Why Rockefeller Says No To BaucusCare

By Big Tent Democrat, Section Other Politics
Posted on Fri Sep 18, 2009 at 11:21:21 AM EST
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Ezra interviews Rocky:

[EZRA:] Can you support the Finance Committee bill in its current form?

[ROCKEFELLER:]No.

[EZRA:]Why?

[ROCKEFELLER:] There are a number of big things. The Children's Health Insurance Program is put into the exchange. That's like putting it into a farmer's market. It loses its defined benefits. And children need defined benefits. Obviously the public option. I feel very strongly about that as a discipline on the private health insurance market. The public health insurance option doesn't have to make a dime. It doesn't have to make Wall Street happy or shareholders happy. It just has to sell a product at cost. That will put pressure on private insurance companies to bring down their premiums. [MORE . . .]

[ROCKEFELLER cont'd:] What's the alternative? My staff has done extensive research on co-ops and everyone says they can't do health insurance. The best health care co-op exists in the state of Washington, and both of Washington's senators are adamantly for a public option. That ought to tell you something.

Another issue is that 46 percent of the American people have health insurance from fairly large companies that self-insure. And they're not included in the regulations. They have to have protection from preexisting conditions and lifetime caps and rescissions too. People hear that the regulations in the bill don't apply to these companies and they think it's not possible. But it's true. And it's almost half of the insurance market!

Another piece is the MedPAC proposal. if you really want to be honest about it, eight to 10 percent of the members of Congress understand health care. At maximum. I chaired the intelligence committee, and health care makes it look like riding on a tricycle it's so complicated. So what you have is lobbyists picking on congressmen who don't know health-care reform, and they say, you know what, you could get a lot more jobs in your state if you only put more money into oxygen or a certain medical device. If you're going to do Medicare right, understanding that the trust fund is going to go downhill in 2016, you can't have Congress making these decisions. You need professionals.

That's why I have well over 25 amendments ready for Tuesday.[. . .]

Read the whole thing.

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Why Rockefeller Says No To BaucusCare | 47 comments (47 topical)

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Thank goodness (5.00 / 7) (#1)
by SGITR on Fri Sep 18, 2009 at 11:32:42 AM EST

Rockefeller sounds like he knows what he is talking about.

That "eight to 10 percent of the members of Congress who understand health care" is scary though.

But (5.00 / 4) (#2)
by Ga6thDem on Fri Sep 18, 2009 at 11:57:04 AM EST

honestly as someone who has actually worked in the insurance industry I can tell you that's he's probably right on that estimate. The majority of the these people are clueless and listening to what the lobbyists are telling them.


And further, ... (5.00 / 3) (#21)
by Donald from Hawaii on Fri Sep 18, 2009 at 02:31:31 PM EST

... if you consider the sheer volume of legislation and mandments that have to be considered by Congress - and not just on health care reform - it's perfectly understandable why many members would defer to the judgment of the subject committees.

What further complicates the issue for members of Congress and the general public - and provides no end of frustration for both - is that Congress neither writes nor marks up its bills using the Ramseyer method of bill writing, which most municipal boards, city councils and state legislatures have adopted.

The Ramseyer method of legislative writing requires that the section of ordinance, statute or session law that's proposed for amendment must be written out and printed in its entirety, with the proposed amendment set in place so someone can actually see how the amended law would actually read, without having to immediately reference volumes of compiled statute. New language that's to be inserted is underlined, while language to be deleted is bracketed and struck through with a single line.

If Congress ever adopted Ramseyer, it would be a lot easier to see and follow what they're doing. But I wouldn't hold my breath waiting for that day. Congress' refusal to write its bills in plain English ensures a steady supply of work for legislative analysts like myself and attorneys, and serves to keep the general public at bay.

Aloha.


: Wow (5.00 / 1) (#42)
by gyrfalcon on Fri Sep 18, 2009 at 11:49:58 PM EST

Thanks for that explanation. You told me something I didn't know, that there's an actual named framework for doing this more transparently.
I really, really appreciate the insights like this that you so frequently bring to these discussions, btw. We laymen are flailing around in the dark on so much of this stuff, and it's really valuable to have somebody with your experience and perspective pointing out some of the nitty-gritty none of the rest of us have any clue about.
IOW, THANKS!

