Health Care Overhaul Dealt Another Blow

Key Group of House Democrats Want Changes in Fast Tracked Bill to Reign in Costs, Address Medicare Payments

(AP)  The drive to remake the nation's health care system suffered yet another setback in Congress on Thursday when a pivotal group of House Democrats demanded changes in legislation the leadership was drafting on a fast track.

The emerging bill "lacks a number of elements essential to preserving what works and fixing what is broken," 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote party leaders. To win their support, they said, any legislation would need to be much more aggressive in reining in health care costs as well as in addressing a disparity in Medicare payments they said adversely affects rural providers.

A group of the moderates met into early evening with House Speaker Nancy Pelosi and Majority Leader Steny Hoyer and arranged to sit down with committee chairmen on Friday to go over proposed changes. Officials said the public release of the bill, originally set for Friday, would occur no earlier than Monday.

It was the second setback in three days for President Obama's top domestic priority, although it was unclear whether it would amount to anything more than a brief delay for a bill of enormous complexity and controversy.

There was upheaval earlier in the week in the Senate, where the Democratic leadership is intent on scuttling a proposed tax on health care benefits that has long been key to attempts at a bipartisan compromise. At the same time, Senate Majority Leader Harry Reid and others went out of their way during the day to emphasize eagerness for Republican support.

As an alternative to the benefits tax, Democrats are considering raising taxes on wealthy investors to help pay for health care legislation, along with numerous other options, according to officials who spoke on condition of anonymity. The proposal to extend the current 1.45 percent Medicare payroll tax to capital gains earned by high-income taxpayers would bring in an estimated $100 billion over 10 years.

In the House, Hoyer sought to minimize the day's developments, which occurred as Democrats on one committee were making final decisions on provisions to pay for the legislation.

"Let me make it very clear that everybody in that room thinks we ought to pass health care reform," the Maryland Democrat said.

One conservative Democrat, Rep. Mike Ross, D-Ark., said he believes no House vote should take place until September. That is well past a midsummer informal deadline set by Pelosi, D-Calif.

"I promised the president that we would have legislation out of the House before we went on an August break," Pelosi said earlier in the day. "That is still my goal."

Despite some success - the nation's hospitals agreed to a cut of $155 billion in projected Medicare and Medicaid payments - progress has been scant and internal differences magnified.

In general, any bill that emerges from Congress is expected to follow Obama's blueprint for reining in health care costs overall while extending coverage to 50 million who lack it.

Another objective is to make sure that insurance companies can no longer deny coverage or raise premiums to unaffordable levels to individuals with pre-existing medical conditions.

But literally hundreds of details are involved in drafting legislation, and gaining a consensus even among Democrats is proving to be remarkably - if predictably - difficult, despite their large majorities in both houses.

As an example, some Democrats are demanding legislation that permits the government to sell insurance in competition with private companies. Republicans overwhelmingly oppose such a plan, deeming it a stalking horse for universal government-run insurance, and many Democrats have concerns, as well.

Some Democrats prefer a plan for a nonprofit cooperative to take the place of government in competing with private companies. Others favor a government role only in cases in which consumers lack a choice in coverage.

Similarly, Democrats are divided on paying for the bill, some preferring more tax increases than others, some favoring more cuts in Medicare and Medicaid.

"We've just got a lot of question and the top of the list would be how to pay for it," said Rep. Marion Berry, D-Ark., one of the Blue Dogs.

"I don't think we have significant cost-containment mechanisms in the proposal yet," said Rep. Adam Schiff, D-Calif. He said he favors provisions aimed at preventing overtreatment of patients and overpayments to doctors, hospitals and other providers.

A dispute over tax increases was at the core of upheaval in the Senate earlier in the week.

Sen. Max Baucus, D-Mont., and chairman of the Finance Committee, has been working for months with Republicans in hopes of gaining support for a bipartisan bill that can command 60 votes.

