The Political Deal: Who Succeeded And Who Failed

You beat him down in every war, you twisted every treaty, you bellied with his wife, you played mock the Monk . . . and then you made him love you for it. --The Lion In Winter

Some may think of my title as pejorative. I do not intend it to be because I think of politics and governing as the end result of societal bargaining. In essence, we make a deal on how we are governed. The deal making comes in many forms - but in a democracy, the key step is elections. The function of a politician and a statesman is to get elected by persuading enough voters that what they will do will be superior to the other choices presented (this leaves aside the entire question of what form of political structures are most efficacious.)

So what was the bargain that has been struck in the health bill? And what politicians delivered? We have spilled tens of thousands of words on the issues, but I think it can be summarized relatively concisely. I'll try to do so on the flip side:

The substantive bargains appear to me as follows:

(1) a mandate that every legal resident and citizen have health insurance in exchange for certain new federal regulations and the creation of exchanges for the purchase of private health insurance by a discrete sector of the population.

(2) a tax on persons making 200k a year or more in exchange for funding enrollment into both the Medicaid public insurance programs and for the providing of subsidies for the purchase of private health insurance through the exchanges.

(3)the ability of states to limit the availability on these exchanges of health insurance that covers abortion in exchange for certain legislative votes necessary for passage.

Of course other bargains were struck, but these were the major ones. Is this deal acceptable? In a vacuum, I would argue that it is better than the status quo.

But we do not live in a vacuum. Given the results of the 2008 election, the legislative procedures available (namely reconciliation) and the problems at hand with health care, the bargain struck by the Obama Administration and progressive Democrats was not a good one. It was a very bad job of political bargaining. The main reason why I think so is because the health bill does not offer a viable path to solutions for the health issues in our country. I do not believe a "regulatory reform" model will work in the United States. We need a public insurance model of reform. This bill adopts the regulatory reform model which is doomed to fail.

Paul Krugman writes:

And exactly what should we blame Obama for? Hereís how I see it. [. . .] [O]n health care, I donít see how he could have gotten much more. How could he have made Joe Lieberman less, um, Liebermanish? And I have to say that much as I disagree with Ben Nelson about many things, he has seemed refreshingly honest, at least in the final stages, about what he will and wonít accept. Meanwhile the fact is that Republicans have formed a solid bloc of opposition to Obamaís ability to do, well, anything.

Krugman accepts the "60 vote" mantra. Proponents of the "regulatory reform" framework would. But if you do not agree that the "regulatory reform" framework is the right path, then you will disagree with the "60 vote" mantra. As you can imagine, I do not agree with it.

In announcing his vote in favor of the Senate health bill, Senator Russ Feingold said:

I've been fighting all year for a strong public option to compete with the insurance industry and bring health care spending down. I continued that fight during recent negotiations, and I refused to sign onto a deal to drop the public option from the Senate bill. Unfortunately, the lack of support from the administration made keeping the public option in the bill an uphill struggle.

While Feingold's criticism of the Obama Administration is accurate, I believe that Feingold himself is more to blame for this result than Obama. After all, I do not think anyone really believed Obama was a supporter of the public option. At least I never did. A supporter of the public option (and by extension, the public insurance reform framework) would have publically and vigorously supported the use of reconciliation as the legislative procedural device for achieving a public option.

Obama never did. Again, this is not surprising. In fact, it would not surprise me if that was part of the Obama Administration's bargain with certain health care stakeholders (again, this type of bargaining is not, imo, per se bad. It is bad when you cut a bad deal.) Obama was never a public option supporter.

But Russ Feingold is one. In fact, that is precisely what he is protesting in his letter. But Russ Feingold NEVER EVER even supported the notion of using reconciliation for health care. In my view, Russ Feingold is at least as much to blame for the loss of the public option as Barack Obama - because he fought against the use of reconciliation to achieve it.

In the end, the biggest culprits for losing the battle for meaningful health care reform were the Senate progressives, who failed to push the reconciliation option for enacting it, despite having the vocal and public support of one of the leaders of the Senate, Charles Schumer. Russ Feingold, Bernie Sanders, Sherrod Brown, Al Franken, etc., the biggest failure in the political bargaining surrounding health care reform was theirs.

