In case you haven't noticed the trend, bills always become increasingly large and more complex incorporating all sorts of secondary topics, and then in the last moment a nice thick layer of pork to attract the needed votes. Make it through a sieve ? Lucky if it will make it through a barn-door.
It would be far better if they would break this into separate bills. Perhaps most reasonable ppl would agree that these features are needed;
1/ Address medicare fraud and demonstrate the savings adding these to the proposed solution. Claims that the gov' will save almost $500Bln over 10 years from MC fraud elimination seems like crazy-talk to me. The fraud is there, but no one has any motivation to stop it. Also in part the fraud makes up for the fact the Medicare underpays it's tab.
2/ Implement mandatory electronic record keeping coupled with privacy reqs and severe penalties for abuse ASAP. Mandate record transfer modalities to make data rapidly available almost everywhere.
3/ Tort reform - I prefer the British "loser pays" method. I hate the US scheme with outlandish pain&suffering claims - those should be capped, but not actual damage amounts.
4/ The problem is not that ppl don't have access to care, but that the care is only available at an ER when it becomes life threatening. So there is little preventative care and no payment for chronic care (diabetis or lupus meds and supplies for example). We need to implement some decent system of preventative and chronic condition care for the indigent - even if it means expanding medicare type programs.
5/ We should find best/cost-saving practices already in existence and see if these can be applied elsewhere in pilot programs.
6/ Pharmacy and medical suppliers should be forced to compete on price. None of this "charge Americans double' on new pharma.
7/ Medicare doesn't pay it's fair share (only ~80% of actual hospital costs) so the burden of hospital costs is already unfairly shifted to insurance and to private payers. As a result some physicians won't accept medicare and more will leave the profession as the government cheats moreso on payments. This must stop. Hospitals in some SW states mustr already underwrite ERs.
I could go on, but the point is that there are a lot clear problems in healthcare that need to be addressed and there are probably good consensus solutions to many of these. Putting a conglomerate bill that includes very controversial parts, like goverment insurance plans and mandates on insurance companies that will certainly raise the costs of insurance dramatically is not reasonable.
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Of course your "representatives" of either party have little interest in actually representing their constituents or in solving problems.
I think they will try to pass this on Saturday, after a few hundred pages of Friday-night pork additions. I hope it is stalled/stopped.
