U.S. Senator Mary Landrieu has been under fire in recent weeks by liberal groups nationally, and progressive activists locally, for her refusal to back a public option under the universal health care bill. Instead, she and six other Democrats support the bipartisan measure Bennett-Wyden that guarantees universal health care revenue neutrally--and truly fulfills the pledge President Obama ran upon, guaranteeing the health care that members of Congress get to all Americans.

Fundamentally, that is the problem with the legislation introduced this week in the U.S. House of Representatives, at huge cost, does neither.

            The $1.5 billion dollar price tag has only scared the Blue Dog Democrats in the house.  One of their leaders, Louisiana Congressman Charlie Melancon observed that the day before the bill was introduced seven of his caucus members (who sit on the committee) opposed the bill.  By Thursday, it was ten of his fellow Conservative Democrats. 

            That is a recipe for defeat of any meaningful health care reform.     

            Others have concentrated on the impact of a public option.   Our editors at The Louisiana Weekly instead choose to look at the essence of Landrieu’s and Melancon’s complaint. 

            All but the smallest of businesses, those with a revenue of $250,000 or less,  will be saddled with a new tax equal to a percentage of payroll if they don't provide health care for their workers.

According to 2006 data from the National Federation of Small Business, firms with between five and nine workers, representing about one million employers, had an average payroll of around $375,000 a year. A report from the Kaiser Family Foundation found that only about half of firms with three to nine workers offered health benefits in 2008.   Many of these are African-American American owned businesss stuggling in the wake of the economy nationally, and with the ravages of the storms locally.

The tax proposed by the House Democratic leadership will be 8% on businesses with payrolls over $400K, and step down incrementally from there.

Businesses with five to nine employees are not only the backbone of the economy during a recession, but they are the very companies that President Obama pledged not to tax in his campaign (ie, no one making less that $280,000).   African-American businesses that are barely holding on during these difficult times would be a prime target.

            Moreover, for those without company insurance, Section 401 of the bill applies. Any individual (or family) that does not have health insurance would have to pay a new tax, roughly equal to the smaller of 2.5% of your income or the cost of a health insurance plan.

The bill authors’ might reply, as one Weekly Standard authored noted, "But why wouldn’t you want insurance? After all, we’re subsidizing it for everyone up to 400% of the poverty line."

That statement would be true. However, if one is a single person with income of $44,000 or higher, then you’re above 400% of the poverty line. You would not be subsidized, but would face the punitive tax if you didn’t get health insurance. This bill leaves an important gap between the subsidies and the cost of health insurance. CBO says that for about eight million people, that gap is too big to close, and they would get stuck paying higher taxes and still without health insurance.

            These are the very Middle Class voters that constitute a majority of the 47 million Americans that currently lack health insurance.  The House bill could make things worse instead of better.

            Landrieu advocates an individual based system that actually removes the costs of health care from most businesses, while providing subsidies for all Americans to purchase coverage.  

            The legislation was written primarily by one of the most liberal members of the Senate, though to hear Moveon.org tell it, Ron Wyden has betrayed the left. 

            Why?  Because the Oregon Democrat would give the same health care members of Congress receive to all Americans.  

            The legislation would tax health benefits on the corporate side, but would correspondingly provide a $3000 a person voucher for every American to purchase health insurance..   Individuals not able to buy on the open market could choose amongst the five policies that members of Congress and federal employees have as their choices.

            Many Republicans do not like the plan since it creates an individual mandate to have health insurance, and eliminates the ability of insurance companies to deny coverage to those with pre-existing conditions.   Without these provisions, though, younger, healthier insurees do not enter the insurance system, forcing up prices for the remainder, and it is unconsciencable in a modern society to deny health care to those that need it.

            Democrats dislike Wyden’s plan because it does not have either the vaulted “public option” or an employer mandate.  They particularly hate the fact that he taxes health care benefits, a perk many of the party’s union supporters have won in extensive contract struggles. 

            Wyden responds that all the House bill does is expand Medicaid to $110 million Americans.  It is a fee per service based system that the liberal Democrat calls “apartied”.  More and more doctors refuse Medicaid patients, a process that Wyden believes would accelerate under the House proposal.   

            And, as the President’s own health expert Dr. Zeke Emmanuel, brother of the Chief of Staff pointed out, a fee for service model is the reason that doctors perform unnecessary procedures.   It is what is driving Medicare into bankruptcy by 2026, and the House plan only accelerates that date.

            Currently, there is a 37 Trillion dollar deficit in Medicare.  Adding most of the population to the public system, according to the Congressional Budget Office, would drive the gap between federal revenue and expenditures even higher--to 7% of gross domestic product in 2020--even if the program begins revenue neutrally now as Speaker Pelosi has promised.  And that's assuming that the economy returns to full employment between now and then.

            Wyden’s bill which coauthored by Mary Landrieu and five other Democrats, along with Utah Republican Bob Bennett and five other Republicans, brings the currently uninsured into the system by taxing the so-called “Cadillac Plans” of the rich.  It ends the separate but equal system of those trapped in Medicaid and those outside of it.   And, it guarantees that those who cannot get health insurance have the resources and the opportunity to win coverage.  

            The first line of the more than 2,000 year old oath that every graduate physician must take before he sees his first patient is "first do no harm". It is good advice when dealing with health care policy as well as patients. As a newspaper that enthusiastically supported the elections of both Mary Landrieu and Barack Obama, we urge the President to listen to the Senator when she renders such advice.

Christopher Tidmore writes for the Louisiana Weekly and Bayoubuzz allows him to supply his writings to Bayoubuzz.com

Christopher Tidmore hosts The Political Roundtable on KKAY 1590 AM Donaldsonville/Baton Rouge from 4-5 PM weekdays or on the web at www.kkay1590.com.  

His past columns for this year can be found at 
http://host1.bondware.com/~Louisiana_Weekly/news.php?NewsSectionId=56

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