The Senate HCR Bill is Out-How Does It Stack Up?

Crossposted at BlogHer.com

Upon hearing the news Senate Majority leader Harry Reid released the Senate version of a health care reform bill last night, I quickly brewed some tea, snuggled into bed, and settled myself in for a long read.

I’ve made it about 400 pages in and I can tell you already, there are some notable differences between the Patient Protection and Affordable Care Act and the House bill.

The New York Times reports,

Though broadly similar to the House bill, Mr. Reid’s proposal differs in important ways. It would, for example, increase the Medicare payroll tax on high-income people and impose a new excise tax on high-cost “Cadillac health plans” offered by employers to their employees.

Mr. Reid’s bill would not go as far as the House bill in limiting access to abortion. And while he would require most Americans to obtain health insurance, he would impose less stringent penalties on people who did not comply.

Many provisions of Mr. Reid’s bill, including the creation of insurance markets, or exchanges, would take effect in 2014, a year later than similar provisions of the House bill.

Of course, despite the bill’s many nuances…it all comes down to money.

Think Progress has wiped up a handy-dandy chart to show the budget differences between the House and Senate bills.

The bottom line? The Congressional Budget Office report says the Senate bill would extend coverage to 31 million uninsured people while reducing the federal deficit by nearly $130 billion over 10 years.

The Washington Post’s Ezra Klein says there’s more to it than that though,

If this piece of the bill was passed on its own, it would be the most important cost control bill ever considered by the United States Congress. But you could never have passed it on its own. You needed the coverage to make the grand bargain work. Republicans like to call this bill a trillion-dollar experiment to expand the health-care system, and in some ways, it is. But it’s also a multitrillion-dollar experiment to cut costs in the health-care system, and it deserves credit for that, and support from fiscal conservatives. It’s easy to talk about cutting costs, but this is the chance for people to actually do it.

But it’s not only about money. Carrie Budoff Brown at Politico reports one of the significant differences in this bill is the delay of reform until 2014.

This is bad news for lawmakers who will need to explain to constituents why the elements that have attracted the most attention — the public plan, the Medicaid expansion and the insurance exchanges — won’t be available for four years.

Some reforms would kick in earlier, Senate aides explained, but the big pieces would still be a ways off.

And then there is, of course, the abortion question. With both sides still debating the ramifications of the Stupak amendment, the Senate bill seems to incorporate a variety of ideas.

While TalkingPointsMemo reports key Democrats are onboard with the abortion language in the Senate bill, others aren’t so happy.

Shakesville writes,

Of course, Azzy’s earlier post outlines why “allowing a woman to use her own private funds” for an abortion is a pretty pathetic solution in a healthcare bill ostensibly designed to serve people who don’t have the funds to pay for their healthcare out of pocket. Again I will note that this fuckery only flies in a culture that treats women’s healthcare and abortion as mutually exclusive concepts.

So now the real work begins. Debate over the bill is expected to last through December with every nook and cranny of these over 2-thousand pages discussed.

OpenCongress has the bill for your tea-drinking, snuggle in bed, reading needs. Join me, won’t you?

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain Blog.

The (White) House Call

crossposted at BlogHer.com

I heard it from my doctor a few weeks ago. Now we’re hearing it from doctors across the nation- health care reform must happen, and happen soon.

Dozens of doctors stood on the White House lawn to hear President Obama urge them to “fan out across the country” and work for health care reform.

“Nobody has more credibility with the American people on this issue than you do,” Obama said. “And so if you’re willing to speak out strongly on behalf of the things you care about and what you see each and every day as you’re serving your patients all across the country, I’m confident we are going to get health reform passed this year.”

150 doctors from all 50 states were invited to the White House event. Prompting some Republican leaders to cry foul.

Rep. Tom Price, a physician, and Dr. Donald Palmisano, former American Medical Association president, said in a conference call that physician support for the Democrats’ proposals wasn’t as widespread as Monday’s event implied.

“We’re very concerned that a handpicked group of physicians were applauding a government takeover of health care,” Price said. “A random sampling (of doctors) wouldn’t show quite so many people applauding.”

However, according to the New England Journal of Medicine, 62-percent of physicians support a reform plan that incorporates both public and private funding.

To further the president’s point, Senate Democrats released a series of videos today with a few of the country’s pro-health care reform doctors:

The American Medical Association has also come out in favor of health care reform.

So why are we all still fighting about it? Don’t you usually listen to your doctor?

