Fred Hiatt Channels Ezra Klein On The Public Option

Via Glenn Greenwald (read his great post), Fred Hiatt channels Ezra Klein:

[T]he reality is that, if the Obama administration wants to get health reform done, it's going to have to back away from the public option sooner or later -- and it's getting awfully late. . . . To listen to some Democrats talk, reform without a public option is scarcely worth doing. This is crazy.

Are WaPo Beltway Establishment Types Klein and Hiatt right on the first part? The evidence does not support this. On the second part, Klein, like Jonathan Alter and other professional "Liberal Pundits," sang a very different tune for years. But my own considered judgment is that the health care reform bill likely to emerge is NOT worth doing without a public option. Individual mandates without a public option is a terrible idea.

Letting Obama declare victory on HCR is not a good enough reason to pass a counterproductive health care bill. I think Hiatt and Klein are wrong on the politics and the substance. No public option, then no mandates. The additional Medicaid funding can be passed without calling it "health care reform."

Speaking for me only

< Sunday Morning Open Thread | Krugman, Reich And Schumer On The Public Option >
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    i now think it's wrong to compare obama (5.00 / 1) (#1)
    by The Last Whimzy on Sun Aug 23, 2009 at 11:54:17 AM EST
    to carter..

    Carter didn't bother to sell himself as successful where he was not successful.

    I'm beginning to see the light when I consider economic recovery without the creation of jobs, so perhaps very serious people like fred hiatt will tell us how great health care reform is without a public option.

    the question is, will these "successes" for Obama, successes that do nothing to improve people's lives be enough to keep the Obama train going through 2012.

    Train running on inertia now (5.00 / 1) (#82)
    by NealB on Mon Aug 24, 2009 at 09:44:05 AM EST
    and outside forces have already slowed it considerably. If Obama doesn't fire up the engine now, his administration and Democrats in general, are going to come to a dead stop. We're going to see the Democratic Party at a standstill on the (wrong) tracks just in time for the midterms.

    Additional (5.00 / 1) (#3)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 11:58:04 AM EST
    Medicaid funding AND increased payouts to doctors (making more doctors available) would be a really good piece of legislation.

    I would praise Mr. Obama for doing that.

    Agreed (5.00 / 3) (#5)
    by Big Tent Democrat on Sun Aug 23, 2009 at 12:00:44 PM EST
    But let's not call that health care reform, or even health insurance reform.

    Could call it (5.00 / 2) (#6)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 12:01:40 PM EST
    Medicaid reform! ;-).  Doctor payouts have been a HUMUNGOUS problem.

    Good enough for me (none / 0) (#9)
    by Big Tent Democrat on Sun Aug 23, 2009 at 12:07:21 PM EST
    Medicaid Reform.

    You'd have to reform it quite a bit (5.00 / 1) (#15)
    by cawaltz on Sun Aug 23, 2009 at 12:21:21 PM EST
    My sister has Medicaid. According to her she has to incur a bill of $400 or more before they pick up the tab. Basically, with that kind of billing requirement she pretty much is limited to the ER. Oh and only one doctor in her area actually takes it.

    I ave a neighbor here in Va who is on disability and she has the same problem with finding a doctor that actually takes Medicaid patients.


    A large reason (5.00 / 2) (#17)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 12:34:15 PM EST
    why doctors don't take Medicaid and Medicare patients is simply because of the ridiculously low reimbursements.

    Increase reimbursements, increase number and quality of available doctors.


    Sounds great (none / 0) (#62)
    by Slado on Sun Aug 23, 2009 at 08:09:47 PM EST
    So Medicare (which is insolvent) would then be even less affordable over the next 10 years?

    Just so you don't think I'm making this up... (none / 0) (#63)
    by Slado on Sun Aug 23, 2009 at 08:11:55 PM EST

    I love when people point to Medicare and Medicaid for examples of what government can do.

    Create a system that isn't sustainable.

    At least wars eventually end.  Healthcare will only get more expensive and the government in any form can't afford to provide it.


    Mandates (none / 0) (#10)
    by waldenpond on Sun Aug 23, 2009 at 12:07:38 PM EST
    Unless you require that doctors take all insurance, this will make little difference.  Care is rationed in our community... doctors are starting to refuse some private insurers not just medicaid and medicare.  People will still be forced to go to hospitals for care without a physician mandate and I would guess that's another deal Obama made (with the AMA.)

