The Senate Finance Committee has been meeting secretly for months — months — reportedly creating a plan to pay for getting Americans something still well short of the full health care coverage enjoyed by every other industrialized country on the planet.
But despite repeated assurances from Chairman Baucus that wonderful bipartisan progress was coming, all these people have been able to come up with so far is a list of options.
It’s not that different from lists reputable analysts had already compiled and published. But the Committee apparently hasn’t been able to agree on anything, because, as Olympia Snowe so thoughtfully explains, deciding how to raise taxes to keep 20,000 people from dying every year is hard work.
According to various reports — Ezra Klein, Jonathon Cohn, NYT — the list includes about 20 options, including the following possible new taxes/savings (estimates are over 10 years): (big thanks to Ezra Klein for the summaries)
1. A tax surcharge on those making $250,000 and above. The surcharge might be 2 percent for the amounts above $250,000, more for amounts above $500,000 and 4 percent for amounts above $1,000,000. The House is seriously considering a surcharge. Estimated revenues = $350 to $500 billion.
2. A tax on health benefits above a very high level. If, for example, the upper-end cost of insuring members of Congress were $17,000/year (Via Kaiser study of employer-provided plans, in 2008, the national average insurance for a family of four cost about $12,800), then a tax would kick in when the benefit exceeds that amount by, say 50 percent. Baucus and economists like the concept, but Obama, labor, and many Dems don’t. Estimated revenues = $90 to $234 billion.
3. Limit the tax deductions for itemized deductions for those with very high incomes. If their marginal tax rate moves from 35 to 39 percent (when Bush tax cuts expire) then limit the deduction to 28 or 35 percent. This Obama proposal is disliked by Sen. Baucus but is still on the table. Estimated revenues = $90 to $267 billion.
4. Raise the current payroll tax on employees/employers by, e.g., 0.3 percent. Estimated revenues = $275 billion.
5. Consumption or value/added taxes. E.g., tax sugary drinks, beer, etc. These are not progressive measures, and their effect on reducing consumption is unclear. Estimate revenues = $30 to $100 billion.
6. Tax insurance companies for each person they insure. Estimated revnues = $75 to $100 billion.
7. And there are various proposals to cut federal payments to Medicare, which WH Budget Director Orszag is pushing on the grounds, e.g., that once more people are insured, current payments to providers for caring for uninsured people will decrease. Estimated savings = several hundred billions.
Under the current less than full coverage proposals, all they need to do is come up with about $1.2 trillion in taxes or cost savings over ten years, in a system that is costing us $2.2 trillion every year and escalating at 3 to 4 times the rate of inflation.
If the nation were in wars that would likely cost $3 trillion, and thousands of our troops were endangered because the Senate Finance Committee couldn’t agree on a revenue plan to pay for their safety, the American people would wonder why these scoundrels weren’t run out of town with pitchforks. Of course, Senate Finance, and Congress generally, still haven’t come up with a plan to pay that $3 trillion.
So when nearly 20,000 people die every year because they can’t afford health insurance and a million people a year face bankruptcy driven in large part because they were uninsured or fraudulently insured by an industry whose persistence depends on denying coverage, we probably shouldn’t be surprised by all the Senate dawdling, but the same accountability principle should apply.
We need less stalling from the Finance Committee, less whining from its members and more results. There are people dying while these Senators dawdle.



74 Comments




Four out of five committees in Congress are moving forward. What’s wrong with Finance?
they are trying to be “bi-partisan.”
very good work bringing this out to the light of day, scarecrow!
How about ending the two friggin wars and stopping the flood of money to war profiteers. That’d pay for anything we need in this country.
Enough already with the bullshit and just stop the killing. Vietnam impoverished this country and these unnecessary wars of choice are going to do far greater damage. Social Security is fine and we could have a universal single-payer system paid for many times over with the money that’s being wasted in Bush’s wars.
Other tax revenues
1. A transaction tax on financial and stock instruments. There is a tax on a loaf of bread but if you want to buy Ford Motor Co. zero – nada.
2. Eliminate the ability to write off salaries paid above ______ .
You know, a TRILLION dollars IS a lot of money to save 20,000 lives. Not worth it especially when it comes from folks who didn’t pay for it. No. No. and No as long as the Republic has breath.
My birthmother died in March because she had no health insurance, and waited until she qualified for Medicare at age 65 to seek treatment. She went into the hospital on Friday, and died on Sunday of emphysema, having waited too long to seek treatment.
