Max Buccus kills Wyden Amendment. Employees to stay Serfs.
"We have stripped this bill of choice and competition," Wyden told the Senate Finance Committee, minutes before withdrawing his amendment. He essentially conceded defeat on a measure he said was necessary to salvage a flawed bill.
"This amendment is an attempt to inject real reform in the bill," he said."Where in this bill does it give choice? I can't find it in this bill, colleagues."
So what happened last night? What was the amendment? Erza Klein:
The Senate Finance Committee finished its markup last night. Pretty much, anyway. It adopted a couple of important amendments, including one from Olympia Snowe cutting the penalties for the individual mandate to less than $800 per person. But the drama came late in the evening. About one in the morning, Wyden's Free Choice Act came before the committee. But it never came up for a vote.
Instead, Max Baucus effectively ruled it out of order. The reason? It didn't have a full CBO score. This came as a surprise to Wyden and his team, who'd gotten the amendment scored by the CBO, and had been in endless negotiations with Baucus, the White House, employers, and labor over the past week. If the score was in fact partial, as Baucus and Conrad claimed, you'd think someone might have mentioned it. No one did.
But suddenly, in the wee hours of Friday morning, the chairs of the Finance and Budget Committees were explaining that the amendment lacked a valid score. ANde an amendment without a valid score is "out of order." Wyden was left with little choice but to withdraw the amendment. It was not deliberative democracy at its finest. But it served its purpose: it killed the amendment.
Corporate lacky Max Baccus totally fucked Wyden through an in your face lie.
Wyden has been less then fulsome in his support of a public option and his various health care maneuverings and pronouncements have been, well, confusing. I have left a couple of mean messages asking him to strongly support a public option and his lackluster support. However after reading up on his Free Choice Act, I came to agree that if we are going to have a multiple insurance system then this is a needed policy change. Klein again:
If the Free Choice Act had passed, politicians could have made a very simple argument to the insured: When this bill becomes law, you will have insurance choices just like those enjoyed by a member of Congress or a government employee. You will have a variety of insurers competing for your business and the opportunity to keep the same insurance even as you change jobs, or fall unemployed, or open your own business. You don't have to take advantage of this if you don't want to. You can stick with what your employer offers. But if you do want the choice, you can have it. It's here for you. That's what reform means, for everyone: choices, competition and continuity.So for the 175 million Americans who have to take whatever insurance their boss offers Wyden was trying to introduce a measure that would allow them to choose. This would break the medieval tie of employee to corporate job and free individuals to have control of their own healthcare. If we are going to stick with the stupid insurance system we have then this seems like a great idea to me. It would both free businesses to stop wasting resources on health care decisions and free workers to work the market.
The fact that businesses were against is another classic case of American Business shooting itself in the foot. From an economic point of view it really doesn't make any sense that businesses are in the health care business of their employees. They should be dedicating their resources to their business. Matt Miller in the Wall Street journal:
Mr. Wyden's proposal, the coalition asserts, would "fundamentally frustrate employers' attempts to administer integrated health improvement strategies." As a factual matter, this is incorrect. But why should "health improvement strategies" be the job of American businesses? Sounds more like a job for American doctors, in conjunction with their patients.And lets not even get into global competitiveness.The status quo crowd also writes that Mr. Wyden's measure "would likely harm employer-employee relations because most employees have a longstanding expectation that their employer will be their primary source for health coverage." But employees already chafe at the shrinking coverage now available on the job. And who wouldn't want more options?
It's clear to anyone who looks that the edifice of employer-based coverage is crumbling. A recent survey sponsored by the Committee for Economic Development, a business-led think tank, showed that 62% of senior executives think the system is unsustainable. While the under-65 population has grown by 25 million since 1999, the number of people who get health care from their employers has declined. Numerous CEOs have told me privately that they'd just as soon get out of the benefits business altogether, which makes one wonder who the National Benefits Coalition really represents
Classic American Business AND Labor Stupidity: If its the government, unless its a handout we are against it. Don't mess with the status quo, even if its killing us.
