Ezra:
Would public insurance be better? It would. I’d be happier arguing for it right now. But that’s not the choice before us. The people this bill will affect aren’t facing divergent futures with public and private insurance. They’re facing divergent futures with private insurance or no insurance. Regulated insurance or unregulated insurance. Exchanges that pool their bargaining power and spreads their risk and a world in which they’re on their own. And people are being awfully cavalier in the abstract about a decision that virtually always comes out the same way when people have the good fortune to make it.
This is not a great bill. But the status quo is very, very bad. The cost controls may be insufficient, but in the status quo, they simply don’t exist. Private insurance isn’t optimal, but it’s better than the total absence of coverage.
Also read this at TPM.
Bruce (formerly Steve S.)
Let me repost a question that I’ve yet to get an answer to. Gay activists sought a gay marriage law in DC. The Roman Catholic church threatened to cease cooperating with DC on charitable programs for the poor if the law was passed. A potential consequence was that poor people could be hurt or even die as a result. Were gay activists morally obligated to cease their quest for a gay marriage law because people could be hurt or killed as an indirect result? More generally, are we morally obligated to support or oppose a law based on whether people might be hurt as an indirect result?
TaosJohn
Ezra and Josh mean well, at least. But here’s what I wrote Josh, regarding the correspondent who felt abandoned:
“As the Senate bill now stands, this person wouldn’t get any relief until 2014 at the earliest, and if he can STILL be turned down, due to the loopholes in the language. By 2014 any premiums will be through the roof, compared to now, due to companies jacking up profit margins in advance of the “reforms,” and the subsidies will likely have been cut because of deficit concerns.
He is likely to be worse off under the Senate bill than if we do nothing.”
I don’t have insurance now — can’t afford it, AND it does no good — and the problem with Ezra’s argument is that the choice before us is intentionally evil, i.e. we are given to understand that this is all there is and ever will be, take it or leave it, which is a crock. Let there be nothing at all, and we’ll all be better off than we would be under the Senate bill. We deserve a public option, a government alternative to private, for-profit insurance. Further entrenching the bad guys is just not the way to go, IMO.
Maude
If this doesn’t pass, there won’t be another bill.
OT I thought Hugh Downs was dead and here his is telling me about cleaning my arteries. With what? Embalming fluid?
Seebach
Can’t we all just agree that Lieberman needs to lose his chairmanships and get kicked to the curb? He’s going to do this exact same thing for every Obama initiative. Let’s get it over with.
MikeJ
@Bruce (formerly Steve S.): The Catholic Church is morally obligated to feed the poor, help the needy, and promote human dignity.
Marriage equality activists are obligated to help promote human dignity. Looks like some overlap in mission there. Who is falling down on the job?
DecidedFenceSitter
For those people out there who want to kill the bill, a sentiment I understand, but don’t agree with, I have a question with a two caveats:
Question: Why do you expect the next attempt to be better?
Caveat: House/Senate remain fairly stagnant.
Caveat: Senators will maintain positions, strengthened by the appearance that they can spike the President’s agenda.
I see nothing to say that another try is better. Now if your statement is “Kill the bill, and let’s wait another 10-20 years” that’s an acceptable, i.e., logical answer; but I’m not sure what anyone who wants to start the process anew now expects to get out of it, considering my two caveats.
Comrade Scrutinizer
@Seebach: Just exactly how is that supposed to happen in the middle of a session?
Raoul
Repeating over and over that having a crappy bill is better than none at all does not make it true. Especially, when the bill would be rescinded when the GOP takes over because of the bill.
Seebach
@Comrade Scrutinizer: Well, if it can’t be done now, it can’t. But someone can take a cane to his head, can’t they?
The Bearded Blogger
@Bruce (formerly Steve S.): Right: you are asking about the consequences of an action that is, in itself, moral. Let’s assume the morality of an action is judged by its consequences (I have no idea if this is or should be so): If the catholic church were to withdraw aid to DC, it would be shown up as the bigoted stinkhole that it currently is, either debilitating it or forcing it to change. On the other hand, other charitable and less crazy organizations would redouble their efforts in DC. So, as far as I can see, it would be moral to push for gay marriage in DC.
Karmakin
Here’s my understanding of the argument. Ezra is banking on the fact that if insurance premiums don’t go down, it’ll be a huge political clusterfuck, and more will be done at that point.
The other side is saying that if the sociopathic centrists were able to do it this time, what’s stopping them from doing it the next time. Obviously public support means nothing to them.
Frankly, the later are probably more right, unfortunately. The “centrists” are simply never going to admit that the DFH were correct.
Now, there’s another question. Is this on its own an unmitigated good? There’s a lot of people who are going to have income drained out going to private corporations for basically nothing. Personally I think this is going to do bad things to the insurance market, premiums and costs are going to go up faster, and nothing will be done politically because it’s good for the investment class. (Which includes a whole lot more people than you might think. Take for example the vapors people are having about falling home prices.)
Ruemara
Here’s my issue. I am not happy with this bill. I DO NOT LIKE. What’s the alternative? Where are those who are busy deriding the president, rahm, lieberman and puppies with an alternative? Do nothing puts you in the same camp as teabaggers-the not fun kind. Who’s got a proposal that can get the 60 votes it needs to end filibuster and start us on the road to healthcare reform in America? And this will not even be the final bill. So who is presenting some set of items that will pass senate, get through conference, etc etc., and be that great progressive item that they want? Anyone know?
Jay B.
OK, let’s talk as moral agents then. This is a horrible story. And no matter what happens in this bill, the writer will, theoretically, be able to find another insurer next year (although I thought that the bill provisions don’t really begin until 2013). They better pray that the insurer doesn’t find “fraud” in his/her application. Or find some other loophole like the one which could potentially cost him/her 3X as much to stay insured as someone younger. Or that his/her premium could be much, much higher than even under COBRA.
Edit: Isn’t then the “moral” thing for those of us to oppose it try and continue to fight for something better that will help more people and bring down health care costs for everyone?
Comrade Scrutinizer
@Seebach: He should have had a boot up the ass at the beginning of this one, but “he always votes with us except on the war.”
Suckers.
MattMinus
Bullshit.
A bad bill = realignment.
I see your sick working poor and raise you the Iranians that President Palin will kill.
The fun never ends with broad utilitarian calculus.
wobbly
So a bill that somewhat improves the situation gets passed this year. Next year, perhaps, another bill that improves upon it gets passed.
I really don’t get the “do or die scenario” here. (Even though I am in immediate danger of losing my job and my coverage, expensive and crappy as it is.)
Emma
TaosJohn: I see your concerns, but you have already decided what will happen by 2014? I know pessimism is the most logical respopnse at the moment, but that’s a while away. Not to mention that this is the SENATE version of the bill we’re looking at. In fact — pace Ezra, Krugman, or anyone else — we don’t yet know what the final bill will look like…
Bruce: I am of two minds, but I keep thinking, we always ask the Republicans to think of the people they hurt. If we’re not looking out for them either, what is the point?
Dreggas
@Raoul:
Last I looked it’s much harder to repeal something once it has become law, especially if it is an entitlement.
The Bearded Blogger
@Seebach: Seconded. If bad actions are rewarded, every fucking democratic senator lacking a conscience (about half of them) will become a lieberwhinybaby otherwise
Sleeper
I know everyone here is fairly taken with Ezra Klein, but I think it’s pretty ridiculous for him to say that he’s actually in favor of public insurance when he’s been arguing pretty consistently that the public option isn’t important but the free-market insurance exchanges will magically fix most of the problems with health care in this country. It’s easy, and expected, to say nice things about someone you never care for at their funeral.
Balconesfault
Why not just clean everything up, then.
Just propose a bill that is a direct subsidy, based on means testing, for individuals to buy insurance on open market.
I agree wtih Raoul. This doesn’t do anything permanent – add a Republican Congress, continue high deficits, and it will get hacked to pieces in no time.
Yes, it’s nice to provide some people who don’t have coverage something in the short run. But in the long term it will likely buy them squat.
If we create a public option, it will create a framework for those people to have government supported healthcare for a long time.
Why do you think that it’s so hard to pass, despite having well over majority support? Because everyone knows that this will be a permament game change – subsidies won’t.
jl
I am puzzled and perplexed about why people cannot wait for the conference bill.
I agree with Ezra that the private health insurance industry as currently exists in the US should not exist. But private insurance can work fine if properly regulated. Switzerland manages it. Greece does too with their odd system of private insurance with a national health service for the providers.
If the conference produces a bill strengthened with some of House provisions, we might have a palatable bill. That is the time to decide whether to give the thumbs up or thumbs down. And that is the time we will get more indications of whether Obama is an n-dimensional chess player, a BigDawg Bill wannabee who can’t handle it, or an arrogant hypocrite.
When that happens, if it does, and the bill promises to work as well as the also quite bad MA system, it might be worth supporting. The MA system is bad, but is enough improvement over what went before that it is overwhelmingly popular, and provides a good solid enduring platform for further reform.
People should stay calm. If the conference bill ends up to be more or less a copy of the Senate bill, and evidence that the WH, Lieberman, Conrad, Nelson et all dictated it, then I will join in the chorus of boos.
Riggsveda
How about if one of the “centrists” get a bug up his ass to take out the out of pocket caps and let the insurance companies have their lifetime limits back. Is it still worth passing then? I mean, really, is there any old skeletized, gutted and smoked proposal they WON”T call “reform” and argue it’s better than nothing? Fuck them. Get rid of the mandate and maybe we’ll call it a draw.
The Bearded Blogger
@Karmakin: the bill is shit if it has mandates. Worse than nothing.
If passed, without mandates, it’s like moving a couple of inches forward.
Mitch Guthman
Ezra makes it sounds as though this was an externally imposed choice. It wasn’t. The reason why the choice is between these particular alternatives is because that’s how the Obama Administration decided to frame it. Pres. Obama could just as easily put forward a bill without massive giveaways to Big Pharma, the medical lobby and the insurance companies. He could have proposed the kind of bill which the Democratic Party has been promising and running on for the past forty years—a bill with a real public option, the ability to negotiate for better prices on drugs and meaningful cost controls. He didn’t propose such a bill because those things were not important to him.
He could have proposed a far better bill, including the public option, and fought for it as he promised to do during the campaign. He didn’t. Instead, Obama gave everything to the corrupt corporate interests and told the rest of us to be happy with table scraps.
