Obama Fights For Health Care Reform


"Our strategy has been to allow this process to advance to the point where it made sense for the president to take the baton. Now's that time," said senior adviser David Axelrod. "I don't know whether he will Twitter or tweet. But he's going to be very, very visible." Another senior White House aide added: "It's time to raise the stakes on this."

Obama today:

A few weeks ago I stated that I believed Obama would go to the mat for health care reform. I think he is doing that.

Speaking for me only

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    Huh? I think health reform poll (5.00 / 1) (#1)
    by masslib on Mon Jul 20, 2009 at 03:44:12 PM EST
    numbers are tanking and he wants to say he did health care so he's getting his butt out there.  But this plan is a giant, big fail.  This is nothing like the social insurance LBJ provided for our entire elderly population.  Nor the social retirement insurance FDR gave all of us.  This is not social insurance.  How can this be deemed "going to the mat" on health reform?  He is squandering the biggest Dem advantage in a generation to make sure we all have to buy private health insurance with absolutely no mechanism for lowering premiums.  

    Huh? (5.00 / 1) (#2)
    by Big Tent Democrat on Mon Jul 20, 2009 at 03:46:22 PM EST
    What part of the plan is a "big fail" in your opinion?

    The fact is Obama is following his plan. I predicted this a while ago and it is not a bit surprising.

    Obama was gonna fight for health care and he is.


    This is not fighting for health care. (5.00 / 4) (#8)
    by masslib on Mon Jul 20, 2009 at 03:52:30 PM EST
    This is fighting for private, for-profit health insurance for all.  Yeah!  What's happened to Democrats that this impresses them?  As I have said countless times, this is the MA health plan and it's a huge policy loser.  This is the No Child Left Behind of health reform.  He needs to scrap this thing and come up with a better plan.

    "The fact is Obama is following his plan." Uh, no.  Obama didn't have a plan, he had a vague idea, and then let Congress shape the policy almost completely on their own.  And, this is a very bad plan.  It's going to raise the number of insured Americans.  This is true.  It's going to do nothing to lower health insurance premiums, deliver better care, lower health care costs, etc..  


    A public option? (5.00 / 1) (#13)
    by Big Tent Democrat on Mon Jul 20, 2009 at 03:59:21 PM EST
    Come on.

    Huh? what do you mean (5.00 / 2) (#19)
    by masslib on Mon Jul 20, 2009 at 04:02:19 PM EST
    a "public option?"  That wasn't exactly Obama's idea.  But what use is a public option that is only available to lower income individuals?  Please tell me how this creates downward pressure on insurance premiums or health care costs, because that certainly hasn't happened in MA, where we do indeed have a "public option" for lower income people.

    Who gives a sh*t whose idea it s? (5.00 / 1) (#20)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:03:47 PM EST
    What the hell kind of objection is that?

    I thought you were referring to my saying (5.00 / 1) (#50)
    by masslib on Mon Jul 20, 2009 at 04:13:23 PM EST
    Obama never offered a plan.  The public option is like Medicaid for more people.  It's not universally available, thus it creates no downward pressure on health care costs.

    We'll see (5.00 / 1) (#59)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:17:21 PM EST
    Well, ok, but we have seen in (none / 0) (#64)
    by masslib on Mon Jul 20, 2009 at 04:20:37 PM EST
    the state that first rolled out this plan.  And, the result was that our premiums went up at a faster pace than they did nationally.

    Yes - that is not what I call a strong public (5.00 / 1) (#65)
    by ruffian on Mon Jul 20, 2009 at 04:22:32 PM EST
    option. Unless it is available to all to buy, it has no effect on overall premiums. (I'm not saying the government should pay the premiums for those of us that can afford them, but if the premiums are a better deal than what I pay now to a for-profit insurance company, I would like to switch.)

    Unfortunately I think the House bill is just like you describe. Unless that is fixed in the final bill, I will not support it.


    oops, meant HELP Bill (none / 0) (#67)
    by ruffian on Mon Jul 20, 2009 at 04:24:08 PM EST
    I need to look at the House bill again...

    No effect? (none / 0) (#78)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:28:15 PM EST
    None at all?

    Well, very little anyway (5.00 / 1) (#85)
    by ruffian on Mon Jul 20, 2009 at 04:34:05 PM EST
    If most of the people eligible for the public option are those who are at such a low income level that they are now uninsured, and those that have already been rejected for pre-existing condsitions, than what effect will it have on premiums for the rest of us? The insurance companies aren't competing for that pool of people anyway.

    Certainly not. Why would it? (none / 0) (#171)
    by masslib on Tue Jul 21, 2009 at 10:06:41 AM EST
    Why would insurers, given an even larger market by the feds, lower premiums?  It makes no sense at all.  There is no downward pressure on premiums, which is why MA premiums, where we already have this plan, have risen faster than the national average.  

    Wait do you seriously (none / 0) (#90)
    by Socraticsilence on Mon Jul 20, 2009 at 04:37:18 PM EST
    think that the Public Option is necessary for those making say 100k- I mean I can't concieve of a Public Option that would be better than a premium health insurance package (delivered at a premium price of course)- heck, that's the case in many single payer countries- particularly Canada and the UK- over and above a certain level of income people are well served to purchase premium supplementary insurance.

    Doesn't have to be better than a premium package (5.00 / 1) (#124)
    by ruffian on Mon Jul 20, 2009 at 05:00:29 PM EST
    at a premium price. If it is good enough, at a price significantly lower than what I pay now through my employer, you bet I would take it.

    Public Option necessary for people at that income level to get insurance? No, of course not. But why not let people at that level buy into it if it makes sense for them? How else do we break the stranglehold of the insurance companies?  


    I take back my 'of course not' (none / 0) (#128)
    by ruffian on Mon Jul 20, 2009 at 05:07:27 PM EST
    For a single person like me it is 'of course not', but I know insurance for a family is a lot more expensive, and I imagine it is a significant burden on a single wage earner making 100k, especially if family members have pre-existing conditions.

    Exactly (none / 0) (#134)
    by cawaltz on Mon Jul 20, 2009 at 05:17:26 PM EST
    As this stands, we are giving insurance companies the authority to pick people's pocket simply because they make a somewhat decent wage. Specifically since we aren't giving them the option to opt out since we will be mandating coverage.

    supplementary insurance. (none / 0) (#172)
    by masslib on Tue Jul 21, 2009 at 10:08:21 AM EST
    People already do that here as well.  They supplement their Medicare.  But they start out with a baseline of coverage provided by Medicare.  And, certainly, even those with high retiree incomes, still use their Medicare.

    I'm waiting for us non-Congresspersons (none / 0) (#21)
    by oculus on Mon Jul 20, 2009 at 04:04:02 PM EST
    to have the same health care coverage Congress does.  Wasn't that the campaign promise?

    John Edwards (none / 0) (#25)
    by Inspector Gadget on Mon Jul 20, 2009 at 04:05:10 PM EST
    promised that.  No one else was so generous of thought.

    Not true (none / 0) (#29)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:05:46 PM EST
    It was even proposed by Joe Lieberman as a matter of fact.

    I was talking about the (none / 0) (#38)
    by Inspector Gadget on Mon Jul 20, 2009 at 04:08:19 PM EST
    people who were considered front-runners (Obama, Clinton & Edwards). Sorry, I'm quite sure you're correct.

    hillary said it plenty... and that's a choice of (none / 0) (#40)
    by nycvoter on Mon Jul 20, 2009 at 04:09:27 PM EST
    private plans

    Still the plan (none / 0) (#26)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:05:22 PM EST
    I think.

    Rahmbo was for it at one time. Bill Clinton told me that.


    Speaking of.... (5.00 / 1) (#31)
    by Inspector Gadget on Mon Jul 20, 2009 at 04:06:20 PM EST
    did you ever do that post on your gathering with Bill Clinton?

    I did a few (none / 0) (#49)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:13:20 PM EST
    I'll explore the archives (none / 0) (#53)
    by Inspector Gadget on Mon Jul 20, 2009 at 04:15:05 PM EST
    I missed them, I guess.

