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Going to throw out some thoughts here. Appreciate the honesty and thoughtfulness of the commenters.

Special note to Boo, point taken. My title does sound like I spent too much time at the Ralph Nader school of charm, maybe, but I think I was feeling so frustrated and confused by the single payer activists and the public option activists. Kind of like parallel play with industrious children. Why can’t we find common ground, is that impossible, and undemoralize the left?

Everyone who believes in Jane a lot raise your hand. All hands go up, including mine.

Everyone who believes in Congress raise your hands. How about who believes in Obama?

Obama used up his slack with me. I suspect he is going to make a case for us trusting the corps tomorrow night. And the corps and the Congress have betrayed us yet again. And if Obama sings their song tomorrow night, so has he.

We wanted health care reform. Now we are begging them not to change anything because they will make it worse. Crazymaking.

We got crumbs from Bush. Now with our bipartisan Pres we are negotiating for croutons. And then, it turns out not croutons, even smaller crumbs. I am saying, why don’t we demand the whole loaf of bread? We deserve it. Unalienable right and all. Universal health care.

Corporations are vendors. Why are the vendors running the show. They cheat you, you fire them.

$2 million a day, they are truly running scared. That is a lot of investment. That is the good news. Bad news is $2 million a day lobbying big investment for influence.

Medicare for all …. could work if the same type of crippling adjustments that Bushco made in 2003 don’t continue on with the prototype. To prevent Medicare from discounting drugs, meant no longer getting 58% pricing like VA, suddenly 100%. And Medicare Advantage D helped the corporations.

Obama has apparently told pharma there will be no discounting on this new plan either.

12,000 private health care companies, which means now there are 25X more administrative personnel than doctors in this country. 1/3 of all health care money goes to overhead, paperwork, advertising, and exec pay.

Health care is 17% of the economy and it is important to take care of those employes but not by bleeding the remaining 83%.

Between 2003-2007 profits for health care companies increased 170%. In these hard times, like Exxon and Goldman, they are riding high.

800 military bases around the world, none could be liquidated to release some money for healthcare to prevent 22,000+ deaths a year from inadequate health care and 1 person going bankrupt every 30 seconds? Wow, why is the military budget so sacrosanct? 27 million underinsured. $100 billion a year goes to upkeep of all those bases. Imperialism can surely be cut back for the common good. Well, in a democracy anyway, not a fascistic state.

Nader points out that so much fraud going on with contractors in Iraq and Afghanistan. Why would domestically the same kind of insane greed not be happening since oversight has been so crippled by Bush and Obama is not that big on accountability in the name of bipartisanship. Nader said, “Obama will sign anything that squirms through a cowardly Congress.” Obama will use his political capital for “pretend reform bill” and hope the media will help him spin. Andrea Mitchell recently dissed any Dem congressperson willing to challenge “reform.” I think we have been damaged enough by the Greenspan family.

129 million Americans were supposed to be covered in the original Hacker PO plan says Kip Sullivan of PNHP. Now the plan being most discussed will cover only 10 million.

Blue Cross may be the outsourcee to oversee health care which is pretty much delegating the fox to run the hen house.

Apparently the legalese is intense in the new proposed bills, hard to comprehend. And loopholes making the po into a Trojan Horse. It would mean people would have to take what the employer chooses for them and not opt for Medicaid in place of a crap plan.

Pelosi asked the backers of single payer to give it up for a robust plan. Robust is not the plan, though she smiles through her teeth and calls it healthy and affordable.

The single payer advocates have been treated shabbily by Congress people and obama. Taibbi’s account of how Baucus had 8 single payer advocates removed from his meeting in handcuffs is appalling. Round tables mean everyone gets to share. obama and baucus and others big hypocrits on that one.

I am not great at details of the plans. It seems clear, though, that with a single payer, if $350 billion is released a year that will be a relief and sustainable and if Medicare can get cleaned up. Maybe S703 is better than HR676 and if that is open for a vote, hot diggedy. But I think HR676 is coming up for a vote and holds more workability.

