Partisan Ire Surfaces as Senators Start Work on Health Bill

WASHINGTON — Partisan anger flared Wednesday as senators began the public drafting of legislation to remake the health care system. By day’s end, lawmakers had settled in for a long, hard slog that may not fit with President Obama’s goal of signing a bill within four months.

“This is about as historic as it gets for all of us,” Senator Christopher J. Dodd, Democrat of Connecticut, said as he opened a day-long session of the Committee on Health, Education, Labor and Pensions.



Another Senate committee, dogged by questions about the cost and complexity of the legislation, postponed its session, scheduled for next Tuesday, until after July 4. Democrats said they needed the delay by the Finance Committee to work on reducing the cost of the bill, intended to provide insurance to millions of people with no coverage.

Mr. Dodd presided over the health committee in the absence of its chairman, Senator Edward M. Kennedy, Democrat of Massachusetts, who is battling brain cancer.

Senator Dodd said he hoped the committee would finish its work and approve a bill by June 26. But he told his colleagues, “My intent is not to jam anything, force anything on people.”

Within 15 minutes after the session started Wednesday, Republicans began to protest. Senator John McCain, Republican of Arizona, said it was ridiculous to take up such a large bill without a complete cost estimate.

He and other Republicans demanded more details of the legislation and more time to digest it.

Senator Orrin G. Hatch, Republican of Utah, said Democrats had made some grave errors.

“You advance legislation by focusing on areas of compromise, not strife,” Mr. Hatch said. “Now unfortunately we are beginning a partisan exercise on perhaps the most important legislation of our lives. I am personally somewhat, well, actually, very disappointed, because I wanted a thoughtful bipartisan compromise that could have become a lasting legacy for my dear friend, Ted Kennedy.”

President Obama is pressing Congress to speed work on the measures, which embody his top legislative priorities, reining in health costs and covering the uninsured. Mr. Obama wants to sign a bill by October, but senators of both parties said it was more important to get the policy right.

The bill before the health committee, drafted by Mr. Kennedy and Mr. Dodd, would require people to carry insurance, with federal subsidies for those who could not afford it, and would require most employers to help pay for coverage of their employees.

The bill would impose stringent new federal regulations on insurers and make far-reaching changes in the health care industry, which accounts for one-sixth of the economy.

Senator Michael B. Enzi of Wyoming, the senior Republican on the health committee, said the panel was moving “too fast to do an adequate job.”

Mr. Dodd said, “I appreciate the frustrations being expressed,” but plowed ahead. “We have a moral imperative to act,” he said.

Mr. Enzi said the bill had been drafted “with no input from Republicans,” and he asserted, “The bill costs too much, covers too few and will cause 10 million Americans to lose the insurance they currently enjoy.”

A preliminary estimate by the Congressional Budget Office said the bill would cost $1 trillion over 10 years but leave many uninsured. The office said an early version of the Finance Committee bill would cost $1.6 trillion.

Senate Democrats conceded that the unexpectedly high estimates had forced them to regroup, and acknowledged that they were still divided over how to pay for the legislation.

But Robert Gibbs, the White House press secretary, said he did not see any setback. “The president, I think, has laid out a timeline to get this done this year, and thinks that we’re on course to do it,” he said.

Senator Judd Gregg, Republican of New Hampshire, said he was on the committee when it considered President Bill Clinton’s plan for universal coverage in 1993-4. “It’s sort of déjà vu all over again for me,” he said.

Mr. Gregg said the Kennedy bill looked as if it had been written by Rube Goldberg, Karl Marx and Ira C. Magaziner, Mr. Clinton’s health care coordinator. Mr. Gregg criticized a provision that would establish a Medical Advisory Council to recommend minimum benefits for insurance policies.

“This is the elite of the elite deciding how everybody else will get health care,” Mr. Gregg said.

Senator Barbara A. Mikulski, Democrat of Maryland, fired back. “Our current system is a combination of Adam Smith, Darth Vader and the ‘Invasion of the Body Snatchers,’ ” she said. “So I like our plan the better.”

Ms. Mikulski said the Republicans’ complaints reminded her of objections to the creation of Medicare in 1965.

“The arguments against Medicare are the same arguments we are hearing now — government control, centralized bureaucracy,” she said. But, she noted, Medicare is hugely popular.

Senator Bernard Sanders, independent of Vermont, said, “The fight for comprehensive, universal health care is the civil rights struggle of the moment.”

And he issued this warning: “To all the lobbyists, all the big-money interests who give us campaign contributions and lobby so successfully with those 30-second ads on TV, I say your time has come and gone.”

Mr. Obama and many other Democrats have called for a new public health insurance plan, to compete with private insurers.

Senator Sherrod Brown, Democrat of Ohio, said such competition would “hold down premiums, discipline the market and keep the private insurances industry on its toes.”

