has everyone seen that the iMAB panel in Reids Mgr Amend, now needs a SUPERMAJORITY to override? the 500b in Medicare cuts WILL HAPPEN

DeMint was talking about it on the floor last night, the GOP is all over it, HotAir has it up

SS ‘reform’ is next

and there is AFAIK no MAX amount that these insurers can charge those with preex conditions through 2014, so the commenter at Glenn’s place may pay far higher premiums for that high deductible coverage that will never kick in and she will be m=forced to buy it

absolutely abhorrent

As is so often the case, Glenn nails it.

How in the hell can someone who is self employed, uninsured, makes $25,ooo a year, now forced to buy health insurance from the industry that has the Dems by the throat. With these premiums and fines most of those uninsured will be worse off than they are now.

This just does not make any sense. Our the Dems just puffing their chest calling it “historic, monumental” What a staged event.

No single payer…no public option…no medicare buy in. Instead sure looks like the “Insurance and Pharmaceutical Industry Profit and Protection Act”

The Dems are going to serve this up as the biggest most colorful Christmas gift for the American people of all times. The Insurance and Pharmaceutical companies dressed up in Santa’s clothing will be slipping out the back door of the White House with their Santa Bags stuffed with money

While I personally believe that this bill does more harm than good, I think it is slightly unfair to quote Glenn as agreeing. His article on the subject today makes it clear that he is ambivalent:

Contrary to what I’ve seen said in various places, I haven’t advocated for the defeat of this bill. I’ve said from the start that there are reasonable arguments on both sides and that one must weigh (a) the corrupt, mandate-based strengthening of the private insurance industry, the major advancement of the corporatism model of government, the harm this is likely to do to some who are now covered and some who cannot afford the forced premiums, and the chances for a better bill if this one is defeated, versus (b) the various substantial benefits to many people who do not now have and cannot obtain health insurance and the risk that defeat of this bill will mean preservation of the status quo. Weighing those factors is difficult and, at least for me, produces ambivalence.

Fair enough, but I honestly believe we can’t understate the consequences of (a), and the awful precedent we set if corporatism prevails against the will of the people.

There is Harkin making apologies to Santa Claus for trumping

Harkin describing Harry Reid’s efforts “Patience of Job, the wisdom of Solomon, and the endurance of Sampson”

Lots of back slapping going on

“Patient Protection and Affordability Act”

The idea that government can serve up its own citizens to rapacious corporations is truly outrageous. They’ve turned the function of government on its head. It’s obscene.

Is “reconciliation” off the table? What are the obstacles to it?

quick driveby. from pnhp on senate bill: Legislation ‘would bring more harm than good’

To the Members of the U.S. Senate:

It is with great sadness that we urge you to vote against the health care reform legislation now before you. As physicians, we are acutely aware of the unnecessary suffering that our nation’s broken health care financing system inflicts on our patients. We make no common cause with the Republicans’ obstructionist tactics or alarmist rhetoric. However, we have concluded that the Senate bill’s passage would bring more harm than good.

We are fully cognizant of the salutary provisions included in the legislation, notably an expansion of Medicaid coverage, increased funds for community clinics and regulations to curtail some of private insurers’ most egregious practices. Yet these are outweighed by its central provisions – particularly the individual mandate – that would reinforce private insurers’ stranglehold on care. Those who dislike their current employer-sponsored coverage would be forced to keep it. Those without insurance would be forced to pay private insurers’ inflated premiums, often for coverage so skimpy that serious illness would bankrupt them. And the $476 billion in new public funds for premium subsidies would all go to insurance firms, buttressing their financial and political power, and rendering future reform all the more difficult.

Some paint the Senate bill as a flawed first step to reform that will be improved over time, citing historical examples such as Social Security. But where Social Security established the nidus of a public institution that grew over time, the Senate bill proscribes any such new public institution. Instead, it channels vast new resources – including funds diverted from Medicare – into the very private insurers who caused today’s health care crisis. Social Security’s first step was not a mandate that payroll taxes which fund pensions be turned over to Goldman Sachs!

While the fortification of private insurers is the most malignant aspect of the bill, several other provisions threaten harm to vulnerable patients, including:

* The bill’s anti-abortion provisions would restrict reproductive choice, compromising the health of women and adolescent girls.

* The new 40 percent tax on high-cost health plans – deceptively labeled a “Cadillac tax” – would hit many middle-income families. The costs of group insurance are driven largely by regional health costs and the demography of the covered group. Hence, the tax targets workers in firms that employ more women (whose costs of care are higher than men’s), and older and sicker employees, particularly those in high-cost regions such as Maine and New York.

* The bill would drain $43 billion from Medicare payments to safety-net hospitals, threatening the care of the 23 million who will remain uninsured even if the bill works as planned. These threatened hospitals are also a key resource for emergency care, mental health care and other services that are unprofitable for hospitals under current payment regimes. In many communities, severely ill patients will be left with no place to go – a human rights abuse.

* The bill would leave hundreds of millions of Americans with inadequate insurance – an “actuarial value” as low as 60 percent of actual health costs. Predictably, as health costs continue to grow, more families will face co-payments and deductibles so high that they preclude adequate access to care. Such coverage is more akin to a hospital gown than to a warm winter coat.

Congress’ capitulation to insurers – along with concessions to the pharmaceutical industry – fatally undermines the economic viability of reform. The bill would inflate the already crushing burden of insurance-related paperwork that currently siphons $400 billion from care annually. According to CMS’ own projections, the bill will cause U.S. health costs to increase even more rapidly than presently, and budget neutrality is to be achieved by draining funds from Medicare and an accounting trick – front-loading the new revenues while delaying most new coverage until 2014. As homeowners seduced into balloon mortgages have learned, pushing costs off to the future is neither prudent nor sustainable.

more at the link

(btw, imo this is a big deal and iirc, himmelstein was previously suggesting that congressmembers should abstain)

hear, hear!

Greenwald and Jane are progressives I can believe in!!

I agree with you about the bill, Jane, but your headline is blatantly misleading. The quote is not expressing Glenn’s own position. It is expressing his summary of Dean’s position.

Please change this. Don’t give the witch-burners over at Daily Kos any more fuel for the bonfire.

Keep in mind that Obama campaigned against the individual mandate. It is what helped him defeat Hillary, who was for it.
But then again, this is turning into the Clinton 2…Bush 3 administration.

Thanks for the comment and the link.

Selise, what’s so darkly amusing about this whole debate is that the numbers and logic are so clearly on our side — yet the “any bill’s better than no bill” clique have been claiming that we’re opposing the Senate bill out of pure emotion-driven spite. (What’s even funnier is that they’re getting more and more emotional themselves, and less and less honest and factual, as they seek to defend an indefensible position.)

Yeah. It was the first thing that led him and Krugman to be at dagger’s point with each other, and led to all the Obama backers that swarmed DKos during the primaries to start hating Krugman. Now they love him again. Go figure. :-)

“The bill’s anti-abortion provisions would restrict reproductive choice, compromising the health of women and adolescent girls.”

These women and adolescent girls who will now have access to healthcare that they lacked before… how would they have paid for abortions in their current state of lacking insurance?

Believe me, I am all for repealing the Hyde amendment because there are many examples of government spending money on things I don’t approve of. However, the overall situation of women and adolescent girls will improve by making sure they have access to affordable care that they lacked previously. Their overall health will improve AND their inability to obtain funding for abortion services is no LESS than it currently is today.

So I am not sure this is a good reason to reject this bill.

I find it remarkable (not really) that those like Jane and Howard who are arguing most forcefully to *keep fighting* for a better bill are mocked, derided, and ridiculed as “defeatocrats” by the very same people who insist that everyone should sit down, shut up, and accept the craptacular as the best “we” can do.

I don’t usually pimp an article elsewhere but this is a must read, in fact if you read anything today it should be this.

It explains the White House strategy or lack thereof, a total fear of actually picking a fight. Though I will say when they pick a fight (like with Rush or now the left) they do so not on the facts, but by attacking the person.

