Good Morning! Thanks so much, Jon.

Mornin’ Jon and Firedogs,

CSpan 1 is presently live streaming the hearing.

also on your teevee

oh lordy, Senator Rockefeller is all bidness :D

asking Comm. Staffer what if any requirements in Chairman’s Mark on Medical Loss Ratios –

staffer witness Fontenot: no figures, just reporting requirements. per CBO, 7-8% of admin costs, but nothing in the mark. eg – House bill(s) requires 85% of premiums be spent on medical care.

Rockefeller – citing ‘Ingenics study’ WellPoint, United Health, & Assurant flouted existing Fed regs on recission by claiming they were following state laws.

Ingenix (sp?) is an in house organ of United Health

I don’t seem able to get a good web link to the hearings. Does anyone have a link that seems to be working?

This is fairly old info. United Health care has since bought the Yellin group universally referred to as “a prestigious study group” by rethug pols.

he’s getting to giant loophole on Oversight in Baucus bill – Jon, this was the LA Times story yesterday. Rockefeller Amendment C13 would keep the fox out of the henhouse

C=span 1 is carrying it.

believe his point was look how poorly they performed even by in house standards

Thanks for the linky downstairs !

did you try this one ?

“junk provisions”

‘they will reduce things like recission for a very brief initial period will go right back to their old ways’

“that’s all they know how to do “

Nelson – FL – dying to drink Chuck Schumer’s weak tea

Rockefeller – ‘not gonna waste time with your concern trolling’

In addition, the Senate Finance Committee is also providing a non-stop live stream at http://finance.senate.gov/sitepages/flash_live.htm .

C-Span 1, according to its schedule page, will stop coverage when the House convenes at 1230PM. C-Span 3 will then take it up. C-Span’s schedule page shows that latter coverage ending at 1. I don’t know whether that’s because the Committee ends its hearing for the day at that point or whether C-Span has simply decided not to cover it beyond that time.

If the hearing continues past that time, I presume the Committee’s own stream will continue to be available as long as the Committee is in session.

What I understand is that they will go until 5:30 EDT and adjourn for a vote and dinner until 7:00

Rockefeller smacking on monopolies and delivering some sweet snark about competition and ‘free markets’ teehee

Is it slightly ironic that someone with the name of Rockefeller is arguing for a public option?

thanks !

It must annoy wealthy Republics that someone born wealthy is not one of them.

Baucus responding to Rockefeller — he agrees with goal of holding insurers accountable, but wants to defend his proposal “the Mark” — notes it will end egregious insurer practices — community rating, renewal even with prior conditions. Says it has greater transparence in revealing how much they pay.

Chairman now explaining what a fierce advocate he is with his toothless mark-

oopsie – Rockefeller now responding – ‘new restrictions’ – ‘but they’ve never followed the rules. bet the farm they’ll change their appearance, but their whole existence is predicated on profit’

Rockefeller to Baucus: Restates the Mark gives the insurers a half trillion, but they have never followed the rules, and lots of testimony to show this. He’s saying, “yes, you have regulations, but you can’t trust the insurers to follow them because “their whole livelihood defends on doing otherwise.”

Baucus — that half a trillion is going mostly to pay people’s claims, so they get the associated health benefits, not just the insurers. So it’s not just a subsidy.

Nelson was an insurance commissioner?!
Go Rocky

shorter Baucus – ‘but they use this great lube’ :D

Now it’s Senator No.

Grassley — speaking for Repubs, they’ve always expresssed misgivings over a Public Option (PO).

Says WH misled in suggesting he never opposed PO — now reciting 3 times in which he told WH that he/they opposed the PO.

He’s just covering his butt the conservatives — nothing to do with the merits.

Thanks!
I’d forgotten that I did a ton of upgrades last week; looks like my Real Player needs to be upgraded to be in synch with the OS and other upgrades.

Silly me.

And worth noting, at msnbc Dylan Ratigan is pointing out how monopolistic and concentrated the healthCo options are in many, many states in the U.S. Significantly, Howard Dean has made the same point — this hurts care providers, as well as individuals and families. So it’s nice to see someone clarify this point for the public; and, when someone tried to get Ratigan off-topic whining about ‘trial lawyers’, he steered them back by saying, ’separate issue, I’ll get to that one another time.’

Good to see someone in the media call healthCos what they are: monopolies. If the word ‘monopolies’ comes up in the Senate Finance Hearing today, I’ll put in $5 to FDL Action for every time that I can count that word in the transcripts of today’s session. (I’m keeping the figure low on the assumption that this word might come up at least 10 times.)

busily addressing his tumbling JAR numbers – never worked to scuttle the PO even though I’m against Rockefeller amendment

Rockefeller smacking on monopolies

Woot!

Grassley and Baucus have no idea what the issues really are. They think the problem is that people need insurance, so they should sign a bill that lets more people buy it from private insurers.

They are in denial about the fact that private insurance is a failed rip-off system run by pirates and that has nothing to do with healthcare.

The public option Rockefeller proposes is really not much better. It’s neither public, nor an option, nor is it affordable, anyway.

rockefeller said 70% of Doctors support PO, but Grassley says other polls said if you ask the question differently, less than majority support.

Grassley: This is a slow walk to single payer. We agree the system is imperfect; we need more coverage, need to control inflation in health costs, and we need better outcomes, especially when compared to other countries — OMG, does Conrad know?