Update- Made some editing changes. Sorry I need to get better about reading before posting.
I accidentally posted a draft of this, "my senator concedes", as a separate entity which I have now deleted. I would like to apologize to the dolphin who had posted a comment and rec'd it (thanks Synch, come on back).
October 2, 2009 7:14 PM | Reply | Permalink
So... I think the goal underlying Wyden's bill (restoring market choice to those with employer-based health care) was both noble and economically shrewd, and I actually found Wyden's original health care bill preferable, at least on a gut check, to some versions of the mainstream Democratic HCR bill. I don't think there's any possible justification for Baucus's backroom maneuvering to exclude Wyden's amendment from consideration.
But: I also don't think it's really correct to say that Wyden's bill would have actually achieved choice and competition, to the point we can say that removing it strips those things out. The problem I always had with Wyden's bill was that for someone who exercises Wyden's opt-out/"choice" provision, the employer then pays 70% of the alternate insurance you purchase. But like... only 70%. What this basically means is that the Wyden bill grants you choice in the insurance market, but only if you either (1) are wealthy enough you can afford a 30% surcharge on your health insurance in order to exercise that choice, or (2) fall into some sort of pathological case where you could be saving at least 30% on the same benefits by switching to a different provider. This would be great for anyone in one of those two groups! But it hasn't been shown to me that this would help enough people that it becomes a make-or-break for either the bill or the notion of choice.
It seems to me that if the vanilla Democratic HCR proposal passes, and my employer joins the exchange and says "pick your plan, we'll pay up to $N", I'm actually left with more choice than I would if the Wyden proposal passed and my employer offered normal health insurance of the kind that would put me under the Wyden proposal's purview. Am I missing something?
October 2, 2009 8:08 PM | Reply | Permalink
I don't disagree with your substantive points, the plan was less then ideal. However, my understanding is that you will not have a choice to join the exchange- your employer will pick for you, unless they allow you to pick. The details are still hazy.
I supported it because it was the only thing out there that began to pry apart the employer/employee health dependency. That I think is fundamentally a stupid concept that both dampens employee mobility and also makes our companies less competitive on the global scale (that is our employees are more expensive then other countries, when the dollar is already weighted higher), leading to more jobs to be exported.
As to your point on how it would affect people- you are probably right but I actually think it would have worked best for people moving jobs and being able to take better coverage from previous employers with them. It would have also opened a door for employees to embrace a potential public option.
I am biased as I have spent much of my life self employed and for awhile had employees. I hate the burden of health care on small businesses, large corps have sufficient purchasing power to negotiate good deals. Small guys not so much. Personally I would simply rather pay people more and not spend a minute of my time thinking about Health care and the complicated convoluted plans the insurers contrive. Also on some level it creeps me out to make those decisions on behalf of my people- I want to be a boss not a patriarch.
But hey- its a human resource tool so I am just not business savy to manipulate things enough I guess.
October 2, 2009 8:40 PM | Reply | Permalink
I might have to reread the Wyden proposal, mcc, but I thought it had merit. Right now, if you have employer-provided health insurance, you pay about 25-30 percent of the premiums, so if you opted out, a la Wyden, that wouldn't change very much. You would simply switch from one 30 percent to another.
Of course, as an individual, you might have less leverage to negotiate a good insurance deal than would a large employer, but since you could stay with the employer's group insurance plan, your decision wouldn't be forced, but could be based on the experience of many others who made one or the other decision.
October 2, 2009 10:53 PM | Reply | Permalink
Saladin, Fred, thanks for your responses. Going to respond to both comments in one go here.