If you are going to eliminate the preexisting condition clause, you have to mandate coverage. Otherwise you will bankrupt the system when people only buy health insurance when they are sick. It is then no longer insurance.

But then again, this is turning into the Clinton 2…Bush 3 administration

What it’s turning into is another ‘Thousand-Year Reich’, and we all know how that turned out.

Who wins with this healthcare bill -
* Big Pharma
* Big Insurance
* Trial Lawyers
* A limited number of currently uninsured people

The losers
Everyone else not included in the above section.

The second you say the bill is good enough you start fighting. Why should Nelson be pushed to give up more, Krugman already said it was good enough?

i agree with greenwald when he says “It perpetuates the very system that supposedly was the impetus in the first place for healthcare reform to pass.”
but it goes far beyond “perpetuating” by forcing 30 million new victims into A system that would be illegal anywhere else

If there was anything positive in the bill, telling the truth would suffice for it’s defenders. The fact that people like Axelrod are telling such transparent lies… saying the president stood up to special interests and won, even as insurance stock prices go through the roof proves that an honest accounting cannot serve the administration’s purpose.

Glennzilla’s leaning more towards our camp, as the paragraphs immediately following show:

I’ve also been fairly repulsed by the 2003-like swarming, bullying efforts of the President’s loyal supporters (both in the White House and from Beltway journalists and their partially cloned liberal bloggers) not merely to dispute, but to demonize and personally discredit, the bill’s progressive critics as insane, crazy, childish, idiotic and drugged-out, Naderite, purist liars who — we now learn today — are the equivalent of “global warming denialists.”  Whatever else is true, progressive opponents of the Senate bill (virtually all of whom offer strategic arguments for improving it, not for preserving the status quo), have been making well-informed and substantive critiques.  I don’t want to overstate this:  there has been some very responsible and informative debate among these various factions, the insults have flown in both directions, and it’s understandable that passions run high on an issue of this significance among opponents, particularly as the process mercifully draws to a close.  Still, it seems clear that campaigns by White House loyalists in government and the media to destroy the personal credibility and malign the character of the President’s critics — and to depict “the Left” as shrill, unSerious losers — obviously aren’t confined to the Bush years or to Bush supporters.

I have no problem with continuing the fight for a better bill. We should get the best bill that we can.

I do have a problem with killing a bill that will help people just because it is not the perfect bill OR just because it has flaws.

I am fortunate enough to work for a company that provides 3 options for healthcare. I choose the low premium/high deductible plan with an attached HSA account because it is the BEST option for me and my family. And if I am reading these bills correctly, that plan would no longer be legal under the new healthcare reform. I don’t want the other two plans. My max out of pocket per year is $5K (including premium costs) and I don’t want to lose that (because of the other two plans, one has a max out of pocket cost of $9K and that doesn’t include the premiums and the other plan has a premium cost of over $6.4K, $1400 higher than my max out of pocket with my current plan). I will be directly impacted by this legislation, and in a negative way. BUT I am willing to support it because this legislation is better than leaving it at the status quo. And ironically, the thing that I want added to the bill (those HSA type plans) are rejected by many other liberals as being a bad plan.

The biggest losers are probably folks with really good employer provided insurance. I see them, and maybe the remaining 19 million without any coverage, as by far the biggest losers. For the 19 million remaining without coverage I guess it will be nothing new, but for those with really good employer provided insurance, they ain’t gonna like when their insurance covers less and less.

well if it ends like the thousand year reich did , then those who survive will be better off for it. unfortunately i dont see who’s going to bring this 100 year reich down. this thousand year reich might last a thousand years if we dont do it.

If this phony legislation passes it’s time for civil disobedience on a scale not seen since the civil rights movement and the Vietnam era.

If there was anything positive in the bill, telling the truth would suffice for its defenders.

Word.

I say we tear up all the roads and start over with private road companies. Right-wingers would love it, because the only roads that would ever get built would be built by private corporations, who would then decide who gets to drive on those roads, where and when, and how much the tolls are… and if no company wants to build a road to your block or your neighborhood, hey, too bad! Start your own road company! At least you wouldn’t have some government bureaucrat standing in between you and your car, right? Private industry always works better!

kill the bill. heres somewhere we liberals can cooperate with the right – types too; in planning to set up and persue any and all court challenges to this bill. i hope the lawyer department is working on something.

Then make the MLR 100%. I’ll take 96%. And close the loophole to lower the % MLR.

Note to CBO:

We are mandated to pay for private health insurance. The Government collects our $$$ and enforces the mandate and/or penalties. If that is the role the government wants, then the health co’s should be at 100% MLR and should be “the government.”

The line between government and private sector with this legislation is so blurred, CBO should not even worry about setting MLR at 100%.

Our government is faced with the choice, apparently, of passing a worthless, corporate-enabling bill, or passing nothing for the next 20 years.

And Harry Reid wants pats on the back for WHAT exactly? Being one of the captains of the Titanic???

The real model of governance for the Republicans is Somali. No functioning government and entirely unregulated markets.

My own (unelected) Senator Bennet, facing a primary challenge from the left next year, has been relatively vocal for the public option and said publicly he’d vote for reform even if it “cost him his job” – and today he is being attacked for *not* making backroom deals a la Ben Nelson and bringing home more pork for Colorado.

I have to say the failure of even one progressive Senator to stand up and say, no you don’t get *my* vote without X, Y, or Z reminds me very sadly of the scene in Fahrenheit 9/11 showing the CBC begging for even one Senator to challenge the Bush coup.

# 19

I guess the point that I’m trying to make is that President Obama is flip-flopping on a lot of issues that were/are important to those of us who put him in office.

And IMO the bill is worse than the status quo.

And that’s ok for us to disagree.

What’s been happening too damned much though (not your post obviously) is those that disagree seem to want to turn to personal attacks rather debating the merits of their position. That has to stop. Everyone that is having these debates on the progressive side is likely to agree on far more issues than they disagree on, and there is a real risk of burning some bridges that might be badly needed in the future.

I’ve been bitterly disappointed at the way the debate has played out amongst progressives. Dammit we’ve got plenty of real enemies on the right to deal with. No sense in manufacturing more than that.

At some point in 2010 this administration is going to be hit by a bus. Pieces will be everywhere. Social programs will no longer be discussed then rejected. Things will change or the people will be in the streets. There will be opportunities. What will be done will range from WPA like programs to martial law. Comments?

See: http://market-ticker.denninger.net/archives/1752-There-Is-No-Way-Out-Of-This-Box…..html

I do have a problem with killing a bill that will help people just because it is not the perfect bill OR just because it has flaws.

And yet, as has been stated in this and previous posts today and the past few days, that is *not* what the main objections are to this bill. That is a caricature being promoted in the official narrative of the WH and GOP, that the loony left idealists whinging from the back seat aren’t grown-up enough to accept anything less than exactly what they want. Frankly, it’s a pretty transparent effort to marginalize those who have been pushing for actual real reform all along by those who apparently never wanted more than “reform” and a giveaway to the insurers and Big Pharma.

a perfect reason why “for profit” health “insurance” should never have been the direction we commit to. it cant be sustained. unless the govt props it up! but govt money, OUR money should be spent on programs with better outcomes. its as simple as that. i dont CARE, what health insurance industry fails. in fact, i hope they ALL fail; they all deserve to.

You cannot make the MLR 100%, as MLR includes cost to process claims.

My point is that CBO stated they could not set it higher because the Health corps would essentially become the government.

That’s what we are getting with this legislation with the mandate in place with no cost controls.

It is extremely difficult for me to understand the argument that somehow it will be *easier* to rein in the industry down the road a bit after we first give them more money and power. Seems a logical inconsistency to me, but maybe I’m missing something. Though, I’ve yet to hear *how* we will fix all those little details later. Asking that question gets one labeled shrill and, worst of all for official punditdom, Unserious.

from this point forward the United States has NO standing to tell other countries how to govern.

We should get a delegation from the Iraqi parliament to come and school US Senators on ethics, process and the meaning of democracy.

The US Senate, what an embarrassment, its corruption makes Wall Street look like Sunday School, it is a cess pool of culmny and mendacity.

