Compromise is bound to lead to disappointment as well as optimism.
Such was the case for members of The State Journal-Register’s health-care reform roundtable when it came to the health-care reform bill approved Thursday by the U.S. Senate in a 60-39 vote that included no Republican support.
“The bill provides some significant advances for millions of people,” said Jeff Bigelow, Springfield regional director for the American Federation of State, County and Municipal Employees.
Bigelow said he’d like to see “much more progressive” language — from legislation previously passed by the U.S. House — inserted into a conference committee bill that is expected to be presented to both chambers for a final vote in January.
The House and Senate would have to approve that compromise bill before the package could be sent to President Barack Obama’s desk and have a chance of being signed into law.
** Read a comparison between the House and Senate version of the bills (pdf) **
Bigelow, 59, said he’s glad the Senate bill, like the House version, would ban the insurance industry practice of denying coverage or jacking up premiums for people with “pre-existing conditions.”
But he wants to see a government-run “public option” for health insurance coverage, which isn’t part of the Senate proposal.
“It’s the best way to both control costs and provide the maximum amount of coverage for people who need health insurance,” Bigelow said.
He also doesn’t like the Senate bill’s plan to finance part of the reforms with taxes on generous, so-called “Cadillac” health plans.
Many of those are simply comprehensive plans negotiated between labor unions and employers, he said. Such taxes would be passed on to union members in the form of reduced benefits or higher premiums, he said.
“It’s hard to rise above the fray, but even if we accomplish just what’s on the table, that’s historic,” Bigelow said. “But we’re not going to give up the fight.”
Majority doesn’t rule
Jim Duffett, executive director of the Champaign-based Campaign for Better Health Care, doesn’t believe a public option will emerge from the legislation now under debate. That piece of reform may have a chance of passing in the next year or two, he said.
Duffett, 52, described the Senate proposal as a “reality bill regarding the politics of having to get 60 votes” and avoid a Republican filibuster that could kill any chance for meaningful reform.
“Majority always rules, but not in this case,” he said.
Duffett said he hopes a compromise bill will boost proposed subsidies that would help uninsured people afford health insurance. He would prefer a tax on wealthy people to help pay for health insurance expansion — that tax is contained in the House bill — rather than the Senate plan’s tax on health plans.
‘Not optimistic’
Dr. Gayle Woodson, a Springfield surgeon representing the Sangamon County Medical Society, said she likes the Senate bill’s requirement that everyone obtain health insurance through their employer or an insurance “exchange.”
But she said she is “not real optimistic about what’s going to come out of this. It all sounds like a good idea, but you don’t know how it’s going work until you fire it up.”
She said she was disappointed that the Senate bill wouldn’t limit legal judgments against doctors in medical-malpractice cases or expand the number of slots in American medical schools.
“There’s a lot of problems it doesn’t address,” Woodson, 59, said, adding that she could support a public option if insurance provided by it would reimburse doctors adequately.
Senate bill preferred
Zachary Hoffman, 39, vice president of operations and finance for Wiley Office Furniture in Springfield, said he prefers the Senate bill and the way it treats small- and medium-size businesses when it comes to requiring them to offer health insurance or pay penalties.
But he said: “I do not have much faith in the federal government being able to implement this bill effectively. This bill will do some good, cost much more than expected to cover fewer people than expected, and will not significantly mitigate the overall rise in health insurance premiums.”
Going in right direction
Dr. Craig Backs, 53, chief medical officer for St. John’s Hospital, said the Senate bill “appears to move in the right direction. The biggest concern is the delay in implementation for four years, with immediate revenue generation — taxation — to accomplish the budget and deficit targets stated and the overall assumptions that cause many to question the financial projections.”
He added, “The most valid criticism is the fiscal impact on the deficit and the potential negative impact on the economy overall.”
Nuance complaint
Terry Broida, a 62-year-old Springfield resident who is uninsured and operates Air Clean Filter Service, called it “a shame” that a few conservative Democrats in the Senate could stop a public option from being included in the bill.
“The public option is dead, at least for now,” Broida said, but he hopes elimination of pre-existing conditions in insurance-coverage decisions would make health insurance available and affordable for him.
“I never expected any giant, sweeping reform,” he said. “Politics is all about nuances, and they’re nuancing the hell out of this.”
Dean Olsen can be reached at 788-1543.
