The Democrat’s Intend On Pushing Health Care Reform Through The Senate Whether Republicans Are On Board Or Not

If you hadn’t heard, the Democrats are trying to work with the Republicans….cough….did I say “work?” I meant shove them aside, in their attempts to cram health care reform through:

It’s been in the works for a while and now, according to senior Captiol Hill staffers, it’s a done deal: The final budget resolution will include a “reconciliation instruction” for health care. That means the Democrats can pass health care reform with just fifty votes, instead of the sixty it takes to break a filibuster.

The deal was hatched late afternoon and last night, in a five-hour negotiating session at the office of Senate Majoriy Leader Harry Reid. A trio of White House officials were there: Rahm Emanuel, Peter Orszag, and Phil Schiliro. Also present, along with Reid, were House Budget Chairman John Spratt and Senate Budget Chairman Kent Conrad.

What exactly is reconciliation? It basically means instructions are issued in a budget resolution for committees to report changes that affect the budget. Debate on the reconciliation bill can be limited to 20 hours, AND amendments can be limited also. Most importantly, the bill can be passed with a simple majority instead of a three-fifths to invoke cloture. A good primer on reconciliation can be found here.

Pejman Yousefzadeh notes that the left’s excuse for using this tactic is the fact that Bush used this tactic also. Big difference tho, his reconciliation bills did indeed affect the budget. Not so with health care reform.

but it may plausibly and easily be argued that Bush Administration reconciliation bills had a direct effect on the budget, thus conforming with the Byrd Rule, because they “produce[d] a change in outlays or revenues” in a manner that was not “merely incidental to the non-budgetary components of the provision[s]” at issue. Does health care reform qualify for reconciliation under the Byrd Rule? Well, according to Ezra Klein, the question is hardly clear cut:

The Byrd rule states that legislation is unfit for reconciliation if it “produce[s] changes in outlays or revenue which are merely incidental to the non-budgetary components of the provision.” I asked Jim Horney, a budget expert at the Center for Budget and Policy Priorities, how you define “merely incidental.” And what, exactly, is a “provision”?

He sighed. A provision, he said, is “not defined anywhere. It goes well below a title or section of a bill and even below a paragraph. But exactly what it is nobody knows.” And the Senate rules offer no more clarity on the definition of “merely incidental.” Asked if anyone had developed an accepted meaning, Horney seemed almost apologetic. “No,” he said. “Absolutely not.”

The matter is not simply academic: The Byrd rule allows senators to challenge the acceptability of any provision (undefined) of a reconciliation bill based on whether or not its effect on government revenues is “merely incidental” (undefined). Thus, if you enter reconciliation with a health-reform bill, it’s not clear what’s left after each and every provision — however that is defined — is challenged and a certain number of them are deleted altogether: the tax portions, certainly. And the government subsidies. But is regulating insurers “merely incidental” to government revenues? How about reforming hospital delivery systems? How about incentives for preventive treatment? Or the construction of a public plan? An individual mandate?

But the Republicans do have one tool to slow down or stop this tactic. Invoking the Byrd rule requires a three-fifths vote to waive it. The Democrats don’t have that, and the Republicans damn well better slow this thing down because 20 hours of debate can only be described as rushed lawmaking. And we all know they are rushing this for a reason. They know there is no strong consensus of government taking over health care.

In fact just recently many different research organizations issued a statement opposing the nationalized health care plans of Obama and they give a point by point reason for their opposition:

A new government health insurance plan

While there may be initial assurances that the plans would operate on a level playing field, the government inevitably will use its regulatory, pricing, and taxing authority to favor its plan. Congress would give the government plan the power to dictate prices so it can artificially under-price private plans and drive them out of this one-sided “marketplace.”

Many people then would be left with little or no choice, as employers would drop their current coverage and send their workers into the public plan. Research by The Lewin Group4 shows that as many as 118.5 million Americans would lose or be switched out of private health coverage. This massive crowding out of private health insurance would undermine the employment-based coverage that most Americans under age 65 have today.

