A reader writes:
Seems to me the easiest way to kill the GOP media momentum of this MA special election is to push the house to pass the senate’s version of HCR. There’s no reason not to – congress spent 9 months debating it and it would be a waste to not.
The key is that we need folks to call their representatives demanding this. Dem reps are probably buying the spin that the loss of a bad candidate in MA (where I live, btw) was a referendum on health care, but it wasn’t. Teabaggers probably think that health care is dead, and will take it easy for a bit. If we flood the lines in support of health care reform and get the house to pass it before the state of the union, it’d show a party that takes its licks standing up and forges ahead. Plus financial reform will be a good populist issue for the Fall, and the GOP is sure to block that thereby giving a good wedge to campaign on.
FormerSwingVoter
Email your Representative now at the following link:
https://writerep.house.gov/writerep/welcome.shtml
FormerSwingVoter
Here’s what I just sent my Rep here in Mass:
edmund dantes
The only caveat to that is they can’t let HCR become a done deal once they pass the Senate version. They need to come back to it again to fix the horrible bits (and there are horrible, democrat defeating bits in that bill come election time).
NR
@edmund dantes: I can get on board with this if the fixes are either passed first or at the same time as the Senate bill.
My current trust level of the DC Democratic leadership is basically zero, so “We’ll fix it later” just isn’t going to fly with me right now.
John S.
I would call my congressman, but I don’t have one since Robert Wexler gave up his seat.
thefncrow
Yeah, the Senate bill isn’t great, but at this point, we need to pass it. The key to this whole thing is that, once we get a basic bill through, we can do a lot in reconciliation to fix the bill, because things that are currently not workable in the reconciliation process will become workable once the basic bill is through.
As I understand it, if we pass the Senate bill now, we can actually add Medicare buy-in and a strong public option via the reconciliation process, both of which would be somewhat questionable if not outright prohibited through the reconciliation process at the moment.
Since we can’t just outright pass a better version of the Senate bill now, the best option left is to pass the Senate bill and fix it with reconciliation.
drlemur
Maybe this was hashed out elsewhere, but I haven’t seen anybody commenting on the fact that MA voters already have healthcare under their state plan. Kinda funny that their special election ended up being the big deal for whether a similar(ish) federal plan gets enacted.
In fact, isn’t it actually in MA voters selfish best interest to oppose the federal plan? None of the uninsured who will get coverage are in the state (they are all covered already), but any federal insurance excise tax or other costs will be shared by them.
Maybe relying on people to vote against their economic interests during a deep recession wasn’t such a hot idea in hindsight.
QDC
I just put in calls to my rep’s office here in central Ohio and in DC.
I’d say CALL NOW, don’t email, the caucus meeting this afternoon is the critical event, and a little push before hand to change the mood might make a big difference. They need to know that there are HCR supporters watching. Please call NOW! Tomorrow will probably be too late.
John S.
Yes, because clearly “We have nothing to fix” is a much better proposition.
flounder
I worked all night and incidentally, I fired off a letter to my Rep (Ann Kirkpatrick) at about 4 AM saying precisely this.
I said pass that crap Senate Bill, fix it before it phases in around 2034. Do a real jobs bill, not a “no cost no jobs” bill like they really want to do, and then spend 6 months making Republicans defend Wall Street Bankers by passing Financial reform in a line by line vote fashion.
And I also suggested that Dems like Kirkpatrick aren’t going to survive by scurrying from health care and hiding from voters for 9 months behind a “blue ribbon deficit cutting commission”.
Sure enough, when I got home first thing I saw on TV was about some blue ribbon deficit cutting commission. Looks like the rout might be on.
Rick Taylor
I agree. I would also put pressure on Democrats to improve it through reconciliation. It’s a tough sell, I’m not sure progressives have much cause to trust the administration to fight for the changes that would make a decent bill, but I don’t see much choice. It’s this or nothing. I don’t understand the mechanics, but perhaps they can pass the improvements immediately following the bill itself.
LT
That would be the easiest way – if the vot4es were there. BFrank says they’re not.
I’d rather they put the PO back in, among other things, and pass what they can through reconciliation. (And just how that can be done has been laid out in detail at several sites.
Malron
I agree. Pass the senate bill now. Add the public option through reconciliation when its time to pass the budget.
mistermix
I think this is the right thing to do, but it’s not going to happen. Barney Frank has already given up (and I think he’s a fairly sharp vote-counter).
