Mandates, Subsidies, The Public Option And Stupak

Back in the Summer, Paul Krugman wrote:

To grasp the problem, you need to understand the outline of the proposed reform (all of the Democratic plans on the table agree on the essentials.) Reform, if it happens, will rest on four main pillars: regulation, mandates, subsidies and competition. [. . .] [K]nock away any of the four main pillars of reform, and the whole thing will collapse and probably take the Obama presidency down with it.

As potential reform, the HCR proposals provide "regulation" (I am not a believer in regulation as an engine for reform of the health insurance industry), mandates (but not employer mandates) and subsidies (inadequate). Absent a public option, they do not provide potential for competition. This is not reform. In July, Jacob Hacker wrote:

The Blue Dogs are right to hold Obama and Democratic leaders to their commitment to real cost control. But they are wrong to see this goal as conflicting with a new national public health insurance plan for Americans younger than 65. In fact, such a plan, empowered to work with Medicare, is Congress's single most powerful lever for reforming the way care is paid for and delivered. With appropriate authority, it can encourage private plans to develop innovations in payment and care coordination that could spread through the private sector, as have past public-sector innovations.

(Emphasis supplied.) I agree with Hacker. And Hacker of course understands that the shadow of the public option proposal he first championed years ago is a "camel's nose under the tent" initiative. He still favors it.

If the public option is jettisoned, reform is jettisoned. Potential cost containment is jettisoned. We are left with an important initiative - health insurance assistance, but not reform.

Since the mandate is regressive and only to be used in conjunction with public competition, it seems clear that if there is no public option, there should be no individual mandate (there already is no employer mandate.)

Similarly, the mandate coupled with subsidies is intended to capture low income person who choose to not purchase insurance because of cost. Without the potential for public competition, the subsidies could be budget busting, to use Broder's phrase.

Couple that concern with the anti-choice measures being extracted by the likes of Bart Stupak, elimination of the subsidy provisions should also be considered. In lieu of the subsidies, the Congress could increase the eligibility for Medicaid even more.

In the end, the good in this bill is the health insurance assistance provisions. And these are important. Providing health insurance for 30 million uninsured Americans is nothing to sneeze at.

But it seems time to end the pretense of health insurance reform. That is not going to happen. The important thing, it seems to me, is to not do anything that will hinder reform in the future. The mandates would do that. The subsidies MAY do that.

Medicaid expansion is clearly a good. I have no objection to the regulations and the Exchange so near and dear to the hearts of the Village Wonks. Let them have their "reform."

But no to mandates without a public option.

Speaking for me only

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    What a squandered opportunity (5.00 / 1) (#1)
    by andgarden on Mon Nov 23, 2009 at 11:05:37 AM EST
    That article is not very encouraging (none / 0) (#9)
    by MO Blue on Mon Nov 23, 2009 at 11:53:43 AM EST
    for anyone who is interested in a bill that would provide affordable health care.

    The political damage for Democrats of passing a public option is not as bad as the damage from doing nothing. But they would still be better off passing something that's not perfect than passing nothing at all. Most voters aren't following this debate really closely and don't understand the nuances of it all. At the end of the day voters are likely to see this as either a bill was passed or it was not. In some sense that should get the Blanche Lincolns and Mary Landrieus of the world in line- they're probably going to face just as much trouble back home whether there's a public option in there or not. But failing that Democrats would still be better off, at least for next year's election, with a weaker bill than no bill at all.

    by norris morris on Thu Nov 26, 2009 at 03:32:35 PM EST
    There is no reason why a bad healthcare bill should be passed by the Democrats.

    Depriving women of their rights in defiance of Roe vs Wade, and decades of struggle for equal protection and choice is a DISASTROUS strategy in order to get anything  passed.

    A bill without a public option that is robust and meaningful is without any possibility of giving the public a break in the playing field of buying insurance affordably.

    A highly compromised bill gives millions of new victims to the insurance monopoly with no other recourse for shopping elsewhere. And private insurers will either delete abortion insurance, or charge even more as "extras" than currently done.  So only [possibly] well off women who are connected, can in some States find abortions.  Shameful. Women used as barter for political convenience?

