The House has a health care bill

House Democrats have reached an agreement on a health care bill, though it won’t be voted upon until September, violating the President’s deadline. The moderate “blue dog” democrats were thrown some bones, so this version should pass. Here are some elements:

Among other things, the House deal, put together with heavy involvement by White House Chief of Staff Rahm Emanuel, would exempt more small businesses from a requirement to provide insurance to employees or pay a penalty. The deal would require that payments to health-care providers under a new public health plan not be pegged to Medicare, the health plan for the elderly. And it would also pare back the 10-year cost of the bill, estimated at roughly $1 trillion, by $100 billion. The cuts would be achieved in part by asking states to share in a planned expansion of Medicaid, which offers health insurance for the poor, and by requiring low-income people to pay higher premiums to purchase insurance. . . .

On the Senate side, Mr. Baucus is close to securing agreement with three top Finance Committee Republicans. The emerging Senate package would expand coverage by creating a network of nonprofit cooperatives that would compete with private insurers. That contrasts with the House bill, which would create a government-run public health plan. . . .

The deal cut by the Blue Dogs didn’t address rank-and-file Democratic concerns about a proposed surtax on wealthy households. The House legislation has included an extra tax on households making more than $350,000 a year, while Mr. Obama has suggested he would support a tax on those making more than $1 million to fund expanded health coverage.

The deal exempts more small businesses from the mandate to provide insurance to workers. The original House bill exempted businesses with annual payrolls below $250,000; the new deal would raise that threshold to $500,000.

Under the revised bill, companies with payrolls from $500,000 to $750,000 would face a penalty equivalent to 2% of payroll if they fail to offer insurance. Companies with payrolls above $750,000 would pay an 8% penalty.

After the changes, some 5.3 million employers would be exempt from the mandate, about 400,000 more than under the original House proposal, said the National Federation of Independent Business, a trade group representing small businesses.

So, setting aside the question we have been discussing of whether the government should take over health care, let’s just consider this proposal. Is this the health care reform that so many people have dreamed of? What will this one do, and what will it not do?

(Notice, for example, that the lawmakers are patting themselves on the back for cutting the price and thus saving taxpayers $100 billion. And they have done that in part by making the states pay for it. But the states have no money–maybe California can pay its share by issuing IOUs–and so such unfunded mandates still have to come from taxpayers!)

About Gene Veith

Professor of Literature at Patrick Henry College, the Director of the Cranach Institute at Concordia Theological Seminary, a columnist for World Magazine and TableTalk, and the author of 18 books on different facets of Christianity & Culture.

  • Rose

    Know this acronym: QALY. “The quality-adjusted life year (QALY) is a measure of disease burden, including both the quality and the quantity of life lived. It is used in assessing the value for money of a medical intervention. The QALY model requires utility independent, risk neutral, and constant proportional tradeoff behaviour.” (Wikipedia)
    QALY is used in Europe to ration care for the elderly. Along with the proposed mandatory “death counseling”, this bill is another attack on life.

  • Rose

    Know this acronym: QALY. “The quality-adjusted life year (QALY) is a measure of disease burden, including both the quality and the quantity of life lived. It is used in assessing the value for money of a medical intervention. The QALY model requires utility independent, risk neutral, and constant proportional tradeoff behaviour.” (Wikipedia)
    QALY is used in Europe to ration care for the elderly. Along with the proposed mandatory “death counseling”, this bill is another attack on life.

  • Carl Vehse

    Having long supported, legislated and funded the genocide of the young in the womb, the demonrats now turn their efforts toward the genocide of the old in this nation.

    “Treason” can barely describe such evil, including having voted for these monsters.

  • Carl Vehse

    Having long supported, legislated and funded the genocide of the young in the womb, the demonrats now turn their efforts toward the genocide of the old in this nation.

    “Treason” can barely describe such evil, including having voted for these monsters.

  • kerner

    I hope the concept of “a netwok of non-profit” health insurers turns out to e similar to what used to exist.

    Is there anybody out there who works for, or remembers, the predecessors of Thrivent Financial (Lutheran Brotherhood and Aid Association for Lutherans)? My understanding is that these were “fraternal” organizations that provided insurance, including some level of health insurance.

    You know, with “group insurance” there is no logical reason why the employer HAS to be the group. If there were large groups that anybody could join, then the employer could still pay all or part of the premium, or all or part of the deductable through an HRA, of the employee’s now portable health plan as a before tax benefit, and employers and workers would still be happy. And the now uninsured could get basic coverage at a much reduced cost.

    If anyone knows how the old fraternal groups used to work, could you let us know?

  • kerner

    I hope the concept of “a netwok of non-profit” health insurers turns out to e similar to what used to exist.