The path of least courage, which is the one Democrats seem to want to take, is just to forget that last year happened. Don’t bring the Senate bill up for a vote in the House, so nobody has to change their vote. Pass a couple of reforms, like eliminating pre-existing conditions, and call it good.
This is the road to ruin, of course, but for Democrats that road is a vaseline-coated superhighway.
El Cid
I think this is a reasonable proposal. I haven’t seen a whole lot of detailed analyses of any other alternatives available, but it’s what I figured would basically be happening at best anyway.
valdivia
Exactly. Do this, now, have the President sign the bill on Friday or Monday or whenever. Stick it to the Reps and prove they have some balls. Finally.
moe99
Barney Frank says he won’t vote for the Senate bill and he knows there are enough Represenatives who will do the same that there is no chance of the Senate bill passing. I disagree with him, but he knows the ins and outs of the House better than me, so I can get that there are a bunch of Dem representatives running like scared rabbits right now.
GregB
It should be noted that after spending 30 years mocking and hating on liberal Massachusetts the Republican party now thinks that those same people are the most important people in the world and their opinion should set the national agenda.
-G
eastriver
Go nuclear. Ignore the filibuster and pass the conference bill.
Do it. NOW.
NUCLEAR OPTION.
Fuck Nelson. Fuck Lieberman. Fuck Baye. Fuck the blue dogs until they’re the blistered red dogs.
freelancer
@LT:
Reconciliation does nothing in terms of reform. It doesn’t get rid of recision, it doesn’t do anything regulator…eh, fuck it.
Bring on the Brawndo.
Glocksman
@NR:
Bingo.
I will oppose the unmodified Senate bill and urge everyone in my shop to do so as well.
If the final product reflects the compromises labor and the WH made earlier, then I’ll work to gain support for it in my shop despite my personal reservations.
My loyalty isn’t to the Democratic Party or the Obama administration, but to my co-workers I was elected to represent.
Betray them, and I don’t give a good Goddamn what your party label is, you’ve earned my undying hostility.
QDC
@mistermix:
You can’t just get rid of preexisting conditions without a mandate to keep healthy people in the market, and you can’t have a mandate without some way for individuals to pool risk (exchanges) and subsidies for those who won’t be able to afford it on the exchanges. So the absolute minimum that can be done is exchanges + mandate + preexisting conditions + subsidies. Which is to say the Senate bill was basically as bare-bones as it gets.
My guess is that if they go through reconciliation, we get medicare/medicaid expansion and maybe some grants to states to implement their own MA-style solutions.
madmatt
Why bother, the insurance company backed COAKLEY, so obviously passing the bill is better for the insurance companies…that is all I need to know about how bad this bill is. I am one of the sick and poor it the bill was supposed to help, then senate bill FUCKS ME by making me pay for something I can’t afford to use. Now I am resigned till waiting 20 years till I qualify for medicare.
At least now I never have to bother voting or donating…it is a suckers play…the dems get their lead from the big corporate donors (which will be bigger tomorrow after the SC decision to put no limits on corporate donations). They only need us for votes…fuck em.
Glocksman
@freelancer:
As a Hoosier, that’s spelled ‘Bayh’.
Or ‘cocksucking DLC asshole’ if you prefer.
FormerSwingVoter
@LT:
Well, yeah. That’s why it’s important we reach out to our Reps. If the votes aren’t there, then we need to convince some of the people who weren’t going to vote for it to vote for it. The votes aren’t there right now, which is why we need to get them.
ThatLeftTurnInABQ
@edmund dantes:
This is my cue to jump in and chant “Elkins Act, Hepburn Act” yet again.
eastriver
@Glocksman:
Bayh. Sorry. And my state’s senior senator spells his name Charles Schoveyourbanksterdickupmyasster. (I think it’s Eastern European. You know those people.)
Rick Taylor
The House has to at least past their version of a health care bill. At the very minimum, pass it, give it back to the Senate, and let the Republicans kill it via a filibuster. If they can’t even get that far, what the hell are they good for? Except of course being the lesser of two evils.
mistermix
@QDC: I think you’re right that real reform needs to be a package along the lines you describe.
