US House Passes National Health Care Bill

I admit that I haven't read the 1029-page bill, but (or perhaps therefore) I'm very happy with the vote in the US House last night in favor of this national health care bill. It's "national" in the sense that it effects the entire nation and endeavors to provide for health "insurance" for the vast majority of people, through a variety of mechanism and mandates:

• Creating a public insurance option to compete with the private vultures;
• Perhaps best of all, increasing taxes by a little more than five percent on those individuals earning more than $500,000 annually or $1,000,000 annually for a family as the mechanism for paying for this plan;
• Prohibiting insurance companies from excluding persons based on pre-existing conditions;
• Prohibiting the sudden rescission of insurance, just as the insured is incurring medical expenses;
• Slowly closing the "donut hole" in which the elderly on Medicare lack coverage for prescription medication;
• Creating a new Secretary of Insurance (or something of the sort) to approve or reject proposed insurance plans and fees offered by the existing insurance companies, with the authority to govern insurance companies in multiple other ways;
• Requiring employers to contribute to health care for their employees or pay a significant fine;
• Requiring individuals to seek to participate one way or another, or pay a fine of up to $250,000 and spend five years in jail, which effectively gives this new system the same obligatory nature of paying the IRS and Social Security withholding, with virtually everyone participating;
• Subsidies for those unable to pay for insurance, which effectively forces the Government to make insurance for the poor financially feasible or put them (us) all in jail;
• Any new law that provides for imprisonment has to be viewed from a uniquely Black point of view and we have to wonder whether it wasn't created to increase the number of Black people in jail. For example, will police demand to see our insurance cards and then arrest us and hold us over for trial if we have failed to enroll, as might easily happen with poor, indigent, substance abusing and homeless people? Will all Black people follow the mandate, or will some fail to do so and end up as insurance prisoners?

Of course there are at least two things in the bill that are outrageous, one of which is absolutely outrageous:

• The approved an amendment that prevents anyone whose subsidized from using the subsidy for to pay for plans that provide for abortions, and prohibits plans that provide abortion from participating in the health care marketplace, which has the effect of banning all abortions except the ones that women pay for themselves, effectively banning a type of coverage that some women already have through their employers;
• The bill forbids undocumented immigrants from participating receiving subsidies to participate in any of the plans that will be offered, and may even (I'm not sure) forbid them from participating even with their own money. This is something we need to be sure about, since undocumented immigrants can be disease vectors just as easily as our own children can be.
  

  Undocumented immigrant children, the US Supreme Court has decided, have a constitutional right to receive a free public education, which puts children who have no access to medical care (e.g. vaccinations) next to those who do. The obvious solution is to recognize the obvious fact that everyone must be vaccinated and provide for this vaccination for everyone, regardless of their immigration status.

• At the same time, the right to go to school seems somewhat empty if you lack the right to receive medical care that will make school attendance possible. As a matter of fact, hospital emergency rooms will inevitably continue to treat undocumented immigrants, but only when the care they need has progressed to the point of being an emergency whose treatment is many times more costly than it would have been had they gone to a doctor earlier.
  

This recognition of the Government's obligation to provide a mechanism for everyone in the country (except the undocumented) to receive medical care is a massive step forward for the United States of America. Although some of the details will inevitably turn out to be flawed and need to be revisited, the commitment brings the US into the community of civilized nations that recognize that health care is not an individual challenge but rather a national responsibility.

The US Senate still has to pass a bill and then that bill and the House bill have to go to conference committee, where anything can happen. And unfortunately many of the provisions of the bill that people most need now will not take effect until after the 2010 elections, when it will be too late for the benefits of the bill to help Democrats running for re-election to the US Congress.

I do understand however, that the ban on pre-existing conditions clauses will take effect sometime next year.

Fortunately, the Democratic Congress realized that there was no way whatsoever that they would get more than one Republican vote on this bill, so they pushed through a bill that had fewer compromises than if the Republicans had cooperated.