Sleeper
@Seebach: Maybe that’s the point to a Lieberman. Obama went out of his way to protect the man and help keep him in place (not that Lieberman was all that eager to join the Republicans I’m sure, much more attention is paid to him this way). Lieberman is a handy ally to have when you want to appease your donors but don’t want to be blamed by your base. There’s a reason that the White House who has no trouble smearing Howard Dean now as being misinformed, irrelevant, and possibly mentally unstable, didn’t make a peep about Joe Lieberman (or Ben Nelson, or Blanche Lincoln…). There’s no gain for them by going to the left, they figure those people will already vote for them. No need to appease your own base.
This is a terrible strategy, by the way, but I think they firmly believe it to be the winning one.
Comrade Scrutinizer
@Ruemara: Oh, it’s simple:
1. Kill the bad bill.
2. Come up with a better bill that includes all the stuff that has been stripped from the bad bill before it became bad, plus ponies.
3. Magic happens, and the evil centrist corporatist faux progressive bastards that have turned this good bill into a bad bill will see the light.
4. The new good bill passes, and a new progressive utopia arrives.
Bruce (formerly Steve S.)
Is it your position then that those who oppose the “current bill” are obligated to oppose the bill rather than worry about the potential consequences of no bill being passed?
Balconesfault
@jl:
Switzerland isn’t besotted with Randian teabaggers.
I go with Kos’s take on the Switzerland analogy:
Those countries also have strict regulatory regimes that heavily regulate those insurance companies. In Switzerland, for example, insurance companies cannot profit from the essential benefits plan everyone must purchase. That’s kind of an important detail missing from the Senate’s monstrosity of a bill. In addition, Switzerland also strictly regulates the price of medicines and medical devices — something this Senate has explicitly refused to allow.
Give me those kinds of restrictions to the Senate bill, and I’ll rethink my opposition.
mr. whipple
Yup, and I’m loving the irony(not) of some young liberal folks saying, “kill the mandate”. The mandate is necessary for essentially socializing risk. Yet all of the sudden, they become libertarians.
Lev
@Mitch Guthman: There’s another term for it: divide and conquer.
fizzlogic
What bugs me most is people buying in to the idea of pooling…as if that’s some new technique unlike the basis from which insurance works. Only now “pooling” is the magic some financial wizard does to maximize the profit at the expense of not insuring everyone. Why not force the insurance companies to insure everyone–in one giant pool. Ah, but that makes too much sense.
Anyway, the bill needs to pass. And for those who can’t afford their policy, they can go to a special debtor prison where they can get full coverage.
Cat Lady
I’m SO tired of all of these ridiculous arguments, and needing to rely on those assholes in the exclusive Senator’s Club. Let’s just learn how to take care of each other. It’s got to be easier.
+ 2
Maude
How come on all of the HCR posts, there are a bunch of new commenters? Not only here, but some other blogs.
MattMinus
@Riggsveda:
You’re missing the point. The insurance companies dream of mandates with no protections. That’s where Lieberman, Nelson et al. will stop.
Just Some Fuckhead
@Seebach: Well, look. *pained chuckle* Joe Lieberman, I’m not hear to talk about what Joe Lieberman might or might not do. *changes subject*
I believe I nailed the script word for word.
NobodySpecial
@jl:
Because reconciliation will not end up with provisions being added back in, because the Senate group will simply tell the House group that it will not pass. And then, given a choice between letting it die and passing crap, they will pass crap.
Mnemosyne
@Bruce (formerly Steve S.):
You’re morally obligated to try and mitigate the hurt that you cause. If the Catholic Church pulls out of its poverty programs and the gay community doesn’t step up and try to help, they’ll look like a bunch of ginormous assholes who only care about themselves. (In this situation, the church looks like a bunch of ginormous assholes either way, so they don’t come into the calculation.)
General Winfield Stuck
@TaosJohn:
That was with direct government involvement with a PO or Medicare. The insurance reforms, ie pre existing conditions would go into effect right away, in the current bill.
But that was to not only raise some cash, but also the time needed to put in place the requisite infrastructure to administer a full blown government program, albeit to be partly administered by a private entity.
Direct subsidies may not take nearly so long as 2014. and with most of these type entitlements, services for the poorest among us, usually go into effect first.
Either way, your going to have to wait, but odds are, it would be less with just subsidies to existing insurance companies. And we still don’t have near a final bill yet.
That said, I remain a firm believer that just regulation alone will not bring down overall cost of health care in the long run. That has never really worked that well, especially with the government setting prices for a private enterprise. Only a non profit government PO thingy will do that job. And it, at some point will have to be open to anyone who wants it, not just the poor.
Only way to be sure.
jl
Also. Interesting how this debate has radicalized some folks who I thought were sensible ‘radical moderate’ (and ex-Republican) progressives. Both John Cole and Cenk Uygur at The Young Turks both say “**** it, let’s have a national health service.”
Me, a sensible moderate, just got done outflanked to the left by folks I thought were well to the right of me. Obiwan Mystic Political Master Obama, I feel yer pain at the unruly shrill dogmatic left.
But, a good NHS would work about well as anything else, if done right. I intrepret them advocating such a move as an implicit decision that the US political system is so corrupt and rotted by legal big corporate bribes that some vital services have to be completely removed from the private sector in order for there to be any real change.
I am about 75% there too, and won’t argue much of people call me a hopelessly optimistic fool.
Bruce (formerly Steve S.)
So could it be said that if the “current bill” is scuttled then somebody will redouble their efforts to get another bill, so it is moral to push for the “current bill” to be scuttled?
Guster
Would someone explain to me why it’s silly for the bill killers to be railing against an unfinished bill when it’s not silly for the wonks to be supporting an unfinished bill?
John Cole
Screw it. Kill the god damned bill. I’m insured. I don’t give a shit anymore.
Mark my words, you kill this bill, you will not see another HCR bill for decades, and if you do, it will be Health Savings Accounts offered up by President Pawlenty as the voter backlash to the Democratic incompetence shifts the reins of power to the Republicans but the Health care crisis has gotten so bad even they feel the need to do something. And then your Health Savings Accounts will get looted by Wall Street, because the Republicans will have deregulated more and put more hacks in at the SEC.
When did the mandates become the new focus of outrage? For christ sakes, you all latched on that faster than the wingnuts latched onto the hockey stick to deny global warming.
mr. whipple
Sigh. Again with the lack of regulations argument:
http://voices.washingtonpost.com/ezra-klein/2009/12/five_cost_controls_in_the_sena.html
Bill E Pilgrim
Let’s be clear about one thing. Pass this bill or not, oppose it or reluctantly support it, don’t lose sight of this:
Lieberman is not threatening to vote no. He can vote no, that’s what he’s there for, to vote yes or no. No, what he’s claiming is that if it isn’t to his liking, he’ll join a Republican filibuster and stop any vote from taking place.
This seems so simple but is simply lost in the shuffle it seems to me. I hear people talking about how they’re “trying to win his vote” and about “how he’ll vote” and so on.
The health care bill would pass a vote. Votes are not the problem. It would pass with a strong public option, with a medicare buy in, god knows with what else. It would get 51 votes without Lieberman and the other Blue Dogs, and no Republicans.
I saw a clip of Chris Matthews grilling Howard Dean and Matthews claimed that what Dean is proposing, going to reconciliation, would “destroy the US Congress”.
That’s what it’s come down to in the Beltway mentality, which Matthews so perfectly embodies. A minority with only 40 votes controlling what passes and what doesn’t, is just fine, just the way it’s supposed to be. Apparently.
Suggesting a majority vote where anything over half wins, on the other hand, that’s “destroying the US Congress”.
People will respond that well, those are the rules, so what are you gonna do? Here’s what: Lieberman and the others threatening to join in sheer obstruction with the Republicans should be shamed beyond belief, should be embarrassed to even suggest such a thing, and any talk of “irritated” should be directed at them, as a good start, instead of all of the ass kissing. Join the fracking Republicans and obstruct what the people want, obstruct the elected representatives from getting the business done that needs doing? How dare you!
Instead, we’ve got the Villagers claiming that even daring to suggest such a thing as letting the majority rule is “destructive”, and letting a minority run the whole show is not.
Yeeeesh.
Just Some Fuckhead
@Sleeper: This.
Oh Canada!
Since they want to take their country back – why not do this: Everything ABOVE the Mason Dixon line becomes annexed to Canada. Everything BELOW the Mason Dixon line gets to be the New Conferate States of America and Dubya gets to be their first presnit for life- sounds like a win to me.
Leelee for Obama
As to the cavalier attitude some have shown towards this bill, I am reminded of a scene in Amistad, where the white abolitionist says the Amistad Blacks might do more good for the cause dead than alive. Of course, Morgan Freeman is horrified and goes on to work for their freedom with the lawyer and John Quincy Adams. It has been stated here before, but those who are bitching the loudest about what this bill doesn’t do are unlikely to be without health insurance anytime, let alone anytime soon. If I and the many others who have no insurance are expendable for the greater good, it’s be nice if they would just say that. At least we’d know where we stand.
Just Some Fuckhead
I’m telling everyone I know to buy stock in publicly traded health insurance companies. Get on the WIN, I sez.
jl
@NobodySpecial: I’m just recommending waiting to see if that transpires, rather than assuming that it will.
But whatever.
Not sure it makes any difference. We have seen how much influence popular opinion that at least this time is same as sound policy advice has on the critical decision makers: none.
NobodySpecial
@John Cole:
When we lost the public option, that’s when. After it was removed, the cost containment needed to make the mandate work was not there. And considering how fast they took the PO out, substituted the Medicare buy in and then had Holy Joe shit all over that, what else were they supposed to do? Pull a Miss Cleo and argue it days before it all happened?
MikeJ
No they won’t. People who want basic human rights aren’t forcing the Catholic church to do anything. Saying marriage activists “made” the church act like pricks is like a husband saying his wife “made” him hit her because she wouldn’t shut up.
Of course you could be arguing that everyone has a responsibility to help the poor, etc. But nobody has any more responsibility just because the Catholic church hates human rights.
Mari
Democrats will lose power unless they deliver something positive to the electorate. If they deliver nothing, they will be voted out for being weak. If they deliver something worse than nothing, they will be buried for it.
In the eyes of an electorate that has seen its real wages decline over the past thirty years, health care reform that forces people to turn over 10% of their income—as a defacto tax—to the insurance industry will be as popular as a reform package that provides a mandatory bullet to the head as treatment for all chronic diseases.
