Tweet
I think the single greatest political disaster in store for Democrats over the issue of health care reform is not about policy, mandates, or taxes; it is about time. Americans for the most part do not know that they will be forced to wait for three years before reform really starts.
A recent Kaiser Family Foundation poll asks:
If Congress and the president did pass a health care reform bill, when would you expect that people without insurance would begin to get financial help in buying coverage?
13% answered this year, 36% answered next year, and only 25% correctly answer three years from now. These are numbers that should completely terrify Congressional Democrats. Basically, half the country expects health care reform to be underway and there to be a noticeable drop in the number of uninsured by the time of the 2010 midterm elections. In reality, most of the reforms (and the decrease in the number of uninsured) will not start until several months after the 2012 election.
Most of the American people will know when “health care reform” has passed, but a majority will probably not realize that it means nothing will really change for next three years. That is a recipe for an angry, confused, and disappointed electorate. I would not want to be a Congressman trying to defend a reform package that has not started. And I would sure as hell not want to while stumping for re-election. Just try to explain to individuals in serious need of health insurance reform that they are out of luck until 2013.
I know delaying the onset of reform caused the bills to have a pretty CBO scores (below the magic $1 trillion). It was a stupid, short-term political calculation. Unless Democrats doing something to rapidly speed the roll out, I believe Democrats will pay a huge political price for this clever accounting trick. Explaining why reform is good is hard enough, explaining why you passed a health care reform bill that has not and will not help any of your constituents for three years is a massive political disaster in the making.
93 Comments
Support this site!
Subscribe to the newsletter
Advertise on Firedoglake
Send
us your tips
Make us your homepage
About FDL Action
So true. I’ve been trying to imagine what Obama’s planning to say during the 2012 campaign…”Just wait till next year…it’s gonna be awesome…trust me!” No I know he will focus on the many other significant reforms (pre-existing conditions, etc.) but I’m pretty sure that for a huge number of people in 2012 insurance will still suck and be too expensive.
There have been some Democrats trying to address this – Clyburn was working on a proposal for pilot programs, but I don’t know where this currently stands. Frankly I suspect many Democrats and probably Obama don’t have enough confidence in the outset of the public option to want to campaign on it – particularly since it will legitimately take a year or two to set up, which pushes us into 2012. In the first year there might be headaches, so that’s why I think they pushed it to 2013.
The day one language in the pledge always bothered me for this reason. It actually meant no triggers, not available from the first day.
Boy, do I agrees with this premise. All this and no tangible, touchable, smellable result. I’ve asked the question to each Representative, Senator’s office I’ve called. It’s met with silence. One office, “great point.”
true, but it is impossible to do something big on day one. “As soon as is feasible while fitting into the overall structure of all the other changes” does not have the same ring.
Of course we could have everything up and running say roughly 6 months after being passed into law
You say this as if it’s a new insight. Have you really not paid attention to the writing coming out of PNHP, especially Kip Sullivan’s work; Trudy Lieberman’s writings at CJR; not to mention the multiple diaries and comments by selise, hugh, letsgetitdone, libbyliberal, montanamaven, myself, et al., on this score?
Well, and actually, try to explain to overwhelming majority of them, who will remain Exchange-ineligible (and therefore PO-ineligible) come 2013, that they’re still out of luck!
On behalf of the ridiculed Cassandras who’ve continually warned about the overselling of the public option, welcome to the goddamn fold.
If they don’t implement it immediately, then we work to have them thrown out. This is our country, and tools that take bribes in place of watching out for us need to be removed for the sake of us all.
What could be more simple, the economy is collapsing, people are losing their homes, wall street is paying bonuses that would pay for health care and we get the shaft.
The inequity is going to cause a major crisis where police will need to be on the streets to watch the middle class erupt into violence. The overwhelming stupidity of congressional folks is incredible.
God is love.
The only real reform is going to be what we, the people, practice, and not what our representatives pass.
