The Senate Health Bill: Chock-Full of Bad Health Policy
Posted July 17th, 2009 at 9:55am in Health Care 
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Senator Harry Reid (D-NV), Senate majority leader, wants to rush the Senate health care legislation through the process by July 27, 2009. It’s not hard to see why.
After 13 days of intense debate, the Senate HELP Committee just finished work on the Senate bill (The Affordable Health Choices Act) and reported it to the full Senate for consideration. During the Committee consideration of the bill, there were hundreds of amendments, dealing with topics ranging from abortions to funding jungle gyms. Much of the internal Committee debate received little attention in the major media. But the Committee’s decisions, if the Senate bill is enacted into law, will affect every American. Consider some of the key decisions:
Covering Abortion. (Mikulski Amendment #201 ) Sen. Barbara Mikulski (D-MD) offered an amendment that would require health insurers to include “essential community providers” in their networks. They would provide “preventive care services” for women. These entities include providers like Planned Parenthood clinics, which perform abortions. Few Americans would be comfortable knowing that federal dollars would be funding abortions. In effect, this policy is directly contrary to previous congressional funding restrictions on abortion payment, such as the Hyde Amendment. Republican Senators’ attempts to exclude abortions from the bill failed.
Financing Neighborhood Construction. (Coburn Amendment #49 ) To foster creation of healthier communities, the Senate Committee bill would provide federal community transformation grants to state and local governments. However, the legislation offers only broad guidelines as to where the money can go and does not limit the size of the grant. Sen. Tom Coburn (R-OK) offered an amendment that would prohibit the use of grant money to build and maintain sidewalks, parks, bike paths, or street lights. Other federal programs already direct money toward these projects. Dollars designated for improving the health care system, Coburn argued, could be spent on far more constructive areas, such as increasing access to health care. Remarkably, Coburn’s amendment failed on a straight party-line vote, meaning taxpayers’ hard-earned dollars can wastefully go towards projects that are already funded by the federal government.
Expanding Bureaucracy. (Coburn amendment #110) The Committee bill grows the size of the government significantly – it creates new administrations and places immense power in the hands of certain bureaucrats. Sen. Coburn’s amendment would have prevented the expansion of government and runaway federal spending by maintaining the current number of bureaucrats. His amendment was defeated. Even as the nation’s unemployment approaches ten percent, the federal bureaucracy will expand.
Expanding Welfare Eligibility. (Coburn Amendment #205) Medicaid is a poorly-performing welfare program. Ideally, it should be reformed, not expanded. Sen. Tom Coburn (R-OK) introduced this amendment to ensure that the Committee bill’s provisions do not expand Medicaid eligibility standards and attempt to increase the number of Medicaid enrollees. State and federal budgets are already heavily strained, and the increased burden of covering the cost of more Medicaid services would be unbearable for taxpayers in many states. Coburn’s amendment failed. This means that the federal government and states, both already in budget crises, will be forced to spend even more on Medicaid.
A Taste of Their Own Medicine. (Coburn Amendment #226) For many liberals in Congress, a new public health insurance plan, to compete against private health insurance, is an absolute “must” for health care reform. Virtually all independent analysts estimate that, given the special advantages of taxpayer subsidies and regulation, that the competition would be rigged, and millions of Americans with private health insurance today would be dumped by their employers into the new public plan. Sen. Tom Coburn (R-OK) proposed an amendment that would require all members of Congress and their staffs to enroll in the newly-created public health insurance plan. This means that they would be required to give up their private insurance coverage (nationwide there are 283 plans competing for federal employees’ dollars), which is today provided through the popular and successful Federal Employees Health Benefits Program (FEHBP). With many members of Congress openly willing to create incentives that would drive Americans out of their existing private coverage, Sen. Coburn put his colleagues to a test. Although 10 Senate Democrats voted against it, the Coburn amendment passed by one vote. Taxpayers should watch very closely whether this amendment is preserved or buried.
Higher Taxes and Doctors Payment Cuts. (Roberts Amendment #207 , Roberts Amendment #208) Senator Pat Roberts (R-KS) offered two amendments that would have prevented the government from raising taxes, increasing the individual mandate penalty, or decreasing payment rates to Medicare providers to cover the cost of subsidies given to low-income individuals for their insurance premiums and out-of-pocket costs. Otherwise, under the Senate bill, taxpayers would have to shoulder the burden of increased taxes, and physicians would be vulnerable to even lower government reimbursement rates for practicing in Medicare. Both amendments failed.