The Democrats are in a lose-lose-lose position. If the Democrats don’t pass any reform, they’ll lose. If they pass a mandate, they’ll lose. They don’t have the support to pass real reform.
Health care reform is a political third rail. Half-measures are fatal but the political will does not exist to solve things properly.
Tom Hilton
@Raoul:
But it isn’t a crappy bill. It isn’t a perfect bill, but that doesn’t make it crappy. The bill covers 30 million people who are currently uninsured. It has a whole range of cost control measures. It sets up the infrastructure (the Exchanges) for an eventual single-payer system. It reforms the worst insurance industry practices. It has penalties for insurance price-gouging. And it has several hundred billion dollars in subsidies for low-to-middle-income consumers. Ezra is right: passing even this flawed, compromised bill would still be a huge step forward. Not the final step, but a huge step.
Edwin
If the bill passes, I still won’t be able to afford to see a doctor. I can still go bankrupt if I have a major illness. And I’ll be forced to pay for this “coverage.”
Those who have dependable group health care are the ones seeing this in the abstract. I’m in my 50s and self-employed. If I get sick, I could lose everything I own. If the bill passes, nothing will change, except I’ll be paying higher premiums for near-worthless insurance.
Sleeper
@jl: The people trying so hard to kill reform, both Dems and Repubs, would be just as opposed to establishing a Swiss system where private health care providers are regulated like utilities and are not allowed to make profits. They are beholden to and besotten with the notion that the primary goal of providing health care is profitability. Not maximizing access, or maximizing quality of life. Maximizing profits. A private system without profits is just as dangerous to them as a public system without profits. They won’t permit it to happen on their watch.
And the reason people don’t want to wait until the bill comes out of committee is twofold, they see it as more pointless theater with a guaranteed result of suck, and it gives this awful bill that much more impetus and makes it harder to kill. There is already serious talk of just adopting the Senate bill as THE bill and ignoring the House altogether. Then comes the full-court press from the White House, the DNC, and Dem Senators on the House to just pass it. Bills just don’t get more progressive in committee. That’s why Booman’s idea that Obama planned to sneak in a public option in committee after the Senate passed a bill without it always struck me as being just woefully naive and Pollyannaish. Would Senators just snap their fingers and say, “Shucks, skunked again! Didn’t that coming, oh well, win some, lose some.” Committee just gives the obstructionists (the Lieber-men?) more time to drag it out and make demands. That’s why people don’t want to wait.
jl
@John Cole: Have you taken Lily for walk in those lovely woods yet today? Weatherman says it is clear and nicely brisk today. You need to take a break.
Bruce (formerly Steve S.)
I’m not sure why the involvement or non-involvement of the Catholic church in good works would calibrate one’s own personal involvement in them.
Guster
@Bill E Pilgrim: That’s so easy to forget, and so central …
I think it points to one of the biggest failings of leftie organizing, too. That’s a pretty simple and effective argument, and we haven’t made it.
You say you want a revolution
John,
Such a kidder. There will be no meaninful change here without the judicious use of C-4 and a few successful sniper shots at health insurance company CEO’s. That’s just the way it is.
http://www.sickforprofit.com
mr. whipple
The public option, by some estimates, was actually going to cost more than the private plans. (Don’t ask me why.)
Further, from the very first House bill, the public option ws restricted to a fairly small group of people. If one thought that anyone could just sign up, they were mistaken.
Jay B.
@Leelee for Obama: @Edwin:
OK, which one of you is right?
My sympathies are with both of you, but knowing our system, who is supporting what and how the interests are placated, Occam’s Razor points to Edwin.
Tom Hilton
@mr. whipple: I think the disconnect here is that the bill killers see the insurance companies as driving costs, when it’s actually healthcare costs that are out of control. So we can tell them over and over about the measures designed to hold down healthcare costs, and they don’t get it because they’re looking for punitive measures aimed at insurers.
Paula
Cracktacular.
Per the bloggy left, this horrible mess of a bill will end up fucking everything up and depressing morale for 2010, so wanting to kill the bill now presumes … what, that the depressed numbers of Dems post-2010 will produce a better bill? Because logic says that health care ain’t being brought up again during election season. Especially since climate legislation and/or immigration reform are next @ bat.
According to actual recent historical precedence for massive health care reform, NOT passing the bill will produce the exact same result that the bloggers predict will happen if the bill were allowed to pass.
So why do they need to waste their breath? The same shitty result for DC Democrats in either scenario, which would be a way to deliver a “lesson” or whatnot (as if). If the bill passes and fails, bloggers can still say, “I told you so”.
lamh31
Whoever it was who linked to the post by Al Giordano (Da Bomb…I think) thanks. It was a good read, and like BJ, it’s great that Girodano will respond to commenters.
Anyway, this update to Giordano’s original post, really struck me:
Health Care: What Would Teddy Do?
Posted by Al Giordano
Bruce (formerly Steve S.)
I think the folks opposed to the “current bill” would say that they want to improve the “current bill” in such a way that this wouldn’t happen.
jl
Dudes, on Switzerland, I was just making a point of principle, to push back against extreme dogmatic lifelong Stalinist collectivists like Cole and Uygur who want a national health system (snark tag here). I was not saying that there was a chance we could get that here in the near term.
But it would be a nice gambit to seriously propose it and force the douchenozzles to explain why it was a commie plot.
My test for the conference bill that is actually produced is whether it stinks worse than the MA reform or not.
Stinks worse: kill it.
Stinks less than or same as: pass it.
NobodySpecial
@mr. whipple:
I’d like those links, given the CBO scoring.
Just Some Fuckhead
@John Cole: That might be a record holdout on yer part.
Tom Hilton
@NobodySpecial:
And what would the public option have done to hold down healthcare costs?
General Winfield Stuck
@Bill E Pilgrim:
The wingnuts used reconciliation with Welfare Reform in 96, and dems didn’t destroy the senate, but now wingnuts threaten to. It is bluster and they know anything other than some short term mischief to make a point would come back to bite them, like it did when they shut down the government in the 90’s.
Americans don’t like that kind of take my ball and go home shit, and to do so would turn to dust whatever credibility of governing the GOP has left.
However, anything is possible when a major political party is helmed by the likes of Rush Limbaugh and Sarah Palin. Nothing whatsoever that they did would surprise me.
mr. whipple
If you are self-employed, you should welcome this. If you’ve tried getting coverage as an individual, you know how expensive it is. The exchanges are set to work like any large group: there is buying power.
Second, yes, you will pay a premium, but if you are low income you’ll be subsidized. If you are self-employed and earn a decent living, you should be insured anyway.
The meme continues to spread that insurance is ‘shitty’. If that’s the case, why do unions take health care negotiations so seriously, oftentimes passing up wage increases and pensions just for insurance?
Sleeper
@John Cole: I have a car I want to sell you. And by that, I mean that I am going to compel you to buy it, by law. It’s not perfect, granted…the steering wheel is a little bit sticky. It only turns to the right. But hey, the gas works fine! You can move to the right as fast as you want! And at least you’re in motion. We all agree that where we are now is not acceptable, so we need to get in this car and go somewhere else. If it turns out that it takes it further away from where we actually want to be, well, we’ll just keep driving until we find another dealership and we can start shopping all over again.
Yes, metaphors are usually puerile and insufficient, but this is how I see the debate right now.
comrade scott's agenda of rage
Here’s what I don’t get:
Let the Senate pass whatever. Then do the heavy lifting in committee to reconcile the two bills.
This assumes the House has
a) more spine, and
b) bigger balls.
Bill E Pilgrim
@Guster: I think it’s only because I’m not in the US, and been too busy to be as obsessively watching this as I normally would. Or because here I never see any TV about it, only what I read online. Or who knows. But it does seem to be getting missed over there. Pretty freaking central if you ask me, yes.
Chris Matthews has pretty much always made my jaw drop with his almost Zen-like perfection of a certain kind of mindless talking point regurgitation. Let the point talk itself, grasshopper, yes. You don’t aim the talking point at the target, it aims you. Be a vessel for it.
NobodySpecial
@Tom Hilton:
Should be fairly obvious. When a plan run by someone who doesn’t need to make dollar one over cost compares to plans run by someone who has to make a profit, guess which one is usually gonna be cheaper?
And yeah, I know, ebil doctors, yadda yadda. They’re far worse than insurance companies. But this is the leverage we had, so it’s what we used. And when it got stripped out, we’ve been told to shut the fuck up.
Jay B.
And if you’re right, then why are the unions opposed to this bill?
Lev
@Paula: Please show me a poll in which Democrats state that the healthcare debate has “depressed” them.
It’s certainly not this one yesterday from Gallup: http://www.gallup.com/poll/124715/Majority-Americans-Not-Backing-Healthcare-Bill.aspx
Dem enthusiasm has held steady for months.
Suzan
My understand is that no one, repeat, no one who is uninsured today due to not having the money/job to pay the freight will be any better off with the current bill. Instead, they will be forced to pay for insurance that has high co-pays and deductibles and low coverage. Thus the insurance empire wins again.
So how is this better for us?
Uninsured due to poverty (and not medicaid eligible).
S
This is not a great bill. But the status quo is very, very bad. The cost controls may be insufficient, but in the status quo, they simply don’t exist. Private insurance isn’t optimal, but it’s better than the total absence of coverage.
mr. whipple
@NobodySpecial:
I gotta run w/wife, but I’m almost positive I read that at Ezra’s. If you do a search there and find it, please let me know, and if not I’ll try to dig it up later in the evening.
Bill E Pilgrim
@General Winfield Stuck: Yes but my point is that even just saying “Okay maybe we should just force an up or down vote” is now being called outlandish by the Villagers. Now that it’s the progressives saying it, of course.
The real point though is that people like Lieberman who are throwing their weight around casually threatening obstructionism should be called on it. From where it matters. And they’re not being.
General Winfield Stuck
@Bill E Pilgrim:
I fully agree.
wasabi gasp
Bill’s great, man. Let’s do the chicken dance.
NobodySpecial
@Suzan:
They don’t believe you. They likely never will.
General Winfield Stuck
@Sleeper:
Jeebus. More used car analogies. Where is my Heroin?