    Drug price containment was already compromised by Obama early [and secretly] in the Spring and has dashed any hope for affordable drugs. Obama's deal to accept 80 billion over 10 yrs from BigPharma is a joke, as last yrs drug co's profits were 77 billion.  We've already been screwed here.

    The reason I voted for Obama was that I believed he would strongly tackle healthcare, halt Iraq and Afghanistan wars, among the other things Obama promised to change.

    He's been weak,compromisingly simplistic, dithering, and takes political cover whenever he can.  He's a surprisingly detached personality who lacks the presence we were led to believe he had when speechifying on the stump.

      As President he is oblique and cool when we desperately need a fighter with the passion and committment that connects leaders to the people.

    The Stupak amendment should never have been allowed in the bill in the first place. Pelosi failed, and where was our Leader?   Missing In Action.

    A bad bill with an onerous fate for women, and deliverance of millions of new victims to private insurers without any other options is a sinking disaster.

    It was Obama's to craft, explain, and fight hard for. His failure to do so should not make us his victims. Now we watch as he's adrift on Afghanistan and is gearing up to send military thousands to fight.


    Clarifying The Healthcare Bill... (none / 0) (#74)
    by norris morris on Thu Nov 26, 2009 at 06:23:52 PM EST
    Calls for real leadership from the White House which has been missing largely because Obama has been timid and delusional about GOP'ers support. His compromising started at the beginning instead of at the end.

    Clarification and specifics were fudged whenever Obama spoke about Healthcare, and leaks from Axelrod and Co. complete with iffy comments were designed to cover for Obama's lack of transparency, guts, passion, and sincerity about exerting Presidential will and political clout when he had the oppotunity to influence the outcome.  Also real leadership involves taking the lead and knowing how to fight.

    The Change Obama promised is what has been lacking, and his fiery and convincing oratory hasn't been engaged to explain and sell this to the public.

    He has remained aloof and protected by political cover, and the result is a diced up compromised worthless bill that protects no one.  His willingness to see women thrown under the bus regarding Stupak has truly upset many in his base, and for good reason.

    Clarification,salesmanship, and leadership we thought we had heard and seen from Obama have
    morphed into the same old, same old.

    Next steps...Send thousands to Afghanistan ala Bush.


    and I lay the blame (5.00 / 4) (#2)
    by kmblue on Mon Nov 23, 2009 at 11:12:00 AM EST
    for that squandered opportunity
    at Obama's feet.
    And so will others.
    No excuses, no more swigs of Kool-Aid.

    and what would be the result ... (3.50 / 2) (#5)
    by nyrias on Mon Nov 23, 2009 at 11:36:47 AM EST
    of this blame?

    Voting for an Republican in 2012? Or not voting at all, which also gives a boost to the Republicans.

    Latest poll shows only 38% is in flavor of the reform.

    http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/hea lth_care_reform

    Can you blame the democrats (and Obama)? How many presidents have the balls to go against public opinion?


    Public opinion today (5.00 / 4) (#6)
    by kmblue on Mon Nov 23, 2009 at 11:39:15 AM EST
    doesn't matter.
    Obama had months to shape today's opinion.
    Did he make an effort to lead? No.
    Therefore, the results today are his fault.

    Sure .. he did little to shape public opinion (2.00 / 1) (#8)
    by nyrias on Mon Nov 23, 2009 at 11:52:37 AM EST
    But once again, what this blame will result in?

    I don't see anything more than venting on this (and possibly) other forums.


    I see you enjoy (none / 0) (#12)
    by Big Tent Democrat on Mon Nov 23, 2009 at 12:06:28 PM EST
    your own venting.

    Honestly, I do not need this in my threads.

    If you have nothing to say, don;t say it in my threads.

    If you have a point of view on the substance of this debate, then say it.

    Your form of venting is not welcome here.


    LOL ... (none / 0) (#17)
    by nyrias on Mon Nov 23, 2009 at 12:09:29 PM EST
    I put up public opinion numbers, and discuss the effect of that, and that constitute nothing to say???

    I suppose personal attack constitutes "substance of this debate" for you??


    Enough (none / 0) (#24)
    by Big Tent Democrat on Mon Nov 23, 2009 at 12:20:48 PM EST
    Go to Jeralyn's threads.