Efforts to raise money to pay for subsidizing the cost of insurance had focused on a tax on health care benefits for workers with high-cost coverage provided by their employers.

Baucus and Republican supporters argued it would also have tended to reduce the cost of health care overall, as well as offset the cost of the bill. But the Democratic leadership stepped in forcefully, citing poor public polling, opposition of organized labor and concerns about taxing middle-income workers.

[ibsteve2u]

"40 members of the Blue Dog Coalition of moderate to conservative Democrats"

lollll...ah, I can just imagine the "trading" that went on among these people - most of whom are Democrats because that was the only way they could get elected, and far too many of whom are wholly owned subsidiaries of various powerful industries - to include the insurance industry, unfortunately.

[erasmus111]

by IThoughtItWasFunnyNay July 10, 2009 6:27 AM PDT

Well, NO, Canada does not have a universal health program, even though everybody THINKS they do...

And even Canadians have to come down into the US to get some of the care their government run plans won't allow them to have.


Well, YES, we do have a Universal health care plan. Each province might vary slightly, but overall the plan is the same throughout Canada.

And the few Canadians that are coming to the U.S., it isn't because of something the government doesn't allow. It's because they are the RICH and think that they are better than everyone else. They can't wait a few days to see a specialist or whatever. The only thing that the insurance doesn't pay for is cosmetic surgery. And that is only after a certain age.

It's really a good thing that no one believes anything you say, because they would have a completely false view of what the Canadian health care system was.

[cydygitt1]

Yep, texassanna is a member of the flat Earth society, and has a totally delusional idea of everything. These are the type of people that enjoy seeing the "vast cesspool of waste" in our current for-profit health care system continue to flow to lobbyists and other non-providers.

[calgal4]

Does anyone remember how the Bush admin butted it's way into the Terry Schiavo? Govt. run health care sure makes me nervous. Wish I knew the answers to this huge dilemma

[Solarrays247]

Doesn't anyone out there get it yet? You(or your employer) are already paying for health care for the estimated 48 million uninsured, and estimated millions of under-insured. And I can guarantee you that the costs will go much higher unless something is done now!

Where do you think the money comes from when a desperately uninsured sick person arrives in the ER at your local hospital? Who, what, where, and when is the "golden goose?" It's YOU, my friendz! Higher premiums, and higher taxes to cover costs of doctors, prescriptions, hospital care, and the lists go on and on.

So....pay for it now....or pay for it later....but you will all pay for everyone's health care costs whether you want to or not! Make the CEOs of the private insurance companies happy...keep feeding in to their piggy banks!

Meanwhile, one of my friends, who thought he had excellent health insurance, is back in the hospital ONE after being discharged after his heart surgery...triple bypass. Seems his health insurance company would only allow three days hospitalization following surgery! The hospital was ordered to discharge him even though there was the beginning of infection in his leg where his vein was removed for use in his bypass.

So now there he is....back in the hospital with internal bleeding, and infection in his leg!

WHAT A COUNTRY! WHAT GREAT HEALTH INSURANCE! SUCKERS!

[Solarrays247]

Typo: I meant to say "is back in the hospital ONE DAY after being discharged......"

[ThermalHunter09]

Reading through the posted comments it becomes obvious: It's time to dust off the guillotine ... too many people are eating cake and believe it is their right.

[Vet_Turner]

I went 25 years of my adult life without health insureance - working one or two jobs the entire time. I even bought health insureance twice on my own and it turned out to be worthless in both cases.

I vowed when I got a job with insurance that I would never forget those times when I could not go tot he hospital for stiches because I could not offord it, I could not go to the hospital to get my bones mended, I could not go the doc when I had been feeling sick for weeks.

The health care system is a mess. There are so many out there who think that why don't the poor working at Taco Bell just go out and buy health insurance, it only costs me $150/month. But in reality, that insurance costs over $1000/month. And when they learn that, then they say, "Well, well...it is socialism and everyone can't have everything." Everything? Health insurance. So people that work hard, who have kids to support can go to the doctors when they are sick or injured?