: That is great information (none / 0) (#47)
by lambert on Sat Sep 19, 2009 at 09:38:57 AM EST

Thanks!

Very useful (5.00 / 1) (#3)
by Coral on Fri Sep 18, 2009 at 11:58:56 AM EST

I'm finding it more and more difficult to keep all these proposals and details straight. The more I learn, the closer I get to single-payer / aka Medicare for All as the only way to get fair and decent universal coverage.

The market is divided into too many separate segments, and the insurers benefit by keeping it that way.

that's probably (5.00 / 2) (#4)
by cpinva on Fri Sep 18, 2009 at 12:01:30 PM EST

the same 8-10% who actually understand economics, accounting and tax law.

Yes. Read the whole thing. (5.00 / 2) (#5)
by oldpro on Fri Sep 18, 2009 at 12:01:41 PM EST

A stunning interview.

Confusing, though. Hard to see what compromises can be made to get this out of committee containing a public option. Maybe the compromises will be about who is appointed to the conference committee with the house, should that surface. Or, who'll be involved in reconciliation, although Rockefeller's warning about that are a bit ominous.

Still...interesting that he is so hopeful at this stage. Sounds like some Dems are getting serious about a bill.

Loved his comment about co-ops, noting that Patty and Maria are strongly for a public option as opposed to replicating Group Health, even though it has been successful on Puget Sound.

More goodies for insurance industry (5.00 / 7) (#6)
by MO Blue on Fri Sep 18, 2009 at 12:05:26 PM EST

The Children's Health Insurance Program is put into the exchange. That's like putting it into a farmer's market. It loses its defined benefits. And children need defined benefits.

Let's destroy every program that works so that the insurance industry gets more and more money. Good job, Baucus. You're going into "Good job, Brownie" territory on health care.

He didn't mention it (5.00 / 3) (#7)
by eric on Fri Sep 18, 2009 at 12:18:50 PM EST

but Minnesota also has a successful health care co-op - Health Partners. (Actually, I think it is bigger that Group Health). Notably, both senators from Minnesota also support a public option!

BTW (5.00 / 1) (#10)
by eric on Fri Sep 18, 2009 at 12:26:01 PM EST

I am actually a member of Health Partners and it works fine. It does not, by itself, keep costs down, however. I hear from my employer that costs have been going quite a bit. It is non-profit, but the costs go up, anyway. Probably by market pressures.

The good part of it is that there is one organization that employs the doctors, and runs the facilities. It is all integrated and there is no third-party insurance company to tell you that something isn't covered. Sort of a mini-single payer. If everyone was in the co-op, it would be pretty much just be a single payer by a different name.


Why are the Senators from the states (5.00 / 2) (#15)
by Militarytracy on Fri Sep 18, 2009 at 01:14:56 PM EST

that have working co-ops advocating for the public option? Are they dissatisfied with the services? Or do they see a pubic option as the single best way to help all of America as quickly as possible? Has anyone gone on the record with their reasons?


: More likely they believe (none / 0) (#17)
by Radix on Fri Sep 18, 2009 at 01:39:16 PM EST

that while Co-ops, if done right, can help, they simply can't achieve the same overall, long term, benefit of Single Payer/Public Option.

: Well (none / 0) (#19)
by eric on Fri Sep 18, 2009 at 02:17:54 PM EST

co-ops are a good option, but it is just another option in our market. I think that the concern is that if you can't afford insurance, you can't afford to pay the costs of the co-op, either. While Minnesota does have the lowest percentage of people without health coverage, the number is still too high.

The good part (none / 0) (#13)
by TeresaInSnow2 on Fri Sep 18, 2009 at 12:39:38 PM EST

you mention is also the bad part. Doctors are likely rewarded for "keeping costs down," and therefore avoid having certain tests done to develop definitive diagnoses.


: At some point (none / 0) (#43)
by gyrfalcon on Fri Sep 18, 2009 at 11:52:25 PM EST

we have to trust the good sense of the docs, and the fact that they really, really would prefer to figure out what's actually wrong with their patients and how to treat it.