Pretty certain this is correct. The point I was attempting to make was that the Wyden plan seemed to me to grant choice for people under a certain set of circumstances, however the exchange by itself also grants choice for people under a certain set of circumstances (i.e., people whose employers decide to opt into the exchange-- which I believe is projected to include most small businesses, but by statute would include no large ones). Wyden's statements though describe his bill as the only vehicle for "choice" or "real reform" in this bill. I think this is overselling it. There is still some mechanism for adding a degree of choice and employee independence in the bill as it stands, even if it one which not everyone can take advantage of (though there is room for expansion-- if the exchange works well a greater and greater set of employers could be convinced to offer an exchange-based plan over time, Congress could open the exchange up to large employers in addition to small ones, etc).
I'm sure the case could be easily made that the Wyden proposal would make the bill much better at promoting choice in the insurance market than the bill with just the exchange would, but that's not the same thing as the Wyden proposal being the end-all and be-all toward that goal-- Wyden's is not the only step in that direction under consideration, and it's still not clear to me that the Wyden opt-out would either be something everyone would necessarily be able to take advantage of in practice.
Okay, so I don't think I'd understood before why it was written the way it was. If that is how they arrived at the 70% number, that they were trying to mirror a way employer-provided insurance tends to work now, that makes a great deal more sense. I'm still a little confused but it sounds like I underestimated (maybe vastly) the group of people to which the Wyden proposal would have been useful.
Again it does really seem like the Wyden proposal does have a lot of merit, I don't want to be actually dismissive of it. I just was a bit concerned by Wyden's rhetoric which (and who can blame him? It's his bill Baucus knifed in the back) seemed to go several steps too far in what this provision's defeat means.
October 3, 2009 3:51 AM | Reply | Permalink
Thanks mcc for the thoughtful reply.
I remain discouraged. I am not supportive of the current plans, but if our haphazard system is what we are going to prop up and subsidize then at the very least Wyden's amendment would have forced some real competition.
Instead, we will simply penalize the working class and send mad cash to monopolized insurers. The majority of people will continue to rely on the benevolence of their employers, and the retarded fee for service structure we have will continue unabated, so costs will rise, and the insane inefficiencies and redundancies will continue to be grossly rewarded. Good times.
October 3, 2009 5:04 AM | Reply | Permalink
Back in the Day, I worked for an employer that offered a wide range of choices in provider, (it was a large entertainment company), every year they would have a day where we'd all go down in shifts to hear the various pitchmen explain various plans to make their case. We even had a Mandarin and Spanish interpreter there to help out.
At that point in time, I had excellent healthcare I could afford and CHOOSE, although I did need to spend an evening or two looking into the various options that worked best for my family.
That was back a loong time ago 1994, or so. 15 years ago.
What seems to be the problem now? Do they think we're stupid and that we don't remember?
Good post, Saladin, and I feel your outrage. How much is too much? The only thing that has changed is CEOs salaries and profit margins.
These little people are sick bastards.
October 2, 2009 9:49 PM | Reply | Permalink
I fear that they do. I see little from our leaders to show otherwise.
I want leadership.
October 3, 2009 5:06 AM | Reply | Permalink
Well, I didn't support Wyden's plan, and I was aghast when Obama labeled it too radical. It says has far the goals have fallen that Wyden's plan offered a reasonable hope of a bad compromise, but that for Baccus dirty lies and manipulation are acceptable to kill any measure that would not fill up the Insurance industry's coffers.
I share your outrage and disgust.
October 2, 2009 11:05 PM | Reply | Permalink
To tell the truth-I expected the plan to be voted down. That Baccus simply lied and told Wyden to Fuck off, shocks me.
I confess that I have always disliked wyden, since Highschool when he was still a representative and came to speak to my class that took a field trip to DC. I was impressed he came but I asked him a direct question and he totally ignored it, speaking nonsensical platitudes. I understand now that that was to be expected but it really pissed me off. Still I voted for him against Gorden Smith.
And I am mad that he has always been inefectual despite his good intentions, but I think a large part of that has been that he is from reliably liberal Oregon. But I am so angry that Baccus totaly dis'd him like this. I understand it Baccus thinks he's a wuss. What is he going to do to redeem himself? nothing. Baccus knows he will vote all the good votes and has nothing to leverage. Crazy left wing Oregon.
