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Here Rahm, let me help you push...
The opt-out provision made a stunning debut, introduced by “liberals” who assured everyone that it was the answer to all our problems. After all, we’ve needed 60 votes to pass anything since the time of the Pilgrims, and we had to do something to get them. And it would never actually affect anyone you know, because the eminently reasonable red states would never opt out. And if they did, the Republicans in them would be committing political suicide, and fuck them anyway.
Or so the story went.
Only it didn’t work out that way. When the CBO scored the opt-out, they estimated that a third of the country wouldn’t be covered once it was included. And how many votes did we pick up? Let’s see. Where’s my pencil. Sharpen it….carry the three, add the two…that would be…zero.
Let’s repeat that. Zero.
But that didn’t stop the Veal Pen Commandos from pushing it. As I wrote at the time, the “opt-out” was a trojan horse, championed by liberals who were negotiating against themselves. It wasn’t a compromise to pick up needed votes, because not one Senator who was in the “no” column already was any more enthusiastic about the “opt-out.”
Maybe some people just aren’t familiar with the negotiating process, but generally when you are going to give something up, you ask what you’re going to “get” for it before you start telling everyone you think it’s a great idea.
And yet there was no shortage of “liberals” who said that anyone who objected to it was “rigid” and “dogmatic,” the kind of “purists” that they just didn’t want to associate themselves with. Who should be very careful, you know, because if they just weren’t willing to compromise, they could kill health care reform period, and then where would all the poor suffering people be.
But it was a wholly successful effort, using a chorus of well-timed liberal voices with ties to think tanks and other veal pen outfits, to further weaken an already weak public option. And it looks like we’re ready for the sequel, “The Return of Trigger,” starring the Urban Institute and other featured players:
A new report from the Urban Institute argues that a “strong” public option — one that is triggered in the event that overall growth in national health spending exceeds a pre-determined target — may do moreto control health care spending than the public option proposals offered in existing legislation….
So let me get this straight…since the people who have been working day and night to weaken the public option have been successful in their efforts, let’s give them what they really want, namely triggers. That is just some really superb thinking.
And then it gets better. Paul Starr has this op-ed in the NY Times, saying we should trade the public option in exchange for speeding up implementation:
For Congress to put off expanding coverage to 2014 would be asking for a lot of patience from voters. It would also give the opponents of reform two elections to undo it. President Obama would have to run for re-election in 2012 defending a program from which people would have seen little benefit.
To speed the process, the legislation ought to give states financial incentives to adopt the reforms on their own as early as mid-2011.
Great! Let’s trade something that achieves $25 billion in savings for something that will cost an extra $400 billion over ten years, even though the President has said he won’t sign anything that has a budget over $900 billion. Can I have a pony too? Because that ain’t going to happen either. But the persistent meme that the public option just isn’t that big a deal shows up in another high-profile spot.
There’s a reason that we’ve never passed health care reform in this country, and it’s because people like Paul Starr have been leading the fight. People who dwell in policy often suck at politics, but they become useful idiots when somebody’s trying to float something.
Well, credit where credit is due — I agree with Richard Kirsch on this one:
“A trigger would be like saying we should give Jim Crow one more chance,” said Richard Kirsch, campaign manager for Health Care for America Now, an umbrella organization for labor and advocacy groups supporting the public option. “Anyone advocating a trigger is just trying to kill the public option.”
And suddenly I notice the Urban Institute report is popping up in lots of places that the DNC likes to float their stuff. And we’re hearing another new refrain — “does the public really care that much about a public option?” Well, it’s more popular than the “Obama health care plan,” for anyone who is pretending they care about what the public thinks.
Maybe these folks would like to explain exactly how this “stronger trigger” gets passed by picking up votes of those whose only interest is weakening a public option. You know, that magic “60″. Because as far as I can tell, it’s just another trojan horse.
Let’s see who’s willing to push this one through the gates.
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Oh noes! Jane does the math!
Burris digs in and says he’ll vote no without a public option:
http://www.huffingtonpost.com/cynthia-gordy/senator-roland-burris-not_b_373648.html
Doesn’t say he’ll filibuster, but if the whole progressive bloc votes no on this bill it will be thoroughly discredited even if it passes. I’m pretty sure Obama won’t let that happen.