The foreigners who come here come for the Cadillac services, Senator Grassley, not for regular healthcare. This is just such a lie.

chuck,

if a government run insurance plan isn’t the answer, why is a private run plan the answer? it’s less efficient and more costly to everyone.

Insurance isn’t the anwer, chuck. the answer is health care. not insurance.

I notice that Grassley was citing an older Republican poll that was asking docs about support if the public option would undercut the current infrastructure, not the current poll that asked about Medicare for All as a public option.

Grassley quotes Ezra Kline. Go figure. He is trying to equate the public option with single payer.

“gonna put private insurance companies outta business”

Single Payer ! Be Afraid ! Be Very Afraid !

Grassley — more foreigners come here for care than Americans go elsewhere for care. Go. USA!

But a govt-run plan is not the answer. If the motivation/goals are affordable, easy access, eliminate discrminationd then . . . then why have a PO? ???

PO will ultimately force private insurers (PIs) out of business. Think tanks run by the insurers told me so.

Some believe it’s a step towards total govt run program. Quotes Obama saying “we may not get there immediately.

Quotes Ezra Klein — this is a sneaky way (thanks Ezra — it’s totally transparent)

Jan Schakowski sp and Barney Frank — said it was best way to get there.

Hopefully there is a time limit on talking. Grassley needs to fast walk move himself out of the room. He doesn’t have anything to add to the debate. Blah Blah Blah.

Now Chuckie is sweating about public option morphing into single payer (as if that is somehow a problem).

If you don’t believe in government of, by and for the people, you sure wouldn’t want a government run health care plan, would you chuck?

Grassley — claims the PO will both compete and set the rules. That’s false; regulations would be set by a different entity.

Claims the PO would force people who like what they have to lose it. Why aren’t the unions opposing this?

Chuck is worried about Universal Coverage finally putting the crooks out of business. Heaven forbid he lose their donations….

No one ever mentions those from here that go to India or Thailand for procedures.

Agreed. He’s been doing his dead-level best to slow this down at any/all costs, and all he’s doing now is saying the same old B.S. he’s been spouting all summer.

Ted Stevens crashed the party ?

Precisely.

where’s my handkie,

those poor dear sweet insurance companies.

Sorry Max, but you’re no Jimmy Dean singing BIG JOHN

http://www.youtube.com/watch?v=BWKGhwwVgKY

What’s this blather about cost shifting? Everything I’ve seen about it says that the Single Payer option that Rockefeller has before them pays more than Medicare. Why is he babbling on about this?

Besides, to fix his complaint, all we need to do is reverse the last 30 years of Republican Medicare cuts…

that’s the former Senator No, smartypants

being chronically clueless about pace and timing, he brings out the Full Pelosi instead of saving it to bat clean up

Grassley — PO would shift costs to private plans, because PO would be reimbursed at lower rates, so private plans would have to pick up the costs. Cites claims that rural hospitals can’t survive on the 80% rates of Medicare.

He’s ignoring the fact that the PO would be open mostly to those without coverage now, and yet they have to treat via emergency — so any coverage via PO would help those hospitals because the payments would be above their marginal costs.

… or those Americans who cannot afford to, or are unable to even travel to other countries (Cuba) for proper medical care.

iow, if you support the status quo

So, this is Grassley’s thinking, a public plan, will attract more people from the private market. In a free market with an option people will choose the less expensive, public option. I guess they don’t believe in price competition.

“This will force employers to put their employees into the public plan to avoid the higher costs of the private insurance plans.”

Ummm… That’s sorta the whole point of it, isn’t it?

Gotcha ! *wink*

Schumer bitch slaps Grassley with MediCare

Grassley is actually doing a very good job of articulating what he sees as a reasonable argument against government run care, for an informationally challenged, inarticulate, dunce with a second-grade education.

Schumer — why do you have Medicare?

Grassley — I don’t; it’s part of the fabric of America.

Schumer: all the “horrors” of a PO should apply to Medicare, but it’s a good system and we all like it.

Grassley claims a public option will need to rationing

I think you meant to write “lead to rationing” … another right-clown claim.

Grassley now citing Heritage Foundation & Leuwen Group figures, even though those have been repeatedly disproven. Says thos are the only figures he WANTS to keep in his head because they’re the only ones that make sense to him.

Grassley — PO leads to single payer, but then he cites Medicare Advantage, which exists in the context of a single-payer Medicare system. Nelson challenges him.

Grassley cites the Lewin group: However, background: the Lewin group assumed the PO would be open to everyone and would use Medicare rates at 80% below the private plans, and given those assumptions, 130 million people would choose the PO. So what.

I’ve always thought Grassley the supreme boob, and this morning, he’s not disappointing!

Ben Nelson notes that there is massive concentration in many states by only a single or 2-3 private insurers. “That doesn’t sound like a lot of competition to me.”

Nelson calls Assley out about shifting all to govt. run. Assley has two authorities including Yellin group.

but Single Payer would destory choice ! jeebus, uses Heritage Foundation study to prove it

then blatantly lies about Iowans having 44 choices – WellMark/Bc monopolizes 71% of Iowa market

Nelson wants to know how Grassley makes the leap from Public Option to Single Payer, and how that would be a bad thing since many states already have defacto single payer with only a single insurance company.

Grassley’s response doesn’t make much sense – saying that people won’t have a choice with the public option no matter what anyone else says.

Schumer smacks again – every evil you cite, is what makes MediCare work

the government is a predator – sez Grassley

Schumer points out that the reimbursement rates would be negotiated.

