House passes controversial healthcare bill
The House of Representatives narrowly passed the "Affordable Healthcare for America Act" (HR 3962) on Saturday, Nov. 7th, by a vote of 220 to 215. Differences between the House bill and the Senate Finance committee's healthcare bill have yet to be resolved, so the healthcare debate is not yet over for this session of Congress.
Both the House and Senate bills leave in place the for-profit private health insurance system in the U.S., and would make it mandatory for all Americans to buy health insurance or obtain it through their employers, or through a so-called "health insurance exchange" or government plan. The House bill would place a tax penalty of 2.5% of income on individuals who do not obtain health insurance. The Senate version would exempt some individuals on economic hardship grounds. The House version would require employers with over $500,000 in payroll to offer health insurance plans to their employees. (See "House, Senate bills diverge on details," Boston Globe, 11/9/09.)
Under both House and Senate versions, the U.S. government would provide subsidies for low-income persons to buy health insurance, meaning, in effect, that U.S. taxpayers would also be providing subsidies to the private health insurance companies through their taxes, in addition to whatever health insurance premiums they would be forced to pay under the proposed mandatory insurance system. Commenting on the House bill today (11/9/09), the California Nurses Association summarized it this way: "Ultimately, the combination of the mandate to buy insurance, federal subsidies to low income families to purchase private plans, failure to adequately control insurance prices or crack down on the abuse of insurance denials make the House bill -- and its Senate counterpart -- look a lot like a massive bailout for the private insurance industry."
On November 6th, New York Democratic Congressman Anthony Weiner withdrew his single-payer amendment to H.R. 3962, the House health care reform bill. Weiner issued a statement that said, in part: "Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal."
Democratic Speaker of the House Nancy Pelosi issued her own statement on Weiner's decision, acknowledging that single payer healthcare was a popular healthcare reform proposal, but making clear that single payer would not be included in the health care reform measure she was helping shepherd through the House of Representatives. Pelosi said:
"Within the next few days, the House will vote on the most comprehensive health care legislation in our history. Our bill will provide affordability to the middle class, security to our seniors, and responsibility to our children by not adding a dime to the deficit. While our bill contains unprecedented reforms, including an end to discrimination for pre-existing conditions and a prohibition on raising rates or dropping coverage if you become ill, our bill cannot include provisions some strongly advocated. The single payer alternative is one of those provisions that could not be included in H.R. 3962, but which has generated support within the Congress and throughout the country."
Pelosi said that Congressman Weiner's "decision not to offer a single payer amendment during consideration of H.R. 3962 is a correct one, and helps advance the passage of important health reforms by this Congress.” Neither Pelosi's or Weiner's statement explained why voting on single payer at this time would have undermined the possibility of passing other health reform measures Pelosi is championing, like an end to discrimination for pre-existing conditions or a prohibition on raising rates or dropping coverage if you become ill. According to Physicians for a National Health Program, President Obama "was directly involved in the decision to not hold a vote on the Weiner single payer amendment."
Dr. Steffie Woolhandler, a founder of Physicians for a National Health Program will speak on the need for a single-payer healthcare system, at Mt. Holyoke's Gamble Auditorium, Wednesday, November 18, 7:30 PM (just off Rt. 116 in South Hadley, MA). A professor of medicine at Harvard Medical School, and co-author of Bleeding the Patient:The Consequences of Corporate Health Care, Dr. Woolhandler is one of the foremost advocates for a single-payer healthcare system in the U.S.
In September of this year Dr. Woolhandler co-authored a study, "Health Insurance and Mortality in US Adults," published in the American Journal of Public Health, that found that nearly 45,000 Americans die each year from lack of adequate health insurance. Woolhandler notes that “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.” (Quoted in Harvard Science, "New study finds 45,000 deaths annually linked to lack of health coverage".) A September 18, 2009 Democracy Now interview with Dr. Woolhandler about this study is available through www.democracynow.org or via iTunes.
For those advocating the continuation of a private for-profit health insurance system in the U.S., the successes of the Swiss model are sometimes cited. (See, for example, Regina Herzlinger, The Atlantic, "Why Republicans Should Back Universal Healthcare".) But important details of the Swiss system are sometimes left out of the discussion, such as the not-for-profit nature of the basic, legislatively mandated social health insurance plan, and the negotiated price ceilings on medical care.
In Switzerland, health insurance is mandatory for every resident, but the costs for low-income people are subsidized. Healthcare insurance is provided by private health insurance companies, and residents may select their own plan provided the insurer meets the conditions to offer the basic plan, the so-called “social health insurance.” The insurance companies are, by law, however, not allowed to make a profit on the basic healthcare plan. They are allowed to profit on sales of supplemental health insurance coverage -- to cover alternative medicines and therapies, for example. (See Swiss Federal Office of Public Health, “Health insurance,” and “FAQ – Requirement to take out insurance.” See also NPR, “In Switzerland, A Health Care Model For America?”, 7/31/08.)
Page last modified: 11/9/09