    Is there anybody out there who works for, or remembers, the predecessors of Thrivent Financial (Lutheran Brotherhood and Aid Association for Lutherans)? My understanding is that these were “fraternal” organizations that provided insurance, including some level of health insurance.

    You know, with “group insurance” there is no logical reason why the employer HAS to be the group. If there were large groups that anybody could join, then the employer could still pay all or part of the premium, or all or part of the deductable through an HRA, of the employee’s now portable health plan as a before tax benefit, and employers and workers would still be happy. And the now uninsured could get basic coverage at a much reduced cost.

    If anyone knows how the old fraternal groups used to work, could you let us know?

  • http://www.oursaviormidland.org/ Larry Wright

    Ultimately this places the control of health-care in the hands of bureaucrats who will be able to decide who is worthy of care and who is not. This has been tried before, in fact the word for it is lebensunwertes leben, meaning “life unworthy of life”

    Quite frankly these kind of decisions are already being made by the government. I am quite surprised that I have not yet heard the media connect the H1N1 flu shots with health care. The government today announced the order in which the American people will be allowed access to the limited supply of the inoculation.

    In words which would parallel Martin Luther with reference to indulgences…Why wouldn’t the government out of love and concern for all Americans, make sure that 600M shots are available, that would be two for every citizen?(as noted as required to receive full protection)

    Why would they not do this as a gesture of how great an example of efficiency of the coming health care plan?

    Why would they not say also how they would then get this vaccine to every American?

    But let us not slip into questions which are steeped in speculation. The reality is that some Americans will receive the vaccine because of a government ordered queue. An American reality also exists. Some who are affluent or can find exceptions and/or doctors who are willing to circumvent the procedure, will also buy access to that for which the government said they should wait.

    Your question, “Is this the health care reform that so many people have dreamed of?”

    I think this is a dream in which the role of the “White Knight in shining armor who comes to save the damsel in distress” is given, by forfeit, to be played by the government. That, to me is not a dream, it is a nightmare…

  • http://www.oursaviormidland.org/ Larry Wright

    Ultimately this places the control of health-care in the hands of bureaucrats who will be able to decide who is worthy of care and who is not. This has been tried before, in fact the word for it is lebensunwertes leben, meaning “life unworthy of life”

    Quite frankly these kind of decisions are already being made by the government. I am quite surprised that I have not yet heard the media connect the H1N1 flu shots with health care. The government today announced the order in which the American people will be allowed access to the limited supply of the inoculation.

    In words which would parallel Martin Luther with reference to indulgences…Why wouldn’t the government out of love and concern for all Americans, make sure that 600M shots are available, that would be two for every citizen?(as noted as required to receive full protection)

    Why would they not do this as a gesture of how great an example of efficiency of the coming health care plan?

    Why would they not say also how they would then get this vaccine to every American?

    But let us not slip into questions which are steeped in speculation. The reality is that some Americans will receive the vaccine because of a government ordered queue. An American reality also exists. Some who are affluent or can find exceptions and/or doctors who are willing to circumvent the procedure, will also buy access to that for which the government said they should wait.

    Your question, “Is this the health care reform that so many people have dreamed of?”

    I think this is a dream in which the role of the “White Knight in shining armor who comes to save the damsel in distress” is given, by forfeit, to be played by the government. That, to me is not a dream, it is a nightmare…

  • http://www.bikebubba.blogspot.com Bike Bubba

    Apparently it still bans people from getting their own insurance (at least without going to government), still has end of life counseling (“Logan’s Run”) mandates, and still has a massive payoff to trial lawyers with permission for them to sue on behalf of others without consent.

    If this is the best the blue dogs can do, it’s time for their district to elect some Republicans who actually know what the phrase “free markets” means.

  • http://www.bikebubba.blogspot.com Bike Bubba

    Apparently it still bans people from getting their own insurance (at least without going to government), still has end of life counseling (“Logan’s Run”) mandates, and still has a massive payoff to trial lawyers with permission for them to sue on behalf of others without consent.

    If this is the best the blue dogs can do, it’s time for their district to elect some Republicans who actually know what the phrase “free markets” means.

  • richard

    Rep. Paul Ryan of Wisconsin is VERY impressive in his remarks on the subject: http://www.weeklystandard.com/weblogs/TWSFP/2009/07/if_every_health_care_debate_we.asp

    Wisconsin is fortunate to have him as a Member of Congress.

  • richard

    Rep. Paul Ryan of Wisconsin is VERY impressive in his remarks on the subject: http://www.weeklystandard.com/weblogs/TWSFP/2009/07/if_every_health_care_debate_we.asp

    Wisconsin is fortunate to have him as a Member of Congress.

