A message to House Democrats: This is your moment of truth. You can do the right thing and pass the Senate health care bill. Or you can look for an easy way out, make excuses and fail the test of history.
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Kryptik
Paul, Paul, Paul…they’re Democrats.
If there’s a way to fail, they’ll find it and stick to it. I’m firmly convinced that the only reason we won in ’08 was because there was literally no way to fail for us.
(and I apologize for being such a shining optimist as of late, but…Christ, can you blame me?)
Neal
Oooh, if they take Option 2, they actually get THREE things. Win.
Ailuridae
I thought this passage was even better:
And anyway, politics is supposed to be about achieving something more than your own re-election. America desperately needs health care reform; it would be a betrayal of trust if Democrats fold simply because they hope (wrongly) that this would slightly reduce their losses in the midterm elections.
Brick Oven Bill
History is not one of the Seven Liberal Arts and Sciences. Perhaps tomorrow we will discuss George Washington.
David
But I keep hearing the Senate bill doesn’t do anything or was written by insurance companies?
Libertini
I love Krugman’s clear thinking and no-excuses style. I just hope the right people are listening. Thanks to all who made calls to their reps today. A call to my rep (Kenny Marchant- R) would be a waste of my breath, as are my regular emails to him on behalf of the American Cancer Society Cancer Action Network. I still grit my teeth and send those, steeling myself for the garbage reply that comes back, but I just can’t take it by phone, and for what purpose would it be anyway. Those with Democratic reps (Progressives and DINOs,) please, please, please make those calls.
Ailuridae
@Brick Oven Bill:
Hey, Coward! Are you going to take my bet that if the Republicans take back the House I leave and never return to this blog and if they fail to do so you, to the relief of all, do the same?
Linkmeister
I would add, “for reasons I don’t understand.”
Mr. President, this is the signature bill of your agenda. Why are you not out there scrapping, demanding, cajoling, making the case to the American people and to the House Dems?
I wrote that, more or less, on the Whitehouse.gov contact form this afternoon. I honestly don’t understand his inaction at all.
Lev
I sometimes disagree with Krugman, but God bless him for being one of the handful of Dems with any sort of vision on this issue. And based on World’s Biggest Asshole Raul Grijalva’s quote about how if the Senate doesn’t want to pass their bills, that it’s their damn problem, I just think the “split the bill” idiots want to blame it on the Senate rather than swallow their pride. At least he’s not pretending to give a shit about poor people. And whatever the problems of the Senate bill, it’s infinitely more progressive than what you saw out of the most ambitious plan offered in 2004 (i.e. Howard Dean’s).
Fucking. Pathetic.
Brick Oven Bill
Hey Ailuridae;
The bet is:
“Barack Obama is my dad.”
Lev
@Linkmeister: This made me feel a little better, but only a little: http://tpmdc.talkingpointsmemo.com/2010/01/cooling-off-period-white-house-takes-step-back-and-leaves-health-care-to-hill.php
Ailuridae
@David:
But I keep hearing the Senate bill doesn’t do anything or was written by insurance companies?
The insurance reforms are pretty good. They’ll be enforced at the state level barring the passage of a national exchange later on so they can obviously not be enforced by a cowardly Insurance Commissioner in Nebraska or Mississippi but they are miles and miles and miles ahead of where regulation is now. And if you read the post about Americablog the first suggested step to get that 60th vote in the Senate is to lessen the pre-existing condition language.
So, yeah. Pass the bill.
Ailuridae
@Brick Oven Bill:
I have no interest in that bet. And I don’t believe you would honor it as you are dishonorable. Why are you scared to make a real bet?
Stroszek
@Linkmeister: The only explanation is that he’s trying to distance himself from this clusterfuck, believing that House Dems will take most of the heat for not passing the bill. But every second that passes, he’s looking less like a community organizer and more like a passive-aggressive middle manager.
I don’t think anyone in DC understands the magnitude of the backlash that’s brewing on the center-left.
wilfred
More rhetorical overload. I mean, at this point you could write a book even.
Linkmeister
@Lev: Thanks. I’m like you, it makes me feel a little better. I don’t agree with the strategy, but hell, I didn’t win an historic campaign in 2008 and I haven’t even won one to find a job, so my track record’s weak. Maybe they know what they’re doing.
Right now, though, they look weak as hell to me, which is no way to inspire the base, already as angry and disheartened as it’s been since January 20, 2009.
Ailuridae
@wilfred:
Not really. Not passing the Senate bill is far dumber of a move than Kennedy not taking Nixon’s counter offer.
BR
This is the first and only column of Krugman’s that I’ve agreed with every word.
Everyone, especially those in congress need to read it.
How do we make sure everyone reads it? Maybe if we use the NY Times email feature it’ll show up in their popular articles?
SGEW
Over the long term, a majority of the questions on the “test of history” involve variations of “have your people been exterminated?” or “is more than half of your population enslaved?” or “what percentage of your population are raped and/or murdered?”
This is the kind of stuff you can flub and still “pass.” It’s not graded on a curve, after all.
Brick Oven Bill
Re: “Barack Obama is my dad.”
This is a bet I would honor Ailuridae. My word is my bond. To this standard I would surely be held.
The bet, make it.
Linkmeister
@Ailuridae: Or Nixon’s health care proposals.
Source.
Lev
@Stroszek: Agreed. Actually, I think there is some reason for hope here, because the notion of dropping HCR and pivoting to the economy/financial regs/unemployment assumes that the base would let that happen without any hassle. That is not at all clear.
But regardless of whether or not the bill passes, I wonder if some permanent damage hasn’t been done. I have been thinking about what the average voter might think of the Dems after this week, and frankly I’m unsurprised that Roy Blunt and Pat “Santorum II” Toomey are up in the polls in their states. Fuck, if I wasn’t a committed liberal I’d probably be doing the same thing.
Okay, if I wasn’t a committed liberal and was politically uninformed.
Citizen Alan
@Brick Oven Bill:
What is this imbecile babbling about, anyway?
Ailuridae
@Brick Oven Bill:
There’s no interest in that bet as again that can’t be enforced. As your repeated lies in other threads indicate your word is worthless.
I’ll cover the man’s bet if you want. Otherwise I suggest you go down the street and see if there is somebody you can play jacks or tiddlywinks with. Its good to see that conservatives aren’t just scared of minorities or military service though.
Ailuridae
@Linkmeister:
That’s what I was referring to. Its bad history regardless (Kennedy actually agreed but then Watergate derailed the process) but the point is the same.
General Winfield Stuck
@Citizen Alan: It’s BoB’s method of stream of consciousness writing. Sorta like a leaky sewer pipe.
BR
Someone with some writing skills needs to post a Dkos diary on Krugman’s column. Folks need to internalize what he’s saying so they can make coherent calls to their congresscritters.
Stroszek
@Lev: A bigger problem for Obama is that he’s nearly lost all credibility with his volunteer pool. If he couldn’t deliver on HCR, how will he deliver against an industry whose executive bonuses dwarf insurance company revenues? What motivation does an exhausted OFA volunteer have for picking up the phone? The White House can’t even be bothered to sit down for five minutes to put together a decent set of talking points for their central policy initiatives.
David
What is with the HCR silence from the Great Orange Satan? Fairly disconcerting, the lack of understanding it’s the Senate bill or nothing there is weird.
Whispers
The argument seems to be “we should reward the conservative minority for bullying the House”. Why is it that the actions of the “centrists” and Republicans are treated as if they are non-negotiable but the expectation of the liberals is that they should constantly compromise?
The problem right now is that the Senate bill is political suicide. People who make ultimatums, as everybody appears to be doing to the House progressives, need to be aware that they might not get their way.
This has nothing to do with “the perfect is the enemy of the good”. It’s “the good is the enemy of political suicide”. Passing a law requiring to buy health insurance they don’t want is political suicide.
Hasn’t anybody considered that?
BR
Now up at DKos:
http://www.dailykos.com/story/2010/1/22/828498/-Pass-the-Senate-Bill-%28Krugman-Says-So-Too%29
Someone posted it. Folks should rec it up.
Linkmeister
@Stroszek: That volunteer pool hasn’t been used much since inauguration day anyway. I get fundraising emails from them (one on Wednesday, as a matter of fact), but they never got really mobilized for HCR, or so it seemed to me.
The Raven
Let’s also go for fixing what can be fixed through reconciliation, now–we probably will not have the chance later. Without cost controls this only delays the day of reckoning, and it’ll hurt on the way down. Besides, if the Dems don’t pass something they’re toast in 2010.
Or not.
More food for corvids!
Lev
@Stroszek: I don’t know that he’s lost all credibility yet, but he will if everything doesn’t come together. But I think your point is largely correct. Seriously, if the Democrats ditch the cause they’ve been preaching for a year now because they lost a special election where the Republican backed health care reform (but not the specific Senate bill), why would the average voter trust them on anything else? Why would I?
