Would a bill with no public option be better than no bill at all? Or not?
Reader Interactions
209Comments
Comments are closed.
by DougJ| 209 Comments
This post is in: Open Threads
Would a bill with no public option be better than no bill at all? Or not?
Comments are closed.
DougJ
This my first post via iPhone and I couldn’t make the categories work.
gizmo
Hard to answer that without seeing what would be in the proposed bill. IMHO, the Obama administration made a big mistake in not putting forth a specific healthcare reform plan of its own. We now have a situation where supporters of reform don’t even know what it is they are supposed to rally around, while opponents of reform are able to paint the whole thing as a big scary prospect with all sorts of horrifying consequences.
pj
Carnacki
Where’s the change I voted for?
scav
Chump change.
Walker
Related to all this, Yves of Naked Capitalism has some very unkind words about Obama today. She says that regardless of the contents of the health care bill, this whole incident has shown that the Obama is incapable of leadership. He is a compromiser, not a leader.
And when the next wave of the economic collapse comes, this means we are screwed. We needed an FDR; we got a Hoover.
joe from Lowell
A equation needs to have numbers on both sides of it.
What’s in this theoretical public-optionless-bill? What does it do to cover the uninsured? What regulations does it put on insurance companies? What does it do to address Medicare costs?
No doubt, there are some health care bills without a public option that are worth passing, and some that are not.
Matthew Hooper
The votes for a public option were never there. We couldn’t get a public option passed, period.
A Ghost To Most
What would be the point? Isn’t the idea to supply coverage to people who can’t otherwise get it?
It would look like Solomon’s half baby; bloody useless.
lawnorder
I think Obama is a lame duck for the rest of his Presidency if he caves in
Bullies don’t stop after they win a fight.
At this point, it is not even about the public option anymore. It’s about credibility and letting yourself be bullied.
Right wingers were right, this is his Waterloo. He loses he is toast. And we will have to wait 4 more years to try to get someone with more spine in there. With him failing spectacularly just 6 months in, the odds of any other progressive making it would be very slim. :/
joe from Lowell
Sure they are, Matthew Hooper. There is a majority in both houses that supports a public option.
Pass a bill without one out of the Senate, then put it back in in conference.
gypsy howell
Why eff-ing bother with the charade of a bill if there’s no public option? All it’s going to do it create a yet-larger captive market for the insurance companies, with some government subsidies to help pay for lavish executive pay and stock dividends to the investor class.
I don’t believe for a minute that the “regulations” would do anything to rein in the rape of the American people by these scumsuckers.
I’d be surprised if most of us even noticed the difference.
Complete FAIL if you ask me.
hoipolloi
The public option is in my view a small element of the framework for reform as currently designed. The public option is only going to be available to those who don’t get their insurance through their employer.
If reform delivers an end to recission, exclusion of pre-existing conditions, if reform delivers quality improvements and cost controls, if reform delivers an end to the abuse of out-of-pocket costs and “cost sharing”, if reform delivers an end to life time and annual caps, if reform delivers insurance to >90% of the uninsured and puts an end to plans that provide inadequate coverage, if all these things happen we’ll have a much, much better health care system than we do today.
Reform has to happen in order for progressive politics to continue to thrive for this generation. This generation’s reform will not be the end of the story. Changes will be required in the future. But future change will be much more likely to be progessive and positive if we succeed than if we fail.
simonee
So much for this once-in-a-lifetime majority in Congress, eh?
Zifnab
There are regulations that need to go into place one way or another. Insurance companies shouldn’t be able to cancel coverage after taking premiums for months or years because they managed to dig up a pre-existing condition (hell, rape has a statute of limitation, but mammograms don’t). We could use a national health care market rather than fifty state markets. And there are a bunch of other buffers and safeguards in the bill that would have been great to get back in the ’90s.
Public Option would have been a game changer. It would have put the insurance industry on it’s heels and forced them to adhere to regulations by the power of the free market rather than letting them litigate or loophole their way free.
We don’t have to overhaul the mailing industry every 10 years because we’ve got a Postmaster General that can just apply tweaks on the fly and let UPS and FedEx catch up on their own. It would be nice if we could say this of the same thing about the insurance industry.
kansi
I hear and understand all the frustration so far, but I am having a hard time condemning Obama to a failed presidency, when we don’t have any idea yet what the final bill will look like. Change is hard….big change is a monumental task. It will be interesting to see if his back seat style on this pays off or if he becomes too marginalized to be an effective President. I am betting on a big payday for the administration. (fingers crossed)
Zifnab
@joe from Lowell:
Cheers to that. Give the old Tom DeLay playbook a dusting off. We don’t need the best bill to come out of the Senate. We just need ‘a’ bill. Then let Conrad and Baucus and Nelson and Bayh vote against all of health care reform if they can. And feel free to twist a few arms.
Dave
W/o a public option there is no pressure on private insurers to lower costs and enhance coverage, and there is no way to at least, in theory, have 100% national coverage. And since that is supposedly the goal, why wouldn’t you have the public option?
Oh. Right. “Bipartisanship.”
Napoleon
No bill at all. Part of the reason is at some point the progressives have to push back hard against people like Baucas and Conrad. It can not be all a one way street with those people. And by the way people saying the votes are not there are just full of it. All they need is 50 votes. None of the Dems should be voting against closure.
@Walker:
And she is right.
DougJ
One thing: in a democracy, there should not be a distinction between a compromiser and a leader. This may well be a compromise too far. I think it is. If we cannot get this thru with this majority,it is fail.
But I am disturbed by the idea of using compromiser as an insult.
cybrestrike
If the Public Option is dead, then it’s going to be a very difficult 2010 for Democrats. Obama folding on this would mean that there’s no chance for Immigration Reform, Climate Change Reform, or any of the major pieces of legislation that were a part of his platform.
If the Public Option is dead, then we were all wrong about this being a change election. At best it’ll be Clinton 2.0, an administration full of minimally incremental improvements, but nothing sweeping because the country is held hostage by the wealthy and the greedy, as well as a complicit Village, and a legislature that worships the all-mighty dollar.
cleek
i seem to recall another president who tried and failed (spectacularly!) to deliver health care reform early in his presidency, but who nevertheless went on to to become a reasonably-successful president.
i just can’t remember his name! can someone help me out here ?
Face
@gizmo: This. Also.
Besides vague generalities, I dont even know what “public option” really means on the micro level. For that matter, dont understand “single payer” either. Of course, I have decent insurance, as do most peeps fencing like me, so many of us are in the “our insurance aint broke, dont fix it and screw it up” mode.
Kryptik
It really has to depend on what ends up in the final bill, though it really doesn’t sound very good regardless if the public option is dead, and in many ways could be worse than nothing done at all (a nightmare scenario I keep hearing put out is a mandate keeping insurance companies from dropping coverage or denial of coverage, but no cost controls keeping them from jacking premiums up).
And like what others have said, the whole thing so far seems to only justify the weak-kneed Dem label and the idea that, despite having a historic majority (if only by numbers if not in practice…damn Blue Dogs), the Republicans essentially won, because they were able to misinform and deceive and Dems did jack all but cave.
Keith
@Zifnab:
That would at least be preferrable to the new Tom DeLay playbook, which involves going on a reality TV show composed of B-thru-D-list celebrities to compete in a dance-off, presumably in the name of Freedom.
maye
It is imperative to pass a bill. Go listen to Bill Clinton’s speech in Pittsburgh a few days ago.
An incremental approach would be to have a bill with:
–no pre-existing conditions rules
–no underwriting
–no recission
–community rating
–exchange based purchasing
–individual mandate
–expansion of Medicaid
–subsidies of up to 300% or 400% of the FPL
Don’t make perfect the enemy of the good.
publius
I agree with hoi. I’d much rather see it in. But I think it’s not even a close question. As it stands, the public option would only be available to a subset of people on the exchanges (and even then it would face other restrictions).
The key for me is (1) regulations ending various evil; (2) indiv mandate; (3) generous subsidies; (4) Medicaid expansion; (5) creation of exchanges. Numbers 1-4 are more important short-term, but #5 is pretty crucial long term. And the public option can always be inserted in future Congresses within the exchanges once they’re up (and I think via reconciliation).
I read this somewhere else — but a wise person said that this isn’t a zero-sum negotiation where giving up one thing should lead to the other side giving up other things. the other side wants to kill it, period. if ditching the public option is absolutely necessary for the larger reform, I’m ok with that. But… it does seem that ditching the public option should require something in return from the Democratic wanker caucus.
salacious crumb
I just feel that Obama has been leading us down a misleading path with this health care stuff now. When he campaigned for Presidency, he was all for a public option insurance plan that competed with the private insurance ones, and this option allowed for people to keep their private insurance if they thought it was a better deal than the govt offered one. That was the big tamale as far as the health care reform went. Now he says “hey, thats just a part of the essential reform and not a big one”. Forcing companies to cover people with pre-existing conditions is now the essential part of the reform, he says. Why are the goal posts changing?!
I mean this health coop shit that he is now open to is essentially what the Republicans and their corporate benefactors have been peddling since this debate got started. If he caves to them on this, then Republicans and the health care industry will declare victory. The GOP will sense weakness and go all out campaigning against him. and I bet there will be a lot of disillusioned progressives who may sit out the next election. Obama was voted over Hillary because he was seen as a man of principle. this is his first test and looks like that principle is being shoveled down the drain.
gypsy howell
@joe from Lowell:
Pass a bill without one out of the Senate, then put it back in in conference.
I have the same “dry powder/ don’t fire til we see the whites of their eyes” feeling about this as I used to get with Kerry’s campaign. And we know how that ended up.
JGabriel
DougJ:
Perhaps, but only marginally. We’d be left with a patchwork of laws and regulations designed to make health care universal, but in reality they would be easily repealed once Republicans gain power again, and/or the insurance companies would find loopholes around them within a few years.
An effective public option, on the other hand, would be expected to become very popular, and just as unrepealable as Social Security and Medicare.
.
evie
For the thousandth time, yes. I honestly think the only progressives against passing a bill without a public option have no pre-existing conditions (or fear of them) and have never faced the possibility of rescission or lifetime caps. It’s a start, people. We need a start.
dr. bloor
Nate Silver sez the benefits of a bill that don’t include a public option is significantly better than nothing at all.
I disagree. It’s a band-aid that makes none of the fundamental changes that are essential for the long-term survival of healthcare and of our economy, and Obama’s presidency is effectively over.
Nice knowing you, Barack. Say hi to Harry and Max for me.
Napoleon
@maye:
The incremental approach does not work.
Zifnab
@cleek:
Are you referring to President Blowington McKilledVinceFosterAlot? He’ll go down in history on the high end of the “Good / Bad” scale for improving the economy and cleaning up the Reagen / Bush 41 mess. But he’s not making it past the footnote section of the history books in fifty years.
The man that aspired to be like Kennedy and LBJ… didn’t.
