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Somehow, the entire occasion seemed strikingly poignant. So many Democrats and Republicans have crashed helmets over the past several months in a raucous, often misunderstood, fight over the future of health care in America.
Yet during this Irish Catholic funeral, congressmen, senators, governors, vice presidents and presidents of all stripes collectively mourned the Senate's "liberal lion," a man who once famously declared the overhaul of America's health-care system "the cause of my life."
This article began last week as an effort to better explain the current Congressional proposal for Senator Kennedy's lifelong cause-health-care reform.
A quick recap of the proposal: existing insurance companies would follow tighter regulations and could not refuse anyone with a pre-existing condition; coverage would become mandatory for all people, based on a sliding scale; a privatized pool of insurers would yield better bargaining leverage with health-care providers; a government-run public option, or perhaps a privatized co-op, would insure a very select group of citizens and help control private costs, and health-care providers would be required to update and streamline their overall systems.
Controlled spending, better access and more options, that's the general idea.
On principle, most Americans agree that the system needs to change. Danbury Hospital president and CEO Frank Kelly, who is admittedly skeptical about some points of the proposal, said there is "no question in the hospital industry that the need for reform is real ... the core objectives should be to expand coverage to all folks."
But as with Mr. Kelly, concerns linger for many. Indeed, the country remains deeply divided on how to fix its at best inadequate, at worst inhumane, system of privatized coverage. As detailed last week, many recent forums and rallies on the topic have been reduced to a series of reactionary rhetoric and hollow catchphrases: "Obama Lies, Grandma Dies" has become a popular one.
That slogan, seen on protest placards countrywide, speaks in part to former Alaska Gov. Sarah Palin's assertion of "death panels" for the elderly. According to U.S. Rep. Chris Murphy [D-Cheshire], that statement is patently false.
"People believe there is language in there for senior citizens to be thrown off their ventilators," Mr. Murphy said recently, admitting that health care for the elderly is often costly. "What it is, there's a provision in the bill for counseling on end-of-life care."
According to Sec. 1233 of the bill, "Advanced care planning means a consultation between the individual and the practitioner" regarding the patient's final days. For several pages, a multitude of provisions detail how to best handle end-of-life care and counseling, as a means of alleviating both cost and suffering. At no point is euthanasia even implied.
A moral concern: federally-funded abortions. That point is debatable. An amendment to the bill, signed July 30, indicates the government will not subsidize such procedures for those in the private sector, but for some covered in the narrow public option, abortions may be covered if they meet with Department of Health and Human Services standards.
In Ridgefield last Saturday, at the same time that Senator Kennedy's funeral carried on three hours northeast, approximately 400 people filled an elementary school auditorium to hear a five-person panel, which included Mr. Kelly, discuss the more talked-about points of reform.
The first item on that agenda, would illegal aliens be extended coverage in the public option?
"This is a plan that would cover all Americans," succinctly stated U.S. Sen. Jim Himes [R-Greenwich]. "The plan would absolutely not offer coverage to undocumented aliens."
His point went unchallenged by the panel, though not all matters were as readily agreed on. Some panelists went as far as to denounce the entire plan, declaring it too invasive and taxing on the American people.
"People don't want to see the government in their doctor's office or at their hospital bed," said State Sen. Toni Boucher [R-Wilton], who claimed she went door-to-door surveying constituents' opinion. "They'd rather see a cost-effective, separate private insurance program for the uninsured."
State Sen. Dan Debicella [R-Shelton] largely echoed Ms. Boucher, but offered a different proposal for reform. He believes citizens should have better access to out-of-state companies, which in turn would broaden competition on a private level. That, coupled with a low-cost privately run insurance option, beholden to some federal oversights, would insure more people without expanding the government.
The privately run insurance option, probably built on public funds, is reminiscent of the co-op recently suggested by President Obama as an alternative to the public option. Mr. Murphy rejects the idea of a co-op as a viable alternative, as it would have difficulty breaking into certain markets, while a public option would not face that obstacle.
Regardless, according to Mr. Debicella, "The public option is the wrong way."
He also believes reform should focus more on preventative care, hospitals and doctors ought to install more cost-effective, computerized information systems and people should be allowed to deduct medical expenses from state income tax.
Apparently Congress agrees with Mr. Debicella on those first two points, as those are already part of the overall bill.
One sentiment shared by the entire panel-deficiencies with Medicare must be addressed. Medicare is the country's largest public insurance program, open to citizens age 65 and older. However, it is highly susceptible to both fraud and waste, and the Medicare Board of Trustees projects its bankruptcy within the next 10 years.
It's a headache for health-care providers, according to Mr. Kelly, as government reimbursements are slow and getting smaller. This concerns Mr. Kelly the most, that the public option will too closely resemble the fiscally insufficient Medicare.
But the beneficiaries of Medicare largely enjoy the program. Many elderly opponents of the reform bill fear that it will cut their Medicare benefits.
The proposed bill would reduce Medicare payments to hospitals with excessive re-admissions. But it would close the "doughnut hole" in the Medicare Part D prescription drug program. The cost of out-of-pocket expenses for prescriptions in this program is unbalanced and features a large coverage gap. At a certain threshold, the government stops reimbursing for drugs. Then, after another threshold, it begins to reimburse again. The area in between is the "doughnut hole," something the bill looks to fillin.
Still, how will this bill be paid for? Not easily.
It will require a combination of tax increases for households bringing in $350,000 yearly, along with spending cuts in more wasteful areas. Mr. Himes said it will be a 1 percent increase for these citizens.
Mr. Murphy claims that he will not vote for anything that would "add to the deficit." That may be true, but as proposed right now the Congressional Budget Office predicts a net increase to the federal deficit of $239 billion over the next decade. Incidentally, the deficit is expected to be $1.58 trillion by year end.
Still, the cost of health care continues to grow exponentially, greatly outpacing the overall rate of economic inflation, which the recession turned to deflation this past March, as Bureau of Labor Statistics data now suggests. Currently, the average citizen spends $8,160 annually on health-related costs. If nothing is done, in a decade that figure is projected to jump about 60 percent.
To many, the cost of inaction is far heftier. But it's more than a matter of finance. President Obama recently called health-care reform a "moral issue," a term often cited by Senator Kennedy.
Perhaps others agree. During the homily at this funeral, the pastor read from the book of Matthew.
"Lord, when did we see you hungry or thirsty or a stranger, or naked or ill or in prison and not minister to your needs?" read the Rev. Mark Hession to a rapt audience. "He'll answer them, amen, amen I say to you. What you did not do for one of these least ones, you did not do for me."