I hate our system. Sure Wyden is a pussy but he's a good man. This plan is smart, not perfect but a vast improvement and actually creates market competition, but no this is how it works. If you don't like it Fuck off.
Viva America. It gets what it deserves. Fuck Baccus. He is scum.
October 3, 2009 5:22 AM | Reply | Permalink
This comment came out harsher then I meant. Still I hate Baccus.
October 3, 2009 2:46 PM | Reply | Permalink
From an economic point of view it really doesn't make any sense that businesses are in the health care business of their employees.
Not economically, but when one considers how the healthcare ties a person to a company and bolsters retention, it does make sense. Healthcare has become leverage for large companies. Some people work simply because they cannot get decent healthcare if they did not. Healthcare is a major incentive to get a job with a large copany and keep it. It discourages people from exploring other options. At this point, the provisions are becoming more meager every day, but we have become accustomed to accepting 10% of something when the alternative is 100% of nothing.
October 3, 2009 1:27 AM | Reply | Permalink
Healthcare has become leverage for large companies. Healthcare is a major incentive to get a job with a large copany and keep it. It discourages people from exploring other options.
Yup. Modern day serfdom is how I think of it. Same principle.
October 3, 2009 2:48 PM | Reply | Permalink
My 2 cents worth.
Health care reform is only possible through the House. The Senate doesn't represent the public - it's obvious they're more concerned with the business aspect of the health care issue instead of the cost to the public.
The Senate doesn't give me that warm fuzzy feeling I can trust their judgment to look out for the public's interest - it's more like they're preparing a cold prickly to shove up our rear-ends without the benefit of lubrication.
All I've seen in the debates is the Senate's opinion that of controlling the cost of health care is through mandating everyone carry insurance and the industry allowed to charge whatever price them deem necessary. I fail to see how that will curb the cost of medical services. Also, I've seen where the industry has ample access to the Senate Chambers to give their professional rationale for the government to steer legislation to suit their business goals. However, what few opportunities for the public to express their views has been drown out by an uninformed opposition based on ideology rather than facts.
In business school, I learned that not making a decision was in fact a decision. My preference for both House and Senate Democrats would be to shelf this legislation for about 4 more years and work out the kinks. In the meantime, let the health care industry keep doing their thing without any government interference. In 4 years, bring this legislation back for debate. I suspect there shouldn't be any opposition to a public option simply because no one will be able to afford simple medical services due to their costs.
October 3, 2009 3:01 AM | Reply | Permalink
I can't exactly understand where we are in the committee proceedings with this bill, including Wyden's amendment. For example, this week (9/30/2009)...
The CBO has been slowly scoring all the many, many amendments to the Senate bills, and IMHO the timeline set by Reid for a vote in the full Senate is unrealistic, considering that the CBO is a relatively small shop ($44 million annual budget).
So I can't understand exactly why Wyden would withdraw his amendment because of problems with the CBO score, when so many other amendments (and the entire package) likewise can't be voted out, for the same reason.
And on Friday night, after the markup was more or less finished, the CBO still hadn't scored it.
October 3, 2009 9:17 AM | Reply | Permalink
Hi Rootie, thanks for stopping by.
Yeah I don't get the delays either, and I am sick of reading about Baccus and the lame games that our senators invent to delay actually doing their job- legislating.
I am inclined to say that he withdrew his amendment because he doesn't have any backbone. He was scared to answer a simple question from a 16 year old. But he might have made some weird backroom deal and his temper tantrum was just for show. You know theater, but who knows?
October 3, 2009 2:45 PM | Reply | Permalink
So is Wyden going to vote against the bill either in committee or on the floor?
Baucus keeps claiming that only his idiotic give-away can get through the Senate. It will be shameful if his plan does get through the Senate. The Progressives in the Senate need to show the same backbone as the Progressives in the House.
Baucus needs to realize that it is futile to offer a plan that can't pass the House no matter how many votes it gets in the Senate.