This US Senate has turned the folk wisdom “There is no better Republican than a Democrat in office” into hard verifiable fact.

We ultimately have no one to blame but ourselves, the Democrats created this and all the rationalization about the GOP’s tactics will not change that infuriating fact.

We could of had this piece of legislation back in October. For this we gave the teabaggers a stage for the entire month of August?

The Democratic Party has in one stroke galvanized the base of the GOP and profoundly (very possibly irretrievably) alienated our own base.

And Dodd gave himself a $100M to get his sorry assed excuse of a Wall Street shill reelected in the face of everything else in this collection bribes for Senators and subsidies for health industry corporations?

It doesn’t matter that the bill might help a few people. The entire thrust of it is flat-out wrong because it empowers the enemy.

What Obama has done in the first year with the Wall Street bailouts, torture, war, and now this, is huge. The coup of the oligarchy is nearly complete. I am ashamed for my country.

Make the apologists explain their disengenuous statements saying providing people crappy insurance equates to providing people HEALTHCARE.

This bill CEMENTS the status quo.

“If I am forced to purchase insurance, even the cheapest plan, and then pay the first 1,200 out of pocket and co-pays, I won’t be able to do anything but pay the premium or the fine. I won’t be able to afford to actually use the insurance.”

Yes! This bill is going to prevent a lot of people from affording health care when they need it because the mandated insurance payments will suck them dry.

It’s like a double win for insurance companies. People will have to pay in but they won’t be able to afford to use the insurance to which they are hostage to get health care.

The anticipated backlash of passage will have a Republican majority in 2011 who will secure further cash flows to their major donor combines comprising the M[ed:il]IC.

I agree that we should stop name calling, though I have been personally guilty of calling an idea or two idiotic. But that doesn’t mean I think the person him/herself is an idiot.

I have no problem with aggressive discussions as long as they are dealing with the arguments made and not the person making the argument. So on that point we agree.

We have all those teabaggers and GOP members who are working to make sure Obama gets no political victory out of this (or anything else for that matter)…

There is one thing that James Carville once said that rings true. Republicans fall in line, Demcorats fall in love. It is clear that the GOP all fell in line behind their leadership (even though several come from states that elected Obama knowing full well that one of his major platform planks was healthcare reform WITH a public option). That is one area where I think the Democratic party has failed. They should be running ads in all the blue states with GOP Senators saying “Your state elected President Obama, who ran on a platform of healthcare reform including a public option, ask your Senator to help give you what you voted for.”. If that would happen, perhaps we could see a couple of GOP defections, making the voices of those conservative Democrats seem less important for passage of the bill.

Good point, my other concern is the impact to the practice of medicine (Doctors & Nurses).

I keep hearing the draconian changes will lead many Dr. to retire/quit. When push comes to shove will this hold?

As a society are we pushing the smart people away from studying medicine..

Cheers

I’ve been de friended on FB yet again – seems they don’t like it much when you point out “Bill Killers !” sounds an awful lot like “Baby Killers!”

Probably all the other families will line up against us. But, it’s alright. These things have to happen once every ten years or so…gets rid of the bad blood

I read an article on Yahoo yesterday when the bill passed that stated the Senate version of the bill contains a not-for-profit plan that would be managed by the same people who manage the health insurance plans for federal employees. Wouldn’t that serve a very similar purpose as the public option (since the MLR could be much higher than the 70% the for-profit insurers want)?

What exactly is the plan here? Kill the bill and then what? What are you proposing to do with Liberman? nelson? Keep the atatus quo until REpublican take back the house and cut medicare, SS and all others? Nice plan….

Oh you can bet the farm there’s going to be challenges in all 50 states. As well there should be. The individual mandate is gonna be challanged before the ink is dry, or I suppose the day it becomes effective since that may be 2014.

No way in hell mandating an individual purchase something from a private entity is constitutional. Of course with the current SCOTUS, I suppose anything goes. Just imagine the lobbyists after that precedent is set though. Won’t it be fun when big oil successfully lobbies a future Republican President and Congress and mandates we all purchase gas guzzling SUV’s?? No way in hell it’s constitutional.

Just saw that Rep Parker Griffith is switching from Blue Dog to full Republican. Was this one of Rahm’s brilliant choices? For effective reform in healthcare and elsewhere going forth, we got the more Democrats. Now we must be mindful that the groundgame must be in development for better Democrats.

“We have all those teabaggers and GOP members who are working to make sure Obama gets no political victory out of this (or anything else for that matter)…”

forget the teabaggers and GOP we, Democrats, have not only NOT delivered a victory we have mobilized the GOP’s base and demoralized, alienated and disenfranchised our own base.

Look at recent poll numbers on “likely to vote” in November 2010…

like I said, “there is no better Republican than a Democrat in office”

This is the argument I use against the people who support the idea that people should be free to choose to not have insurance.

“If you are free to choose to not have insurance and then you suffer a catastrophic loss, then you are using ME as your unpaid insurer when you go to the ER and cannot afford your medical bills. Those costs are passed on to me and everyone else who pays for their own insurance. So while you get to bask in you so called freedom, you make me your slave”.

It doesn’t win everyone over, but it is a start. :)

You’re standing on the wrong side of the majority. A majority of people in this country want healthcare reform. If you screw them with an insurance industry give-away which looks very much like it will make things much worse, that’s a good plan?

A while back several thing became quite evident, that the Senate is corrupt and dysfunctional, that the Obama Administration is self tasked to preserve a broken Free Market ideology, that this bill rewards the Insurance Industry more than helps the un/under insured.

From my point of view, the greatest immediate and incalculable harm in passing this bill at this point, would be that it would embolden this Administration to double down on forcing upon the population draconian deficit reduction measures, accompanied by fire sales of Publicly owned Parks, Utilities, Infrastructure and Entitlements.

If we don’t want to awaken to a that Neo-Feudal landscape painted for us by emptywheel, we need to deny this President the sort of wins that reinforce a broken Ideology, a broken economic model, as attested to by Greenspan Himself. This is far more than just about a Non-reform reform. This is about a wholesale rape and pillage of America.

alank

We were all made to belive Obama was a Progressive.

Obama and Rahm are ConserverDems/Republicans.

Obama wants a republican congress in 2011

The powers that be hate progressives, they knew a progressive could win in 2008, so they came up with a plan put Obama out front, he can act like a progressive. Once he gets to the white house they knew he would turn into a Republican. (Obama mentor was Lieberman, he picked Rahm for COS)

The powers that be want Obama to demoralized Progressives, so they will stay home in 2010.

Welcome to the HOPE A DOPE.
Sponsored by Obama and Rahm

Progressives must Organized!

Obama the Candidate will return in 2011, along with the Troops Coming home.
I can see Obama the Candidate hugging Bloggers and the Net Roots now in 2011.

We have been HAD!

Oh, I’m not arguing the merits of the mandate. What you say is true, and a mandate is probably good policy too insofar as increasing the risk pool.

I’m merely saying IMO there’s no way in hell it’s constitutional.

I don’t want insurance. I want healthcare. BIG difference.

I totally agree!

Parker Griffin, gets the best of both worlds as a republican. He gets to vote for the Bill and than Bash the Bill.

What a joke this whole thing is becoming.

Progressive must organized like never before

He definitely got money from Rahm’s DCCC, and he was in their “Frontline” program as a Dem to be protected at all costs.

Aetna needs your money because they provide a service: they skive off 30% to keep us from feeling too financially secure.

This is exactly my reasoning. Where is the AMA? This is going to hurt the healthcare industry badly.

“forget the teabaggers and GOP we, Democrats, have not only NOT delivered a victory we have mobilized the GOP’s base and demoralized, alienated and disenfranchised our own base.”

Well, the teabaggers are also making it harder on themselves because they are seeking to eliminate everyone that they consider to be a RINO. Doing so helps the Demcorats. And most of the teabaggers and others protesting at these rallies likely never supported Obama in the first place.

