scholars and rogues

The considerate deliberation of health care reform

by Djerrid

The end result will probably not be what I would have crafted, but the careful and deliberate formation of health care reform is admirable. For two-and-a -half hours last night, 180 House Democrats went line-by-line through the entire 1000+ page bill that is still being hammered together. During this time they were told to sit down and shut up until their aids got through the whole thing. After that they went another two hours through all of the questions they had. As one Representative put it, “No one’s going to say we haven’t read the bill.”

Those with the hammers are moderate Democrats and Republicans who are working through the big issues and all the nitty-gritty details. These big players who hold the center have been going at it in twice a day in multi-hour sessions for weeks now, and are not letting up until they create something they all can be satisfied with.

I remember back in 2003 when the prescription bill was railroaded through Congress in the dead of night. Knowing how substantial that bill was, I hoped that when the Democrats came back to power they would be more mindful and considerate when crafting an “overhaul”.  So far, so good.

Categories: scholars and rogues

20 replies »

  1. With all due respect to the meticulosity of Congress, I’ve reached a point where I care less about the process than I do the results. At this stage of the game, it looks like we’re about to get a well deliberated pile of diddley.

  2. For something this complex, I don’t think you’ll get anything good without due diligence. So this is a least a start.

    • Not sure I agree. What this IS is proof that Obama can’t get REAL health care reform done. If I’m a Republican/insurance exec, I’m dancing naked in the streets about this particular process.

  3. So you’d rather have him run roughshod over the whole process? That’s what Clinton did. Didn’t work out too well for him. I’d rather have this approach than going all benevolent dictator on us.

    • Djerrid, you’re presenting a terribly false dichotomy here. “Dictatorship” and “deliberative process” not only aren’t the only choices, they don’t even describe the REAL dynamics taking place. What we have here is precisely what we’ve had for some time now – a sham process in DC that serves a particular set of corporate interests and nothing else. It’s spurred along by a media noise machine that provides cover for the fact that polls show consistent and substantial public support for major government intervention in our alleged health care system.

      You’ll know we’re making real progress toward this goal – or any progressive goal, for that matter – when you hear me say “hey, I’m really surprised that they pulled that off.” Same old same old isn’t necessarily guaranteed, but that’s how the smart money is betting.

      Call me cynical if you like, but if you’re going to, then prove me wrong.

  4. I had a Cuban doctor stay at my house a couple weeks ago. He told me in Cuba he is responsible for 150 families- for their healthcare. He tours these houses and checks on his people and treats most things right there. Prevention and maintaining health are a big part of his job. I thought it sounded lovely. Ever think America can get there?

  5. 2.5 hours, 1000 pages….that works out to 9 seconds a page. Even with simple speed reading, skimming just the bullet points would tax Evelyn Woods. Perhaps they hired an auctioneer to read it.

    Jeff

  6. True, Jeff, true. That body is extraordinarily adept at putting on shows of all types. This is a complex issue, but i’m not sure that it is 1000 pages complex (even considering the legalese writing).

    I’m glad that they’re actually reading it…and what does it say that we’re glad for our representatives fulfilling a portion of their job description? On the other hand, i can’t help but feel that anything coming out of Congress will be shite until i see something that proves me wrong.

    I’d also like to see them all lose their gold-plated coverage and have to get their health insurance on the open market…then they can debate the issue and make some decisions. As it stands, they’re making huge decisions that do not concern them in the least.

    • Important point to note: Congress has the exact same coverage as the other 9 million or so federal workers, who all get to choose one of 16 privately administered health plans. Most federal employees choose a Blue Cross/Blue Shield plan (don’t recall which, though).

      Gold plated it may be, but it’s not any more gold plated than any employer with 9 million employees could wrangle out health insurers. Magnitudes of scale apply here just as they do in the “free” market.

      Which is one of the reasons that insurers are terrified about a “public option” – if 9 million insured gives the government dirt cheap health insurance because the bargaining power is so great, imagine the bargaining power that 50 or 60 or 80 million insured gives the government? And that’s even without the government being able to control costs by legal fiat should the choose to do so.

      I don’t begrudge the feds their awesome insurance because it’s fundamentally no different than my insurance plan. My employer pays my insurance directly – an insurance company is contracted to administer the plan, but the costs of treatment, drugs, etc. are actually borne by my employer directly. If I need an MRI, my employer is stuck with 80% of the bill (or 100%, if I’ve hit my out-of-pocket maximum for the year) while I pay 20%.

      The difference is that my insurance costs me a lot per paycheck because my employer is only 30,000 employees or so in the U.S., while the feds are 9 million.

  7. Lex,
    You’re so right, it’s just a show, a symbol. Still does not mean anything except as a PR stunt. You’re also right in that congress should ditch their gold plated coverage and rely on the open market just like we do. But, they’re congress and take care of themselves first. I was reading a book covering the 1976 election and it was said that healthcare was a big issue back then, with the same exact arguments of today. If the government couldn’t do anything in 33 years, why expect anything they will make a health care reform work now. This government wrangling, stalling, and obfuscation is the reason I expect very little from the government, except roadblocks in front of productive people. The government in it’s present form is the reason why people need to rely on themselves. They do a great job in creating victims and exploiting them to increase their own power over our daily lives. Our elected officials, on both sides, only care about one thing….getting re-elected.

