Monday, December 21, 2009

It's The People, Not The Process, Fools

Sometime between now and the day next year President Barack Obama signs the historic healthcare bill into law -- based on the path they are now headed -- I want to know how much the private insurance carriers gain in all this.

We know they will gain potentially 31 million new customers. We know some of their practices of arbitrarily denying claims and refusing to insure persons with pre-existing conditions will be curbed. We are led to believe competition from new non-profit insurance markets will increase competition and keep premiums from rising as fast as they have the past six years.

But until more detail comes out, I have a gnawing fear the health care industry that includes Big Pharma will have undisputed control of one-sixth of our national economy. It's not because government should take total control. It's because I don't trust the bastards running the insurance cartels.

Meanwhile, we have to settle for the hanky-panky -- Republican Sen. Tom Coburn rightfully described as corruption -- on how the Senate got to 60 Democratic votes to override a filibuster. It's known as the Cornhusker Windfall. We're talking process here, folks. Not what's best for you and I.

Here's what Sen. Ben Nelson, the last Democratic holdout negotiated to secure his vote, the last needed by  Majority Leader Harry Reid.

Everyone knows he secured wording prohibiting federal funding for abortions and for U.S. taxpayers to pick up Nebraska's Medicaid costs. According to the New York Times, Reid paid tribute to senators from many states.

1) Increased Medicare payments to doctors and hospitals in any state where at least 50% of the counties have population densities less than six people per square mile. Although Nebraska fails that yardstick, Montana, North Dakota, South Dakota, Utah and Wyoming comply, according to the Congressional Budget Office.

2) A grant of $100 million to an unnamed "health care facility" affiliated with an academic health center at a public research university in a state having only one public medical and dental school. Translation: the most likely would be Commonwealth Medical College, a new school in Scranton, Pennsylvania.

3) Amended the original health bill imposing new restrictions on referrals of Medicare patients by doctors to hospitals in which doctors have financial interest. The effective date was delayed from Feb. 1, 2010, to Aug. 1, 2010, allowing time for Bellevue Medical Center, scheduled to open next year in Bellevue, Neb., to escape the tougher controls. Molly Sandvig, executive director of Physician Hospitals of America, which represents doctor-owned hospitals, said Sen. Nelson "has always been a friend to our industry."

4)  Included victims of asbestos exposure from a vermiculite mine in Libby, Mont., 10 years ago to Medicare coverage immediately based on the June 17, 2009, declaration that it was a public health emergency. Montana Sen. Max Baucus has been trying to help those patients for the past decade. He was able to deliver finally as chairman of the Finance Committee and a principal author of the health care bill.


5) Increased Medicare payments to certain "low-volume hospitals" treating limited number of Medicare patients. This amendment would apply to Iowa hospitals in Grinnell, Keokuk and Spirit Lake, courtesy of Iowa Sen. Tom Harkin. Keep in mind all taxpayers will pick up the difference in these costs.

The political column "The Fix" in the Washington Post listed winners and losers in the healthcare debate. One of the winners was Nelson.

The Nebraska senator played the legislative process like a virtuoso, not only getting stricter language about abortion funding included in the final bill but also scoring another huge plum -- the promise of full federal funding for the expansion of Medicaid in the Cornhusker State. Of Nelson's bargaining, one Senate Democratic operative said: "A one-man study on how the Senate works -- they should teach this in civics class."

Among other winners:

The National Republican Senatorial Committee: Strategists at the Senate GOP campaign arm were rejoicing over the weekend with the news that targeted Democrats including Blanche Lincoln (Ark.) and Michael Bennet (Colo.) were going to vote for the measure. Unlike Nelson or even Louisiana Sen. Mary Landrieu (D), who is up for reelection in 2014, neither Lincoln nor Bennet got anything major in exchange for their vote -- meaning they could face the blowback from those unhappy with the legislation in their respective states without an accompanying sweetener to make the bill more palatable. And, will the vote of Sen. Byron Dorgan (D-N.D.) for the package be just the leverage the NRSC needs to get Gov. John Hoeven (R) into the race? Tom Coburn: The Oklahoma Republican's procedural maneuvering -- including demanding the bill be read aloud -- had his Democratic colleagues living in fear of what he might pull out of his bag of tricks next. And, despite his hard work to kill the bill, Coburn's upfront attitude about his opposition kept him from attracting too much ire from his Democratic colleagues.

Of note, the public failed to make the winners or losers list.

Hey, guys. This is supposed to be about us. Not the process.

1 comment:

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