Is Health Care Reform Worth Doing Without A Public Option?

This is a loaded question, inspired by this from Matt Yglesias:

Al From has one of these op-eds where you urge liberals to drop hopes for a public option in the interests of being pragmatic and passing health reform. I sort of agree with thisóreform is worth doing even without a public option.

(Emphasis supplied.) Matt expresses the view of the "progressive" Village wonks (Ezra, Jon Cohn, Steve Benen, himself, Kevin Drum etc.) and I urge people in the coming weeks of intense negotiations to read whatever they write on the public option through that prism - they do not really care about the public option.) I suppose I could imagine a health care "reform" (reform to me means more than just giving more money to Medicaid and subsidies for purchasing insurance to the less well off) proposal without a public option that would be worth doing. But my imagination is not the playing field - the actual health care proposals in play are. And there is not one of them, none, that is worth doing without a public option. Indeed, without a public option, they are very worthy of strong opposition. Most especially because of the individual mandates that they include.

I really think this is an important point, and one progressives in Congress need to make - that they do not see, say BaucusCare, for one example, as an improvement but rather as a step back and they would feel no compunction at all voting against such a bill. It is a bad bill. On policy and politics. If the choices are BaucusCare and nothing, nothing wins by a country mile imo.

Speaking for me only

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    Why doesn't the White House understand (5.00 / 1) (#1)
    by oculus on Fri Oct 16, 2009 at 11:39:49 AM EST
    this?  People are going to be mightily pissed if BaucusCare passes and Pres. signs it.

    Why do you imagine they don't? (5.00 / 4) (#51)
    by lambert on Fri Oct 16, 2009 at 02:09:31 PM EST
    I mean, at this point, why assume that the voters are the constituents of the Democratic Party?

    I am a cock-eyed optimist. (none / 0) (#73)
    by oculus on Fri Oct 16, 2009 at 04:50:14 PM EST
    Politically... (none / 0) (#3)
    by Jerrymcl89 on Fri Oct 16, 2009 at 11:43:17 AM EST
    ... Obama needs a bill, even if it's a bad one. The question is whether progressives in Congress will or should give him one. Their interests are not identical to his.

    Obama can get legislaton (5.00 / 2) (#5)
    by Big Tent Democrat on Fri Oct 16, 2009 at 11:46:43 AM EST
    progressives like through reconciliation.

    Which some conservative radio (none / 0) (#6)
    by oculus on Fri Oct 16, 2009 at 11:48:15 AM EST
    talk show guy (not Limbaugh) derided last night as "behind closed doors" and an oligarchy.  

    Which, in fact, is true (none / 0) (#52)
    by lambert on Fri Oct 16, 2009 at 02:10:59 PM EST

    1. The "behind closed doors" part (by definition);

    2. and the oligarchy part.

    Not an oligarchy... (none / 0) (#70)
    by NealB on Fri Oct 16, 2009 at 04:24:08 PM EST
    ...when it's the democratically elected President, Senators, and Representatives.

    Oh dear (none / 0) (#71)
    by Spamlet on Fri Oct 16, 2009 at 04:37:20 PM EST
    You had to say this:

    the democratically elected President, Senators, and Representatives.

    Granted, some of the senators and representatives must have been democratically elected. Indeed, in my lifetime I've seen this happen. But our president was Democratically elected, and aspects of that process do seem to have been of a piece with the oligarchical elements now evident in our situation.


    Yes (5.00 / 5) (#7)
    by TeresaInSnow2 on Fri Oct 16, 2009 at 11:55:22 AM EST
    As long as the law goes into effect AFTER his re-election, it's good for him.

    BUT IT'S good for ONLY HIM and only HIS re-election.  Although maybe not good for his post-administration book deals if the public hates him for it, once they figure out what it is.

    However, a bill like Baucuscare is BAD, BAD, BAD for Democrats in the long run.  BAD.

    I believe Baucuscare is FAR WORSE for Democrats than the Iraq War was for Republicans.


    Personally, I think the ONLY thing (5.00 / 4) (#18)
    by Inspector Gadget on Fri Oct 16, 2009 at 12:28:26 PM EST
    that would be good for Obama politically is to do one of two things:

    1. Demand a HCR bill that is good for the people of this country, or

    2. Refuse to sign a bad bill on behalf of the people of this country.

    If he signs a bad bill just to sign a bill, he will be lucky to keep congressional majorities in 2010, and his own job in 2012.

    To prove himself ready for his job, he needs to act like the people of this country are important enough for him to fight for what is right.


    Obama Needs A Bill Even A Bad One? (none / 0) (#95)
    by norris morris on Sun Oct 18, 2009 at 03:20:57 PM EST
    We did not vote for Obama's political cover.

    If we don't get a good healthcare reform bill from Obama he will have reneged on his promises.

    A mid to lousy bill simply enriches Insurance and Drug Industry to an obscene level. Imagine all those new victims who have no other bargainng recourse, and must use existing Insurance monopoly rates?