    One. (none / 0) (#68)
    by oculus on Mon Jul 20, 2009 at 04:24:24 PM EST
    I posted the results of my google search for descriptions by bloggers present.  Still waiting for your overview and opinion.

    We'll both be waiting a long time (none / 0) (#75)
    by shoephone on Mon Jul 20, 2009 at 04:27:45 PM EST
    Ain't gonna happen. Not with these Dems. Not with the plans being floated.

    I hope your long term care insurance (none / 0) (#88)
    by coast on Mon Jul 20, 2009 at 04:36:38 PM EST
    is good because you will be waiting a long time before that happens.

    I strongly disagree (none / 0) (#22)
    by CST on Mon Jul 20, 2009 at 04:04:15 PM EST
    with your views on MA healthcare.  It sure has worked for the people I know who couldn't have health insurance without it.  Is it perfect, no.  Is it better than what we had before, absolutely.

    Wow, I wonder who you know. (none / 0) (#28)
    by masslib on Mon Jul 20, 2009 at 04:05:40 PM EST
    I have never met one person who likes the MA plan.  Further, MA health insurance premiums have risen faster since the plan then they have nationally.  Perhaps the people you know qualify for the public option.

    They do (none / 0) (#34)
    by CST on Mon Jul 20, 2009 at 04:06:45 PM EST
    and they wouldn't have health insurance without it.

    Well, great for them. I don't qualify for that (none / 0) (#41)
    by masslib on Mon Jul 20, 2009 at 04:09:45 PM EST
    and can't afford the private choices.

    Yea, great for them, they're so broke (2.00 / 1) (#45)
    by CST on Mon Jul 20, 2009 at 04:11:29 PM EST
    Could you afford health insurance before?  Would you rather they not have health insurance?

    Like I said, not perfect.  Better than nothing.


    Not better than nothing for me. (none / 0) (#52)
    by masslib on Mon Jul 20, 2009 at 04:14:38 PM EST
    Sorry, but I'm a voter struggling with health care costs.  I get to ask "what's in it for me?" aside from a mandate to buy private insurance I can't afford.

    Indeed (5.00 / 1) (#58)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:16:42 PM EST
    They change we have been waiting for.

    And you wonder why pols are pols?


    Fine (none / 0) (#61)
    by CST on Mon Jul 20, 2009 at 04:17:28 PM EST
    But you can put in your anecdotes, and I will put in mine.  I know a good number of people it is better for, including close relatives.  They are also voters struggling with all costs.  And there is absolutely something "in it" for them.

    For anyone else who's interested (5.00 / 2) (#93)
    by CST on Mon Jul 20, 2009 at 04:39:11 PM EST
    This is a good article that I think sums up the pros and cons of MA health.

    Some key points:
    "When health care reform was first legislated, state officials estimated that some 379,000 Massachusetts residents were uninsured. But data from Commonwealth Connector, the state agency that helps residents find health insurance, show that nearly 440,000 residents have become insured since the program took effect. Estimates now suggest that as many as 97 percent of working adults in the state now have coverage."

    "Exceeding the projected numbers means that the plan will cost more--perhaps hundreds of millions of dollars more. ... "from a budget perspective, the program is a victim of its own success in outreach and enrollment." The extra costs are exacerbated, of course, by Massachusetts' acute budget problems in the wake of the economic crisis."

    "By design, the Massachusetts reform initiative first addressed the problem of insuring more of the state's uninsured. Having substantially met that challenge, the focus is now shifting to try to address the proverbial gorilla in the room that was purposely ignored until now: health care costs.

    "The big challenge is cost containment,"  ... The Massachusetts legislature introduced some cost containment measures this past August that are just beginning to play out, he said. "

    emphasis mine.

    You gotta start somewhere.  That doesn't mean that once you start that you have reached the end of the road.


    Not having insurance won't be an option (none / 0) (#114)
    by cawaltz on Mon Jul 20, 2009 at 04:50:11 PM EST
    A portion of people are going to be forced to pay large premiums because they will not have access to this public plan.

    Or they will be penalized for not buying into (none / 0) (#123)
    by shoephone on Mon Jul 20, 2009 at 04:56:58 PM EST
    an insurance plan they can't afford in the first place. I think of this as the "Squeezing Blood from a Turnip" plan for health care.

    BTW (none / 0) (#24)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:04:47 PM EST
    What makes you think the public option is going to only be available to "poor people?"

    The poverty level (5.00 / 1) (#80)
    by cawaltz on Mon Jul 20, 2009 at 04:29:20 PM EST
    is based on an arcane formula(it still uses the assumption that food comprises the largest expenditure in a household) and 400% is probably going to work out to somewhere around $77,000 which is hardly a princely sum for some localities.

    If the purpose is to provide pressure on the insurance companies then each and every individual ought to have access to the public plan, not just a select few. This is a great big sloppy kiss to the insurance companies, who evidently it is more important to placate, than the actual constituency that our government is supposed to be representing.


    77k a year covers what percentage (none / 0) (#83)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:31:00 PM EST
    of households in the country.

    It will cover a good portion (none / 0) (#107)
    by cawaltz on Mon Jul 20, 2009 at 04:47:10 PM EST
    since the median is somewhere around $42,000. That being said, it also leaves localities like those out in California with high costs of living in a lurch. They had the same problem when they attempted to patch the housing problem because housing costs(which by the way is what actually DOES constitute the largest portion of household expenditure)were through the roof there.

    A good portion (none / 0) (#110)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:48:17 PM EST
    should have effects on costs.

    What about that person (none / 0) (#120)
    by cawaltz on Mon Jul 20, 2009 at 04:54:36 PM EST
    who is making $77,000 a year? Do you really believe that it is fair to tax the private insurance you are forcing him to purchase(and he is likely being gouged for since he doesn't have the option of getting the public plan)and then look him in the eye and say "too bad" when he tells you the insurance companies are raising his premiums through the roof?

    The way this is being set up isn't fair. I say that as a family that will have access to the public plan.


    Fair? (none / 0) (#122)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:55:45 PM EST
    Meaning what?

    I mean that living in a portion (none / 0) (#133)
    by cawaltz on Mon Jul 20, 2009 at 05:15:31 PM EST
    of the country like San Diego could preclude you from having the public option as an option.

    $77,000 is a decent wage where I live(Southwest Virginia). When I lived in California though it was difficult to make ends meet making $60,000 and that was 10 years ago.

    I don't want to leave broad swaths of people behind simply to say we reformed health care. I'd rather it was done right the first time.

    Why let the insurance parasites have a monopoly on upper middle class anyway?


    The median in San Diego (none / 0) (#125)
    by cawaltz on Mon Jul 20, 2009 at 05:00:31 PM EST
    right now is $74,900. The average person in San Diego by 2013 when this is enacted will not qualify.

    People 400% above poverty (none / 0) (#39)
    by masslib on Mon Jul 20, 2009 at 04:08:44 PM EST
    for a family of four or less is what the HELP plan calls for.  The rest of the plans being floated about all have a similar threshold.  There are also rules about who can purchase the public option based on whether or not you employer already provides insurance.  The devil is in the details.  There has been no plan presented to date that would allow anyone of any income and any insurance status to purchase the "public option".

    400% above the poverty line (none / 0) (#43)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:10:36 PM EST
    My point exactly.

    I'm not sure (5.00 / 1) (#169)
    by jnicola on Tue Jul 21, 2009 at 05:26:30 AM EST
    where you're all getting the idea that participation in the public plan will be limited to those making 400% of the poverty line. While the bill that comes out of conference could very well be different, the current House bill allows anybody who is eligible for the Insurance Policy exchange to take part in the public plan. That's anyone buying insurance for themselves, the self employed, the uninsured and, in the first year, small businesses with fewer than ten employees. In the second year businesses with fewer than twenty employees can join in; thereafter it may or may not expand depending on what the Commissioner decides - but the pressure on him will always, obviously, tend towards expanding the program.

