forced into a Volkswagon for the same $25,000.
For those possessed with a modicum of logic, ponder this. Just how does dictating what an insurer or single payer government system pays a provider change the operational overhead of the provider? When you’re done with that, try this on for size… How long do you think we can continue shorting the medical service providers their overhead costs, and still receive the same quality of service?
Welcome to health care fiscal reality. Cost “reform” vs insurance “reform” That’s the debate in a nutshell.
Health care cost problems lie with such realities as the administration of simple tetanus shot costing $100; a tablet of aspirin that costs twice what a bottle of 500 tablets does at Walmart; outrageous lab fees; and unnecessary tests conducted for litigation protection. Get the picture? Think $650 toilet seats….
And another thing… there doesn’t have to be a huge rigamarow about pre’existing conditions, and I’m bloody well tired of the widespread talking points lies about this. For those of you who didn’t know, Title I of HIPAA prohibits pre’existing conditions for group policies for longer than 12 months. Additionally, they regulate what can be determined pre’existing conditions.
So what’s the inexpensive answer? More groups… not much taxpayer burden in that. And probably doesn’t even need Congress involved. That’s a bonus…
But the most obvious reason this is all a political scam…. vote on *what* bill?? Have you heard even one of the White House press “corpse” ask… “Where is the bill text you want Congress to vote on, Mr. President?”
Echoing movie character, Jerry McQuire: SHOW ME THE MONEY! Or, in this case, SHOW ME THE BILL!
Fact is, there is no bill that resembles Obama’s proposed “reconciliation bill”, posted on WH dot gov. This is where he touted supremely there were GOP ideas incorporated into his new plan. Today, he says he adds yet more GOP ideas.
Where is the bill that incorporates all these ideas, Mr. President?
Or are we, and our elected officials, supposed to take your templates, outlines, speeches and proposals as a substitute for legislative text? Are we supposed to trust you to pass what you have now, and add them later?
The lack of a real bill to vote on is only one fly in the soup. With the legislative rules on the budget reconciliation process, neither the House nor Senate bills would survive in their entirety. Even staunch proponent, WaPo’s Ezra Klein, states reconciliation would not work for these bills because many of the key issues would not fit budget muster.
I’ve argued before that reconciliation will not work for comprehensive health-care reform. Today, Kevin Drum comes to the same conclusion. Stan Collender, a budget expert, backs him up. I go into the reasons in more detail here, but the Health Insurance Exchanges would probably be thrown out. The insurance market reforms would probably be thrown out. Prevention and wellness, modernization, delivery system reforms, and much else would likely be out the window. And we can’t even quite predict what would be lost, so it’s hard to know what would actually work at the end of the day. We could end up with a bill that simply doesn’t work, much as a car doesn’t function without a transmission system.
Kaiser Health News goes into more detail about how the groundwork for this reconciliation, specifically including health care, was already laid down last spring, at the behest of Rahm Emanuel.
Every year, the House and Senate draft a budget resolution – a blueprint of anticipated federal spending and revenues for the coming fiscal year. To get the reconciliation process going, the House and Senate budget committees may include reconciliation instructions to one or more committees in the budget resolution that directs them to produce legislation by a certain date that meets the mandatory spending or tax targets.
~~~If reconciliation is used, the Senate Finance and health committees each are supposed to send proposed changes in laws within their jurisdictions to the Senate Budget Committee with changes that would save $1 billion over the next five years. The House Ways and Means, Education and Labor and Energy and Commerce Committees would face a similar challenge and have to report changes to the House Budget Committee.
Those proposed changes would then be translated by each budget committee into House and Senate bills.
When those bills reach the House and Senate floors, members have a maximum of 20 hours to debate them – and almost no opportunity to offer amendments – before taking a vote. In the Senate, the bill may be challenged on the floor by any senator who asserts that a provision runs afoul of the “Byrd Rule.”
Assuming that the House and Senate bills are approved, they generally are sent to a conference of House and Senate negotiators to be melded into a single piece of legislation. That final conference report, as it is called, is then returned to the floor for a final vote by the two chambers under strict rules that set a timetable for action and that prohibit any amendments. The compromise measure is also subject to Byrd Rule objections. If the bill is passed, it would then be sent to the president for his signature or veto.
With Obama’s supposed GOP add ons, there are a lot of proposed changes that have to be constructed with the “how to’s”, what new agencies and/or councils are created (nothing gets done with new councils or agencies anymore…), and then melded into existing bills, eliminating conflicts. And anything not budget related is discarded, leaving only a shell of the original idea.
Anyone think such a magic bill could be drummed up in acceptable form, presented, debated and passed in Pelosi or Reid’s chambers within Obama’s deadlines? Hang, it’s their own party holding up the coronation for almost a year now. So much for that choice.
The other bill to vote on is the unseen, unpublished version that was concocted by the chosen few in the the back rooms of the WH.
Yet even the majority of Congressional membership hasn’t seen the fruits of that gathering of fiscal vampires, working furiously thru the midnight hours creating this mystery bill. It’s creation was prior to the health care summit, so it doesn’t incorporate Obama’s latest promises.
Nor has the public been privvy to seeing the final text. Call me crazy, but I doubt there is a Democrat, up for election, that is willing to cast the die on their political seats using unseen legislation, and banking on this President’s lip service.
This means that either bill scenario is bound to fail.
Obama’s demand today was laying down the political gauntlet for an election ploy. This POTUS and his political handlers are no fools, and stage plays are second nature skills to community organizers. The plot was simple, as I paraphrased above… appear to be bipartisan, force the issue to the floor incomplete, cry foul and paint the GOP as the enemy – all in time for the mid terms.
The goal? Keep majority power, and live to fight another day.
Sans divine intervention, this POTUS and his team of PR/community organizers know they’ve virtually lost this battle. What we see now is all part of regrouping in the back rooms. They are no longer seeking health care… they are seeking political redemption in time for the election.
If they succeed, the battles begin anew.
UPDATE: Manu Raju and Carrie Budoff Brown are reporting that Sen Tom Harkin told Politico that his chamber has decided to attempt the reconciliation route. They must first prove to Pelosi that the Senate has the needed votes, and she will set to work on the House membership to pass the Senate bill as is, “…followed by a package of fixes through reconciliation.”
In the interim, the phantom bill is still floating around, as Harkin notes they are “coming to closure” on legislative language to send to the CBO for analysis… which could take a few weeks.
This means they are asking House members to accept, on faith, that the Senate can successfully make any promised “fixes”, sans difficulty. Harkin says they will make “a convincing gesture”….. uh huh.
Does this alter my opinion this is still a failed attempt? Not in the least. Never suspected they wouldn’t try when I penned this piece. They have no other choice but to force a vote, somehow, in order to move on thru the election cycle. As I pointed out in a comment below, a failed attempt, successfully blamed on the GOP, is superior to continued gridlock.
To get a pulse on the elected ones’, Hugh Hewitt has provided “the hit list” of Dem targets.
UPDATE #2: The Hill reports Howard Dean warning passage of current bills would do more harm than good.
“The plan, as it comes from the Senate, hangs out every Democrat who’s running for office to dry — including the president, in 2012, because it makes him defend a plan that isn’t in effect essentially yet,” Dean said during an appearance on the liberal Bill Press Radio Show.
Dean, who has clashed publicly with the White House over the healthcare proposals favored by the administration, said that by passing the bills under consideration, Democrats would essentially be conceding defeat to Republicans.
Vietnam era Navy wife, indy/conservative, and an official California escapee now residing as a red speck in the sea of Oregon blue.