Tweet
I’ve spent all year immersed in health care policy. It is unfortunate to see some of my arguments criticized based on a complete lack of understanding of the subject matter. Nate Silver attacked my suggestion of removing the individual mandate because he claimed it would increase the CBO score:
Why? Because such a bill, with good reason, will be scored terribly by the CBO. You would definitely have very high premiums and would probably have a bill that was no longer deficit-neutral (the government is on the hook for some of those higher premiums to the extent that it’s paying subsidies). Is Ben Nelson going to vote for a bill with a $1.1 trillion price tag that raises premiums by 30 percent?
This is just wrong (I disagree with Gruber’s exact numbers, but not the general trend). The individual mandate is only a way to force the young and healthy to buy insurance, and make them subsidize older Americans. (Since the young people will also be subsidized by the government, it is, in fact, a way for the government to indirectly subsidize health insurance for older Americans twice.) This is how it helps keep average premiums down on the exchange. But the individual mandate does not reduce overall health care spending, use of health care services, or cost to the government. Removing the individual mandate would have the net effect of reducing the CBO score not increasing it.
The individual mandate would also not change the amount the vast majority of Americans will personally pay for their health insurance on the individual market because of how the tax credits are structured. It does not get us, as a country, to real universal health insurance. If the goal is to get as many people “into the system” as possible, policy people should be pushing as hard for a real employer mandate as they are for the individual mandate (something I have not seen). Because it will be illegal for undocumented immigrants to buy insurance on the new exchange, their only real hope of getting insurance is through their employer. The CBO says the Senate bill will reduce the number of low income people getting employer-provided insurance in this country by 5 million. The House bill, with a real employer mandate, increases number of people with employer-provided insurance by 6 million.
Finally, Sliver’s health care continuum shows a lack of detailed understanding of the subject. He ranks the Wyden-Bennett bill on par with single payer. This is simply a conclusion I don’t think can be reached looking at the facts available. (It is arguable that the Dutch or German health care system might be on par with single payer, but Wyden-Bennett lacks many of the critical cost control mechanisms found in those systems.)
Ignoring that most of Wyden-Bennett supposed “savings” come from failing to properly index the subsidies, its basic goal is to put every American on the FEHB exchange of private insurance plans. The problem is that the FEHB and private insurance companies are a proven failure at reducing cost. Health care costs on the FEHB have grown at the same rate as the rest of the market. On the other hand, it cost roughly 25% less to insure someone with Medicare than with private insurance. Wyden-Bennett might result in a minor reduction in health care spending. Medicare-for-all would cut our health care spending by roughly 20%, and do a better job of slowing our health care growth rates. There is no comparison.
If Silver thinks Wyden-Bennett is as good as single payer, it is no wonder he tries to diminish the importance of the public option. I think a public option is critical because all the data indicates public insurance has done a dramatically better job at controlling health care costs than private insurance. I think his continuum is all wrong. The reform bill with a truly robust public option (Medicare buy in) would rank dramatically above Wyden-Bennett. A Medicare buy-in that would be around 11-25% cheaper than private insurance companies. It would have a much better chance of reducing health care spending than any system of private insurances exchanges that lack a central provider reimbursement negotiator.
I also understand people think any expansion of coverage is a step forward, but it is only a step forward if it proves popular. If this health care expansion proves too expensive and unpopular, it can serve to discredit progressive efforts to later reform. I would happily work for a smaller house with a truly strong foundation. I don’t think a bill that enriches, empowers, and entrenches the enemies of reform is a good foundation.
63 Comments
Support this site!
Subscribe to the newsletter
Advertise on Firedoglake
Send
us your tips
Make us your homepage
About FDL Action
The only way Nate’s objections make any sense is if he’s convinced of one or more of the following:
1) This is our one chance for reform, and thus we must:
a) pass even a crappy bill as it’s better than no bill
b) pass something now with the idea we can make it better later
2) If we don’t pass a bill, that will slaughter the Dems this coming November “just like it did in 1994″.
I suspect that #2 is the most basic anxiety here. Guess what? Rahm’s demoralizing the Democratic base by ramming NAFTA down our throats had a lot more to do with Dems staying home in 1994 than did not having a health care bill.
If we can just get people like Nate Silver and Paul Krugman to stop internalizing #2 (and to stop confusing killing the Senate bill with killing all hope of HCR), we’d be getting somewhere.
