The health bill is quite an achievement. While I know it awaits conference, it will, in a form likely similar to the Senate bill, become law early next year. Many fellow liberals see it as a giveaway to insurers and fatally flawed due to the individual mandate and lack of a public option plan. I hear the concerns but think it does a great deal of good and will stand the test of time as a landmark piece of social legislation.
And in considering whether its good enough I am reminded of what the noted historian William E. Leuchtenburg wrote about the social security law in his history of the New Deal, Franklin D. Roosevelt and the New Deal, 1932-1940.
Leuchtenberg called it “an astonishingly inept and conservative piece of legislation.” In no other welfare system in the world, he observed, “did the state shirk all responsibility for old age indigency and insist that funds be taken out of the current earnings of workers. By relying on regressive taxation and withdrawing vast sums to build up reserves, the act did untold economic mischief.” However, Leuchtenburg concedes that the act was “a new landmark in American history” in that it “reversed historic assumptions about the nature of social responsibility,” and “established the proposition that the individual has clear-cut social rights.”
This health care act builds on that very proposition but also brings a twist into it, matching the presumption around social rights with the idea that citizens also have responsibilities for caring for themselves, i.e. via the mandate for health insurance. The mandate was an idea Bob Dole raised during the debate over the Clinton health plan in 1993. Mitt Romney brought it to the table in our own landmark state law. Obama opposed it during the campaign but quickly recognised its importance in passing reform this year.
And I should also mention that the bill has pushed the Republicans further to the political right. The bill is a amalgam of ideas from the right and left and yet the GOP has run away from it. It might gain them short term points due to the political mess their demogoguery has brought to the debate. But long-term, it will once again show conservatism on the wrong side of history.
So thank you Harry Reid and President Obama for perservering so far. One more hurdle to go and then we can really celebrate a truly remarkable legislative achievement.
Indeed, where would so many of those too old to work, but without pensions be without social security?
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p>Those of you with pensions had better be aware YOU are in the minority. Most of US have only whatever we can save, and social security.
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p>Will the very poor be fine, and those with more than 100k in income be fine, and those between 50k and 100k be worse off if without employer health insurance?
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p>For so many of us, the details will determine whether this historic legislation is helpful, or another bag of rocks to drag along after us. I do not claim to know for sure.
Will the politicians make good on the promise? I noticed the US military now spends more than the 50 states combined.
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p>It doesn’t take much thought to see how healthcare could be paid for if we just stopped killing people that cannot hurt us.
Everyone who cheers on the Senate’s abomination health care industry subsidy bill refuses to hold OUR president accountable for 1) allowing lobbyists to write legislation a practice he campaigned against 2) accountable for helping to deliver a public option which he campaigned for and now denies, 3) and accountable for reversing his position on a individual mandate.
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p>This bill does many good things but it is not reform, it’s builds on a broken system.
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p>The worst thing it does is create a legislative mandate for every American to enrich the private health insurance industry or face a cash penalty levied on their gross income and collected by the US Government, the IRS without providing them with a public option.
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p>Anybody who has followed the legislative process in the Senate knows the Senate is broken if two Senators can gut serious reform and at the same time, benefit so greatly from it.
Two Senators can’t gut reform. 41 Senators can. There is a big difference. The reason the Senate can’t get anything useful done is that the Republican party has decided they aren’t interested in doing anything useful. I personally like having the Senate require a supermajority, because it makes it harder for controversial things to pass (imagine what the Republicans would have done in 2004 without the threat of a filibuster). But the system doesn’t work when half the country is voting for people who want the government to fail.
It takes 60 senators to make reform, which we have in the caucus. Feel free to blame Republicans for this instead of holding Democrats accountable but you’ve got no reason to expect their support, you don’t give them yours.
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p>We can hardly expect nevermind demand the opposition to cooperate with the party platform and the president’s campaign planks but we can certainly expect and demand caucus members to support their caucus and the leader and the party platform and the president with procedural votes… rather than threaten to use them against the bill until their demands are met, especially demands that are precisely contrary to the will of the American people such as public option, medicare expansion, increasing premiums to 300% for older people solely to benefit private interests – the health insurance industry.