    For people under the 400% poverty line there are subsidies and cost caps which don't apply to those over the line, but participation isn't limited by income.

    The best summary of the House plan is, unsurprisingly, Ezra Klein's.


    Mhmm, you know what is happening in my (none / 0) (#63)
    by masslib on Mon Jul 20, 2009 at 04:18:19 PM EST
    state?  Boston Medical is suing the state for illegally diverting federal funds that were supposed to go to the free care the hospital provides to the poor, to pay for their health insurance scheme.  The leg just voted to strip 30,000 legal immigrants for their public health coverage.  This is not the the answer.  It's bad policy.

    What kind of health care (5.00 / 5) (#11)
    by Carolyn in Baltimore on Mon Jul 20, 2009 at 03:57:09 PM EST
    is he fighting for? He wants credit for 'a' plan but he will take anything that sounds sort of like what he asked for.
    Public Option - that has no universal access and doesn't start till 2013?
    Mandating that we all buy insurance?

    The plan as it is shaping up may be like the climate change bill - sounds good but when you get into the details it is a giveaway to the clients of the free-spending lobbyists.

    Lipstick on a pig.


    If they pass a plan (5.00 / 1) (#18)
    by CST on Mon Jul 20, 2009 at 04:01:58 PM EST
    with a public option that is more than has ever been done to date.

    You gotta start somewhere.


    Seriously, (5.00 / 1) (#92)
    by Socraticsilence on Mon Jul 20, 2009 at 04:38:45 PM EST
    the simple existence of a Public Option would be huge- and would likely expand not contract from what is initially established- see virtually every other social safety net type program.

    What do you mean (none / 0) (#15)
    by Big Tent Democrat on Mon Jul 20, 2009 at 03:59:57 PM EST
    by universal access?

    She/He means (none / 0) (#62)
    by cawaltz on Mon Jul 20, 2009 at 04:17:57 PM EST
    that people who have regular insurance premiums will be locked in to their plans and not have access to the public option.

    Everyone should have access to the public option, not just those unfortunate enough to have crummy jobs.


    I agree (5.00 / 1) (#76)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:27:50 PM EST
    Now what?

    Now we push Congress (5.00 / 1) (#127)
    by cawaltz on Mon Jul 20, 2009 at 05:05:02 PM EST
    to drop the idea that only a limited number of folk should be allowed to opt in. If there is to be a public option it has to be open to everyone.

    We send a message that this needs to be more than a half ass attempt at reform. There needs to be real pressure on the insurance industry to reform or they can go the way of the dinosaurs.


    BTD, Obama is fighting for pampering parasites-- (5.00 / 1) (#166)
    by jawbone on Mon Jul 20, 2009 at 10:58:03 PM EST
    he demands that health CARE be sacrificed on the alter of free markets and profit.  The BHIP (Big Health Industry Players), especially the Big Insurers, must be permitted to continue to suck as much revenue off the body politic as it is possible for an increasingly downsized workforce to provide to these parasites.

    He also wants to be able to say he got something passed. It cannot be single payer, which would actually meet the needs he outlines so well; no, it must not be "disruptive" of the current for-profit set up.

    Obama is just not that into people getting health CARE; he does want, now, to mandate that the get some kind of health insurance. It may not do much for them, as is happening now to so many. People pay nearly $20K/year in monthly premiums, co-pays, huge deductibles -- and get very little care covered.

    It's a protections racket. Nice little house you got there, Ms. Middle American, too bad you might lose it. Unless you pay up some for insurance.  Nice little savings account you got there, Mr. Middle American; too bad something might happen to it unless you pay up.

    Yes, I am profoundly disappointed in our Dems.


    Well, (5.00 / 1) (#4)
    by bocajeff on Mon Jul 20, 2009 at 03:49:09 PM EST
    Actually it is. It will be a lot of money spent doing somethings well and somethings not so well. In our giant race toward the bottom the notion that "health care" and "health insurance" are problems that can be fixed without sacrifice of most of the population is simply ridiculous. It might be politically expedient - but I think there are so many better ways to "fix" health care. These reforms will just move problems from one pile to another.

    Sacrifice to whom? I have no problem (none / 0) (#10)
    by masslib on Mon Jul 20, 2009 at 03:56:34 PM EST
    "sacrificing" tax dollars to social insurance as I do today to Medicare and Social Security.  I have a real problem sacrificing my money for the profit of health insurance executives.

    False assumption (none / 0) (#126)
    by bocajeff on Mon Jul 20, 2009 at 05:03:47 PM EST
    You assume that your are 'sacrificing' your money for health insurance executives. Are you also 'sacrificing' your money to grocery store executives? After all, food is more of a basic necessity than health care - think about the amount of people who go to bed hungry every night. Do you think we should just have a universally paid grocery store so we can get rid of executive salaries and administrative costs and advertising costs and that will lower the price of food? If you think that will lower the cost of food while making the quality of the food go up then you have a point.

    Groceries stores charge me and then (5.00 / 4) (#168)
    by ruffian on Tue Jul 21, 2009 at 04:43:22 AM EST
    let me leave the store with what I bought. They don't charge me and then try to take stuff out of the basket.

    Grocery stores make about 1 percent profit. (none / 0) (#135)
    by masslib on Mon Jul 20, 2009 at 05:18:11 PM EST
    Their entire model is a short-term finance model.

    Two things about the clip that (5.00 / 5) (#32)
    by Anne on Mon Jul 20, 2009 at 04:06:27 PM EST
    drew my attention: one is that he referred to what is underway as "health insurance reform" and said nothing about health CARE (I realize he probably said more than this in total, but this is what was in the clip), and the other is that he can say all he wants about this not being about him, but it's clear that he's not about to let this issue be his Waterloo.  His numbers on health care are heading south, and that, I think, is more important to him than anything; it's always about winning and not so much about what it is that is being won.

    He can tweet and have prime-time pressers and give major speeches, but when some 72% or more of Americans are already on board for a universal, single-payer system, he is, essentially, preaching to the choir.  The choir, in the meantime, is phoning, faxing, e-mailing and protesting and going to DC, all in an effort to communicate their wishes to the people who represent them in the Congress, and who are crafting a reform plan.  If Obama wants to hector anyone, he should be on the phone with Max Baucus and Charles Grassley and Kent Conrad and every other member of Congress who is part of designing a plan that will do for the insurance industry what they did for the financial industry - while the little people are left hoping their decimated pension and IRA funds will come back before they have to use them, the banksters are once again hauling in truckloads of cash.  Under the Congress' reform plan, I have no doubt that while more people may have insurance, they will still be paying too much for too little, and the insurance execs will be joining their finance industry brethren in hauling away semi-tractor trailers full of cash.

    So, he's for a public option even he cannot or will not define, and he's for key elements - but so what?  If he's not willing to put an actual plan into the Dems's hands and tell them to get it done, he's no better than bloggers urging their readership to whip their representatives to pass "something with a public option" - even if it isn't the right something, and even if it isn't fully formed enough to know what is being supported.

    If this is something he believes so strongly in, he ought to have more that talking points to wave in front of the camera; if this is passionate, I'll eat a bug.

    I'm sorry, but I do not believe this is about doing what is right for the people, but about besting the GOP by passing a plan, even if the plan sucks and the people who wrote it are too chicken to implement it before the 2012 election cycle.

    It has ALWAYS been health Insurance (5.00 / 4) (#46)
    by Inspector Gadget on Mon Jul 20, 2009 at 04:11:44 PM EST
    reform...all these plans talked about making insurance available to everyone not medical care.

    I have very good health insurance. Can't afford the co-pays, deductibles and my 20%. So, I do not have access to medical care.


    Pols are pols . . . (none / 0) (#35)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:07:22 PM EST
    He can't hide behind that anymore. (5.00 / 3) (#44)
    by Anne on Mon Jul 20, 2009 at 04:10:53 PM EST
    And we/you should not be letting him; you don't push elected representatives to do anything that way.  At some point, he's got to commit, and a speech/tweet/presser does not a commitment make.

