[REBORN FROM THE ASHES][comment][12.22]

豆腐店的86UID: 2512956

America's health-care bill
Nearer and nearer
Dec 21st 2009 From Economist.com
生词
读多遍才懂的句子
好句子，好表达法
======================================================================

A procedural vote in America's Senate brings Barack Obama's health-care reforms closer


IT NOW looks certain that Barack Obama will get what he wanted for Christmas—a health-care reform bill passed out of the Senate, probably just a few hours before Santa begins his rounds. Republicans, who have been fighting tooth-and-nail to block passage of the bill seem to have given up the fight, and have given warning instead that this will be a wish that he comes to regret.

Shortly after 1am on Monday December 21st, the health bill cleared the first, and the most difficult, of the procedural hurdles it has to leap in order to secure passage through the Senate. Technically only a motion to end debate on a “manager's amendment” put together by the Senate's majority leader, Harry Reid, what the vote really represented was a crucial exercise in nose-counting. The result was a vote on precisely partisan lines, with all 40 Republicans opposed, and all 58 Democrats plus the two independents who are grouped with them voting in favour. Since 60 votes is the precise number needed to avoid a filibuster, there was no room for error whatsoever, the reason why the procedural motion had taken so long. But with all 60 members of the “Democratic caucus” now signed up, the final vote, on Christmas Eve, looks like a formality.

From the point of view of the Democrats, this victory has come at a high price. The health bill has been stripped of something very dear to many of then: a “public option” of a government-backed insurance scheme that would compete with private insurers in order, supposedly, to keep costs down and guarantee access. The version of the bill already passed by the House of Representatives does contain just such a public option, one of several reasons why final passage of a reconciled bill is still a way off. Some Democrats hope, however, that a public option can be added later on, after the initial bill has gone into effect.

Still, the Senate version does tick most Democratic boxes; it obliges everyone to have health-insurance, and sets out a generous system of subsides to help the uninsured obtain coverage, along with a system of government-regulated exchanges that should encourage competition among private insurers. It fines employers who do not offer health cover to their workers. And it makes it illegal for insurers to refuse people coverage on the basis of pre-existing medical conditions, as well as putting strict limits on the way that premiums are allowed to increase with age. The hope is that tens of million of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders.

Republicans, however, hate the bill, mostly on the ground of cost. The advertised price-tag of the Senate bill is a bit under $900 billion over the next ten years, but Republicans contend that the numbers will be much higher than that, as the cost of subsidies has been underestimated and predicted savings will not materialise. Even at the stated number, this is a large bill at a time when America is running huge deficits that it urgently needs to tackle. The Senate bill is "paid for", but only in the sense that it provides for large charges on the most expensive private insurance policies, and because it factors in deep cuts to Medicare the health-insurance scheme for the elderly. Republicans say these will never be enacted. Past history provides them with evidence to back up that claim.

Less politically involved observers also note that it is unprecedented for such a substantive and expensive bill to have been forced through Congress on such a narrow vote. The bill passed the House on a margin of just five votes, and in the Senate it has no safety margin. With no bipartisan support at all, Democrats will be held solely responsible if the reform turns out to be a disappointment. Some studies have suggested that private insurance premiums could rise substantially in response to the new burdens being placed on insurers.

Completion of work on the bill is by no means a formality, though it does now look more or less certain that the Senate will vote the bill out before Christmas. The next difficulty will come in producing a single “reconciled” version from the very different bills that the Senate and House have produced; that reconciled bill then has to go back for final clearance by both chambers. The public option is one big stumbling block. It is clear that the Senate cannot pass any version of a bill that contains a public option, so the House will have to give ground, which is going to require a lot of presidential arm-twisting in January. And the two bills are funded in very different ways, one with a tax on the rich, the other with an insurance-policy surcharge. As of today though, health-care reform, expensive and imperfect though it is, is looking a lot more likely.

