Ben Nelson and Joe Lieberman are running around saying that they’ll kill any bill that has a public option. Quite predictably. And everyone in the media (and on the Hill) are kowtowing to them, saying that this means that it will have to go. Their calculus is that progressives in the House will want health care passed so badly that they’ll eventually cave and vote for a bill that doesn’t have one.
Now, maybe this is true. But as someone who counts votes like other people count sheep, I’m not getting it. Someone is going to have to explain the math.
There are 258 Democrats in the House now that Garamendi and Owens have been sworn in. There are 177 Repubilicans. Everyone voted on the bill, which means 218 is a majority. If all the Republicans vote against a bill, that means they can only lose 40 Democratic votes and still pass a bill (258 – 40 = 218).
According to Jim Clyburn’s own count, the Stupak amendment only bought them 6-10 votes. And in the end, there were 39 Democratic “nay” votes on the final bill. Because Republican Joseph Gao voted “aye” that meant they could allow 41 Democratic “nay” votes and still pass it.
So they threw the biggest piece of red meat culture-war social conservatism issue at the ConservaDems they possibly could — and abortion means a heck of a lot more to the conservative base than something as new as a “public option.” It’s been deeply ingrained for decades. And they still only picked up 10 votes maximum. This is after PhRMA has spread so much money around the Democratic caucus that they’ve lured just about everybody over to the “pro” side they possibly could. If they tossed the public option out, MAYBE — just MAYBE — they could pick up another 10 votes. And that’s really, really optimistic.
But let’s say they could. Who do they lose when they do that? Do they lose more than they gain?
I think they do. Because progressives only have to muster 1 more vote against the bill for every one that leadership picks up when they lose the public option. Can the progressives hold 11 votes against any bill without a public option? Even if Gao stays in the “aye” column, I think they can do it. In reality, I think they only need to muster more like 5-8, because the GOP is going to go straight at everyone who is vulnerable between now and then, and will probably be able to recruit strong challengers to many in the post November election period, which is when that kind of thing starts to happen. Which should scare some of the freshmen, and probably some sophomores too, into the “no on anything” column.
So the absolute best, most optimistic outlook for passing a bill in the House without a public option means that 13 or fewer progressive votes could stop it. Well, here are 16:
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Rep. Raul Grijalva | “Our insistence on this is based on real public policy — we don’t want a trigger, we don’t want a public plan that has no network of providers…I think the President respects the fact that these are principled issues we’re taking. This is not petty. I’m not saying “no” just to be spiteful, or petulant. This is a principled vote. It’s a principled decision.” |
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Rep. Keith Ellison | “I will not vote for any healthcare that does not include a public option. I will not do it, that’s a guaranteed no vote and I will not be dissuaded from that.” |
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Rep. Maxine Waters | “For the majority, I think, of our members a public option is a compromise — we wanted single payer as you know, and we backed off because they said that was going to be impossible to do. Again they brought up the more conservative elements, etc. etc., and so we will not support any bill that does not have a public option in it.” |
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Rep. Emanuel Cleaver | “I have said from the very beginning and I will say even to the end that I will not support any health care program that does not have a very strong public option. If there is no way to guarantee from the very beginning that every American will have access to adequate insurance coverage, that I will not support it.” |
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Rep. Lloyd Doggett | “We do need reform of health care so desperately. And I’ve joined in the communications to our leadership,and I’ve said withing the Ways & Means Democratic Caucus — no public plan, no vote for me.” |
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Rep. Bob Filner | “We need to do this now. People say we are rushing it, we have been waiting since 1948 to take health care reform seriously. We cant afford much longer at this rate….So lets get the public health option, and I am not going to vote for any healthcare reform plan that does not include such a public option….We need the guarantee of accessibility on day one. Any trigger as far as I am concerned, kills my support for the bill.” |
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Rep. Jerrold Nadler | “In May, I began whipping my colleagues on the absolute necessity for a public option and convinced many of them to commit, as I have done, to voting against any health reform bill that excludes the public option. This commitment will give us leverage to oppose the insurance company lobbyists, and force inclusion of a robust public option in the developing health insurance reform plan.” |
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Rep. Chellie Pingree | “I’m not going to vote for any House bill that doesn’t include a robust public option without any triggers or coops–that’s a must-have for me.” |
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Rep. Phil Hare | The purpose of having a public option — and that’s why I can’t vote for any bill that doesn’t have one — is that without the public option, people don’t have any place else to go, except for the insurance companies.” |
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Rep. Barney Frank | “I am a strong supporter of single payer, and I do reluctantly accept a full public option as the best we can do. So I am strongly committed to a public option and I will not vote for a bill that does not include a nationwide, genuine public plan … I am not talking now about a trigger, which I greatly oppose.” |
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Rep. Carolyn Maloney | “I have decided I will not vote for a health care bill in the House that doesn’t include a real public option and I Pledge to uphold the public option principles agreed upon by the Progressive Caucus.” |
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Rep. Lynn Woolsey | “Oh I will vote against anything that does not include … and it’s got to be real. I mean, you can call it anything you want … I believe there are enough of us, among the 120 in the tri-caucus and the progressive caucus, that can stop any votes…. Any health care reform that does not include a strong, robust public option for all Americans will not be health care reform.” |
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Rep. Yvette Clarke | Rep. Clarke: There is no health care reform without a robust public option.Eve Gittelson: You are saying you will not vote for any bill through conference that does not have a public option.
Rep. Clarke: That is correct. |
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Rep. John Conyers | “The centerpiece of this reform is a robust Medicare-like public health insurance plan tied to the Medicare provider system. Like many of my colleagues in both the House and Senate, I will oppose any health care reform bill that lacks such a plan. I will also oppose any legislation that seeks to replace a robust public health insurance option with health care cooperatives or which ties the availability of the public option to a trigger mechanism.” |
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Rep. Robert Wexler | Committed to vote against any bill that does not conform to the principles of the CPC, which means that it must contain a public plan that has no triggers and is available nationwide to everyone, and that it must also have the ability to negotiate for rates in order to keep costs down. |
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Rep. Donna Edwards | “Taking the FDL pledge… the pledge is consistent with what I’ve outlined as important components for any reform to be called reform. Signing up for the pledge now. But, progressives need to hold tight on this one. We cannot allow the language of robust reform to be used to describe something that is not.” |
I actually have others members on record saying they’ll vote against any bill that doesn’t have a public option (no co-ops, no triggers) which I haven’t released yet.
Now I know where the strengths and weaknesses of the list are, and they do too. But you’re talking about a group of people who have been screwed over, disrespected, spat upon, forced to vote against everything they believe in over and over and over again “for the good of the team,” who have had to kneel down and get stomped on so their Blue Dog caucus brethern can collect all the campaign cash and the district pork and the “wins” that will get them re-elected. On the war supplemental. On Waxman-Markey. And now on choice.
I imagine that list of progressives who will vote “no” on any bill that doesn’t have a public option is somewhat larger and stronger after the Stupak debacle, because progressives who hail from strong Democratic districts once again look weak, ineffectual and unprincipled to their constituents after they voted for a bill that included an amendment that is certainly the worst attack on choice since before Roe v. Wade became law. They’re ready to take a stand.
So unless someone tells me how Maxine Waters, Jerry Nadler, Raul Grijalva, Lynn Woolsey, John Conyers and Keith Ellison suddenly abandon everything they’ve worked for and take one for the team just so they can be led around by the nose by J0e Leiberman to compensate for Harry Reid’s weak leadership and Rahm Emanuel’s decision to drive health care reform into a ditch, I’m feeling pretty good about the fact that no health care bill will pass without a public option. Period. Because the list of “no” votes in the House is already packed with Democratic members who think they’ll lose their seats if they vote for any health care bill. That list is pretty much uncrackable — and it only gets bigger and stronger from hereon out.
The White House calculates that the “give” is on the House side, or they would have been putting pressure on the Senate “centrists” all along. They’re not. Rahm Emanuel’s over-confidence that he can continually roll progressives in the House created the situation where Pelosi couldn’t pass a bill without one in the first place. He’s gone to that well too many times. I don’t think he gets another trip.
And until the White House and the Senate face that reality, we’re looking at no health care legislation passing in this Congress. Until Joe Lieberman and Ben Nelson start facing consequences for handing the party a huge legislative defeat for their recalcitrance, we’re looking at a repeat of the Clinton failure of 1994. And that, as many will recall, handed the House Democrats a 54 seat swing to the GOP. But it won’t be just a House phenomenon this time. Lieberman and Nelson wouldn’t suffer the consequences of their own actions in 2010 because they’re not up for reelection, but Harry Reid and Blanche Lincoln certainly would. Probably Evan Bayh, too.
Because Democrats in the House do not have the votes to pass a bill without a public option — no opt-outs, no trigger, no co-ops. And that’s the reality of the situation.




















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So we may yet get lucky and see health insurance reform wither on the vine. Then maybe we can take a stab at health care reform and see how that goes…
I’m sadly coming to the conclusion that this is ending in a train wreck.
The WH seems to exist in an alternate reality.
If Rahmbo really believes this,
then he, and his boss, can really believe that his HCR stratergery is working.
finished my own count about a half hour ago – and came to the same conclusion. Leadership now “needs” our votes bwaaahhaaahaaa. something tells me that is particularly sweet for Grijalva and Woolsey and frankly hope they let bunglers Clyburn and Hoyer dangle for a while
Jane – can we get MediCare+5 back ?
Only if there are 40 members willing to vote against a bill that doesn’t have Meciare +5, and as witnessed by the Saturday vote, there just aren’t.
If I’d thought they would do it, we would’ve whipped, because it’s important. But they just weren’t going to draw that line, because the Blue Dogs had enough votes to kill it in that case. And the progressives were never willing to take the bill down over that. I actually laughed directly when a member of Congress told me that they were.
