Healthcare: Deal or No Deal? Senators begin work

 

Tuesday, Apr 21,2009, 2:51:49 PM   Click:

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WASHINGTON_This time, it will really happen. Or so they claim.

Senators get to work next week on the ideas in the legislation to cover some 50 million people without health insurance and contain costs for all others. Hopes are high that the Democrats and Republicans can find common ground for a bill to come out by summer.

They will have to defy history.

Grand plans to revamp health care have a half-century history of collapse. Provide more targeted, such as the creation of Medicare in 1965, succeeded.

Legislators are far apart on some of the most important issues today, the scope of government to the responsibilities of employers and individuals. And guarantee coverage for all could cost $ 1.5 trillion over 10 years, an eye-popping sum in a time of recession and mounting national debt.

Yet major constituents are often at odds now calling for change. They range from consumer groups to insurers, employers for doctors and hospitals. President Barack Obama has promised to oppose the ideological hard to find compromises.

"It is the most difficult problem we have ever taken on _ each party has had the chance to explode," said Iowa Senator Charles Grassley. He is the first Republican on the Finance Committee of the Senate, which oversees government health programs and taxes, and plans to start work on Tuesday.


Grassley said he is reasonably certain that he and the chairman, Senator Max Baucus, D-Mont., Can produce a bill that calls on average. "Our only hope is that if we do it in a way that retains the majority of both parties are in the same direction," said Grassley.

Senator Ron Wyden, D-Ore., Sees the opportunity. "It is very attractive in the truce philosophical grasp of the Senate," he said.

"Democrats are right on the idea that we have to cover everybody. Republicans have been right on the role of the private sector, not to freeze innovation and staying away prices," said Wyden . "You meld these philosophical views and you are on the way from 68 to 70 votes."

Consensus is growing on many points: the modifications should be based on the current system, not scrap it, hospitals and doctors should be paid for quality, not quantity; insurers should not be extent of discrimination against people with health problems, small businesses need special attention.

But the differences remain huge. Three of the most difficult questions are:

Costs:

Obama set aside $ 634 billion in its budget as a "deposit" for health care over 10 years. Many experts estimate that less than half the cost. Covering the uninsured could cost $ 100 billion to 150 billion dollars per year or more.

The Liberal Democrats want to follow Obama's example and get half the money from tax increases and half of the spending cuts. High increases in income tax and sales tax increases of alcoholic beverages, tobacco products and sugary soft drinks are still under discussion.

But Republicans and fiscally conservative Democrats want more funding to come from reduced spending and make the health care system less wasteful.

Mandates:

Health insurance is based on the at risk: the premiums of the vast majority of healthy people to cover patient care. For the system to work, economists say, everyone should have health insurance from the beginning to the uninsured will eventually go to the emergency room and rising costs for everyone else.

Because insurance is expensive, requiring individuals and businesses to pay for it is politically difficult. Most people now get insurance from their employer, but companies are not required to offer and the economy are smaller skates.

Obama and the Democrats are considering a set of requirements on individuals, parents and employers, with exemptions for small businesses and regressive subsidies for families with more than $ 80,000 per year.

Republicans opposed an employer mandate in the 1990s, but have mixed views on a requirement. The insurance industry is an office support person. The unions are pushing for employer mandates.

Public:

Obama and Democrats want to give the middle class and working families the opportunity to participate in a government-sponsored insurance would be offered alongside private partnerships through a new insurance.

Supporters say a government could be a testing ground for innovations and control of private insurers. Republicans see it as a step towards thinly disguised a government managed system. Insurance companies say they would not be able to compete with a government plan.

Efforts are underway to find a compromise, perhaps by limiting the scope of the public. But Rep. Dave Camp, who plays a leading role in the House, said he did not think an agreement is possible. "The public is brilliant for us," said Camp, R-Mich.


Senators begin their work in public Tuesday at a meeting of the Finance Committee of the Senate on how to change the health care system to make it more effective. They will meet next week in closed session to discuss specific proposals that might affect doctors, hospitals and other providers.

Similar sessions are planned on expanding the coverage and payment of an overhaul of the system. The leaders are hoping that the committee can vote on a bill by mid-June

In addition, the Senate Health, Education, Labor and Pensions is working on a complementary bill in order to merge the two in the full Senate. He did not know if the Senate Republicans offer their own bill.

In the House Democratic leadership intends to introduce legislation by the end of June The bill will be considered by three committees that have jurisdiction over health care. Republicans plan to propose their own measures.

Democratic leaders want the whole of each House and Senate to pass legislation before Congress leaves town for its August break.

Democrats will probably allow the use of a legislative package that will pass a bill of health in the Senate with 51 votes, instead of the 60 needed to overcome the obstruction. Republicans say that would be an act of bad faith and could poison the chances of an agreement.

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On the Net:

Senate Finance Committee: http://finance.senate.gov/

White House: http://www.whitehouse.gov/agenda/health_care