This is kind of interesting:
What’s all the fuss about? After all the noise over Democrats’ push for a government insurance plan to compete with private carriers, coverage numbers are finally in: Two percent.
That’s the estimated share of Americans younger than 65 who’d sign up for the public option plan under the health care bill that Speaker Nancy Pelosi, D-Calif., is steering toward House approval.
The underwhelming statistic is raising questions about whether the government plan will be the iron-fisted competitor that private insurers warn will shut them down or a niche operator that becomes a haven for patients with health insurance horror stories.
Some experts are wondering if lawmakers have wasted too much time arguing about the public plan, giving short shrift to basics such as ensuring that new coverage will be affordable.
I was actually thinking about this on the flight home yesterday- when did I first hear about the public option? I couldn’t decide, but I am thinking it had to be sometime this spring or this summer. I certainly know no one was using the phrase “the public option” during the campaign last year, so for me, at least, it was a recent development.
At any rate, it is kind of amusing that the public option, a part of the debate that was, to me, at least, a new part of the debate very recently, has become the bitterest battle, and when you look at it, it really is kind of not that big of a deal. We already offer public insurance for many things, but for some reason or another, this has been the line in the sand for the moderates. Just weird.
Or maybe the public option has been there all along and I just wasn’t paying attention.
aimai
I don’t get the confusion. The “public option” is just the obvious settlement point for the “left”–such as we are–who really wanted a total overhaul of the entire health care system towards something like Single Payer. We weren’t allowed to ask for that so we ended up asking for something like a serious public option to allow patients and consumers a real choice and to drive down the cost of insurance for the rest of the country by scaring the insurance companies.
Its a “line in the sand d” for so called moderates because, if properly implemented, it would drive the insurance compaines right out of business. The fact that its not going to be properly implemented is the result of the “moderate” attacks which have all been incoherent and false but have worked nonethless. Exhibit A) has been the continued “Moderate” insistence that they are against it because it would raise the deficit when the more robust the option the less it would cost the government. When lies are allowed to drive out truth the end result looks absurd, but there you are.
aimai
Comrade Jake
It seems clear to me that there’s a pretty large chasm between what many would consider a robust public option and the sausage that is likely to come out of Congress. One of these has teeth, whereas the other will cover a very small number of people and likely have premiums that are more expensive than private plans.
The most telling point is that the private health insurance sector is fighting the PO no matter what it looks like. They clearly see it as an opening salvo in what will be a long haul towards moving people away from private insurance. I think they’re probably correct in that assessment, which makes the pressure from the left for there to be any sort of PO in the bill all the more important.
Davis X. Machina
It must be, because I can’t see why they would spend tens of millions lobbying against a bill that’s going to use the coercive tools of the state — a mandate — to drive customers to their door.
Yeah they’ll lose the ability to pull shit like recission, etc, and the various caps and bans will cut into their per-unit profit, but the Federal government’s basically legislated that they can make it up in volume.
J.W. Hamner
Both sides… moderates against it and progressives for it… have been thinking of “the public option” as Trojan horse single payer, even though people like Ezra Klein have pointed out repeatedly what a non-factor it really is.
But why the hell not, I guess… mountains out of molehills is politics… and this way, both sides have the opportunity to move the goal posts and say “it wasn’t really that big of a deal anyway” if they lose.
And who knows? Maybe it really will be the path to single payer.
Balconesfault
How do you ensure that future care will be affordable?
I mean – it is what it is. The dirty secret of the insurance industry is … the more expensive medicine is in the US, the more money they will make. Period. Everyone up and down the insurance food chain, from the agents writing the policies, to the exec compensation packages, to the shareholder profits, are tied to the amount of dollars are flowing through the system.
More dollars, more commissions, bonuses, and dividends.
No government competition – no incentive to act as part of the solution to holding down costs.
valdivia
I may be wrong but I am pretty sure the person who came up with it as full conceptual approach to health care is Jacob Hacker (formerly of Yale now out west I think).
Here is his pitch.
freelancer
On Friday, Tim F. also made an ominous observation about the dangers a weak PO poses to voter acceptance of the successes or failures of HCR in general. It bears repeating:
It’s almost as if lawmakers have forgotten the prime motivating force of a capitalist economic system.
/sarcastic naivete.
Comrade Jake
Was John Edwards the guy who introduced the idea of a robust public option into the Dem. primaries? I’ve read this elsewhere, but never had the chance to look into it in detail.
Corner Stone
@aimai:
I thought being confused was Cole’s stock in trade?
The public option was the sellout compromise to the “left” that they have been bait-n-switching with for months now. It has lived and died through several iterations, each time coming through weaker and more irrelevant. And as aimai points out, even if some form of Public Option passes now it will be so ineffective as to be virtually a non-entity in the overall HCR scheme.
This is what the people owned by Aetna et al wanted, along with being a huge win for Republicans. The Public Option will be passed, it will cover far fewer people than anyone ever indicated, it will add to the deficit, it won’t even tickle health insurers (in fact they stand to have a huge windfall), and Republicans will scream to the Heavens about how it has added to the burden of the downtrodden middle class.
And since no one will actually see any difference in their care or coverage, who will they believe?
The only way to reduce costs (and FSM how I fucking hate that HCR has been reduced by *both* sides to being about COSTS) was volume. That is not going to be allowed to happen.
jwb
@Comrade Jake: “and the sausage that is likely to come out of Congress…”
Well, it really depends on whether the sausage is the plastic shit that is generally sold off as hot dogs in this country or something like a good bratwurst with kraut, spicy mustard, on a nice hearty roll. At this point, we just don’t know what Congress and the White House are going to come up with. Yes, it’s frustrating not knowing what we’re going to have for dinner, so to speak, (or even whether that dinner will ultimately be palatable—or even edible) but really I’m not going to judge the sausage until they deliver the meal.
Anonymous
Something like the public option was a central piece of John Edwards’ health care proposal. I believe it was intentionally meant as a path to single payer.
I don’t see how you control insurance companies without it, unless you resort to heavy regulation ala Switzerland.
Kryptik
Slightly OT:
Lieberhack, on Face The Nation, says not having any bill would be preferable to the health care bill we have now.
Dustin
@ 7 freelancer
Don’t forget: while simultaneously forcing the healthiest clients, by threat of legal sanction, to keep buying private insurance because either A) they work for a large company, or B) have insurance offered through work.
Option my ass.
Splitting Image
@Comrade Jake:
Very possible. The main thing I remember from that part of the primaries was Obama being pounded by the other two candidates for not having a mandate in his plan. I don’t recall any of the three pushing a single-payer model even then.
Just Some Fuckhead
I’m standing by my original prediction that we’re gonna get a shitty bill that will make us wish nothing had been done. And if that isn’t actually the case, the Republican-Drudge-MSM pipeline will certainly have us all believing it in no time.
jwb
@Just Some Fuckhead: And if that’s the case, the Dems will get the heads handed to them on platters in 2010—as they should; but God help us and the world if that happens.
John Cole
I’m curious what some of you seem to think I am “confused” about. All I said was I couldn’t remember the first time I heard about the public option and I thought it was odd that it became the line in the sand when I couldn’t remember hearing about it before a few months back.
FWIW- I thought the biggest battle would have been over pre-existing conditions or something like that.
ruemara
I’m not even sure if it’s this ineffective because Pelosi went with the less progressive version or if this is the progressive version. The last time I heard the score for that, it was supposed to cover 36 million. wtf happened?