Blocking Anti-Rationing Amendments. (Roberts Amendment #1 , Coburn Amendment #9, Enzi Amendment #7) The Committee bill calls for an increased role of comparative effectiveness research (CER). A number of Senators fear that federal officials could use the data to determine payment, treatment, and coverage decisions, subordinating professional medical judgment in the treatment of patients to regulatory or budgetary considerations. These three amendments would have prohibited the use of CER to mandate coverage, deny care, or ration. CER, if used as a rationing tool, would obviously interfere with the traditional doctor-patient relationship. All three amendments failed on straight party-line votes. You can learn more here.
The giant Senate and House health bills would impact the personal lives of 300 million Americans. Ordinary citizens should understand that these measures are not merely focused on ways to control costs and expand coverage; they touch on how and what kind of care Americans will get, and under what circumstances they would get it. The disposition of these Senate amendments is just one indication of how members of Congress really feel about some of the most contentious issues in health care policy. It is time for every American to read these bills.
This post was co-authored by Julius Chen.
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20 Responses to “The Senate Health Bill: Chock-Full of Bad Health Policy”
Robert Griffin Las Vegas Ne. on July 17th, 2009 at 9:55am said:
it is true that we need to work at inproving our existing health plan, which is by for the best in the world bar none. But we sure don,t need the gov.involved. It should be between the patint,doctor and Insurance provider to get right we need to keep the gov. out, and free competion
among the insurance providers. we must keep our country free from socialism
Edna Earle, MS on July 17th, 2009 at 9:55am said:
Evidently “the powers that be” are more concerned with power and money than they are with health care. The amendments offered by Tom Coburn and Pat Roberts were good amendments and should have passed. Just what is the hidden agenda of those who are rushing to pass this “reform”? In my opinion, it is not health care.
Dale, Cincinnati on July 17th, 2009 at 9:55am said:
Health care, energy policy, the economy and our society in general, demand attention. Unfortunately, these issues require local attention, not the attention of Washington. The best and brightest are rarely elected officials or employees of the US government. If so, they would have less difficulty filing their federal income tax returns. Centralized planning will fail. Look to the Soviet model for recent evidence. The United States is a truly great and diverse nation. We are, to a large degree, great because of that diversity. The South, Midwest, West Coast and North East are, in many ways, more dissimilar than the individual countries of the European Union. US governmental agency “middlemen” are rarely in touch with the interests and needs of local communities. Washington’s practice of returning federal taxes to state and local communities reeks with inefficiency and corruption. Multi-trillion dollar stimulus programs will promote record levels of fraud. Look to Medicaid and Medicare for excellent examples.
Here is a plan that may serve to bring our elected “public servants” (both parties) back from the edge. The plan’s design is to give our US Senators and Representatives a does of reality. Reality is defined as:
1-Elected officials are employed by “We the people”.
2-Elected officials are not self employed.
3-Employees do not set their own pay. Only business owners have this privilege. Do you see the problem.
4-Employees do not set their own benefit packages, only business owners do. Again, do you see a trend.
5-Employees do not qualify for full benefits on the first day of employment. Once again.
6-Employees are not guaranteed the same compensation as their peers. Yet another example of our imperial governmental mindset.
My proposal is to initiate a movement for a constitutional amendment. The amendment would stipulate that salaries and benefit packages for US Senators and Representatives and their staffs would be set and funded by the respective states. The specific method for fixing salaries would be left to the discretion of each state. One option would be to have salaries and benefits voted on by state legislatures. I’m sure there are numerous other options. Let the people decide.
Obviously, this plan doesn’t have a rat’s chance in hell of being enacted as a piece of legislation in Washington. The only solution is an amendment to the constitution. With the current economy and recent socialistic actions of the Washingtonian elite the mindset of the voting population is ripe for a movement to take our country back from the brink. This is the first step in reestablishing the original definition of the term “ public servant”.
Sally, Ohio on July 17th, 2009 at 9:55am said:
http://www.cprights.org has additional info on the bad health care plan if you need to see more….please everyone pay attention on this life altering bill…
Omaha, NE on July 17th, 2009 at 9:55am said:
Just let me shop across state lines – health care reform done. How hard is this?