Rick Taylor
__
I’m not sure where I stand in this debate, but this is a bit obtuse. Mandates were always the compromise that would make requiring insurance companies cover pre-existing conditions palatable to the right. A public option or some sort of competition or choice was what made mandates palatable to the left. The argument is that requiring people to buy insurance from private companies protected against antitrust would be disastrous without some minimal competition from the public sector to prevent them from jacking up premiums or cutting services. We can argue whether these arguments are valid or not, but the connection is straightforward; I’m nervous about it myself.
Tom Hilton
@NobodySpecial: All of which has nothing whatsoever to do with the things that drive healthcare costs. The public option wouldn’t have done anything about costs. So it’s kind of dishonest of you to try to claim that there’s a connection.
Pubic Option
See – I be like the frat boy Rethuglicans now. Got you’re attention. We’d all like a public option – except those of us who wish we were among the 40,000 people a year who die because they have NO health care insuancel. Whiskey Tango Foxtrot? – these people will be out on the astro turf Tea Bag trail.
Rick Taylor
__
My understanding is that people who have pre-existing conditions who can’t buy insurance at all would benefit, as they’d be able to buy the same policies as anyone else. And that people who are very poor would benefit as they would receive subsidies and so be able to afford insurance they can’t now.
General Winfield Stuck
@Suzan:
this is where you are wrong. The current bill will raise the dollar amount of those who would otherwise qualify for Medicaid to at least 50 thousand income a year. And depending on which state you live. it may well end up being higher than that.
I saw it on CNN – Liz Cohen this morn.
Lev
@Rick Taylor: You’re wrong. Practically every blog on the left viewed Obama’s campaign HCR plan as deficient because it lacked a mandate. Krugman alone brought it up on about 20 different occasions in his print columns. Many used this to extrapolate a lack of progressive commitment from him, and they figured that John Edwards would be better, because he was a “fighter”. Of course, he had been a standard DLC Democrat for his entire career before that, but whatevs.
Now, the mandate is anti-progressive. George Orwell wrote that orthodoxy entails absolute faith in constantly changing propositions. A lot of people were simply invested in the “Obama’s no liberal!” storyline, and even though he eventually flipped on the issue, this is now evidence of how he’s selling progressivism out.
Wile E. Quixote
@Comrade Scrutinizer
And let me present the equally specious logic from the “pass the bill, it’s better than nothing and we can always improve it side.
1. Pass the bad bill
2. Come up with reforms to the bad bill that include the stuff that was stripped from the bad bill before it became bad, plus ponies.
3. Magic happens and the evil, centrist, corporate faux-progressive bastards that have turned the original good bill into a bad bill will see the light and not stonewall the reform of the bad bill.
4 The reforms to the bad bill pass and we end up with something that doesn’t suck and is actually functional at delivering health care so that people who are paying into the system actually get money for value received.
General Winfield Stuck
@Rick Taylor:
Yes, And where are these morans getting all this bad info? I wonder. Did they hire Dick Cheney to write talking points, like with the Iraq War? And turnabout is fair play libtard phony DFH”s.
General Winfield Stuck
@Lev:
No PO Pony has drove many on the left to madness, now believing any piece of bill kill propaganda they are fed. History revision is on the march.
jwb
@General Winfield Stuck: What, there are goopers sailing under false colors, spreading misinformation through the left blogosphere? I’m shocked, shocked.
willf
I must disagree.
Like Atrios said back in the `o8 election: “Why mandates? Why not just sign everyone up?”
Of course that doesn’t mean that bloggers like Ezra Klein felt the same way.
Mandates were presented as the compromise for insurers no longer using techniques like recision, and having to accept everyone.
Having a public option was an attempt at instituting a non-regulation market force to keep those mandated policies affordable.* Everyone had to pay in, to avoid people waiting to buy insurance until they got sick.** But the public option (initially) meant that you could choose a medicare-like plan if you didn’t want any of the private plans the gubmint was going to force you to buy.
*As originally envisioned, anyway.
**Has anyone seen the numbers on this? Because this practice of “not buying insurance until already sick” has been referred to again and again, but normal insurance policies have tools for dealing with behavior like this, not even counting recision, and its abuse.
NobodySpecial
@Tom Hilton:
Because, of course, no insurance companies actually make a profit. Right. Or don’t bury it in increased compensation. Ok. I’ll shut up now, your logic has convinced me. :eyeroll:
Wile E. Quixote
@John Cole
Way to stick it to those DFH’s John! You go girlfriend!
Guster
There is no current bill.
danimal
@Wile E. Quixote: I know you’re being sarcastic, but your scenario is much more likely than you may think. A lot of the opposition to the bill is based on optics–“piss off the liberals…” Once the bill passes, both parties will be interested in making adjustments to the bill. Lieberman, for example, won’t have any problems running to the left prior to his reelection campaign in 2012. Same for the Maine contingent. Once reform is the law of the land, our negotiating position improves dramatically.
John S.
Take it away Al Giordano:
Nice to see so many progressives “sticking to their guns” by switching positions when it’s politically expedient to do so.
General Winfield Stuck
@Guster:
I know. but today, we are all Alice in Wonderland
NobodySpecial
@mr. whipple:
I didn’t find it, but I did figure out why I find Ezra so irritating on this issue:
I got news for Ezra: According to Gallup, 3 in 10 people who make less than 36K don’t have insurance or Medicare/Medicaid. Link. So reality for most of us isn’t what Ezra thinks it is, and it’s his reality that he’s pushing with this ‘bad bill is really good, in a bad way’ nonsense. And those people, as I’m one of them and can tell you, don’t often have the luxury of passing on a job because it doesn’t have insurance. And don’t get me started on bad insurance plans like Starbridge, which is Walmart’s favorite and was offered where I worked too. At the time, it had a $1,000 cap on benefits a year, which is worthless. I doubt it’s gotten any better, but it counts as ‘insurance’ in the world of Ezra Klein.
Texas Dem
The discussion in this thread is slightly academic at this point because HCR is DEAD. The final nail was driven into the coffin by our old friend, Ben Nelson. And don’t count on Snowe or Collins to save the day. The next phase is the blame game, with “moderates” and “progressives” fighting over who killed health care. Meanwhile, we inch our way closer to 1994, the sequel. The final act ends with Speaker of the House Cantor, Majority Leader McConnell, and President Palin. Cue the speech to the joint session of Congress by President Palin and the military strike on Iran. Then progressives will really have something to complain about. Enjoy your time in the wilderness guys, it’s going to be long and bitter.
Tsulagi
@Just Some Fuckhead:
Maybe, but guessing too late for the good money. Lieberman, other serious congressional adults, and industry lobbyists likely bought shitloads of options long ago.
Really, they should call the current crap on the table what it is, it’s not HCR, it’s the Health Care Industry Stimulus Package of 2009. AIG and even Wall Street are probably looking at this saying “Fuck, we only got coffee money.”
John S.
In your own retarded way, you more or less described how things like Social Security, Medicare and Civil Rights came to be as they are today (minus all the snarky half-witted bullshit).
Rick Taylor
@Lev
I remember that. I don’t see what it has to do with my post, but I have marveled at how ironic it is that the Obama campaign attacked Clinton for including mandates, and now he’s getting attacked from the left for the same thing.
__
But it’s perfectly consistent to say one supports mandates provided it’s accompanied by measures to introduce competition so keep insurance companies from gouging customers who have to buy their product, but opposes them otherwise. As Atrios put it,
__
__
Again, I’m not saying I agree with these arguments; I know there are other arguments (the public option isn’t the only way to control costs, for example). Honestly, I’m undecided. I just think accusing the people making them of having bad faith or exercising Orwellian double-think is wrong.
DougL (frmrly: Conservatively Liberal)
@Sleeper: “It only turns to the right.”
Three right turns makes a left, right? Works for me! Hell, in the late 70’s I had an old ’57 Ford wagon with a bad tranny that eventually only moved in reverse. My Mom thought I was nuts driving it but it got me back and forth to the local store and work for three months. During that time I was pulled over twice and both times the cop let me go without a ticket.
If you still are offering it then I will be glad to take your car. Just drop it off and I will do the repairs necessary. It’s a heck of a lot easier to fix a car on hand than it is to fix a car without a car to fix. ;)
John Cole
@Wile E. Quixote: So let me get this straight- I support the bill, I am attacking the DFH. I say to hell with it, kill the bill, I am attacking the DFH crowd.
I’m beginning to understand why people like punching the hippies.
Paula
It ain’t an astroturf misinformation campaign. I was against the mandates in the Edwards/Clinton bills and was declared anti-progressive, as was the Obama platform. In the midst of the fight over “mandates”, bloggers pretty much failed to delineate the context in which they occurred. So whether any of these bills fully articulated cost-controls or established a full-on Medicare-style public option was mere “detail” in the face of the “mandate question”.
FWIW, Jacob Hacker in Feb 2008 on Clinton v. Obama in health care cost controls and the mandate obfuscation: http://www.latimes.com/news/printedition/asection/la-oe-hacker26feb26,0,775241.story
The Health Care blog:
http://www.thehealthcareblog.com/the_health_care_blog/2008/02/hillary-clinton.html
http://www.thehealthcareblog.com/the_health_care_blog/2008/03/a-detailed-anal.html
It’s only when mandates became a real possibility in these current bills that the tide turned.
So am I surprised that the whole public option thing has been so tenuous? No. The groundwork wasn’t done AFAIK in 2007-08.
John Cole
@Texas Dem: Yep. But everyone got to stick to their principles!
Rick Taylor
__
Well if I understand things correctly, the whole point of banning denying people with pre-existing conditions from getting insurance is that it would make these tools inoperative.
Tom Hilton
@NobodySpecial: so if you think a public option actually addresses the factors that are driving healthcare costs, how about making a case for that instead of trying to cover up your ignorance with braindead fucking sarcasm?
danimal
@Texas Dem: I hope you’re wrong, but there’s a 50/50 chance you have it right. I still have hope that Snowe and Lieberman will come around; Nelson is probably a lost cause.
John Cole
@Texas Dem: You should see aravosis and HunterDk and crew burning it up on twitter. They’re just loving it.
Even Marcy Wheeler is offering up wingnut logic: “If we can’t regulate DOD well enough to prevetnt insurgents from hacking our predators, how will we do Health Care?”
Surprised she didn’t go with the tried and true Post Office bit.