And, by the way, why wasn’t the spin out of every Democrat’s mouth on Tuesday that the Brown election wasn’t a defeat for HCR because BROWN SUPPORTS THE PRINCIPLE OF HCR? It even happens to be true, as far as spin goes. I’m positively convinced that the major problem with the left is that there is no media apparatus and aside from Obama, Barney Frank (despite his recent gaffe) and Al Franken, there’s almost nobody who can articulate a coherent message. It’s a party of Nancy Pelosis, only minus Pelosi’s legislative skills.
slag
If this were RedState, you all would be trying to get us to send House Dems pairs of used Nikes in the mail right now. Of course, there’s a reason this isn’t RedState.
Linkmeister
@BR: I just recommended it. Predictably, two of the first eight comments were “Kill the Bill!” What planet do those folks live on?
Ailuridae
@The Raven:
Exchanges, pre-existng conditions, community rating, removal of recission can’t be passed through reconciliation. This was known months ago and repeated here in every thread about health care by myself and others for three fucking months.
Pass the bill that is in front of the house now and you can amend the funding (excise, payroll and income tax) and subsidies in reconciliation.
drillfork
@Ailuridae:
The states? Our broke fucking states are going to enforce this?
Hahahahahahahahahahahahaahahahahahahahaahahahaha!
Linkmeister
@The Raven: What’s that daily comic strip with the vultures trying to persuade the tortoise and dog to cross the road? There’s a resemblance here, somewhere. ;)
General Winfield Stuck
@Whispers:
Most of these that will be unhappy will be young folks. And they don’t usually vote in big numbers, especially ones who would do so over a single issue.
Republicans are politically braver. Sometimes that works for them, other times it doesn’t. I very much would like dems to be a little more like repubs in that regard, though with their brains turned on to temper that bravery with common sense.
Wingers, of course, have a sordid lack of common sense, nor any sense at all for that matter.
Ailuridae
@Whispers:
The problem right now is that the Senate bill is political suicide. People who make ultimatums, as everybody appears to be doing to the House progressives, need to be aware that they might not get their way.
This has nothing to do with “the perfect is the enemy of the good”. It’s “the good is the enemy of political suicide”. Passing a law requiring to buy health insurance they don’t want is political suicide.
yeah passing the individual mandate in MA swept all of the relevant officeholders out of office. Oh, wait it didn’t.
David
@Whispers: The House bill has mandates too, so bringing them up is pointless. Any bill the House and Senate agreed on was going to have mandates, there’s no way around it.
I can understand conservatives/moderates not being invested in HCR and being willing to kill it. I cannot understand opposing it because it’s not good enough, and killing HCR for decades.
The elections will be worse for if they don’t pass HCR, they’ve all already voted for it, so it can be used against them.
Ailuridae
@drillfork:
In America we have a concept called federalism. Welcome to civics class.
Ailuridae
@David:
The House bill has mandates too, so bringing them up is pointless. Any bill the House and Senate agreed on was going to have mandates, there’s no way around it.
But the house bill’s mandate let’s you buy a pony!
The elections will be worse for if they don’t pass HCR, they’ve all already voted for it, so it can be used against them.
Yep its either a problematic vote and a legislative accomplishment that you may or may not be able to campaign on. Or its a problematic vote and a record of failure.
Oh and there are the 30M people you would be providing economic security too. But, yeah, that doesn’t matter to progressives. Wait, what the fuck does progressive mean again?
Stroszek
@Whispers: That’s the problem with you and the gentrified “progressives” in the House. You’ve actually convinced yourselves that the uninsured don’t want insurance. That’s a crazy f’n rationalization for being a prideful hardass, IMHO.
Here’s the reality:
The number of uninsured who want to be uninsured is really, really, really small.
A 2.5% tax in exchange for the right to sign up for insurance whenever you want is a really good deal for people who want to be temporarily uninsured.
The number of uninsured who are going to lose all faith in the Democrats if they don’t get any help is going to be enough to decimate the party for at least two election cycles.
MikeJ
Totally ot, but William Gibson’s twitter feed had this that made me think of DougJ:
# Don’t take your admiration for Reinhold Niebuhr to a knife fight. about 14 hours ago
The Republic of Stupidity
@Citizen Alan:
I’ll be damned if I know… lucidity and coherence don’t seem to rate very high in his priorities. Be thankful he isn’t babbling about prions or Orwell.
Lev
@Whispers: I wonder who you supported in the primaries. Was it Obama, a/k/a the only one who didn’t include a mandate in his plan at the time? I’m going to bet dollars to donuts it was Edwards. I just get that sense.
The Raven
@Ailuridae: I know, I know. We fix what we can, and hope it’s enough. It’s down to a choice between, at best, severely handicapping women, the young, and small independent businesspeople for a generation, and letting matters stand as they are. If I supported this without trying to fix as much as possible I wouldn’t be able to look half my friends and colleagues in the eye for the rest of my life.
The Raven
@Linkmeister: I don’t remember the comic. Hee, er, croak!
SGEW
@MikeJ: Great, now I have to follow two twitter feeds. Sigh.
The Republic of Stupidity
@slag:
If this were RedState, we’d all be chanting welcome to our new dark overlords in Chinese right now… ’cause that’s who’s gonna end up owning our azzes before long.
J. Michael Neal
@Whispers:
Then all I can say is that you must oppose universal health care as a principle, because every version of it, from the Senate bill, to the regulated systems in the Netherlands, to the single payer systems in France and Germany, to the British NHS involves an individual mandate. Everyone must buy insurance. Many, though not all, of them cloak that fact by making everyone pay taxes and using those tax revenues to purchase health care, but it’s still a mandate. If you think that an individual mandate is suicide, and must be avoided, then you are arguing that we shouldn’t have universal coverage. It’s that simple.
Uriel
@Neal:
Or, as Michael Scott would say, “win/win/win.”
reality-based
@drillfork:
see, this is why the Senate bill is – don’t faint, folks – a piece of crap. And you know what? Thinking it’s a piece of shit – and saying so – does NOT make me responsible for this whole debacle.
None of this mess was made by the DFHs – but rather, by the “pragmatic centrists” in the party, who have been driving this whole clusterfuck.
1. “No, you DFH’s can’t have single payer, because it can never get through, and anyway, Max Baucus is going to get some Republicans to vote for HCR if there’s no single payer – so you DFH’s shut up and do as you’re told, and you’ll get a public option. ”
2. “OK. So the whole Baucus thing was a waste of time. But no, you CAN’T have a public option, because our current fantasies involve Olympia Snowe voting for the bill, and President Snowe doesn’t WANT a public option. So you DFH’s shut up and do as you’re told, and we’ll get you early buy-in to Medicare, Instead.
3. OK, so the whole Olympia Snow thing was a waste of time. But no, you DFH’s CAN’T have a public options, and you CAN’T have Medicare buy-in, either, because us pragmatists have now sold our souls to Joe Lieberman and Ben Nelson. So you DFH’s shut up and do as you’re told, support this lousy bill, and we’ll fix the really awful parts in reconciliation. ”
4. Oops. Us “knowledgeable party professionals” were so busy congratulating ourselves on passing this shitty bill that we failed to notice an epic disaster brewing in the wilds of far-off Massachusetts. So listen up, DFHs: You can’t have single payer, you can’t have the public option, you can’t have Medicare buy-in, and you can’t make any changes to this shitty bill. Just shut up, do as you’re told, and pass it. ”
And by the way – this whole debacle? This whole 10-month clusterfuck, brought to you courtesy of the Democratic party Leadership? None of this is OUR fault at all. It’s all the fault of you DFHs, who do not shout “Please, sir, may I have another?” loudly enough to suit us.
First, the “no rescission of benefits” clause in the Senate bill is a piece of crap. It allows Insurance companies to cancel your insurance if patients “deliberately misled the underwriter about their health status. ” Which is precisely the claim the insurance companies always make – that they can cancel your insurance after you get breast cancer because, hey, you fraudulently neglected to tell them about the acne medication you took when you were 17.
Now, California already has laws banning fraudulent rescission of insurance. AND it has a tradition of aggressive State Insurance Commissioners, who last year fined CA Blue Cross/Blue Shield a million dollars for precisely that infraction.
Which fine BCBS has not paid. And has no intentions of paying. And the State of Ca doesn’t have the money or the bandwidth to make them pay.
Meanwhile, BCBC of CA continues on it’s merry way fraudulently canceling the insurance of thousands of it’s member who had the misfortune to actually get sick.
So let’s be clear here – the Federal govt is going to be in charge of making sure that everybody buys the lousy insurance from the private companies – and fining citizens (via the IRS) if you don’t.
But it’s the STATE insurance commissioners – a widely assorted lot, I don’t think Texas even has one – who are going to be charged with enforcing the no-rescission and no-pre-existing-condition ban on the insurance companies – and fining insurance companies if they don’t comply.
