10 hours and 35 minutes ago
To hear the GOP members of the Kansas congressional delegation tell it, passage of health reform will end liberty as we know it. Rep. Todd Tiahrt, R-Goddard, is already talking about trying to repeal or defund any bill that makes it into law. Kansas Insurance Commissioner Sandy Praeger (in photo), also a Republican, has concerns about the unlevel playing field a public option could create, but she remains optimistic about reform overall, telling the Topeka Capital-Journal: “If we go with a plan that retains as much flexibility as possible, keeps the states are regulators, allows us to continue to be there for consumers, and we could get a national system in place in terms of no pre-existing condition exclusions and everybody have coverage and meaningful subsidies, I think we’d all be better.”
The Congressional Budget Office concluded this week that the GOP health care reform proposal would end up adding about 6 million people to the ranks of the uninsured. By 2019, 52 million people would be uninsured (up from 46 million today). In comparison, the CBO determined that the Democrats’ bill would leave about 18 million uninsured. The Democrats’ bill also would reduce the deficit more than the Republican plan, the CBO calculated. “The only thing worse than having no health care reform plan is releasing a bad one, getting thrashed by CBO and making the House Democrats look good in comparison,” wrote Ezra Klein of the Washington Post.
Senate Majority Leader Harry Reid, D-Nev., proposes letting Americans in some states have the “public option” while leaving out other Americans who happen in lives in states that choose to opt out. The politically motivated idea offends Washington Post columnist David Broder. “Consider the precedent that would be set if a major piece of social legislation were to be passed with a states’ rights provision,” Broder wrote. “Imagine, for example, if Franklin Roosevelt had signed the first Social Security law with the proviso that any states with Republican governors and legislatures could exempt themselves from its coverage. This might have seemed a minimal concession to conservative opinion. But what would have followed? How long before some states would have demanded an exemption from the wage-and-hour law that established a minimum wage? And what about the clamor in a broad swath of the country when the first civil rights law was passed?”
Abortion remains a sticking point in health care reform legislation. The House version of the bill would allow people to use federal subsidies to buy private insurance that covers abortion, but only if the federal funds don’t go toward paying for an abortion. In other words, the insurance companies would have to use money from other sources, such as private employer insurance premiums, to pay for the coverage. But some House Democrats, led by Rep. Bart Stupak of Michigan, want a complete ban, and may have enough votes to derail the bill.
Sen. Pat Roberts, R-Kan., responded to those who’ve criticized his role in health care reform as partisan and unproductive. “This is not my first rodeo. I know how things can be achieved in the minority,” he wrote in a letter, noting his work on behalf of helping the contaminated town of Treece, securing funding for the national biolab at Kansas State University and keeping terror detainees out of Fort Leavenworth. “But this time, the deck was stacked very firmly against the minority voice. . . . Efforts to negotiate a better health care reform bill had already collapsed when the Obama administration set a rushed and arbitrary deadline for signing a reform bill into law. Despite the fact that compromise negotiations were under way with colleagues who I deeply respect, including the chairs and ranking members of the two committees, it was made clear there were going to be no compromises. Even now, Majority Leader Harry Reid and a select few are merging the two Senate versions of the bill behind closed doors, contrary to the president’s promise that the creation of the bill would be on C-SPAN for all to see.” Roberts concluded: “Rest assured, as the debate — which I expect to get even more heated — continues, you will hear my voice loud and clear. I’ll stand up for what’s right. I’ll offer and support alternative measures that I think make better sense and I’ll continue urging Kansans to share their concerns with me. I am saddled up and ready to ride.”
A public health insurance plan appeared dead two weeks ago, but both House and Senate Democratic leaders announced this week that their reform bills would include the option. The comeback may be fueled by opinion polls showing that a majority of the public wants a public option. Fifty-seven percent of Americans favor a public insurance option, according to a Washington Post-ABC News poll. Support among doctors is even higher — 63 percent favor giving patients a choice that would include both public and private insurance, according to a survey released last month. Overall, however, the public is still divided on the health care reform bills in Congress, with 45 percent favoring the broad outlines of the proposals and 48 percent opposed.
State Rep. Brenda Landwehr, R-Wichita, and other GOP legislators have jumped on a national bandwagon aimed at opting out of national health reform state by state. “We were created to have state sovereignty,” Landwehr said. “We were not set up to have the federal government tell the states who, what, when, where and how.” But their Health Care Freedom Amendment requires two-thirds support in the Legislature and majority approval at the polls, which can be hard to come by in Kansas. And if the constitutional amendment prevailed and Kansans were protected from federal health insurance mandates, would they find it any easier to get and keep insurance and access affordable health care?
