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The Democratic Platform and the Senate Health Bill (from my blog, The People's View): http://www.thepeoplesview.net/2010/02/democratic-platform-and-senate-health.htmlI will summarize, quickly, but you have to go to the link for all the specifics and sourcing: You can throw a dart at the left-ideological blogosphere and if you aim it roughly for health care reform, chances are you are going to hit a post about how the Democratic party is violating its own platform with the Senate bill. Horror!
The 2008 Democratic National Platform divides each policy area into subsections about what the Democratic platform says about that policy area. I am going to list them and assign points based on a rather simple idea: ...each goal under the main health care umbrella will get the same amount of points assigned. Sound fair?...
Before I go on though, I'd like to begin with a reminder to my fellow Democrats about this President and this Democratic Congress' commitment to health care and children: On February 4th, 2009, the President signed into law a big expansion of SCHIP. The Recovery Act dedicated more than $145 billion to investments and reform of health care systems...
Now let's move on to the particular sections for health care in the 2008 Democratic platform. Each category, except one one-liner, will be worth 20 points. First up:
I. Universal coverage and insurance options - 20 points possible.
Subdivisions:
Coverage, 10 points possible (100% coverage possible)
The Senate achieves 94% coverage, so it gets a 9.
Health care choices: 10 points possible - 5 for public plan, 5 for affordable choices.
Senate bill does not have a public plan. Zero for that. Health insurance choices are alright, costs are largely a wash with the House bill, although it could always get more subsidies. So it gets 4 out of those 5 points. So 4 out of 10 here.
Category I Score: 13/20.
II. Shared responsibility - 20 points possible.
Sure sounds to me like it's at least quite open to a mandate. Given a whole lot of delegates (Clinton and Edwards delegates) were pledged to candidates who openly campaigned for a mandate, this is a reasonable assumption. The Senate bill has a mandate - an affordable one. The Senate bill provides employers with incentives to provide coverage, with small business tax credits for health insurance going into effect immediately. The Senate bill does as good as the House bill to ensure high quality care - with both reforms in care delivery and defined minimum benefits...
I give Shared Responsibility on the Senate bill its full 20 points.
Category II score: 20/20.
III. End Insurance Discrimination (pre-existing condition) - 20 points possible
The Senate bill eliminates discrimination (all discrimination, including in price, not just in acceptance) based on pre-existing conditions, although not until 2014, when the exchanges start. Pre-existing condition discrimination against children is banned immediately... The Senate bill also allows insurance companies to charge older people 3 times as much. That'll cost some points. Largely because of this, I'm giving it a 15 in this category.
Category III score: 15/20.
IV. Insurance Portability - 10 points possible
10 points is good enough for this. Portability is basically achieved through the exchanges, which are present in the Senate bill. Some will quibble that insurance on a national exchange is more portable than insurance on state based exchanges. Fine. 9 points.
Category IV score: 9/10.
V. Meaningful Benefits - 20 points possible.
Well, the Senate bill's minimum coverage isn't quite what Congress has, but the basic package is modeled after it. No junk insurance. Affordability and cost control measures include the exchange (marketplace), the ability of state and federal regulators to monitor premiums and kick out insurers from exchanges, the 85% MLR requirement, out of pocket caps, excise tax, etc.
But both the Senate and the House does a disservice in terms of abortion coverage - although the Senate bill is lesser of the two evils on that. I do believe abortion is a "meaningful benefit." So, take a few points off the top for the imperfections (lack of abortion coverage, mainly), 17. That's a B. Sounds fair to me. The House bill would lose more points on abortion coverage, and stand at about a 15.5 for me.
Category V score: 17/20.
VI. Prevention and Wellness - 20 points possible
This thing is on steroids in the Senate bill... This bill does as well as can be done with legislation on prevention and wellness. Full marks.
Category VI score: 20/20.
VII. Modernized system that lowers cost and improves quality - 20 points possible
Consider this: in 2008, the average family health plan cost $12,298, or about 18% of the median income for a family of 4 that year, $67,019. If you are a median family, with let's say the primary policy holder about 45 years old, the Kaiser Health Reform Subsidy calculator estimates your premium to be $11,080 under the Senate proposal. You would be eligible for subsidies, and the federal government would pay $4,512 of that cost. That leaves your family with $6,568 in premiums. So to you, the drop in cost is well over the $2,500...
Electronic medical record and technology upgrades? Check. Independent board to find out what works best and the most effective care? Check, at least for Medicare (waiting for Sarah Palin to start screaming 'Death Panel!' anytime now).
Now the Senate bill doesn't let Medicare negotiate drug prices, and points are coming off because of it. The Senate bill also fails to allow for drug re-importation. Something will be taken off the top here. The Senate bill protects brand-name biologics drugs for 12 years, but in fairness, so does the House bill. The Senate bill, however, slaps $2.3 billion in annual fees on brand name biologics makers.
Overall, I'm giving this modernizing system to improve cost and quality category a C. That's a 15.
Category VII score: 15/20.
There are a few other areas of the health care platform, but legislatively, they are generally addressed in different areas, and thus would not make sense to include here. These are:
* Building a strong health care workforce through incentives and training
* Commitment to eliminating ethnic, gender, sexual and other discrepancies in health care
* Public health and research
So from the 7 areas above, I don't think I have been particularly generous in scoring. As you saw, a total of 130 points were possible: 6 areas with 20 points each and one with 10. My scores, in those 7 areas, total 109 points. That's 84%.
In other words, we are getting about 84% of the Democratic health care platform in the Senate bill. 84%. That's pretty damn good! Maybe that's why two staunch proponents of the public option, House Majority Whip Jim Clyburn and Sen. Al Franken agree that the Senate bill is a 'very good' bill. Now we can sit here and squabble about the other 16%, we can hold or we can make sure that we get this bill passed and get the 84% of the health care platform of the Democratic party - and possibly more! Once again, this is a rather small summary - the whole piece, I hope, may be worth your read, with links and sources, as well as expanding on I presented here. http://www.thepeoplesview.net/2010/02/democratic-platform-and-senate-health.html |
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