    No more commenting in mine.


    Teh poll numbers are Obama's way out (none / 0) (#28)
    by Salo on Mon Nov 23, 2009 at 12:22:22 PM EST
    He was never serious about reform.   KNew it the moment I clapped eyes on the guy.

    Ras? (none / 0) (#11)
    by Big Tent Democrat on Mon Nov 23, 2009 at 12:05:01 PM EST

    In any event, what matters is what people who may vote on election day think


    Exactly ... (none / 0) (#13)
    by nyrias on Mon Nov 23, 2009 at 12:07:06 PM EST
    the HCR supporters really need to learn to play the game better. It is all about who you can get to come out to vote on election day.

    And assuming Obama, or anyone else, has any other agenda, is unrealistic at best.


    Leave my threads (none / 0) (#25)
    by Big Tent Democrat on Mon Nov 23, 2009 at 12:21:18 PM EST
    Thank you.

    No it's about seizing the day. (none / 0) (#38)
    by Salo on Mon Nov 23, 2009 at 12:41:25 PM EST
    And perhaps having a a serious leader willing to sacrifice his short term career for long term revolution.

    midterm voting (none / 0) (#46)
    by jedimom on Mon Nov 23, 2009 at 02:00:13 PM EST
    you know who 'comes out to vote' Seniors that's who
    did you catch Arlen Specter saying the iMAC panels will indeed by cutting 500b from Medicare in this plan?

    no mandate without the Medicare like public plan


    Depends on where the cuts are (5.00 / 1) (#48)
    by Inspector Gadget on Mon Nov 23, 2009 at 02:27:01 PM EST
    in Medicare.

    If they are in putting in red flags to more readily spot the billions in fraud, that's a wise cut....stop handing Medicare dollars to the frauds (a growing industry).

    If they are going to monitor some of the tests performed on seniors while they are in the hospital, that's a wise place to cut some costs.

    I think my mother was put through some 3-4 invasive and exceptionally expensive tests every day during her first stay. Then, they told her they were going to re-run all those tests 9 months later when she went back in. Problem was, they knew why she was there...a blood clot in her leg. They knew her liver was failing from all the medications they were pumping into her. They knew those tests were going to come up empty, but that Medicare would pay for them, so they wanted to give their staff practice time.

    There are some cuts to Medicare that are wise and necessary....they probably amount to 500b. Now, if they are going to continue allowing the fraud and unnecessary tests while they cut basic care instead, that's a problem.


    Last night's 60 minutes (5.00 / 1) (#56)
    by coigue on Mon Nov 23, 2009 at 06:03:16 PM EST
    discusses this very abuse.

    The problem is (none / 0) (#53)
    by BrassTacks on Mon Nov 23, 2009 at 05:53:53 PM EST
    as much as we may hate it, Rasmussen has been the most reliable polling in the last three rounds of elections.  We ignore him at our peril.  

    That is absolutely false (5.00 / 1) (#58)
    by Big Tent Democrat on Mon Nov 23, 2009 at 08:14:02 PM EST
    Really? (none / 0) (#62)
    by BrassTacks on Tue Nov 24, 2009 at 01:47:45 PM EST
    Check real clear politics pols for the last three elections.  Rasmussen either nailed it, as he did when Obama ran, or he was the closest to the final results.  I'd provide you the link except I can't on this browser.  But it's easy to find.  

    hrc (none / 0) (#45)
    by jedimom on Mon Nov 23, 2009 at 01:58:23 PM EST
    Hillary had the balls to do it

    Squandered Opportunities (none / 0) (#66)
    by norris morris on Thu Nov 26, 2009 at 03:35:34 PM EST
    I totally agree.  We've been rolled over on every issue Obama promised to change.

    no, (5.00 / 6) (#3)
    by cpinva on Mon Nov 23, 2009 at 11:13:20 AM EST
    If the public option is jettisoned, reform is jettisoned. Potential cost containment is jettisoned. We are left with an important initiative - health insurance assistance, but not reform.

    what we'd be left with is the greatest boon to health insurance company's bottom lines since they dumped most of the admin work on the insured and their dr's.

    absent a robust public option plan, and it's simply more profit to the already obscenely profitable.