Sorry, I’m lost at this point why anyone would care about triggers or opt-outs. The irrefutable is whichever variant is chosen, it’s a VERY BAD Bill. So, why argue particulars? Why would any Democrat vote for a Democrat who settles for this? This is a singular opportunity. Why shouldn’t every “Democrat” simply say : “enough is enough, if this is the choice you give us we choose to drive you out of office.”
bmull, Who are the members of “the progressive bloc” in the Senate as you see it?
Because it’s an empty threat that didn’t stop the war?
There are two choices before us now: A) a bill without a public option or B) a bill with one. You can ask for pie but you can’t have it.
If the bill gets through the Senate without a public option, members of the House have said they will kill it. But they’re not going to kill the one they just passed, as evidenced by the fact that they just voted for it.
So. People advocating that people stop working on “A” need to take responsibility for the fact that if that happens, we get “B.” It would be helpful to know how you think that’s a better outcome.
Jane thank you for all you are doing!
““A trigger would be like saying we should give Jim Crow one more chance,” said Richard Kirsch, campaign manager for Health Care for America Now, an umbrella organization for labor and advocacy groups supporting the public option. “Anyone advocating a trigger is just trying to kill the public option.”
I attended the hearing where Senator Snowe said that there have been “decades of inaction”
The Insurance companies have had decades to do the right thing to help folks who can not afford to get on the health care bus “decades” Why in the hell would they provide them with an opportunity to make billions of dollars by doing the right thing NOW. Which we know they would not do anyway.
Pull the “trigger” on the Inusrance companies now!
Burris is pleasantly surprising me on this, much as Owens in NY-23 did.
Especially when the folks in Congress who claimed to be backers of “C” were strong and puissant backers only so long as the bill didn’t actually come up for a vote.
Oh God, Jane, what a fucking mess!
Just open Medicare to those who want it. So simple, so clean, so straightforward.
But since we have a bought and paid for political class, what’s in the best interest of the American people is never what happens.
Pitchforks and torches.
Well, hell, we can’t be worried about this until Eldrick Wood comes clean!
I love the smell of D.C. think tanks in the morning – it smells like a Village cocktail party:
Check out Mrs. Michael Beschloss:
Because derivatives and structured products are exactly what
the intended beneficiaries of the World Bank need.
As if the show stopper in this bill was how the public option would be neutered.
Now that the PO will not drive down costs, whether it is opt-in, opt-out or nationwide, none of this is relevant.
That would be the entirety of the Dem leadership whose opening bid was to give everything away… UNLESS their intention all along was to create a giant corporate welfare package they could sell to the public as being for the common good in time for the midterms.
At this point I’m leaning toward the second explanation.
Pitchforks and torches.
Right on, sister.
Jane and bailey2739, For those who want an alternative to this argument of Jane’s see:
http://seminal.firedoglake.com/diary/15194
http://seminal.firedoglake.com/diary/15486 and
http://seminal.firedoglake.com/diary/15873
If you still agree with Jane’s very concise putting of the issue after reading these, then keep fighting for the crippled bills before the House and the Senate. If not, then work to kill this bill.
I know Jane will say it’s impossible to kill this bill given the present political context. But Jane may be wrong about that.
All us humans are wrong from time to time including myself, of course. And I’m not sure that claims of impossibility have served us well recently.
Anyone remember how the claim that it was impossible to pass SP, so let’s support the PO worked out for us?
The Village really really does not want a public option. This has nothing to do with its merits or demerits, but with its association with a new political class that will eventually supplant the Village. It is about power.
The health-care opt-out option is unacceptable because it presents myriad unnecessary (and undiscussed) problems that other options, such as single payer, won’t encounter, including ethical, financial, and political issues.
If one explores how the individual states administer education and prison systems and provide for their mentally ill citizens (a high percentage of which are, ironically, in the prison system), it’s abundantly clear that states can’t be trusted to make the best decisions for their citizens.
Exchanges have been suggested in connection with the opt-out provision. Obviously, a group of states will have less bargaining power to negotiate fees and prices than the country as a whole. Furthermore, exchanges would necessitate the establishing of oversight bureaucracies, which will further decrease the potential savings of health care reform.
According to the latest information I have, one in seven American families moves in any given year. With the opt-out provision, it is highly probable that families will move in and out of states that do and don’t have automatic care. Such moving will create nightmares of expensive data tracking and continuing care for citizens with a chronic illness.
How will the states decide whether or not to opt-out? The only purely democratic way of deciding would be by state-wide balloting, yet another unnecessary expenditure even further decreasing the savings. To have Govenors or legislatures choose would raise the enormous problem of having states go back and forth, according to whatever party is in power, from opting out and opting in.
