Senate Reaches Agreement on Health Care

Lots of news sources are reporting a "broad agreement" has been reached in the Senate on health care.

The AP is further reporting (in an article with a time stamp two hours from now) that the agreement includes tossing the public option. Are they right?

Democratic senators say they have a tentative deal to drop a government-run insurance option from health care legislation. No further details were immediately available.

But liberals and moderates have been discussing an alternative, including a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage. Additionally, talks centered on opening up Medicare to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the over-65 population.

Jon at Firedoglake is not impressed with the likely details of the Medicare proposal. It won't cover that many people and is not really a buy-in. By the time they are done, it may not even really be Medicare.

Update: WaPo: The public option is being shelved in favor of other alternatives.

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  • Display: Sort:
    "A broad agreement" = Olympia Snowe (5.00 / 6) (#5)
    by Cream City on Tue Dec 08, 2009 at 09:15:46 PM EST
    is responsible for it?  That broad seems to be running the country lately. . . .

    Her reign as queen of the Senate will be (5.00 / 1) (#6)
    by andgarden on Tue Dec 08, 2009 at 09:23:37 PM EST
    short-lived. The place will either change its rules or cease to function at all next Congress (the margins will be smaller).

    Yes, Snowe's reading list (5.00 / 2) (#7)
    by Cream City on Tue Dec 08, 2009 at 09:30:03 PM EST
    ought to include a few bios of Mary, Queen of Scots.

    Hah! (5.00 / 1) (#17)
    by gyrfalcon on Wed Dec 09, 2009 at 01:17:26 AM EST
    So who's Darnley in that parallel?  And who, God help us, will be her Bothwell?  Not Reid, surely!

    The Senate (none / 0) (#31)
    by Socraticsilence on Wed Dec 09, 2009 at 12:36:42 PM EST
    has always been a slowdown, what's changed is the purpose of the filibuster- over the last decade or so its basically made governing impossible- no party can pass any major item on its agenda without approaching a 2/3 majority (to prevent moderate defections from being the tipping point).

    More Reasons To Think Democrats Are Move Evil (5.00 / 1) (#8)
    by Dan the Man on Tue Dec 08, 2009 at 10:05:02 PM EST
    Than Inept.  On the one hand, they are smart enough to realize attaching the word "Medicare" to the plan makes it more attractive (because people like Medicare).  On the other hand, they aren't willing to really expand Medicare to more people even though it would be easy to bash Republicans opposing the expansion (because the people like Medicare and Republicans claim they like Medicare also).

    They should open Medicare (none / 0) (#9)
    by nycstray on Tue Dec 08, 2009 at 10:09:44 PM EST
    to everyone 55+ AND everyone who is eligible for the "exchange". They would get a lower risk pool that way, I would think.

    That would help people (none / 0) (#10)
    by caseyOR on Tue Dec 08, 2009 at 10:48:03 PM EST
    not insurance companies. Since the real reason for this appears to be a guaranteed expansion of the customer pool for the insurance companies that kind of Medicare expansion will never pass in this Congress.

    Once they let any sizable group buy-in to Medicare, more and more people will want in and that would cut into insurance profits. And we can't have that.


    I'll be interested to see the details (none / 0) (#12)
    by nycstray on Tue Dec 08, 2009 at 11:25:49 PM EST
    on the news, they said 55+ uninsured could buy in. That leaves me and many out in the dust if the mandate starts before we turn 55. Hopefully on 55+ they'll adopt the exchange rules so small biz and independents can buy in . . . but I guess that would come with a spotted pony.

    Join the AAYP (none / 0) (#15)
    by lilburro on Wed Dec 09, 2009 at 12:26:53 AM EST
    we have 2 members...but we want mandates and Medicare for All in the Exchange...

