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Sunset Mandates, Eliminate Excise Tax, Then Support Health Insurance Premium Assistance Bill

By Big Tent Democrat, Section Other Politics
Posted on Sat Dec 19, 2009 at 08:50:04 AM EST
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If I have understood correctly the concessions to Ben Nelson, I am prepared to support the bill - with 2 conditions - sunset the mandates in 2019 and eliminate the excise tax, using instead the House financing approach. Of course this bill is not health care reform - but it is health insurance premium assistance for the less well off paid for by the wealthy (IF the House financing provisions are used).

In order to have another chance to reform health care, the bargaining chip of the mandates needs to be put back on the table at some point in the future. Sunsetting the mandates will do that.

Nothing to have a parade about, but with those two changes, Democrats can argue they did some good with this health insurance premium assistance bill without crippling the chance for real reform in the future.

Speaking for me only

< Ben Nelson, Pushover? | So When Can We Address Health Care REFORM? >

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    Sunset Mandates, Eliminate Excise Tax, Then Support Health Insurance Premium Assistance Bill | 152 comments (152 topical)

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    Not exactly what I wanted for Christmas (5.00 / 1) (#4)
    by MO Blue on Sat Dec 19, 2009 at 09:06:41 AM EST
    Senate Majority Leader Harry Reid (D-NV) is expected to file for cloture on health care reform this afternoon. TPM
    If they have any sense at all, (5.00 / 4) (#10)
    by MO Blue on Sat Dec 19, 2009 at 09:15:31 AM EST
    they will use the House financing approach.

    What people will remember is Obama saying over and over again "If you like your insurance, you will be able to keep it." That will be a flat out lie that people will notice and punish Dems accordingly if they tax people's current insurance plans.

    Good comment MO Blue, (5.00 / 2) (#26)
    by Andy08 on Sat Dec 19, 2009 at 09:36:12 AM EST
    I agree that's exactly what people will remember.

    Everyone around me ill end up paying a lot of more taxes and  losing even more coverage....  ( we are middle class; under state plans negotiated by unions which cost close to 11K (individual) in a very expensive state and which doesn't even cover a check up every year!)

    In 2009 we had already 3 major changes in terms of copays--were raised 3 times in 1 year!--  new limitations of coverage and much higher  deductibles. All out of pocket expenses
    at least tripled in 1 year.

    This bill helps in no way controlling the insurance and pharma companies while it  helps make health coverage and health cost much worse for me: and this, this I will remember forever.

    Parent

    Um (1.00 / 1) (#80)
    by Steve M on Sat Dec 19, 2009 at 10:30:52 AM EST
    What new tax, exactly, do you see you and all your friends paying?  The excise tax is not assessed on the policyholder.

    Parent
    That's silly Steve (5.00 / 2) (#84)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:35:30 AM EST
    The tax will be tacked on to the price of the policy.

    But n a sense, you are right, to AVOID the tax, the value of the policy will be reduced.

    In essence, the tax will be on the quality of his health care.

    Parent

    Right (1.00 / 1) (#90)
    by Steve M on Sat Dec 19, 2009 at 10:44:26 AM EST
    so the statement that what people WILL remember is paying A LOT more taxes is a little... wrong, wouldn't ya say?

    Maybe you're right about the impact of the excise tax, maybe the CBO is right, but this idea that union workers are all going to see a massive tax increase is based on a fundamental misunderstanding of what's in the bill.

    Also, the next time the Dems propose a new corporate tax and the GOP tries to act like it's a massive new tax on middle-class Americans, I don't want to hear any whining!!!

    Parent

    "Cadillac" plans will be replaced (none / 0) (#115)
    by kempis on Sat Dec 19, 2009 at 11:14:42 AM EST
    ...with cheaper but less comprehensive policies, I fear. Keeping those "cadillac" plans has been a breath-holding issue for my bargaining unit every time we open the contract to negotiations. Such plans are already pricey to employers and require concessions from unions. Now, with the excise tax, they will likely be priced out of reach for some employers and, with even less room for concessions in an age of flat cost-of-living raises, will likely be phased out and replaced with lesser policies--lesser in price and coverage.

    I hope I'm wrong, and I may well be. But as 55 year old with chronic pain who is working now mainly for insurance, I worry. So if someone can tell me I'm wrong and there's nothing to worry about, I'll be grateful.

     

    Parent

    It's a real concern (none / 0) (#118)
    by Steve M on Sat Dec 19, 2009 at 11:22:04 AM EST
    I don't discount it at all.  In fact the excise tax is less of a revenue-raiser and more of an attempt at encouraging the elimination of the so-called "Cadillac" plans.

    Where BTD and I sometimes butt heads is on the question of what will happen if the Cadillac plans go away.  My thought is that if your union had the bargaining power to negotiate for the Cadillac plan in the first place, it probably has the bargaining power to say "okay, if you're making our insurance coverage worse, you're going to have to give us something else in exchange."

    For someone in your position, it's probably a raw deal, because you'd personally prefer to have better insurance coverage as opposed to, say, a slightly higher wage or some other benefit.  Other workers may be just fine with the tradeoff.  But I definitely empathize with your situation and I hope your insurance coverage continues to be strong enough to meet your needs.

    Parent

    Thanks, Steve (5.00 / 1) (#132)
    by kempis on Sat Dec 19, 2009 at 01:40:59 PM EST
    At this point, we'll just have to wait and see. I know that the AFL-CIO and SEIU will be fighting the excise tax tooth and nail. Their support of the public option wasn't grounded in the day-to-day reality of the lives of union members like the "cadillac" plans are. So perhaps, as BTD suggests, they can negotiate a more livable limit to it. As it currently stands, it's just not possible for the unions to support it. If they do, their own memberships will revolt.

    Parent
    Won't happen (none / 0) (#141)
    by Andy08 on Sat Dec 19, 2009 at 06:39:39 PM EST
    ""okay, if you're making our insurance coverage worse, you're going to have to give us something else in exchange."

    This is incorrect. Nothing will replace the value, money and health-wise of the loss in the insurance coverage. Do you as Derek Thompson think that workers will bring some more money home as a consequence of losing their health coverage? That's just a fantasy, I am sorry. And besides, nothing (money or some other stupid perk) will replace the value whatever insurance coverage is lost. Nothing.

    Parent

    Maybe it's a fantasy (none / 0) (#142)
    by Steve M on Sat Dec 19, 2009 at 07:07:54 PM EST
    but I think unions have bargaining power, or they never would have gotten those good insurance plans in the first place.