A further and timely consideration concerns the status of those states that are currently under severe financial stress and likely to remain so in the foreseeable future. How will they, the states, be able to deliberate and act on healthcare reform legislation?
Death to the infidel!
heh. was over there myself this morning –
just to see how it trended wrt Professor Domhoff’s take on the veal pen . . .
color me surprised
ironic as hell it got it’s start monitoring Great Society programs
hi CBL. Spirited threads this morning eh?
Gee – how great of the solons at the Urban Institute to decide our health care economics for us. And they have such expertise to draw on, too.
Why, start with the President, Robert D. Reischauer. He’s such a clever insider Harvard appointed him their Corporation Board in 2002.
Wow – and he even impressed Larry Summers. Ain’t that grand?
Maybe Bob can help Harvard recover the 40% of their endowment they pissed away under Summers. After all , much of that loss came once Bob was on the seven member Corporation Board.
But until Bob can clean up the mess he helped preside over at Harvard, he’s got a lot of damn gall presuming to advise anyone in applying a band-aid, much less deciding our health care for us.
Only the Village would give a proven incompetent like Reischauer a chance to fail again – at all of our expense.
good afternoon baby – woobie still here for another hour
jane, you are a much stronger person than i am. Once i realized exactly how bad the bill was going to be, and reflected upon what that says about our reps’ moral character, I just quit. I stopped giving a shit.
When you care about your constituents, about your people, you want to give them something good. And these people just don’t care.
i don’t support the current bill, i don’t support the democrats, I’ve given up on the progressives, and the odds that i vote for anyone that’s not a third party candidate are very high.
so good onya jane for fighting the good fight against some really bad people. I can’t deal with it anymore.
no public option. no vote in 2010.
A) B) C) . . . well, there is a D) which I call the “let if fester, lester,” approach. That is to Kill the Bill and start re- agitating for Medicare For ALL and let the premiums continue to skyrocket and the pre-existing condition and rescission stories to proliferate and let small and medium businesses start howling about how they can’t remain competitive, and continue to hold the free clinics, and support and join “Protest Groups for Healthcare” who have put their freedom and bodies on the line-(and encourage much greater media coverage) and make all candidates in all upcoming elections pass a litmus test on Medicare for All (yes I said litmus test-nothing is more important to this country at this point in history.) Keep pounding away at one simple, explainable theme: Medicare for All. And see if we can enlist the folks on Medicare to help explain it to folks in a grandparent-ey sort of way.
“All that is necessary for the triumph of evil is that good men do nothing.”
Stay with us and fight.
Because that would take courage, brains and stomach to get done.
We needed the opt-out just to get us to 50 votes and guarantee at least something could pass in reconciliation. Unfortunately, I think there are only around 45 senators who would vote for an opt-out-free public option through reconciliation. The opt-out has a small chance of getting us to 60 but that was always unlikely and never the main strategy.
Why is that?
Yeah, because letting people hurt and die is soooooo progressive.
Sort of OT, but maybe not, Glenzilla has a piece that resonates with me as an Indiana resident:
The face of rotted Washington
I can barely stand to look at Evan Bayh’s photo…
Which one? You or I?
Let me get this straight. The assumption that single payer would never pass was wrong?
That’s how you’re bolstering your argument?
Single Payer didn’t pass because its most extreme advocates spent their time trolling in comment threads rather than doing meaningful political outreach. You failed miserably. You achieved absolutely nothing, except alienating people by having faith in unattainable plans and insisting that everyone else should too.
Please take responsibility for the complete and utter failure of your strategy and everything you advocated for before going on to criticize the tactics of others.
And no,”you didn’t support me” is not a mature excuse.
Read the CBO score on it. They have said the current PO would likely end up charging HIGHER premiums than the private insurers. Pretty hard to drive down costs on the private insurers when the PO is already higher.
The idea was a strong PO, with Medicare +5 rates, and an existing network of providers, could offer coverage at LOWER premiums, thus forcing the private insurers to drive costs down. Not gonna happen with this PO, as evidenced by the CBO itself.
I love ya Jane, always will. But I do think killing the bill is a possibility, thus there is an option C. I agree it’s the least likely of the three, but I just don’t agree that it’s impossible. As always, YMMV.
the sausage . . . it stinks!
fyi – went through something that sounds similar about a month ago. . . suspect lots of us did. hope you will rejoin us – your voice and energy matter
Because the CBO says it won’t because it has been engineered so that it does not threaten insurer profits except in the most rare of circumstances.