    Hiding? (5.00 / 3) (#47)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:12:15 PM EST
    I am asking people to take off the blinders.

    WHY is Obama going to fight for health care reform?

    Because it is essential to him politically.

    That's politics my friend.


    Satisfying for-profit health insurance (5.00 / 2) (#60)
    by dk on Mon Jul 20, 2009 at 04:17:28 PM EST
    companies is what is essential to him politically (because he needs their money and general support for his re-election campaign).

    I seriously doubt that (none / 0) (#72)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:26:51 PM EST
    We'll see.

    If he were to go against the insurance (none / 0) (#84)
    by dk on Mon Jul 20, 2009 at 04:32:24 PM EST
    companies, not only would he lose their direct support and campaign cash, but he would also lose the support of the village media, which is allergic to health care reform addressed to help people.  From the perspective of winning re-election, he has no incentive to bring forward a plan that has any other effect than to help the insurance companies.

    Obama does not need campaign money (none / 0) (#101)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:42:03 PM EST
    from anybody in particular.

    He can raise more money than any other pol ever could.


    HIs seed money came from Big Money -- (5.00 / 1) (#167)
    by jawbone on Mon Jul 20, 2009 at 11:00:40 PM EST
    Now, after four years, will he get the same response?

    To be determined.

    Especially if the his "stimulus" plan continues to work for the Banksters, not Main Street and the little people. And if he mucks up health CARE reform.


    That's why I also mentioned the (none / 0) (#112)
    by dk on Mon Jul 20, 2009 at 04:49:26 PM EST
    media support.  If he loses health insurance company support, he not only loses their money (which I still think is pretty significant) but he also loses the media.  

    The Media (none / 0) (#119)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:54:05 PM EST
    I think Obama can win that battle with the insurance companies.

    Moreover, I think he is ready for that fight.

    I think he has to win that fight for his own political fortunes.


    But he is not battling the insurance (5.00 / 1) (#130)
    by dk on Mon Jul 20, 2009 at 05:11:45 PM EST
    companies on this.  He is giving them what they want.  

    But, do we have to just accept that (none / 0) (#51)
    by Inspector Gadget on Mon Jul 20, 2009 at 04:14:05 PM EST
    while the country collapses because we only have pols in leadership roles in our gov't, or should we start putting leaders in those positions?

    Give it a try (5.00 / 1) (#54)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:15:19 PM EST
    Never gonna happen though.

    You know why? Because WE are the change we are waiting for, and we (the American People) stink.

    I wish people would consider WHY pols act like they do.


    Pols act like they do because they (5.00 / 4) (#152)
    by Anne on Mon Jul 20, 2009 at 05:56:23 PM EST
    are not beholden to us as much as they are beholden to corporate money - that is why they can ignore the 70-some percent of us that want a single-payer plan, or even -here's something novel - a plan that at least has room to evolve into one.  But even that isn't happening - did you miss our Sec. of HHS assuring that this legislation would be crafted to exclude that possibility?

    And a "public" option that is neither public, nor an option for too many people, is in the category with "Healthy Forests Initiative" and "Clean Air Act" - not what it purports to be.  Imagine getting a spiffy new public transportation plan that you couldn't use because you already own a car - that's the kind of public option that's being offered.  

    It is estimated that the insurance lobby is spending over a million dollars a day - a day! - to fight any reform that's going to threaten their turf.  Where does that $1M/day come from?  Where do Aetna and Wellpoint and United Health and all the others get that kind of money to fight against any plan that might give people more control over their lives?

    What Obama fails to understand - and this may reveal him to be quite a bit less brilliant of a politician than he thinks he is - is that any plan that will not go into effect until after 2012 is not going to sit well with people who have waited and waited and waited for help on this front.  And if, somehow, the Congress finds the moral courage to make it happen sooner, if it isn't a good plan, Obama's not going to be scoring any political points just for getting the bill through - it's actually going to have to work for there to be political benefit.  It's a lot more than "Health care?  check!"

    The pols are not listening to us; that is becoming more evident every day.  This may well be Obama's Waterloo, but while he may be off in a corner, licking whatever political wounds he sufers, we - the people - are the ones who will pay the highest price.


    Well (none / 0) (#102)
    by Socraticsilence on Mon Jul 20, 2009 at 04:42:32 PM EST
    I have to think he's probably getting a mixed message what with people being morons and turning against health care reform in parts again- see the poll being touted about treform only having 49% support and all.

    That was a quick transition! (5.00 / 1) (#66)
    by oculus on Mon Jul 20, 2009 at 04:22:43 PM EST
    Shoulder to the wheel. . . . Pols are pols.

    Hardly (none / 0) (#71)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:26:23 PM EST
    Pols put their shoulder to the wheel when it is in their political interest to do so. No other time.

    and he will only put shoulder to wheel (5.00 / 1) (#129)
    by Carolyn in Baltimore on Mon Jul 20, 2009 at 05:10:55 PM EST
    long enough to get a politically acceptable plan through. He will not work for the best plan or even a really good one - just one that gives him political cover. Pols are pols.

    Hilarious (none / 0) (#132)
    by squeaky on Mon Jul 20, 2009 at 05:15:31 PM EST
    Do you think he should fight for an unacceptable political plan?

    We don't need a health care martyr thank you.


    BINGO (none / 0) (#161)
    by allimom99 on Mon Jul 20, 2009 at 09:47:34 PM EST
    Did He Say Where He Was on 2013? (5.00 / 2) (#74)
    by BDB on Mon Jul 20, 2009 at 04:27:38 PM EST
    Because right now that's the effective date of the House bill for the public option.  

    So far the bills coming out of Congress - even the "better" ones - have been fairly pathetic and they have yet to be watered down further.

    I think they'll pass something.  But I also think that something will suck and we're heading for cuts to Medicare.  Obama and his folks are obsessed with the idea that we get too much care rather than the truth which is that we pay too much for care, twice what other countries do.

    Forgot to Add (5.00 / 3) (#81)
    by BDB on Mon Jul 20, 2009 at 04:30:22 PM EST
    That I don't think Obama is really fighting for healthcare reform.  He's fighting to get a bill he can claim is reform and those are not, IMO, the same thing.

    Don't forget (none / 0) (#86)
    by Slado on Mon Jul 20, 2009 at 04:36:14 PM EST
    that our healthcare is better which means it's also more expensive.

    • The American five-year survival rate for prostate cancer is 99 percent, the European average is 78 percent, and the Scottish and Welsh rates are close to 71 percent. (British data were incomplete.)

    • For the 16 types of cancer examined in the study, American men have a five-year survival rate of 66 percent, compared with only 47 percent for European men. Among European countries, only Sweden has an overall survival rate for men of more than 60 percent.

    • American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared with 56 percent for European women. For women, only five European countries have an overall survival rate of more than 60 percent.

    Our Healthcare Is Not Better (5.00 / 1) (#108)
    by BDB on Mon Jul 20, 2009 at 04:47:42 PM EST
    A few statistics about a few kinds of cancer does not mean that we, as a country, overall get better care.  I'd note, for starters, that a lot of prostate cancer hits older men, who are covered by Medicare and not private insurance and Medicare - a single payer system - has significantly less administrative costs than private insurance.  

    There are millions of people in this country who have no access to care at all for treatable diseases like diabetes.  In fact, estimates are at least 18,000 Americans die every year because they lack access to healthcare due to a lack of insurance.  On average, Americans do not live longer, healthier lives than people in Europe.  In many cases, we live shorter, less healthy lives.  

    Moreover, there is some research that indicates that better care is not more expensive care.  The Mayo Clinic delivers some of the best care in the country and at a lower cost than a lot of other, more expensive medical facilities.


    The Mayo Clinic (5.00 / 1) (#117)
    by Slado on Mon Jul 20, 2009 at 04:51:57 PM EST
    opposes the current dem plans by the way so Obama should stop quoting them.

