The health care reform bill as currently configured — without a public option — is nothing but an insurance company windfall. It should be defeated. Senator Lieberman (I-Aetna) should be stripped of all seniority. Today.
We should follow Howard Dean’s lead and kill the current health care reform legislation. I call on Senator Kerry and soon-to-be Senator Coakley to lead the charge towards killing the current monstrosity.
I will not support nor vote for ANY legislator that votes to enact this travesty.
Please share widely!
Is will the compromise contain the individual mandate after all is said and done?
If this health care reform bill goes down, then it essentially guarantees that the status quo — which we all agree is flawed — will be with us for years to come.
<
p>Of course, your argument is that this bill is nothing more than an “insurance industry windfall” and a “travesty”. My question: compared to what? A single-payer system? Well, maybe it is a colossal disappointment compared to that, but single-payer was never a realistic possibility for now. But compared to the status quo, this bill is a major improvement. Consider:
<
p>(1) The bill prohibits insurers from dropping people based upon pre-existing conditions. This is a major piece of the bill, and hardly a “windfall for insurers”.
<
p>(2) The bill expands subsidies for the currently uninsured.
<
p>(3) The bill significantly expands the eligibility for Medicaid.
<
p>(4) Though we’re waiting on the final word with the current bill, the CBO has consistently said that the health care reform bills in both the Senate and House would cut costs (thus helping to preserve Medicare/Medicaid for the long term) and insure far more people than currently.
<
p>All of these are progressive elements. Even the individual mandate is not a “windfall” — first, it is necessary if the bill is to have a ban on dropping those with pre-existing conditions, and second, it helps establish the principle of universal coverage for the first time, which can be significantly built upon in the future.
<
p>It is frankly not just wrong, but absurd, that so-called “progressives” are threatening to derail health care reform. Many of them, including Kos, consistently complain that “the Democrats” are spineless and worthless and thus get little done. But here we are on the precipice of real health care reform, and some “progressives”, true to form, are letting the perfect be the enemy of the good. Is it “the Democrats” who are failing here, or these so-called progressives?
Well, that’s really the question, isn’t it. Are we really talking about the perfect being the enemy of the good? Or is it more like the good being the enemy of the bad, or the mediocre?
<
p>If there’s a real individual mandate with penalties and all, but no public option, no Medicare buy-in, pretty much nothing to encourage health insurers to keep premiums under control, I’m hard-pressed to call the final product “good.” Can’t you just see it now — a year down the road, everyone in America is hit with 20% premium increases because of all those awful people with pre-existing conditions that the mean ol’ government made the insurers cover. Yikes.
And when that happens, will the conservadems say to themselves, “Oh my! I should have supported a public option!”
<
p>They might, but no one will notice because they’ll all be out of office.
Never underestimate the power of incumbency and corporate gratitude.
You missed my main point, which is that this bill (along with the individual mandate) establishes for the first time in American history the principle of universal health care coverage. That alone makes this final product “good”.
<
p>Not to mention the other benefits of the bill, some of which I noted above (particularly the expansion of Medicaid and more subsidies to individuals).
<
p>Can’t you see it now — “progressives” lock arms with Republicans and kill this bill, thus preserving the status quo. A year down the road, health care inflation has eaten up a larger part of working people’s (and small business owner’s) paychecks, millions more are without health insurance, and nothing has been done to preserve Medicare/Medicaid for the long-term. Real “progressive” indeed.
In fact, your main point — the alleged “universal coverage” — is IMHO the biggest problem in its current form. It’s not really “universal coverage” if you just pass a law that says you have to buy private insurance, but that’s essentially what the Senate bill would do.
<
p>Here’s DFA’s take (just arrived via email):
<
p>
<
p>Sounds about right to me, I’m afraid.
We have gone through the same thing here in MA. And MA has been fortunate to enjoy a better unemployment rate than other states for the last 18 months and we still have a lot of people who can’t afford the Commonwealth Connector and the additional costs are breaking the budget.
<
p>I think the mandate of the Healthcare Bill will create an onerous burden to middle Americans and there’ll be millions of people opting out of insurance comepletly by paying the $1,000 fine. This will do “nothing” to bend the curve on costs since these people will still go to hospitals to get care when they are sick.