  • NQB

    I was extremely impressed by the Paul Ryan video.
    Perhaps my favorite part of it, however, was the very end. I couldn’t help but notice that the two headlines being advertised for after the break were “Katie Holmes Car Explosion Story Goes Up in Flames” and “Jennifer Lopez Birthday Phone Ban Doesn’t Ring True.” We wouldn’t want a health care discussion to dominate the tv screen while such pressing matters are still hanging around.

  • NQB

    I was extremely impressed by the Paul Ryan video.
    Perhaps my favorite part of it, however, was the very end. I couldn’t help but notice that the two headlines being advertised for after the break were “Katie Holmes Car Explosion Story Goes Up in Flames” and “Jennifer Lopez Birthday Phone Ban Doesn’t Ring True.” We wouldn’t want a health care discussion to dominate the tv screen while such pressing matters are still hanging around.

  • http://katiesbeer.piperblogs.org/ Theresa K.

    If offer a story from my dad’s Canadian upbringing…

    At lunch yesterday, my 71 year young father was telling me a medical miracle story from his childhood which I had forgotten. The doctor in town treated everyone and he lived well. I asked my dad, “And this is the same Canadian healthcare system which killed your mother years later?” (QALY indeed!) He replied, No! Back then it was just doctors and people. The people paid the doctors.” His statement really got me wondering if we could ever return to that model of people paying doctors and cutting out the healthcare companies which exorbitant manager salaries. Would doctors today even vote for such a model? Just curious…

  • http://katiesbeer.piperblogs.org/ Theresa K.

    If offer a story from my dad’s Canadian upbringing…

    At lunch yesterday, my 71 year young father was telling me a medical miracle story from his childhood which I had forgotten. The doctor in town treated everyone and he lived well. I asked my dad, “And this is the same Canadian healthcare system which killed your mother years later?” (QALY indeed!) He replied, No! Back then it was just doctors and people. The people paid the doctors.” His statement really got me wondering if we could ever return to that model of people paying doctors and cutting out the healthcare companies which exorbitant manager salaries. Would doctors today even vote for such a model? Just curious…

  • DonS

    “The moderate “blue dog” democrats were thrown some bones, so this version should pass” — I don’t think so. That is the intention of House leadership, but I think they have made a huge tactical error. The membership now goes home to their districts for a month, with a specific detailed bill in process that will be reviewed and vetted and fisked over and over again. Have you seen the town meetings that have been held on this issue? Constituents are overwhelmingly against government health care, especially in the “blue dog” districts and these members are going to get pummelled for even thinking about voting for something so stupid.

    This is the reason Democrats typically like to rush legislation through without giving folks the chance to read it, on the pretense that they are dealing with an “emergency”.

  • DonS

    “The moderate “blue dog” democrats were thrown some bones, so this version should pass” — I don’t think so. That is the intention of House leadership, but I think they have made a huge tactical error. The membership now goes home to their districts for a month, with a specific detailed bill in process that will be reviewed and vetted and fisked over and over again. Have you seen the town meetings that have been held on this issue? Constituents are overwhelmingly against government health care, especially in the “blue dog” districts and these members are going to get pummelled for even thinking about voting for something so stupid.

    This is the reason Democrats typically like to rush legislation through without giving folks the chance to read it, on the pretense that they are dealing with an “emergency”.

  • http://www.bikebubba.blogspot.com Bike Bubba

    Theresa, I know I would go for some version of what you describe. For my family, a heavy duty “full service” plan is over $1200/month, but major medical that takes my status as a nonsmoker who gets exercise…$500/month, and a huge benefit of major medical plans is that they don’t nitpick everything that comes through, because (of course) you’re paying for it.

  • http://www.bikebubba.blogspot.com Bike Bubba

    Theresa, I know I would go for some version of what you describe. For my family, a heavy duty “full service” plan is over $1200/month, but major medical that takes my status as a nonsmoker who gets exercise…$500/month, and a huge benefit of major medical plans is that they don’t nitpick everything that comes through, because (of course) you’re paying for it.

  • DonS

    Bike @ 10: Check into an HSA-eligible high deductible plan. It’ll be about the same money ($500 or so a month for a family) with a $3,000 deductible, and you can have a health spending account with it. For a family, you can put up to $5950 into the HSA this year, tax-free, use that money for any medical expenses not covered by your insurance or below your deductible, and roll it over year to year. You never lose it, like the old FSA’s some big companies offer, you can build up as much as you want, and there are no income limits. Once you hit the deductible for the year, the plans are very comprehensive.

  • DonS

    Bike @ 10: Check into an HSA-eligible high deductible plan. It’ll be about the same money ($500 or so a month for a family) with a $3,000 deductible, and you can have a health spending account with it. For a family, you can put up to $5950 into the HSA this year, tax-free, use that money for any medical expenses not covered by your insurance or below your deductible, and roll it over year to year. You never lose it, like the old FSA’s some big companies offer, you can build up as much as you want, and there are no income limits. Once you hit the deductible for the year, the plans are very comprehensive.

