Commentary: Joan McCarter
Baucus and Grassley’s Health Care Reform Dance
Why does Republican Charles Grassley loom so large in Max Baucus's health care reform effort, when he's opposed to almost everything Baucus wants to accomplish?
By Joan McCarter, 6-08-09
You don’t need Grassley’s tweets to understand that he isn’t approaching health care reform in good faith or what his vision on bipartisanship is when it comes to health care reform. Bipartisanship in his mind means what it usually means to Republicans--Dems capitulating on a public option. He makes it absolutely clear in a letter he sent to President Obama, along with a handful of his Republican colleagues.
A group of Senate Republicans sent a letter to President Barack Obama declaring their opposition to including a government-run plan in a health-care overhaul, saying it would be a “federal government takeover” of the health system.
“Creating a brand-new government program will not only worsen our long-term financial outlook but also negatively impact American families who enjoy the private coverage of their choice,” said the letter from nine Republicans who are working on bipartisan health-care legislation.
That “working on bipartisan” legislation really should be in quotes in the original. What these guys are working on is obstruction, as usual. So none of that’s new.
Given that, though, how much more is it going to take for Max Baucus to wake up and smell the coffee? Why is Max Baucus still insisting on crafting a bill that Grassley will sign off on? From an interview they did together last week with reporter John Harwood:
HARWOOD: Are you guys confident that this is going…
Sen. BAUCUS: I’m quite confident that we’re going to get there.
HARWOOD: ...you’ll get a bipartisan bill?
Senator CHARLES GRASSLEY: I want to have--I want to have a bipartisan bill because most of what we’ve done in the Finance Committee and what it takes to get things through the Senate is bipartisanship....
HARWOOD: Right. There will be an individual mandate to purpose coverage?
Sen. BAUCUS: There’ll be a shared responsibility. That is that all Americans will have an obligation to have insurance of some kind or another.
HARWOOD: Yeah.
Sen. GRASSLEY: And I can say there’s a lot of people in my party believes the same thing.
HARWOOD: And that shared responsibility extends to employers as well? You either insure your people or you pay into the system? Can you support that?
Sen. GRASSLEY: No. There would be a great difference in my party on that. There’s two things that my caucus feel very strongly about. One is not to have a public option, and number two, not to have what you call play or pay.
HARWOOD: And are you opposed to pay or play? You will not support the bill that…
Sen. GRASSLEY: I’m opposed to play or pay.
HARWOOD: So how will you handle the issue of getting employers to participate?
Sen. GRASSLEY: I will handle that because if you have an individual mandate, then the individual’s responsible for their own health care. And for people that can’t afford it, there’ll be refundable credits.
And it goes on. There are a number of issues in this interview which Grassley just flat out refuses consider. Yup, Republican bipartisanship for you. Not that any of this is new, which makes the whole Baucus/Grassley partnership even more baffling.
Go back to March, when Baucus laid out his reform plan, with a few main policy points: an individual mandate to buy health insurance; choice would be preserved, nobody would have to drop their plan if they didn’t want to; a health exchange would be created as a marketplace to shop for health insurance, all plans in the exchange couldn’t deny care based on pre-existing conditions, and government subsidies would make premiums in the exchange affordable; and, a public health insurance plan would compete with private plans in the exchange.
On March 5, at the White House summit, Grassley laid out his opposition to the public plan. He’s continued those attacks on the public health insurance option in the press and in editorials:
In his policy paper, Baucus called for the creation of an Independent Health Board to regulate the insurance exchange. On April 10th, the Des Moines Register reported that Chuck Grassley opposed an Independent Health Board, saying “I will continue to raise concerns about any group sometimes called a national health board… It tends to centralize health care decisions, but more importantly it tends to direct health care dollars, and we have to be very, very concerned about a national health board being set up.”
Baucus advocates for comparative effectiveness research and health IT to give doctors information about what therapies work in his white paper. Grassley said that Rush Limbaugh and other conservatives should spread baseless claims about the policies: “I think they ought to hype them right now because people’s attention needs to be brought to it, and that’s the only way you’re going to get their attention. When the dust settles, they won’t have a leg to stand on and we will have and we will have a study and a tool that will be useful for doctors to use but not to dictate medicine.”
Baucus called for eliminating overpayment to private insurers in the Medicare Advantage program in order to lower health care costs in his white paper. Grassley is opposed to eliminating these corporate giveaways.
Since Baucus released his white paper last November, Grassley has systematically come out against point after point. The Hill reported that Grassley is also working on an alternative health care proposal to rally behind if/when he decides Baucus’s proposal is unacceptable:
“In tune with our responsibility as the loyal minority and loyal opposition, with emphasis on ‘loyal,’ we have to have a constructive alternative, with emphasis on ‘constructive,’ ” Grassley said. “So we have to be developing a bipartisan package with Baucus, with that being our goal and right now our only goal, but [we] can’t wait until the midnight hour to have something that Republicans can rally behind.”
