To recap where we’ve been for anyone who missed it:
The right wing mobs freaked out over the public option, and as a direct result of this and fox news, the blue dogs are shaking in their boots. Realizing the fury out there (while simultaneously denying its legitimacy) Obama tried to back away from the public option, then re-backpedaled when the left went apoplectic.
Now, in his big speech Obama has backed away again.
Now, Reid and Pelosi have just stepped slightly away for the first time.
Is the public option going down?
Will the left be able to cope if it does? (Sidebar question: what are you gonna do about it!)
The left seems so absorbed with how great Obama’s speech was that they can’t see that they may have lost their minimum goal, the public option. I find this weird, but I ask you lefties to enlighten me.
Are you OK with losing the public option, or not?
http://www.foxnews.com/politic…
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p>Now, I honestly don’t know any good reason that democrats have always opposed medical malpractice reform, but it seems like Obama caved to the republicans on that one, too.
Seriously. If I offered $500,000, would you allow me to pay for surgery to remove it? How about a mil? Two mil?
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p>This is the crux of medical malpractice. The GOP wants limits on the amount for which I can sue, as if the GOP knows the value to me of my body parts.
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p>I wouldn’t sell my left arm for anything less than $10MM. If you offered me $9,000,000 right now, I’d say no. So look — if I go in for surgery on a broken bone near my elbow, and as a result of gross malpractice (not unfortunate coincidence, bad luck, the best effort just wasn’t enough but rather a clear failure by the medical team to follow appropriate procedures) I get gangrene and my arm has to be amputated, then I ought to get $10,000,000. That’s what I would have charged you to buy my arm, and they effectively stole it from me.
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p>Why does the GOP want personal accountability and free markets, except when it comes to doctors failing to do their job right and not wanting to pay restitution?
Seems like we could create a market-based solution here to discover the true price of the mistake, couldn’t we? Let’s get the Republican think tanks working on that one.
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p>I think that under such a system the payouts would be much, much higher.
The problem is punitive awards. Caps have been proposed on punitive awards, not actual damages.
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p>It so bad in parts of Illinois (in the south) that pregnant women cannot find available OBGYNs … they’ve been priced out of existence because of Illinois’s lack of tort reform. They end up going to MO and KY instead. This causes health insurance coverage problems.
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p>Sometimes doctors make mistakes, without malice, but it’s the huge punitive awards that make malpractice insurance unaffordable, not to mention creates massive defensive medicine expenditures ($1.4 billion in MA alone.)
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p>Democrats supports ATLA, ATLA gives $$$ to Democrats, hence, no tort reform.
This Globe article points to doctors moving to Texas in significant numbers. I do know in MA there has been drastic reductions in OB/GYN doctors for exactly that reason (malpractice lawsuits). The story points out that people in Texas are having a hard time finding lawyers to represent them
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… do you think the current system is sustainable?
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p>From where I sit the complete and utter collapse of the current system of health insurance provisioning is a fait accompli. It’s just a matter of how long we want to limp along with predatory corporations giving us just enough health insurance to make us think we’re ok… Any sane and intelligent person looking at this issue will come to this conclusion.
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p>Obama (mostly, it seems to me, at the insistence of his Chief of Staff) is trying ever-so-cautiously to push us over unto that slippery slope. At the bottom of that slippery slope is the inevitability of single-payer. Obama knows this. The insurance companies know this. Senators and Congressmen know this. Lobbyists know this. Medical device companies know this. Citizens know this.
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p>And, by and large, most of us simply want to already be at the bottom of the slippery slope, with single payer… Yes, even the teabaggers, who, after all, are arguing, just like I am, that health care is an entitlement. we just don’t want to take that wild slippery fall first. And while the insurance companies are madly clinging to the top with aching fingers and sweaty knuckles, Reid and Pelosi are gently trying to request permission to stomp on their fingers in order to get them to let go…
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p>I say just stomp ’em.
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p>Now, as for the particulars of the bill: worst case scenario, as I see it, is a bill with no public option but with greatly enhance regulations against care-denial (pre-existing conditions, arbitrary coverage parameters, etc…)
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p>If that happens, in five to ten years bankrupt health insurance companies will be begging the federal government to implement a public option. Their entire business model is based upon the ability to reject care and if you remove that ability… game over.