    This is not acceptable. No bill allows us to fight again and harder, and that includes Obama. He has mishandled this from the start. Where is the open dialogue he promised,and why didn't he come out clearly for what he wanted in the bill?

    He has dodged,and whined. Last week Obama said"Change is hard. Real change even harder."

    Er, no kidding? He didn't know this as he regaled us to vote for him as The Change Agent Of Our Age?
    I voted for Obama.  He has done nothing on healthcare except to make backroom deal with BigPharma and Insurance. In looking for political safety he has acted like jello, and allowed the heaps of misinformation and confusion to develop because he was MIA.

    The fiasco in the senate has been deceptive and frantic.
    It's given Republicans the ability to control and
     frame the debate with no rapid response team to clarify.

    I have to wonder when Arnold Schwarznegger appears on TV saying "I am for President Obama's bill".  How does he know what the bill contains when all we've seen is the horror Baucus crafted
    for his Insurance bosses?  So Ahnold knows something we don't know, or thinks Baucus stinkbomb is what we will get?

    Obama has to fight hard to convince us he will put himself on the line for a decent healtcare bill that gives the public a level playing field.
    Without it we simply enrich Insurance pigs even more.


    First Schumer, now (5.00 / 4) (#2)
    by MO Blue on Fri Oct 16, 2009 at 11:41:30 AM EST
    Rockefeller publicly pressuring Reid for inclusion of public option.

    In an interview with Bloomberg Television, Sen. Jay Rockefeller (D-WV) put the responsibility for getting a public option squarely on Senate Majority leader Harry Reid's shoulders.

    ROCKEFELLER: Harry Reid can put into that mark whatever he wants. And so if he puts in mine - less likely - Chuck Schumer's - more likely, - if he decides to do that, then it'll take 60 votes to take it out because it will be in the mark and that's the genius of that melding of both ways. FDL

    Rockefeller is hanging tough (5.00 / 2) (#47)
    by oldpro on Fri Oct 16, 2009 at 01:50:57 PM EST
    and speaking out.

    Even non-constituents should contact and encourage him...I did.  It matters.


    Rockefeller's constituents from WV... (5.00 / 2) (#53)
    by lambert on Fri Oct 16, 2009 at 02:12:19 PM EST
    ... still need to the government to work for them, and know it.

    That's why he's gotten a spine on this one.

    So, yes, reward good behavior.


    By phone? Or Mail? (none / 0) (#55)
    by Inspector Gadget on Fri Oct 16, 2009 at 02:15:06 PM EST
    Considering all our congressional members serve on specific committees, we should all be able to readily communicate with every single one of them. I get really frustrated that the online forms for sending them emails require you to live in their districts (reps)/states (senators).

    Is there another communication channel I've not found yet?


    Phone is always good. No snailmail. (none / 0) (#68)
    by oldpro on Fri Oct 16, 2009 at 03:42:27 PM EST
    It takes weeks, months even, to get through the screening.  Email...try this formula:

    first name underscrore last name @ last name dot senate dot gov

    So it looks like this:  Maria_Cantwell@cantwell.senate.gov


    Thanks!!! (none / 0) (#69)
    by Inspector Gadget on Fri Oct 16, 2009 at 04:17:44 PM EST
    I'll certainly give that a try.

    Response from Durbin, Illinois (none / 0) (#74)
    by mmc9431 on Fri Oct 16, 2009 at 04:56:49 PM EST
    I e-mailed Durbin that I wanted at least the public option in any HCR. Here's the response:

    We will put an end to discrimination based on preexisting conditions. Insurance companies will be prohibited from refusing you coverage, or dropping you, because of your medical history or because you get sick. There will be no annual or lifetime caps on the coverage you can receive if you need it, and no one will be charged more because of their gender.

    To help keep costs manageable, insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses. Basic preventive care, which can reduce costs in the long run, will be provided without charge. We are also working on reforms that will reduce costs for families, businesses, and the government by paying providers for the quality of the care they provide rather than the quantity.

    If you like what you have today, you can keep it. But for the millions of Americans who have no security in today's health care market, these are some of the key steps needed to fix what is broken while we protect what works. People who are uninsured or unsatisfied with their coverage will be able to choose a plan that better addresses their needs.

    I don't read anything in this e-mail to give me hope of a public option


    Nope. But then, Dick Durbin is (none / 0) (#89)
    by oldpro on Fri Oct 16, 2009 at 11:43:39 PM EST
    Obama's man...so what does that tell you?

    These people are hopeless.


    Burris (none / 0) (#93)
    by mmc9431 on Sat Oct 17, 2009 at 05:13:12 AM EST
    The e-mail I received back from my other senator, Burris is very adament about the public option! But I doubt if Burris would buck Obama or Durbin when it comes to a vote. Though seeing as he's only keeping the seat warm, he has nothing to lose by standing firm.