James
Even if USA Today’s projections are accurate, and I have no reason to believe they are, that’s still almost 6 million people who can’t get health insurance now. Even USA Today notes that these would most likely be people in the poorest of health who have been dropped or denied private health insurance, but most likely with enough income to disqualify them from medicaid. Six million people isn’t as fucking trivial as USA Today seems to think.
James
What @Just Some Fuckhead said.
Just Some Fuckhead
@John Cole:
Hell, insurance companies already know how they’re gonna get around those pesky requirements.
ruemara
BTW, if you do support any sort of public option or single payer, contact Ms. Nancy and remind her to add Kucinich’s single payer opt in for states,”Managers Amendment” to H.R. 3962.
Speaker Nancy Pelosi: Washington, DC, office (202) 225-4965; San Francisco office (415) 556-4862
We might yet be able to get a good state by state single payer despite congressional sausage making.
Comrade Jake
@Just Some Fuckhead:
I don’t think any of us should be surprised if a shit bill is the end result. Such is the state of the US Congress.
However, there has been a fairly dramatic shift in public perception of health care that I’m not sure isn’t a heckofa lot more important: that government should play a significant role when it comes to citizens and health insurance. Small consolation to many of us, for sure, but I don’t think we should discount that shift completely.
I think there is a strong argument that can be made along these same lines that if we’re not going to have a good PO, it should probably be scrapped completely. A PO that sucks and will be a target for ridicule might just reverse this shift in public perception. Blaming Joe Lieberman for the PO’s downfall probably has a bigger upside.
Brien Jackson
Not that I don’t like single payer in theory, but can someone explain to me why you’re supposed to get credit for acknowledging reality in governing now?
Brien Jackson
@Corner Stone:
Well, no, quite a few people have been saying this for some time now. But instead of listenting, you decided to call us moderatesquishthirdwayDLCestablishmentlovinghippiepunching sell outs.
Robertdsc-iphone
@ruemara:
No amendments will be allowed to the House bill because a Dem Blue Dog has an abortion restriction amendment ready to go that would kill the bill for loss of pro-choice votes.
Had Pelosi chosen the Medicare-based PO & the Senate Finance bill added on Wyden’s Free Choice amendment (which Baucus killed by his own hand), then the PO would have had a chance to succeed. As it stands now, though, it’s not going to have the same impact as it could have.
Of course, people will be getting access to health care with it, but I suppose that’s not an issue worth mentioning, I guess.
kommrade reproductive vigor
Not that I don’t trust USA2day’s analysis [snerk], but could anyone tell where exactly do the got this number? As usual, there’s no link to the actual report so I’m assuming they’re referring to this Oct 30 letter to Max B.
Does anyone know?
ruemara
@Robertdsc-iphone:
every time blue dog dem legislates, jesus cries. maybe when the bills combine.
eemom
I wish people would stop saying that whatever we’re going to get is worth than nothing at all. That is a steaming pile of bullshit argument because NOTHING could be worse than what exists now.
Making it so the insurers can’t discriminate based on pre-existing conditions, can’t dump people when they get sick, and can’t impose lifetime caps, is a HUGE step forward and will help a lot of people.
I’d like it to be better, but this all or nothing hysteria attitude is really getting us nowhere.
eemom
damn, no edit button. I meant to say worse than nothing at all.
Andy K
@Corner Stone:
No, it was part of Obama’s Blueprint for Change over a year ago, though it wasn/t called the public option at the time:
[emphasis added]
4tehlulz
>>sometime this spring or this summer
That’s what I remember too, first as a litmus test against Blue Dogs by Kossacks, then by
Blue Crossthe teabaggers in their crusade against the muslin death panels.Andy K
[Or not added….D’OH!]
JHF
KILL THE BILL! The info is out there if you look for it, and it will enrage anyone with a conscience. Substantial rate increases for private insurers are cooked in, anyone not insured decently now is still fucked, and the few real “reforms” are essentially meaningless. Rates are already shooting up. WellPoint is quadrupling rates for healthy young adults in some states, for example, and people will have nowhere to turn.
Passing this bill will only knock true reform off the table for decades. “Health care reform? We DID that!” Everyone — EVERYONE — will pay a lot more, get less in return, and have absolutely no recourse. I’m pulling for the crazies on this one, absolutely. Go Coburn! Go teabaggers! Go, go, go!!!
This is the most tragic, cynical robbery and deception in my lifetime of watching politics. Our political system is beyond broken, it’s not even a “system.” We’re all being played. If you’re complacent, you’re complicit.
JHF
The real info and action is on Twitter, BTW, not the progressive blogosphere, which seems hopelessly fixated on “winning” vs. the wingnut crazies without understanding that we’re being duped….
jwb
@JHF: Or: this is the scare line of the insurance industry trying to ensure no reform…
sparky
@eemom: not true. a worse than useless public option with skimming by insurers is worse. screaming just do something is not always the best answer. and i say this as a person who does not have group insurance.
Armando
@John Cole:
Do you infer anything from the fact that insurance companies are not balking at that, or the exchange or the mandate?
Do you infer anything from the fact that the public option s the battle they have chosen?
Corner Stone
@Brien Jackson: I don’t understand what you are arguing here?
Cain
Re-posting Frank Rich’s column or in other words a summary of what we discussed here at the big BJ:
Here
cain
freelancer
@James:
Those 2% are known as “The Expendables”.
Cain
crap sorry guys last message was o/t.
Cain
@Robertdsc-iphone:
Yeah, fuck you, Max Baucus. I wanted that, it would have made Oregon put out a stronger heatlh care reform setup which I for one would love and I suspect a lot of small businesses would as well.
cain
Corner Stone
@Andy K: From that same PDF you cite –
“My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don’t have health insurance, you will have it after
this plan becomes law.”
So I find that interesting as well considering where Obama is or isn’t in the current debate.
monkeyboy
For info on what the USA article is based on , see CBO: Public Option To Attract Only 6 Million Enrollees & Doesn’t Offer Lower Premiums from thinkprogress.
Brachiator
@Corner Stone:
You got it. The USA Today article makes pretty clear that the public option not only will be pitifully weak, but that some provisions won’t even kick in until 2013. Someone appears to have built in a 2012 presidential election poison pill into the legislation. And between now and then, the insurance companies will snipe at the public plan, pushing patients that they don’t want onto it and stealing the healthier patients, until the public plan collapses under its own weight.
The bill, if passed, may become a political nightmare. If people who do not have health insurance cannot get it so after the bill has been passed, no amount of speechifying can possibly turn a betrayal into a promise of better days. Imagine if the Voting Rights bill were passed, but its provisions would not kick in until 5 years after it was signed into law.
The Democrats have decided that getting “something” in place was more important than actually reforming health care. They can sell this as playing a long-term strategy game all they want, but it can’t give them cover for their stupidity and cowardice.
Corner Stone
@Andy K: And if I had edit i would’ve added –
Plus, the more important part of what I said was the whole “bait-n-switch” part of the PO.