Now, there are probably many people who voted to make sure Obama won and that we had enough votes in the Senate to support Obama’s healthcare legislation because they lack access to affordable healthcare currently. If we kill a bill that would have given them access to affordable healthcare just because it isn’t perfect… THOSE people are going to not vote for us anymore and we will really lose the majorities we currently have.

I just called Senator Brown of Ohio and spoke with a staff member about his support of this sham of a bill. I made it clear that forcing people to buy insurance under threat of penalty by the IRS is not reform and I am surprised that my senator was going along with it. I expressed my disbelief that he wld think it was ok to tax union workers health care benefits after Obama said he wld not during the campaign. I also told him that just bcz Obama is going to be a one termer does not mean he has to be one also, so he shld quit going along to get along. Finally, I admonished him for not getting something for his vote like Nelson did. If you are going to vote for this bad bill anyway at least get something for the state of Ohio out of it. Despite my calls to my senator, and the money I sent his campaign, he is still going to vote with Obama on this. Which means my vote and money really dont have much influence with the dems. I am supposed to give to them bcz they are better than the repubs- right? Our phone calls and letters and marching means nothing, the only thing the dems fear is losing their access to corporate funds. If they are not in office they cant get paid by their corporate masters. Our only leverage is our willingness to let them lose the next two elections. Progessives are going to have to swallow the bullit and let the dems know that this bill will cost them our support. No if ,or ands about it. If they vote for this we are staying home in 2010 and 2012. Progressives not coming out to vote is the only thing they really fear bcz without us they dont win elections. We have to draw a line in the sand sometime and now is as good a time as any. They have to choose private insurance and big pharma or us, they cant have both.

If it is constitutional to force me to pay for the insurance of other people (Medicaid, people who lack insurance and use the ER but cannot pay, etc) then is HAS to be constitutional for the government to require those people to pay a fair share towards their own coverage.

This bill is nothing if not this Administrations camel’s nose under the tent on the path to dismantle SS and privatize all entitlement programs. If this passes it will embolden the Ideologically bankrupt Administration to destroy the Fabric of America as we know it.

Obama will usher the exact nightmarish economic changes that Democrats have been fighting off from the Republicans forever. Stop these Thieves & Crooks, – stop this and every subsequent deficit reduction inspired bill!

And I agree that this bill should be paid for like the House bill and not off the backs of union labor.

Not “just because it isn’t perfect.” There you go again.
Kill it because it rewards incompetence and inefficiency and it entrenches the very system responsible for the need of reform.

Point of clarification – he voted nay for Healthcare bill.

INTEROFFICE MEMO

TO: United States of America

FOR: All Voters

FROM: Punk’d and Pissed Progressive Voters

RE: Wanted: 2012 Democratic Party Presidential Primary Challenger

We have an immediate opening for a 2012 Dem. Presidential Primary Challenger. We desperately need your help in finding an actual PROGRESSIVE to fill this new position. If you know a potential candidate please refer him/her to Human Resources in the D.C. branch.

Job Responsibilities:

1. Display leadership and political courage (it’s in the job description, really)
2. Listen to your base instead of fat cat corporate lobbyists (important)
3. Tell the truth to your base
4. Understand that your base put you there in the first place
5. Actually do what you say you’re going to do (no, we’re not kidding)
6. Ignore Hopey, Changey urge to engage in window dressing bi-partisanship fads with opponents who don’t even allow the words bi-partisan or compromise in their vocabulary
7. Seize opportunity to take bold action when the going gets tough (even if you might kind of, you know, actually have to get your hands dirty taking an icky out front stand on important issues from time to time)

Qualifications:

Must have spine. Must have cahones. Must have REAL principles. Must have never previously employed R. Emmanuel, T. Geithner or L. Summers in any capacity.

Additional Qualifications:

Must understand that Republicans are dangerous and can’t be persuaded to be nice just because you think it would be really, really super-neato cool if they did.

Applications to be accepted the day after the upcoming November, 2010 mid-term election debacle.

Thanks,

Mgmt.

Dean is not saying kill the bill anymore, but he is still in favor of the public option. “This bill has improved over the last couple of weeks. I would let this thing go to conference committee and let’s see if we can fix it some more, because this…”

http://www.dailykos.com/story/2009/12/20/804127/-Dr-Dean-on-Meet-The-Press:-Softening-His-Stance

Health Insurance Stocks Soar in Value

Wall Street has reacted favorably to the Senate bill.

Stock prices of health insurance companies have been soaring since October 27, when independent Senator Joe Lieberman announced that he would filibuster any healthcare reform bill that included a public option.

Since then, the stock value of CIGNA has jumped 29 percent;
Aetna, 27 percent;
UnitedHealth, over 20 percent;
and Humana, almost 14 percent.

During that same period, the Dow Jones Industrial Average has risen by just over two percent.

can it be any clearer?

any doubt about who has the power in the United States of America?

The house bill also builds on the same system. It keeps for profit insurance in play. And while there are significant differences between the two versions, we know that the Senate bill can pass the Senate. We also know that the house bill cannot pass the senate.

I would rather have a bill that rewards incompetence and inefficiency AND provides access to affordable healthcare for millions of Americans who currently lack it than have a bill that eliminates incompetence and inefficiency that cannot pass the Senate.

I hope you are not suggesting that we try and replace conservative Democrats in swing districts with more progressive candidates who cannot win? Because if you are you did not learn anything from NY-23 (where the conservatives sought to remove the RINO from the election and handed the election to the Democrats who won the election in a district that had elected a Whig candidate more recently than a Democrat).

The teabaggers, along with the club for growth, are pushing for ideological purity. And they will lose seats because of it…. unless we make the same mistake.

after what we’ve seen over the past six months I would like to think the conference committee will turn the sows ear into a silk purse but fairy tales won’t cut it anymore…

already those behind the Stupak amendment are saying the Ben Nelson’s Senate version on abortion funding watered down the Stupak amendment and they won’t vote to pass a bill that doesn’t revert to the original Stupak amendment…

and happy talk from the White House…

You’re missing the forrest for the trees, people!

This bill is Obama’s first step to Privatize every publicly owned piece of the common good in sight! From Public education, SS, Medicare, to National Parks, Highways and infrastructure!

Wake the fuck up!

what difference does it make if we lose seats or gain seats if we get legislative process and product like this alleged health care reform abomination?

go read the polling data on likely to vote in 2010…the damage is already done our base is not going to turn out as things stand now…what do you see happening to change that?

This bill is going to provide affordable healthcare!? Does Jane’s second quote not resonate? In four years some people MIGHT be able to go to the doctor IF they can pay the deductable?

Has anyone here tried to pay the mountain of bills that come from the hospital from rejected claims for extensive care? Have they had to call again and again, or written letters to insurance companies arguing the points of a policy’s fine print?

The government is going to improve this by fondling the balls of the insurance lobbiests and extorting another 30 million “customers?”

I don’t see a problem with the Democratic Party suffering losses in 2010 or 2012. I’ve never been a registered Democrat, and it’s never been more obvious that the Democratic Party is a wholly-owned subsidiary of One World Corporation. So, when people say “we” will suffer losses in 2010, I respond, “What you mean ‘we’, blue dog?’

Yes, Greenwald largely sympathizes with FDL’s position and says much in its defense, but I think it couldn’t be clearer that he is currently ambivalent — because that’s exactly what he said. Hell, I wish he weren’t ambivalent; I wish he’d unequivocally support the progressive position, too, but personal biases shouldn’t misrepresent a respected liberal voice, as the headline does.

If you think he shouldn’t be ambivalent, though, head over to Salon.com and offer some feedback. (That’s what I did. :P)

i agree, that’s my take as well.

welcome to my world PW. only wish it wasn’t so.

I’d rather kill them both, not trust the falacious assertion you’re going to save anyone with this card trick, and wait until the financial and medical problems this country will surely face in the upcoming couple of years bring people to the voting booths to elect people not in bed with the entities imposing the misery.

