Sunday, November 08, 2009

Health Insurance Passes In The House

By a vote of 220 - 215, a $1 trillion bill passed in the House of Representatives just before midnight CST. The bill will be substantially changed after a Senate vote and conference reconciliation, but it is a victory for President Obama and the Democrat leadership in the House.

Elections have consequences. This is a bill written and pushed through without transparency as has been promised for over a year by the Democrats. The days of expecting Democrats to live up to their pledge to put legislation online for all to read for 72 hours before a vote are long gone. I doubt even President Obama knows the details in this legislation. He left it all up to Congress, as is his way.

This is a bill that will not decrease insurance premiums, as touted by the proponents. The Congressional Budget Office (CBO) came to the conclusion, while 'scoring' the bill's costs, that premiums will rise as will the deficit. Fines and fees will be abundant. The cost is guesstimated at $1.052 trillion, greater than what is being claimed by the Democrats. It is a bill described by The Wall Street Journal as the "worst bill ever" because it is so poorly written.

There is no tort reform in this bill. Even Howard Dean said this is not true reform without tort reform. As a physician he supports tort reform and the discontinuing of trial lawyers becoming wealthy on the backs of practicing physicians. It was ironic to watch House Democrats on the floor chastising insurance companies as the enemy of all, even though it is exactly through payment from insurance companies after trials that these lawyers became wealthy. Irony was rampant throughout the debate.

There were great leaps of logic during the hours of heated debate. There was a time when cancer was placed in the same category as an unwanted pregnancy. Babies and young children were paraded before the audience as props for whichever side was speaking. Wheeling and dealing from the White House was evident all the way up to voting time.

Much rode on this passage, especially for President Obama. His standard line to guilt members into voting is that if health insurance reform isn't passed, his presidency is in jeopardy. With a narcissist in the Oval Office, it is common knowledge that every action is all about him. He released a written statement from Camp David after the vote was taken.

The run up to the final vote included a vote on a GOP alternative - one that was much less wordy than the 2,000 page Democrat bill - and included tort reform, buying insurance across state lines, Medicare reform, and other more effective common sense solutions. It was voted down on a party line vote.

An amendment stating that no federal funds be used for payment of abortions passed. This freed up Blue Dog Democrats to vote for the final bill. It also freed up the lone Republican voting for the final bill. Rep. Joseph Cao was of the last to vote and he cast his with those voting in favor of it.

Why did Cao vote for the bill? Let's remember which district he represents. He took office as the successor of William "Dollar Bill" Jefferson - the corrupt, convicted Democrat from New Orleans who was caught with a freezer full of money. He brought new meaning to the expression "hard, cold cash". The District is 75% Democrat and Cao was lobbied hard by the White House. He has been promised all kinds of future goodies for his District, still recovering from Hurricane Katrina due to the corruption already in place there.

Cao had only one objection to the House bill that he repeatedly voiced - the refusal to vote in support of the final bill if federal monies were allowed for abortion services. That was eliminated in the Stupak amendment. Cao agreed to cast his vote after the 218 threshold was met of yes votes. He abided by his word - he voted on a bill that didn't include money for abortions and he waited to vote as one of the last three votes. He quickly left the House floor after voting and didn't stop to answer questions from the press. He later issued a statement: "Today, I obtained a commitment form President Obama that he and I will work together to address the critical health care issues of Louisiana including the FMAP crisis and community disaster loan forgiveness, as well as issues related to Charity and Methodist Hospitals."

No Democrat in leadership has guaranteed the amendment concerning abortion funding will survive in the reconciliation process. It would be a surprise if it did. It will be interesting to observe the response from Cao if and when it is abandoned in the legislation signed into law by the President. Many pro-choice women do not support federal funding of abortion, myself included.

No doubt Rep. Cao will feel the wrath of conservatives from both sides of the aisle. Thirty-nine Blue Dog Democrats voted against the final bill. Cao is said to have been deeply conflicted as he decided on his vote. His primary objection was resolved and he was promised additional support for his district. His District is 75% Democrat and he is a conservative Republican. He will probably not be re-elected but he appears to have responded with what he thought was best for the district.

Elections have consequences. One party rule in Washington - regardless of which party - is not good for legislation. This bill is a shining example of that.


vicki Bennett said...

Another well written post, with many parts I take exception to. As I was reading it I was wondering what was going on in the House leading up to the vote on social security legislation and wishing we had old video tapes to listen in on those discussions. My opinion is that, given the nature of politics these days, there was no hope at all for a health care reform bill that has the wrinkles ironed out prior to a vote- at least in my lifetime. And I want to see it for my family and the millions of other Americans who need it- yet in my lifetime. It will be interesting watching the next few weeks and if it does pass Senate, the next few years.

In my opinion, abortion is one place the government doesn't belong, either against or for and so, even as a fairly liberal Democrat and social worker, I'm okay losing that piece of it, though most of my fellows will argue persuasively that it throws the poor and the ignorant- those who can least afford children OR abortions- under the bus. And there are many many pieces of this 2000 page bill that can certainly be picked apart and rightly criticized, such as the lack of tort reform, but right now, I believe it's all about the big picture. The social worker in me says this is a basic human right and the shame of this nation is the way we lag behind in health care for all of our citizens.

As I said- I think this is another thought-provoking and well written post, Karen.

namaste said...

this is so disappointing. they will feel the backlash in 2010. they basically ignored the voices of the American people.

great writing here as always.

Michael Kirsch, M.D. said...

Actually, there is tort reform in the bill - Pelosi style. States are given incentives to pursue tort reform, but are not permitted to use caps on non-economic damages or to address attorney's fees. What's left? In addition, states like mine (Ohio) who have enacted tort refrom are not eligible for any incentives. In other words, punish states that have done the right thing, just like Pelosi & Co. do to successful individuals. See