If HoJo gets his way and makes Reid and the entire caucus bow before him, I think the bill is dead, no matter what the White House tries to do to resuscitate it. They will also launch a war within the party, because there are too many good candidates sitting on the sidelines, waiting to see how things play out.
thank you. was just wondering how much leverage we had.
Or as BTD suggested at Talkleft, we cut the Gordian knot Stupak created by limiting the affordability subsidies to the public option plan. Uncle Sam won’t subsidize private insurers nor tell them what they can or cannot cover.
I like that idea.
But those who need the PO will still be w/o reproductive choice.
Or am I missing something?
Jane,
what about Labor ?
how in the hell is Harry going to get around them (and his re election efforts)by letting HoJo kill the bill ? If folks like you and Jon Walker are well aware of Harry’s options, surely Trumka et al are as well – so it’s not like he’s going to be able to blow any ‘HoJo did it!’ smoke up their skirt.
Thanks Jane, this gives me some hope. As it stands, this is not a good bill. If its failure presents us with the opportunity to remove some Corporatecrats from office, then there may yet be a silver lining to this dark cloud.
Just to be clear, I think you have done a tremendous job leading the fight on the public option and I am greatly heartened by our success (our first success of any kind that I can recall — at least since I started paying attention during the MCA fight).
Still between Stupak and Eshoo and the inability of everyone to have access to the public option, I sincerely hope this attempt at reform fails. The public still wants reform, so we will still retain some momentum to try again. Then perhaps we can get something that will be more likely to achieve the dual goals of universal coverage and cost reduction. Even if we have to wait until 2011 when Blanche (and others) will have more quality family time ; )
That’s a question of process. Which is why we’ve been working to force the issue.
If Harry Reid brings a bill to the floor without a public option, we never get to find out who those Dems are, because they never vote against anything. Right? That’s why we’ve been saying “no silent filibusters.” Because even Joe Lieberman had the AFL’s help in 2006 (many people don’t remember that).
He effectively protects them from retribution if he doesn’t make them do it on the floor. Which means that Mr. 38% approval rating should get ready to absorb all that himself. Which is why that phone bank logo is up in the top right hand corner of the front page, ready to use any time he decides to protect individual members of the caucus from exposure. Which he has done oh so many times before.
He’s betting labor won’t move against him in that case, and he may be right, but that’s when the base steps in. With targeted tools like phone banks.
Remember, Harry Reid’s last Kos straw poll approval rating was 5%. That’s probably higher than Dick Cheney. There’s going to be a lot of rage if Harry tries to pull a “Joe Made Me Do It,” and many — including both Markos and myself — have said we’ll be laying the blame at Reid’s feet if that’s what happens.
Devastating post. We’ll see…always darkest before the dawn, eh?
Yeah, I do too. If public option advocates can get both pro-choice AND pro-life Members to agree on this, that would be such an enormous break for Obama, Pelosi and Reid that there’d be a lot of leverage that they could pushing the bill back left (e.g. Medicare +5, open to all, faster startup, etc). Heck, go for Pete Stark’s Americare bill (Blumenauer, Ellison and Schakowsky are cosponsors), negotiate down from there. :o)
http://seminal.firedoglake.com/diary/5749
thank you very much.
I think Reid would be an abject fool to think Labor will give him a pass this time on such a signature issue – a failed effort deflates their base as well.
Hunh. Wishful thinking, anyone? That “Must.Pass.Something” motivation is more accurately attributed to the WH and Lamestream Democratic Party Leadership is it not?
Jane, how you’re keeping your sanity following this day after day after month, I just don’t know. Thanks for all you’re doing!
FunnyWheelieDiva
What do you all think of Cao’s vote? I think its incredibly honorable of him to be loyal to his constituents, and hope it won’t cost him his political career. But there has already been quite the backlash http://www.newsy.com/videos/lone_republican_votes_for_health_care_reform
My bold.
Shouldn’t that be 2010? Short Ride is definitely up for reelection in 2012.
[modnote: good eye, thanks.]
AND THE KILLIN’ GOEZ ON AND ON AND…
Citizen Hamsher and the Firepup Freedom Fighters:
Not only is the public option safe but the Stupid amendment actually gives the Democratic Party an opportunity to bring several of the most important contituencies in the Democratic coalition together to get real healthcare reform and also kill the abortion issue as a wedge once and for all. Healthcare reform and women’s health, when has there ever been an issue that brings 54% and 68% of the voting base of the country together in one issue? So how then, prey tell can the Democratic Party NOT pass strong healthcare reform unless they are willing to piss off a majority of their base and get killed in 2010?
KEEP THE FAITH AND PASS THE AMMUNITION, FIGHT THE FIGHTS YOU CAN WIN DON’T NEGOTIATE!!
Good counting!
I’m not sure Evan Bayh would be out. Flat out – he would not lose a primary short of his father Birch running, and I’m at a loss to come up with a credible Republican challenger of even Dan Quayle’s caliber. I hope I’m wrong and the Senator from Wellpoint could be unseated.
Are you admitting here, Jane, that there’s a possibility this bill could fail, while at the same time you’ve called this possibility “unrealistic” elsewhere?
I sure hope you’re right. I just have seen so many Dems abandon their promises to their “far left”/s that I’m not sure I believe it.
I need health insurance – through a public option – but we’re getting awfully close to a bill that I would rather see be defeated, because it will make things so much worse.
I’ll add my gratitude for your persistence and ability to understand these calculations. I always thought I was pretty smart, but it’s getting beyond my capacity to comprehend.
But maybe that’s just because my head explodes so often listening to MSM and other idiots.
They care more about their corporate campaign donors than their constituents – forgetting how grassroots efforts in the form of small (but many) donations can still get people elected.
I sometimes sincerely think no one is listening to us and it scares me to no end.
Yeah,. that’s pretty much the basis of my fears, too.
Also, I fear that the pols are as bad as the pundits in believinng their numbers are going down, and that election results mean that voters think they are too liberal, too bold, instead of too conservative and too timid in the face of the right-wingers. (and I include the blue dogs in that group)
As I perceive it without the Stupak ammendment an enrolee could get a policy on the exchange and if receiving a government stipend, use it on the policy and buy a rider separately. If buying on their own they could just buy a policy that includes it. With the Stupak/C Street ammendment an insurance company on the exchange could not offer anything on it. Is this accurate?
In this sentence near the end . . .
I believe you mean 2010.
I agree 1000%. It’s astounding how little faith they have in the people they represent. It’s like Stockholm Syndrome in the House and Senate.
I have to go home now – I’m at work – I’ll pick up this thread later on.
Have a good night everyone!
Whatever Reid puts on the floor is going to be the Senate bill and if he wants to pass something it will have to go through reconciliation. Like the poor guy in The Time Traveler’s Wife and clothes, you can’t take insurance regulations with you through reconciliation. However a strong public option open to everyone will be a stronger motivator for insurers to shape up than any new regulation or exchange. If House PO advocates are part of the team that negotiates what’s in Reid’s final bill, then once the Senate passes the bill, it can can cross over verbatim to the House for a vote with no need for a conference committee process.
Well, since someone brought up Labor, this is interesting:
State Dems (WA) Facing Revolt by Labor.
But of course the Party leadership is saying they’re being self-destructive, blah, blah, blah. More power to Labor. The answer for the big “D” dems is pretty simple…listen to the base. The closer your “least worst” gets to what Republicans would do anyway, the less your traditional base should support you. Duh.
FunnyWheelieDiva
Reid should let it leak that he is preparing bills to go the reconciliation route.
Yes, in a superficial interpretation. And I think this is why some House reps may have voted for it, without thinking it through.
The actual fact, in real-life terms, is that nobody is going to buy a “rider” to cover an abortion that every woman believes she will never need/have. Nobody will ever admit the possibility is strong enough to spend extra money for it.
Even a former co-worker who has had, at last count, four abortions, always thinks it will never happen again.
So this provision means, practically, no access.
If Rahm gets one more trip to the well it’s rhetorically a one way trip to the bottom. Lots of lucky nickels down there.
Anyone who thinks Rahm wouldn’t welcome a war within the party isn’t paying attention. Rahm would happily do what he did when health care failed the last time: leave public service for a wingding welfare slot at Goldman Sachs, bank enough to pay for his kids’ college, and then float back into public service in the late teens.
It could happen. A Democratic civil war might serve Rahm’s longterm career plans extremely well.
And also, to foothills mike:
For economic reasons that I can’t quite articulate (but there are plenty of sites that do, including Jon Walker’s piece whose title includes ‘wrong about Nita Lowey.” I’m not sure that’s the clearest explanation; google a bit, but knnow your source.
Oops, my point was that ultimately, because insurance companies will have lots of people getting subsidies to buy their policies, they will stop offering any policies that cover abortion.
And the progressives were never willing to take the bill down over that. I actually laughed directly when a member of Congress told me that they were.
They were never going to take the bill down over that? Kind of a gamble to circulate a letter saying that they would then, wasn’t it?
A gamble we lost.
As a result, it would hardly be shocking if this threat being issued now isn’t viewed as credible.
In order to establish credibility, they are actually going to have to follow through.
The best bill the people on your list can expect is one with an opt-out — an inadequate bill, according to what you’ve written here; one that would need to be defeated.
What this means is that the people on your list need to be preparing themselves — steeling themselves — to defeat the bill that comes out of conference. They should consider the need for this not as a possibility, but as a certainty.
And that we should also prepare for this, by arguing in favor of their doing so. As of now, I’m not sure the progressive blogosphere would have their backs.
D.C. Politics Roadshow coming soon to PBS
The factual context of this discussion remains that these elected officials have full faith in and credit with the people they represent — corporations and other interest group lobbies that underwrite their re-election campaigns.
This isn’t a hostage situation; it’s a captive market where the massive power of representative government is sold out to the highest bidder.
Wow, that’s more cynical even than my thoughts on Rahm.