Well, THAT’S going to work out well.
David
@reality-based: Even if what you say is true, it doesn’t matter. The POS bill that the Senate passed and the House needs to pass is an improvement over the status quo. In case anyone needs reminding that the Senate bill actually accomplishes quite a bit, here’s your reading material: ThinkProgress, everyone’s favorite “538” and that raging corporatist Senator Bernie Sanders.
So House Democrats? Do your job and pass the damn bill.
Ailuridae
@reality-based:
Hey Look a health care thread. A rare poster making shit up. It has to be a coincidence. This one really has the FDL points down.
First, open left polled the caucus on the public option. 43 yays. Multiple hard Nays including Lieberman. Reid got 59 Yays for the Medicare buy-in and that was it. We lost. Now why did you think there would be 60 votes for that? Because Jane or Avarosis heard it from Sherrod Brown that no member of the caucus would cast a procedural vote to block the bill over the PO? Well, guess what? We love Senator Brown but won’t be relying on him for whip counts in the future. Sorry one of the good progressives misled about the realities of the Senate.
First, the “no rescission of benefits” clause in the Senate bill is a piece of crap. It allows Insurance companies to cancel your insurance if patients “deliberately misled the underwriter about their health status. ” Which is precisely the claim the insurance companies always make – that they can cancel your insurance after you get breast cancer because, hey, you fraudulently neglected to tell them about the acne medication you took when you were 17.
I’ve read the Senate language. Have you? Maybe you should because you have your facts wrong. There may be unjust recissions in the future. But there will be far, far less of them. And that’s progress and that can be improved (recission is possibly the least popular thing insurance companies the most unpopular institution in America do).
But it’s the STATE insurance commissioners – a widely assorted lot, I don’t think Texas even has one – who are going to be charged with enforcing the no-rescission and no-pre-existing-condition ban on the insurance companies – and fining insurance companies if they don’t comply.
Well, THAT’S going to work out well.
In a lot of red state with Republican Insurance Commissioners its going to suck. And that’s where you push for a national exchange with national plans independent of state exchanges with a national administrator. Things like that, as stand alone legislation will pass the 60 vote threshold just fine.
freelancer
@Kryptik:
C&L is trying to beat you to it and fulfill the self-fulfilling Dem Prophecy.
w00t! Manic-progressives!
/emopants lilly-livered lib.
Left wing politics isn’t all about individual self-esteem. SRSLY. PASS THE FUCKING BILL!
reality-based
@J. Michael Neal:
yes, BUT – you are only telling half the story.
In all the countries you mentioned, people are able to choose to buy EITHER a non-profit, govt-run plan –
(aka, the Public Option, which got killed –
)
OR a standard, plain-vanilla, non-profit plan, offered by private companies but standardized, priced, and heavily regulated by the Federal Governement.
Which the senate bill ALSO does not have – merely weak-ass state exchanges, meaning basically no regulation at all.
In short, you are forcing people to buy insurance – but you are forcing them to buy it from for-profit private plans, and then offering them absolutely NO protection from the rapacious insurance companies.
Look, it’s simple; if the government is going to force everybody to buy insurance then the Government must ensure that people can get GOOD insurance, and not get ripped off by private insurance companies. Which the Senate bill does absolutely NOTHING to prevent.
I’m all for an individual mandate – WITH a private option, or a strong federal plan.
But an individual mandate – in which the FEDS enforce the mandate on the citizen, but the STATES are in charge of regulating the insurance companies – is a pure and simple gift of millions of new customers, and billions of taxpayer dollars, to the rapacious, for-profit, unregulated health insurance companies we already have.
Individual mandate + no Public Option= citizen gets screwed.
Remember the huge rise in insurance company share prices on Wall Street when the Senate killed the Public Option? There was a reason.
Uriel
Just to get into the spirit of things:
@Whispers:
No, passing a bill that requires people to pay for health insurance they may or may not need at the time is a political and financial necessity, if you also want to address the the issues of pre-existing conditions or rescission. Anything else is a house of cards. This isn’t a matter of eleventy bajillion level triangulation chess, it’s simple logic.
Absent such a requirement, you are faced with the completely unsolvable problem of how to address people who suddenly show up in their local insurance provider’s office at 8 a.m. saying, “Look, I just nail-gunned my foot last night on a bet- damn that tequila!- but now I kinda regret that. So, I’m going to need some coverage for like, eight hours. Now don’t get me wrong, I’m coming in tomorrow, once I get the stitches and the vicodin, and I’m going to cancel that coverage because, hey, I don’t want to buy coverage I don’t want, but whatever, that’s your problem. Also, my frat’s got a kegger this weekend, so if the anti-biotics I’m prescribed say no alcohol, I’m totally going to ignore that. Which means I might be back in a couple of weeks with a raging staph infection, so you might want to keep my info handy, because I’ll be taking out another policy. No, I won’t keep that one either, not for more than a day or so. But I’ll want it, and you’ll have to give it to me. Thanks.”
Now if your main argument is “But didn’t Obama campaigned against that?” my only response is, unfortunately, yes. If you want to throw in a “Did he flip-flop on that topic?” Again, I’ll have to give you a yes. But at that point, I’m also going to have to add, “Is it a good thing he did, and suggest that might be interested in actually governing, rather than just saying stuff and clearing brush?” To which the answer is also, yes.
Ecks
@freelancer:
Dear fucking god.
Their egos are trampled all to hell, they’re sick of taking it and taking it and taking it… Completely understandable. Now they need to grow a fricking spine and do the right thing and PASS THE DAMN THING ANYWAY. Fixes can be done in the future if it’s passed. Nothing will happen for decades if it isn’t passed. Nothing. Noth. Thing. Thousands will die because you can’t suck it up for one more damned vote, and do the right thing even though it hurts.
Yes, it’s not fair. Welcome to being a goddam grownup who signed on the dotted line to run for high office.
Ailuridae
@reality-based:
yes, BUT – you are only telling half the story.
In all the countries you mentioned, people are able to choose to buy EITHER a non-profit, govt-run plan –
(aka, the Public Option, which got killed – )
OR a standard, plain-vanilla, non-profit plan, offered by private companies but standardized, priced, and heavily regulated by the Federal Governement.
It would be awesome if they did that. Of wait, a fucking minute:
Require the Office of Personnel Management to contract with insurers to offer at least two multi-state plans in each Exchange. At least one plan must be offered by a non-profit entity and at least one plan must not provide coverage for abortions beyond those permitted by federal law. Each multi-state plan must be licensed in each state and must meet the qualifications of a qualified health plan. If a state has lower age rating requirements than 3:1, the state may require multi-state plans to meet the more protective age rating rules. These multi-state plans will be offered separately from the Federal Employees Health Benefit Program and will have a separate risk pool.
That sure sounds like each exchange is going to have two non-profit plans and at least one of those plans must be run by a non-profit entitiy.
You might want to start gettting you information here: http://www.kff.org/healthreform/sidebyside.cfm
Or from the bill itself.
In short, you are forcing people to buy insurance – but you are forcing them to buy it from for-profit private plans, and then offering them absolutely NO protection from the rapacious insurance companies.
See above. Complete and utter fucking bullshit. Please try harder.
But an individual mandate – in which the FEDS enforce the mandate on the citizen, but the STATES are in charge of regulating the insurance companies – is a pure and simple gift of millions of new customers, and billions of taxpayer dollars, to the rapacious, for-profit, unregulated health insurance companies we already have.
Yeah, maybe they are talking about the state level OPM.
David
@reality-based: My earlier comment is in moderation, but your objections don’t hold water. The senate bill is an improvement over doing nothing and the House needs to pass it. There was never going to be a public option after the House and Senate were done, so it’s a moot point.
And remember, if you’re arguing against the House passing the Senate bill, you are advocating killing HCR for decades.
Not sure why you think everything in your post can never be improved either…
Ecks
@reality-based:
Here’s a lesson from a Canadian:
We only get 1 choice of health insurer: The federal government. And it’s mandatory, we cannot choose to not pay for it. It’s taken out of our taxes.
And sometimes there are problems with the care that results – waiting lines get too long for things*, etc.
You know what happens? Because the gov is making us buy that care, we get pissed at the gov, and because this stuff is so important, we make credible threats to withhold our votes over it. And THAT message sure as hell gets through.
Right now insurance can suck here, and nobody tries to blame it on the gov, even frecihtards who blame every damn hang nail on the government. But when the gov is MAKING you buy that insurance, yet you’re getting horrible recisions and stuff, then you start marching on Washington, or Tallahassee or wherever, and now the dems find themselves cowering before voter anger that they HAVE to make it better.
That’s a better place to be.
*Yeah, there’s waiting lists, for NON-URGENT stuff. My buddy blew out a disk in her back, and was in an MRI machine the next day. If you need it, it’s right there. Triage is a miracle of modern medicine, and has been for hundreds of years now.