    Every talking point on head of a pin (none / 0) (#90)
    by good grief on Fri Oct 16, 2009 at 11:50:11 PM EST
    This letter is a virtual PR template including every platitude on HCR we've heard repeatedly for the last 7 months mouthed by Obama and Baucus and my own Blue Dog representative. Not only does it say nothing about a public option, it says nothing about the forced-buy mandate with non-compliance punished by fines and, in the absence of a PO, nothing about limits on premium rises, one of the merits of competition with a PO. In other words, it leaves out the heart of the matter which we need to make clear to Congress and Obama (as BTD argued this week): No public option, then no mandate.

    I send them faxes... (none / 0) (#91)
    by suzieg on Sat Oct 17, 2009 at 12:02:45 AM EST
    Great! I would if I had one! n/t (none / 0) (#94)
    by oldpro on Sat Oct 17, 2009 at 12:04:40 PM EST
    Harry Reid (none / 0) (#96)
    by norris morris on Sun Oct 18, 2009 at 03:26:44 PM EST
    Our Senate leader is basically worried about getting re-elected in Nevada.  More Jello.

    No legislation is better IMO (5.00 / 2) (#4)
    by MO Blue on Fri Oct 16, 2009 at 11:45:50 AM EST
    than BaucusCare. Without meaningful costs containment via a public option, the legislation turns into nothing more than an insurance give away program.

    Bad legislation forced on the American public will result in the Dems losing their majority position after implementation for years to come.  

    I would also argue that a (5.00 / 1) (#9)
    by Anne on Fri Oct 16, 2009 at 11:58:30 AM EST
    public option that isn't available to all, that ends up being public in name only, isn't going to be of much use, either.

    My fear is that when a weak public component fails, and costs do not go down and the playing field is still as uneven as ever, and insurance companies are making more money than ever, and a lot of people still have no insurance, and care is not more available, we can kiss any idea of a real public option goodbye.

    So, we'll see, but I'm getting tired of the continuing push for us to accept less and less, and to try to act happy about it.


    I share your concerns about a (none / 0) (#10)
    by MO Blue on Fri Oct 16, 2009 at 12:18:42 PM EST
    weak public option. I do see a glimmer of hope if a public option based on Medicare +5 and with Medicare provider lists is passed. The strongest House bill does allow the expansion of eligibility for employer based access in the 3rd year after implementation.

    A level playing field public option OTOH will not IMO create competition  and  has a much greater chance of failure.


    Camel's nose under the tent (none / 0) (#12)
    by Big Tent Democrat on Fri Oct 16, 2009 at 12:20:51 PM EST
    Either you accept it or you do not.

    If you do not, then you should vigorously oppose any bill short of Medicare For All.


    There's a big range between (5.00 / 1) (#32)
    by dk on Fri Oct 16, 2009 at 01:07:45 PM EST
    a maximum of 5 million people ten years from now, and the entire population of people under age 65 tomorrow.  The size of the nose has significance.

    We're being snookered (none / 0) (#98)
    by norris morris on Sun Oct 18, 2009 at 03:52:40 PM EST
    into accepting a "lesser, but something bill".

    This is brazen brainwashing. Many people will think it's "better than nothing", but it's worse than nothing.

    We will be enslaved to the insurance monopoly, with no opportunity to revisit creation of a good bill and hold our elected representatives and the president accountable.

    With the Democrats in the majority all the way, their weak behavior lets us see the lack of leadership from Obama.  We were spun to compromise from the start?

    This is a snow job, and I don't mean Snowe. She will NEVER vote for a decent bill when it finally reaches a vote.

    This is bait and switch and I'm amazed that so many bloggers would even contemplate accepting this sellout?


    Baucus Bill Enriches Insurance Monopoly (none / 0) (#97)
    by norris morris on Sun Oct 18, 2009 at 03:32:43 PM EST
    Unless we see an honest bill that levels the field with a public option [really the public's choice of insurance], we have been broken by big insurance and drug lobby. Our president will simply have become another shill.

    We will be run by Insurance that will literally hold our lives in their hands, and we will have no recourse.

    Oh yes, the emergency room. Or  after waiting 15 hours we can conveniently die.


    Sometimes nothing is better (5.00 / 2) (#8)
    by mmc9431 on Fri Oct 16, 2009 at 11:57:31 AM EST
    The logic that any bill is better than no bill is a disaster waiting to happen for Democrat's. Do they really believe that the voters will accept that logic? Every poll I've read shows where the American public stands on this issue. If there's mandates, there has to be a strong public option.

    Even with Snowe vote, this bill is owned by the Democrat's. Republican's  aren't going to jump on board. So as long as they're own it, they may as well do it right.

    re voters (5.00 / 6) (#21)
    by sj on Fri Oct 16, 2009 at 12:39:04 PM EST
    I got a call the other night from the DNC asking for money to help President Obama get health care reform passed.

    Told them that I would LOVE to donate to get Health Care reformed, but wasn't interested in supporting a massive give-away to insurance companies.  The caller sighed and said that she was hearing that alot.  Told her that I'd volunteered for/donated to the party for many years, but wasn't now and wouldn't until they started sounding and acting like Democrats.  