As a member of the two U.S. Senate committees tasked with crafting health reform bills, Sen. Pat Roberts, R-Kan., has played the critic more than the architect, objecting noisily on cost and other grounds. That’s probably why he hasn’t been a go-to guy for reform champion and former Kansas Gov. Kathleen Sebelius, the Democrat now leading President Obama’s Department of Health and Human Services. “Even though we know each other very well, she knows how I feel about how health reform, so she’s trying to go where she can get votes,” Roberts told the Kansas Health Institute News Service. “I would welcome — if she had the time — at least an hour discussion to go over these facts (about health reform) with the secretary. I can’t imagine if she were still in her previous role that she wouldn’t be jumping up and down about all this.” Perhaps, but Gov. Mark Parkinson has strongly advocated reform.
In a recent NBC/Wall Street Journal poll, concern about the economy was paramount across gender lines. But “46 percent of women rank health care as one of their top two concerns, versus 34 percent of men who think that — a 12-point difference,” noted MSNBC’s First Read blog. “On the other hand, a combined 39 percent of men rank the deficit and spending as a top two concern, versus 29 percent of women who do — a 10-point difference.”
Experience teaches that many residents of Sedgwick County either don’t know or don’t care that the county bans fireworks in unincorporated areas and that a lawbreaker risks a $1,000 fine. (A similar situation exists in Wichita, where banned 6 feet-plus fireworks are everywhere every Fourth.) But is the proper official response to illegal behavior to make it legal? Lifting the ban and letting state law prevail — one option that county commissioners are considering — would ease the enforcement burden on county fire officials. But would it serve public safety? And given the risk of fire and injury, residents’ free exercise of an expanded right to shoot fireworks wouldn’t come free to taxpayers.
It’s not on the table in Congress right now, but columnist Ross Douthat supports the government providing universal catastrophic health insurance while maintaining a free-market system for non-catastrophic care. Doing so, he wrote, “would marry a central conservative insight — that we’ll never control spending so long as Americans are insulated from the true price of their medical care — to the admirable liberal premise that nobody should go bankrupt paying for lifesaving treatment.”
Kansas legislators just lost one reason not to legalize medicinal use of marijuana, something former Kansas Attorney General Robert Stephan has endorsed. It made no sense for Kansas to join the 14 states with patient pot laws as long as the Bush administration was prosecuting cases related to prescription marijuana. But on Monday the Obama Justice Department formally directed federal prosecutors to refocus their efforts. “It will not be a priority to use federal resources to prosecute patients with serious illnesses or their caregivers who are complying with state laws on medical marijuana,” said Attorney General Eric Holder, adding, however, that “we will not tolerate drug traffickers who hide behind claims of compliance with state law to mask activities that are clearly illegal.”
Judging from the Kansas Republicans’ votes and statements on health reform this year in Congress, you’d think most of their constituents would be pro-status quo. But a new survey from the Docking Institute of Public Affairs at Fort Hays State University found that 56 percent of Kansas adults think the government has the responsibility to ensure that all Americans have health care coverage and that 88 percent think the Kansas health care system needs change — major change, according to 58 percent.
Though Kansas dropped from 18th to 23rd in a national ranking of health system performance, it improved dramatically in its percentage of children who received needed mental health care, the Kansas Health Institute News Service reported. The Commonwealth Fund ranked Kansas in eighth place in the mental health care measure, up from 28th in 2007. But the report noted that more than 1 in 4 Kansas children who needed mental health care didn’t get it — so there is still room for improvement.
As for Kansas’ overall drop in the rankings, Jason Eberhart-Phillips, health director at the Kansas Department of Health and Environment, likened it to changing “seats in a rowboat that’s still running in last place” — referring to the World Health Organization’s ranking of the U.S. health system as 37th in the world.
As the Senate Finance Committee prepared to vote on its health reform bill this afternoon, Sen. Pat Roberts, R-Kan., got in touch with his Dodge City roots oratorically: “I am terribly concerned that we are riding hell for leather into a health care box canyon, full of spending quicksand, cactus tax hikes, policy briar patches, complete with CMS (Centers for Medicare & Medicaid Services) regulatory scorpions, rattlesnakes and bad news bears — something like riding your pickup over a whole tangle of barbed wire. And getting out of this, Mr. Chairman, and back on solid ground to make Medicare solvent is going to be a mighty rough and long ride.”
Are the official pleas to get an H1N1 vaccine coming into conflict with a high distrust of government, at least in Kansas? In the latest SurveyUSA poll, sponsored by KWCH, Channel 12, 60 percent of those surveyed said they would not be getting the vaccine, with 33 percent of those folks saying they don’t believe the vaccine is safe.
On the safety question: Andrew Pekosz, an associate professor of molecular microbiology and immunology at Johns Hopkins University’s Bloomberg School of Public Health in Baltimore, told the Washington Post that all the data indicates the H1N1 vaccine is “just as safe as the regular seasonal flu” vaccine, adding that “this was expected, since the 2009 H1N1 vaccine is made in exactly the same way as the seasonal flu vaccine.”