Uriel
Just to be clear, at the time I started that, the @Whispers: meme was going strong in the thread, and it seemed like the thing all the cool kids were doing. Then I got all expansive and stuff, and my slow tying speed became a factor, and the discussion seems to have moved on. So while that “get into the spirit” thing was relevant and edgy and what everybody-who’s-anybody-is-into at the time, I get that it was dated by the time I actually hit enter.
Ecks
Going to bed. But I used the “email it” feature of the Krugman page, and rec’d the Kos diary, so hopefully those things will bump up their respective rankings, and more people will read it, and…
Yeah… tired… and have never in my life had such sympathy for people who voluntarily smash their heads into stone walls. Repeatedly.
Uriel
@Ecks:
Golf clap, I say.
Uriel
OK-just replace my @whispers with the currently acceptable @reality-based. Works either way.
Which is pretty fucking telling, talking-point-wise.
Citizen Alan
@Ailuridae:
Hippie Punching Prophylactic: I’ve already called my Blue Dog congressman and urged him to vote for the Senate bill and plan to do so again tomorrow.
That said, what I think is going to be the single most awesome fucking thing about this whole stupid debate is that if the progressive House members eventually just give up, roll over and pass the god-damned Senate bill and then five years from now the bill proves to have all the horrible effects naysayers are predicting now, people like you are going to be bitching and moaning about how it was all the fault of those stupid hippie progressives who wouldn’t fight for a better bill when they had the chance.
BR
@Citizen Alan:
Doubtful. In 5 years there will have been hundreds of bills onto which they could have attached health care related amendments, each of which is probably not controversial on its own, and thus can slip under the radar. In total, these amendments will rectify many (not all) of any potential terrible things some folks think might happen if the senate bill is enacted.
reality-based
@Ailuridae:
Ok, God Damm it – now I’m pissed. I have no tolerance for the FDL tactics, nor did I get my points from them. In fact, I’m still split on whether the HOUSE should pass the Senate bill.
So please – point out where I am factually wrong?
1. “We didn’t have the 60 votes for the Public Option or Medicare expansion. “ Yeah, well – us DFHs never BELIEVED in the magical 60-vote unicorn in the first place.
WE wanted to go the Medicare expansion-via-reconciliation route – and were shouted down by all you “pragmatists” who thought you could get a shitty bill passed with 60 votes.
Ok, well – now we’re at reconciliation anyway, aren’t we? Only instead of passing a GOOD bill with Medicare expansion via reconciliation, you centrist geniuses are hoping against hope you can get a shitty bill passed via reconciliation. Way to strategize, guys.
And who do you blame for this? Oh, heaven FORFEND it should be SAINT Emmanuel, or all you other DLC-types who specialize in losing. Oh, my no – It’s all the fault of the DFHs, who didn’t like our strategy to begin with.
2. Yes, I fucking well HAVE read the senate language on rescission. Can you deny that it is MUCH vaguer and easier to sidestep than the language in the house bill? Please, by all means – POINT OUT the language in the Senate bill that is going to lead to fewer rescissions. Especially – since you admit that enforcement is going to suck in weak-regulation states – show me where there will be fewer rescissions. Are there any new enforcement mechanisms? Is there any enforcement AT ALL on the Federal level? if not – it’s status quo.
3. you said (re enforcement)
In a lot of red state with Republican Insurance Commissioners its going to suck. And that’s where you push for a national exchange with national plans independent of state exchanges with a national administrator. Things like that, as stand alone legislation will pass the 60 vote threshold just fine.
So you admit that, as written, the bill is going to really suck for people in many, many states. And we should work to get it passed because -= let’s see –
ok, everything we’ve told you about the magical 60-vote unicorn has been mythical so far – but TRUST US ONE MORE TIME – even though we have fucked this whole thing up royally for the last 9 months – If you trust us one more time, then REALLY, after we get our shitty bill passed, we’ll REALLY go to bat to get all these changes through for you. REALLY! we MEAN IT!
Lucy. Football. Charlie Brown. right. After this drawn-out sausage-making debacle, we can trust the Democratic leadership to immediately turn around and introduce MORE healthcare bills, and make them their top priority, and move heaven and earth to get them passed?!?!?! With 60 votes? In what alternative universe is THAT going to happen?
This is what I think is so funny – all the DLC’ers accusing the DFHs of being “unrealistic” – when actually, the DFHs were the most hard-nosed realists around.
Because we never believed in Chimeras like “moderate Republicans” or “Centrist Olympia Snow” or “Trustworthy Joe Lieberman” – and you did.
J. Michael Neal
@reality-based:
I want a citation to the part of the California code that says this. I have no trouble believing that it prohibits the fraudulent rescission of insurance; in fact, it probably doesn’t even need to state this, because, basic contract law would prohibit an insurance company, or anyone else, from rescinding an insurance policy, or any other contract, under false pretenses. I have a very hard time believing that it prohibits the rescission of an insurance contract that was agreed to due to fraud on the part of the applicant. If that were the case, how would it be possible to be in the insurance business, if someone can lie to you on the application, and still collect on the policy?
I’ve looked through some of the California Insurance Code, to try to find what you claim, and I’m not seeing it.
Ailuridae
@Citizen Alan:
How is it hippie punching to point out someone posting in a thread is being cravenly dishonest and then demonstrating that they are doing so?
That said, what I think is going to be the single most awesome fucking thing about this whole stupid debate is that if the progressive House members eventually just give up, roll over and pass the god-damned Senate bill and then five years from now the bill proves to have all the horrible effects naysayers are predicting now, people like you are going to be bitching and moaning about how it was all the fault of those stupid hippie progressives who wouldn’t fight for a better bill when they had the chance.
I love this “people like you” shit. You have no idea what my politics are. All you know about me is that I am arguing for a bill, a clearly progressive bill in an intellectually honest way and that the people I am arguing against time and time again are shown to be just making shit up out of whole cloth.
Even if there were nothing else in the bill but the 40B in Medicaid and Sanders language’ I would support it as the economic impact of that Medicaid funding the next three years will be huge. But, yeah, this bill won’t fail any more than Medicare failed but if it were to I’d own up to it.
You can count on zero fingers how many times people lying about the bill here have admitted to it despite people quoting the actual text of the bill back to them. But yeah, its my integrity thats in question.
J. Michael Neal
@reality-based: Your post 58 is such an egregious misrepresentation of what’s in the bill that it’s not even worth trying to sort out. Read the damned thing.
David
@reality-based: There is no better comprehensive health care bill from the Senate, reconciliation or not. Step up and choose between the Senate bill or killing HCR for decades. Don’t pretend there’s another option, especially with your rant about the Senate.
I doubt you’ll get much disagreement from anyone here that the Senate is broken, but that’s why the push is to “pass the Senate bill!” and not have to send anything back there.
Ailuridae
@reality-based:
WE wanted to go the Medicare expansion-via-reconciliation route – and were shouted down by all you “pragmatists” who thought you could get a shitty bill passed with 60 votes.
The public option which is weak sauce compared to Medicare expansion was whipped and had 43 votes. There is zero chance a straight medicare expansion would have more. But you know what’s great? Nothing is precluding anyone from passing that tomorrow or the day after the other bill passes. If you have the votes have your beloved Senator Feingold introduce it. End of argument. I’d like to see it as a matter of policy. Call Russ and ask him to do it. I got a kick out of his LA’s response to my idea.
2. Yes, I fucking well HAVE read the senate language on rescission. Can you deny that it is MUCH vaguer and easier to sidestep than the language in the house bill? Please, by all means – POINT OUT the language in the Senate bill that is going to lead to fewer rescissions. Especially – since you admit that enforcement is going to suck in weak-regulation states – show me where there will be fewer rescissions. Are there any new enforcement mechanisms? Is there any enforcement AT ALL on the Federal level? if not – it’s status quo.
yeah the existence of a non-profit plan run by a non-profit company in every exchange operates as a great stop against such practices (assuming they stem from a profit motive) as will the fact that each of these two plans in each state will extend across two or more states.
ok, everything we’ve told you about the magical 60-vote unicorn has been mythical so far – but TRUST US ONE MORE TIME – even though we have fucked this whole thing up royally for the last 9 months – If you trust us one more time, then REALLY, after we get our shitty bill passed, we’ll REALLY go to bat to get all these changes through for you. REALLY! we MEAN IT!
I think its a good but imperfect bill. I look forward to use passing a Medicare expansion via reconciliation. That will certainly improve it.
This is what I think is so funny – all the DLC’ers accusing the DFHs of being “unrealistic” – when actually, the DFHs were the most hard-nosed realists around.
Because we never believed in Chimeras like “moderate Republicans” or “Centrist Olympia Snow” or “Trustworthy Joe Lieberman” – and you did
I’m not a DLCer and I would guess there isn’t an actual Democrat in the caucus to my political left. And I, unlike Harry Reid, didn’t have any illusions that Lieberman wasn’t a snake.