    Not to worry (5.00 / 2) (#21)
    by MO Blue on Sun Aug 23, 2009 at 12:43:14 PM EST
    Good possibility that many U.S. doctors will become just as unnecessary as factory workers. Big push for outsourcing actual medical care to India, Singapore, Thailand etc. to obtain cheaper prices. Medical tourism is gaining business as prices rise. Couple of insurance companies have sent out trial balloons on people's willingness to go out of the country for cheaper medical care.

    Can't have the nasty U.S, government involved in our health care so instead we will go to a totally government run system in another country to receive services.  


    I'm considering dental tourism (5.00 / 5) (#23)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 12:55:39 PM EST

    I need 2 root canals and two crowns.  The cost for the two is literally higher than the cost I incurred for both a surgeon and an anesthesiologist during abdominal surgery.

    Dental healthcare is an area sorely in need of reform.


    I'd agree (5.00 / 6) (#45)
    by cawaltz on Sun Aug 23, 2009 at 02:37:15 PM EST
    and it is particularly egregious when you take into consideration all the problems that can occur healthwise when you don't get proper dental care. It OUGHT to be considered a component(with the idea that dentists are a specialty) in health care rather than a separate entity IMO.

    Very true (5.00 / 2) (#50)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 03:17:12 PM EST
    How dental care became separate I'll never know.

    And individual dental insurance is basically pay for service in advance.  The greatest benefit you get from it is the insurance company negotiated reimbursement rate.


    Desperately in need, IMO (none / 0) (#34)
    by gyrfalcon on Sun Aug 23, 2009 at 01:17:58 PM EST
    Living a few hours from the Mexican border (none / 0) (#70)
    by MojaveWolf on Sun Aug 23, 2009 at 10:26:13 PM EST
    Every lower middle class and poorer person I know who has a reliable vehicle goes to Mexico when they need dental work (except for those who go to dental training schools).  

    ".....require that doctors (none / 0) (#13)
    by NYShooter on Sun Aug 23, 2009 at 12:16:18 PM EST
    take all insurance?"

    How could you require doctors to take inurance payments that don't even cover their costs?

    What you're asking is impossible, imo.


    why is it (5.00 / 2) (#16)
    by The Last Whimzy on Sun Aug 23, 2009 at 12:30:02 PM EST
    that when people say "cover their costs" i always tend to think that really means "protect their profit."

    I'm not great doctor's advocate (5.00 / 1) (#20)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 12:42:20 PM EST
    however, I will say that Medicare/Medicaid payouts are notoriously low.  Any doctor with a business sense would sorely limit the numbers of these patients that they take.  The reimbursement rates have got to improve.

    This is why, while I'm for single payer universal healthcare, I'll never say "Medicare for all".


    i agree totally (none / 0) (#22)
    by The Last Whimzy on Sun Aug 23, 2009 at 12:53:49 PM EST
    but i just saw the existential question rear it's ugly head.

    we do need to be a society that rewards doctors for their expertise, and yet we also don't want to consider the possibility that doing so means some people -- people who don't have anything to reward doctors with -- in our society will, to be blunt, die.

    the image of doctors going through their kids piggy banks to make ends meet doesn't ring true to me.  if that was the image that was indeed projected.


    Doctors (5.00 / 1) (#25)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 01:00:38 PM EST
    definitely aren't generally poor.  I don't think anyone was projecting that image.  However, they do need incentive to take patients who are now "costing" them money.

    (I am a welfare brat.  I'm in no way trying to protect any member of the rich class. I'm just stating realities.)


    Easy solution then (none / 0) (#27)
    by The Last Whimzy on Sun Aug 23, 2009 at 01:05:29 PM EST
    tax them another 10% and then raise the reimbursements 8%, and then go build some stuff employing 1000s of people with the other 2%.

    They (none / 0) (#35)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 01:21:23 PM EST
    will figure out that they're losing on this proposition.

    Want fewer doctors?  Good way to make that happen.


    Already happening re general (5.00 / 1) (#37)
    by oculus on Sun Aug 23, 2009 at 01:29:16 PM EST
    practinioners/family medicine, per recent NYT article.  Not what medical students are choosing to go into.

    This has been true for some time.... (none / 0) (#87)
    by sallywally on Mon Aug 24, 2009 at 09:57:19 AM EST
    never the most lucrative practices, no expensive procedures, etc. It has been considered an area good for women - work part time and raise families, etc.