They will, and have been lauded by people who do not agree with them on the public option. To the folks who bested them in the political negotiation, they are "heroes." To me, they are failures. I judge politicians on how well they can ACHIEVE the policies I espouse, not just whether they espouse the policies I espouse. What good is a politician's speech if it does not translate into some tangible policy? For me, nothing. The progressive senators failed to move the ball forward on public insurance reform. They have failed to shape this bill in such a way that public insurance reform is more likely in the future.

As politicians, they have failed from my perspective. It is important that people know they have failed.

It is fun to lay it at the feet of the President, and he deserves blame, mostly due to his dishonesty in the debate. He's getting and will get blame. But so too should Feingold, Brown, Sanders, Franken and the rest.

Speaking for me only

< Prisoner Abuse Legislative Fix Introduced | Except For The Mandate And No Public Option, HCR Is Exactly Like What Obama Promised >
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    This could be true. (5.00 / 2) (#7)
    by dk on Mon Dec 21, 2009 at 09:02:09 AM EST
    But on the other hand, you seem to be assuming that 50 votes in the Senate would have achieved a better bill than this one.  Personally, I'm not so sure, since IMO this bill is pretty much what the national Democratic leadership wanted, not what they settled for.

    Real problem IMO if they do not (5.00 / 1) (#11)
    by MO Blue on Mon Dec 21, 2009 at 09:07:43 AM EST
    change the financing mechanism. Taxing insurance coverage a real vote loser IMO.

    I assume that will be stripped out (none / 0) (#13)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:09:20 AM EST
    I can not imagine the unions letting that stay in.

    I seriously doubt it will stay (5.00 / 1) (#44)
    by CST on Mon Dec 21, 2009 at 10:06:45 AM EST
    Even the white house has said it's problematic.

    There is already pushback from the Unions on this provision.  They've given up on a lot of things in the bill, but not that.

    I found this to be pretty telling as well (from that article):

    "According to information released by the White House, Stern has the distinction of being the most frequent visitor to the executive mansion since Obama took office nearly a year ago."

    I think the excise tax is coming out.


    They'll just include an exception for union (none / 0) (#72)
    by suzieg on Tue Dec 22, 2009 at 02:30:50 AM EST
    members as they did for their own plans.

    I think Nelson said yesterday (none / 0) (#14)
    by andgarden on Mon Dec 21, 2009 at 09:11:38 AM EST
    that this would be a sticking point. He's not going to accept the surtax.

    Well (5.00 / 1) (#18)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:14:20 AM EST
    There are other ways to skin a cat.

    1 - take out the excise tax and do less deficit reduction

    2 - increase the Medicare tax for people earning over 500k.

    In other words, don't call it a surtax.

    Nelson ain't stopping the deal now imo.


    I would imagine there is (none / 0) (#16)
    by dk on Mon Dec 21, 2009 at 09:13:17 AM EST
    another way to buy off the union leadership while maintaining the excise taxes.

    Very doubtful imo (5.00 / 1) (#19)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:14:44 AM EST
    Unless it is adding EFCA to the health bill.

    Wow, could you imagine that? (none / 0) (#23)
    by andgarden on Mon Dec 21, 2009 at 09:16:30 AM EST
    In this context, it might slip through without much discussion.

    There would be a lot of discussion (none / 0) (#27)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:18:48 AM EST
    There is no real constituency for the excise tax except the wonks.

    It is going imo.


    It might actually be interesting to see (none / 0) (#29)
    by andgarden on Mon Dec 21, 2009 at 09:19:59 AM EST
    what the tax would do in practice. Some NYT article a few months ago predicted that it would be treated like the AMT and routinely set aside.

    You could probably carve out (none / 0) (#20)
    by andgarden on Mon Dec 21, 2009 at 09:15:12 AM EST
    any healthcare plan purchased in the context of a collective bargaining agreement. But then you'd probably not have enough money to make the program deficit neutral (on paper. . .).

    Disagree (none / 0) (#22)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:16:20 AM EST
    This does not raise that much money in the short term.

    Obviously it screws up the 650B in the second 10 years number. But there are other ways to skin a cat.