Direct question: if you could have passed Medicare expansion my reconciliation why not pass the bill and do it immediately? Nothing changes about its availability under the Byrd Rule. You just need 50 votes. Now I know why you won’t do that. And I suspect you do too. Which is why its so tiresome arguing with you. But really, just answer me the question – if you had 50 votes for a Medicare expansion on January 20th, 2009 why don’t you have those votes today?
Ailuridae
@J. Michael Neal:
I think you are reading fraudulent as modifying a different noun. (S)he is arguing that a recission for BS reasons by insurer is “fraudulent”not that an insurer can’t cut off a policy if the holder entered into it under false pretenses.
reality-based
@Ailuridae:
Ok, LET”S unpack these things. Since words do acuatlly ahve meanings, and so on.
you quoted:
so that’s ONE plan offered by a “non profit entity” in each exchange. (not two. One is fewer than two. Try to keep up. )
Great. You know who they mean by “non-profit entity”? If everybody was really lucky, it would mean somebody like Kaiser. except it’s probably going to mean firms like Blue Cross/Blue Shield – which in many states (NoDak, for example) – are still structured as non-profits.
to quote James Ridgeway:
Almost half of Americans with private health insurance are currently covered by non-profit plans. As a whole, they haven’t proven themselves much—if any—better or cheaper than the for-profit insurers. The giant Kaiser Permanente is a non-profit. And while some of them have privatized, many of the Blue Cross-Blue Shields are still non-profits as well—and, in fact, got started as co-ops. Some of these non-profit insurers are well known for paying huge executive salaries and hoarding huge reserves, while charging the same high rates and offering the same rationed care as private plans—and enjoying tax exemption to boot. One report by the Consumers Union found the non-profit “Blues” stockpiling billions in cash even as they raised premiums and co-pays.
David
@reality-based: You keep ignoring my request to state your preference between passing the Senate bill and killing health care reform for decades. It’s pretty hard to take you seriously if you can’t even do that.
J. Michael Neal
@Ailuridae:
Maybe. However, if that’s the case, the (s)he is making a completely off-topic argument. The language in the Senate bill is that rescission is permitted in the case of fraud on the application. That has absolutely nothing to do with whether or not rescission is permitted under fraudulent pretenses on the part of the insurer.
I suspect that reality-based is playing games with the English language, and trying to get everyone to think that the California Insurance Commissioner was talking about one thing when he was really talking about something else.
J. Michael Neal
@reality-based:
Of course, that’s where the restrictions on payout percentages come into play.
reality-based
@J. Michael Neal: @J. Michael Neal:
Michael, you said:
Good Lord – sir, have you been following the Rescission problem at ALL? the Insurance companies claim “fraud ” whenever they want to cancel a policyholder that has started costing them money.
please, see the articles that the LA times has been running on the Rescission problem in CA for the last three years. (I started to google, but there’s just been so many)
The bottom line is -when an insured comes down with an expensive illness, insurance companies start scouring their histories for any reason to terminate their coverage. So if, for example, you forgot about the acne treatments when you were 18, and didn’t list them – the insurance company,rather than pay for your breast-cancer chemo thirty years later, declares that your failure to remember the acne treatment constitutes fraud on your part – and drops you –
ANTHEM BCBS of Ca has actually been fined 23 million dollars for such practices recently. It’s the collecting that’s the hard part –
please – google the la times series.
some samples:
David
@reality-based: OK, so recission is a problem. How does killing the Senate bill and then not doing anything else fix that? Because if the Senate bill doesn’t pass the House, there isn’t another alternative, that’s it, over and done.
Ailuridae
@reality-based:
Kaiser will likely bid in something like 35 states. You demanded
OR a standard, plain-vanilla, non-profit plan, offered by private companies but standardized, priced, and heavily regulated by the Federal Governement.
The Senate bill clearly provides that. Now you might hate who wins the bidding and think they aren’t really a non-profit but they’ll be a non-profit running regimented standard care consistent rates and all will be subject to a 80% MLR in the and and 85% in the group policies.
I’m sorry, but that’s what you demanded and thats what you got. I suspect Medicare would do thinks 5-7% cheaper overall than a private plan run by a non-profit. And it stinks that isn’t an option. But according to you all Russ needs to do is introduce Medicare expansion and we’re all good.
Ailuridae
@J. Michael Neal:
I agree. And most people don’t use fraud to describe dishonest attempts to hit someone with recission by an insurer to avoid confusing the issue. Its not what fraud means.
J. Michael Neal
@reality-based: No one is denying that rescission is a problem. You can make all of the citations to the LA Times you want. What I asked you to do was to support your assertion that California prohibits rescission in the case of fraud on the application. You haven’t done that. Pointing to instances where insurance companies were fined for improperly rescinding contracts doesn’t do that, unless you can show me that they were fined despite being able to show fraud on the application.
There are two instances where there is some restriction on insurance companies, even in the case of fraud, but both are also bog standard applications of contract law. One is that insurance companies can be prevented from using a claim of fraud on the application to avoid paying health care providers if they have provided services in good faith prior to notification of rescission. That’s also not the same thing, and nothing there prevents the insurance company from rescinding the policy. It prevents the insurance company from harming the health care provider when they told the provider that the patient had insurance.
The second is that there have been cases where the insurance company was prevented from rescinding a policy for fraud, when the insurance company had known for some time that the fraud had occurred, but didn’t take any action until the insured filed a claim. One of the basic principles of contract law is that, in a case of breach of contract (of which fraud is an instance), the wronged party must take reasonable steps to minimize its own damages. Clearly, by not rescinding the policy as soon as they discovered the fraud, the insurance company failed to take reasonable steps to minimize the harm. Therefore, they were not allowed to rescind the contract.
I’m starting to think that you just have no idea what the issues are here.
J. Michael Neal
@Ailuridae:
People who are familiar with what fraud is don’t. I suspect that this qualification leaves reality-based out.
reality-based
@J. Michael Neal:
you said
s)he is making a completely off-topic argument. The language in the Senate bill is that rescission is permitted in the case of fraud on the application.
Off topic?? THAT ONE PHRASE is the heart of the whole damn topic! (And I’ve followed Rescission closely for years. )
Please note, that the very heart of the rescission problem is that insurance companies claim that failure to disclose ANY medical fact, whether relevant or not – such as having had acne treatment 30 years ago, or having been raped, or having had a doctor write something in your chart that you never even knew was there – ANYTHING they can find, that you didn’t remember to tell them, constitutes fraud on your part and can be the basis of cancellation. (Of course, they don’t go looking for these things until you start costing them money. )
The “fraud on the part of the applicant” is exactly the kind of vague language that makes it necessary for every state insurance commissioner to tackle this problem – what constitutes deliberate fraud on the part of the applicant, and what constitutes bad faith on the part of the insurer, can keep zillions of lawyers busy for years.
And not a damn thing in the Senate bill affects this at all.
Also, the idea that having one – not two, one – plan in each exchange offered by a non-profit entity – i.e.m BCBS – will affect this problem at all is laughable. In California, where the rescission problem has been extensive, and extensively litigated – Non-profit Kaiser foundation has what, 22% of the market.?
So the whole “non-profits will inhibit rescissions” idea is silly. Besides, how are you going to know – when you are forced to buy a plan off one of these state-regulated exchanges – in, say, Oklahoma – what the rescission rate of the various policy offerings is? Who is going to track that for you, and publish the information?
See, this is what makes me nuts – if proponents of the bill were just honest about it, I’d stop being so pissed – maybe even support it. But claiming that it has a fair, non-profit public-option-lite – when it doesn’t – or that it stops rescissions – when it doesn’t at all – or that it has enforcement mechanisms – when it doesn’t – or that the lifetime out-of-pocket cap language isn’t loophole-filled –
well, it’s the dishonesty that makes me nuts.
And the idea that after this ugly hash, ANY health care bill will be considered by the Democratic leadership until after 2010, is just laughable on its face. So the “Pass it now, and we’ll fix it right away” argument is dishonest, too.
It might be passed now – I”m agnostic about that – but I guaran-damn-tee you that it won’t get fixed for years, if ever.
But mostly, I am really sick and tired of people claiming that ANY opposition to this bill is either uninformed or unrealistic. I am emphatically neither. I just think the bill, in it’s entirety, is both a political and policy mistake.
So here’s an idea – how about if we take the good parts of the bill we agree on – the Medicaid and Medicare, the Sanders clinic stuff – and just pass that? Can we get 60 votes for that?
Meanwhile, for Chrissake, QUIT KICKING the DFHs – WE”RE NOT THE ONES WHO SCREWED THIS UP!