Anyone want to handle this one?
http://www.dailykos.com/story/2009/12/21/817417/-Devil-in-the-Details:-Mandate-not-mandatory
I hear more and more comparison between auto insurance and the individual mandate, and they are not comparable at all.
People don’t need to buy auto insurance unless they drive. The individual mandate will force everyone to buy insurance (barring still-murky “hardship” qualifications). You can choose whether or not to own a vehicle, factoring in the costs of insurance as part of ownership. Or you can simply be too poor to own a vehicle and rely on public transportation or family/friends.
But when it comes to the individual mandate, there is no saying no. You live, you have to pay up. Forced to give money to a private corporation, regardless of the quality of the product. While the GOP bleat about violating the Commerce Clause simply as a means of obstructionism, there is a whiff of truth to it.
It should be plainly evident this so called HCR is about the AHIP sabotaging any American Single Payer Plan coming to the fore.
This fake reform is better seen and described as a hijacking of the entire American healthcare discussion first and secondly digging trenches for extended AHIP/Big Pharma trench warfare where the side with most money to throw wins.
What is being done here is putting several big for profit health insurers right in the middle of the intersection where all the money in American HC must pass through and they get the skim.
Imagine Social Security being reverse engineered to look like this mandated forced join/pay in or suffer the penalty game.
Not one national SS plan administered by one federal system but a plethora of SS plans administered by several private,for profit corporations. How would SS be looking in such a setting? My SS plan would be different from yours and both of ours would be different than others SS plans. No uniform one plan but a exchange of SS plans with employers having to straddle the paperwork and process circus this would bring on.
I like Paul Krugman’s general viewpoints very much but he is wrong on this one. This is a really bad idea being pushed by some truly ignorant and greedy people.
Killing the mandated forced join and pay in to AHIP gangsters really is best and nearest exit out of this crash and burn fiasco
Regarding #2, this may be related. Below is an exact quote from Ron Wyden on the ‘Ed Schultz Show’ on msnbc:
“But we shouldn’t hand a win to the far right, and if they win on this Ed, make no mistake about it, they are going to bring hyper-partisan ship to every issue. They will do this on climate change, they will do it on energy, they will do it on taxes. ”
Imo, this is a fundamental misreading of the politics and the Republicans. I believe that regardless of this bill, Republicans will STILL bring hyper-partisanship to every issue. What ends up happening, is Dems appear weak – and rightfully so. Independents see this and don’t want the country in the hands of people who will cave without courage of conviction; then they vote Republican and we’re back where we started…
Exactly! It the only game they’ve got.
It’s time we start to acknowledge that politics, like the market are ultimately driven by greed and fear, the greed for wealth and power, and the fear, once wealth and power have been grasped, of loosing it.
The reason we are not seeing our interests represented in Washington, and the reasons the positions of the progressive left are not being promoted by the democrats is that we have neither distracted our representatives from the corporate trough, nor have we demonstrated any understanding that we will have to frighten them if we really expect change.
My own guess at this point is that since the corporate interests have nearly infinite ability to drown our voices in mountains of campaign contributions, our only hope is in showing up in Washington in unprecedented numbers, we must provide the sort of demonstration that leverages the only other force that these pols understand, fear.
We must convince our representatives that no amount of money will be enough to overcome our resolve to replace them.
We’re going to have to march on Washington if we expect change.
That’s pretty much where it stands now don’t you think? They want Obama and the dems to fail. I’d say they’ve been pretty smart. In a matter of 12 months the dems are getting ready to commit political suicide.
Someone linked this morning to a kos diary that quoted part of the bill, indicating that the penalty wouldn’t be enforced. If that’s accurate, I see lots of people not ponying up at all.
The only way the Senate bill “works” is if people believe Obama and the Village’s rhetoric that it is an improvement. I know the Village drums can beat together and on cue. I know that Obama’s rhetorical skills beat any president since World War Two, barring JFK and Bill Clinton. But when it comes to the costs of health insurance and access to health care, people are going to believe their lying eyes, not Obama.
The Senate bill uses the same sleight-of-hand as a used car salesman. It focuses on shiny objects such as a “low monthly payment”. It doesn’t tell you in capital letters that there’s no warranty, that the car may be a lemon, and that, regardless, you’ll have to pay that “low monthly payment” until the cows come home.
Oh, that’s a promise I would believe from this government, this Department of Justice, this Treasury, and this IRS.