They’re hopelessly lost anymore–especially as far as time goes. Time is speeding up. They’re perennially behind the curve on all the changes we need NOW. So, f*** them. What do we need representatives like that for, anyway? Let’s just do it ourselves!
Or, better, let’s replace the government with people who represent us.
I work for a company that develops the software for Medicaid administration applications, and I have to say, unless the public option was legally an expansion of Medicare, I honestly don’t see how it’s logistically possible to have something up and running in less than three years. It takes us almost that long to put in a new Medicaid system, and we have the advantage of a pre-existing knowledge base and a core of pre-existing code we can adapt.
I really don’t understand why we’re signing up to pay a whole lot of money to develop the administration apparatus for a whole new program instead of changing the eligibility modules on Medicare, but wiser heads than mine, etc.
Hi ralph, I don’t feel ridiculed, perhaps just a bit ignored, however. It’s interesting that many of the PO advocates on this site never link to diaries by SP supporters even when we make points that they use later. It’s not very neighborly, I think.
I have also been saying this for months. It is the new news, the polling data, which gave me a chance to make the point again.
Sorry for tearing into you on this. The latest round of distortions, including the newly shifted goalposts on “robust,” have got me a bit touchy.
i finally got around to actually reading the cms report from last week that jon linked to earlier. turns out with hr 3200 total national health expenditures are supposed to go up compared to no reform (even without taking all the increases into account).
wow, never saw that one coming!
also, providers are expected to be squeezed by additional patient load and so choose to treat private insurance patients and limit / stop seeing medicaid patients (don’t suppose it might help if providers didn’t have to spend so much of their time fighting with insurance company bs and could instead focus on patients?)
not done yet but will post some relevant bits that might add to the political time bomb we’re building.
jon, thanks for letting us know that. as ralphbon said above, that pov has not been, um, so well received here previously. your posting on it now is imo a big step forward. thanks very much!
I believe Obama said in a speech that some of the more conventional insurance-related provisions, such as getting rid of pre-existing-condition clauses, would take effect immediately upon the bill’s being signed by Obama. If that comes about, that could be very helpful, as it would show some useful progress.
A bad bill will be a major hit to Democratic electoral prospects for as far as the eye can see. How does forcing Americans into the arms of insurance companies without a way to control premiums help Democrats get reelected. What will the Democratic response be to electoral outrage when this occurs? Are they thinking Americans won’t know the difference? Incredible!
The progressive response ought to be that no bill is better than a bad bill concocted to gain votes from blue dogs and republicans, even if it means defeating a health bill. Blame it on the blue dogs and make the next election about health care. Then the poll numbers will show whether the blue dogs really believe that their constituents wouldn’t support a public option.
If that is the Progressive decision, it should also be accompanied by the warning that the health bill will come back, and single payer will be the minimum acceptable bill. Each time these bills come back, the health, drug, hospital, doctor and insurance industries lose a little more ground. Make them pay for not coming to their senses now and accepting the best deal they are going to get – ever.
Medicare went up in 11 months, and operates well. Why Obamacare wouldn’t be an eligibility expansion of Medicare is beyond me — but I bet the answer has to do with insurance companies operating the exchanges, etc.
Profit before people.
A year is perfectly reasonable to get things up and running.
Three years is a joke.
The only things that wait until 2013 are the exchanges and the public plan. The prohibitions of denial of coverage, rescission, and caps begin almost immediately (as soon as the regulations implementing them are “promulgated”).
That is not to take away from the time issue. Which is why some in Congress are pushing for a Medicare E to cover the gap between passage and the implementation of the exchanges and public plan by opening Medicare to at a minimum those over 50.
But you are exactly right. If people don’t see changes before November 2010, they will think it’s a failure and vote accordingly.
Well, if you cover from 25-35 million more people than otherwise — people who get little or no coverage today, you’d expect the total national expenditures to go up, right?
And since we’re spending much more on these particular folks then we would have paid without the reform, then average per person would also rise after the initial phase in.
