blog

New Year's Blog

My new year began in earnest on Monday, January 4. Full of the spirit of a fresh start, I began with 25 minutes of aerobics on the elliptical machine and lifted some weights. Feeling self-righteous, I luxuriated in one of the best holiday gifts ever from my husband Bob – a one and a half hour massage. I went straight from there to get a manicure, went to Jenny Craig and started on the annual diet, got my hair colored and cut, and now, I am fully ready to launch into 2010! Coiffed and polished, I am heading off to Washington to see about a health care bill.
 
The challenge is to craft a bill that makes health care affordable and available to all Americans regardless of income or health status or gender or geography, does not compromise women’s access to abortion services, is paid for in a way that does not burden middle class people, seriously controls the unbridled power and greed of the insurance industry – and can get 60 votes in the Senate.  “Ah, there’s the rub.”

The House bill, with the exception of the abortion language, is a far superior bill. 
 
# The House bill includes a Public Option to compete against the private insurance companies and thus to drive costs down. The Senate does not.
 
# The House bill covers 36 million currently uninsured Americans. The Senate covers 31 million.
 
# The House bill lowers premiums and cost sharing through more generous affordability credits than the Senate.
 
# Major coverage provisions in the House bill begin in 2013; 2014 in the Senate bill.
 
# The House bill closes the Medicare prescription drug “donut hole” (coverage gap) starting in 2010 and completely by 2019. The Senate bill never completely closes it.
 
# The House bill creates a national insurance exchange for the uninsured, self-employed and small businesses, increasing leverage for millions of Americans with a nationwide pool. The Senate bill creates state-based exchanges that will have far less bargaining power.
 
# To promote competition, the House bill eliminates the health insurance company anti-trust exemption. The Senate does not.
 
# The House bill is paid for through a surcharge on income beginning at $500,000 for an individual and $1 million for a couple. The Senate bill includes a surtax on so-called “Cadillac” insurance plans.
 
# The House bill increases enrollment in private employer-provided coverage by 6 million Americans. The Senate reduces employer coverage by 4 million people.
 
# The House permanently increases physician payments for Medicare and Medicaid. The Senate does not.
 
# The House bill allows undocumented immigrants to purchase insurance in the Exchange with their own money. The Senate does not.
 
Both bills prohibit denying or dropping coverage for pre-existing conditions, allow children to remain on their parents’ insurance until age 27, end gender rating, eliminate life-time caps (the House eliminates annual caps as well),  invest in an expanded health care workforce and community health centers, and immediately create a new insurance pool for people who can’t get coverage today.
 
The differences, however, are very significant, and the goal is to move the final bill as much toward the House version as possible.
 
To those of you who are thinking, “Why not a simple single-payer system?” The answer is simply and sadly, we couldn’t pass it. Nevertheless, I remain convinced that such a health care financing system is by far the best. Now my efforts will be on getting the best possible system that helps the most people, and preparing to make the necessary improvements as we move ahead.  
 
Let me know what you think.
 
I wish you a most Happy New Year to you and yours!