Thursday, February 4

Health Care Reform Defriibulated

In this interview on the Young Turks, Rep Debbie Wasserman-Schultz lays out the current path forward on Health Care Reform to Cenk.

Definitely worth a listen all the way through. Transcript Here.

Essentially DWS describes the path to passage that I outlined last week with a couple small modifications.

CENK UYGUR: Yeah. Now you have a Senate version which I think is an absolute gift to corporate America. They love every piece of that legislation. You guys say you're not going to pass that in the House, right? Or if you do, you need a second bill that goes through reconciliation.

REP. DEBBIE WASSERMAN SCHULTZ: I think we'll pass this. I think we'll pass the reconciliation bill with a majority of the House and a majority of the Senate before we agree to vote on the Senate bill. So if it goes down like that, what I think will happen is, we will hold the Senate bill at the desk in the House, pass the reconciliation bill with a majority of the House, send it to the Senate, wait for them to pass it, and only then would we pass the Senate bill.

CENK UYGUR: All right, now we're making news.

Acoording to Wasserman-Schulz the House is currently working on a Reconciliation Amendment to the Senate Bill that can pass constitutional muster. My thoughts last week were that the House would need to pass the Senate Bill first, then work on a Reconciliation Amendment to fix it afterward - apparently they're doing exactly that but in the reverse order. Pass a fixing/correcting Amendment - then vote to pass the Senate Bill which will then include those corrections.

The problems are that anything included in the Amendment has to directly relate to funding issues and the House is currently working with the parliamentarians to outline what can and can not be included.

Just as Chris Mattew's told Alan Grayson you can't possibly get everything under the sun through Reconclliation, because it only allows you to fund or defund existing programs, however what you can do is pass an Amendment to an existing bill.

CENK UYGUR: Okay, and of course, the other major question everybody's got on their minds is, will it also have a public option in it?

REP. DEBBIE WASSERMAN SCHULTZ: It's unlikely that we can do in public option in a reconciliation bill because it's not funding related.

CENK UYGUR: Wait, I... Wait, whoa, whoa, whoa. I don't understand that at all. I thought the public option was completely funding related.

REP. DEBBIE WASSERMAN SCHULTZ: No because, it's...I mean, it's not a funding, I mean, mechanically, it's not a funding issue. The public option is the way you would structure, I mean, I'm trying to find the best way to explain it.

CENK UYGUR: No. I understand. It's, you know...

REP. DEBBIE WASSERMAN SCHULTZ: It's not a funding mechanism.

CENK UYGUR: But it certainly affects the deficit. It certainly affects the budget, and I thought that was the necessary requirement for being included in a reconciliation bill.

The Public Option is not a current or active program, therefore it can't either have it's funding increased or decreased through Reconciliation. In the past Reconciliation has been used to fund the Iraq War (which was already ongoing) to implement the Bush Tax Cuts (which are clearly a funding issue) and the expand SCHIP (which was already an active program) - the Public Option is none of the above.

For the same reasons Drug Re-importation probably can't be included, nor can drug renegotiation. But you can do some things to modify or even exclude the excise tax as well as some other spending/funding modifications.

More importantly Cenk is forgetting or ignoring the power of the Insurance Exchange to help maintain cost controls.

As I've said before, the Public Option is pyrate - the Real Gold is the Exchange...

Klein: There's a 80-90% Chance that we'll have Insurance Reform this year, which will ban Pre-existing conditions, and you'll have Health Care Exchanges - which will lower the prices for small business and individuals.

Klein: The Public Option is peripheral to the really important stuff here.

Ed: It's not.

Klein: I've been covering this 20 years, you can have Universal Coverage without a Public Option. What does the Public Option do? It's give bargaining power to the public against the insurance companies - that is precisely what the Health Exchange Does!

The Exchange actually does provided the Interstate Competition that Repbulicans have been clamoring for. It provides for choices and an economy of scale that can drastically lower prices. Further with pre-existing conditions banned (or at least limited), as well as a mandated medical loss ratio of 80-85% which ensures that most of the money provided in premiums actually goes directly into care and not into inflating stock prices - there is quite of bit of cost containment even in the Senate Bill.

CENK UYGUR: How. There's no public option. There's no check. How are you going to bring the cost down?

REP. DEBBIE WASSERMAN SCHULTZ: Because you're broadening the pool. You're prohibiting them from dropping people for preexisting conditions. You're requiring the insurance to be Guaranty Issue, you're setting the premiums... Just look what we're doing for women. Women pay on average a 48% higher premium, Cenk, right now, simply because of our gender. We're going to prohibit that and only allow very basic things for the premiums to be based on. That's gonna bring down costs all by itself.

CENK UYGUR: I don't want the audience to get misled into thinking that I don't think there are good things about this. There are. You do expand coverage.


CENK UYGUR: There's no question about that.


CENK UYGUR: Ok. You expand coverage. What the things that you mentioned are absolutely true. But I'm going to guarantee you right here that our premiums are going to skyrocket.

REP. DEBBIE WASSERMAN SCHULTZ: You are wrong. And I will come, I'm happy...

CENK UYGUR: The things that you mentioned are not cost containment. They expand coverage.

REP. DEBBIE WASSERMAN SCHULTZ: Okay. I will bet you that that's not true and I will come back on your show so that we can have another conversation about that so you can congratulate me that I was right.

CENK UYGUR: Okay. Two years from now, if my premium goes down, I'll pay for your insurance.

REP. DEBBIE WASSERMAN SCHULTZ: That sounds good. Perfect.

CENK UYGUR: If my premium goes up, you pay for my insurance.

REP. DEBBIE WASSERMAN SCHULTZ: It works for me. I gotta run though. I'm sorry.

Cenk expresses more than a bit of skeptiscm that without a Public Option the price gouging that the Insurance Companies have been engaging in will be curbed - this is an issue I've addressed repeatedly - and I still maintain that even without the public option costs are likely to GO DOWN.

The proof of this isn't theory, it's History. During the 90's simply the threat of implementing a Health Care system that included Exchanges (which at the time were called "Associations") under the original Hillary Clinton plan did the following to the cost of private health insurance.

No Public Option was even considered at the time, yet medical inflation costs actually dropped below the Consumer Price Index and Wage inflation. The Public Option is a nice "get", but it's not a Must have.

But there's something even more important that Cenk and Debbie discuss here that goes by without being seriously considered - costs are not and should not be the bottom line issue, it should be about SAVING LIVES!

Even if Cenk is right and Debbie is wrong expanding Health Care coverage to another 35 Million Americans will put a huge dent in the 45,000 Americans who DIE each year from lack of coverage. Over ten years that could potentially save as much as 400,000 Lives.

How much is too much to pay for that?

Democrats have had such a difficult time with this because they've been repeatedly arguing about spare change rather than addressing what the Republicans and Tea-Baggers have been talking about - Life and Death. And the sad part is that we've always been on the winning side of that argument, but have failed to use the fact that expanding healthcare protects and save American Lives as a rallying cry.

It's time we got on the Moral side of this issue, and stopped squabbling over lose sheckles. What isn't perfect in the bill now, can be fixed in the future - meanwhile children who had been blocked from care because they had to temerity to get sick, will be able to get it.

There is no price tag too high for that.


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