Will The Excise Tax Kill The Health Bills?


With support for the [excise] tax eroding, Congressional leaders are searching for alternative sources of revenue. [. . . L]abor leaders have backed away from the [exise tax compromise] in the wake of the special Senate election in Massachusetts. “I do not believe there will be an excise tax enacted,” said Larry Cohen, president of the Communications Workers of America. [. . .]


A wide range of House Democrats continue to criticize the tax as bad policy, even with the changes negotiated by labor leaders and the White House. Moreover, House Democrats said, the tax is bad politics because it would set the middle class against the poor — people struggling to keep health insurance against people struggling to get it. [. . . A]s a practical matter, labor leaders said, the excise tax was killed by the election in Massachusetts, where the Republican candidate, Scott Brown, won the Senate seat long held by Edward M. Kennedy. In opinion polls and in conversations with lawmakers, Massachusetts voters expressed deep hostility to the excise tax. [. . .] Representatives Edward J. Markey and Richard E. Neal, said they were struck by the vehemence of opposition to the tax in their districts. Mr. Markey recalled that a constituent had poked him in the chest and said: “Eddie, I’ve voted for you my whole life. But if you think you will tax my benefits and give the money to Ben Nelson in Nebraska, you’re crazy.” Senator Nelson, Democrat of Nebraska, voted for the bill after it was rewritten to provide extra Medicaid money to his state.

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    gee, ya think? (5.00 / 2) (#1)
    by Capt Howdy on Tue Feb 16, 2010 at 03:39:36 PM EST
    it would set the middle class against the poor -- people struggling to keep health insurance against people struggling to get it.

    middle class v. poor (5.00 / 4) (#4)
    by lilburro on Tue Feb 16, 2010 at 04:08:01 PM EST
    pretty much what Republicans thirst for in an election.

    That's the feature part (5.00 / 1) (#29)
    by lambert on Wed Feb 17, 2010 at 12:27:33 AM EST
    Where's the bug?

    * * *

    I'd argue that the ONLY policy that doesn't set the middle class against the poor is "Everybody in, nobody out" -- single payer.


    That is absolutely hitting the nail on (none / 0) (#3)
    by MO Blue on Tue Feb 16, 2010 at 04:02:47 PM EST
    the head.

    The health insurance bill does nothing to fix the underlying problems of why our system costs 2 to 3 times more than systems in other countries. What it does is take away benefits from a large segment of people with coverage to give overpriced insurance that may or may not provide actual health care to others.

    A lot has been said about selfish seniors, most who have paid into the Medicare systems since its inception. Yet both Democrats and Republicans have said that Medicare is an unsustainable entitlement program which needs to be modified or eliminated at the same time that they are establishing another unsustainable entitlement program for other segments of the population.


    Three unsustainable entitlement programs... (5.00 / 1) (#30)
    by lambert on Wed Feb 17, 2010 at 12:29:04 AM EST
    ... that go unmentioned:

    1. The empire

    2. Bailing out the banksters

    3. The rich going untaxed

    A few trillions to be had there, I'd say

    Key Cost of Medicare (none / 0) (#25)
    by BackFromOhio on Tue Feb 16, 2010 at 09:02:37 PM EST
    is it not substantial fraud, with admin after admin refusing to put major funding behind prosecuting the fraudsters?  So I've read....

    No (5.00 / 1) (#27)
    by gyrfalcon on Tue Feb 16, 2010 at 09:35:18 PM EST
    That's an anti-Medicare GOP talking point.  There is some fraud in Medicare, as there is with everything, although nowhere near the extent of Medicaid in the various states, but I think if you Google for reasonably objective sources of info, you'll find it's not anything close to a "key cost" nor "substantial fraud."  And that's more likely to be the reason nobody's wanted to put a great deal of time and money into investigating and prosecuting it.

    Now there's an idea every plutocrat could love (none / 0) (#15)
    by pluege on Tue Feb 16, 2010 at 07:58:25 PM EST
    Oh Wait!