Health care reform received a significant boost Wednesday with the release of a Congressional Budget Office analysis concluding that the Senate Finance Committee bill actually would reduce the federal deficit by $81 billion over the next 10 years. It also was aided by former Sen. Bob Dole, who called for passage of health care reform (though he opposes the public option). Dole also said that Senate Minority Leader Mitch McConnell, R-Ky., told him not to say that he supported reform, and Dole said that the public was the loser when Congress couldn’t agree on reform when President Clinton proposed it (and he took partial blame for that failure).
Columnist Thomas Frank noted the “curious reversal” by Republicans who argue that private insurance companies wouldn’t be able to compete with a “predatory” public option insurance plan that covers all comers, including those private companies won’t insure. Thomas wrote: “Just think of the conservative caricatures that must be inverted for this argument to work: All those soft liberal bureaucrats? Ferocious man-eaters. The welfare state? Law of the jungle. And the actuarial-minded hardliners of the insurance biz, the ones who deny your claim or cancel your policy? A gentle but endangered species that needs our nurturing, sort of like panda bears.”
Rather than leave health care reform to Democrats, “conservatives should seize the mantle of reform and lead,” Louisiana Gov. Bobby Jindal wrote. He offered 10 ideas to increase the affordability and quality of health care (nearly all of which have been around for some time). The proposals include voluntary purchasing pools, lawsuit reform, increased transparency and payment reform, electronic medical records, tax-free health savings accounts, rewarding healthy lifestyle choices and requiring coverage of pre-existing conditions. “The public is interested in solutions that will improve America’s health-care system, not dismantle it,” Jindal wrote. “Republicans can lead on this.”
For years, Democrats wrongly portrayed GOP proposals to curb the growth of Medicare as attempts to kick medicine out of Granny’s hand. Now the roles have reversed, and Republicans are falsely accusing Democrats of cutting Medicare benefits as part of the health care reform proposals. Some may cheer this role reversal as “turnabout is fair play.” But it shows how both parties are willing to scare seniors in order to score political points. No wonder it is so difficult to reform entitlement programs.
As proof of how they aren’t just sitting on the sidelines and saying “no” to health care reform, GOP lawmakers point to all the amendments they have offered, and how Democratic lawmakers aren’t interested in making the bills more bipartisan. But Dana Milbank of the Washington Post reported that many of the GOP amendments are aimed at playing to the GOP base or some special-interest concern. For example, Sen. Orrin Hatch (in photo), R-Utah, offered an amendment, apparently facetiously, that would have added “transition relief for the excise tax on high-cost insurance plans for any state with a name that begins with the letter ‘U.’” Rep. Chuck Grassley, R-Iowa, offered an amendment that Milbank said sounded like a GOP parody: It would eliminate fees charged to private health insurance companies and make up the shortfall by reducing benefits to poor people. The amendment was defeated on a party-line vote.
Columnist Bill Roy recently recalled, with some astonishment, having met a man at a town meeting held by Rep. Lynn Jenkins, R-Topeka, who said he relied on government-paid dialysis, which cost $28,000 a month, but strongly opposed government-run medicine. Roy wrote: “It is not uncommon for people to grow to dislike those they are totally dependent upon.”
The man, Matthew Asher of Holton, responded in a letter to the Topeka Capital-Journal: “I hate that my treatment is paid for by the government. Yes, I said ‘hate.’ The more the government pays, the more control it wants. And that control will be between you and your doctor. Is that the kind of care you want?” He also wrote: “I may have lost control of my medical treatment, but I have not lost the right to voice my concerns about the direction some in Washington, D.C., are trying to take us.”
“If the Democrats in the House and in the Senate think that the American public wants to have the government take over health care, then I think it will be at their own peril.” — Rep. Todd Tiahrt, R-Goddard, on Fox News
Sen. Pat Roberts, R-Kan., argued that a 72-hour delay between the Senate Finance Committee’s markup and vote on a health care reform bill was needed to give time for “the people that the providers have hired to keep up with all of the legislation that we pass around here, and the regulations that we pass around here, to say, ‘Hey, wait a minute. Have you considered this?’” That’s a reasonable suggestion, as lobbyists are an important part of the legislative process.
But the Democratic National Committee produced an ad claiming Roberts’ comments revealed how the GOP is protecting the health insurance industry. The “Colbert Report” on Comedy Central lampooned Roberts’ “bold admission” that the delay is really about giving time for health care lobbyists to change the bill. Host Stephen Colbert congratulated Roberts for coming “out of the closet” about his committed relationship with the pharmaceutical and insurance industries, noting the campaign donations Roberts has received from both groups. “I say, ‘Good for you, sir,” Colbert said of Roberts. “The truth shall set you free.”
Singer Paul Hipp is making his own contribution to the health care discussion with his catchy video “We’re No. 37,” highlighting the World Health Organization’s ranking of the United States as 37th among health systems. The Web site PolitiFact.com noted that other WHO rankings have put the U.S. system in 15th place and first place (the latter for responsiveness). “Still, this is a rock song, and a well-sourced one at that. So we find Hipp’s claim to be Mostly True,” the fact-checkers declared.
