Blue Mass Group

Reality-based commentary on politics.

The Health Care Compromise Is Good News

By

The news today was that the Democratic leadership and the Blue Dogs made a deal exempting some businesses from the employer mandate and refusing to let the public plan impose Medicare rates on providers.

Now, I don’t think that this compromise was optimal as a matter of policy. But I do think that it bodes well for the Democratic Party. The fact that there are several factions within the party shows, first, that we are still a Big Tent party. Compare that with Bob’s observations on the future of the GOP. Only a Big Tent party can govern at the national level, in my opinion. So let’s hear it for the Blue Dogs.

Second, the fact that our various factions can agree on major legislation (well, I suppose I can only say that tentatively until we see what happens in the Senate) shows that, again unlike the Republicans, we have the discipline not to put ideology over the practical necessities of governance.

My point is that some of us will like the bills that come out of Congress and some of us will wish they are better, but at least the Democratic Party, for now, is in the business of practical governance instead of the business of pandering, or speechifying, or whatever.

TedF

Please share widely!
fb-share-icon
Tweet
0

Comments

  1. and the reasons have nothing to do with ideology. They have everything to do with the goals of cost-effective, equitable, quality health care for all.  The starting points for this so-called “compromise” were worse than disappointing. What was allowed “on the table” represented a sell out to the corporate power brokers who all but control Congress.

    <

    p>If you want to know more about the BlueDogs’ (would be more aptly named BadDogs) obstructionist role in health reform go to this post on the health policy and politics blog HealthBeat that’s run by Maggie Mahar at http://www.healthbeatblog.com/…

    <

    p>I’ve comment one comment that’s among many there

    • It appears to me a public option is on the table

      <

      p>

      While the federal government would still establish and run a new public health insurance program, to compete with insurers, the new entity would not use Medicare rates to pay doctors and hospitals. Instead, the government plan would negotiate rates with health care providers, just as private insurers often do.

      <

      p>To me, that’s something to celebrate.  It really needs to be picked apart a little further to understand all of the details, but the public option was my main concern, as well as where the tax increases will be.

      • The government forces doctors to treat Medicare patients at a rate that the government decides. For the most part this rate is below cost.

        <

        p>One reason private rates are so high is that the doctors have to over-charge private insurers to make up what they are losing by treating government patients.

        <

        p>The basic difference between the government and private insurers is that the government doesn’t need to negotiate with doctors, it can just tell them they have to provide the service at the rate the government sets.

        <

        p>If the “public plan” could force doctors to take on more patients at the government rate, that would force private insurance costs even higher, so the “public plan” would drive them completely out of business.

        <

        p>At that point, the government would have total control over the doctors… probably there would begin to be a serious shortage, as they couldn’t make enough to pay off their schooling and other investments.

        <

        p>The Blue Dogs represent some huge private insurers who are very happy to have the government mandate that people buy their products. They just want to be on the profitable side of this equation rather than shut out.  

        • …the final point is that the super-liberals want this to happen, they want the public plan to kill off private insurance, because they hate people making a profit.  

          • making a profit. We hate people making a profit by interfering in the marketplace and skimming off money that should go directly to health care providers.

            <

            p>Health insurance companies serve little (some would argue they provide a moral hazard to health care usage; I’ve yet to see numbers). In other words, they play a role in rationing health care.

            <

            p>Health insurance is a legalized protection racket. We pay them, and they provide as little protection as possible. The only difference betwen health insurance companies and Tony Soprano is that Tony was conflicted about killing people.

          • Yes, some of us won’t complain too loudly if this happens, but as I’ve mentioned before the existence of public education has not killed off the private education business.

            <

            p>No, we don’t hate making a profit in principle, just the ways in which certain profits are made.  Denying coverage is definitely a way by which we hate people making a profit.

      • I infered the previous comment about something not being on the table as refering to straight-up single-payer.

    • Ann, I’m not sure I disagree with you on the merits. I’m not talking about the merits of healthcare, but about the Democratic Party’s ability to pass major legislation. And I do think that, in a sense, your comment has illustrated my point, and I don’t mean that as a criticism.

      <

      p>TedF

  2. We now have a clear measure of how ideological, expensive, and useless the “bipartisanly correct” option is. One commentator compares it to the Missouri Compromise.

    <

    p>We see clearly that “centrism” is an ideology, diametrically opposed to pragmatism.

    <

    p>So here’s to hoping that this puts an end to splitting the difference with the party of George W Bush.