Jack
@Raoul:
That’s perhaps the most perfect summation yet. With one caveat. It could also read “made worse by Republicans” after they get elected because of it…
BombIranForChrist
I am just not convinced that the status quo is somehow worse than this bill. The status quo is that insurance is really, really, really expensive and not mandated. The bill will create insurance that is merely very, very expensive, and it WILL be mandated. And for those who can’t pay it, the government will subsidize it. Sounds insane.
It still bugs me, though, that John, TPM, Ezra, etc. think it’s fine. I think they are right about most things, so … what am I missing here? How is this not basically a new huge subsidy for an industry that has no effective cost controls on it?
General Winfield Stuck
@John Cole:
Though my crystal ball is on the blink, and HCR reform (The Bill) may fall and fail. But I see the 52 liberal senators say hell no, we won’t go, again to 1994. And then ram just a PO thru the senate by reconciliation, Then Harry Reid will lay an egg on the senate floor and the day is saved.
My goat entrails reading will be at 10 pm tomorrow. Don’t miss it.
Rick Taylor
@Texas Dem:
We’ll see. It’s one thing to threaten to filibuster the bill; it’s another thing to go through with it, and to be forever known as the lone Democrat who single-handedly torpedoed health care. I strongly suspect Lieberman would much rather neuter the bill to the point progressives would kill it than to be the one who killed it himself; he could keep his image of being a high minded soul who wanted to deliver health care as he claimed. I’m not so sure about Nelson, but I’m not drawing any conclusions until it all plays out.
J
Couldn’t agree more strongly with Bill E. Pilgrim’s point upstream (@45). It’s a sign of how dysfunctional our political/media culture that his point isn’t constantly put front and center. Crazy as it may be that Lieberman is opposed to a bill because it contains measures he is on record as supporting, that’s not the main issue. Not content to exercise his right to vote against it, Lieberman is going to support a parliamentary maneuver to prevent the matter from coming to a vote at all (something he is on record as opposing, for what that’s worth). Instead our well-fed, ill-informed, overpaid media greats have elided the difference between voting against a bill/sabotaging the vote on a bill.
There must be thousands of feet of film (or however one measures data storage these days) of Lieberman and like-minded Republicans pontificating about the evils of obstructionism, the vital importance of an up/date vote and so on. A media that was doing its job would rub their and our faces in this until we were all well and truly sick of it, but had got the point.
Leelee for Obama
@Jay B.: Well, I’m close to 59, not employed right now, just spent 6 years caring for my elderly Mother, so out of practice and needing a job in the biggest recession in my lifetime. I’m not college educated and rarely make a hell of lot of money. This bill might do me some good, we’ll see. I’m not fighting for myself. I’m fighting for younger people with families that are getting buried alive by this shit.
Occam’s Razor may give Edwin an edge, I really don’t know.
James K. Polk, Esq.
@John Cole: As we approach peak wingnut, the DFHs are driven to insanity.
Does anyone else hear Cthulhu approaching?
ZALGO
NobodySpecial
@Tom Hilton:
I told everyone already in an earlier post: Public option was the tool we were given in the bill. That’s what we had to go with. It’s not a matter of them writing a bill that fits my particulars exactly – but when they pulled all the tools off the table, I’m unsure what, exactly, I was supposed to be striving for that would make you happy.
As it is now, if the bill passes as it stands, it certainly won’t contain MY costs, and I very probably won’t have good insurance to show for it. But yet, if I treat it as less than a win, I’m told by folks like you to just quit whining. Ok, you win.
Rick Taylor
@BombIranForChrist:
__
The bill would make it possible for people to buy health insurance even when their sick, and impossible for them to be dropped just because they got sick. Or at least that’s the argument; others are arguing the insurance companies we’ll find ways around it. But assuming it works, that’s huge.
__
There are also arguments about exchanges helping to pool people, and other approaches to bringing costs down, but I don’t understand those arguments so well.
General Winfield Stuck
@Leelee for Obama:
I am 57 and just turned 56. Go figure!
Jack
@Sleeper:
Spot on, all the same, in describing the debate.
BombIranForChrist
Also, one more thing, if the Republicans + Lieberman / Centrists are going to filibuster everything, and this seems to be their plan, how will anything ever get passed ever again? I don’t get it. There is no way the Dems are going to win more seats in the next election. At the very best, they will simply maintain them, more likely they will lose them. What then? What will ever get passed again? Should we just get Lieberman, Snowe and Nelson to vote and send everyone else home?
Something needs to be done about this obstructionism, and the healthcare debate is the time to do it. Rather than just saying, Well, gee, this is the best we can do in Murka, you stupid Hippies, now go back to smelling flowers so that we can continue our long reign of mediocrity in the halls of congress.
BombIranForChrist
@Rick Taylor:
Thanks, Rick, for clarifying that. If it is true that the insurance companies won’t find a way around it, it’s a very good reason to vote for this bill. I guess I am just worried that there will be loopholes …
Seebach
@BombIranForChrist: THIS! Nothing will be able to get done by Obama until Lieberman gets solved. This is going to be repeated over and over and over and over.
General Winfield Stuck
@BombIranForChrist:
LOL. does the sun rise in the east. Can Little Richard sing weird songs. Can Dick Cheney not tell a lie.
Such things are immutable universal truths, as are loopholes in passed bills.
Tuity Fruity — I rest my case.
Jim in Chicago
Dean says state regulations that keep the insurance companies in check will be eviscerated by this bill, driving up costs in states that have good regulation (like VT). You really want to tell me you know better than Howard on this?
http://www.openleft.com/showQuickHit.do?quickHitId=12566
If Howard is right (and I’m sure he is), how is that not a deal killer right there?!
Jack
@Seebach:
That’s only true if you think that the “Lieberman v. Obama” even hints at describing what’s actually happening.
beergoggles
@Balconesfault:
So ur basically saying the only way to kill this boondoggle is to let it pass and elect Republicans in the future who will repeal it? Be careful what you wish for.
terry chay
@Raoul: Yeah because when the Republicans took over the presidency and congress, the first thing they did was rescind Medicare.
Hmm, and come to think of it, Medicare was pretty crappy in its first incarnation.
@wobbly: The deal is that a failure to pass anything at this point would end any attempt at health care reform until 2013 at the earliest. The last time a HCR bill went down in flames it took 15 years to be considered.
Each time it goes down, the sequel is weaker than the first.
Now if it passes, your suggestion of incrementalism has a lot of weight. The provisions in the bill become the status quo and it is very difficult to reverse it.
Seebach
@Jack: Alright, I promise I won’t say “I told you so”, then.
Leelee for Obama
@General Winfield Stuck: Some other members of mi familia have perfected that talent. I have to be the right age to balance them out!
Texas Dem
I agree with you about Lieberscum, but trying to nail down Nelson’s vote is going to be like trying to nail jello to the wall. He represents a deeply red state, and his ties to the insurance industry are well known (so are Lieberscum’s, but then Lieberscum represents a blue state, so he can only go so far before he nukes himself politically). My guess is that Nelson will just keep moving the goal posts until the bill finally dies of its own weight. If you want to keep folks like Nelson in line, get Obama’s approval rating back up to the mid or high fifties (good luck). Now that Obama’s support is declining, red state Dems like Nelson are going to go to ground and stay there. And even if (as I expect) the Dems lose Congress next year, Nelson will continue to be a player. Republicans will court him and other “moderates,” just as they were courted when GWB was in office, because they hold the balance of power. Nelson knows that better than anyone.
Wile E. Quixote
@John Cole
No, actually you’re attacking the DFHs when you tell them that they should shut the fuck up and eat whatever shit sandwich that the Democratic party decides to serve them. You’re just being snotty and annoying like certain editors at Reason who shall remain nameless but espouse libertarian ideals while getting their health care in France.
Here’s the thing that angers me about you John. You’ll shake your finger at Joe Lieberman, Ben Nelson, et al for shitting on this bill and watering it down but at the end of the day you just sit there meekly, shrug resignedly and take whatever they give you. You and I both know that these bastards are just grandstanding for their own political gain and that neither one of them is interested in any sort of meaningful health care reform that might take one red cent out of the pockets of their insurance company sponsors. You and I both know that even if they were given everything they wanted they’d just move the goalposts even further. You and I both know that Nelson is trying to poison the process by insisting on the Stupak/Pitts language so that he can force progressives to vote against the bill. But despite that you’ll still go along. Nelson is still grandstanding over the abortion bullshit, and Lieberman hasn’t said that he supports the compromised bill or that he won’t filibuster it, so negotiating with them has accomplished absolutely nothing except to water down the bill and alienate progressives, who are being told by everyone to eat shit and accept the demands of Joe Lieberman and Ben Nelson because, well because, forget it progressives, it’s Senatetown.
Attempting to negotiate with Lieberman or Nelson is like, well, to use a really great analogy that a wise man once posted on some blog somewhere it’s like trying to negotiate dinner with your crazy girlfriend, you want Italian, she wants tire rims and anthrax, so you end up having tire rims and anthrax with a tasty marinara sauce. And it seems that your anger is reserved more for those of us saying “Hmmm, I really don’t think that tire rims and anthrax with a tasty marinara sauce is much better than tire rims and anthrax much less a viable alternative to Italian.” than it is for the bastards who are trying to shove tire rims and anthrax down our throats.
Answer a question for me John: let’s assume that Nelson is given his way, that the Stupak/Pitts language is included in the bill and that he promises to vote for it. Will you still support the bill then? I want to know at what point will the tire rims and anthrax no longer be palatable, regardless of the amount of marinara sauce and cheese you put on top of it? At what point, if any, are you willing to stop compromising, because if you can’t define that for me then it just seems that all of this is DFH punching.
Citizen Alan
Oh, if the bill passes, the Republicans will never kill it. They’ll just reduce the subsidies whenever possible and weaken what little consumer protections are there. Why on earth would they ever get rid of a requirement that lower middle class people pay for overpriced shitty insurance and subsidize the insurance of even poorer (and likely blacker) people with their taxes, when the Repukes can just funnel all that lovely money to their insurance company backers and blame the Democrats for everything? I predict that within a year of this law going into effect, one minority person somewhere in America — just one — will figure out a clever way to game the system and make some extra cash, and the Repukes will be talking about “Obama’s Insurance Queens” for the next ten years.
This is the domestic equivalent of the Iraq War — an obvious catastrophe in the making and yet somehow completely inevitable.
Tom Hilton
@NobodySpecial:
And I have explained to you that the public option does nothing for healthcare costs.