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p>Democrat Ben Nelson and Independent Joe Lieberman, member of the Senate Democratic Caucus, were the two short of 60. These are just two who subverted reform to benefit private interests.
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p>That said, this is the bill the president wanted and he too should be held accountable for his campaign promises, the ones he stands by and the ones he knows disowns.
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p>All Democrats in elected office will be the ones to pay for the negative blow back that will come not just the two most notorious ones.
but we were never going to get everything we wanted. Compromise was always going to be necessary.
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p>I imagine you must feel just as strongly about the Massachusetts health law which, similar to the federal bill, places a mandate on individuals to buy private insurance. Boon to them no doubt, but we also cover 98% of our people here in the Bay State.
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p>Of course you have to recognise that the tradeoff with all these propositions is that while insurers get new healthy clients to make profits from, they also have to cover a lot more people they don’t want to cover – those with pre-existing conditions, etc….
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p>I’m not one to defend the health insurance industry but if you ran one of them and were told that you had to cover a whole bunch of people you’d lose money on, you’d likely want to make up the gap somewhere. All regulation of industry, whichever the industry, leaves room for a certain level of profit or the industry would die. I assume you’d like the health insurance business to wither, but that was not something politically feasible.
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p>And the whole principle of insurance, whether private or publicly provided, is that insurers make money from everyone they don’t ever have to pay out on while losing on those they do. Even with unemployment insurance, we all pay in, but many of us will never benefit from it. And in some cases, such as auto insurance, we are forced to have it and buy it off of a private provider. I imagine if you hate the bill just passed so much, you also hate the way auto insurance works.
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p>There is something unseemly about profitmaking from people’s illnesses but all insurance is a hedge against the risk of misfortune. For all the tens of millions more Americans who will have health care because of this bill, and thus lead more secure and healthier lives, some extra profit may just be a price worth paying.
lanugo, I will not debate your straw man. Why do you even write such silly statements? Is it to argue against them successfully? Please read what I say, take issue if you do but refrain from arguing against assumptions, somewhat outrageous and clearly unfounded assumptions, which in this case is untrue.
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p>Mandating insurance is not the same as providing access to health services. A September 2009 Kaiser Commission review of the MA experience had this to say:
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p>Emptywheel provide the analysis:
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p>You want a debate? Debate the last paragraph in bold.
Its the best bill we could get, its not the Democrats fault that we have a larger coalition, it is in fact its greatest asset. You want to join a regional party that will never run a national government again? Become a Republican. You want a party that is pure in its progressive ideology but largely sits on the sidelines then become a Green. If you want to stay a Democrat understand that in order to be effective one needs to get his hands dirty, they don’t compare governing to sausage making because it is clean or easy.
I have followed your posts re Obama’s seeming reversal of campaign promises about health care. Read this article by Peggy Noonan in today’s WSJ http://online.wsj.com/article/… for another take on our president. Essentially she is saying that he is taking it from all sides, but that most Americans are still with him. Campaign promises and political realities are two different things; keep working for incremental change. Best wishes.
Thanks for the link, it was a good read. I stopped reading Peggy Noonan when Hurricane Katrina hit New Orleans and she wrote that all looters should be shot on sight. I wondered what happened to her belief in due process even as I presumed she was ignorant of the facts that some very respectable citizens were looting the corner grocers for food and drink to sustain life while help arrived.
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p>I support Barack Obama. I bet I support him a lot more than Peggy Noonan does. He was my candidate and I bet John McCain was Peggy’s.
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p>I want Barack Obama to be the kind of transformational president he advertised himself to be and the one I supported.
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p>He has a chance to make the happen by influencing the conference bill and twisting arms to get it passed in the Senate. Everthything we’ve heard from him since the Senate bill passed indicates he is backing away from his campaign plank on the public option, including claiming that he did not campaign on it.
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p>Barack Obama promised accountability. I will insist on it. I’m sorry to see so many Democrats willing to accept less.