Baucus needs to realize that he’s got no partner in Chuck Grassley when it comes to meaningful, effective health care reform. He needs to worry more about crafting a proposal that the HELP Committee and the majority of House Dems, not to mention the President, will sign off on. That was the whole point of structuring this so the bill can pass through reconciliation.
[End of article]
Grassley oppposes the Obama health care plan for a simple reason. It is bad for America. Since when has the federal government run any large program efficiently and in a cost effective manner? Point to one example. WQhat makes you think they can manage health care. Look at Medicare - it is a mess, rife with waste, and is bankrupt. Costs will go up and quality will come down. Look at Canadian & European health care programs - anyone who can afford it opts out and comes to the US for medical treatment at their own expense. Our medical coverage system and its costs are screwed up, but Obama Care is not the answer. Oh and by the way, if it passes, most people's taxes are going up!!
Comment By Matt Singer, 6-09-09Medicare controls costs better than private insurance. The Veterans Health Administration does even better. That's not my opinion, that's reality:
http://healthaffairs.org/blog/2009/06/05/dangerous-confusion-on-medicare-cost-control/
Our private insurance system is extremely expensive, ranging from every different insurer processing reimbursements differently (which triggers huge administrative costs for hospitals) to fee-for-service financing mechanisms that encourage wasteful spending by doctors and hospitals.
Max Baucus's white paper was great. Unfortunately, Sen. Grassley is opposing the portions of it that would do most about seriously addressing the huge inflation in our healthcare system. Seems to me he is way more beholden to the drug companies and insurance companies than he is worried about actually addressing this crisis.
To Matt Singer: You don't get it. The only way to "reduce costs" under govt medicare is to keep the published cost or price to the consumer fixed at an artifically low number and to restrict treatment for patients (govt bureaucrats will decide who gets what treatments and when), while increasing taxes to subsidize the program and cover its true cost and deficits. Look at Medicare, Medicaid and the VA Health programs - which by the way I do not think are better than the private health care available in our society - just ask anyone forced to use them. You need to look at this on an after-tax basis cost to the individual. It is BS to implement a program that costs more to run, and to increase taxes to pay for it, but claim that it costs less than the current program.
Comment By Steve Wells, 6-09-09Both Grassley and Baucus are terrified of single payer health insurance. Neither will publicly debate their ideas against single payer experts because their ideas would lose. They would rather arrest doctors and nurses than debate the issues.
Both Baucus and Grassley take big buck from health care companies. Last year Baucus raked in $1,826,652 from the health care industrial complex and Grassley raked in $1,161,826
http://www.opencongress.org/people/show/300048_charles_grassley
http://www.baltimorechronicle.com/2009/053109Zeese.shtml
It's clear who these two jokers really work for and it isn't us. But it should be. Call or write them and tell them you want single payer
(202) 224-3121.
A switchboard operator will connect you directly with the Senate office you request.
Get government out of it. And we need tort reform so scumbag trial lawyers will quit feasting on everybody. Oh, I forgot, the trial lawyers did much to elect the Sun King. But don't worry, Joan, the evil Republicans aren't going to keep us from universal coverage. The Sun King will deliver.I just hope we don't get sick. Welcome to Toronto, London, Berlin. Take a number. Get in line. We'll see you in six months, if you're still alive.. And Joan, why are you wasting your time at New West? Your future is at MoveOn.org or the Daily Kos. Another balanced view from Joan McCarter, Tribune of the People. One more thing, Joan. Why the animosity against the "obstructionist" GOP if in the end they lack the numbers to be legislatively effective in opposing Obama's policies.? Your side holds all the cards. Or do you? This will be an interesting fight (like Sotomayor's confirmation), because even some on the Left are starting to see Obama as the calculating, cynical ideologue that he is.
Comment By flounder, 6-10-09Grasserly should either prove how much he hates Government health care and introduce a bill getting rid of his own government health care, the VA, Medicare, and Medicaid. If he doesn't have enough conviction in his beliefs to do this, he should STFU, crawl back in the clown car he came from, and let the grown ups do their work.
Comment By mike oliphant, 6-11-09I sit on the board with Utah association of Health underwriters and http://www.BenefitsManager.net for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a "no loss" or "no gain" over competing carriers in the insurance exchange portal which is http://www.UtahInsuranceExchange.info. On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that need to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.
Comment By BozoneBill, 6-11-09I get so tired of hearing how our current system allows "choice" for medical consumers. Do tell me how someone without insurance has any "choice" at all? Do they let you choose your emergency room doctor when you put off that head cold until you have a raging infection and have nowhere else to go? As far as a national health plan being bad for the economy, consider the benefits for everyone if we relieved people of the worry of health care. Those stuck in dead end jobs they hold solely for the purpose of insurance coverage would be free to market their labor elsewhere or (I know this sounds crazy) but actually start businesses of their own.