    Well, the one thing I do agree (none / 0) (#26)
    by andgarden on Mon Dec 21, 2009 at 09:18:37 AM EST
    with the Republicans on is that the budget projections for this are probably totally wrong. But I assume we can pretend to find another funding source. How about a special tax on imported wine? ;-)

    Raise the Medicare tax portion (none / 0) (#28)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:19:32 AM EST
    on person earning over 500k per year.

    It just finally got cheap...sheesh (none / 0) (#40)
    by Militarytracy on Mon Dec 21, 2009 at 09:37:15 AM EST
    France is all twelve stepping.

    May be possible to buy off the union leadership (none / 0) (#30)
    by MO Blue on Mon Dec 21, 2009 at 09:23:35 AM EST
    but they can't go into the voting booth with their rank and file. Can't see a lot of union members pulling the lever for a D if this is included.

    Why not? (none / 0) (#32)
    by dk on Mon Dec 21, 2009 at 09:24:50 AM EST
    Enough pro-choicers will to keep the Democrats in business.  Why not union members?

    And what have the Dems done lately (5.00 / 2) (#58)
    by Spamlet on Mon Dec 21, 2009 at 12:04:01 PM EST
    for pro-choicers?

    I would have said that they threw them (none / 0) (#71)
    by MO Blue on Tue Dec 22, 2009 at 12:04:46 AM EST
    under the bus but they were already there. Pro-choicers don't have to pull the lever for the D either. They have a choice to vote 3rd party, leave blank, stay home or decide that even a bad Dem is better than a Republican. See I'm pro-choice on more than one issue.

    How many Senators were hiding (5.00 / 2) (#31)
    by ruffian on Mon Dec 21, 2009 at 09:24:26 AM EST
    behind the 10 or so vocal opponents of the Public Option plans? I tend to think there were not even the 50 votes needed for reconciliation. I think a more enthusiastic WH and Senate leadership willing to really put the hurt on the recalcitrant could have changed that, but we do not live in that world. No Henry IIs or Eleanor of Aquitaines to be found.

    This deal will probably pass more or less as-is. It won't work very well for the people, and Dems will have lost a chance to do something that really worked. That will have very bad long term consequences for government in general.

     Will doing nothing be any better? In the long run I think so. I think, despite appearances, we have not reached bottom yet in health care. When some large corporations that employ a critical mass of people are forced by premium hikes to raise insurance costs to employees another 25-50% over the next few years, people will decide they have had enough and then maybe we can do better. It seems odd to say so, but too many people are not in enough pain yet to demand better fromt heir government.

    It Was Obama's Responsibilty To Lead (none / 0) (#62)
    by norris morris on Mon Dec 21, 2009 at 01:59:03 PM EST
    Feingold, and all the other poor Dem bargainers and hypocrits sold their souls.

    They never play chess well, and the White House fostered weakness this through indifference and clearly not prefering the public option. We've been snookered on Drugs by Obama's outrageous sellout to Big Pharma. I drug I've received for $4.00 has JUST been taken off Medicare. No more generic. It now [Levsin] costs over $70.00

    We can thank Obama for this horrific sellout and devious backroom dealing in July when this was
    done with the lobbyist that gave us the donut hole, Billy Tauzin former Republican  with help from his pal  Tom Delay.

    If Obama can't be trusted and cannot offer leadership on his central program, we cannot blame the corrupt and uncontrollable behavior on the part of the Senate. Rahm made his deal with Nelson willingly. Obama has been missing inaction and has failed miserably with Afghanistan,  &amateur run for Olympics. Was a disaster in Copenhagen,&  has been considered a disastrously
    "feeble" President in English press after Copenhagen. His bragging about his succsses is embarrassing.
    His head of HEW Katherine Sibelius is out to lunch and has remained so during this debate.

    The corruption and lack of leadership and control exist in all areas of the financial gurus who are the same bunch that put us in this mess.

    When Obama finger wags and scolds Wall St with one of his speaches, he's snickerd at on the Street Of Wall Street Dreams.
    Obama's miscalucalations have empowered the GOP even more amd the pushback from voters will be
    considerable. Other than Obamabot Villagers, he's managed to disenchant the right and the left, independents, and his base which is vanishing.