BerkeleyMom
Now that the public option is killed, the righties will go after something else in the proposal. They are sharks who smell blood in the water. Next on the block will be the outlawing of recision and no discrimination of those with pre-existing conditions. The Repubs will not stop until the bill is gutted and then they will vote against it and call the Dems a bunch of wimps for compromising. They must be laughing their asses off that a public option polling at 70% approval is dead. Pretty powerful stuff for a minority party that was trounced at the polls last Nov.
I am mad at Obama for not fighting harder. I am mad at many Dems for being industry tools. I am mad at Sibelius for signaling weakness at every opportunity. Good grief–you wouldn’t negotiate buying a car like this–you’d get hosed. Great job Dems.
Dracula
This is great news for John McCain.
MattR
Why is it that under a Republican led Congress, centrist Democrats would vote for cloture and then vote against the final bill, but under a Democratic led Congress those same centrist Democrats won’t even vote for cloture on a health care bill they disagree with? At this point, I don’t really care how Baucus or Nelson vote on the final bill if they were willing to vote for cloture to allow it to get an “up or down vote”.
Darius
Yeah, I could get behind that. But they’ll have to get rid of the mandate, though. I won’t support any plan that effectively forces people to buy private insurance.
The Moar You Know
There is, at the moment, no bill in the Senate at all, so this is pure speculation. We also don’t know what will happen in conference, once again – more speculation.
While I don’t agree with this – yet – I must ask what happened to the Obama campaign machine that was able to get out in front of the smears and counterattack the same day? That fucker’s gone!
The administration has handled virtually every challenge handed to it since election day horribly. PR disaster. No leadership on the auto bailouts, the bank bailouts, any of it. Just absolutely disastrous from a public relations standpoint. I find it hard to believe that with a 60/40 Dem advantage in the Senate and similar numbers in the House, that we are getting creamed, messagewise, by the minority party. I find it harder to believe that we are bending over backwards to “give them a voice” or whatever bipartisan fantasy our president is indulging himself in; it’s fucking ridiculous. You’d think he’d have learned after the first stimulus bill – they wrung him dry for concessions, crucified him in the court of public opinion, and then voted in lockstep against it anyway.
The only person who so far I hold absolutely blameless is Pelosi. She knows how to handle the House and has done so with an iron fist – which is the only way to negotiate with the GOP. No mercy and no quarter – same as they did to us 2000-2006. It’s not her fault that she’s delivered every vote that she’s been asked to, and then had Reid and the Obama administration piss it away.
eastriver
No public option would make it health insurance reform, not healthcare reform. The country needs both.
This isn’t really really germane to the issue, but it rankles my cockles that the insurance guys will think they won. That they once again put a beatdown on the dirtyfuckinghippies.
That leaves a very bad taste in mouth. Not really the point, but for me, personally, it hurts.
eastriver
No public option would make it health insurance reform, not healthcare reform. The country needs both.
This isn’t really really germane to the issue, but it rankles my cockles that the insurance guys will think they won. That they once again put a beatdown on the dirtyfuckinghippies.
That leaves a very bad taste in mouth. Not really the point, but for me, personally, it hurts.
JWC
Yes, getting a bill (without public option) is better than nothing. We should be putting our energy into making the co-ops work as well as possible, instead of whining about not being able to get the public option.
People that I know that are not progressives, could give a hoot about the public option, as long as there is “insurance reform”…
If the votes aren’t there, they aren’t there. I think it would be better to have an imperfect bill, than to have no bill for another ten years. Much easier to make some fixes as we go.
MBSS
so there is a good debate going on about this topic on open left. and the person most quoted is, surprise, surprise, james carville. he’s contending that a watered down bill can do untold damage to the dems in the long term. others tended to agree, and so do i.
i think the argument that is salient is having individual mandates in conjunction with weak governmental aid. putting a burden on young, healthy americans, and turning those who provided obama with so much support last year, away from him, and the dems in general.
Tsulagi
Depends on what the Pubs let the Dems pass. Maybe it’ll be as good as the Decider’s prescription drug bill.
maye
@Napoleon
It might not work for you, but it might save my life.
Ian485
I respect President Obama for how much he is willing to listen to people he may not agree with, but there comes a time when you need to stand your ground. I’m worried that Pres. Obama will not take that stand.
My two cents; he should have at least supplied an outline for how he wanted the bill to work. That would give he supporters something to rally around.
Obama has great potential as a leader. He knows the destination. Instead of pointing toward it, he should be out in front urging the country to follow.
Leelee for Obama
I think you should read Krugman today. He’s talking about the Swiss system, which is basically HR 3200, w/o a PO. It is magnitudes better than status quo, and Switzerland is not the s-word. It is the kind of incrementalism that would leave options open for (later on) a PO. If it was seen to be needed, after all the regulated free-market stuff was allowed to play out for a bit. Which I think it will, but I’m not sure.
Read also (hear spooky music), two other op-eds today about curbing spending on the extreme elderly to free up money for health insurance for kids and the young adults. One, believe it or not, by Ross Douthat, who acquits himself quite well.
You mostly know my situation with Mom, and both articles are spot-on.
I also want to, in the interests of full disclosure, tell you guys about my Mom’s “Living Will”. It was filled out and signed by her in an ER, a few days after I got her here to FL, as she turned gray and passed out 4 days after the plane landed. Mind you, no Dr. or Nurse to help. Just a clerk who though the Terry Schaivo situation was appalling-because Michael was murdering his wife and the courts were complicit. We need the End of Life amendment more than the PO.
Obama is doing what’s needed in this ridiculous system we have.
Violet
I’m fine with no public option. Provided they also eliminate ALL forms of soci ali zed medicine. That means NO MEDICARE.
Obviously it’s a horrible, horrible thing to have the government pay for medical care. So take it all away. Let the market decide. Then in a year, let’s talk about grandma and those death panels.
Evinfuilt
This makes it even harder in the future to get a Public Option, if not impossible. Looks how hard Medicare has made it for a Public Option, they’re all happy and ready for no change.
I don’t understand how Obama has yet again pushed a pre-compromised idea and watch it get watered down even further. All to watch the people he was compromising for vote against it anyways.
John Hamilton Farr
Kill all bills, build case for single-payer.
dr. bloor
@eastriver:
This isn’t really really germane to the issue, but it rankles my cockles that the insurance guys will think they won. That they once again put a beatdown on the dirtyfuckinghippies.
They won’t think they won. They will have won.
The government may get another chance at it in my son’s lifetime, but hopefully he’ll have fled to a civilized country before then anyways.
MikeN
Jeeze Louise people…this is a trial balloon. Nothing more. Go ahead and squawk, but do so in the context of “IF they do this, THEN it will be a huge mistake and make teh internets very very angry.”
With all of the attention that the Deathers have been getting, you couldnt blame Obama for doing this deliberately, just to make sure we were all still out here.
dr. bloor
@MikeN:
If that’s the case, our job as responsible citizens is to let them know their fucking “balloon” is full of lead. No?
par4
no public option,let the country burn
Zandar
Short answer, no.
Long answer, the Republicans will simply object to all the other provisions and Democrats will cave until the progressives finally say screw it and the bill dies. Progressives will then be blamed for the bill’s failure. 2010 will be fugly.
If a bill passes the Republicans lose for twenty, thirty years. Therefore, no bill will pass.
John Hamilton Farr
“Better than nothing” crowd is incredibly self-defeating. You’d think we have no damn power at all. No one recognizing or using inner strength here. THINK!
Nobody doesn’t want free health care! NOBODY! We waste all our money on killing brown people in mud huts on the other side of the world, giveaways to Wall Street, leave corporations untaxed. There is plenty of money, duh. Fix this, free care for all. Settle for anything less and you are gutting your own children’s future. If you think you’re being “realistic,” look again: you’re only visionless.
Elie
I will wait to reserve judgement till I see what ultimately happens. I am very disappointed if the public option in some form is eliminated…hard to see how this all would work.
I do think that we will get some sort of reform even in the worst case, but as I said, and I am an ardent Obama supporter, I will wait and see. I would be very very disappointed if it was not there but am not sure that I would wholy blame Obama, but also the Democratic House and Senate.
feebog
Lets make it clear just what the public option is; it is the first incremental step towards a single payer plan for the country. I think there are a lot of progressives who don’t want to admit that. The Insurance Companies know this of course, and it scares the crap out of them. They know if a public option is included in the bill it is the beginning of the end for their industry. Sure, people can still retain their insurance, and intially you are going to see a small percentage of the insured move to a public plan. But that small percentage will grow, and that growth will snowball. It may take 12 or 15 years, but it would happen. Can’t happen fast enough IMHO.
Patrick
With no public option, there is no health care reform. With no health care reform, there will be big question marks on the Democratic side of the aisle about the rest of the agenda. On the Republican side of the aisle, the water will be so thick with chum that it’ll be a feeding frenzy for the remainder of this Congress.
Health insurance reform is not health care reform. Voters know it and politicians damn sure know it. I don’t know that passing a health insurance reform bill instead of a health care reform bill will be the iceberg to Obama’s Titanic, but it will be pretty damn close to it.
I do know this: You can kiss EFCA and any real energy legislation goodbye if the political minority is allowed to lie and scream a public option off the table. All the old lessons do not appear to have been learned after all.
As a longtime Democrat, it never ceases to amaze me how you can take a strong Democratic majority, give them a compass and a map and a GPS unit and then ask them to point out which way is north and get many different fingers pointing in all directions. Un-fucking-believable. And deeply disappointing.
Janet Strange
I’m with Ezra:
What I want is “Medicare for all.” But as many above have pointed out, a bill that gets most people the health care they need even if they have a “preexisting condition” and without fear that it will be cancelled if they actually get sick is important and worth doing. Sucks that we’re still propping up the vile insurance industry, but getting people the care they need is top priority for me.
winguts to iraq
why don’t we fire bomb glen beck?
lotus
Until now, I really had no idea how much adult ADHD and chronic depression run riot in the lefty community.
Yes, though the devil will be in the deets of the final version, and we have only a hazy idea what we’re even talking about until we see that — even with that big question-mark — if I had it, I’d bet $1,000 that it’ll be better than we’ve got now, public option or no. On top of everything publius names, it’s apt to cover mental as well as physical healthcare, and right here in this thread, we see a crying need for that.
Alien-radio
if the democrats pass healthcare reform without a PO, the republicans still lose. their aim is to scrap the thing entirely, and the political fallout for them failing is fatal.
They’ve staked their entire relevence on their ability to control from the minority. If Obama passes anything it puts lie to that, and faultlines within the republican legislators will begin to grow wider and wider as the gravy train leaves them behind
If BO passes a healthcare reform bill without a PO, he
* beats the republicans
* Wins the framing of the current situation as untenable
* beats the republicans
* Will get community rating and some needed sturctural change in the private market
* beats the repulicans
and it’s all about keeping score.
He wants the PO, however there are several ways of getting there without explicitly putting it in a bill, gradual expansion of existing programs etc. he could also allow non profit co-ops to merge.
He has the following in his favour,
* conservative dems have more to lose in the long term if a healthcare bill doesn’t pass, and the progressive cauccas has votes they need. they can’t let it fail or they’ll be replaced by republicans.