    Parent
    Once the health plans (none / 0) (#144)
    by Andy08 on Sat Dec 19, 2009 at 07:45:29 PM EST
    disappear because of the excise tax the unions can bargain to high noon those coverage won't be back. That is a real loss in health coverage and a terrible blow.

    If you had cancer and had to go to a special center for treatment and now face the loss of your plan which will probably be replaced by one that doesn't include that place any more then you would lose your sleep over the excise tax. Because the union will never be able to get exactly that plan back.  I don't want extra money: it'll be useless, hopeless: do you have any idea how much a single radiation treatment costs?  
    Do you know the reality between afford going to center A that does conformal radiation at high energy machine which is tolerable and center B that has an older machine that operates at lower energy and burns the hell out of you?  That's for example the difference between plans at cost A and cost B.  I pay my share but the excise tax will make my employer/insurance stop offering the plan altogether. I will be stuck. This is very real.  I didn't work my A$$ off and sat with my union at the negotiating table exchanging higher earnings through decades in exchange for benefits to lose them now when I need them the most.

    The excise tax will have a discriminatory impact on plans that cover older workers and retirees, or workers in high cost regions or high risk occupations, and plans serving women.  The net result of the 40 percent excise tax will be to force many plans to cut back important health care benefits.  "New" plans will cut back coverage; eliminate care, limit access and increase substantially co-pays and deductibles.

    Parent

    Exactly: won't be able (none / 0) (#140)
    by Andy08 on Sat Dec 19, 2009 at 06:34:52 PM EST
    keep my health insurance: contrary to what POTUS has reassured the american people. You have no idea what insurance companies do to pass the buck onto you.

    I guarantee you, no, I know for a fact that I will pay about 1,5K more in taxes b/c of this than I do now.

    I understand the bill pretty well.

    Parent

    Show me in the bill (none / 0) (#143)
    by Steve M on Sat Dec 19, 2009 at 07:08:48 PM EST
    where your taxes go up.

    Parent
    As my plan (none / 0) (#145)
    by Andy08 on Sat Dec 19, 2009 at 07:56:30 PM EST
    disappears, as my deductibles, co-pays and mainly lack of access sky rockets my "out of pocket" cost of health insurance will be more than significantly higher it is now. If you don't think that's form of  taxation and a loss of earning then we understand the meaning of a tax on an individual very differently.

    Remember also you have to pass a high threshold in your income tax to be able to deduct any medical expenses. So we will still be paying taxes on these (higher) expenses.

    The worse part though will be the loss of the plan: that is NOT what we were promised. Where is the
    "If you like your plan you'll be able keep it" ? It will NOT be offered any more.

    You have no idea what health care means until you really need it....

    I wanted health insurance reform.  Not diminished health care coverage.

    Parent

    Yes (none / 0) (#146)
    by Steve M on Sat Dec 19, 2009 at 08:05:24 PM EST
    You're right, we do understand the meaning of "tax" very very differently.

    Parent
    Of course you could also (none / 0) (#152)
    by Andy08 on Sun Dec 20, 2009 at 10:06:59 AM EST
    have the alternative to the above which could be keep the plan at an "extra fee" categorized so that it doesn't seem part of the actual premium and equivalent to the 40% tax of the amount above the 8,5K. For me this would be less catastrophic than losing the plan and what I need from it. Money doesn't replace access to the health care you need. What is for sure is that no insurance co. will absorb and pay themselves the 40% excise tax. So, who do you think will be really paying it?

    Parent
    If this is still in the Senate's (none / 0) (#151)
    by MO Blue on Sun Dec 20, 2009 at 08:08:05 AM EST
    bill, it will definitely increase the taxes that very sick people pay.

    To help pay for provisions that would make health coverage more affordable, the new Senate bill would raise the threshold to 10 percent of AGI. This change would target the tax deduction towards people with the highest costs. However, filers over age 65 would remain eligible to deduct expenses in excess of 7.5 percent of their income until 2017. link


    Parent
    I think the unions (none / 0) (#12)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:18:27 AM EST
    will work hard to get it out.

    We'll see.

    Sunsetting the mandates seems to not be on anyone's radar.

    For the record, it is not that I oppose mandates as policy, but rather I think mandates are the only chip we have to work for real reform on the federal level.

    There are other things to do as well - specifically, allow states to offer Medicaid as part of the Exchange in their states.


    Parent

    There is another backstop (5.00 / 1) (#13)
    by andgarden on Sat Dec 19, 2009 at 09:20:29 AM EST
    which is that the insurance model for healthcare is fundamentally broken, and this really can't last as a reform.

    But who knows how long it will teeter on. . .

    Parent

    It's not as broken (none / 0) (#15)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:23:51 AM EST
    because the Congress will pass a bill shoveling wealthy people's money into the system.

    That puts off the crisis for a bit.

    Parent

    The politics of that are. . .interesting (5.00 / 2) (#19)
    by andgarden on Sat Dec 19, 2009 at 09:29:01 AM EST
    It's not far from fee-for-service, where the Government pays all the fees. I'm trying to think of what the insurance companies incentives are under the new regime. Probably to just ask Congress to keep giving them more money. People will demand it.

    This is likely to cost way more over time than any other imaginable proposal.

    Parent

    Indeed (none / 0) (#21)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:30:36 AM EST
    It is a Rube Goldberg contraption without a doubt.

    Parent
    The question lurking in the back of my mind (5.00 / 1) (#24)
    by andgarden on Sat Dec 19, 2009 at 09:33:30 AM EST
    is how it compares to Hillarycare. It seems like instead of getting government regulated HMOs, we're instead getting federally financed PPOs, or something to that effect.

    Parent
    Something like that (none / 0) (#25)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:34:30 AM EST


    Parent
    whose money? (none / 0) (#45)
    by Andy08 on Sat Dec 19, 2009 at 09:50:12 AM EST
    I don't see wealthy people shouldering this nor pharma nor teh insurance companies.  Pharma is really happy!!

    Parent
    Even under the Senate bill (5.00 / 1) (#49)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:54:51 AM EST
    The major amount of the taxes fall on the wealthy.

    The House bill is obviously much more progressive in this regard.

    Parent

    I agree with your argument on (5.00 / 2) (#28)
    by MO Blue on Sat Dec 19, 2009 at 09:37:22 AM EST
    sunsetting the mandates and the rationale behind it. Just don't think anything like that will happen. It makes too much sense and I don't think the intention of many in Congress is to really hold the industries accountable.