    She sounded so sad and resigned to my response that I felt kind of sorry for her and said (truthfully) that I know how hard her work is, didn't want to dampen her own enthusiasm, and wished her well in her efforts but that support for the Party would have to come from some where else.  It sounded like their phone banking efforts weren't yielding what they'd hoped for.


    Good news is (5.00 / 2) (#36)
    by BackFromOhio on Fri Oct 16, 2009 at 01:23:26 PM EST
    that inability of DNC to raise money for this reason might have an impact.

    Good for you (5.00 / 3) (#38)
    by Spamlet on Fri Oct 16, 2009 at 01:24:49 PM EST
    And I hope your response and the same response from others is getting passed on to the DNC, since money is apparently all they care about these days.

    Why does Obama need MONEY to help get (5.00 / 2) (#49)
    by Inspector Gadget on Fri Oct 16, 2009 at 02:04:09 PM EST
    HCR passed? What a farce!! Is he buying the Democratic congressional member's votes?

    I nearly went there (none / 0) (#62)
    by sj on Fri Oct 16, 2009 at 02:22:41 PM EST
    during phone call, but I know that the pitch wasn't her call.  When phone banking the volunteers don't write the script.

    But, good point that all they (the Party) were doing was trying to shake the money tree.  


    You got (5.00 / 1) (#66)
    by Zorba on Fri Oct 16, 2009 at 03:23:02 PM EST
    a more polite (or more resigned) caller from the DNC than I did, sj.  When I got my call, I told her much the same thing as you did, and she hung up on me in mid-sentence.  And I was not rude or yelling, or anything like that.

    Me too! Got a letter from Bill Clinton and (5.00 / 1) (#92)
    by suzieg on Sat Oct 17, 2009 at 12:05:36 AM EST
    sent it back on their dime!

    And so what? (5.00 / 2) (#56)
    by lambert on Fri Oct 16, 2009 at 02:16:15 PM EST
    What do I care about the Democrats? Let 'em deliver something.

    I'd far rather have nothing than be forced to buy junk insurance with the IRS acting as a collection agent. (And it's going to be even more unpleasant when the only people doing anything about that are lunatic winger tax resistors.)


    Nothing Is Nothing (none / 0) (#99)
    by norris morris on Sun Oct 18, 2009 at 03:54:00 PM EST
    Nothing is not better.  Not in the real world.

    If a bill with no public option (5.00 / 1) (#11)
    by ruffian on Fri Oct 16, 2009 at 12:20:30 PM EST
    was stripped down to just the regulation of the insurance companies with respect to pre-existing conditions and denials of coverage, and then the creation of the digital medical records system, I could see it being worth doing.

    In other words, nothing to do with mandates or exchanges.  And any Medicare changes would be handled separately.

    Nothing like that will happen in the real world though, since Obama and most of Congress accept as a basic premise that the insurance companies have to be happy with what they do.

    Even this bill would prove unpopular, (5.00 / 1) (#19)
    by HenryFTP on Fri Oct 16, 2009 at 12:32:54 PM EST
    assuming it could be passed over the screeching indignation of the insurance companies and the senators they own, because premiums would skyrocket as insurers lost their favorite techniques for maintaining profitability. Do any of you really think the current administration is going to institute tough antitrust enforcement against the insurance companies, even if the McCarran-Ferguson exemption is repealed?

    Nope, I don't think it would (5.00 / 2) (#23)
    by ruffian on Fri Oct 16, 2009 at 12:49:08 PM EST
    be enforced well enough to be worthwhile. As I was typing the comment I realized it would not really work unless there were price controls and the regulations were so tough and well enforced that they were essentially a single payer system.

    I always come back to the point that single payer, or Medicare for all, is the only thing that really makes sense.


    Heavy price controls (5.00 / 1) (#67)
    by Zorba on Fri Oct 16, 2009 at 03:29:37 PM EST
    would be the minimum acceptable, if they want a mandate with a weak (or no) public option.  We could go the Swiss route- they have private insurance, everyone participates, but insurance companies are severely controlled in what they can charge for basic care and hospitalization (the Swiss are allowed to buy what we would call "Medi-gap" insurance for more coverage).  I don't think our insurance companies would go for this, at all.  I wouldn't be deliriously happy about it, myself (I prefer single-payer), but I could accept this.  

    Digital records is a boondoggle waiting to happen (5.00 / 1) (#57)
    by lambert on Fri Oct 16, 2009 at 02:18:27 PM EST
    It's going to be a horrible systems integration disaster that enriches only the usual suspects and then: FAIL. The real issue is all the separate insurance company systems that NEED to be integrated. (That, and them using systems issues as yet another excuse to deny care.)

    Precisely (none / 0) (#13)
    by Big Tent Democrat on Fri Oct 16, 2009 at 12:21:24 PM EST
    where is that bill?

