21 March 2010

A Step Toward Socialism?

Well, ladies and gentlemen, congratulations. As of tonight, the Democrats in Congress, save for 34 of them, have given the country healthcare reform. A nationalized healthcare plan that requires every American citizen to have health insurance by 2014. If you cannot afford health insurance, a government subsidization plan will be set up for you to purchase it at a substantially reduced cost. If you choose not to purchase and maintain health insurance, you will be fined and policed by the Internal Revenue Service.

I watched the entire debate, from beginning to end today. From the debate on two points of order on the resolution to consider the debate on the rules for debate on the Senate bill and reconciliation bill to the Senate bill all the way until the 216th vote on the vote to pass the reconciliation to the Senate bill. A short(ish) summation:

First, Republicans made two points of order on the resolution to consider the rules for debate of the Senate bill, which I will hereafter refer to as HR3590 (the Senate Amendment's House bill number). The first point of order was on a rules question, while the second was on allowing HR3590 to be considered because it contained earmarks (the so-called "Cornhusker Kickback," "Gatorade" earmark, and "Louisiana Purchase," among others), which the House had issued a moratorium on for one year. There was 10 minutes of debate on each point of order, followed by votes on each, and each point was denied passage.

After that, one hour of debate proceeded on the rules for general debate on the bill itself. Most of the members of Congress used this opportunity to enter either one-minute remarks on the merits of the bill and for "unanimous consent agreements." The latter is where the member of Congress stands and asks the chair (the Speaker of the House's designee) "for unanimous consent to revise and extend my remarks in support/opposition of this flawed/great bill." The chair then responds "Without objection," and that member then has the ability to put his or her remarks on the bill into the House journals without using up their side's time in debate.

If you don't know how debate works, by the way, each side of the argument controls a certain amount of time - 5, 10, 15, 30, 60, or more minutes - that a member of each side can control and dole out in increments to his/her supporters. Typically, members ask for certain amounts of time - one minute here, 45 seconds there, 15 seconds for questions - based on how long they need to speak on the floor. The House must be in order for them to do this, and time can be suspended to get the chamber under control. If you watch C-SPAN enough, you will hear the chair bang the gavel and tell members to "remove their conversations from the floor... the member has a right to be heard." When all time expires or both sides yield back to the chair the remaining time they control, then the chair can move on to calling the vote, tabling further proceedings until later, or entertaining motions.

The voting process is easy. Members, depending on the type of vote being called, commonly have either 5 or 15 minutes to cast their vote by "electronic ballot" - the member swipes a card with his ID and pretty much pushes either yes, no, or present. There are currently 431 members of the House with four vacant seats, so the magic number for a win on any vote is 216. Very often, you'll see a vote run out of time and yet stay open. The chair can keep the vote open for a short time after time to vote expires to accommodate any members that are in line waiting to vote or who are rushing in the door. It usually doesn't take more than a couple extra minutes to get in everyone, and then the chair reads the vote totals and typically says that "the motion to recommit (re-examine the question) is laid on the table (postponed)."

Okay, so procedure aside, during the debate on the rules, Rep. Bart Stupak (D-MI) held a press conference to announce a startling turn of events. Stupak, along with a few other members of the House, were the main Democrat holdups on getting 216 votes, mostly, if not totally because HR3590 contained language that did not specifically stop federal funding for abortions except in the case of rapes, incest, or to save the life of the mother. Without him and his colleagues, the Dems were looking at having only 214 votes for the bill, as opposed to 217 votes against. Stupak's announcement that he had just come from a meeting with President Obama, who had promised to sign an executive order stopping federal funds in this bill from going to fund abortions, sealed the deal for Democratic victory on HR3590.

After debating the rules for debate, the House voted on the rules, which marked a milestone vote in the proceedings. How close the vote on the rules ended up being was a portent of how the vote on HR3590 was going to go. The rules vote ended up being 228-202 with 1 not voting, meaning that it had passed by a margin of 12 votes over the 216 threshhold. There was a good deal of making "parliamentary inquiries" by the Republicans - that is, they tried to use procedure to stop the bill from going forward by claiming that parts of the bill or the way it was being handled by the House were in violation of the House rules - and a good deal of parlaying aside such inquiries by the Democratic chair. I probably should mention that I think the chair did a good job in most of his work, as he is technically not allowed to respond to certain things like hypothetical questions or procedural clarifications which had not happened yet, and that's most of what the GOP Congressmen were trying to do.