No one can deny that it has melted down to something unrecognizable but yet is still being fought over for some reason.
freelancer
@Cain:
It’s okay, Rich’s column today is pretty decent.
eemom
@sparky:
I wasn’t screaming just do something. I was pointing out that some of the things being done have value, and you haven’t said anything substantive to refute that — just “screamed” back about “useless” and “worse.”
mcc
The public option can be critically important from an activists’ perspective even if it doesn’t cover that many people. For one thing, the public option has the potential to grow into something more important later; once we have it established that the government stepping into the insurance space as a player is normal, a later Congress might use the government’s presence there as a tool to solve problems. For another thing, it is not so much important how many get covered by the program but who gets covered. The reason we want health care reform is to help those most in need; this entire reform is carefully tailored to work around the fact that, as we keep hearing, those who have coverage already are mostly happy with it. The public option is great in that sense because it functions as an “insurer of last resort”– an insurer which gives some minimally acceptable, affordable standard of care to those who the market has otherwise totally failed. I feel that this is especially critical given the presence of a mandate to buy health insurance in the bill. I cannot find it acceptable that the government would institute a law requiring me to buy insurance without making that personal guarantee that there will be some minimally acceptable plan available to purchase. Otherwise I cannot help but expect that insurance companies will feel free to become even more cutthroat, despite the new regulations designed to prevent this, in denying care to those in the worst situations– as those persons no longer even have the recourse of dropping their insurance if it is not paying their bills. (If they removed the mandate, I for one would say fine, maybe we can drop the public option too. But that’s not going to happen.)
Along these lines, I think this article is kind of silly in trying to belittle something by saying it would only cover “two percent”. That “two percent” is a million people. Again, the reform is designed for a minority of the population, the group who the current system does not serve– the entire point of this health care reform debate in the first place is to do something about the 20 percent of americans under 65 who are uninsured. Because we’re apparently not interested in actually adopting a universal (single-payer) health care plan, the reform necessarily must consist of a number of different tactics designed to shave numbers off of that twenty percent. The mandate will shave off a certain number, the subsidies will shave off a certain number, the right to buy coverage will shave off a certain number, the public option will shave off a certain number. If the public option covers 2 percent of the population, that’s 10 percent of the number we are trying to reach.
On a final note, we must remember the reason it is as low as two percent: Because that was what we compromised down to with the conservadems. The public option, in its final compromised form, is legally only available to people under a certain specific set of circumstances (people who can participate in the exchange); and because the Blue Dogs forced Pelosi to agree to a negotiated-rates public option vs a medicare-plus-five public option, if you look at the CBO scores you will find the public option on average is more expensive than a private plan. Because to the average consumer the public option will be more expensive, the public option we’re getting will appeal only to a limited number of people (I assume, to only those insurance buyers who are not average). Had we gotten the form of the public option the CPC wanted, the public option would be cheaper and surely many more people would be participating in it.
Comrade Jake
@Brachiator:
The Dems have designed a lot of this stuff to phase in late from the very beginning. Whenever they’ve been asked about this, they’ve always said that it will take several years to get everything correct after the legislation is passed, which makes zero sense to me.
I recall Howard Dean being asked about the phase-in during an interview with NPR, and he thought it was brain-dead because it will allow the GOP to grossly mischaracterize it in the run-up to the elections. That seems about right to me.
Dustin
You want to know how a PO can be worse than no change? Easy. No access to the “public” option + mandatory coverage + ineffective price regulation (nearly a given at this point) + insufficient subsidies (likely to appease fiscal “moderates”) = people being forced to decide if risking fines/jail is worth more than putting enough food on the table or paying their utility bill this month. This is especially likely if the insurers aren’t allowed to kick people to the curb anymore to keep their cushy profit margins in place. That’s how you fucking get worse than our current system.
Think it can’t happen? I wish I had your confidence, but the Frankenstein bullshit that the Senate’s been cobbling together doesn’t exactly make me think it’s out of the question.
Just Some Fuckhead
Discrimination By Insurers Likely Even With Reform, Experts Say
John Cole
@Armando: Sure, it is obvious they have figured out that the mandate will drive enough customers to them that they can handle pre-existing conditions.
There seems to be a tone here that I am against the public option. Remember, for at least the past five years I’ve been stating that I think single payer is an inevitability at some point in my lifetime. It is just a matter of how much worse we make things and how much we ending screwing the treasury for with transfer payments to the insurance and medical communities. Personally, I would nationalize the whole damned thing ala the UK and the first thing I would do is change the way we train doctors.
mcc
No access to the “public” option + mandatory coverage
If you’re in a situation for the personal mandate to bite you, then you have access to the public option. The exchanges (from which the public option is available) are as I understand available to anyone who does not already have coverage from their employer. A bigger concern here might be exactly how much the conservadems raised the price of an an individual plan by killing medicare-plus-5 and whether they have succeeded in pricing the public option out of people’s reach.
Armando
@John Cole:
I do not think you are against it. I think your post is pretty clear – you do not have a strong opinion on it.
You know, I spent 2008 like that. Probably shouldn’t have.
Corner Stone
@mcc:
Your entire post is contradicted by the quote from you I post above.
For the PO to cover 2% is a disaster. Disaster.
How do you build in cost controls? With population. With eligibility. With volume.
To have 2% (and I realize this is real people we are discussing) in the pool is the worst possible outcome. HCR will be discredited for another 15 years or more if this stands.
Corner Stone
Reebok may have just aired the most sexist commercial not associated with a beer company.
And I think I’m in love.
Corner Stone
F@#$CK*&%NG TEXANS!!
sparky
@eemom: well, actually, neither of us knows what the final draft will look like so we are both equally speculating. all i said was that it was certainly possible that the bill as final product could indeed be worse than nothing. do i know that’s so? no. but you can’t be certain it’s going to be better, either, and that’s all i was disputing.
Edwin
I want to know what percentage of people who do not have access to group health insurance are affected by the public option. That’s the important number, because if you don’t have employer-provided insurance today you’re pretty well screwed, and without a public option will probably continue to be screwed.
“Two percent” is as misleading as saying that only .5 percent are subject to rescission. Doesn’t sound like much until you consider that about half of everyone who has a catastrophic illness under an individual policy could lose their insurance.
Brachiator
@mcc:
I don’t think that anyone should give a rat’s ass about an “activists’ perspective.” The point of health care reform is to improve the quality and delivery of health care in this country. If it fails to deliver, it doesn’t matter how many activists might be able to dance on the head of their narrow ideological pin.
.
This is absolute rubbish. The point is to get universal health care, not to try to divine who is most worthy to get health care.
Not entirely true, and a problem that points out a central weakness of the Congressional plan. The health care plan would force low income people to pay for health care, even with subsidies. But the insurer of last resort is the hospital emergency room, which must provide care without regard to ability to pay. And some people who can get it for free will balk at having to pay anything. You see evidence of this with the Massachusetts system, which is running into trouble meeting costs and getting people to enroll in its equivalent of a public option.
Activists are stuck on the totally false idea that universal health care means single payer because they have a fetish for replacing the insurance companies with total government funding of health care. This has been as much an obstacle to reform as anything coming from the GOP.
Yep. In the absence of a meaningful public option, there is really no reason for this health care bill to become law.
sparky
@John Cole: interesting conversation you two are having here.
i agree WRT to the UK. but i disagree with you about the heavy outlay insureds. they will all be pushed into the public pool. we already have models for it: it’s the risky driver pool in states like NJ, and the no coverage pool for windstorm in Florida (Citizens). the net result will be a mammoth skim and a further subsidy to the insurers, who can then funnel that money to GS et al to reinflate our Hindenburg economy.
mcc
To have 2% (and I realize this is real people we are discussing) in the pool is the worst possible outcome. HCR will be discredited for another 15 years or more if this stands.
