Think Medicare Pt. D is bad? Brace Yourself for the Enzi Bill

From the folks who brought you Medicare Part D(isaster), here's yet another bad idea for health care reform: the so-called Health Insurance Marketplace Modernization and Affordability Act (S.1955), known here in the Beltway as the "Enzi Bill." From the bill's intro:


...to expand health care access and reduce costs through the creation of small business health plans and through modernization of the health insurance marketplace.


Sounds harmless enough, right? In reality, this is an extremely dangerous bill that, if passed, could jeopardize the health care of 85 million Americans. Find out why after the jump. If you can't wait to do something, a coalition of national organizations is sponsoring a national call-in day tomorrow, May 3rd. Please take a minute tomorrow to call your Senators, toll free--1-800-828-0498--and tell them to vote NO on the Enzi bill.

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Kennedy On Healthcare

On Wednesday, I was fortunate to take part in a call with Senator Ted Kennedy. While the call was brief and focused at least to a certain degree on the release of his new book, the Senator was refreshingly open to various topics and easy to talk to. Going in, I had two questions in mind, one tough and one less so. I figured it would be best if I started with the less tough question. Unfortunately, since we ran out of time, I never got to hear a more in-depth explanation for his position on the proposed wind farm in Nantucket Sound.

Early on in the call, Kennedy referred to the recent Massachusetts healthcare bill which he supported as a "down payment on a universal program." As someone who is less than pleased with the Massachusetts plan, I found this to be an interesting claim. By mandating that people purchase their own health insurance plans if one is not otherwise provided to them, Massachusetts is certainly moving toward a system that is "universal," in that more people are covered. However, it's a universal plan in which the burden falls largely on the individual, especially among the middle class.

Kennedy, whose penchant for both bipartisanship and incrementalism was recently profiled in The Washington Post, responded that he's hopeful that plans like the one recently passed in Massachusetts can be replicated in other large, industrialized states, or encourage other states to take greater action on healthcare. While he doesn't see the structure of the Massachusetts plan as the ideal answer for the problems of the American healthcare system, it does use a variety of unique approaches to tackle the problem of the uninsured at the state level. While I can sympathize with that position, my concern is that the developments in Massachusetts move the debate in the wrong direction, shifting access to healthcare not from a privilege to a right, but from a privilege to a burden.

I sincerely believe in the tenet that you shouldn't allow the perfect to become the enemy of the good. But that argument becomes cliche when it's trotted out to defend bad policy in context of even worse policy. The feeling I was left with after speaking with Senator Kennedy on this point was that he views the Massachusetts plan as a way to open the debate about the public responsibility for guaranteeing some measure of universal health coverage. On that, we can agree. I just hope we continue to move in the direction of making healthcare more universal rather than more individualized.

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Deflating the Massachusetts Healthcare Bill

When it was announced that a form of universal health coverage was coming to Massachusetts, quite a few people on our side of the aisle were excited by the news. After all, isn't universal coverage something progressives have been striving for for the better part of the last century? There were a few notable dissenters, however. John Sweeney of the AFL-CIO was perhaps the loudest, and while I think his criticism may have been a bit harsh, I agree with his general read of the situation.

This legislation leaves middle-income families dangling without a safety net, jeopardizes families who currently have employer-sponsored health care, and gives employers a free ride.

The bill protects workers with the lowest incomes, but punishes middle-income families. A typical family in which the husband and wife each earn a little more than $30,000 and who have two children would be forced to purchase health care, but would not be qualified for any help even if their employer does not offer any coverage or they can't afford their share of the premium. With the average employer-sponsored insurance premium costing more than $4,000 a year for single workers and close to $11,000 a year for working families, Massachusetts' new requirement will bankrupt many middle-class families.

Yesterday at The American Prospect, Robert Kuttner waded into the debate as well. He exhibits some mixed emotions, seeming to come down on the side of of those who would say this is not a great bill, but is perhaps the best we're going to get at the moment, even if it is based on "three dubious assumptions" made by Governor Mitt Romney. They are "that basic health insurance could be had for $2,400 a year,""that 'market reforms' could liberate hundreds of millions of wasted dollars to redirect to coverage," and "that health insurance is like auto insurance; government should just make everyone buy it." Economic writer that he is, Kuttner sums up the facts about the bill quite well.

Given these limitations, the bill that finally emerged is a small miracle. It cobbles together several pots of money -- Medicaid, the existing uncompensated-cost pool, projected savings from "market reform" and from sick people being treated by doctors rather than in emergency rooms. It adds $125 million a year in new state spending, and another $50-100 million from proceeds of a $295 per worker charge and other assessments to be paid by employers who fail to provide insurance and whose workers disproportionately tap the free care pool. Romney delicately calls this new tax a "fee." It is pitifully low, compared to the several thousand dollars per worker that insurance costs. It is far too feeble an incentive to induce any non-insuring employer to provide decent coverage, but it was all the business lobbyists and Romney would deign to accept.

The key criticism there is the same one made by the folks PLAN. The $295 fee per uninsured employee is an absurdly small stick with which to disincent employers from refusing to provide coverage to workers. When the pay for CEOs is averaging somewhere in the neighborhood of four hundred times that of workers, it's ridiculous that the corporate penalty for not insuring their workforce should be over three times less than the penalty imposed on the workers.

The need for universal health coverage is rapidly becoming an unavoidable fact of American life. There are a variety of ways this can be achieved and, to be sure, the Massachusetts plan is one of them. But as John Sweeney points out, it's straight out of "the Newt Gingrich playbook for health care reform." It's largely a 'market-based' approach to a problem that the market has consistently proven incapable of dealing with effectively. Worst of all, while it may not be so bad for those living in poverty or those whose employers wouldn't dream of taking away their health benefits, the hardest hit are the middle class. At the median income level, the bill for quality health insurance represents a huge chunk of the family budget.

The progressive alternative to this is some form of increased public involvement in healthcare, whether it's in the form of a single-payer system or a hybridized system of public subsidies and private add-on coverage. Point being, the Republicans are warming up their healthcare fixes, from the Massachusetts plan to Health Savings Accounts, and I'm not hearing enough from Democrats about alternative proposals. This is one debate we cannot afford to lose.

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My Liberal Fantasy: Russ Feingold's 2008 Nomination Acceptance Speech




Good evening, I love New York! Applause. Smiles broadly and waits for silence. And I proudly accept your nomination for President of the United States. Crowd erupts with sustained applause and cheers.


My friends, the time has come for an American renaissance of community, values, and justice. Almost seven years ago in this great city Osama Bin Laden unleashed his terror and the Republican Party unleashed a reign of indecency. Tonight we begin anew in the very city where it all went wrong. We bring hope.




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Russia Readies Bird Flu Vaccines

Ready for this?

Russia readies bird flu vaccines
SCIENCEDAILY

MOSCOW, April 6 (UPI)

Mikhail Zurabov, Russia's health minister, said Wednesday that clinical trials of three vaccines based on the H5N1 strain could be completed within three months.

He said Russia would be able to produce more than 8 million doses of bird flu vaccine a month once the testing is over and it would take no more than five weeks to modify the new vaccines, should the H5N1 strain mutate.

Some 190 people in more than 50 countries have been infected so far and 107 of them have died.

The Russians can afford to survive, unlike stupid Americans who squander their treasure on pointless wars. Too bad for us, eh?

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