We need health care reform.

[rhs648]

Joe_NY_15 July 10, 2009 7:27 AM PDT
That sounds like just enough to send the democrats packing and get Republicans to take their seats.....Thanks !!!! Just what we needed to re-take control in 2010

That may be easier than we think when people see how much their taxes will be going up. The blue states will shoulder much of the cost of universal health care. Couple that with the trillions of dollars of Obama spending. This will be a plum to the red states. Expectt to see mass defections from the Democratic party. It won't be long.

[ramos1129]

A national health care plan is coming. Here is my prescription:

1. Form an independent political free commission respected by everyone.
2. The commission should study the national health care plans already in place in Canada, England, etc. Our own Federal Emlopyee Health Plan needs to be added.
3. Identify the pros and pros of each plan. Then come up with a plan suitable for us borrowing the best aspects of each studied plan and disregarding the cons.
4. Set a time limit for the Commission to report. Make the report available over the web and to the general public.
5. Set up a national plan based on all of these items.

Why reinvent the wheel?

[Joe_NY_15]

Blue dog democrats = Red Dog States in 2012.......LOL

[babooph]

Not enough republicans -No problem,the lobbyists just bribe the dems-must be what they call "democracy"!

[Aldymac]

After reading the posts that are all for the demacrats plans without anyone opposing those plans are people who have never worked for a living, they have always been in the system and therefore will always fight for the system. Once they have lived off the system most of their lives they want to see more people taxed with higher taxes so the living on the system gets better.
The drawback of that is that once there are more on the system there will be less paying in, the higher taxes the rich have to pay will shut the rich down and cause more unemployment, even more on the system, less paying in. If you can't see where this is going, then you can't see in the realm of reality, but those who can only see higher taxes and even higher taxes are those who only plan to live off those taxes, and the benefits of what those taxes are supposed to buy, NOT pay them.

[thusspokezara]

How to control health care and increased coverage.
1. Put a ceiling on doctor's income.
2. Do not cover brand name medications unless shown to be more effective or safer than generics
3. Link reimbursement to quality of care and outcome
4. Do not cover end of life care. Dying is not a medical disorder.
5. Do not cover physical problems caused by gluttony, addictions, or poor life style choices. e.g. You get drunk. You fall and break a leg. You need surgery. YOU pay for it. You can't afford it? No surgery.
6. Emphasize preventative treatment.

[GiveMeFreedom]

OK great. Now who the flock is going to spend the billions and R&D to make new drugs only to see the work given away and a cheap generic used instead. Ever thought this through moron?

[cydygitt1]

"The U.S. health care system, as you probably realize, is a vast cesspool of waste. We spend nearly twice as much on health care as the average advanced country and have no better results to show for it. Alas, every dollar of what we call waste is what somebody in the industry calls 'income.' So anything that makes the system more efficient makes somebody unhappy, and that somebody has a team of lobbyists."
-------------------

All the derranged rightwads want is MORE OF THE SAME -- a continued failed health care debacle festering in a "vast cesspool of waste," as GREEDY for-profit insurance companies and pharmaceutical companies continue to push their idiocy onto the American people through their immoral and corrupt lobbyists!

[jsd330]

Let's not stop with for profit healthcare, why not make every business in th U.S. non profit. We could start with all insurance companies(auto,home,life, ect.) then the oil companies, electric companies, natural gas companies, grocery stores ect. How long would it be before evry buisnes in the U.S. was run by the government. then we can become a socialist country.

[jon2012-2009]

jsd330, where are your facts? There are reasons to believe that we can achieve better health outcomes at much lower costs in delivery of health care. For crist's sake, it's happening in more than 30 other countries.