Schumer — wrt to Medicate Advantage, it competes with Medicare — so he’s says Grassley is denying that same choice by having no PO, but only private insurers.

Grassley — if you want competition, you don’t want the government running anything.

Schumer — so you don’t want Medicare?

Grass — Medicare is part of fabric of American, but PO would kill choice.

Grassley: “This will kill choice.”

How so? The bill & amendment specifically restrict access to the public option, so how will this eliminate private insurance? Also, how is this a bad thing?

Why isn’t this on CSPAN????

Well, Nelson is going to support some variation of the public option

wow, my mouth dropped.

Orrin Hatch now boobing on the costs. Guess CBO forgot to tell him that this program will SAVE the government $63 Billion dollars.

Amazing, these guys are now for “choice”.

it is

It is on C-span 1 until the house comes in then on 3

Hatch — Medicare has $38 trillion in unfunded liability. It’s awful. That’s $300,000 per family.

Medicare/Medicaid shifts costs of $89 billion/year to others.

Notice that we’re not debating PO any more. The Republicans are arguing against Medicare.

PO is a trojan horse for single payer.

dfh CW says Nelson and others will vote yes out of committee but vote against the final bill – most of the Nelson crowd really want to vote yes on the weaker of the 2 Schumer amendments

Only when it works for their Corporate Overlords …

“level playing field” “true competition” For whom?

Lewin was cited by Grassley, this needs to be corrected by Dems. Lewin is owned by UnitedHealth, there is nothing, zero independent about Lewin.

How can there be true competition in health care?

If I’m comatose after a car accident, how am I capable of choosing the hospital that offers the best deal?

Hatch’s arguments are so stupid its beyond belief. The reason so many seniors have to keep seeking new benefits is because Medicare dumps them out of the hospital before they are fully recovered.

And how can he DARE to compare PO with the R banking bailout (which isn’t working) & the auto industry bailout (which appears to be working), instead of comparing it to Medicare, Medicaid, Tri-Care & VA?

Now bitching about Medicare reimbursement rates, despite the fact that THEY are why Medicare/Medicaid reimbursements are so low!

these repiglican senators are pissing me off.

It is

Are these guys saying that the public option is going to work so well that it is going to put insurers out of work?

At least I found my mute button.

Hatch, I’ve got news for you, the decisions are being made by the insurance companies — just ask Wendell Potter.

Hey, Orrin, competition isn’t the solution, it’s the problem. Competition drives companies to focus on short-term profits and the cost-cutting measures that lead to the denial of health care claims.

Hatch is making a short story long!

Tony Benn on the concept of “choice” as promoted by corporate actors, from SICKO:

This idea of “choice” which capital talks about all the time, “You’ve got to have a choice,” choice depends on the freedom to choose. If you are shackled with debt, you don’t have the freedom to choose. People in debt become helpless and hopeless –become people who don’t vote. If the poor turned out and voted for people who represented their interests, it would be a real democratic revolution. And they (people with power and wealth) don’t want it to happen.

Keeping people hopeless and pessimistic – see I think there are two ways in which people are controlled. First of all, frighten people. Secondly, demoralize.

An educated, healthy and confident nation is harder to govern because “they” (the citizens) will get out of control.

Top 1% of the world population own 80% of the world’s wealth. It’s incredible that people put up with it. But, they’re poor, demoralized, they’re frightened. And therefore they think perhaps the safest thing to do is take orders and hope for the best.

Choice arguments “sell” here because we in the US assume “FREEDOM of choice.” Corporate “choice” is the promotion of corporate profit. They choose. There is no freedom involved.

Hatch: Government run plan will be too inefficient to allow health care providers to stay in business.

Grassley: Government run plan will be too efficient & put insurance companies out of business.

Me: WTF? How can this be? Methinks these people are just throwing out any argument they can think of and hoping it sticks.

“Single-Payer” -> Socialism -> cats and dogs spreading santorum!

Hatch: Government run plan will be too inefficient to allow health care providers to stay in business.

Grassley: Government run plan will be too efficient & put insurance companies out of business.

Me: WTF? How can this be? Methinks these people are just throwing out any argument they can think of and hoping it sticks.

Good catch!

Hatch:

The buffalo chips are burying this committee in a blizzard of crap drifting over our heads the longer I go on and on about Washington government-run plans!

HCAN Study/White Paper (pdf) factually destroys Rep. arguments on choice and costs

If Orrin hates Washington so much, why doesn’t he leave it? He complains about government making decisions for Americans but he does just that everyday frigging day of his life.

Hatch now citing his experience with medical liability cases.

Just curious, Orrin… When did you have that experience, and how is that experience in any way relevant to the current situation?

I will never understand how Teddy could have been such buddies with that twit. Never.

What if the cats and dogs want single payer?

Gosh Orrin, and corporations, who have no interest in my freedom and rights,should be making my decisions?

I’ll take government over privatized.

When the Republicans speak, I always think of the Monty Python skit about the Spanish Inquisition: “Amongst our weaponry are such diverse elements as: fear, surprise, ruthless efficiency, an almost fanatical devotion to the Pope, and nice red uniforms ” or some updated version thereof.

fyi – Hatch’s open secrets page

yeah I know, I was surprised too X~o

Hatch’s argument re private/public health care amounts to the same we’ve seen in the last 8 years re private/public military.

If he’s right about the joys of private sector health care, then why wouldn’t it be a good idea to dismantle the branches of the military and turn the show over to a set of corporations like Xe (Blackwater)?