It is one thing to make tradeoffs where you give away something good to get something good, but here we’re giving away something good to get something bad.
After entering into negotiations surrendering your best opening gambit, it does not make any sense to be giving away the store on the third gambit. Unless, of course, enslaving Americans to toil for the health insurers was the goal in the first instance.
Plus, the current PO will only be available to what? 4-6 million people? This is a tiny risk pool filled with the sickest people. To drive down costs it needs to be available to A LOT of people.
Jane,
I don’t think the “opt-out” was ever presented to really win votes on the bill. It was offered by some conservatives to give them a reason to vote against the bill and sound “reasonable”…but they’d simply play musical chairs and suggest another rationale if it was included.
That said, by calling their bluff the Senate Dems see this as a political advantage…not to win votes on the bill…but to win votes in 2010 and 2012. It puts the Red State governors and legislators at serious odds with their parties…denying their citizens access to reasonable health care coverage, while forcing them into mandatory insurance plans, will be a “hot potato”.
The Congressional Republicans can say “we didn’t vote for this”…but they’ve passed the buck to their States.
Of course, that “hot potato” will only be confronted IF the bill is passed WITH a public option. Without it…there’s no differential for the vast numbers in “opting out” Red States vs. Blue States.
Now what will happen if the Senate doesn’t support opt-out? The Red States will get the public option and mandatory requirements for insurance. Dems may pick up votes from those that benefit from the PO, the extension of exchanges, and rules against dropping or denial of coverage (that is, if they vote rationally). They’ll only find resistance in those that were compelled to purchase an individual plan, or those unable to obtain anything but an individual plan. They won’t consider the increase in policy costs as actually less than if the plan hadn’t been introduced. They’ll simply see “I’m paying more than I was under Bush”.
So perhaps the Dems have done the political calculus and think that the opt-out will score more votes in ELECTIONS than not having one? But it does deny many Southerners and Mid-Westerners the possibility of getting adequate health care. They’re being used in this game of “chicken”.
So we collectively kill the bill and demand they vote on S703 or HR676 … and put them on notice. Or step 1 … we kill the bill, but don’t let the right get the credit for it. We do it loudly and righteously!!!! We send Lieberman some flowers for doing it for us … we do it loudly. The right and us, strange bedfellows but we live in extenuating times.
And if we get totally ignored we are fighting for the BEST most honorable plan for ourselves and we ramp up the moral war on Congress and the Prez and we start spreading that drumbeat that has heart. Time to teach America to speak of “universal” health care. That should be the talking point. EVERYBODY IN, NOBODY OUT. Empathy is important.
What are they talking about, we are covering 94% of the people. bull shit, bull shit, bull shit. And if you guys have cooked those statistics, why not go for the last 6%? And the bill when it FINALLY kicks in will it have perks and protections that are worth the ambushes that are clear and not yet clear in 2000 pages of loopholed lawyer corporate speak? It sounds like they will sound good, but pricing and workarounds will protect the fat cats and profiteering. TROJAN HORSE LIKE IN THE PICTURE ABOVE. Look at the bankster bonuses. Do we think anyone in the medical industrial complex has learned ANY lessons in empathy? Bribery, yes, but not decency. After the bailout…. the banksters have no conscience for the plight of the taxpayers whose money they were rescued by.
HR 676 30 pages. The secret for such simplicity? Corporations out of the equation.
So 35,000 more troops are having their lives offered up for corporate aggrandizement, oil and other imperialistic ventures. All that is happening … health care and the war and climate change and unemployment … it is about the war on us by the oligarchs. As the guy on Bill Moyers’ said, “The class war is over. We lost.” NO, WE MUST NOT SURRENDER.
The public really wasn’t linking “public option” with the real ultimate human and civil right of universal coverage.
We don’t weaken our stance now that corporate-prostituted Congress and administration have neutered the public option, we tighten and harden our stance by saying you crossed us and we are uniting and fighting. And first we are saying take your faux-reform and shove it. I like that slogan. “TAKE YOUR FAUX-REFORM AND SHOVE IT!” “TAKE YOUR FAUX WAR OF NECESSITY AND SHOVE IT!” It works for much.
Progressives in Congress sold out. Majorly. Some still talk progressive talk, but when push comes to shove, how many Lucy footballs are we gonna be tortured with?