Ailuridae
@reality-based:
Please note, that the very heart of the rescission problem is that insurance companies claim that failure to disclose ANY medical fact, whether relevant or not – such as having had acne treatment 30 years ago, or having been raped, or having had a doctor write something in your chart that you never even knew was there – ANYTHING they can find, that you didn’t remember to tell them, constitutes fraud on your part and can be the basis of cancellation. (Of course, they don’t go looking for these things until you start costing them money. )
Was not is. Given community rating and the limited ability to price people outside of age, family size and smoking (all of which most people agree are ok) I don’t see what relevant medical fact there is that could subject someone to a fraud recission except lying about one of the three. I suppose you could still lie but given that it doesn’t affect your pricing and you can’t be denied for a pre-existing condition why would you?
See, this is what makes me nuts – if proponents of the bill were just honest about it, I’d stop being so pissed – maybe even support it. But claiming that it has a fair, non-profit public-option-lite – when it doesn’t – or that it stops rescissions – when it doesn’t at all – or that it has enforcement mechanisms – when it doesn’t – or that the lifetime out-of-pocket cap language isn’t loophole-filled –
well, it’s the dishonesty that makes me nuts.
On what grounds could an insurer hit you with recission if they can’t change prices or deny you coverage based on anything except age, smoking and family size?
So here’s an idea – how about if we take the good parts of the bill we agree on – the Medicaid and Medicare, the Sanders clinic stuff – and just pass that? Can we get 60 votes for that?
Meanwhile, for Chrissake, QUIT KICKING the DFHs – WE”RE NOT THE ONES WHO SCREWED THIS UP!
Sorry but yes, yes you were. Insisting on chasing 60 votes for an expansion of public insurance besides Medicaid weakened the shit out of the Senate bill. The votes were never there and people just lied their fucking heads off that they were.
I’ll bold this last question as all of these FDL bots never answer it:
Direct question: if you could have passed Medicare expansion my reconciliation why not pass the bill and do it immediately? Nothing changes about its availability under the Byrd Rule. You just need 50 votes. Now I know why you won’t do that. And I suspect you do too. Which is why its so tiresome arguing with you. But really, just answer me the question – if you had 50 votes for a Medicare expansion on January 20th, 2009 why don’t you have those votes today?
Third time you’ve been asked. I’m waiting.
drunken hausfrau
anyone see Tom Toles today? pretty much says it all…
reality-based
@J. Michael Neal:
ok, I actually made the effort to go back to the orginal comment, and see exactly WHAT I said that so confused the issue –
obviously, when I said Now, California already has laws banning fraudulent rescission of insurance, i SHOULD have said Now, California already has laws banning bad-faith rescission of insurance
Which goes back to my original point – insurance companies can use ANY undisclosed medical fact, no matter how forgettable, or irrelevant, or even unknown to the applicant, as proof of fraud and grounds for rescission. Then the policyholder, or the insurance commissioner if they’re lucky, has to litigate to prove bad faith on the part of the insurance company.
Good luck with finding the time and money to do that, in between the chemo treatments and the bankruptcy hearings.
And I’m sorry – if you haven’t read the LA times serieis on rescission, than you haven’t been following this issue at all.
J. Michael Neal
@reality-based:
The reason that I’m insisting that you provide me a citation is that you will never, ever see any language *other* than what is here. In fact, I doubt that any court would uphold a statute that prohibits rescission in the case of fraud. It is a basic principle of contract law, and has been for centuries, that, if there is fraud, then there is no valid contract. Any law you get is going to say basically the same thing. Please show me a citation to the House bill that says otherwise.
The question, of course, is what constitutes fraud. The rest of the bill makes changes to the provision of health insurance that produce an entirely different environment. Even if the language allowing for rescission in the case of fraud remains exactly the same, there will be a lot less of it.
That’s because fraud has a very specific definition. It must be a misrepresentation. It must be either deliberate or willfully negligent. And, most importantly for our purposes, it must be material. Materiality is determined by whether or not the harmed party relied upon the misrepresentation in deciding to enter into the contract. It’s impossible to overstate how crucial this is.
In the current environment, an insurance company can claim that, had they known the actual health history of the insured, they either wouldn’t have entered into the contract, or would have charged different premiums. Under the Senate bill, they can’t make this claim. With community rating and a ban on rejecting people for pre-existing conditions, they would have had to enter into the contract even had they known the information. The number of things that could have legally affected their decision is reduced drastically. That means that the number of misrepresentations that can be considered fraud has been reduced drastically.
This is why I keep insisting that you need to actually know something about what fraud *is*, and not just the sorts of claims that insurance companies currently make, in order to have any idea what the effects of the rescission language would be. It’s pretty clear that you don’t know what fraud is. The argument that the Senate bill would allow them to behave in the same way that they do currently is ridiculous on its face. The very nature of the bill would prevent that, even if it had no language regarding rescission at all.
Ailuridae
@reality-based:
Again, this bill changes that. If medical history can’t change rates and cant change acceptance what is the positive incentive for an applicant to not be honest. What reason would a person have to not immediately turn over the entirety of their medical records voluntarily?
reality-based
@Ailuridae:
if you had 50 votes for a Medicare expansion on January 20th, 2009 why don’t you have those votes today?
jeez, I don’t know – maybe because that was before the GOP had nine months to perfect the art of obstructionism?
Because 9 months ago something like 70% of Americans favored healthcare reform, as opposed to the 30-something that favor it today?
Before Palin and the Teabaggers spent the summer screaming “HCR will kill Granma with death panels ” while you centrists sat around for THREE MONTHS waiting for Max Baucus and the Imaginary Bipartisan Pony?
Before Mary Landreau and Ben Nelson got to commit public extortion? Which you and I know as business as usual – but this stuff was done under the spotlight?
In short – before you centrists had so thoroughly poisoned the well, it was possible. Not now
and re ” the hippies were not at fault”
Sorry but yes, yes you were. Insisting on chasing 60 votes for an expansion of public insurance besides Medicaid weakened the shit out of the Senate bill.
please explain HOW that weakened the Senate Bill. Especially because, Goddamn it – and we’re arguing in acircle here – the DFHs didn’t think there were 60 votes to start with! YOU FOLKS DID!!
Your used your 60-vote strategy, you got your lousy 60 vote bill At least have the guts to own it.
Ailuridae
@J. Michael Neal:
In the current environment, an insurance company can claim that, had they known the actual health history of the insured, they either wouldn’t have entered into the contract, or would have charged different premiums. Under the Senate bill, they can’t make this claim. With community rating and a ban on rejecting people for pre-existing conditions, they would have had to enter into the contract even had they known the information. The number of things that could have legally affected their decision is reduced drastically. That means that the number of misrepresentations that can be considered fraud has been reduced drastically.
This is why I keep insisting that you need to actually know something about what fraud is, and not just the sorts of claims that insurance companies currently make, in order to have any idea what the effects of the rescission language would be. It’s pretty clear that you don’t know what fraud is. The argument that the Senate bill would allow them to behave in the same way that they do currently is ridiculous on its face. The very nature of the bill would prevent that, even if it had no language regarding rescission at all.
This. Written much more clearly than my attempts to do so. I have a 5 AM appointment with a squat rack (New Years resolutions stop soon I hope) so I’m out of here in a few
J. Michael Neal
@reality-based:
Maybe they can, but that really has nothing to do with the nature of the Senate bill’s language. No matter what language a bill uses, the fact is that the money is in the insurance company’s bank account, and if they refuse to write a check, someone is going to have to go to court to force them to do it. If your position is that, so long as they can make you go to court to be covered, then they have all the power, then there is NO solution to this problem. None.
In practice, the fact that they can’t make a claim of fraud that even meets the definition thereof, even before looking at the facts, changes things. They’ll get laughed out of court, and possibly sanctioned, if they try to avoid payment on this basis. Yes, there will have to be enforcement, but that would be true under any language.
Ailuridae
@reality-based:
Again, this was whipped. There were 43 yays for a public option which is far more palatable than Medicare for all. Some of those Yays were out of loyalty to the President and party. If the President had gone from running on public option to Medicare for all he would have maybe had 35 strong Yays.
It weakened the Senate bill because the 10-12 Senators they had to pursue to expand public health care against their will before finally pulling it out after Lieberman each demanded stupid shit they wouldn’t have otherwise. As just one example they lost the removal of the anti-trust exemption in trying to get the Conservadems on board with the medicare expansion. The excise tax became more onerous etc.
J. Michael Neal
@Ailuridae:
Not to step on you, but I really want to emphasize that even this isn’t required. If the information can’t change acceptance, and can’t change the premiums, then blatantly lying about it can’t be fraud. One of the reasons for that definition of fraud is exactly because it means that courts don’t have to get into the question of whether or not there was a deliberate misrepresentation, or what anyone’s motives were. When possible, judges really like to avoid those questions. Obviously, there are a lot of instances where they can’t, but in this case, they can. And they will.