Okay, well then either start harrassing the CPC members quick (the CPC originally pledged to vote against a bill unless it used medicare+5 rates, but the most recent letter from Grijalva implies the CPC will negotiate that away in exchange for an amendment vote and some changes to the bill) or have fun holding your Palin 2012 sign then, because this is the House version we’re talking about right now, the most progressive possible legislation at this point in time. If you don’t like the plan the House goes with then the only other options are a Senate-sponsored bill without a public option at all (but still with a mandate) or nothing at all (and, as history shows from the last time we tried this, if this bill fails then HCR will be neglected as a third rail for 15 years anyway).
I think as long as some form of the public option is allowed to go into practice in this bill, it will be relatively easy to patch the public option to the point of acceptability later, at least it would be much easier to do this than it would be to pass a new HCR bill creating a public option where none exists.
mcc
First paragraph of that last post was intended to be a blockquote.
The Raven
It’s like voting. We keep hearing how our votes don’t matter. But if that is so, why is there so much effort made to keep us from voting? Krugman, a while back, wrote:
So the public option will make a difference. That seems to be why it is being fought so hard.
leo
@J.W. Hamner:
Exactly. And you know it by who’s for and against it.
It’s not the best outcome we could imagine but it’s the best outcome we’re likely to get. And it’s a start.
Ron Beasley
There would be no confusion if you would only realize we live in a Corporatocracy. The politicians will do everything they can to make it look like they are doing something for “the people” without pissing off too many of their oligarch sugar daddies. The insurance companies were only part of the problem – probably not even the biggest – but they were an easy target. There won’t be any “real” reform because the big players like things just the way they are and their servants in congress won’t really go against them.
sparky
@mcc: i have to disagree with you. much of your argument seems to hang on the hope that whatever is wrong with this bill can be fixed later. that is a bad assumption, for two reasons, i think.
1. this bill will create its own path dependencies, special interests, etc. those interests will be crafted to maximize returns from the bill as enacted not some future version. therefore, entrenchment will begin forthwith. example: imagine the difficulty in changing Bush’s prescription plan now.
2. a small public option will (i think) basically become the dumping ground for the insurers. i say this because this is a model they are already familiar with (see my other comment re autos and hurricanes) and it is easy to implement. the history is an old one–skim the cream give the government the crap. the result is the government gets stuck with a huge bill, the insurers make even more money and the public option becomes known as a huge sinkhole when the administrators have to come back to Congress for additional funding.
Brachiator
@aimai:
Single payer is a fetish of those on the left who care more about driving insurance companies out of health care than they care about providing meaningful health care reform.
It’s ironic that the American left couldn’t be bothered to look at what worked in other countries’ universal health care systems and tried to use this to keep Congress honest. They couldn’t even hold fast for a robust public option.
The result is this compromise crap that provides a soft target for the insurance companies to attack for the next 5 years, and to dismantle entirely if they can get Republicans back into a majority and the White House.
@Comrade Jake:
The Democrats end up hoist on their own petards on this one. You can’t say that health care reform is necessary to getting the economy rolling again, and also say that major provisions of your health plan won’t even kick in until 2013 or later.
mcc
Okay, then let me give you a reason to care: If the public option is not in the bill, the activists will defeat it. If some compromised, watered down, undesirable version of the public option is in the final bill, it will be possible to shout down the angry yelly blog people and get HCR passed. If the public option goes away, this is no longer possible, the yelly activists will be able to convince the leftmost part of the CPC to vote against the bill, the House democratic caucus splits, and no bill passes.
I’m sure that’s what democrats would claim to want, yes. But this is not, never has been, and even if the CPC got to write the final version never would be a universal health care bill. The current HCR plan is not trying to be a universal health care bill. Look at the CBO score! (I’m uncertain what it means this is “preliminary”.) What this bill does is move us from 80% coverage to 95% coverage over like ten years. Every other version of the current bill, including the Baucus bill and one with a super-nice robust public plan, would only bump that final number up or down a percent or two to some other number which is not 100%.
We abandoned the idea of universal health care sometime in 2007, when Clinton, Edwards and Obama all simultaneously proposed slightly different variants on the current health care plan and no major democratic candidate chose a plan which could in some possible scenario provide universal coverage. I think that was a fair trade-off because I have serious doubts a universal plan could have passed at all, but given we did make that trade-off it is silly to start talking about universal health care now.
Okay. Show me a proposal for a universal health care plan without single payer, and I’ll drop this idea.
Corner Stone
@Brachiator:
I disagree with both your statement and your conclusion here.
There is nothing “fetish” about the best possible health care outcome. Everybody in, nobody out.
And if health insurers go the way of the dinosaur then so be it. All they do is provide a big pool and skim from that. Like Govt couldn’t do that in a more efficient manner? Like any number of private concerns couldn’t do that if the anti-trust exemption wasn’t there?
The conclusion is fals because it leans on a false assumption – the “left” did try everything they could to pressure Congress. They just lost to the special interests. I do not believe that the weak PO outcome can be tied to an inattentiveness by the “left”. It seems far more likely to me the result is due to a Congress that cares far too much about it’s ad-buying ability in the next election, and the lucrative employment after they leave public office.
freelancer
@Brachiator:
This.
The Democrats are more splintered in their presentation and agenda than the last girl I dated.
Brachiator
@Corner Stone:
I am not sure what your point is.
Does every industrialized country with universal health care depend upon a single payer system?
No.
Senyordave
It would nice to think in some parallel universe Joe Lieberman would be seriously ill with no insurance.
Never really could imagine having this level of contempt for a politician as I do for Lieberman. A true crawling piece of shit.
maye
perhaps the best thing that could happen is for Lieberman to get his wish, the bill fails in the Senate, and Rahm, et. al., are forced to put it through budget reconciliation.
It could then be very simple: Everyone not eligible for employer based insurance can buy Medicare.
Cerberus
@Brachiator:
No, they have universal national health care, but apparently that was too much for conservative democrats, so there was a big compromise right up front and all of us nasty evil liberal filthy hippie types were asked to get on board.
But that wasn’t enough for conservative democrats, so now they want to take away the small stream of piss we have left and replace it with something obscene.
And this is what we’ve got. We can fight for tiny small dent into how we look at health care in this country, getting it closer to a basic right or we can “lose” or pass something that doesn’t help and only hurts. Either way, things are ”off the table” for a decade same as if “we win”.
So, finally, it brings me great pleasure to shout this at some moderate dem fetishist whining about the mean old lefties, but Shut the fuck up and trust the president you whiny piece of shit.
Seriously, none of the universal coverage countries let the private insurers piss on us like our country does. There’s a reason we suck and it’s not “too much mean old government”.
Oh yeah, and “expensive” people who aren’t being treated? Weren’t going to be treated. You don’t get care in this country if you get really sick. You get kicked out. I’ll take any cost to take care of those people because health care is a mother fucking human right and it’s damn time we learned that instead of whining about money when money never seems to get brought up to how much we waste on military and war.
Oi.
