How could such a bad bill pass the House?
By, Fran Bradley:
11/18/2009
Ideology run amok," is the way Minnesota Democrat Congressman Collin Peterson characterized the recent health care reform bill passed by the U.S. House of Representatives. He added, "I have so many problems with this bill I don't even know where to start."
In fact, 39 Democrat members of the U.S. House voted against the bill -- it passed by the narrow margin of 220-215. The Wall Street Journal called it "The Worst Bill Ever."
How could such a hugely controversial bill pass? What is it about the bill that seems to be so distasteful to all but the far left?
It appears that it passed due to some old-fashioned politics-as-usual arm twisting and deal making, not because of the merits of the bill. One Republican vote appears to have been "bought" with the promise of improved Medicare reimbursement rates.
A Blue-Dog Democrat vote seems to have been "bought" with the promise of many millions of dollars for a medical school in his district. AARP has been accused of lending its support with the promise of more money for its Medicare supplement plan endorsement by gutting the competitive Medicare Advantage plans. The American Medical Association support appears to have been "bought" with the promise to repeal the programmed 21 percent cut in provider rates.
Provider groups lobbying for payment reform were given a weak plan to study "pay for value" by the Institute of Medicine with a return more than a year away. Providers concerned about inequities in the Medicare payments system were given another weak plan for a study of the "appropriateness" of regional disparities.
Studies are a typical ploy to put off issues. Who knows what might come back in more than a year?
The marginal "victory" should be a warning sign that there are many problems with the congressional effort to reform our health care system. As with any illness, recovery depends on the right prescription, not just any prescription. The strong support for the need to control health care costs should not be abused by enacting legislation that will likely increase costs for average Americans while massively growing entitlements and government control.
Let's review some of the most concerning areas of the House bill.
1. The bill would spend an incredible $1 trillion when the U.S. has no money. That's more borrowing at a time when our creditors and fiscal experts are warning us that the U.S. debt is reaching dangerous levels that threaten the very existence of a viable America.
Using clever techniques like putting more than $200 billion of expenses for the "doc-fix" (buying off the projected 21 percent cut in provider rates) and covering six years of expense with ten years of revenue add to the mistrust of fiscal responsibility.
2. The bill does virtually nothing to curtail health care inflation. In fact, the huge growth in taxpayer-funded entitlement programs where artificial cost controls shift expenses to privately insured people will exacerbate the problem. Expanded government mandates will add additional costs for average Americans. Taxes and penalties will be passed on to the consumer for further cost increases.
3. Taxes, fees and penalties will hit job producers the hardest. At a time when unemployment is at historic highs do we really want to risk more business closures and reduced employment? A total of $572 billion in new taxes is a huge burden on an already shaky economy.
4. Seniors are deeply concerned about the massive cuts to Medicare. A total of $170 billion in cuts to Medicare Advantage Programs may eliminate these popular competitive options. With many providers beginning to deny new Medicare patients because of low payments can we really afford more cuts? Reducing fraud and abuse is a commendable goal, but can we really expect huge projected returns when these attempts have been tried often.
5. The bill represents one of the largest entitlement expansions in our history. Families making more than $60,000 per year would be eligible for taxpayer-funded subsidies for their health insurance. Asset tests would be eliminated providing a huge opportunity for abuse.
6. Detailed regulations intrude on our freedom.Bureaucrats would define "essential benefits," qualified plans, and countless insurance requirements.
7. The "Public Option" greatly expands the federal government as an insurer. Instead of increasing competition, the Public Option would likely compete unfairly and shrink the private insurance market.
What is missing are true reforms that could reduce costs - consumer empowerment, medical malpractice reform, insurance standardization, improved private-market competition and other free market reforms.
Let's hope the U.S. Senate takes a more common sense and balanced approach.
Fran Bradley, R-Rochester, is a former Minnesota lawmaker who served as chair of the House Health Policy and Finance Committee.