* The republicans have shot their load on this health bill, If democrats increase their margins, in 2010, and people find their health care almost unchanged/marginally better a second round of legislation aimed at fixing the inertia will come
* he just needs sentate democrats to not vote to sustain a republican filibuster. a senate domocrat voting to susatain a republican fillibuster really wouldn’t look good to his electorate, ben nelson might try it, but the backlash could be painful.
I think this is mostly status quo posturing from some people who want some loving. Given Obama’s track record of miraculously getting exactly what he wants, I’d be tempted to say the public option will seem doomed, then suddenly ressurected. (heck it seemed like Obama kicked it to the curb ages ago, but the moment this fight comes around and he’s actually supporting it enough that it’s generated this kind of pushback).
but I think he should still pass healthcare legislation even if it doesn’t contain a public option.
kay
@Walker:
I wish I trusted the stock market as a rational indicator of anything, but I don’t.
All of a sudden investors are taking a clear-eyed look at value and acting accordingly?
The same investors who bet the farm on a bunch of house-flippers, right? Who drove the market to record highs based on, what, exactly? AIG?
When did they get so smart? Yesterday?
My faith in the wisdom of whatever the hell happens on Wall Street has been destroyed beyond repair. I don’t care if it goes up, and I don’t care if it goes down.
PaulW
My biggest concern is that Obama and the Dems give up Public Option thinking it will appease the Far Right, and tomorrow the Far Right will go after everything else.
LIKE WE ALL (except those with their heads up their asses in DC) KNEW BACK IN JANUARY. The Republicans are gonna want to kill every bill and every effort the Democrats are gonna attempt to fix the damage done from 8 years of Bushism. Give the Republicans an inch and they’ll want your whole arm. Nothing less is going to satisfy them. Because they have no shame right now.
If I were in the White House right now, I’d be calling for federal investigations into these lobbyist groups bussing these protesters about for fraud and racketeering. This isn’t about free speech, this is about MONEY, and we need to hit those bastards where it hurts.
ThatLeftTurnInABQ
@hoipolloi:
What he/she said.
Real reform isn’t going to pass until we have fewer Blue Dogs and more progressive Dems in Congress. That isn’t something that is going to happen in a single change election, no matter how badly the GOP gets whupped. At this point, the Blue Dogs are the “loyal opposition”. Getting the public option is going to be a long hard slog spanning multiple electoral cycles. In the meantime, you either pass or fail to pass legislation with the Congress you have, not the Congress you wished you had. And this Congress is not as progressive as in needs to be, in part because Congressional reps tend to lag behind public sentiment due to the powers of incumbency and the slower pace at which the Senate (which is the key bottleneck) turns over its membership.
In the meantime, it would be nice to reign in the worst excesses of the private insurers w/ regard to pre-existing conditions, etc.
And shrieking over Obama’s bipartisanship fetish is I think missing what he is really up to – it is less about Dems vs. GOP than it is about the WH vs. Congress – scaling back the imperial Presidency by letting Congress take the lead on drafting important legislation, a lesson-learned from the way the WH and Congress battled against each other during the last 2 Democratic administrations which enjoyed Dem majorities in Congress and still couldn’t get anything passed. Obama is bending over backwards not to repeat the mistakes of the Carter admin and the Clinton admin prior to the 1994 wave election. Instead they are going to get “something” passed no matter what.
The Main Gauche of Mild Reason
Hey, maybe if the house progressives kill any attempt at a health insurance reform bill because it doesn’t include the public option–the electorate will love Democrats as much as they did in 1994 and everything will be awesome!!
Seriously, we’ve been down this road before.
BFR
Would a bill with no public option be better than no bill at all?
Yes.
If you’re like me (in the land of permanent pre-existing conditions), then yes a deal without a public option is still a win.
There’s a bunch of problems with our current health insurance. If you can’t solve all of them at once, better to solve the ones you can and try to come back down the road to improve on the rest.
eric
@Walker: Here is the fundamental question: how do you lead when your opponent have no honor?
It is easy to say he should use the bully pulpit and should call people liars and beat up on dems with threats of lost pet projects, but where is the evidence that will work? Sure, you can say it has never been tried or that he has been co-opted by corporate interests.
However, Obama is not arguing against a counter-ideology. Obama is not debating on the public airwaves.
The System has been never presented a level playing field to progressive interests, ever. I think the overall silence of progressive voices on health care on a national platform suggests that Obama is not the only one being bullied by the corporatist MSM.
Remember, the public option is itself a compromise position from the more progressive single payer option which was dead on arrival.
eric
Darius
It’s not about appeasing the Far Right; it’s about appeasing Corporate Dems like Conrad.
p.a.
Does anyone in this admin not have a soggy noodle for a spine? Can the admin impound the funds for Congressional medical coverage? Or can the Prog Caucus sponsor a bill to eliminate it? That kind of symbolic but ultimately meaningless ‘street theatre’ makes me puke, but christ these whores only seem to respond to issues if they are personal or if they feel the pain.
Elie
ThatLeftTurn@64
What you said…
Dr.BDH
I’m with Farr. Obama should have presented the case for single payer — everyone covered (including legislators), funding collected by the IRS (most cost-effective collection agency in the country) and distributed by CMS (most cost-effective payer in the country). After all the screaming about socialism and death panels and what else the corporate shills could dream up, the walk-back from that proposal could at least leave all Americans covered, unlike the POS that will come about now.
oh really
It probably depends are who you are.
If you’ve got a job, reasonably good insurance, and reasonably good health, then the answer would be yes.
If you’re poor, chronically unemployed, or in poor health, then the answer is more likely “no.” Or more accurately, it won’t make any difference.
For several decades now the focus of legislation has been largely on making sure those who have get to keep. This “reform” seems consistent with that focus.
If there is a mandate requiring everyone to have insurance and there is no public option, then instead of generous subsidies to help people obtain insurance we’re more likely to see generous exemptions to the requirement to buy insurance. That will mean no appreciable gains for the people who can’t afford insurance. We also may see a significant increase in the underinsured.
On the other hand, there seems to be little likelihood that any of the bills being considered now will have a meaningful impact on the rising cost of health care. If the original purpose of reform was to get costs under control and insure (nearly) everyone, then this legislation is likely to be a failure. Obama has apparently negotiated away major drug cost savings and there will be no public option to compete with private insurers to help keep costs down. All reform will mean is that insurance companies will be forced to offer people with pre-existing conditions insurance they can’t afford, and the insurance companies won’t be able to drop people who get sick while insured. The latter is a worthwhile change, but it could have been accomplished without all of the upset we’ve had since Obama began pretending he was going to deliver sweeping health care reform.
Davis X. Machina
Which one gives the greatest prospect of a glorious defeat?
Health care reform is the Democratic party’s mirror image issue to the GOP’s dynamic on the abortion issue. It’s been around forever. It’s something to run on. It provides litmus tests for candidates. It’s a tool for measuring team spirit. It’s a reliable fund-raising warhorse for individual contributions.
Similarly, if you need to buff your maverick cred you can buck the party on it. And advocacy of half-measures to address the problem will get you savaged by the base of your own party,
But the day you do something to address the problem, all of that goes away. You can’t run against a solved problem.
So there’s a distinct constituency for a glorious defeat, in addition to the coalition of the bribed, and the waffle caucus.
Defeat is the real liberal/progressive’s only diet, like koalas and eucalyptus leaves. They exist to lose — lose elections, lose legislative battles. If you win, it’s because you compromised, and if you compromise, they throw you out of the tree-house.
Winning is dirty. Only defeat is pure.
lotus
Ooo. Wee. Apropos of my point at 60^, Ms. Bachmann sez she’ll run for president if God asks her nicely.
Riggsveda
“Would a bill with no public option be better than no bill at all?”
No.
lotus
I mean my point at 61^.
Hunter Gathers
A bill without Public Option – Win
No Bill – Lose
It’s that simple.
A bill that passes will be a setback for the GOP, who want to kill it outright. It will knock them back onto their heels, and when Obama get Immigration Reform on the table next year, it will be the sucker punch that knocks them down for 20 years.
If the GOP doen’t go all out anti-immigrant during the Immigration debate, the teabaggers will turn on them. And if they do go all out crazy, they’ll doom themselves to being a regional party, only getting pissed off old white people to vote for them.
Alan
I’m just laughing at the naivete of all you people who think it will be worth it if “insurance reform” bans recission and discrimination against people with preexisting conditions. The Pukes will never allow any such regulations to have teeth, like attorneys fees and punitive damages awards for insurance companies who break such regs — if you think this “death panel” rubbish is bad, wait to the Pukes start wailing about “greedy trial lawyers.”
ERISA was supposed to have been health insurance reform back in the 70’s. Instead, it became a shield for the insurance companies against bad faith denial claims, because if you have ERISA-covered insurance and the company denies you for even the most frivolous reasons, your only remedy is to sue in federal court and all you can hope to get back (after spending 3+ years and a few grand or more on legal fees) is the amount the company was supposed to have paid you in the first place.
The Main Gauche of Mild Reason
@Davis X. Machina: You’re an idiot. The Democrats have the example of FDR; they KNOW that doing the right thing policywise can win you the allegiance of at least a couple generations of voters. This whole “Democrats don’t want to solve healthcare because then they’ll have nothing to run on” is so obviously false that it’s a little insulting to even argue it.
lawnorder
Clinton was indeed successful. But we got trounced on the mid 2nd term elections and we got Bush in 2000 and 2004
A second time we have a dem prez and a dem congress with ANOTHER failure will be even worse. The right will know they can win with 22% and birthers, the left will be disgusted and the middle of the road will see weakness and won’t like it.
I see letting teabaggers and death panels win as a big strategic failure.
The Main Gauche of Mild Reason
It’s up there with the “drug companies have a cure for disease x, but they won’t sell it because then it’ll kill their profits!!!” conspiracy theory lunacy.
eric
@Davis X. Machina: I have to respectfully disagree with the analogy. Were the GOP to deliver on its GGG (god, guns, gays) issues then it would not translate into broader electoral success beyond the appeasement of the base.
By contrast, you reform health care and it succeeds you can pull people into the dem coalition by meaningfully improving their lives. That is what Kristol recognized in 94 (the only thing the guy has ever been right on).
Moreover, the dems got a bill from the House for the first time EVER. There is going to be a bill on the Senate floor for the first time EVER. Obama has led his Dems, but for two or three right-dems, who have the power to do serious PR harm to the cause, and that they are doing. I think the dems are serious.
eric
matoko_chan
yeah…what MikeN said….trial balloon to see how pissy the progs would get.
and the public option was always a bargaining chip n/e ways.
i think co-ops can replace it.
Something will pass.
and that means 40 years in the wilderness for the teabaggers.
the religious left enters the fray
linda
if there’s no public option; the progressive caucus needs to nuke whatever comes thru.
stand for something, democrats! these watered down compromises are worse than bullshit; you not only fail to provide a key policy victory, but you grovel getting there and absolutely ensure that any policy initiatives that follow will be defeated.