    Some of the best docs I know work in this area. They are dedicated, do not work part time, and do it for the love of the profession.

    And not all women, either.

    When I was a kid, our pediatrician lived down the street in the less expensive part of a moderate suburb of Cleveland. Not a lot of money then, either.


    Like I said above (none / 0) (#38)
    by The Last Whimzy on Sun Aug 23, 2009 at 01:34:13 PM EST
    we need to be a society that provides great rewards for being a doctor.

    back to where we started.  only rich people can afford health care.

    the push and pull of this fundamental equation is unavoidable.


    shan't i make (none / 0) (#72)
    by lilburro on Sun Aug 23, 2009 at 11:59:52 PM EST
    a few kisses and bows to the hippocratic oath and fix things though?

    It's about time that we realize the medical profession is about $$$...


    My neighbor's daughter (5.00 / 2) (#60)
    by cal1942 on Sun Aug 23, 2009 at 07:01:37 PM EST
    is an MD.  The last couple of years she's made over $400,000 per.

    She was complaining that health care reform could end up lowering her earnings.  She got this from the AMA.

    She's probably right, her earnings probably would decrease, but, as her father told her; if you can't live very, very well on maybe 3 or 3 50 a year there's something seriously wrong with you.

    IMO, good for dad.

    My primary care is a young guy who works for a corporation.  Works less than 40 hours per week.  I don't know how much he earns but I saw a picture of his new digs.  Geezuz.

    I know that not all physicians earn that kind of loot but I've never heard of one on relief.


    i'm sure she'd tell you with a straight face (5.00 / 1) (#65)
    by The Last Whimzy on Sun Aug 23, 2009 at 08:44:14 PM EST

    "i'm just barely covering costs."


    develop (5.00 / 1) (#73)
    by lilburro on Mon Aug 24, 2009 at 12:01:10 AM EST
    a MedCorp?  dunno.

    I guess I don't understand (none / 0) (#30)
    by NYShooter on Sun Aug 23, 2009 at 01:08:13 PM EST
    what you're trying to say.

    I'm not trying to be argumentative, but it seems like you're asking that doctors treat everybody, even if they lose money doing it. How can you require doctors to take anything that's offered? One company could offer $300 for a procedure; another offer $100. Is that fair?

    Where am I wrong?


    You're not wrong. (5.00 / 1) (#32)
    by The Last Whimzy on Sun Aug 23, 2009 at 01:13:00 PM EST
      you're just avoiding the consequences of an entire system predicated on what you're right about.

    Again, percentage (5.00 / 2) (#33)
    by waldenpond on Sun Aug 23, 2009 at 01:16:36 PM EST
    Some doctors bill $100, some $300.  Some insurers pay $80, some $200.  Some doctors inflate their cost.  You pay when that doctor decides to take all staff to Hawaii for a 3 days for a 1 day conference.  That's 'cost.'  Fair?  Who knows but it's already happening.  Some doctors refuse to take medicare, some will take 5% of patients as medicare.  Mandate the 5% and increase the payout.

    The 3 day vacation (none / 0) (#36)
    by TeresaInSnow2 on Sun Aug 23, 2009 at 01:24:53 PM EST
    for the 1 day conference happens in every industry (see banking).  And we always pay for it in one way or another.

    Take away the riches and you'll see fewer doctors.  Do you think they look down viral throats for fun?


    Not as much as it used to be (none / 0) (#42)
    by The Last Whimzy on Sun Aug 23, 2009 at 01:52:18 PM EST
    Banking yes.  Doctors yes.  Probably even insurance companies.

    Not sure I want to be the patient of a doctor... (none / 0) (#90)
    by sj on Mon Aug 24, 2009 at 02:15:07 PM EST
    ...who is only in it for the riches.  I've seen the work of some of those who chose a career path because that's where the money is.  Don't care to entrust my health and well-being to one of those.

    Medicare (5.00 / 1) (#68)
    by Madeline on Sun Aug 23, 2009 at 10:01:54 PM EST
    pays well in re physician billing and geography.  In my area, a GP physician will charge 150 another 85. For mental health, my reimbursement is 94.  However, the Medicare client can be charged the remainder to make up the rate per visit.

    Also where I live, a large percentage of physicians have some ownership in the diagnostic centers who do all the testing.  And in this area, I mean all testing. That is a significant increase in revenue for them.  