Once private plans have been driven out of the market, people will realize that the government plan will not be able to sustain the quality and quantity of benefits they were promised. Government instead will begin to ration care and services, driving out innovation, competition, and patient-centered quality.

An employer “play-or-pay” mandate

Employers would be required to pay an unspecified “meaningful contribution” toward their workers’ health insurance or pay a new tax to fund the government plan. If they are not “playing” in the new system by directly providing health insurance, then they will be “paying” to fund the government plan. It is a political certainty that the option to “pay” this new health insurance tax will be set lower than the current levels at which employers now “play” by providing their own coverage, enticing many of them to transfer their employees’ insurance coverage to the mercies of the new government plan.

Whether they choose to pay or to play, small employers will be hit especially hard by a new mandate to finance all or part of the health insurance premiums for their employees, directly or through new taxes. Any initial subsidies to them will quickly be overtaken by higher mandated costs. As they absorb new tax burdens they cannot control, the result will be more lost jobs and lower wages for workers.

A uniform, government-defined package of benefits.

Decades of experience in the states confirm that whenever benefit packages are determined politically rather than by the marketplace, legislators find it very difficult to say no to anyone asking that their services and products be included. People would have a “choice” of only the expensive one-size-fits-all plan mandated by government, significantly increasing the cost of health coverage. Workers would pay for this more expensive coverage through lower wages, lost jobs, higher taxes, and lower-value health care.

A mandate that individuals must purchase insurance.

If the federal government requires everyone to purchase health insurance, it must define what qualifies as insurance. All signals indicate this would be a very expensive benefits package, designed as one-size-fits-all in theory but delivered as one-size-fits-none in practice. Sweeping government mandates create a conflict between escalating costs, limited resources, and the false guarantee of rich coverage – triggering price and supply controls.

Many individuals will need subsidies to receive coverage that otherwise would be unaffordable to them, but taxpayers will resist filling an abyss. As a result, political leaders will try to cover rising costs indirectly and invisibly – through general revenue subsidies, tax increases, deficit spending, and escalating fees, fines, and taxes imposed on employers. And to make the mandate work, the government also must establish and enforce binding penalties for individuals who do not comply.

A National Health Insurance Exchange extending federal regulatory powers over private insurance.

A new National Health Insurance Exchange is being proposed to “streamline the purchase of health insurance.” It actually would steamroll over private choice and patient preferences by providing a vehicle to extend sweeping federal regulation into virtually every corner of our health sector. This would reduce choice for patients and discourage or prohibit innovation and flexibility in health insurance offerings that today are helping many companies and families balance their health costs with other needs.

Federal interference in the practice of medicine through a federal health board, comparative effectiveness review, and other government intrusions into medical decision-making.

Congress appropriated $1.1 billion in taxpayer funding for comparative effectiveness research in the economic stimulus bill, establishing the Federal Coordinating Council for Comparative Effectiveness Research, which will assess medical treatments available to Americans. This provides an irresistible temptation for politicians to go beyond providing better information and start restricting the treatment choices available to patients. House Appropriations Chairman David Obey (D-Wis.) said the intent was that drugs and treatments “that are found to be less effective and in some cases, more expensive, will no longer be prescribed.”

The clear and present danger is that any centralized health board will use the cover of comparative effectiveness findings to meet budgetary bottom lines, at the expense of patients’ medical needs and personal preferences. This is a particular danger to the health of people who suffer from rare conditions or who need access to specific medicines and treatments but who may lack the political power to influence the reviewers’ decisions

While Republicans may be virtually powerless to stop this process our only hope is that the votes just won’t be there. Democrat Sen. Kent Conrad is against the tactic, as is Sen. Robert Byrd….lets hope the Republicans stand strong against this, and a few Democrats with us.

Curt

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