    Compromise of this huge kind leads to defeat.
    He's helping to ruin what's left of the "majority" party. Obama wooing Snowe was anther show of amateur negotiating skills and foolhardy illusions.


    Village bloggers also (5.00 / 1) (#42)
    by lilburro on Mon Dec 21, 2009 at 09:58:50 AM EST
    did little to pave the way for reconciliation, quite the reverse actually.

    The way they got sidetracked on the topic of "changing the Senate" was harmful too I think.  Just a way of presenting 60 votes as the only possible path.  They're right the way the Senate is set up sucks, but deciding to whine about it rather than force through a bill is just stupid.

    I am upset at all of them. (5.00 / 3) (#49)
    by inclusiveheart on Mon Dec 21, 2009 at 10:29:02 AM EST
    But I guess I will always be most unhappy with Obama because I get the impression that he not only lacked interest in the public option and other progressive principles, but also actively worked to undermine both.  That is a betrayal that I won't likely be able to forgive.

    As for Feingold, I've always thought he was great at hiding out just until the deal is done and coming out to announce that his "principled" stance on whatever issue is still alive in principle, but not in practice.  To which I generally respond, "Who cares what you think now?  Where were you when the debate was going on?  Whre were you when saying something might have made a difference?"

    Honestly, I don't really trust Feingold.  Never have and probably never will. Okay, maybe if he actually mounted an effort to "fix" FISA, The Patriot Act and MCA, like he said he would after those abominations passed, but I'm not holding my breath that ever is going to happen.

    Completely with you (5.00 / 1) (#51)
    by Militarytracy on Mon Dec 21, 2009 at 10:39:19 AM EST
    I CAN'T TRUST ANY OF THEM (none / 0) (#63)
    by norris morris on Mon Dec 21, 2009 at 02:02:37 PM EST
    Thanks for your post. My ideas exctly.  

    Huge betrayal from Team Obama.


    Understood. As a constituent (none / 0) (#66)
    by Cream City on Mon Dec 21, 2009 at 04:17:10 PM EST
    involved in the campaign -- for another candidate -- when first Feingold won Senate, I had concerns.  They arose again with his Ashcroft vote, plus a few others.  And yes, it is past time for him to make good on his promises to do something about FISA, etc.; but the inability to form effective coalitions is essentially part of the definition of a self-determined "maverick."

    Above all, for those of us who have watched him for decades (in the state legislature, too), he is a pol and a savvy one.  And he is a pol up for re-election in a state where a Dem needs two areas: Milwaukee and Madison.  For Milwaukee, a majority-minority city, he has to be careful about going too much in Obama's face.  For Madison, well, think of it as Teh Village West, and you know the Villagers are for this bill.

    It is a disappointment, yes.  Now I wait to see whether he will come through on Afghanistan -- but again, I did not see (I may have missed) a speech from Feingold in debate on the massive war funding bill a few days ago, either.


    You have hit the nail on the head as ususal, BTD (5.00 / 2) (#55)
    by esmense on Mon Dec 21, 2009 at 11:09:19 AM EST
    This outcome was probably inevitable. Because, let's be honest, the Democrats have been pursuing the same intentional (although personally unacknowledged?) strategy, for the last 30+ years; using ultimately unworkable welfare sops to brush the consequences of massive economic change under the rug.

    Over the decades, as economic change devasted inner city African American communities, pushed the working class into two and three job (and now no job) poverty, destroyed private sector unions and hollowed out the middle class, when push came to shove, they always, always, always sided with the most powerful interests. Offering at best a few welfare sops to obscure that fact. This sell out on health reform is only the last iteration.
    When, in the 60s & 70s, our major cities were being de-industrialized and minorities, the last ones in so to speak in terms of reaping benefits from industrialization, were stranded in collapsing economies, did the prevailing "liberal" discourse frame this in terms of the broader economic problem it was, treat people affected with respect, make honestly discussing our economic future (automation, globalization), protecting working class interests and re-vitalizing our cities a priority? No. "Liberal" leaders, specifically Moynihan, led a debate over the "underclass" that, for the next 30 years, substituted an argument over welfare (whether it was deserved, how much to provide, who should pay for it) for honesty about what was happening to the American economy.