    BTW (none / 0) (#15)
    by Big Tent Democrat on Fri Oct 16, 2009 at 12:21:47 PM EST
    I seriously doubt those "reforms" would do a hill of beans anyway.

    They would be used by the industry (5.00 / 2) (#20)
    by andgarden on Fri Oct 16, 2009 at 12:33:33 PM EST
    as an excuse to raise prices.

    Industry doesn't get... (none / 0) (#25)
    by MileHi Hawkeye on Fri Oct 16, 2009 at 12:56:37 PM EST
    ...to raise prices on "excuses".  Rate increases have to actuarially justified in their rate filings and the filings have to be approved by the regulating entity.  

    They don't get to unilaterally "raise prices".


    Well, that's a relief (4.00 / 3) (#39)
    by Spamlet on Fri Oct 16, 2009 at 01:27:22 PM EST
    Rate increases have to actuarially justified in their rate filings and the filings have to be approved by the regulating entity.

    So glad we have those regulating entities.



    Requiring them to ignore preexisting conditions (none / 0) (#26)
    by andgarden on Fri Oct 16, 2009 at 12:59:41 PM EST
    will not be an "excuse" for those purposes?

    IIRC the state of Maine is currently being (none / 0) (#31)
    by MO Blue on Fri Oct 16, 2009 at 01:06:46 PM EST
    sued because they refused to guarantee Anthem Blue Cross a 3% profit margin.

    States don't "guarantee" anything. (none / 0) (#42)
    by MileHi Hawkeye on Fri Oct 16, 2009 at 01:35:18 PM EST
    Exactly why the rates are filed and reviewed.  BCBS filed for a 3% profit and risk increase and were denied by the State.  That is what they are appealing.  



    We'll see how that appeal turns out (none / 0) (#45)
    by Spamlet on Fri Oct 16, 2009 at 01:48:20 PM EST
    Even when the so-called regulators try to do the right thing, they can be overturned by the courts, especially in view of the insurance companies' deep pockets. I find your faith in the so-called regulatory system naive.

    I find your ignorance... (none / 0) (#46)
    by MileHi Hawkeye on Fri Oct 16, 2009 at 01:50:19 PM EST
    ...of how government works stunning.

    Fair enough (5.00 / 2) (#64)
    by Spamlet on Fri Oct 16, 2009 at 02:48:59 PM EST
    With all due respect, however, you actually know nothing of my ignorance, nor does cynicism necessarily betoken ignorance.

    I'm sure you do know more than I know about how government is supposed to work. But all of us commenting on this thread have had our faces rubbed in how government can fail to work as it's supposed to. So, if you will, pardon my cynicism.


    No, I won't. (none / 0) (#85)
    by MileHi Hawkeye on Fri Oct 16, 2009 at 08:42:34 PM EST
    Besides being ever so tiresome, your so-called "cynicism" does not give you free rein to insult me or the many, many people who work hard every single day to protect consumers.

    It's a real shame that you're so beaten down by life that cynicism is all you have to add to the conversation.  I almost feel sorry for you.  Almost.  



    In that case, (none / 0) (#88)
    by Spamlet on Fri Oct 16, 2009 at 10:08:56 PM EST
    I hope you will accept my apology.

    I don't. (none / 0) (#17)
    by MileHi Hawkeye on Fri Oct 16, 2009 at 12:24:15 PM EST
    heh - precisely why I called them (none / 0) (#30)
    by ruffian on Fri Oct 16, 2009 at 01:05:53 PM EST
    regulations and not "reforms".

    Just another set of rules that the insurance companies would find a way around.

    I think a public option is the minimum threshold for anything calling itself reform.


    You can't regulate (none / 0) (#29)
    by TeresaInSnow2 on Fri Oct 16, 2009 at 01:04:37 PM EST
    pre-existing conditions clauses without regulating premiums.

    But I believe when mandates don't exist, some form of pre-existing condition clause is fair.  Otherwise, some people will aquire insurance AFTER they develop a major illness -- which is of course, not what insurance is about.


    "pre-existing conditions" (none / 0) (#48)
    by Stellaaa on Fri Oct 16, 2009 at 01:52:27 PM EST
    The Baucus bill has a high risk pool that will be capitalized with Govt. money till 2013 to take care of the pre-existing conditions.  In 2013 the insurance companies will have to take it on.  As far as I am concerned, even this is not real reform but rather once again the public taking the risk and the privates taking the profits.  

    Pre-existing conditions as they currently (none / 0) (#50)
    by Inspector Gadget on Fri Oct 16, 2009 at 02:09:13 PM EST
    exist in my area are only in the case that a person has been uninsured for a period of time. The reasoning behind it is so people don't find out they have something that needs treatment or surgery, buy insurance, then cancel it as soon as they are well again.