No, instead of honest debate about the issues we heard about how some doctors in the White House news conference forgot their white lab coats. Instead of talking about the AMA’s stance or the stats from the New England Journal of Medicine, we heard that the White House was insulting our intelligence with the big “Halloween” on the lawn.

All because the ones who forgot their lab coats were given some. It’s not like they gave them firefighter coats and asked them to fake like they were something they weren’t. I mean, this may be shocking…but it turns out a doctor in a suit is still a doctor.

47 million people uninsured in this country and it’s come down to who remembered to bring their lab coat instead of debate about policy.

As it turns out, not all Republicans are concerned with lab coats. Today California Governor Arnold Schwarzenegger announced he is backing the President’s plan.

“Our principal goals — slowing the growth in costs, enhancing the quality of care delivered, improving the lives of individuals, and helping to ensure a strong economic recovery — are the same goals that the president is trying to achieve,” Schwarzenegger said in a statement.
“I appreciate his partnership with the states and encourage our colleagues on both sides of the political aisle at the national level to move forward and accomplish these vital goals for the American people.”

According to Reuters, no Republicans in Congress currently back the Finance Committee proposal to overhaul the $2.5 trillion U.S. healthcare system, or any other put forward by Democrats.

At least my doctor supports it, telling me “It’s inevitable.

We’ll see just how inevitable it is as the Senate Finance Committee is expected to vote within days and a final bill is put before lawmakers.

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain Blog, where she does not have a white lab coat.

Is the Public Option Dead?

Crossposted at BlogHer.com

I was sitting in my doctor’s office at UCLA when I got news the Senate Finance Committee shot down two public health insurance options.

Five Democrats joined with all the Republicans on the committee to reject an amendment by Sen. Jay Rockefeller (D-W.Va.) in a 15-8 vote.
Three Democrats then joined the Republicans to defeat a second public-option proposal. By a vote of 13-10, the committee rejected an amendment by Sen. Charles Schumer (D-N.Y.).
Schumer, however, said the debate is far from over. He acknowledged during the debate that the public option doesn’t yet have the 60 votes on the Senate floor it needs to overcome a filibuster, but he emphasized to Huffington Post outside the hearing room: “Yet. I said ‘yet.'”

So if the public option doesn’t have the 60 votes why not 51? Jane Hamsher at Firedoglake explores the idea-

Chuck Schumer and Max Baucus just said that there were not 60 votes for the public option in the Senate.

The Public Option doesn’t need 60 votes. It needs 51. That is, unless the GOP filibusters it. What Baucus and Schumer are saying — explicitly — is that there are Democrats who would support a GOP filibuster to keep the public option from having an up-or-down vote on the floor of the Senate. They are saying that there are Democrats who would vote with the GOP to block a vote on something that the President says he supports — a public option.

My physician, Dr. Daniel Cole of UCLA Medical Center, wasn’t happy with the news of the amendments failing. “They are just postponing the inevitable” he told me, shaking his head. He then explained to me how he voted for Obama but really wants him to be stronger on the public option.

My own doctor, MY OWN DOCTOR then sat there telling me how patients he sees can’t take these insurance hikes any longer. How people can’t pay their bills. How a public option NEEDS TO HAPPEN and WILL HAPPEN EVENTUALLY because there is just no other way.

As it turns out, public support for health care reform is up to 57%, and support for a public option at 65%.

So where does that leave us?

CNN reports:

In efforts to bridge differences, the Finance Committee proposal dropped the public insurance option and a mandate for all employers to provide health coverage. It would require individuals to have coverage or face a fine of up to $1,900 for a family of four but includes subsidies to help low- and middle-income Americans obtain health care plans.

The committee began debating the compromise measure last week, with arguments erupting over Democratic proposals to reduce subsidies for some Medicare coverage while eliminating fraud and waste in the government health care plan for senior citizens.

Republicans argued that the changes would reduce benefits for senior citizens, but Democrats say the overall effect would be minor. Some advocacy groups cite reports that the amount of money involved is no more than 5 percent of overall Medicare spending and therefore won’t adversely affect benefits for the elderly.

Another compromise being discussed? One by Republican Sen. Olympia Snowe. Snowe has brought up a “trigger” mechanism that would create a public option in the future if specific thresholds and costs are not me. But the “trigger” has yet to be included in any proposal.

However the last, best gasp for any public option seems to be that magic 51 number. Will it or won’t it ever get to that? Who knows. Wonkette takes a stab

Well, it can: if the Dems can come together as 60 in a cloture vote, then the final floor vote on a public option would only need 50. Would you like to be one of the few Democrats standing on the floor, with the entire Republican caucus, to filibuster a health care bill from reaching an up-or-down vote on the Senate?