    From everything I've read (I read a lot), the so called regulations will not even present a challenge to the industry's lawyers to find ways around them. To me, this is just a massive give away to the medical industries, propping them up and making them more able to defeat any real reform in the future. IMO it will impede any real reform, do little or nothing to lower the actual cost of care,  and may mean that more people will be covered by insurance but everyone will be pushed to receive less actual health care.

     

    Parent

    the mandate is STRENGTHENED and JUSTIFIED (none / 0) (#58)
    by azhealer on Sat Dec 19, 2009 at 10:03:47 AM EST
    implying that we should support it if the mandate has a 'sunset' means you are living in 'oz' or 'neverland' since that has NEVER been on the table, and never will be.

    Parent
    Well, you aren't going to get (none / 0) (#67)
    by Militarytracy on Sat Dec 19, 2009 at 10:17:07 AM EST
    it ever either if you don't even ask or push for it.  Ben Nelson folded due to something.......I think it had to due with losing everything his pocket liners stood to gain.  I'm a fighter though.  I never anticipate a day without some kind of fight in it :)

    Parent
    the best way for states to get their low income (none / 0) (#89)
    by azhealer on Sat Dec 19, 2009 at 10:43:44 AM EST
    residents equal care through the exchange would be to DROP OUT OF MEDICAID ALTOGETHER... a completely legal and rational thing to do...

    then low income folks will not be forced into the second class Medicaid system and the federal government will pick up the full tab of paying for them in the exchange... and state budgets will be saved.

    Parent

    BTD, thanks for this post (5.00 / 1) (#14)
    by Andy08 on Sat Dec 19, 2009 at 09:22:13 AM EST
    I think the term "health care reform" is incorrect. What we needed in this country was "health insurance reform" (!). Anyway, re. the excise tax the other day I posted a link to a good article by Megan McArdle on 12/17/09  at The Atlantic (Business): Who will be paying for the "Cadillac" Tax.  In particular I agree with her when referring to those who will be hit by this excise tax (eg. union members with negotiated health care plans ) she writes:

    The notion that these people are grotesquely overpaid freeloaders is usually a Republican talking point.

    How could the DEMS. come up with this scheme and believe --with a straight face--  it is "fair" to the middle class (?). It is preposterous....

    We should be freeing people from the indignities (5.00 / 1) (#16)
    by esmense on Sat Dec 19, 2009 at 09:24:11 AM EST
    of our welfare system, not throwing middle class people into it. "Premium Assistance" is not an acceptable alternative to genuine affordability and choice.

    This dog has to die.
     

    It's not an alternative (none / 0) (#17)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:25:14 AM EST
    But a bill with the changes I describe is better than the status quo imo.

    Parent
    I think "premium assistance" (5.00 / 2) (#78)
    by Anne on Sat Dec 19, 2009 at 10:28:18 AM EST
    is a term that leads people to think they are the ones getting the help, when in fact, it's the government telling the people how much of their income they are expected to contribute, and guaranteeing the insurance companies the difference between that and 100% of the premiums they wish to charge; if there's premium assistance, it's the government assisting the insurance companies in maintaining premiums at a level that comports with the bottom line the insurance companies desire, isn't it?

    What is in any of the planned legislation that controls the rise of premiums, and what happens when the government cannot justify the additional "assistance" it has to pay over to these companies as a result of the rise?  If it ends up having to be shouldered by the individual, what "assistance" is that for them, really?

    Where is the accountability on the part of these insurance companies?  I have the distinct and uncomfortable feeling that these companies will be taking a page out of the books of the banks, who pretty much stonewalled Congress each and every time it tried to get information about how they were using the government's money.  What makes anyone think the insurance companies will be any different - or even worse?

    I just wish I could get over the feeling that all of this mad planning and scheming will have the effect of preserving the stranglehold the insurance companies have, and doing nothing to prevent the inevitable unsupportability of the planned structure.

    If I am not understanding any of this correctly, please feel free to set me straight.

    Parent

    Spot on post! (none / 0) (#129)
    by rennies on Sat Dec 19, 2009 at 12:45:46 PM EST
    Furthermore, what kind of policy ceiling will be imposed on insurance companies for insuring people with previously deniable pre-existing conditions. That is, what good is to disallow pre-existing condition denial, if the customer cannot pay the high premium?  I haven't heard anyone address this issue.

    Parent
    How is better, really (none / 0) (#35)
    by Andy08 on Sat Dec 19, 2009 at 09:45:52 AM EST
    especifically who is this better for the majority? Will it cover more people?  At what cost and to whom? (in terms of health welfare).
    I see NO cost to the insurance and pharma companies and the huge taxes to new medical devices don't ring to me as forward scientific thinking. What do they want?  It's backwards thinking. If it were not for these medical devices most people would still be getting radiation treatments from those old machines that used low energy and burn your skin in horrible ways and/or non-digital mammograms (which by the way is what most of the data in that federal panel used; idiots...).

    One more thing: why the federal panel that came out against mammograms before 50 seems to be given -in this bill- a lot of new power to set what preventive care is covered?

    Parent

    meant (none / 0) (#38)
    by Andy08 on Sat Dec 19, 2009 at 09:47:02 AM EST
    "especifically HOW is this better for the majority?"  (not "who")

    Parent
    It's not better for the majority (none / 0) (#43)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:48:42 AM EST
    It's better for the less well off.

    This bill oes nothing for the middle class and could do harm if the excise tax is not removed.

    But I am in favor of helping the less well off with money from the wealthy, even if insurance companies make out like bandits.

    Parent

    The Dem politicians and their media (5.00 / 2) (#85)
    by MO Blue on Sat Dec 19, 2009 at 10:35:43 AM EST
    promoters keep preaching that not passing this bill will seriously damage the Democratic Party.

    This bill does nothing for the middle class and could do harm if the excise tax is not removed.

    IMO this will harm the party even more.

    Parent

    Well, I did want (none / 0) (#63)
    by Andy08 on Sat Dec 19, 2009 at 10:06:21 AM EST
    health insurance reform!! Every year I pay more and more and receive less and less. This year has been a travesty (see my other comment in this thread). Expanded coverage for the well off is fine but depends on who's paying for this because in the short and hence the long run, insurance and pharma companies are going to make us  (middle class) pay hard for this while continue to make record profits and taking year after year health care from us: this is already real in my case. They took away the annual check ups until you are 50 (it's every 2 years now); the cholesterol checks now every 5 years until you are 60, and so on... and this is an individual plan that costs 11K a year has high copays and deductibles... Things have been eroding like this at an accelerated pace  and there is nothing in this bill that will stop this nor the rising costs (to me for sure).