If you’re focused on the national picture, and not just the federal budget — which I agree is the right thing to do — the question is whether, after the new folks are in, the growth rate per person is affected over time and how that rate compares to GDP growth, or some other national measure of wealth. At least I think that’s the right metric. Make sense?
Jon — thanks for raising this point — agree that its important, because they seem to have created expectations they can’t meet.
ONLY from the relatively affluent leafy neighborhood Dems could this f’king bullsh** be teneable. ANYONE notice how millions don’t vote, or, vote randomly? ANYONE notice how large that ‘middle’ of the electorate is AND ANYONE notice that 98% of that middle HATE both parties?
maybe they’ll f’k this up so bad, and with the continuing unravelling of 30 years of casino economics coming home to roost, we’ll FINALLY be able to unemploy all these worthless-to-us invaluable-to-themselves SELL OUTS?
rmm.
“Americans for the most part do not know that they will be forced to wait for three years before reform really starts.”; correct. Of course ‘for the most part’, Americans don’t know is very accurate about many ideas/situations/etc..
It is why Leen and I wrote diaries to try and address the nonsense.
And I think Teddy ‘nails it’ when he wrote ”
Medicare went up in 11 months, and operates well. Why Obamacare wouldn’t be an eligibility expansion of Medicare is beyond me — but I bet the answer has to do with insurance companies operating the exchanges, etc.
Profit before people.”
Here’s a dirty little secret that no one is addressing: already doctors are refusing to see Medicare [not Medicaid] patients.
I live in Hawaii. There are few doctors, fewer specialists. [For instance, there's ONE rheumatologist for the entire STATE, and he doesn't even live here, but "commutes" from AZ.]
Among the few doctors here[especially on the "outer islands," i.e., not Oahu/Honolulu],it’s almost impossible to find one who’ll take a patient on Medicare.
I have friends in Alaska who have it even worse: doctors “firing” their patients once they turn 65, refusing to take Medicare patients, just not being there.
Actually, I’m in favor of “Medicare for all,” because of the timing problems discussed above, but I think it would be useful for someone to address this problem before we sign ourselves up for something that’s more of a problem than a solution.
Fierce Urgency of Now, – Ha!
And, does this allow insurance companies to continue to raise rates by 13% or more in each of the next several years? Horrible. Just like allowing the credit cards to jack up fees and charges before meaningful limits are enacted. Medicare for ALL!
Heavy price we could lose the House and the Senate plus Obama could be a one term President.
And more for others to consider: “People might be surprised to know that only 2.8 cents of every one of their federal tax dollars is dedicated to that trio, energy, environment and science, where 37.4 cents of every one of their tax dollars goes toward the military.”
Yeah, he did make a statement like that, but I’m not sure it’s true; there are dozens of measures that kick in over a period of years, a group each year. I think the most important insurance reforms take effect with the mandate and the exchanges with subsidies (and a PO) — i.e 2013 — those are a package that support each other. Then the reforms phase in later for the employer-based market, and on a different schedule (or exempt) for corporate self insurance plans.
At least one of the bills has an interim catastrophic insurance program that Obama mentioned that would kick in next year, while everyone is waiting for the exchanges to open in 2013.
Where do you get your Stats from?
I thought that our DOD, Homeland Security, all our Spook agencies etc, plus actual cost of Wars came out to over 65 cents per tax dollar.
Here
So! What precisely WILL take effect immediately and what will not? Will the mandatory aspects and fines take place immediately? Or only after the three year delay takes effect on the benefits? If a trigger is instituted would the monitoring for that take place only when the bill takes effect…or would it start NEXT YEAR, the following YEAR, or the Next Year? In other words, do the insurance industry get up to four years to continue to rape the public before they finally get hit with some watered-down public health option?
Conversely, does the bill tell insurers “Cut costs substantially, NOW through 2010, as you promised” or else “we’ll start the PO in three years…no matter what you do after year one. It’s a hair-trigger.”
