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"!