    Secondly quality and access are two different questions.

    No need to deny the reality that once you are seen by a doctor and assuming you can pay for it you are much better off in an American hospital then anywhere else in the world.

    Why liberal/progressives feel the need to diss our healthcare system is mind boggling.   The issue is not enough people can afford it or have acess to it.   Not that it's bad care.

    If care was the issue wouldn't we be talking about care?  Is the care going to magically get better when we all have insurance?


    Good point (none / 0) (#131)
    by Socraticsilence on Mon Jul 20, 2009 at 05:14:24 PM EST
    also why do people pretend the Quality of Life in a Place like Haiti or the Sudan is bad- if you can afford it Quality of Life in those countries is quite high.

    On paper this appears to be true (none / 0) (#159)
    by vicndabx on Mon Jul 20, 2009 at 07:04:57 PM EST
    Medicare - a single payer system - has significantly less administrative costs than private insurance.

    The reality is this is the case because the costs that go into processing Medicare claims, employees, real estate costs, and everything else that goes into running a business is counted elsewhere in the federal budget.  Private insurers contracted by the federal government are the ones who actually process the claims.  Whatever numbers purport to low administrative cost never take this into account.

    This is definitely true:

    Moreover, there is some research that indicates that better care is not more expensive care.

    This is where the focus needs to be - savings in the delivery of care is where we can truly cut costs.


    Link please? (none / 0) (#97)
    by gyrfalcon on Mon Jul 20, 2009 at 04:40:53 PM EST
    I believe those figures have been disputed.

    That's why taxes need to be raised (none / 0) (#98)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:40:58 PM EST
    My chart (none / 0) (#100)
    by lilburro on Mon Jul 20, 2009 at 04:41:47 PM EST
    Link, please. (none / 0) (#115)
    by phat on Mon Jul 20, 2009 at 04:50:19 PM EST
    A source would be nice.

    Link (none / 0) (#121)
    by Slado on Mon Jul 20, 2009 at 04:55:34 PM EST
    Oh geez (none / 0) (#143)
    by phat on Mon Jul 20, 2009 at 05:28:10 PM EST
    You're quoting the Manhattan Institute? Are you kidding me?

    and yet our mortality rates are still higher. (none / 0) (#144)
    by cawaltz on Mon Jul 20, 2009 at 05:29:41 PM EST
    It swell that you gave us Cancer rates of survival. Cancer isn't the only thing that kills though is it?

    Bipartisanship: Blue Dogs vs Progressives (5.00 / 1) (#136)
    by Carolyn in Baltimore on Mon Jul 20, 2009 at 05:18:47 PM EST
    Since the republicans have opted out the battle is for which Dem version will pass. The normal route (and the ne Rahm has been playing) is to give away enough to get Blue Dog DINOs on board enough to pass a bill.
    The interesting development is the blogs whipping the progressive caucus, aiming to get enough commitments to a robust public option that a bill can't be passed without them. The progressives usually cave.

    Prssure is coming to bear on the progressives and the Blue Dogs are getting ads in their districts about their sellout mentality on healthcare. Obama asked them to stop but now he is starting to pressure the BDs.

    Too soon to think it is working - the insurance industry has very deep pockets.

    But it sure is fun to watch - and make a few key phone calls.....

    Telling choice (5.00 / 1) (#138)
    by lentinel on Mon Jul 20, 2009 at 05:20:01 PM EST
    Sanjay Gupta emerged the other day...

    And I was reminded that Obama offered him the position of Surgeon General of the United States. (!)

    So, you will pardon me if I remain skeptical about Obama having our best interests at heart when it comes to health care.

    According to today's NYT, (none / 0) (#3)
    by oculus on Mon Jul 20, 2009 at 03:47:51 PM EST
    the governors (Republic and Democratic)are vocally opposed to unfunded mandate to expand elibibility for Medicaid.  NYT

    Is it clear what specific health care reform President Obama is pushing for?

    He has not backed a particular plan (none / 0) (#5)
    by Big Tent Democrat on Mon Jul 20, 2009 at 03:50:25 PM EST
    But he has backed key elements, including the public option.

    He has put his shoulder to the wheel.

    More importantly, he has learned his lesson from the stimulus and ditched bipartisanship as a goal.


    He has backed a "public option" (5.00 / 3) (#56)
    by dk on Mon Jul 20, 2009 at 04:15:48 PM EST
    that most Americans are prohibited from having the option to choose.

    Most Americans (none / 0) (#87)
    by cawaltz on Mon Jul 20, 2009 at 04:36:25 PM EST
    will be able to choose the public option since the median income is somewhere around $42,000. That being said, ALL Americans ought to have access to the public option. Elsewise, it really isn't going to compel the insurance companies to compete with the plan. The closest analogy I can come up with would be how cable companies often have "agreements" with each other not to poach. Insurance companies will have a monopoly on providing coverage on middle class and upper middle class workers while the government will be providing coverage for lower middle class and poverty level individuals.

    Hope he talks about paying for it (none / 0) (#6)
    by ruffian on Mon Jul 20, 2009 at 03:50:27 PM EST
    by rolling back the Bush tax cuts for the rich, instead of calling it a surcharge or surtax on the rich as I heard the talking heads over the weekend. It is just terminology, but as I said in the open thread, I think there is a lot more support if he calls it 'rolling back the Bush tax cuts'. Also he needs to hammer home that the trillion dollar cost the CBO is talking about is over 10 years. As opposed to the 1+ trillion we gave the banks in the last year alone.

    It seems clear to me that the financing of it is how the opponents will hold it up, without ever even having to talk about the merits of the various plans.

    My usual caveat applies, that if there is no very strong public option avaialable and affordable to all who want it, I hope it does fail.

    He has proposed (none / 0) (#7)
    by Big Tent Democrat on Mon Jul 20, 2009 at 03:51:21 PM EST
    a tax on incomes above 350k a year.

    Which is essentially rolling back the Bush tax cut (5.00 / 1) (#9)
    by ruffian on Mon Jul 20, 2009 at 03:55:00 PM EST
    for those people. I just think it sounds better when put like that. Could be one of those things that just bugs me and doesn't really matter.

    Seems to me any reform is (none / 0) (#12)
    by oculus on Mon Jul 20, 2009 at 03:57:32 PM EST
    going to be met with Nimbyism.  But, hey, I'm ok with incomes over 350,000 being taxed!

    Me too (none / 0) (#17)
    by ruffian on Mon Jul 20, 2009 at 04:01:39 PM EST
    But then we are among that dying breed - supporters of the progressive income tax. See digby on that that.

    Bush tax cuts are already (none / 0) (#105)
    by coast on Mon Jul 20, 2009 at 04:46:59 PM EST
    planned to be rolled back.  This is an additional surtax on their modified AGI.

    I wouldn't mind a surtax (none / 0) (#141)
    by cawaltz on Mon Jul 20, 2009 at 05:24:06 PM EST
    if it was going to benefit everyone. I don't see that being the case though. It looks like the insurance companies will be allowed "business as usual" as long as you are making over $80,000.You won't even have the option of going naked anymore. Not only that but you may end up with the privelege of being taxed for a program that you will not even be allowed to join, so you can be taxed on the front end and gouged on the back.

    That's $80,000 for a family (5.00 / 4) (#147)
    by caseyOR on Mon Jul 20, 2009 at 05:39:52 PM EST
    For and individual the cut-off is around $43,000 . The Tri-Committee plan prohibits people with employer paid insurance from buying the public option unless their yearly premiums exceed 12.5% of income. That is is just premiums, not deductibles and co-pays.

    You are stuck with your employer plan even if it is a terrible plan. The public option appears to nothing more than an expansion of Medicaid. And Obama is counting on way too much $$$ coming from cuts to Medicare to finance all of this.

    So, we have a plan that forces people to buy insurance, almost always from private insurance companies, with no mandated limits on premiums, co-pays or deductibles. How is this anything but a boondoggle to private insurance companies?