    Hmm ... (3.50 / 2) (#10)
    by nyrias on Mon Nov 23, 2009 at 12:04:41 PM EST
    I don't think you need to resort to false facts to bolster the reason for a public option.


    And i quote, "Health insurance profit margins typically run about 6 percent, give or take a point or two."

    "Profits barely exceeded 2 percent of revenues in the latest annual measure. This partly explains why the credit ratings of some of the largest insurers were downgraded to negative from stable heading into this year, as investors were warned of a stagnant if not shrinking market for private plans."

    Let me put it this way. I really don't care abt the insurance industry since I am not in it. So a public option that even knocks their profit down more (say to NOTHING) is probably a win for me (and hopefully my premium goes down).

    But saying their profits is obscene is just not true. Let's have some integrity in our arguments, shall we?


    If you dig deeper (5.00 / 3) (#47)
    by TeresaInSnow2 on Mon Nov 23, 2009 at 02:21:32 PM EST
    You'll find that the low profits are greatly due to bad investments and the stock market downturn, not low premiums/high payouts or anything else that might be consumer-friendly.

    Just speculating, likely some of those "bad investments" were about buying certain stocks to boost stock prices, so insurance company insiders could bail out of them.


    Oooookay (none / 0) (#15)
    by kmblue on Mon Nov 23, 2009 at 12:08:17 PM EST
    let me just find that list of
    insurance companie CEOs again...
    darn, where is it...

    here it is (5.00 / 1) (#18)
    by kmblue on Mon Nov 23, 2009 at 12:11:09 PM EST
        * Aetna, Ronald A. Williams: $24,300,112
        * Cigna, H. Edward Hanway: $12,236,740
        * Coventry, Dale Wolf: $9,047,469
        * Health Net, Jay Gellert: $4,425,355
        * Humana, Michael McCallister: $4,764,309
        * U. Health Group, Stephen J. Hemsley: $3,241,042
        * Wellpoint, Angela Braly: $9,844,212

    list is (none / 0) (#19)
    by kmblue on Mon Nov 23, 2009 at 12:12:13 PM EST
    their compensation for year 2008

    that must be where the profits went.  Oh dear!


    Could we have the link to that? (none / 0) (#55)
    by BrassTacks on Mon Nov 23, 2009 at 05:59:05 PM EST
    I've got some republican friends who need to see you list of CEO compensation.  Why do shareholders put up with this?  Why don't they demand their piece of the action?

    And why would that .. (5.00 / 1) (#20)
    by nyrias on Mon Nov 23, 2009 at 12:12:59 PM EST
    have to do with health insurance industry profit?

    All CEOs are making a lot more than others, not just in the health insurance industry.

    Making health insurance industry makes LESS profit is still NOT going to change that. We need a hugely different solution if CEO pay is your thing.

    Plus, that does not change the fact that it is still factually INCORRECT to say that the health insurance industry has high profit margins.


    No profits means no companies (none / 0) (#54)
    by BrassTacks on Mon Nov 23, 2009 at 05:57:21 PM EST
    Companies who don't make any money go out of business.  Not saying that's necessarily a bad thing..............but I would prefer that my insurance company continues to exist.  

    Containment? Your're Kidding. (none / 0) (#67)
    by norris morris on Thu Nov 26, 2009 at 03:46:51 PM EST
    There is no cost containment for we the people if we cannot shop for insurance in a competitive marketplace that contains a public option.

    You have a poor understanding of cost containment. My 2010 insurance has just been sent to me and I am close to becoming uninsured.

    Without a ROBUST OPTION, MY INSURANCE WILL CONTINUE TO GO UP.  As will everyone's.

    As a woman I will no longer be free to choose. Pro choice offered by Roe vs Wade will be gone.
    Millions of women will face backroom and/or self inflicted abortions and die. Possibly, IF some insurers cover abortion there will be additional
    charges, which will limit this option to the well off.

    So it's ok to let millions of women [yes look at the statistics] become damaged or die because Pelosi and Obama were to f.....g weak and politically corrupt to stop this?

    Women and Independents will desert Obama and the Democrats in droves, and if this stinker passes as is, I'm one Democrat who will stay home.