-----------------------------------------------------------------------------------------------------------------
tooth-and-nail  以牙还牙， 这里指猛烈争斗
amendment   the process of amending by parliamentary or constitutional procedure
nose-counting  NOT FOUND
partisan   a firm adherent to a party, faction, cause, or person;  especially   : one exhibiting blind, prejudiced, and unreasoning allegiance
filibuster the use of extreme dilatory tactics in an attempt to delay or prevent action especially in a legislative assembly  
caucus   a closed meeting of a group of persons belonging to the same political party or faction usually to select candidates or to decide on policy;  also   : a group of people united to promote an agreed-upon cause
formality   an established form or procedure that is required or conventional  *the interview was just a formality*
public option A public health insurance option (public insurance option or public option for short) is a proposed health insurance plan that would be offered by the U.S. federal government.
scheme a plan or program of action;  especially   : a crafty or secret one
House of Representatives 众议院 The United States House of Representatives, commonly referred to as the "House," is the lower house of the bicameral United States Congress, the upper house being the United States Senate.
way off 差得厉害，有很大距离
oblige to constrain by physical, moral, or legal force or by the exigencies of circumstance  *obliged to find a job*
premium NOT SURE  a : a reward or recompense for a particular act  b : a sum over and above a regular price paid chiefly as an inducement or incentive  c : a sum in advance of or in addition to the nominal value of something
redundancy the quality or state of being redundant  : SUPERFLUITY  这个词我是明白的，但是就是不知道在句子中怎么解释，求教了！
price-tag 价格标签
contend to strive in debate  : ARGUE
materialise  a : to make material  : OBJECTIFY  b : to cause to appear in bodily form
factor in   to include or admit as a factor ? used with in or into
unprecedented   having no precedent  : NOVEL 空前的
stumble to come to an obstacle to belief
substantive   considerable in amount or numbers  : SUBSTANTIAL  *made substantive progress*
give ground  退回，撤退
presidential arm-twisting   the use of direct personal pressure in order to achieve a desired end
surcharge  an additional tax, cost, or impost

----------------------------------------------------
comments
The American health bill is now around the corner, though it has not been released, the day will not be later than Christmas, according to the writer. This Senate version of health care policy was raised on Obama’s presidential campaign and caused an intense discussion. Up till now, this very issue is still remain controversial that Republicans doubt the efficiency of the policy since they believe $900 billion is not enough to pay this bill. On my point of view, it is the right time to pass the health care policy which the Obama government promised to its people for such a long term. However, problems that people concern are still there and the government have figure out a way to solve them. Apparently, such issues are going to wait to be listed on the 2010 agenda.

dingyi0311UID: 2627919

Note
The health bill has been stripped of something very dear to many of then: a “public option” of a government-backed insurance scheme that would compete with private insurers in order, supposedly, to keep costs down and guarantee acces
final clearance
The Senate bill is "paid for", but only in the sense that it provides for large charges on the most expensive private insurance policies, and because it factors in deep cuts to Medicare the health-insurance scheme for the elderly.
partisan 党派支持者
stumbling block 绊脚石
nose-counting 人口调查
美国的政治结构还不了解

My comments

This report briefly illustrate for the readers several reasons why this policy, which can benefit every single person in the United State, can hardly be passed both in the government and the public. Several reasons explained it suggest themselves. First, the price of the ensurance is much to high both for the government budgets and the general publics. It will cost 900billion on the government parts and more charges on any individual who participate in. it is beneficial to those elder and frequently ills.

In my opinion, this bill can be constructive to the society through prompting the economic of the society, which was not mentioned in the article, since there are insurance out there to guarantee their medical treatment in the future, people will less likely to save money for medical fees in their later live in the bank, more money therefore are spent and make the economic vigorous; the mechant can make money and have their goods selled, This is very important especially when the whole country are experiencing the economic depression.

Even this bill will cost a lot, it does not mean it is not worthy. People will always become old, even it less likely for those young people to get ill and spent much money on the medical treatment, they will finally spent money when they are old and some may even spend much more than their total preminium have paid in their lives. Nobody can make sure whether they will not severely ill or not. And if there are no insurance, those opponent of these bill may even regret when they are old and have little money for medical care.