    Percentage (5.00 / 5) (#18)
    by waldenpond on Sun Aug 23, 2009 at 12:34:16 PM EST
    Some doctors take medicare and medicaid... they do it, at say, 5% of their business.  When you have doctors refusing to take individual insurers?  The govt can force individuals to purchase insurance... the govt can't apparently force doctors to take a percentage?  What's the point of the individual mandate?

    My sister on Medicare has never (5.00 / 1) (#79)
    by sallywally on Mon Aug 24, 2009 at 09:28:32 AM EST
    been turned down by any doctor she sees. She's got a lot of problems so she sees a bunch of docs regularly. Never has had a problem being accepted as a patient or being covered.

    It isn't that the doctors are "refusing" (none / 0) (#86)
    by Anne on Mon Aug 24, 2009 at 09:53:49 AM EST
    to accept private insurance, it is that they are not participating in plans where they are tied to accepting whatever the insurance company will pay.

    My doctor's practice does not participate in any insurance plans; they are happy to process the claims, but expect payment at the time services are rendered, with check for whatever the plan pays going directly to patient from insurance company.

    Know what that means for me, as a patient with BC/BS that I pay for myself?  It means that when I need to see my doctor, he can spend as much time with me as he needs to, and I never feel like I am being pushed out of the examining room because there is an office-full of patients waiting.  The practice does not have to supersize the caseload just to make a living from the pitiful amounts negotiated with benefits managers.

    Does it cost me more?  Maybe some, but I don't think it's a lot - and I feel like I have a real doctor who cares about my health and my concerns.


    Pretty much (5.00 / 7) (#4)
    by andgarden on Sun Aug 23, 2009 at 11:58:49 AM EST
    Congress will be unwilling to regulate like the Swiss, so doing this reform without a public option is bad politics and bad policy.

    Exactly (5.00 / 4) (#28)
    by ruffian on Sun Aug 23, 2009 at 01:07:31 PM EST
    When we are willing to regulate like the Swiss, we can try the rest of their system.

    I'd pass additional Medicaid funding (5.00 / 3) (#7)
    by inclusiveheart on Sun Aug 23, 2009 at 12:05:40 PM EST
    and call it "Additional Medicaid Funding", but who am I?  That would be way too straight forward for these political pretzels.

    I'm afraid (5.00 / 2) (#8)
    by kmblue on Sun Aug 23, 2009 at 12:05:42 PM EST
    no matter what insanity they pass, they will call it health care reform.
    And  here I am turned down for insurance.  Again.

    I hear you. (5.00 / 3) (#19)
    by shoephone on Sun Aug 23, 2009 at 12:36:01 PM EST
    And I'm sorry you have to go through that.

    Did you happen to watch Bill Moyers the other evening? It went right to the heart of the matter, all about denying medical care to the great unwashed and letting them fend for themselves until it's total crisis. The producer of the piece followed three families living without health insurance.

    I'm planning on sending a copy to my very pale blue senators, both of whom have been so tepid on a public plan and have shown new talent for hiding out from their constituents.


    Hiding out from their (none / 0) (#31)
    by oldpro on Sun Aug 23, 2009 at 01:12:40 PM EST
    constituents?  How is that possible?  Have you considered a sit-in in their district office?  They have one near you.

    I hound them continually (5.00 / 4) (#39)
    by shoephone on Sun Aug 23, 2009 at 01:37:06 PM EST
    and yes, I know where their offices are. I and two others met there with one of Cantwell's assistants, regarding Iraq. He was very nice. She never responded (duh, because she never does). My back problems and other medical issues make it impossible for me to "camp out" there indefinitely.

    However, among other things, I staged a lone protest outside an event she held with Obama in 2006, castigating her for her statement that she had "no regrets" about her Iraq War vote. Dozens of people who were waiting in line to get inside the venue came over to talk to me. Every single person expressed support for what I was doing. Then Cantwell's goons approached me and threatened to have me arrested immediately if I didn't stop and leave the premises.

    Just like at Bush rallies, where protesters were threatened with arrest for exercising their right to free speech.

    I've hardly been silent where Cantwell is concerned. She is a joke and always has been.


    P.S. Sorry about your back (5.00 / 2) (#48)
    by oldpro on Sun Aug 23, 2009 at 02:58:58 PM EST
    and other medical issues.  I know all the words to that song and it isn't fun.  Makes one cranky if not depressed.  I try not to be both at the same time but it doesn't always play out that way.