But of course the Democratic majority would never actually make the opposition go through with a real-life filibuster. Tacky!

Tacky, maybe. But my doctor and I will take tacky over NOTHING any day.

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain blog, where she’s really tired of sitting in doctor’s offices.

BlogHer is non-partisan, but our bloggers (like me!) aren’t! Read more of our coverage at News & Politics.

Hey Sen. Kyl: Maternity Care MATTERS

crossposted at BlogHer.com

I curse and yell “PATRIARCHY!” a whole lot, but today I went through the roof and my screams got a bit louder.

Why?

Senator Jon Kyl of Arizona.

Senator Jon Kyl of Arizona and how he is seemingly no friend to mothers across this country.

From Talking Points Memo:

Just before the Senate Finance Committee wrapped up for the long weekend, members debated one of Sen. Jon Kyl’s (R-AZ) amendments, which would strike language defining which benefits employers are required to cover.

Sen. Debbie Stabenow (D-MI) argued that insurers must be required to cover basic maternity care. (In several states there are no such requirements.)

“I don’t need maternity care,” Kyl said. “So requiring that on my insurance policy is something that I don’t need and will make the policy more expensive.”

Stabenow interrupted: “I think your mom probably did.”

Here’s the video of the exchange:

Senator Kyl’s amendment, which was defeated, comes on the heels of learning most health insurance plans do not cover maternity care and consider c-sections a pre-existing condition. We also learned this week that seven states consider domestic violence a pre-existing condition.

In other words, insurance companies and, it appears, certain Senators from Arizona, don’t really care too much for women.

Think Progress drills down on the Kyl amendment:

As Igor Volsky notes at the Wonk Room, Kyl’s amendment “would prohibit the government from defining which benefits should be included in a standard benefit package and would permit health insurance companies to design policies that exclude higher-cost beneficiaries.”

Maternity care, in fact, is a perfect example of why Kyl’s amendment is so bad. Most individual health insurance markets don’t cover maternity care. In fact, according to the Kaiser Family Foundation, only 14 states have a requirement for such coverage, and the number of plans without maternity coverage continues to rise dramatically. Anthem Blue Cross — which has been actively fighting health care reform — considers pregnancy optional and therefore not necessary to insure:

“The point of insurance is to insure against catastrophic care costs. That’s what you’re trying to aggregate and pool for such things as heart attacks and cancer,” said an Anthem Blue Cross spokesman. “Having a child is a matter of choice. Dealing with an adult onset illness, such as diabetes, heart disease breast or prostate cancer, is not a matter of choice.”

“A well defined minimum benefits package would compel health insurers to provide basic services to all Americans,” adds Volsky. “The Kyl amendment, which ultimately failed, would have allowed the industry to continue profiting from discriminatory practices.”

Women already get the short end of the stick when it comes to health care.

From the New York Times:

Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers.

Some insurance executives expressed surprise at the size and prevalence of the disparities, which can make a woman’s insurance cost hundreds of dollars a year more than a man’s.

So on top of having to pay more, Senators like Kyl don’t find things like maternity care ‘necessary.’

Imagine, if you will, all things ‘maternity’ related being ‘unnecessary.’ Prenatal care. Ultrasounds. Labor. Delivery. Birth. Postpartum care. ‘Unnecessary.’

How many of you could afford to have a child if these were all considered ‘unnecessary’ by your insurance company? What if you found yourself pregnant and realized you could not afford all the costs associated with having this baby?

Is this really a way for Republicans to discourage the termination of pregnancy? Or could we see those numbers rise if Senators like Kyl got their way?

Yes, Senator Kyl, I echo Senator Stabenow. Your mother needed maternity care. All mothers need maternity care. And you’d be wise to yield the floor to the women who know better.

Erin Kotecki Vest also blogs at Queen of Spain blog, where she talks about her two children born via that pre-existing condition known as a c-section.

BlogHer is non-partisan but our bloggers (like me!) aren’t! Read more of our coverage at News & Politics.

Starting My New Life As Someone With A “Chronic Illness”

crossposted at BlogHer.com

I bought one of these 7-day pill boxes today…and felt like the oldest 34-year old in history.

Then I came home and proceeded to fill it up, and felt 50 times older.

My life right now

This is my life right now. 12 pills a day, not including those I only take ‘when symptoms’ arise or vitamins.

12 pills every. single. day.

Am I feeling better? Yes. Am I feeling like myself? No.