    • I think the article you cite is mostly referring to the bi-partisan discussions in the Senate Finance Committee, which, I agree, have been bad. I am talking now about intra-party discussions in the House, which have, in my view, not been so bad.

      <

      p>TedF

  4. <

    p>Since they’ve been so effective at delaying and ‘centering’ the health-care reforms, let’s reflect on how many people are going to suffer and die because of their efforts. Then we can offer up an appropriate appreciation.

    <

    p>[One third of Boy Scout salute, accompanied by Bronx Cheer]

  5. does this mean the Congressmen will actually have time to read and understand the bill before they vote on it… how original. Of course, Obama didn’t want that since he believes in vote for the bill then read it later (like the Stimulus). Of course, before he was President he was all in favor of reading bills and publically criticized any “rushing” of bills as being jammed down Congress’ throat. Funny how things change.

    <

    p>Let’s see what’s buried in the 1,000+ page bill and what common folk like me đŸ™‚ think about it.

    <

    p>PS How do you think Ted Kennedy’s brain cancer would have been handled under the new proposed healthcare system? Would his case be approved based on his age and general health? Would he have gotten the top-shelf care he actually received?

    • it’s obvious that you don’t know what you’re talking about

      <

      p>

      Would his [Ted Kennedy’s] case be approved based on his age and general health?

      <

      p>Age-related withholding of care is not and will not be in any of the major bills in Congress; it looks like you’ve been getting emails from the shameless lying liars who are hell-bent on killing any reform bill. It’s straight-up fear mongering so be smart and don’t fall for it.

      <

      p>Yes, having time to read a bill before it’s brought to a vote is good–in stark contrast to the Massachusetts legislators who were given less than 24 hours to vote on the individual mandate law (Chapter 58) that forces all state residents to purchase private insurance or pay a steep fine, and that forces us taxpayers to subsidize purchase of wastefully expensive private insurance through the nose–but let’s not lose sight of who’s spending $1.5Mil PER DAY to de-rail national reform.

      <

      p>It’s the cartel of the insurance-drug-medical device companies and their Wall Street backers who don’t want anyone, including Congress, messin’ with their profits.

      <

      p>Shame. On them. And shame on Congress.  And shame on Obama, unless he uses his clout to turn things around to put healthcare for people before profits.

          • because it us a 1,000+ page reform and Congress is now infamous for sneaking all sorts of shit in large bills. I know the devil is in the detail on anything in life, but if the DEMS pushing this reform wanted to make this simple with no hidden agenda than they certainly could have done that. However, when you wan to throw all sorts of shit into the fray then the MO is too deluge people with data and slide all your sneaky stuff in between the lines somewhere.

            <

            p>If your side is so hell bent on ramming this through then tell them to NOT lie or omit information and details.

            • I’m working for health care reform that will benefit my community, my patients, and my family.  

              <

              p>To put a human face on this issue: I’m a health reform activist so that my two young children will be able to grow up and pursue work that best fits their talents and interests without it having to be “a job that carries health insurance benefits”. Tying health insurance to certain jobs (and not others) isn’t good for my kids nor anyone else’s, nor for our economy.

    • What’s the matter – never read a book that long?  Not that I’ve read this particular bill cover to cover, but citing it’s length per se as criticism is pretty lame.  This is after all legal code we’re writing and if it were less specific we’d end up with regulators and judges doing lots of interpreting which something tells me you’d whine about as well.

      <

      p>As for Ted Kennedy, I’ve heard the public option described basically as giving everyone the option to by into a plan like what members of Congress get.  Therefore, I don’t see much changing for his personal situation.  Here is Factcheck’s take on the age issue.  The trick is to get EVERYONE the quality of and access to care that Kennedy already enjoys.  Fortunately, Kennedy himself understands this and is not letting his own health situation keep him from working as hard as ever to see that that happens.

  6. Public Option is intact but rates are no longer tied to Medicare, the rates will be negotiated separately via the HHS.  Plus they reduced the amount of assistance for those who live in between 300 and 400 percent of the poverty level.  The percentage is very small, but it cuts the costs somewhere between 100 to 200 billion.

    <

    p>The biggest impact is allowing for the vote after the recess.  This allows for a Republican hail mary attempt in August.  Better that this gets done now, but that’s not going to happen.  Look for the wingnuts to start going crazy, but August is a slow news month, so I don’t think it’s going to pick up enough fervor sway votes in September.