But Mr. Hatch said, “Medicare and Medicaid are already on a path to fiscal insolvency; creating a brand-new government program makes no sense.”

Health insurance for men: what are the best options?

Should men be taking a closer look at health insurance, following news this week that they are more likely than women to get many common types of cancer?

More worrying still, this research showed that men are far more likely to die of certain cancers, compared to women with the same condition.

Although the report, from the National Cancer Intelligence Network, found "no biological reason" why this should be so, it is thought men's unhealthier lifestyles and their reluctance to get symptoms checked by a doctor at an early stage are largely to blame.

Of course, spending hundreds of pounds a year on health insurance won't stop you getting cancer – or any other disease for that matter. But it will ensure that you are in a better position to deal with the financial consequences of serious illness; and taking a more active interest in your health may mean that early signs are detected sooner.

The question remains though, what type of health insurance is best?

There are a number of different types of policy. The best known is probably private medical insurance (PMI), which basically pays for private consultations and treatments, allowing policyholders to bypass NHS queues. Some employers will offer this insurance to staff, and it can also be bought individually. The main drawback is that it can prove expensive for comprehensive cover – particularly as you get older.

Cheaper, and far more widely bought, is critical illness insurance, which is often sold to those taking out a mortgage along with basic life insurance. Rather than pay directly for private treatment, this insurance is designed to pay out a tax-free cash sum on the diagnosis of certain life-threatening diseases. The idea is that this money will enable policyholders to pay off the mortgage, reduce their working hours or take extended leave while they recuperate.

Most critical illness policies cover about 30 conditions, and all should cover cancer, heart disease and stroke. But within these broad definitions there are numerous exclusions. Certain types of breast, prostate and skin cancers, for example, which are not considered "life-threatening" are routinely excluded on most policies.

Another option is an income-protection policy. Rather than cover specific ailments, this pays out a regular income to those who are unable to work through ill health. Provided a doctor has signed you off sick, these policies should pay up, regardless of the nature or severity of the illness. As well as covering cancer and heart disease, these policies help those with back problems, stress or depression.

The final option is a "cash plan". These schemes are relatively cheap, but the benefits are more limited. However, those who contribute to one of these plans can claim a contribution to regular medical bills, such as dental charges, opticians fees, physiotherapy and so forth.

So what should you buy, given most of us don't have the inclination or the financial wherewithal to pay for them all?

Alan Lakey, a financial adviser specialising in protection policies, says: "Both men and women should ask themselves what would happen to their income if they had a long-term health problem or illness. Those who work for an employer like the police or the NHS may have more generous staff benefits that would pay long-term sick pay at a reasonable rate. But most people won't have this luxury to fall back on. If this is the case, then income protection should be your first port of call."

He said critical illness could be useful, but it does not offer the same flexibility. He added that some customers may want to opt for private medical treatment, but this in most cases is unlikely to be their main priority – particularly given the cost.

Matt Morris of Lifesearch, a firm of advisers, agrees: "Anyone with dependants or debts who relies on their salary to live should ensure that they have adequate income protection in place as a first priority. Ideally, everyone would have an income protection, critical illness and a basic life insurance policy – usually in that order of importance."

Further information on each of these main products is given in the linked stories below, so men and women can decide what policy would give them the protection they need.

Critical illness
Income protection
Private medical insurance

The great uninsured--decreasing the surplus population

Strange times we live in. We are now evaluating if we really need to do something about health care--the very sustenance of existence. We are not talking about who should get a tax break but who should be cared for so they may survive their time on our planet. The stakes don't get much higher than that for the millions of the great uninsured.


I spoke with a woman who told me she had just lost her home in Florida. She is a realtor and has a nice home in the Chicago land area. Maybe in her fifties. We chatted about real estate and selling my two flat and somehow we started talking about doctors. That's when she dropped the bomb and said she was uninsured and that she couldn't afford to get sick.

She said she couldn't afford health insurance and worse no one would insure her because she has pre existing conditions. This is not a poor person. This is not someone who doesn't pay taxes and has a mortgage. She simply cannot get insurance. Depending on where you come down in this debate you may say it is this woman's own fault. She should have been working for a company instead of a straight commission job. She should make more so she can afford health care.
The truth is everyone could become this woman.


The argument against Universal Health Care is that it will knock down the quality of our health care. But to the millions of uninsured in this country, some health care is better than no health care. I suppose it comes down to your view of America. If we are a country that takes care of it's people then you believe that health care is a right. But if your view is that it is every man and woman for himself and take the more Darwinian approach of survival of the fittest--then we should stop all the pretense and just say good luck to people like this woman.
There are a lot of people finding themselves in the unemployment line now. Some will never be rehired and will lose their benefits. Some will get old outside the corporate safety net without health insurance. So if we decide to tell all these people they are own, then like Scrooge, we should also tell that if they are going to die, then they should do it, and decrease the surplus population.