It’s time we start to acknowledge that politics, like the market are ultimately driven by greed and fear, the greed for wealth and power, and the fear, once wealth and power have been grasped, of loosing it.
The reason we are not seeing our interests represented in Washington, and the reasons the positions of the progressive left are not being promoted by the democrats is that we have neither distracted our representatives from the corporate trough, nor have we demonstrated any understanding that we will have to frighten them if we really expect change.
My own guess at this point is that since the corporate interests have nearly infinite ability to drown our voices in mountains of campaign contributions, our only hope is in showing up in Washington in unprecedented numbers, we must provide the sort of demonstration that leverages the only other force that these pols understand, fear.
We must convince them beyond a doubt, that no amount of money will assure them re-election if we decide they must be replaced.
We’re going to have to march on Washington.
Read it for yourself.
Kill the fuckin’ thing right now!!
Glad you clarified the Wyden amendment. I was just pondering another Silver error in what I thought would be a 538 walk back post. It wasn’t
http://www.fivethirtyeight.com/2009/12/insidious-myth-of-reconciliation.html
Nate claims that reconciliation was doable because “The Bush tax cuts were popular; health care is not” – wrong Nate.
Regardless, what health care reform polling reveals is beside the point!!
The government knows that ‘doing the right thing now’ will not only stem a worsening affordability issue (and therefore accessibility issue) but it is key to the economy recovery. Americans vs health insurance profit is the issue. Reconciliation is the right thing to do.
Devil in the Details: Mandate not mandatory
*
heh, interesting terminology. It is still mandatory but there are no actionables attached. No punishment.
I signed the petition.
I wanted to say that the expansion of coverage to 30 million uninsured, the establishment of the exchange, and the restrictions on preexisting conditions and lifetime caps were worth the imperfections and the cost.
I wanted 8-1/2 months of ridiculous and bitter Congressional wrangling to be worth it in the end.
I wanted to believe we could take half a loaf and get by with what we need.
But the problem is and always has been PRIVATE HEALTH INSURANCE, and this bill does not cure–or even begin to address–that disease.
As long as we have a system based on for-profit healthcare providers paid by for-profit private insurance companies, we do not have a health care system. We have a business.
The healthcare system is broken, and any bill that does not eliminate or at least offer alternatives to the private business called, American healthcare, won’t fix the problem.
Everybody knows it, too. This is a classic, Don’t blame me! moment in American government.
Interesting dkos diary. Presumably the amount owed would still accrue interest, and would also affect your credit rating. Also, if Massachusetts is any guide they will tighten the mandate in a few years.
I’m not sure what the mandate would do to the CBO score, but probably not very much either way. The best reason to defer the individual mandate is that the health industry is not required to control costs and there is no employer mandate. So we’re requiring individuals to buy a defective product.
If the mandate isn’t mandatory then they should take it out. As things stand, even if the DKos diarist’s reading is correct, they can still use it to damage people’s credit as bmull points out, thus further disadvantaging people who are already hurting financially as it is.
“It’s time we start to acknowledge that politics, like the market are ultimately driven by greed and fear, the greed for wealth and power, and the fear, once wealth and power have been grasped, of loosing it.”
You mean you’re just now figuring out what motivates these bandits?
It isn’t until people band together and force change on the political establishment that anything will actually change. Dr. M.L. King knew this when he organized the people’s protest march on Washington in 1967.
An effective mesage could even be sent by way of a citizen’s boycott on mandated payment of any moneys to any insurance companies at all. Something on the order of a tax revolt comes to mind. Maybe if we hit them in their wallets, they might start listening to us.
Just a thought.
On the subject of CBO scores, you’ve gotta love this post over at TPM:
Yes we can…meet arbitrary budget impact targets determined over arbitrary time horizons by shifting the date aspects of the proposal come into effect.
Wake up Josh.
Casting the IRS as the bad guy in policing penalties for failure to buy health insurance is great theater that imposes a heavy fine on civil disobedience.
People already think of the IRS as the bad guy, and have done so since its state and federal predecessors attempted to collect colonial liquor taxes. The IRS has a quiver full of penalties it can use to enforce cooperation. Most obviously, it can impose interest, fines and penalties. To collect them and taxes due, it can freeze your assets, put a lien on your wages and pensions, and yank your passport. It can ruin your credit and thereby keep you from getting a job. (If bankruptcy results, IRS claims will survive it.) If all else fails, the IRS can take you to court and send you to jail.