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p>Best case scenario: a robust public option which people will flock to and drain the coffers of private insurers. Single payer here we come… !
Answer: None
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p>If you can point to a single one let me know. We are were we were prior to the recess, the framing of your question is baloney.
Story Sen. Blanche Lincoln (D-Ark.), still facing the prospect of a tough re-election in 2010, has reversed her position on the public insurance option, saying Tuesday she will oppose the measure as a part of health care reform after previously expressing support for the policy, the Arkansas News reported.
But here’s another…
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p>Blue Dog Ross Comes Out Against Public Option
By Perry Bacon Jr.
Rep. Mike Ross (D-Ark.), the Blue Dog congressman who battled with Democratic Party leaders for much of July before reaching an agreement on health-care reform legislation, said Tuesday that he could no longer back the government-insurance option included in the bill he voted for before the congressional recess.
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p>”I have been skeptical about the public health insurance option from the beginning and used August to get feedback from you, my constituents,” he wrote in a statement his office released publicly. “An overwhelming number of you oppose a government-run health insurance option, and it is your feedback that has led me to oppose the public option as well.”
beat me to it JohnD
Obama is meeting with them.
Mike Ross – (D-Arkansas)
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p>31 July – The House Energy and Commerce Committee passed it’s version of HR 3200 (WITH THE PUBLIC OPTION) by a vote of 31 – 28. Congressman Mike Ross vote for the bill.
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p>AFTER the August recess:
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p>Congressman Mike Ross is quoted:
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p>”I have been skeptical about the public health insurance option from the beginning and used August to get feedback from you, my constituents,” he wrote in a statement his office released publicly. “An overwhelming number of you oppose a government-run health insurance option, and it is your feedback that has led me to oppose the public option as well.”
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Just follow the big bucks.
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p>”I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. Corporations have been enthroned, an era of corruption in high places will follow, and the money-power of the country will endeavor to prolong it’s reign by working upon the prejudices of the people until the wealth is aggregated in a few hands and the Republic is destroyed.”
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p> Abraham Lincoln
I heard him lamenting about many differnt parts of healthcare reform. He almost went “out of his way” to minimize the public option aspect…
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p>Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. And the insurance reforms that I’ve already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Now, let me be clear. Let me be clear. It would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.
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p>So if the PO will only effect a “teensy weensy” percent of the population, how it is going to “single handedly” save healthcare for all by controlling costs? If we remove insurance companies profits from the equation, how much money do we save for actual healthcare coverage? If we remove the “healthcare bureaucrats”, how much additional medical procedures happen which increase healthcare costs?
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p>Removing healthcare bureaucrats will indeed raise the level of insured care but decrease the level of uninsured care (i.e. emergency room care, pound for pound the most expensive health care there is or governmental programs) Or did you think the 47+ million uninsured are avoiding any and all care?? Or, put another way, why is it that:
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p>According to one study, of the $2.1 trillion the U.S. spent on health care in 2006, nearly $650 billion was above what we would expect to spend based on the level of U.S. wealth versus other nations. These additional costs are attributable to $436 billion outpatient care and another $186 billion of spending related to high administrative costs.
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p>In 2006 we paid 2.1 trillion. Other nations of comparable wealth would have paid 1.4 trillion. (if they had comprable populations…) The difference is in outpatient (ER and other expensive options…) and administrative overhead.
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p>You tell me which is better: going to a EENT regularly, or paying emergency room staff?
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p>That’s kinda like sending people on welfare to a fancy restaraunt every night of the week: We can pay for welfare, and WIC and AFDC and they can cook groceries up themselves or they can have Mario Batali do it for them, for an exhorbitant sum…. which is going to cost more? So, if we provide for WIC and AFDC et al, yes, we’ll be paying more and probably more food will be eaten overall, but at a much lower cost: not nearly as much as if we paid Mario Batali to make dinner for them every night. So too with health care: we can provide more (lower cost) health care for everybody or we can wait til they’re at exigency and pay premium for the privilege.