But real reform isn’t going to happen. What’s going to happen is a couple of quickie bills cobbled together at the last minute, designed to show that Democrats did something. Imagine the bare minimum Congress could pass and say they did something, subtract about 50% from that, and you have the legislation that will pass. They might even get a few Republican votes because R’s will want to show that they influenced the process with their opposition.
And malpractice reform, also, too.
Osprey
I seriously hope I’m wrong, but does anybody think most of the Dems actually WANT to pass HCR? To me, the whole thing seemed like a bunch of kabuki, “Oh, look how much time we spent on this, but we just couldn’t come to an agreement, filibuster, bipartisanship and all that”. They spent how many months fumbling for a good excuse, and now they have one with the Brown victory.
And with financial reform, shit, you thought the cock-blocking on HCR was bad?
Well, you’d figure HCR would be a big populist issue…since, you know, there’s 30 some-odd million without health coverage..and the GOP blocked it at every turn. The Dems again will find every excuse to not get anything at all, or anything proper, done with financial regulation. They don’t want to reform Wall St. just as much as the GOP doesn’t. At least the GOP is honest about their cavernous greed and stupidity.
I said it before, and I’ll repeat it. Yes, the GOP will block pretty much everything. You know it, I know it, the people know it. But running on GOP obstruction isn’t going to win any elections. The Dems rode to big victories because the GOP fucked up, NOT because they obstructed anything. Voters don’t want excuses. In 2010, if the Dems run their campaigns on “well, we couldn’t accomplish anything significant because the GOP obstructed our 59-41 majority, so vote for us”, they’re fucked. The GOP will open fire with everything on how the Dems had huge majorities, and the WH, and couldn’t do anything to create jobs, fix health-care, or reform Wall St., and they’ll win.
flounder
Maybe we should write our letters and make our calls or not and let the little staffers scurry back and forth throughout D.C. and let Barney Frank count his votes again in a couple days when the shock and anger subsides and the realization that passing a shit bill and then fixing it is the least horrible way to proceed sinks in.
mistermix
@Osprey: The key to understanding Democratic Congressional politics is that banks and insurance companies achieved regulatory capture via PAC contributions long ago. There was always little chance that a real reform — one that addresses the cost drivers while providing care to the uninsured — would pass.
In addition, the majority in this country is still insured, so, like Massachusetts, healthcare is still a future problem. And there’s less political pressure to solve future problems than current ones.
It’s 20/20 hindsight, but financial reform, which I grant is subject to the same regulatory capture, might have been an easier sell.
Glocksman
@eastriver:
No problem.
If you’d said ‘Evan Motherfucker’ the only problem I would have had is the assumption that his Mother willingly agreed to have seks with Oedipus Evan.
FWIW, my opinion of Bayh is only microscopically higher than my opinion of Charles Schumer, and the only reason for that is Chuckie’s advocacy of gun control*.
In fact as much as I hate to admit it, our Repub senator (Richard Lugar) has demonstrated some smarts WRT diplomacy and foreign policy.
Evan Bayh has not.
IOW at this point I’d support Lugar in a hypothetical Bayh v. Lugar election.
*as if you couldn’t have guessed from my user name. :)
kindness
What do you do in ‘Damned if you do & damned if you don’t’ situation?
Those here who are pleading with us to support the passage of the Senate bill in the House have not addressed a very important aspect of that bill. Specifically, it sucks! It doesn’t reduce costs in any way. It does absolutely nothing for most Americans and Mass voters just said as much. The adding 33 million americans to insurance? Bullshit! Yea, you would now be offered a policy from an insurance company that covers your pre-existing conditions, but you couldn’t buy the policy because right now with the Senate’s bill you know the quoted price would be out of anyone’s ability to pay for it. Then these same folks would get fined for not having insurance!
Yes! By all means, let’s get the progressives to do everything they can to get more republicans elected in ’10 & ’12.
FormerSwingVoter
@kindness:
Concern troll is concerned.
