Tag Archives: U.S. health care system

Laws and Sausages

Posted on by

U.S. Capitol BuildingWho knew the U.S. Congress was so exciting? This is my initial reaction after following news coverage of health care reform’s laborious march from the Senate and House to President Obama’s desk, back to the Capitol Hill and then back again to the White House for another presidential signature. The run-up to the March 20 vote in the House contained nearly as many cliffhangers as a decent novel. Will the Democratic House members get the magic 216 votes needed to pass the bill? Who is twisting whose arm and what, if anything is being promised behind closed doors? Will Republican amendments sidetrack the legislation or create a inescapable deadlock? What does “deem and pass” mean anyway? And did you know the U.S. Senate has a parliamentarian?

So which analogy for Congressional procedure seems more apt: a sports contest or a well choreographed dance?

Another fascinating example I just learned about: the “two hour” rule (number 26 in the Standing Rules of the Senate), which can cause Senate committee activity to effectively shut down after two hours based upon the objection of just one member. In their anger at the passage of health care reform, Republican members employed rule 26 in order to force the cancellation of scheduled committee hearings for two days.

Democratic Senator Carl Levin appeared to be pleading as he tried to convene the Senate Arms Services Committee to discuss North Korea on March 24. “We have three commanders scheduled to testify this afternoon. They’ve been scheduled for a long time. They’ve come a long, long distance,” Levin said, from posts as far away as Korea and Hawaii. “I would, therefore, ask unanimous consent that the previously scheduled and currently scheduled hearing … be allowed to proceed.” Fellow committee member and Republican Senator Richard Burr replied that while he had “no personal objection” to continuing the planned hearing, “there is objection on our side of the aisle. Therefore, I would have to object.”

And with that, afternoon work ground to a halt. Also canceled: an oversight hearing on police training contracts in Afghanistan, a hearing on the cause of western U.S. forest fires, two judicial nominations, and a hearing on medical prescriptions for nursing home patients.

As I discover new intricacies to the American legislative process, I am coming to the conclusion that the key to being a good Member of Congress must be an encyclopedic knowledge of the rule books so one is as well armed as they can be with strategies and tactics to move legislation forward or block it, depending upon the ultimate goal.

Do these little known rules make our legislative process too complex or subject to pettiness? Or do they provide individual Senators and Representatives with necessary tools to make more of a personal impact in the process, rather than just being counted in a “yea” or “nay” vote tally?

As 19th century German statesman Otto von Bismarck reportedly said, “Laws are like sausages, it is better not to see them being made.”

The Ever Present Health Care Debate, Part 2

Posted on by

About ten months ago, I wrote By The People’s first story about health care. I called it, “The Ever Present Health Care Debate.” I noted how the debate over U.S. health care dates back to World War II.

Since then, several of us bloggers have covered the debate as it’s unfolded over the past year, generating some of our most lengthy and interesting comment threads. Along the way we discovered that not only was this an issue that stirred strong passions among Americans, but international audiences cared deeply as well.

Now President Obama is on the verge of signing the first major health care reform legislation in decades, a law that will provide more coverage options at affordable prices, the White House says. (For more specifics on the health care changes, I recommend playing with this New York Times interactive graphic.)

Upon the bill’s passage, President Obama spoke to the American people. A quote caught my attention: “We proved that this government — a government of the people and by the people — still works for the people.”

The fact that Obama worked in the name of this very blog reminds me of something that has been easy to overlook in a year of contentious political debate: in democracy, people control political outcomes as much as the politicians do. The fight over health care reform was as heated as it was because Americans chose to be involved – showing up at town halls, staging boycotts, persuading their friends on Facebook, and much more – because they believed they could influence the process.

There’s a reason I titled this entry “The Ever Present Health Care Debate, Part 2.” Sure, there may be new health care laws guiding this land, but that is not going to stop the debate. Not in a government by the people.

The Ever Present Health Care Debate

Posted on by

doctor and patientI stopped by my doctor’s office today. It was actually a pretty pleasant visit. A few years ago I got pretty sick and over many months of appointments, I developed a nice relationship with my doctor. So I don’t mind occasionally going in for checkups, as it’s an opportunity to catch up with a person that feels a bit like an old friend.

But she and I both know this relationship could end as quickly as it began. For if I were to switch jobs and get health insurance that her office does not accept, I would have to find a new doctor.

When I talk with people from other countries, I find one of the things they think is mystifying about the United States is our health coverage system.

The United States spends about 16 percent of the country’s gross domestic product on health care, significantly more per capita than any other nation. It is the only industrialized country that does not mandate access to health insurance for all citizens. But that does not mean that there is no government assistance – the poor and elderly are eligible for government insurance. And no hospital can turn away a patient needing emergency treatment.

Most Americans receive health insurance at a subsidized cost through their employers, and polls show most are happy with the insurance they have through this system. (I am one of those people happy with the insurance I have.) Yet many Americans acknowledge there is room for improvement.

President Obama has frequently referred to the U.S. health care system as “broken.” Congressional leaders in the House of Representatives say they aim to have a health care reform bill passed by the end of July.

Feel like you’ve heard about this story before? One of the reasons for this debate, which dates back to around World War II, is that there is no national consensus on how health care should be provided. There are disagreements over whether all Americans should be required to have health insurance and over how much of a role the government should play in providing health care.

Some people say it is the government’s responsibility to make sure their citizens have access to health services. Others say individuals need to be responsible for their own welfare. What do you think?