(pffft… sometimes i crack myself up)
AdamK
Whatever they pass, it’s going to be crap, and the country will continue its swirl around the toilet bowl.
Punchy
This whole disaster has usurped my interest in politics in general. Feel like all my money, enthusiasm, and support does nothing to change the status quo.
CaseyL
I have an ugly taste in my mouth and despair in my heart, and it isn’t just because Obama has indicated he’s willing to let a PO die.
It’s because he’s indicated he’s willing to let a PO die after he’s already folded on DADT, surveillance programs, and closing Gitmo.
It’s because he’s indicated he’s willing to let a PO die after allowing the GOP to set the terms of the recovery act, and after almost let them get away with ending Cash for Clunkers.
It’s because he’s indicated he’s willing to let a PO die after every GOP and Blue Dog Congresscritter has pissed on him, sometimes on the very same day he made a big show of how happy he was to be working with them.
It is because Obama cut Daschle loose the instant he looked to be a liability – Daschle, who everyone said was vital to getting HCR through. This not only deprived Obama of someone who was essential to the effort but also signaled, early in his Administration, that he would NOT FIGHT for what or who was important to his Administration.
It is because Obama has made a point of marginalizing and dismissing, not only progressives in general, but Howard Dean in particular. Howard Dean – the man who made the 50 State Strategy his centerpiece, and was successful at it; the man who is a doctor for fucksake and understands the healthcare system; the man who was a Governor and, IIRC, made some healthcare policy his own self.
I just don’t trust Obama to break a sweat over this. I can’t adequately express the despair in my heart. I’ve been in tears just about every day watching the HCR debate/debacle, watching Obama say one thing at Town Hall meetings and his Administration officials say another, until I don’t know who to believe. I have no sense of what Obama will or won’t fight for.
It hurts. It hurts so badly, not so much because “this is the last best chance we have” as because the country is going down the shitter so fast and Obama barely seems to notice.
El Cid
Yes, absolutely — but dependent upon what the rest of the plan would do.
But I think it’s lunatic for liberals and progressives to already be talking about that instead of mainly concentrating on what hell they intend to raise to get what they want (the better policy).
Blue Dogs and conservative Democrats and Republicans and teabaggers seem to be aware that they have to make noise or demands in order to get what *they* want.
Why are so many liberals and progressives taken by surprise by that need to raise hell to get your preferred policies?
The Main Gauche of Mild Reason
I’m also not sure people realize that if the progressives kill the bill without a public option, there won’t be another bill. Full stop. There will be seats lost in the House and Senate next year, and any pressures that made legislators reluctant to negotiate on a bill will be even more extreme. The media will interpret it as “OMG, healthcare is radioactive!!!” because they’re unable to distinguish between a bill killed by progressives and a bill killed by republicans. The media will start talking about the “brilliant strategy” by which the Republicans used their deathbaggers to kill healthcare reform, and such tactics will be repeated in the future.
You have to be an idiot to want this scenario.
JackieBinAZ
If we can’t get something that 70 percent of Americans support, then it’s simply not our country anymore.
matoko_chan
no….anything that passes will doom the GOP.
in game theory terms, the GOP framed their game goal as stop healthcare reform == break Obama in order to whip the Teabag Demographic into a lather.
If anything passes, even if it is just insurance reform and a co-op or voucher plan, the GOP loses.
It is not Obama’s waterloo…..it is theirs.
;)
Elie
I also think that many here (including me) do have to realize what a huge change this is to our economic and cultural reality. This is 17% of our GNP! Sounds obvious and beside the point, but you would have to assume that the piglets on the teats would squeal to high heaven….there are lots of rich piglets that benefit from this, even in industries that are not exactly healthcare or insurance but related (data warehouse companies and consultants).. EVERYBODY gets something from this huge pig and therefore they are going to fight like mad to keep the last bastion of excess profits…
Also, provider supply is not a trivial part of this…Right now I am not sure there are enough docs to cover the additional people so steps need to be taken to rapidly expand that number. This could include shortening residencies and or allowing more advanced practice Physician’s Assistants and Nurse Clinicians to provide care.
This is a very very big thing to implement (which I welcome), but do not underestimate the complexity of it and the complex planning and choreography necessary to pull of this transition..
eric
@CaseyL: All of this means, that if we lose the public option, then all the talk about “wait until after health care” for DADT, etc. means it’s after health care bitches, pony up.
eric
Demo Woman
@lotus: God told me that Michelle is deluding herself but she should go ahead and run. We need to let Michelle know that it’s okay.
matoko_chan
Read Nate.
It is sausagemaking.
Unpretty, but something will pass.
Kristol knows it.
If anything passes, even if it is just health insurance reform, which the insurance companies have already signed on to, it will be enough better that the GOP will be doomed to an extra 40 years in the wilderness.
This is their last stand, the demographic timer on nonhispanic caucs is running out.
MBSS
the problem is that there are two different issues here.
1. what is good for the democrats.
2. what is good for the nation.
unfortunately passing a watered down bill may be good for the dems in the short term, but i don’t see how it’s good for the nation as a whole. modest improvements aside, it really just slightly delays the inevitable health care doomsday scenerio, which looks fast approaching.
Stooleo
What bothers me about private insurance and what nobody seems to talk about, is that it is motivated by perverse incentives. For example if I buy a hamburger and it sucks, I won’t return to buy another one. But with health insurance, what you are buying is a wink and a smile, and when the time comes when you actually need it, especially if its serious (think cancer), it is in their best interest to deny services. The public option is the only player that will not be perversely motivated, and it will force the rest of the insurance companys to become honest brokers. This is why they are fighting like hell to kill it. Also, say what you will about government run entities but the one thing that they are good at it writing checks and basically that is all that this is.
matoko_chan
wingnuts to iraq,
we already firebombed Beck.
he lost all his advertisers.
DBrown
Obama is NOT going to win on his current policy approach- read ROSS DOUTHAT’s article in the NYT-he is right on the money. Ross cuts to the chase and points out why Obama will never win with a Public Option while trying to cut Medicare costs (i.e. threaten Medicare.) The most powerful public group (seniors) is threatened and will follow any rumor or wingnut group to fight back to protect their self interest. Short of attacking SS, Obama is threatening a group that is too greedy to ever listen to rational thought. Obama’s approch has been very stupid to date – Obama needs to realize his mistake and win these greedy parasites over.
Demo Woman
My concern is with the cost of obtaining heath care. If insurance companies can’t refuse coverage but there are no mandates, my rates are going to double. I can’t really afford it now.
Davis X. Machina
“Democrats don’t want to solve healthcare because then they’ll have nothing to run on
Some Dems would be better served by failure. The House CPC would be better off with no solution than a flawed solution.
Zifnab
@Demo Woman: Don’t worry. I’m sure there will be lots of big lawsuits and 5-4 SCOTUS decisions that declare all of this unconstitutional on the grounds that Thomas Jefferson never intended for the Constitution to apply to insurance companies. :-p
Elie
I would obviously like the public option to be in the final bill. My real bottom line however, absolute show stopper for me if not present — is that EVERYONE in the country is covered. EVERYONE… If that is too expensive without a public option, f—- it — I still want it. Everyone has got to be covered some kind of way in some plan. My guess is that there will be some form of public option but it will probably be an expansion of Medicaid and/or Medicare… Fine by me! Call it anything you want — but those are indeed a version of the “Public Option” and if particularly Medicare is expanded to younger groups — I am totally satisfied. (Of course I just oversimplified this to be absolutely too simple but you get my point)
PeakVT
The prospect of no public option is discouraging, but I’ll wait to see the final bill before declaring success or failure.
There’s always plenty of blame to go around after a major cock-up (which health care reform may turn out to be). But I think the largest share will be placed on one aspect or another of the Senate – the gerrymandering, the cyclical lags, the stupid self-imposed rules, and the personalities (or lack thereof in the case of Reid).
Darius
See, I’m just not buying this. If the Dems pass a bill without a public option, the Repubs can claim that they forced the Dems to make major concessions to the bill (despite the fact that these concessions have more to do with Corporate Dems than they do with Republicans). It may not be a 100% “win” for them, but it won’t be a “loss” either.
Elie
–Just curious…would people here be against an expansion of Medicare or Medicaid as the “Public Option”? What do you policy wonks think?
joes527
@matoko_chan:
wait … I though that single payer was the bargaining chip and public option was the end game. Now we are saying that public option is the bargaining chip and co-op is the end game???
But by signalling the death of the public option now, we reset the clock with both single payer and public option off the table (they are over in the corner with impeachment and prosecuting war crimes.)
That doesn’t leave co-op as the end game. That means co-op is in play and will have to be bargained away for the REAL end game which will be “All your bases are belong to the insurance companies”
I am in favour of bipartisanship.
I am in favour of compromise.
But the democrat party seems to think that this means that they need to jettison every idea that they have when some lady in Alaska writes a mean essay on her Facebook. AND THEY GET NOTHING IN RETURN.
The Anti-reform coalition hasn’t moved an inch since this whole thing started. They are, if anything, stronger than when this started. The democrats have established that reality will not be a required element for negotiations (death panels).
If I were negotiating with these dickless wonders I would just sit back and wait for them to completely abandon reform.
Watch. It. Happen.
The Main Gauche of Mild Reason
@Darius: We all know the media doesn’t examine the contents of bills. I think you’re assuming the ‘Merkin public is more on top of things than it is.
Legalize
If there is to be no public option in the bill, then the it should also repeal medicare and social security. If it’s old people who are going to fuck things up, then fuck them. Two can play at that game. Wind down the trust funds and distribute the funds in a manner proportionate to what has been paid in. It’ll make my paycheck go a hell of a lot farther.
Demo Woman
@Darius:
The Republicans are going to have trouble campaigning for a bill they voted against. If there are a few carrots for the masses, they lose. I think this only works if the elderly get (free) help in forming living wills though because they have such a large voting bloc.
Corner Stone
@maye:
I’m just so tired of hearing this thrown out again and again and again.
Nobody’s saying they’ll only accept *perfection*. Lots of people are disgusted by the way this has moved but are still ready to fight for a good outcome.
If we’re not willing to fight and scream for perfection in order to get a *good* outcome, then what good are we?
Don’t let this useless analogy become the enemy of the truth.
Demo Woman
@Elie: I’d phase in MediCare slowly. If you were laid off and are nearing 60, forget about affordable health insurance.
REN
I would like to say first that there sure are a lot of very smart people that comment on this blog and it is a genuine pleasure to read your comments. It is one of the few things that I do every day that gives me hope for the long term future of this country.
I am disabled by a bad accident I had at work and am on Medicare. My wife has no insurance. We cannot afford it, and even if we could she had” abnormal” cells removed from her cervix when she was 25 so she will NEVER get non-government sponsored health insurance.
The State of Wisconsin is now in the process of ramping up a new program for low income people,so that is our only hope to get her some coverage as I see it. She is in good health now but she is going to be 50 soon and diabetes and heart disease run strong in her family.
I relate this story not to exact any sympathy,we all know life comes with no guarantees. My point is that I have been waiting for the other shoe to drop for awhile now and I know that a day will come when we will be filing for bankruptcy. How would you like to wake up to that everyday?