    Nock does a great job in illustrating the fact that the government is not our friend.

    Jeff

  8. So, just to make sure I’m on the same page as everyone else:
    All acts of public or private deliberation are just a ruse to con the public into thinking that our elected officials are actually working to improve the state of health care in America and care about the well-being of their fellow man. Then, depending on which side of the aisle you sit, they are either ideologically bent on reshaping the country’s political system into a Socialist State, or they are subservient to monied interests and will do all within their power to keep the corporation’s coffers full by rearranging the furniture but not really changing anything. Amirite?

    I wrote this article up to see if I could garner any appreciation whatsoever for the amount and quality of the work that was put into the overhaul by all those involved. Well, it looks like I got my answer.

    • I don’t think I suggested that a lot of work hadn’t been put into it. Everything I have accused them off requires a lot of work. All I’m saying is that I don’t give a damn how hard you work if what you’re working toward is useless or worse.

      In addition, I never argued that there are two simplistic extremes here. I told you what I see happening (not what I imagine happening, but what IS happening) and explained what I felt was going on. So let’s not go lumping everybody together for purposes of constructing a single, highly conflicted straw man.

      I don’t have to argue the end result with you right now. We’ll all know the truth of health care “reform” soon enough, and at that point I know I’ll be happy to apologize if it turns out I was wrong. I’ll be ecstatic to be wrong, in fact. But I’ll bet that I’m not. And if you feel as confident about your position, then let’s see can we agree on the terms of a wager the next time I see you….

  9. Doc, that comment wasn’t directed solely at you, just the comments in general (here and elsewhere) that dismiss the reform as entirely under the purview of self-interested parties that have no intention of serving the common good. I’m not insisting they are saints; I just don’t see the value of knee-jerk cynicism.

    My point was that if the pols were (for the most part) trying to do what’s right, then carefully studying the problem and bringing all of the experts in so that they can be as informed as possible before working through a joint compromise to improve the cost and quality of health care would be my preferred approach. So far, that is what I am seeing.

    That said, I can’t predict the end result, except to say again that it wouldn’t be what I would put together (I would have gone Single Payer to reduce cost and complexity). So,all bets are off. But even though we may still get a crappy bill at the end, this approach would be the only feasible course to getting something good.

  10. I’m not upset that federal employees have good health insurance. Many of them actually work 40+ hours/week and deserve a quality health insurance program. But a Congressional rep makes close to $175,000/year. They actually work (in Congress) 3-4 days/week. And they spend an inordinate amount of time raising money and working to get reelected to their $175,000/year jobs.

    And if you ask me – with my admitted knee jerk cynicism – they do precious little to actually earn their salaries. My feeling is that they are paid to carefully deliberate issues and craft quality legislation (that doesn’t mean i need to agree with it).

    I have a hard time being congratulatory about someone doing the job that they are paid to do. They aren’t going above and beyond the job description by actually reading the bill (and certainly not by having their aides read the bill).

    I’ll admit to knee-jerk cynicism. And i’ll stop reacting that way just as soon as it’s generally unwarranted. But as it stands, this body rarely gets things done/right…and when it does it’s generally in spite of itself. I wouldn’t bet against Sam on this.

    And i don’t think that Congress is exactly controlled by monied interests. I think that they’re controlled by their own drive for wealth, power and reelection; the monied interests are simply an easier, more efficient route to that than doing a difficult job well.

    • And i don’t think that Congress is exactly controlled by monied interests. I think that they’re controlled by their own drive for wealth, power and reelection; the monied interests are simply an easier, more efficient route to that than doing a difficult job well.

      You say potato, I say potahto.

  11. I just had an interesting phone call. Jarid Polis, who represents both Sam and I, was on the line with dozens of his other constituents. He pretty much called out of the blue and said to stay on the line for a virtual town hall. So, for the next hour, I did. He took questions, one by one and you could punch in at any time to be put in the queue. The questions were all over the map and Polis seemed a bit over-eager to try to answer everything completely and cram in as much as he could. Still, he was very well-informed and earnest. I had the impression that he has a pretty good handle on what is going into the reform bill and why. And he went into detail about the various previsions and amendments that he supported and co-sponsored that directly addressed the questions.

    I’m just having a much harder time than many of you at dismissing this as merely performance art. I see the danger in being so jaded that when something authentic and worthwhile shows up, you’ll not recognize it as such.

    • Jarid Polis, who represents both Sam and I…

      It remains to be seen how much Polis represents me. I voted against him with gusto in the primary and am appalled at how low the bar has sunk for “boulder libruls.”

      Maybe I’ll feel better once he’s able to get a charter school up on every corner….