    Oh Yea! (5.00 / 2) (#11)
    by CDN Ctzn on Tue Dec 08, 2009 at 11:19:34 PM EST
    So the poor insurance industry wins again, and all the spineless congressmen can collect their nice "christmas bonuses" from the health care industry while the rest of us get royally screwed.
    So tell me then, how is it we benefited from electing a Dem President along with majorities in the House and Senate?
    I seem to remember those of us who were supporting Independants and Third Party Candidates being ripped a new one last fall along with cries to support the Dems because issues like Health Care were too important to play with. That's working out really well isn't it?

    Yeah, and what (5.00 / 1) (#18)
    by gyrfalcon on Wed Dec 09, 2009 at 01:19:19 AM EST
    kind of "health care reform" do you think the GOP would get us, huh?

    it almost seems (5.00 / 1) (#21)
    by Left of the Left on Wed Dec 09, 2009 at 04:37:43 AM EST
    like we're finding out

    Touche (none / 0) (#30)
    by gyrfalcon on Wed Dec 09, 2009 at 11:53:08 AM EST
    Hyperbole, but it's good hyperbole.  Sit down and listen to GOP's actual proposals for health care reform sometime and you'll be grateful for even the crumbs it looks like we might get.

    Being able to choose (none / 0) (#33)
    by Wile ECoyote on Thu Dec 10, 2009 at 06:35:59 AM EST
    from 1300 different insurance plans is bad?  

    I remember that too.... (5.00 / 1) (#24)
    by kdog on Wed Dec 09, 2009 at 08:16:08 AM EST
    in '08 and '04...the issues of the day are too important to vote for somebody possibly worth voting for or something like that...don't ask me cuz I never got it.

    Oh well, at least we are getting more poetic waxing than we got from the last batch of crooks...that and 6 bucks will buy us a value meal.

    The infuriating part is we'll fall for it again in '12, '16, '20 and beyond.  I guess its true that its easier to believe the lie than to face and deal with the truth.


    Ah, and the Democratic platitudes, (5.00 / 3) (#13)
    by shoephone on Wed Dec 09, 2009 at 12:04:53 AM EST
    that we should all get to have the same kind of health care that they--our congress cowards--enjoy, is yet another fleeting memory from campaigns gone by...

    So hard to piece together what that much-vaunted "reform" was all about.

    Explain in more detail, please (5.00 / 2) (#16)
    by lilburro on Wed Dec 09, 2009 at 12:30:41 AM EST
    as far as I can tell, the Medicare plan is better than any PO on the table since Medicare negotiating rates were shot down in the House.  Big issue - if it were opened through political shrewdness to anyone in the Exchange, that's a victory.  If it's just opened to the 55-65 bracket...well, as BTD might say, that's not reform.

    You are right though...mandate that I buy insurance...but only I get to say what is AFFORDABLE.  That seems fair.  It all seems relatively common sensical doesn't it?  I guess common sense has too much metal in it to make it pass the doors of our Congress.

    Diogenes conflates different issues (5.00 / 1) (#25)
    by mcl on Wed Dec 09, 2009 at 09:48:11 AM EST
    Diogenes remarks: You all may have the illusion that doctors are all rich and greedy, but most hospitals are on the edge of going broke and can't afford such cuts.

    In America, doctors are rich and they are greedy. And in America, some hospitals are going broke.  The two are not casually connected.

    First, let's take a look at whether doctors are overpaid. So let's check the pay for doctors in America as compared to another group of extremely high-skilled workers, say, physics postdocs who graduate from MIT.

    The average salary for an E.R. doctor in America with less than 1 year of experience? From $103,000 to $197,000. Now compare with the average salary of a physics postdoc who just graduated from MIT but has yet to find a tenure-track position at a college: %25,000 to $30,000.

    Now let's ask a simple question. What percentage of applicants does MIT accept?  10.7%.  What percentage of applicants do medical schools accept?  44.6%.

    Something's badly out of whack here. An MIT physics PhD is orders of magnitude smarter than your typical E.R. doctor and has worked much harder -- yet the E.R. doctor makes tons more money when both are less than a year out of school.