Well, haven’t we seen the results, especially since early 2003? Much higher costs. Much lower quality. Things falling apart.

But to be logically consistent, wouldn’t Hatch have to agree that the Xe’s of the world would be much better than the United States armed forces at fighting wars?

Menendez (D-NJ) now on. Saying that this is all about choice. Says “We are all about choice until one of the choices is a public option.”

Grassley needs to use his health insurance plan and get checked out for dementia.

Senator Menendez aka Senator Menaflex

The freedom to choose consumer products. :/

If only we were the consumers. Right now, the HC corps are the consumers.

Menendez wants to know why they are so afraid to allow the public option, saying that it will simply be another choice, and will not be run by the government, so why are they so scared of it.

Says Medicare is an entitlement, but the PO is simply NOT an entitlement and will be privately managed & run, without government funding (aside from the subsidies, of course).

we know what the senators are afraid of—the slowing down of the gravy train from the medical industrial complex.

good point he makes with that

Hatch: Government run plan will be too inefficient to allow health care providers to stay in business.

Grassley: Government run plan will be too efficient & put insurance companies out of business.

Me: WTF? How can this be? Methinks these people are just throwing out any argument they can think of and hoping it sticks.

Excellent point!

I supposed I’d answer you by saying that Hatch at least sincerely believes what he’s say. I think he’s sincerely concerned.

Grassley is just a (fill in the blank) who is trying to invent concerns so as to have any “justification” to oppose what would obviously be best for the American people. Any doubt that he’s just a piece of sh*t looking out ONLY for the corporations and their profits went out the door in 2005 when he successfully advanced “reforms” in bankruptcy laws.

Now citing state after state where there are two companies that control >80% of the market in those states.

“Grassley needs to use his health insurance plan and get checked out for dementia.”

Clearly a pre-existing condition. I don’t think his plan would cover it.

“Hey Chuck. Stop whining and have another bite of pudding…”

Citing studies by the AMA showing that insurance companies are interposing themselves into the medical care process between doctors & patients.

Hatch’s argument is that private insurers will refuse to lower premiums and preserve the value of their plans even with a public plan as an option competing against them. And that will lead to mass exodus to the public plan, which will become a single payer plan by default.

It’s not a trojan horse, Senator. It’s the unwillingness of the insurance companies to, uh, compete, in, uh, you know, a market.

Grassley needs to use his health insurance plan and get checked out for dementia.

The man would be a whole lot less dangerous if he actually did suffer from dementia.

His problems are much deeper and have more to do with profound moral failings.

goes a step further to show how said monopolies undermine Doctors with their take or leave it

Someone should read the Preamble to the Constitution into the record.

Ensign worried that doctors will have to participate of they accept Medicare.

Perhaps Ensign can hire the insurance execs and carry on with their spouses to relieve their pain?

Thanks. Hard to keep up typing and listening.

Republicans: “IT’S A PLOT!!! OMG!!”

Healthcare coverage administered through the government is not scary. It clearly works for the countries that do it. The people fighting against it are hatemongers and liars who don’t deserve to be in the discussion.

You don’t get to accuse me to secretly wanting to destroy my own country and then say “Hey, come on, be bipartisan and include all MY ideas!” That’s BS.

Republicans are assholes.

Hatch oozes sincerity

Baucus spreading his cheeks a little wider – telling Bingaman(?) Rockefeller’s amendment compels any MediCare participating Docs would have to comply with Rockefeller PO rates

oh no, here comes Jay – ‘doctors in my bill are specifically allowed to opt out of MediCare participation’

Obviously, the Senate Republicans have been denied coverage for their mental illness…

Health ins. co bureaucrats mission – eliminate as many payments as possible to enhance profits. reinforced by bonuses.
Government bureaucrats mission – get paycheck on friday
I’ll take the latter.

Bingamon (?) says he doesn’t see Rockefeller’s language allowing physicians to opt out of accepting Medicare. Rockefeller told him where (repeatedly).

Sorry, but as I watch these proceedings I have to reassert my assertion of a couple of days ago, i.e. the culture of Democratic leadership is so very much different from that of the Republicans. Remember them abusing procedures and jamming things through, no debate? I don’t agree with everything that I’m hearing during this debate, but it’s happening – there is debate – and it is being televised. I’m proud to say I voted for Democrats and thrilled that they won in 2006 anad 2008!

Bingaman? No. Ensign.

Nelson – FL – ‘PO in NJ is “disaster” does Menendez care to respond?’

Menendez – ‘there is NO PO in NJ nitwit’

Gosh you mean he is no longer worried about czars?

Conrad wants a “public option” that isn’t “public” (defining “public” as government run).

Hatch oozes sincerity

I don’t agree with him, but I do believe that he believes what he’s saying and is sincerely concerned. That’s a huge leap from the deep pile of sh*t that Grassley buries himself under.

Hatch oozes sincerity

Fixed it.

No, wasn’t Ensign. Ensign has white hair. Speaker had dark hair. Couldn’t read the name plate, but it began with a “B”.

Senator Conrad (D – Blue Cross) – ‘if we enact Rockefeller PO, every hospital in my state goes broke’

Jeff Bingaman, New Mexico

This guy’s a Democrat, right?

Conrad wants to look at the various other countries medical models (British, Germany, France, Japan, etc.).

Knox, you are a welcome addition to the Lake. Your are always upbeat and interesting. Glad you joined us.

What was the term Conrad used for his co-ops: Public Option ___?

