This isn't just about getting the uninsured a brand-spanking new insurance policy with a little coupon book for their monthly premium payments; it isn't even just about capturing those who currently make too much to qualify for their state's Medicaid program.  

It's really about all of us being captive to an industry whose focus is not on care, but on making money - that's what businesses do, and just because this is the people's health - physical, mental and financial - that is at stake matters not one whit.

You are absolutely right that we should be providing relief to the poorest among us, but the state of health care and health insurance is such that any one of us - unless we are multi-millionaires - could be among the poorest with one serious illness or accident - even though we have insurance, have a good job, have some money in the bank.  And it is that essential reality that dictates that we have to truly reform the system.  As soon as you make provisions for those at the bottom of the pile, there will be a new bottom - and the people in it will be just as deserving as the people who came before them.

Marcy Wheeler has a couple of posts that take the Baucus plan apart in ways that Ezra hasn't; the reality of the numbers in the Baucus plan are eye-poppingly ridiculous, to the point where I wonder what planet he lives on. Oh, yeah - planet DC.

Is it possible to triage the system, such that it can be fixed in stages?  Maybe, but I don't know that anyone in Congress or the White House has really taken the system apart to the extent that those stages could be identified and planned for.

Sure, I would be happy to see 10 million people who need help getting that help, but it has not been shown to me that the help will come in the form of actual care.

Or for hourly wage earners whose hours may flucuate seasonally, from month to month, or even from week to week?

How about those who work on commission?

All of the above are the very people who need some better, more affordable insurance options than those that are readily available now.

Will they find they have coverage one month, or one quarter, but earn too much to qualify for coverage the next? What will that mean for their ability to secure consistent medical care? And what happens if their earnings for a particular time period do, in retrospect, turn out to exceed the limits for that time period? Will they have to repay their "benefit?" Perhaps having to repay an "undeserved" benefit from a slightly more prosperous month or quarter out of funds earned in a much lower earning month or quarter?

How much time and energy will they have to devote to determining or proving they qualify for a subsidy? To trying to ensure continuous coverage, etc?

Subsidies are great for the insurance companies -- but for many of the working poor, small business owners and their employees, the self-employed, commissioned workers, young workers who work less than full time while acquiring training and education, etc., they are a much less than efficient solution. One that many, unless coerced, may decide is more pain than gain in the long run.

Furthermore, considering the extremely high cost of individual insurance -- even high deductible insurance -- in many parts of the country, will these subsidies really be generous enough to make such insurance affordable?

Count me as extremely skeptical about subsidies.

If it weren't for the fact that we're all petrified that we're going to get hit with unexpected medical events and end up in bankruptcy, most of us could probably afford to pay to see the doctor for the occasional sore throat, or UTI or sinus infection - and the heck with the parasitical insurance companies.  And the doctor could collect his or her fee knowing it was purely fee-for-service and didn't have to be artificially inflated so he could pay the insurance-processing staff, or so that the reimbursement he got from the insurance company would have some basis in reality.  Silly analogy, but when my kids were in school and would come home with all these fundraisers that involved selling pizza or cookie dough or gift wrap, I would just write a check to the school for $50 because I didn't need pizza or cookie dough (gift wrap I always bought!), and that way all of my contribution went to whatever they were raising money for, and didn't first have to go for the cost of the product that was being sold.

So, where is all the "extra" money going?  To the same people and the same entities that are going to benefit from whatever reform gets passed.

And this is how one ends up realizing that as long as there is this middle-man - insurance companies - that stands between us and those who deliver health care, it is ALWAYS going to cost more - a lot more - than it would if we had a way to eliminate that impediment and facilitate the access and delivery of care.

If you want universal health care (or as close as we can get), get behind the public plan.  It seems pretty simple now.  

I agree, no mandates without a public option, but then we're essentially left creating a benefit for the poor. Which is both noble and useful, but not popular enough in our broken political system.

By demanding comprehensive reform, the President has raised the stakes, perhaps too high. The liberal intractability on the public option is completely understandable. If this is "the moment" for health care reform, then it is imperative that they get their key policy goals accomplished. If that doesn't happen now, they cannot expect that to happen anytime soon (if ever). But what they require is simply too much for moderate Democrats, especially those in McCain- and Bush-voting districts. [ed-This is where the President's political efforts will have failed.] If the President scaled back his ambitions, the final bill would not be as far to the left as the liberals like, but since it is not comprehensive they could at least plan to fight for the public option another day. Then, Obama could pick up enough moderates to pass it, and he could declare victory.