Davis X. Machina
PNHP, a pro-single payer organization, lists them here.
mcc
I’m really curious what plan the people bashing the “compromised” public option would have liked to have seen. Most of the criticisms of Pelosi’s new plan (which is basically the plan HELP passed and Reid last week endorsed) I’m seeing here also applied to the original, CPC-endorsed, “robust”, best-case-scenario plan. For example the public option always took five years to start up (is it even possible to create a national health insurer more quickly than that?) and from very early on has been limited in its availability. “Dumping” to the public plan would have been possible even if the public option paid out less and had cheaper premiums (actually I think it might be easier, since if the public option were cheaper then you would have to raise your premiums relatively less to drive the undesirable customers away). If you don’t want this plan, which plan do you want? And whatever your preferred plan is– how exactly would we go about passing it? If not even the CPC could get on board with such a plan, then how would one build Congressional support for such a plan– either in the first place, or now that we’re at the end of the process and are suddenly deciding we don’t like the exact thing we’ve been pushing for for eight months?
And if your position is that you’d find the current bill a good one so long as it had a “robust”/medicare+5 public option (despite still possessing the 5-year gap, the limited availability, and the dumping problem)– okay, what do we do about it? How do we get there from here? This isn’t gotcha, I’m legitimately asking what I’m supposed to be doing right now. We have one chance left to prevent the medicare+5 public option from being removed from the debate entirely, when the House next week either votes on an amendment to add medicare+5 back in, or chooses whether or not to vote against the bill entirely because Pelosi wouldn’t allow that amendment vote. (Even winning that vote of course just puts us at the beginning of a fight since you still have to get through conference and not one single committee in the Senate has endorsed a medicare+5 option, but let’s worry about first steps first.) How do we win that vote? Where does one go to push the swing House votes toward taking a vote that supports medicare+5 rather than negotiated rates? I’m serious. Let’s either do this or stop whining about it.
Dan
LIEBERMAN!!!!
The Grand Panjandrum
@Brachiator:
True. But NOT ONE of them allow insurance companies to sell basic healthcare insurance policies FOR PROFIT. Not one. That is the simple fact of the matter. Every industrialized nation that relies on the insurance system to be the intermediary in payment REQUIRES any insurance that wants to do business within its borders to have a non-profit subsidiary that offers health insurance if they want to be in the business of selling insurance for other purposes.
The problem isn’t that health insurance exists. The problem is that it exists as a profit center.
Cerberus
@Davis X. Machina:
Yup, and they are great…
They are also, every one of them, more liberal than the current plan. After all this fighting, you think we’d get Danish Health Care or the NHS when the wimpiest of public options with a 60 seat power in the Senate is under threat and constant attack?
That’s pretty much the only reason why there’s an uproar on the left for this tiny scrap.
I have Danish national health care now, it’s fantastic, I don’t expect to see it in America regardless of what this bill looks like for at least another 20 years, if not 50-100. It’s inevitable, but it’s the way it goes. You cover who you can and do the best.
For those worried about “dumping”, sure, but what do you think “medicare” is? Huge ass dumping ground and it’s super popular, hopefully we can continue to hammer that in the long fight for sane health reform in this country in the long run.
Joe Buck
The key is that once the public option exists, even if it starts at 2%, it will be a powerful constraint on insurance company behavior. If they continue to jack up rates and screw people trying to buy individual coverage, the public option share will grow. That’s why the insurance companies are fighting so hard.
Wile E. Quixote
@Senyordave
His wife is a fucking whore too, as are Susan and Evah Bayh. All of them deserve to die of something horrible, painful and incurable. I wonder if we can get John Hinckley paroled and tell him that if he snuffs the Liebermans, the Bayhs and Max Baucus that he’ll get a date with Jodie Foster.
Elie
While I hear and feel much of your exasperation upstring on the deficiencies in the public option being proposed (at least as much as we know now), I agree with eemom. It is not just nothing if we have everyone covered for the first time evah!
Now, I would not dream of disagreeing with those of you with very specific knowledge and expertise on the pros and cons of this or that being part of the PO, but how do we realisitically live with the nature of our political system while pushing to get the most we can?
Ad nauseam, we already knew up ahead that we have had years of self serving corporatists in both parties, filling their pockets and mouths with the gold from the insurance and provider industries. We knew of course that these people were in key power positions and that they would not, could not be overlooked, ignored, jumped over, muscled into complete silence.
We are fighting this war with those people as our soldiers and major strategists! How can we make this work best we can? Instead of grinding away at how awful this will be, are we really worse off than if nothing had happened? Really?
Right this minute, we have more children insured in this country thanks to the expansion of CHIP. Perfect? No. But they can get major illnesses addressed and preventive care too…34 states already have high risk insurance pools, allowing people to get health care coverage after they have blown through previous lifetime limits. Perfect, heck no! But are we to say to these people, we would rather you have nothing? Really?
Now, I am not going to say at all that we don’t have to push and critique to help our leadership get the best best deal we can, and that we have to keep pushing after that, but please, please don’t say, for all the people who truly need this, that somehow, their not having it is better. That is just plain immoral to me. Immoral. You can’t have the capability of giving it, and withhold it as a cold blooded strategy, in my opinion.
Brachiator
@mcc:
You didn’t think much of the public option, except as a tool to mount a later activist plan to mount a more comprehensive health care plan.
Your own words bash the current public option.
Meanwhile, here are some of my objections.
A plan that doesn’t immediately cover more people is a waste of time.
A plan that does not include a more robust public option is a waste of time.
A plan that does not include a public option that is competitive with the rates charged by private insurance is a waste of time.
A plan that does not force the private insurers to become more competitive (in the absence of increased regulation) is a waste of time.
Mark S.
@The Grand Panjandrum:
Exactly, and that is key. It is also why I prefer single payer, because if we did mandate that basic insurance be nonprofit, it would only be a matter of time that the Fonzis of freedom and other idiots would let them go back to being for-profit. If the health care debate has accomplished anything, it has been to show me how much special interests actually run the show in this country.
mcc
I cannot see how this bears resemblance to anything I have said.
Elie
Also, not to wreak havoc on anyone’s idealism with a dash of cold reality: insurance companies are big time employers themselves; most of their employees being little people, you know, salaried workers. They also get their health care coverage throught these organizations.
Same thing with the big provider groups.
Just remember that when you talk of driving all the insurance companies out of business. These are not evil people. They just have jobs they try to do to make a living.
Also think about, how the administration of any new health care system will happen, and using what kind of management and organizational infrastructure. Right now, if the insurance companies disapper, that structure does not exist. Making up from scratch is expensive and time consuming.
Think about the practicalities of implementing whatever your hearts desire, not jut the pie in the sky outcome. Real people, real consequences, all around.
latts
@The Grand Panjandrum:
This. Although I’d argue that while the profit issue is important, not-for-profits can still spend tons of money unrelated to actual healthcare– marketing, lobbying,and obscene compensation structures are all considered normal operating costs. That’s how HCR opponents get away with bloviating about the poor insurers’ miniscule 2-3% margins, because that’s the net, calculated after all of the above has already been spent.
No, the IMO key word here is “REQUIRES,” because that issue– regulation— is the real reason a lot of us have fixated on a public option. We know what happens to regulations when the political winds shift, and even before then, when the public is no longer paying attention to an issue. The US does not regulate business interests effectively or consistently, period.
Corner Stone
@Elie:
Where was this again?
How did 2% of 40 million conflate to “everyone”?