Therefore, the bill is generally good for people in the long run, and I’m looking forward to seeing our country passing a similar bill in the future.

emteddybearUID: 2699606

so short but so difficult to me

Senate:参议院  health-insurance:健康保险 redundancy：冗余  nose-counting:????  on the ground of cost:ground 是理由的意思  by no means :绝不  give ground：让步    Senate：参议院  House ：众议院 tooth-and-nail 竭尽全力
probably just a few hours before Santa begins his rounds.什么意思？？？
good sentence:
1. The hope is that tens of million of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders.
2.Republicans, however, hate the bill, mostly on the ground of cost
3.Past history provides them with evidence to back up that claim.
4.As of today though, health-care reform, expensive and imperfect though it is, is looking a lot more likely.

my comments:
This report is so difficult for, beacause of the lack of background knowledge.However after rodgood  gave me some directions, I got it quickly. Thanks him again. This report is mainly about the health-insurance reform. Although Democrats succeeded in the  vote, but there are many problems. Just as the democrats say the vitory has come up at a high price.As for health-insurance reform, I want to talk something about it in my country. At present, the rate of the development in country is quite astonishing, and our life is better and better on the surface. But the social welfare is quit unsatisfactory. Even though we don't talk about the unemployment, because this problem is worldwide. Here we only talk about the health care and social security. As an ordinary people, we all pray that there is nothing wrong with our body, and keep health is our greatest wish. That is not that we are undue, but that if there is one person in a family  sick, the whole family is destroyed. Because we really can't afford the expensive costs. That is normal in our country many years. And I hope there are some health-insurance reform in our country, and it must be all the Chinese people's  desirableness.

aladdin.ivyUID: 2596664

As completing this health-care reform bill, whose aim is make every American have health-insurance, the first substantive task facing by President Barack Obama. The passage of the bill would be so crucial a transition point that it might determine Obama’s future policy history.

At present, analysts pointed out that, Obama faces a difficult dilemma in the process of promoting this reform. If he adhere to the timetable according to his own plan for the implementation of the reform, he likely to lose the support form the Republicans even from the inner Democratic Party, which become a stumbling block for the implement of Obama’s future policies. However, if the Congress to act according to their timetable, this medical reform will certainly not be implemented within this year, thus, that will make Obama’s difficult to govern by a plummeted popularity.

This reform, said by BTV news- a official news program, will bring benefit only for 15% of American people, and most cost, $900 billion over the next ten years, of improving this reform would bring from those taxpayers who do have health-insurances. Although it is nearer and nearer, as the title of this report said, to the moment when a health-care reform bill passed out of the Senate, with the fact that 52% American people disagree to implement this health-care reform, whether Barack Obama will get what he wanted for Christmas remains to be seen.

绿色的大字有助于保护视力:loveliness:

AdelineShenUID: 2630498

America's health-care bill

Nearer and nearer

Dec 21st 2009 From Economist.com

A procedural vote in America's Senate brings Barack Obama's health-care reforms closer


IT NOW looks certain that Barack Obama will get what he wanted for Christmas—a health-care reform bill passed out of the Senate, probably just a few hours before Santa begins his rounds. Republicans, who have been fighting tooth-and-nail to block passage of the bill seem to have given up the fight, and have given warning instead that this will be a wish that he comes to regret.

Shortly after 1am on Monday December 21st, the health bill cleared the first, and the most difficult, of the procedural hurdles it has to leap in order to secure passage through the Senate(参议院）. Technically only a motion to end debate on a “manager's amendment” put together by the Senate's majority leader, Harry Reid, what the vote really represented was a crucial exercise in nose-counting. The result was a vote on precisely partisan lines, with all 40 Republicans opposed, and all 58 Democrats plus the two independents who are grouped with them voting in favour. Since 60 votes is the precise number needed to avoid a filibuster, there was no room for error whatsoever, the reason why the procedural motion had taken so long. But with all 60 members of the “Democratic caucus” now signed up, the final vote, on Christmas Eve, looks like a formality.
（The health bill cleared the most difficult hurdles.)

From the point of view of the Democrats, this victory has come at a high price. The health bill has been stripped of something very dear to many of then: a “public option” of a government-backed insurance scheme that would compete with private insurers in order, supposedly, to keep costs down and guarantee access. The version of the bill already passed by the House of Representatives does contain just such a public option, one of several reasons why final passage of a reconciled bill is still a way off. Some Democrats hope, however, that a public option can be added later on, after the initial bill has gone into effect.