Sweetheart of sweetheart deals, the IRS has outsourced an indeterminate amount of its audit and “collections” work to the private sector. The social costs of doing so include greater overall costs, lower quality and confronting average, down-at-heel Joes and Janes (not the well-heeled Marc Riches) with the calm, restrained hands of bounty hunters.
These tools and penalties are premised on the claim that an individual’s non-compliance with his or her tax obligations harms all of society. (A claim not heard much when corporate taxes are due and owing and unpaid.) Here, the force of law is bent to endow the earnings of private insurers, and to solidify their dominant role in the American health care-health payment system. Mr. Obama has made his bed. And you’re not in it.
The CBO score fetish was always sorta one-sided. And if rescored without mandates, I imagine Elmendorf would cook a reason to cook the numbers for a higher score. The medical cost ratio review shows that they have a hand on the scales to favor the Kent Conrads of the world if not the healthcare industry.
There’s a link to that diary at #2.
I believe you, just not the other guy.
Not quite. The Wyden argument–the Party argument–gives the Republicans much more t work with than anything they have now. It gives them some real issues, issues that “prove” that non-military government spending is just pork for the elite few. It gives them at least the appearance of the moral high ground, something they have not had in my lifetime.
How will Democratic pols fare in 2010, just when the voters are finding out that the “win-one-for-the-President-at-any-cost” approach has forced them to buy “insurance” that comes with copays, deductibles, and benefit caps that make all “covered” care effectively 100% out-of-pocket expenses? Do they think that Republicans will not campaign on this, especially when the IRS is the enforcer, and the Wall Street bailout recipients are major beneficiaries?
And do the Party’s new patrons in PhRMA and insurance really think that the the Republicans won’t punish them for switching sides? That cozy relationships between Big Government and a “few” Special Interests won’t be part of the attack ads and tea-party rallies–at least until the money switches sides again? They should know that there is no honor among thieves, if anyone does. Republican self-aggrandizement and partisan vindictiveness willblow away supposedly “pro-business” ideology.
I think the current crop of Democratic Party leaders and elected officials have committed collective politicial suicide and somehow filed to realize the fact.
I presume that Elmendorf had to get permission/directives from Reid and/or Pelosi before doing that bullshit.
The deals that Obama cut with PhRMA and AHIP are out-and-out corruption. The Merriam-Webster definition of “bribe” is “money or favor given or promised in order to influence the judgment or conduct of a person in a position of trust.” The GOP have not difficulty grabbing the moral and legal high ground on that except for the fact that they want to become once again the receiving party of that corruption.
Yet, if what is being said at Daily Kos is true, then we are being presented with a golden opportunity to send a clear message to the insurance industry and congress about covert taxation in the form of a “mandate.”
I suspect one of the principal reasons why there is no actual penalty for failure to pay the mandate is that congress knows the mandate is a form of taxation that would never stand up to a judicial test of its validity.
Therefore, the chance to strike back at the insurance industry in the form of a “tax revolt” is at hand. I believe this would serve to get someone’s attention on Capitol Hill.
Jon writes: “The individual mandate is only a way to force the young and healthy to buy insurance, and make them subsidize older Americans.”
Is this a grouse about the mandate? I thought that was the whole idea. The fact is, this is how health insurance should have been run all along. If you live long enough, you’re going to get old. And if you simply start paying for insurance when you need it, the system won’t work. And, even the public option won’t erase that away.
Obviously, the only sure way to make this system work is through single-payer. We all know that. But the mandate is still essential in this bill. The problem is not the mandate, it’s the fact that the there is a huge swath of lower-to-middle income people who will not qualify for exemptions or subsidies that are going to get screwed. THIS is the real change that needs to come out in conference between the Senate and House.
Unless FDL gets its way, there IS going to be a bill that passes. My vote is to focus on the parts that CAN be changed, not on those that are politically impossible.
I was thinking the same thing, but you beat me to it.
No one is “forced” (or expected) to buy auto insurance, unless they choose to buy a car and/or drive someone else’s, and then, usually, the car owner’s insurance will cover them.
Most people know whether they can or cannot afford a car, and all of its attendant costs. I do believe that we can safely assume most people can be counted on to make similarly responsible decisions about whether or not to buy health insurance.
