Scale Back and Slow Down

In order for health care reform to survive after Senator Brown's win in Massachusetts, it will have to be scaled back and slowed down.  This will of course take a true bi-partisan effort, which should produce a better bill.

One of the biggest issues against current bills in congress is that they do nothing to curb out of control costs.  They simply throw subsidies at them to make them more affordable.  It will have to deal with making medical costs more transparent.  Consumers need to know what everything costs, so they can shop around for best cost and quality. The bill will also need to deal with the cost shift that occurs from Medicare and Medicaid.  These government programs only reimburse doctors and hospitals around 50 cents on the dollar.  The loss they are taking from these patients is made up from patients with private insurance, and that of course is reflected in premium renewals.

If they are going to achieve any sort of reform, both parties will need to sit down with each other and work out options that curb costs, is cost effective and make sure the people are on board with. This in itself is not an easy task, but it is easier than trying a complete overhaul of the system with no republican and dwindling democrat support. 

If Brown wins in Mass. is Health Reform Dead?

The special election on Tuesday to fill the late Ted Kennedy's seat has everyone around the nation on the edge of their seats.  Whether you are for or against health reform you are watching closely. If Brown wins, the democrats super-majority is gone, if Coakley wins they will keep their super-majority and health reform will likely go through.

However, even if Brown wins the democrats have a few options to still pass reform:

• House passes Senate bill unchanged:   This is the most viable option.  If the House goes ahead and passes the Senate Health Reform Bill unchanged the Senate will no longer need the 60 votes to pass it again. However, many remain skeptical if the House has the 218 needed votes to pass the Senate bill. 
• Delay the Confirmation of Brown: This tactic has many Republicans worried. Massachusetts and the Democrats may delay the confirmation of Brown so the democrats still have a super-majority in the Senate.  However, Barney Frank (D-MA) has said they will not do this.
• One Republican comes on Board: The democrats will reach out to moderate republicans, such as Olympia Snowe (Maine).  If one, republican comes on board with reform it will surely pass. 
• Reconciliation:  Democrats can use this legislative process if they tie the bill to the budget.  Any bill that can be tied to and deemed necessary to the budget can bypass the need for a super-majority.  Here they would only need 51 votes, which they surely have. However, if this process is used, the bill would likely have to be stripped down and many items would be thrown out.  

If Brown wins, health care reform is not dead for democrats but it would definitely make it more difficult.  If Coakley wins, democrats will probably have it passed in the next month. Tomorrow night should be interesting to say the least.