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p>Here’s the thing: most administrative overhead of private insurers is directed at pointing people at the outpatient services… So the extra cost of overhead is going directly to feed the extra cost of outpatient services…
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p>I don’t know about you, but the word ‘insane’ leaps to mind at this situation…
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Why are you so concerned about making sure that insurance companies can continue to loot the American public? What do they bring to the table? Why should you or I care if they go broke?
How about life insurance? Bond insurance? How many other businesses are “facilitators for us? Why have pharmacies since the drugs come from pharmaceuticals? Why Home Depot… just buy grass seed from Scott directly?
I agree your analysis is the conventional wisdom: the most likely outcome will be tens of millions of new customers for the insurance companies paid for by the government. That’s more or less what happened with the banking bailout — lots of public money for the most powerful corporations — so health care may follow a similar paradigm. Perhaps there will be some quid pro quo in the form of increased regulation for the insurers — pre-existing conditions, and no coverage caps are possible examples.
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p>A separate consequence may be that the ranters at the town hall meetings tar the entire G.O.P. as an extremist fringe who can’t be trusted with political office, and the party loses even more seats next year. That might indeed happen if the economy continues to improve and some form of health insurance reform is passed over G.O.P. shouters, Deathers etal.
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p>As to the public option, I think it will be a tragedy for every small business in America if it is not passed. Indeed, for the country as a whole, because the current miserable system imposes a 5% tax on our economy to pay for insurers who impose huge inefficiencies on all of us. What to do? Keep up the pressure until the ink is dry, and celebrate whatever improvements, if any, actually result from reform.
First, Obama stated that the health care exchange wouldn’t be implemented for FOUR YEARS!
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p>Why do we have to wait 4 years? Maybe, because of Obama’s other promise. He needs the bill to be deficit neutral. So, “character of the nation” be damned for 4 long years because the Bush administration was so irresponsible with their profligate spending (i.e., Iraq War, Medicare Part D) and tax cuts for the rich.
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p>Side Note: If we’re waiting 4 years anyway, why the hell is anyone talking about a public option “trigger”?
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p>Then, Obama implied that the public option would ONLY be available to people who could not get health insurance in any other way. I interpreted that to mean that he’s proposing something like we have here in Massachusetts, where MassHealth and the Commonwealth Connector are only available as a last result. As soon as you’re eligible for Medicare, Unemployment’s Medical Security Plan, or your employer’s health coverage plans, MassHealth and the Commonwealth Connector drop you like a stone.
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p>I’d rather have a system where everyone is free to choose the public option. If you don’t like any of your employer’s plans (a likely scenario for many), you could always choose the public option. Obama implied that would NOT be the case. So, the public option becomes less attractive. You have to be poor and unemployed with all your unemployment benefits expired before the public option is available to you. No wonder Obama believes at most 5% of the US would utilize the public option.
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p>So, are we willing to go to the mat for such a lame program? I don’t know. I am much more willing to go to the mat for a public option that’s available to EVERYONE.
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p>And, consider the blue dog democrats and Joe Lieberman. Isn’t Obama turning the argument around on them. By limiting the applicability of the public option, he can pressure them by asking, “Why would any Democrat vote against a bill that curbs such major health insurance abuses as pre-existing conditions and arbitrary caps just because they don’t want such a limited public option?”
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p>So, I predict that health reform will pass with a public option limited to those who can’t get health insurance in any other way. And, I don’t see any trigger because we’re waiting 4 years anyway.
5% of the US population is 18 million people. Not 5%, eighteen million of your friends, family and neighbors. Our fair Commonwealth has already begun to deal with the health care mess and as a result almost 95% have insurance. That still leaves 300,000 Bay Staters without it.
Many other places are much worse. One in 4 Texans have no health insurance. Only 82% of Californians are insured.
Take a look at the employers with the most employees on Mass Health. Top of the list, Walmart. Are you OK with subsidizing Walmart?
Look, we have to start somewhere and this is a massive undertaking. It will take a while to set up and implement. What time frame would be better?
If anything, I thought the public option emerged from the speech in better shape than it’s been in awhile. He finally explained it and defended it and I certainly come away from the speech more confident both in its effectiveness and my own ability to talk about it than previously.
I’ve read all 1,018 pages of HR 3200. I vote NOT to let HHS set the terms and conditions of my health insurance whether or not the provision of that insurance is from my employer and from a private entity. Which is what HR 3200 will do.