    No joke. Maria may not (none / 0) (#44)
    by oldpro on Sun Aug 23, 2009 at 02:27:57 PM EST
    be the senator you wished for but she's miles ahead of her predecessors all the way back to, and including, Scoop Jackson.

    Patty, not so much...she's not in Maggie's league.  Not yet, anyway.

    And if Iraq is your issue, what's your take on Afghanistan and the Vietnamization of the Obama team?  Nationbuilding, fer crissakes.

    At least Maria is hanging in there with us on a healthcare public option...unlike 'the one.'

    So, locally, who ya backing for mayor?


    Unfortunately, both Cantwell and Murray (none / 0) (#51)
    by shoephone on Sun Aug 23, 2009 at 03:39:17 PM EST
    are very inaccessible to their constituents. A lot of people besides myself have had this complaint about them for years. They very rarely hold town meetings, so how are constituents supposed to ask them questions? Their office people never seem to know what the senators' positions are on anything. The answer is almost always, "the senator hasn't made a public statement about that yet." They tell me to check the website, but the websites don't tell me what I need to know either. Contrast that with McDermott's and Inslee's offices, where the staffs bend over backwards to help on communication and constituent services.

    One difference is that at least the people in Cantwell's office are nice. Murray's office -- horrible.

    Iraq is not my only issue. But, since you asked, I have a lot of trepidation about what's supposedly being planned for Afghanistan because I feel certain that Bush and Cheney already destroyed our chances of success there. I watched Mullen on MTP this morning and honestly, I think this administration doesn't have a clear plan either. And when asked "what's the definition of success in Afghanistan?" the response is everything we heard about success in Iraq: security + political goals.

    Health care is my biggest issue. I am willing to fight, and push back very hard on it. At least McDermott is in our corner.

    As for my choice on mayor: wow, have we ever had such slim pickin's before? I need to hear many more specifics and less platitudes from Mallahan. He can't afford to come off as Mr. T-Mobile at City Hall. He does have experience as a staffer in state legislature. (Not sure how well that translates to running a major city.) McGinn is thoroughly unqualified, in my view. A one-trick pony -- all he's got is anti-tunnel, and he would lose that fight if he bacame mayor. City council and state govt. have made their positions clear.  Theresainsnow2 disagrees with my low opinion of him. But... I live in Seattle so I get to vote on it.


    Apologies, BTD! (none / 0) (#52)
    by shoephone on Sun Aug 23, 2009 at 03:51:45 PM EST
    I just went way off topic.

    Ditto. My fault, actually... (none / 0) (#75)
    by oldpro on Mon Aug 24, 2009 at 02:11:46 AM EST
    I led you off the beaten path into the weeds...but thanks for responding!

    Well (5.00 / 3) (#12)
    by Ga6thDem on Sun Aug 23, 2009 at 12:14:46 PM EST
    if you look at it in short term goals then yes, passing any HCR would be a "win" for Obama. However, IMO, that win would be very short lived when for the next two to three years people like me continue to get annual policy increases of 10% or more. It would either signal to voters that the HCR caused or exacerbated the problem or did nothing to stop the problem. Trying to tell voters well, we passed HCR but it's going to take effect until 2013 seems pretty out there.

    Short-term win? It's only (none / 0) (#26)
    by oldpro on Sun Aug 23, 2009 at 01:02:56 PM EST
    a win if you can convert it into support....votes or money or both.  Whose support would such a 'win' attract?



    well (none / 0) (#47)
    by Ga6thDem on Sun Aug 23, 2009 at 02:58:39 PM EST
    that's pretty much my point. It would be considered a win because he "passed something" but it wouldnt hold up long term and would probably be worse than passing nothing.

    Put me down as 'first with (none / 0) (#49)
    by oldpro on Sun Aug 23, 2009 at 03:01:50 PM EST
    the obvious.'

    Time for a break...


    Mandate without public option is not a bug... (5.00 / 8) (#14)
    by lambert on Sun Aug 23, 2009 at 12:18:54 PM EST
    ... but a feature.

    The mandate is, and has always been, a bailout for the insurance companies because it guarantees them a market.

    That's why the leadership in both parties supports the mandate (just like the leadership in both parties supported the bailouts for the banksters).

    So, if there's a mandate that everybody has to buy insurance -- and with the IRS acting as collection agent -- that's a guaranteed revenue stream for the insurance companies (from which both parties will collect a cut in exchange for preventing future "incremental" reform).