    Parent
    You did not get it in this bill (none / 0) (#65)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:08:25 AM EST


    Parent
    My opinion for what it's worth (5.00 / 2) (#23)
    by Florida Resident on Sat Dec 19, 2009 at 09:33:30 AM EST
    Without a public option of some kind to offer a reasonable cost to the country, mandates for any amount of time are wrong.  I am on Dean's side with this one.  Kill the bill and summit another one.

    Obama Beer Summit with Dean and Lieberman? (none / 0) (#57)
    by Politalkix on Sat Dec 19, 2009 at 10:02:40 AM EST
    Post # 23 says "Without a public option of some kind to offer a reasonable cost to the country, mandates for any amount of time are wrong.  I am on Dean's side with this one.  Kill the bill and summit another one"

    Obama Beer Summit with Dean and Lieberman?

    Parent

    shoud had said submit (none / 0) (#60)
    by Florida Resident on Sat Dec 19, 2009 at 10:04:17 AM EST


    Parent
    What a Joke. (5.00 / 3) (#27)
    by bselznick on Sat Dec 19, 2009 at 09:36:46 AM EST
    Anyone waking up this morning in any other industrialized nation on Earth is shaking their heads wondering what's wrong with those Americans.  How can they not feed and provide health care for their own people.  Then they probably start to chuckle and smirk, thinking what a strange bunch of people.

    PS: I never thought I'd be getting health care anytime soon, and I'm still sure of that.  As a couple of VERY hard working Americans the wife and I have been "Cash Pay" for nearly 10 years.  We had to make "The Choice" that's replacing the "American Dream".  That choice is health insurance or mortgage payment.  Today's middle class can't afford both!  We decided to keep a roof over our heads.

    True (none / 0) (#29)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:37:52 AM EST


    Parent
    If the Dems don't sunset or outright eliminate the (5.00 / 1) (#62)
    by esmense on Sat Dec 19, 2009 at 10:06:13 AM EST
    mandates now, the GOP will do it when they take power. Their small business constituency will demand it.

    Mandates and the excise tax make the wrong political enemies -- those independent and moderate middle class voters that the campaign spent so much time courting last year. (I don't understand why the beltway crowd is so convinced that their approach will only create political problems with an easily dismissed "left.")

    The people who will be most outraged by mandates and excise taxes vote, very dependably (unlike the poor, the young and the working class). They are the same people who are least likely to be mollified by "Premium Assistance" -- middle class small business owners, independent contractors, the self-employed, etc. who will be most affected by "reform. For these people, whose income fluctuates, who must make major investments to generate income, for whom cash flow is an issue, maintaining consistent eligibility for subsidies will be as much of a problem as maintaining consistent insurance coverage is right now. Plus, subsidies will require an intrusive, resource consuming amount of time responding to government oversight and proving eligibility that may at best be very spotty.

    If reform is not a good deal for people for whom reform is most important, it is not reform at all. Taking a welfare approach to reform with this constituency, combined with mandates and the excise tax, is a gigantic political mis-step.
     

    GOP supports the (5.00 / 1) (#112)
    by gyrfalcon on Sat Dec 19, 2009 at 11:11:39 AM EST
    mandates.  They're good for the insurance companies.  What they'd do is more likely reduce subsidies.

    Parent
    Yup (none / 0) (#114)
    by andgarden on Sat Dec 19, 2009 at 11:12:42 AM EST
    That is a scary prospect. But if the subsidies are implemented as I understand them to be (i.e., like tax credits), then would have have to override a veto to do that.

    Parent
    Only if there's a Dem. (5.00 / 1) (#131)
    by gyrfalcon on Sat Dec 19, 2009 at 01:40:31 PM EST
    in the White House at the time.

    Parent
    Let's not be naive (none / 0) (#121)
    by esmense on Sat Dec 19, 2009 at 11:27:39 AM EST
    The GOP won't support mandates once they are in power. Why would they? There are plenty of ways they can compensate insurance companies for loss of the mandates -- while making the libertarians in their coalition happy.

    You think MANDATES are the most important, or even a very important, item on the insurance industry's agenda? Let's not forget that mandates don't just hand them more customers, they hand them a lot of customers they would rather not serve.

    As part of reform that is real reform, mandates would play an important role. But mandates aren't desirable enough to get the industry to agree to real reform. You don't think they'd trade them away less regulation and "privatizing" Medicare?

    The policy wonks who are so wedded to mandates at any cost are getting played politically.

    Parent

    I meant to say (5.00 / 1) (#127)
    by esmense on Sat Dec 19, 2009 at 11:46:03 AM EST
    "you don't think they'd trade them away FOR less regulation and privatizing Medicare."

    People who insist we must pass this now or the moment for real reform will pass don't seem to consider that IF we pass this now the moment for real reform may pass.

    If "health reform" is perceived as a loser -- too intrusive, without making real progress on affordability -- by middle class voters, the Democrats will be punished for it.

    I keep hearing people say that if we get this turkey through now, it can be improved later. But what if, as I think is very possible, getting this turkey through throws the Democrats out of power? It can always be made much worse later.

    There absolutely no guarantee that Obama will be more than a one term President, or that the Democrats won't, in the next couple of election cycles have their legislative power seriously curtailed.

    I see no reason to believe that this legislation will strengthened their position with middle class voters, or encourage the less well off to have confidence in the administrations agenda and its willingness to fight for their interests,and therefore make it easier for better reform later.

    If you see reasons to believe this, please lay them out.

    Parent

    If this double rant is (none / 0) (#130)
    by gyrfalcon on Sat Dec 19, 2009 at 01:39:44 PM EST
    directed to me, you picked the wrong target, honey.

    Parent
    It will be politically difficult (none / 0) (#125)
    by Steve M on Sat Dec 19, 2009 at 11:35:59 AM EST
    to reduce subsidies, I'm fairly confident of that.

    Parent
    Let's hope so (none / 0) (#126)
    by Big Tent Democrat on Sat Dec 19, 2009 at 11:37:13 AM EST


    Parent
    All they have to do is (none / 0) (#135)
    by gyrfalcon on Sat Dec 19, 2009 at 04:28:48 PM EST
    keep them from increasing to match the rise in premium costs.  Pretty soon, the subsidies will be insignificant.

    Parent
    Sure (none / 0) (#137)
    by Steve M on Sat Dec 19, 2009 at 04:44:38 PM EST
    that sounds simple!  surely no one will oppose it.