J. Michael Neal
OT: Jesus, Cameron White can hit the ball. Three consecutive sixes, and all of a sudden, Australia is right back in this match.
Ailuridae
@J. Michael Neal:
I know. I’m arguing that there is no positive incentive to be dishonest (which is different than being fraudulent) If I were with serious health problems and were signing up for a new health plan I would just literally hand my records over.
Again I only the three or four issues that allow the price of the plans to vary being grounds for fraud (smoking, age and size of family)
And I’m out of here.
Tomlinson
If I were a dem congress critter, I’d think about this scenario.
Let us presume that they pass nothing, very likely. A good chunk of their base is going to (correctly) surmise that the dems are, effectively, worthless – and they will stay home.
You are likely to see a republican majority some time soon.
That majority, if they are smart, will be virtually certain to take up and pass a HCR reform bill of their own, probably without universal access, but a pretty OK bill. And fast.
Now who goes down in history?
And who can actually get things done?
Who gets credit for solving one of the largest problems facing this country, ever?
And who will be wandering in the wilderness for the rest of their days?
That is where we stand. HCR may be polling down, but that’s a temporary PR problem, even if it gets you chucked out of power for a cycle or two. The inability of a large majority to take any action whatsoever in the face of an obvious crisis – that’s a generation of irrelevance.
The notion that this bill is not progressive enough is pure bullshit, because what’s riding on this bill is the future of any progressive progress, probably for our lifetimes. Do nothing, prove your irrelevance, forget anything else.
And the stakes all got higher with the campaign ruling yesterday. This is their one bite at the apple, their one path to continued existence.
But by all means, let’s let our individual egos get in the way.
There is the small matter of 30 million people with coverage, etc, to consider as well.
Tomlinson
BTW, this is where Obama is proving his real mettle. He should be stepping up to take control of this, he should be providing air cover and PR cover and taking the heat.
He’s taking a pass.
My overall take on that is that he’s just out of his league.
I really could not be more disappointed in him than I am right now. I will give him this, given the choice of lead follow or get out of the way, he’s at least getting out of the way.
rachel
@Linkmeister:
Not a few are from the planet of Fuck You I’ve Got Mine. The rest are from I Reject -Your- Reality And Replace It With -My Own- The Land Of Oz.
georgia pig
@J. Michael Neal: Man, you folks must not sleep. This is a difference, but it’s not unreasonable to worry that, in practice, it may not matter because of the asymmetry in the relationship between insured and insurer. The argument of changed circumstances for consideration of the fraud issue is premised on a somewhat idealized view of the legal system, i.e., in theory, a policy holder that is canceled because of alleged fraud should prevail because there is a factual basis for presuming the failure to inform was unintentional. However, that you have to go to court to do this, which may be problematic for someone who is sick and broke. So, an insurer could engage in bad faith recissions on a bet that they would get away with it in most cases. I guess the plaintiff’s bar is sufficiently creative to make this a cause of action that would generate a lot in punitive damages, but you know how they’re under attack. The point is, there is no answer to these kind of questions: the issue is whether passing the Senate bill moves the ball. I think it does for the reasons one of our Canadian friends described above, but reasonable people can disagree.
Honestly, this health care debate is less ominous than what that corporate tool Roberts and his minions puked out yesterday.
Mari
@Ailuridae:
That’s a lovely piece of disingenuous argumentation.
Just because an element of someone’s medical history (supposedly) can’t be used to price their premiums does not mean that an insurance company cannot decide that patient failure to disclose a piece of pricing-insignificant medical history constitutes fraud justifying recission. In fact, the insurance industry does this right now.
Teenage acne treatments don’t generally effect adult premiums 20 years later. The insurance industry, however, has used this completely pricing-irrelevant data to kill cancer patients on the grounds that failing to disclose acne treatments constitutes fraud.
Lieberman-Stupak does absolutely nothing to prevent bad faith recissions based on medically irrelevant, pricing irrelevant, medical history. No amount of hippie punching or whining about FDL and ponies will change that.
J. Michael Neal
@georgia pig:
I was watching cricket from Australia, and it just ended, so I’m headed to bed now.
I don’t even disagree with this, entirely. I think that the insurance companies will be hard pressed to make a go of it, but, in a state with a really ineffective regulator, it could conceivably be a problem. However, I completely stand by my point: this worry has nothing to do with the language in the Senate bill. If the problem is in the legal system, then no language that would withstand a court challenge will be able to prevent it. While there is reason to stay alert to the problem of improper rescissions, this doesn’t constitute any sort of reason to refuse to pass the Senate bill.
reality-based
@J. Michael Neal:
sorry, had to go for a break –
Jesus, what are we all doing up at this hour, anyway?
believe me – I do understand what fraud actually IS. As you said, It must be a misrepresentation. It must be either deliberate or willfully negligent. And, most importantly for our purposes, it must be material.
That’s not the point. The point is, that insurance companies – CA is the state I follow the closest – baselessly ALLEGED fraud on the part of the policy holder as a prestext to cancel thousands and thousands of policies, after the policyholders began making claims and costing them money.
And they have continued – in the face of aggressive action on the part of the CA Insurance commissioner, and multi-million dollar fines – to aggressively cancel policies. Because it’s cheaper to fight the state in court than pay the claims.
Now, as Ailuride says, the institution of community rating should make such rescissions even more indefensible. Great. Who’s gonna enforce it?
If I live in Texas, and my insurance company says that I forgot to tell them about my German measles when I was 12, so they are going to cancel my policy now that I’ve broken my back at age 55 – who’s going to go to court for me, and point out that my German measles are no longer relevant? (they never were, but never mind. ) Is there any federal enforcement or regulation in the bill? I thought not.
And Ailuride, the whole crux of the California Rescission battle is NOT that people deliberately failed to disclose, but that people FORGET medical stuff, like the German measles or acne treatment. OR they didn’t know that having been raped – as in one famous case – constituted a pre-existing condition. Or – as in another case – that they never NEW about some notes a doctor had once made in their file.
See, you two think that the insurance companies are actually going to be constrained by the legal language in the bill.
And i think that – well, they’re insurance companies. They weren’t constrained by the lack of actual fraud when they canceled policies BEFORE this bill.
AndThey are going to dodge and weasel and sue and cancel policies for YEARS after this bill goes into effect. And there is NO federal enforcement mandate to stop them.
Look, guys, I am NOT a FDL-er. Getting in bed with Grover Norquist? Please!?!?!?
And if I had any realistic expectation that the problems with the bill would actually be fixed in the future, I’d hold my nose, call my congressman, urge him to vote for it.
But Ailuride – realistically now – what do you think arer the chances that, after this bill is passed, the leadership would allow ANY bill dealing with health care to come to the floor until at LEAST after 2010? Realistically now, – give me a percentage. What are the chances?
Mari
@Tomlinson:
I’d be spending my time punching hippies as hard as I can so I can get the better Wall Street, lobbyist, and corporate board jobs when I retire. The more hippies I punch, the better post-Congress payoff I get.
Congress has no skin in providing healthcare, or otherwise improving the lives of average people in any way. That’s why we’re in this mess.
J. Michael Neal
@Mari:
You aren’t paying attention. Insurance companies can make this claim now, because it’s certainly true that they *could* have chosen not to provide coverage had they known that information. It may not seem very likely to folks here, but it was at least possible. That means you get into a murky debate of what the motives of the person filling out the application were, and what the insurance company might have done in a hypothetical scenario that never happened. Once you start getting into those sorts of arguments, it really is the case that insurance companies can win court cases, and they can certainly drag it out to the point where people can’t afford to fight them.
What would change with passage of the Senate bill is that it is certainly true that they *couldn’t* have chosen not to provide had they known that information. This changes the nature of any court challenge profoundly. Most likely, it would never even go to trial: the judge would dismiss the case in a preliminary hearing, because the insurance company couldn’t demonstrate, even if their factual claims were true, that the standards of fraud were met. There might (given enough instances, change that to will) be some instances where that doesn’t happen, but they will be a small percentage. Given the sanctions they could face for refusing payment on such patently bogus premises, the cost effectiveness of trying to rescind policies on flimsy premises drops a lot. If you think the California insurance commissioner has fined them a lot under the current rules, wait until he gets to go after them when they can’t even make a prima facie case of fraud.
Again, using examples of what the insurance industry gives as cases of fraud now to illustrate what they would do under the Senate bill is silly. It’s another case of making arguments against the bill based only upon what it says explicitly without understanding the non-eplicit consequences it has.
mr. whipple
They live on the planet where they are employed with bennies, and make a good buck.
Sucks to be me.
Of all the things that shock me in this mess, was that progressives would turn Libertarian.
reality-based
@georgia pig:
re the Roberts “EXXON can TOO buy elections” ruling –
geez, you should read the NYT editorial – they really called out Roberts, in particular – and baldly stated that this horrible decision is a bookend to and of the same awfulness as Bush v Gore.