If there is similar underlying economics in other industries, sure we should be open to government playing a role. The whole idea is efficiency: better results, less costs. So the facts? Maybe this concept of capitalism and markets offering the best solution is not perfect. But we need the data, not dogma.

[robinspp]

Government run Health insurance is another choice to choose. Few private companies join together and swindle the people?s money. The Republican Party is always for the rich corporate, because they get millions and millions of money from those companies, not only to run their party but also for them. Few democrats also are being bribed by the big corporations. Obama is for the people, because he is not benefited and he is not corrupt. It is better for the people to go behind him and support the health care reforms.

[Joe_NY_15]

"Obama is for the people, because he is not benefited and he is not corrupt." .....all righty now

Thanks for the laugh, I could use a good laugh on this Friday.

[GiveMeFreedom]

You are serious with your assertions, correct?

Republicans are in the pockets of rich corporations and democrats all care about the little guy right?

I can see that Carville has succeeded in building the idiot. We have arrived.

[jon2012-2009]

Joe_NY_15, GiveMeFreedom: So you don't agree that health care reform is for the greater good of this country. Anything you can present by way of facts so that people on the other side can at least begin to understand where you're coming from? When people say the U.S. health care system is the most expensive in the world and is no better than the top-ranked 30 health care sytems, and that our health care costs continue to outpace inflation by a factor of 3, that seems an argument for both improving our health care outcomes and reducing those costs. When other industrialized countries offer universal health care at lower costs and with better results, that seems like we have a lot of room to improve. So what's the problem?

[jab232]

The Blue Dog Democrats are in the pockets of the big lobbies. To me it is simple. Let congress vote to make the same excellent public option health care they receive available to be bought by all of us. Otherwise, they are just treating us like worthless dirt.

[jab232]

The Blue Dog Democrats are in the pockets of the big lobbies. To me it is simple. Let congress vote to make the same excellent public option health care they receive available to be bought by all of us. Otherwise, they are just treating us like worthless dirt.

[payasyougo]

"Health Care Overhaul Dealt Another Blow"
----
the title is wrong. its"

National Medicare/Medicaid Refinancing Dealt Another Blow.

[omnibus66]

The US is the only industrialized country in the world that does not have a universal health care system for its citizens. So our system, which boasts the highest prices for prescription drugs in the world, the most expensive doctor and hospital rates in the world where every doctor is a multi-millionaire, is right, and everyone else is wrong.

Just proves what a bought and paid for government can do to its people.

[jon2012-2009]

Canada is one of the 30 countries in the Organization for Economic Cooperation and Development that on average spend less than half our health care costs per person and yet provide coverage for all its citizens. They aren't faced with runaway health care costs that rise three times the rate of inflation, as we do in the U.S. Long term, they don't have to worry that their health care costs will simply overwhelm their economy. Health care is going to account for 20% of U.S. GDP in 2017.

What's more, Canada's health outcomes put ours to shame because their health care system is ranked higher than the U.S. on various measures of quality. (France is ranked #1 but the others--UK, Germany, Italy, the Scandinavian countries--still beat us. We don't make the top 30. If you can believe this, some Third World countries rank ahead of the U.S. in this survey. In a 2003 study of hospital deaths from medical mistakes in 19 industrialized countries, the U.S. had the WORST results.) What we should do, if we can't replicate Canada's health care system in the U.S., is outsource our health care to them since they're just next door. If we want to make hospitals and doctors rich, maybe let's give the money to those who can provide these services more efficiently.

[indivthinker]

Every doctor is NOT a multi-millionaire, and if they are and you are jealous of that kind of money, then why don't you get off your butt and become one?

Becoming a physician is the most difficult profession to enter, because there is more school, more training, and more on-call shifts than any other degree requiring job. You have to have a high school degree, a bachelors degree, four years of medical school, a minimum of three years residency (just to be a general family practice physician), and many more years of training if you want to be a surgeon or specialist. Some doctors are not finished with their schooling until they are thirty-five to forty, and until then they are stocked up with hundreds of thousands of dollars worth of debt, and they make barely enough to feed their mouths!

