Matthew Holt

Thinking the unthinkable–no Health Care bill?

Matthew Holt

After a resounding Democratic Presidential election win, a terrible recession, and a bruising year of politics, it would be just like America that a crazy election result torpedoes the health care reform bill. It would be the first Republican Senator win in 43 years in Massachusetts, a state that’s bluer than blue, and the actual seat being elected on Tuesday hasn’t been won by a Republican since 1947!

But it’s becoming more and more possible, and the latest polls are all over the map.

Let’s play out what happens if we go back to a 59–41 Senate. The current Senate rules basically allow the minority to shut down proceedings. Harry Reid has in fact performed miracles to keep Lieberman, Nelson and some of the rest on board. Obama, Reid & Pelosi are now working the deal out with the unions and all the rest to make sure that what’s a pretty slim majority in the House will essentially accept the Senate bill—with some sop to the unions on the “Excise tax”. There are some other technicalities about the Exchange et al, but in the end we have a fair idea of what’s going to be the result.

Unless …

Now the right just don’t care about the uninsured—or least not as much as they believe in protecting the health care industry’s ability to do what it’s been doing for 50 years, combined with their desire to hand Obama a defeat.

Much of the left and a plurality of Americans (polling data bears this out) believe that what’s in the bill is not enough—and because the Senate is not a democratic body, they’re angry enough to sit this out.

Almost inconceivably, but not surprisingly given their records of veracity, via AHIP the major health plans (with the very vocal exception of Kaiser Permanente) have been playing both sides of the street and have given money to the US Chamber of Commerce to oppose reform, while Karen Ignagni has always maintained that AHIP was in favor of reform. And of course several sensible commentators on THCB disagree with me and think that the current bill doesn’t do enough to fix America’s health care delivery crisis to be worth the cost of fixing (some of) its uninsurance crisis.

So there are lots of people who think that the current mealy-mouthed compromise is bad for one reason or another. But if the vote happened right now it’ll pass the Senate with 60 votes.

If, and only if, the 60th is the new Democratic Senator from Massachusetts. If the Republican wins I cannot see a way for a compromise bill that will get Snowe or Collins (the two most liberal Republicans) to be the 60th vote, while keeping the mainstream Democrats in the House on board.

And remember what this means for the health of the health care system and of America.

No bill means we’re not coming back here again until we are forced back. It means that the number of uninsured will go up—way up as states run out of stimulus money and start cutting back on Medicaid (as has been happening in California). And more and more people will continue to lose insurance at work.

There won’t even be any of the pilot programs buried in the Senate bill for reforming the delivery system payment mechanism. I know I’ve derided them, but they’re better than nothing. And of course if the 2010 elections are as bad for the Democrats as many predict, the ability of the Feds to muster the will to change even Medicare alone will be gone.

To sum up: no bill means in 5–10 years a huge rise in uninsurance, no reform of the delivery system, and no prospect for a rationalization of health care spending. That will mean the collapse of large parts of the health care system in a spasmodic unplanned fashion.

After the next serious downturn the health system will crash rather than soft land. The bubble will truly burst and the most likely result will be an austere single payer system.

I’m not sure that’s what the opponents of reform want, but it’s pretty much out of their hands. Unless of course the voters of Massachusetts—who ironically already have a health system much like the Senate bill promises the rest of us—decide that they’re angry enough about, well, everything and nothing to do something crazy.

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クロムハーツ ネックレス コピーMarjoryMike WilliamsCaron Mc CatthyHenry Massingale Recent comment authors
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Marjory
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Hi to all, it’s actually a fastidious for me to visit this website, it consists of
precious Information.

Henry Massingale
Guest

There is a unity lost between Governing Parties that is needed to help the people feel secure. The moral building block for Health Care. To see the true Health Care Tax forum you must stop thinking in 3-D,This multi tax forum is against a $100 Trillion Dollar system.. … To force pay into another system of failures within Health Care Insurance Groups. This economy will not balance with this concept of a tax forum against the Health Care System. The issue of how to force pay into this system of Health Care may have worked but I am still troubled… Read more »

Henry Massingale
Guest

3/08/2010 To force pay into another system of failures within Health Care Insurance Groups. This economy will not balance with this concept of a tax forum against the Health Care System. The issue of how to force pay into this system of Health Care may have worked but I am still troubled over the progressive tax forum within this Bill. It covers so many items and Countries that it only forces the system to adjust itself. In some areas, increases against the people and the troubled economy, and in other areas, less effects will be felt. But this is my… Read more »