They can start from scratch with healthcare, but it is really not scratch if they do the sane and humane. It is just expanding Medicare. And we need to start waking up our fellow ostrich citizens. Those “good” people ostriches who got excited over Obama brand and now don’t want to know for nothing how screwed over we all are getting.
No more crumbs. No more croutons that turn out to be smaller crumbs.
Everybody in, Nobody out. Congress and Prez, get a heart and a soul!
Jane,
With all due respect, I’m not tracking with you here. Could you untangle for me where my thinking is going wrong?
The bill that passed the House has a thin-gruel public option. Let’s assume the bill that passes the Senate does not have a public option at all. They go to conference. Let’s assume the no-public-option proposal wins out.
Then what?
It would seem that there should be a handful of members of the Senate who would agree to vote “no” on cloture if the public option is stricken in the final bill, thereby blocking passage in that house.
I’m also wondering if there aren’t enough progressive votes in the House to take it down there.
In either case, it would seem that the proposal could be sunk . . . by progressives.
Full disclosure: I do believe that, at this point, the proposals should be deep-sixed because what’s being proposed is, in the long term, worse than having nothing at all. This opinion was confirmed when I read this on the Washington Post site this morning: http://tiny.cc/sl2zM .
So, I would like to see the effort taken down at this point, but perhaps I’m not well-enough informed to see that that’s impossible.
Enlightenment, please. If you have time.
Kill the bill and begin again with full scale hearings on single payer. Do it right this time. Not the horrid, Rube Goldberg bill we have now. It is getting to the point that it is not going to solve anything and will please exactly no one.
Do the entire process in the light of day and stop the back room deals!!
This thing will go through with Republican votes, because it is sooo bad.
If Burris and sanders go south on it, Snowe and Collins will cross. If Sherrod goes south, they’ll find an R to replace him.
There comes a time, perhaps once in a life time, when we are forced to admit and tell ourselves softly, and humm and repeat: ‘This is not my beautiful house’
One of the main problems is that it may be no better the second time. The lobbyists, the drug companies and the health insurance industry will still be there. I would like to think that the House and the Senate would see that we are determined and give in but I’m not betting on it.
Every single payer call I made to Congress and people I spoke with helped not hurt the “public option” platform.
Public optioneers DILUTED the entire sensibility of UNIVERSAL HEALTH CARE and the single payer fighters. Lets was right. It became a tactic that took over the goal, eclipsed it, the public option.
I was busy writing my comment, Jane, and didn’t read your put down.
So, instead of reaching across the progressive bridge and uniting. Which we NEED to do as progressives, we are the 20% who are AWAKE in this god-forsaken country, you disrespect people who weren’t working “hard enough and pragmatically enough” in your humble opinion, disturbing your website????? We were and are enriching your website and I thought you had the moral maturity to get that. I thought there was good will and appreciation but I was naive.
I have to go. But I am disappointed. Don’t kill us as messengers for having been right about public option and its fate and fighting for what we deserve NOW, universal health care as a human and civil right!
I think you need to compare what the current PO costs are vs. that without the current PO.
BTW COST= Cost to the taxpayer via subsidy (not including premium contribution paid by the user)
The argument is that the current PO, because it would attract people who have serious health issues who are currently UNINSURED the cost would be more than private insurers because the latter would not cover these individuals.
But let’s eliminate the PO. Insurers would still not take these individuals (so they would be handled by the emergency room services that currently raise health care costs overall)…or if THEY were compelled to accept them their total costs would be MUCH higher. They would insist of public subsidy to cover these COSTS.
So it seems that there is a bit of a political bookkeeping trick being played here about “costs”. The existence of a PO WOULD compel the private insurers to lower overall costs to premium purchasing members of the public…even to a level BELOW that of the PO. That’s because the PO would be dealing with the unhealthiest people.
But still the overall cost to the taxpayer would likely be much lower…because you are reducing emergency room visits, shifting people off of more expensive publically-supported care options, and even taking in some people who drop their gawd-awful expensive insurance plans.
Now use logic here. Why would someone with a chronic healthcare issue enroll in a more expensive public plan if there was a less expensive private plan available? The reason is that the “cost” is subsidized in the PO..and they must pay more (out of their own pocket) to the PRIVATE insurer.
And you might ask yourself, “well, how did I get here?”
And, yes, indeed, I did see the Talking Heads in the “Remain in Light” tour at the Armadillo World Headquarters (RIP) in Austin in 1980.
Agreed. We’re clearly not getting the strong PO Jane advocates, so the choice between the two options is irrelevant. It’s like asking whether you want burnt coffee with or without curdled milk.