    Ruh Roh ... Friday News Dump from Whiny Joe ... (5.00 / 2) (#16)
    by Ellie on Fri Oct 16, 2009 at 12:24:03 PM EST
    OR, are they wrangling a chorus line for the weekend Bobbleheads?

    via David Drayen at FDL

    Even now, ConservaDems are planting stories suggesting without saying firmly that they wouldn't enact cloture on a health care bill with a public option, in particular Joe Lieberman. I guess "moving the process forward" isn't in their vocabulary.

    This is what is meant by the silent filibuster.

    In my mind, what this means is that (5.00 / 8) (#24)
    by Anne on Fri Oct 16, 2009 at 12:55:35 PM EST
    when you consider that it is the Finance Committee and Baucus that have had the open support of the president, and the Finance Committee bill that is seen as being "the" Senate bill - HELP committee bill notwithstanding - and there's been all that footsie being played by Obama and the industry, the strategy has to be set for no public option in the Senate bill, with the result that whatever the House bill contains in the way of a public option will get shredded, Obama and the rest of the industry-dependent Dems will be assured of an open and generous cash pipeline to help maintain a status quo that only seems to be working for the industry and the politicians.  And we will not only get screwed, but will be made to feel bad for not being happy about it.

    The crickets you hear from the WH ought to tell you everything you need to know about the chances we will be getting meaningful reform.


    Watching JoeMentum for a mere afternoon sickens me (none / 0) (#34)
    by Ellie on Fri Oct 16, 2009 at 01:18:29 PM EST
    Via Digby (just up):

    A prince's prerogative is to change his mind.

    U.S. Sen. Joseph I. Lieberman, [I-Conn. Dems], whose vote could be crucial to breaking an expected GOP filibuster on health care legislation, Thursday said he would consider voting to move the bill forward, even if he ultimately casts his ballot against the reform package.

    Democrats will need 60 votes to override a filibuster of a health care reform bill in the Senate. ...

    Presumably he's picking up the slack from the Snowe Queen. They're not even half-@ssedly making a game of it anymore.

    (I'm tuning in later in the aft, and during prime time to see what's in the infodumpster for dinner and late night enws.)


    Yeah, can't we talk to the party leader on this? (5.00 / 2) (#59)
    by lambert on Fri Oct 16, 2009 at 02:19:30 PM EST
    Oh, wait...

    Rep Weiner (5.00 / 3) (#40)
    by BackFromOhio on Fri Oct 16, 2009 at 01:29:31 PM EST
    last night on Rachel Maddow said he believes that a healthcare bill without a public option will not pass in the House.  He also discussed the opposition of conservative Dems.

    baucus (5.00 / 2) (#22)
    by Turkana on Fri Oct 16, 2009 at 12:44:09 PM EST
    is just a gift to the insurance industry. it's corporate welfare at public expense. more importantly, a bill with no public option is destructive because it has too many holes, and leaves too many people without adequate health care, but allows the politicians to pretend they've done something, while kicking the can down the road for another generation or so.

    Evidently my idea of what is (5.00 / 1) (#27)
    by MO Blue on Fri Oct 16, 2009 at 01:03:40 PM EST
    pragmatic differs from the so called "progressive" Village wonks.

    They seem to think that it is pragmatic to pass anything labeled HCR regardless of whether or not it will provide AFFORDABLE health care. To them it will be a fail only if nothing passes.

    My idea of being pragmatic is passing legislation that actually works to produce good quality, affordable health care. To me it is a fail if the legislation is so poorly designed that it doesn't work.

    PoliPrag (5.00 / 2) (#35)
    by Illiope on Fri Oct 16, 2009 at 01:20:28 PM EST
    they are being politically pragmatic. which has the tendency to sell the actual people they claim to want to help down the river.

    if being pragmatic, to them, means simply passing a bill so that they can declare a political 'victory', nevermind the deleterious effects of such a bill on the taxpayers, i don't want to anything to do with such pragmatism.


    No (5.00 / 3) (#28)
    by Illiope on Fri Oct 16, 2009 at 01:04:13 PM EST

    AHIP gave up preex last March (5.00 / 1) (#76)
    by jedimom on Fri Oct 16, 2009 at 06:13:08 PM EST
    AHIP agreed to waive all preex last March when they came on board for reform. In exchange they want/need the universal mandate, the big pool of risk Hillary wanted. Obama flipped on them and at the last minute caved on a strong mandate, leaving them without the customers yes, but also clearly without the risk pool to keep them fiscally stable once very sick people sign up, which with subsidies they will.

    Rockefeller will sign off on a weak trigger or no public option co op, once he gets the Union buyoff SEIU is looking for. Once the unions are exempt from the income cap for subsidies/excise tax for high dollar plans, then they will roll over.

    Thanks to the Dems picking Obama over Hillary (the candidate who truly believed in the need for this, who fought for this for so long) we have Mr Pragmatist and Baucus and Snowe are rolling over the needs of the people. As predicted.

    I am off the rez now totally. I have gone dark side. I am fighting the plan b/c IMO it is better to have just the limited bare bones reform we can get under bipartisanship, ick, than it is to let them do what Obama has always done in his short career, voting present, letting a middle road, yes man to everyone, no one is happy, POS bill go through that puts a weakened mandate with low susbidies on a middle class that is already flat on its back. That and the unchecked spending with no jobs to show will leave Dems without a majority for generations.