Sleeper
As others have said already, the House left (ugh, I hate the meaningless term “progressive”) should only get on board with passing the Senate bill IF it’s coupled with a reconciliation fix in the Senate. Immediately. Not some day perhaps, when it’s easy. Now. This can be a position of maximum influence for House liberals – the White House is loudly declaring that HCR WILL pass, and clearly Obama feels he needs a win on this, and he may be right. The left needs to go to the White House and make them play their game for once – “You want us to pass this? Go breathe down Harry Reid’s neck, go twist the arm of every Blue Dog budget hawk, go throw your weight around for OUR benefit for a change.” The WH had no problem pressuring Dorgan over drug reimportation, for example. Their backs are against the wall. The left needs to play hardball – right now, they have the power to blow up the bill, which means they have the power to change it for the better. If they choose to exercise that power, that is.
baxie
they’re going to pass this disgusting insurance company giveaway and y’all who think anything is going to be improved later will be in for a rude fucking awakening.
or does anyone honestly think that flooding the insurance companies with cash will make them *less* resistant to future efforts at reform?
The senate bill is an abomination that throws women under the bus and does fuck all to protect consumers from getting kicked to the curb when they get expensively ill.
Mandated junk insurance is still junk insurance.
I don’t know what dream world y’all live in where “coverage” equals “care”, but it isn’t the same planet ruled by Blue Cross and their pals.
And politically strong-arming people into supporting the blood suckers isn’t going to play well either, especially when the people being strong-armed figure out how insurers operate.
sacman701
I don’t understand how anyone can view the MA election as a referendum on health care reform. MA already has a system almost identical to what’s in the house and senate bills and basically won’t be affected. If the voters there really don’t want a system like that, the state wouldn’t have one to begin with.
Does Barney Frank seriously think that the status quo is better than the Senate bill?
kindness
Formerswingvoter….
You may be a former swing voter. I’ve been a liberal since the 70’s and still am.
Call me names but answer my point, which I see you made no attempt to do….who is the asshole here? it isn’t me.
J. Michael Neal
@kindness:
Yes, it does. The problem is that you don’t like any of the ways that it reduces costs, such as an individual mandate and the excise tax. You want a Magic Health Care Pony that provides endless benefits and has no costs to anyone. tough luck.
Massachusetts voters are wrong, and so are you. Aside from the millions it will help to get insurance right now, it also reduces risk for most of the rest. People will have the knowledge (or would if they looked into it) that, *if* something happened to them, they would still be able to get coverage. *If* they lose their job, they will have an alternative. *If* they come down with a serious, chronic illness, then they will still be able to get coverage if they lose their old policy.
The reduction of risk is a very real benefit, and almost everyone in the country would get it.
No. Look into the subsidies available.
No. Look into how the fines actually work. Aside from the fact that, if the basic policy costs more than 10% of your income, you are not subject to the fine, the fine is low enough that it’s probably the rational way to go for many people. The fine is the greater of $1,500 or 2% of your income. For a hell of a lot of people, that means that it would be cheaper for them not to buy the insurance, and then pay the fine if they do get sick and need coverage. That’s a big flaw in the plan, actually; the fine needs to be large enough to provide a real disincentive to getting hit with it in order to do its job.
As people mentioned above, you can’t have community rating (i.e. requiring the insurance companies to take people with pre-existing conditions at the same price as those who are healthy) without an individual mandate. You’ll have an enormous adverse selection problem. This has a further caveat, which is that it *will* cause the insurance premiums for healthy people to go up. There is no way to avoid that. If you want people with pre-existing conditions to be covered, you must accept that. It’s part of the package. If you aren’t willing to pay that price, then you aren’t in favor of universal coverage. It’s that simple.
Note that this has nothing to do with whether or not there is a public option, or Medicare buy-in, or just what we have now. That fact might get disguised by simply collecting income tax to pay for the system, but it will remain true. Now matter how you structure it, at the margin, healthy people will pay more for health insurance if they have to pay into the same pool as those who are already sick.
There are a lot of problems with the Senate bill. I agree that a public option, or just Medicare for all, would be a much better approach. I’m not stupid enough to think that it can be done without raising the price of health insurance for healthy people. That’s just a fact of life. There are a lot of inefficiencies to be wrung out of the health care system, but not enough to change that. If you raise the amount of overall health care provided, which universal coverage will do, *and* reduce the cost for those that are most expensive to treat, which it will also do, then you *will* increase the costs for everyone else. Live with it.
ThatLeftTurnInABQ
@kindness:
A reasonable request, which I’ll try to do. Above I noted “Elkins Act, Hepburn Act”. That is how the railroads in TR’s day were regulated by Congress between 1903 and 1906. Back then they were the closest analog to what we have in the health insurance sector today – an immensely wealthy and powerful industry sucking the life out of the rest of the economy via excess profit taking, and with a political stranglehold on the Senate in particular.