Even at that, I don’t really understand why he chooses the fights he chooses, or why a Democratic party civil war would be a goal.
No trouble believing he’d take advantage of it, but as a goal? “Here, I’ll join the White House staff, work hard to ruin everything my party stands for, and when that’s done, I can go back to Goldman.”
I’m not really arguing with you, Teddy. I just don’t understand why he would want to take the short-term policy position in the first place; why not just have stayed in the private sector? Why be a Democrat at all?
Such goals are surely utterly Republican?
If what the House passed was a win.
And a public option was never about controlling costs or offering competition to the insurance industry in order to make premiums more affordable, why do we need a public option?
If there are mandates, how can an insurance company turn you down?
We don’t need a public option as a dumping ground for the sick. Seems like a waste of time, money and energy.
“Follow the money.” Hal Holbrook in All the President’s Men
i was appalled watching Sheldon Whitehouse glued on Clinton like sperm on a blue dress, it was nauseating, appalling, – this Democratic party is pathetic sell out to special interests and not a party representing hard working Americans. Vote this thing down!
Thanks, FD! You’re assuming I still have it (my sanity…)
;)
‘“Follow the money.”
Hal HolbrookDeep Throat in All the President’s Men”fixed it for you.
So assuming your premise is true — that a “public option will be a dumping ground from the sick” — the alternative, no public option, means the sick will have nowhere to go.
I think most people here would find your solution cruel.
The Stupak amendment exists merely to be stripped out in exchange for progressives abandoning the PO. Fuck em, and we should not allow such ploys to to leave more Americans uninsured due to rising costs. Reform can only mean the erasure of a for profit HC system.
Another way this could be done…
Everyone gets a health care allocation based on their income…like a tax credit. It’s direct to the user. They can then enter into exchanges, which are not funded administratively by the Feds but are supported by a portion of the allocation. Or the allocation can be used to buy directly from an insurer. Since there would be no direct payment from the Feds to any insurer, but this would be the decision of the consumer, it would not be the government subsidising abortion. Government would be subsidising the health care needs of PEOPLE.
Well, you never know.
If Bayh fucks the unions on EFCA like he’s threatened, you may be surprised.
;)
Why do we need a public option if it is not about offering competition and controlling costs?
In the exchange there will be a basic plan that all in the exchange must offer. There is a mandate. Why do we need a public option?
Are you saying we need a public option for those who the insurance companies refuse to cover? That’s one of the basic principles of why we have mandates is that the insurance companies must accept everyone?
Hmm. I need some time to chew on this and digest it.
“But those who need the PO will still be w/o reproductive choice.
Or am I missing something?”
This is true but as it stands now, many those who need the PO can’t even pay for prescription drugs or doctor visits, much less any kind of surgery. So with or without the PO (and this was true for the House bill pre-Stupak), folks will be without abortion coverage, the difference is that the PO would give them medical coverage for everything else. What Stupak did was impose the existing Hyde Amendment restrictions (on federal health plans) onto private insurance plans as well. This means women who have abortion coverage right now under their current plan would lose that coverage as the insurance exchanges phase in and absorb the health insurance market. So the dynamics are different where people already have full medical coverage, the only thing the reform will change is.. loss of reproductive choice. The only reason Stupak had a hook into private insurance decisions is because the HR 6292 and the Baucus bills give hundreds of billions (I think Rockefeller put the 10 year number at $500 billion) in federal subsidies to private insurers.
You’re right, limiting the subsidies to a restrictive POD is a suboptimal outcome but I’d rather health reform give Public Option recipients something important if not everything we’d hope for, especially if the alternative is a health reform that gives women with private insurance nothing except for taking away something important.
Re the House, you wrote:
Essentially, what you’re saying is that Progressives will vote yes on a bill “that is certainly the worst attack on choice since before Roe v. Wade became law” so long as they get something called a public option. I suppose that’s what we saw last Saturday, isn’t it? Very pathetic.
So, the best we can hope for is that Reid caves to Lieberman, pulls the po out of the Senate version, and that the final merged garbage has stupak language for the exchange and no po. Then the Progressives will find the cuglioni to finally say enough.
(Yeah, I say it’s already time to say enough, even with a po, if it means that we’d have to accept “the worst attack on choice since before Roe v. Wade became law.” The fact is, if the Democrats don’t find a way to get the stupak out of this legislation, all I’d have to do is sit back and watch the Republicans sweep back into power next year, as the Dems will have committed political suicide.)
I’m going to get more pissed over EFCA than I am about healthcare. You haven’t seen pissed.
That is/was pretty much the argument for the bill (and the so-called agreement not to touch the abortion-funding status quo) pre-Stupak.
Those folks don’t think that way. They think in terms of controlling everyone’s behavior to conform with their own moral beliefs.
Great post and thread, thanks to all.
Sure, if universal lobotomy gets enshrined as law.
I know I’m getting too far ahead of things… but I’m a curious guy, ya know?
Any idea who the reconciliators will be for the Dems??
might be. not will be.
Thanks – Hal Holbrook played the garage lurking, state secrets spilling patriot.
An interesting test of just how bad the bill is could be brought about by the progressives attempting to block it. If the insurance companies think they have succeeded in subverting most of reform, I predict that enough Republicans will come over to pass it. Wouldn’t that be horrible? I agree with you that the present bill in the House is bs.
I hope you won’t take this too badly – but to me, this is the same weak-need argument we’ve fallen for for 30 years, and which has resulted in the shrinking of our rights, especially women’s rights of choice, by a little bit every time.
At some point,we MUST take a stand. The republicans take stands, dig in their heels, and refuse to compromise. We start compromising before we walk in the roojm to negotiate, which is what happened here, when single-payer was compromised away before the start.
I am just about ready to dig in my heels and draw the line – NO bill is better than a TERRIBLE bil.
Unlike physicians, nurses, allied health professionals, doctors, Big Pharma, and medical device makers, the health insurance cartel provides no value to patients. The cartel also doesn’t want to insure people who need insurance. They socialize risk (Medicare and Medicaid) and privatize the profits. They have zero incentive to make health care affordable.
Rahm is not Dem Centered, nor is he Rahm centered as you or Teddy suggest.
He’s first and foremost AIPAC centered, and secondly, and TOTALLY in conjunction with AIPAC and Isreali Right Wing Needs, Corporate Centered.
AIPAC, and Corporate America, fully united to do business, sell weapons, acquire resources.
That’s where Rahm’s center is.
Once you accept that, the rest of his actions are clear as a bell.
And unfortunatley, both Dems and Pubs alike are equally centered.
That’s what we are up against. That’s what any of our progressive hopew are up against, that’s what any prog elected officials we support are up against.
I’m not quite sure I understand this post, aside from it posits that there’s a good chance progs in The House can kill HCR Bill if it has Stupak in it. If that’s the meat of the post, I’m all FOR killing the bill in the House! Force them to start all over again!
But I’m concerned about Stupak NOT being an issue, as it’s used in conference to DELETE and ELIMINATE items in the already weak PO as to render the PO useless, purely useless. In other words, Stupak will get dumped in trade for dumping good things that are left in the PO.
All in all, what we have in the House bill, aside from Stupak and Eshoo, is a piece of shit that’s doomed to fail as reform (which will doom the people and the Dem Party sooner than later).
I don’t see the Senate IMPROVING the House Bill, and I don’t see Conference improving the House Bill.
So I’m all for defeating this crap, and starting over.
I agree.
That’s right. And that is why, in part, I’m ready to throw this one, with its huge subsidies and mandates to people who can’t afford to pay, out the window and start over.
With different Congress people.
or go the other way:
If all $$ is fungible, then Catholic hospitals cannot receive any federal tax $$ for any reason, they being a religious, tax-exempt entity.
Wouldn’t that be fun… It would of course require the Corporatecans to stand up to the Tea Baggers… heh heh… Not. gonna. happen. But it is a lovely picture to contemplate ; )
You can almost see the heads of Rush, Beck, Billo, et al., explode with the confusion of it all: must do the bidding of the corporatocracy, must whip tea baggy base into frenzy, can’t do both… ARGHHHHH! Poof!
It would be untidy, but fun to watch ; )
I have no confidence that this will happen. What I’m hearing, outside of progressive blogdom, is, “Come on, girls, you can give up just a little bit of abortion rights. don’t pull the whole building down for one little not-very-important bit of abortion restriction.”
I think this whole thing was handled horribly – the kind of background work that should have been done before anything was brought to Congress is just beginning, in small ways.
Public appearances, tv appearances, meetings, ads, going over what people already knew, piecemeal, about the horrors of our current health insurance/coverage “system” should have blanketed the country for several months. There should have been ads, articles, etc. explaining how the European systems that work really work; there should have been visits to key house and senate leaders (Max Baucus, who seems to have no clue that there are other systems that work) BEFORE there was anything proposed, let alone introduced, let alone sent to a narrow committee, in Congress.
Not doing any of this just doomed the whole thing from the start. “Getting a bill through”, any bill at all, is NOT good enough.
End of rant.
If the “no bill” alternative is still “out” in your imagination, and the choices are between a bill with a public option and a bill without one, then the Senate CAN pass a bill without a PO, and your diary here is wrong.
If “no bill” is a real possibility, then your repeated suggestion that it is “unrealistic” to hope for such a thing is wrong.
If we are going to get a bill with a public option anyway, then why worry?
Which one is it, Jane?
I “imagine they will?”
They did.
How do you propose to get 40 Democrats to vote against something they just voted for?
I guess I should just cut and paste this over and over again and save the effort.
We will try to address all comments that are reality-based in the reality-based community. But these are the facts:
1) The Democrats have 60 votes in the Senate, a majority in the House, and the Presidency. You cannot stop them from passing a health care bill if they want to.
2) The House did not want to stop this bill, nor will they. That’s why they voted to pass it.
3) Your choice is between a public option and not a public option. Until things gets significantly worse, there is no Door #3, “none of the above.” See #2 above.
