Government Spending

The Votes, Some Fine Print, in The House Health Care Bill

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Here's a USA Today story that has a full list of how various representatives voted on the health care reform bill.

Also included, a handy-dandy list of the main differences between House and Senate versions, a prediction that the whole thing faces an uphill battle in the upper chamber (thank god):

COST House: $1.2 trillion over 10 years.Senate: $829 billion over 10 years.

MAJOR TAXES & FEES House: 5.4% income tax surcharge on annual incomes above $500,000 for individuals and $1 million for households. Senate: 40% tax on value of insurance premiums that exceed $8,000 for an individual and $21,000 for a family, plus billions in new annual fees on health care industries.

ABORTION House: Prohibit people who receive subsidies from getting abortions through public or private health insurance plans. Senate: Require insurers to separate federal subsidies from private funds so only private money is used for abortions.

PUBLIC OPTION House: Create a government-run insurance plan similar to Medicare that would negotiate how much it pays doctors and hospitals for services. Senate: Not included in Finance Committee bill, but Majority Leader Harry Reid said final Senate bill will include a public option that would let individual states opt out.

More here.

The differences between the House and Senate plans are, shall we say, minimal to the maximus, especially when you figure the cost comparisons are almost certainly way low in terms of how the much either plan will cost in the real world (see decades of history with every other government-run health care system). And it really isn't clear what it will mean for a state to "opt out" of the public option but it seems unlikely that it will mean that a state will, you know, actually be able to forego the program and associated costs altogether. And the House version's mandated coverage is disturbing in its implications

Worse still, of course, is the complete lack of workable ideas that actually combine those quaint old virtues of market competition, individual choice, and more. Time to reread Whole Foods CEO John Mackey's thoughts on the matter, and to watch this video in which he spells it out.

NEXT: Our Dangerous Cold War Nostalgia

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  1. If you’re going to thank Me, Nick, the least you can do is capitalize My name.

  2. a public option that would let individual states opt out

    In typical coercive fashion, our overlords create an “option” that states can opt out of, not in to. So it’s no option at all. It’s like the “free” credit report you get that signs you up for a load of useless crap you never wanted that was mentioned in the fine print you never read.

  3. In attempting to jam this through regardless of public opinion, the dems seem to be banking on the notion that once an entitlement program gets enacted, it becomes an untouchable sacred cow forever afterward.

    At some point that dynamic is going to break down and hopefully that time is nigh.

    No Congress can bind the actions of any future Congress. If the liberal dems can be swept out of power by 2012 and lose the executive branch as well, then whatever they have passed can be totally repealed or drasticlly modified and rolled back.

    1. One can hope. But the three worst parts of this legislation are the mandated minimums on the insurance coverage, the mandate on companies not to exclude preexisting conditions, and the mandate on individuals to be insured.

      As I understand it, the Republicans support the second. Given the second, insurance companies will demand the third. Given the second and third, insurance companies are happier with the first.

      In the end, all this legislation does is turn insurance companies into profit-guaranteed utilities. Will the Republicans want to undo this in the future? Will the insurance companies want the Republicans to undo this in the future?

    2. This is assuming that there is a candidate that is both able to win in 2012, and willing to do anything about this monstrosity. I don’t know about anyone else but I just don’t have any confidence in republicans. If this thing passes I see it doing exactly what it’s supposed to do and make the U.S. more of a welfare state. The more you make people dependent on the state the easier it is to expand it.

  4. Serious question: Does either version spell out the health care people will get in prison?

    1. Are you planning on robbing a bank, and do you have a pre-existing condition?

      1. No. I’m mostly wondering how the civil disobedience folks are going to be treated. I’m serious: Has anyone seen language in the bills dealing with this?

  5. “Create a government-run insurance plan similar to Medicare that would negotiate how much it pays doctors and hospitals for services.”

    This formulation always bothers me- one of the central features of medicare is that it’s funded by a payroll tax. The other central feature is that it sets rates that doctor have to accept. The public option, as proposed, wouldn’t be like this at all. In what sense would it be ‘similar to medicare?’

    1. It would be a massive waste of taxpayer money.

  6. …it becomes an untouchable sacred cow forever afterward.
    At some point that dynamic is going to break down and hopefully that time is nigh.

    We could run out of money. Sooner or later the host dies and the parasites have to move on or die themselves.

    1. Oh well

      We had a good run didn’t we?

      1. Not that good.

  7. There’s a reason why movie audiences cheer whenever the White House or Capitol Building is obliterated by space aliens.

    1. While I appreciate your enthusiasm, Earthlings, I am just an amused observer.

  8. ‘ABORTION House: Prohibit people who receive subsidies from getting abortions through public or private health insurance plans. Senate: Require insurers to separate federal subsidies from private funds so only private money is used for abortions.’