Still, the Senate version does tick most Democratic boxes; it obliges everyone to have health-insurance, and sets out a generous system of subsides to help the uninsured obtain coverage, along with a system of government-regulated exchanges that should encourage competition among private insurers. It fines employers who do not offer health cover to their workers. And it makes it illegal for insurers(保险公司） to refuse people coverage on the basis of pre-existing medical conditions, as well as putting strict limits on the way that premiums（保险费） are allowed to increase with age. The hope is that tens of million of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders.
（The aim and measures of the Senate version)

Republicans, however, hate the bill, mostly on the ground of cost. The advertised price-tag of the Senate bill is a bit under $900 billion over the next ten years, but Republicans contend that the numbers will be much higher than that, as the cost of subsidies has been underestimated and predicted savings will not materialise(使具体化）. Even at the stated number, this is a large bill at a time when America is running huge deficits that it urgently needs to tackle. The Senate bill is "paid for", but only in the sense that it provides for large charges on the most expensive private insurance policies, and because it factors in deep cuts to Medicare the health-insurance scheme for the elderly. Republicans say these will never be enacted. Past history provides them with evidence to back up that claim.
（Republicans hate the bill because of the high cost.)

Less politically involved observers also note that it is unprecedented for such a substantive and expensive bill to have been forced through Congress on such a narrow vote. The bill passed the House on a margin of just five votes, and in the Senate it has no safety margin. With no bipartisan support at all, Democrats will be held solely responsible if the reform turns out to be a disappointment. Some studies have suggested that private insurance premiums could rise substantially in response to the new burdens being placed on insurers.
(Less politically involved observers also note that it's unprecedented for such a substantive and expensive bill to have been forced through Congress on such a narrow vote.)

Completion of work on the bill is by no means a formality, though it does now look more or less certain that the Senate will vote the bill out before Christmas. The next difficulty will come in producing a single “reconciled” version from the very different bills that the Senate and House have produced; that reconciled bill then has to go back for final clearance by both chambers(会议厅，议所）. The public option is one big stumbling block（绊脚石）. It is clear that the Senate cannot pass any version of a bill that contains a public option, so the House will have to give ground, which is going to require a lot of presidential arm-twisting in January. And the two bills are funded in very different ways, one with a tax on the rich, the other with an insurance-policy surcharge. As of today though, health-care reform, expensive and imperfect though it is, is looking a lot more likely.

Comments:

The debate on the US government's health-care reform is a hot spot in 2009. Now the health-care bill is nearer and nearer. The Democrats and Republicans hold defferent views. Most Democrats support the health-care bill, which is good for the coverage of insurance in elder and less healthy people. Most Republicans hate the bill because of its high cost. Now the bill is passed on Congress in a narrow vote, and the public option is a big stumbling block.

Public option is proposed health care reform that would give individuals and employers a choice between government-provided healthcare or private healthcare. It is a kind of hybrid system between single-player, or universal, healthcare and the current system serviced primarily by private insurance companies.

In my point of view, public option is a must in the healthcare system of US in the future. It is a reconsiled system between the government and the private insurrance company. Government could provide healthcare insurrance for those who fear losing the insurrance through redundancy or ill-health because of the private company's strategy. For those well-off people who want to get better healthcare insurrance, private inssurance company might be a better choice for them.

Some is worrying that the private companies will not have the ability to compete with the government health-care system and the economy of America will get in more trouble. Others are worried about the huge bill of the new health-care system which is under-estimated by the government. Since pure govenment or private healthcare system is not suitable for America, public option is a good choice for American people.