4) Of those two choices in #3 above, if you don’t like the public option, please argue why it’s better to give Joe Lieberman his way and pass something without a public public option, because those are the only real possibilities right now. See #1 above.
5) Stopping the fight to keep the public option in the bill by fighting for “single payer” right now means that Joe Lieberman wins and the public option comes out. Again, if this is what you want, please explain why this is a preferable outcome.
6) None of this presumes that the public option in the bill is adequate, or that it is better than no bill at all. But since a “better public option” or “kill the bill” are not realistic options right now, you’re still stuck with the choices in #3 above.
7) If you’re worried that the public option will be a “dumping ground” for the sick, please explain where they will go when they are dumped if there isn’t a public option, or why insurance companies wouldn’t “dump” them if there wasn’t one.
Straw man arguments will not be addressed, so please check carefully 1-7 above to make sure you aren’t putting one forward and we will happily respond to your comment.
1) The Democrats have 60 votes in the Senate, a majority in the House, and the Presidency. You cannot stop them from passing a health care bill if they want to.
2) The House did not want to stop this bill, nor will they. That’s why they voted to pass it.
3) Your choice is between a public option and not a public option. Until things gets significantly worse, there is no Door #3, “none of the above.” See #2 above.
Yup an income-based voucher plan could work, but since Stupak and his crew would still consider it “abortion funding”, I’m not sure it moves the ball forward. Besides why should our taxes pay for private health insurance when it’d be more cost-effective to just pay for health care.
You just reminded me, back in the early 90′s, economist Laurence Seidman proposed an income-based national health insurance plan. His “Health Card” plan wouldn’t look at your income to set the premiums (it’d be funded by taxes, so premiums weren’t necessary) but rather to set the deductible and copayment cap. I forget the exact numbers but in the ballpark of 1% of income annual deductible, then a 50% coinsurance til your maximum annual obligation of 5% of income was reached, after which Uncle Sam picked up 100% (of course all those percentages could be easily adjusted up or down depending on income levels).
The doctor or hospital wouldn’t know what your income is, they’d just bill your federal health card account and receive payment from Uncle Sam. In turn, the IRS, which does have a pretty good idea of your income, would then bill you 1% of said income and the coinsurance payment as required.
Here’s a story from the early 90′s about Seidman’s “Health Card” plan.
http://www.udel.edu/PR/UpDate/94/8/5.html
Got link for that quote? While you’re at it, please explain how single payer could have got through a Congress that would have dumped the PO if not for the fact that Jane and a few key allies (and their readers) knew what was in the wind and were ready to forestall it? (Remember, the Cons’ chief opposition to the PO is because it’s the “Trojan Horse” for single payer.)
We are in agreement the House bill, with or without Stupak, should fail.
I’m only suggesting the BEST bill we can get, will be worse than the House Bill as is.
I’m convinced Stupak is a bargaining chip.
And I’m convinced the final bill after conference will be FAR worse than the House Bill as it is.
Eshoo will stand, Stupak will disappear, and there will be a horrible, horrible bill that MIGHT save SOME small percentage of the uninsured by 2014 or so.
That’s not reform, that’s not even a tactical victory, that’s pure and utter defeat.
Kill it all now, force a redo.
Nice straw man construction, I must say. Though the straw Jane with whom you’re dueling doesn’t resemble the actual one all that much.
I know, I know. I appreciate your reality-based counts, really.
I guess I was posting about emotions more than reality.
I jsut have one question (a serious one)- do allb 60 of the Democrats really want to pass something? I get the feeling that several really don’t want to do anything at all. That’s just my feeling, from their public announcements/behavior, but I trust your on-the-ground counting.
And I am not seriously advocating starting over right now on single-payer. I’m just close to feeling this one is terrible, terrible.
Already saved that, thank you. It really helps.
If the Senate passes “not a public option,” then that’s “not a public option.” Then they fight it out in conference, to see if it’s “public option” or “not a public option.”
Then it goes back to the House, and you’re saying “don’t fight for the public option, it’s not worth it,” and “not a public option” wins.
But that hasn’t happened yet, the House hasn’t been presented with that option yet, and until they do, there’s no “door #3,” namely “kill the bill” possible.
We’re talking about right now, not a hypothetical future. But were such a future to exist, you’re saying “don’t fight for a public option, let Joe Lieberman have his way,” whereas I’m saying “that’s the point you fight to kill the bill.”
Forgive me, for not getting this, Mz. Hamsher, and I really WANT to get it . . . I do.
What’s best for the greatest amount of people in this mess HCR is in?
What is it you are ADVOCATING for?
If we only have a choice (not ours, but Congress) between a PO, or NOT a PO, will you support and advocate for a watered down PO WITH Stupak and Eshoo in it? Or would you oppose that?
Do you think we can get a watered down PO without Stupak and Eshoo?
If there was no Stupak and no Eshoo, would you advocate and support NO public option?
I’m NOT being contentious, I’m just REALLY, REALLY confused with ALL the comments and options and scenerios described in your post and in comments.
I LOVE the 7 items list! VERY clear. But it don’t answer what we should be supporting or advocating for?
Thanks for all you do.
Uh, am I missing the point that you are addressing the Senate issue, and I’m thinking of the FINAL issue, post conference? Is that what I’m missing?
Thanks . .
….
again.
Obama and Reid will resort to reconciliation before they let the bill die. What I want to know is, if they go this route, how strong a public option is possible that can still pass the House? If it’s a public option available to everyone or a public option tied to Medicare+5 rates or both, can we get enough support for it in the House? Because if we are unable to pass insurance industry reform under reconciliation, we need a public option available to everyone. I still say opening Medicare to everyone would be a brilliant solution. Just let people buy into it with premiums based on monthly income. That’s seems a lot harder for Congressmen to argue against. I’d rather pass something like that than anything else at the end of the day.
I appreciate that. It’s complex, I understand. I believe we should be advocating to keep the public option in, because the only other real option right now is giving Joe Lieberman his way and take a public option out.
If and when that happens, perhaps there will be the will in the House to kill the bill. I hope so and I think so. But that hasn’t happened yet.
Speaking of reconciliation, I’ve been wondering whether Reid will force a real filibuster, instead of his usual cave to the threat alone. Perhaps it’s too soon to tell on that question.
The Democratic leadership is going to have to force the Republicans and their friends to actually filibuster. Even if it shuts down the Senate for months, the daily spectacle of these fools blocking the public will on this matter will be great propaganda back in their home states.
I still find it hysterical that the republicans went on record being against the Stupak amendment! Can’t wait for their reelection year next year!
Since I mistakenly argued with Jane under false pretenses for a couple threads in a row, I am agreeing with her about everything for the time being.
I think that may be the disconnect.
It isn’t possible to kill the House bill now, it just passed. The Senate will take up health care, and what they will do is unknown. If the bill comes back to the House post-conference without a public option, the progressives may be willing to kill it at that point. I hope so. So yes, this is what the post is addressing — post-conference.
Oh NO!! My life would get so boring.
;)
I seriously appreciate those who take the time to argue their point passionately and engage. We all learn.
If I understand correctly, anything can happen in conference (even single payer), depending on whom Pelosi and Reid appoint. Right?
Thanks to Jane and Larue. I think I was letting my cynicism and despair about how Dems/liberals always manaage to pull defeat from victory get ahead of myself.
I certainly don’t advocate giving up on the public option. I guess I just leaped to the conclusion that it was hopeless.
Thanks for the cold water splash to buck me up. ;)
Every single Republican but Shaddegg voted for Stupak. Shaddegg voted “present” hoping to force anti-abortion Democrats into voting against the final bill.
http://politics.nytimes.com/congress/votes/111/house/1/884
Ok, thanks, I’m going to assume you refer to the SENATE version only, at this point, WRT a PO or no PO.
And I’d concur whole heartedly with fighting for a PO in the Senate version, which is yet to be determined.
And as I understand it, there ARE no Eshoo or Stupak like provisions in the two versions of the Senate Bill, at this time.
Once the Senate bill is finalized, for conference, I guess we’ll know a lot more of what we are up against.
And then, conference becomes the fight du jour.
And then, finally, one singular bill to discuss and ponder.
It’s tough keeping track of all the short term games, while having an end game in mind, ain’t it.
*G*
Never mind what the TradMed say … the momentum is with us !
Failure is not an option …
Not against Stupak! Against any HCR at all.
That will sell in their home districts faster than candy.
“Keep government out of my health care”, that’s the overriding mantra of the 23% whackaloons.
Pugs won’t lose anything WRT Stupak . . .
I suppose “anything can happen in conference” is technically true, but expecting something to come out of conference that couldn’t even get a vote on the House floor is probably not realistic.
We’re really working to try to promote single-payer from the ground up. It’s what needs to happen at this point. You’ve got to build this movement starting at the grass roots, and that’s what we’re trying to help organize. We’re working with PNHP and others to try and marry the movement dynamics of single payer with online activism techniques. It’s just not going to happen in a day, people are going to have to be patient — and willing to put in the work.
Saturday’s malarkey was very upsetting, and I’m a Canuck … we will exact our pound of Flesh, in retribution.
Bless ya for your saintly patience.
*sheepishblush*
As long as you spill not one drop of blood!
FWDiva
Thanks, Petro. I needed that.
I’d like to tell Jane I volunteer for the long-term work for single-payer, but am truly not sure I have the emotional fortitude for it.
I like this and Monday’s Kucinich thread a great deal. Really helps to know and discuss overall thinking with Jane and everyone else.
Thanks for this Jane and firedogs.. it really sets us apart from other progressive blogs.
Yes, absolutely. Without FDL, I would be even more confused than I am.
The following is a transcript of a key portion of an address John Conyers gave on July 30 to a Medicare for All rally in South Senate Park:
HR 3200, following consolidation of the committee versions, is HR 3962.
