AFF Sentinel Vol.6#30

The Democratic leadership and the White House are working behind closed doors to figure out what the final bill will look like. Two Senate bills, the Baucus bill and one from the Health committee, will have to be fashioned into one for the Senate to vote on.

There are three bills in the House - including the infamous HR 3200 that so riled much of America this summer - that must be shaped into one. Of course, HR 3400 - an alternative bill with a different approach developed by Republicans - is not likely to contribute anything to the final bill.

The toughest fight will be in the Senate, where getting 60 votes to shut down debate - and probably a filibuster - will be the biggest hurdle. If the Democratic leadership gets that done, they will do the work they couldn't do on the floor in reconciliation. The House bill will certainly include more liberal concepts and higher spending that nearly all Republicans and a number of Blue Dog Democrats and moderates of both parties will find objectionable.

You may wish to encourage House members to consider next year's elections and the country's future before voting on amendments and the final bill. Senators up for reelection provide another opportunity. Key, also, will be the make up of the Conference Committee that decides what stays and what goes in the final version.

Some bullet points to ponder regarding the make up of that final version, as you make up your own list to discuss with your members of Congress:

• Will the bill include a government option or coop or some trigger designed to make a government-run health care program inevitable? Any version or precursor of a government program will mean the type of bureaucracy that makes the Post Office hum, the Internal Revenue Service friendly and efficient and Fannie and Freddie prudent lenders would soon be in charge of your doctors and hospitals and your medical bills.
• Will there be any real tort (lawsuit) reform? While still allowing for reasonable redress of real medical malpractice, will the bill remove the costs associated with huge awards, unreasonable standards, too easy assembly of class actions and other factors that lead both to huge malpractice insurance premiums for doctors and defensive medical tests and practices that add greatly to medical costs?
• Will the bill include allowing insurance companies to operate nationally, instead of having to deal with 50 different sets of state standards?
• Will there be a mandate for employers to provide health care for all employees, with penalties for noncompliance?
• Will there be a mandate for all citizens to purchase health insurance, with penalties for noncompliance?
• Will there will a changing of the tax treatment afforded employer-provided health care insurance vs. individually purchased health care insurance?
• Will there be a requirement that patients provide identification to receive government-provided health care?
• One insurance company was recently reprimanded and others warned against merely informing clientele of possible changes in a government health program. How far would future, more all-encompassing government programs venture into stifling, filtering - or ordering - information to the public regarding health, nutrition or food consumption or lifestyle issues?
• What mechanisms will be included to improve feedback between patient, provider and payer? Often in our present system - private or governmental - the patient does not know the true cost of services or products, someone else pays for the care and price comparison between providers is not encouraged or possible. Cost control with less rationing is only possible when the patient is empowered to make decisions based on cost and quality issues.
• Taxes being considered to fund national health care include taxes on health care plans, taxes on health care like medical devices or drugs, as well as taxes on income. If a program is so large, so expensive and so invasive that a government must consider taxing particular versions or components of health care itself to pay for it, does that say something about how huge the requirements for funding are, how dictatorial and narrow the judgments must be to decide which to tax and which to encourage, how invasive to individual and collective freedom such a program and its funding must be?

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