When I was in grade school 35 cents bought my lunch and an extra milk.
Off to the weekly public service activity.
Namaste
apologies if I am repeating anyone here, but delay has the added benefit of allowing dems to say “we passed it” without having to face criticism of how well it is/is not working out in practice.
I’m in south California and asked my doctor’s office manager if the doctor accepts Medicare. She laughed out loud. I said, “But the office is filled with old people.” She admitted that he would accept one of the specialty plans that Medicare patients pay extra for but he sure wasn’t going to deal with someone who didn’t pay for that higher paying plan.
The circle back again and again is and will be after this so called reform/trigger/opt out/dither and wait stroll that Single Payer or a expanded Medicare Universal Plan were where this needed to start.
This is where it must end eventually in order to make American labor and capital competitive with the rest of the western industrial world not alone the Asian economic manufacturing giants.
Single Payer/Medicare Universal could have been introduced on schedule that would first address the current 30 million most severely disadvantaged Americans simply based on current Medicare expansion being funded like Washington funded the Iraq Occupation. When it needed it as much as needed. How many times did Congress do just this?
Too bad how this train wreck acoming reform has been too clever by half.
Why the Democrats have been so ignorant of the political optics of this string along out to 2013 before any Public Option begins is going to prove explosive by mid 2010 and surely by 2012 will have been fully gone over to pure voodoo doll political attacks by those who hate it now and will only use three years to grow that hate.
Barack Obama will have no one to blame but himself. Enjoy the comeuppance.
But if EVERYONE is in Medicare, then doctors could take the pay or retire. Open more med schools for primary and/or geriatric care and train more nurse practitioners for basic care. Or bring in even more Indian and Philipino doctors….who we in s.calif. see mostly with many of the insurance companies.
Profits will live, people will die.
That’ll be popular.
Oh. I guess I just said the opposite of what Ralphbon said…just saying some might prefer to kick the can down the road some more
Reimbursement must be fair. As I mentioned on another thread, I received my Medicare Provider Number and planned to do counseling for the elderly. The reimbursement rate was so low that I would not have been able to pay to rent even a nasty little office with no secretarial assistance……and I didn’t think that a mobile counselor doing therapy in her car was the way to go.
Yup… a couple months after President Dean takes office.
Obama and the Democrats are a slow motion train wreck. On every issue, progressives have tried to warn them. It is not a question about agreeing or not agreeing about certain policy positions as opposed to others. It is about what will work and what will not. Without exception, Obama and the Democrats have chosen what will not work, and not just that, but what will fail disastrously. I get the same sick feeling with them that I used to get watching Bush and Cheney.
What progressives need to do is drop these long exhausting fights where the fix was in from the beginning and defeat was pre-ordained. We need to effectively pull our support from Obama and the Democrats and start supporting only progressives who will stick with our ideals and values. There is going to be a large backlash of anger and disappointment at some point with this Congress and this President. Rather than tying our political fortunes to theirs, we should be thinking about how to catch that wave of resentment and using it to put progressives in office who will fight for us, for solutions that work, and that help ordinary Americans.
Having a PO or exchanges (or whatever crap they come up with) kick in after the ’12 Prez election is too clever by half, IMO. This, again, stinks of Rahm’s strategizing.
I absolutely agree!
I’m not a religious man.. but I can’t think of a better reply to your comment than. Amen!
Don’t have time to read the comments, but implementing a strong public option starting now would solve the problem.
By strong public option, I mean a public option where anyone could join, with bargaining power over prices, with publicly available benefits plan that was easy to understand and with periodic review with public input.
If you want an opt-out for states, that is fine with me as long as feds put in requirement for public referendum for final decision, either in or out. My guess is that, if public referenda were reequired, states opting out would be a very short lived phenonemon with dire consequences for political factions that backed opt-out.