    Parent
    Did I say no one would? (none / 0) (#147)
    by gyrfalcon on Sat Dec 19, 2009 at 08:37:18 PM EST
    Of course "someone" will oppose it.  But it would go through unless we have a strong Dem. congress and president.  Any bets on how likely that is?

    Parent
    I disagree (none / 0) (#149)
    by Steve M on Sat Dec 19, 2009 at 10:51:37 PM EST
    that's like saying the GOP will be able to cut Medicare unless we have a strong Dem Congress and President.  It's not like the Republicans get a bare majority and instantly get to eliminate the social safety net!

    Parent
    And it's not like the Dem. present and (none / 0) (#150)
    by oculus on Sun Dec 20, 2009 at 12:02:21 AM EST
    Dem. Congressional majority might not do it first!

    Parent
    I think the tanning bed tax is clever (5.00 / 1) (#66)
    by andgarden on Sat Dec 19, 2009 at 10:10:11 AM EST


    Just out of curiosity, (none / 0) (#69)
    by MO Blue on Sat Dec 19, 2009 at 10:22:03 AM EST
    since I can't access the PDF, how much are they taxing tanning beds?

    Parent
    10%, I think (none / 0) (#71)
    by andgarden on Sat Dec 19, 2009 at 10:24:06 AM EST


    Parent
    For use or purchase? (none / 0) (#75)
    by nycstray on Sat Dec 19, 2009 at 10:26:49 AM EST


    Parent
    Use, I believe (none / 0) (#77)
    by andgarden on Sat Dec 19, 2009 at 10:28:18 AM EST
    I think the amendment is on the c-span site. but I'm not sure reading it would be much help.

    Parent
    I was just curious :) (none / 0) (#93)
    by nycstray on Sat Dec 19, 2009 at 10:47:00 AM EST
    Not much into tans myself. I wonder who's idea this was, lol!~

    Parent
    It's called (5.00 / 1) (#102)
    by coigue on Sat Dec 19, 2009 at 11:02:04 AM EST
    the George Hamilton amendment.

    Parent
    John Boehner Amendment (none / 0) (#139)
    by caseyOR on Sat Dec 19, 2009 at 06:33:59 PM EST
    is, I believe, what the tanning bed tax is called. It is named in honor of the House Minority Leader. Personally, I think it will prove to be a failed attempt to garner Boehner's vote on the final bill. : ).

    Parent
    As a public health issue, I think this is (none / 0) (#95)
    by andgarden on Sat Dec 19, 2009 at 10:49:05 AM EST
    a reasonable target. I've read that tanning beds can cause skin cancer. (But by that standard why not similarly tax beach vacations?)

    Parent
    Heh (5.00 / 1) (#96)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:53:12 AM EST
    Indeed, also a more progressive tax.

    Parent
    Charlie Crist will never switch parties now! (none / 0) (#100)
    by andgarden on Sat Dec 19, 2009 at 10:57:04 AM EST


    Parent
    And cruises! (none / 0) (#98)
    by nycstray on Sat Dec 19, 2009 at 10:55:23 AM EST
    Or better yet, tan people! All those folks in FL and CA could really help the cause ;) {goes to buy sunscreen stock}

    Parent
    American Association of Dermatologists. (none / 0) (#124)
    by oculus on Sat Dec 19, 2009 at 11:32:42 AM EST


    Parent
    Really? (none / 0) (#70)
    by Militarytracy on Sat Dec 19, 2009 at 10:23:33 AM EST
    There is such a thing in there :)?  Southern women will revolt!!!!  They now bleach their teeth in the tanning bed too at the same time.  I had my teeth bleached at the mall in San Antonio this time.  They've  had a place among the kiosks for about two years now that does it, and I finally did it while Josh made fun of me.  I liked it and the owner told me that the tanning bed system is very similar.  I only need one more time to have really brilliant lustrous teeth :)

    Parent
    andgarden, the SFC bill (none / 0) (#116)
    by MO Blue on Sat Dec 19, 2009 at 11:17:22 AM EST
    had a mechanism that reduced subsidies if revenues were insufficient. In fact, the related CBO report stated that in years 2 and 3, the subsidies could be reduced by 15% due to this provision. Can you tell if this is still in the current Senate bill?

    Parent
    Sorry, I can't tell (none / 0) (#120)
    by andgarden on Sat Dec 19, 2009 at 11:22:46 AM EST


    Parent
    Wait till they find out that Vitamin D-therapy (none / 0) (#138)
    by Ellie on Sat Dec 19, 2009 at 05:04:33 PM EST
    ... via tanning beds isn't just a vanity quirk.

    Bio-available Vitamin D, amped up with exposure to full UV/A/B light (both sides in less time it takes to fry an egg) is increasingly being accepted as efficient preventative, therapeutic and curative method for a huge list of health problems.

    I happen to like my eggs with a dab of Mayo:

    Vitamin D is found in many dietary sources such as fish, eggs, fortified milk, and cod liver oil. The sun also contributes significantly to the daily production of vitamin D, and as little as 10 minutes of exposure is thought to be enough to prevent deficiencies. The term "vitamin D" refers to several different forms of this vitamin. Two forms are important in humans: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is synthesized by plants. Vitamin D3 is synthesized by humans in the skin when it is exposed to ultraviolet-B (UVB) rays from sunlight. Foods may be fortified with vitamin D2 or D3.

    The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. Recently, research also suggests vitamin D may provide protection from osteoporosis, hypertension (high blood pressure), cancer, and several autoimmune diseases.

    Rickets and osteomalacia are classic vitamin D deficiency diseases. In children, vitamin D deficiency causes rickets, which results in skeletal deformities. In adults, vitamin D deficiency can lead to osteomalacia, which results in muscular weakness in addition to weak bones. Populations who may be at a high risk for vitamin D deficiencies include the elderly, obese individuals, exclusively breastfed infants, and those who have limited sun exposure. Also, individuals who have fat malabsorption syndromes (e.g., cystic fibrosis) or inflammatory bowel disease (e.g., Crohn's disease) are at risk




    Parent
    Is there a tax on Viagra? (5.00 / 2) (#103)
    by Radiowalla on Sat Dec 19, 2009 at 11:02:22 AM EST
    Definitely I favor a tax on boners.

    I also favor passing an imperfect bill instead of nothing because I think that it is essential to establish once and for all that health insurance is the right of every American.  Once we get past that hurdle, it will be a lot easier to work towards single payer.

    Don't think so (5.00 / 1) (#110)
    by Steve M on Sat Dec 19, 2009 at 11:08:01 AM EST
    but apparently there is a new tax on tanning beds!!