<
p>This burden, especially in states that have very high “uncovered” rates, will have a huge political cost to Democrats who supported this bill. And for the record, I don’t know if a Public Option would have offered these people much lower rates.
This bill does nothing to address or restrain the scenario you paint of the consequences of its defeat. All those same things will happen anyway.
<
p>Kill it. Now.
But If this bill can’t significantly contain costs (not just increase subsidies), and still contains the individual mandate, we aren’t helping anyone but the insurance company. That kind of irresponsibility would warrant replacement of Congressional leadership.
<
p>I am thrilled that people with preexisting conditions would have expanded access to insurance, as I am one of them, but if they can’t afford it and are forced to get it, have we really helped?
Yes, we will have to make sure that subsidies are adequate. This bill would significantly expand subsidies, but it remains to be seen whether it is enough.
<
p>However, to suggest that the individual mandate helps only the insurance companies is, I believe, short-sighted. The main effect will be to establish the principle of universal coverage, making later changes to the system (i.e. cost containment and expansion of subsidies) politically easier because this is in place, not harder. If everyone is forced to get health insurance, not only does this spread risk (a good thing) but if and when health insurance costs continue to rise, the newly insured will direct their ire toward those increasing the costs (the insurers) and demand that the government do something about it. That’s when we’ll get true cost containment.
<
p>On the other hand, there’s little or probably no chance at cost containment if we let reform die now.
Alternatively, the newly (forcibly) insured will direct their ire toward those responsible for putting them in this fix in the first place — the Democrats. Palin ’16.
Though it is more likely, I believe, that the ire will be directed to those actually sending the health insurance bill — it won’t be from “the Democrats”, but rather Aetna or whoever. “The Democrats”, on the other hand, will be the ones sending people subsidies to help pay for this coverage, while the Republicans are the ones who want to not only strip you of your health insurance but torpedo these subsidies coming to you in the mail.
<
p>It’s a win-win politically for the Democrats. Not to mention it will spread risk and move the political football a few more yards down the field, thus enabling future changes (particularly the public option, or preferably the expansion of eligibility for Medicare).
But realistically we will lose this PR game. I mean, we lost the PR game while public opinion was on our side! If people are going to be paying more money, playing right into the GOP hands, how on Earth are we going to spin out of that one? (Even if the spin is the truth?)
<
p>Literally, the Republicans have one game plan: the Democrats will take more money out of your pocket. They buy their time until they see the opportunity to spin a story in that direction and strike. And you know what? It has worked pretty well for them in the past.
At least in my own mind it would be much easier to do PR for that than what’s currently being discussed.
at the suggestion that the “newly insured” will do anything at all. Since 2001, premiums have increased 78% and nothing has been done to curb that. What makes you think that this will be different? Especially with the Repubs focusing all the blame on the Dems.
First of all, the Republican will focus all the blame on the Dems no matter what they do. Should we really be surprised or worried about this?
<
p>To the main point — I would dispute the suggestion that establishing the “newly insured” will do anything at all. Tell that to the newly insured, who now can get health care coverage and increased subsidies to pay for it as an alternative to never going to the doctor, never getting treatments, and dying early.
<
p>I’d agree that this bill does not do enough to reduce health care inflation (though the CBO does estimate that even the watered-down bills will help a bit). However, it moves us a bit closer to being able to do so by establishing a new baseline for government oversight of health care. The things that will really help control costs — the public option, government negotiation of prices, re-tooling the fee-for-service model, etc. — can be built upon this structure.
<
p>It’s certainly not everything we need, or even most of what we need, but without this bill the possibility of getting anything good for at least the next decade will slip away.
aka corporate welfare.
<
p>As much as I’d even be willing to pay bad, private companies that corporate welfare, if it meant good, quality coverage for Americans (which it won’t, but I’ll ignore that point for now), I must fix your quote.
<
p>”This bill would significantly expand subsidies until the next congress, when Republicans and conservadems tear them apart.“
<
p>There, fixed.
<
p>Tell that to the people (including children) who would receive these subsidies and are finally able to be insured for the first time. Tell them, when they are still uninsured 10 years from now because “progressives” helped kill this bill, that it is “corporate welfare.”
<
p>And to fail to pass a bill simply because “Republicans and conservadems” may reverse the progress later is patently absurd.
