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Monday, July 27, 2009 | 2 a.m.
Rep. Dean Heller
Dina Titus
Shelley Berkley
Sun Blogs
AP Coverage
To understand the complexities in crafting a health care bill that could gain enough support to pass Congress, consider the concerns raised by Nevada’s House delegates.
Democratic Rep. Shelley Berkley wants to rearrange what she calls the “bass-akward” approach to health care by putting more emphasis on prevention and less on end-of-life care.
Republican Rep. Dean Heller says if the so-called government-run public option is so great (he doesn’t believe it is), the bill should require all members of Congress to sign up.
And Democratic Rep. Dina Titus wants to cover the uninsured, but she doesn’t want to tax her wealthy suburban households that earn more than $350,000 a year to pay for it.
“We’re not there yet,” said Berkley, who serves on the Ways and Means Committee, one of three committees handling the bill. “We’re trying very hard.”
President Barack Obama’s ambitious plan to revamp the nation’s health care delivery system and provide coverage for the 47 million uninsured is grinding its way through Congress, tangled in the varying agendas of the 535 members.
Senate Majority Leader Harry Reid announced the inevitable last week when it became clear his chamber would not have a bill ready for a vote before adjourning Aug. 7 for a month.
The Senate will not vote before the break. Whether the House, which adjourns this week, will vote before Friday remains unclear.
Nevada has among the highest proportions of uninsured residents in the nation — nearly one in five, or about 500,000 people.
The House bill would create a new method for the uninsured to buy health care by establishing a national health care exchange, a marketplace where those ineligible for employer-sponsored plans could buy their own insurance.
One of the plans offered on the exchange would be the public option — government care, which supporters say will provide needed competition to bring down the price of plans offered by private companies. Detractors denounce this as socialized medicine.
To help people buy insurance through the exchange, the bill offers subsidies. People making less than $44,000, or $88,000 for a family of four, would be offered credits to buy their own health plan.
In fact, $770 billion of the $1 trillion health care bill over 10 years comes from the credits that will be offered to help Americans buy insurance.
So how do we pay for all of this?
About half is to come by cutting costs, the rest from raising taxes.
The House bill would put a new tax on individuals making more than $280,000 and joint filers making more than $350,000. The tax would be staggered as incomes rise, topping out at 5.4 percent for joint filers making more than $1 million, or $800,000 for single filers.
All of the new taxes would apply only to income exceeding the limits — for example, the 1 percent tax would kick in on the first dollar earned over $280,000 for single filers and $350,000 for those filing jointly. The 5.4 percent tax would be charged on the first dollar earned over $1 million.
Republicans mostly dismiss the bill as government-run health care. They say it will lead to higher costs overall.
Heller is among those Republicans who argue that 114 million Americans will lose their existing coverage through their employers if the reform legislation is approved. The figure comes from a widely circulated report by the Lewin Group, a consulting firm owned by a health insurance company.
Heller, who also sits on the Ways and Means Committee, offered an amendment that would require citizenship verification before individuals or families could receive the subsidy to buy insurance.
Democrats say illegal immigrants are explicitly banned from coverage in the bill, much the way they are prohibited from accessing Medicare and Medicaid. But Republicans argue that immigrants can use fake documents to access the system.
But mostly, the hang-up on advancing the health care bill — even among Democrats who support the overall goal — is the new tax.
Titus voted against the bill in the House Education and Labor Committee because she opposes the tax on high-income households. She said many families making more than $350,000 in her Southern Nevada district are small-business owners — including those who run the mini-mall shops and restaurants that make up a large part of the suburban economy.
“This was a difficult vote,” Titus said in remarks submitted to the committee.
She had campaigned in part on health care reform. She held a telephone town hall in her district, hosted several round-table meetings and received 1,000 mail-back postcards from constituents whose views she sought on the issue.
Titus’ committee pulled an all-nighter to pass the bill — working until 6 a.m.. The committee approved an amendment Titus offered to increase the size of small businesses that could buy insurance on the exchange — enabling more small-business employees to participate.
But she voted against the bill. She said she thinks the taxes on high-wage earners would snare too many constituents, many of whom are struggling with underwater mortgages in the Las Vegas area’s disastrous market.
“Increasing taxes that can affect small businesses in my district will make it harder for them to be the engines of growth that pull us out of this recession and put people back to work,” Titus said.
Berkley said she, too, had reservations about the tax. But she voted for the bill in committee because she thought it was the “least intrusive way” to provide the revenue needed.
“We are talking about a surtax that only applies to 1.4 percent of Nevada taxpayers — and I’m in that income bracket,” Berkley said.
Both Berkley and Titus strongly opposed earlier suggestions to raise the money by taxing workers for the employer-backed benefits they receive. Workers now enjoy those benefits tax-free.
Facing pushback on the tax-plan from her rank and file, House Speaker Nancy Pelosi has floated a proposal to tax only those with incomes in excess of $1 million — the millionaires’ tax.