I do realize, now that I think about it – and in light of yesterday’s decision – that we probably should pass this HCR thing, since the 2010 elections are going to be wholly owned by Exxon, BCBS, Big Pharma, and Goldman Sachs.
shit.
rootless_e
http://www.dailykos.com/storyonly/2010/1/22/828686/-The-invisible-cabinet-of-Obama
J. Michael Neal
@reality-based:
No, that really is the point. All of the examples you give are instances in which they can make enough of a claim of fraud that it has to be litigated. If you change what even *could* be a material misrepresentation, then you change the game entirely. There is an enormous difference between a situation in which the facts alleged by one side would constitute fraud, and so you have to determine whether their allegations are true, and a situation in which, even accepting the facts exactly as that side states, there is no fraud. The nature, and length, of the litigation is completely different.
I’m unimpressed by this argument. There are at least as many states where transferring enforcement to the feds would be a negative for consumers as there are where it would be a positive. There are NO circumstances under which there could be a bill that means that we don’t have to rely on enforcement from someone. That’s just a simple fact of life. Saying that the regulations might not be enforced has nothing whatsoever to do with the language in the Senate bill. It’s just a fact of life.
So what? UNDER THE SENATE BILL, A PRE-EXISTING CONDITION IS NOT MATERIAL. Bringing this up is irrelevant. That’s the point.
No, I don’t think that they are going to be constrained by the language in the Senate bill. I think they are going to be constrained by the language in regulatory codes regarding what constitutes fraud. Language that already exists, and is used on a daily basis in courts around the country.
That’s because they weren’t prevented by the language in regulatory codes as to what constitutes fraud from being able to make an arguable case that fraud existed so long as it was *possible* for their alleged facts to meet the definition.
Sure, because the next time there is a Republican administration, the citizens of New York are going to be so happy that you pre-empted state regulation. Except that it probably won’t make much difference, because the insurance companies won’t be able to make even a flimsy case that fraud occurred.
Again, I’m not saying that the problems you argue will happen, can’t happen. I think that the magnitude of them will be a lot less than you do, but they are certainly possible. However, that’s not a problem with the language in the Senate bill. It’s a problem with the legal system that will exist no matter what language you use.
Brian J
@Tomlinson:
You have it exactly right.
rachel
@Tomlinson: I don’t think the Reps could do that–at least not right away. There was all that fuss they make about how awful government-run healthcare would be. How would their tea-bagging base react to this volte-face? And who would get stuck with the bill? Their voters would object based on the fact that they elected Republicans because they didn’t want HCR, especially HCR that they’d have to pay for. The Reps sure as hell aren’t going to cross the insurance companies. The only HRC they can plausibly offer is tort reform, which won’t do anybody except doctors a blind bit of good. Think the MDs and hospitals will pass on the savings to their patients? Ha!
Bush-the-Lesser had an opportunity to do what you propsed after the Clinton HRC debacle, and he did nothing. I think there are very good reasons for that.
The Truffle
@rootless_e: Thanks for the linky. Geez, these blogs are getting depressing.
Here’s my opinion: It’s not the lack of spine. It’s the lack of solidarity. Lots of conservadems and Blue Dogs believing GOP frames.
Napoleon
So I just got into work and there is an e-mail waiting for all employees that our medical coverage cost are going up 31% this year and they are now looking at alternatives.
I am so glad Obama and Congress is on top of this issue (roll eyes).
ChrisNBama
I’m sorry to say it but Health Care Reform is dead. There is zero political will on the part of democrats to do what must be done. There is one reasonable option: passing the Senate bill in the House with promises to change the taxing and subsidy provisions through reconciliation. But apparently that ain’t happening. Obama has pivoted to the economy, the Senate has punted to the House, and the House is sulking and pointing fingers at the WH and Senate. It’s over. The democrats have fumbled the ball on the one yard line. Like Lucy with the football, the democrats are the party of Charlie Brown.
As for me, I will never phone bank, donate, or otherwise involve myself with the democratic party again–well, I lie. I might donate to Alan Grayson. He’s the only democrat with balls. Otherwise, they are a bunch of feckless losers.
bob h
Would not taking the reconciled bill to the Senate floor and making the Republicans filibuster it for a few weeks be better than skulking away like dogs? At least Reid and Pelosi could say to our base – we tried. It would also serve as a public demonstration of how preposterous the filibuster is.
With Brown supporting the Mass. healthcare law, and favoring a national law as long as Mass. is not additionally burdened, Tuesday was definitely not a referendum on HCR.
The Sheriff's A Ni-
@Tomlinson: Old Vulcan proverb: “Only Nixon could go to China.”
And now I’m seeing why.
jenniebee
Late to this thread, but the argument I’ve heard in favor of passing this piecemeal is that it’s going to be damned hard for even Republicans to refuse to allow a vote banning recission and eliminating pre-existing conditions. That’s the scaled-back “bi-partisan reform” they’ve been asking for, it’s in their own documents, etc. And yes, it would cause a death-spiral if that’s all that got done, which is exactly why health insurers would have no choice but to respond by breathing down Republicans’ necks and informing them that it was absolutely necessary to expand the pool of insured to include more healthy people.
So far, insurers have had the choice between Republicans preserving the status quo and Democrats changing things in a way that preserves insurers’ viability. Democrats have been taking the hit politically for combining popular measures with things like mandatory universal private coverage because 1) it’s the responsible thing to do, and 2) they thought throwing a bone like that to insurers would get everybody together in one big happy bipartisan family. It didn’t, and now it’s time for a big “fuck all y’all with a chainsaw sideways.” I’ve said it all along: power in negotiations belongs to the party that is willing to walk away from the table; passing this piecemeal will give the Republicans no choice other than to play Let’s Make a Deal.
Xanthippas
You guys have to help me, because I haven’t been able to stay on top of the news. I don’t honestly understand why anyone in the House who supports health care reform in general (progressives especially) thinks it’s a good idea to start all over again and pass only what you can via reconciliation. For one, that’s not going to produce health reform that’s as sweeping or effective as even what the Senate bill proposes (that’s Krugman saying that, not me) and how in God’s name does anyone think that’s a good idea politically? We’ve spent a whole damn year watching them make the sausage, and now they think it’s a good idea to drag it out for a few more months and then pass a limited package that makes the people at FDL happy??
Tomlinson
And there, I think, is the crux of the matter.
Look what happened in Mass. A recent poll of Brown voters showed that his views on national HCR were actually a *slight negative* for him. Brown was very careful to support Mass HCR,but was very negative on national HCR.
And Brown totalled Coakley.
What did we learn here? Was it a referendum on HCR? Nope. It was a straight race between two candidates in a very blue state. And the red guy won – he was just a better candidate.
Why?
*Because the dem did not have a wedge issue.* Mass *has* HCR. National HCR was simply not a factor.
And the dem lost.
So why are the dems so quick to distance themselves from HCR, why are they so happy to have an excuse to drop it like a hot potato?
Because they actually could pass it.
And then their voters will be like the greyhound that caught the rabbit, and they won’t run nearly so fast ever again. Their wedge issue will be gone.
So there you have it, IMO. You can forget about HCR from the dems. But the republicans have every reason to pass it.
And I expect that, ultimately, they will.
4tehlulz
>But the republicans have every reason to pass it.
Wut? If they did so, they lose their wedge of “teh guvmint’s g0tz itz handz on mai Medicare ZOMG”, never mind that they would lose their greatest future funding source in the insurance cos.
Tomlinson
Abortion. Guns. Role of religion.
These are all super hot on the right, more tepid on the left.
Mary
Recently, when I try to navigate to this site, I get a message that the server is busy. Is the traffic up or something?
TJ
Jeez, who’da ever thunk it? While the President and the Senate are running away as fast as they can, the House members actually refuse to suicide on command and take one for the team and history. And the minimal deal they require for face-saving is out of bounds because the House of Lords might get pissed. Why they won’t pass it anyway is beyond me.
Gus
Who in Congress gives a shit about the test of history? The only thing they worry about is their phony baloney jobs.
Koz
What a pile of crap from a lame hack. Rep. Stupak was quoted a day or so ago that the Senate bill, as is, doesn’t have 100 votes in the House. Maybe it has more than that, but it’s not like finessing or bulldozing one or two guys in the Senate.
Phoebe
@Brick Oven Bill: You must be referring to this!
kay
@jenniebee:
Why wouldn’t they just raise rates on the whole pool? 85% of people have health insurance.
Sure, I guess eventually there would be a “death spiral”, if insurers were forced to cover those with preexisting conditions and not rescind contracts, but there’s nothing stopping them from offering policies to sick people at ridiculous rates, and jacking up all other premiums.
If the Democrats pass this piecemeal, everyone’s rates go up, and no one gets affordable insurance.
Republicans aren’t going to get in the way of that.