The railroads were regulated in two steps. The Elkins Act was regarded (with considerable justification) by progressives in 1903 as a watered down crappy bill which didn’t do what they wanted, which was to cut into railroad profits and reduce their stranglehold on the national economy. In effect all it did was to mandate that the railroads couldn’t play games with their prices so as to favor some customers (e.g. their friends in the trusts) over others. All it did was establish fairness in pricing, but it did nothing to control costs.
The Hepburn Act passed 3 years later – and it did finally put regulations in place to control costs. It succeeded where the Elkins Act had failed, in part because once a level playing field was established with regard to railroad rates, then everybody using them had an interest in bringing costs down. The Elkins Act, failure that it was, at least got the ball rolling on railroad regulation and most importantly it helped to create the political environment which made the later and more successful Hepburn Act possible.
I submit that this is a close analog to the HCR today. We are trying to solve problems of access, fairness, and cost. If we can level the playing field with regard to access and fairness today, that sets the stage for Act II of this drama, which is to regulate costs.
Chris Andersen
Absolutely. Nothing would change the narrative quicker than for the current Senate bill to be signed by Obama within the week. It would be a giant fuck you to the pundits who are rehashing their tired “Democrats in Disarray” storyline.
J. Michael Neal
@Sleeper:
This is the exact same thing as saying that we shouldn’t pass anything. The House has no leverage, because there are too many Senators that would be perfectly happy to walk away from it rather than accept concessions. 41 Republicans, Lieberman, Nelson, Bayh, Landrieu, Lincoln, Webb, and Conrad have all made it clear that they have no interest in any further changes. Byrd is too in love with the rule that bears his name to go for the reconciliation process. I’m pretty doubtful that you can get all but one of the other Nelson, Baucus, Pryor, Warner, Carper, and Hagan, which means you can’t get to 50. That’s not even looking at Senators who haven’t said much about the subject, but come from conservative states, like Tester, Johnson, Begich, and McCaskill, who really just want the subject of health care reform to go away.
If you believe, straight up, that the Senate bill should be killed, then fine. I disagree with you. However, don’t try to cloak your opposition in talk of supporting it if the Senate agrees to wide ranging compromises. You won’t get them, so that’s the same thing as outright opposition.
TJ
Really could care less. If the Senate really cannot do anything with 59 votes we’re screwed as a nation anyway, HCR or no HCR. And a temporary blip from ramming the crappy Senate bill thru and claiming a victory won’t last past the next unemployment report.
Comrade Kevin
@TJ:
Perhaps, but having it fail completely will cause a lot of damage.
TJ
Barack Obama, via TPM.
So you centrists should start coalescing immediately.
Sleeper
@J. Michael Neal:
I’m not being a stealth Republican, I meant exactly what I said. The House left in fact does have a lot of leverage here – not with the Senate, but with the White House. The White House needs a win. So start making some demands. Get Emanuel and Axelrod and the rest to go to work for them.
And if the White House can’t bring pressure to bear to get even 50 votes in the Senate, then this conversation is more or less academic, because the Obama Administration is finished. Because they’ll never get 50 votes on anything in the Senate. The Dems in the Senate would be perfectly happy to twiddle its thumbs for the rest of this Congress, and take their chances with the voters by running away from Obama.
Sleeper
@TJ:
Un-fucking-believable.
Oh, but remember, Obama is powerless to intervene in the business of the Congress now. Unless it’s tie the Democrats’ shoelaces together so that the Republicans can catch up. You know, out of fairness.
Corner Stone
@Chris Andersen:
President Obama:
J. Michael Neal
@Sleeper:
That’s nice, but anything that involves changes must get passed by the Senate. The Senate is not going to vote for significant changes in the bill. I want a straight answer: faced with a choice of passing the Senate bill as is, or passing nothing at all, which is your choice. Those are the only two realistic choices you have, and hiding behind talk of passing a different bill is cowardly.
scarshapedstar
I say pass the shitty Senate bill out of pure spite.
I heard Ari Fleischer wailing and gnashing his teeth last night about how if the Democrats were unfair enough to simply pass the Senate bill in the House then the American people would never, ever, ever forgive them. Scott Brown says the same thing.