I think Obama is going to tell us tomorrow night things like big pharma has promised to save us $80 billion in the next 10 years and we should say thank you and wait. And one more time we are asked to trust the untrustworthy.

No crumbs. No croutons. Time to demand the full loaf of universal health care bread. Call the question with a vote on 676 or 703. And let us exit denial and see the leaders taking us down the garden path to further fascism, Obama most likely included. At least we can put the heart back into our community. Asking for what we deserve and fighting for it. Going the distance. I called my reps and I am still calling reps and saying don’t vote for a PO that is a Trojan Horse, AND vote for 676. I also mention I want torture accountability to go all the way up to Pres. level and that I think Goldman Sachs needed a windfall profits tax levied against it when it got $13 bill from AIG bailout. Where is the oversight? The list is long but those are my top three this week.

Thanks for listening to all this.

I am not trying to be a troll of any kind, here. I don’t think the campaigns against a non-robust public option and for single payer should be so divorced. I think Jane is a brilliant strategist and maybe could be a catalyst to help with such a re-bonding and re-rallying.

I don’t know what is up with Obama. Personality issues or moral ones. Or did he have to sell out a lot to get elected.

Thanks to anyone who waded through all this. I am putting this down from top of my head and most of my statistics are from my last 4 or 5 diaries. Sorry not to leave links.

libby

To be clear, Conyers would be among the last in Congress to concur that averting co-ops and triggers ensures a “real” public option. I have heard him speak forcefully and disdainfully about the public option as written into HR 3200. Additionally, he is on record as pledging not to vote for any bill from which the Kucinich state single-payer amendment is stripped. So no one should expect that the mere absence of coops or triggers will necessarily be sufficient to secure his vote on a public option bill.

Since you mention unit costs, I’ll just mention that there’s are reason that microeconomics and macroeconomics are separate subjects. Widget sales and production don’t always scale up the way you think they do in the real world.

Basically, I’m committed to the idea of a strong PO, and I don’t think we should rethink that. There is no workable (underlying.. not insurance) cost containment mechanism in 676 (or in Medicare for that matter), and thus 676 just represents a naked transfer of premium obligations from individuals and corps to the government (which I’m fine with, by the way, if you could figure out how to make it work) without corresponding cost containment or a competitive mechanism to contain underlying healthcare costs (when those underlying covered costs are growing at about 8-10% a year, even within Medicare). Trying then to “take” those costs back from corporations only exacerbates this problem and would quite possibly be illegal (by the way, how the heck would you plan to cost this “tax” – premium rate – when the underlying premium cost of Medicare is effectively zero?). We have to solve the underlying costs problem. This is a healthcare problem NOT an insurance problem.

The underlying problem with Medicare’s cost structure is illustrated here;
http://www.brookings.edu/~/med….._small.jpg

You have to first solve this problem before Medicare-for-all works.

The hybrid system (with the Strong PO) and a price-taker mechanism gives us a shot at simulating a competition mechanism that might contain costs. Unless we stop paying twice as much for healthcare services as the rest of the OECD, both within and without Medicare, then this problem will continue to be in place with any single payer system that does not actually nationalize at least part of the underlying service provision system. The whole system is performing with a flat price elasticity of demand far below the production possibility curve. Get rid of private insurers and you just buy time, without improving the underlying system.

For these reasons, I frankly can’t think of a major OECD health system that depends on single payer without at least partial public ownership (and thus financial/budget management) of hospitals, clinic, etc. You’d do better to advocate for VA-for-all or the Canadian system (eith of which I would support). Either that or the strong PO with portability and dual mandates. Now, if you want to put forward a viable proposal for outright system nationalization combined with harsh cost cutting after takeover, I’m all ears.

There’s plenty of money being spent on healthcare that doesn’t need to be. Much of it has to do with the waste and inefficiency of the health insurance industry. That’s not to say there isn’t other waste, or that the other parts of the problem will go away. It does make the biggest waste go away, though, and it does give the government considerable leverage over the other cost drivers, like lack of preventive care.

Actually it was Grace Kelly who won the day

JANE H = OUR Grace Kelly