    Opposed to regulation? (5.00 / 2) (#4)
    by inclusiveheart on Mon Nov 23, 2009 at 11:33:27 AM EST
    Then call it a contract.  If the government is going to subsidize healthcare insurance, surely there should be some minimum guarantee of delivery of services attached to that cash outlay otherwise this would be an even crueler joke than it already has become.

    Then again, by routing the payments through individuals, it is easier for all of the power players in this charade - government and private insurers - to blame the victims for not getting their money's worth; and say that it was the consumers' fault for choosing the wrong plan or something along those lines.  The vaunted personal responsibility excuse for government failures of epic proportion.

    The mandates, penalties and subsidies must come with something meaningful in return from the private insurers.

    Obama doesn't give a crap (5.00 / 1) (#7)
    by Militarytracy on Mon Nov 23, 2009 at 11:44:26 AM EST
    what Paul Krugman has to say.  At least not this minute because the chitstorms don't look that bad to him yet and those who surround him must surely be telling him there is no way they can get that bad.  I somehow feel certain that Obama would tell you that Paul Krugman is an extremist.

    Yeah, Krugman is a nutter who (5.00 / 4) (#14)
    by inclusiveheart on Mon Nov 23, 2009 at 12:07:10 PM EST
    is essentially saying that building a car without any wheels won't work.  Crazy extremists.  If the car has really nice leather interior, why would anyone need wheels?

    Obama's Car That Can Swim (none / 0) (#68)
    by norris morris on Thu Nov 26, 2009 at 03:50:46 PM EST
    Wheels?  Why not ask the car to swim?  Krugman has to be wrong because amphibian autos are the next best thing?

    Obama must be banking on (5.00 / 4) (#21)
    by oculus on Mon Nov 23, 2009 at 12:13:18 PM EST
    the U.S. voter not being educated by 2010/2012 elections, as the "reforms" don't kick in ASAP and it U.S. media is just beginning to report on the details of HCR.  

    Yes, that's what I see as well (5.00 / 3) (#22)
    by Cream City on Mon Nov 23, 2009 at 12:16:46 PM EST
    and I'm beginning to feel liberal fatigue.  If the stoopidity of those just too busy watching American Idol to see what is happening . . . if those are the ones to rule the polls again, then at my stage of life, and with all the job losses and needs in my family, I may just have to stop caring about the stoopids, too.  They don't care about me and mine.

    Why would they ... (none / 0) (#27)
    by nyrias on Mon Nov 23, 2009 at 12:21:55 PM EST
    want to see what is happening?

    They are the ones who HAVE adequate insurance. It is hard to ask people to spend THEIR money (i.e. tax) to cover other people.

    It is hard to convince people that you can find the money somewhere else (i.e. more efficient by using competition, or take it out of the profits of insurance companies).

    That is the thing right .. you don't care about them .. they don't care about you. A perfect symmetry.


    The structural change i was looking for... (none / 0) (#33)
    by Salo on Mon Nov 23, 2009 at 12:32:11 PM EST
    ...was a publicly administered insurance plan that a union could buy into and that would alter public perception very quickly as the superior state run product demonstrates it's true worth.  Not even the Dems will go for this, sadly.

    That's about it. Health  insurance companies are paracites on the public at large.   They need to be demolished.


    This would have cost no one (none / 0) (#40)
    by Salo on Mon Nov 23, 2009 at 12:44:45 PM EST
    a penny.

    It's all Reid's fault: (none / 0) (#43)
    by oculus on Mon Nov 23, 2009 at 01:41:18 PM EST
    AP on Reid and Dodd's vulnerability in their next reelection campaigns

    Obama adviser David Axelrod said the president strongly admires Reid and Dodd, and believes they best serve their home-state constituents by being national leaders on big issues such as health care and financial oversight.

    "If health insurance reform passes, it will be an enormous accomplishment for Senator Reid," Axelrod said in an interview. "The same is true on financial reform" for Dodd, he said.

    It's All Obama's Fault (none / 0) (#69)
    by norris morris on Thu Nov 26, 2009 at 03:54:18 PM EST
    Reid's fault?    You're kidding. Did you ever hear of Presidential Power and Leadership?

    I guess we've all forgotten that a strong leader can accomplish what he promised.

