What we're left with falls short of what health care reform could have been—it's no masterpiece—but it's better than it almost was, and it lays a workable and long-overdue foundation for health policy in the United States that, I predict, will eventually win support even from the Republican Party.

A look at the reconciliation bill, which still has to win support from a few more Democrats by Sunday.

Comments

[Account Deleted]

I am not at all happy about the provision that raises the Medicare payroll tax. I do not need anymore of my money, even 1 percent of my meager salary, being taken out to give to the federal government for any reason. I hope there are some common sense Democrats out there who oppose the bill for that very reason.

Have a nice day.

[Bubba]

For a much more accurate assessment of the proposed monstrosity, here is a cross-post from Guarino in response to Roch's ""Where is the 'government run' part?"

Take your pick.

Cato's Michael Cannon:

"Myth: This isn't a government takeover of health care.

This legislation would force all Americans to purchase health insurance coverage. Government would control what kind of insurance you purchase, where you purchase it, how much you pay and what kind of medical care you receive. Our health care sector would be 'private' in name only.

Once government controls those decisions, there will be nothing left to socialize. Make no mistake -- this is a vote on socialized medicine."

He adds this at NRO:

"It is fitting that Democrats included the final stage of a slow government takeover of the student-loan industry, because it shows that this legislation is yet another step in the ongoing government takeover of health-care sector."

[beelzebubba]

they tried reform like this in education, for the children of course, because something had to be done. Now they're shutting down schools and laying off teachers for the children because something has to be done. I've seen cartoons of government agencies fighting blazes that they set themselves with streams of money provided by proles but the humor hasn't caught on everywhere, yet. Some people could have a funnybone disorder. This'll fix it because something has to be done.

[Ed Cone]

We tried to fix the highly localized education system by slapping a testing regime on it, which just led people to teach to the test.

This is the kind of reform we have not done -- those curriculum debates would be entertaining, to say the least.

[Bubba]

Here's another perspective on the monstrosity's chances of passing:

W"ith two days to go before a scheduled vote of colossal importance, passage of Obamacare isn't looking likely — although a great deal will be determined by how much the American people keep the pressure on wavering representatives and counterbalance the intense pressure being applied by the Obama administration and congressional leaders.

That being said, the bill's chances primarily depend on the number and sizes of the bribes quid pro quo being offered to the Dem fence sitters, and their greediness and corruptabilty ethical rationalizations regarding acceptance of such.

[Jim Caserta]

JS - are you referring to the Medicare tax increase on those making > 250k, or is there an across the board increase somewhere? I'd be happy for you if that increase applies to you, but then I would disagree with your assessment as 'meager'.

[Jim Caserta]

The pdf linked is the amendment document, not the full bill. It is hard to find out what is actually going to happen because it says, 'strike this', 'as mentioned in that section'.

[Roch101]

"are you referring to the Medicare tax increase on those making > 250k," -- Ed

I might be wrong, but I thought it was 200K and only on non-earned income.

[Jim Caserta]

250k is joint, 200k individual. This is potentially a big bill, for albeit high earners. I would prefer this to be a marginal tax increase. Assume 4% not 3.8% for simplicity. So you make 300k, with 100k from non-earned income, your increased bill is $4k. If it were marginal non-earned income above some amount, say 50k, your increased bill might be zero or only $2k.

Since this is on unearned income, no matter what, it wouldn't be based on your salary...except for the trigger point.

IMO a poorly designed tax increasing complexity.

[Roch101]

Thanks for the insight, JC. That it is not marginal doesn't bother me. The idea of marginal rates is to create a progressive tax system. Applying a 4% medicare tax to the investment income of people making over $200,000/year doesn't seem contrary to that intent.

I do wonder, though, if it would apply to investment income that is currently tax free, such as on returns in a Roth IRA.

