Tag Archives: health care

Sestak vs. Toomey for PA Senator

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Now that the primaries are behind us, the brawl for the Pennsylvania Senate seat is heating up. This blog post will be one in a series of posts I hope to write in which I lay out the stances of various candidates that will be on the ballots this year.

I hope that reading about those issues that matter to you will get you to the ballot box, and that this blog has helped you make an informed decision.

Update — WHYY’s Marty Moss-Coane interviewed with each of these candidates on her radio show, “Radio Times.” Follow the links below to listen, or find them for free in the iTunes store under “Radio Times”:

(Note — I’ve culled most of the information on the candidates’ stances from their own campaign sites (links: Toomey, Sestak), from OnTheIssues.com (links: Toomey, Sestak), and from ProjectVoteSmart.com (links: Toomey, Sestak). )

– Economy and Business

  • Toomey
    • Tax cuts (for both individuals and businesses) and deregulation to spur economic growth
    • Opposes the Jobs Bill
    • Opposed the Stimulus Package
    • Make the Bush tax cuts permanent
    • Decrease government spending
    • Voted to end offshore tax havens
  • Sestak
    • Supported the Stimulus Package to stabilize the economy
    • Tax cuts for the middle class
    • Allow Bush tax cuts to expire
    • Federal investment in new industries
    • Supported the TARP Program (bailouts) to stabilize the financial sector
    • Close tax loopholes
    • Supported “Employee Free Choice Act,” which would end the need for a ‘secret ballot’ to vote on unionization after a majority of worker signatures have been collected
    • Increase the minimum wage
    • Discretionary spending caps
    • Voted to extend unemployment benefits during the recession
    • Invest in small business
    • Supported HOPE for Homeowners to help people refinance their mortgages
    • Supported government purchase of ‘toxic assets’ to help keep credit flowing
    • Supported Credit Card Holders’ Bill of Rights
    • Supports Pay-As-You-Go, which requires increases in spending to be accounted for

– Health Care

  • Toomey
    • Opposes the recent Health Insurance reform
    • “Giving individuals who buy their own health insurance the same tax benefits that employers enjoy when they buy health insurance for their employees”
    • Allow health insurance companies to compete across state lines
    • Tort reform
    • “Allow small businesses and groups to join together to form association health plans to lower the cost of providing health care”
    • “Encourage a market for renewable health plans to help people with preexisting conditions keep their health insurance”
    • Increase awareness of health care cost
    • Voted to help establish tax-exempt Medical Savings Accounts
  • Sestak
    • Supported the recent Health Insurance reform
    • Opposes single-payer, but supported public option
    • Stop insurers from discriminating against people with pre-existing conditions
    • Health Insurance Exchanges
    • Support of stimulus package that provided funding for states so they could avoid cutting Medicare/Medicaid.
    • Invest in preventive care
    • Voted to regulate tobacco as a drug
    • Voted to expand the Children’s Health Insurance Program

–Immigration

  • Toomey
    • Opposes amnesty for illegal immigrants in America
    • Secure America’s borders
  • Sestak (I cannot find Sestak’s position on this issue)

–Energy and the Environment

  • Toomey
    • Offshore drilling for oil
    • Nuclear power
    • Utilize the Marcellus Shale
    • Opposes Cap and Trade
  • Sestak
    • Favors alternative energy sources
    • Supports Cap and Trade
    • “Reduce the human impact on climate change”
    • Reduce carbon emissions
    • Tax credits for renewable energy
    • Fund research and development of alternative energy
    • “Increase investment in water infrastructure development.”