It’s also too bad no one is talking about what might be traded for a weak public option. Can we get something real in return for an eviscerated public option? Repeal McCarran-Ferguson and/or inclusion of the Kucinich Amendment?
This is a possibility. Jeff Cohen over at Michael Moore’s website writes that O will probably follow in Clinton’s footsteps (NAFTA) and join with the R’s to start pushing through crap like this Health care bill and other issues.
The Health Insurers Welfare Act of 2010 will be Obama’s NAFTA.
The opt-out creates a new wedge issue in every single state. I think Democrats sort of like that because they think it’s a wedge issue that’s going to go their way. In the meantime, a lot of sick folks are going to go without care, but what do they care. It’s all about elections. If it wasn’t, we’d be talking about a simple extension of Medicare.
Well . . . as I understand it, most of this bill won’t even go into effect until 2013 or even 2014. How many people will suffer and die by then? Hey, it’s ALL cruel.
100,000 Americans will die. How many will be premanently impaired? How many will suffer un-necssarily. How do we make the Villagers participate in this suffering?
Triggers are transparent nonsense. It amazes me that these supposedly liberal organizations are going along with this. The Urban League, Think Progress, and everyone else pushing this nonsense to the detriment of the people whose interests they supposedly represent should be ashamed of themselves.
If we have faith in the legislative process which is, starting today, providing a democratic forum to allow every Senator to offer and vote on amendments for the next several weeks and weekends (according to Harry Reid this afternoon on the Senate floor) – yes, we just might “get something real,” even without the need to give up something in exchange.
[Please Note: Unlike the "undemocratic, broken, dysfunctional" Senate, NO such time or opportunity (none) to offer and debate amendments on the floor (aside from the Stupak amendment) was provided to the 435 members of the "democratic" House.]
For those interested, the “managers” of the Senate Health Care Bill (presumably Harkin and/or Baucus and their Republican counterparts) will be taking the Senate floor in about 5 minutes (3 p.m. Eastern) to officially kick off the Senate debate and amendment process on the health care bill. Available streaming on-line here: http://www.c-span.org/Watch/C-SPAN2_rm.aspx
OutWest @ 41 – I believe Jane has made it clear in the past that post-Senate action (not to mention post-conference), the whole dynamic may change, as to the feasibility and/or wisdom of blocking the bill as-amended. But first things first.
I am putting my voice and energy to one purpose and one purpose alone: destroying the corrupt and rotten two-party system, which is actually more like a one-party system these days.
I agree that if single payer is off the table and the public option is hanging by a thread, that given the impossibility by circumstance of providing universal care, that the opt-out would be a good organizing tool to change hearts and minds in states considering opting out.
Many of us assume that since single payer pencils out on the ledger that it does so in public opinion as well. That is not the case, we still have more work to do, and contesting the policy fight at the state level is one way to advance that debate more vigorously.
Those like Jane who dismiss opt-out have already made their compromises and are in effect criticizing others for bringing different progressive priorities to bear, resulting in different trade offs. I’m not sure where that gets us when the real challenge should be to the values that inform the tradeoff. Often, these are just judgement calls. Sometimes, we’ve just got to admit that reasonable minds often differ and agree to disagree without the attacks.
I do see a consistent thread amongst progressives that they have to impose their will from on high on a reluctant population because they don’t believe that they can prevail one on one. I’ve found that this often does not work at face value and can produce all sorts of unintended consequences.
As I understand it, the CBO is predicting that severely weakened PO will have only 2 million members, assuming no opt-out, and a PO policy will be more expensive than private insurance policy because the insurance companies will dump their older and sicker clients forcing them into the PO.
Why opt-out if private insurance is cheaper? Seems like opt-out is pointless.
No reason for a trigger either.
Looks to me like the PO is guaranteed to fail within a few years, given the likely composition of its members, which prevents spreading out and sharing the risk. Therefore, the high medical costs they are likely to incur will financially bankrupt the PO, unless the government increases the subsidy substantially and coverage is reduced by increasing deductibles and co-pays to such an extent that there will be no coverage for most medical expenses.
I agree with LGID and libbyliberal. We need to kill this faux bill now and insist on Medicare for All.
I second your motion.
It is not farfetched to assume that the Senate will pass to conference a bill with no PO, while the House puts forth its version with a PO. The conference reconciled bill will then move to each respective branch for final passage either with or without a PO. And then either of these two versions will either become law or not.
