Congressman Massa today sent his constituents an e-mail explaining his vote. Since I have very little knowledge of the bill myself, and I'm more apt to believe the conclusion of somebody who has reached that conclusion in a way that forces them to speak out / act / vote against their original position on an issue, I'm allowing my own opinion on this to be guided by that of my Congressman:
Congressman Massa's basic conclusion was that the bill does not accomplish what he hoped it would (provide healthcare for the vast majority of uninsured Americans), and in fact entrenches and legitimizes many of the current problems by putting them under the auspices of the federal government.
Unfortunately, H.R. 3962 will not deliver these goals. Its primary strategy is to achieve more and better care by the federal government's regulation of the private insurance industry. But the so-called "Public Option," which is supposed to compete for customers with private providers, is too weak to be much of a competitor. Estimates are that it will attract only six million customers; and this will make its risk pool too small and too dominated by lower-income, less healthy purchasers whom the private companies do not much want anyway. This will ensure our national dependence on publically subsidized and partially regulated private insurance, provided through employers, the permanent and central element of U.S. health care for the indefinite future. But if private insurance sold to employers was the answer, we would not be in the mess we are.I recognize that the reasons that Congressman Massa voted against H.R. 3962 were because it wasn't "left / liberal" enough, and I agree with his thinking: If you're going to have a massive new government program on par with Social Security in scope, (a) there's no arguing that it is going to be liberal since the main haeccity of liberalism is big government programs (and vice-versa), and (b) there's no sense doing a big liberal program like this it if it's going to be liberal milquetoast.
More importantly, I appreciate the fact that Congressman Massa was willing to vote against the wishes of his party, and willing to vote against a bill that utterly fails to deliver what he hoped it would. I recognize that there may have been an element of political thinking involved in his vote, since NY-29 is a generally Republican district, but calculated thinking like that can be respected if it leads to behavior in line with your conscience. (The Fighting 29th blog disagrees with the political aspect of this vote.)
Personally, I think that Congressman Massa is doing a good job so far.
Read the entire e-mail after the jump.
Because you have previously been in touch about health issues, I am writing to let you know why I voted "no" on the 2009 major health care reform bill (H.R. 3962). Being accountable to you for my actions, perhaps you will forgive a detailed response.
Since entering Congress on January 6, 2009, I have devoted more time and thought to health care reform than any other issue. Health care has been discussed this year in every one of my more than 60 town halls and 300 house parties. My staff and I read, digested and replied to over 15,000 letters, faxes, emails and phone calls, went over countless briefs, white papers, studies and analyses, reflecting every possible perspective and interest.
Not a single day went by without representatives of professional health care providers, patients, specific disease groups, insurances companies, unions, academic experts, think tank executives, medical students, medical supplies sales people, hospital executives and a surprising number of sick people, contacting us. Every single voice and concern was carefully listened to.
Various draft bills were read and discussed with Congressional colleagues and the House leadership. I continuously listened and read; and tried my very best to absorb and understand all this information.
At the very beginning of this debate, I made clear my support for a single-payer health system. This is rooted in experiences in the US Navy and as a survivor of a deadly cancer. Achieving health care reform is - and remains - a very high priority.
Having spent much of the last ten months studying, listening to constituents and considering this, I could not support H.R. 3962, the health reform bill presented to us by House leadership. This position is best for my constituents and best for our country.
Now let me briefly explain my vote.
At the start of the debate earlier this year, many agreed the objectives were to: make clinically needed health care available to all Americans; to ensure health care is affordable for most individuals and families, so more Americans could pay for their own coverage; bring total annual health care expenditures into line with the rest of the developed world, below 17.7% of gross domestic product; ensure consistently high quality care; and reduce the total money spent on system waste, fraud inefficiency and poor management.
Unfortunately, H.R. 3962 will not deliver these goals. Its primary strategy is to achieve more and better care by the federal government's regulation of the private insurance industry. But the so-called "Public Option," which is supposed to compete for customers with private providers, is too weak to be much of a competitor. Estimates are that it will attract only six million customers; and this will make its risk pool too small and too dominated by lower-income, less healthy purchasers whom the private companies do not much want anyway. This will ensure our national dependence on publically subsidized and partially regulated private insurance, provided through employers, the permanent and central element of U.S. health care for the indefinite future. But if private insurance sold to employers was the answer, we would not be in the mess we are.
Private insurance premium costs will continue to increase and more people will lose access to care. Further, the individual mandate forcing private citizens to buy mostly private care or face substantial annual fines, may not be constitutional. And burdening private businesses with the legal burden of providing health care insurance will leave them at a serious competitive disadvantage with foreign companies who face no such costs. Many firms will be fined and further harmed for not providing care.
The bill, compared to the size of the problem, does little to truly force out waste, fraud, abuse and mismanagement; and this in turn increases the money that must be raised either by new revenue streams or reductions in existing health programs, to pay the new bills.
The bill leaves rural health care providers permanently disadvantaged. And the expansion of Medicaid eligibility could lead to significant pressures for higher New York state taxes and county real estate taxes. The middle of an economic down-turn is a bad time for tax raises.
It does very little to increase the number of primary care or family physicians who, along with advanced practice nurses and nurse practitioners, are central to more prevention and wellness programs. Overall, this bill makes our national health care system administratively more cumbersome, bureaucratic and unnecessarily expensive.
So I entered the House of Representatives on Saturday, November 7th, 2009 and voted "no." This decision bitterly disappointed some of you. It saddens me too, as the nation badly needs a system which can do a better job of helping us to be healthier, at lower costs. Unfortunately, the House bill's passage through the Senate and a subsequent conference will almost certainly further weaken an already-flawed piece of legislation.
So what can I say to those who need health reform now?
Whether or not any act emerges from Congress, the health reform process will go on; and I am sworn to work with all constituents to build a better system. In the days ahead you will be hearing from me on continuing steps to reform our nation's health care system.
We cannot give in to apathy or cynicism. That would be a betrayal to us and our children.
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