health insurance antitrust exemption history
health insurance antitrust exemption history
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Health Care Reform: Another victim of U.S. presidentialism
The vote by the U.S. House of Representatives on health reform has been hailed by many as a victory for the millions of Americans lack any type of medical coverage. Certainly, there are important new developments, which Rose Ann DeMoro of the California Nurses Association made a very good job of explaining. Some of these measures are part of Obama's campaign platform during the 2008 campaign.
However, the concept of a tax-financed single taxpayer, not to speak of a "socialization" it is not in sight. Still sounds strange to people like me, who lives across the pond (where the systems, it should be noted, differ terms of organization, funding and quality, but still based on the principle of free or nearly free health care for all), the largest economy in the world could choose not to grant what is regarded as a right (in general, as enshrined in the Constitution) in most advanced countries in the world. Autocratic Germany adopted the Health Insurance Act 1883, which was gradually extended the entire population, Britain has created the NHS in 1948, Italy formally established in 1978, so only a few examples. Too often, I heard horror stories of Americans (including personal friends) who developed serious illnesses, and thanked the foreign destinations, so that obtaining free medical care in their new country of residence.
Now, how the U.S. draft Law has been drafted and adopted is, in my opinion, further corroboration of the fact that the American presidential system has been designed over 200 years to achieve a specific objective, namely the prevention of "radical" legislation must be approved by the political system. As I indicated in my book The Roots of Contemporary Imperialism: The Founding Fathers, the U.S. Constitution and 200 years of the dictatorship of companies, the Founding Fathers were smart enough to design a system that would create "a path strewn with obstacles in the belief that it would promote a policy rather slow intentional, who were his ideals, "as Daniel Lazare has argued, or, as Charles Beard said, the" disintegration of the Affirmative Action. "The political system he devised to preserve the status quo rule, ie by a business elite and powerful people. Only pressure People crushing crisis and extreme risks implosion of the system have led to significant legislative progress (or, rather, "concessions" elite), for example, to only a few examples, the Competition Act Sherman 1890, the National Labor Relations Act of 1935, the Minimum Wage Act 1938 and the Civil Rights Act of 1964. In fact, any disturbances in the street or a widespread popular revolt, oriented towards obtaining a National health care seems a remote possibility, the vicissitudes Bill of Health show the veracity of these allegations.
The constitutional engineering alone does not explain the shortcomings of the presidential system.
There are three elements additional, not strictly related to the U.S. Constitution, which, however, overlap and help create a situation where that:
* Party candidates are not necessarily activists of the party (after the primaries), and thus their political platforms are necessarily consistent with their parties;
* With few exceptions, only "prepared to" go along to get along, "said William Domhoff, it is ie those who are willing to accept donations from large companies will win a seat in Congress or the presidency, a phenomenon that is clearly not Only Democrats and Republicans, but concerns, so that further alienating Democratic voters and potential;
* The election system, acting with the size of American territory, encourages fragmentation and thus the weakness of the party, causing a lack of discipline parties, a situation exacerbated by the influence of corporate interests of elected politicians.
These three elements overlap with the Other Constitution, as the rigid separation of powers: two separate houses, elected in different ways and at different times, and Executive (ie, President), elected by a state based on an electoral college. Thus, the President is not guaranteed a majority in a house, let alone two, or the president could take a majority for a limited time, then lose the election mid-term, or it may be a majority for the duration of his mandate, but this does not justify the party discipline or a common plan with specific topics (with the Democrats to be a perfect example of support, for example, emancipation in the North and Jim Crow in the South). In addition, the President has not even been allowed to introduce bills in Congress, and therefore resort to Congress that Congress and fragmented into a multitude of committees and subcommittees, which in most cases, do all the work and leave only the final yes or no to the House as a whole. In addition, it happens once an invoice for a house, the other House does not vote on the same bill, but submit their own and then vote on it, a conciliation committee will meet to reach agreement between the two rooms (which was still delayed and softened the legislation). As a complex, fragmented can not help but fall prey to lobbyists. The same applies to the European Union, where the system is completely incomprehensible, even for experts, and overlap different agencies and levels of government complicates things, and paved the way for a massive lobbying by business. In my book I argue that a system Parliamentary might mitigate this phenomenon. This does not mean that advocacy and engagement would have gone far away. In many parliamentary systems, Commissions are very powerful and invoices are kept in private meetings of committees; filibuster is a common practice (eg by introducing hundreds or thousands of amendments, both in committee or on the floor of the House, or giving endless speeches on each of these changes), there coalitions and minority governments, which can slow the action of a government that needs to compromise with their partners or more other parties Parliament, lobbying and funding elections can be aggressive, and often a bill must be passed by both Houses of Parliament, although often the upper house can delay passage of the law, but not prevent, and the government needs the confidence of the House only). After all, the existence of pressure by powerful economic interests to influence the work of elected bodies is inherent in the capitalist system, whether parliamentary or presidential democracies. However, when one party or coalition of parties has a clear agenda before an election and win the majority and have the opportunity to Bill, Bill of government, and defend on the floor of a house where the parties instead of individual parliamentarians, are the main actors, then things will be clearer and the liability does not exceed a certain piece of legislation will be easier to run.
