Bob CollinsWhen I checked a few minutes ago, of the few dozen people who answered the question posed in this morning’s Five at 8, 83% said they knew little to nothing about the specifics of the health care debate taking place in Washington.
How could that be? Because it’s happening in Washington where process is most important.
Example. Read this article from the Associated Press. I’ll wait right here.
Welcome back. Did you notice something about the article? There wasn’t a single word about what’s in the legislation or what the major points of contention are. Not one word. There is a reference to the Blue Dogs — conservative Democrats — being concerned about “tax increases and the impact on rural health care and small businesses.” That’s it. So what’s in the House bill that specifically has them concerned?
It’s no wonder that talk shows — which boil legislation down to small talking points, some of which are occasionally in context and accurate — steer the political debate.
But what if you want to be informed about the specific issues?
For the most part, it’s piecemeal. Pick an editorial here or there, read a blog and piece it together.
Here are a few salient points.
Democrats propose increasing taxes on the wealthiest Americans – about 2 million taxpayers – to help pay for reform. The surtax would be imposed on families earning more than $350,000 a year and individuals earning more than $280,000 a year. The tax rate would range from 1 percent to 5.4 percent.
The New York Times provided separate views of this proposal in a blog post here. “Should the Rich Pay for the Uninsured?” Included were these details.
Doctors’ reimbursements:
The baseline budget calls for large cuts over the next decade in doctors’ reimbursements under Medicare. Congress has always voted to waive these cuts. The health care reform bill will make this waiver permanent at a cost of more than $200 billion. It is disingenuous to get outraged over this expense, since we always knew that Congress would not allow the baseline cuts to go into effect.
Capping health insurance premiums:
Senator Max Baucus, chairman of the Senate Finance Committee, wants to cap the tax exclusion to put a lid on inflationary health insurance and restore fairness to the tax code. Workers could still keep their health insurance at work, but they would have a new incentive to stay under an annual cap of, say, $15,000 for a family policy.The company could still deduct any amount it spends on insurance, but employees would be motivated to stay under the cap.
Maggie Mahar, who writes the Health Beat blog for the Century Foundation, says misinformation is growing. She took apart a Wall Street Journal editorial which, she says, are full of falsehoods. She provides a few more details of what’s actually in the bill.
The House bill actually protects and increases employer-sponsored insurance. According to official CBO numbers, 2 million more people would be covered under employer-sponsored insurance than is projected to be the case today – 164 million compared to 162 under current law.
But the best analysis of what’s in the House bill — which is H.R. 3200, by the way — may be the Congressional Budget Office:
The legislation would establish a mandate to have health insurance, expand eligibility for Medicaid, and establish new health insurance exchanges through which some people could purchase subsidized coverage. The options available in the insurance exchange would include private health insurance plans as well as a public plan that would be administered by the Secretary of Health and Human Services. The specifications would also require payments of penalties by uninsured individuals, firms that did not provide qualified health insurance, and other firms whose employees would receive subsidized coverage through the exchanges. The plan would also provide tax credits to small employers that contribute toward the cost of health insurance for their workers.
… and …
Changes to the Medicare Part D program… would establish a new prescription drug rebate program for some people who are eligible for both Medicaid and Medicare, while expanding drug coverage to beneficiaries that are currently subject to a gap in coverage (often referred to as the Part D “doughnut hole”), saving $30 billion over the 2010-2019 period.
A read of the actual bill shows a few other provisions:
>> A grant to train more nurses, and to provide more diversity in the nursing profession.
>> Health clinics in schools
>> Low-interest student loans for primary care students.
>> Home visitation programs for families expecting children.
>> Optional Medicaid coverage for low-income HIV individuals.
It’s not a perfect way to get up to speed on the actual issue of health care, but it’s better than what we’ve had so far.
As for the politics of the debate, which are getting the lion’s share of coverage, a guest on this morning’s Midmorning program succinctly told us all we needed to know about that:
“Every dollar in the health care system is someone’s income.”
It was good listening.