As much as I understand the math (5.00 / 4) (#8)
by Anne on Fri Sep 18, 2009 at 12:19:58 PM EST

on needing 60 votes, I remain troubled by the leverage that is created when Rockefeller makes it clear that they neeeeeeed the vote of an Olympia Snowe in order to get a bill.

As I see it, what is on the table is already a double gift - for the insurance industry and for the GOP - as it was designed not to promote the best policy, but to attract Republican support. And, sadly, to make sure that the spigot that controls the flow of cash from the industry to PAC's and re-election campaigns remains wide open.

We need more explanations on the legislation that are as succinct as the one Rockfeller provided, but when there are so few in the Congress who truly understand the complexities of the issue, we are not likely to get them.

Ezra doesn't know much about healthcare (5.00 / 1) (#14)
by Militarytracy on Fri Sep 18, 2009 at 12:52:23 PM EST

either. Even if he tries to write like he understands perfectly what the ungrateful, uneducated, and unwashed masses don't.

: I think (5.00 / 2) (#16)
by Ga6thDem on Fri Sep 18, 2009 at 01:22:59 PM EST

the same thing.

The Baucus Proposal (5.00 / 1) (#22)
by KeysDan on Fri Sep 18, 2009 at 02:38:16 PM EST

also brings into question how the magnitude of "savings" will be obtained so as to both sustain Medicare and to fund a major portion of the new and extended coverage for those under the age of 65. Even that good candidate for "savings" Medicare Advantage is continued, albeit with a modification in reimbursements from benchmarks to plan bids. Modifications for Part D also do not offer much either in terms of "savings", efficiencies or markedly different benefits. Yes, the donut hole is tinkered with so it is more of a croissant but that is about it. Even terminology for drugs is revelatory as to provenance. For example, generic drugs are "non-innovator" drugs. Senator Bill Nelson (D. sort of Fl) has even expressed concern that cuts in benefits are lurking in the proposal--maybe he attended a town hall in the Villages.

Excellent source to compare (5.00 / 1) (#23)
by Anne on Fri Sep 18, 2009 at 02:53:48 PM EST

proposals:

Kaiser Family Foundation.

You can compare as many or as few proposals on as many or few issues and print the results.

You can also skip all the picking and choosing and just download and print a pdf file with all the choices - 44 pages.

Thanks for the tool (5.00 / 1) (#25)
by MO Blue on Fri Sep 18, 2009 at 03:06:14 PM EST

Don't have time to do the comparison until next week but am happy that there is a resource.

Trying to keeping track of what is in each bill has been burdensome.


kaiser (none / 0) (#31)
by Dadler on Fri Sep 18, 2009 at 05:59:47 PM EST

wow, now there's a story for you. just what their healthcare "non-profit" does with its billions in actual profit, well, lets just say the mafia would be proud of such a skim job. Scratch that, scoop job.

This is not (none / 0) (#32)
by Anne on Fri Sep 18, 2009 at 06:10:17 PM EST

Kaiser Permanente, but the Family Foundation.

From their site:

The Kaiser Family Foundation is not associated with Kaiser Permanente or Kaiser Industries.

Sometimes it pays to look before you leap.


Any Foundation... (none / 0) (#34)
by MileHi Hawkeye on Fri Sep 18, 2009 at 07:35:44 PM EST

...that has Bill "Bugkiller" Frist and Cokie Roberts on their BOD deserves some skepticism.


Frist is (5.00 / 1) (#45)
by gyrfalcon on Fri Sep 18, 2009 at 11:58:48 PM EST

"cat killer" Frist. It's DeLay who's the bug killer.


: Yep... (5.00 / 1) (#48)
by MileHi Hawkeye on Sat Sep 19, 2009 at 11:08:30 AM EST

...I knew I had the wrong one right when I posted it. Hard to keep all those GOP sociopaths straight.

Well then, by all means, do not (none / 0) (#35)
by Anne on Fri Sep 18, 2009 at 07:52:05 PM EST

deign to look at the comparisons of the plans; I'm sure you would do much better reading, analyzing and collating the information on them by yourself.