I’m feeling medicated and a ghost of me. A foggy ghost. After 5 days in the hospital and what felt like 300 tests, the doctors are finally in some agreement as to what’s wrong with my body.

Gastroparesis.
Diverticulosis.
Gall stones.
Severe reflux.

Those are the big ones. There some other little minor things but those are the answers to the million dollar, tubes up both ends of me, nuclear sandwich eating, xray’d until I glowed, questions.

Not cool

So what are we doing for my broken belly? Medication. Tons and tons of medication. They tell me it will be temporary. They tell me I should be popping these pills for 8-12 months. They tell me this all can be fixed. Maybe.

Right now I’m too foggy to care. But at least I have my handy dandy pill holder to remind me. And my brand newly downloaded iPhone pill app. Alarms are set to remind me to take my meds. They go off 4 times a day. They make my life easier but they also make me want to cry.

But I refuse to cry. REFUSE. So instead what do I do? I get this 34-year old body a brand new tattoo and I threw a kegger at my house. I’m also plotting a trip to Vegas for my birthday if you’d like to come along.

Admittedly there are others out there coping with their issues much more constructively than myself.

@thatwoman tweets “National Invisible Chronic Illness Week! If you have one-blog it so we can all learn.” She also has some great resources over at her Tummy Troubles blog.

JoAllison writes about her gastroparesis diagnosis as well, and blogs about the foods she can and can not tolerate:

I’ve largely been okay physically in this month that I haven’t posted. I had about 4 days of a bad time (GERD breakthrough, bloating, constipation, pain, general yuckiness) but I went back on a liquid & yogurt/pudding/ pureed soup diet for about a week & increased the mirilax and it went away, thank the Lord.

Over at “The Road I’m On” there is a comprehensive overview of gastroparesis and all it entails.

Me? I tweeted about my party, because it took my mind off what that ONE beer I had would do to my stomach. Like I said, not nearly as constructive.

But there goes my phone alarm. Telling me it’s time to wrap up this post, and take two more pills. All part of my new life as someone with a chronic illness.

Contributing editor Erin Kotecki Vest also blogs at Queen of Spain blog, where she dreams of drinking beer and eating fried foods while debating politics with friends.

Complacency, Security, And 9-11

cross posted at BlogHer.com

On September 11, 2001 I was sitting under the two tallest buildings in Los Angeles.

On purpose.

I was sent there as events unfolded by my news director at KFWB to “wait and see if something happens in LA.”

As we all know, nothing did. However, across the country everyone was on edge. That’s probably an understatement as you remember that day. We were over the edge.

As Nicole at Pink & Posh remembers,

“It was just an out pour of sadness and events and terror. Terror. She made it home safely with only scars on her feet because she couldn’t walk in her pumps any more and decided that being barefoot was a better option. Anything seemed like a better option that day.”

So my job at the time, as a reporter, was to figure out what happens next. As the country was working to grieve and to heal, I was working to find out how and if something like this could happen again. Where was the US vulnerable and what did we need to do to protect ourselves?

It was quickly determined the nation’s critical infrastructure: our ports, our water supply, our communications, electricity…all those things could be hit and our country could be crippled.

I set out to investigate two of these infrastructures: ports and water supply. To say the results were astounding would be yet another understatement. I’m not sure, at that point in time, having just been hit with the 9-11 attacks, we could have felt more vulnerable…but what I found made me hesitate to tell the public just how easily this could all happen again.

At the ports of Los Angeles and Long Beach, which are our nation’s busiest and 2nd busiest ports, respectively, I could access tankers, major bridges, tank farms, and was unchallenged for hours as I slipped through holes in fences, unlocked gates, and from personal water craft. What’s important to note is the amount of the nation’s economy dependent on this port, and how commerce west of the Mississippi would halt if anything were to happen on these precious docks.

At LA’s largest aqueduct, I pulled a lock off a gate that was wide open, which I gave as a souvenir to my news director. No one stopped me. No one was around. No one seemed to care. LA’s water supply was wide open and waiting for an attack. I couldn’t even find a security guard.

I then sat down with Mayor Hahn and told him of my findings. He was as stoic as a politician can be in that situation, however just as deeply disturbed as I.

Since then, and I am proud to say as a direct result, millions upon millions of dollars have been spent in Los Angeles to beef up security. This went on as well across the country. From increased patrols (including aerial here in LA) to reinforced gates and cameras, to sophisticated security procedures, the critical infrastructure of this nation was shored up. And shored up fast.

But where are we now? So many years later and already seemingly forgetting about these threats. As it turns out, the Ports here in LA now tout their security on their website.