I am so mad and frustrated with Washington right now!
Richard, rural Texas on July 17th, 2009 at 9:55am said:
Dale, Cincinnati, I like the proposal you put forth, but to go a step further. We need to go back to the old method of electing the Senate, let the two Senators be chosen by the state legislatures. Further, allow the states to collect all the taxes, they can then give the federal government only what it needs. We need to return to the constitation and only allow the federal government to do what is set forth, and the states need to provide the other needs to the people as set forth by the states and not a central government body. The government needs to be returned to the people and only the people.
tk hawaii on July 17th, 2009 at 9:55am said:
I have real problem with our policitical representatives,they always says there are looking out for interests of the American people when was the last time your representative asked you about the affairs of this country? THEY ARE LINING THERE POCKETS FROM LOBBIST WHO LOOK AFTER THERE OWN NEEDS.THIS NATION WAS BUILT ON A FREE RIDE,BUT HARD WORK,AND ALOT LABOR FROM PEOPLE WHO WANTED A BETTER LIFE.iTS TIME TO STOP THE FREE HANDOUT.
Rich, rural Arizona on July 17th, 2009 at 9:55am said:
This is such an unbelievable scam! Madoff got over 100 years in prison for ding the same thing!
Here’s another look at what could be done with some of the Obamacare…since they feel that they have to give it to illegal aliens.
1. Stop all health care to indigents and illegal immigrants in hospital emergency rooms unless it is an actual life threatening emergency.
2. The Federal Government will establish, furnish and staff clinics for the treatment of all indigents and illegal immigrants in the neighborhoods with the highest concentrations of these populations.
3. If a person cannot prove by certified birth certificate or passport that he/she is a U.S. citizen, and health care is provided, that person’s country of origin will be billed for all medical and related costs to include, but not limited to, reimbursement to law enforcement agencies, medications, all transportation services provided, all staff services provided and all medical services provided, plus a 10% administrative fee.
4. All persons who are not able to provide proof of citizenship will be deported to their country of origin within thirty (30) days after medical clearance.
5. The initial treatment expense would be borne by the U.S. government. All billing to countries of origin will include a 10% administrative fee. (medical and other services plus 10%) The 10% administrative fee would be used to offset the services provided to indigent citizens.
6. This could provide a savings of millions of dollars to tax payers, and still provide services to indigents and illegal immigrants.
RS from AZ on July 17th, 2009 at 9:55am said:
I’m sick of it. I’m tired of it. I’m fed up to HERE with it. These fools in congress are trying to spend us into oblivion just to keep the annointed Comrade Obama happy. Obama doesn’t give a damn about health care. Who’s he trying to kid. He just wants his name on a bill. Isn’t he wonderful. People get the government they deserve. I believe that. So just how stupid are we in this country? It’s time for term limits for every congressman and senator and especially the bozo in the white house. How about six months?
Barb, NW Indiana on July 17th, 2009 at 9:55am said:
Dale of Cincinnati: We need to take our country back one Congressman at a time. Rich: Love your health care plan. I would not want abortions funded in it though and I think a 15%-20% administrative fee is better.
Bill Lee on July 17th, 2009 at 9:55am said:
Richard rural Texas I like your comment! But it will never be.Central government has become too powerful.
Hope the Coburn admendment to give Congress and all Federal Employees the same medical insurance forced on Americans,comes to pass.
I do think it is time for Americans to stand up and force Washington to come down several notches.
The People need to show Washington who is in charge.
We need to drill here in America and do it in an environmentally sound way. American Oil companies in this country will do it better than they do overseas. You think Russia or Nigeria, or any Middle Eastern country drill in a responible way?
So in order to protect the world wide environment we need to drill here: Gulf of Mexico, Alaska, and out West, ie oil shale. It makes no sense to ship oil from overseas with the environmental damage from drilling and transportation risks of spills.
This will put Americans to work and cause wages to go higher for working class! Less people on unemployment! When we are economically sound again we can give tax incentives for development/research of alternative energy development.
All of this will reduce money being sent to terrorist activities. This has got to be a good thing for America.
Drilling is a win/win situation for America. However maybe the Democrates don’t want America to prosper? Maybe Obama and company want America to be in a crises? Do you think it is possible that Rev. Wright has affected Obama over 20 years and he is trying to hurt America? Maybe this is the revenge(pay back) that Rev Wright seemed to preach and hope for America?