“If we kill a bill that would have given them access to affordable healthcare just because it isn’t perfect… THOSE people are going to not vote for us anymore and we will really lose the majorities we currently have.”

asking…excuse me that would be legally mandating… a family of four earning less than $40K to pay 20 percent of their income for health insurance providing an ill defined quantity questionably affordable (copays) of health care isn’t going to endear anyone to the Democratic party and if you think so you are one of two things…a GOP operative masquerading and lurking here as something else…or a Democrat comfortable with the idea that our party is run by and for the benefit of corporate interests…

…in the final analysis there is no difference between those two

via private insurance?

….

jmo, but different people are going to have different lines and different ways to weigh the pluses and the minuses. and the more good info we can all get the better we will all be able to weigh the issues according to our own values (and personally, i appreciate being able to argue the issue with people who disagree with me because it helps me learn more and think better about the issues, and sometimes i am convinced to change my mind.)

my big objections right now are 1) the position of “any bill” and 2) spin, misleading arguments, dishonesty, etc.

““If you are free to choose to not have insurance and then you suffer a catastrophic loss, then you are using ME as your unpaid insurer when you go to the ER and cannot afford your medical bills. Those costs are passed on to me and everyone else who pays for their own insurance. So while you get to bask in you so called freedom, you make me your slave”. “

When you manadate everyone buy coverage, and then subsidize some peoples payments to the insurance cartels with taxpayer money, that makes you their slave as well.

Personally, I would rather have my taxdollars go straight my fellow citizen in the form of a single payer system. I would much rather be “enslaved” by my fellow citizens than by the insurance cartels.

If this bill were to pass as is…
It would remove any chance I have to access health care.

If I am forced to purchase insurance, even the cheapest plan, and then pay the first 1,200 out of pocket and co-pays, I won’t be able to do anything but pay the premium or the fine. I won’t be able to afford to actually use the insurance.

This is also true for me. I just gave up my high-deductible insurance because I got nothing from it. If I had enough of a claim for it to pay anything, my savings would be wiped out before I was finished with co-pays. I am now uninsured.

Here’s the deal, something is going to pass and get signed. We might as well accept that and try to make it as good as we possibly can. That’s the reality of the situation. And a lot of the mandate stuff will probably never come to pass. I don’t think people will put up with it.

Yelling “NO! I refuse to submit to being raped!” is not ideological purity.
Saying “We’ve got to compromise until we’ve accomplished a negative result,” is definitely a sell out.

You are absolutely wrong, mandates are never required for the purpose of insuring a well functioning risk sharing pool. In every case, people enter this sort of risk pool because there is a demonstrable advantage to them for doing so. If that advantage is not there they are under no obligation to share in that pool.

The advantage of sharing risk is that when you need coverage your cost for care is less than what you contribute in taxes or premiums. Only then is the arrangement to your advantage, a mandate is never the reason for you enter the risk sharing pool.

It has been shown that under Medicare you pay a progressive 2.9% progressive tax based on your income, in return for which you get comprehensive care at no cost to you. As opposed to this, the proposed bill requires that you pay up to 8% of your income in addition to co payments and deductibles for muuch more restricted services. This arrangement is not affordable for many of lower and middle incomes. Therefore there is no advantage for them to enter into this plan.

If there is no advantage to the plan there can be no mandate.

Exactly.

Then where does it end? Big Oil CAN lobby for a mandate for us purchase gas guzzling SUV’s? The Beef Industry can lobby for a mandate that we purchase at least 30 lbs. of beef per year or face an IRS penalty?

Sorry, comparing being forced to purchase something from a private entity to being forced to pay taxes that provides services to others is not the same. It just isn’t, IMO.

Take your Shock Doctrine Outcome and Be Grateful

Watching Obama pronounce this permanent profitability guarantee for Big Insurance & Pharma as the most important leap forward in the public interest by reforming health care access. quality and cost containment in decades, he’s taken on that a deer in the headlights demeanor.

Obama knows that this result is a monumental sellout, which is only compounded by his outright lies.

We can debate the political fruit of this poisoned tree, but one thing is clear — for all the talk of change in process and outcomes — this adminstration and congress operates within very narrow boundaries defined by the corporate interests that fund their election campaigns.

If you listen carefully when Obama’s lips move, you can hear the sound of a hundred million cans getting kicked down the road.

I lurk alot but have learned so much from FDL. Thank you.
With that said, I face a bleak future too, as the commenter at Pam’s said. I cant even fathom what this bill will do to my husband and I (60, 57), as we dont have insurance, are on foodstamps and barely scraping by. We’ve managed to keep the house but only with getting a lower payment through some program (gov? donknow spouse applied) for 6 months w/2 mns left. And now with an insurance mandate coming, are you fucking kidding me?? It’ll be prison for the majority of us. Like another commenter – is this the reason for the increase in prisons the last few years?? Are we looking at martial law soon when we revolt…because it’s gonna happen. Nobody i know is gonna sit back and take this.
Scary times we’re living in. REally scary.

This reminds me of when Candidate Obama spoke against mandates in the primary, saying that “if the mandate was the solution, we’d end homelessness by mandating that everyone buy a house.”

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

“What’s costing the president are three things: a laissez faire style of leadership that appears weak and removed to everyday Americans, a failure to articulate and defend any coherent ideological position on virtually anything, and a widespread perception that he cares more about special interests like bank, credit card, oil and coal, and health and pharmaceutical companies than he does about the people they are shafting.” Drew Westen, Leadership Obama Style

I think it is more that last of the three than anything else, and explains the others. Obama is captive to special interests, as are many of the key members of the Congress, and the Obama Administration, and the Federal Reserve. And I should add his two predecessors.

It explains why he cannot articulate a coherent ideological position and make it stick. Make no mistake, he is a smart and verbally adept individual, a gifted person intellectually. But he cannot adhere to principles because he has abandoned whatever principles he may have had to serve a variety of corrupting interests. And he appears laissez faire and distant because he is a figurehead, a household servant, and not in control.

What makes Obama a greater failure than either Bush or Clinton is that he was elected on the promise of reform, a promised change, a political renewal in a country sickened by the erosion if not betrayal of its republic by men who view the Constitution as ‘just a goddam piece of paper.’

“what difference does it make if we lose seats or gain seats if we get legislative process and product like this alleged health care reform abomination?”

The difference is all the other things that conservative Republicans would vote for if they are in office.

Again, we are cutting off our noses to spite our faces if we think that eliminating people who caucus with the Democratic party for people who are more ideologically pure who cannot win.

mekathleen @ 99

ok, that is it. Obama has *clearly* had some sort of brain transplant.

what. a. fucking. mess.

maybe the bill will get so bad in conference that people will fall by the wayside on all sides and everyone else will *finally* head for the streets. there is some hope of that I suppose.

go Jane. (how the hell do you keep all this up, girl?)

a family of four earning less than $40K to pay 20 percent of their income for health insurance providing an ill defined quantity questionably affordable (copays) of health care isn’t going to endear anyone to the Democratic party

What bill are you reading that would allow for such a situation to happen. Even the “top 10 reasons to kill the bill” places the maximum premium payment at 8% (assuming no subsidies at $40K, 8% would be $3200. To get to 20%, you would need 4800 in cost sharing. Assuming an 80/20 split for coinsurance, that would mean the person had a medical bill of $24000. Now you answer me this. What do you think that person with a salary of $40,000 would rather pay, $8000 towards the cost of their health bills or $24000 towards the cost of their health bills? I think the answer is pretty clear.

And the healthcare option that I have at work, a low premium/high deductible plan with an HSA account (something many liberals oppose, for whatever reason) the max I would ever pay out of pocket is $5K total (including premiums).

if you think so you are one of two things…a GOP operative masquerading and lurking here as something else…or a Democrat comfortable with the idea that our party is run by and for the benefit of corporate interests…

…in the final analysis there is no difference between those two

Nothing like trying to shoehorn someone into one of two manufactured groups. I am far from a GOP operative. Between March and December I cohosted the only progressive radio show in the New Orleans radio market (and only left it because of a disagreement with my cohost). And I am not comfortable with the idea with the Democratic party being run for the benefit of corporate interests.

I want a better bill. But I also understand that if we don’t have the votes to GET a better bill that we need to get the best bill we can get. Period.