– National Security

  • Toomey
    • Supports SDI (“Star Wars”)
    • Supports War in Afghanistan
    • Supports War in Iraq
    • Sanctions on Iran
  • Sestak
    • Improve care for returning soldiers
    • Supported employing additional troops to Afghanistan
    • Voted to provide “additional equipment to protect our troops in harm’s way”
    • Ensure civil liberties while providing for National Security
    • Reassess the Patriot Act
    • Support G.I. Bill
    • “Economic instability around the world [is] the primary danger to our nation’s security”
    • Close Guantanamo Bay
    • Treat veterans with Post-Traumatic Stress Syndrome
    • Withdraw from Iraq
    • Restore habeas corpus for detainees

– Abortion

  • Toomey
    • Pro-life
    • Encourage adoption over abortion
    • Opposes using tax dollars on abortion
  • Sestak
    • Pro-choice
    • Voted to support stem cell research
    • Ensure access to contraception

– Education

  • Toomey
    • Supports charter schools
  • Sestak
    • Increase Pell Grants
    • Support early education
    • Increase funding for Head Start
    • “Reauthorize the Teach For America program, which recruits and trains recent college graduates seeking to enter into the teaching profession.”
    • “Establish tuition repayment program for individuals with degrees in Mathematics and Science who commit to serve as a teacher.”

– Gay and Lesbian

  • Toomey
    • Constitutional amendment banning gay marriage
    • Banning gay and lesbian people from adopting children in Washington, D.C.
  • Sestak
    • Supports civil unions
    • Provide “federal civilian LGBT employees with the same partnership benefits that are currently offered to all spouses of federal employees”
    • Repeal the “Defense of Marriage Act”
    • End discrimination in the workplace
    • End discrimination in the military

– Gun Rights

  • Toomey
    • Few limitations on gun rights
  • Sestak
    • Regulations on gun ownership
    • Federal ban on assault weapons

– Internet

  • Toomey (I cannot find Toomey’s position on this issue)
  • Sestak


Band-Aid Plan To Fix Health Care Won’t Work

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(Published in the Main Line Times and the Delco Times)

As the attempt to reform our health-care system crescendos, it is difficult to pinpoint exactly where the debate lost its way. Perhaps it never truly began in the right direction.

Between the fear-mongering and the screaming, it seems some of the most pressing issues – medical inflation and warped incentives – have been sidelined. And why? Perhaps because they are more complex. These issues require quite a bit of explanation and historical context, which doesn’t always fly too well in a sound-bite culture.

One of the main problems regarding our health-care industry is its lack of any organization. There was no grand design in its creation; it is a Frankenstein monster, cobbled and patched carelessly together since its birth in the wage controls of the World War II era, with little regard for consequences.

Yet, any grand design is practically doomed from the beginning, as the only two viable options – a single-payer system or a complete overhaul of incentives and the creation of a truly free market – are both met with opposition. Consequently, we receive a bill that is the worst of both worlds.

True, the House bill does work at creating a marketplace in the health insurance exchanges (an important, but underplayed, provision), but it also includes a public option. Supposedly, the public option is meant to control prices by adding a more virtuous competition into the marketplace, but when you look at the details – its limited eligibility, and the fact that prices will be set by negotiations with health care providers – it doesn’t seem as if it will control prices at all. After all, medical inflation has not left Medicare and Medicaid, two government plans, unscathed.

So, who is to blame? The Democrats or the Republicans? Both. To their credit, the Democrats have actually gotten the ball rolling on health-care reform and have put forth a bill, though their proposal remains flawed.

The Republicans, on the other hand, are too busy trying to give President Barack Obama his “Waterloo” (this can be seen in the misnomer “Obamacare,” which would be more accurately titled “Congresscare”) and preaching about fictional provisions such as nonexistent “death panels” to actually provide legitimate criticism and a legitimate alternative.

Both accept money from the big health insurance and pharmaceutical giants and allow them to actively craft the bill as well.

We, the citizens, are also to blame. We are too easily led by the talking heads to one particular conclusion. A single-payer system is not the devil, and it does not ration care any more than our current system does. Any system we adopt will require a give-and-take.