    How do we explain this?  Simple: the AMA operates an antic-competitive cartel in restraint of trade to jack doctors' salaries up, just as the ABA operates an anti-competitive cartel to jack lawyers' salaries up (in both cases by artificially inflating the cost of medical school and law school, and by artificially restricting the number of doctors and lawyers).

    Doctors, like lawyers, are not only wildly overpaid and greedy, they're part of a greedy corrupt cartel that works hard to insure doctors' salaries stay sky-high relative to other professions with similar intellectual requirements.

    An MIT physics postdosc is hands down smarter, has worked harder, and deserves more pay than your typical doctor. Doctors don't get paid stratospheric amounts of cash in America because they're smart -- a 48% acceptqance rate by medical schools guarantees your plumber is smarter than your doctor. And doctors don't get paid well because they work hard -- that illegal immigrant working off the books in the barrio sweatshop stitching jeans 14 hours a day works a lot harder than your doctor does, but she gets paid $5 an hour, while your doctors gets paid 10 times as much.

    Doctors gets paid well because they operate a monopoly cartel which should be illegal -- just like lawyers.

    However, none of that has a thing to do with whether hospitals go broke.  Some hospitals go broke -- specifically, private hospitals with emergency rooms that are required to take all patients are rapidly going broke. Private hospitals?  Nope, they're doing great. Hospitals without ERs?  Doing fine too.

    The reality is that doctors really clean up when they go into business and start private labs. Those labs wildly overcharge hospitals for simple blood tests and other kinds of trivial tests and the doctors make out like bandits. The hospitals pay some of those costs on to insured patients, but those hospitals which can't, get screwed and go broke.

    Don't believe the typical American medical procedure or test costs insanely more than comparable medical procedures and tests in other countries?  Take a look at the hard evidence. Scans and imaging fees, individual doctors visits, simple lab tests, drug prices, all cost astronomically more in American than in other countries. Not just 2x or 3x times other countries' cost -- noooooooo, 5x, 6x, 10x other countries cost. That's greed. Pure greed, classic greed, insanely self-destructive greed. That's doctors who want to drive a Bugatti Veyron getting together and setting up a lab that charges $500 for a simple blood test that costs $25 in France or $30 in Germany.  

    So one of the most important reasons why hospitals are going broke is that they're hemorraging money for insanely overpriced tests -- tests performed by labs owned by doctors, run for profit, because 3 mansions and a vacation home in Acapulco and 2 yachts and 4 sports cars and a mistress just isn't enough for your typical doctor, no, he wants more.

    The truth is that some hospitals are going broke because so many people are left without insurance in this country. But that's not the fault of the doctors -- it's the fault of the insurance company. So while doctors running private labs that wildly overcharge hospitals for tests play some role in public hopsitals with ERs going broke, the ultimate responsibility for that problem falls to the insurance companies.

    My say on hospitals (5.00 / 1) (#26)
    by MO Blue on Wed Dec 09, 2009 at 10:22:44 AM EST
    Marble columns and extremely expensive buildings and decorations add to the hospital's expense and do nothing to heal a patient.

    Extremely expensive surroundings (none / 0) (#28)
    by sj on Wed Dec 09, 2009 at 11:38:35 AM EST
    In and of themselves, do nothing to heal a patient.  But beautiful or even just pleasant surroundings absolutely do.

    Where do you want to recover?  In pleasant surroundings or in a noisy, drab room?  As a recoveree, I can tell you.  It makes a difference.


    If the difference is between being able to access (none / 0) (#29)
    by MO Blue on Wed Dec 09, 2009 at 11:48:22 AM EST
    health care at a reasonable cost and a posh hospital setting, I think I will opt for the health care.

    Pleasant surroundings do not have to be extremely expensive.