    It's an awful plan (5.00 / 1) (#149)
    by cawaltz on Mon Jul 20, 2009 at 05:46:20 PM EST
    you won't get any argument from me :)

    I want real reform and from where I am sitting this isn't it.


    Yes, the funding seems to be (none / 0) (#153)
    by KeysDan on Mon Jul 20, 2009 at 06:14:22 PM EST
    about half from taxes (surcharges or the like) and the remainder from the already  financially troubled Medicare, with the reallocated  "savings" coming from reductions in hospital and doctor reimbursements as well as new approaches such as some preventative medicine and, apparently, restricted tests.  Several of these changes are needed, but the net savings seems overly optimistic.

    I'm with you, ruffian. (none / 0) (#162)
    by allimom99 on Mon Jul 20, 2009 at 09:55:34 PM EST
    Plus, he DID promise to repeal the Bush tax cuts during the campaign, so that would constitue actually keeping a promise, for a change.

    I am actually getting tired (5.00 / 2) (#36)
    by Steve M on Mon Jul 20, 2009 at 04:08:06 PM EST
    of taxes on the rich being the sole method of paying for anything, not that I'm opposed to rolling back the Bush tax cuts.

    Guaranteed health care is a fundamental part of the social safety net and it should be paid for by the people who benefit from it, which is everyone.  Obviously I'm not saying we should tax homeless people, but middle-class entitlements should be paid for by the middle class and not just the upper crust.

    I'm sure taxing the rich is the politically safer path but I really don't like telling people don't worry, you can have everything you want for free, Bill Gates will pick up the tab for you.


    Let's see if rolling back the tax rates (none / 0) (#42)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:09:46 PM EST
    to Clinton levels covers the costs.

    Then we can consider whether we need to do more on the cost side.


    How about let's roll (5.00 / 1) (#57)
    by gyrfalcon on Mon Jul 20, 2009 at 04:16:22 PM EST
    back the tax rates to the Nixon era?  Nobody complained then about killing entrepreneurship and "punishing" small business people, and the top marginal tax rate was 90 percent.

    There were some folks on Fox Business screeching in hysteria the other day because some right-wing think tank had come out with figures they said proved that by the time Obama got done with health care, the total tax burden on Americans was going to be just horrible and insufferable and insupportable-- the same percentage, the think tanker was forced to admit, as we had during Reagan.


    No argument from me (none / 0) (#73)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:27:17 PM EST
    That would not even come close. (none / 0) (#118)
    by coast on Mon Jul 20, 2009 at 04:52:39 PM EST
    The current proposed rollbacks don't even come close to covering the projected deficits, even without heath insurance reform being included.

    I do agree (none / 0) (#48)
    by ruffian on Mon Jul 20, 2009 at 04:12:35 PM EST
    I would roll back all the Bush tax cuts myself - I don't think they helped the economy one bit. I think most people would rather have jobs that government funding subsidizes than unemployment and lower taxes on the money they aren't earning.

    It's just that rolling back the Bush middle class tax cuts was off the table for everyone during the campaign last year, and in fact further middle class tax cuts made it into the stimulus.

    I thought the Clinton era tax rates were working pretty well.


    Everyone won't be benefitting though (none / 0) (#99)
    by cawaltz on Mon Jul 20, 2009 at 04:41:40 PM EST
    if you do not open the public option to everyone.

    I think we disagree (none / 0) (#137)
    by Steve M on Mon Jul 20, 2009 at 05:19:01 PM EST
    about the meaning of a universal benefit.  Social Security benefits everyone even though most Americans are not getting anything from it, and many never will.

    Most Americans (none / 0) (#145)
    by cawaltz on Mon Jul 20, 2009 at 05:32:00 PM EST
    believe that they will benefit from it, even if they aren't reaping the benefits now.

    Getting "nothing" isn't quite correct (none / 0) (#151)
    by Radiowalla on Mon Jul 20, 2009 at 05:55:41 PM EST
    Social Security is a form of income replacement insurance which pays off if you need it.  

    If you die when you are 40 and have minor children, they will get your SS until they are 21.    If you are disabled before your retirement, you can get SS.  If you are lucky enough not to die and leave minor children, then you don't collect that benefit.  Just like fire insurance, it only pays off if there is a loss.  

    If you die before you are 65  and don't leave survivors, then you do get "nothing."  But SS is intended to replace income and not to be a savings account or an IRA.  


    And indeed (5.00 / 2) (#156)
    by Steve M on Mon Jul 20, 2009 at 06:38:32 PM EST
    that is why it is incorrect to say that some people will receive "nothing" from this health care plan!

    Yes, exactly. That's why this has no (none / 0) (#173)
    by masslib on Tue Jul 21, 2009 at 10:15:43 AM EST
    political legs.  However, we are all entitled to a social program we all pay for, but this isn't a social program.

    You know what, maybe we should change (none / 0) (#14)
    by masslib on Mon Jul 20, 2009 at 03:59:47 PM EST
    the structure of social security, just tax high income individuals, and only pay out to lower income people.  That's got real politic legs and would solve the social security "crisis", right?

    It should have legs (none / 0) (#16)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:01:16 PM EST
    as a question of policy.

    How about taxing social security fully?


    I frankly, think that's a terrible idea. (none / 0) (#23)
    by masslib on Mon Jul 20, 2009 at 04:04:16 PM EST
    The legs under social security are that we all pay in and then we all get back, more or less, what we put in.  That's why it's not welfare.  If you want to tax the wealthy, tax assets, and use that money in the general fund.  

    I think that is part of masslibs point (5.00 / 3) (#96)
    by cawaltz on Mon Jul 20, 2009 at 04:40:17 PM EST
    unlike Social Security where we all pay in and we all receive benefits this health care plan will only provide benefits for a limited number of people even though everyone will be paying in. It's particularly upsetting when you hear that they are considering taxing those with insurance to begin with in order to pay for it but will not let those people in to the option.

    I respectfully disagree (none / 0) (#37)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:08:19 PM EST
    Taxing social security benefits as ordinary income would be treating it like any other pension plan.

    Stop it, you two. Next you will propose (none / 0) (#27)
    by oculus on Mon Jul 20, 2009 at 04:05:23 PM EST
    a co-pay and cap on Medicare.  

    Great idea (none / 0) (#33)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:06:40 PM EST
    How about we start at folks earning more than 360k a year?

    Just throwing this out there (none / 0) (#157)
    by jbindc on Mon Jul 20, 2009 at 06:38:44 PM EST
    While I agree with the sentiment, (and again, Aaron Sorkin was prescient), what do you think about the counter-argument (yes, taken from The West Wing)

    Henry, last fall, every time your boss got on the stump and said, "It's time for the rich to pay their fair share," I hid under a couch and changed my name. I left Gage Whitney making $400,000 a year. Which means I paid twenty-seven times the national average in income tax. I paid my fair share. And the fair share of twenty-six other people. And I'm happy to 'cause that's the only way it's gonna work. And it's in my best interest that everybody be able to go to schools and drive on roads. But I don't get twenty-seven votes on Election Day. The fire department doesn't come to my house twenty-seven times faster, and the water doesn't come out of my faucet twenty-seven times hotter. The top one percent of wage earners in this country pay for twenty-two percent of this country. Let's not call them names while they're doing it is all I'm saying.

    And no, for the record, I don't make anywhere NEAR this kind of dough, so it wouldn't affect me, which makes it easier for me to say "tax the rich"


    I always hated trhat speech (5.00 / 1) (#165)
    by Big Tent Democrat on Mon Jul 20, 2009 at 10:20:17 PM EST
    It is so stupid that it defies belief.

    It reminds of "Let them eat cake."

    Seaborn was supposed to not understand the Common Good?

    Effing really?

    Sorkin could be so stupid sometimes. That was one of them.


    If there were a middle man (none / 0) (#30)
    by ruffian on Mon Jul 20, 2009 at 04:06:11 PM EST
    called the Social Scurity Insurance Corporations taking profits out of NOT paying social securiry benefits, maybe the situations would be analogous somehow. SS is government run retirement insurance. Much like single payer health care would be, if Congress had the nerve to do it.