MA had few alternatives, given our federal system, so I supported the state’s reform, which is similar to what is now proposed on a national level, as a realistic improvement. But the federal government does have alternatives, from removing the anti-trust exemption for insurers to the public option and others.
<
p>If reform means strengthening and expanding the existing system — which is what the current legislation essentially now appears to do, despite the tweaks discussed above — it will simply exacerbate the problem over time. Critically, it will further retard our international competitiveness by maintaining the “tax” of about 4-6% of GDP that we pay as a premium for our dysfunctional system relative to our economic competitors.
<
p>Better to force the issue, use reconciliation, and get reform rather than expansion of the status quo.
Actually, I take the reverse position: the individual mandate on the state level (i.e. the Massachusetts system) is far less likely to lead to realistic improvements than its introduction on the national level. Forcing people to buy insurance from insurance companies will (politically) invite greater government oversight of those companies. If you do this just on a state-by-state level, the political leverage you gain over insurers is minimal. On the national level, it is far greater.
<
p>I’d agree with you on the anti-trust exemption, the public option, etc. as a matter of policy. However, it is clear that these changes do not enjoy the support of the necessary 60 Senators to proceed, and, unlike some have suggested, reconciliation is not a panacea and is likely not even possible given the nature of the new structural changes (as opposed to just budgetary changes) in the bill. I’d say change the structure now, and then use reconciliation as necessary later for the clearly budgetary aspects of the bill.
<
p>By the way, I’m somewhat amused by the reference to “tweaks” in the current health care reform package. It’s quite interesting that one of the most far-reaching aspects of the bill — the ban on preexisting conditions — has been relatively uncontroversial and is referred to as a “tweak” in the current system. The insurers certainly do not see this as a “tweak” — it attacks much of the current model of health care insurance practice, and rightly so.
<
p>Why is it necessary? Congress can regulate the insurance companies any way they want to. Did we have to force people to buy cars in exchange for requiring seat belts? Did we have to require people to buy drugs in order to improve FDA regulations? Did we force people to go to amusement parks in exchange for regulating the safety of the rides? Did we require people to borrow money in return for banking regulations? Of course not. We have a government. Their job is to regulate every person and company in the country. If they tell the insurance companies that they can’t drop people for certain reasons, that’s all there is to it. The individual mandate is a separate policy decision. Just because the insurance companies wouldn’t like it doesn’t mean it can’t be done. That is a choice that members of congress have to make. And they will do what their constituents tell them to do, if their constituents are sufficiently clear about what they want.
You are correct that the mandate is not strictly “necessary” in that it can be passed as a separate measure from the ban on pre-existing conditions.
<
p>By “necessary” I meant it in the practical sense — that the ban without a mandate would drive up health care costs by allowing individuals to wait until they got sick to purchase insurance. This defeats the whole purpose of spreading risk and spreading the cost of health care. If we’re worried both about banning these health insurer practices AND serious about reducing health care costs, we need to have both of these elements (mandate and ban) in the bill.
loopholes littered throughout
<
p>subsidies that could go away in any congress
<
p>a mandate without an option
<
p>no choice
<
p>people forced to buy bad insurance or pay large penalties to the IRS
<
p>yearly caps in coverage
<
p>crap, crap, crap.
<
p>if the Senate bill is what the final bill looks like, it’s worse than the status quo and will be political suicide for the democrats for a long time to come.
…will you then vote against him in 2012?
<
p>I hope the answer is YES.
<
p>With a significant majority in the House and a fillibuster proof Senate, the Dems are sure in a mess. Nancy barely pushed it through the House and will now have an even more difficult time. Harry is trying his best to herd cats in the Senate. The bribe … err “cost” in the form of earmarks for buying votes just went up.
<
p>Can’t blame the “Party of no!”.
<
p>
provided that there aren’t many more major cutbacks.
<
p>We’ve learned many important lessons with this debate. One important thing is that we gave too much away from the very beginning. The Dems introduced and rallied around a bill that was basically the center compromise. It allows the other side to easily rally in opposition. When we start from the center, the only place to go is to the right.
<
p>We’re already following the same strategy for things like Climate Change, for which we’ve announced that compromises like Cap and Trade are the starting point, not the actual ending compromise.