So for all those lucky enough to have some form of health insurance, this is the dark side that you are all much closer to than you can imagine. Especially meant for any lurking wingnut teabaggers.
Corner Stone
@eastriver:
This is good, I like this one. Except I think I’m going to use “rankles my cankles”.
And to your point about the perception of the insurance industry winning – I couldn’t care less personally because with the good outcome lots and lots of people would only ever remember what was delivered, not how it appeared at the time.
Demo Woman
@Elie: I should also add that the fees for those who are younger than 65 should help pay for the coverage.
lotus
Have you ever just sat down and generated a letter-perfect essay, or brief, or report, without bothering with a draft (or several)? I may have once or twice in my longish writing life but certainly not often. And this legislation (let’s call it the Kennedy Act) ain’t no dinky little essay, it’s a magnum opus.
The Dems have to get something on paper in the Federal Record before the real writing can begin. A project like this demands several years of determined commitment to dogged fine-tuning — it isn’t something a legislature and administration just blurt out “FTW.”
You know? Hah?
Robert
The situation in our country has become such that anything that benefits the health insurance industry will inevitably harm the American people. And the industry execs and their lobbying hordes know this. That is why they have stopped at nothing to crush the public option. They know that health care reform without the public option is no reform at all.
Furthermore, the Republicans now smell blood. They will gut any reform bills to the point where any legislation that passes will be toothless. Worse still, these bills will probably even further strengthen the insurance industry and the pharmaceuticals.
And now that the Republicans and their corporate masters have seen how weak and inept the Obama administration truly is, nothing of any value on any legislation that matters to Progressives will get passed.
The public option element of health care reform was the line in the sand for the Democratic party leadership and the Republicans repeatedly slapped them back from that line again and again.
Elie
Its interesting to me how quickly people here throw in the towel and assume the worst!
Did you all think this would be easy? Just do a bill with everything that YOU want in it and pass it through Congress in two weeks, tops, (to include complete single payer) — and at week three and a half Obama signs it into law and there are rainbows and unicorns jumping up and down with delight?!
Geez, how much have anyone of you done to get this done except bang key boards? Any of you even write or call your Congressman or Senator?
I bet many here just like to lay back and criticize? Where is your skin in it? Some pretty harsh opinions upstring — stuff about failure and success like YOU did something. Did you?
I totally support health reform, not just insurance reform. I would like a single payer but know that is not happening but can wait and keep pushing. I want public option and will push for it. I have gone to a Town Hall and communicate with my Congressperson (who was kind of wishy washy but seems to be bucking up). What have YOU done?
Mnemosyne
@El Cid:
That’s what I keep wondering, too. The reason the crazies have been able to take over the Republican Party is that they worked their asses off to do so for the past 30 years. Why the hell are progressives sitting around whining that they haven’t had their entire agenda handed to them on a silver platter after winning two (2) whole elections in 4 years?
Get off your lazy asses and work for what you want. Congress isn’t going to magically divine your wishes and provide everything you want without you lifting a finger. Yes, it sucks to have to constantly fight to get what you want but, like it or not, that’s what we’ve got and complaining about how it’s unfaaaair isn’t going to do squat.
If you’re pissed off about the public option, get off this website and go call and/or e-mail the White House, both of your senators, and your US rep and tell them you want a public option. Otherwise, all they’re going to hear is the screamers and assume that they represent the rest of the country.
Corner Stone
@Janet Strange: This trope that Ezra is pushing is also garbage. How exactly is it germane to compare the two periods in US history, and make a relevant outcome?
Completely not useful to the current debate.
Andrew
A bill without a public option is destined for failure, as it will become susceptible (rightfully so) to the argument that it will unjustly force Americans to buy insurance from the same insurance companies who continue to discriminate against persons with pre-existing conditions and rescind coverage when they get sick.
Corner Stone
@Alien-radio:
I do not even know what this means.
The Repubs have done what now?
Chad N Freude
@Stooleo:
Bullseye! I’m a for-profit insurance company CEO, and I can make more money by denying payment for care. I would be remiss, and probably turned out by angry stockholders, if I didn’t maximize profits.
Jack
There are three issues, intertwined.
1. Policy. Some reform is better than no reform, but only if the news laws and regulations don’t become a cover for the subject industry.
Since politics is largely compromise, getting a passable bill out of both chambers will result in compromised policy, including the “public option.” That’s the way it works, all ideology and moral grumblings aside. Sometimes, the end result is fecal matter, as in NCLB. Sometimes it’s got teeth, as in Glass-Steagall 1932 (later improved in 1933), or the original New Deal programs.
2. Republicans and conservatives. They are playing for electoral success, which means they’re playing to hurt Obama and the Democrats. They don’t need a plan. They don’t need an alternative. They don’t need to debate. They just need to damage their opponents. In politics, bleeding bodies soon become corpses. Yes, even Bill Clinton.
3. Perception. As in, public perception. The Democrats have to propose a plan, show how it will work, and most importantly, why we should do it. The Republicans just have to attack. It shouldn’t be to hard for folks here to understand that the GOP has the easier task.
These factors in mind – who is winning, even with a compromise bill passing both chambers of Congress, sans the public option?
It’s not the Democrats. It certainly isn’t Obama. They have failed to explain the policy. The one aspect of policy popular and popularized with the American people – the public option – is the one place they continually show weakness and outright vacillation. Mixed messages. Constant reframing. Rhetorical and procedural weakness. A win on overall reform is still a loss, since they will be giving ground to the…
Republicans. In forcing the Democrats and Obama to shift to their tempo, and play on their ground, they come out the winners. Not procedural winners, not electoral winners. Winners where it counts:
Perception. Strength, efficacy, capacity, will, power – these count in politics, even if we liberals tend to rosy eye our view of human nature. Winners get benefits. Losers get blame. Any failure on the one aspect of policy familiar to most voters, in reaction to initiative taken by Republicans who don’t have to do anything yet but attack, results in the following general outcome – Dems are weak, liberals don’t stand their ground.
Even if rescission is banned and community ratings govern how premiums are determined, this could very well be a fatal success for the Dems, in so much as the cost winning one battle to which few are paying attention is losing on the field where everyone is watching.
Montysano (All Hail Marx & Lennon)
Obama can’t pull the wagon all by himself. Who is giving him any help? Meanwhile, he’s got DINOs like Max Baucus dragging him down.
If every Dem in Congress got the message that we will vote them out and send their asses home if they don’t get health reform right, we’d see some action. And that’s just what we’re getting ready to do: rise up en masse and……. oh look! The new season of Dancing With The Stars starts tonight! Now…. what was I saying?
Demo Woman
@REN: One thing that I have done is put spare pennies into my IRA. I have insurance, a house and some savings but every year I still try to put money into my IRA even though I could use it for something else. The IRA can’t be touched during bankruptcy proceedings.
valdivia
@lotus:
this.
also–I love how drudge declares the public option dead and all the media follows and the lefties declare defeat. just wow. good to have you all in the ditch when we need you. there are posts here saying Obama is so far the worse president evah? is this Free Republic of all of sudden.
No wonder the republicans always win. It isn’t Obama who has no testicular fortitude, it is the left who moans about everything.
johnosahon
at 5 Walker:
that does NOT make any sense, we are currently in an economic collapse, is she/he judging with this in mind, why is he/she looking at the next economic collapse?
Da Bomb
@Mnemosyne: I seconded that. Again, it’s funny watching all this unfold. It reminds me of September 2008 all over again.
MBSS
@REN:
i stress out considerably over minor things. for instance, the fact that my vehicle registration hasn’t been processed yet is creating stress for me. then i stop and remember that there are people out their with real stress, and that puts things in perspective.
i think everyone having this debate needs to be reminded constantly that their are millions of americans in your shoes. that’s too many of my fellow americans with a dark cloud hanging over their heads. this really is about our uncles, brothers, friends, and co-workers lives in the balance. it cannot be overstated.
scarshapedstar
I think this reform package is entering Schiavo territory. Time to pull the plug.
Mandate – public option = $$$$$$$ for HMOs. Fuck that noise.
zoe kentucky from pittsburgh
Something must pass, with or without a public option. I am all for a public option because I see it as a backdoor way to move towards a single-payer system. I think most of us feel this way, be honest. So drop it if that means that we’ll still have strong health care reform and tough regulation of the insurance industry. This must happen now or it won’t happen again for another 10-20 years. We cannot afford that, either as dems/liberals/progressives OR as a country. Period.
At this point the public option just needs to be called something else, maybe even separated out entirely from this bill and put up as its own independent program– as mentioned above, it could be part of an expansion of medicare/medicaid for the uninsured. Then let the GOP try and vote AGAINST medicare. The GOP can demonize hc reform as “socialism” at the same time riling up those who have socialized health insurance (seniors) but eventually that absurdity will become clear. Once seniors aren’t afraid they’re about to lose their medicare then much of the heat will dissapate from this issue.
Da Bomb
@valdivia: I seconded that as well. The headline was from AP(flunkie outlet for McCain and Drudge ran with it).
The television headline said “may” drop the public option and we are already declaring it DOA. I use to write for television news, so I know the BS they play.
THERE IS NO FINAL BILL.
There are five bills floating around, the one bill left to be completed is the Senate Finance Committee bill, which Baucus and the other foremntioned twits are on. All the other FOUR bills has a public option within them.
This is complete political theater.
Tropical Fats
@Alan:
This is exactly true. Everybody needs to understand this. The insurance companies have no incentive to not screw you, since their worst-case scenario is that after you sue them in federal court at the cost of tens of thousands of dollars in legal fees you can’t recoup, is that they have to pay your bill. The only reason they don’t do this on every single claim is if everybody knew this the game would be up.
This exact thing happened to my wife and me. It was only because of some extremely creative lawyering by our attorney, which raised the possibility of us being able to sue them in state court (where the insurance laws have some teeth) instead of being forced into federal court by ERISA, that we were able to force them to settle for an amount that covered her bills and our legal fees. (And saved us from bankruptcy.) We were extremely lucky, because we had put $25K of our own money at risk to cover the attorney’s bill. Of course, we were turned over to a dozen collection agencies in the meantime, so it wasn’t a clean win.
If you think you have good insurance, you’re wrong. Every single one of is is one illness away from financial ruin, no matter how much money you have in your HSA and no matter what your insurance is theoretically obligated to cover. We are all defenseless against the insurance companies, and will be until they are either out out of business or we have a public insurance option.
kay
@Tropical Fats:
Great post, and I’m so glad you had both 1. state law, and 2. a good lawyer.
REN
@Demo Woman
Thanks for that. I do have an IRA that came from when I was employed but I have to say that there really are no spare pennies in our budget.It’s a fact of life that many baby boomers that find themselves trying to live on SS are going to find out soon.
blahblahblah
I give up on Democrats. I give up on the United States of America. I’m getting the fuck out of here before the nation implodes from insane unsustainable spending policies for impossible to win wars (never mind wars without goals), hyper-inflation from the Fed trying to print enough money to offset that spending, and a wealthy elite who couldn’t give a rats ass about constitutional limits and citizenship.
