Bingaman Video Exclusive
by: Lauren Reichelt on September 30th, 2009 | 9 Comments »
I had the good fortune to travel to Washington, DC., and interview Senator Jeff Bingaman on September 18 about Medicare for All, the Baucus Bill and other topics related to health care reform.
Everybody’s favorite diarist, Land of Enchantment, was kind enough to edit my video and post it on YouTube.
Thank you LoE for putting up with me and editing the video which is embedded after the fold. A summary (not a transcript) of Parts One and Two follows the videos for the YouTube impaired.
First, a disclaimer:
I am not a professional journalist and I happen to like my Senator. Last winter, a few New Mexico County health directors got wind of a quiet Bush Administration plan to eliminate emergency rooms serving the uninsured through an arcane change of regulations. We could not believe the lack of news coverage, and went to Senator Bingaman for help. He took on the issue (with no help from leadership in either party, or any other Senator), and successfully pushed through a moratorium on the rules changes as an amendment to the budget for Iraq. I diaried our Medicaid Rules adventure here and here.
Senator Bingaman could just as easily have let all the indigent and teaching hospitals go under and then blamed the Republican Party, but he didn’t. That’s why I like him.
Here’s the vid in two parts. Please don’t hold the camerawork against me!
Part 1
Summary Part 1
Me: I (along with most of my readers) am a supporter of Medicare for All. Many readers of blogs are dissatisfied with the shortcomings of the Baucus Bill. How do we get from what we have to what we want?
Jeff Bingaman: I was involved in the writing of the HELP and finance bills. The Baucus Bill is an improvement over what we have today. There is some disussion regarding how much we can afford in subsidies. The HELP bill includes substantially more in subsidies than does the finance bill. We can move the Finance bill in the direction of the HELP bill but probably can’t get it all the way there. There is a strong public option in the HELP bill and we will try to include it in Finance but we may not have the votes.
Me: Assuming that Finance produces a conservative bill, what opportunities exist to reintroduce the Public Option and how can my readers help?
Jeff Bingaman: Yes. We will pass something out of Senate Finance next week [this was filmed on 9/18, prior to the addition of Senator Kennedy's replacement]. Then Senator Reid will have to merge the two bills keeping in mind that we need 60 votes to avoid a fillibuster. Once the bill reaches the floor, it is open to amendment from anyone.
We will need sixty votes to pass the bill on to the House [this has changed] and then again after the conference between the House and the Senate, so at every stage we will need 60 votes. Your readers can help by persuading additional Senators to support the Public Option. [This dynamic changed on September 24 when Paul Kirk, Jr. was appointed to replace Ted Kennedy in the Senate, giving the Democrats the 60 votes required to block a fillibuster. Once cloture is invoked, the Democrats will need only 51 votes to pass the Public Option. Thus, a conservative Democrat can vote to block a fillibuster and then, in the "up or down vote," vote against the Public Option, thus passing it without resorting to unusual parliamentary procedures.]
Summary, Part 2
I asked the Senator about several provisions in the Baucus Bill.
Me: Will the “Free Rider,” penalize employers for hiring low income persons who require a federal subsidy for health care, while creating a greater incentive to hire undocumented workers, especially in poor border states like New Mexico?
Jeff Bingaman: This is a difference between the HELP and Finance bills. The HELP bill requires employers who have 26 or more employees to either provide coverage or pay the federal government $750 per employee per year. The Finance bill tries to avoid a federal mandate. If an employer hires 51 or more employees, then s/he must pay the cost of the federal subsidy of each employee that is subsidized by the government (with a cap). I agree that this discriminates against employers who hire low income workers so I support the HELP version. Finance adopted the alternative strategy due to pressure from business groups but the provision places an undue burden on low income Americans. I prefer the HELP “Pay or Play” provision.
Me: You worked very hard to get prevention measures, and especially obesity prevention measures, included in the HELP bill. Diabetes is huge in New Mexico. What happened to those provisions?
Jeff Bingaman: They will probably end up in the final bill. The Finance Committee didn’t actually object to them. It just didn’t have jurisdiction over those measures.
Me: Poor states like New Mexico experience tremendous gaps in services. The average age for a dentist in New Mexico is 55 and we have no dental school. We lack specialists in many fields including behavioral health. I don’t know why we call what we have capitated care. It seems like it should be called decapitated care because it doesn’t cover anything in the head.
Jeff Bingaman: The HELP bill includes provisions for training of physicians and medical personnel. We include incentives in the Medicare payment sshedule designed to attract physicians to primary care.
Senator Bingaman wished the readers of Tikkun Daily a Shanah Tovah (although this ended up on the cutting room floor.)
What an incredible job of reporting and how fabulous that bingaman spent the time with you to talk about this honestly. Thank you so much for sharing this story! It certainly gives me hope to hear an elected official speak so frankly. And thank you so much for making this trip.
I’ve been paying attention to Senator Bingamen’s votes in the Finance Committee deliberations as well as those of my own Senator Maria Cantwell and the rest of the Democrats. I consider the Republicans a lost cause when it comes to promoting the interests of the voters rather than the interests of the insurance companies, and the amendments they offer and the votes they cast prove rather than disprove my cynicism.
But Bingamen has worked to advance the interests of his constituents for the most part. I am really glad to have had a chance to see this interview and to get acquainted with him a bit better through your videos. Thank you.