kulewy531UID: 2603031

4# splendidsun
Nose-counting在这里的意思应该是“记票”吧？

kulewy531UID: 2603031

America's health-care bill

Nearer and nearer
Dec 21st 2009 From Economist.com

A procedural(程序上的) vote in America's Senate brings Barack Obama's health-care reforms closer
IT NOW looks certain that Barack Obama will get what he wanted for Christmas—a health-care reform bill passed out of the Senate, probably just a few hours before Santa begins his rounds. Republicans, who have been fighting tooth-and-nail(拼命) to block passage of the bill seem to have given up the fight, and have given warning instead(这个instead的位置好诡异啊) that this will be a wish that he comes to regret.
Shortly after 1am on Monday December 21st, the health bill cleared the first, and the most difficult, of the procedural hurdles（障碍） it has to leap in order to secure passage through the Senate. Technically only a motion to end debate on a “manager's amendment” put together by the Senate's majority leader, Harry Reid, what the vote really represented was a crucial exercise in nose-counting（“数鼻子”——人口调查）. The result was a vote on precisely partisan lines, with all 40 Republicans opposed, and all 58 Democrats plus the two independents who are grouped with them voting in favour. Since 60 votes is the precise number needed to avoid a filibuster, there was no room for error whatsoever, the reason why the procedural motion had taken so long. But with all 60 members of the “Democratic caucus（利益集团）” now signed up, the final vote, on Christmas Eve, looks like a formality.
From the point of view of the Democrats, this victory has come at a high price. The health bill has been stripped（剥去） of something very dear to many of them: a “public option” of a government-backed insurance scheme that would compete with private insurers in order, supposedly, to keep costs down and guarantee access. The version of the bill already passed by the House of Representatives does contain just such a public option, one of several reasons why final passage of a reconciled bill is still a way off. Some Democrats hope, however, that a public option can be added later on, after the initial bill has gone into effect.
Still, the Senate version does tick most Democratic boxes; it obliges everyone to have health-insurance, and sets out a generous system of subsides to help the uninsured obtain coverage, along with a system of government-regulated exchanges that should encourage competition among private insurers. It fines employers who do not offer health cover to their workers. And it makes it illegal for insurers to refuse people coverage on the basis of pre-existing medical conditions, as well as putting strict limits on the way that premiums are allowed to increase with age. The hope is that tens of millions of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders.
Republicans, however, hate the bill, mostly on the ground of cost. The advertised price-tag of the Senate bill is a bit under $900 billion over the next ten years, but Republicans contend that the numbers will be much higher than that, as the cost of subsidies has been underestimated and predicted savings will not materialise. Even at the stated number, this is a large bill at a time when America is running huge deficits that it urgently needs to tackle. The Senate bill is "paid for", but only in the sense that it provides for large charges on the most expensive private insurance policies, and because it factors in deep cuts to Medicare the health-insurance scheme for the elderly. Republicans say these will never be enacted. Past history provides them with evidence to back up that claim.
Less politically involved observers also note that it is unprecedented for such a substantive and expensive bill to have been forced through Congress on such a narrow vote. The bill passed the House on a margin of just five votes, and in the Senate it has no safety margin. With no bipartisan support at all, Democrats will be held solely responsible if the reform turns out to be a disappointment. Some studies have suggested that private insurance premiums could rise substantially in response to the new burdens being placed on insurers.
Completion of work on the bill is by no means a formality, though it does now look more or less certain that the Senate will vote the bill out before Christmas. The next difficulty will come in producing a single “reconciled” version from the very different bills that the Senate and House have produced; that reconciled bill then has to go back for final clearance by both chambers. The public option is one big stumbling block. It is clear that the Senate cannot pass any version of a bill that contains a public option, so the House will have to give ground, which is going to require a lot of presidential arm-twisting in January. And the two bills are funded in very different ways, one with a tax on the rich, the other with an insurance-policy surcharge. As of today though, health-care reform, expensive and imperfect though it is, is looking a lot more likely.

Comments：
As conservative party members, Publicans always approach an issue from the aspect of individualism. On the other hand, Democrats focus more on public wealth. The conflicts of these two parties compose the political map of the nation. Obviously, these conflicts are suddenly stimulated by the financial crisis, which symbolizes redistributions of social wealth. Both Democrats and Publicans are eager to maximize their own interest during the crucial periods, so the tension between the two parties is strained.