And, again, as I mentioned in another thread, one of the possible negatives that I have not seen mentioned is that many people will possibly have to compromise or scrimp (even more than they already do) when grocery shopping.
Clearly, the best road to good health and away from any sort of chronic illness lies in eating well.
What an Irony!
We’re about to have a non-#hcr bill foisted upon us that will actually prevent many people from taking as good care of themselves as they might if they were allowed not to obey the “mandate” that will likely cost them too much money for health insurance they will not be able to afford to use when they do get ill, because they are no longer eating as well as they did in the past. Before the mandate.
a mandate with no criminal penalties and preventing the IRS from placing a lien – it looks like the analysis is correct. This is a mandate with no enforcement mechanism. Toothless. But, wait and see what actually becomes law.
I agree that fear has to be brought into the process. But I’m not convinced that marching on Washington takes us anywhere.
I’ve never been convinced that peace marches had much to do with ending the Vietnam War–the bodies of peoples’ children were what did it. The marches always looked to me like they wer more about participants celebrating their own importance.
In these tmes, only the political fringe can take the time to demonstrate in DC. People have jobs that they are struggling to keep. Or, if they lack jobs, they have no way of getting to the march.
Marches are also easily dismissed in the age of Big Media. Numbers will be underestimated and participants will be dismissed as lunatic fringe. After all, don’t they have jobs that they need to be working?
And finally, as we saw in Denver during the convention, the authorities are adept at keeping demonstrators out of view of their “representatives” and out of view of the media. Civil liberties are routinely trampled in these circumstances with the collusion of police, politicians, and the courts.
So what can be done? Simply refusing to vote for unacceptable candidates is the best that I can come up with. I will show up at the polls in 2010, but I will not vote for a single one of of my party’s nominees to national office. Period.
Like all good threats, we have to know that following through is going to hurt–minority Republican candidates may “win”. But we have to discredit the current money-driven machine somehow. We have to show that the one thing the donors and party bosses do not and cannot control is our votes. They can, perhaps, deny us candidates by blocking or buying off primary challengers. But they still have to have that one thing that we can withhold and that they can’t get elsewhere.
We need more and more severe Virginias. But we need to make them unspinnable. We can’t stay home. We need to show up, cast ballots, and NOT vote. We need to go in saying that we are explicitly punishing Democrats for playing to the Right.
I apologize if this has already been explained, but I do not understand how the ban on preexisting condition discrimination can function without a mandate? If there is no mandate, why wouldn’t an economically rational person forego insurance, and then enroll once they become sick/injured?
It is impossible to do any significant reform of the insurance industry without a mandate. If people are not required to carry insurance, and if the insurance company is required to accept anyone, only sick people will be in the insurance pool. Healthy people won’t pay until they get sick.
Guess who originally championed the idea of mandates? That would be Ted Kennedy in Massachussets. The nation is now adopting the Massachussetts model.
Do you think Ted KEnnedy was a shill for the insurance industry? I think not.
The criticisms that progressives make of the reform bill are true, the reform bill bribes the special interests. But the point is to establish a beach head, embed in law that health care is a right for all citizens, and the government will work to fulfill that right. That’s a watershed achievement.
If you look at this reform bill as the final step, then it is indeed a bad move. But it is just the first phase. The next phase is to get the upper hand on the special interests through regulation. Also, the burden of subsidizing poorer people will make public plans attractive, if not financially necessary.
Ted Kennedy was a strategic, long-term thinker.
“The GOP have not difficulty grabbing the moral and legal high ground on that except for the fact that they want to become once again the receiving party of that corruption.”
Yes, but I doubt that hypocrisy is a difficulty for the Republicans. Particularly since, following the Rove model, they want more than to just get the goodies again: they will want to teach PhRMA and insurance a little lesson, to insure that their once-and-future donors give more in the future and never stray from the fold again. Republicans know how to play hardball and how to make it hurt. Unlike Democrats, they know that power is the end and money is only means.
You also need cost controls, or the whole idea of reform is pointless, unless the point is to transfer vast quantities of wealth from the middle class to private, for-profit corporations.
I’m confused. Are you saying that there should not be a mandate at all, or just in the context of the current Senate bill? A mandate is essential to a sustainable health care system. If you don’t pay insurance, and you break your arm and can’t pay for it, hospitals are (rightly) required to treat your arm. So, if you are billed and can’t pay for it, who do you think pays? It’s either: (1)taxpayers as a whole, or (2)people who pay insurance premiums. Hospitals pass the cost along by charging more for care. So, just to say you’re against mandates seems to be a bit ignorant of how the system works.
