Saturday, November 28, 2009

Healthy Debate

The latest battle in the health care reform war is between the House health care bill and the Senate health care bill. Although the House bill was passed with much fanfare by the Representatives, it is the Senate bill, or some modified version of the Senate bill, that will ultimately pass, for two reasons. The first is that the Senate just generally gets more respect than the House, since there are fewer Senators and they serve for longer (also “Senator” just sounds cool).

The more important reason is that although the House bill would probably be better for the average American, they have managed to construct it so that there is a reason for everyone to hate it. In a good negotiation, all the parties involved should believe they got a little more than they should have. With the House plan, everyone gets to feel like they got a lot less. The New York Times did a breakdown of some of the key differences in both bills. Let’s look at them to see why the House bill could never become law.

Public Option: Both plans have a public option, but the Senate plan would allow individual states to opt out. Having options sounds great, but what this means is that states with strong pro-corporate lobby groups could kill a public option in states that really need one, states where the big insurance companies are crushing average citizens. As far as the average American goes, the House gets the edge on this one. However, strong proponents of states’ rights, the ideology of say, your average center-right Republican, now have a reason to hate the bill.

Employer Contribution: House plan: Most businesses are required to provide insurance or pay an eight percent payroll tax. Senate plan: Employers are not required to carry insurance for employees but if they have 50 or more employees must pay a $750 penalty per worker if any workers receive federal subsidies. What would happen here under the House plan is probably that most people with jobs would get insurance. Under the Senate plan, employers with over 50 employees would simply make sure that their employees make enough so that they do not qualify for Federal subsidies, or, failing that, hold steady at 49 employees. Again, as an average working stiff, you probably want the plan where they have to give you insurance. As a small business owner, however, you now have a reason to hate the House plan.

Abortion: Those receiving Federal subsidies for insurance can’t get a plan that covers elective abortions under the House plan. The Senate plan allows choosing a plan that covers abortion, but subsidies cannot be used to pay for the abortions. The Senate plan isn’t much better, but guess what? Now everyone who is pro-choice has a reason to hate the House plan.

Illegal Immigrants: Under the House plan, illegal immigrants can get national health coverage, but not with Federal subsidies. Under the Senate plan, illegal immigrants can’t. If illegal immigration is your issue, you now have a reason to hate the House plan.

Paying for the Plan: A 5.4% surtax on high income people pays for the House plan. This by itself is enough to send the average conservative spiraling into a rage. Those on the left will argue that this is a very small percentage of the population and the tax will not affect their lifestyle significantly, while a health care plan will ultimately bring down taxpayer health care costs due to fewer emergency visits and more preventative care. The very rich, and many of those who plan to someday be very rich (which is essentially, everyone else), will be outraged at the prospect of shouldering the entire burden for keeping the poor (who many of them hate and find responsible for their own poverty) healthy. Now the wealthy and those who aspire to wealth hate the House plan.

Clearly, most of the provisions of the House plan are going to be abhorred by your right wing conservatives, but there is enough in there for those on the left and center-left to find disagreeable too. The Senate plan, by being less offensive to everybody, will also probably be less effective, but more likely to pass, or at least pass in a modified form.

That’s politics for you!

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