This is not good-faith advice, to state the painfully fucking obvious. Nothing would please me more than to see Scott Brown’s sole claim to fame die with a whimper as he never gets to filibuster the bill, and then see him unseated in 2012.
I don’t like the Senate bill but if they give up now then there will be no health reform. Ever. We don’t have the luxury of waiting another decade. Pass the bill, rub it in their faces, and if they call foul tell them to go kiss Ted Kennedy’s dead ass.
Sleeper
@J. Michael Neal:
It’s amazing how you let the White House off the hook completely here. I’ve said, twice now, that what House liberals need to do is demand from the WH their strident support and intervention with conservative Dems in the Senate, and a guarantee of a reconciliation vote to fix the abysmal Senate bill the best that they can, before they agree to pass it. Your whole argument proceeds from the position that there’s just no way that Obama or his people could possibly influence, threaten, or bribe Senators into going along with them, which I do not believe to be the case, as they’ve twisted arms before when it suited them.
Or maybe you are misunderstanding me. I am not saying the Senate should rewrite their bill. I realize that that won’t happen. I am talking about a reconciliation repair job, which IS within the realm of possibility – if the left demands it and pressures the White House to help them get it.
But what you really want me to say, I think, is that the House should just pass the Senate’s bill verbatim, with no conditions, not even a promise of fixing it later, and things will just sort themselves out because at least we’ll have saved the president from an embarrassing defeat, I guess. I won’t say that because I don’t believe it. I think that would be a disaster. The Senate bill is awful. Not just imperfect, but actively damaging to Democratic chances this fall. Because it’s bad policy, and people can see that. No one likes this bill. Passing it won’t save Blue Dogs, and it will tarnish the House liberals in their blue districts, which won’t drive their constituents to vote GOP but will certainly depress their turnout and support.
Now saying this probably just makes me a bill-killer to people here. Fine, whatever. I get the feeling some people here wouldn’t give up on this bill if it was whittled down to nothing but killing funding for PBS in order to subsidize sending every American a bottle of Advil in the mail. Past a certain point of compromise, you have to be willing to call it a day, otherwise you have no business negotiating.
J. Michael Neal
@Sleeper:
That’s our big difference, then. I don’t think that anyone has enough leverage to force the Senate to do anything. Institutionally, everything about the place gives extraordinary power to individuals and erodes any tendency to party discipline. The Republicans have overcome this, though that comes with caveats. They are more united in opposition (in the Senate at least) than they ever were when in the majority; they’re a lot less cohesive than the GOP in the House; most importantly, they have the structural advantage that they can please the money suppliers and their base at the same time. Democrats have to choose between the base and the money, and that cripples attempts at party unity in the Senate.
It’s not so much that I’m letting Obama off the hook. I think he’s made some pretty egregious tactical errors, though I suspect that you and I disagree about what those are. It’s more that, from where we stand right now, I just don’t see the Senate passing very much. They sure as hell aren’t going to agree to a reconciliation package in short order. If it happens, it will have to be later. The only way forward is for the House to pass the Senate bill and work towards improvements in the future, with no guarantee that they will happen. They might, but they might not. Insisting that the only way to pass the Senate bill is with a concurrent package of reconciliation changes is the same thing as saying that there will be no passage of any bill.
Not quite. I want you to say either that, or what you did say. I disagree with you. I think that your conclusion about the Senate bill is based upon an extremely simplistic reading of it and not understanding the various moving parts.
I agree with that, but this bill is nowhere near that point. It will provide, immediately, access to catastrophic coverage for people with pre-existing conditions. It will provide, immediately, a number of other benefits. Down the road, it sets up the exchanges. It provides huge subsidies for people to buy health insurance. It allows all of us to get coverage.
I said above that a lot of the people who get incensed over things like the mandate simply don’t understand how insurance works. If you oppose a mandate, then you can not be in favor of community rating. The excise tax is an imperfect way of doing something very important. Two things, actually; it reduces the ridiculous part of the tax code that taxes people who buy coverage on the individual market for the same thing that is not taxed as an employee benefit, and it holds down cost growth over the long term. Again, if you want cost containment, then you have to be in favor of things that are going to hurt. The idea that there is enough waste in the system to provide universal coverage and contain costs without some painful elements is fantasy.
maus
@TJ:
This would make sense if centrists were anything about fiscal policy. Instead, they leisurely walk over to the latest industry-sponsored numbers (or from their ass punditry/thinktank numbers) and attempt to alter reality.