Now, if you’re talking about mandates without a public option, that is definitely a huge difference, and maybe there is a way to work on that (again, maybe) by strengthening the subsidies for those who can’t afford premiums. But at this point, we are going to get NOWHERE by signing a petition to kill this bill. It is not going to be killed, and this is not just pessimism. Time to get real and deal with what we have.
Getting the young to subsidize the old is the argument for single-payer. The young are paying in to the same funding pool as the old and will all draw out about the same benefits when their times come (everyone gets old).
This mandate is nothing like that. This mandate requires young people to buy one of many high-profit, private insurance products aimed specifically at them on the assumption that they must pay premiums but are unlikely to ever draw benefits–by design ONLY the healthy and young will be in the pool. Subsidies for this demographic will just pass through the pool directly to the insurer’s bottom line. As they age, the once-young will be shifted into other plans with triple the premiums and pools of subscribers that contain no healthy, profitable young people–just sick old people. So the young will never draw benefits from the pool they paid into–only the insurance profiteers will. Instead they will continue to pay into a new pool that never gives them a return on their money. Government subsidies will subsidize only the insurers.
Moreover, all policies will soon come with such high deductibles, coinsurance, and total benefit limits that almost everything will be an out-of-pocket expense. We will all, in effect, be in worthless “catastrophic” plans. We are starting to see this locally in the new year’s employer offered plans. Plus a 20% hike in premiums. Health CARE costs will continue to skyrocket. Health INSURANCE premiums may fall a little. But insurance value will fall more. Insurance profits will thus skyrocket, because out-of-pocket payments will pay for everything that insurance once coverd
Kill the bill.
We also have a transportation PUBLIC OPTION in most areas (though not as many as there should be). It’s called “public transit”.
I wish I had more faith in the ballot box as a deterrent, but 2000 and 2004 demonstrated the fact that control of the election infrastructure in a few key states, Florida in 2000, and Ohio in 2004 can effectively trump the will of the people.
I feel we have to convince the democratic leadership that it is they who are in danger of oblivion, not the progressive left, or the Republicans.
While I agree that the effectiveness of the Viet Nam era demonstrations can be questioned, I’d say the poor people’s march on Washington, and the more recent Latino marches in solidarity with Hispanic immigrants were very effective demonstrations of peoples resolve to be counted.
Even faux news couldn’t spin the fact of 4 or 5 million people taking a stand in our capitol.
Yes, I have a job, and a family to look after, but left to their own devices my representatives are well on their way to fixing that minor detail.
Please go rec up Slinkerwink’s diary over at Orange.
Without sufficient price control mechanisms, wouldn’t this bill have MORE savings without a mandate? I think I read it here by another blogger but imagine that X is the amount of money a middle class family is willing to pay for health care. Y is the amount of government subsidy. Now, given that there is a mandate, why would a policy ever not be less than X + Y, or to put it another way why wouldnt Big Insurance just take all the government money and bilk the consumer for all they can?
If there were no mandate, then in order to get the subsidy and get the new policy on the books, the insurance companies would need to be competitive and charge less than X+Y in order to entice people into these programs. It looks like that mandate will actually cost money. Additionally, there are what 20 million still uninsured by this bill, the argument behind the mandate is to get more or all people in and share risk, and it does not do that.
2000 and 2004 showed how methodical political attacks on the procedural mechanisms that protected elections for a century could throw an election. But even so, it was a close-run thing that required the intervention of the Supreme Court to pull it off. Ohio also exploited the introduction of ill-considered electronic voting and tabulating systems that were susceptible and/or designed for abuse.
Neither of the above is a sustainable tactic. I think both had as their aim the permanent establishment of rigged electronic voting. But failed.
That said, a ballot boycott is harder to hide than swigning a close election. No doubt that is why it is the tactic of last resort in countries where ballot-box rigging is the norm.
Insurance and healthcare are two separate parts and with this bribery and graft laden so called HCR AHIP is working very hard to keep focus on insurance part and do a full misdirection on the healthcare part.