    When these structural changes began to most seriously affect the white working class, "liberals" did little more than suggest they simply train and educate themselves out of the working class. Once again refusing to rock the boat or upset their increasingly important Wall Street supporters, by honestly discussing, much less addressing, the larger problem of structural change -- the ways unregulated financial elites were taking advantage of that change, and the inevitable consequences for almost everyone else down the line.

    Why, as the rot of a failing economy continues to spread farther and farther up the economic ladder, should we expect anything more from them than just another sorry, totally inadequate, welfare sop?

    The problem isn't that they aren't well-intentioned, or don't care. The problem is that they don't know (much). And that it isn't in their own personal interest, economic and political, to do so.

    Among the many problems created by the welfare approach the worst is this; it fails to frame the problem, correctly, as one that affects the entire society and will have consequences for everyone down the road, and instead makes it a problem that pits the interests of one group against another (the middle class against the "underclass," rich against poor, etc.)and destroys social unity.

    Sorry to rant, I guess it is my way of coming to terms with frustration and massive disappointment.

    It will appear in the Congressional Record soon (none / 0) (#1)
    by andgarden on Mon Dec 21, 2009 at 08:39:58 AM EST
    but Tom Harkin took the floor yesterday afternoon and made essentially the same claim. He said that we could have used reconciliation, but that the President wanted to include Republicans. It's funny how quickly some people will allow their institutional prerogatives to be subsumed when they don't want to take responsibility for things. It's the other side of the "Obama doesn't have a vote in the Senate" coin.

    As to the deal that was struck, the Times has an excellent interactive comparison of the House and Senate bills.

    According to Times article, (5.00 / 1) (#43)
    by MO Blue on Mon Dec 21, 2009 at 10:00:24 AM EST
    the House bill has a much stiffer penalty for not complying with the mandate. Also, Senate's penalty is phased in over a period of 3 years.  

    Penalty: Tax equal to 2.5 percent of adjusted gross income over certain thresholds ($9,350 for individuals, $18,700 for couples).

    Penalty: $95 a year per person in 2014; $350 in 2015; $750 or 2 percent of a household's income, whichever is greater, in 2016 and beyond. No penalty if the cost of cheapest available plan exceeds 8 percent of household income.

    The 8% cap on household income is somewhat deceptive IMO. At least on the statements made by the Dems selling the bill. If the catastrophic insurance premium is less than 8% of income, you would be forced to buy that or pay the penalty.


    If the cheapest plan (5.00 / 1) (#46)
    by nycstray on Mon Dec 21, 2009 at 10:10:48 AM EST
    exceeds 8% of your income and you can't afford it, shouldn't you be subsidized? And isn't there something in the bill that says even the cheapest plans have to provide some basics, not just catastrophic?

    Current Senate bill (none / 0) (#52)
    by MO Blue on Mon Dec 21, 2009 at 10:43:16 AM EST
    Premiums for silver plan (70% actuarial value) equals 9.8% for people between 251% and 400% of FPL. No subsidies over 400%. It is my understanding based on what I've read and this wording "cost of cheapest available plan" that you can only get a waiver on the mandate if there is no plan whose premium is under 8% of household income.

    Don't think House bill offers catastrophic coverage. Plans have higher actuarial values and more in subsidies.



    Thanks (none / 0) (#54)
    by nycstray on Mon Dec 21, 2009 at 10:56:02 AM EST
    Oh, and what a truly superb film (none / 0) (#2)
    by andgarden on Mon Dec 21, 2009 at 08:43:09 AM EST
    The Lion in Winter is. (I can't speak to the play, but I doubt you could beat the cast of the film).

    So I'm reading around (none / 0) (#3)
    by Militarytracy on Mon Dec 21, 2009 at 08:49:45 AM EST
    Biden says that we can now make some good changes, and then I'm reading around that Nelson has said that anything less than what he wants gets a NO vote. What do you think andgarden about that badland that lies between the two?

    There are probably changes around the edges (5.00 / 2) (#4)
    by andgarden on Mon Dec 21, 2009 at 08:54:55 AM EST
    that won't piss off Nelson so much. What I would like, but haven't checked into, is for there to be a right of action for consumers to sue their insurance companies for specific performance on the new regulations in Federal court.