    • When you rush these budgets that are a foot high, and nobody has any idea what’s in them and nobody has read them … and it gets rushed through without any clear deliberations or debate. Then, these kinds of things happen, and I think this is, in some ways, what happened to the Patriot Act. I mean, you remember there was no real debate about that. It was so quick after 9/11 that it was introduced that people felt very intimidated by the administration.

      <

      p>Yes Obama wants this crammed down the throat of everyone before they can actually read it. Oh Dear, now they have a chance to read it and find all the little “provisions” I put in there. Any more AIG BONUSES? Any more money for ACORN? Obama should stop being a hypocrite and encourage Congress to read EVERY bill before they sign it.

      • Why don’t you get back to me about the oversight he added with the money.

        <

        p>This has been in committee for weeks, everyone knows and understands what is going on.  They have been briefed on the details.  I got a secret for you, every page of every bill does not get read, they have a staff to do most of that for them.  You’re starting to sound like Michael Moore : ).  The recess is nothing more than a tactic to use the recess as a means to try to attack the bill for a month and see where that gets them.

        • I totally disagree with you concerning ll the Congressmen knowing what’s in the bill. There is ZERO harm in either them or their staff reading the entire bill. Don’t you think there are some bills which really require their full attention? Doesn’t $1 TRILLION deserve a little more time and a little less “Rushing before the sky falls”. We heard it a few times already and they sky has yet to fall.

          <

          p>And in the month or so they have to review the bill, they may find reasons to “attack” it and that would be a good thing, don’t you think? Or are you so biased and mesmerized by your politicians that you believe they got 100% of the 1,000 page bill just perfect out of the chute. Be a little open minded here will ya???

          • I think a lot of people are getting cold feet on the health care bill, and I can’t blame them. They SHOULD know what is in those thousand pages. I want my Congressman to be able to answer my question….how will the passage of this bill affect me? my family? my current health plan? my taxes?

            • It was in committee, but I would be hard pressed to think reps don’t have a clue of what’s in the bill, outside of they haven’t been doing their job over the past month.  This whole topic is a load of BS.

  7. Marie Cocco:

    “The need for this action is plain,” Johnson said in signing the law in Truman’s hometown of Independence, Mo.

    “And it is so clear indeed that we marvel not simply at the passage of this bill, but what we marvel at is that it took so many years to pass it.”

    Now we marvel again at the long and contentious legislative path that health-care revision is taking. We hear the same arguments against a national health insurance plan that were made nearly half a century ago.

    But now we have Medicare, and its demonstrated history of delivering exactly what Johnson said it would. And the marvel of our own time is that we ignore this success, while promoting untried alternatives that may well fail.

    • Paul Krugman has a nice piece today pointing out both how uninformed Medicare patients are about who administers their health insurance  

      <

      p>

      At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program – but the voter, Mr. Inglis said, “wasn’t having any of it.”

      <

      p>and how all of us working poor, working middle class and working rich who get at least decent health insurance through our employers don’t realize how much our government already subsidizes our health care.  

      <

      p>

      Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care – never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.

      <

      p>

  8. 53 House members have signed a letter that says, in part:

    We regard the agreement reached by Chairman Waxman and several Blue Dog members of the Committee as fundamentally unacceptable. This agreement is not a step forward toward a good health care bill, but a large step backwards. Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates – not negotiated rates – is unacceptable. It would ensure higher costs for the public plan, and would do nothing to achieve the goal of “keeping insurance companies honest,” and their rates down.

  9. It should be made available to the public.

    <

    p>I’ve been searching for more information on this bill. There seems to be no more information coming our way.

    <

    p>I do have concerns about what we are going to end up with.
    An exchange has been out of the vocabulary for a week now.

    <

    p>I could be wrong, but it seems to me the public option will only be available to low income people.  I don’t think that is what anyone was hoping for with regard to being able to choose a plan.

    <

    p>I feel like there is some protection of corporate entities going on here.  It seems like these Blue Dog Democrats want the public plan to fall in line with the corporate plans. If they do that, the price of healthcare will never come down.  And if they don’t allow the whole range of middle class people to choose the public option, this whole thing is just a big joke.

    • It should be made available to the public.

      <

      p>Actually, like all congressional bills, it is available to the public. Indeed, THOMAS even has a highlighted link to it, available here. It also has a current summary, the CBO cost estimates, cosponsors, the latest actions on the bill, etc.