The elite are driving this country to a civil war. I want the fuck out before the shooting starts.
Bill E Pilgrim
No waxation without representation!
http://1.bp.blogspot.com/_T-J2hjN2HaE/SodM4KNjXOI/AAAAAAAACCw/SD15ws18GoE/s1600-h/asignnando.jpg
ThatLeftTurnInABQ
@Elie:
I’m on the same page. I said this a greater length on a health care reform thread a few days ago, so this time I’ll keep it short: we won’t get a public option, much less single payer, until the overwhelming majority of people in the US reconceptualize health care as a human and civil right, not as something you deserve by earning the right to get some (which implies that some people are deserving enough). And making sure that everybody has coverage is a stepping stone in that direction.
Here’s another thought – why not work through the state legislatures via a proposed Constitutional Ammendmant mandating a public option. Make each state rep go on the record as to whether the folks in their own state deserve health care as a basic right or not. Sure we won’t get the neo-Confederate Southern states, but we might be able to put enough pressure on the border states to get over the top when you add in the solid blue states. If nothing else, it would make Big Pharma/Big Insurance have to spread their cash around over a wider playing field trying to stop reform at the state level in addition to what they are already spending at the national level. Wear them down by attrition that way.
kay
@Tropical Fats:
“which raised the possibility of us being able to sue them in state court (where the insurance laws have some teeth) instead of being forced into federal court by ERISA, that we were able to force them to settle for an amount that covered her bills and our legal fees. ”
Tell this to the liberals who are advocating trumping state health insurance regs for a uniform federal scheme, because there are a lot of them. Tell them about how wonderful federal schemes are as far as gaining any kind of relief for individuals harmed.
Keith G
@publius: #26 Correct idea – as usual.
This is part of a long war, unfortunately. Nonetheless, a war that favors our side. The weaker the bill, the faster it will be revisited as more and more teabaggers and deathers get screwed over (and many killed off) by their beloved corporations.
If insurance reform is weakened enough by lobbying, I would think the next major bite of the apple will be within 8 yrs – half the time since ’93.
By then, a public plan could well be a legislative no-brainer and single payer may be a serious part of the debate.
All before SamKitten’s 10th birthday.
valdivia
@Da Bomb:
I agree. I said this to a friend the other day–the left just loves to chicken little over everything. Remember all the blogs moaning about how Obama could never win the election because he was not a real progressive, how he did not know how to fight, etc etc. I am waiting for Oct-Nov when the bills are voted on and reconciliation happens. I will be ready to make a judgment then, all this we are doomed talk just pisses me off. The righties really know how to wind the left, that is for sure.
4tehlulz
@Da Bomb: I’m glad someone’s paying attention to what’s going on instead of what wank material the Village is making for itself.
At this point, I say let Baucus pass whatever the hell he wants and then make him watch the disembowelment in reconciliation.
ThatLeftTurnInABQ
Edit to my prev comment:
(which implies that only some people are deserving enough).
Will
Taking nothing over no public option included is fool’s errand. If anyone thinks Obama will be less politically damaged after getting ABSOLUTELY NOTHING passed on healthcare, then they haven’t been paying much attention.
I’m not the first to point out that the bill in its present basic structure is still far more progressive and sweeping than the “most progressive” health care bill proposed by Howard Dean in 2004. That bill had no public option, and covered fewer people.
Jack
@ThatLeftTurnInABQ:
“If nothing else, it would make Big Pharma/Big Insurance have to spread their cash around over a wider playing field trying to stop reform at the state level in addition to what they are already spending at the national level. Wear them down by attrition that way.”
Now that is sound strategy.
zoe kentucky from pittsburgh
The dems need to learn something right now– this is no longer a “bipartisan” effort. Not a single republican will be able to vote for health care reform because they’ve allowed their party to demagogue themselves into a corner. Any moderate republican who votes for it will lose their seat to some rightwinger challenger who will say they voted to kill grandma. So forget the GOP, forget the “moderate” republicans, they are no longer part of this now.
So now the Dems truly own it, it’s merely an issue of getting a dem coalition together, of getting enough dems on board for it to pass. They need to do whatever it takes for it to pass and stop treating the GOP like they have a stake in this other than for it to fail.
Maybe after the dems get back to dc they will collectively realize that they no longer need to pretend that they care about bipartisanship– because who in their right mind tries to negotiate in good faith with the other side when they are irrationally accusing you of trying to kill their grandmother? Fuck them and their lying, screaming madhatter hordes.
jcricket
I think others have said this, but the answer is: it depends. The public option and associated regulations are far, far from a perfect solution, but they’re very important building blocks. Having any kind of real public plan in there, even with extreme restrictions, makes it 1000% easier to loosen those restrictions and cover more people down the road. Having to add a public plan will be as big, or bigger, a fight down the road (they will say “the last healthcare reform bill was supposed to fix everything, and they were wrong. Now they want SOCIALISTIC NAZI MANDATED INSURANCE !!! NO WAY!!!”).
If we end up with some kind of co-op exchange that sucks, and all the other regulations (which don’t suck), over the objections of the Republicans but with united Democratic support – I will count it as a win. IOW, compromising some to get united and full-throated Democratic support will help us in more than just this battle.
If we end up with co-ops that suck, 1/2 of the regulations (or all of them watered down) and still have no Republicans and perhaps not even united Democrats then what’s the point of compromising?
So we should be focusing less on compromise in general and more on hammering the conservative Democrats to get them on board with voting for cloture. Make it clear that if they want to vote against the final bill, that’s their right, but voting against cloture is killing the bill. I suspect the conservative Dems will vote in favor of whatever makes it to the floor, and that’s why they’re trying to stop the public option now.
In short: Harry Reid sucks as a parliamentarian, and the Obama team is doing a crap-ass job of using their political mandate and marketing skills to work the Senate. That is the sum total of the real problem right now – the rest is noise.
asiangrrlMN
I gotta say, I would be pissed off if there is no public option, but I am in the wait-and-see mode. This happened during the stimulus debate as well. All the “It will never pass!” “Obama will have to cut off an arm and a leg to get it to pass!” noise that was going on really got me down. Then, one pundit let it casually slip that of course the bill was going to pass in the end and went on to discuss some other minutiae that mattered not a whit. It was a light-bulb moment for me. I didn’t read or watch anything political for the next four days, and I felt much better afterwards.
In other words, I want to see the big picture before I make a decision or get to invested in the machinations of politics. Bottom line: I want everyone in America to be covered. The rest is all up for negotiation.
Jack
@asiangrrlMN:
It’s not enough to have “everyone covered” if the final plan obligates the purchase of health insurance from private companies who still get to use experience ratings.
Michael Carpet
I have to agree with matoko_chan @91. A flawed bill (that Ezra reminds us is more progressive that Howard Dean’s plan in 2004) is a win; an ugly win, true, but it is also a beginning. With persistence it becomes the foundation on which other reforms are built.
bago
@Bill E Pilgrim: Real Merkins don’t stand for that sort of thing!
TimO
My new slogan, “PO or NO!”
SenyorDave
The dems need to learn something right now—this is no longer a “bipartisan” effort. Not a single republican will be able to vote for health care reform because they’ve allowed their party to demagogue themselves into a corner. Any moderate republican who votes for it will lose their seat to some rightwinger challenger who will say they voted to kill grandma. So forget the GGreat point!OP, forget the “moderate” republicans, they are no longer part of this now.
zoe kentucky from pittsburgh,
Great point! That has to be something the Democrats push. Not that they have much chance of affecting the debate at this point. For me it all ended when they dropped the end-of-life directive. I really believe Obama should have started the first town hall by reading what was in the Senate bill regarding end-of-life, and saying that if Palin thought that it implied a “death panel” either she misread it, or the words had too many syllables for her to understand.
Da Bomb
@valdivia: Exactly, that’s when all the fussing should ensue, during reconciliation. Obama is stroking Waxman and all of the other dipshits on that Senate FInance committee so they can get a bill created, because they are holding up the process.
This happens all of the time, whenever there is a big major bill that needs to pass, congress sits on their collective asses till recess, then when back in session they really start to work. In between that time, it’s complete political theater.
The same shit happened with the stimulus bill. All of these same fools, screamed they weren’t going to vote for it. And in the end, they did. It’s all about saving face and stroking egos.
Broken
Walker sez:
“[Obama] is a compromiser, not a leader.
And when the next wave of the economic collapse comes, this means we are screwed. We needed an FDR; we got a Hoover.”
FDR wasn’t a compromiser? The guy who called himself “just a power broker”?
Elie
asiangrrl and valdivia
What you both said…
jcricket
@Broken:
In fact, it was FDRs compromise in 37/38 with the fiscally hawkish types that sent the economy back into the Depression.
At least FDR learned from that. Although I thought Obama had learned a similar lesson already with the stimulus plan – esp. when he said so publicly.
But here we are less than 6 months later and we’re already starting from the compromise position. Blegh.
Ash Can
::skims the thread::
Good fucking grief. You’d think from this thread — starting with the title (which I suspect and hope is supposed to be tongue-in-cheek) — that Obama just either 1) vetoed a reform bill and announced that he’d changed his mind about reform altogether and wouldn’t sign a reform bill even if it promised everyone a million dollars, a lifetime supply of beer, and a pony, or 2) signed into law a bill that awards every private insurer the first-born, house, bank account, and CD collection of each US citizen living here and abroad.
I hereby resolve to ignore every health-care-reform thread here from now on, until there’s a REAL LIVE, ACTUAL BILL out of Congress and on the President’s desk. Cripes. Sometimes the smell of burning hair is stronger here than at Daily Kos, and that’s saying a lot.
Da Bomb
@asiangrrlMN: My sentiments exactly.
Maude
@Elie:
Medicaid did expand and some funding was in the Stimulus bill.
Obama had talked about making Medicare more efficient. It has a 3 per cent overhead now.
The phrase Public Option has ignited the whackos. So, the phrase get dropped.
Because Medicare and Medicaid exist, they can be made to include more people.
Medicare for everyone would do well. The Republicans don’t want to see that happen.
Obama has to tread carefully on health care. If he dug his heels in at this point, he’d fail.
This is far from over. It’s a good thing that the screaming fits are going on now instead of in October. People can carry on at full tilt for only so long. They get tired, the media gets bored and then they have nothing.
I hope Medicare becomes available for all.
A valid Social Security card is needed for Medicare. That could, in the future, shut down the “you can’t give medical care to illegals” crowd.
What is very good is that people are talking about health care.
Da Bomb
@Ash Can: Valdivia, AsiangrrlMN, Elie, 4tehlulz and myself are all on the same page with you.
I am sure there are others I left off who agree with you as well.
Sit back and watch the pearl-clutching commence.
valdivia
@Da Bomb:
yes and what really *really* gets to me is to see people here declaring the Obama presidency dead–this is *exactly* what the teabbaggers want but the left seems to embrace the republican frame out of fear every single time.
valdivia
and @Ash Can, AsiangrrlMN, Elie, 4tehlulz and DaBomb
so glad to see people still focus on the big picture while the rest of the bloggosphere runs around screaming about the doom!