A trillion dollars is a ten year estimate, 20,000 is a yearly death toll.
Consider remedial arithmetic and logic.
Slightly off topic, pro-pubic option demonstration in front of Kay Hagan’s district office
http://www.youtube.com/watch?v=TCqpaHcU1ek
Very sorry, indescribably sad.
the only bi partisan aspect to this tragedy is contributions – Grassley, et al are benefiting while Baucus keeps the window open
as I’ve commented previously, Baucus has become a major sugar daddy to many on these committees – personally, I think that is why Harry told Max enough was enough – can’t have him getting too big for his sugar britches after all:
Who’s Your Daddy ?
Still too much. These people didn’t PAY for it. The government should not be giving from one group of people to give to another. That’s socialism.
People abroad must think Americans are dumb as rocks.
3000 died on 9-11 how many trillions have we spent and how many lives have we dedicated to attempt to remedy this.
Dumb and greedy – see # 12
Hurray for a surtax.
No one around here is probably old enough to remember, but LBJ imposed a brief surtax to pay for Vietnam. What I’d really prefer to see is a surtax to pay for Iraq, but since that’s not going to happen, use a surtax to pay for health care.
And please start with the AIG bonuses.
OT
Donna Edwards will be live blogging at Open Left at noon eastern. Might be a good chance to question her.
Scarecrow -
thanks very much for the above summaries – my attentions have been on the whipping/lobbying, esp in the House so they are much appreciated
About that comparative CBO scoring that Baucus received but will not share with his employers (you, me, and the people of Montana). What exactly do you reckon it showed?
As I understand it, the actual figure from the CBO for the currently extant plan from HELP is $620 Bn, or about half of what you are claiming.
To DLoerke@12: Who do you think is paying for the emergency care and expenses associated with caring for the uninsured right now?
The fact is that providing insurance coverage for those who are currently uninsured would probably save us millions. Getting the vultures in the insurance industry out of health care would likely save billions (just think of what their profits were last year as the cost savings minimum…).
Furthermore, since the current plan is for the program to pay for itself with no additional input of Federal funds, how would anyone be getting anything they didn’t pay for? Your ignorance is showing…
Did he get a CBO score on single payer?
Every person who dies while congress plays patsy with the insurance companies deserves to have those involved charged with manslaughter unless the doctor, insurance company and hospital can prove positively that medical care would not have saved their lives.
Hey, the federal prison system is probably short of doctors and hospital workers. Win win situation.
When are we going to face the fact that all these new taxes will flow right into the coffers of the healthcare industry? Without real reform (ie: cut the 30% of premiums that go to waste, fraud, excess compensation), our country will go broke trying to pay for healthcare.
We have best Congress/government that money can buy. A focused special interest whose profitability rest with legislation will win out over the diffuse general interest. This is even more so when the general interest is obfuscated by those very special interest via mass media.
Can only hope that enough people are reading/responding to sites like firedoglake, huffpost, etc….
Define forward.
The Finance Committee is just overwhelmed by the wealth of possibilities, so many bogus plans to choose from.
These fuckers in Congress don’t give a rats ass who should die waiting for healthcare because it will never be them or their families.
I thought I was outraged at all the things bushco did, but never did I dream that so called democrats would the ones getting in the way of a good bill with a robust public option. Increadible disgust….
You’re making too much sense, james. Folks in the US aren’t capable of processing information that makes sense.
Aha! So I take it you admit that to take from the regular populace, the taxpayer, and give the money to financial corporations that would fold without it, or to car companies that would be driven from business due to the inability to finance their products, is socialism. It’s corporate welfare. Somehow, the average taxpayer has to find a way to compensate himself for the error of the financial genius’ capitalist ways. They want to assert that health care is a human right, as is food.
That shows such a depth of ignorance of all things economic that if you aren’t a banker you should have been.
Amazing just amazing….next time you walk into your public library, or take your kids to a public school or call the fire department you will have used a socialized service,…. like the creation of the internet for instance….that it benefits people AND society clearly is beyond you as it seems that you prefer the concept of ‘you are on your own’.
Emasculated is what we are.
Take off the cap on payroll tax.
90 % tax rate on anything over $ 5 million. If you CAN’T get by on $ 5 Million a year, pick another country.
I believe the rate was this high in the fifties and we thrived.