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p>I want to retain my RIGHT TO CHOOSE all that.
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p>Letting Kathleen Sebelius dictate the terms and conditions of my health insurance is an erosion of my rights.
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p>The public option eliminates those rights.
The public option is another choice. It doesn’t eliminate any choices.
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p>Why get all worked up about this unless you happen to be a health insurance company employee and don’t want more competition for your company.
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p>The opposition to the public option is bought and paid for by the insurance companies and believed by the easily led, with respect BS.
Why is it if you disagree with any aspect of the healthcare reform bill, you are stupid? Why can’t we agree that the bill has controversial issues and that many of them are debatable on the surface (should we have a public option) while other issues cause debate based on a “direction” (will preventive care really reduce costs)?
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p>Obama says not passing the bill will cause people to die. Does fear mongering help this debate?
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p>Bob says opposing the public option means we are “easily led”. So I guess we can have no “educated” or “informed” reason for opposing healthcare, just stupidity.
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p>In this instance, it helps that it is true. Until and unless we reform the health care system in this country, people will die because of it. And it’s not just death: people will suffer longer illnesses and even minor problems (sprains and breaks) will heal improperly and not only decrease quality of life but productivity also.
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p>Anybody who believes the overheated rthetoric (death panels?) or the comparisons of Obama to Hitler (really? Hitler?) is easily led. The very fact that you’re not laughing your self stupid at some of the antics of your co-religionists is really all one needs to know about the debate. Barney Frank doesn’t need to stomp on people comparing Obama to Hitler, YOU DO.
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p>To date I’ve heard three, and only three, reasons to oppose health care:
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p>1.) Obama is a Hitler so anything he’ll implement is Nazi and therefore bad.
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p>2.) Cold hearted cut throats will sit on the panels reviewing, restricting and rationing care: who lives and who dies will be based solely on the basis of expense and resource
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p>3.) The reforms will be so popular and so effective that private insurers will wither on the vine if reform is adopted.
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p>I’ve heard variants of these three argument. And nothing else. Nothing educated and nothing informed. No other arguments are proffered. Oh, by the way, #3 also has the benefit of being the only true statement…
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p>Even your vaunted Tom Coburn puts forth a variant of #2 above as reason for his plan. Quoth he:
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p>“The Patients’ Choice Act of 2009,” transforms health care in America by strengthening the relationship between the patient and the doctor; using choice and competition rather than rationing and restrictions to contain costs;”
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p>It’s pretty difficult to reform something that exists only in your mind.
The same people that claim the market will provide better care at less cost should be allowed to prove it. Doubtless, however, is the simple fact that whatever the end product of any bill is, it will be crafted to give the most to those that pay the most to buy our elected reps.
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p>Now I worry about the possibility to make a fortune on death. I just read the NYT article and see the merge of health insurance, life insurance, Wall Street shenanigan, and the penchant for government corruption (we like to say “incompetence” now)to make a killing (pun intended, of course). How much can WS make by purchasing the life insurance, killing off the insured early in treatment and using the profits to reinvest in more insurance? (This sounds like something that would get the Republicans on board.)
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p>Is it time to grab your weapons and canned foods, stuff ’em and your loved ones into the station wagon and head for the mountains? Should we wait ’til Soylent Green goes on sale?
The story in the Globe today titled
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p>”Public insurer support fading
Moderates move away from option”
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p>Senator Claire McCaskill, Democrat of Missouri, said the issue had become a “distraction”
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p>Senator Jeanne Shaheen, Democrat of New Hampshire, voiced support for a public option but said Democrats should keep the big picture in mind.
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p>Senator Olympia J. Snowe, a Republican from Maine who is one of the most influential voices in the debate, said the public option is politically out of the question. “I urged the president to take the public option off the table,” Snowe said on CBS’s “Face the Nation.”
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p>Senator Jay Rockefeller, a Democrat from West Virginia, said he would continue to fight for one. But he stopped short of saying he would not vote for a bill without one.
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p>Also from the story…
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p>Nothing has been settled and we still have plenty of time for “anything” to happen, but the trend seems to be in favor of a reform bill which we badly need and against a public option.