    Parent
    Yup, I'll lobby for that (5.00 / 1) (#111)
    by Militarytracy on Sat Dec 19, 2009 at 11:11:04 AM EST
    Wanda

    Parent
    I'm 100% for a D!ck is Dead Death Panel (5.00 / 2) (#133)
    by Ellie on Sat Dec 19, 2009 at 03:24:29 PM EST
    ... that decides whether to allow Viagra scrips after seeing that note from Three Women!

    And let's see that three-fer be co-signed by religious counsel acceptable to Obama to guarantee there's hanky panky in the works.

    Wouldn't want ANY health coverage & care being wasted on immoral types.

    [/gawd I love Wanda]

    Parent

    This bill must die (1.00 / 1) (#31)
    by Honyocker on Sat Dec 19, 2009 at 09:44:07 AM EST
    All the maneuvering in the world can't undo the fact that this bill is a disaster.  Two thousand plus pages of government health care reform, with some insurance reform thrown in, that creates numerous new government agencies, taxes, mandates and regulations...in other words the bill is designed to empower government.  Power is, after all, a zero sum game.  The more power politicians and bureaucrats have over health care...the less power individuals have over their own lives.

    The president and the Dems blew it through blind stupidity driven by arrogance, and what seems to be a genuine love for statist involvement in every aspect of American life...scrap it and start over.

    Obviously (5.00 / 1) (#36)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:45:57 AM EST
    This is not a critique I agree with in any way.

    Parent
    Question: what prevents the Dems (none / 0) (#1)
    by andgarden on Sat Dec 19, 2009 at 09:02:57 AM EST
    from amending the bill for the better post-cloture? If you ping-pong those changes to the House, you don't need 60 votes again for a Conference report.

    Trade the excise tax for the opt-out public option, maybe?

    You need 60 for the conference report (none / 0) (#2)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:04:15 AM EST


    Parent
    Not if you don't need a conference report (none / 0) (#3)
    by andgarden on Sat Dec 19, 2009 at 09:05:48 AM EST
    Here's my scenario: cloture vote is held, and the opt-out public option is added back to the Senate bill before final passage. If the House passes the Senate bill, that's the end.

    Parent
    BTW, that's probably why they get cloture on (none / 0) (#5)
    by andgarden on Sat Dec 19, 2009 at 09:07:21 AM EST
    the manager's amendment first, and not the underlying bill. It would be too easy to dupe people like Nelson and then say "sorry, we're not voting for your changes."

    Parent
    You can't ping pong (none / 0) (#7)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:07:58 AM EST
    an unpassed bill.

    They have to pass the EXACT same bills.

    Parent

    I know, but that's not what I meant (none / 0) (#9)
    by andgarden on Sat Dec 19, 2009 at 09:11:40 AM EST
    I was thinking that the Senate could improve its own bill after cloture is invoked but before final passage. However, I'm realizing that any amendment would probably itself be subject to Rule 22.

    What a stupid body the Senate is.

    Parent

    I say abolish the Senate. (5.00 / 1) (#148)
    by oculus on Sat Dec 19, 2009 at 09:37:13 PM EST


    Parent
    It's (none / 0) (#6)
    by Ga6thDem on Sat Dec 19, 2009 at 09:07:21 AM EST
    not going to happen. The mandates are here to stay. I simply can't believe that you think they'll be taken out when for months and months this is about one of the only thing that has remained consistent.

    Not taken out (none / 0) (#8)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:08:36 AM EST
    Sunsetted.

    Parent
    Well (5.00 / 2) (#22)
    by Ga6thDem on Sat Dec 19, 2009 at 09:31:53 AM EST
    I hope I'm wrong since Obama is determined to pass any piece of garbage and call it "reform" but I don't think it's likely that the mandates are even going to be sunsetted. You have to remember how horrible these people are at negotiating.

    Parent
    I think this is a wonderful idea (none / 0) (#11)
    by Militarytracy on Sat Dec 19, 2009 at 09:15:53 AM EST
    Thought it was the first time I read it, and we've used sunsetting to avoid destructive entrenchment many many times before.

    Parent
    reading the amendment and they actually (none / 0) (#18)
    by azhealer on Sat Dec 19, 2009 at 09:27:31 AM EST
    try to justify the constitutionality of the mandate on page 67...

    they strengthen the individual mandate penalties

    they allow states to effectively ban abortion

    they allow big companies to make new employees wait indefinitely for insurance coverage

    they allow national plans with lowest common denominator coverage, decimating state mandates

    they BUY OFF NELSON BY PAYING FOR NEBRASKA'S MEDICAID EXPANSION FOREVER...

    and that's just the first part of the amendment!!!

    Not correct (5.00 / 1) (#20)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:29:49 AM EST
    "they allow states to effectively ban abortion"

    No, they do not. They allow states to opt to not allow abortion coverage to be offered on the exchanges.

    Any law that would do that would have to comply with the undue burden requirements under Casey.  

    Parent

    Women with money have always (5.00 / 1) (#47)
    by MO Blue on Sat Dec 19, 2009 at 09:52:37 AM EST
    been able to get abortions.

    IMO many bible belt states will opt to not allow abortion coverage to be offered on the exchanges. Making abortion an out of pocket expense will effectively deny poorer women this right.  


    Parent

    That's true (5.00 / 3) (#48)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:53:48 AM EST
    But much different than what is stated in the comment I am responding to.

    I would add that it is the status quo as well.

    Parent

    BTD - sorry, but (none / 0) (#30)
    by azhealer on Sat Dec 19, 2009 at 09:40:55 AM EST
    already Medicaid does not cover

    and bill gives states to prevent exchanges from covering.

    since nearly 100% of non-illegal residents will be in one of these two... it will be nearly banned in several states.

    Parent

    That's just absurd (none / 0) (#32)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:44:33 AM EST
    Do you know what the word "ban" means?

    Parent
    If McRae had come out differently, (none / 0) (#37)
    by andgarden on Sat Dec 19, 2009 at 09:46:21 AM EST
    you could imagine that this might be construed as a ban.

    Parent
    True (none / 0) (#40)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:47:29 AM EST
    But that is a different point.

    Parent
    The question comes down (none / 0) (#33)
    by andgarden on Sat Dec 19, 2009 at 09:44:34 AM EST
    to what happens to employer-offered group plans in those states.

    Parent
    If the law requires something happen to them (5.00 / 1) (#39)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:47:04 AM EST
    then it will violate Casey.

    I expect South Dakota will do something like that and then there will be a law suit and then the law will be struck down.