I am a young white liberal college student, the ideal Obama demographic, and even I am smart enough to realize that the ‘transformational change’ was a bunch of baloney to win over votes. He can’t be both a centrist and a liberal, and if you read his book and listen to his speeches, especially his reasoning on Afghanistan, he is clearly governing from the center. I think he was naive to think Republicans would be willing to play ball with him, and he has been incredibly naive in governing his own party and assuming he was its undisputed leader, but ideologically he has never been anything other than a centrist. A Democrat that spends a whole chapter of his book praising Ronald Reagan among other conservatives and Republicans is not a dyed in the wool liberal. Barack Obama was also the first Democratic Presidential candidate never to utter the phrase “health care is a right not a privilege”. These should have been tell tale signs he was moving to the middle, not to the left. You can only blame yourself if you feel duped, the writing was on the wall.
to the advantage of progressive causes. Sometimes great presidents are made; they need to be pushed. Here’s how:
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and a bit surprising, too.
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p>Like Neil, Noonan has said and written stuff that irritates me, but she can also pleasantly surprise on occasion.
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p>May everyone’s holidays be filled with pleasant and unexpected surprises!
Paul Krugman has been a pretty vocal critic of Obama in the last year, but is generally pleased about the outcome of Obama’s efforts for healthcare.
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p>As an aside, Andrew Sullivan makes this observation:
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p>”Paul Krugman, someone one doesn’t associate with much wit or humor, pens this paragraph about the John Birch Society Republicans:”
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p>Similarly, the original Social Security Act didn’t even cover domestic and farm workers, a blatant concession to the Southern segregationist wing of the 1930’s Democratic coalition. Yet the Act was later amended to include these workers and significant new benefits, like coverage for disability.
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p>A key to any of the versions of the Health Care Reform Act is that it creates a government regulated system to better assure health insurance coverage. Establishing that principle in a concrete enactment, however flawed, is big deal in the ultimate ideological direction of the country — that’s why the Right is so hysterical. You can bet that if McCain had been elected, or the Republicans controlled more of Congress, at best we’d be talking about some kind of meaningless tax credit — insurance market reforms wouldn’t on the table, and a public option wouldn’t even be part of the debate.
The Senate version does not
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p>Single payer would have done that, a strong public option would have been close to doing that, but corporate welfare that fails to insure tens upon tens of millions of Americans, whilst not solving the cost problem for hardly any Americans or the government (which is become bankrupt because of it) does not accomplish those goals.
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p>People who criticized social security back then, right or left, were wrong, because it did do all those wonderful things. People who criticize this proposed Senate health care “reform” are right, because it doesn’t.
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p>I wish we took health care reform in a series of efforts, instead of one big bill, because support was able to be divided when we tried to accomplish so much in one bill. Then it allowed bad Senators to leverage the bill just to ‘save’ it. If we had just taken a few pieces of reform at a time, passing a series of them over a few years, we would have been much more successful IMO.
The result is that we have just taken a few pieces of it. Whether we take more in the future or not remains to be seen. If the insurance companies actually stop denying coverage as a result of this bill, it will have accomplished something. I don’t think they will, which is why I don’t support it. But I would be happy to be proven wrong.
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p>I actually think that this bill will contribute to progress by making things worse. Right now, people are unhappy about health insurance in this country, but not sufficiently upset to force Congress to actually do something about it. Any politician that fought to weaken this reform is going to be voted out within a few years (that includes Obama). The ones that supported it but argued for it to do more might even lose elections, depending on how bad things get. The Republicans will not gain anything politically.
On your analysis, I just think it may not kick in immediately how bad this bill is, because people won’t be forced to buy the plans until 2014. But, yes, this will hurt in the upcoming elections, then get real bad in ’14 and beyond, unless we change it to make it better.
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p>As for my point that I wish we broke it up in pieces, I think it would have been better because this bill, which is terrible, caused a lot of HCR fatigue. It caused a lot of people to become afraid of the issue, so they’re not likely to come back to it. If we had passed small pieces of reform, popular with America, it would have given us incentive to keep at it and built more and more capital to pass the tougher pieces. Imagine if we had passed a patient’s bill of rights in August, focusing on things like banning discrimination based on preexisting conditions, lifetime and annual limits, etc. Then we could have focused on a medical reimportation from Canada bill, to help address cost. Then we could have built up to a reconciliation bill that would expand medicaid, medicare, create a public option and created subsidies to try to insure every American (maybe then including the mandate).