Ed Brayton is a journalist, commentator and speaker. He is the co-founder and president of 
If you really want to understand the reconciliation process and the changes the House will attempt to make to the Senate version of the health care bill, you need to read this article at the Michigan Messenger by Mike Lillis. It goes into great detail on the differences between the House and the Senate bills and how they hope to smooth them out using the reconciliation process after the House passes the Senate bill.
One thing that jumped out to me is the Medicaid reimbursement fix, which was not in the Senate bill but will likely be added after the bill is passed. Currently, Medicaid only pays about 65% of costs, which is why so many doctors don't take Medicaid patients. That problem is bankrupting hospitals, who really can't refuse Medicaid patients; they're being forced to shut down units, particularly OB units, because of this problem.
Comments
I was glad to see this Michigan Messenger article featured as a top story at the Washington Independent. So much of the debate on TV and in print has focused on everything but the actual content of HCR and its ramifications relative to doing nothing.
The Messenger's Eartha Melzer did a great job of laying out the impact of HCR failing for women in Rep. Stupak's district, another example of alternative media focusing on the merits of what is being advocated rather than silly sideshows that are actually changing policy, e.g., Sarah Palin's 'death panel's' and Joe Wilson's 'you lie' regarding illegal immigrants and HCR.
The illegal immigrant prohibition in the exchanges, even though they aren't getting any affordability credits, is as stupid and harmful to optimal results as removing advance directives because they were falsely described as 'death panels'. However I wonder how many illegal immigrants can afford an unsubsidized health insurance policy? I would hope that if HCR passes, this and the advance directive initiatives will be later introduced into Congress. A "no" vote would be equivalent to describing yourself as zealous idiot, a winning formula in many GOP districts.
I also think the public option can one day pass, perhaps even in the next couple of years. It was hard to market that aspect when there were so many other moving parts and given the effectiveness those on the right have making their case. However it's a great idea on its merits as evidenced by other countries' success.
One aspect that wasn't covered in this article that Brett Baier should have challenged the President on in his recent Fox News interview and an issue I wonder about is the cost feasibility of purchasing mandated health insurance after receiving one's affordability credit, if any. I think this is the most radical aspect of HCR and the one aspect most prone to protest once its implemented. Yet I hear nary a peep about the mandate except some challenging its constitutionality.
Posted by: Michael Heath | March 19, 2010 1:08 PM
Actually, that article was written for the Washington Independent and I took it for the Michigan Messenger (we use material from other sites on the network when we feel it's appropriate). Mike is the congressional correspondent for TWI.
Posted by: Ed Brayton | March 19, 2010 1:49 PM
Michael Heath @ 2: "the cost feasibility of purchasing mandated health insurance after receiving one's affordability credit, if any. I think this is the most radical aspect of HCR"
"Radical" means going to the root, addressing the core of a problem rather than just the symptoms. The mandates are the core inasmuch as they're the main reason that Obama and his corporate backers wanted HIR in the first place, but they certainly don't address any problem related to health care and hence do not deserve to be called radical. Rather, they make sure that we stay perpetually with the same basic failed model of buying health insurance from a corrupt oligopoly (and a later addition of a public option would just increase the size of the corrupt oligopoly by one). Far from radical, I'd call them the most reactionary aspect of HIR.
Posted by: Miko | March 19, 2010 6:01 PM
I was shocked, shocked I say, to read the Michigan Messenger and find that this Mike Lillis fellow is doing actual journalism. Seriously, it's great to be able to access these details.
Posted by: HalfMooner | March 20, 2010 4:03 AM
All that is being discussed is the obvious but literally superficial aspects of the bill, the financing mechanism. That's all insurance is. It is appalling that the media does not look below the surface.
The mandate is necessary because otherwise no insurance would cover anyone with preexisting conditions. Obviously no one would sign up until they got sick.
There are a lot of fixes in this bill. Most are in the form of carrots to doctors and hospitals that improve their quality of care which in turn reduces costs.
Building an additional 1500 Community Health Centers which will provide excellent primary health care (including dentistry) to an additional 25 million people is part of the bill. And there is funding to attract more doctors and nurses into primary specialties will produce more staff to staff them. These are real cost savers especially since they prevent most ER visits for non emergencies.
Yes, immigrants of any type should be allowed to buy in; that way they are contributing and will be more able to get services before they get seriously ill.
The end of life counseling is back in with slightly changed wording.
There is to much to explain; go read the section titles and learn how really good, and dare I say radical, this bill is.
Call your congress critter and tell him to pass the bill.
Posted by: Sui Generis | March 20, 2010 6:51 AM