In an ideal world, a public option that was open to everyone (which was not the case with any version of the PO in any version of the bill) would, in the short term, have some impact on the cost of insurance–but even then it wouldn’t have any impact on the healthcare costs that drive the cost of insurance, so in the long term it would do pretty much nothing. And that’s the ideal version of the public option.
To deal with healthcare costs, you have to deal with delivery systems and the whole fee-for-service model. There’s no magic bullet. That’s why there are a bunch of different pilot programs in the bill, trying different approaches to different aspects of costs. Some will work better than others, but it’s at least a start.
And as for insurance costs, as I understand it there are three general approaches. According to Ezra, insurers who overcharge get booted from the Exchanges. The excise tax provides an additional deterrent to overcharges. And the Exchanges will make the market more competitive–more choices, more transparency in comparing plans, and even consumer feedback (think Amazon reviews). Any of these should do more to hold down insurance prices than a level-playing-field public option available to 2% of the public could possibly do.
CalD
Something to Think About?
Seemed pretty obvious to me.
Wile E. Quixote
@John S.
You don’t really know anything about how these were passed, do you? You’re just repeating someone else’s talking points and hoping that no one will call you on it. The bills you cite didn’t have a downside, they didn’t make people worse off than they were before they were passed. This one does, you’re forced to buy health insurance of dubious value, there are no meaningful prohibitions upon rescission, there’s nothing that keeps the insurance companies from gaming the system and offering lousy plans that really don’t offer that much coverage. This bill does. You’re forced to purchase insurance from a loosely regulated monopoly that has demonstrated over and over again that it acts in bad faith with regards to its customers sometimes killing them in the process.
So you’ve got health insurance now, big deal, that doesn’t mean you have health care, it doesn’t mean you can’t go bankrupt still and it’s nothing like what Barack Obama promised in his change speech when he said.
So in short John S. I have no respect for you because you have no original thoughts or any evidence to back up your positions. You just repeat other people’s talking points like some sort of stupid and badly programmed bot. Give me 30 minutes and I could write a shell script that would make more meaningful posts than you can or have on this subject.
terry chay
@Suzan: Your understanding is wrong. It’s wrong when you use rhetoric like “forced” mandates instead of the correct one: individual mandates.
1) There is around more than $800 billion dollars in subsidy in the bill. Anyone who is poor and uninsured will be getting a huge discount on their insurance: basically, they pay out of pocket around $4000/year on what costs the insurance company charges $20,000/year in coverage.
Now before you say that in the end it’ll be less than $4000/year in real coverage, it will be pointed out, despite the rhetoric that there is none, there are a number of insurance cost controls in the system (as well as a framework to test a number of various attempts at health care cost control measures). This means that realistically the insurance company is making about $900 of this plan, but their maximal overcharge us fixed at $2000—$18,000 of those dollars have actually be spent (to pharmeceuticals, hospitals, emergency care, and the like)… Note that the $2000 has to include things like paperwork, paying the salespeeps, etc, so that’s why $900 is the maximal realistic (and historical) profit.
2) The only real cost control directed at health care (as opposed to health insurnace) in this measure is due to the mandates and exchanges. They allow for collective bargaining and pooling and put self-employed and small business closer to parity with larger corporations.
3) Let’s say your family cannot pay the $4000/year (hey it happens). Well if you make less than $50k, then there is nothing “forced” about the mandate. You can freely take a pass on this sweetheart deal with no penalty and let the emergency room care pick up the public health fortune you’ll cost this country just like the status quo currently does.
If you make more than $50k, you then are indeed “forced” to pay a $95/person penalty (in the first year). No doubt since that is what it means by “individual mandate.” But nobody is forcing you to buy insurance at 8% of your income.
Of course, there was a time I was making $18k/year when I would have jumped on insurance at 8%. There was none.
…
See that’s the problem with the truth. The facts are messy and honest. It’s far easier to say that nobody will be helped by this thing (when 40 million people will be helped, but some will slip through the cracks), that there are no cost controls (when there are a number, but it definitely falls short because there is no way we can solve that problem with just insurance reform alone), and that you’ll be forced to pay for insurance (when the insurance is a sweetheart deal for those eligible and nobody is forcing you to do anything—unless you make less than $1250/year in which case the penalty is as much as the policy cutoff).
NobodySpecial
@Tom Hilton:
I told you already. You win.
Ruckus
@Edwin:
Two peas in a pod.
But bankruptcy is always out there as a possibility. With what we have now, nothing, it’s a big possibility in the crap shoot of small business. What if you can afford to go to the dr before it gets bad and things can be fixed for a lot less or fixed at all? I wouldn’t like it being that I can still get completely screwed and have health ins but that’s still a little tiny bit better if the benefits paid make up for what I can’t pay now.
Tom Hilton posted above you that this really is not a crappy bill as it now stands. It is not a great bill. It is not even in my opinion a good bill. But this is not a business were we get to make the decisions. This is where we get to have decisions made for us. And I think most of us don’t like that. And so we get to accept or not those decisions.
I’m old enough to remember when medicare became law. It was fought tooth and nail and it was crappy. It still is not great but it is much better. Now my problem is that was 44 years ago and I know that it will probably be 44 more before this bill gets better. Unless we pull together and fight for it to get better at every step of the way. Giving up is exactly what the assholes want. They don’t care how they win, only that they do. The bought and paid for whores in congress don’t care if you don’t like them, only that the money keeps coming in.
All that said I am tired of the fight, I am tired of being on the shitty end of the stick, and I don’t even care if I win anymore, I just want to live. But what else is there but to continue to fight?
kris
I am a long time lurker and posting for the first time. For the people saying support the bill, I have a question: What’s the difference between denying insurance, and making it so expensive and bad that it is essentially unaffordable? To me the two are pretty much equivalent. Further, this bill forces people to buy insurance even though it is unaffordable. This is rather like agricultural tax collectors, who would collect taxes from the serfs even when crops failed. I think Marcy Wheeler’s feudalism analogy is pretty much perfect.
What is really shameful is that this is a bill that a democratic president is backing, the corporate republicans are probably jealous that he is doing such a good job with their agenda.
Marcy Wheeler’s analysis:
http://emptywheel.firedoglake.com/2009/12/15/health-care-on-the-road-to-neo-feudalism/
and her rebuttal of the “competition” argument peddled by Ezra Klein (who is far too enamored with the “free market in insurance”):
http://emptywheel.firedoglake.com/2009/12/16/captive-consumers-and-oligopolies-do-not-make-effective-markets/
NobodySpecial
@terry chay:
I’m still wondering where all these poor people have $4k a year to drop on this. If you bought cable/internet/phone from one company, THAT would set you back about $2k a year, and I know lots of poor folks who don’t have it because they can’t afford it. Hell, it might be a larger yearly cost at $4k than gas and electric together if you’re careful.
Emma
I give up. All the way. I’m insured and when I retired I have enough socked away that I can go live in a little town in Spain and pay for health insurance out of my own pocket there.
But before I go I want to say one more damn thing: the only way to solve this problem is to get more progressives into Congress and/or amend election finance so the bastards are not beholden to the special interests. In a real presidency, where the Constitution is not treated as a piece of shit, Congress makes the laws.
All I see now is the wasteland we will have when President Pawlenty gets elected. But so help me, if I see anyone bitch and complain about the assfucking the Republicans are going to deliver if they get power again, I will go postal.
terry chay
@BombIranForChrist: Of course there are loopholes.
The point is the loopholes are not as big as people are trying to insinuate.
For instance, currently the insurance industry takes 7 cents off every health care dollar (keeping a little then half as profit and the rest as cost). The new bill allows them to issue plans (if they can do it) that take 10 cents off every dollar.
That’s a 3 cent loophole…in a plan where this person would not be insured at all.
We all wish there was something else out there that only took the 4 cents that was absolutely necessary, but there isn’t. Even the public option (in the incarnations that actually had a chance) would have actually been less efficient than this one.
Comrade Luke
@NobodySpecial:
Also: the 2009 poverty level is just shy of $11k. They’ll be going to the ER.
ruemara
So, what I’m seeing is that the “kill the bill” people feel that it either does everything it should right now or we go back to the beginning and ???? and profit. But if there was at least no mandate, then this bill would be tolerable.
The “keep the bill and fix it” crowd say that there is a benefit to having just the interim fixes this bill promises and there’s a method to improve it because the bill starts the process. Even if at first it’s goddamn awful.
Here’s the $2100 question, what is actually in the bill? And, once again, since the answer I got lacked any actual solutions, what is to be done if we do “succeed” in stopping this bill? Will we all run out and spend the next 8 months organizing to add better Dems to the Senate? How do we add Republicans to this bill or Conservadems? Infect them with Congressional Swineflu? Is anyone actually taking this back to Reid and saying put the good stuff back, take the crap out and let these morons filibuster the hell out of it, be sure to lace the congressional coffee with diuretics?
I think this ridiculous blogwar has to be the stupidest thing I’ve seen since, well, the last one. Whining online doesn’t solve anything and the questions being asked are ridiculous. It’s not “is Obama good or bad”, or “is Rahm too powerful”? What are the solutions to a better bill? What is in the bill that is good, & what is bad? How do we deal with Conservadems? What the hell will pass and what will have to be done in conference?
And don’t post more people’s blogs, that’s not a solution, that’s part of the half-assed, half-cocked reactionary problem.
Cat G
@jl: “You have been the voice of reason on these threads all day. Good work.
strawmanmunny
@Emma:
This, minus enough money to go to Spain.
If everybody that is bitching would just think for a minute. A medicare buy-in can be done in reconciliation. But, the bill has to pass and this can’t be brought up because if it is, then Lieberman,Nelson, et al. will use it to break the bill.
This is the first step. I don’t know what is so hard to understand about that. It’s ONLY the first step. More steps can follow. Keep all that outrage until after the bill passes and then use that to pressure Congress to follow up with the medicare buy-in.
This whole country is batshit insane. Truly. Everyone running around thinking their way is the only way. The bottom line is that when you have 52 people supporting something but need 60, you DON’T have any power. The 8 that you need have the power. That’s just the way it is. There is nothing you can bargain with because 2 or 3 Senators(Lieberwhore and Nelson) would just as well have no bill than some bill. There is no leverage. You really think stripping Lieberman of his chair would make a difference? Puh-lease. He would just torpedo the bill and make nice with the new Republican led Senate and start bombing Iran.