We could have had a Swiss style private system that works and would not be more expensive in terms of GDP per capita than France or Germany. But the financial industry could not stand the strong federal regualtion that would be required and would ensure their ethical and socially efficient behavior. The insurance companies and health plans have opted for more obstruction, so they have effectively voted for their own eventual extinction, except in providing supplemental policies for benefits above and beyond those of a public plan. The only question is how many years and how many needlessly shortened lives and suffering occurs in the meantime.
Public option in competition with poorly regulated private comprehensieve insurance is not my favorite way to go, but it is the best way forward now, and has widespread, and firm public support. If we luck out, and private sector does not learn how to game the resulting unstable system too quickly, it could ratchet us towards a good system. Probably heading towards a Medicare-for-all type single payer system like Australia, or the old Dutch system that had majority public funding with private and public insurance competing for contracts to administer payments for a publicly determined benefits package.
So, go with public option. Everyone should tell their (for the most part) cowardly and corrupt representatives, Senators and executive to get it started asap. Or they are cooked as far as money and support goes in the next election.
Catch the wave of resentment?…I feel like a lot of us around here are the beginning of the gathering wave of resentment.
I know what you mean though. May as well make plans according the the inevitable.
Hugh, “There is going to be a large backlash of anger and disappointment at some point with this Congress and this President”, such is already happening. I talk to people everyday, both that voted for Obama and those that voted for McCain, and ALL of them are pissed at our ‘Representatives’. They come at it from different angles but the anger,disappointment, AND resentment are all too palpable.
bits from cms report (my bolds):
We certainly could.
I just noticed that Blanche Lincoln’s web site has NO indication that she is a Democrat. I therefore thanked her for helping to tank the Democratic Party come the next election. She’s not even a DINO — she doesn’t have any connection to the Democratic Party on her web site…….shit; we are so fruqued!
Nice thing about public option is that would accomplish a lot of other reforms that are needed quickly, through people voting with their feet and money to go into public option. A couple of years ago, not sure I wouild have signed up with a public option, but after what I have seen since this spring, and my own insurer’s behavior in cutting benefits and unbelievable preimium increases, now I would sign up the first day a public option was available.
I have contacted my reps several times. Live in a so-called progressive district, and one good Senator. DiFi shows no sign of respecting a situation where majority of public backs good policy on public option, but I have considered her hopeless for some time now.
But your congresspeople, tell them you are the boss, not corrupt corporations or a WH that is arrogant and conceited, and showing some of its promises where empty, at least on domestic front.
They’re not wiser. You’re right!
Jon, I don’t think you addressed my comment. Did you?
Good point. That is why a Medicare for all approach, with some flexibility on higher reimbursements would be a good way to go.
Me too. Jon, if a bill comes out of Reid that has a 2013 Day one for the PO, and a PO where eligibility is restricted as it was in Senate HELP, will you support it? If so, why? If not, will you advocate for its defeat?
TJ11, you and I agree entirely. See this one.
Sorry. It’s this one.
But if we’re focused on that sort of metric, then isn’t it clear that we shouldn’t be fooling with this PO stuff at all; but should simply enact HR 676 and be done it (and also them, of course).
absolutely. also expect other things like forcing insurance companies cover pre-existing conditions, etc. to also add to cost.
ah, good point. i guess i think both metrics matter (both total national health expenditures and their trajectory — as percent gdp or similar) for the 10 year projections. total costs for the short-medium time frame past the projection period and trajectory to give us some idea about more long term.
problem is though that hr 3200 doesn’t appear to affect cost growth rate, at least according to the cms report:
i’m going to have to finish reading the report tomorrow (printer is busted and eyes are too tired to read on computer)… and will need to think about it some too.
Mauimom, If we enact “Medicare for All” Doctors will have to take Medicare patients, simply because there will be no others. Of course, they could migrate to other nations, as some Canadian Doctors migrated to The US when their Medicare was first enacted. But I think they’d be unlikely to do that, because even at Medicare rates, I suspect that US Doctors have higher compensation than those in any other nation. Also, where else can they go? Every other nation is either single-payer, or highly regulated.
