It was reported that health care legislation was advanced in the Senate and that a vote will be held shortly. It is hoped the vote will occur before Christmas. It is anticipated that the bill will pass. Some in the Senate no doubt feel that its passage will be a welcome present to their constituents. If nothing else, it will give them a little time off. A host of last minute amendments and deals have made the final vote possible although they have created a maze of compromises and amendments guaranteed to ensure that the issue will be revisited often in the future.
The House and Senate bills still must be reconciled, so the deal is not quite done yet. Both bills would compel almost everyone to possess or purchase some form of health insurance. The House bill requires coverage individually or through an employer. The Senate bill simply threatens people with increased taxes if they choose not to purchase insurance. Neither bill would deny coverage or increase premiums due to pre-existing conditions. This is because the government has the luxury of not needing to make a profit to stay in business. Private insurance companies do. Requiring them to insure people almost guaranteed to generate a loss essentially amounts to a tax on insurance companies. The House bill would require businesses that employ more than 50 employees to pay $750 per employee if the government opts to subsidize coverage. What the costs would be if the government does not subsidize coverage is unclear. Congress will also squeeze business by collecting fees from those that receive government subsidies. Presumably those that do not receive government contracts or subsidies will be similarly compelled, if not now, then in the future.
The Senate bill would raise income taxes, and coerce $20 billion from medical device manufacturers. It will also compel individuals and small businesses who do not have, or pay insurance, to get it or face fines. Like the Hose bill, small businesses with more than 50 employees will have to pay a "fee" of $750 per employee. They too, face penalties should they choose not to comply. Like feudal lords of old, the government will charge fees from those who would ply their trade on its land. It would be extraordinary if those fees were not passed along to consumers: just the thing for a sagging economy.
Both bills compel individuals to acquire insurance themselves or through their employers or be fined. In the House bill, everyone would be required to obtain insurance or pay a penalty. The penalty proposed is 2.5%. It can be assumed that penalty will go up: taxes and fines always do. The "very poor" can obtain wavers. But, since poverty is a moving target, the costs of providing wavers will shift over the years. For a bill that is claimed to be demanded by the public, it contains an awful lot of compulsion, fines, and threats.
Many other issues and items need to be reconciled, such as coverage for elective procedures, abortion, and illegal immigrants. None of those are issues that will be resolved in any meaningful sense of the word. They will cause headaches for generations to come. If Congress decides to extend coverage to illegal immigrants, it can be expected that it will be an expense that will only increase in cost since it will provide still another incentive for people to sneak into the country. Interestingly, though illegal immigrants will not receive coverage under the health care bill proposed by Congress, they will be not be pursued. As their numbers increase, so will the demands that they receive some kind of coverage. That care will have to be paid for by someone. If nothing else, providing coverage will help the clinics and hospitals that treat them to recoup some of their losses as well help guarantee job security to those who make a living advocating for immigrant rights.
The complexities of both bills is staggering. It is unlikely that there is anyone in Washington who understands them in their entirety. Both bills will cost hundreds of billions of dollars, which makes the fact that so few, if any, understand every thing in them all the more troubling. What is consistent in both bills is the effort to strong arm the private sector into making good on the government's promise to provide health care for everyone. National health care may be portrayed an an issue of justice or fairness, but it is also a political and social liability rife with coercion and opportunism that will be haggled over in perpetuity.
There is a misapprehension by many that the government will provide free, or at least "affordable" health care. The bills under discussion do nothing of the sort. Health care will cost billions. Raising taxes on the "rich", and levying taxes, fees, and penalties on business may obscure the costs in the mind of taxpayers, but it does not reduce them. Trillions will be spent on health care. That money will need to come from somewhere. It would take an economic recovery of near biblical proportion to increase tax revenue enough to compensate for the cost of everything being proposed in Washington. If tax revenue does not increase sufficiently, taxes will have to be raised or the money borrowed. Spending could be reduced, but that is the least likely option. What is certain is that the American public is going to pay for national health care one way or another. If we don't, our children will. The Chinese are not going to pay for it. They might loan us the money, but they are not going to pay for it.
The ardor with which the president and his supporters in Congress are pursuing national health care is alarming. It is almost as if they fear that if American people think too long about it, or examine it too closely, they will change their mind. But if the bills are sound, they should be able to withstand scrutiny and debate. Moreover, if there is a genuine demand for health care reform, as is being claimed by many in Washington, that demand will not ebb over several months, or even a year. The country has persevered for a long time without national health care, it should be able to last a few more months, even a year or two if that is what it takes to produce effective and desirable legislation. The zeal for its quick passage indicates an impatience out of place for so important an issue.
The ancient Pharaohs built magnificent pyramids as monuments to their greatness and to ensure they would not be forgotten. Over the years, many presidents have sought to create monuments of their own. Presidents such as Theodore Roosevelt, Woodrow Wilson, LBJ, and FDR, have sought to create testimonies to themselves and enshrine their names in history. To simply execute the law and defend the Constitution is no longer enough to satisfy the ambitions of those who would be president. They must have a pyramid. Clinton failed in his effort to build a pyramid. Obama is determined to succeed with his. It is likely he will succeed if only because so many people want a new pyramid. And if one is to be built, many in Congress want their names inscribed on it.
I only hope national health care works as Obama says it will. I am starting to feel ill.
No comments:
Post a Comment