Yelling “NO! I refuse to submit to being raped!” is not ideological purity.
Saying “We’ve got to compromise until we’ve accomplished a negative result,” is definitely a sell out.

Fine. Put up a bill with a public option that caps MLR at 90% and that fully funds abortions. You think that will pass? I sure don’t.

You are absolutely wrong, mandates are never required for the purpose of insuring a well functioning risk sharing pool.

Mandates are required if you eliminate preexisting conditions. How else do you stop antiselection?

In every case, people enter this sort of risk pool because there is a demonstrable advantage to them for doing so.

If you eliminate pre-existing condition clauses and you don’t mandate care, it then becomes desirable to only purchase the insurance product only when you intend on using it (like when you are about to plan a pregnancy or if you are already feeling sick). That is antiselection.

The advantage of sharing risk is that when you need coverage your cost for care is less than what you contribute in taxes or premiums. Only then is the arrangement to your advantage, a mandate is never the reason for you enter the risk sharing pool.

The reason people purchase insurance now is because they cannot wait until they have a condition they want treated so it is advantageous for them to buy into the plan now when they are healthy (assuming they can afford it). Again, if you drop the preexisting condition clause, it them becomes advantageous for people to wait.

“It has been shown that under Medicare you pay a progressive 2.9% progressive tax based on your income, in return for which you get comprehensive care at no cost to you.”

Well of course there is a cost to you! The cost is the money you put in as part of your employment for your life.

As opposed to this, the proposed bill requires that you pay up to 8% of your income in addition to co payments and deductibles for muuch more restricted services. This arrangement is not affordable for many of lower and middle incomes. Therefore there is no advantage for them to enter into this plan.

Lower and middle income people will be obtaining subsidies that will likely make their payment MUCH less than 8% of their income. And, I keep bringing up this point, the person who is lower to middle income would much rather pay 20% coinsurance up to the max out of pocket figure instead of paying 100% with no “max out of pocket” except for what you declare in bankruptcy.

If there is no advantage to the plan there can be no mandate.

See my response to teoc for the advantage.

“Fine. Put up a bill with a public option that caps MLR at 90% and that fully funds abortions. You think that will pass? I sure don’t.”

Do you think, however, that the majority of the american public doesn’t support that? I believe they do, – so, passage is a matter that reflects on the health of our democracy, and in that respect we are suffering from an enormous deficit.

Then where does it end? Big Oil CAN lobby for a mandate for us purchase gas guzzling SUV’s? The Beef Industry can lobby for a mandate that we purchase at least 30 lbs. of beef per year or face an IRS penalty?

The reason for the mandate is to eliminate anti-selection. There is no real anti-selection argument in the purchasing of SUV or the purchase of food products.

Sorry, comparing being forced to purchase something from a private entity to being forced to pay taxes that provides services to others is not the same. It just isn’t, IMO.

Ignore the medicaid argument then and focus on the ER. When an uninsured person uses the ER, the hospitals pass the costs on to you and me via higher costs. So we are paying our private insurers more money to provide healthcare to those who are uninsured. On top of that, the healthcare they are receiving is emergency care, something that is much more expensive than preventive care.

So if I am going to be paying for it anyway, either through higher insurance premiums to cover their more expensive emergency care OR by paying tax dollars towards subsidies to enable that person to get affordable preventive care, I choose the option that enables them to get cheaper preventive care. And since I am being forced to pay for their healthcare either way, it is only fair and equitable that they be asked to pay THEIR fair share as well. Call it equal protection under the law, something guaranteed by the 14th amendment.

I cant even fathom what this bill will do to my husband and I (60, 57), as we dont have insurance, are on foodstamps and barely scraping by. We’ve managed to keep the house but only with getting a lower payment through some program (gov? donknow spouse applied) for 6 months w/2 mns left. And now with an insurance mandate coming, are you fucking kidding me?? It’ll be prison for the majority of us.

What is your income? Even though the “top 10″ list says that the cost will be up to 8%, if you still make too much money to qualify for medicaid yet you still have food stamps, I cannot imagine that 8% is a lot of money AND you should also qualify for subsidies that would bring down your percentage much further.

Like another commenter – is this the reason for the increase in prisons the last few years??

They removed the language from the Senate bill that would make it a criminal act. It only attaches civil penalties that can be only collected via excess withholding.

“Fine. Put up a bill with a public option that caps MLR at 90% and that fully funds abortions. You think that will pass? I sure don’t.”

Do you think, however, that the majority of the american public doesn’t support that? I believe they do, – so, passage is a matter that reflects on the health of our democracy, and in that respect we are suffering from an enormous deficit.

With the abortion language, no. I think a majority of America agrees with the Hyde amendment in that the only abortions that can be funded from federal funds are those coming from rape or where the health of the woman is in danger.

Of course I don’t think we should have the Hyde amendment to begin with but this isn’t about me, it is about the bill and what people want.

And of course we do not live in a Democracy, we live in a Republic. Nothing at the national level ever requires a simple majority of the voters to pass it. And thank goodness for that, because I don’t think we would have had civil rights advancements.

So, again, I am back to “would such a bill pass”. And I don’t think it would. I want to pass the best bill that we can pass. It does us no good to write a bill that both you and I would agree is better for our nation than the current Senate bill. But if that bill cannot beat a filibuster and will not make it to Obama’s desk, then all we have done is an exersize in staring at our navels.

I also feel the need to point out that the post over at the empty wheel makes one really bad assumption. The post calculates healthcare as a post-tax expense instead of pre-tax income.

All my premiums and contributions to my insurance and health savings account are taken out of my income before taxes are calculated.

And I, again, have to repeat, that the both families without insurance in the empty wheel scenario, assuming an 80/20 cost sharing split of coinsurance, would have paid just under $40K of medical bills without that insurance. Welcome to bankruptcy.

That article is probably the best thing ive read all week or even all month. I whole-heartedly agree with nearly every point made.

How long will it be before big business/corporations will have bled every working American totally dry? The massive giveaway to Wall Street only left other sectors of U.S. capitalism hungry for their share of the predatory fleecing of America. So now its time for the health insurers and Big Pharm (who want to cement the windfall they already got with Medicare Part D).

Come on, everybody, jump right in.

And, oh, did I forget the defense industries? They are sitting pretty right about now, too.

If it weren’t for Jane and Marcy and everyone here at FDL, the crooked fake-progressives in Congress would be parading their false reform and slapping each other in the back.

And Senators Franken and Sanders and Harken, don’t try and pull your progressive credentials out of the fire, because we know where you stand.

Politics of the possible = Failing the American people.

“I want a better bill. But I also understand that if we don’t have the votes to GET a better bill that we need to get the best bill we can get. Period.”

This bill is the first step in privatizing all public good in the name of discredited Free Market ideologies that have created a global recession.

On the other hand, if you are going to mandate insurance, you better add price controls.

I know the reason for it, and smart folks will be able to come up with very good reasons for why their product/service should be mandated too.

Orange growers could point to studies showing drinking a glass of orange juice a day extends life and prevents illnesses, thus increasing worker productivity. OK, mandate that. After all, your taxes are paying for subsidies of others health care, therefore, if drinking orange juice everyday saves medical costs, then an equal protection argument could be made that folks should be mandated to purchase orange juice so you’re not paying more than you should for their care.

Like I said, you set a precedent that government can force citizens to purchase goods/services from private entities, then there’s going to be a lot of smart folks working out the next good/service to be mandated. Call it the slippery slope if you like.

Of course, the courts could rule (correctly, IMO) that this is unconstitutional. Then what happens to “reform?” The mandate is kicked out, the healthy don’t purchase insurance, and premiums skyrocket for the rest of us.

Or, they rule it is constitutional, and lobbyists in every other industry begin their arguments for why their good/service should also be mandated. Lose/lose situation it seems to me.

Let’s keep things simple.

People are willing (never mandated) to pay into a large risk pool irrespective of their health because when they become ill their health cost will have already been assumed by both their contribution and that of others.

People enter into that arrangement willingly for the advantage derive. A mandate is never a consideration in their decision it is only the advantage they derive that governs their decision.