Conrad is now touting “not for profit” insurance in the non-British methods.

If he thinks this is such a great plan, why hasn’t he advocated this method previously?

You mean like “if we raise the minimum wage there will be devastation in the land?”

In Germany all the insurers are non profit and they have high regulation of prices. Government is intricately involved. THE COSTS ARE REGULATED BY GOVERNMENT.

‘France and Japan kill people !’

falsely cites Japan as #1 in infant mortality

Conrad:

This is an extremely dishonest discussion. We’re talking about propping up private insurance, so they can continue to overcharge their clients and pay for the Medicare and Public Option participants in North Dakota, who don’t get reimbursed at cost.

Dump the for-profit insurance model. It doesn’t work.

yeah. let’s be more like Japan.

Says France doesn’t have government run health care (!), but rather no-for-profit and has best in the world care. Comparing our system to France & Japan (says they have employer-based, non-profit insurance methods). From what I’ve seen, France & Japan would likely be surprised that they don’t have government run plans.

Anyone have a link to an video/audio feed?

Thanks! I think it was Rachel Maddow mentioning FireDogLake last week that was the trigger, so to speak. For the moment, I’m going to step out and just listen to the discussion.

The worst FL ever had. Gave the state to them.

I thought he said they had the best infant mortality rate (e.g. – lowest rate of deaths per 1,000)…

Earth to Conrad.

The CSPAN1 feed is at http://www.c-span.com/Watch/C-SPAN_rm.aspx

Japan seems to do it a lot better than we do.

Conrad has previously dismissed the system that is used in Japan as being a poor fit for us (requires too much regulation, IIRC).

The “culture of America,” Kent? The culture of America is about killing people for profit.

Ezra’s latest tweet on Conrad:

“Conrad keeps saying that France and Japan just have government providing insurance to poor people. He even admitted to me this isn’t true!”

Conrad makes me wish for an Annie Hall/Woody Allen/Marshall McLuhan moment where I could pull TR Reid out from behind his blue sign and he would say, “I’ve been listening to what you say here, and you know nothing of my work.”

Calling France a private-sector plan is such a royal piece of sophistry, and if Conrad doesn’t know it, then he is an even bigger simp than he appears.

Says tying reimbursement rates to Medicare would bankrupt his states’ hospitals.

Senator Conrad (D – Blue Cross) – ‘if we enact Rockefeller PO, every hospital in my state goes broke’

I find that hard to believe. There have to be at least a few Critical Access Hospitals in his state that are guaranteed to be reimbursed by Medicare at cost + 1 percent (I believe is the rule). A good non-profit hospital can’t go broke that way — and if I understand the amendment correctly won’t it pay something like 5 percent above standard Medicare reimbursement?

As he points out, this is really ‘outside the thinking’ of the US Senate to date. He’s saying, ‘this is what we really need to be talking about — take the profit piece out.’

I happen to agree with him.

FWIW, a very successful health care atty that I know thinks the book that Conrad cited, comparing health care systems all across the world, is ‘the best book out there’ (along with Howard Dean’s) on this whole health care topic.

Conrad is really talking ‘outside the box’, and you see that by the fact that Ensign can’t process the concepts that Conrad is talking about.

The book is by Reid.

Conrad can kiss…. me!

He’s a nasty pig.

Could not believe Baucus kept saying “let’s be fair” several times a while ago.

Where were the Republicans during the last eight years in regard to health care for all? Where were they?

This is the time for the public option….50 years ago. The trigger was all ready pulled. Republicans had their chance and they blew it and now the Blue Dogs and the rest of the Dems better back them all the way into the corner. The Re thugs blew it

As Wendell Potter has said anything less than a “public option” should be called the “Insurance Industry Profit Protection and Enhancement Act” that is who Baucus and most of the Republicans are fighting for the profits of the Insurance companies. The bottom line $$$$$$$

One last thing. I sent the following letter to Speaker Pelosi yesterday via http://www.speaker.gov and would like to encourage others to do the same…

Dear Speaker Pelosi,

I write as a Democrat who lives in Tennessee’s 2nd Congressional district, which is represented by Congressman John J. Duncan, Jr.

From what I am learning about the health care debate in Washington from several sources, including Jane Hamsher at FireDogLake, you are the leader who is calling for the public health care option and who is working the hardest to get members of President Obama’s administration and the Blue Dogs to support REAL health care reform, which MUST include the public health care option.

As a Democrat whose views and values are not being represented by the votes of my representative to Congress, I have contributed to Health Care for America NOW!, to FDL Action’s ad telling Arkansas Senator Blanche Lincoln and Representative Mike Ross to START ACTING LIKE DEMOCRATS, to the Democratic Congressional Campaign Committee (DCCC), to the Democratic National Committee (DNC), and a little less to the Democratic Senatorial Campaign Committee (DSCC).

I am also writing to you to ask you to continue representing all Americans as the elected Speaker of the House and to continue working hard for REAL health care reform that includes the public health care option.

Thank you.

Sincerely,
Brc

Conrad “objective analysis of outside observers” Just who would those objective observers be?

Sorry, that’s utter horse shit.

Ensign now claiming that we have higher quality outcomes if you exclude metrics like auto accident survival & gunshot wounds. Says we have higher cancer rate survival. What he forgets is that he’s comparing survival rates for stage 4 cancer, and forgetting that in Europe, most cancers are caught BEFORE stage 4, and byt he time it reaches stage 4 it is highly resistant to treatment.