    The idea of a new tax on (5.00 / 2) (#2)
    by ruffian on Tue Feb 16, 2010 at 03:51:49 PM EST
    health benefits to provide health benefits is just an automatic 'no' to even people like me who would support raising income tax rates progressively.  I know the proponents of the excise tax have complicated reasons why they think it is fair and would lower costs, etc, and maybe they are even right, but those reasons can't be explained clearly and convincingly to the average person.

    Maybe someone has done an analysis on how much they would have to raise the tax rate on the top 3% to provide the same amount of income as they would get from the excise tax. Let people compare it that way and I bet they would prefer the tax rate raise as a fairer way to go.

    Eddie, I've voted for you, etc. (5.00 / 1) (#5)
    by oculus on Tue Feb 16, 2010 at 04:55:58 PM EST
    Sums it up nicely.

    P.S.  I must saw it is sooooo much easier to read and comment on Talk Left on a lap top as opposed to on my Blackberry!

    Somehow "if you like your plan you'll get to (5.00 / 6) (#6)
    by esmense on Tue Feb 16, 2010 at 05:45:03 PM EST
    keep it" changed to "if you like your plan we're going to tax it because too-good health insurance is what's most wrong with the system (and most needs to be "reformed")."

    Over at orange it got really (5.00 / 5) (#7)
    by inclusiveheart on Tue Feb 16, 2010 at 06:55:36 PM EST
    interesting when the proponents of the excise tax started arguing that the problem with the American healthcare system stemmed from Americans having "too much" healthcare.  That is when they really jumped the shark - the highest and most ridiculous jump that I witnessed anyway.

    Funny how we had a healthcare crisis that we were responding to that all of a sudden became a crisis of "too much" care and these very same people are now invoking the tens of thousands of unnecessary deaths that can be attributed to lack of healthcare.

    The real irony is that theirs is the most Soviet "solution" to the problem of them all - complete with the inherent corruption and ridiculous inequity driven by political rather than practical concerns - except that they are intent on protecting the "royal" families and other wealthy elites from taxation - which makes it even weirder and, frankly, stunningly inane on almost every level.


    If they can't figure out a better way to explain (5.00 / 2) (#10)
    by ruffian on Tue Feb 16, 2010 at 07:31:36 PM EST
    it than by telling people they have too much healthcare, they are not going to win over very many people. Exhibit A of a horrible talking point.

    It is a divide and conquer tactic. (5.00 / 1) (#24)
    by inclusiveheart on Tue Feb 16, 2010 at 09:01:55 PM EST
    By making people believe that they could have better if their neighbor wasn't taking "too much" they think that they can get a bill like the one coming out of the Senate passed.

    Luckily, as this excerpt BTD has posted points out, some Democrats have finally caught onto how they were being played through really bad policy.


    Just think (5.00 / 1) (#34)
    by cal1942 on Wed Feb 17, 2010 at 02:22:10 AM EST
    of the mentality that required an embarrassing election loss to understand that the excise was ugly policy.

    It took people outside the Village no time at all to understand that the excise is horrible policy.

    Our ruling Village is indeed walled off in its own little universe.

    That's a sign of real decline.


    Good for the people then (none / 0) (#44)
    by ruffian on Wed Feb 17, 2010 at 09:11:47 AM EST
    that they were not divided on this one point. Everyone hates this idea.

    Yeah, the video of the woman (none / 0) (#11)
    by observed on Tue Feb 16, 2010 at 07:35:59 PM EST
    dying on the floor of an ER because she didn't have insurance sure showed how pampered Americans are.

    There's a kernel of truth in that (none / 0) (#9)
    by observed on Tue Feb 16, 2010 at 07:16:33 PM EST
    argument, in that overutilization of medical resources is a significant factor in total medical spending; however, that doesn't mean that sticking it to the low guy  on the totem pole---the middle class guy with good insurance---is the  only possible answer!