    Of course not (5.00 / 2) (#5)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:00:58 AM EST
    My gawd, they want tort reform, you think they would create a private right of action?

    BTW, does this prove the uselessness (5.00 / 1) (#17)
    by andgarden on Mon Dec 21, 2009 at 09:13:46 AM EST
    of the "regulatory reforms" or what? You have to count on your state insurance commissioner to keep the insurance companies in line. To some degree, this makes the availability of the OPM national plan essential. That will be the only competition. (If it's ever even created).

    So that's most likely hopeless (none / 0) (#8)
    by Militarytracy on Mon Dec 21, 2009 at 09:03:25 AM EST
    Could you limit the remedy to (none / 0) (#9)
    by andgarden on Mon Dec 21, 2009 at 09:04:21 AM EST
    specific performance? We're all about "compromise," right?

    If attorney fees are excluded (none / 0) (#10)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:06:25 AM EST
    who could afford to file an action?

    You create a market in selling (none / 0) (#12)
    by andgarden on Mon Dec 21, 2009 at 09:08:18 AM EST
    sue the insurance company insurance!

    Yeah! (none / 0) (#15)
    by Militarytracy on Mon Dec 21, 2009 at 09:13:07 AM EST
    They have those attorneys that a large group pays a small monthly payment to.  I've never used one.  I would do that though. I know that a whole bunch of people who are sick won't be able to afford something like that.  But perhaps those of us who can and who will can throw some deadfall off the road for the others...unless they gag everyone and no news is good news for the insurance companies.

    I'm actually a bit disappointed about that (none / 0) (#65)
    by Socraticsilence on Mon Dec 21, 2009 at 02:50:49 PM EST
    why not offer tort reform it would have provided substantive cost controls and possibly brought some republicans on board.

    Substantive cost controls? (none / 0) (#68)
    by oldpro on Mon Dec 21, 2009 at 04:30:13 PM EST
    Where's the evidence?



    Such an excellent excellent idea (5.00 / 1) (#6)
    by Militarytracy on Mon Dec 21, 2009 at 09:01:14 AM EST
    I cannot help but think about such things.  Actually I'm tormented by such fears and desperate for some sort of solution that could work if they attempt to harm us.  I saw Tricare do some odd things during this debate, like when they approved Joshua for an hour of physical therapy weekly for 25 weeks.  That was huge.  I've never seen anything like that before.  When I woke up this morning and began reading, one of my first thoughts and sinking feelings was that that Christmas is now over.

    I have one more "tell" coming down (5.00 / 1) (#34)
    by Militarytracy on Mon Dec 21, 2009 at 09:27:23 AM EST
    the pike that I will use to measure whether the insurance debate was affecting the current preformance of the insurance companies.  Tricare has denied payment on every single surgical Xray that Joshua has had taken in the past two years.  When you get to the bottom of the denial it comes up that the insurer claims that they did not understand it was a surgical Xray, that it could have been due to a third party injury and no paperwork was turned in proving that it wasn't.   It usually ties up the provider receiving payment for a good year.  After a year of that crap and many people having their Xray bills turned over to collections for nonpayment and nobody understanding why if they have full coverage they have something so common not paid for and now in collections, Tricare told us that it was an unfixable glitch in their automated paperwork system and there was nothing they could do about it on their end.  We must all fix it individually from our end.  Understand that if a radiologists billing clerk doesn't understand the current nonpayment scam being run on her employer, they end up with a big backlog of unpaids from every single Tricare patient they must send those forms to and wait for them to be returned filled out.  And if they have a clerk switchout - that clerk will not know what the heck to do about any of it and turn it all over to collections.  So this last surgery in San Antonio, I went to the business office of the hospital to fill out the forms I knew I would need to fill out anyhow in six months and have those turned in with the billing. But the clerk was gone that day.....BLEH!  If the radiologist gets paid this time though, odd how they got that unfixable glitch finally fixed.