I can't speak for anyone else, but I know I eagerly await the results of your efforts at that task.

Oh, and what do you know about the other members of the Board of Trustees? Or how long they serve?

Yeah, that's what I thought.


: Wow. (none / 0) (#36)
by MileHi Hawkeye on Fri Sep 18, 2009 at 07:57:36 PM EST

...a little touchy today are we?

I'm with paradox (none / 0) (#9)
by lambert on Fri Sep 18, 2009 at 12:21:21 PM EST

Massive takedown:

[...] I'm reminded again of how unruly, haphazard and zig-zag-to-face-plant this utterly ridiculous legislative process has been. Liberals and progressives get slapped from the git-go for having to give up what would really work (single payer), only to desperately swivel attention between four competing Congressional healthcare bills that absolutely must have a new vague concept (public option). Of course it all stalls and when one plan (Baucus) emerges it's instantly ridiculed from all quarters.
Please. As a loyal Democrat who's developing a nuclear bitterness at all the progress we're not making (living in California doesn't help, where we're having our own little show of meltdown) there are still firm plans, nonetheless, to remain a Democrat. But these four jockeying plans for a desperately needed healthcare solution that never makes any progress is impossible to sustain for any political party, in any country, any time and place.
Baucus is a total dud turd of a bill. Fine, let's never talk about the putz again and DOA the thing. What plan, then, with what concrete-never-to-be-compromised elements are we supposed to get behind?

"No" is easy. But what are the Dems saying yes to? Besides bailing out the insurance companies?

Didn't Krugman suggest:: (none / 0) (#18)
by ChiTownDenny on Fri Sep 18, 2009 at 01:41:46 PM EST

Public Option
"pay or play" mandate to employers
a larger budget

thus nullifying BaucauCare?


: But I asked... (none / 0) (#37)
by lambert on Fri Sep 18, 2009 at 08:01:11 PM EST

... what the Dems were for. Not what Krugman's views were.

wydens is up now at (none / 0) (#11)
by Jlvngstn on Fri Sep 18, 2009 at 12:36:52 PM EST

ezra.

Read what he said to Obama.

"at cost" (none / 0) (#12)
by lilburro on Fri Sep 18, 2009 at 12:37:20 PM EST

I don't think Obama has even laid out the rationale for the public option so reasonably.

I'm amused (none / 0) (#20)
by bocajeff on Fri Sep 18, 2009 at 02:30:04 PM EST

by the authority in which most people on this blog comment on other people's lack of understanding of health insurance yet they understand it just fine...

I admit that I (and most if not all others) have limited knowledge of these things.

The only way to get to universal coverage is to either 1) raise revenue to cover it, 2) accept a lower level of service (for those who have great plans), 3) understand that costs are going to keep going up regardless if it's government or insurance company run...

Medicare runs huge deficits, you can't get eligible people to sign up for free plans because the process is too difficult (the same bureaucrats who will still be in charge), etc...

That's why some people don't support the public option and single payer - they know when something is too good to be true - as well as knowing when they aren't being told the whole truth...

Single payer works fine (5.00 / 3) (#24)
by Dadler on Fri Sep 18, 2009 at 03:04:13 PM EST

And we have a myrdiad of examples all over the world. We have concrete examples to use, adapt, follow, whatever we need to do to make it work. But the notion that keeping an industry alive which serves no purpose but to profit by denying care as a corporate middleman, come on, it's just stupid beyond all measure. Do we hate government so much that we trust corporations more? I guess so. Of, by, and for the profit.


Ok (none / 0) (#26)
by bocajeff on Fri Sep 18, 2009 at 03:52:34 PM EST

Then why not say, "Look, we think it's best if we insure all citizens. That means that some will have to pay higher taxes, some will have to have very good but not great health care, and that there will be budget problems along the way. But this all worth it because all of us will be insured."? Instead of bending the truth in order for the above to happen.