1. It does not contain a “real” public option as defined by Conyers in the statement quoted above by Jane, much less as defined by the Progressive Caucus in its June 8 set of public option principles, or by the criterion of Medicare-linked rates to which the CPC pledged itself in a press conference given on the same day as Conyers’s statement.
2. It does not contain the Kucinich amendment.
3. It contains mandates.
Conyers voted for HR 3962 anyway. So did every other progressive except Kucinich and Massa.
I have no doubt that they’ll at least vote for a reconciliation bill whose PO contains opt-outs, since opt-outs never explicitly became part of the picture until late in the game and are supported by the likes of Schumer and the sainted Dr. Dean.
I suspect that they’ll also cave on co-ops that have been spun as a kind of PO, particularly if Schumer and allies give their approval.
The PO as currently structured is already triggered through delayed implementation and optional expansion. (Scarecrow concurs.) Maybe even a worse trigger would be the bridge too far for our hapless progressive Reps. But I’m doubtful.
I have no faith that any of these Reps will say no to Pelosi in the end for anything short of the absolute absence of a PO. And even then, if she says go for it, I have my doubts that they’ll disobey.
They’ve already signed on to a disastrous piece of crap. Why not just see it through?
Tej, I’ve been a week or more trying to figure out why it seemed I WAS disconnected from others, not just Mz. Hamsher’s ideas, when I really thought I was IN ACCORD with prog values and the best interests of we the people.
I believe I simply missed that often folks were talking about one chamber or another, and NOT the big picture post conference, while I was mostly always thinking in terms of post conference.
This has been a long, complicated battle to me only because it was only until a few days ago, I learnt there was another vote in BOTH chambers post conference!!!
MY problem with getting with it all along was due to a lack of procedural protocols in our governing process!
At least I think I can recognize the dif between the Preamble, The Bill Of Rights and The Constitution.
I think . . . course, I wouldn’t go on the steps of our nations Capital and start quoting any of them without doing my homework . . . ;-)
Go Progs!
*G*
The Democrats can’t pass water on their own. I just hope I live long enough to be able to knit beside the guillotine as politicians and Wall St. execs get their heads loped off in the ensuing revolution. But first we must pass through the Gilded Age Redux.
“. . . marry the movement dynamics of single payer with online activism techniques.”
That’s VERY kewl, eloquent and simply put, thanks for that one!!!
Many, many steps along the way, and in general as is happening to me, a lot of educating to do for many who thought we knew what was going on!!!
On we learn, on we hope, on we march.
Your Musical Odysseys also set FDL apart from all other blogs. *g*
LOL – well, as you know, that puts you way ahead of any number of elected officials….
Thanks everybody who contributed – my understanding has been advanced, my resolve bucked up, and my brain exhausted.
There are cats clamoring for dinner, so I’ll take a mental rest. BBL.
The mandate to purchase insurance was designed as a way around the progressive tax code. Because it requires a percentage of income, up to a capped amount, be used for health insurance, the poor and middle class will always pay more than the wealthy. If we used the existing tax system and gave everyone a voucher, the rich would pay more.
Compare the subsidy for health insurance to welfare: welfare is sustainable because a small percentage of the population receive it. A much larger percentage of the population will require a health insurance subsidy. It is simply not sustainable. The only way this country can afford health care is by cutting out the 30% waste and excess profit of the insurance industry. The current bills in Congress should be killed – they just entrench the existing, disfunctional system.
It’s good to take a break now and again, to refresh and rejuvenate. Regardless of what gets passed in this Bill, Progressives must keep pushing for Single Payer.
Laying the infrastructure will take time, because for many years it has been destroyed but together, we must persevere.
If the conference report has a public option that is like the House Public Option where:
The public option would attract about 6 million enrollees by 2019 and charge premiums that are “somewhat higher than the average premiums for the private plans in the exchanges.” This is because the public option would “engage in less management of utilization” by its enrollees and “attract a less healthy pool of enrollees,” the office concludes. Moreover, since the House bill expands Medicaid up to 150% of the federal poverty line, it’s possible that the enrollees that would have enrolled in the public option went into Medicaid instead.
complete wih links to the CBO
http://wonkroom.thinkprogress.org/2009/10/29/house-cbo/
meaning it offers no competition, and thereby has no effect on premiums, and so useless and on the path to a death spiral because it is more expensive, with a sicker pool
will you call it a win?
“. . . the last King is strangled with the entrails from the last Priest.”
Or something like that . . *G*
Say Petro, OT, what might it cost, roughly, to fly Vancouver to Nova Scotia, or thereabouts?
Any idea? Don’t research, just curious off the cuff I am . . .
If they pass this legislation w/o fixing the problem they created in order to get this fake victory, I won’t have to stop them. They’ll have committed political suicide, exactly as I wrote at the end of my comment @ 53.
That’s a fact. That’s not a straw man argument, or any other logical fallacy.
What I’m trying to point out to you is that, while you may have better skills than I do and a better capacity to figure out the right way forward, you’re definitely going the wrong way if this is your best argument for how to go forward, to accept an immoral position on reproductive rights.
I responded to your comment at my diary, btw. Here’s a link to your comment, with mine directly following it.
Agreed, not to mention the education I got!!! *G*
You are too kind. *s*
You may be right, and I thought about not including Conyers on the list because of that.
But I think they collectively decided not to push it on Medicare +5. They realized the Blue Dogs etc. had the votes to kill it if they did, and they decided (rightly or wrongly) that it wasn’t worth it to make a stand.
Since enough ConservaDems voted to pass this version of the health care bill, that fear isn’t present any more. Were it to come out of conference in this form, it would (theoretically) pass again. And I think enough of them have agreed to stand together to keep it from passing WITHOUT this version of the public option such that Conyers would join them.
I actually feel better about his vote in that coalition than some of the others, so I included him. But yes, his statement and those of the others to the effect that he was willing to kill it if it wasn’t tied to Medicare rates was maddening the day it came out — because we knew they’d never live up to it.
As I noted the other day, you were right to call out Dennis the K, and by extension the SP groups, for not even attempting a methodical whip effort on the Kucinich amendment.
That said, I’ll be curious to see how you hope to reconcile your views on the value of preserving a homeopathically dilute PO with those of PNHP, which says kill the bill.
Thank you. Reading all this has made my head hurt. I can only imagine what your’s is like.
There are some deals available, depending on when you’re planning on going.
E-mail me and I’ll look it up for you.
LOL … “homeopathically dilute” … clever !
Finally, Jane!!! What’s news?? This has been obvious for months!
The dozen you mention are the tip of the spear – they’ll bring along around 50 no votes. And don’t ignore the Senate – there are probably almost 50 votes against a bill without a public option there too. Ok, many of those will give in, but at least a dozen won’t, not to mention people like Sanders and Burris who wouldn’t even consider it. I figured this out months ago and I’m sure Rahm and everyone in the WH has too, unless they’re morons. That’s why I’ve always known that any proposal that compromised more than the opt-out was DOA (triggers, opt-in, Carper, etc.)
It’s about time they realized that if you reward the bad boy prima donnas instead of the good soldiers, you buy yourself nothing but trouble. I get the feeling Rockefeller, for one, is getting a bit tired of being asked to take it for the team on things he sees as major career accomplishments like CHIP so that idiots like Max and Joe can rake in more power to go with their piles of lobbyist money.
I’d like to see Weiner and others start talking up letting people buy into Medicare if they are uninsured as a stop gap while all the prima donnas preen. Tell those seniors who make sure they make it to the polls that many of us want to save their Medicare funding by paying our premiums into that system instead of to rich CEO’s. Don’t even talk about subsidies until the seniors see it as a lifeline. I’d like to see the Blue Dogs beat up on seniors as well as women and then try to get themselves reelected. It disgusts me that beating up on women alone isn’t enough to get their asses canned.
Ding fuckin’ dong *g*
That’s a winner if there ever was one.
I’d love to see his father come back at age 82.
B. Bayh ’63-’81
Quayle ’81-’89
Coats ‘ 89-’99
E. Bayh ’99-’11
B. Bayh ’11-’17 ? :-)
Evan essentially rode his father’s name recognition into being Governor, then Senator when he termed out. He’s still riding on his dad’s good image and perpetuating the myth that Indiana is conservative. You’re on to something with EFCA, labor is underappreciated as an influence in Indiana politics. USW and UAW both have power if they quit having incumbent-itis.
A Lugar mold Republican would be a lot better for hoosiers than Evan Bayh. Unfortunately Indiana Republicans are well exemplified by Mitch Daniels and Mark Souder, Lugar is an anomaly.
I’d like it if there were a decent D to run against Evan. Can’t think of any state legislators or Congresspeople, nor any state executive branch pols that qualify. Maybe Lee Hamilton, but he’s not going to defy the state party any more than Birch would.
Oh no, just VERY mild curiousity, WRT potential future relocation from CA, VERY future.
Lemme get ya a glass of Bushmills on the rocks for the trouble . . . *G*
*whistleshisthanksinVenusianDragonSpeak*
*bows*
LOL … I sent you an e-mail with a link, for future reference.
I would hope that what happened to Weiner and Stupak would be a lesson to them all. Don’t trust what they tell you and don’t take one for the team. The squeaky wheels will get greased and the good soldiers will get shafted. But all Democrats risk their jobs for being incompetent even if they can argue they are not sell-outs.
That connection will have very serious consequences for a lot of people.
?
Really, all this hand wringing about who will or will not vote for the public option is beside the point and a waste of energy. The question should be: Will the PO as currently formulated accomplish the objectives of insuring the millions without health insurance, compete with the insurance companies effectively to lower premiums and costs and provide basic, reliable health care to everyone who needs it regardless of their income. Don’t we already know the answer ? The PO has been fatally compromised and everyone, including the progressives, know it. We are now entering the smoke and mirrors endgame where the politicians will try to convince their constituents that they really, really did try to get HCR passed, but_______ Just fill in the blank with whatever excuse you want. Obama will sign a bill that does pretty much nothing for anyone except the insurance and pharmaceutical industries and then have nerve enough to crow about his accomplishment when seeking re-election. We need to stop fighting for a piece of crap and instead tell the Democrats we know this is bogus, go back to the drawing board and give us universal healthcare or the donations stop. Period. And that includes targeting every single Democratic Senator and Representative, not just the Blanche Lincolns.
