Health Care Reform

[Voronwë the Faithful]

There are a lot of different issues tied up in the whole question of euthanasia/right to die, religious, moral, ethical, practical, financial, political, etc. Those issues are certainly can be related to health care reform, but they may be better discussed in a separate discussion. I don't know.

Meanwhile, as to pure practicalities of where things stand, the House adjourned for its August break this evening, but not before the Energy and Commerce Committee passed its version of the bill, after intense negotiations amoung House Democratic Party moderates, conservative Blue Dogs, and progressives resulted in a deal that satisfied enough of each wing of the party to get it passed. No Republicans voted for the bill in any of the three committees that passed it. Part of the deal that was reached, in addition to waiting until September to have a floor vote on a final version of the bill in the full House, was that Pelosi agreed to also allow a floor vote on the progressive's single payer play. I think there also will be a floor vote on the Republicans rival plan. Needless to say, both of those are just pro forma votes, with neither having any chance of passing. The House leadership will use the break to try to reconcile the three versions of the bill passed by the three different committees so that enough members will support the final version so that it passes (presumably with no Republican votes at all). Meanwhile, all sides will be ramping up the rhetoric during the break. I expect it will get pretty ugly, for all directions.

Meanwhile, even though the Senate still has another week before it goes in break, the latest word is that the Finance Committee will not have a final version of its bill ready before they go on break. That does not bode well.

Key House committee passes health care bill

[Primula Baggins]

They're simply going to be bypassed, I suspect, if that is the case.

My knee-jerk reaction is, and a good thing, too. I do not see why two or three Republican Senators deserve more of a voice in the final bill than the significant majority of Americans who believe reform is needed, or even the many moderate and liberal Democrats who are also in the Senate. I'll bet dollars to doughnuts that not a single Republican will vote for the final bill, no matter how weak it is.

After watching this process closely in recent weeks, I can no longer believe anything but that this is a delaying tactic and an attempt to make sure that what is passed is as weak as possible. I believe that they have no intention of supporting any of the changes they're insisting on. The Democrats might as well pass a bill that might be effective; the final vote will be the same.

I know that I may be wrong about this. But that's what I see, and what I deduce from it.

[Voronwë the Faithful]

I do not see why two or three Republican Senators deserve more of a voice in the final bill than the significant majority of Americans who believe reform is needed, or even the many moderate and liberal Democrats who are also in the Senate. I'll bet dollars to doughnuts that not a single Republican will vote for the final bill, no matter how weak it is.

It won't pass without at least a couple of Republican votes in the Senate. Fortunately, I'm not quite as pessimistic as you are. Though I do think that the (in my opinion) misguided advertising campaigns that certain progressive organizations are launching against moderate Democrats in the Senate are probably the single biggest threat to passing comprehensive health care reform.

[Andreth]

I didn't mean to start a separate discussion on right to die per say. I was just indicating some parts of the bills that are to me, personally troubling.

I'm still not sold on the need for a complete overhaul right this minute especially when the overhaul is badly written and expensive.

[sauronsfinger]

The National Journal magazine has a good article detailing the strategy of Senate Republicans that they hope will help defeat the bill.

www.nationaljournal.com/njmagazine/cs_20090801_9803.php

Several of the more moderate Republican Senators give their comments on the bill and their voting prospects.

And fitting right in with this is an article from the NY Times discussing on how a bill can be passed even with the Republican objections.
http://www.nytimes.com/2009/08/02/us/po ... ml?_r=1&hp

[Voronwë the Faithful]

I didn't mean to start a separate discussion on right to die per say. I was just indicating some parts of the bills that are to me, personally troubling.

I've looked into what the provision says, Andreth. It appears that it simply authorizes paying physicians who counsel elderly or terminally ill patients about what medical interventions they would prefer near the end of life and how to prepare instructions such as living wills. I think that is a badly needed service. End of life care, and clarity as to the desires of an elderly or terminally ill person near death, is too often lacking. I think it is telling the American Medical Association supports this provision.

"These are important discussions everyone should have when they are healthy and not entering a hospital, so they are fully informed and can make their wishes known," said association President J. James Rohack. "That's not controversial; it's plain, old-fashioned patient-centered care."

http://www.msnbc.msn.com/id/32247482/ns/politics//

[axordil]

It won't pass without at least a couple of Republican votes in the Senate.

It's going under reconciliation. That means they don't need 60 votes. They need 51.

[Voronwë the Faithful]

Do you have a source for that, Ax? The last I had heard, Obama had all but ruled out trying to get it passed through reconcilation, which as we have talked about before, really is not designed for this type of thing. If it really were going through reconcilation, what would be the point of all the extended negotiations in the Energy Committee?