Sleeper
@J. Michael Neal:
If that’s the case, then it was a mistake to try and get any serious legislation passed. I just can’t accept it. To me, that just smacks of the majority making convenient excuses for its own spinelessness and lack of integrity. While the GOP suffered its share of defeats during the time it had both the Congress and WH, it still accomplished far, far more, with significantly fewer votes. I think to just say that Democrats are intrinsically ineffective and therefore we need to lower our expectations is wrong.
If you find the Senate bill as it is unacceptable, then that’s not a way forward. Once the bill passes, the pressure will evaporate and that reconciliation fix will never, ever, ever happen. If you say that you can live with the bill as is, but you’d really really prefer to make improvements, then you’re going to live with the bill as is. And a lot of Dems are saying that that’s not acceptable for them. What’s the benefit? Bad policy that will never get repaired, PLUS bad politics by pushing this unpopular bill through?
But unless someone threatens dire consequences, it’ll continue to slide towards that point. Saying how desperately important it is for the left to take whatever conservatives crap on them is not a good way to achieve policy goals.
We do indeed differ on the reforms offered in this bill. I think if there was any real chance that this bill would do some good then the insurance companies wouldn’t be so ecstatic about it. I think the regulations will prove to be toothless, the subsidies will be insufficient, and that a mandate to buy insurance WITHOUT offering a public option is going to be an albatross around our necks. I’m for single payer or an American NHS but I realize that the country isn’t there yet. I want legislation that will help nudge us in that direction, not entrench and enrich the fucking insurance companies even more and make real reform even more unlikely. You disagree and, I presume, see market-based reform as the way to go, and I respect your opinion but disagree with it pretty strongly.
J. Michael Neal
@Sleeper:
I don’t disagree with this, but I think you are picking the wrong targets. The biggest case of spinelessness is in the Senate.
No, it won’t. The Senate bill is a finished product. There isn’t any more sliding. It is what it is.
This would be a better argument if the insurance companies were ecstatic about it. They aren’t. They got behind it initially because they thought it was better than other possible bills that might pass. Now that it’s this or nothing, they are shifting to opposition. This bill is only good for them relative to other options that are no longer on the table. Relative to the status quo, this is *not* good for them. They’d rather there be no reform at all.
That said, I also think that this is a ridiculously stupid way to look at it. Frankly, whether the insurance companies like the bill or not doesn’t matter to me. If they benefit, great. If they don’t, I’m fine with that, too. I am much, much more interested in improving health care for the rest of us than I am with sticking it to the insurance companies. The sorts of reforms I’d implement if I were made dictator would really stick it to them, but that’s incidental, not a desired goal. Thinking that, if they like it, we must oppose it is juvenile thinking.
You contradicted yourself. There is no such thing as legislation that will nudge us in that direction that doesn’t do things that you think will entrench them. There is no way to implement incremental reforms without involving them and making them a part of the process. Your approach boils down to straight single payer or nothing, because the caveats you place prevent anything else.
I also disagree with you that this bill further entrenches the insurance companies. On the contrary, it makes their long-term future questionable, which is the reason they don’t like it. It removes their entire reason for existence, namely separating people by risk. If we don’t allow them to discriminate based upon pre=existing conditions, then they are nothing but paper pushing middlemen. In the short run, that means simply paying them for waste. In the long run, it destroys them, because they become extremely easy to remove from the equation.
Well, part of that is because you have made false and unsupported assumptions about what I believe. In the long run, I don’t think that there’s any way to avoid the fact that health care is so broken as a market that it’s silly to think of it that way. I agree with you on the long term goal of single payer.
Where we disagree is on the effects of this bill as a next step. I think that that’s because you don’t really understand how market incentives work. There are a lot more consequences than you get from reading each piece individually. The way the individual mandate is written, it has second order consequences that will keep the cost of premiums down. The most effective ones aren’t explicitly written, but they are still there. Stopping your thought process at only the explicit parts doesn’t work.
sacman701
Barney Frank is at least making sense again.
http://tpmdc.talkingpointsmemo.com/2010/01/u-turn-frank-says-with-assurances-hell-vote-for-the-senate-health-care-bill.php?ref=fpa