    And if there's no public option to "keep the insurance companies honest" (as if that were even possible) then the insurance companies are free to game the system to maximize profit, just like now -- as it is their fiduciary responsibility to do.

    So, just as the financial crisis was used to reinforce the power of the banksters, so the health care crisis will be used to reinforce the power of the insurance companies.

    (Of course, from the perspective of a single payer advocate, the fight between the right and the Finance Democrats, and the "progressive" public option advocates is a fight between a system that we know doesn't work, and a vague proposal that, at the very best, cannot be shown to work. Yay! I'm on the side that the other two sides are trying to suppress... )

    Yup, now we're just talking crazy (5.00 / 5) (#24)
    by ruffian on Sun Aug 23, 2009 at 12:56:53 PM EST
    To listen to some Democrats talk, reform without a public option is scarcely worth doing. This is crazy.

    Yeah, that's almost s crazy as thinking that getting out of Iraq while leaving 14 bases there is not really getting out of Iraq, or that saying people broke the law without prosecuting them for it is letting them get away with it.   Crazy talk!!!! But what do you expect from the left of the left DFHs.

    Just a guess (5.00 / 1) (#29)
    by ademption on Sun Aug 23, 2009 at 01:08:01 PM EST
    I think that the Fred Hiatts and Ezra Kleins of the world have talked to Washington insiders from Congress and the White House and have concluded that the White House plans to drop the public option (probably the co-ops too) for the 5 yr fallback plan. Yes, what emerges will still be called healthcare reform.

    This is a bailout for the health insurance industry nothing more nothing less. Once the baby boomers begin retiring, they are going to lose a significant amount of business. The LA Times mentioned this in an article back in June. The insurance companies need new customers to make up for the losses in baby boomer customers that will go onto Medicare. Yes, they'll have Medigap supplemental insurance, but that's still nothing compared to the insurance they offer baby boomers now. It's the demographics stupid!!

    The insurance companies have already won this battle. Check out this article from Businessweek from a few weeks ago:


    Read the whole article. It tells you a whole lot about what the health insurance companies will be getting out of this so called healthcare reform....

    If there isn't a robust public option (5.00 / 4) (#46)
    by cawaltz on Sun Aug 23, 2009 at 02:45:50 PM EST
    and they pass a mandate "I'm going to get on the anybody but the incumbant" bus and encourage people I know to do the same. I'm done with Congress thinking they can ignore us and still keep their jobs.

    If the Congressional Dems are going to do their best to feed corporate coffers just like the GOP then I see no reason to see them or do any differently with them then I would do with the Republican that did the same thing.

    Daschle. Yawn. Color me (5.00 / 1) (#53)
    by oldpro on Sun Aug 23, 2009 at 05:31:45 PM EST
    not surprised to find who is calling the plays on the White House healthcare team.

    It ain't the quarterback.

    I know.  It sounds like he's calling audibles but that's just lip synching.

    The guy in the orange alligator shoes (or is that lizard?)isn't just the coach...he's also the rep of the team owners.

    Hooray for Daschle! (none / 0) (#57)
    by lentinel on Sun Aug 23, 2009 at 06:15:34 PM EST
    He gave no thought whatsoever to the bill permitting Bush to invade Iraq. He joyfully and energetically pushed it through the Senate.

    Now he is being consulted by our current leader.



    Consulted? He was (5.00 / 1) (#58)
    by oldpro on Sun Aug 23, 2009 at 06:34:17 PM EST
    appointed to the cabinet with two portfolios, one of which was Healthcare czar with an office in the White House!  Remember?  Of course, he was also on the draft Obama squad after losing his own senate seat...then having to withdraw - oops - from Obama's appt. of him as HHS Sec.

    Daschle/Obama...joined at the lip.


    O ba bababa (5.00 / 2) (#54)
    by lentinel on Sun Aug 23, 2009 at 05:35:55 PM EST
    "I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody....everybody in, nobody out.

    A single payer health care plan, a universal health care plan. And that's what I'd like to see.

    But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."

    ---Obama speaking to the Illinois AFL-CIO, June 30, 2003.

    Could someone let him know that the Democrats have taken back the White House, Senate and House of Representatives?

    We have?! (5.00 / 2) (#55)
    by nycstray on Sun Aug 23, 2009 at 05:45:57 PM EST
    Coulda fooled me . . .