Titus said she would be more willing to support a millionaires’ tax, because fewer of her constituents earn incomes that high.
But if the tax remains at the current level of $280,000 for individuals and $350,000 for joint filers, Titus would have a difficult time supporting the final bill and may have to vote against it on the floor.
“She doesn’t like it,” Titus spokesman Andrew Stoddard said. “It’s not something she intends to or would support if it comes to the floor in the same manner it came to committee.”
The details of "the plan" are getting the public scrutiny that will expose these legislature wonks deserve. EVERYONE needs to see "the plan" as it's written, you'll laugh or scream.
I have a concern about the section dealing with "end of life" plans, care level to be decided for the elderly. Seems to follow comments from Obama that when one reaches a certain age, "sometimes it's more cost effective to take the medicine (pain) than have surgery"??? Perhaps early "life termination"? Oh yes it's in there, they choose which doctors decide when it's appropriate to OFF someone, when cost benefit is factored.
Thank goodness this has been slowed down. Maybe the CBO cost estimate, over a trillion so far, has gotten some to think about their re-election.
Republicans and Democrats as well, both, do not (yet) comprehend the American anger and passion expressed in voting trends in the recent national election for public policy and decision making over the last few years, and the failure to move forward on national agendas.
Congress will perform, or there will be more change in 2010, perhaps in both parties. It's not good enough to come home and answer to a few influential families at the local country club anymore. Americans in great numbers are prepared to vote in more new faces.
Al Franken, God bless him, is anything but a politician. But, he kept trying, hung in there, and finally, barely, got in the door out of rural, farm country Minnesota. Like he states, he's good enough, he's smart enough, and well, people like him. That type person may well be what the country needs, for a change.
In Texas, as but once such example, a state of 25 million people will add another 20 million people by 2050. There is now talk that the state legislature should start meeting every year, vs every two years, because the changes that are coming in sheer numbers demand much more attention.
Without a sustained drive to improve both education and healthcare for the rural and poor in Texas, the state will no longer be an economic leader.
Such is the state of the United States today. If we do not move forward with a combined will, we are setting ourselves up for much bigger problems down the road. We can fix education, and we can fix healthcare, but what we cannot fix as a society is all the problems that accumulate and manifest from decades of stalemate in Washington DC. We cannot fix people, over time.
The proposed tax increase will affect 4% of small business owners, most of whom derive their income from multiple sources. Either Titus is misinformed or getting bad advice. One hopes it is not because she isn't that bright. Her logic isn't very good in this report.
I do not know Ms. Titus. Is she smarter than Ensign?
Read about the negligence, costs, cover ups and crimes at a government run, government funded, government staffed mental hospital in New York. This article in today's paper tells anyone we don't want the government running our health care and they should get out of the ones they do.
http://www.nydailynews.com/ny_local/2009...
neiman-
No, that's what happens when Republicans succeed in defunding government! How ironic that Republicans cry about "big government", then defund these very same programs that they later use as examples of why "government doesn't work". When government services aren't properly funded, regulated, and overseen, then of course this becomes a self-fulfilling prophecy!
Pragmatist-
I think she's been getting a lot of bad advice lately. Dina needs to stop appeasing the Seven Hills jet set and remember the 98.5% of 3rd District residents who will NOT be paying more taxes but will be getting better health care.
Got to get rid of this cracker Titus ...she is a big mistake.
When is some congressman going to have the balls to say what is necessary..we need to eliminate for profit health insurance companies.
You cannot fix a problem without pain. Our country is becoming less and less competitive on world markets because we're selling goods and services that have bloated prices due to runaway medical costs. There is also the moral issue of how can you call yourself a country...a society...if you're willing to look in the mirror and say..."oh well, those who are uninsured will have to die...or live lives of pain and dependency on the public dole..." That is utterly bankrupt thinking. Plus the fact that American medical care as a product on the world market, no other country would even think about buying. "Habit, if not resisted, soon becomes necessity."
This healthcare bill is dead. Harry Reid has just now figured out there's a residential foreclosure problem, though now he's clueless about the coming commercial foreclosure wave. Perhaps while on his re-election campaign for the next one and a half years, Reid will figure out there is an unemployment problem. Quick to campaign but late for the party Reid.
Here's our elected officials...
(CNSNews.com) - During his speech at a National Press Club luncheon, the chairman of the House Judiciary Committee, Democratic Congressman John Conyers (D-Mich.), questioned the point of lawmakers reading the health care bill.
"I love these members, they get up and say, 'Read the bill,'" said Conyers.
"What good is reading the bill if it's a thousand pages and you don't have two days and two lawyers to find out what it means after you read the bill?"