By the way, I agree with your statement that:
<
p>with one twist: I would treat Lieberman exactly the same way that he’s treated the Democratic caucus. To wit:
<
p>(1) Give assurances now to Lieberman that he will maintain his seniority and chairmanship, so he’ll go along with some other Democratic initiatives in 2010.
<
p>(2) Keep giving assurances to Lieberman in advance of the new congressional session beginning in 2011 that he will maintain his seniority in the new Congress, so he feels safe. Perhaps throw in assurances that the Democratic establishment won’t target his seat in 2012.
<
p>(3) After the new Congress is sworn in, publicly back-stab Lieberman by announcing to the media (without telling Joe first) that from this point on Lieberman will be stripped of his chairmanship and will forthwith have the lowest seniority in the Democratic caucus.
<
p>(4) Just like Lieberman has done to the Democrats, this will screw him at the most inopportune time. Now he’ll be forced to switch to the Republicans (or at least caucus with them) with little chance before the 2012 election to pivot back to the left.
<
p>(5) Recruit Richard Blumenthal to run against Lieberman, who is now a Republican with little wiggle-room to “make up for it” in front of the Democratic-leaning Connecticut electorate. Given that this will be a presidential year with a high turnout, Lieberman will have little chance of political survival.
i like it. it’s the Lieberman principle, old testament, eye for an eye.
Senator Lieberman would know it as the Torah. 😉
on which books you’re talking about. Technically, the Torah is not the same as the Old Testament.
Except that in this case it is. Torah = Genesis, Exodus, Leviticus, Numbers, Deuteronomy. And as far as I know, the “eye for an eye” ideal has been extracted from various lines of the Torah.
But that doesn’t mean that Torah = Old Testament.
If I didn’t know that, I might fail my Intro. to Scripture 1 class! 😉
Right, it means that Torah ⊂ Old Testament.
ACTUAL MOVIE VERSION
Obi-Wan: It’s over, Anakin, I have the high ground.
Anakin Skywalker: You underestimate my power!
Obi-Wan: Don’t try it.
(Light Sabre S-L-I-C-E!)
<
p>MY FANTASY VERSION
Harry Reid: It’s over, Joe, I have the high ground.
Joe Lieberman: You underestimate my power!
Harry Reid: Don’t try it.
(Party Procedural S-L-I-C-E!)
<
p>Later…
<
p>ACTUAL MOVIE VERSION
Darth Sidious: [Vader’s new mechanical body arises from the steam] Lord Vader… can you hear me?
Darth Vader: Yes, Master.
Darth Vader: [Vader looks at Sidious] Where is Padme? Is she safe? Is she all right?
Darth Sidious: It seems in your anger, you killed her.
Darth Vader: I…? I couldn’t have! She was alive… I felt it!
[Vader growls, and his Dark Side strength crushes everything around him in the room. He frees himself from the metal stretcher, and steps off. Palpatine has a smirk on his face]
Darth Vader: Nooooooooooooooooooo!
<
p>MY FANTASY VERSION
Darth Insurance Exec: [Lieberman’s new mechanical body arises from the steam] Darth Lieberman… can you hear me?
Darth Lieberman: Yes, Master.
Darth Lieberman: [Lieberman looks at Insurance Exec] Where is my committee chairmanship? My senate seat? Are they safe? Are they all right?
Darth Exec: It seems in your vanity, you killed them.
Darth Lieberman: I…? I couldn’t have! They were alive… I felt them!
[Lieberman growls, and his Dark Side strength crushes everything around him in the room. He frees himself from the metal stretcher, and steps off. Insurance Exec has a smirk on his face]
Darth Lieberman: Nooooooooooooooooooo!
<
p>
is causing page loads to be delayed. I went to their website to see if there’s a way to report the problem (assuming it an adserver side delay) and found none.
<
p>I’m a techie but I don’t do web apps. Is there a way to do the load so it doesn’t wait to load, it just loads onto the page when it arrives?
Almost from the start, I knew I was not going to like this version of “health care reform”. We never even touched the issue of creating mechanisms to drive costs down in the area of preventive diseases like diabetes, heart disease and obesity (a nice junk food tax would cure that). And when we whispered the other cost driving factor–the last 30 days of end of life care–we got death panels. True health care reform must not only be universal, but would drive costs down from the crushing 16% of GDP.
