By MARTIN SCHRAM
Scripps Howard News Service
September 16, 2009
Duck One: They failed to see the clear need to put sensible limits on malpractice awards -- because it is one reason doctors are unnecessarily propelling healthcare costs ever skyward. (And it is a bill we all ultimately pay.)
Duck Two: They failed to find a workable way to assure that illegal immigrants cannot get federal health insurance subsidies. (Yes, the issue over which yet another South Carolina Republican has disgraced himself in public -- faster than you can say: "You lie!")
Liberals have resisted common sense resolutions to these two relatively secondary issues because conservatives have fired up their faithful by using front-burner demagoguery on both issues. (Indeed, they successfully conned America into thinking the issues are hardcore independent politics -- faster than you can say: "I'm Lou Dobbs!")
First, the doctors. Huge malpractice awards have led to soaring malpractice insurance rates that have forced many doctors to abandon their practices. Mainly it has led many doctors to order many tests they feel are not really necessary - just to cover their aspirations in the event something later goes wrong and a malpractice suit is filed. No wonder costs soar.
Another reason, as we've discussed previously, is many doctors now order tests done by labs they also own -- an abhorrent conflict that continues by virtue of the loopholes their lobbyists manufactured in their sweat shops on K Street. (I don't know how the word "virtue" bought its way into the previous sentence.)
Now onto the bleating heart issue of illegal immigrants. As President Barack Obama said in his speech to Congress, illegal immigrants will not be provided for in the health insurance reform legislation. As Obama didn't really say, the House bill didn't have an enforcement provision by which officials can assure an illegal immigrant isn't getting access to a subsidy or the "exchange" that will make insurance options available to citizens. Neither the House bill nor the White House has proposed a way to determine that an applicant is indeed a U.S. citizen. But the Senate has been working on just such a compromise.
There are some available tools -- notably, E-Verify. It is an electronic verification system, begun by the George W. Bush administration that matches workers' Social Security numbers against Homeland Security Department and Social Security databases to determine whether a person is eligible to be working. Federal contractors are now required to use the Internet-based program to determine whether present or prospective workers are eligible for employment. With the program is due to expire at the end of September; however, Congress is expected to extend it.
Obama's new director of the U.S. Citizenship and Immigration Services, Alejandro Mayorkas, said in a recent press conference: "E-Verify is a tool to ensure a legal workforce. It assists employers in abiding by the law and it also protects the workforce. If E-Verify is not renewed, in my opinion we will need a different vehicle to accomplish those very fundamental objectives."
E-Verify has its e-critics. The congressional Hispanic caucus and various activist groups have argued that efforts to check citizenship can cause a hardship to workers whose names or data has changed. Indeed, E-Verify is not always e-Veritas. A reported less than one percent of valid applicants were reported as lacking proper identification. It is a small percentage, but it looms large if you are the immigrant who abided by all rules and are erroneously trapped. Fingerprint and other biotech methods are also being studied.
Now this: The U.S. Chamber of Commerce filed a suit to block E-Verify, arguing it should only be used to determine the status of future workers, not those presently employed.
So if conservative ranters mean what they say, they must stop shouting at the president and turn their decibels against their U.S. Chamber of Commerce brethren. Let the Grand Old Party call out the corporate special interests. Tell them to get with the E-Verify program -- and do their patriotic duty.
E-mail him at martin.schram(at)gmail.com
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