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July 18, 2009

Let Us Read the Health Bill Before You Pass It

By Charles Andrews

A call for a public airing of any health reform bill to stop last-minute, wee-hour passage of a bill that could ruin health care for a generation.

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On behalf of the common people of the United States, here is what we need before Congress passes a health reform law:
Whenever you legislators are ready, freeze the bill for two weeks. Let everyone read it. Let commentators, local meetings convened by any group from garden clubs to trade unions, talk show callers, and whoever else have their say.

Then let Congress vote the bill up or down. If the proposal is defeated, Congressional committees can try again.

The previous big piece of health legislation, the Medicare Part D drug benefit, was passed in the dead of night at the end of 2003. Many members of Congress had no opportunity to read the final bill before they voted. Voting was extended for three wee hours while arm-twisters lined up the last several votes they needed for passage.

In the rush we got a law making it illegal for the federal government to negotiate the best price for pharmaceuticals.

We got a Part D program with the infamous "doughnut hole": a sudden suspension of government drug benefits while a senior meets a requirement to spend a few thousand dollars out of pocket for drugs before federal help resumes.

The right of consumers to buy U.S.-made drugs from vendors in Canada, where prices are often lower, was denied, and the Food and Drug Administration rattled its sword against border-state governors who talked about importing pharmaceuticals anyway.

The law directed seniors to choose among drug plan offerings from insurance corporations. The insurers can change their list of drugs covered at any time - but seniors must wait for the next open enrollment to change plans.

With increasing frequency on major legislation, Congressional representatives have no opportunity to read the final text before they vote. (True, many representatives do not even care to read bills.)
  • Congress voted on the Patriot Act in 2001 without knowing what it was.

  • H.R. 1, the stimulus package passed last January, might as well have been locked in a safe, for all the access representatives had to it before it came to the floor.

  • The recent climate change bill was put to a vote with a 300-page amendment package that House representatives had no chance to read.

When I was in high school, we were carefully taught that the United States is a republic, a representative form of government, not a direct democracy. Supposedly, democracy was okay for a city like ancient Athens, but it is not practical for a big country. I don't know whether they still teach that doctrine, but it is flim-flam. James Madison and the other main movers of the Constitution crafted layers of "representation" because they wanted to stifle the demands of common people, no matter how big or small the unit of government.

Democracy need not be limited to small New England towns. The suggestion for a Congressional two-week freeze on a final health reform bill would begin to show what can happen in this country of 306 million people.

For months the Administration has actively suppressed voices speaking for a single payer health plan, which is basically Medicare for all - that is, Medicare the decades-old, efficient, publicly financed guarantee that seniors can go to any available doctor, clinic, and hospital. Common people were shoved aside, and even physicians and nurses who showed up at Congressional committees to speak for single payer were arrested.

At this writing, one of several committee bills just emerged with a section allowing individual states to enact single payer. Advocates need two weeks to verify the language in the final legislation.

Nationally, though, so-called health reform has turned into a monster. It appears you'll be told that you and your employer must buy a private insurance plan unless you qualify for a poverty alternative. If you want good care, you'll need to be well-to-do; otherwise, "cost containment" will be achieved literally over your body, ruling out more and more actual care while enriching insurance companies.

Change we can believe in? How about starting with change we at least know about - and two weeks to speak up on it.



Authors Bio:
Charles Andrews has been active in the single payer health reform movement for 15 years. His forthcoming book is No Rich, No Poor: Why a failed economy must give way to a program of common prosperity (Oct. 2009).

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