The water supply, after being declared secure on a national level, remains on high alert. As I drive by today you can still see the dozens of police cars, gates, and uniforms surrounding it’s perimeter.

Secretary of Homeland Security Janet Napolitano tells the Washington Post as a nation, they are doing everything possible to “reduce the risks” but individual Americans need to be involved as well:

“Well, probably not as prepared as we could be, and that is why this month, which just happens to be National Preparedness Month, we are really sending out the message about shared responsibility for individuals, it’s, have a plan; make a kit; get some of your training updated, or get some training if you haven’t had any before; go to ready.gov, which is our website, which has some pretty straightforward things that individuals and families can do.”

Napolitano also touches on he quadrennial Homeland Security Review currently underway and due in December:

“I think it will probably show that, for a young department, we have come a long way, but we have a ways to go. We have a ways to go in terms of information sharing, partnerships with state and local law enforcement–both of those are big priorities for us.

I think we have some things that we can do better in terms of explaining to the American people why some things are the way they are, particularly, for example, in the travel environment.”

But even with reassurances from the government they are doing everything possible, concern still exists. Just today the Coast Guard was involved in an incident being labeled as a “miscommunication” near the nation’s capital. CNN reports:

“The U.S. Coast Guard promised a ‘thorough review’ after a training incident Friday along the Potomac River briefly triggered concerns about the security of President Obama on the eighth anniversary of the September 11 attacks.

Federal agency emergency operations centers were not aware of or notified about the exercise on the Potomac, and they began implementing response procedures, a federal source said.

Even the police department’s Harbor Patrol, which is responsible for patrolling the river, was not notified, law enforcement sources in Washington said.”

And as of 2006 only 5.6% of the containers coming through ports in the US are inspected as they enter the US.

Not very reassuring.

As Barbara at Mommylife.net writes,

“Today I feel sad that our country seems to have forgotten that liberty requires vigilance – and gratitude for our country.”

Vigilance is important, and considering today’s stark reminders on news and all around us, perhaps we will remain as such.

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain blog

BlogHer community keynote

My favorite part of BlogHer Con- go watch, you won’t regret it

Obama: Pushing Health Care Reform or Patronizing?

crossposted at BlogHer.com

President Barack Obama fired up his base today…or was he just patting us on the head?

The Democratic National Committee’s Organizing for America held a conference (via email, phone, web video and in person) with volunteers and supporters of the Obama Administration and campaign to rally for health care reform. Marlene H. Phillips writes at the Huffington Post,

“On Thursday afternoon, when President Barack Obama entered a room of 50 volunteers, with thousands watching via webcast, he was greeted with the campaign cry of ‘Yes We Can.’

The President smiled, then removed his jacket and rolled up his sleeves. The symbolism was clear; that catchy phrase helped get us here, but now we need to work for it.”

And it felt like a rally, which was a welcome change in the national battle over reform. But during the 90 or so minutes supporters hooted and hollered and discussed health care, one line from the President stood out to me more than any other:

“…We’re going to get this done. One way, or another.”

One way or another…which I can take to mean as “with our without the public option” OR “with or without those pesky Republicans.”

Jake Tapper and Sunlen Miller took the latter from it, “Before a crowd of loyal Democrats this afternoon, President Obama said his party would pass health care reform with or without Republicans.”

But after all this time and all this compromise and effort to get the GOP on board, color me skeptical. When I heard the President speaking of getting it done “one way or another” I immediately thought “by giving up more to make the Blue Dog Dems and the Right happy…”

But perhaps, just perhaps, those lefty brethren of mine made enough noise this past week to make sure the White House and Dems stayed on track with their message and keeping the public option. Digby writes,

“The bottom line is that, until progressives rallied behind the public option this week, the air was out of the balloon. The base of supporters are energizing this debate, and they will reward any lawmaker that reflects their values and actually seeks to follow through on their promises. They now represent the last, best hope for real health care reform. And they won’t cotton to being kicked around, dragged through the mud, or played as pawns any longer. 2012 lies in the balance.”

If the air was out of the balloon is was certainly inflated again today, as twitter, facebook, and blogs buzzed with “YES WE CAN!” and chants of “FIRED UP! READY TO GO!”

I remarked on BlogHer Chatter and Twitter while watching the OFA event that this is exactly what some of us advised White House Senior Advisor Valerie Jarrett to do to get health care reform front and center again in the news: make it like the campaign, get the grassroots moving. Perhaps, just perhaps, she listened.

Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain blog
BlogHer is non-partisan but our bloggers (including me!) aren’t! See more of our coverage in News & Politics.