But, call it dimensional chess if you want. But all the moves are in progressive hands if they would play their cards right. But, no bill, no hope for any changes. Period.
Pass the gd bill and keep the pressure on.
Sly
Semi-OT:
Lieberman denied an extra minute of pontificatin’ time. President McCain furious.
David Gregory would never stoop so low as to deny Vice President Droopy Dog a chance to slosh his jowls for another minute. That’s why he’s a serious journamalist and Al Franken only cares about non-serious things like rape. Wowsy wowsy, woo woo.
Cat G
@Bill E Pilgrim: Word. Why don’t the Conn. lefties resurrect that giant kissing puppet they used during the last Senate campaign and follow him around. He’s put himself on a sanctimonious pedestal. He deserves only scorn.
terry chay
@NobodySpecial: Good point, which is why I put real numbers behind it.
If you make less than $50,000 a year, you don’t have to take the plan of $20,000/year in coverage (note that this is a coverage that costs $18,000 a year just to maintain!) for $4,000/year. You can drop the plan at no penalty.
If you make more than that, you do indeed are bilked for an extra $100 in taxes that year ($400 for a family of four). I’m sure you can afford it, and it’s a small price to pay.
Why? Because you’re statistically going costing this country more than $4000 a year in emergency room fees and danger to public health.
…
As you point out, rightly, where is someone going to come up with $4000 a year? Some are basically already living paycheck to paycheck.
I know personally when I was making $18k a year, I could have and would have set aside the $120/month for health insurance had it been available, but everyone is not me. I understand.
Nonetheless it is $4000/year (as high as $8000/year if a family member gets catastrophically injured) for coverage that actually costs $18,000 in real terms, even if we could wave our magic wand and wish the insurance industry goodbye.
Some people, faced with bad luck, well that $8000 would mean bankruptcy still. In this way the bill isn’t perfect. It’s not perfect because it also allows people to slip through the cracks in the mandate either (paying a small tax penalty or none at all), but I don’t hear people crying about that lack of cost control because some people are going to opt out and weaken the collective bargaining the mandate represents.
But you know what? I guarantee if they were uninsured every single one of them would be bankrupt anyway. Statistically speaking though, there is a huge chunk of people who would not be and whom this insurance will definitely save their life.
A few will be hit with a small tax penalty, some will not benefit at all, but many will. And because of a few people, we scuttle the entire bill?
If I had that attitude I wouldn’t be for this bill either, I now, thankfully sit in an income bracket that makes me safe either way this thing falls.
MNPundit
I can’t do it. I’m sorry. And you’ll hate me for it, and rightly so.
But the only way to break the power of the Blue Dogs and Lieberscum and the GOP is to be as willing to let good people die as they are.
Edwin
@Ruckus: You’re right, we shouldn’t give up the fight. That’s why I think the current Senate bill should be changed or scrapped. Does it offer some small, but real, value? If it does, I can’t see it. I don’t think it’s any kind of foundation to build on.
Keith G
@John Cole: A-fucking-men, brother!!
Cat G
@Texas Dem: There are 16 Dem Senators seats in the next election. You do the math. Ben Nelson doesn’t want the Senate to change parties… The minority party loses staff and other perks, and he didn’t have much fun when the R’s ran the place. They were pretty damn ruthless. Who cares how he votes on the bill itself, it’s the freaking fillibuster that screws up the dynamics. There have to be sanctions for bucking your party & the Pres on the No. 1 priority.
John Cole
I’m with you, man. Sometimes you gotta break a few eggs to make that omelet. Down with this shitty bill- I got good coverage, what do I care.
Maybe in a couple more decades we’ll have real Democrats and we’ll get a bill true progressives like you can support.
Keith G
Takes ice pick to own eyes.
Davis X. Machina
Massachusetts is talking about ditching fee-for-service and going with capitation for any insurance it either buys outright (MassHealth) or subsidizes (Commonwealth Care).
That would be the biggest cost containment move of all.
Cat G
@strawmanmunny: quote from your post:
“You really think stripping Lieberman of his chair would make a difference? Puh-lease. He would just torpedo the bill.”
He is already torpedoing the bill. Losing his seniority/chairmansip is a very big deal. It’s staff, budget, nicer offices, power & prestige. It means on any committee meetings he would talke last, etc. etc. He’s got 3 more full years before his next election. In addition, he would be humiliated to be stripped of it by the Dem caucus.
Remember Spector? Keeping his seniority was the quid pro quo for changing parties.
There are other things Reid could do, like, you know…make the Republicans actually FILLIBUSTER. The 60 vote threshold is just bulls**t. It’s evolved because it’s clubby and good old boy stuff.
Keith G
@John Cole: What I am thinking is that the howling here wont matter, thank the gods.
The bill will pass and it will be signed into law mid Jan. *and we will have a national health policy* and many of its moving parts will suck and we will spend a bit of the 20-teens getting it closer to right.
Probably not that much and this will be on of the first bugs fixed as suburban families get squeezed.
Davis X. Machina
Sorry, LeeLee, it’s just not your time
I am sure people like you will come to understand your role in the inevitable forward march of progress, and will understand. Progress has its price.
Later, when we all have single-payer-and-a-pony we can have, like, a day of commemoration for them. Or something*
The prospect of such a memorial I am sure will provide you and the others with great comfort in your present and preventable future suffering.
*Or a stamp. Would you like to be on a stamp?
Cat
@Edwin:
I think people believe the bill would some how make insurance companies start giving out group rates to individuals and there would be some magic ‘open enrollment’ like you get if you have uninterrupted coverage and you move from group plan to group plan.
If you are a median household with median income you can’t afford the ‘gold plated’ insurance for your family and anything less then ‘gold plated’ is a ticket to bankruptcy for any major illness.
DougJ
But the only way to break the power of the Blue Dogs and Lieberscum and the GOP is to be as willing to let good people die as they are.
This is the kind of comment I just can’t take. I don’t think you mean this.
Unless this is industrial strength snark, in which case, bravo.
Cat G
@Keith G: All good points. As for the howling, if you say the bill is fine with you, it will never get better. The bill has moved in the direction of those A$$es who have been making demands. The mistake the lefties have made is to go along quietly instead of making a whole lot of noise. It’s just basic human nature. You shout and yell and know that you’re not going to get even 1 Rep vote. Bloody some noses to get as much as you can and then vote for the bill.
bystander
This is crazy. As if the DFHs could actually kill the bill. Sure. Right. The point to whatever full court press the left can offer is to claw back, or create an opportunity for getting, as much of the House bill into the final product as possible. No one seems willing to argue that the Senate bill is better than what came out of the House. And, most believe that something will pass; by hook or by crook, come hell or high water, the Democrats will deliver a bill because they cannot afford not to.
The effort is directed at making the final bill as helpful as possible to the American public. We won’t get everything in the House bill, but why not try to get as much of it as we can? To do anything else is to slink back into the corner like good little sheeple and agree that the corporations can have whatever they want, through any process that’s open to them, anytime they want it. And, what politician dependent on corporate donations for elections is gonna fight that kind of voter choice? They’d have to be crazy.
For those of us with our shoulders to the wheel, hammering legislators, donating to efforts to bring Joe Lieberman down (though rumor has it he’s considering running as a Republican when he’s next up), doing the phone bank drill in Nevada to pressure Reid, and so on… this Screw it. Kill the god damned bill. I’m insured. I don’t give a shit anymore. is not helpful. Frankly, I have two thoughts. First, How lovely for you. Second, seems someone’s amygdala needs recalibrating.
General Winfield Stuck
@Keith G:
I think she had some work done. And ain’t half bad, now that’s she’s sober.
Cat
@John Cole:
We can’t help the fact that people who hold opinions that are similar to ours are complete idiots. It does not make us idiots or our opinions invalid because someone uses poor logic and hyperbole to come to the same conclusions.(See global warming)
John Cole
@bystander: I thought it was pretty obvious I was being sarcastic.
Keith G
@Cat G: Fine but do not act like a four year old whose cookie got taken. (Note: I am not saying that’s you.)
Where were all these energized progressive voices in June, July and August?
Let’s get a bill signed so there is a *national health care policy* then let’s set about bloodying noses and asses to make it better. If the law is that bad, we should have a lot of help. But let’s first get that law.
Cat
@terry chay:
I dont know what your source of this info is, but its horrific if its the real bill. This bill is meant to help those 50k a year families instead they just get the benefit of not being fined until they get a pay raise one next year and earn that extra $500 a year and now they owe the IRS 2250.
This really is a bill people want to get behind and say, yes we passed it?
Ruckus
@Edwin:
There is no good side to this “bill”. There is a “good” start on the road to an acceptable program. It has been pointed out many places that the 3 big social programs passed in the last 70 years, Social Security, Civil Rights, Medicare all were crappy at their start. ALL of them. But they were a start. They are all better today. ALL of them. Could they be better? Hell yes they could. Hell, Civil Rights should never have even been needed if this were a more, I don’t even know what the words are, maybe better, nation. Could any of them be killed by any congress in the foreseeable future? No. Watered down maybe. See teabaggers saying don’t take away my medicare.
But humans, or at least americans seem to like the big whatever, the big fix it all at once, the all or nothing answer. But nothing works that way. Electricity production – Solar!, No, Wind!, No, Nuclear!, No, Clean Coal!, No, drill,drill, drill!, my car runs on water!. None of it is the answer by itself and some is BS. It takes baby steps and fighting each step of the way. This is the second biggest change in 45 years in the way we see this country. The other was when we started to take care of our seniors (medicare) and when we recognized that all animals born with human DNA were actually human (civil rights). Both of these were in the 60’s and took softening up of the legislature over years to get them to pass. I was young in the 60’s but I remember the fights and I didn’t understand why things shouldn’t be the way they ended up. And they didn’t go far enough. Now I understand. Some people are selfish, some are assholes, some are ignorant. Nothing has changed there in 50 or even in the last 5000 years. But this is our time. This is when we get to make change. Will it be enough? Hell no, it never is. Someone the other night accused me of pissing and moaning because I didn’t get the pony. My response was I was not buying a pony. I didn’t expect the pony. And I didn’t get pissed because I didn’t get the fucking pony. I am pissed because that’s what happens when I and millions of my closest friends get unnecessarily and selfishly screwed.