The web of Rahm. Topic for another post, another day.
Last night, PBS rebroadcast T.R. Reid’s Frontline program on health care reform. It’s worth an hour of your time, if you haven’t seen it.
Sick Around the World: Can the U.S. learn anything from the rest of the world about how to run a healthcare system?
I don’t assume that this Congress can pass single payer. And Jane has repeated herself, again, in the comments section here (see #72), to the effect that “no bill” is not a choice. Which makes the part of her diary where she says:
a bit confusing.
I’m not dueling with Jane, nor do I have any straw man constructions in what I’ve said. I simply want her to choose sides between 1) “the bill can fail” or 2) “the bill can’t fail.”
Two reasons:
Assume you have 5 insurers in the exchange, 1 public not for profit and 4 private and for profit, and that they all offer a similar minimal plan of coverage. There are 50 million people eligible for the plans in this exchange.
The minimal plan in the public plan will be cheaper than the others because it is not for profit. However it functions at a disadvantage from the others because it can not determine beforehand the likely health cost of the people it will be insuring. Therefore the PO can not take that into account in setting the corresponding premium rates, whereas the other plans do take that into account when they set their premium rates.
This is because the poblic plan sets rates based exclusively on age, gender and location whereas private plans set rates based in addition on the degree of illness. The result is that the public plan’s premiums are less expensive if you are ill, but expensive to cover.
If there were no public plan then the premiums for the sickk would be higher still because their premiums in addition would have to account for the profits included by private insurers.
This is what I foresee [and fear]. The House bill is SUCH a piece of crap, with or without a public option, that Dems should vote against it.
I fear Rahm and Obama will pressure the lump of Blue Dogs to support this dreadful bill, and then Republicans will come racing over to support the bill, declaring that they have “shaped it up” enough that they can support it.
What a ratfuck on Democrats that they will now be linked to all the horrible things in the bill: mandates, no cost controls, IRS enforcement of people who don’t buy insurance, extension of patent protection for greedy PhARMA, and on and on.
I see, so you would fight to kill the bill (a proposition which you currently think is “not realistic”) if there were no public option in it?
There’s a point about your sentence construction that I’m trying to grasp. I think it occurs here:
So you would only admit of the possibility of killing the bill if the public option were to fail. Do I understand you correctly here?
Who is organizing this now?
Ah, gotcha . . . thought you were referring to the Venusian Whistling thang, old Sci Fi book.
Option 7,I think is not right.
If there were no public option in the exchange then the sick would have to be covered by whichever private plan they applied to, but at very high rates. Presumably the taxpayer would have to subsidize whatever cost the applicant could not assume.
Also the private insurer once it received a sick applicant could no longer be allowed to dump them, nor would they want to since the premium rates it sets are adequte to meet the costs it incurrs, even though that cost is borne by the taxpayer.
This is why I still don’t understand why “kill the bill” is not an option if the public option survives the Senate conference.
Appreciate the hard work you’re doing Jane – really helpful in guiding my thoughts on this process.
i’m in.
the grass roots has been there, doing the long term work of on the ground organizing, education, policy analysis, legislation, human rights focussed social movement politics, etc), but having a hell of time getting media coverage. if that grass roots work could be amplified with fdl’s national visibility, jane’s talent with narrative while adding in fdl’s electoral political experience and focus — well that sounds like a dynamite combo to me.
maybe sometimes wishing for a pony isn’t as crazy as i thought!
[p.s. just don't ask me to promote the po *g*]
That is not consistent with the CBO scoring of the Public Option that the House included in its bill(which was the bluedog PO I believe):
If the conference report has a public option that is like the House Public Option where:
The public option would attract about 6 million enrollees by 2019 and charge premiums that are “somewhat higher than the average premiums for the private plans in the exchanges.” This is because the public option would “engage in less management of utilization” by its enrollees and “attract a less healthy pool of enrollees,” the office concludes. Moreover, since the House bill expands Medicaid up to 150% of the federal poverty line, it’s possible that the enrollees that would have enrolled in the public option went into Medicaid instead.
complete wih links to the CBO
http://wonkroom.thinkprogress.org/2009/10/29/house-cbo/
meaning it offers no competition, and thereby has no effect on premiums, and so its useless in that respect, and on the path to a death spiral because it is more expensive, with a sicker pool -which will only increase over time on till the PO dies. Where conservative can say, see, that sucked.
will you call it a win? Is that worth fighting for?
i agree. and why i think it’s important to oppose the bill, even if it is not possible to block it — because otherwise progressives will also be linked to it and if the public hates it that will not help our credibility for future efforts for universal healthcare.
my 2 cents, obviously opinions vary widely on this.
there is nothing about what Jane is saying that is ambiguous as regards the PO.
As of now the options are between a bill with a PO or no PO in the upcoming merged Senate bill. Which outcome you prefer is up to you to justify.
She further argues that if the Senate votes out a bill w/o the PO then there will be no bill at all. But that this will not happen because not having a bill is not going to happen given the makeup of the congress and the WH.
There is the other confounding issue which also bears on the ultimate outcome and that is the Stupid Ammendment. If it is included in the merged Senate bill then again the outcome will be no bill at all, since it will be voted down in the House.
If this is right then the outcome will be a merged Senate bill with a PO and w/o the Stupid Ammendment or else no bill at all. And morever at this point the die is cast.
This is the ambiguity here. Why even discuss the possibility of “if the Senate votes out a bill w/o the PO” if it’s not going to happen?
cbo says not, because of adverse selection.
regulation for community rating, guaranteed issue, etc apply to private insurance as well. plan rates will no longer be based on illness or pre-existing conditions (unless regulation totally fails).
this i agree with 110% because whenever healthcare reform is in the news, it’s an opportunity to educate, etc. — this is where i think some of the disconnect may lie, pushing for single payer now does not mean i think congress is going to magically do the right thing this election cycle. it means i think that to further even a little bit the goal of universal healthcare, single payer needs to be part of the discussion. so even if no one else brings it up, i will.
again, just my 2 cents.
Ditto!
there is nothing about what Jane is saying that is ambiguous as regards the PO.
As of now the options are between a bill with a PO or no PO in the upcoming merged Senate bill. Which outcome you prefer is up to you to justify.
She insists on framing it that way. But why is a PO in name only a success? I haven’t read a single argument for the PO that didn’t center around the PO offering competition to the insurance industry and bringing premiums down. You know, to make reform affordable, like the act is named.
If a PO is in the final bill, yet it doesn’t accomplish the goals of offering competition, will you consider that a win?
Are your goals truly, any PO will do, even if it is set up to fail?
If there are mandates and no public option, then the private sector becomes the dumping ground for the sickest of the sick. Doesn’t it?
[And to wigwam, commenting at the some moment, @ 86]:
That is indeed the question of the moment.
There is a scenario shaping up here, which deserves some contemplation. Genuine filibusters are generally much more of a threat and thus effective (and easier to pull off) when the Senate is up against a hard deadline for action that the person filibustering is happy to see missed. [KagroX was addressing some of these scenarios in a DailyKos post the other day.] But there is also an enormous soft spot in the Senate available for exploiting by, say, a proactive Majority Leader who wants to pass the best health care bill he can. That soft spot is the allergy of Senators to working weekends and/or holidays (unless a long recess immediately succeeds the unusual workday). [Even Mondays and Fridays are generally free days anymore in the Senate.]
So: A Republican wants to extend debate on and/or filibuster Ron Wyden’s Senate floor amendment to expand the Public Option into a meaningful option? Fine, says Harry Reid: we’ll see you Saturday, and Sunday, and Monday, and, etc… Even if it’s Thanksgiving week, or pressing upon another holiday. In other words, given the season, Harry Reid has some extra leverage available to exact pain for pointless filibusters, if he has the guts to use it, and can manage to work it to his (our) advantage. Of course, if that leverage is bungled (or given away with a Unanimous Consent Agreement for no-filibuster 60-vote margins on floor amendments), those filibustering may gain the upper hand by using that same intense peer pressure and desire to go home for the holidays to get their way without even the need to put up much of a fight.
Larue said:
Indeed it is. [By the way, as another FYI, it's worth noting that the conference report (the final bill) eventually produced (post-conference, obviously) cannot be further amended by either the House or the Senate, but it can be filibustered in the Senate.]
wigwam @ 91:
There’s one seemingly-inevitable fact about the eventual conference process on this legislation [meaning the negotiation between (supposedly) the House and the Senate to resolve the differences between their two bills, as opposed to the "reconciliation" process in the Senate intended to avoid filibusters], which is that the Democratic Party leadership will – behind closed doors – completely dominate those negotiations, regardless of who the formal House/Senate “conferees” may be. The Party is, and has been, in complete control of this process, formal institutional roles and responsibilities (and Constitutional separation of powers) notwithstanding.
The formal conferees are likely to be drawn from the five key committees of jurisdiction – three committees in the House (Ways & Means, Energy & Commerce, Education & Labor), two in the Senate (HELP and Finance). The lieutenants in the negotiations for the Party leadership will be those powerful committee chairs formally appointed to the conference committee, including (presumably) Dodd/Harkin & Baucus in the Senate, and Waxman/Dingell/Pallone, Rangell, & Miller in the House.