Tropical Fats
@kay:
“Great post, and I’m so glad you had both 1. state law, and 2. a good lawyer.”
Thanks. We were very lucky in those respects, and lucky that I could put my hands on $25K to pay our attorney if I had to. I would guess that 99.9% of people in that situation have to declare bankruptcy. I’m sure that’s what the insurance company was counting on us doing.
A couple of times since then I’ve used that story in trying to persuade some conservative friends that they worry far more than they need to about government using its power to control them and not nearly enough about powerful private entities using their power to screw them. I haven’t ever convinced anybody. I’m deeply pessimistic that we’ll ever get real reform (i.e. single payer) until the insurance industry screws a numerical majority of the country. It’s not just that people don’t understand, it’s that they are deeply resistant to understanding.
Bobby Thomson
@Will: Dean’s bill didn’t have mandates.
Republicans are salivating over a Democratically-enacted law that forces the uninsured to buy policies that they can’t afford. Subsidies? Yeah, right. This is a country where you have to pull teeth just to pass cost of living adjustments and “welfare reform” is seen as a way of balancing the budget, despite welfare constituting a tiny portion of expenditures. You can’t afford the insurance? That’s your fault, parasite. Blame the Democrats for making you buy it.
Without another player in the exchange to keep the game honest, insurers will be able to game the shit out of things and their profits will explode from being able to write the new policies.
Jack
@valdivia:
A mischaracterization. A person doesn’t have to be a doom junky to point at that Pyrrhus won, fat good that it did him.
Bobby Thomson
@asiangrrlMN: I don’t remember any serious doubt expressed by intelligent, non-crazy people over whether the stimulus bill would pass. The question was whether the administration’s bill would be large enough.
Jack
@Bobby Thomson:
This. Any “reform” which creates a captive market and which feeds the faux populism of Palinites should considered for its consequences, intended and unintended. Experience ratings plus mandatory coverage equals Republican win.
Morbo
Damn, I see no news all weekend, sleep in, and wake up to find that the public option is dead, the hell?
For the record, I’m not buying it at the moment. The smart money seems to say that a bill with the public option costs 9 votes in the Senate but one without it costs 75-100 in the house. That smells to me like something that will be passed in reconciliation.
NoVa Commie
I think we should all be explicit about how we see the problem, and what we want legislation to accomplish. Here’s what I sent to Senator Mark Warner (D-VA), who makes lots of noise about being ‘centrist’ and ‘pro-business’:
According to virtually any credible quantitative data I can find (OECD studies, for example), America spends roughly twice the amount per capita as other industrialized nations on health care, without any perceptible increase in either quantity or quality of services received by the insured public. In addition, we leave millions uninsured, unlike these other nations.
This fact suggests to me that our health care problem is not one of cost, but rather one of price. Even our higher rate of obesity, and the resultant increased incidence of chronic diseases such as diabetes, does not explain a 2X difference in per capita “costs”.
Controlling price increases in any market requires structural changes. Given the high barriers to entry in the supplier markets – whether providers, insurers, or drug companies – I do not see how price control can be realized without similar concentration on the buyer/customer side. The push for many insurers and providers to compete in the capital markets by continually demonstrating above average ‘growth’ only increases the pressure to provide less value for money to the patient.
This is why I support the creation of a public run insurance option with access to a similar risk pool as private insurers (not just limited to the poor, elderly, or those temporarily unemployed). Private insurers that insist on double digit year over year growth will find it difficult to compete – but there is nothing in our constitution that guarantees any enterprise the ‘right’ to perpetual growth at the cost of the general welfare.
Price control could also be imposed anywhere along the value chain (drugs, care providers, insurers) via regulation, but I am not hearing that discussed by anyone – outlawing rescission, and/or exclusion due to pre-existing condition is a worthy goal, but useless for controlling costs if insurers retain the right to adjust either prices or level of coverage to maintain the status quo (decreasing value for money).
While I understand your desire to appear ‘centrist’ in this ‘purple’ state, I do not support a ‘bipartisan’ bill that does not directly address the structural pricing problem with the current health care system in the U.S. I realize that the legislative process is far from complete, but wanted you to know, in advance, where this constituent stands on the issue.
Thank you,
Elie
DaBomb, Ashcan, valdivia, asiangrrl, Maude and others..
Yep.
Its really amazing that smart people think something this big and complex could be enacted without ugly parts showing at different points. We really were totally influenced by the command and control Republican tenure that holds that you want something and therefore you just do it. Signed, the end. No appreciation for complexity, strategy or the evolution of what making this happen looks like. Just Ta-Ta —you just write a bill, send it through and sign it — just like you want it the very first time against huge media, corporate and right wing and racist crazy! Just-like-that!
Also, what I don’t hear from all the “pearl clutchers” is “what can we do?” “how can we held get this done”? No — lets just recline on our divans and admonish others to get this done. “We hired you boy to do this so just go do it or you’re fired and a failure! ”
We are a nation of tantruming adolescents — unable to really build or sacrifice much but instead demand, demand, demand. No understanding and therefore no patience for how to accomplish anything — the operational reality of doing it. They want it NOW…and they want it like they want it — perfect — first time…. No sweat.
valdivia
@Jack:
but people declaring a defeat or Pyrrhic victory when we do not know what the bill looks like is indeed fear mongering. fight for what you want but declaring the effort worthless when the fight is not even engaged yet is pretty stupid.
Common Sense
Support Systak. Nothing will put the fear of God in these Dems more than seeeing that having the biggest warchest isn’t enough in 2009. Pretty sure it was Nate at 538, but I read an article a few weeks back that pointed out how much more bought and paid for Senators from small states like MT and ND are. Smaller populations mean it’s easier for an industry to purchase a politician since the pol won’t be raising a lot from donations. An advertising dollar goes a lot further in Butte than New York City. A national network pushing well funded primary challengers could really knock em into at least voting the right way when the chips are down.
Da Bomb
@valdivia: Even Dean said this morning that the President knows that tru healthcare reform won’t occur unless there is a public option. He said, verbatim that the President will be signing a bill with a public option after reconciliation in December.
Baucus supported a public option back in November of 2008. Here’s the linky:http://passthrough.fw-notify.net/download/116389/http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf
If the left believes that Baucus would vote against a public option in the final bill, then you are falling for the game. So, proves my point, this is essentially political theater.
Elie
Y’all — we HAVE a public option place holder already. Its called MEDICARE. The question will be (as Maude upstring suggests) is how to expand it. That is difficult but not impossible but will require some political sleigh of hand. The organization is already there. The policies are already there…(obviously would have to be amended but the structural foundation is there). Its pedigree is perfect — its parent is social security…not new legislation. “Just” have to make sure that seniors keep what they have as the pops covered are expanded….
Any way, that is one possible option you crepe hangers!
Mark S.
Well, if we’re going Swiss, what will that mean?
1. Switzerland spends about 11.5% of its GDP on health care, which ain’t great compared to other countries, but of course it’s a lot better than the US (17%).
2. Will the US adopting such a system lower us down to 11.5%? I don’t think the US will adopt tough enough regulations on insurance companies. I’m also guessing that the Swiss system works there because they have very low levels of poverty.
Elie
Mark @ 176 —
Its less about the levels of poverty than the need to generate huge incomes for providers and the US insurance industry. Coverage and care that people need are not necessarily that expensive — until you tack on the need to support “Lifestyles of the Rich and Famous”.
Bill E Pilgrim
@bago:
Speaking of “coverage”, as everyone seems to be.
Tax Analyst
The Moar You Know said:
“The only person who so far I hold absolutely blameless is Pelosi. She knows how to handle the House and has done so with an iron fist – which is the only way to negotiate with the GOP. No mercy and no quarter – same as they did to us 2000-2006. It’s not her fault that she’s delivered every vote that she’s been asked to, and then had Reid and the Obama administration piss it away.”
Agreed, and I can’t understand all the criticism she has been getting from the Progressive side. There have been a couple issues where I may have had a quibble or two with her approach, but for the most part she has tried to move the process forward to where it needs to be. Contrary to what appears to be a popular progressive belief, she is not physically attached to Harry Reid’s body, and should only be held accountable for rounding up the Democratic side of the House. I think she’s done a pretty damn good job of that so far.
People, “Vote them all out!” is an un-informed voter position which is being molded now as a GOOPER theme. What they mean is “We hold no better than 2/5th of the various Federal legislative seats, so by all means throw the incumbents out”, and after they convince enough fools of that they will turn around and re-elect their usual Regressive Representatives and Sack-Sucking Senators so they can get back to the important business of banning abortion and cutting taxes and making sure that Health Care in NEVER substantively reformed.
I’m not even close to giving up on Obama, though. Patience is admittedly hard to come by in these times, and while it appears the GOP has diverted the message I don’t know what how that could have been avoided considering the Media has decided that bald-faced lies. distortions and misrepresentations are an equivalent argument to facts and actual reality. I think most of the public is sitting back and feeling more than a little confused and annoyed. Concerned, but not afraid or angry to the extent the media portrayal is presenting things. Right now the lack of an actual bill allows the Republicans to get away with a whole lot of absurd bullshit. I think Obama believes the time to really make his case will be when the actual potential rules are written into a document. His “all options are open” stance is pretty much the truth right now. What would you have him do? Announce that certain features are “non-negotiable? Sure, hand the opposition a stick to beat you with before an actual bill is on the table. How can you make a concrete case for ideas that are still floating around in an ethereal state?
I have an idea – invite a tea-bagger to lunch and then tell him to get fucked and leave them with the bill. At least he will have something to legitimately complain about for a while.
Corner Stone
@Ash Can:
But won’t it be a little late to cripe then? If we can’t influence the bill *now* then how are supposed to have anything to say when it’s ready to be signed?
ominira
@El Cid:
Bless you – I’ve been waiting for someone to say this. I believe that raising hell and letting Dems know there will be consequences for failure wrt healthcare reform in ’10 and ’12 can actually produce a decent health bill.
Corner Stone
@matoko_chan:
I still don’t see how this is in any way a logical conclusion.
jenniebee
Something I never understood was why this wasn’t all just being done as a Medicare expansion. Why create a whole new program? Just let other age populations buy into Medicare. The infrastructure is already in place, there’d be some IT upgrades needed, sure, but not a ground-up rebuild. And the politics of it would be marvelous – letting younger people buy into the system while continuing to subsidize the elderly’s premiums would broaden the pool of insured, improving the program’s solvency. And the Crazy People would have to mount their campaign against Medicare, not the Imaginary System Of Doom.
Somebody explain why we aren’t going this route?
EthylEster
@Leelee for Obama: Um, you do know that the Swiss do not allow the insurance companies to make a profit on their mandated coverage, right?
In what universe are US insurance companies going to allow this aspect to be legislated? That’s what I don’t get about the “compromise”. How are costs to be controlled if the insurance companies have to cover everyone? The rates must go up. I mean, they are not going to stop making profits. I don’t see how the insurance companies can be reformed in any meaningful way that addresses costs. And controlling costs is as important as universal coverage IMO.