October 3, 2009 9:30 AM | Reply | Permalink
We shall see.
When it comes down to voting Wyden, like Obama, will support anything remotely resembling health care reform. He's a wuss, but his heart is in the right place.
October 3, 2009 2:38 PM | Reply | Permalink
What is the economic cost to working folk in proposing a complete overturn of our existing healthcare system? Is there zero impact? In the current economic climate with high unemployment, is it the wisest choice to upend an important segment of our economy and perhaps create even more unemployment?
Healthcare isn't just the wealthy folks at the top--it's the folks who clean the floors and serve the food in hospitals...or the X-ray technicians. What impact do your proposals to upend our existing system in a more wide-ranging manner have on these folks? None?
October 3, 2009 12:45 PM | Reply | Permalink
cube3u, My proposals aren't on the table so spare me your sanctimony.
I am talking about a simple amendment which would allow employees to have choices over their own healthcare. You know let the market work.
I personally want to scrap it and start over, and that would I understand that would create a lot of upheaval. I personally am fine with that but I understand that many wouldn't be and they have very good reasons.
October 3, 2009 2:35 PM | Reply | Permalink
I think we align the priorities differently. My top priority is to establish national control of healthcare--in setting policy standards and in regulation of the same. This would de-fang the individual states' insurance bodies to a large extent and establish the principle of national healthcare. Obviously the states are not going to be very happy about this.
I suspect that you believe that a "free market" exists at the state level now and that if your employer would just get out of the way you would be able to get the insurance you want. I don't believe that market exists in all 50 states (perhaps not in any of them); if it did, I would see competitive ads for health plans here in St Louis. I haven't seen that sort of ad in decades--so much for "free market".
I believe this is going to be a quite difficult transition for individuals and businesses without amendments making it more confusing. Recall how hard it was for Medicare folks to decide on a policy for prescription drug coverage--it was very confusing and created a lot of problems initially.
We're going to provide enough anxiety for folks without adding to it. I realize you don't agree because you believe that you can make these decisions without much anxiety. I accept that you can. That doesn't mean that millions of folks can make good decisions about health care without experience in making those decisions.
My two cents....
October 3, 2009 4:15 PM | Reply | Permalink
With all due respect cube3u, what the hell are you talking about?
I suspect that you believe that a "free market" exists at the state level now and that if your employer would just get out of the way you would be able to get the insurance you want.
You suspect wrong. Most of the country is served by regional monopolies, and if you bothered to read some of my above comments you would know that I have spent most of my life self employed. I get hosed now, and will get hosed under the baccus plan with or without the Wyden amendment.
this is going to be a quite difficult transition for individuals and businesses without amendments making it more confusing.
Really? Why? What plan are you reading?
For most people everything is going to stay the same- only better (insurance will cover more and loses the ability to discriminate). Particularly under the baccus plan, where the only real change will be for those without insurance will be mandated to buy it and businesses will have to contribute. And what's so damn confusing about amendments?
I realize you don't agree because you believe that you can make these decisions without much anxiety
Hi nice to meet you, so glad you know me so well. Actually I hate picking insurance, I am not a doctor or an accountant and these plans are ridiculously complicated. If you want the truth I currently hold castrophic coverage only and pay out of pocket every time I visit the doctor, dentist, and optometrist. I am considering going abroad for a knee surgery I need.
I do agree with you about the need for national control. But you are right that I do have a different prioritization then you:
1. I want everybody covered,
2. I don't want anyone ever to go broke because they get sick,
3. I want us to collectively spend lot less (16% of gdp down to 10 to 12%).
Somewhere farther down my list would be national control, probably after scraping medical student loans, but they are simply details.
October 3, 2009 5:48 PM | Reply | Permalink
I believe it's Max Bupkus.
October 3, 2009 12:59 PM | Reply | Permalink
So have it scored by the CBO so the amendment can be voted on when the bill comes to the floor.
October 3, 2009 2:22 PM | Reply | Permalink