After debating the rules, two hours of general debate followed, all of it broken up into 45 second-to-2 minute intervals, on either the Democratic support for the bill and their arguments in support of it or on Republican opposition to the bill and their reasons why.

Basically, the Democrats' support rests in these points (which I make no claims to support as facts beyond that they were mentioned by members of Congress on the floor of the House):
- HR3590 provides for extended health insurance coverage for 32 million people
- It does not increase the deficit
- It will allow those already with health insurance to keep their coverage if they so choose
- It allows children to be covered through their parents' plans up to age 27
- It stops insurance companies from denying coverage to someone based upon their having a pre-existing condition

The Republican oppostion rests in these points (which I again do not say are facts beyond that they were also mentioned during debate today by members of Congress):
- HR3590 increases the deficit by several hundred million dollars over ten years, and by $1.2 trillion another ten years after that
- It violates the 72-hour notice rule of the House, having been proposed only last night
- It contains "backroom deals" like the Cornhusker Kickback, Louisiana Purchase, and Gatorade amendment which gives specific money to specific states in exchange for support on the bill
- It is not a bipartisan bill, having not incorporated things like tort reform, buying insurance across state lines to increase competition and reduce costs, and other ideas, and that it is in fact only bipartisan in that both Republicans and some Democrats oppose the bill rather than support it.
- The executive order deal was nothing more than a quid-pro-quo method of buying a couple quick votes, and that the executive order has no force of law and can be repealed at any time by any president.

During general debate, most speakers on the Democratic side praised the "historic" legislation as being on par with the Civil Rights Act of 1964 and the New Deal and Social Security of the 1930's. Many brought up emotional stories of a constituent, family member, or friend who was diagnosed with this or that disease and denied coverage because of pre-existing condition rules or being too broke to have health insurance. A select few really debated on the issue itself, rather than chastizing the Republicans for not being caring enough to pass healthcare reform today.

On the Republican side, members quoted statistics and facts, responded to Democratic statements, and railed the executive order deal as not having the force of law. A few gave their own stories of their constituents or friends and family while making the point that just because the bill is historic, it isn't necessarily good for the country. Some got heated enough to elicit responses from the Democrats, while others stuck to unanimous consent remarks.

From Arizona's delegation, I watched Rep. Jeff Flake (R-AZ06) discuss the earmark point of order in the beginning of all this debating, Rep. Franks (R-AZ02) talk during the general debate, and Rep. Shadegg (R-AZ03) discuss the rules during the rules debate. Rep. Grijalva (D-AZ07) also managed to give his take during the general debate for the Dems.

Finally, debate time expired, and the House took three votes on the legislation: first, to pass HR3590, which was approved 219-212. Second, to recommit the bill back for revision and undo the first vote, which failed by several votes. And third, to pass the reconciliation bill (which makes changes to HR3590 which had just passed) which was approved by a similar margin.

As of this writing, I'm still going through the bill itself and trying to read it so I know exactly what's in it. It's not an easy task by any means. The bill is 2,409 pages long, entirely in "legislative-ese" - the term I'm borrowing from J.D. Hayworth to describe the legalistic writing style of legislation - and amends and refers back to so many other laws and changes tham that you basically have to cross-reference everything to find out what its impact is.

Personally, I'm not impressed. As someone who does need health insurance since I am unemployed and not covered under my parents' plans any longer, I could say "screw it" and just accept the subsidy I'm getting. I'd rather oppose this bill on my ideological principles and hope it gets struck down by the Supreme Court through the 40 state Attorneys General who are planning to sue the federal government over the new law. I'd rather the House start over and incorporate both sides' plans into the bill... extending parental coverage to 26-year-olds AND allowing insurance to be bought across state lines... stopping government mandates for buying health insurance and the associated fines AND changing insurance company regulations to force them to insure people with pre-existing conditions... writing explicit non-abortion language into the bill AND capping insurance costs and rate increases.... You get the picture.

We as a country can do better. This one-and-done shot in the dark to either improve healthcare or cripple the economy is reckless, it is dangerous, and it is undemocratic.


  1. Hey Andy, who did you vote for in the 2008 presidential election?

  2. As with any election, my anonymous friend, I choose not to say for whom I voted or for what I voted. I think you may be able to figure it out if you piece together my blog posts over the past year or so, but in the interests of my personal privacy, I don't make public my voting record.