Brilliant Republican logic: “if it was not for gun deaths we would be number one”. (next day, they vote against gun control)

I’ve been priming mine to help with the revolution.

Conrad (with the help of his corp bosses) totally cherry picks Reid, Ezra destroyed him on this – will look for link

I think Ezra’s not getting all of Conrad’s points.
What Conrad is talking about is actually what I’ve heard some in medicine where I live discuss: get the profit out of the system.

I’m actually surprised the conversation got this far in the Senate.
Rockefeller’s bill and Schumer’s also at least take a whack at the whole problem of profiting from illness.

The U.S. is always number 1. Number 1 in having highest number of bought and paid for members of Congress.

Chairman Meow

Hate to say this but when you send money to DCCC and DSCC you are supporting folks like Mike Ross and Blanche Lincoln.

Oh, I agree with you. I’m just asking why he hasn’t previously advocated highly regulated, not-for-profit insurance. I’d be quite happy with that solution (provided it includes adequate subsidies for the poor, etc.), but that has been “outside the box” for Conrad until today.

So what’s so desirable about employer-based insurance again?

Profits or access to health care. What will win?

Sorry, but I think that you seriously misunderstand him.
Reid’s book is highly regarded by several people that I know who have years of knowledge about the problems with health care delivery in the U.S.

You may disagree with Conrad, and let’s all hope for Rockefeller’s plan, but in fact by aiming at the dark heart of ‘profiteering from illness’, Conrad’s actually hitting at the heart of a problem in our culture, in our economic delusions, and we see it play out in our messed up health care system.

I’m still grateful to Rockefeller.
But Conrad is stating ‘the unspeakable’: get the profit out of the health care delivery. Period. (FWIW, that’s what the Vet’s system does.)

Missed the exchange on co-ops.

Bingaman on now, wants to compare Rockefeller’s amendment with Schumer’s amendment.

Zack Space

Trying to force people to work. “No work==no insurance!”

Oh, thanks for that explanation.
I have no idea why he is finally talking about this ‘unspeakable taboo’, but I think we should all be **thrilled** to see Conrad even raise this topic.

What’s interesting is how clueless Ensign is; can’t even get his head around the notion. Wonder whether Kyl, “I don’t need maternity benefits so no one should have them” even heard what Conrad said… ?

Not to mention voting against light rail and other forms of public transportation.

Bingaman seems to dislike the provision that ties PO rates to Medicare. Notes that Rockefeller’s will not negotiate pricing until after two years, and Schumer’s are negotiated immediately (as far as I can tell).

“No jobs==No work==no insurance!”

Poor Ensign is probably just not getting any and Coburn isn’t helping him anymore.

Rockefeller saying that this is the point. It gives the PO a chance to get started and then to negotiate rates thereafter. Also, tying rates to Medicare initially is a way to help limit growth of rates.

anymore

Yeah, that truly sucks. I don’t agree with tying it to employment, just pointing out the apparent rationale. Some people really believe that the unemployed are unemployed by choice, not because there aren’t any jobs available.

love how he pointed out BC/BC started out as non profits

No clue, Leen.
But I’m still really amazed that Conrad broke that taboo about never even questioning why we allow profiteering from illness – at least in our public discussions.

Conrad’s idea is **not** news to some in health care in my region.
Not by a long shot.

IMVHO, Conrad’s actually going beyond what Rockefeller is saying. Rockefeller wants real competition; Conrad is questioning the underlying problem of even allowing profiteering from illness.

I’m really impressed that Conrad broke that taboo; hope the House picks up on that theme.

I strongly support a Public Option, BUT.

Anyone have the actual data on preventable deaths. I find it unlikely that guns and cars account for the whole difference. For example, does the analysis the rethugs point to include all auto deaths? Anyone know where a real analysis of this can be found. It’s good to be able to refute this crap.

late to the party. Have they voted on the Rockefeller amendment?

Ah! Bingaman does dislike tying PO rates to Medicare. He’s afraid that someone will try to extend it beyond the initial two-year period.

looks like we are no where near a vote – but everyone on the Chairman’s list has spoken so who knows ?

Crazy to have insurance tied to employment. If I had a boss that person wouldn’t be paying for my car insurance. Health insurance used to be a way to provide a perk for employees and was sometimes used to circumvent giving raises. This was a long time ago.

Bingaman seems to think that not having a PO available for two years would be preferable to having rates tied to Medicare for two years.

Maybe Bingaman should try doing without insurance for two years…

BC/BS is still a non-profit in Michigan – being a non-profit doesn’t really mean anything helpful to the insured.
http://firedoglake.com/2009/08…..y-holders/

Actually, in my region some docs have strict limits on how many Medicare patients they see. It actually **costs** docs money to see Medicare patients, so they ‘lose’ money each time they see those patients, but they still have to pay the receptionist, lab assistants, etc, etc.

So Medicare pricing is a problem, but until we break healthCo monopolies that problem can’t really be solved. (At least, that’s what I’ve been told.)

Just spoke to Stabenow’s office and was told the vote is taking place right now…

Ah. Delaying then. Who would have guessed?/s

Schumer is up now.

Schumer also declines to discuss his own amendment, saying that he supports Rockefeller’s amendment and if necessary they can discuss his amendment later.

Medicare reimbursement rates have been limited by Republicans. They used to be competitive when I was a younger man. Besides, rates can be made higher (they are tied, not matched).

Also, one of the largest costs many Physicians in TX have is the cost of the staff to handle insurance claims. My own GP has tripled his staff for that over the past few years, but his rates have remained (for the most part) unchanged.