  • http://www.bikebubba.blogspot.com Bike Bubba

    I would if I had the choice. Thankfully, I am no longer “participating in the Pelosi/Reid/Obama economy” (unemployed), and my employer has one choice.

    Which is pretty close to what you’re talking about, thankfully.

  • http://www.bikebubba.blogspot.com Bike Bubba

    I would if I had the choice. Thankfully, I am no longer “participating in the Pelosi/Reid/Obama economy” (unemployed), and my employer has one choice.

    Which is pretty close to what you’re talking about, thankfully.

  • http://operationcounterstrike.blogspot.com OperationCounterstrike

    Will there be PAYBACK for the murder of Dr. Tiller?

    Will there be COUNTERTERROR against right-to-lifers?

    If a right-to-lifer gets counterterrorized TO DEATH, will that be murder, or JUSTIFIABLE HOMICIDE?

    WHO would be the most effective TARGETS for counterterror?

    WHERE do they live?

    AICH TEE TEE PEA:operationcounterstrike.blogspot.com

  • http://operationcounterstrike.blogspot.com OperationCounterstrike

    Will there be PAYBACK for the murder of Dr. Tiller?

    Will there be COUNTERTERROR against right-to-lifers?

    If a right-to-lifer gets counterterrorized TO DEATH, will that be murder, or JUSTIFIABLE HOMICIDE?

    WHO would be the most effective TARGETS for counterterror?

    WHERE do they live?

    AICH TEE TEE PEA:operationcounterstrike.blogspot.com

  • DonS

    Bike @ 12: Aw, I am sorry to hear that. Best to you in your job hunt.

  • DonS

    Bike @ 12: Aw, I am sorry to hear that. Best to you in your job hunt.

  • http://theoldadam.wordpress.com/ Steve Martin

    More expensive, less available, less comprehensive healthcare for all!

    That is “change” alright.

  • http://theoldadam.wordpress.com/ Steve Martin

    More expensive, less available, less comprehensive healthcare for all!

    That is “change” alright.

  • Rose

    The ‘Cash for Clunkers’ program that began Monday was suspended Thursday night because the government didn’t anticipate the great demand. They said the program would last until November. How can a government that fumbles a simple rebate program be trusted with our health care?

  • Rose

    The ‘Cash for Clunkers’ program that began Monday was suspended Thursday night because the government didn’t anticipate the great demand. They said the program would last until November. How can a government that fumbles a simple rebate program be trusted with our health care?

  • http://theoldadam.wordpress.com/ Steve Martin

    “How can a government that fumbles a simple rebate program be trusted with our health care?”

    It can’t.

    Great point, Rose.

  • http://theoldadam.wordpress.com/ Steve Martin

    “How can a government that fumbles a simple rebate program be trusted with our health care?”

    It can’t.

    Great point, Rose.

  • Peter Leavitt

    Any government administered program is eventually doomed by inevitable political pressures from both the executive and political branches.

    GM recently compromised its business decisions by keeping open a parts distribution center in Massachusetts scheduled to be closed due to pressure from Barney Frank. Also, GM located a new plant in Orion Michigan due to pressure from both the obama administration and Michigan Congressman. A less expensive plant was proposed in Tenneseee.

    The other major factor is that government employees simply lack the incentive to ex cel and be efficient, as they lack the discipline of the bottom line.

  • Peter Leavitt

    Any government administered program is eventually doomed by inevitable political pressures from both the executive and political branches.

    GM recently compromised its business decisions by keeping open a parts distribution center in Massachusetts scheduled to be closed due to pressure from Barney Frank. Also, GM located a new plant in Orion Michigan due to pressure from both the obama administration and Michigan Congressman. A less expensive plant was proposed in Tenneseee.

    The other major factor is that government employees simply lack the incentive to ex cel and be efficient, as they lack the discipline of the bottom line.

  • Carl Vehse

    As the saying goes, “A picture is worth a thousand words.”

    And, surprisingly, even though this picture comes from the PR-managed, TOTUS-operating, TV-saturating White House, it ends up revealing a lot about who is concerned about helping the senior citizens and the handicapped and who is concerned about getting back to hyping a abominable health care package with its required euthanisia-advocacy program for the elderly and infirmed.

  • Carl Vehse

    As the saying goes, “A picture is worth a thousand words.”

    And, surprisingly, even though this picture comes from the PR-managed, TOTUS-operating, TV-saturating White House, it ends up revealing a lot about who is concerned about helping the senior citizens and the handicapped and who is concerned about getting back to hyping a abominable health care package with its required euthanisia-advocacy program for the elderly and infirmed.


CLOSE | X

HIDE | X