I am disturbed by the fact Dina is more concerned for her wealthy supporters then the majority that don't even come close to making that kind of money. Also what about the loss of jobs in Vegas and many here who don't have any insurance. I would be willing to bet those making over $280,000 make sure they have insurance and they are financially in a position to afford it. If they bought a home over their heads that's their problem. I would love to have a six figure income but I was a small business owner and never came close to that big of an income. But the reality is even now with Dina Titus we see money talks. Of course this is only my opinion and I could be wrong.
Canada's AWFUL health care system:
From http://www.huffingtonpost.com/steven-web...
Canadians enjoy a quality of health care (and, subsequently, quality of life) that has been demonized by the bitter mouthpieces for the corporate health cabal in these United States, who themselves have much to lose if American citizens choose a national health care plan:
How many cases of Hobson's Choice must Americans hear before they realize that they are being colossally ripped off; that the pay-or-die option so generously offered by the medical and drug industry actually, really does not represent the best care in the world? All the fear-mongering, political obstruction and verbal gymnastics opponents of a national health care plan for the United States have been spewing are nothing more than frantic attempts to keep money in the bottomless pockets of Big Pharma. And the stranglehold the pharmaceutical industry has on the country is the same one the banks have, tenaciously hanging onto their primacy as the physical well-being of the country it professes to care about ebbs away.
In fact, the greatest threat to the health of individuals in the US is the lack of a nationalized, affordable health care program. Why the spin to cast it as socialist or downright deadly? Because to some, it ain't medicine which makes you live a better life.
It's money.
And that's the only reason everyone from the Blue Dog to the fair and balanced Fox hates the idea of people paying less and ultimately becoming healthier and detached from Big Pharma's slow drip.
And listen, Canadians also seem to have skirted (for now, anyway) the housing and real estate crisis which has gripped its big shot, big-assed cousin by their wallets. Canadians are still making tidy profits on sales and construction, the same ones Americans enjoyed for so many years of blissful indulgence. Only, the Canadians have hold of their senses. And it shows in their stable economy and satisfied health care recipients.
And once again, ONCE AGAIN (Zeus, it is so boring to have to say it over and over) the obvious need for universal health care, the kind that works so well in most other technologically advanced countries, is prevented from being implemented by the same folks whose job, apparently, is to obfuscate the necessities rightfully due all American citizens; who brought us the tragically corrupt morass in Iraq; who instigated the unregulated banking fiasco; who toil in the dark cause of relentless profiteering while cynically cloaked as Conservatism, as Republicanism, as reliable news and information, as food and drug regulation -- you name it, they corrupt it. The people who want to bring health care down want to bring you down.
From up north it's easy to see the cure for what ails.
How many Americans would be in favor of legalizing ALL 'illegal' drugs and then taxing/regulating said drugs. We could use the taxes to pay for a Universal Health system for all. It would take care of 3 problems at once.
1) All Americans would have a basic safety net for health care. the 75 Americans per day who now are dying because of 'no health' insurance.
2) War on drugs would be 'won' finally. (in the same respect that the war on alcohol & cigerettes was 'won')
3) Prison budgets would be reduced by 80% because the people in prison for drug related offenses would be released.
I was a Republican until I watched "SICKO" the documentary by Michael Moore. I realized that I had been fed lies by Fox News & the Republican party.
If you think you can handle 'THE TRUTH' about the the 'headlock' the insurance companies have us under, here's some information for you.
http://freedocumentaries.org/film.php?id...
Click the link below the 'preview' that says: Watch this film.
shrek-
Thank you, thank you, thank you! The radical right always tries to scare us with the Canadian, British, and French "socialized medicine bogeymen", but never tell us that in all 3 of these nations, along with all other developed nations with single-payer health care, that they all have overall higher life expectancy and a better standard of living. (Hint: Look beyond the initial per capita income to see what they can pay for with their money as we toil away at our work just to barely get by and pay for the HMO plan, prescription drugs, other out-of-pocket expenses, etc.).
And for all the usual arguments that "America has the best health care system in the world" and "people from all over the world come here for good care", they also forget to give us a little caveat. "America's best health care" is only available to the super-wealthy that can afford it! What other developed society has so many of its people rely on the emergency room for primary care, has so many uninsured people, so many "insured people" who still pay through the nose for inadequate care, and so many damned diseases ravaging the population?
What happens in Canada, Germany, or anywhere else with socialized healthcare does not matter. These places do not have the illegal immigrant population that we will be contending with. Without specific eligibility requirements and standards in place there is no way this plan will work the way it is supposed to. President Obama has already said that he thinks there needs to be an exception for illegal children. This is just the beginning.
This is a colossal mess! The government running our Health Care system is a disastrous prospect. Government and efficiency does not go hand-in-hand. This should be dumped in whole and start over to fine tune what many consider the best Heath Care system in the world. All politicians who vote for this Goliath screw-up WILL be held accountable! AND if you think our Health Care system is expensive know wait till it's FREE! Government run health care is not the answer.
Since it looks like they're going on vacation without putting this to a vote, they might actually take some time during their 5 weeks off to read this bill and realize how absolutely devastating it is.