    We could have had it all. Hillary was always always the real progressive in the race. And the fighter. And the one who cared. And people like BTD who consistently aid it didnt matter Obama or Hillary, that they didnt know that much about health care but their positions didnt seem that different, that the media liked Obama better and that was the way to go. Please. Hillary would have beaten MAC hands down. It was our year. 20 million people voted for her. She is the one who knows, as Stirewalter put it in the WashExmainer today, how to manage the levers of power.

    AHIP press release March 2008 (none / 0) (#77)
    by jedimom on Fri Oct 16, 2009 at 06:14:56 PM EST
    here is the Bloomberg piece from March 2008 when AHIP proposed an end to pre ex for a universal mandate

    Why do "progressive" Village wonks (none / 0) (#14)
    by HenryFTP on Fri Oct 16, 2009 at 12:21:30 PM EST
    apparently believe that AHIP is only bluffing when it says that the health insurance companies will jack up premiums sky-high even under BaucusCare? Given the acceleration of premium increases in the past 15 years, and the absence of real as opposed to notional competition, is there any reason to suppose that the conservaDem "compromise" approach won't have this outcome, with the added "benefit" to us all of being coerced into buying over-priced insurance in the bargain?

    I understand why the Obama administration thinks it's "smart" to appease the vested interests (no Harry and Louise ads) but I don't understand how they think they can sell BaucusCare to the Party's base -- it's the functional equivalent of Bush Senior's rollback of tax cuts for the Republican Party base. It may play OK with the Village and fat cat campaign contributors but when Obama tries to sell it in the country he's likely to be told "don't piss on me and tell me it's rain."

    On the other hand, I do understand Obama's desperation to "get a bill", no matter how bad -- that's clearly because Obama, and frankly most of the Democratic Party leadership, would never dream of using the failure to enact meaningful health care reform as a rallying cry for the 2010 elections, attacking Wall Street and the insurance companies. FDR and Truman did it, of course, but that's now ancient history.

    Were you paying attention (5.00 / 7) (#43)
    by Spamlet on Fri Oct 16, 2009 at 01:35:40 PM EST
    last year? Have you been paying attention this year?

    I understand why the Obama administration thinks it's "smart" to appease the vested interests (no Harry and Louise ads) but I don't understand how they think they can sell BaucusCare to the Party's base.

    Obama and the DNC do not care about the party's base--neither the old base, thrown under the bus during the primaries, nor the new base, gazing up at the bus's chassis and convinced it sees heaven itself.


    I understand their thinking (none / 0) (#44)
    by HenryFTP on Fri Oct 16, 2009 at 01:42:41 PM EST
    but I certainly don't agree with it. I think even the short-term political "gain" they think they're getting is questionable and I believe they're going to be in for a nasty surprise in the 2010 midterms.

    Two assumptions (5.00 / 3) (#63)
    by lambert on Fri Oct 16, 2009 at 02:24:05 PM EST
    1. The Dem constituency is the voters;

    2. Getting elected to Congress isn't a stepping stone to the real money on K Street.

    Both assumptions are, arguably, not true. If they are not, what do the Dems care about the 2010 midterms? "Elect more and better Democrats." Feh. Let 'em deliver on something to somebody other than the banksters and the health insurance companies, then we'll talk.

    Let the changes begin (none / 0) (#33)
    by mmc9431 on Fri Oct 16, 2009 at 01:17:47 PM EST
    The thought of Obama sitting up on Mount Olympus waiting for the country to "come together" for three more years is frightening.

    I realize he doesn't want confrontation, but that comes with the job. He's given his bipartisan schtick 10 months. What has he gotten from it? Has he changed the tempo in DC or the country? No, if anything, partisanship has reached a new high. He's even succeeded in alienating people within his own party.

    It's time he stops passing the buck to Congress and accepts the role of the party leader. He needs to tell Congress what he will and will not accept out of the HCR bill

    According to Tom Harkin (none / 0) (#37)
    by Coldblue on Fri Oct 16, 2009 at 01:24:33 PM EST
    via The Hill
    During a conference call hosted by the liberal activist group Families USA, Harkin indicated that Senate Democrats had narrowed their choices to a full public option, a proposal that would allow states to opt out of the program and Sen. Olympia Snowe's (R-Maine) idea of creating a "trigger" that would launch a public option in any state where insurers fail to meet residents' needs.