    Can you start cc'ing Joe Lieberman (5.00 / 1) (#47)
    by ruffian on Mon Dec 21, 2009 at 10:15:58 AM EST
    and President Snowe on your paperwork? I think a movement like that is our best bet.

    If all this fails (5.00 / 1) (#50)
    by Militarytracy on Mon Dec 21, 2009 at 10:36:33 AM EST
    Something is going to have to be done.  Things have been changed by this debate.  Before all this I was this one woman and this little boy being ground down daily by the insurance industry.  I would meet other parents along the way, but we were very weary.  We were defeated and resigned to it.  This gave us hope, we started hoping a lot.  I don't know if we can go back to being easily defeated and demoralized again.  It's too horrible to think about.  The insurance industry daily grind on us all had us all ground down and fear ridden.  This debate opened doors to the possibility that we wouldn't have to live that way until we died.  So what if they shut them in our faces.  We saw a glimpse of the other side and we are much more organized now, much more organized.  That's why I will not dog Jane.  This fight is NOT done.  It is sadly very far from it, and we may even lose her before this is done.

    And you what else? (none / 0) (#56)
    by Militarytracy on Mon Dec 21, 2009 at 11:14:51 AM EST
    They already know all this stuff.

    That's not just Tricare (none / 0) (#67)
    by Inspector Gadget on Mon Dec 21, 2009 at 04:20:07 PM EST
    Every insurance company uses the same delay tactics. They hope that the patient pays the bill and eventually gives up or forgets they never resolved.

    The number of claims that end up with a form being sent to the insured patient requesting more information on anything that might have been an injury is staggering. The health insurance companies try their best to subrogate the claims to other insurances (homeowners, PIP, auto, workers compensation, etc.). And, if you don't send the forms back in, you default to not being covered by your insurance policy.


    Yes, it is hard to believe that (none / 0) (#69)
    by Militarytracy on Mon Dec 21, 2009 at 10:29:16 PM EST
    most of this stuff was going on when my 20 year old daughter was 2 years old, but it was.  Back then there was still Champus.  We loved Champus.  You sent Champus the bill and they just paid it.  It was amazing.  Medicare was rough, payment for services was small but we had a lot of them.  Medicaid paid fairly well then, I think they paid providers better then than they do now.  Every other insurance company though was always running some kind of scam or several to slow down payment for services.  The coding clerks and the billing clerks were run ragged, but as soon as one got wise to a specific scam and they figured out how to stop the delay process, that information went everywhere to whomever they could think of that would need it.

    Oh yeah, and Tricare doesn't send (none / 0) (#70)
    by Militarytracy on Mon Dec 21, 2009 at 10:33:08 PM EST
    anybody a form for this now.  They just deny it.  They actually have made it the providers problem to get the forms and send them out.....hoping that they will be sent back in.  The receptionists for the radiologists should just have the forms at the front desk to be filled out along with anything else needed, and I was going to suggest this to their billing clerk.  But he wasn't in.

    Progressives? (none / 0) (#21)
    by Pat Johnson on Mon Dec 21, 2009 at 09:15:25 AM EST
    Show me a "progressive" and I will show you a capitulator.   This bill is not fashioned on behalf of the public it is a windfall for the industries who bought and paid for this gift as soon as they realized that "reform" was on the table with a Dem win.

    Obama is nothing more than a paid shill who could not care less.  Just place a "win" in his column and he is satisfied.  But those who "stood firm" but who eventually caved in are those who could have made a difference but chose another path.  You are correct in your outline.  We have been once again been pushed under the bus to satisfy the whims of those who continue to seek to maintain their hold on their elected offices.  

    Sad but true.  When courage was called for we got nothing but hot air and a lot of empty rhetoric that amounted to nothing.

    Corporatism (5.00 / 2) (#48)
    by waldenpond on Mon Dec 21, 2009 at 10:23:57 AM EST
    at it's finest and extremist.  I don't think I've ever seen anything this blatant.  It's appalling.  A convergence of a corrupt governing system with a corrupt industry.  This immoral insurance industry is now entrenched.  There will be no regulation and we will get gouged to the tune of nearly 20% of income.

    It is difficult to understand (none / 0) (#24)
    by lilburro on Mon Dec 21, 2009 at 09:16:32 AM EST
    why no-one followed Schumer's lead on reconciliation.  Specter was tentatively prepared to do so.