Saying, as you do, that sick people enter into the risk sharing plan is saying the obvious. Why else does health insurance exist?

When you say that forcing insurance companies to assume the high cost of insuring the sick without the forced premiums of healthy people is not profitable, that is true. But making profits for insurers is not to the advantage of healhy people. Their advantage lies only in securing benefits when they become ill.

Again, mandates are never a consideration in why people choose to enter into a health risk sharing pool. I would love for you to give me a counter example of this statement.

This bill is the first step in privatizing all public good in the name of discredited Free Market ideologies that have created a global recession.

How is it the first step in privatizing public good? Medicare, Medicaid, CHIP, the VA, etc are all remaining government run programs.

Again, isn’t there going to be a nationally available non-profit option offered via the exchange that is managed by the same people who manage the federal employees health insurance plans?

I know the reason for it, and smart folks will be able to come up with very good reasons for why their product/service should be mandated too.

I am fairly certain that nobody will be able to come up with a good reason for why other things (like gasoline, beef, orange juice, etc) would need to be mandated. You are basically invoking the slippery slope logical fallacy.

Like I said, you set a precedent that government can force citizens to purchase goods/services from private entities, then there’s going to be a lot of smart folks working out the next good/service to be mandated. Call it the slippery slope if you like.

That’s what I get for not reading the entire post first. But I had to leave in my response for humor value. At least you acknowledge that it is a slippery slope argument.

Of course, the courts could rule (correctly, IMO) that this is unconstitutional.

Of course they could. Of course they would then have to eliminate Medicare as well, since we are forced to pay for that. The very fact that we have funding for medicare taken out of every paycheck seems to verify that government can mandate that you pay for a healthcare service.

Then what happens to “reform?” The mandate is kicked out, the healthy don’t purchase insurance, and premiums skyrocket for the rest of us.

Either that or the pre-existing condition clauses would have to return.

Or, they rule it is constitutional, and lobbyists in every other industry begin their arguments for why their good/service should also be mandated. Lose/lose situation it seems to me.

I doubt any lawyer would be able to find a rational basis to mandate the purchase of OJ, Vehicles, or any other consumable good or service.

One thing people at this point are not looking at is what to do in the event the bill passes, with all its attendant ill effects. I think we should be looking at the prospect of this outcome long and hard, not in order to accept its ill effects but to counter them.

In my mind we should draw the line at the inclusion of mandated purchase of insurance for two reasons. One is that in the absense of mandates the whole effort is like to fail. And two if it is passed into law it is the easiest provision to overcome by simply refusing to comply, and making that intention clear.

Because defeating the passage of this bill or improving it seems unlikely it behooves us to consider what must be done should it become law as is. We have to start developing a range of actions to pursue.

One aim is to rebutt claims that in defeating this bill we hamper the well being of millions of uninsured. The other is to make the case that this is a huge transfering of wealth to private predatory firms. And lastly we need to consider what collective actions we can take to counter the ill effects of the bill.

I think also that we should be clear on a set principles to stand by, such as the elimination of private insurance companies in favor of Medicare for all. Also make the case of the complicit nature of government in order to install reforms as relates facilitating their removal from office, for cause.

I think we should anticiapte that unless we do something we will be burdened with the worst and most likely scenario. We better do something fast and make our intentions clear.

My response to the CBO is “so what?” Since when does the CBO set policy? They are number crunchers. And if a 90% or higher MLR makes it a gov’t program, so be it.

Let’s keep things simple.

Ok, though this is hardly as simple subject.

People are willing (never mandated) to pay into a large risk pool irrespective of their health because when they become ill their health cost will have already been assumed by both their contribution and that of others.

True, but currently their individual health status could determine their ability to purchase insurance because of the existence of pre-existing condition clauses.

People enter into that arrangement willingly for the advantage derive. A mandate is never a consideration in their decision it is only the advantage they derive that governs their decision.

True. And I am sure that if the cost made it possible for them to purchase the insurance that many of the currently uninsured (or underinsured) would be likely to buy insurance without the mandate, especially those who currently have health problems. But many might look at their current financial situation and say “the money I would be required to pay towards my insurance could be spent on other things, so let’s just wait on the insurance purchase until I need it”. And then it stops being insurance.

Saying, as you do, that sick people enter into the risk sharing plan is saying the obvious. Why else does health insurance exist?

Health insurance exists to provide healthcare for people when they get sick. The way health insurance works is that you insure a large enough pool that when some people get sick, others are not. But those others are still paying for the insurance so the entire system does not collapse. It would never work if people would be allowed to only start paying for premiums once they believed they needed to see a doctor.

“When you say that forcing insurance companies to assume the high cost of insuring the sick without the forced premiums of healthy people is not profitable, that is true. But making profits for insurers is not to the advantage of healhy people. Their advantage lies only in securing benefits when they become ill.”

I didn’t use the words “not profitable” did I?

If we had a not for profit public option, it too would fail if we did not mandate coverage as well because people would have a financial incentive to use anti-selection.

The reason why we have pre-existing condition clauses now is to prevent anti-selection. If we eliminate those clauses, we need to find another way to prevent anti-selection. The only way I can think of is mandated coverage. Now, mandated coverage is only fair if it is available on a sliding scale based on your ability to pay.

Unless you can come up with another way to eliminate anti-selection while eliminating pre-existing clauses, then you have to go with mandated coverage.

Again, mandates are never a consideration in why people choose to enter into a health risk sharing pool. I would love for you to give me a counter example of this statement.

Mandates are never a consideration currently because mandates do not currently exist. You are creating a false argument. You are arguing that people do not use something that does not exist as a deciding factor. Of course that is true. It is also irrelevant. It is like saying that people don’t consider the color of flying unicorns when determining if they should enter into a health risk sharing pool. Again, a true statement but it means nothing. So you are being disingenuous when you ask for a counter example.

This is a waste of time since I’m guessing neither of us are lawyers and have no say in how they’ll rule anyway. But did want to respond to one point and then leave. Again you’re comparing apples to oranges. Medicare is paid through taxes. No one is arguing taxes are unconstitutional. That is not the same as the government forcing you to purchase something with your (after tax) money from a private entity no matter how you try to spin it. It’s. Just. Not. The. Same.

And the mandate isn’t the only problem with the bill (wish it were), and, further, IMO the mandate is good policy. I just think it’s unconstitutional. I think having Barack Obama sign an executive order providing single payer to all Americans would be good policy too, but I’m pretty sure that would be unconstitutional as well.

This bill needs to die because of it’s other features, such as no real cost control mechanisms, which in time will lead to fewer folks receiving subsidies. As well as not doing what health reform should do, which is prevent folks from dying due to lack of health care or going bankrupt for using it. There are still going to be deaths due to lack of healthcare, and there are still going to be bankruptcies due to using it.

And for folks with really good insurance paid for by their employers, they’re going to gradually (or maybe not so gradually) see their plans become worse so as to not trigger the excise tax. These (mostly working class) folks are going to remember well which party did this to them.

This bill doesn’t do what health reform should do; it doesn’t really do anything to control costs of healthcare; it provides some with health insurance but doesn’t guarantee them care; it solidifies the role of the immoral for profit insurance industry, and in fact expands it and provides it with new meat and more profits; it harms those with employer paid plans that are very good; it leaves millions without care; and it will not be “improved” or “fixed” within the next decade. I’ll bet anyone on that.

Have a great day.

Again you’re comparing apples to oranges. Medicare is paid through taxes. No one is arguing taxes are unconstitutional. That is not the same as the government forcing you to purchase something with your (after tax) money from a private entity no matter how you try to spin it. It’s. Just. Not. The. Same.

Medicare is forced payment of funds so you have health insurance later down the road.

The mandate is a forced payment of funds so you have health insurance now.

And why would the mandate be with after tax money? My current health insurance premiums and contributions to my HSA account are all pre-tax expenditures.

I am not saying that forced medicare payments and forced insurance payments are the same. But they are similar enough for comparison purposes that I do not see a challenge to them being successful.