Henry Massingale
Guest

1.2/25/1010 Now somebody is not telling the truth, on both sides. So I did a little number check with my friends on the net and I was right, so enjoy the truth, of force pay through the Bill and the freedom of choice offered By me and my friends in and for FASC Concepts .This Prime Directive on page 100 at our site will not be completed until 3/1/2010, but hey please drop on by and see what the fuss is about…….. A Prime Directive  For Health Care   In all things there must be a guideline in order to… Read more »

Henry Massingale
Guest

The How to; President Obama, asked for the help, of a way to cover the sick. And it is a simple concept that is presented before all to see. Health Care Insurance Companies will not cover the sick, {This will not make dollars for them.} Our tax failure within our system will not be able to carry the load because of cost. Within this United Forum, as Health Care Insurance Companies do join and earn money by helping the pay in form and the Health Care Tax Forum within our Medicare Tax system all ready in place, the concept of… Read more »

Mike Williams
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Mike Williams

I believe in true, meaningful, health care reform. I do not believe that government should run healthcare or act as a provider, but should engage in its role as a facilitator of needed reform and change. Socialized, government run healthcare has been proven to be costly to taxpayers, results in lower quality care, long lines and waiting periods and essentially equates to healthcare rationing in order to control the costs. Rather than throw out the current system, why can’t we start from the beginning and work our way back? First, government should partner with insurance companies, hospitals and physicians to… Read more »

Caron Mc Catthy
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Caron Mc Catthy

You all should check Costs . over my years in the medical Billing field we see Pay for Billing triple…another “Cost of doing Business” and more of these Higher paid workers are needed for the tiniest of practices…..Who pays for that tripling of employees? Every time Government puts a program into action…it costs the average person MORE..and The Average Person can track that FACT by checking Costs over the years… When I worked in the field..for several years as a PA I was amazed to see that a Visit for an ear infection REFUNDED the Doctor at $1.00 and the… Read more »

Henry Massingale
Guest

I have weighed this issue Health Care Bill vs. Constitution, and if a Political Party Gains control over a people because if the Health Care Tax Dollars, then it is laws with out moral value. You see when tobacco companies became under fire the laws were based on a moral value because of the issues within. The moral building blocks from Bill to Law is not supported because these Laws are for increase taxes and force pay against the people and a increase tax forum in a wide coverage stated to be in the best interest of the Country. exmp.,… Read more »

Peter
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Peter

“If the government wanted to cut costs, maybe they should focus on malpractice and start to passing legislation limiting these premiums and liabilities.”
Welcome, many states have already done this – what more do you want?

charlesbrooks
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charlesbrooks

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WelcomeToMyPractice.com
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I am satisfied with the direction of the healthcare bill. Early on it was looking like Doctors were going to be heavily affected, especially in their wallets. As an owner of a medical marketing company, <a href=" http://www.welcometomypractice.com, I was very concerned that my business would be affected from Doctors cutting back on marketing and spending. My hope is that the government listens to the public. We want those who can not afford healthcare to be covered, but not at the cost of losing the smartest and best due to their inability to make enough money to continue practicing medicine.… Read more »

Nate
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Nate

“If any of you know of a Private Health Insurance plan that follows Medicares lead on Never Events. I certainly would like to know.”
Hundreds of them, now that there is legal cover it is common plan language to exclude never events.

Gary Lampman
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Gary Lampman

I want you to know that the term Death Panels is not just a governmental Theme. We have Death Panels in Health Insurance Today. Your Contract determines what is to be covered and more Importantly. What is not covered.Terms like preexisting,Experimental,exclusions,max lifetime benefits etc. Then there are the financial decisions for exorbitant life saving Procedures that requires a large Down Payment. The Growing Conservative movement has it right,If you cannot $$$(afford)$$$ to live than Die Quickly.However,this does not reflect my sentiments on the matter. Government is not always the bad Guy! If the President had not BAILED OUT the BANKS… Read more »

john c. williams
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john c. williams

Health care blog
please introduce — health care reform in one page
is it not true that congress wants a health reform bill that costs the USA treasury little and is affordable to all?
USA population over 300,000,000.
multiplied by $20.00 monthly payment for each person in a family. equals over 6,000,000,000.00 (6 billion) a month for national health care.
A NON PROFIT COMPANY CONTROLLS THE MONEY not insurance companies. that means more for health care services.
Tell me where I am wrong?
JOHN age62 finance degree