Bingaman Open Secrets page
here

oo thanks, cbl

Not surprising; Coburn probably can’t even psychologically get his head around the idea that medicine should not be delivered in a ‘for profit’ model.

And Schumer’s making some really good points about the flawed economic assumptions that underlie this really bad system.

I’m still waiting for Rockefeller, and whatever Wyden has to say.

Actually, Schumer just did a very decent thing when he pointed to Cantwell as the ‘unsung hero’.

She is.
She knows a TON about health care issues.

Schumer saying that their primary imperative right now is to get costs down.

Is it just me, or are all of the republicans and insurance-owned democrats extremely incoherent as to why they’re against everything? They sound like little kids constantly changing their reasons why they won’t eat their vegetables.

Says he recognizes that insurance companies are doing what they are supposed to (protecting their share holders’ profits), and so we need to have a PO to provide a competitive option to consumers.

Last minute calls to your Senators if you’re in the mindset: 1-877-264-4226

Coverage switching to CSPAN3 at http://www.c-span.com/Watch/C-SPAN3_rm.aspx

Ack!

http://cspan.org/Watch/C-SPAN3_wm.aspx – windows

http://cspan.org/Watch/C-SPAN3_rm.aspx – real player

Perhaps if doctors didn’t have to spend a disproportionate amount on attempting to get their funds from insurance companies then maybe Medicare wouldn’t be a finance burden.

CSpan now switching to CSPAN 3

What kind of clue does a title of Lobbyist give you? Is it a lobbyist for the boy scouts or for goldman sacs?

is schumer right that for-profits are more efficient?

Schumer saying that he believes that for-profit companies are more efficient than not-for-profit companies. Calling Grassley on his opposition to government plans but supports Medicare, which is a government run plan!

Schumer says that it is clear to him that the obvious solution is to have both public and private insurance options, and to try and make the competition fair (level playing field argument).

I tip my cap to you for that comment.
Brilliant on every point.
And it’s the GP’s who are hardest hit in the existing system.

And Schumer is also reiterating the problem with allowing health care to be delivered by legal entities (i.e., corporations) whose primary responsibility is to deliver profit to shareholders.

I’m actually pleasantly surprised by the points Schumer makes; now, let’s see how he votes.

Profit is assumed to be the key to efficiency; but that is *not* true in the case of monopolies.

Thanks! Bastards cut off the important proceedings. Gah!

it’s also on CSPAN radio if your connection is as lame as mine

http://cspan.org/Listen/C-SPAN-Radio_wm.aspx -Windows

http://cspan.org/Listen/C-SPAN-Radio_rm.aspx real player

I think you’ve summarized nicely.
Fascinating to see it in ‘real life’ and in ‘real time’, isn’t it?

Even he admits it is an open question. In my experience, not-for-profits are more efficient, and often have much tighter budgets.

Says that Rockefeller’s amendment only provides seed money to get the PO up & running, and that the PO will HAVE to compete on its own merits.

Comparing the PO to University (public vs. private). Wants to offer the same type of competition to insurance companies that Universities have.

Did Schumer really say that? I’d counter with an argument that in Minnesota for-profit insurance companies are barred from doing business in the state (ironically, UnitedHealth Group is based here). Minnesota also ranks near the top in terms of quality of health care and controlling of costs. Seems to undermine the notion that for-profit is more efficient.

Baucus wants to get a vote before lunch, and wants to break for lunch if he can get agreement to hold the vote now.

Yeah but my head gets sore from banging it on the desk.

Well, he says he BELIEVES that for-profits are more efficient, but that he has no supporting studies or information.

shorter Grassley – “but we want to read the phone book”

ooh up next, disgraced adulterer Ensign

Ensign now saying that the PO is NOT popular despite the polls, citing the August break circus as evidence that the people don’t support it.

well, it was for a minute there

So he just pulled that out of his ass

Call Voinvovich…his conscience has been showing the last few years

Ensign says 44% of insurance is “not-for-profit” and that “a lot of them” in the chart displayed earlier are included in that 44%. Seems to be intentionally missing that the problem is only partly profit.

Basically, yes. :)

Ensign – what’s so wrong about health care for profit?

Ensign wants to know how this wouldn’t be a government run plan if the administrator works for the government.

jesus boys, your script is showing ! – 44 Choices in Iowa, 44% is not for profit, only 44% approve of PO, etc

Ensign says insurance costs are too high BECAUSE Medicare has rates that are too low, and that this would create a spiraling type effect that would force more and more people into the plan.

totally logical /s

Ensign just repeating all the old Republican talking points lies.

Ensign repeating all of the myths. Continuing to try to scare folks. It is all about the profits for this guy.

the Re thugs are running scared..they had eight years and they blew it. they do not give a rats ass about the uninsured and that’s a fact.

All they have is scare the public that is all they have

Ensign says 1 in 3 Canadian doctors refer patients to the USA, because we have the best outcomes in the world.

Guess he didn’t get the info from WHO that shows we don’t have the best care.

Back to cancer survival rates, comparing 5-year survival rates without recognizing that cancers are detected in other countries at much earlier stages, so he isn’t comparing apples to apples, despite his claims that he is.

Maybe we should drive less and shoot fewer guns?

New Thread

Thanks Jon!

Ensign just pissed on/pissed off the NRA about violent deaths.

Maybe we should drive less and shoot fewer guns?

Damn commie!