    No there really is no kernel of (5.00 / 4) (#12)
    by inclusiveheart on Tue Feb 16, 2010 at 07:44:48 PM EST
    truth to that myth.  The reality is that we have an elite system of healthcare that is not only concentrated amongst the wealthiest Americans, but also has overall poorer outcomes than other western nations that have national health plans.  It makes sense that we would have poorer outcomes if we are not saving people who can be saved purely on the basis of their financial position in this country.  It isn't that rich people get "too much".  It is that all people aren't getting a chance on the basis of their potential to survive or simply heal quickly.  This issue isn't unlike education in the sense that if you offer the broadest possible population of students the opportunity to succeed, you have a greater chance of creating a highly educated population.  If you limit good education only to the wealthiest population, the odds are that you will miss out on cultivating and utilizing brain power that is out there, but unable to pay to be groomed for success.

    An additional deficit created by our current system is actually in the area of research and development of therapies.  If we open up healthcare to more people, we are more likely to make better and greater advances in the science.  If we limit the access to healthcare only to people can afford it, we are at a huge disadvantage when dealing with public health crises like pandemic flu as well.  I am a single-payer proponent and I think everyone should pay the same basic rate for the same basic care (adjusted for income, of course).  That is the only way that I think we can really overcome most of the critical issues from cost, access to quality per dollar spent.


    You are very kind (5.00 / 1) (#20)
    by Militarytracy on Tue Feb 16, 2010 at 08:31:19 PM EST
    and considerate.  I for the most part have to walk away from even imbibing the digital verbage of such a bunch of psycho ignorant kool aid swilling gentle on Obama while suckling his Clenis whack jobs.

    A good enough portion of those (5.00 / 1) (#23)
    by inclusiveheart on Tue Feb 16, 2010 at 08:59:27 PM EST
    people are paid activists over there these days so that it is difficult for me to walk away from them when they are spreading such lies and misinformation about the problems we face.

    That was what I was suspecting (none / 0) (#48)
    by Militarytracy on Wed Feb 17, 2010 at 10:16:32 AM EST
    was going on.  No proof though other than there is an organized attack of anyone criticizing the President in any sort of successful way over something he deserved criticism for.  I suspect a few blogs are bought off now too.

    we're talking about different things (none / 0) (#13)
    by observed on Tue Feb 16, 2010 at 07:53:28 PM EST
    the idea behind the excise tax is that it would cut down on the wasteful spending which everyone agrees occurs. The horrible thing is that there is so much waste, and yet so many people without care.

    I'm talking about too many (none / 0) (#14)
    by observed on Tue Feb 16, 2010 at 07:56:35 PM EST
    medical tests and too much of certain kinds of major surgery.

    You're talking about a tiny fraction (5.00 / 2) (#16)
    by inclusiveheart on Tue Feb 16, 2010 at 08:02:22 PM EST
    of the population that has both the financial access and the compulsion to see a doctor when the slightest thing goes wrong.  Besides, testing would be more targeted in part if patients and doctors were able to build long-term relationships which is impossible under out employer-based system.

    I'm talking about a large dollar (none / 0) (#17)
    by observed on Tue Feb 16, 2010 at 08:06:58 PM EST
    amount---a sizeable fraction of total medical costs.
    Anyway, I agree with you, and the way the excise tax has been sold almost seems designed to create class resentment between different segments of the non-rich population.

    Max Baucus is no spring chicken. (5.00 / 0) (#19)
    by inclusiveheart on Tue Feb 16, 2010 at 08:30:42 PM EST
    He knows a good poison pill when he sees one.  He never ran this process to create hcr, he was there as a gatekeeper either to kill or maim the efforts to reform that would hurt the insurance providers.

    What is too much, though? (5.00 / 5) (#21)
    by Anne on Tue Feb 16, 2010 at 08:43:25 PM EST
    My husband has his insurance through the VA; he's a Vietnam vet who developed Type 2 diabetes, and found out that because it may have been related to exposure to Agent Orange, he is fully covered; he pays nothing for the coverage and also receives a small disability payment.  