Older
Perhaps that poor little 2% should be added to the much larger percentage of Americans who already enjoy public health care plans, some single-payer, some not. I refer to those who subscribe to FEHB, Tri-Care, Medicare and Medicaid. All good plans in their different ways, and all perfectly good models on which to base a much-expanded plan that would offer benefits to everyone. I’ll know congresspeople are serious about this “public” thing when they start seriously considering a “Medicare for All” or “FEHB for All” plan. Anything less is just there for window dressing, while they continue their long-established practice of kissing the insurance companies’ behinds.
Brachiator
@The Grand Panjandrum:
RE: Does every industrialized country with universal health care depend upon a single payer system? No.
This does not in any way refute my point that single payer is a fetish of the American left, but is not central to health care reform.
By the way, a Kaiser Health Care Foundation article on previous efforts in California to reform health care on the state level contains this little nugget on how progressives sabotaged reform:
This makes me wonder whether some of the crap changes to the Congressional health care plan came from some liberals and not conservative Democrats.
You realize, don’t you, that this does not mean that for-profit health insurance is not allowed alongside the non-profit subsidiaries.
Americans love the fantasy that an easily identifiable enemy is at the root of all their problems. For conservatives, the enemy is teh liberal. For many liberals, teh enemy is profit.
Both sides need to freakin’ grow up.
Vincent
It’s amazing how many people here are essentially hoping that Lieberman kills HCR. Because what I’m hearing is that the final bill won’t be perfect so let’s just kill off everything. We’re near the finish line and people are getting cold feet because they’ve suddenly discovered the reality of sausage-making.
So let’s have the Democrats be the party that kills HCR. Surely that won’t hurt their credibility or ruin any further future attempts at health care reform!
Yes, it’s possible that what could become law could be worse than doing nothing. But if you were so damned worried about that then you should never have started this process at all! Making things worse has always been a possibility but so is making things better even marginally. It’s rather difficult to be a progressive if one is too terrified to actually change anything.
Now if the bill submitted for voting turns out to be an abomination then by all means Congress should vote it down. But what’s the point of acting like it’s a foregone conclusion that the bill will suck?
Dustin
“Just remember that when you talk of driving all the insurance companies out of business. These are not evil people. They just have jobs they try to do to make a living.”
Oh cry me a fucking river. They make a living defrauding people of their money by taking in premiums and finding ways to refuse to pay out settlements. It’s what they do and that’s why we’re even having this discussion.
Does this mean that we can’t feel bad for the peons that work for the insurance companies? No, but we should’t feel any worse for them then anyone did for Al Capone’s accountant.
Little Macayla's Friend
I know nothing’s final, but the sooner the better for anything that restricts abuses. Time lines are some of the devils in the details.
H.R. 3962 provisions taking effect immediately :
http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-Immediately-102909.pdf
Implementation timeline here:
http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-IMPLEMENTATIONTIMELINE-102909.pdf
Shorter version of bill:
http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-SUMMARY-102909.pdf
There also needs to be a war at the state level of regulation to make HCR like single-payer as much as possible.
Wile E. Quixote
@Elie
What a stupid thing to say. Yeah, my heart is just bleeding for the little guy at CIGNA seven years ago who said that CIGNA was denying my care because they felt that I should have been discharged from the hospital already. Or those little guys at Blue Cross who were just canceling the coverage of people with expensive illnesses because it helped them earn bonuses and get better performance reviews. Or the little guys at CIGNA who heckled Hilda Sarkisyan when she demanded that they apologize for letting her daughter die.
Pull your head out of your ass Elie, look me or anyone else in the eye and tell us that the people who heckled Hilda Sarkisyan and gave her the finger aren’t an evil bunch of shits.
Little Macayla's Friend
Thanks to this site for the links at #96 (I assumed WP wouldn’t allow four links in one comment):
http://rodonline.typepad.com/rodonline/2009/10/pelosi-and-democrats-introduce-house-health-care-reform-bill.html
Mr Furious
@Brachiator: This, exactly…
Even if they passed the most “robust” ass-kicking reform bill possible, the fact that what they want to take credit for won’t exist until after the next TWO election cycles is unbelievably stupid. Not to mention cowardly.
What they should do—especially now that the GOP has gone all-in opposing anything, is get aggressive, and have the plan kick in as quickly as possible and begin helping as many people as possible.
A good plan—a Medicare-like plan—would be a phenomenal success: People would be helped, Dems would get ALL the credit, and the GOP would get buried.
Instead, these pussies are afraid of their own shadows, don’t want to face voters with whatever they pass in place and have punted.
Out of bounds.
On their own 30 yard line.
People are in need NOW. The economy is in turmoil NOW. More and more people will become unemployed and uninsured NOW, and these asshats are worried about getting through the next two elections before helping anyone.
They deserve to get pummeled, and at this point they’ll be lucky to earn my vote. this whole charade has been disgusting.
Corner Stone
@Vincent: What fucking planet are you from?
jcricket
@mcc: I like the points you make here. It’s establishing a beachhead. It’s far, far, far from perfect, and Dems are going to have to withstand the inevitable “see it’s not perfect, let’s kill it” from Republicans (see Amtrak for the future of the current public option).
Let’s not forget the percentage of people covered by insurance through work has been steadily dropping for 30 years. More and more people unemployed, self-employed, working part time, or working for employers full-time that don’t offer healthcare at all. So, while the insurance companies would prefer to collect their fees ad infinitum, corporations will be doing the “dirty work” of pushing all kinds of people off the private insurance teat.
I think even without substantial reform you’ll see the public option covering 10% of people by 2015 or so. And at some point the combination of factors (costs that can only be brought down by risk pooling, too many people barely able to afford private insurance, etc.) will force an opening up of the public option to virtually everyone.
EXACTLY LIKE WHAT HAPPENED TO OLD PEOPLE AND MEDICARE. Once insurance companies recognized Medicare’s “potential”, they shunted the sickest, then the poorest, then everyone over 65 into the government’s hands. And we responded by making Medicare a lot better (and cheaper, per person).
These things have never happened overnight, but it’s important to start somewhere.
I think people are reading far too much into it to think the nuances are going to hurt Democrats. Republicans are running so far to the right, and against any kind of reform, that the only way the Dems lose on this issue is if they cave to Republicans, or fail to note 1 out of 20 positive things to come from the reforms their passing. Who gives a flying fuck if premiums aren’t super cheap on the public plan or not everyone’s eligible – just blame Republicans for that.
Cerberus
@Brachiator:
Nngh, profit =/= evil.
However, profit on a basic human necessity like health care quickly leads to evil.
We’ve tried to run for-profit health care in this country. We pay more for less. No other industrialized nation allows this, they cover everyone for much less cost.
So my question to you is present a system wherein for-profit medicine and insurance rule the roost but in which universal CARE exists and I’ll jump on board just as I did for the public option, but otherwise, I have no idea what your point is other than “smelly damn filthy hippies rargh rargh extremists rargh rargh real problem rargh rargh”.
Cerberus
@Brachiator:
Nngh, profit =/= evil.
However, profit on a basic human necessity like health care quickly leads to evil.
We’ve tried to run for-profit health care in this country. We pay more for less. No other industrialized nation allows this, they cover everyone for much less cost.
So my question to you is present a system wherein for-profit medicine and insurance rule the roost but in which universal CARE exists and I’ll jump on board just as I did for the public option, but otherwise, I have no idea what your point is other than “smelly damn filthy hippies rargh rargh extremists rargh rargh real problem rargh rargh”.