Right Dearie. Bills on the table now do allow them to continue to jack up rates and Americans will be paying 40% more for insurance by 2013.
also appreciate a comment you made on another thread today, but fits here:
amen.
Which bill is that?
It’s long past time to bring all the troops home.
You’re simply articulating the Democrats’ hope that no one will notice the degree to which they’re still being screwed prior to the earth-shattering transformations of 2013 and then that they will not complain about the snail’s pace at which those transformations (theoretically) begin unscrewing them.
I could be wrong and that could be how it goes. The capacity of ordinary Americans to fail to recognize how and by whom they’re being screwed is, after all, broad and deep; cf What’s the Matter With Kansas? Plus it is true that some vital provisions, especially regarding recission and preexisting conditions, will kick in sooner and genuinely help people. Democrats might, if clever enough, and if cleverness suffices, play up those changes to stave off the pitchforks in the 2010 and 2012 elections.
Or not.
Hugh, You and I are in complete agreement. Yes we can jettison Obama and his regime of Clintonites. Or is it Clintonians?
wow. i’d read about one of the mayo clinics not taking any more medicare patients but i had no idea it was so bad in HI and AL.
where i live in MA, there are very long wait times especially for primary care (last time i went looking for a doc, the first three i called weren’t taking ANY more patients and the fourth had a 7 month wait for the next available new patient appointment. so i made the appointment and went with #4).
…. i’m with you on the medicare for all (i want hr 676, expanded and improved medicare for all, which has first dollar coverage to take care of the under insurance problem too). one additional benefit is that if healthcare providers had to spend less time with insurance companies hassles, they might have more time for patient care which could give us a little bump in supply to accommodate some of the increased demand.
wesgpc, I don’t agree. the best way forward now is here.
agree!
looks like the ama has the process hijacked. which is why it’s all fucked up.
http://seminal.firedoglake.com/diary/9748
I don’t know if that would “solve the problem,” but it would be the compromise I’d be willing to sign onto (with the additional proviso that the public plan be built off the Medicare infrastructure).
Problem is, the likelihood of a universally accessible public plan finding its way into any legislation currently being hammered together roughly equates to the likelihood of the Weiner HR 676 guerrilla floor vote magically passing.
Nah!!! It can’t happen. People are too close to the breaking point. As insurance rates increase over the next few years, more and more employers will give up the insurance ghost, and more and more individuals will find they can’t afford insurance, even they technically now have the right to get it. The resulting wave of anger will not be something the Administration can turn aside without fixing whatever bill they pass now.
Thanks for your comment; it’s incredibly important. As recently as this past April, Jacob Hacker reiterated his insistence that a public option plan be built out of the Medicare infrastructure. It makes no sense to reinvent an entirely new wheel as opposed to expanding and repairing the existing one…except to those looking to distance the public plan from Medicare specifically to make it harder for the new plan to morph into single payer.
i agree except on one point. we can’t support “only progressives who will stick with our ideals and values” because that assumes a level of knowledge about the future we don’t and can’t have. we don’t know for sure which politicians will stick. look at all the work howie goes through to screen candidates for blue america. supporting better candidates is important, but it’s always something of a crap shoot and we don’t actually know their ideals and values, we only know what they do.
i’d rather see progressives define ourselves by the policies we develop and advocate instead of the politicians we support. politicians are NOT our allies, they are people we may work with on some issues and oppose on other issues.
We do not disagree that much. I am not sure even the strong public option as currently envisioned would do much, since as far as I know, it would only be open to those not currently insured.
But, I think that pushing for a public option, in a strengthened form, is the best hope of getting some reform and ratcheting the system towards real reform.
“solve the problem” was shorthand for saying that competition from a strong public option (open to everyone, with all powers of a private third party payer) is the best way to get quick changes in insurers’ behavior that cannot be achieved through sufficiently strong regulatory reform of the private market place.