Now, Obama used to be in favor of single payer, as a state senator. In a Youtube video, apparently dating back to 2003, said: "It happens to be a champion of health program single-payer universal. I see no reason why the United States of America, the richest country in world history, spending 14 per cent of its GNP on health care can not provide basic health insurance for all. And that's what Jim is talking about when he said that the whole world, no withdrawal. In a health insurance plan pays for care, universal health care. That's what I like to see. But as you all know, we can not escape. Because first we must return White House we need to reclaim the Senate, and we must regain the House. "Apparently, he changed his mind. Change Your opinion is legitimate, of course. However, the funny thing is that Obama has become increasingly convinced of a single payer, as his political career followed, first the U.S. Senate, then as a candidate for the Democratic Party primaries and then as party candidate (source). Obama change of heart, however, does not seem too extravagant. Money certainly talks: insurance companies contributed about $ 2.3 million for his campaign, and the health sector, with nearly $ 19.5 million. Ultimately, the platform of Obama on health care completely denied that he had supported as a senator Illinois, that is single payer.
The History of the Bill is particularly revealing to show the shortcomings of the system U.S. Presidential.
When Bill Clinton was president, business is fiercely opposed to health reform. You must therefore provide Bill was shot down, even for large parts of his own party.
Obama's plan, however, not clear, because the system U.S. Presidential does not allow presidents to present a clear and definitive "take it or leave it or ask the president / King / Queen to dissolve Parliament and go to new elections "could be the case in a parliamentary system. Obama has made some proposals more or less clear during the election campaign, the safe. However, the bill, or rather bills for the health reform pushed like mushrooms in the various centers of power. Obama can talk with members of Congress, visit the Congress to convince recalcitrant Democrats (as it did November 7, a very unusual), but still just can impose its will (where appropriate on the subject), the majority Congress.
The New York Times gave a detailed explanation of history of invoice.
Thus, in late March 2009 and with the consent the insurance industry, concerned about the rising costs of health care, the (all) Democratic chairmen of the five congressional committees had adopted a law requiring everyone to have insurance for employers should help pay for, and allows the government to provide a system of universal health insurance as an alternative to private insurance.
However, while House Democratic leaders submitted a draft law on June 14, in addition to a public system, including efforts to slow the pace of the costs of Medicare, a tax on high incomes and sanctions for companies that do not provide their workers "of the seven members of the so-called Blue Dog coalition, including" fiscally conservative Democrats, threatened to block the full House. After 10 days of deadlock, agreement was reached to reduce the cost of the bill and exempt many small businesses to provide health benefits for workers. The draft Bill was approved by the Committee on Energy and Trade on July 31 by a vote of 31 against 28, with five Democrats in the Republican panel join the opposition. The agreement also provides for the establishment by the government of "a public insurance plan to compete with private insurers, but also negotiate rates with health care providers health instead of fee schedules from Medicare to pay doctors and hospitals. States could also create Non-profit cooperatives to provide coverage to individuals, families and small businesses. "
Meanwhile, the Senate followed its own path, "Health, Education, Labor and Pension Committee has worked on a bill with a public insurance plan, while the Senate Committee Finance, led by Senator Max Baucus, Democrat of Montana, worked on a bill that sought to avoid, Mr. Baucus believed it was necessary to obtain bipartisan support. "The proposal of the Health Commission has seen the light of day, July 2:" The Employers with 25 or more workers would have to provide coverage or pay the government an annual fee of $ 750 for each full-time worker and $ 375 for each halftime. The government would pay the initial costs for public insurance option as a loan to repay, and premiums are set up so that the choice is ultimately self-sufficient. "The law was approved July 15. However, Senator Baucus has introduced another draft law in late August that "Does not include a new government plan of health insurance to compete with private insurers and," unlike other projects law … This would impose a special tax on insurance companies that sell insurance premium. The bill does not require employers to provide coverage. But employers with more than 50 employees must reimburse the government for part or all of the costs of subsidies to employees who buy insurance on their own. "This proposal was approved October 14.
Meanwhile, Obama, President, and therefore the head of government, simply a speech before a joint session of Congress in September and the visit of the Democratic Center, November 7.
Thus, the law has been passed in the House. However, most commitments were to be reached before the House may actually give its approval. To allay fears Democratic conservatives losing their seats in Congress, has been decided that in terms of public choice "will have to negotiate rates that insurers not private, instead of offering a fixed rate, slightly above what Medicare pays, "and" the plan are also faced strict controls on abortion. After strong pressure from Catholic bishops, the measure was amended to strengthen the restrictions on coverage of abortion in the benefit plans purchased through the exchange of insurance, to ensure that no money Federal used to pay for an abortion. The two base changes Pelosi angered the Liberal Democrats, but nevertheless decided to support the project law.
What happens next? Head of Senate Majority Harry Reid has already "paid the difference between a bill committees health which included a public choice and a bill that the Finance Committee for a cooperative system, announcing that the bill merging includes a government plan to allow states to "opt out". A Republican filibuster, however, is too distant an option, as Senators independent, such as Joseph Lieberman, have already announced their opposition to any bill that includes a public option, and support for Democrats is conservative Guaranteed. There are those who fear that reform will remain dormant in Congress for a long time to come.
The future of health care reform In Health in the United States is still uncertain. Anything can happen: a different version can be approved after further negotiations between the two chambers, or reform could even be postponed until Doomsday. Yet this is exactly the kind of chaos that the founding fathers wanted to preserve order and stability. Whatever happens in the Senate, health care is not the first casualty of the race U.S. presidential will not last.
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