    These are not ‘minimal’ differences.

    The House version forbids federal payment for elective abortions, which is the policy of the Hyde Amendment – a policy which has been in place since the 1970s.

    The Senate bill would use Enron accounting to allow federal subsidies for elective abortions.

    This basic point was explained back in August by Nick Gillespie himself.

    1. Everyone with an IQ higher than that of an average Oprah show viewer (the Oprah show is my new standard for stupidity) knows this will work about the same as not being able to buy liquor with food stamps. That little bit of cash you threw on the counter – well, that covers the booze. Only the food was charged to the WIC/food stamps. Everyone wins!

      My personal opinion is that if you are on a public insurance plan, abortion should be the first prenatal care offered. Right-size that womb. May as well tie a few knots while they’re in there too.

  9. I just wonder why more people are not discussing the “fine” we will imposed if we do not have health care insurance. The IRS will be given the “job” of imposing and collecting this “fine”. I don’t like that the government already has decided what we can “afford” in Medicare. If you get $10,000 a year in retirement your premium is the same as those receiving up to $70,000 a year. If you as a disabled or retired individual cannot afford the Medicare Part B Premium and opt out, you are given a “fine” of $121.00 a year for every year you “opt” out. Also, the undocumented worker will be considered a “resident alien” as they are considered by the IRS and will be able to buy into the public option. But then they will qualify for their premiums to be paid by Medicaid. Umm..

    1. You can’t be serious about these concerns.

  10. But George, it’s not really a tax.

  11. It is incredible to me that this was rushed through in such a reckless and “in your face, Americans” mentality. What happened to openness and discussion? Oh, I know, it doesn’t matter what the people think. What a sham our gov is turning out to be. I suppose it explains in part why when I checked the price of gold this morning with the widget, ExactPrice, that it had jumped up to $1111.60 and ounce. The financial markets see the dollar tanking in the face off all this spending by our gov and so bounce goes the gold. Just amazing. No wonder India and China are trying to use their dollar reserves to purchase other investments.

    What gets me is that I’m seeing reports that you will have to show you are insured on you income tax and if not you will be fined and face prison! Is this America? And it would seem the illegal and legal immigrants are exempt from this. Talk about a bizzaro world if this true.

    Oh, and check out this Real Time US Debt Clock. Incredible.

    1. +1
      They took advantage of the news cycle being fully consumed by the Ft. Hood shootings to sneak this thing through on a Saturday night. Not much in the way of transparency..

    2. Similar to the Cap and Trade bill that was rushed to a vote while the media was still covering Michael Jacksons death 24/7….

  12. House: 5.4% income tax surcharge on annual incomes above $500,000 for individuals and $1 million for households.

    Does anyone seriously believe that this won’t eventually grow to swallow the entire middle class like the income tax did?

    Senate: 40% tax on value of insurance premiums that exceed $8,000 for an individual and $21,000 for a family, plus billions in new annual fees on health care industries.

    Yeah, this won’t destroy private insurance at all.

    1. Plus, there’s nothing in the bill that adjusts these income limits for the inflation they plan to dump on us soon. Pretty soon, minimum wage will be about $500k a year.

  13. > Nancy
    > Pelosi was touring the countryside in a chauffeur-driven
    > car. Suddenly, a cow jumps out into the road, they hit it
    > full on, and the car comes to a stop. Nancy , in her usual
    > charming manner, says to the chauffeur, ‘you get out and
    > check – you were driving.’
    >
    >
    > The
    > chauffeur gets out, checks, and reports that the animal is
    > dead but it was old.
    >
    >
    > ‘You
    > were driving; go
    > and tell the farmer,’ says Nancy .
    >
    >
    > Two
    > hours later, the chauffeur returns totally plastered, hair
    > ruffled with a big grin on his face.
    >
    >
    > My God,
    > what happened to you?’ asks Nancy .
    >
    >
    > The
    > chauffeur replies: ‘When I got there, the farmer opened
    > his best bottle of malt whisky, the wife gave me a slap-up
    > meal and the daughter made love to
    > me.’
    >
    >
    > ‘What
    > on earth did you say?’ asks Nancy .
    >
    >
    > ‘I
    > just knocked on the door and when it was answered, I said to
    > them: ‘I’m Nancy Pelosi’s chauffeur, and I’ve
    > just killed the old cow.’

  14. Create a government-run insurance plan similar to Medicare that would negotiate how much it pays doctors and hospitals for services.

    The only problem with this is that Medicare doesn’t negotiate anything with anybody. Rates are published annually. Take it or leave it.

    But other than that . . . .

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