Cerberus
Huh. Not sure why the double post. Sorry everybody.
Corner Stone
@Dustin:
That was the guy almost shot by Sean Connery in Canada that one time, right?
Cerberus
@jcricket:
Exactly, since the “liberal” line has been “we wanted to give you more than this” and every conservative voice and republican has been “no, what about profits and we love the insurance industry”, I’m not seeing how anybody is going to come out of this regardless of outcome thinking anything other than “fuck conservatism”.
If republicans and conservadems had shut up and not loudly boasted about how proud they were to kill even moderate reform and whine about costs, then maybe the “see see” strategy would have held water, but everyone under medicare age that I know seems to be cursing the conservative democrats and republicans pretty consistently and they’re the ones who are going to have the most shit on their faces come election even if “reform” is shit.
eemom
Right on, Elie, as to both your comments!
For example, a few years ago my husband I both had jobs where we weren’t eligible for health insurance. We couldn’t get individual coverage anywhere because we both have pre-existing conditions, even though we could have afforded the premiums. As I understand it, the legislation under consideration will fix things for people in the position we were.
And, though I’m sure people like us are not worth abandoning hysterical “all or nothing” stridency for, we do have two innocent children, as well.
Cerberus
@Cerberus:
See the response to the stimulus after similar republican caterwauling and watering downness.
Mr Furious
@eemom:
You guys just need to stay healthy until 2013, and you’re all set!
Do none of these morons even see the backlash that will happen as soon this thing passes, and people think they can now get insurance, only to find out this is some abstract, as-yet-to-be-finalized plan, that may or may not be affordable for them four years from now?
eemom
Insurance companies ARE large employers, and it’s very, very far from “ridiculous” to point out that not every one of the thousands of people they employ is a fat cat bonus-glutted gazillionaire who deserves to die. Also.
bago
Personally, I’m just curious as to when we are going to discuss the impact of the public option when it comes to parcel delivery.
Mr Furious
The Fantasy Mr Furious Healthcare Reform Package:
1. Any uninsured persons can buy into existing Medicare coverage effective 2010. Subsidies available for those who cannot afford it.
No mandate.
Congress gets to work tweaking Medicare to provide for a younger customer, perhaps putting together some tiered coverage…
2. In 2012—(maybe this could be the “trigger” if rates haven’t come down) anyone currently insured on their own or through an employer—can now buy into what will now be a fine-tuned Medicare system, that has some different options available.
3. What am I missing? I’m sure there’s plenty, but I’d rather something like this take effect sooner than later. Especially if the later is a shitty mandated, but not cost-controlled boondoggle.
oh really
@Mr Furious:
The timing of this is not surprising. It is not designed to deliver needed help to millions of Americans in a timely manner. It’s designed to deliver political advantage to Barack Obama and a relatively few Democrats.
Pass the bill now. Delay implementation. Run for president in 2012 as the guy who accomplished the impossible. Of course, no one will know yet if the legislation is effective or adequate. By the time that is known, Obama will either be safely into his second term or he will have been defeated for other reasons — economy still sucks, wars rage on, etc.
It seems these days like everything in this country is designed to avoid accountability for our political leaders.
cat48
This was curious to me also. Barack Obama did not campaign on a public option. In 2007 in a speech and on his campaign website, he did refer to a “public plan”. The thing he did mention when he discussed health care was “an insurance exchange like Congress has.” All federal employees get their insurance this way. It normally has at least 5 cos. which each have 3 plans to choose from. It certainly has variety to choose from, but I am not sure how much cheaper it is.
But it is curious how progressives decided we want single payer, we can’t have that so we want a robust public option, and we are drawing a line in the sand about this. All righty, then. On the Ed show everyday he says, “Single payer is in the Democratic Party Platform and we’re just working for what was promised us and what the party stands for” OK, but my party platform copy doesn’t say that. This is what mine says:
“Covering All Americans and Providing Real Choices
of Affordable Health Insurance Options. Families and
individuals should have the option of keeping the coverage they have or choosing from a wide
array of health insurance plans, including many private health insurance options and a public
plan. Coverage should be made affordable for all Americans with subsidies provided through
tax credits and other means.”
You obviously could not go with single-payer in this country as the opposition party is strongly anti-government and anti-taxes. We have an employer-provided system and until that changes dramatically, as it slowly will, a large numer of citizens are going to be against this change. They are kicking their feet and screaming about giving the uninsured coverage. Passing any health care without excluding the sick and uninsured would be huge change.
D-Chance.
$1trillion +… for 2%.
Math like that makes the tea-baggers seem sane by comparison.
Elie
WiLE:
My goodness man, I would of course not say that anyone who heckled a little girl was an ok person…thats a bit off the main point I think.
For the most part, people who work for insurance companies are just average workers — Are you implying that they are all evil hecklers? My goodness, that kind of universal paint brush is pretty extreme — and reckless..
As for instructions to me about what to do with my head. I think its pretty clear wherever YOUR head is, its not thinking very clearly
Your whole thought process and what exists of any coherent argument you are trying to make in your post is just a hash of emotion and invective.
Get lost. You cant clearly state your argument. All you do is call me names. Pfft….
Brachiator
@Cerberus:
My point is pretty simple. People who insist that universal health care by definition means single payer are not only factually incorrect, they are often obstacles to health care reform.
I don’t agree with you that “profit on a basic human necessity like health care quickly leads to evil,” but I don’t think that agreement on this point is necessary to get us to good health care reform. However, simply declaring “thou shalt not profit” does nothing by itself to solve funding issues for any particular health care proposal.
Health care reform began with a number of reasonable goals specified by the president (portability, coverage of pre-existing conditions, cost containment, increased availability). Given that neither the president nor the Congressional leadership wanted to take on the insurance companies, then I think that a strong public option was the way to go.
But what has emerged is a mess that not only fails to achieve some of its objectives, but also capitulates to all kinds of special interests.
And hippies? What is this, 1969?
Elie
What I read over and over is that no one likes the output coming out of the political and governmental system that we HAVE NOW.
Everyone wishes that we had a much better outcome/results. Somehow, it must be SOMEONE’S FAULT that the very f—- up system can only give us something that everyone is at best only lukewarm about. At worst, not worth passing, will make us worse off and shoot, even though people need it, lets just scrap it and start over..
What to do?
The system is the system. We gotta try to work the levers. Lets keep pluggin away and work it the best we can. We know we have a lot of house cleaning to do over the next freakin decade to get rid of the dead wood corporist do nothings in congress, but lets use what we got — well because we have to live in this world right now, not the one we want…
Plan B: change the system. Hmmm. Is that really a short term strategy given we are at least somewhere down the road to some sort of health care fix? Lets do a revolution next week? Are y’all ready? Got your networks in place? Hmmm – well… no.
Do we just chuck it all and walk away as some purists insist…? Do we keep kicking the people trying to get the f—-g machine to work some sort of way, figuring if we kick them harder and spit on them, we will get a better outcome? And lets heap on the abuse too to anyone who tries to point this stuff out because they are just stupid and dont get how this is so f—cked up so it must be THEIR fault cause this should have just been easy to do and done just like that — BECAUSE!!!
Jack
I think the first three posts sort of covered it, really.
Jack
@cat48:
I’m really not sure that what Obama campaigned on is the point. He’s not the whole of the federal government.
There is, nonetheless, an expectation that Democrats will attempt demonstrable reform of the insurance industry.