    Big Tent I'm confused on the public option (none / 0) (#55)
    by nycvoter on Mon Jul 20, 2009 at 04:15:23 PM EST
    one of the Republican talking points is that a government plan (public option) would always undercut the private plans and eventually run them out of business thereby leaving only the public option.  Since the goverment can subsidize all it wants, won't it be able to "decide" what enough profit should be and undercut the private sector and either effectively set prices or drive them out?  Also, what about the idea that every corporation would want to cancel their private plan and buy the government plan because it's cheaper (I thought I heard there's a provision for that, but I'd like to hear more if you know

    Only in my dreams (5.00 / 1) (#77)
    by ruffian on Mon Jul 20, 2009 at 04:28:00 PM EST
    None of the public option plans on the table are that powerful. The government as we know it today is not going to subsidize it to the point that insurance companies get hurt that badly. The insurance companies are well protected.

    What's the problem with doing that? (5.00 / 2) (#79)
    by dk on Mon Jul 20, 2009 at 04:28:41 PM EST
    Who doesn't want health care with less overhead?  Did you know that the U.S. pays over twice as much as other industrialized countries for health care costs?

    That's exactly why Obama is prevaricating when he states that his plan has a public option.  A public option is only a true public option when all people have the ability to participate in it.


    Why the heck (5.00 / 4) (#89)
    by Steve M on Mon Jul 20, 2009 at 04:36:40 PM EST
    would the government want to lower prices just to drive private insurers out of business?  They get nothing out of it.  I don't see Medicare going around aggressively trying to get people to switch out of private insurance plans to join it.

    As for corporations switching to the public plan, I believe that's why the current discussions center around letting only a defined class of needy people opt into the public plan at this stage.  There is a general sense that, over time, everyone will become eligible, but they want to assuage these fears that there will be a mass exodus.

    By the way, as an employer myself, I kinda laugh at the notion that everyone will suddenly switch to the public plan because it's cheaper.  Heck, there are cheaper private plans I could switch to today if saving money were the only goal.  Of course, if the public option was cheaper AND just as good as the private plan we currently offer, naturally we'd switch, but what ever happened to all those people who said the government can't do anything right and would never be able to deliver anything as well as the free-enterprise system?  Suddenly everyone is convinced that government could offer health insurance just as good as what's privately available AND do it cheaper AND that this would be a huge problem!


    you're right. (none / 0) (#103)
    by Slado on Mon Jul 20, 2009 at 04:42:41 PM EST
    Medicare doesn't ask people to join but yet they still try to pay less for the same procedure then private plans and many doctors stop treating their patients.

    Why?  Because they're bankrupt and they need to save money wherever they can.

    You say you won't switch plans and then you say you will as long as the plan is as good.  Once you say that then how much worse does it have to be?  And how can  private insurer compete with something that's free?

    The devil's in the details and if you have any confidence that this congress will spit out something that won't result in whole nother set of problems then I have a private insurance plan you might be interested in.


    Medicare isn't free (5.00 / 1) (#146)
    by cawaltz on Mon Jul 20, 2009 at 05:34:25 PM EST
    You pay a portion of your wages into it and so does your employer. When you are old enough to be enrolled the plan you choose comes out of benefits that you paid into.

    Private insurance reimbursement rates (none / 0) (#104)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:45:22 PM EST
    are keyed to Medicare reimbursement rates.

    To wit, if they are kept low, then private insurance reimbursement rates are also low.


    Umm, that's not entirely true (none / 0) (#158)
    by vicndabx on Mon Jul 20, 2009 at 06:58:21 PM EST
    The basis for the physicians' now-annual argument to Congress is that reducing Medicare payments will cause more physicians to drop Medicare patients and make their living from privately insured and self-paying patients only. Indeed, anecdotal evidence indicates that some physicians have already done so,[8] as Medicare payments are already significantly below those of private insurance by almost 20 percent for physician services overall and by 12 percent for primary care.
    Details here.  

    Actually it is entirely true (none / 0) (#164)
    by Big Tent Democrat on Mon Jul 20, 2009 at 10:17:31 PM EST
    "Keyed off" does not mean the same.

    It means medicare sets the base and private insurance goes above it by say, 20%?


    Hm? (none / 0) (#139)
    by Steve M on Mon Jul 20, 2009 at 05:20:52 PM EST
    So it will be free for employers to sign up for the public option?  Many of your "facts" are complete news to me.

    Not free (none / 0) (#142)
    by cawaltz on Mon Jul 20, 2009 at 05:26:29 PM EST
    I think the cost will be something like 8% of payroll costs for employers who choose not to make health care coverage available to their employees.

    Not to mention (none / 0) (#155)
    by Steve M on Mon Jul 20, 2009 at 06:36:54 PM EST
    they will need to increase wages to compensate or else risk losing all their employees.

    Dropping the employee health care plan is a unilateral cut in compensation.  Odd to see the "free market" fetishists who think employers can unilaterally cut compensation with no consequences.


    Current market does not (none / 0) (#160)
    by coast on Mon Jul 20, 2009 at 08:41:16 PM EST
    support this outlook.  I have plenty of clients who have cut wages unilaterly with no loss in their workforce.  Where are the people going to go?  The market may chenge, but curren unemployment figures are still trending up.

    Well (none / 0) (#163)
    by Steve M on Mon Jul 20, 2009 at 10:12:29 PM EST
    my point was not that employers can never ever get away with cutting compensation, but simply that if market conditions permit them to do so, then they can do it with or without a public health care option providing the excuse.  And if market conditions don't so permit - and this economy will not last forever - then they don't get to magically escape the dictates of the marketplace.

    so you think the public plan (none / 0) (#176)
    by nycvoter on Tue Jul 21, 2009 at 01:49:34 PM EST
    just won't be as good? I guess it could have less bells and whistles than a private plan and employers who want to provide better plans would not opt for the public one.

    I appreciate everyone's thoughts here, thanks.


    Don't know what the mechanism is (5.00 / 1) (#94)
    by gyrfalcon on Mon Jul 20, 2009 at 04:39:45 PM EST
    but there isn't a rat's chance in hell Congress is going to pass anything that would permit companies to ditch their existing private insurance and sign up with a public plan.  None.  (Unfortunately.)  I suspect they will also be prevented -- or so heavily fined as to make it impractical -- from ditching employer-provided insurance altogether and cutting their employees loose to find insurance on their own.

    Whether the "public option" as envisioned right now will have room for any kind of group enrollment, I have no idea.

    What this seems intended to do is to make some kind of insurance affordable for people who aren't poor enough for Medicaid but not wealthy enough for the existing private insurance options, and who have no employer-provided plan.  So the aim is near-universal health insurance.

    Secondly, it sticks a few toes in the door, not even a whole foot, toward public health care.  A few toes is better than no toes.  If it works out well, there will be enormous pressure to expand the "public option," and employers will be clamoring more and more loudly to be allowed to get in on it.

    It also seems to me likely -- and we've already seen this a bit -- that private insurance companies are going to be so terrified of any kind of "public option" and the likelihood of a growing groundswell of support to expand it that they will restrain some of their more egregious behavior in raising premiums and cutting people off who get sick.  They might even -- gasp! -- engage in a little actual competition for the business from employers.

    This is not, and never was going to be, wholesale, wide-ranging reform, but it's more than just tinkering on the margins.  And it's HUGE for those millions of us who have not had access to health insurance and therefore health care at all.

    I have no clue what's in any of the plans that's supposed to address health care and/or insurance costs.  Reducing even further the reimbursement rates for Medicare and Medicaid strikes me as total insanity.  It's extremely difficult to find physicians who will take those patients as it is, and the problem is growing more acute by the day as more and more of us Baby Boomers become eligible for Medicare.