KiKi~淇水滺滺UID: 2679824

Of course this bill seems perfect for the American common citizens. It obliges everyone to have health-insurance, tens of millions of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders. It also seems as a win-win situation for Obama, whose first health-care bill submitted passed out of the Senate and the common citizens can avoid what they are afraid of——the health problem. During this financial crisis period and with the above 10% unemployment rate, this bill likes rain to the arid fields.

However, what I’m cared about is the enforcement of this bill. After it is actualized, how many benefits will actually flow to the common people? Maybe it’s too early to say anything or judge this bill now; we still need time to believe this bill will bring real benefits to the people in America.

sunflower_irisUID: 2720580

Supplemental Information

China outlines plans on health care reform in 2009

·
Source: Xinhua

·
[08:10 July 24 2009]

China's State Council Thursday issued a medical reform plan of 2009, as its first year's move of the three-year health care reform.

The plan called for acceleration in building basic medical insurance system and essential drug system, and promotion on primary health care facilities and pilot reform of state-run hospitals.

According to the plan, about one hundred state-run hospitals chosen from 12 cities will be designated as the pilot hospitals for the reform.

It also includes the access of nearly six million retirees from bankrupt stated-owned enterprises to the basic health insurance.

Moreover, the number of employees and citizens in urban areas joining basic health insurance is to reach 390 million by the end of this year, an increase of 72 million from a year earlier.

The standard of building primary health care facilities will be released this year, with 986 county hospitals, 3,549 town hospitals and 1,154 community medical service center to be established.

The nation unveiled a three-year plan on health care reform on April 7 this year. With 850 billion yuan (124 billion US dollars) investment, the plan is considered to lay a solid foundation for equitable and universal access to essential health care for all in China by 2020.

COMMENT
Comparing with the health-care reform in China, obviously, Obama’s bill faced more blocks. Because the basis of health-care system in two countries are totally different. In China, a large number of people are uninsured and poor, so the reform will have a significant impact. But in the US, the bill will only benefit 15% people due to others already have their insurances. Even though China will be challenged by the fiercer competition in the near future, but in the long term, giving more people access to health care should boost the market. On contrast, in US, the reform will cost much more than it will benefit in such a economic crisis.

hugeseaUID: 190158

comments

The Senate passed a historic health care reform bill Thursday morning, handing President Obama a Christmas Eve victory on his top domestic priority.

President Obama is right when he says that the U.S. health care system needs reform. The U.S. health care system has serious problems. It costs too much. Too many people lack health insurance. And quality can be uneven. However, can President Obama’s reform accomplished smoothly and effectively? The answer to me is “no”. A government takeover of the health care system, as proposed by the president, would be a step in the wrong direction.

Health insurance should be personal and portable, controlled by individuals themselves rather than government or an employer. Employment-based insurance hides much of the true cost of health care to consumers, thereby encouraging over-consumption. It also limits consumer choice, since employers get final say over what type of insurance a worker will receive. It means people who don’t receive insurance through work are put at a significant and costly disadvantage.

Would president Obama not get disappointed after his reform were to carry out? Let us wait and see.

都说了不是又八UID: 2728357

5th article


Seldom a reform wanders without frustrations and confrontations. Japanese cabinet have been tussling on the reform of mailing institutions, and America faces the problem of health-care. So what's exactly the block in China's way? Propaganda and the media? Probably. At least, we're frequently irritated by ridiculous news and policies everyday.


Just wanna find an exit on the issue. No exit actually, but at same time we have to ask why the compensation and aftermath cleaning are totally absent. It's been enough.




Nearer and nearer

A procedural vote in America’s Senate brings Barack Obama’s health-care reforms closer

It now looks certain that Barack Obama will get what he wanted for Christmas – a health-care reform bill passed out of the Senate, probably just a few hours before Santa begins his rounds. Republicans, who have been fighting tooth-and-nail to block passage of the bill seem to have given up the fight, and have given warning instead that this will be a wish that he comes to regret.