[Jim Caserta]

OK, my point should have been, you make $199k as an individual, with $50k from investment income. If you earn $2k more, pushing you over the limit, your tax bill goes up by 4% * $50k = $2k. No extra money in your pocket! I haven't had to do taxes in that bracket with significant capital gains yet, and probably never will.

I do not think it applies to non-taxable investment income "The Medicare tax wouldn’t apply to income in tax-deferred retirement accounts such as 401(k) plans."

via Tax prof - http://taxprof.typepad.com/taxprof_blog/2010/03/house-health-bill-.html
link to Bloomberg/Businessweek - http://www.businessweek.com/news/2010-03-18/health-bill-said-to-add-3-8-medicare-tax-on-unearned-income.html

[Roch101]

Ah, I see your point, JC -- no buffer zone, just a hard line. The same thing, sort of, ticked me off about the home-buyers credit, where one had to have been in their home for five years by April 30th to qualify and if your 5th year anniversary were May 15th -- out of luck.

That bit about retirement accounts is assuring. Thanks for finding that!

[Roch101]

In practical terms? This cost calculator from the Kaiser Foundation might cut through the mongering. It shows how the law would affect your insurance costs.

[Bubba]

"I do not think it applies to non-taxable investment income 'The Medicare tax wouldn’t apply to income in tax-deferred retirement accounts such as 401(k) plans.'"

No, that comes in a later appropriations bill when all "non-taxable" investments will be subject to new and more inventive taxes and fees, and some new and equally outrageous explanation will rationalize the action.

[Bubba]

Meanwhile, the voodoo accounting favored by the Corruptocrats and their enablers is astounding, particularly given the historical evidence:

"What happens if opponents are right and these CBO numbers bear no resemblance to reality? Obviously, ObamaCare will add substantially to an already preposterous deficit. And the trillions in actual spending that national health care will incur doesn’t include additional 'fixes' that Congress will be forced to make once it becomes clear that reality has knocked those pretend CBO numbers into a cocked hat. Subsidies for citizens to buy insurance will almost certainly rise as the cost of premiums skyrocket — a fact of life in Massachusetts where mini-me ObamaCare has been the law since 2006 and projected costs are already way out of whack with actual expenditures.

None of this matters — not the CBO, not history, not the cautionary tale that is RomneyCare, and certainly not the warnings from responsible lawmakers, economists, health care professionals, and others who insist this bill will not do what Democrats claim it will do. The only thing that matters to the Democrats is achieving a triumph for President Obama. And if that means destroying the health care system, impoverishing future generations, and threatening the individual liberty of American citizens, so be it.

Power has its own logic. In this case, it is a logic glimpsed through a looking glass where up is down, black is white, and political whims are substituted for the will of the people."

Furthermore, it's pretty obvious the Corruptocrats know about the Big Lie meme they're propagating.

[Bubba]

Bill Kristol:

"What's more, the reconciliation bill the House will be voting on has several clear Byrd rule violations. Senate Republicans will be able to use the Byrd rule to strike these provisions from the bill. So if the Senate then passes a modified reconciliation bill, it will return it to the House, which will have to vote on a version of this bill AGAIN.

The Democrats would actually be better off -- well, less worse off -- simply voting to pass the Senate bill. But by embracing the Slaughter Rule and this package of reconciliation fixes, they've managed to make a bad political situation for themselves worse. Congratulations!"

[Bubba]

Here's the tacit admission of the voodoo accounting surrounding health care "reform":

"Democrats are planning to introduce legislation later this spring that would permanently repeal annual Medicare cuts to doctors, but are warning lawmakers not to talk about it for fear that it will complicate their push to pass comprehensive health reform. The plans undercut the party's message that reform lowers the deficit, according to a memo obtained by POLITICO.

Democrats removed the so-called doc fix from the reform legislation last year because its $371-billion price tag would have made it impossible for Democrats to claim that their bill reduces the deficit. Republicans have argued for months that by stripping the doc fix from the bill, Democrats were playing a shell game."