As the Patient Protection and Affordable Care Act migrated through the House over the last few weeks, the Senate version (passed on Christmas Eve) ultimately passed the House and was signed into law today. I was one of the few people that actually watched C-SPAN for nearly 5 hours this past Sunday. Honestly, I was disheartened by the passage. Believe it or not, not solely because of the content of healthcare bill but because of where this bill has taken our political system in this country.
One congressman or congresswoman would say it would lower the deficit; the next person would say that it would add billions to the deficit. One person would say it would help small businesses; the next person would say it would cost billions in new taxes to the small employer (Caterpillar: Health Care Bill Would Cost $100 Million). The question that kept rolling around in my head was, “Is one party universally uninformed as to the contents/impacts of the bill (and spending nearly a trillion dollars) or do both parties know the realities–and one is lying and simply trying to mislead their constituency and hold onto their seat in November?”. I often wondered about the 32 million uninsured people that were referenced literally by the moment with no discussion of the other 276 million people (the other 90% of the country with an official population of 308 million) that are being served by the system (and will be affected by taxes on durable medical equipment, prescriptions and the costs of mandates of increasing coverage levels to the legislative levels or the newly installed premium taxes). How do we solve the affordability issues by legislatively increasing the cost of the items we are specifically trying to make affordable?
I often heard references of the ”excellent programs” of Medicare and Social Security, but not one person seemed to talk about the fact that they are both bankrupt (Status of the Social Security and Medicare Programs)! Nobody seemed to mention that they are both horrendously underfunded, and it does not appear that anybody has any answers as to how to sustain them on a go forward basis. There was no shortage of trumpeting the two programs’ effectiveness. How effective is a program that is not able to be financially sustained? When people were trumpeting the attributes of Medicare, nobody was talking about the fact that doctors and hospitals are beginning to limit the amount of Medicare beneficiaries they are treating (Mayo Clinic to Stop Accepting Some Medicare Patients).
Finally, the thing that saddened me most was the lack of partisan support. We are all in agreement that there are problems in the system and that some things need to be reformed. But to have a single party take control of the legislative process–where they pass a piece of legislation right down party lines using terms of “avoiding the filibuster” in the Senate, resorting to reconciliation of a “simple majority” to ram a piece of legislation through–caused me to pause. This is arguably the largest public entitlement program ever passed (with subsidies built in for families of 4 making $88,000 per year), and we do not have partisan support–in fact, it seems to have been designed and negotiated to “accomplish the bare minimum in order to pass it” as opposed to getting the most votes and the resulting best possible piece of legislation. As American citizens, given that 40% of the members in the Senate didn’t like it and just shy of 50% of the legislators in the House did not approve of the bill, I do have to ask, “Did we end up with our best solution?” Again, going back to Medicare in 1935 and Social Security in 1965 (History of 1935 Social Security Act), both had some level of bipartisan support when they were passed.
Finally, from all the polls that I saw leading up to the vote, it seemed that the American people were concerned, worried and suspect of THIS BILL and wanted the politicians to slow down and rework the document to come to a partisan solution. Unfortunately, it does not appear (in this instance) that the government of the people, for the people, paid much attention to their constituents.
So where we do we go from here? Well, as mentioned earlier, the Senate version of the law has passed and was signed into law today by the President. Simultaneously, as the Senate bill was passed, the House sent a separate bill to the Senate to “clean up” things that they did not like about the Senate version for Senate consideration. In past congressional sessions, normally these differences are ironed out before the inital bill was passed. HOWEVER, in this instance, because of the aforementioned political wrangling and the Democrats’ loss of a seat in the Senate since December (Scott Brown [R-MA]), they could no longer impose their will so they DID NOT want to open up the orignal bill for reconsideration (thus a revote). So they came up with this solution…pass the originally passed Senate version (which they did not like) and then immediately send a separate bill (with a hope and a prayer) to the Senate to amend the things the House did not like about the original Senate bill. Harry Reid (Senate Majority Leader) allegedly produced a letter for the House Democrats prior to the vote showing that 51 Senators had vowed to support the House bill that would be sent back to the Senate in the event that they passed the prior passed Senate Bill. It is expected that the Senate will pick up the second bill this Thursday. From our carriers’ perspectives, it appears that most carriers are immediately taking the “wait and see” approach to see if (or how quickly) the second House bill indeed makes it through the Senate (the one that amends H.R. 3590) before jumping into the original legislation (when, in fact, it could be immediately amended).
My hope at this point is that the Republicans see the situation for what it is. A bill was passed, and it has already been signed into law. I am hopeful that the Senate will pick and choose their battles over the items that are indeed crucially important and NOT take the approach of muddying up the waters out of spite for being railroaded on the prior piece of legislation. Make no mistake about it. I do believe the law will be worse for America and Americans, but I also realize the bulk of the damage has been done and will continue to be done as the states try to pass their laws to amend/contradict the various aspects of the Federal law that they disagree with (for example, Individual Mandate). Unfortuantely, I suspect this law will meet numerous lawsuits about items being constitutionally sound (where some states feel their soveriegn rights have been infringed upon).
Bottom line–I believe America is tired of hearing and dealing with this. They just wanted it done right–the first time. It is unfortunate, but I feel that our legislators failed us on that goal. Now the damage is done. Our politicians (who are supposed to represent us) have cast their votes. Now we want to get on with dealing with it. The fact is that employers and individuals need their brokers now more than ever in order to assist them in navigating this new complex healthcare environment as it unfolds in the days, weeks, months and years to come.
My only intentional political statement in all of this is to ask if you are unhappy with the path this bill took to become a law. If you feel that the ‘checks and balances’ that our forefathers wrote into the Constitution were circumvented or manipulated (if nothing else by sheer congressional composition), cast your vote in November to make sure that the people we put there are held accountable to you as their constituents and perhaps get more of a balance where the two parties will be FORCED to work together to get anything done.