    The nut 'graph (5.00 / 3) (#116)
    by shoephone on Mon Jul 20, 2009 at 04:50:36 PM EST
    What this seems intended to do is to make some kind of insurance affordable for people who aren't poor enough for Medicaid but not wealthy enough for the existing private insurance options, and who have no employer-provided plan.  So the aim is near-universal health insurance.

    You have perfectly described my situation. And frankly, if I was 25 years old, "some kind of insurance" might work for me. What this plan really produces is a very whittled-down BASIC insurance option for people in my position. But I'm not 25. I'm about to turn 50, with more chronic conditions and high-risk for cancer than you can shake a stick at. BASIC health insurance will do very little for me that paying out of pocket at a community clinic doesn't do now.

    Either Obama and the Dems are creating a plan that equals truly "universal access to health CARE" or they aren't. Clearly, they aren't. And the grand ideal of mere plebes like me getting the kind of health care my Senators and House representative enjoy is nothing but a fantasy.


    That;s the claim (none / 0) (#69)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:25:37 PM EST
    Of course Medicare does that now so I think the argument lacks merit.

    All your concerns are valid and there (none / 0) (#82)
    by Slado on Mon Jul 20, 2009 at 04:30:24 PM EST
    is not a good answer to them.   The idea that some half assed public option is going to control costs is ludicrous.   Either the gov't takes it all over (bad idea) or gets out of the healthcare game all together (never going to happen).   How can Obama say that a "public option" will provide more choice when there are 1900 insurance providers in this country.

    No it will provide another "free" choice in that only a few of us on this blog will actually pay for it.

    Gov't is already way to involved with Medicaid and Medicare.  They already set much of the pricing because private insurers don't want to pay more then the government.  How is more Medicare in another form going to help?  Nobody in the Obama administration and congress can explain that.  Instead they use Bush style scare tactics to convince us that it's important.   Unfortuantely he doesn't have high approval numbers anymore and we've already been burned by promises about the stimulus and budget so most of us aren't buying.

    How is the gov't going to control pricing when all the proposals are going to up the demand by insuring more people?   How can something cost less when more people are not only going to demand it they're going to demand it with no consideration to the costs?

    Econ 101 people.  More demand with no change in supply means one thing....more expensive.

    Only one way to reduce costs.  Reduce demand through rationing.

    Say hello to socialized medicine.  

    The problem with the current options are they do absolutely nothing to control costs.  Nothing.  We need more doctors and more nurses and more hospitals to increase the supply.  Increase the supply and providers will lower their prices to attract demand.

    Anything short of that means that you either don't get the healthcare you need or it's more expensive.

    This whole debate is maddening because the simple facts are rarely discussed.


    Health care is (5.00 / 1) (#170)
    by kmblue on Tue Jul 21, 2009 at 07:19:47 AM EST
    already being rationed.
    It's only available to those who can afford it, or haven't been denied insurance because of a pre-existing condition, or those who belong to a large (employer-based) pool.

    It's also rationed (5.00 / 1) (#174)
    by TeresaInSnow2 on Tue Jul 21, 2009 at 10:29:12 AM EST
    by people like me who have THREE THOUSAND DOLLAR deductibles.  I'll never meet my deductible, therefore I'd just as soon not go to the doctor.

    Deductibles (none / 0) (#175)
    by Inspector Gadget on Tue Jul 21, 2009 at 11:36:00 AM EST
    Are they still every real dollar you paid? I resent that during the deductible period I have to pay 100% of the bill, where my insurance only pays the negotiated amount when it's their responsibility to pay. I did have a policy once where only the "allowed" amount by the insurance company applied toward the deductible, so it cost a lot more than $250 to satisfy.

    I also don't go to the doctor.


    Thank you (none / 0) (#91)
    by vicndabx on Mon Jul 20, 2009 at 04:38:22 PM EST
    the simple facts are rarely discussed

    Well (5.00 / 1) (#95)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:39:53 PM EST
    Opinions are not facts and Slado offered opinions.

    Here are the facts (none / 0) (#109)
    by Slado on Mon Jul 20, 2009 at 04:48:00 PM EST
    Offering insurance to 20 to 40 million people free of charge (to them) will up demand.

    Those people will then start showing up in the ER's and offices of doctors demanding the care that is their right.

    There will not be a single doctor or nurse added to handle these people.  This will add cost and nothing anyone is proposing will do anything about that.

    Instead the money will be pulled from the rich (during a recession) to pick up the slack and then we'll all wonder in a few years why things cost more and the economy is still in the dumps.


    No (5.00 / 2) (#111)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:49:02 PM EST
    Those are opinions.

    In theory (none / 0) (#148)
    by cawaltz on Mon Jul 20, 2009 at 05:41:28 PM EST
    you may be right. You could also be wrong too.

    Theoretically, increasing the minimum wage during the 90's was going to cause calamity too. It never actually happened though.


    He should be fighting Rep Tiahrt (none / 0) (#70)
    by kevsters on Mon Jul 20, 2009 at 04:26:14 PM EST
    I can't believe he actually implied that Obama's mother may have had an abortion if they were free.

    This was in reference to the possible provision of giving poor women access to free abortions.

    Watch it here.


    Some of the Blue Dogs blocking reform (none / 0) (#106)
    by magster on Mon Jul 20, 2009 at 04:47:09 PM EST
    like Billy Bright from Georgia, have ties to Bill Clinton.  I'd like to see President Clinton start leaning on these Blue Dogs.

    President Clinton (5.00 / 2) (#113)
    by Big Tent Democrat on Mon Jul 20, 2009 at 04:49:50 PM EST
    has no political power now.

    The ACTUAL President is the guy to do the leaning.


    Bill is busy (5.00 / 1) (#140)
    by Democratic Cat on Mon Jul 20, 2009 at 05:23:42 PM EST
    Leaning on drug companies to get cheaper drugs for AIDS and malaria treatment in less developed countries.  Maybe our elected officials should try doing the leaning.

    "fight" for reform (none / 0) (#150)
    by diogenes on Mon Jul 20, 2009 at 05:49:59 PM EST
    How about reforming the tax-draining tax-free employer-provided health insurance by making employer-provided health insurance taxable.  This would help raise some money to pay for the other "reforms".
    Oops--steps on too many union toes, I guess.

    You know it, I know it (none / 0) (#154)
    by joze46 on Mon Jul 20, 2009 at 06:21:04 PM EST
    You know it, I know it, and every body knows it

    We the people have to jump right into the new system; the cost will be adjusted on the way through time. The basic health care plan can always be reworked or if you like made over again. Of course those in the present system are raving mad for any change" they will loose profits", of course Obama has a plan that will cut into profits on the crummy system we have now. Sheesh you have got to be a dummy not to realize that. But the best of the best in medical treatment will earn even more money, they will stand out those doctors and nurses that do a good job will be awarded with honor and better pay. A new program will likely rid the system of quacks and our system is loaded with them.  

    Face it even with the Stimulus plan, the Republicans will not spend money given to them with in guidelines to promote an end the depression we are in. And I repeat Depression. This is typified by the secrecy in the Federal Reserve and Treasury. As openly as many have said they want Obama to fail. But for me none of this is Obama fault this stuff was recognized years ago with the media sitting on it supporting Bush. Well Ladies and Gentlemen of America these kinds of political persons are in no way even remotely conservative. I am conservative and deplore, despise and condemn these open Republicans they all should consider the eternal consequences. For me, the continuum is likely supportive for a healthy planet.

    These Republicans can be identified as "Terri Schiavo" in osculation. The time when Republicans practically took control of the Terry Shivo case were Terry  Schiavo's husband wanted to terminate his wife's life because technically she was a vegetable? For me if it was a time I would want my wife in the same case I would want her to go to the after life.  

    Or, remember the Republican chant about the government should be run like a business, were in the heck is Romney. Now that Government is taking an active roll to create competition. Now when Democrats take the initiative to move the economy America is looking like socialism or the communist party with a bazillion Czars. Frankly I don't care if it takes bazillion dollars to kick start health care it's a good thing war is not...