And thank you both for taking the time to watch! Legislation is complicated and part of the reason the left has been ineffective is that we don’t understand the process. We take refuge in ideology and leave the messiness of legislation to paid lobbyists.
Problem is, we’re not the ones payin’ ‘em. We probably should be. There are four hundred something full time health care lobbyists working against our wishes and not even one lobbyist for Single Payer.
We need to get pragmatic and stop bashing folks like Bingaman who can work the process. And I am not using “pragmatic” as a synonym for “cynical.” I mean, we need to start passing our legislation.
Lauren,
Very professionally done with respect to breaking down some of the issues for those of us who need assistance in describing the process. I learned a lot, and have renewed respect for Bingamen.
Lauren, thank you for those videos.
I am for a single payer health care plan. We do not have to reinvent the wheel on this plan. We have a proven health care plan on the books. It is Medicare. When the Medicare bill passed, it added to it at a later date, the children with disabilities act. We can put in a part E. E meams Medicare for Everyone. I borrowed this idea from Thom Hartmann of Progressive Radio.
I am sick of my country for her insensitivity toward most Americans. The Nazi Party or the GOP wanted to pass an amendment saying that we are a Christian nation. Everytime I hear that we are a Christian nation, I want to vomit. How can we be a Christian, when we fail to practice the “Golden Rule?”
How can we be a Christian NATION, when we fail to practice the “Golden Rule?”
Or, when we do not accept the Eleventh Commandment that was given to us by Jesus at the Last Supper? LOVE ONE ANOTHER AS I HAVE LOVED YOU!
When it comes to praciticing Christianity, the United States is a joke.
I am not a Christian so I can’t help with this. I agree that Medicare for All is the best system. Unless we want to establish it via armed revolution, which is nasty, brutish and basically unappealing, we need to use the legislative process.
The purpose of the video is to help us influence that process to achieve our desired outcome. That means mucking about in negotiations for votes in various committes and on the floor. At the moment, we need 60 individuals to vote for cloture and then 51 to pass a bill. We can’t get 51 to pass Single Payer at this point in time. In part, this is because we do not have even one entity on the hill lobbying for it. If we are serious, we need to find some talented former staffer and hire him or her as a full time advocate on our behalf with a budget, an office and a suit.
So, we can do nothing, or we can try to pass a meaningful public option and then build on our success.
All that being said, the Torah certainly commands us to care for the least among us. I’m not sure how social Darwinism became a substitute for Christianity. Meaningful healthcare reform would be a first step in the right direction.
You did a most excellent job on both the interview and flushing out certain issues. However, the question and reply about physician shortage deserves much more attention on all fronts. Recently I participated in a Health Care Town Hall and one physician after another stood and said it is our government based health programs, Meciare and Medicaid, which are driving them out of business. I also worked for private providers for 20 years and have seen one good doctor after another leave the profession because they were not being reimbursed for their work to the point of bankruptcy. Government is the number one payor in health care now and we have more fraud and waste under that system than the profit taking private insurers. You speak of denitstry here in New Mexico – most dentists stopped accepting Medicaid because of below cost reimbursemen. There are areas in this state where not one physicain will accept Medicare. It is not enough to idealize a single payor plan – the history of this country – which capitalism has made the strongest country in the world – would support the idea that competition is the best way to make any system efficient. What good will it do to have coverage for all if you have no providers? Physicans and other providers cannot continue to provide a service which costs $35.00 and be reimbursed $15.00 by our state and federal government. We need to fix the programs we have in place, then we would have something good to build on.
Great comment, Rhonda! There are huge issues with reimbursement rates for Medicare and Medicaid that need to be addressed, and there are some regions of the country that fare better than others. I believe this is one of the issues raised by te conservative democrats. You are absolutely right that it makes no sense to respond to legitimate issues with platitudes and there are few who know more about Medicaid and Medicare payment rates than do you.
Just yesterday, I was told by my allergist that he may soon be withdrawing from BCBS, a private insurer, because their reimbursement rate was lower than the cost of the provision of care. He was willing to sustain the loss in the past because only 20% of his patients carried BCBS. But now the major employer in town is picking it up and 90% of his patients will be BCBS. We do not have an allergist in Espanola, and no other allergist in Los Alamos is currently accepting BCBS patients so unless I want to travel pretty far, I am SOL. I do very well with shots but without them, I develop horrible asthma and bronchitis that keeps me bedridden for weeks at a time.
A few months ago, I developed an anti-biotic resistant ear infection (also due to allergies) and was referred to an ENT in Santa Fe. When I was called, I was told they could not see me for three months. I was in a lot of pain and got into a loud shouting match with the receptionist. In the end, my PCP prescribed me something horrible that made me throw up a lot but it got rid of the ear infection before my eardrum burst.
It is becoming increasingly difficult for everyone to access health care, even those with insurance. If my allergist leaves Los Alamos because BCBS won’t pay him enough to stay in business, then the wealthiest town in NM (and indeed, one of the wealthiest towns in the US) will experience a startling gap in their service delivery system. We are used to getting the dregs in Rio Arriba but I doubt Los Alamos is accustomed to going without care. I still believe in Single Payer. I never experienced shortages of care when I lived in Japan or when my husband was in the military. But I agree that payment rates need to be sufficient to support medical practice.
BTW, great to see you here my fellow Medicaid Rules adventurer! I am surprised. I hadn’t even sent out the link.