    And why didn't the opt-out idea work?

    Because the insurance industry (5.00 / 5) (#25)
    by Big Tent Democrat on Mon Dec 21, 2009 at 09:17:46 AM EST
    knew what the real threat was.

    It sure as hell ain't Ezra's precious exchanges.


    Democrats Pin 2010 Hopes on this bill (none / 0) (#33)
    by MO Blue on Mon Dec 21, 2009 at 09:26:31 AM EST
    Slumping in the polls and struggling to pass climate and financial legislation, President Barack Obama and Democratic leaders are counting on an historic health care victory to buoy their electoral prospects in 2010. link

    OMG. that is delusional. (5.00 / 1) (#35)
    by ruffian on Mon Dec 21, 2009 at 09:28:52 AM EST
    Probably (none / 0) (#36)
    by andgarden on Mon Dec 21, 2009 at 09:30:41 AM EST
    I'd say there's a non-zero chance of it, though.

    heh- yeah, non-zero is a safe bet (none / 0) (#37)
    by ruffian on Mon Dec 21, 2009 at 09:32:22 AM EST
    I'd even go up to 30% if this bill had been delivered cleanly in June without all the public sausage making.

    I was thinking about 30% (none / 0) (#39)
    by andgarden on Mon Dec 21, 2009 at 09:36:53 AM EST
    That probably about the same as the chance that it will make things worse.

    Kos had some very sobering poll results (5.00 / 2) (#45)
    by ruffian on Mon Dec 21, 2009 at 10:09:11 AM EST
    on projected Dem turnout that he talked about on one of the Sunday shows. I'd say there is a lot of work to do in the next year if they want to keep the House.

    I think they are hurting their chances (5.00 / 3) (#38)
    by ruffian on Mon Dec 21, 2009 at 09:34:59 AM EST
    even more by playing it up as some 'historic achievement', ' no one has done this in 7 presidencies', etc, etc,. Selling it as a modest first step would go over better. But that would be way out of character.

    Initially, I misread (none / 0) (#59)
    by Spamlet on Mon Dec 21, 2009 at 12:09:30 PM EST
    the word "buoy." I read "bury."

    Slumping in the polls and struggling to pass climate and financial legislation, President Barack Obama and Democratic leaders are counting on an historic health care victory to bury their electoral prospects in 2010.

    probably a more likely outcome (none / 0) (#64)
    by ruffian on Mon Dec 21, 2009 at 02:09:55 PM EST
    oddly enough, (none / 0) (#41)
    by cpinva on Mon Dec 21, 2009 at 09:46:55 AM EST
    Obama was never a public option supporter.

    that's not the impression he gave, during the primaries and general election. in fact, that was among the few areas he actually gave specifics, if i recall correctly.

    i could be wrong, i'll need to go back and check.

    excellent post (none / 0) (#53)
    by oculus on Mon Dec 21, 2009 at 10:53:00 AM EST

    Krugman gets it right at the end (none / 0) (#57)
    by Manuel on Mon Dec 21, 2009 at 11:24:15 AM EST
    But back to Obama: the important thing to bear in mind is that this isn't about him; and, equally important, it isn't about you. If you've fallen out of love with a politician, well, so what? You should just keep working for the things you believe in.

    Even Howard Dean mentioned yesterday that this bill signals a choice for the country to pursue the private insurance path for health care. We better get ready for the regulatory fights ahead. Moreover, if it is true that we have picked the private insurance path, how can we continue to work for single payer and public funding of health care?

    The trouble is, "we" didn't pick (5.00 / 2) (#60)
    by Spamlet on Mon Dec 21, 2009 at 12:15:53 PM EST
    the private insurance path. First "we" picked hope-n-change, and then "we" picked a public option, as polls consistently showed throughout the putative debate and the pathetic negotiations.

    In short, "we" are not represented by our so-called representatives. "We" chose something other than what they chose. The Dems now appear to have merged with the anti-choice Republicans in just about every respect.


    Good post. (none / 0) (#61)
    by Maryb2004 on Mon Dec 21, 2009 at 12:20:03 PM EST