Cat G
@Keith G: It’s waaaaaaay to early to try & kill the bill. But it’s not too early to make fighting noises. It appears that Reid & the White House have absolutely taken non-conservative senators & constituents for granted. The core problem is that Dems have brought no weapons to the war. And the Repubs are at war. They are fighting everything. The Senate Dems are behaving like it’s an afternoon tea. In politics you never take your ball home. All the action now is giving Lieberman & Nelson a veto. And the effing White House had better start paying attention to their base instead of badmouthing Dems who are objecting. They’ve looked pretty damn amateur. It’s pretty depressing.
Cat
@terry chay:
Are you talking premiums or just max out of pocket expenses?
And again, this insurance plan they are signed up for is terrible. Any major illness and said median income family is bankrupt. What point is reform if people are still going bankrupt when they get sick and working poor dont have health insurance?
The working class can’t bear any more. They can’t afford tax increases to pay for better schools in their towns, they can’t afford to save money in their 401(k) for retirement, they can’t afford to send their kids to the state university, and now we are asking them to pay more for their health insurance and get less coverage then the rest of us?
Its breaking my damn heart to think of how much the middle class is screwed.
harlana pepper
This was my exact situation back in 2007 which also came on the cusp of a breast cancer diagnosis. My only choice for insurance was a state pool for which premiums are exorbitant, continue to rise, with a $1500 deductible. I hope your state has a better deal than SC. The only reason I’m not bitching constantly is because my wonderful family helps me with my premiums so I can continue to get my meds and see the doc, since I am out of work and have had no employer based coverage since 2007l Best of luck to you, hopefully some sort of subsidy will be available after passage of whatever passes, I hope to God we don’t have to wait until 2014 for even that.
harlana pepper
You know, I am not saying kill the bill. All I have been saying, the only thing I’ve been saying, is that this is NOT the time for progressive to shut up, this would be the absolute worst time for progressives to stay silent. I don’t know why that’s a bad thing, I’m just mystified why so many on this blog are so pissed and even enraged at progressives for not sitting on their hands at this crucial moment in time. Agitation and pushback serves a useful purpose, as it has throughout the history of this country. You’re pissed at progressives for being pissed and bitchy, but that is their role here. As another commenter noted, it’s not like the WH or the Senate is going to pay all that much attention, but they may pick up a signal or two that the peeps are upset.
bystander
@John Cole: Thanks for the clarification. Rejoinder withdrawn with an apology for misunderstanding you.
Hugs to my favorite online dog. I could use a little Lily about now.
Jack
In summation ( :>) –
Enter stage center, adjusting glasses, very well enumerated wonk with good insurance:
This isn’t what I want for you even though I’ve been pooh-poohing all the alternatives for the better part of a year, but really now, you poor and working poor people, and oh yeah, you working class folks characterized as “middle class” – did you really think that Hope and Change were anything more than campaign slogans?
Offstage, Clapper:
Yeah, that! I voted for pragmatism. And centricity. And the guy who wanted to run the machine better than Bush and not make the professional clerks and bankers look so bad. And all you dirty fucking hippies hate poor people! Yeah!
In the cheap seats, Poor person:
But I already cannot afford…
Center stage, to the right of wonk, Cheerleader, twitching with apoplexy:
STFU and eat it, ingrate! Whaddya want, Bush? Think the Republicans will help you? This is our only chance. Apocalypses and future Republicans. Dirty hippies!
SRO, Mother without insurance, two children:
We already cannot afford insurance. Now we have to buy bad insurance on the promise that maybe one day the mighty will scrape their generosity and give us a little more?
Stage left, DFH:
That’s about the right of it, far as I can tell.
Clapper, this time louder, and angry:
Shut the fuck up, hippie. Ponies. Manic progressives. I gots mine, suckers! You hate the poor. You want President Palin. You’re an idiot! Nitwit!
Ben Nelson, Connecticut Joe, Very Serious Chessmaster Obama, from the balcony:
You didn’t think we actually wanted to change the system, did you?
Curtain fall.
bystander
@John Cole: Peace offering via GGreenwald on twitter; Steve Benen on the wonks vs the activists.
harlana pepper
@Jack: heh
harlana pepper
activism is not just for elections
and, yeah, communication and telegraphing the message is a part of that, however much the recipient does not want to hear said message
Jack
@harlana pepper:
It bears repeating, this.
Matt Y. didn’t put in twelve hour days as a ten year old because very, very pissed working folks scared the bejesus out of their bosses, took over their mills, joined militant unions, started their own papers and presses, got very red and even took over a few cities…
mo
@BombIranForChrist Here’s basically how it works. First, good insurance is expensive because good healthcare is expensive. But it’s even more ridiculously expensive when you’re on the individual market for a few reasons: 1) you don’t realize how much you’re actually paying when your employer is paying for it (your overall compensation holds steady but your wages are shifted to cover benefits); 2) you don’t get the tax subsidy; AND 3) large employers create natural risk-pooling (combining the healthy and the sick alike, the good risks and the bad, all in the same plan for the same cost).
What the combination of the health insurance exchange, insurance regulations, AND the mandate does is ensure that #3 happens for both small businesses and those stuck on the individual market.
To see how important this pooling is, I can just give you my own personal anecdote – I am young and healthy and was unemployed last year. I was able to find insurance for $70/month. Yes, it was high-deductible ($5K, I think) but still fairly affordable. My dad and stepmom, on the other hand, did not have insurance and could not find HIGH deductible insurance for less than $1500/month.
A world where both of us had access to the same insurance at generally the same cost is very different than the world we live in now – it means I pay a little more but they pay A LOT less.
AND then if I can’t afford it, I am likely to receive subsidies – or Medicaid. If the costs to me go over 8% (I think that was the last number at least) of my income, I’m not subject to the fine. (What kind of insurance that buys me is still an open question, I think. The insurance offered on the exchange has to meet a certain bar – but what that bar is has been a matter of debate. A good area for progressives to start focusing on in leiu of the public option to improve the bill, perhaps?)
(Also, yes, the bill does allow insurance companies to charge differently based on age – but that’s one area that has gotten better in the Senate bill as time has gone on. And they have to offer the same policies at the same costs regardless of pre-existing conditions.)
Finally, this bill makes small starts to address number 1 (ie, holding down the growth in overall costs of healthcare), but nobody really knows how to do this (other than draconianly rationing care). So what this bill does, to the best of my understanding, is start experimenting and seeing what might work so that we can build on the successes later.
tenkindsagrumpy
I drove to Bangor to lobby both Snowe and Collins office on behalf of reform today. All the way over there(a one hour drive) I wavered between the angry guy venting his spleen in a fit of rage,and mister nice guy asking for consideration for working stiffs without health insurance. What finally emerged was a hybrid person making his case with a smile on his face though clenched teeth. I gave a ten minute speil with an aide frantically scribbling to get it all down. In the end I don’t know if I made a difference, or even if I was coherent, but I felt better afterwards. I don’t like what is on offer in the senate and my gut reaction is to tell them, Dems and Repugs, to shove it, but in the end I want something to come of all this work in my lifetime.
danimal
@tenkindsagrumpy: Thank you, grumpy.
angler
I love TPM but the AK pst is really inufriating. If you fuck with the prez you are denying a 52-year old access to medicine. 2014! as others have said. This person won’t get their access to exchanges and fed subsidy until 2014. They have to wait four years in the wilderness under the current bill. AK is going to be voting Republican by then because the bill left them out in the cold and there’s no damn difference between the parties. That is, if AK is still alive.
Joel
My dad used to repeat this point to me ad nauseum, and I feel it’s worth repeating here:
The world ain’t fair.
rachel
@Raoul: There you are again. You know, you never gave me the link I asked for; the one that told you how much your insurance would be based on your salary.
Jack
http://demosthenes.blogspot.com/2009/12/perfect-stom-of-financial-and-physical.html
robertdsc-PowerBook & 27 titles
This thread is just about dead, but i scanned it just in case because a very good question was asked:
The unions are opposed to the bill because the excise tax on “Cadillac” health plans can and does fall squarely on those folks who have negotiated for “Cadillac” coverage. Many unions have this kind of coverage and are thus targeted. Major problem for unions, but perfect for the President who stated that such a tax kept things in the health care sector and thus contributed to lower prices overall. I won’t go into the fact that this tax is an attack on the working class and is a direct violation of every statement the President made on the campaign trail regarding protecting the working/middle class.
In contrast, the House bill’s tax mechanism is a surcharge on people making 500K and up.
Separately, the union I’m a part of by family connection, the Teamsters, issued a statement during the summertime that HCR was fine without a public option. AFL-CIO President RIchard Trumka has repeatedly said that his union has problems with a bill without a public option. Andy Stern of SEIU has acknowledged that the Senate bill has problems but that it should be passed anyway and sent to conference.
American in Exile
@ cat g @160
You wrote “Ben Nelson doesn’t want the Senate to change parties…”
I really don’t think he cares one way or the other. If Republicans reach the point at which they can take over the Senate if Nelson and Lieberman switch parties, do you really think Nelson and Lieberman WON’T switch parties?
Jack
On why Ez and Yg are continuously fucking wrong:
http://emptywheel.firedoglake.com/2009/12/17/21-of-people-in-ma-still-forgo-necessary-medical-care/
scott
John
People can argue the politics of the HCR bill until the cows come home, and both sides are entitled to their opinions as to what will happen if progressives who oppose it end up killing it and whether or not that will be good or bad for the Dems.
But there are reasonable people who believe that the bill, as is being developed in the senate, is simply bad policy and that it actually makes the current bad situation much worse — even when taking into account those currently uninsured poor who will receive insurance.
So what’s with all vitriol during recent posts that you direct at people — on your side I might add — who simply want to see a better bill in place of one that many of them believe will make matters worse for more Americans than get helped and who honestly believe that no bill would be better for America than this bill?
Its reminiscent of your recent attitude toward us Gheys when we got angry at Obama about broken promises regarding DADT etc. You didn’t agree with us and accused us of having a narrow world view and that we weren’t taking into account the big picture . . . so you basically called us names and insulted us with a condescending attitude.
But then you sent me an email several weeks later saying the vote in New York killing gay marriage had changed your mind for you and you now thought we were right to be pissed. And I appreciated that — both the email and the change in attitude.
But in the meantime there was all that unnecessary bile directed at people with whom you previously disagreed — who are and always were, on your side — and which, at the end of the day, is completely unhelpful to everyone involved.
Maybe in the future you should think about that a bit before you hit the publish button.