Marshall Hill MI. on July 17th, 2009 at 9:55am said:
Health Care in America is working for Congress and
some 8,000 Goverment Employees in D.C.
When can we sign up to get whats already Available?
Gar, MN on July 17th, 2009 at 9:55am said:
Got to understand, as a retired government employee, I got to carry my medical insurance into my rertirement. My wife is 77 years old and still has maturnity benefits. Good ole Govt mandates. I still have to pay about $350 a month for the “family plan”, but what they don’t tell you is the Govt picks up over $700 a month of the preminum. Would I give up my benefits if I had a choice? No, I might be crazy, but I’m not a fool. Even the FEHP needs revised, but not this new plan. Get the govt(state and fed) out of mandateing coverages, and let policies cross state lines, coverages be dependent on what you are willing to pay for. Understand, life is not a right, if that was true, God would let us live on earth forever.
Beverly Williams Brady, Texas on July 17th, 2009 at 9:55am said:
vote NO on health care bill. We the people say No dont sell us out.
Scott Noren DDS, Ithaca New York on July 17th, 2009 at 9:55am said:
The insurance industry that charges, lets say, $1,000 per month for a family policy when they could charge $700
The insurance company that charges $405 for an individual policy when they could do ok with $275
The pre-existing clauses, high deductibles and non-portability all needs to go away.
Many people can afford to pay for reasonable and GOOD policies
The rest can be covered under existing government programs
It shouldn’t be the other way around (more in government programs)
Obesity and smoking will make all this fail if not addressed BY THE PUBLIC and reiterated by Congressional members not afraid of re-election
For an alternative candidate not interested or obsessed with multiple terms, not taking lobby money or even individual money from insurance and financial company employees….
http://www.norenforsenate.com
That’s me…Dr. Noren from NY
John Rosky Andover,Mn on July 17th, 2009 at 9:55am said:
If we need to pay for abortions, than the person needs to accept to be sterilized to avoid paying for it over and over. Why would we want to pay for it again if they can’t understand birth control. We also need to stop the amount paid for wellfair when people keep producing children just to get paid more. Set a total limit that they get and see if they want to produce more than they get pay for.Taxpayers should not have to pay for any of this. My wife and I knew we could support two children and that is all we had. I do not see why just because you are on the Federal Tab you think that we owe you everything.
Thomas Guzman, Monterey Park, Ca on July 17th, 2009 at 9:55am said:
The House Health bill just passed, Nov.7, 2009.
Remember when the French people wanted bread, and Marie A. told them, “Let them eat cake!”
If this bill is so good, then Congress should abandon the over 200 private insurance plans they voted themselves, and be fined if they don’t sign up for this health bill.
Barbara Mullis on July 17th, 2009 at 9:55am said:
I protest this health care plan. Seniors will suffer and die. Taxpayer pay for abortions > that means we pay for murder.The first Lady stated it is the first time in her adult life she was proud of her country >well it is the first time in my adult life I have been ashamed of where my country is heased to socialiam
Larry Parmiter, Murpy NC on July 17th, 2009 at 9:55am said:
Bill Lee, you are right on target. I have to agree with everything you say, however, you say americans should speak out to Washington. We have, no one is listening that I can tell. I write, call, never even an acknowledgement to my complaints or suggestions. I believe the Obama bunch, like you said, wants to hurt us. They don’t want to drill, I feel, because some corporate oil company just may make some money. They want to take the country to its knees, then rebuild it to the socialist standards they desire. Control, control, control, and taking your health and 1/6th of the economy into control, plus cap and trade will do it. Third world countries can’t achieve our levels, so we go to their level, spread the wealth my friend.
Katrina, Bullhead City on July 17th, 2009 at 9:55am said:
So I think it is safe to say we all dont seem to agree with the bull that the senate is putting out. However this bill is still far from being over it will be altered and rewritten a few more times, by then most of the american people will be so confused that they give up..and just be sick of it. and let it be.. Whatever happened to protests on the steps in washington?? cant we start voting these people out of office?? We the people need to be heard. By the time My kid is an adult or her kids are adults they wont know any better. We the people need to figure out something now. I may not know everything I may not be the smartest crayon in the box but I do know that socialism is not the way to go.. and it is not what our forefathers would have wanted..So I ask anyone what do we do to stop this BS??