Comment By Peter, 6-12-09To Matt-
Wake up-and smell the coffee. A nationalized system, and this is what we have should Obama get his way, will be bad for most anyone who is truly sick, or suffering in this nation. Look to existing nations that embrace the socialized systems, and if you have cancer, or serious health issues, you suffer-plain and simple, you wait longer, and while you wait, you suffer. Time is the villian when it comes to cancer, or other disease-and extended waiting time is what you get, due to limited resources of nationalize coverage. Medicare does not work-stop looking to it as the great example of how to fix the overall system. They underpay, and delay pay, and rely on the private sector to make up the difference to health care providers. And, you compare costs-remember, the Euro systems play with their numbers-being careful to hide true costs. Heck, after 20 years of waste and damage, both Canada and Britain are now leaning back towards private coverage-they explored, and realized how bad the social impace is on its people-and what are we exploring? The same failed experiments. Socialism and Communism work well on paper, in the minds of college professors, and their dreamy foolish followers-in the real world, its croni-ism, its a ponzi scheme, and it cripples the good, the strong and the achievers, to find a sluggish common ground. Look at the leaders of the left-how many of them have their kids in public school? Very few-why is that? They would rather have their kids in private schools, yet they don't want the poor to have an option regarding charter schools. They put the priorities of the teachers unions and the support they get come election time above the needs and welfare of the poor kids in failing public school districts. The left will cry, we don't give enough financial support to these failing schools! Wrong-the inner city schools in NJ, NY, PA get more than the successful schools, because the teachers unions have the schools hostage. In 3 years a teacher in NJ gets tenure. Show me another industry, aside from the UAW where workers get such protection! Its a crime-and society and the kids suffer-and the unions continue to get protection from the left, because they promise the votes come election time.
Stop pretending to care you left leaders and for once in your life, be honest.
The right talks about how bad socialized healthcare is and how the people who have it, hate it. Please give me one example where such a system has ever been eliminated by popular efforts of the people acting democratically.
Comment By mike oliphant, 6-12-09comment from http://www.AHealthInsuranceQuote.com to RCM2....you must be in the business from some touch point to make that statement as well as everyone else (except Matt). When you are in the system from any touch point (insurance, provider, hospital, Medicare or patient) you get it because of real time experience.
I often quote the Switzerland system as an example of tough questions that we will have to face at some point down the time line. Did you know that premature babies there are not re cessitated upon birth if they cannot draw breath? Did you also know that is the same with senior care? They don't extend life of a senior with multiple failures like intubation.
These decisions were made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or definition of when to incubate a newborn or a senior? To define the conditions? With a litigious society I think not. This is why we need tort reform. Without tort reform medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. With health insurance carriers it translates to about 10% of every premium dollar collected.
I don't think we are hearing about tort reform because most of the house and senate are lawyers. In the healthcare system there is no total innocence. Insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their door with no insurance.
France has the best health care system in the world and it spends half of what America does. There is NO gatekeeper. Anything a doctor ORDERS has to be paid for by the insurers. And the system is privately run. The INSURANCE companies run it under goverment rules. They CANNOT override ANYTHING a doctor orders.. There is NO reduction of health care.
In fact treatments that American insurance companies will NOT cover ARE covered under the French System.
The insurance companies are making a fortune on administrative fees and secondary health policies that pick up the co-payments of the patients.
Right-wingers need to be more honest and tell us what they really think. If you hate pulbic health care, speak clearly about eliminating VA, Medicare, Medicaid, CHIP, Indian Health, and taxpayer-subsidized plans for Congress. The 47-50 million Americans without health care of any kind are beginning to feel singled out, disgarded. The price of private insurance premiums, which you seem to love so much have already priced in millions of unecessary emergency room visits. This group will grow. Rates will keep going up. What is the right-wing plan? Do nothing, I suppose.
Comment By Bill Smiley, 9-08-09Senator Grassley has not given up his Senate Health Insurance! If he becomes unemployed he still will have fabulous health insurance unlike us slobs who really work for a living. Wait a minute we don't work for a living anymore. You know why! The really great socialists Mr. Grassley really supports are only interested in their own profit and re-election - he is on his six term and needs to be removed instead of removing jobs out of the USA for the bottom line of the good old boys.
Tongue in cheek you betcha. The Democrats are not much better! Chuck asked today where does the Federal government need to provide Medicare in the constitution? My answer is health care is a human right above the constitution - it is a right for all humans and animals, especially those free and living freely on our planet. Take away the freedom of beings on earth and he will be happy - remember he has the greatest insurance for life. I would trade him for mine any day. He does not think the government should not run anything but does not give up his pay or benefits and uses the mail he so criticizes to get people to re-elect him. It is time for Iowans to wake up and get rid of him. I only have picked on him because he is biting his tongue in cheek.
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I i saw yer blog
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