The very minute”That Nancy Pelosi” threatened us with JAIL for not having health insurance I changed from a Democrat to an Independent!I know they or no-one really gives a damn,but as a lifelong Democrat and a wholehearted backer of Obama, that was it for me.And now what was it all for? The Republicans have ruined it for everybody.I’m so sick of them,esp.the ones that are so called religious.Everywhere I turn there are mean,rude,uncaring people who don’t give a damn about anyone besides themselves and their families/friends,etc.I do believe this bill does more harm than good,and I do believe the young lady may become homeless.I was homeless for almost 5yrs when I lost my job as a nurse,and I lost my job due to the same mentality as these obstructionist senators,and I couldn’t afford health insurance when I had the job.I have PTSD from being on the wrong end of Republican /religious mentality.They truley are “It’s people like you that make people like me have to take medication.” And now they don’t wanna give health insurance for people harmed as the consequences of their actions.

calculations for a typical family of four with a 40 year-old-head of household in 2016 from MIT’s Jonathen Gruber based on CBO official cost estimates

http://voices.washingtonpost.com/ezra-klein/2009/12/the_most_important_table_youll.html

$36,275 (150 % of federal poverty line)

costs w/o reform

annual premium $12,042; annual out of pocket max $12,600 total risk $24,642 (68 percent of income)

costs with reform

annual premium $1,966; annual out of pocket max $4200; total risk $6166 (17 percent of total income)

total risk for $48,367 annual income (200 percent federal poverty line) is 21 percent

total risk for $60458 annual income (250 percent federal poverty line) is 20 percent

total risk for $72,550 annual income (300 percent federal poverty line) is 23 percent

total risk for $84,642 annual income (250 percent federal poverty line) is 22 percent

ok less than $40K is 17 percent of income but that is money not going to a college fund, bottom line this is yet another transfer of wealth from the bottom and middle to the top…

I assure you the difference between a social compact and a private contract is quite sharp.

Oh, by the way, if you’re looking for a Democrat blog, try dKos. The D party can stop trying to hijack the word “progressive” any time now.

OK unicorn let’s see where you and I differ as regards mandates, of which you seem enamored.

I claim that mandates never are a consideration when determing the reason people enter into an insurance scheme, health or otherwise. You claim that in the current Senate bill we ought to have mandates otherwise it will not be workable for private insurers in amassing their profits, regardless of the fact that this is of no benefit to those being insured. I of course claim that what you contend is absurd.

What makes insurance attractive is the advantage of defraying the cost of the outcome of risk with others. The more the merrier. That advantage accrues only when everyone shares in the risk. But it is always the advantage that flows from everyone partaking that people seek and what makes the scheme worth having. Not any mandating of partaking in that risk.

In your interpretation you claim that we must have mandated sharing of risks even if there is no advantage to those that join the scheme. But rather because that allows for profit companies to continue to profit. Which is absurd.

Or are you claiming that for profit insurers do not profit. Or that there is an advantage to those that pay premiums to insurers and get little in return.

Far from acceding to joining merrily into the clasps of private insurers for the sake of their profit what needs to be done is for those that can forego health insurance now to absolutley refrain from the mandate to buy insurance. In so doing they will make it unworkable for insurers to take in sick people and to be unable to rescind sick people. The ffort is to make the current scheme that benefits only the private insurers fail.

What you are missing from my post is that the family of 4 wont be able to afford insurance premiums that high and will likely go uninsured. So if they had an injury or condition that made them hit that max out of pocket for the year figure, with an 80/20 coinsurance that is fairly standard in regular health insurance plans, they would have incurred $63,000 in medical costs.

And I would ask where that $4200 figure for out of pocket maximum comes from. (I know from Ezra Klein who got it from an MIT study based on the CBO, what I am asking is where in the legislation (and which legislation) establishes a $4200 out of pocket maximum for a family of 4?

OK unicorn let’s see where you and I differ as regards mandates, of which you seem enamored.

It is not that I am enamored with mandates, I just know that we need to avoid antiselection… public option, non-profit nationwide plan offered via the exchange, or private plans all need to avoid anti-selection. Because once it behooves someone to wait to get insurance until they are sick, it stops being insurance. Period. If you have a suggestion on how to remove the pre-existing condition clause without having anti-selection be a problem… I am all ears (or eyes, technically).

I claim that mandates never are a consideration when determing the reason people enter into an insurance scheme, health or otherwise.

And I explained to you that your claim is a false argument because right now we don’t HAVE mandates, so OF COURSE it is never a consideration. Right now insurance companies use the pre-existing condition clause to remove antiselection.

You claim that in the current Senate bill we ought to have mandates otherwise it will not be workable for private insurers in amassing their profits, regardless of the fact that this is of no benefit to those being insured. I of course claim that what you contend is absurd.

NEVER did I base my argument on profits. That is YOUR strawman argument. Antiselection would KILL the public option (that I 100% support and wished we had the votes for it), it would KILL a not-for profit option and it would kill private, for profit industries. You seem to not grasp that point. Are you familiar at all with the insurance industry?

What makes insurance attractive is the advantage of defraying the cost of the outcome of risk with others. The more the merrier. That advantage accrues only when everyone shares in the risk.

But an insurance product becomes more attractive if you can wait to buy it until after you know you are sick. Because then you do not have to pay all those pesky premiums while you are healthy. It no longer becomes risk management. It becomes a medical discount card and it is NOT how an insurance plan works (even the public option insurance plan, which would NEED a large pool, just like all other insurers would need)

But it is always the advantage that flows from everyone partaking that people seek and what makes the scheme worth having. Not any mandating of partaking in that risk.

Again, you are arguing that people don’t consider something that doesn’t exist.

In your interpretation you claim that we must have mandated sharing of risks even if there is no advantage to those that join the scheme.

WRONG! In my interpretation, I say that we must have mandated coverage in order to prevent anti-selection. Once you allow anti-selection to enter into the picture you eliminate any sharing of risk.

But rather because that allows for profit companies to continue to profit. Which is absurd.

This discussion will go nowhere if you keep erecting strawman arguments. I am talking about anti-selection, not profit. Keep up.

Or are you claiming that for profit insurers do not profit. Or that there is an advantage to those that pay premiums to insurers and get little in return.

I am claiming none of that. For some reason you keep insisting on misrepresenting what I am posting.

If we kill a bill that would have given them access to affordable healthcare just because it isn’t perfect… THOSE people are going to not vote for us

You don’t seem to get the point that we’re trying to kill the bill precise because it won’t give the people you refer to access to affordable health care.

We’re not holding out for “perfect.” We’d like “good” or “workable,” not “mandates giving money to the enemy to make them even stronger.”

There are SO many features of this bill that assure that things will get worse for the very people you seem to be worried about. How do you think they’re going to feel — and who do you think is going to help them realize those feelings — when this travesty delivers NO improved health care or access thereto? How do you think those folks are going to vote then?

You don’t think we could attach a public option later on down the road?

I have seen on many sources that the Senate Bill has a not-for profit nationally available plan that will be managed by those who run the federal employees health system. People will be able to use subsidies to get into that plan. Do you not think that is a reasonable enough of a substitute for the public option for now?

And this plan WILL insure many people who are currently not insured. What about them? Just hang them out to dry because we couldn’t get a bill with everything we want in it? If those families have a major medical issue, I guarantee you they would rather have paid the $12,000 max out of pocket as opposed to $60,000 that they would have been required to pay without insurance. Would they RATHER a plan better than one that has a $12,000 max out of pocket plan? Sure! Would I rather a public option be in the plan? SURE! Do I want a plan that allows me to keep my low premium/High deductable HSA plan that works the best for me in my situation (even though such plans do not work for everyone)? ABSOLUTELY! But sometimes we have to give up some things in order to make some progress.

I have seen no GOOD arguments as to why this bill doesn’t make progress. Yes it has flaws, yes I am not happy with public subsidies going to private insurers. And yes I wish we could pass the house bill over the Senate bill. BUT WE CANT.

Reconciliation also fails to give us what we want (and I disagree with the idea that the public option could be passed via reconciliation, there is more to the public option than budgetary concerns).