Do Americans pay in on schooling insurance? Do we pay in on clean water insurance? Do Americans pay in on insurance to have electricity? Answers in all three of these examples is no — we pay for the service directly either through tax based revenues or on billing for use/usage. Americans understand how this works. Why would we want to pay a profit based insurer first who then pays for schooling or electricity?
This so called reform is doing very little about the healthcare part. All Americans understand how our roads,airports and schools are paid for and insurance has nothing to do with it. American healthcare does not need for profit insurers in the middle of our healthcare doing skim offs for Wall Street investors or paying for the suits who sit at top of this perverse system collecting multi million dollar pay packages.
American Social Security is premised on all paying in and all collecting.
American healthcare can be done along similar patterns of pay in/pay out.
Fully based on income being taxed for all Americans no matter where from.
What we need is healthcare that is open to access. Provides equal care despite household income,education or social status.
Americans get this. The Pentagon is set up on this premise. We all pay for it and we all in theory benefit from mutual defense Pentagon in theory provides. Clearly the Pentagon works so good as an institution for moving money into and back out other problems present themselves.But we do not have Pentagon Insurance. We pay directly for the Pentagon.
AHIP surely wanted Single Payer taken out of consideration and Barack Obama took Single Payer off the table. Why did he do that?
AHIP kept the insurance part front and center during this 2009 HCR merry-go-round ride. AHIP does not want to fall out of American healthcare. AHIP is perverse in this thinking. Healthcare reform does not require AHIP or its members. AHIP would prefer to misdirect regarding this truth and with this mandate places itself at the middle gong forward.
AHIP and its members are not needed.
Barack Obama and the D Party are letting them stay on and do the skim off.
Why is that?
Pick your most reliably progressive representative or senator. The one you think has the most backbone and integrity.
He or she is going to vote for this bill. That says nothing at all about the bill, but it says a lot about how weak even the best elected democrats are.
I can never again be convinced to vote for or donate to anyone with a “D” after their name.
It’s becoming apparant that there are two ways to reduce the CBO score when it’s in conference:
1) reinstate the public option
2) remove the mandate
If there’s no public option, constitutionally there can be no mandate. So if they keep the mandate and install the PO, where does that leave us fiscally?
I don’t see anyone fighting for the PO with any legitimate vigor within the Dems at this point, so I’d say that we need to unite to remove the Mandate ASAP.
It’s all about the money!!
Remember those bribes the GOPhers were taking for 8 long years?
Well, the Repukes stalled this bill long enough for the lobbyists to grease the palms of those easily-corrupted. This is why the Blue Dogs can no longer be trusted and must be run out of office. Now that we know who they are and what their twisted ideology is, the progressives can move against them.
Every Blue Dog democrat will pay in 2010 and 2012 with the loss of their seat.
The labor unions will ensure it!
Following the passage of healthcare, we need to develop a system for unseating every Blue Dog and ALL Repukes who obstructed the people from obtaining the healthcare that should be a “right” of every citizen of this country.
We need a home base and a systematic approach so we can begin primarying each of them with progressives and use the unions to help fund their campaigns and get them into office.
I believe this is the only avenue left to the middle class and the unions to destroy this bloc of obstructionists we have in congress right now.
Now “Mumbles” Lieberman is shooting off his twisted orifice and condemning Obama for never pushing the public option with him. What a toady douchebag this health industry prostitute is – both he and his disgusting wife, Hadassah.
I’ll bet Toad Lieberman has warts on his a$$ to prove it.
Because the GOP have destroyed this country and turned it into fascism before our very eyes.
Remember: Obama has been in office 1 year – one measly year – 12 months.
George Bush and his dictator Cheney were in office for 8 years, infiltrating our system of justice with their ‘lifers’ so there can be no justice.
I know we progressives want to pin all of this on Obama because of dashed hopes; the truth is that we need to begin an investigation into the money trail of Dems and Republicans alike in Congress to see how many “bribes” they’re talking about. Graham opened the can of worms today – let’s ram it down his own throat. How long has Graham been in office? Let’s see….
that would mean that in addition to vulgar campaign contributions over these terms of office, his offshore account where the money is stashed is overflowing.
We’re just beginning to see that we no longer have a democracy thanks to the criminals of the Bush Cabal and their co-conspirators in the GOP….we’ve descended into a fascist oligarchy where Bushies are still running the show – and running Obama.