    Lots of reports (none / 0) (#1)
    by waldenpond on Tue Dec 08, 2009 at 09:03:39 PM EST
    out there.  The gist was an expansion of medicaid to 150% of poverty (already dropped as the states can't afford their portion) and a buy in to Medicare (I just can't see the insurance industry allowing this) and a trigger for a public option.  Would like to see details on what they sent to the CBO.

    Medicare expansion + trigger? (5.00 / 2) (#2)
    by andgarden on Tue Dec 08, 2009 at 09:05:34 PM EST
    That's the kind of package that I'd almost want to vote for, but the mandate would give me serious pause.

    Useless (none / 0) (#3)
    by waldenpond on Tue Dec 08, 2009 at 09:09:19 PM EST
    The trigger would never be pulled so this is in effect the death of the PO.  I imagine the medicare buy in will be restricted to a great degree just as the po would have been.

    Breaking News!!!  Hospital and physician groups already have statements out.... they are opposed to any expansion of medicare!!!


    The problem is that the public option (5.00 / 2) (#4)
    by andgarden on Tue Dec 08, 2009 at 09:11:45 PM EST
    was already weak. So for me this whole discussion has been about whether there would be anything compelling enough in the final package to support the mandate. So far, no.

    This is great for Insuance companies (5.00 / 1) (#20)
    by ding7777 on Wed Dec 09, 2009 at 04:32:44 AM EST
    better to get the 55+ out of the private pool; and/or will be a windfallif it includes an "advantage" premium paid to insurance companies for each 55+ who opts for private insurance

    Predictable from the start (none / 0) (#19)
    by mcl on Wed Dec 09, 2009 at 03:46:35 AM EST
    Expanding Medicare remains worthless since most doctors and hospitals won't take patients who are only covered by Medicare -- the reimbursements are too low.

    So what we've really got is what was entirely predictable at the outset: no public option and a mandate for everyone to buy fabulously expensive private insurance. Then, of course, with their wonderful new captive market, watch the private insurance premiums zoom out of sight. After all...what's your option?  Zero. None. The government mandates by law that you must buy private insurance.

    The medical-insurance industry execs are coming in their pants over this development. They're high-fiving one another and shouting, "Hawaiian vacation! Bugatti Veyron, baby!"  These people buy luxury yachts and sports cars with sick dying peoples' life savings, and now they've found a way to vampire even more cash out of more victims.

    You have to wonder how long it will be before families with dying kids who can't find any hospitals to treat 'em because they only qualify for expanded Medicare will start strapping dynamite to themselves and blowing up hospitals.

    "uninsured" (none / 0) (#22)
    by diogenes on Wed Dec 09, 2009 at 06:54:27 AM EST
    Wanna bet that lots of 55 year olds with insurance suddenly cancel it to be "eligible" to buy Medicare at a cheaper price, with the government picking the tab.  Of course, Medicare pays providers much less than insurance does.  You all may have the illusion that doctors are all rich and greedy, but most hospitals are on the edge of going broke and can't afford such cuts.

    It looks like, with all (none / 0) (#27)
    by JamesTX on Wed Dec 09, 2009 at 11:25:01 AM EST
    our best efforts (and anyone can surely agree that this was the most effort the left could ever muster again), we lost.

    I think it may be a time for a new strategy for the downtrodden. If raw capitalism is rule of the day, and it constitutes the highest calling for our society, and all the suffering is worth it, then we need to basically concede and begin to look at it differently.

    I would suggest attacking the "regulation" which the raw capitalists favor (such as physician licensing other government measures that actually serve to manufacture value through scarcity). Other things would be deregulating drugs (marijuana, pain killers, and others). The reasoning here is that if we don't have a right to health care, then we have a right to a humane and least painful death or dying process.

    As usual, the proponents of the capitalists have hundreds of little socialistic mechanisms in the system which they favor and profit from. If we can't have health care, then they can't have those things. If there is no regulation, fine. Toss the CFR in the trash, dismantle all the agencies, and let's play monopoly. Let the poor buy what they need (buy the way, it's cheap!).