I don’t see a middle way.
matoko_chan
Darius, any healthcare reform will be bad for the GOP.
And they know it.
The conservos lost power in great britain for 10 years after a national healthcare bill passed.
Membah this?
“Fourteen years later, we find ourselves at the same point in the political debate, with a Democratic president-elect promising to deliver some variety of health-care reform. And, like a cuckoo emerging from a clock, Mr. Kristol’s old refrain is promptly taken up by a new chorus. “Blocking Obama’s Health Plan Is Key to the GOP’s Survival,” proclaims the headline of a November blog post by Michael F. Cannon, the libertarian Cato Institute’s director of Health Policy Studies. His argument, stitched together from other blog posts, is pretty much the same as Mr. Kristol’s in 1993. Any kind of national medical program would be so powerfully attractive to working-class voters that it would shift the tectonic plates of the nation’s politics. Therefore, such a program must be stopped.
Liberal that I am, I support health-care reform on its merits alone. My liberal blood boils, for example, when I read that half of the personal bankruptcies in this country are brought on, in part, by medical expenses. And my liberal soul is soothed to find that an enormous majority of my fellow citizens agree, in general terms, with my views on this subject.
But it pleases me even more to think that the conservatives’ nightmare of permanent defeat might come true simply if Democrats do the right thing. No, health-care reform isn’t as strategically diabolical as, say, the K Street Project. It involves only the most straightforward politics: good government stepping in to heal an ancient, festering wound. But if by doing this Barack Obama also happens to nullify decades of conservative propaganda, so much the better for all of us.”
Be chilly Darius.
We are going to win just by doing the right thing.
Elie
I think we may be, Jenniebee, but not calling it ‘expansion of Medicare”. Stealth. We drop term “public option” and the crazy right thinks they killed it… so be it — they killed the TERM but not the thing itself…
matoko_chan
also……
EthylEster
@jenniebee: Somebody explain why we aren’t going this route?
My 2 cents.
Medicare, as currently configured, is not sustainable for the elderly and expanding it will hasten the arrival of the “It’s eating our economy and killing our productivity” moment.
Which is OK by me. Let’s get started NOW on changing medicare so that less than X% is spent in the last Y months of life (where X is double digit number and Y is a single digit number). But that’s going to trigger another round of fear-mongering. And our spineless representatives (that is, ALL elected folks who are supposed to serve in the public interest) are obviously not up to making hard decisions, which medicare reform is going to require.
So basically we’re screwed. That’s what I keep getting back to… ;=)
EthylEster
@matoko_chan: I really don’t like an argument that is based on “This policy is good because it will cost the repubs votes”. That’s great for political parties but doesn’t help people. And what good does it do to elect dems if they are blue dog dems? 30% of the people in this country think Palin is presidential material, aka they are unreachable. Do you think that if the senate was 70-30, that would be sufficient? I wonder.
Wile E. Quixote
I think that we need to get rid of Harry Reid in 2010. Fund a primary challenger and if that fails fund his Republican opponent and say “Look, Harry Reid is a spineless, brainless incompetent wimp who never should have gotten the majority leader position and is way out of his depth. We need someone who isn’t a dipshit in this job and losing his seat to a Republican is better than letting this incompetent moron continue bumbling on.”
We should also work at taking out Johnny Isakson. Spread rumors that his speech about end-of-life care was an olive branch to the Obama administration and that he is going to switch parties to the Democrats right after the election. Get some wingnuts, jack them up on stupid, tell them that Johnny is going to stab them in the balls and bus them to a few of his events to help spread the meme and get some media coverage. When Isakson denies that he’ll be switching parties it will just add more fuel to the fire.
Elie
EthylEster:
I think Medicare has suffered much of the same fear mongering but that said, its solidly run with administrative costs a lean 3%. That care costs a lot at the end of life is no different than the inflation of costs all along the life span in regular insurance. Reason: our health care costs are hugely inflated by the need to generate wealth for providers and insurance companies (and other hanger ons). I always bridle at the argument that people require too many services rather than what they have access to is inflated in price and is designed to create more services rather than actually meet peoples’ needs. That is NOT the fault of the beneficiary who so called wants too many services or too many at the end of life. Its ALL inflated and way too many services that don’t work. (this is a whole other issue from giving everyone care — more about how to assure quality and effectiveness)…
I say we expand Medicare but I realize that its going to be ticklish — as implementing any government payer option would be necessarily. I think our side has to come up with finessing the terminology without changing the thing itself…
Anyway — as our discussion illustrates — this is pretty tough stuff and very complex — not just push through legislation and sign it — Done — like some on this thread have insisted…
4tehlulz
@Wile E. Quixote: Are you now, or have you ever been, Richard Nixon?
matoko_chan
Ethyl….you missed the part where I said we are going to win just for doing the right thing….the conservatives are the bad guys.
;)
I can’t wait for immigration reform tho……
It will be splendid to see the GOP troglodytes courting hispanic voters with Rage-Grampaw chewing on their ass.
Sleeper
@DougJ:
Good leadership involves knowing when to compromise and when not to. I think that’s the distinction here. Obama seems to prefer compromise as his first option. If he caves on this, the Republicans will expect him to cave henceforth, and if he doesn’t, they’ll decry his new partisanship and get him to buckle eventually.
Alan in SF
A bill that prohibits negotiating for lower drug costs, sends taxpayer money to subsidize private insurers profits/bonuses/CEO salaries/jets, locks in and expands the absurdly wasteful employer-based system, and doesn’t cover abortions is worse than no bill at all.
Sleeper
@cleek:
Do you mean the guy who signed DOMA and NAFTA, gutted welfare, signed the repeal of Glass-Steagall, and still was pilloried as a murderer and rapist and was impeached by the Republicans? That guy.
Bill Clinton survived. Any progressive agenda he might have had certainly did not.
Sleeper
@maye:
But sometimes, the good is just not good enough.
We will get one shot at this, and whatever passes will be locked in for a generation or more. The idea that we can go back in a couple years and try a public option if that fails now is simply wrong. Losing the public option is going too far, and any bill lacking that ought to be killed by the progressive Dems.
Leelee for Obama
@EthylEster: What is the motivation for the private insurers in Switzerland? It’s got to make them money or else what are they doing in the business?
Our problem here has always been that there are profits involved. However, is that it, or is it a matter of getting the health care insurers out of the stock market? I’m really asking, not snarking, so any answers are welcome.
lawnorder
The worst part of this article is that I am starting to agree with the writer…
Obama fighting for his presidency, not reform
By: Chris Stirewalt
Political Editor
August 17, 2009
http://www.washingtonexaminer.com/politics/Obama-fighting-for-his-presidency_-not-reform-8114039-53354747.html
matoko_chan
Sleeper, why does the camel’s nose work for creeping socialism but not for healthcare reform?
ans. it does work.
it can be incremental.
Elie
“We will get one shot at this, and whatever passes will be locked in for a generation or more. The idea that we can go back in a couple years and try a public option if that fails now is simply wrong. Losing the public option is going too far, and any bill lacking that ought to be killed by the progressive Dems.”
Sleeper
You are just wrong. We have to start something but we don’t have “just one shot” as you term it. You don’t know what you are talking about. Your ignorance then just fans the flames of the others who don’t know indeed how a big bill becomes law. Go read up on how Medicare came into being…pretty hard stuff.
Its big, VERY big. Lots of steps, lots of complexity not only about setting up but also the implementation (ya know, at the end, something has to happen, right?)
People like you are very hurtful. You don’t know what you are talking about and you spread a lot of emotional misinformation…There is no one way that health care reform happens…its a political and technical process…its a campaign…multiple initiatives and decisions coalescing into a bill (which we do not currently have, but to your mind exists and was defeated I guess). its a war also with strategic and tactical goals. Not every general knows what is happening on every front and I know YOU don’t for sure.
You don’t know what you think you know. Like everyone else, of course, you are entitled to an opinion — but opinion is not necessarily fact.
EthylEster
@Leelee for Obama: My understanding is that they can make money on the extras. So everyone is mandated to carry basic coverage, even rich people. However, you can buy extras, a nicer room, etc.
However, Awesome0 in the next thread is dumping pretty hard on the basic coverage so who knows? I have Swiss friends visiting me in October and we will be talking a lot about this.
Comrade Luke
@hoipolloi:
You make it sound like that’s an insignificant number of people. It’s not, and it’s growing every day.
Flobear
First we heard that single payer would not fly with the Republicans; now its the public option. Isn’t it obvious that the Republicans are going to fight against any “reform” at all. Democrats are now in the majority – why don’t they act like it and pass a bill with health care available to everyone.
Jim
No public option, then kill the whole bill and let the country stew in the current mess.
Sleeper
@Elie:
That must be why in the 44 years since it was passed, Medicare has been slowly and methodically expanded to cover more and more categories of Americans, until today almost everyone is covered. Oh, it hasn’t? But how can that be? You spoke of incremental expansion so casually and so assuredly.
The public option already IS incrementalism, for Christ’s sake. The whole package is fairly weak tea set up to largely benefit the same private insurers who’ve caused this mess. But a narrow public option that succeeds gives us the opening for later expansion, and it’s the best we can get right now…and we CAN still get it, if we fight, if we scream and yell and push back against every attempt to drop it. And part of that means you have to draw a line in the sand over some things. You can’t put EVERYTHING on the table, you can’t let them whittle this down to nothing. The moment Democrats back off of the public option, the Republicans will go after co-ops. And when people like you tut-tut us for being unreasonable about THAT, and say we should cave on that as well, they’ll move on to their next target. If you think otherwise, then you’re being foolish.
Now, I would never presume to tell you, a perfect stranger, that you are being “very hurtful.” Particularly not over blog comments that mean nothing. But if I were, I might say that people who scream and yell that we should just take what little the Republicans will let us take, with a looming health care crisis, and a Democratic president, and a Democratic Congress with huge majorities, who fail to see this as literally a once-in-a-lifetime opportunity and want to nickel-and-dime it, are the hurtful ones. But, of course, I’m not the kind of person who says things like that.
Of Bugs and Books
This has at least been alluded to by some, and maybe ignored by others, but if health care is at 17% and going up, not down, no bill at all will not be a win for any group of “deciders”, and certainly not for a political party that votes no right down the line. The 17% is projected to become 18%, then 19%, etc. Has the opposition offered anything more than 3 pages of circles and arrows, or “cut taxes”, or “deregulate” or Grassley’s (literally) cartoons? It may be much better to be the party that tried, but failed, than the party ignoring / encouraging a problem that is not going to stay static. Likewise, if the regulations, etc., get twisted to benefit the insurance companies, again, the cost per person goes up and the pressure for change increases. Whatever the strawman arguments now, the real problem will become obvious to more (but never all) people. And I suspect the systems in countries with single payer or single provider will be more easily defended now from privatisation, after they’ve seen the corruption and absurdity put on display here in the U.S. Maybe many lives will be saved in any event, they’ll just be in other countries.