    This is Obama's turkey carved up by Rahm/Axelrod and it's a tasteless bird.


    To Cream City:Part of me feels the same... (none / 0) (#44)
    by christinep on Mon Nov 23, 2009 at 01:55:43 PM EST
    in that the gambit all around will probably be premised on the perceived "memory" of the electorate next fall. Clearly, the PPP poll seen today only reinforces a political concept that is almost a truism among the political scientists. That is: Usually the public rewards action and punishes inaction--or, if you spend a lot of time and a lot of publicity trying to get something passed and fail at passage, you also fail in the coming election. That is what I've been whining about in recent days <that we are in too deep as a party to lose the bill now without losing the whole thing, including healthcare reform for a long time to come> and that a real nasty outcome would be the Republican crafty snark that the Democrats are a "do-nothing congress" and need to be replaced (ironically, of course, by the real do-nothing bunch.)  I remember even going back to the old Michigan Survey Research days as well as some of my husband's later research about Congressional "mavericks" that: The public finally remembers the overall product--either there is one or there isn't.  According to PPP today, that might not have changed much in domestic legislation.  But, looking on the bright side, that simple PPP effort also may push some of the so-called "centrists/moderates" to casting their lot with the rest of the Democrats or be the most at risk in losing their seats because their party lost. So...I've got to hope there are some twinges of a wake-up call now for any Democrat who would scheme to filibuster their own party.

    Ah, your attempt to find a silver lining (5.00 / 1) (#51)
    by Cream City on Mon Nov 23, 2009 at 03:45:11 PM EST
    is helpful; thanks.

    Primary Dave Obey! is my new clarion call.  To your list of folks to oppose if they filibuster in the Senate, I add those who voted for Stupak-Pitts.  And especially Obey, who is not a Dem in a threatened district.  He just is awful on women's issues -- and to women pols.


    But the Democrats Are....... (none / 0) (#70)
    by norris morris on Thu Nov 26, 2009 at 03:58:29 PM EST
    A weak bunch who've shown us they can't govern and that Obama has not delivered on his word.

    Gridlock.  Obama promised change.  He's done just about nothing and fumbled healthcare dramatically.

    He's politically ruthless enough to allow women to be offered up as sacrifice for his lousy ill crafted mess of a junk bill that offers nothing.

    So we're supposed to take this dreck to save his Presidency? It's his to save.


    we know that Obama's DKos Brigade... (5.00 / 2) (#32)
    by Salo on Mon Nov 23, 2009 at 12:28:19 PM EST
    ...have already done so.

    Dr. Dean (5.00 / 1) (#16)
    by lilburro on Mon Nov 23, 2009 at 12:08:45 PM EST
    feels the same way you do:

    "This thing has been pretty watered down. Right now, it's about as watered down as it could be and still be a real bill. For example, there's really no insurance reform in this bill, already," Dean said on MSNBC.

    He added that the Senate bill is "decent" and the House bill is "better." But, he said, insurance companies can still charge double for those with pre-existing conditions under the House bill.

    "There's not a lot left to this bill. The public option is about it," Dean said.

    Was he duped? (none / 0) (#30)
    by Salo on Mon Nov 23, 2009 at 12:25:39 PM EST
    I'm beginning to suspect that something is really amiss here.    Dean sounds utterly defeated and deflated.

    But who (none / 0) (#35)
    by lilburro on Mon Nov 23, 2009 at 12:33:39 PM EST
    promised Dean anything?

    Dean is probably (5.00 / 2) (#36)
    by Cream City on Mon Nov 23, 2009 at 12:35:01 PM EST
    forgetting to tune in the news on his teevee again.

    I try to be good... (5.00 / 2) (#49)
    by huzzlewhat on Mon Nov 23, 2009 at 02:58:56 PM EST
    But I find this snark delicious. I guess I haven't gotten over as much as I thought I had.

    Dean appears genuine about (5.00 / 1) (#37)
    by Salo on Mon Nov 23, 2009 at 12:39:40 PM EST
    publicly administered health care.  He's got the record.  So I think he was a bit hoodwinked in the primaries, or maybe promised stuff that was never going to be followed through on by the boss.