A single-payer system will cover everyone, unburden businesses that pay for employees’ health care (and thus help small businesses). It will purge the system of waste, but everyone will be required to pay through taxes and waiting lines — secondary, optional care will be a bit longer (though primary care may very well be shorter, as it is in Britain).

Remember, the government is already inextricably involved in our health-care system. A complete rebuilding of the health-care free market, hand in hand with other reforms (like tort reform), can control prices through innovative market forces and reshaped incentives. Both plans are bold and both have their strong and weak points. What we can’t afford is another plan that simply slaps a Band Aid on the issue and kicks it along to the next generation.


What You Need to Know About the House Health Care Bill

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The House of Representatives passed their version of the health care reform bill last night. But what does it all mean? The media coverage on the issue has been decidedly mixed. I’ll try to boil down for you the most important points on the House bill.

The first thing I should probably spend some time on is clarification. With all this debate over the validity of so-called “Obamacare”, many people may not realize that there are various versions of health care reforms bills floating around, and that none of them were authored by Obama (hence the irony of the name “Obamacare”).

Here are the details of the House version of the bill: (a good source of information are the NYTimes, and an NPR podcast entitled Health Care Legislation Deconstructed)

–How the House Bill Expands Coverage to Uninsured Americans

  • Projected to cover 96% of legal residents under age 65.
  • Provides subsidies for individuals up to 400% of the federal poverty level $88,000 for a family of 4)
  • Expands Medicaid to 150% of federal poverty level ($16,000 for an individual; $33,000 for a family of 4)
  • No denial of coverage or higher premiums due to pre-existing conditions

–How the House Bill Effects Businesses

  • Most employers will be required to provide health care for employees or pay a penalty of up to 8% of payroll.
  • Businesses up to $500,000 in payroll a year are exempt.
  • Penalties are phased in for businesses from $500,000 to $750,000
  • Small businesses are provided with tax credits to help them purchase health care

–The House Bill’s Public Option

  • No state opt-out
  • Negotiated Rates — the public plan will talk to hospitals, doctors, and health care providers to negotiate a state-level payment rate

–Costs of the House Bill

  • Gross Cost $1.1 trillion over ten years.
  • However, the Net Cost is $894 billion because of revenue raisers.
  • Revenue will come from surcharge on high income earners (taxes on individuals that earn above $500,000, or on couples that earn above $1 million  – projected to raise $460 billion)
  • Penalties for businesses who don’t provide health care (up to 8% of payroll)
  • Penalties for individuals who don’t buy health care (2.5% of income — but can apply for hardship waivers if can’t afford)
  • Medicaid/Medicare cuts
  • Corporate taxes/ fees

–Health Insurance Exchange

  • The Exchange is essentially a marketplace where people can go to shop for health insurance. Currently, with our employer-based system, you can only really choose from the plan(s) your employer offers. Going out and buying your own insurance is expensive and messy. The Exchange creates a market of insurances options and allows you to choose which plan you want, allowing market forces to take their toll — the better plans will thrive and the uncompetitive ones will die.
  • Would begin in 2013.

Lobbyists’ Role in the Bill

  • Why was there no large-scale campaign launched against this reform by insurance industries, drug companies, and the like? Because this time around, they were brought into the fold. Yet, with lobbyists winning, the biggest loser stands to be — in many instances — the consumer. The pharmaceutical industry has lobbied for amendments, like one that would grant 12-year exclusivity to biologics, instead of 5. Read the article in TIME for more on that, but basically, it means that instead of allowing generics onto the market after a shorter waiting period (say, 5 years), it will now take 12 years for this to happen, when concerning biologics, which is rapidly growing. The downside to this is that generics help control costs by offering similar solutions for much less money. Essentially, this monopolizes the market for 12 years for each new biologic.

There was a Republican alternative to the House Bill, which included:

  • No public option
  • Individual mandate
  • State high risk pools
  • Not having language barring pre-existing conditions
  • Businesses can combine resources and buy health insurance across state lines
  • Reforms to control costs