And Dadler, do you believe Big Food should be exempt from making a profit so more people can go to bed with food in their stomachs? Supermarkets serve no other function than being the middle man between food producers and consumers. Why should they exist? I'm not being facetious - really, just let me know. More people suffer from an imbalance in food supply in this country than from no health care.


I think most of us who believe single (5.00 / 4) (#27)
by Anne on Fri Sep 18, 2009 at 04:01:59 PM EST

payer is the right policy feel that it is the best way to make sure - insure, if you will - that every American has access to health CARE. Not that everyone has their own spiffy insurance policy where some will still have gold-plated care and others will still be struggling to pay premiums and co-pays and deductible and as a result will not have actual care.

Care, not insurance, is what this should be about.

CARE.


Grocery stores (5.00 / 1) (#29)
by TeresaInSnow2 on Fri Sep 18, 2009 at 04:03:00 PM EST

consolidate food in one location.

If we all had to get our bananas from Jamaica, buy our rice from the rice vendor, our meat from a slaughterhouse, etc individually, then we couldn't afford to eat.

Grocery stores aren't a good example. Please try again


try again? (2.00 / 1) (#40)
by bocajeff on Fri Sep 18, 2009 at 09:43:33 PM EST

I'm talking about the profit, not the location.

People don't like that the insurance companies make a profit on health care. I'm saying it's interesting that hunger is a bigger problem (that leads to health care issues) but we don't talk about Big Food and their profits. I.E. Why do vegetables and fruits have profits attached to them when they are healthy for people.

Someone upthread mentioned WIC and Food Stamps but that still doesn't address the profit motive of Big Food. WIC and Food Stamps would be like S-Chip or Medicaid.

I'm speaking about profit. Young kids go to bed hungry at night which have a bad effect on their health as well as education. Why aren't we speaking about Big Food then?


: insurance companies (5.00 / 3) (#41)
by Steve M on Fri Sep 18, 2009 at 10:04:04 PM EST

do not distribute health care. hospitals distribute health care.

wic and food stamps? (none / 0) (#28)
by Jlvngstn on Fri Sep 18, 2009 at 04:02:19 PM EST

and free lunches? We have federal programs to help with food. Although we could use an expansion of those benefits right now.


Don't be silly (5.00 / 1) (#44)
by gyrfalcon on Fri Sep 18, 2009 at 11:55:52 PM EST

All that money we're currently paying private insurance companies for coverage will instead be going to taxes under a single payer system. Not only would it not mean higher cost in the end for the taxpayer, it would mean substantially less.

Next phony objection?


Doesn't sound like the same Rockefeller (none / 0) (#30)
by pluege on Fri Sep 18, 2009 at 04:43:25 PM EST

that bent over, aided and abetted, and gave the criminal bush regime every criminal endeavor they wanted as long as it was labeled 'War on Terra'

: That's because WV needs.... (5.00 / 1) (#38)
by lambert on Fri Sep 18, 2009 at 08:02:54 PM EST

... government to really work for them. Appalachia, in general, does (back to TVA days in the New Deal).
Rockefeller is responding to his constituents. I think it's that simple.

: I'm leery of Rockefeller (5.00 / 1) (#46)
by gyrfalcon on Sat Sep 19, 2009 at 12:01:08 AM EST

too, but health care has been almost as big an issue for him almost as long as it was for Teddy Kennedy, so I think this may possibly be a bit different. He's getting pretty old now, too, and may well see this as the last chance, and that maybe will stiffen his spine.
I saw him on Charlie Rose last night, and I was struck by the uncharacteristic fire in his eye on this issue. Let's hope, but I wouldn't put a single dime on Rockefeller holding fast.

Plans are way too complicated (none / 0) (#33)
by NealB on Fri Sep 18, 2009 at 07:12:31 PM EST

For a bill that's going to affect every American sooner or later, you'd think simplicity would be a priority. Whatever Obama passes, if anything, will be understood by almost no one (including by Rockefeller's report 90% of the members of Congress considering it).

When people learn what's in it, a constituency will rise very quickly to repeal it (whether Krugman or Ezra think it's better than nothing or not). Down it will go, and for all I care at this point the godforsaken Democratic Party right along with it--in flames. Just deserts.