    Dean Was Not Used By Obama (none / 0) (#73)
    by norris morris on Thu Nov 26, 2009 at 05:26:13 PM EST
    Dean hasn't been used as part of any real Healthcare Reform effort from the WHouse.

    He's been kept on the sidelines and given no power to exert his medical expertise and desire to fight for a robust public option.

    There has been a conscious effort from our administration to keep him on the sidelines, and it's really been our loss.


    Dean Is Right (none / 0) (#71)
    by norris morris on Thu Nov 26, 2009 at 04:03:58 PM EST
    There is nothing left of this aborted bill.

    It's pro-life, anti option to shop around for less costly coverage, and has so many kinks in it including an almost total ban on legal abortions, that it's a dead turkey.

    If voted on it will be the leftovers that will take the Democrats down without Obama's help.


    House bill (5.00 / 4) (#39)
    by mcjoan on Mon Nov 23, 2009 at 12:42:51 PM EST
    has employer mandates. Whether they survive conference is a big question, but for the record, they are at least in one bill.

    Providing? (5.00 / 1) (#41)
    by good grief on Mon Nov 23, 2009 at 12:54:10 PM EST
    Providing health insurance for 30 million uninsured Americans is nothing to sneeze at.

    You mean requiring (mandating) that 30 million uninsured Americans buy health insurance policies without sufficient competition (at best a small, weak PO option likely to wither further) to control prices or a realistic means to protect benefit quality, etc? In short, to manage the monster (I agree regulation by and large won't work).

    Why do so many people say "provide" when "require" is the word? "Provide" is the way insurance industry sold the Massachussets plan and the current national healthcare "reform" modeled on same. "Provide" folds in nicely with a soft-sell liberal style, comfortable and reassuring. If one means "provide" subsidies, that's not insurance but an elaborate welfare system built on top of corporate premiums with profits to Wall Street, hardly "liberal" but that's where Obama and most Dems have brought us (a screamable moment).

    "Nothing to sneeze at," boiled down to its essence, is plenty to throw up at when one considers the consequences this HCR boondoogle could bring to American consumers and to the Dem party. Not a "budget buster" but a Treasury buster (already busted so we print dollars unendingly). Why are we accepting this? Why are we not fighting back. Even if we lose this battle, we'll win the next one, especially if we show bravery and great arguments? We have to be willing to lose one if we want to eventually win. We're in an unacknowledged economic civil war and refusing to fight. Fighting for the strongest possible PO and going down in glory is better than caving in on a weekly basis. Palin is popular because she is perceived as "fighting back." Dems, meanwhile, are perceived as wimps.

    "No mandates without public option" should be "strong/robust PO available to all from the start" since I doubt the PO as currently formulated (with opt-out or triggered opt-in -- as weak and whittled down as humanly possible -- is going to get bigger and stronger. No, with lack of political resolve in this WH and Congress as a continuing trend in next decades the PO is going to get weaker and smaller until we are standing naked under mandates with little protection at all.

    It's economically irresponsible not to be fighting like hell for single payer/Americare (Medicare for All), even a matter of national security (it could be argued) if only to avoid sandbagging the Treasury to subsidize commercial premiums when we could largely cover the low-income/uninsured margins with the mandate windfall under an SP system. Instead, that mandate windfall goes largely to Wall Street which has little loyalty to our national (economic) security.

    The proverbial argument against SP, "Don't let the perfect be the enemy of the good," is countered by the notion that this bill is the enemy of the good and should be killed and we should start over with SP's far more compelling selling points. This will probably require a new non-party public interest movement to turn over Congress and the WH, sweep out corporate corruption and get some real democracy going. Not in my lifetime but this is where we should be going.    

    Competition? Tort Reform? (2.00 / 1) (#57)
    by BrassTacks on Mon Nov 23, 2009 at 06:07:37 PM EST
    Why were neither of those things even under discussion?  Why can't we have competition across state lines?  Why did the democrats never mention that?  Ditto Tort reform.  Wouldn't that save us some money?  

    I seem to recall that originally HCR was to get everyone covered AND save money.  Now I don't see either of those things happening.  On top of that, they're going to cut medicare to seniors!  WTF?????  We're not getting squat AND we have to pay more for it!  