Hey DLoerke, stop using roads that I paid for. Build your own roads with your own money — oh, and stop using money printed on socialized presses. I guess you’ll have to print your own money too.
No one knows because he’s not released them.
My guess. Probably not.
A devout biblist
now Susan,
I employed that argument in a WH Facebook ‘event’ on healthcare the other day – whole lotta patriotic crickets chirping
they wouldn’t respond to charges of their socialistic ways in providing lifelong subsidized care for Congresscritters and their families either
Yes, I’ve made the point to his office that his PAC money should be spent educating his constituents about single payer, the reality of the estate tax not affecting them, how to avoid pay day loans, and a host of other topics. But no, I know, our Senators want their constituents stupid. Max’s money goes to his buddies. “Bipartisan Compromise= The People are About to Get Screwed.”
DLoerke’s comment is one of the reasons (by no means the only one) why the United States is held in such low esteem in the more civilized parts of the world. Europeans in particular have a hard time getting their minds around the heartlessness of the American public, to whom the notion of social solidarity seems anathema. It’s very sad, and possibly incurable. Selfishness incarnate.
I should say that if single payer were the plan being considered in Congress, aside from some start up costs, we would be talking about money saved not extra revenue needed. As it is, these taxes are in no way new or original. They are the standard smorgasbord of tax proposals that have been around in many cases for decades. The taxes on the rich I think are especially deceptive. The CEOs cashing out their stock options in the current suckers market will report the money they receive as capital gains not income and so be taxed at a much lower rate. Even on the income side, an increase in marginal rates of a couple percent is laughable. And Orszag’s ideas about cutting payments to Medicare are largely about cutting care in Medicare.
about 2 weeks ago, there was a fluff piece by one of his staffers in the Missoula paper – lots of interest, and then one of you reality based Montanans got in there and went to town with the facts – must have been close to 300 comments – his defenders didn’t have a prayer. very encouraging to see folks hungry to know what was really going on – and I suspect his upcoming annual family fun camp is going to have some uninvited guests :D
Finance is the one not moving forward.
OT, but does anyone know anything about this? will this impact the Progressive Caucus effectiveness on health care?
The Congressional Progressive Caucus has fired Bill Goold, its executive director, leaving the House Democrats’ liberal wing without a staff-level chief as they head into a critical legislative fight on health care.
Absolutely, bang on, as usual.
yep. I’m having daydreams about 99% excise taxes on insurance industry exec bonuses until this thing passes… insurance lobbyists too ;)
by the way.. I’ve been googling for a list of the 40 Blue Dogs who signed the sabotage letter. Does anyone have it? I need to know if I need to write a harshly worded letter to my critter.. she’s a DLC member but doesn’t consistently vote with them, so who knows.
wow. my guess – he’s responsible for the bogus leak about CBO Scores on the 3 House Committee proposals the other day
oh and note to the Caucus – Jane Hamsher would make a great Exec Director
tough to make out who they are from their signatures over at TPM – but we do know 3 of them – was going to go back over there later and see what I could decipher.
and think about the 12 who didn’t sign – the weasliest of the weaslies
yeah.. what’s this cowardly, don’t even bother to provide a list of signatories thing that’s going on here. Could it be that they’re actually ashamed of being the chumps that they are?
Why is uncapping the payroll tax not on the table?
The tax surcharge looks good. Plus limiting itemized deductions on incomes over $250,000, with a bias to the upper end.
Why are there no corporate deduction reforms on the table?
One of the keys to stimulating jobs is to reduce the marginal utility of additional income beyond a certain point, such as $5 million, which reduces the temptation to suck so much cash out of the business, making actual investments in increases in production more likely and de-incentivizing the race to the bottom on wages. It worked from FDR through Eisenhower.
Check here: http://www.house.gov/melancon/…..orces.html
Thanks.. yeah, I was just wondering who the actual 40 who signed were (as opposed to the 13 who couldn’t be bothered). It does looks like the Treason Letter was restricted to the Dogs.. DLCers don’t seem to be involved.. yet. The Hill reported that there are TWO Blue Dogs who have indicated support for the Public Option, joining with a number of DLCers/New Dems and progressives. I just have no idea who they are.
Again you have not defined what moving forward in the other committees means for you. A committee can come up with a crap bill but moving forward in such a case is the opposite of being productive.
For the sixth or seventh time I called Senator Feinstein’s office in SF and asked what her stand on a public option in the health care bill was…
For the same number of times I was told “she is OPEN to a public option“…which of course is a totally meaningless statement…showing to me that she doesn’t want to commit to anything.