“I’d rather see progressives define ourselves by the policies we develop and advocate”
I agree with that statement, except we will have to tolerate some disagreement about exactly what policies are worthy goals. Otherwise we will end up tearing ourselves apart, like it looks like the teabaggers are getting ready to do.
I do not care whethre we have a private Swiss style system, a social insurance system with multiple private and public payers, or a Medicare for all type Australian system, or even an Canadian style single payer system. I think I know what are good and not-so-good ways to design each one. As long as we can agree on a general direction and goal, and good ways to move towards them, I agree with what you say.
I’m 49, I’ve NEVER voted fascist cuz they’re fascists. I grew up as a teenager on welfare (thank you community) with food stamps (thank you community) and used tons of student loans & financial aid to get culinary training and my math degree and my math teacher cert (thank you community)
WHY are gov’t programs so ineptly run? WHY do we keep handing soundbites to the wingnuts? Ya know why?
cuz the Democratic Party is run by this managerial / professional class with NO f’king clue what life is like for the bottom 80%, and, running these inept programs ineptly is the jobs program of the Democratic Party – let’s keep hiring this professional / managerial nitwits to write memos and create more byzantine process and more indecipherable lawyer happy b’shit rules! In the good old days, you got a job with the city or the state sweeping the streets, IF you delivered your precinct or ward. That system led to incredible corruption, gov’t services were wisely ‘professionalized’, BUT, we do NOT have professionals running these programs, we got goddam bureaucrats making bullshit.
WHO could justify all these idiotic fucking rules but the professional class which is paid well to administer these fucking bullshit rules?
Oh yeah, I do NOT vote fascist, cuz, they’re fascists.
rmm.
Sorry, dude, that’s not acceptable. While I’m sure your heart is in the right place, you’re cheerleading legislation that will ultimately hurt Americans.
If you know the Pyrrhic Option:
-is not a program open to most Americans (hence, not really a public option)
-will not come into existence for 3-ish years
-is not in line with the expectations of most healthcare reform supporters (and aside from this poll, note how Olberman, Dean and others describe the PO as being like ‘Medicare for All’ –god only knows where they got that idea)
-will not, as a ‘sliver’ of HR 3200, contain future healthcare costs
If you know all of this, then what the fuck are you supporting?
More importantly, WHY are you supporting this nightmare when, by simply changing the eligibility of Medicare –a program that already exists, that its users like, and only has a 3% overhead– voila: real healthcare reform begins for everyone?
Medicare for All / HR 676: Don’t accept any substitutes or legislative rebranding of the only real option for the American public
agree 110%
for me that means stuff like: no bs (strive to be as intellectually honest as we can), we use honest argument to persuade while attempting to keep an open mind to other povs, don’t triangulate, don’t marginalize, practice little d democracy and respect the work and roles of insiders, outsiders, pragmatists, idealists.
ouch!
righteous rant.
Three guesses what the insurance companies will be doing with the generous time frame they’ve been given to “adjust” to the new rules. The same thing the credit card companies are doing now, of course– jacking up the rates as high as they can. In three years, many millions more will be uninsured thanks to astronomical premiums and the public option won’t amount to squat. This is all a bunch of crap.
oh what a crazy idea! so crazy, it just might work!
clearly, voting for the least worst, no matter what in even numbered years as the Democratic Party chases the (R)’s over into utter corporate fealty has not been a winning strategy.
as Matt Tabibi lamented yesterday:
my emphasis
I recall Obama saying that “we” will provide immediate relief for the uninsured in the interim, while the new program is being established, but I haven’t seen anything about what that would consist of. As I recall, my impression was that he was talking about actually providing insurance or access to health care, not just implementing policies about things such as pre-existing conditions. Without some kind immediate interim help, the 3 year thing is truly stupid and insensitive. You don’t describe something as a “crisis”, build up the momentum, and then have people hugely let down. So what was he talking about? Weird to leave it hanging.