Excellent points, ralphbon @ 104. [John Conyers: The epitome of corrupt power.] With regard to this fact you cite, and to what we might expect to see emerge from a White House-dominated conference between the House and Senate…:
…please note this statement from Dennis Kucinich about his state-waiver amendment:
“Cringe,” I presume, because Dennis Kucinich is conceding here – or perhaps trying to forewarn us – that the Speaker and Majority Leader are prepared to allow the White House to be fundamentally in control of the final legislative product here, barring only determined intra-Party opposition from legislators (like, say, Bart Stupak) who don’t back down despite implied threats, bribery, appeals to Party loyalty or to Presidential attempts at flattery and solicitous lobbying.
In that looming mostly-backroom-conducted battle of wills, power-serving, “Party-loyal” moves like this one by Rep. Grijalva, from the first round on the House floor, will finish completely out of the running:
Finally, as to Ms. Pingree of Maine, obedient member of the House Rules Committee: Her vote to pass (or abstain from) a rule – first in committee and then on the floor – for the consideration of a conference report, including one without a public option, is a given (same for every other Democratic member of the House Rules Committee, including Dennis Cardoza). Pingree has already demonstrated on the House-passed bill – both in committee and on the floor – an intense impatience with waiting any longer for this legislation to pass. [She thinks haste in passing this bill equates to haste in providing needed health care services to Americans; I'm not sure she had the patience to actually read what she's so impatient to pass.] In short: anyone who agrees to utterly forego their own independent judgement as the price for serving on the House Rules Committee – where they ruthlessly enforce Majority Party rule at the expense of minority voices – on behalf of the Speaker, should not be counted on to “do the right thing” in the face of top-down Party pressure to conform.
You keep advocating for keeping costs down by cutting off health care for the sick.
Why would you do that here?
there’s only a dumping ground if there is enough adverse selection to overcome any cost advantage the po has (probably won’t have any, or very little, the way it now appears to be set up). can work the same for private insurers that function to provide healthcare instead of profit.
so, no po doesn’t mean there is no where to go, it means we depend on the quality and strength of the regulation and enforcement (but the ability of the po to function in a multi payer market also depends on the strength of the regulation and enforcement). see MA.
(p.s. this is one of the reasons the po in a weakly regulated multi payer market never made any sense to me policy-wise)
Let’s discuss the real bill, instead of a fantasy bill.
What you’re talking about is a difference in regulation, and there’s not reason to believe regulation would be different with a public option than without one.
The insurance companies will try to dump as many sick people as they can. The only difference is whether there will be some place for them to go.
The bigger problem is keeping the sanctimonious scolds from driving everyone away, or dragging everything down with unrealistic goals and wasting everyone’s energy with endless arguments rather than taking constructive action.
Whatever structure you design has to weed these people out if they can’t keep their self-righteous moralizing in check.
I think you’ve just convinced me it will never work. “If only we had more publicity” is never the problem. If people can’t see that the entire political “single payer or nothing” effort has been a complete, hideous failure of monstrous proportions, there isn’t a lot of possible upside.
If nobody can acknowledge the need for fundamental change, it isn’t going to change. And I don’t want to waste a lot of time as a matter of policy on things that aren’t possible.
Besides, if people think the public option effort was a failure, I don’t have a lot to offer. So I think you’re right — we’ll just stick to working on pharmaceutical patent reform with the medical students, who are very happy for our help. They’re very pragmatic and I haven’t heard them scold anyone. That should make everyone happy.
Thanks, selise. I was trying to decide where I was going to focus our efforts going forward, and this conversation has helped clarify things.
How am I doing that?
No public option does not mean poor people have no place to go!
The purpose of the mandates is to make up for the fact that reform says everyone must be insured. Everyone! The PO is not designed to be a place for the poor. Wow.
The problem being, there are no real cost controls in the reform, so all of America is at the mercy of the insurance companies.
Generally, people who argue for a robust public option are looking to offer competition, an alternative to private insurance. As Obama has said frequently, to keep insurance companies honest. To effect premiums.
Such a public option also brings down the cost of HCR, because it effects premiums. That is why conservative attacks are hollow.
Now, the PO in the house bill fails at this, according to the CBO report:
The public option would attract about 6 million enrollees by 2019 and charge premiums that are “somewhat higher than the average premiums for the private plans in the exchanges.” This is because the public option would “engage in less management of utilization” by its enrollees and “attract a less healthy pool of enrollees,” the office concludes. Moreover, since the House bill expands Medicaid up to 150% of the federal poverty line, it’s possible that the enrollees that would have enrolled in the public option went into Medicaid instead.
complete wih links to the CBO
http://wonkroom.thinkprogress.org/2009/10/29/house-cbo/
All true but not really meaningful in this sense.
Manage utilization, meaning co-pays, shared insurance costs and other transfers of costs to the enrollee represent a profit advantage to private insurers and a cost aburden to its enrollees. Even with lower premium rates the cost to the enrollee is no better than if he were to pay higher premiums in the PO, which does not engage in these cost transfers. One would presume so anyway until shown otherwise.
The overall cost to enrollees in the PO and private plans is not the comparison that was made by the CBO. To compare premium cost alone is meaningless. This is more particularly the case for the chronically sick with high management utilization costs. It’s the overall costs assumed by the enrollee not just the premium cost that is a meningful parameter for the enrollee.
Moreover, premium rates are set without considering the degree of illness in the PO whereas as they are set correspondingly higher in the private plan which does take the extent of illness into account.
The upshot is that for sick people the cost burden in the PO would be lower than in a private plan when these two factors are taken into account. For healthier people their premiums will be lower as they increasingly enroll in the PO rather than the private plans. Whether they will or not is an open question.
I have never understood on what basis the CBO claims that the overwhelming majority of those eligible for the exchange will opt for private plans rather than the PO.
due to the size of the pool, because that is the way the weaker PO was designed. It was set up for failure. It was set up to offer no competition, because the blue dogs were successfully lobbied. It’s at the link I provided.
We need more Dems like these. Lloyd Doggett is solid.
Better risk adjustment modifications in Conference are key to a robust PO.
Just for completeness in including the entire train of the argument, I guess.
It is made explicit though that the Senate will see that is is futile to vote out a bill w/o the PO that will fail in the House, unless they are suicidal and the premise that they want to pass HCR is false.
Jane,
Can you articulate what the purpose of the Public Option is at this stage? What is it supposed to accomplish by being present? I’m really confused at this point.
- Help keep aggregate premium prices down.
- Be an insurer of last resort.
What? The first one seems about as likely as the LHC devouring the planet in a man-made blackhole. The second seems like a non-sequitur since the exchange will be present for that.
?
Thanks.
You seem to have lost track of your own argument. You say the public option will be a dumping ground for the poor.
So if there is no public option, the insurance companies will not dump them? Because why, there is going to be much stronger regulation somewhere?
Please do tell us where this magical regulation comes from, because nobody has seen it.
Otherwise, when you’re arguing for there to be no public option because it’s too expensive, you’re saying there should be no place for them to go.
1) The Democrats have 60 votes in the Senate, a majority in the House, and the Presidency. You cannot stop them from passing a health care bill if they want to.
2) The House did not want to stop this bill, nor will they. That’s why they voted to pass it.
3) Your choice is between a public option and not a public option. Until things gets significantly worse, there is no Door #3, “none of the above.” See #2 above.
4) Of those two choices in #3 above, if you don’t like the public option, please argue why it’s better to give Joe Lieberman his way and pass something without a public public option, because those are the only real possibilities right now. See #1 above.
5) Stopping the fight to keep the public option in the bill by fighting for “single payer” right now means that Joe Lieberman wins and the public option comes out. Again, if this is what you want, please explain why this is a preferable outcome.
6) None of this presumes that the public option in the bill is adequate, or that it is better than no bill at all. But since a “better public option” or “kill the bill” are not realistic options right now, you’re still stuck with the choices in #3 above.
7) If you’re worried that the public option will be a “dumping ground” for the sick, please explain where they will go when they are dumped if there isn’t a public option, or why insurance companies wouldn’t “dump” them if there wasn’t one.
the CBO says the PO in the House bill will “attract a less healthy pool of enrollees,”
your the one saying the sick will have no where to go.
I think this should answer your question:
http://tpmdc.talkingpointsmemo.com/2009/10/public-option-premiums-higher-on-average-in-house-health-care-bill.php
The theory behind the public option is that, by injecting a major non-profit insurer into the marketplace, it will force private competitors to cut down on administrative waste and other excesses, and, therefore, drive premiums down for everybody.
jane, if you think my v enthusiastic comment was scolding, especially after i spent several hours today volunteering on what you said you needed help with, then i really don’t know what to say.
i will, though, try to clarify three points for the record.
1. i don’t represent anyone but me. my views are only my own. so there’s really no reason to take what i write as indicative of anything or anyone else.
2. i never said “If only we had more publicity” – and if my comment implied that, i regret it because i did not mean it. i think more visibility for what single payer hr 676 is, how and why it would work, and news in general etc would be a good and helpful thing to educate more people and i was very frustrated by the lack of coverage. but not, definitely not, “if only.”
3. i’ve know exactly one person to say “single payer or nothing” — maybe you know different people than i do, but as far as i can tell is and was always “single payer or something that will work” (where work is universal healthcare). i’ve even had a very active member of pnhp pitch me pete stark’s hr 193 (after i asked about it) which was a public option type plan (although i think very different than the hacker plan). if healthcare is a human right, i don’t see anything wrong with wanting to work with a policy for universal healthcare.
the “dumping” being written about is the effect of adverse selection, not that people would actually lose their private insurance. see MA. we have the mandate, the exchanges, etc. but no public option.
that’s the theory, but i don’t think it’s ever worked that way when it’s been tried. am i wrong about that?
So then you’re saying that the point of the public option, as it’s currently constructed, is to be an insurer of last resort?
I’m failing to see how the mandates, the subsidies, and the exchange don’t “solve” that problem. It’s a terrible solution on whole, because it’s still a demand-side subsidy on an uncapped commodity price, forcing prices up faster, but it’s still fulfilling the function of insurer of last resort, making the existence of a public option rather dubious.