This time I was also told “she’s holding back to see if the public option is robust and not so watered down that it is toothless”….
I always reply that since a robust public option is supported by almost 75% of Americans and 90% of Democrats SHE SHOULD BE LEADING ON THIS ISSUE, not waiting for others to do something about it!
It won’t be the Republicans who defeat this public option…it will be gutless politicians like our own DiFi here in California.
Right on Hugh. Single payer is the answer to a more efficient and cheaper system. Without real tax reform, these parasites will slither out of paying their fair share. Let’s just return to the way we operated during WWII. We are in a crisis. Let’s act like it.
does anyone know anything about the counter letter that reportedly went out right after the Blue Dog letter..? Where 22 DLCers and two Blue Dog defectors, led by Lois Capps allegedly wrote to back Pelosi’s position against the Dogs? Can’t seem to find anything ‘cept the writeup in the Hill and on Democratic Underground.
I am so sorry…that gap before 65 is critical….people get ill, lose jobs, etc. Peace & prayers.
9/11 is a matter of national defense, a protection against enemies of Ameria. No one guaranteed food or health care in the Constitution…and “general welfare” doesn’t count–it was precatory language not intending to grant power.
The internet was developed by PRIVATE companies. THe fact that contractors like my company helped DARPA design the specs doesn’t hide the fact that the ‘net is a private consortium. Now libraries…the best ones are private.
Orszag’s ideas are mostly about changing the incentive structure of payments, plus recognizing that if more people/business contribute to health insurance, then there’s less need for the fed to budget to compensate providers for the limited care the uninsured currently receive. But the main piece is changing the incentives, and I couldn’t cover that piece in this post.
Interestingly, David Brooks talks about this today, but then he can’t reach a workable solution.
The bottom line is that the real “savings” in the current system would come from paying insurers and providers less $$ per patient but somehow getting better care, because they practice medicine better – but that requires massive instutitional/attitudinal changes which may or may not be achievable in any of the mechanisms being considered. Even sp alone does not get all of it; it too would require not only the elimination/reduction of most of the middlemen costs, but also changes in how providers practice medicine and how they’re compensated. No matter what we do, the whole thing makes my head hurt.
Emergency care for the uninsured are costs eaten by the hospital as they fulfil their Hippocratic Oath. Medicaid and Medicaire are programs that show why the Federal government should not be involved in health care. As someone who wrote the Medicare billing system programming for a major Southwestern hospital, the whole system is designed around inefficiency and can’t be any other as long as Federal procurement and auditing rules are followed. Not to mention the fact that medicine can’t be practiced by the numbers.
From the Trudy Lieberman piece “Groundhog Day” in the CJR another weasel move is identified:
Many of these are worthwhile options, though I think SS and Medicare need to be improved, not have money taken away from them. This is a sop to the Right, which is still trying to abolish them. Stop it. Just stop it, Obama and Friends. Let the Right carry its own water.
Predictably, the Right, including conservative (aka “centrist” Dems, according to the MSM) will opt for the most annoying taxes in order to make passage difficult or slam the middle class and the poor while protecting the wealthy.
Taxing the employing on the cost of the employer’s contribution toward the employee’s health care is likely to push more people into a credible public option – if there is one. As with many of these taxes, it only makes sense to tax these benefits where the employee makes above a threshold income. The middle class can’t afford the direct costs of insurance and care now.
Re: Medicare and Medicaid accounting rules. If you are talking about the micro-managed fee-for-service system that those rules implement, that is a result of the Reagan reforms to Medicare to “control costs”.
I have argued for some time that these rules, and the private insurance copying of these rules in their own operations is one of the sources of high administrative costs.
Case in point: some private insurance IT shops under contract for processing Medicare claims have a rule that prohibits a second X-ray in the same day. It is supposed to be a check for duplicate billing. But it kicks out even legitimate cases of second X-rays, which the patient has to pick up because only the hospital’s computers (and not people) can talk to the Medicare contractor’s computers (and not people).
It’s not unique to government programs; it’s endemic in a micro-managed fee-for-service system.
Add in precertifications and rebillings and the information flows are nightmarish.
This European has a hard time consoling this loathing of any form of organised social solidarity with the kindness, generosity, and helpfulness individual Americans show individual strangers.