    Parent

    After Carhart II, I doubt it (none / 0) (#42)
    by andgarden on Sat Dec 19, 2009 at 09:48:04 AM EST


    Parent
    I disagree (none / 0) (#46)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:52:30 AM EST
    Remember the SCOTUS is a political animal.

    Carhart involved "partial birth abortion." This would be like a ban on insurance for  all abortions. Undue burden for sure.

    Kennedy will not go that far.

    Parent

    Sure, Kennedy is the sole remaining keeper (none / 0) (#50)
    by andgarden on Sat Dec 19, 2009 at 09:55:07 AM EST
    of Casey. He says what "undue burden" means.

    Now typically, that would be good news, because Kennedy has a pretty keen sense of personal liberty, but with respect to abortion rights, he's fainthearted.

    Parent

    Disagree (none / 0) (#51)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:56:39 AM EST
    He follows the polls.

    Thus he has effectively ruled bans on "partial birth abortions" constitutional. He would not do the same for earlier term abortions imo.

    Parent

    I'm not sure that he follows the polls, so much (none / 0) (#55)
    by andgarden on Sat Dec 19, 2009 at 10:00:28 AM EST
    as he channels Fred Hiatt. He is the village Justice.

    Parent
    I think Hiatt (none / 0) (#56)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:02:24 AM EST
    would fall on the side of unconstitutional.

    Parent
    Maybe (none / 0) (#61)
    by andgarden on Sat Dec 19, 2009 at 10:04:27 AM EST
    When you look back at Casey, it's pretty amazing what restrictions were not considered "undue burdens."

    Parent
    Nothing like (none / 0) (#86)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:36:30 AM EST
    a prohibition in insurance coverage.

    Parent
    Well, there was the waiting period, and the (5.00 / 1) (#91)
    by andgarden on Sat Dec 19, 2009 at 10:45:09 AM EST
    record keeping.

    I think here it's a question of how we understand not allowing plans that cover abortion into the exchange. To what degree is the right really implicated? I'd have to go take a look at the recent cases.

    Parent

    We don't all have employers (none / 0) (#41)
    by nycstray on Sat Dec 19, 2009 at 09:47:58 AM EST
    and small employers will be through the exchange will they not?

    Parent
    Well, abortion coverage is already not available (none / 0) (#44)
    by andgarden on Sat Dec 19, 2009 at 09:49:54 AM EST
    to people without insurance (unless they pay cash). So the question is whether there's any impact for those who do.

    Parent
    the language from the bill (none / 0) (#52)
    by azhealer on Sat Dec 19, 2009 at 09:56:49 AM EST
    ``SEC. 1303. SPECIAL RULES.
    8 ``(a) STATE OPT-OUT OF ABORTION COVERAGE.--
    9 ``(1) IN GENERAL.--A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition.

    which part of this is unclear?

    Parent

    None of it (none / 0) (#53)
    by Big Tent Democrat on Sat Dec 19, 2009 at 09:57:29 AM EST
    Sort of my point.

    Parent
    Group health plans don't go through the exchange (none / 0) (#54)
    by andgarden on Sat Dec 19, 2009 at 09:57:57 AM EST


    Parent
    while true.. the fact of the matter is that (5.00 / 1) (#72)
    by azhealer on Sat Dec 19, 2009 at 10:24:54 AM EST
    the bill will, over time, push more and more into the exchange (which is what the insurers want)...

    the cost of compliance for companies will be so great, they will be much better off just not offering insurance and paying the fine.

    and, making more and more employees work less than 30hrs/ week to not qualify  

    and, avoid employing single moms and others who are at higher risk of being eligible for more in subsidies

    Parent

    I have insurance (none / 0) (#76)
    by Militarytracy on Sat Dec 19, 2009 at 10:28:17 AM EST
    It's Tricare and abortion coverage isn't there for me except for instances of rape and incest.

    Parent
    100 percent? (none / 0) (#106)
    by gyrfalcon on Sat Dec 19, 2009 at 11:06:32 AM EST
    You do not understand the basics of the bill.  The vast majority of people will continue to get their health insurance through their employers with no government involvement, exactly the same as before.

    Parent
    Do you have more info on this: (none / 0) (#34)
    by nycstray on Sat Dec 19, 2009 at 09:45:18 AM EST
    they strengthen the individual mandate penalties


    Parent
    they make it very complex (none / 0) (#68)
    by azhealer on Sat Dec 19, 2009 at 10:19:36 AM EST
    but... dollar amounts are not simple like in House bill (2.5% AGI) or in SFC bill...

    instead there is a very complex formula based on income with the lower limit raised to $495 dollars from $350

    (read starting page 67)

    Parent

    Thanks (none / 0) (#73)
    by nycstray on Sat Dec 19, 2009 at 10:26:06 AM EST
    I couldn't get the pdf to open, so I'll cruise around and look for it a bit later :)

    Parent
    Nelson demands Senate bill be THE bill (none / 0) (#59)
    by MO Blue on Sat Dec 19, 2009 at 10:04:09 AM EST
    Nelson: I'll Filibuster Post-Conference Health Care Bill If House Forces Major Changes

    "Without in any way intending to be threatening--to be more in the more of promising--let me be clear, this cloture vote is based on full understanding that there will be a limited conference between the Senate and the House," Nelson said. "If there are material changes in that conference report, different from this bill, that adversely affect the agreement, I reserve the right to vote against the next cloture vote--let me repeat it--I reserve the right to vote against the next cloture vote if there are material changes to this agreement in the conference report. And I will vote against it if that is the case.
    After his cave in already (none / 0) (#64)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:06:59 AM EST
    He really got almost nothing, 43 million for Nebraska? That's all?

    I think he can be rolled.

    The insurance industry wants this.

    Makes you think Nelson would have rolled on Medicare Buy-In.

    Parent

    why should Arizona get the same deal? (none / 0) (#92)
    by azhealer on Sat Dec 19, 2009 at 10:46:05 AM EST
    our medicaid costs are killing the state budget --- $45 million per year is a lot of teacher salaries...

    if you care

    Parent

    Don;t need McCain;s vote (5.00 / 2) (#94)
    by Big Tent Democrat on Sat Dec 19, 2009 at 10:48:53 AM EST
    won;t ever get it.

    You get something when you vote for something.


    Parent

    $43 million (none / 0) (#123)
    by Dadler on Sat Dec 19, 2009 at 11:31:44 AM EST
    About two dollars and change per Nebraska resident. Joke.