But this does not seem to exhaust the possibilities. As Sen. Sanders points out, the passage of a bill out of the Senate w/o the PO may be both inevitable and not necessarily a bad thing if it is viewed as a more limited attempt to reform private health insurance only. Meaning no rescissions, no exclusions for prior conditions, and moving more patients into Medicaid.
Admittedly this is a more limited approach, but it avoids mandates and thereby rewarding private insurers with more forced enrollees. The task of moving to a more expansive Medicare program is then left for the following year.
Chris Dodd will again be carrying the load for the HELP Committee, instead of its new Chairman Tom Harkin. Therefore the floor managers for the Senate Health Care Bill are Max Baucus, Chris Dodd, Mike Enzi, and, I assume, Chuck Grassley.
Barbara Mikulski of Maryland is now on the floor offering the first amendment from the Democratic side, with Reid’s blessing. A Republican amendment will follow, with votes on both to be held in abeyance until at least tomorrow.
Jane, Thanks for your reply. It doesn’t address any of my posts linked to @15, nor any of the arguments in those 3 diaries, but focuses only on my final comment and also mis-states that.
You said:
But that’s not what I said, what I said was:
So, two points:
1) The impossibility of passing SP, even if true, doesn’t mean one shouldn’t advocate and fight for it, as I make very clear here;
2) None of us can really tell whether the assumption that SP would have never passed even if the progressive movement had supported it was wrong, because the progressives didn’t do that. Instead the progressive movement split, and is still split, as we all know.
After misrepresenting what I said, you did the classic political thing of not answering my question, but of raising the entirely different issue of why SP didn’t pass. And you said:
Now this reply is truly ridiculous for any number of reasons. First, What evidence do you have that people who “spent their time trolling in comment threads” are the “most extreme advocates” for SP? Also, how do the people who are the “most extreme advocates” of SP differ from others who are just advocates for SP, or from still others who are weak advocates of SP, and why do you think they are “trolls”? And what is a “troll” anyway, other than someone whose views you don’t agree with?
Also, why do you say that people who spend time on comment threads are not reaching out “meaningfully” to other people? Aren’t people here at Firedog Lake who are participating in comment threads reaching out “meaningfully?” Also, don’t many of the people who comment here also spend a lot of time reaching out to their representatives to make a difference, or spend time in their local communities organizing?
Second, You say that “you failed miserably.” Well, not taking that personally, SP advocates certainly did fail miserably. So what? What does that undeniable fact have to do with my question:
Answer: zilch!
Third, you want me to take responsibility for the failure of SP strategy and what SP groups advocated for before going on to criticize others? Well sure, I’ll admit that the efforts of SP advocates were totally unsuccessful, but I won’t ignore all the reasons why they were unsuccessful, just because you think:
Well, I don’t know who made you the decider of what’s politically mature and what’s not, but apart from the obvious fact that the lack of success of SP advocates is attributable to a number of factors, other than to flaws in their strategy and tactics, I think that the efforts of many people who decided long before the President was inaugurated that SP was impossible to pass, and that therefore they and all progressives ought to advocate for a public option, were certainly a material factor in the failure of SP to win out.
I’ll leave the details of running through this history to folks like selise, ralphbon, and Kip Sullivan who have studied the political history of this in detail, and who, I suspect, will discover this thread in due course. I can make my point, here, however, by saying that the progressives in Congress were captured by PO advocates by the time of Obama’s inauguration, and from that point forward the cause of reform was pretty much in the hands of PO-favoring groups who did as much as they could to marginalize SP and to see to it that the argument for reform would not be “confused” by PO advocacy.
So, my point is, whatever responsibility SP advocates may have had for letting PO advocacy gain the upper hand among progressives, and therefore for leading us all down the primrose path, from the beginning of this Administration, it is the PO people who have had the primary power on the left to advocate for reform, and therefore it is the strategy and tactics of the PO people that needs to be seriously evaluated in view of the obvious, unequivocal, and miserable failure their PO-advocacy-based strategy has produced which, at best, at this point will give us a program that will still allow roughly 108,000 fatalities due to lack of insurance between now and the time the exchange with or without the PO goes into effect, and even if things work out according to the forecasts of the CBO, will likely be responsible for another 77,000 fatalities before the first decade is out, even after the exchange goes into effect.
My view, outlined in detail here, is that PO advocates made a big mistake in not pushing SP from the beginning, and that they are still making that mistake. I believe that had they done so, we would have a much better reform on the table now.