Memo to Ensign: Maybe we should exclude coverage for things like automobile injuries & gunshot wounds since we don’t seem to be able to control costs because of these things! /s

New Thread

That’s the old classic Adam Smith economic assumption out of 1776.
Schumer doesn’t really say it quite clearly, but without competition then for-profit becomes a monopoly. A monopoly is almost always incredibly inefficient, and its primary objective is to save itself at the expense of everything else.

But if you took profit out of the system, then you have other incentives — cost reduction at the fore — that make systems more efficient b/c they have to sustain themselves. They’re more steady-state at that point; you don’t see huge earnings on Wall Street for those, so I am surprised that Schumer is being so articulate.

Oh, and Ensign claims that health care reform is ‘not popular’ ;-)))
“Many of us on this side believe [public option] will lead to single payer…” Ensign claims that the profit motive has been ‘demonized’ by Rockefeller. Hmmmm…

And it’s interesting to watch Ensign focus on what might be called ‘extreme stories’, focusing on once people are very ill. He misses the whole piece of the puzzle about prevention. He talks about ‘healthy behaviors’, but he doesn’t seem to recognize how Rockefeller’s bill enhances wellness and prevention.

Ensign sees you/us, and he sees very narrow problems; he doesn’t seem to get the Big Picture.

Rockefeller, Wyden, Conrad, Schumer, Cantwell all see the Big Picture.

As if the Dems are seeing a huge, vast epic while Ensign and Grassley see one story here, one there, but can’t link it to the bigger structure. Interesting.

Ensign says that the British system was put in place as an emergency response.

Total B.S.! It was created as a permanent solution to private insurance because private coverage was increasingly expensive and left too many people uncovered.

Correct. But that’s the part that Ensign and Kyl miss.
‘Non profit’ does NOT mean that you can’t accumulate a truckload of $$$. Not all non-profits are the same.

cbl, you’re funny!
I believe these numbers (and I thinks it’s actually 47% against any changes to health care) are from the poll in the DesMoines Register, a very conservative newspaper.

So to answer my own question about the source of the death rate claims see:

http://www.commonwealthfund.or…..lysis.aspx

The key here is that this analysis is referes to “amenable mortality” which is defined as: “deaths from conditions considered amenable to health care, such as treatable cancers, diabetes, and cardiovascular disease.”

Once again, the rethugs lie, obscure and mislead. The US is LAST in preventing preventable deaths from DISEASE, not car accidents. (Although we’re probably last there too.

I actually knew someone who knew (very slightly) British P.M. Clement Attlee, who was the P.M. when the British system was cobbled together on a very pragmatic basis after WWII.

The book by Reid gives more background, IIRC.
The explanation that I was told about it all was that the Brits fought WWII, the nation had urbanized, and the nation needed a way to provide health care, with a lot of worries about epidemics. (Remember, even back in Shakespeare’s era, the Black Plague swept through Europe and England.)

The Brits have that history of epidemics; you can’t be healthy if your neighbors are ill, so they understood that any workable, functioning health care program had to cover **everyone** in order to protect anyone.

It was a cool story.
Attlee wasn’t a political Einstein; he was a pragmatist.
He saw a problem, and did his best to solve it as simply as possible.

Oh, I sense that your point is a good one.
I’ve not actually seen reliable breakdowns of how much it costs the docs to ensure they’re paid for visits.
But at least with Medicare they don’t have to justify their every breath and statement and prescription; at least Medicare pays the bills that they receive.

Recess!

What I learned from the Republicans today:

1. Guns kill a hell of a lot of people in America.
2. Choice is ok for some things and not for others.
3. Competition is really a dodgy thing when someone offers a lower price, people will choose it and that is not good for capitalism.
4. Insurance corporations are not large bureucracies, they are nice fuzzy personable entities that have my individual interest at heart.
5. Public option is the entry drug to socialism.

Thanks for your comment. It is quite on the mark.

You don’t get to accuse me to secretly wanting to destroy my own country and then say “Hey, come on, be bipartisan and include all MY ideas!” That’s BS.

And Knoxville, welcome!

so pathetic and right on the mark

A few comments about the debate over the PO:

- Health insurers do not provide a service, the service is provided by doctors, nurses and others. Insurers pay for the services of these providers using funds derived from premiums. In this transaction private insurers keep a portion of the payment for themselves.

A public insurer carries out this same transaction at a lower cost because it does not keep a protion of the payment for itself.

The question then is whether a private or public insurer makes this payment at a lower cost.

- The answer is given by comparing how efficiently private insurers and the medicare public plan pay for health providers for their services. Between marketing, profit and administrative cost private insurers divert up to 40% of every dollar the y pay for health services as opposed to 5% for medicare that operates without marketing or profit.

- Another advantage of medicare is that it insures a much sicker and costlier population, those over 65 years old, while excluding no one. It is for this reason that it’s costs are high. In contrast, private insurers cover a much healthier population, those under 65, those without prior illness and by dropping those who become ill. And they do this while constantly incresing premiums.

- The main argument for providing a medicare like public plan for those that have been excluded or priced out of private insurance is not really to promote competition and allow market forces forces to prevail. In the paying for health services there is no competition involved. Either you make that payment directly as in a public plan or you let a private plan make the payment and in doing so you allow it to keep a portion of the payment for itself and to cover the cost of promoting itself.

Private insurers are completely incidental and superfluous when it comes to payment for health services.

It was Nelson (FL) Lincoln, Conrad and Baucus that killed the public option.