    Parent
    Subsidies are still at 400% of poverty but... (none / 0) (#74)
    by katiebird on Sat Dec 19, 2009 at 10:26:34 AM EST
    Does anyone have a link to a chart of what that is with various-sized families?  I keep seeing references for families of 4 but not other options.

    Nevermind (none / 0) (#79)
    by katiebird on Sat Dec 19, 2009 at 10:28:20 AM EST
    Poverty

    Parent
    Wow, a couple of a years and one (5.00 / 1) (#82)
    by Militarytracy on Sat Dec 19, 2009 at 10:34:31 AM EST
    more child at home ago and my family would have qualified for a subsidy too.  That's encouraging on one hand.  On the other hand, what a hand out to the insurance industry.  This is going to be expensive.

    Parent
    At this point my family qualifies (5.00 / 1) (#87)
    by katiebird on Sat Dec 19, 2009 at 10:37:35 AM EST
    So, I have some relief.  I'd still rather it go for a Public Option.  But, I guess I'm enough of a slut to take it.

    I'm still reading through the thing to see what the percent-of-income limits are for premiums & total health care expenses....

    Parent

    When it comes to health (none / 0) (#88)
    by Militarytracy on Sat Dec 19, 2009 at 10:42:02 AM EST
    and saving people, we are all sluts at this point. If the Obama administration can get a sunset in here he too can possibly go down in history as having passed something that long term benefitted the poor in this country like Bill Clinton did :)

    Parent
    I'll happily be a sl*t (5.00 / 2) (#97)
    by nycstray on Sat Dec 19, 2009 at 10:53:18 AM EST
    if it helps get me more affordable health insurance :)

    Parent
    I owe you photos (none / 0) (#101)
    by Militarytracy on Sat Dec 19, 2009 at 10:58:31 AM EST
    The puppies are beginning to totter around.  Teeth are showing up a bit.  Everyone who makes their way to my feet in the kitchen gets their first lick of peanut butter right now.  Their ears are still little blobs of cartilage and in this line the ears are a very thick cartilage and I don't get a solid up ear until about a year old, but it is so funny when that first taste hits their taste buds and they try to put their ears up.

    Parent
    This only gives figures up to 300% (none / 0) (#81)
    by Militarytracy on Sat Dec 19, 2009 at 10:31:55 AM EST
    But perhaps it is beneficial.  Chart

    Parent
    Thanks, Tracy! (5.00 / 1) (#83)
    by katiebird on Sat Dec 19, 2009 at 10:35:12 AM EST
    It's so frustrating that none of this info is easily accessible.

    Parent
    I wonder how this will work. (none / 0) (#105)
    by MO Blue on Sat Dec 19, 2009 at 11:04:24 AM EST
    To qualify for subsidies in Medicare and Medicaid, you pretty much have to have no assets. How are they going to determine subsidies in the exchange? On straight Gross Annual Income, people could have the income to qualify and have assets hundreds of thousands above what Medicare and Medicaid allow.  

    Parent
    We should make it as easy as possible (none / 0) (#107)
    by andgarden on Sat Dec 19, 2009 at 11:06:45 AM EST
    If you have to go through an intrusive assessment, you defeat the purpose of the scheme.

    I think it works like a tax credit.

    Parent

    Help me out here :) (none / 0) (#119)
    by nycstray on Sat Dec 19, 2009 at 11:22:14 AM EST
    How would that work?

    Parent
    Wow -- that's a good question! (none / 0) (#108)
    by katiebird on Sat Dec 19, 2009 at 11:06:57 AM EST
    (back to reading)

    Parent
    Krugman: (none / 0) (#99)
    by andgarden on Sat Dec 19, 2009 at 10:55:42 AM EST
    "this is too flawed a bill for joy[.]"

    Ok, that's not quite fair context. But he speaks here.

    thanks for posting this (5.00 / 2) (#109)
    by coigue on Sat Dec 19, 2009 at 11:07:34 AM EST
    it's somewhat reassuring.

    What I keep worrying about is this:

    Everyone keeps saying how many more Americans will get health INSURANCE with this bill.

    What I want to know is: does that translate to those people getting the actual care they need?

    Because we all know that health care insurance does not always equal health care.

    Parent

    It doesn't and it can't (5.00 / 1) (#113)
    by andgarden on Sat Dec 19, 2009 at 11:11:41 AM EST
    Insurance is a broken model for providing healthcare (you really can't insure against guaranteed occurrences). But we're going to try and jerry-rig it again, and maybe buy some less suffering on the edges. (I.e., make people less fearful of visiting the Doctor).

    Parent
    Sorry for stating the obvious (5.00 / 1) (#122)
    by coigue on Sat Dec 19, 2009 at 11:31:18 AM EST
    but I get tired of hearing pols crow about how many are going to be covered....without knowing what that actually means in real doctors visits (etc)

    Parent
    and.... (none / 0) (#117)
    by coigue on Sat Dec 19, 2009 at 11:20:20 AM EST
    basically dance around the fact that this should never be a for-profit industry.

    I guess it's better than nothing, and I am also breathing a sigh of relief like PK.,,,and in spite of myself.


    Parent

    A very fair assessment (none / 0) (#104)
    by Militarytracy on Sat Dec 19, 2009 at 11:02:30 AM EST
    He speaks of what we can get in reconciliation too.

    Parent
    I think Krugman is wrong on the politics. (none / 0) (#134)
    by dk on Sat Dec 19, 2009 at 03:52:54 PM EST
    At best, this will not have any impact on the Democrats' political fortunes in 2010 or 2012.  At worst, it will hurt them.

    To be honest, though, now that the Democrats are the party of restrictions to women's rights and throwing money at for-profit insurance companies, I can't really get myself to care what the Democratic party's fortunes will be.

    Parent

    When you have lost the socialists... (none / 0) (#128)
    by Honyocker on Sat Dec 19, 2009 at 11:59:34 AM EST
    Sen.Bernie Sanders D-VT: "Can I sit up here or stand here with a straight face and say, 'We've got strong cost-containment provisions in this legislation?'That if you're an ordinary person who has employer-based health care, that your premiums are not going to go up in the next eight years based on what's in this bill?' I can't say that. It's just not accurate."

    Even the Senate Socialist thinks this thng is awful.

    Even? (5.00 / 1) (#136)
    by gyrfalcon on Sat Dec 19, 2009 at 04:32:14 PM EST
    Do you know what a socialist is, or a democratic socialist, which is how Bernie characterizes his beliefs, actually is?  Doesn't sound like it.

    Parent
    Sunset Mandates, Eliminate Excise Tax, Then Support Health Insurance Premium Assistance Bill | 152 comments (152 topical)

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