    No - (none / 0) (#56)
    by lentinel on Sun Aug 23, 2009 at 06:10:43 PM EST
    We haven't.
    They have.

    Nevermind what they say... (none / 0) (#59)
    by oldpro on Sun Aug 23, 2009 at 06:39:18 PM EST
    watch what they do.

    Somebody write that down.  Or maybe we could have it etched into the stone over the entries to the house and the senate?

    Just a thought...

    Better yet...anybody know of a cheap skywriter in the DC area?


    Who? (none / 0) (#61)
    by lentinel on Sun Aug 23, 2009 at 07:57:15 PM EST
    Who are we watching do what?

    Pols...to quote BTD. (none / 0) (#64)
    by oldpro on Sun Aug 23, 2009 at 08:16:59 PM EST
    Talk is cheap.  Campaigning is predictable.  

    Governing is hard...but that's what counts.  It's what they do that matters...not what they say.


    What (none / 0) (#66)
    by lentinel on Sun Aug 23, 2009 at 09:14:24 PM EST
    are they doing?

    Are you funnin' me? n/t (none / 0) (#69)
    by oldpro on Sun Aug 23, 2009 at 10:16:30 PM EST
    Qne he didn't campaign for this (none / 0) (#81)
    by sallywally on Mon Aug 24, 2009 at 09:41:08 AM EST
    or even say such a thing in his presidential run....

    No public option, then no mandates. (2.00 / 0) (#43)
    by Abdul Abulbul Amir on Sun Aug 23, 2009 at 02:00:29 PM EST


    That is a winning idea.

    Common sense (none / 0) (#2)
    by waldenpond on Sun Aug 23, 2009 at 11:54:23 AM EST
    To reduce costs on a national level the public option is needed.

    Lieberman... 'the gang of six are our great hope, they agree on 75%, let's pass that, wait until the economy improves, incrementalism, focus on insured over uninsured, etc.  (he doesn't mention cost control)

    Cardin... 'focus on reducing cost.  A public option will do that.'

    Lugar... Obama made a mistake bringing up health care in this economy.  Bring it up later. (ha)

    I would agree with any that refuse to give their money to the Corporacrats in the insurance industry.  It takes just a little common sense to figure out how to reduce costs for the nation.

    For some reason (could be that majority that supports the public option) the new talking point of incrementalism isn't working yet.

    Sometimes nothing is better (5.00 / 4) (#11)
    by mmc9431 on Sun Aug 23, 2009 at 12:13:54 PM EST
    Just like they were going to come back on prescription drugs and FISA.

    Four years ................college (none / 0) (#67)
    by NYShooter on Sun Aug 23, 2009 at 09:56:43 PM EST
    Four  years................. medical school
    3-5 years...................internship/residency
    2-5 years...................specialty training
    Lifetime.....................continuous study.

    So, by their mid-late 30's, a doctor can finally start earning a living, at the bottom of the totem pole of whatever hospital/practice they join.

    To get to this position doctors have forfeited anything resembling a normal life, as 80 hr. workweeks, at virtually no pay, or rather, barely subsistence pay, is not the exception, but the norm.

    And to make the job even more enticing, new doctors carry a school debt load of several hundred thousand dollars with which to begin their careers.

    So, you have every right to be angry, but please vent your anger where it's appropriate.
    Doctors aren't the bad guys; Wall Street are the bad guys.

    We spend 2 ½ Trillion on health costs; "care" is 1 1/4 Trillion; Wall Street, administration, and profits, the other 1 1/4 Trillion.

    Finally, pointing out anecdotal examples: "I know a doctor who.....," or my nephew, the insurance agent...." Is just nonsense, completely unhelpful, and the dictionary definition of a canard.
    Bottom line: We spend $8,000/person for healthcare, inferior to Europe & Asia, who spend $4,000/person.

    The whole discussion is about paying extortion/welfare to an unnecessary industry, much as the horse & carriage industry was, and which is bankrupting our country.
    Cut out the middle man, bring us in line with the rest of the civilized world, and our economy will shoot to the moon.

    Politics? That's another issue. But first, understand the facts.

    i know how to resolve this (5.00 / 1) (#71)
    by The Last Whimzy on Sun Aug 23, 2009 at 10:56:27 PM EST
    i won't say doctors make too much money if doctors don't pretend they can't cover costs.  my definition of someone who can't cover costs is someone who is going through their kids' piggy bank to buy bread.

    perhaps you'd like to come up with a different definition.


