Monthly Archives: November 2009

Healthcare 101

The 72 hour clock has begun to tick as Congress begins its final march to a vote on a healthcare reform bill.

After months of internal debate, discussion, talking to experts, and hosting town hall meetings all across America, two things are clear: 1) Health care costs are on an unsustainable rise in America and must be addressed, and 2) there are too many uninsured Americans in the US today. So the big debate in Washington should be how to address these concerns. Right?

Sadly, since the beginning of the year, the debate in Congress has centered on the majority’s desire to completely redesign our healthcare system overnight. No doubt something needs to be done, but no one has convinced me that it needs to be a wholesale re-write of the system.

A few other facts are also important to note: The health care industry represents 1/6th of our nation’s economy and 85% of all Americans currently have healthcare insurance. I add these facts because I believe they are important to keep in mind as one contemplates this important issue.

This week, Republicans introduced what is called a substitute amendment to the current proposal being considered. I am extremely impressed with this alternative and the concepts included in the proposal have restored my faith in the legislative process – when it is allowed to work. My biggest concern now is the fact that this very thoughtful proposal will most likely never see the light of day or get the debate on the House floor that it deserves. The Republican proposal received its CBO score today and the news justifies my excitement over the proposal.

The most positive fact about the Republican plan…it is the ONLY plan that actually begins to reduce costs according to the CBO, the non-partisan Congressional Budget Office. That means that one of the key public policy concerns over healthcare can be addressed immediately. The substitute addresses other aspects of the problem incrementally, realizing that addressing the concern over insuring as many as 30 million people is best addressed in small doses, and not by the creation of larger government bureaucracies.

The CBO reports on these two bills illustrate two entirely different methods to get at healthcare reform. Here are some high points:

  • The GOP substitute decreases the deficit by $68 billion over ten years. The Pelosi plan increases the deficit by $250 billion.
  • The GOP substitute costs $61 billion, or 5% of the $1.3 trillion cost associated with the Pelosi bill.
  • The GOP substitute “would reduce health care costs directly by reducing premiums for medical liability insurance and associated costs and indirectly by slightly reducing the utilization of health services,” according to the CBO.
  • The GOP substitute cuts premiums 7-10% for small businesses (15% of total private premiums); 5-8% for the individual market (5% of total private premiums); and up to 3% for people working for large businesses.
  • In the individual market, Republican plan’s premiums are $5,000 less than premiums in the Pelosi bill. (Under the Pelosi bill, premiums would be approximately $15,000 annually, compared to the current law of $11,000. The GOP substitute would reduce that to $10,120).
  • The GOP substitute does not include any new taxes on Americans. Under the Pelosi plan, there are $729.5 billion in new taxes and fees.
  • The GOP substitute protects small businesses by reducing health premiums. The Pelosi plan includes $152 billion in taxes on small businesses. Additionally, it includes a $135 billion tax over 6 years for noncompliance with the employer mandate to provide insurance to all workers (CBO).

I normally avoid writing about issues and providing laundry lists of facts, but this issue is too important to rely upon three second sound bites. If anyone is truly serious about this debate, you owe it to yourself to understand all the facts – on both sides of the aisle.

I have what I call a healthy distrust of government. I trust the government implicitly with protecting me. I don’t have the same level of confidence when it comes to the delivery of social services. That’s where I am happy to allow some government intervention and lots of private market influence to take root.

The GOP substitute does that and it takes care of lots of “fixes” that must be addressed to attack the high costs associated with medical care today. By CBO’s own admission, it is the only proposal that does so. I am all for taking it slowly, addressing the concerns incrementally, and developing a solid plan to attack one of the key issues surrounding healthcare reform debate today – costs.

The GOP substitute focuses on costs but includes numerous other reforms as well – from enhancing health savings accounts, to allowing dependents to remain on their parents’ health plan, to allowing Americans to buy insurance across state lines, to guaranteeing coverage for pre-existing conditions.

While the GOP approach is not as broad sweeping as the Pelosi plan, its authors realize that it only begins to attack the entire problem. But I see nothing wrong with that. Healthcare is too large a project to re-write at once. It is too large to consider for only six days. It is too important to rush. The GOP substitute is a start.

I am far more comfortable with a more deliberative approach – one that is incremental, slow, with care and debate, compromise, and an open and fair exchange of ideas and views. That’s the way we will fix this problem.

We all deserve at least that much.

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Posted by on November 5, 2009 in Uncategorized


Tuesday’s Real Message – Caution to the GOP

Yesterday was by any account an interesting day in the Commonwealth and around the country. Were the election results a statement on the Obama Administration’s policy agenda? Was the result in Virginia a statement of discontent with the way Democrats are running Washington?

Clearly there is dissatisfaction in the air. On Tuesday, the newest key voting bloc – Independents – flexed their collective muscle once again and made a statement that things are askew and we need to get back on track. Tuesday’s election will certainly be analyzed over the next few weeks and the political pundits will issue their assessment of the votes, but a few things are immediately clear.

First, President Obama was not able to recreate the magic that he generated one year ago. Perhaps people are disillusioned; perhaps they feel that the change they supported has not been delivered upon. The only reality here is that voters were not as engaged as they were last year and the challenge for all candidates will be to figure out how to tap into that excitement and woo the same coalitions back to the polls in 2010. President Obama did actively campaign for the Democratic candidates in New Jersey and Virginia. Some will say that his influence has been deflated in two states that he easily carried just twelve months ago. While this is an important trend that should not be underestimated, there is a bigger message that needs to be addressed.

That message comes straight from the Congressional race in New York. In this much watched race, three candidates vied to replace Congressman John McHugh, a Republican. The Special Election in New York’s 23rd District went to Democrat Bill Owens in this largely Republican congressional district of New York. Congressman-Elect Owens defeated the candidate of the Conservative Party of New York, Doug Hoffman. But this race is notable because of the division between conservatives and GOP leaders. GOP leaders selected state Assemblywoman Dierdre Scozzafava, a moderate Republican, as their candidate, over the Conservative Party of New York candidate, Hoffman.

The Democratic candidate, Owens, headed into Election Day trailing in polls. However, over the weekend, the GOP candidate, Scozzafava, withdrew from the race citing her sudden drop in polls amid continued conservative criticisms, and subsequently endorsed the Democratic candidate.

I know, if you didn’t follow this race, you might think that I was making up this stuff, but it’s all true! While the New Jersey and Virginia Governors’ Races are the headlines today, I think there is an important underlying lesson that must be learned from this race before the 2010 mid-term congressional races – the Republican party must figure out the right balance of standing up to their convictions for conservative principles without being intolerant to a wide array of political views.

With only two major political parties, there are bound to be a myriad of views and opinions within each political party. Not everyone will agree on every principle 100% of the time. The GOP must look forward to embracing the differences that make us strong. A diversity of opinion, and an acceptance of those differences, will allow the party to address the needs of those they represent with a broader appeal.

If the tent becomes so small that we are intolerant of the diversity of opinion within our own ranks, the GOP may never fully realize their potential. In my opinion, that is the real message behind Tuesday’s election results.

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Posted by on November 4, 2009 in Uncategorized