It’s as if American empathy depends on some form of interpersonal relationship. “Puppy eyes” may suffice, but “the uninsured” is too abstract.
The socialists certainly have the masses in an uproar. Still, the tricky part is paying for the whole thing. Math is not the best subject of most socialist.
The biggest myth of all is that people are out there dying due to no health coverage. Actually they jam the emergency room on a daily basis. Many can afford health insurance but consider it a “bad investment.”
Again, all I can say is the socialists have really done a great brain washing job on the simple minds of our nation.
Health care is not an entitlement. People have to work for such things.
That’s very clever you make that connection. Why didn’t I think of that?
Some studies you might consider:
http://www.ncpa.org/sub/dpd/in…..le_ID=6684
http://www.rockymountainnews.c…..printer=1/
http://www.mysanantonio.com/bu….._html.html
http://www.pnhp.org/news/2008/…..00_uni.php
It’s no wonder why this economy is not recovering when you have so many people out there misrepresenting information on everything from health care reform to stimulus package spending.
Typical Hannity is at it again. Watch!!!
http://progressnotcongress.org/?p=2112
Unfortunately, I just don’t have time for a long discourse regarding the fullness of your comment(s), I just have time for a brief hit and run. But I felt I must say this: of course, health care is an entitlement. It became an entitlement when the laws set down penalties for not helping someone in peril due to a medically curable situation or condition. It became an entitlement when the law mandated hospitals to not turn away people with emergency conditions, people in danger of dying if not treated, simply because they had no means to pay for treatment. The law entitles people to care when it determines that if a potential good sumaritan turns his back rather than trying to help another human being, they are guilty of depraved indifference. And the federal gov’t pays for many indigents who are dressed in tatters and obviously cannot pay for themselves. I’ve seen them in emergency rooms myself.
Actually the two big items in the federal budget: Social Security and Medicare are called precisely that: entitlements. They have been for what 60-70 years. It is just goofy for someone to come along now and say healthcare is not an entitlement. What we are talking about is the extention of that entitlement to the general population because private enterprise has so fucked healthcare up. It is why Obama and the Congress’ plans to keep healthcare in the private sphere will fail. As happened in the financial meltdown, the power to fix things is being given to those who created the disaster in the first place. This approach has not worked in the financial industry. It will not work in healthcare either.
That’s because the computer systems are not programmed to deal with the complexity of medical care. You can’t program by the numbers. And it doesn’t control costs. But between that and the trial Liars definition of “reasonable care”, the costs are indeed inflated. That will be under any system including a government run one. Oh…that’s right, the government won’t let itself be sued. So let’s figure this out. It’s OK to sue private docs for all sorts of things, but not the government? DOesn’t make sense to me….
Where in the Constitution are we “entitled” to health care? Just because statute law has made a mess of thing does an establish an entitlement under any circumstances.
No…the answer is to reform/cut/repair Medicaid and Medicaire. They were bad programs to start and continue to worsen and will bankrupt the country unless abolished in their current form.
Yep! Can’t understand al all. Some are too ignorant for words. Every other developed nation in the world has public health cover except the US.
Ours,(called medicare by the way) is less than perfect, but is in orders of magnitude better than your current system. Oh and we still have private health care for those who want it.
Yep! Can’t understand al all. Some are too ignorant for words. Every other developed nation in the world has public health cover except the US.
Ours,(called medicare by the way) is less than perfect, but is in orders of magnitude better than your current system. Oh and we still have private health care for those who want it.
Should be in response to post *13 sorry
One can sue the government; many corporations and individuals have, and succeeded in getting restitution.
The issue with liability is that performance measures are putting time pressure on doctors to the point that it is much easier for them to make simple but damaging mistakes; not blood typing a donated liver for transplant, for example.
The fact is, most medical malpractice doesn’t go to suit at all; patients and family either aren’t aware of it or are not the suing kind; only egregious cases go to suit and in only a small minority of cases are the awards huge. And subsequent court action often reduces that amount after the press has had a field day with reporting the amount.
Actually that is what healthcare insurers have be doing all along; that is what actuaries are for. And that is what outcomes analysis in government plans is supposed to do. Does it reflect the quality of care? Of course not. And there would be a lot less need for complex IT systems if our institutions stopped believing that only what is measured is important. That is a surrogate introduced to make it possible to maintain the illusion that one is having accountability is large complex institutions.
And one of the things adding complexity to the healthcare system today and as proposed for reform is the perpetuation of this error.