I’m sure you’ll disagree with this evaluation, but my reasons for it are laid out in my diary, and if you disagree, I’d like to see your reasons why you think I’m in error. And completely apart from that, I’d also like to see your reasons for thinking that continued pursuit of a PO-based strategy, regardless of whether or not an emasculated PO survives these final stages of the legislative process, makes sense for the future.
I don’t believe in crying over spilled milk, but we all need to learn the lessons of the past correctly, including why the milk was spilled, and I’d hate to see us, once again, as we did in 1994, draw the wrong lesson from this experience, such as that now we have to redouble our efforts at supporting PO-based reform in future years. I think such a lesson would only lead to further failure, and that what we need to do now is to return to ground zero and support nothing but Medicare for All every single legislative session until we get that. We haven’t tried to get real SP through since Harry Truman. It’s time to try for the real thing again.
Hi OFG, if option “C” is a possibility then that’s what we should go for, because options A and B are unacceptable.
Thanks lib. Your heart is always welcome.
Who is it cheaper for? When the CBO is estimating cost it ISN’T saying “how much will this cost to the consumer”…it’s saying “how much will this cost to the government”.
That’s a critical difference. If the actual policies offered by private insurers were, in fact, cheaper to the consumers than the PO then NO ONE would take the PO. What the CBO is saying is that private insurers will get less from the Feds(via such stuff as Medicare reimbursement) than the public option. Well whoop-te-do! Who could have guessed THAT…with the fact that those who are sickest will be dumped to the PO.
So this gets to the real comparison we must make. What will the cost be to the individual without the public option? Will it be higher or lower in the private insurance market.
It would be higher, much higher. Because if the private insurers are compelled to accept those using the PO they will raise rates to cover those individuals. The CBO might say that this is “cheaper” to the Feds…because it will be the other consumers subsidizing the “sickest of the sick” not the Feds. So that is great for deficit hawks. But for the public, not so good.
The third option is to let the insurers deny these folks coverage. This is the status quo approach…and guess what…the cost to the insurer (and those insured by them goes down). But the cost to the Federal (and State and municipal) gov’t shoots up since these people are now using the Emergency rooms. Heck, if one wanted to lower costs of premiums even further you should allow the insurers to apply absolute denial, for any illness!
I’d like to know what you think you “got” when you “gave away” single payer, a strong public option etc etc. Do you really believe that strong and unrelenting opposition from liberal activists would have had zero influence? If you believe you are influential, don’t you think your support for trading down to just better than nothing had an influence? You could have fought, without giving an inch, for single payer from day one. You think caving was better? What did you get though? There was always going to be something in it for the masses. The question was always going to be how small the elites could make that something. So what did you actually get?
welcome to my world.
Of course, the failure of the PO will play into the Republican narrative about the ineffectiveness of Government in solving social problems.
:) ((((lets))))
well, i’m an extreme advocate of sp, unabashedly so, and i have been trolling the comments here [and at other blogs], hoping to let people know that if they want single payer and not a public option, that they are not alone.
so when i’m not blogging, or trolling on other peoples blogs, i’m out talking to my friends and neighbors about medicare for all, in person, face-to-face [and generally one-on-one, so it's a slooooow business]. it’s not flashy like being on tv or influencing congresscritters, and it’s not nearly as much fun as making fun of people, and granted, it’s not even real organizing, but movements don’t grow without it.
and besides, talking, actual moving-your-mouth talking, none of this here keyboarding stuff, is what i’m best at. :)
Have Dems put their brains on the shelf? Do they not get that this kind of crappy public option, no cost control and no manifest benefits in 2010 will spell their doom? Is Obama beholden to Rahm the total Corporate Tool? No other logic makes sense.
On Countdown, Sheldon Whitehouse’s announced his capitulation, from Robust Public Option to Trigger is shameful. As Nancy Pelosi said a Trigger is an excuse for doing nothing. Thus Whitehouse joins the ranks of do nothing Dems.
hipparchia, Sorry, I don’t see anything extreme about you. Now, if you were advocating armed overthrow of the Government, or replacement of the present constitutional system with a dictatorship of the uninsured, then you’d be an extreme advocate of SP. As it is now you’re just a citizen of a democracy who favors a particular policy solution to a problem. Big deal! What’s extreme about that?
The irony is palpable, isn’t it?
mind blowing actually.
very kind of you. single payer is the furthest right i want to go, so i think this puts me left of the left of the left. or something. :) but you are correct, i have zero desire to shoot anybody.