[vison]

I guess I'm pretty pessimistic about the whole thing. It's a shame.

[Voronwë the Faithful]

Why, vison? Are you pessimistic about any reform going through, or about reform that you think would be sufficient going through. Or just generally down on the whole process?

[vison]

I'm not "down" on the process, but I guess I think it was easier in Canada. Your system is so different from ours! And, to be fair, our plan was passed during a time when such things were more acceptable - to be honest, I don't know if a government could do it now. Though you may not see it, I see that Canada has moved to the Right. Our current prime minister cannot undo what has been done, but I suspect he would never sponsor or support such a thing.

It seems so obvious! Adopt a Canadian-style system of government provided insurance and let the private insurers waste away - Americans owe those companies nothing. The companies owe Americans, but they are welshing on their debts.

Business is meant to earn profits. After all, I am in business and if our business doesn't make a profit we don't have a place to live or food to eat, theoretically speaking. But we are not in the business of supposedly insuring people.

[axordil]

Do you have a source for that, Ax? The last I had heard, Obama had all but ruled out trying to get it passed through reconcilation, which as we have talked about before, really is not designed for this type of thing. If it really were going through reconcilation, what would be the point of all the extended negotiations in the Energy Committee?

They still need to hammer out the versions the House and Senate will vote on. That means working with what the committees put out. But assuming some version passes in both houses, the whole mess will end up in conference, and a take-it-or-leave-it version will emerge.

I don't believe any option is off the table. Obama will use whatever legislative strategy yields the results he wants. He certainly can't be said to be pushing anything down anyone's throats at this point, after letting the various committees futz around for months.

[Voronwë the Faithful]

Thanks, Ax and vison, for answering my questions!

Ax, I think it is possible that Obama will use the threat of reconcilation to compel a final deal. But I really doubt that it will actually happen.

This fall is going to be interesting!

[Hachimitsu]

Vison, I totally agree with your feelings about the current Prime Minister. Although I still stunned he helped bail out car companies, although thinking it I don't think he rally had a choice just thinking about the GM pensioners alone, is pretty mind boggling. (I am from a town that has a GM plant.)

[axordil]

I thought the participation of the current Canadian government in the car company bailout was telling. Whatever the economics of it, the politics of it was obviously compelling.

[Faramond]

Next time the Republicans are in power ( if it ever happens ) they'll just use "reconciliation" to pass everything they want as well, if the Democrats do it now for health care. Maybe it's not a bad thing. Maybe it should just be majority rules, even in the Senate.

[vison]

What's wrong with "majority rules"? This puzzles me.

That's how we're governed up here. The party with the most seats is the government. Works for us.

[sauronsfinger]

from Faramond

Next time the Republicans are in power ( if it ever happens ) they'll just use "reconciliation" to pass everything they want as well, if the Democrats do it now for health care.

Yes, that could happen. Which is probably why it is a last resort measure. But we do not have to anticipate the future to see how the Republicans might use reconciliation to pass their program. The past provides us with an accurate record.


The Bush tax cuts on upper income groups in 2003 were indeed passed by the Republicans using reconciliation. This article details the process including the party line vote that gave the bill a very narrow passage. Reconciliation was the tool that made it possible.

http://en.wikipedia.org/wiki/Bush_tax_c ... ve_History

[Primula Baggins]

The fact is that both parties will use this tool, or the threat of it, when it's to their advantage. I agree with Voronwë that it is unlikely actually to be used in this case. But I'm hoping that it's not used because they can get 60 votes to cut off the filibuster, even if some of the Blue Dogs then vote against the bill itself (a vote for which they will need only 51 senators, or 50 plus Joe Biden).

I would think a lot better of Harry Reid's "leadership" if he manages that.

[Voronwë the Faithful]

One unanswered question is whether they will be able to get Byrd, and particularly Kennedy, to be available for a vote. Those two votes would make a big difference.

But I'm hoping that it's not used because they can get 60 votes to cut off the filibuster, even if some of the Blue Dogs then vote against the bill itself (a vote for which they will need only 51 senators, or 50 plus Joe Biden).

I would think a lot better of Harry Reid's "leadership" if he manages that.

Prim, this is exactly why I think that the often quite vicious advertising campaign being waged by progressive groups against moderate/conservative Democratic Senators like Bill Nelson is so mis-guided. I think that these attacks will make it much less likely that people like Nelson will be at all cooperative, even in defeating the fillibuster. I think it is very short-sighted.