<
p>But we didn’t get anything close to this. So here we are today. Maybe no public option (we only need 51 votes on reconciliation), maybe restrictive abortion language (thanks to Ben Nelson). Absolutely disappointing on so many levels that it would take me hours to articulate. But in the end, we–Democrats–need a win in the health care column. As a party that needs to advance its agenda on several fronts (no matter how minute the advances will be), we will be better off with the passage of this weak-kneed legislation than with a lose.
<
p>
The biggest factor in the Democrats losing Congress in 1994 was the Health Care Implosion between the Clinton Whitehouse and Moderate Dems on Capital Hill. Now I don’t think we’ll lose either branch of Congress next election, and I recognize that the House Dems of 1993 were far more entrenched and corrupt than the current Dem Congress. But deep-sixing health care will result in far more Democratic defeats in ’10, than if we passed something that had some value (and it does).
<
p>We’re all frustrated that we can only get this much done with big majorities in Congress…imagine how little we will advance with considerably smaller majorities.
Not necessarily the political result in a majority-flip, but in both cases there was a tinkering with the system we have rather than a complete overhaul of the system. I believe there are 88 co-sponsors in the House for HR 676, certainly big enough to form a force to be reckoned with, but they never pushed.
I think the tipping point for ’94 was less health care, and more Democratic fail: Dan Rostenkowski arrested and indicted for kiting checks and stealing stamps (and he simply the most powerful dem to get caught doing it…) and Tom Foley spending much of the year fighting a mostly ineffectual rear-guard action against noted ankle-biter Newt G. I also think that the health-care effort in ’94 was tone-deaf, both to popular sentiments and political realities.
<
p>So, not only is the Democratic breach much smaller, I do not see anybody on the Republican side with the foresight or the sheer gall to exploit the breach, never mind with the tactical brilliance, as did Newt G.
Why not pass what’s there, which we all like (if perhaps not in a vacuum), next week. (This part, with all the subsidies, is ironically the part that is unpopular with the people.)
<
p>Then use reconciliation for public option and/or medicare buy-in.
<
p>If I could control the progressive movement, I’d urge them to pursue this course of action rather than the political suicide of “KILL THE BILL!”
I say it to create an equal amount of pressure on Obama to tell Rahm to tell Reid to negotiate with progressives.
<
p>Lieberman waited until they were near the end to declare what he would filibuster. He didn’t have to negotiate. The negotiations had been going on since July in committee, then committee of six, then committee of 10, then Reid announced a deal, then Lieberman pulled out his line item veto pen. Obama told Rahm to tell Reid to deal with Lieberman.
<
p>I don’t say KILL THE BILL to KILL THE BILL, I say it to create an equal amount of pressure on Obama to tell Rahm to tell Reid to negotiate with progressives.
we refused to use Reconciliation to pass this bill.
<
p>The effing Republicans used it for 3 tax cuts for the wealthiest Americans and attempted to use it to drill in ANWA, but we can’t use it to provide landmark health care reform when we’re the only country in the world not even attempting to provide coverage to all its citizens? BS.
<
p>If the American people want to punish the Dems for using it, then SO BE IT. Those are the consequences of being a real leader, making the tough decisions and dealing with the short term consequences.
<
p>However, that ship has sailed, and we may never see it again for a long time.
Here’s Nate Silver’s take on the “Kill the Bill” movement.
<
p>As difficult as this has been for me, he just made it a little harder.
they’re pissed at Howard Dean and they’re thanking Joe Lieberman; the White House labels Howard Dean as “irrelevant.” (Try to ignore “journalist” Mika Brzezinski declaring the news without “naming names.” My god, is everything off the record?)
<
p>
Rahm Emmanuel is pissed at Howard Dean! Unbelievable.
<
p>If Rahmmy could ever get over himself, we could possibly have an effective, hard-charging HHS Secretary that is leveraging the majority that he built, rather than the absent midwestern second-choice option thrust in there.
Single-payer is so much easier in practical and moral terms AND I think people would be surprised how easy it is politically if people just started beating the drums for it. It requires leadership from many angles and levels. Businesses should also favor it as it lets them off the hook for providing employee coverage thus eliminating a key competitive disadvantage with other countries. Such legislation already exists so let’s get it through the process. For public consumption we need less nitty-gritty about details and more prophetic voice that it is WRONG that so many people can’t get the care they need, go bankrupt, and even die in the richest country on the planet while so many others have proven themselves willing and able. I realize serious primary challenges to an incumbent President are rare, but if Dean wants to try in 2012 I’d at least give him a look.