Getting into medical school is more difficult than you might think. First, you are required to take certain college science prerequisites which many shutter when they hear the name of (like organic chemistry and biochemistry). Second, you are required to take the MCAT, a standardized test which I spend over FOUR HUNDRED hours studying for, only to receive a mediocre grade that barely got me into a med school. Then, you have to spend weeks going through the application processes, interviews, and preparations for med school. Even then, only 40% of those who apply to medical school get accepted somewhere. That is ONLY forty percent of the most diligent, hardest working, most intelligent people in America that work their butts off for years.

Getting through medical school is the second part. In my first and second years in medical schools, I spend EVERY minute (except for eating) from eight in the morning to eleven at night studying. Other than friday nights, I had NO life other than the life with my fellow classmates. I had to postpone my wedding for two years because I did not have the time to plan a wedding much less spend time with my fiance. My third year (and my forth year will be this way too) required me to spend around 60 hours a week in clinical work to help prepare my way for residency and liscensing. In my future residency, I will have to spend up to EIGHTY hours a week working in the hospital. The only reason that it is not more than eighty hours is because congress passed a law limiting it to just eighty. At this point, I will make approximately 30k a year for eighty hours of medical work a week. Hospital techs make more money than that.

Finally, once I get done with my residency and take the Medical Licensing Exam, I can find a job. I will have acquired 20k debt from my undergrad loans, and 80k debt from med school, plus the tens of thousands of dollars that I will pay for interest.

I will be thirty before before I can finally get started paying this stuff off, and making 200k a year is not as much as you think. When you take into account all of my debt, plus the potential for a house and family, and the fact that I must pay almost FIFTY THOUSAND dollars a year for malpractice insurance because morons like you want easy cash so you sue because the doctor looked at you funny, then you realize that don't make much at all. I make a COMFORTABLE, but not EXQUISITE salary.

I, of course, will be at the bottom of the pyramid when it comes to physicians because I aim to just be a pediatrician. As for those who are cardiac or neurosurgeons, they can make around 500k a year. But these are the people who spend several more years in residency enduring hell. They also have more responsibilities, and they do the most sophisticated stuff in the medical world... stuff that I can't even understand. They are the smartest, most dedicated, and psychologically toughest people in America, so they deserve to have a good lifestyle and make more money than most can ever dream of.

omnibus66, if you want that kind of money, EARN it yourself. Otherwise just shut up about stuff you know nothing about. People who make that much deserve it, for years more of hard work than anyone else does.

[TPS2]

by skyk-2009 July 10, 2009 3:48 AM PDT
Nothing this nation has EVER done to benefit all has been easy or come without much discussion and debate.

That is exactly the point, discuss it and debate it for a change, instead of pencil whipping legislation like we have the first half of this year. I am glad at least somebody has read the damn thing!!

[retirevet]

60 years of debate isn't enough for, would you like to go another 60. Let's get this done. No more debate.

[platteman]

Any health care bill will have to include all members of congress, the President of the USA and all family members and they must all be a part of the same health care bill that is forced down the rest of the USA's throat. Anything less will be a travisty. When Congress has to go through the same process as the rest of America, then and only then will we see a real advancement in health care.
Also with the present plan, Medicare and Medicade will be gutted and those of us who are on it will be left to die instead of what we have now.

[johninpennsyl]

You are right-they should have the same as us.
As it is now ,we pay for everything,they get the best,and we get nothing. Democracy in action.Also BS in action.

[jsd330]

That will never happen, you won't even get the same kind of plan that Federal employee's have. The National healthcare plan will end up like medicare. In order to have decent coverage you'll end up paying for a supplement plan to pick up all the procedures and office visits that the plan doesn't cover or pay for it out of your own pocket.