Obama, Clinton and Edwards all made it very clear that they would tackle the issue, as much as Presidents can. They major point of disagreement, in fact, between those three was health care reform, health insurance reform and the means by which it is accomplished.
I don’t think liberals should ever have expected Obama to drive the debate to the left. His was the least “progressive” policy recommendation.
Which is precisely why boots-to-the-pavement liberalism is so important. To pressure triangulating politicians into consider a fourth corner (us).
Jack
should read ‘considering’
Brachiator
@Elie:
The Republicans who came to the White House with Dubya had a plan to dismantle the liberal agenda. The used a legislative agenda, signing statements, recess appointments to keep getting what they wanted, and dared the Democrats to stop them.
The Democrats most recently had the time between the Clinton health care debacle and the November presidential elections to get their ducks in order. Instead, they seemed to be stunned into indecision. “What we won? The White House and the Congress? What do we do, now?”
They knew what the opposition would look like and even had an easy retort to any Republican complaint: “After you defeated the Clinton health care proposals, why didn’t health care get cheaper and more widely available to consumers?”
The Democrats had plenty of time to look at the previous work of Ted Kennedy and others, and to look at the best of other countries’ plans.
Instead, they dithered.
I am hardly a purist, and there are some things in the present plans that are workable. But as I have noted elsewhere in this thread, the Congressional health care plan is pointlessly insufficient, and includes easily exploitable weaknesses.
i will even allow that the plan, if passed, allows room to fight for better benefits in the future. But the need for some of these fights would not be necessary with a better initial plan.
Elie
Brachiator:
I agree with you. We are and have been greatly hampered by the weakness and captive nature of the Democrats. No disagreement from me there or with your point that we freaking have to fight and push for what we need, even as we “win” intermediate “victories”…
I guess I just want to believe that we know what its going to take, and for us to stop carping about how hard we are going to have to work to do it and how much tail we are going to have to kick and make accountable. We.have.our.work.cut.out.
But my up side of this is – damn, though I wish we were in a better place with better legislation, we ARE making progress — we are pushing forward and that is the best thing.
Constant negativity breeds defeatism and cynicism. We are, very much like, planning the first trip to the moon, as under John Kennedy and those clips showing the rockets blowing up one after the other are not without some similarities to what we face. We just have to keep doing, keep working the machine…
What alternative is there other than what you just said and what I added?
Elie
Brachiator: These are the things I think about to give me strength in these times.
In my lifetime, I remember being 12 and watching my grandma cry that the civil rights bill was passed in the Congress — she remembering near slavery in her time — she never thought that she would live to see it happen… she cried and ironed…( gotta keep your work in front of you)
Much later, after many people died, got attacked by dogs and endured ongoing racist polices across the spectrum of daily life, we watched a black man inaugurated as President in this very imperfect system.
To this day, black people experience discrimination and are disproportionately poor and imprisoned. But things have improved a bit and each step forward is not always spectacular but we move the chains, so to speak ..(bad analogy)
My only point: how can we take on anything big, if the only way that we evaluate outcomes is immediate and without a perspective of ongoing struggle? How can we teach our children to push for stars, to dream of the impossible if we can give them no tools to weather hardship and tackle committment?
Is our only model to be the demand followed by banging and screaming till we get what we want?
This weekend, out here in the State of WA, on the creek where I live, we spent another afternoon planting trees and doing in stream work in order to hopefully reestablish a run of chum salmon in a local creek. We put out eggs in the late winter and have tended millions of eggs to send out salmon fry into the great unknown sea in the spring. After 6 years we have seen about 2 salmon. I dont know if and when we will see more. Each year, people and their children from the community come out and help prepare the way for these cherished and imperiled members of our beat up eco system.
Each year and at this time for us, we make the investment. We cannot whine and we cannot doubt it. We just MUST do it
Brachiator
@Elie:
A great deal of the Civil Rights movement came about because people demanded a whole loaf of bread when they were offered a crumb called “go slow” or “with all deliberate speed” or “it’s not time for that yet.”
Now is the time.
It is neither negativity nor defeatism to demand that the people in Congress do better, especially when their demonstrated inclination is to waffle, and when legislators are looking for the next election rather than having the guts to do the jobs that they were elected to do.
There are good ideas out there, and people willing to work hard to implement them. There are still people willing to join the Obama administration, for example, and there is still a high expectation of this new direction offered by the Democrats.
The Democrats need to believe in themselves as much as the American people believe in what might be done with sufficient political will.
Elie
No disagreement Brachiator. Just that “political will” is a complex construct — taking a indeterminate amount of time and surges frequently rather than ongoing, even flow to a given point. Like some weird game, those of us who advocate and care, inside and out of the administration, must keep the momentum going forward…breaking free even as we get slowed down ..
We wish the same thing
Brian J
It’s hard to now exactly what will happen if we have any sort of public option, primarily because we don’t know exactly what sort of form, if any, it will take. That said, a lot of people think that it could act as a meaningful push in the right direction towards better health insurance, the arguments against it seem to be largely incoherent, and if there’s one fact about it that seems like it will stick, it’s that it will only be open to small portions of the public at first.
It sounds a lot like we are experimenting to see if anything good can be done. What’s so bad about that?
John Lloyd Scharf
USPS/IRS Health Care
Of those “50 million,” that lack insurance there were 45,000 who died without health care. With health care, 98,000 died FROM health care because of malpractice.
The question is do we want to trust that largest corporation in the world, the U.S. Government.
Do not expect house calls anytime soon.
We have seen how well the government delivers on its promises and its bureaucracies pursue the money without giving us benefits on so many levels. Imagine another organ of the government that only ultimately must listen to the Secretary of the Treasury – another “service” of which is the IRS.
http://theprogressivecapitalist.blogspot.com/2009/10/affordable-health-care-for-america-act.html
I have listed a connection to the HR3962, a few videos, two summaries, and the new taxes coming from this health care “reform” on my blog listed above for detailed information.
If you believe the promises of this bill, you have to deal with the lie that it fosters competition with a government option called the “Public Option” and establishes the government as a monopoly making its own rules.
mclaren
Sorry, but I must agree that John Cole has missed the point here. An impotent public option which covers so few people will wind up immensely benefiting the insurance companies (as mentioned, they dump all the dying cancer patients with 3 million dollar per year treatment costs on the public option and cherry-pick the healthy people) and helping the reptilicans (who will shriek that this is what they warned everyone about when families start getting thrown in jail because they can’t afford mandatory insurance coverage and can’t pay the fine) while wrecking the dumbocrats.
Reform will arrive in our broken health care system, however.
But not by legislation.
Reform will come when the current trickle of people flying to India for cheap medical treatment turns into a gusher and then a torrent and finally a mass stampede. When hundreds of planes daily get chartered by hordes of people who’ve combined their buying power to negotiate group deals at third-world hospitals for health care they can’t afford in America, the AMA will react like a wounded rattlesnake and fund (translation: bribe) federal legislation banning overseas trips by anyone who’s ill.
Of course, the stupid congresscritters will eagerly pass such a law and at that point, everything comes unglued.
Imagine DHS goon arresting and tasering sick dying cancer patients in wheelchairs because they’re traveling overseas for treatment they can’t afford at home. The mass revulsion throughout America will spur an uprising the likes of which we haven’t seen since Martin Luther King’s march on Washington in 1963.