    Where is your evidence (none / 0) (#74)
    by NYShooter on Mon Aug 24, 2009 at 01:04:45 AM EST
    for your "one-size-fits-all" smear, "doctors make too much money," or your equally silly caricature featuring "piggy banks?" Compared to whom do they make too much money? Show me some facts; you can't. And you'll excuse me for not touching the piggy bank delusion.

    By any criterion, Doctors stand out as having earned the right to make a very good living: intelligence, hard work, perseverance, dedication, and a willingness to sacrifice "the good life" until they're old enough to be grandparents. Compared to most others in our Capitalist, free enterprise, society, Doctors, for what they put in, receive far, far less than their counter parts in other, more lucrative  industries.

    My problem with your characterization is that you said, "Doctors." You didn't say, "Some doctors," or "a few doctors"; you denigrated all doctors, an entire profession.

    And that's just plain wrong.


    where is your evidence (none / 0) (#76)
    by The Last Whimzy on Mon Aug 24, 2009 at 02:13:17 AM EST
    to show doctors can't cover costs?

    if what you meant was can't make as much money as they want, then I think that's fine.

    And yes, all individual doctors are different.  I know one who dedicates 50% of her time to patients who can't afford health care, and I know of one who won't do a procedure (spinal fusion) without 250k for 4 hours worth of work.

    the original question was this:

    How could you require doctors to take inurance payments that don't even cover their costs?

    so there was a generalness to the topic that I think could be discussed without harping about saying "some doctors.." or "a few doctors."

    most people get the point.

    but I'll make it more clear.

    Your question above is OK to ask.  But you have to understand a lot of people like to inflate their costs.  especially when they are negotiating for a reimbursement.  

    as far as doctors are concerned i doubt it gets this bad, but think about a CEO telling the people he's laying off that the company can't "cover costs".  and then he gives himself a raise with the money the company saved by not employing so many people.

    actually, i bet SOME doctors are just as bad as that when they claim they can't cover costs.

    just to answer your question.....

    How could you require doctors to take inurance payments that don't even cover their costs?

    Easy when you know all the other payments they receive not only covers their costs but nets them 400% profit.

    The other option is to tax the income on all those other payments and then give that tax revenue to insurance companies and welfare recipients who will then be able to make the payments that do cover the costs.


    Aw Jeesh, (none / 0) (#77)
    by NYShooter on Mon Aug 24, 2009 at 08:29:53 AM EST
    Look, I'm not comfortable debating convoluted opinions; if you're saying doctors should do more pro bono work, well o.k. Some do a lot, some, none. If you want to sanctify that into law (I think Theresa touched on this) get used to self medication cause there ain't gonna be no mo doctors.

    I really, really don't know what you're trying to say, other than using a mash-up of stereo types, and patently unrealistic suggestions.
    I don't want to argue, I really don't, so just chaulk me up to being a fuzzy headed geezer, and let it go at that. O.k?



    I don't believe higher income taxes (none / 0) (#89)
    by The Last Whimzy on Mon Aug 24, 2009 at 11:39:05 AM EST
    resulted less people wanting to be CEOs.

    let's pretend my general assessment of doctors is wrong and, by and large, they are all struggling to make ends meet and perhaps even a percentage of doctors have had to file for bankruptcy and default on mortgages and all that.

    well then, sure, if that was the case then who would want to become a doctor if you can't cover costs?

    but i don't believe I'm wrong, I think it's more like people who make 300k would then be making 250k and if I'm right about that then I see no reason to believe less people will want to become doctors.

    the ultimate reward would still be pretty high compared to 98% of all the other jobs that exist in our society.


    When they're "sacrificing the good life" (none / 0) (#83)
    by sallywally on Mon Aug 24, 2009 at 09:45:27 AM EST
    they are already making more than most of us. Check the residency salaries at the teaching medical centers.

    please watfch your language (none / 0) (#84)
    by Jeralyn on Mon Aug 24, 2009 at 09:47:55 AM EST
    use asterisks for "b*ching"

    Sorry! (none / 0) (#85)
    by sallywally on Mon Aug 24, 2009 at 09:53:07 AM EST
    Sorry again - b*tched" - n/t. (none / 0) (#88)
    by sallywally on Mon Aug 24, 2009 at 09:58:09 AM EST