Bernie Sanders withdrew his single-payer amendment less than an hour ago.
<
p>I would love to see the breakdown on a vote like that. Everyone says that it is not politically feasible – I suspect that it probably true (certainly this conventional wisdom does not help make it any more feasible) – but I wonder what the gap really is. If it’s an 80-20 thing, fine. If it is 60-40, though, we need to start pushing much more vigorously for it.
<
p>Hutchinson is on the Senate floor right now saying that a single-payer system would remove choice. So dumb. What choice? The choice of which set of companies get to add huge administrative costs to your coverage?
Presumably all healthcare providers would be covered. No more not being allowed to go to your family physician because the plan you’re on won’t let you, as was my case with my longtime pediatrician for a few years growing up.
We’re not supposed to know that.
…Sanders withdrw the amendment to stop the clerk from reading all 700+ pages of it. A Republican (Coburn I think) moved that the Clerk read the bill into the record, though someone should have moved to waive reading (which should have had enough votes to sustain) OR the chair could have just ruled Coburn’s request diliatory. In practice routine presiding duties generally falls to freshman Senators. We just need one of them to be in the chair at the right time (Franken for example) to finally say, “I’m getting sick of this even if Reid isn’t; you’re point is out of order.” There may be an appeal, but I’d be happy to see the Senate stall just long enough to thrash out these procedural issues and make people defend the antics.
I will, too, make my vote contingent on this bill.
<
p>If anyone votes for a mandate without a public option, they will not get my vote in the next election. Period.
Not voting for Coakley is supporting Scott Brown.
Than vote for Scott Brown.
<
p>Coakley continually boasted about her support of a public option. If she sticks to that pledge, she’ll have my wholehearted support in the coming election. If she says she’ll vote for this bill without the public option, I won’t vote for her (or any candidate for that office) on election day. That’s what I’ll pledge to here, re: Martha Coakley.
Reid came out and announced an agreement – ditch the public option, add the medicare expansion and non-profit health care insurers – Martha Coakley announced her support for the bill. I posted a link to the news piece on an earlier thread.
I’m sure her people will be out polling to find out how many voters feel the same way as Ryan. I really have to question the people (not Ryan of course) who make this “promise” about not voting for Martha. It reminds me of the people who would be moving out of the country if GWB was reelected to a second term… he was reelected and nobody moved.
<
p>And remember, a non-vote for Martha is a “half vote” for Scott Brown.
she’s ok with a compromise that does not include a public option?
Can’t challenge someone with no-one and in MA these people will be re-elected so overwhelmingly that they won’t notice that you sat on your hands in the general. Ed O’Reilly lives in Gloucester – maybe he could challenge Tierney. Health care was the main issue reason I supported him over Kerry last year.
http://thehill.com/blogs/blog-…
<
p>
then we might get a better bill than the Leibercare, which doesn’t have Medicare expansion (not because Lieberman disfavors it – in fact he loves the idea – but because he heard Rep Anthony D Wiener liked it.)
<
p>(Why does Isadora Lieberman hate A.D. Wiener? Sounds like a personal problem to me. Anyway who am I to stand in the way of “comprimise”?)
<
p>Obama needs a bill NOW and Lieberman is satisfied… so everyone stfu and smile. This is the best we can do. Did I mention, Obama needs a bill NOW? Whatever, just sign it. I think Obama said “Sign it NOW or the country will go bankrupt.”
that assumes Lieberman can be negotiated with, which would assume he has an actual interest in health insurance reform passing that would actually help people. He doesn’t. His two interests are getting revenge against the party and doing the bidding of his many insurance-lobby allies.
<
p>So long as Bernie Sanders and House progressives say they won’t vote for a bill that doesn’t include a public option (or maybe large expansions to medicare, medicaid and chip), the ONLY plausible option to pass real health insurance reform is reconciliation. That’s it. It’ll take a little longer, but this country has waited for decades. It can wait a few months more.
no cloture until I get some of what I want.