    Thanks for the comment, though.

  3. This Anonymous blogger seems to ask the right questions and appears very bright and intelligent.

  4. Without a doubt, Maximus Anonymous.

  5. As a Dem, I could go along with nearly all of the ideas about fixing the bill. I worry about the buying across state lines unless there would be significant consumer protections put in place.

    We should have learned our lesson about that when all the credit card companies moved to South Dakota to avoid state laws.

    What I would really want the Republicans to work with Dems on is to find a way out of employer provided health insurance. My biggest complaint about the HCR bill is that it pushes people more toward employer plans than toward the exchange. I think that's even worse than the lack of a public option & the individual mandate.
    Consumers should be allowed to pick their insurance provider & the plan that best suits them. They should be able to keep it when they change jobs, get divorced, or retire. Employers shouldn't have to spend as much money & time as they do to coordinate & administer benefits when they could just issue a voucher towards the exchange.

    (I'm a different Anon btw. I'm the one from the Dean/Rove debate)

  6. Anon from Rove/Dean: Heh, thanks for the clarification. The first Anon was a friend of mine who didn't want to sign in to comment lol....

    Regarding buying across state lines, I concur - there would need to be consumer protections put in place, but I don't see why that couldn't be done and included in HR3590. Seems to me the idea was ignored because it came from the GOP. Call me crazy....

    I would just love it though if we could scrap the whole healthcare debacle and start over with a fresh sheet of paper. The whole thing - and I do mean the entire issue - has just been so completely, dismally, utterly screwed up from the very get-go that it's almost not worth trying to fix the leaks anymore. Take a beat-up old car, for example... when the brakes go and the car's two years old, you replace the brakes. When the car is four years old and you need a new alternator, you buy an alternator. When the transmission goes and the car's got 150,000 miles on it after 10 years, you buy a new car. We're at about 250,000 miles on our bad healthcare, and the engine block seized up a couple decades back.

  7. I don't think that it was ignored because it came from the GOP, it just feels like it. I heard the idea considered several times in the senate, but I think Dems felt the exchange gave a very similar outcome without having to reinvent the wheel with a federal regulatory framework. They could just leave the state insurance commissions alone.

    Do you really think if we scrapped it and started over that we would get anywhere?

    To get at your title, if you look at the bill objectively, is it really socialism?
    An entirely private insurance mandate.
    An expansion of choice through the exchange.
    An expansion of consumer options by limiting exclusions.
    No price fixing (excepting the 3x elderly rate).
    No public insurance (excepting the CLASS act).
    No Medicare expansion.

    This thing was more conservative than Nixon's health care reform plan.

    Are there things I would like changed? Yes.
    Are there changes or additions we could agree on? Yes.
    Would anyone really want to go back to pre-existing conditions, recisions, 20% annual increases, medical bankruptcies, ER primary care, etc, etc.

    The sooner Republicans can swallow the hard political loss of the bill and accept the benefits its bringing to citizens, the sooner they can start running on ways to improve the bill.

  8. You're right: it does just feel like the GOP was ignored. Sadly, that's the kind of thing the GOP can energize its base with for 2010 - something the Dems don't want.

    No, we wouldn't get anywhere if we scrapped it and started over. It's just wishful thinking.

    As for my title, there's a reason I included the question mark. I do agree with you that this bill has a lot of good provisions in it. I think it does move closer to what most people think of when you define the term "socialism" - government control over an area of society or some issue. That being said, what I would really love for them to have done is (again, wishful thinking) phase these good provisions in over time. I'm not even entirely convinced that all the conservative points you made above are necessarily the best choices, and by doing things over time - and maintaining a proactive approach to the issue - we would be able to see what works and what doesn't. We can keep what works and expound on it, and we can redo what doesn't or try another idea.

    My biggest concern with the bill as is is that a big one-and-done shot like this has as much chance of failing big time as it does of succeeding big time. And with the fragility of our current economy, I just think that if the HCR bill causes a market hiccup (you might have seen the latest projections from a bunch of major companies saying that they stand to lose $14 billion in profits because of the bill's new requirements) there's the possibility of sliding back into recession.

    That's my biggest beef with HR3590, not necessarily much of the actual changes (though there are definitely parts).

    Not to be too cliche here, but in reality, only time will tell if this helps or hinders.

  9. I agree 100%