The mandates come with a pre-existing condition exclusion. What are they going to do? Pass a mandate to buy, but allow insurers to still reject you completely? Essentially forcing you to violate the law simply by being alive?
With respect to the number of Democrats, all we need to kill this wreck is to get 11 of them to block with the Republicans. To get a better Public Option we have to get 51 of them to move for it. I guess it’s possible that it’d be easier to get 51 of them to suddenly become a lot more progressive, and you’d definitely know better than me, but it seems like there would be a handful of progressives to stand against it, and maybe a handful of Blue Dogs, totaling 11.
In short, if the public option is dubious at best, what are we doing here? It seems like a coalition of convenience could be struck with the Republicans here, if we can at least agree that what we’re erecting as HCR is more likely to be parasitic than it is helpful. Is that the sticking point?
I’m not sure. I don’t think anyone has tried to preserve profits for an industry and reform it in the same manner we are attempting. What we’re getting is typical DLC triangulation. It’s folly. Give the industry what they want, score a small victory. Most places regulate and actually go for reform. That’s not what we’re dealing with.
By most accounts of what I’ve read, the fear is if it works too well, it kills the industry (not a good time for that in this economic climate). But if it is too weak, it’ll have no effect. The idea is to strike the right balance. All we have to go on is the CBO, and the policy wonks who check their math.
I think it is well known that mandates, with no checks, means skyrocketing premiums. But you know that if you live in MA. I think that will be a disaster for the people outside of subsidies, or with not enough subsidies. People who have had stagnant wage growth for a long time. People living paycheck to paycheck. Those are the people I am fighting for. Contractors, temps, everyday people.
No selise, I don’t think your comment was scolding and didn’t mean to imply that it was. Nor do I think you’re a “single payer or nothing” person. And I appreciate you volunteering.
But there is a huge problem organizing single payer enthusiasts, as this comment thread indicates. They tend to be certain that they’re doing everything right, if only everyone would just agree with them. What happens is they spend all their time arguing and don’t want to do the work that needs to be done.
They need to be doing candidate recruitment. Door knocking. Voter identification. Phone banking. Fundraising. Motivating people. Movement building. There are online tools that can help, but if people aren’t predisposed for whatever reason to do these things, I’m not sure it would be a productive exercise to attempt it.
I love the PHNP people. I love the PDA people. I LOVE Bob Fertik and David Swanson. I love the passion of our “single payer or die” commenters, even if I want to knock their heads sometimes. And I love the idea of trying to connect everybody with social networking tools to do regional grassroots political organizing, because I think that’s what needs to happen.
I’m just not getting the “this is all going to come together” feeling that you want to have at this stage of the game. You know what I mean?
As the House bill is construed now all insurers will be required to accept all comers, regardless of how sick they are. No exclusion from coverage regardless of prior existing conditions. What varies is how much the insurer can charge for coverage.
Also, no insurer will be allowed to drop coverage for any reason. Rescissions will be disallowed.
The fantasy you presume in No. 7 is the supposition of what would happen to sick people if there were no PO and all other provisions remain equal in the House bill as it is currently construed.
In this flight of fancy supposition, everyone is obliged to be covered by all insurers and none can drop already covered enrollees. Of course your prior conditions 1 through 6, preclude the possibility of legislation being passed w/o the PO, if it were to pass at all. Rendering your supposition of what would happen in a fantasy outcome that did not include a PO pointless.
It’s not my fantasy, it’s someone else’s.
I’m also a little confused by this response, because it doesn’t articulate an answer to the question I was trying to ask.
Which was:
I appreciate you pointing out what you see as the political landscape currently ongoing, but I was hoping to get some elucidation on why specifically this policy point of a Public Option is still valuable considering how it’s been constructed in each proposal.
I’m not trying to be a pain in the ass.
Someone at PNHP was pitching Stark’s HR 193 (the Americare bill I linked to back in #15) to you? That’s interesting, and here I thought they were the mothership of the HR 676 or nothing crowd. I can understand Jane’s frustration, the White House had dismissed HR 676 very early ,so the best available route to improving the healthcare bill was lobbying for a robust public option. It was the president who, I think wrongly, put his “opening position” too far to the right, Jane’s on the side of the angels for pushing the Congress’s opening position further to the left (no Jane, I’m not try to butter you up). :o)
I’ve seen the Weiner Amendment as submitted to the CBO, even if Congress was ready to throw private insurers under the bus in one fell swoop, asking them to endorse a new 14% payroll tax increase (8 on the employer, 6 on employee) at the same time is asking an awful lot. I still think Pete Stark offered the better plan, “a public option on steroids” that provided universal coverage without raising taxes. And since it’d allow employers to keep their current health plans, women with reproductive choice coverage could keep it instead of being forced to switch to a single payer plan that would invariably have a Stupak Amendment attached.
Selise,
!t dawned on me after I mentioned linking (at #15) to HR 193, that I was directing you back to a diary that was posted by… you! Sorry for telling you something you already know. :o)
The problem is that the mandates will not provide coverage for all. There has already been pressure to lower the fines and otherwise soften the mandates because it is neither practical nor politically palatable to mandate the purchase of iffy products at uncontrolled prices. Massachusetts has a significant number who pay the fines rather than buy the insurance. These people are not only still not insured, they have less cash to pay out of pocket because they are paying twice as much to the IRS every year.
I would think that if there is at least a public option, even if it has higher premiums than hoped, it can be a starting point. Enough people pay more for their food because they don’t want to eat crap and subsidize those who profit off producing crap to keep little guys around even with all the stacking of the deck agribusiness has managed. If there is no alternative farming operation, you are stuck. If there is even one, you can work to get it enough business to keep it going and maybe even get momentum for expansion. If you refuse to accept anything other than the complete demise of agribusiness from the git-go, you’ve got to convert the entire lazy country and it’s going to take a long time if it ever happens. Convincing all those people who haven’t had enough of a health problem to realize their insurance is crap to give it up for something unknown to them is like trying to get all those who haven’t got e coli to pay more money and take more effort to get their hamburger. Even at the height of the scares, significant numbers of people continue to buy the same stuff from the same places.
While I still struggle with just where along the line incremental progress slides into worse than doing nothing, I completely agree that incremental progress is all there is going to be at this point. If I thought doing nothing would bring about a crisis big enough to push the all, perhaps an all or nothing approach would make more sense. But in a country where a significant number of people refuse to believe that Obama was not born in Kenya or that the ice caps melting has nothing to do with human activity, I can’t see where all or nothing makes a lot of sense. Living in California has made me even more cynical about how much obstruction can come from even a small minority, especially when they have moneyed interests on their side.
There may be a way to not have the cake but for Democrats and Americans in general to still eat a good chunk of it. If the Democrats don’t have the courage or the votes to fix the bill it should be put out our misery. But immediately afterwards push through half a dozen much smaller bills that reform the private health insurance and pharmaceutical
racketsindustries i.e. remove anti-trust exemptions; drop anything like extended drug monopolies, tight rules on medical loss, no more getting booted out of your coverage because of a pre-existing condition, etc.No amendments.
Advantages: Cost to the American people, zero dollars, zero cents. Bills are short, easy to follow, easy to whip. Completely reverses the political dynamic. Want to protect the right of private insurers to dump sick patients? Harder to do when you can’t blame some culture war distraction. Creates space for Americans to understand what the Hyde amendment was, and for passions to cool. Creates some leverage to finish the work in the near future by providing the most efficient and cost effective method of covering those who remain uninsured having proved change can be profound and fiscally prudent.
clearly, it is.
If the public option was never about controlling costs or offering competition to the insurance industry in order to make premiums more affordable, why do we need a public option?
Why fight for a public option that is doomed to failure? A public option, that when it dies, conservatives can point at and say see, the govt run program, and those like it sucks?
What do all you supposedly proggresive obsessives not get about the public option (or are you just trying to be a pain in the ass)? Everyone from Rush Limbaugh to Ed Schultz knows the purpose of the public option:
IT’S A TROJAN HORSE FOR SINGLE PAYER!!!
Weaker than we like? Of course. Possible that it won’t be opened up to everyone for a long time? Sure (fight on Wyden!). But the fact is it’s the first legislation in American history that starts an experiment with single payer and even contains instructions for how the HHS secretary can open it up to everyone.
Wake up people!
thanks. i wasn’t expecting the end of strife or bad decisions. just a chance to together move and build in a positive direction. i see the work for universal healthcare as a very long term effort. and what can i say, i get easily enthused.
here’s a better explanation of what is being described here as “dumping” (i think it’s important to clarify, because now i see that the word usage is confusing) from robert parry (the article is about other stuff, i’m just pulling out this bit for the purpose of explanation):
You forget one important thing, politicians go back on their word all the time. So it will pass and it will do amazing things for the system! http://cli.gs/23yYaM/
I know what “dumping” is:
It’s going to happen, PO or no. So where to they go if there isn’t one?
We get it. You don’t care if sick people have nowhere to go if they get “dumped.” It’s “apocalypse for political advantage” and it’s a tough sale around here, but that isn’t stopping you.
LOL, that’s a hoot. i was just using that as an example that single payer activists are, at least in my experience, concerned with universal healthcare rather than being single payer absolutists. single payer may be the best policy, but it’s the means. universal healthcare is the goal. drsteveb is the pnhp activist i was referring who pitched hr 193.
i think it all depends on the quality of the regulation. maybe something like what we have in MA with our exchanges and mandates? (if we’re lucky, as far as i can tell the MA reform is far superior to the house’s bill — and an aide in my rep’s office assures me that since we already have a waiver from the hhs, we can keep our exchanges. hard to believe i’m glad about that.). anyway, i live in MA and so far have not been kicked off of my insurance (even though the monthly cost of just one of my scripts is about the same as my monthly premium $500). but that’s nothing like the cost of a really expensive illnesses, i might try to track down some data/info on those cases here.