Henry Waxman has cut a deal with the conservative Blue Dog Democrats that moved the House version of the health care reform package out of the House Energy and Commerce Committee (of which Rep. Waxman is chair) so it can be voted on in September. But the deal is unlikely to satisfy the 57 liberal Democrats who have put it on record that they will vote against any bill that does not include a strong public option:
“This agreement will result in the public, both as insurance purchasers and taxpayers, paying ever higher rates to insurance companies,” the letter says. “We simply cannot vote for such a proposal.”
If Republicans oppose the healthcare bill on the floor en masse, 57 Democrats voting “no” would defeat the bill.
The agreement between four Blue Dogs and House leaders cut $100 billion off of the price tag of the bill. Under the proposal, reimbursement rates in the government-run “public plan” would not be linked to Medicare. It would also reduce subsidies to make a government-run “public plan” more affordable.
Liberals say those changes undermine the public plan by making it too expensive for people to join.
House liberals did manage to extract a concession from Waxman that has at least symbolic significance:
House liberals have struck a deal with Henry Waxman to bring legislation that would establish a single-payer health care system up for a floor vote this fall, a senior House Democratic staffer tells Mother Jones. H.R. 676, a bill that would create a national single-payer system—essentially Medicare for all—has been languishing in Waxman’s Energy and Commerce committee for months. “Waxman is saying our request will be honored,” the staffer says.
The Waxman-Blue Dog deal is a boon for the private health insurance industry — and why wouldn’t it be? Industry execs and lobbyists paid for that, and it seems they are getting their money’s worth. Ryan Powers points to a Washington Post article by Dan Eggen on how insurance companies’ campaign contributions affect health care legislation. Powers quotes from Eggen, as follows (bolds are Ryan’s):
[T]he [Blue Dogs] set a record pace for fundraising this year through its political action committee, surpassing other congressional leadership PACs in collecting more than $1.1 million through June. More than half the money came from the health-care, insurance and financial services industries, marking a notable surge in donations from those sectors compared with earlier years, according to an analysis by the Center for Public Integrity. […]
A look at career contribution patterns also shows that typical Blue Dogs receive significantly more money — about 25 percent — from the health-care and insurance sectors than other Democrats, putting them closer to Republicans in attracting industry support.
and comments that this kind of influence-peddling by various industries has more to do with bribe-ability than ideology:
The business of influence and access peddling in Washington is often thinly veiled in pseudo-respectable claims that industry groups donate to candidates who they believe are predisposed to agree with their public policy priorities. But I think it is more accurate to say that industries donate to individuals who they perceive as predisposed to being bought. Indeed, if the health insurance industry really based its contribution decisions on who they thought would be more likely sympathize with their desire to keep the health care system as it is, they would do well to always direct a majority of their cash to GOP candidates. But they don’t.
Apparently viewing House candidates as commodities to be bought, they appear to invest in the party that they believe will be in a position to most directly affect their industry’s future. The hope it seems is that their contributions will make their industry’s calls to stall reform a bit louder than the public’s calls for significant changes to the health care system in the U.S.
Powers follows this up with a chart that reveals a strong connection between campaign contributions and whichever party happened to be in power:
In every House campaign cycle in the last 20 years the health insurance industry has invested quite literally in the status quo — choosing to funnel a majority of their campaign funds to members of the ruling party in the House[.]
Matthew Yglesias points out the corollary:
This is why the very same members likely to be concerned that expanding coverage to the poor is too expensive also tend to be the same members who oppose saving money through the introduction of a robust public option embedded in a strong health insurance exchange. There are some visions of “health care reform” that are compatible with the interests of insurers, and the job of on-the-take Democrats is to try to steer legislation into that harbor.
In other words, it’s not truly about saving money — it’s about pleasing the insurance industry and using cost as a fig leaf.
It really isn’t subtle, either. Here are the opening paragraphs of that WaPo article by Dan Eggen:
On June 19, Rep. Mike Ross of Arkansas made clear that he and a group of other conservative Democrats known as the Blue Dogs were increasingly unhappy with the direction that health-care legislation was taking in the House.
“The committees’ draft falls short,” the former pharmacy owner said in a statement that day, citing, among other things, provisions that major health-care companies also strongly oppose.
Five days later, Ross was the guest of honor at a special “health-care industry reception,” one of at least seven fundraisers for the Arkansas lawmaker held by health-care companies or their lobbyists this year, according to publicly available invitations.
Now pair this with the mortality figures for Americans who do not have access to health care:
Let’s see, what’s the number of Americans who die every year because they lacked health care? Somewhere between 18,000 and 20,000, last I heard. I suspect that’s a low estimate. Money taken from the health insurance industry to block health care reform is blood money. There is no other way to look at it.[Lots] of people are just plain being ground down for lack of decent health care. They don’t necessarily die prematurely, but they suffer more health care problems than they should.
Barbara also draws our attention to this article in Roll Call, which among other things points out that you can’t get a complete picture of the factors driving up health costs just by doing cost comparisons:
Why is it then that the health of citizens in these two [states] lags far behind the nation as a whole? Could it be that once given health insurance and other benefits — by way of reaching the dual entitlements of Medicare and Social Security — when they turn 65 years of age, Louisianans and Mississippians must eventually pay a heavier price for a lifetime of neglected health needs?
In Texas, 16 percent of the population lives in poverty, and per capita health care spending is far below the U.S. average ($4,601 vs. $5,283). Yet Medicare per capita spending in Texas is far greater ($8,292) than the U.S. average.
Babies in all three states have among the lowest life expectancy at birth — not because of what’s invested at the age of 65 and beyond, but rather because of what is not invested in children and young adults all of their lives.
States that have low poverty rates and relatively stable investments in health care throughout the lifetime of their citizens often show a very different picture. Vermont, smaller and far less diverse than its southern counterparts, has a poverty rate of 10 percent and spends about $6,000 a year on all patients, including Medicare beneficiaries.
Consider again how all of this matches up against the comparisons to other developed nations. On average, child poverty in OECD nations is 13 percent compared with more than 21 percent in the U.S. (and 5 percent in Norway). In single-parent households in the U.S., child poverty rates come close to 50 percent. While most discussions in the current debate have focused on the cost of clinical care, insurance rates and primary vs. specialty care, we may be missing the bigger picture.
But that is not what’s troubling House Republicans. No, they are upset about the inclusion of a “common ground” abortion provision in the Waxman-Blue Dog deal:
By a vote of 30 to 28, the committee approved an amendment setting forth abortion policy. The proposal, offered by Representative Lois Capps, Democrat of California, was supported by most Democrats and opposed by Republicans.
The amendment said abortion could not be included in the “essential benefits package” to be defined by the government. Further, it said insurers would not be required or forbidden to cover abortion. But, it says, in every part of the country, the government must ensure that there is at least one plan that covers abortion and at least one that does not.
Under the bill, health plans would receive federal subsidies to help pay premiums for low-income people. But under the amendment, subsidies could not be used to pay for abortions.
Democrats described the amendment as a compromise. But Representative Phil Gingrey, Republican of Georgia, who opposed the amendment, said, “We don’t compromise on the use of taxpayer funds for the destruction of human life.”
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