Sporkovat, I loved that Taibbi post, “Elizabeth Warren for President”. Thinking outside the box, as they say. I found it inspiring. We don’t have to be prisoners of the party leadership or the administration.
If they are going to get rid of pre-existing conditions from day one, we’ll also get the MANDATE from day one, with absolutely no control over what the insurance companies charge. I hope that is not the case.
As the great George Clinton sang:
“Free your mind and your ass will follow”
folks who care about peace, social justice, the environment, health care for all, need to free themselves from their unreciprocated devotion to the Democratic Party.
I just fear that there will be enough folks, who will “retain” private insurance and its higher reimbursement rates, whether because they’ve got some sort of contract that provides them this coverage, or because they are rich enough to pay for it themselves.
To me it seems like a twist on the “boutique” doctors concept [certain doctors who, for a big up-front payment, will assure you that they'll see you, etc.].
I know that logically, enacting Medicare for all suggests that there won’t be competing programs, and thus doctors will HAVE to accept Medicare patients and their shitty fee payment rates. But I think that even “Medicare for All” doesn’t mean “and ONLY Medicare will be available.”
Unfortunately, because Obama ceded “control” over this entire issue to the corrupt and inept Congress, there’s no series of issues that must be addressed. If, instead of his oh-so-smart-Rahm-foolery, Obama had begun with a list of problems that needed to be solved by any health care reform legislation, then whatever proposals were put forth could be evaluated in that light. [For instance: cover uninsured, no exclusion for pre-existing conditions; no cancellation upon sickness; control over premiums/deductibles; AND doctors must accept patients on Medicare.
I don’t think anyone has looked at this “but I can’t find a doctor who takes Medicare” problem, and I’d like someone to do so.
you are exactly right about the problem of “boutique” healthcare in any kind of multi payer system. i guess that is what we are starting to see now with medicaid and medicare patients being refused.
hr 676, and other single payer / “medicare for all” systems, do address this by preventing private insurance companies from competing with the gov plan. that is why it is called “single payer.” unfortunately, in the past year, public-option-in-a-multi-payer-system have been co-opting the rhetoric of the single payer movement (hr 676 has always, since 2003, been “expanded and improved medicare for all act”) and that has confused the issue somewhat in many people’s mind.
anyway, for an example, here is the relevant bit from hr 676:
there can be a tendency to underfund gov insurance programs, but at least with us all in the same program everyone’s incentives are aligned because we all want adequate funding for the program we’re in, and we’re all in the same program.
just my opinion, but i think multi payer systems make for stupid healthcare financing policy (even if there is a public option) and you’ve put your finger on one of the many reasons why.
Unfortunately, “progressive” organizations in the last year have been defined more by the policies they develop and abdicate.
sigh. yeah. since sometime after oxdown was turned over to hcan, i’ve fantasized about writing a diary with a title something like, “A Note on the Taxonomy of Astroturf and Grassroots Organizing.”
We need term limits.
That’s assuming that the resulting bill is not *grossly punitive* and counterproductive. They tried as hard as they could to make it grossly punitive and counterproductive. That seems to have been the reason for the delay, no?–have the stink bomb blow up in the second Obama term when it’s too late.
*Maybe* things won’t end with a grossly punitive bill, but that would certainly be a late development and not at all in the original plan.
Because that would just be too logical.
Yes. I’ve also heard that there are a lot of younger uninsured people…college age ‘invincibles’. They might help to balance or offset the cost of covering more (sicker) people. I’ve also read that one thing driving up cost is emergency room visits, and that once people start getting regular checkups and preventive medicine, that should help contain costs over the long term. Risk adjusters to spread costs and standardized prices negotiated by the government on behalf of all insurers, private and public, would help contain costs. And Wyden’s idea of national plans uses economies of scale to lower costs. A public option, if it isn’t contracted out to private industry, should give private plans a run for their money, but for that to work, application – and, critically, enforcement – of risk adjusters to spread risk associated cost is essential, otherwise the public plan will attract all the sick people.