      • I’ve seen it before,  It seems I can never find what I’m looking for using their search tool. I’m probalby doing it wrong.
        I looked through the bill you linked to. It doesn’t have the changes made in it by the recent compromises.
        In any case, it helps a lot to read the information from here than trying to pick apart what you get in the news.

        • The search tool isn’t the greatest, though it is a bit more useful when you figure out its idiosyncrasies.

          <

          p>As far as compromises, THOMAS will have everything that is officially filed (including all amendments), as well as everything in the congressional record (remarks and committee hearings), though of course the (unofficial) cloakroom stuff is unavailable until something “official” happens with the bill.

  10. If you read small articles, more notes form reporters who have contacts inside the congress you will see that a public option is dead. HMO/insurance firms will provide low income folk with stripped down plans that cover most costs but not all. This will be acceptable to blue dawgs and Obama will sign because 85% of the country has healthcare and he knows during the recess that we will find out that his initial plan cost us each around 14K in “new” taxes.  

    • Take a peek at the recent passage of a biologics bill. Consumer groups and generic drug makers wanted less protection of biologic patents to save consumers money on exepnsive biologic drugs. They lost. Waxman and democrats signed a bill to give 12 year exclusivity to biologic drugs. Again special interests win and consumers lose. When congressman go home for recess they will hear it big time from 85% of their constituents that have healthcare. Fall will be the death knell of a public option. I say this because no know has read about the biologics bill and no one really cares either. The devil is in the details.

      <

      p>Consumer Groups Threaten To Withdraw Biologics Bill Support

      <

      p>By Jared A. Favole, Of DOW JONES NEWSWIRES

      <

      p>WASHINGTON -(Dow Jones)- Leading proponents of creating a pathway to bring cheaper, generic versions of complex biologic medicines to patients told Congress on Thursday that no bill is better than a bad bill.

      <

      p>In a strongly worded missive to the chairman of one of three key committees overseeing health-care overhaul, influential consumer and employer groups threaten to pull support for any legislation that gives brand-name pharmaceutical companies 12 years of protection to market their products before facing competition from cheaper alternatives.

      <

      p>”In all frankness, we cannot be supportive of any generic biologics legislation that would be an empty promise to the Americans we represent and serve,” the letter said. The letter, signed by AARP, the Consumers Union, the Coalition for a Competitive Pharmaceutical Market and other groups, was sent to House Energy and Commerce Committee Chairman Rep. Henry Waxman, D.-Calif.

      <

      p>The groups have long supported creating a pathway to bring cheaper, generic versions of biologics to the market as a way to save consumers money. Biologics are complex and costly medicines derived from living cells. Companies such as Amgen Inc. (AMGN) and Genentech Inc. specialize in developing these drugs, which treat diseases such as cancer and can cost in the six figures for one year of treatment.

      <

      p>There is currently no mechanism for cheaper, generic versions of these products, called biosimilars or follow-on biologics, to reach the market. President Obama has said creating such a pathway is a crucial part of reducing Americans’ health-care costs.

      <

      p>The letter, also signed by the Generic Pharmaceutical Association, urges Congress to “reject the fatally flawed” biologics legislation proposed by Rep. Anna Eshoo, D.-Calif., and criticizes biologics legislation passed in a Senate committee earlier this week. Eshoo wasn’t immediately available to comment.

      <

      p>The Senate and Eshoo bills would give brand-name biologic makers 12 years of exclusive rights to sell their products, a number the pharmaceutical industry says it needs to make developing the costly drugs worth their while.

      <

      p>Waxman, the Federal Trade Commission and the White House say the industry doesn’t need that many years of exclusivity. The FTC says 12 years would harm patients by unnecessarily delaying access to affordable drugs. Waxman wants to give biologics five years of competition protection, while the White House recommends seven.

      <

      p>The letter says the group would “outright oppose” any legislation that mirrors Eshoo’s bill or the legislation passed by the Senate Health, Education, Labor and Pensions Committee. A regulatory pathway for follow-on biologics that is based on either of the bills would “serve as little more than a cruel hoax to some of our most vulnerable American citizens.”

      <

      p>Eshoo’s bill has about 130 sponsors in Congress, and she has said she has enough votes to get her proposal passed through the Energy and Commerce Committee. Waxman’s bill, by contrast, has 13 sponsors.

      <

      p>-By Jared A. Favole, Dow Jones Newswires; 202.862.9207; jared.favole@ dowjones.com

Archives