    This comment seems a nonsequitor (none / 0) (#42)
    by Big Tent Democrat on Mon Nov 23, 2009 at 12:56:37 PM EST
    Don;t know what you think you are responding to. Clearly it is not to a post calling for stripping mandates.

    If only the bill WERE a camel's nose... (5.00 / 10) (#50)
    by lambert on Mon Nov 23, 2009 at 03:16:03 PM EST
    Dr. Margaret Flowers of the PNHP and the Baucus 8:
    "Is the House bill better than nothing?" Angell asked. "I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right."

    It's a bad bill. The Dems should pass a clean bill with includes only the parts that help people immediately, strip out the Rube Goldberg contraptions like [a|the] [strong|robust]? public [health insurance]? [option|plan], and figure out a way to declare victory. Then reboot the process, and make it open and transparent this time.

    If only the camel's nose WERE under the tent... (5.00 / 1) (#52)
    by FoxholeAtheist on Mon Nov 23, 2009 at 04:21:28 PM EST
    No profantiy (none / 0) (#26)
    by Big Tent Democrat on Mon Nov 23, 2009 at 12:21:42 PM EST

    fair enough (5.00 / 2) (#29)
    by Salo on Mon Nov 23, 2009 at 12:24:05 PM EST
    But that polling info is exactly what the Rahmists and Axelites have been waiting for. I half expect they are partly responsible for making it so.

    Its funny but I just spent the Weekend (none / 0) (#59)
    by Socraticsilence on Mon Nov 23, 2009 at 11:34:01 PM EST
    Reading S1796- The Baucus bill- and while overly complex (seriously, its like a stereotype of a Clinton State of the Union-- various micro-iniatives, and state-level experiments-- some actually interesting- like the experiment of an alternative malpractice system- and the 90% FMAP long-term care initiative) it does provide an employer mandate- at least that's how both Baucus and the Kaiser Family Foundation characterizes its treatment of employers of 50 or more, those who employ less are exempt though. Not sure about the Brass tacks of HR 3200, the comparitive study I'm crafting involves HR's 676 and 3400 (crazy funny-- its a collection of the last 2 decades of Republican shibboleths- Deregulation, Tort Reform, Tax Credits, Vouchers!!!)  as well as S1796.

    It does not (none / 0) (#61)
    by Big Tent Democrat on Tue Nov 24, 2009 at 01:00:34 PM EST
    It contains a free rider penalty.

    Did you actually read the bill?


    Stupak Is Mockery of Healthcare (none / 0) (#60)
    by norris morris on Mon Nov 23, 2009 at 11:36:52 PM EST
    ANY bill that includes Stupak amendment that makes women pay the price of so called reform is a plain mockery.

    Women will not stand for this and we will find it unacceptable to vote again for ANY Democrat, I can assure you.  If the only way the Democrats can push a bill through at the expense of millions of women, they are clearly corrupt and unfit to govern.

    Obama has been clearly absent on this and many other issues regarding Healthcare that he was obliged to show leadership on. He's fumbled,
    dodged, dithered, and travelled a lot. But he hasn't been in touch with us as people, and finds it acceptable to destroy decades of women's struggles for equal protection and choice away if he finds it politically convenient.

    I'm amazed that fellow Democrats haven't seen the callousness of this, and haven't been able to simply understand that without a clear and robust public option there is only one thing that will happpen:

     Millions of people forced to take private insurance and deliver billions more to insurance monopoly, and no possibility of a public option as a safeguard that would level the playing field
    by offering a real choice.

    In other words, we've been screwed already and Obama's willingness to fritter away and compromise
    is appalling.

    Public Option (none / 0) (#63)
    by stephhunter on Tue Nov 24, 2009 at 08:35:25 PM EST
    the public option is working tremendously already in Ohio because it's been structured well and has been well thought out.  The same program could be extended to the nation if done wisely.  http://cli.gs/z3AtaY/

    please don't advertise sites here (none / 0) (#64)
    by Jeralyn on Tue Nov 24, 2009 at 09:43:32 PM EST
    this space is for comments.

    Tell This To Obama (none / 0) (#72)
    by norris morris on Thu Nov 26, 2009 at 05:20:05 PM EST
    You must impart this bit of wisdom, because the House and Senate haven't given it a thought.