Shortly after 1am on Monday December 21st, the health bill cleared the first, and the most difficult, of the procedural hurdles it has to leap in order to secure passage through the Senate. Technically only a motion to end debate on a “manager’s amendment” put together by the Senate’s majority leader, Harry Reid, what the vote really represented was a crucial exercise in nose-counting. The result was a vote on precisely partisan lines, with all 40 Republicans opposed, and all 58 Democrats plus the two independents who are grouped with them voting in favour. Since 60 votes is the precise number needed to avoid a filibuster, there was no room for error whatsoever, the reason why the procedural motion had taken so long. But with all 60 members of the “Democratic caucus” now signed up, the final vote, on Christmas Eve looks like a formality.


From the point of view of the Democrats, this victory has come at a high price. The health bill has been stripped of something very dear to many of then: a “public option” of a government-backed insurance scheme that would compete with private insurers in order, supposedly, to keep costs down and guarantee access. The version of the bill already passed by the House of Representatives does contain just such a public option, one of several reasons why final passage of a reconciled bill is still a way off. Some Democrats hope, however, that a public option can be added later on, after the initial bill has gone into effect.


Still, the Senate version does tick most Democratic boxes; it obliges everyone to have health-insurance, and sets out a generous system of subsides to help the uninsured obtain coverage, along with a system of government-regulated exchanges that should encourage competition among private insurers. It fines employers who do not offer health cover to their workers. And it makes it illegal for insurers to refuse people coverage on the basis of pre-existing medical conditions, as well as putting strict limits on the way that premiums are allowed to increase with age. The hope is that tens of million of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders.


Republicans, however, hate the bill, mostly on the ground of cost. The advertised price-tag of the Senate bill is a bit under $900 billion over the next ten years, but Republicans contend that the numbers will be much higher than that, as the cost of subsidies has been underestimated and predicted savings will not materialize. Even at the stated number, this is a large bill at a time when America is running huge deficits that it urgently needs to tackle. The Senate bill is “paid for”, but only in the sense that it provides for large charges on the most expensive private insurance policies, and because it factors in deep cuts to Medicare the health-insurance scheme for the elderly. Republicans say these will never be enacted. Past history provides them with evidence to back up that claim.


Less politically involved observers also note that it is unprecedented for such a substantive and expensive bill to have been forced through Congress on such a narrow vote. The bill passed the House on a margin of just five votes, and in the Senate it has no safety margin. With no bipartisan support at all, Democrats will be held solely responsible if the reform turns out to be a disappointment. Some studies have suggested that private insurance premiums could rise substantially in response to the new burdens being placed on insurers.


Completion of work on the bill is by no means a formality, though it does now look more or less certain that the Senate will vote the bill out before Christmas. The next difficulty will come in producing a single “reconciled” version from the very different bills that the Senate and House have produced; that reconciled bill then has to go back for final clearance by both chambers. The public option is one big stumbling block. It is clear that the Senate cannot pass any version of a bill that contains a public option, so the House will have to give ground, which is going to require a lot of presidential are-twisting in January. And the two bills are funded in very different ways, one with a tax on the rich, the other with an insurance-policy surcharge. As of today though, health-care reform, expensive and imperfect though it is, is looking a lot more likely.

中原527UID: 2707367

12.22
Words
tooth-and-nail 竭尽全力
leap in 跳进；急于做某事

Filibuster v.
阻碍或延宕国会或其他立法机构通过提案

Formality n.形式上的措施

redundancy n.剩余；裁员

margin n.页边空白；边缘，差额

Bipartisan a.两党的，代表两党的

好句
The hope is that tens of million of Americans currently without coverage will now be able to get it, and many tens of millions more, who have insurance but fear losing it through redundancy or ill-health, will have those worries lifted from their shoulders.（没有医疗保险和有医疗保险的群众，两者递进~）

Past history provides them with evidence to back up that claim.

Comments:

There are two conflicts, the long-term interest and the recent interest, the most people who have no heavy fortune and the little rich. Obama’s health-care reform arise the worry of Republicans that the cost of subsidies has been underestimated and predicted savings will not materialise.
But also the reform hurts benefit of every chaebol(大财阀). Even though the action contribute the people who currently without coverage or have insurance but fear losing it through redundancy or ill-health , the people who have the high income must pay more taxes , and some doctors , hospital and the pharmaceuticals company will be worried that they may lost some income of treatment. The next huge obligation that Obama should do is to balance the benefit of every social forces.