    No need to confront the dilemma-- (none / 0) (#41)
    by KeysDan on Fri Oct 16, 2009 at 01:30:11 PM EST
    is something better than nothing, or nothing better than something, since it seems as if we are likely to get both: something that is nothing. At least, nothing near to what we really need. Among key issues left on the table are public option or not, and mandates or not.  I have long felt that a "public option" will be included if only with a fig leaf of respectability. While many recognize this likelihood, the public option  is still seen in the short-term as providing a competitive edge to private insurers and in the longer-term (both by advocates and opponents) as the camel's nose in the tent for expansion in both depth and breadth.  So too, I see the importance of the inclusion of mandates (even without a public option).  In the short-term mandates spread the risk pool, forestall gaming of the system, and protect a critical aspect of the "something"-- cancellation for pre-existing conditions or for getting sick. And, in the longer-term, the mandates offer a political nose in the tent for remedial and, maybe, real reform with a wide base of affected/disaffected.  While, of course, an inexact comparison, the situation does, in a way,  make me think of military policy development with a draft versus a volunteer military.

    Nonsequitor (none / 0) (#60)
    by Big Tent Democrat on Fri Oct 16, 2009 at 02:20:13 PM EST

    It's a nonsequitor because (none / 0) (#75)
    by Big Tent Democrat on Fri Oct 16, 2009 at 05:36:10 PM EST
    I did not post about "viewing the health care reform legislation through the refracted candlelight of Senate intrigue."

    Indeed, as I understand your most recent comment, you actually want me to look at it through that prism.


    Donald is right (none / 0) (#81)
    by Steve M on Fri Oct 16, 2009 at 06:20:43 PM EST
    the correct spelling is "non sequitur"!

    smart alec(k) (none / 0) (#82)
    by oculus on Fri Oct 16, 2009 at 06:23:45 PM EST
    I am for Ross' "proposal" (none / 0) (#61)
    by Big Tent Democrat on Fri Oct 16, 2009 at 02:21:45 PM EST
    Why are you yelling at me? Habit?

    He's not yelling, (none / 0) (#65)
    by Zorba on Fri Oct 16, 2009 at 03:18:52 PM EST
    BTD.  Can't you see that his response isn't all caps?  ;-)

    Actually, not (none / 0) (#79)
    by lambert on Fri Oct 16, 2009 at 06:17:57 PM EST
    A Medicare implementation is one camel's nose I could bring myself to support, even if I had to reach for the bucket while doing so (for reasons stated).

    [A|the] [strong|robust] [Federalist?] public [health insurnace?] [option|plan] isn't, because I think the health exchange idea is farcically bad.


    Idiocy? (none / 0) (#78)
    by lambert on Fri Oct 16, 2009 at 06:15:09 PM EST
    "Even the great ones..." ;-)

    Ah, "the Versailles subjunctive" (none / 0) (#80)
    by lambert on Fri Oct 16, 2009 at 06:20:06 PM EST
    "I would urge..."

    Aloha, indeed....

    You completely missed Matt's point. (none / 0) (#83)
    by s5 on Fri Oct 16, 2009 at 07:26:47 PM EST
    His point is that "centrist" Dems should give in on the public option, not the other way around. His point is that if moderates agree that the public option isn't that big of a deal, then why must progressives do the compromising? If it's not that big of a deal, then moderates should try compromising for a change.

    It was a post in support of the public option. By selectively quoting his post, you've conveyed the exact opposite point that he was making. Why?

    Why should the progressives (none / 0) (#86)
    by BackFromOhio on Fri Oct 16, 2009 at 08:56:32 PM EST
    do the compromising any way on the public option?

    Yes, and that was Matt's point. (none / 0) (#87)
    by s5 on Fri Oct 16, 2009 at 09:29:47 PM EST
    That progressives shouldn't compromise on the public option. If moderates really believe that the public option is no big deal and not worth killing reform over, then they should be willing to compromise and pass a bill with a public option. If it's no big deal either way, then why does it always default to progressives doing the compromise?

    That was Matt's point. I'm surprised that was lost so easily.


    As a retired Navy Officer (none / 0) (#84)
    by lcdrrek on Fri Oct 16, 2009 at 07:49:53 PM EST
    I really don't worry about my healthcare but I am worried mightily about the health care of my fellow citizens.  I am with Big Tent Dem and feel that without a public option then there should not be a bill.

    I will be mighty pissed if the President signs a bill without a public option and increases the insurance rolls by millions and thereby pours more $ in to the pockets of the health insurance executives.

    I am bout ready to bolt the Democratic party as it is.

    Fellow Citizens (none / 0) (#101)
    by norris morris on Sun Oct 18, 2009 at 05:22:00 PM EST
    Great post. I admire your take on the current healthcare swindle.

    Corporate Socialism (none / 0) (#100)
    by norris morris on Sun Oct 18, 2009 at 05:19:50 PM EST
    Wall Street, the Insurance/Drug Drug monopoly, and Banks are the beneficiaries of our largesse.  Our government supports them with OUR money- as they  rip us off, and then allow them to  dictate the terms without any intervention.  

    We have become wholly owned subsidiaries of the Insurance/Drug, Wall Street, and Bank monopolies.

    We haven't even be permitted to see the Feds balance sheets on the Wall St/Bank and Insurance bailouts.

    And the irony is that we Democrats prevail in all branches of government.

    Don't we know how to lead?