Jon Walker wrote:
If less is spent on high-cost ER care and more on regular preventive care and other kinds of care not available through an ER, then better care for more people is a win. Whether we save anything huge from this approach is hard to say. I could easily imagine the CBO having a hard time sussing this out.
Jane, thanks for the invitation to all of us. Been reading for more than a year, having discovered FDL before the election. THis has been a huge resource for me the last several months trying to come to grips with the profound sell out on Obama’s part— sometimes its hard to believe he is the same man we worked so hard to elect!
Blogs here are on point, intelligent and clarify the mass of disinformation spewing through the media. Job well done on this recent health care debate and the auditing of the Fed!
Also wholeheartedly support your call to build bridges across the progressive spectrum as well as allies on the right/ libertarian persuasion who understand we are being abused by the corporate elite.
Its great to see you and Ed Schultz and Kos and DEan on the tube and cross checking the propoganda.
As we say in Minnesota when we remember Paul Wellstone, “Carry it forward!”.
If the reform were a suicide, then why do the Republicans scream so much about needing to stop it?
Why wouldn’t they just stay quiet and let it go through … to their benefit?
I think the politics of it are that the Republicans simply oppose anything and everything Dems want. They see it as a disaster for the Dems to simply be in charge, much less to pass any legislation. So, the content of this HCR bill probably isn’t much of an issue with them. Of course, they favor helping the corporations, but I don’t sense that as their primary view of things.
Dems lose if they don’t pass it. So, they will pass something. The only question is what.
Thus, we should continue to push for flaws and omissions in the bill(s) to be fixed. ymmv
The R Party is not running this WH. D Party is.
D Party here in 2009 is in control of Congress.
This HCR is not a R Party product. They would not have started this HCR in first place. R Party would have suggested AHIP get more power. Oh –wait — the D Party is doing that too.
Others have suggested this is not a L vs. R reform. Not a R Party vs D Party reform. Suggest instead this is Top vs. Middle vs. Bottom fight. Or a Haves vs. Have Nots fight. This seems the more accurate reading. It surely has more to do with campaign funding payouts and traffic control then Barack and the D Party are letting on to.
False R Party vs. D Party framing is the distraction anymore. The misdirection anymore. Both of these American political parties are pro Pentagon. Pro corporatist. Both corrupted by money politics and pay to play gaming in WashingtonDC. Both populated with pro polysci consultants and mages. Doing the in/out revolving door career cash in/cash out game.
Elections in America are not about democracy working as intended. As we are seeing with Barack Obama or the D Party first hand. What both were selling in 2008 surely is not what either is doing here in 2009. Used car salesmen get in trouble doing this kind of stuff. Mortgage firms get in trouble doing this kind of stuff. Wall Street gets in trouble doing this kind of stuff. Barack Obama and his D Party are heading for trouble here.
The R Party did not make Barack Obama do what he is doing. Did not make the D Party do what it is now doing. Barack Obama and his D Party did this on their own. Several polls over and over show the popular thing to do or with this HCR is not getting or being done. Barack Obama is going against what majority of Americans were seeking or wanted here. This disconnect may be haunting Barack Obama and his D Party going forward.
If the R Party is not too stupid to figure this out it can take and use it against D Party.
D Party may get lucky if R Party goes with being stupid — doing so being the R Party default reset position. As readily seen with R Party postures on climate change,being warmonkeys and coming up with zingers like death panels,T Baggers,Sarah Palin as VP candidate and holding Rush Limbaugh in reverence. All examples of R Party going with the stupid happily.
And don’t you get the drift that it is just plain unpatriotic and unDemocratic if we even mention it? It will be OUR fault for being so mean to the President if there’s a loss in 2010 for the party. Fuck that.
Congress is swallowing a lot of cum in going along with this but don’t expect me to shut my ears, mouth and eyes.
How will they enforce the mandate to buy Insurance when people that are unemployed or under employed do not have the money to buy it. What are they going to do start putting people in jail?
How will they enforce the mandate to buy Insurance when people that are unemployed or under employed do not have the money to buy it. What are they going to do start putting people in jail?
Easy: the White House plans on having the IRS outsource enforcement to Blackwater.
In a way, I see your point. On one hand, if you dont drive, you dont need insurance, but on the other hand, I can guarantee you that you will need a doctor or hospital at sometime in your life. Young people are not immuned to cancers, appendicitis, tonsilitis, etc. The cost of a simple surgery could run you $20,000 or more easily. Everyone should have health insurance.