    The VA - at least the one here in Baltimore - has really impressed both of us; when my husband told them he was concerned about his cardiac health after his younger brother underwent quintuple bypass surgery, he got a thallium stress test, and an echocardiogram.  Is that excessive, considering that family history may be indicative of higher risk?  We didn't think so, and it's pretty reassuring to know that my husband's heart is in excellent condition.  

    Does he see the doctor more now that he has "free" coverage?  No, because he never liked going to the doctor in the first place.  But when he got what he thought might be shingles on his forehead last year, he not only got an immediate appointment, but he was seen by the ophthamologist to make sure there was no eye involvement, and got an anti-viral and pain medication the same day.

    I don't know if I can adequately express the feeling of knowing that no matter what is wrong with you, it isn't going to break you financially, that you don't have to agonize over whether you should or shouldn't at least make the phone call to talk to someone about your situation.

    Everyone should feel that way; health should not be something that has people lying in bed at night, unable to sleep because they are afraid of the cost.


    Oh, i agree, and actually I have (5.00 / 1) (#22)
    by observed on Tue Feb 16, 2010 at 08:51:10 PM EST
    not seen anyone show the  link between having great insurance coverage and excessive testing or procedures.
    I agree with you that people who have good insurance are not itching to go to the doc just because they can!

    I'm grateful that those (none / 0) (#52)
    by Militarytracy on Wed Feb 17, 2010 at 01:49:52 PM EST
    exposed to agent orange have begun to receive what they always should have long ago.  During the Sheehan protest I met a Vet who came because he said that finally he could do something like that, the problems that he was having were finally recognized as due to agent orange exposure and they began to pay him a bit in disability. My Uncle always feared what was going to creep up on him.  He said they used to sleep on the bags sometimes after coming back in from an exhausting recon.  Sometimes they were wet too and smelled funny but they didn't think they could actually be killing themselves doing that.

    Not buying it, sorry (5.00 / 5) (#28)
    by gyrfalcon on Tue Feb 16, 2010 at 09:42:15 PM EST
    It's beyond me how one "overutilizes" health care.

    Consulting a medical professional when there's something wrong with you and you're NOT competent to diagnose or treat it yourself is the way health care is supposed to work.  It's not a flaw, it's how you prevent disease and lousy, expensive outcomes.


    Agreed. The French pay half what we do... (5.00 / 1) (#31)
    by lambert on Wed Feb 17, 2010 at 12:33:26 AM EST
    ... and live two years longer on average, and that's after the smoking, the butter, the cream, the eggs, the wine.

    In 2007, per capita health costs were:

    United States: $7290
    France: $3601

    First, put a rational system in place -- single payer, if you're a centrist, or socialized medicine, if you're on the left -- and then worry about optimizing care.


    Your numbers sort of establish my (none / 0) (#37)
    by observed on Wed Feb 17, 2010 at 06:22:11 AM EST
    point: Our per capita spending is twice as high, and there are 50 million who aren't even covered in this average. That means the actual per patient amount is more than twice as much.
    We spend WAY too much on some patients, but without improving the outcome.
    The fact that the overall mortality figures are not better than Europe tends to support the idea that the extra spending is not improving care.
    Again, I'm not in favor of the excise tax, but insurance costs are rising in part because costs are soaring. Costs have to be brought under control, somehow.

    Most extra spending... (5.00 / 1) (#39)
    by lambert on Wed Feb 17, 2010 at 08:02:57 AM EST
    ... is because the health insurance companies are involved: Adminstrative overhead, CEO salaries, and profit eats  up thirty cents on every dollar in this country.

    Every country that's doing better than we are (again, half the per capita cost, better outcomes) has eliminated the insurance companies from the equation. Which makes sense, since they add no value whatever.


    How much of the cost (none / 0) (#47)
    by BTAL on Wed Feb 17, 2010 at 09:57:33 AM EST
    differences often quoted here are attributable to Dr. and specialist's compensation?

    Some quick research shows that the Europeans pay is ~1/3 less than their US counterparts.

    For any given procedure, how many professionals are involved in the complete transaction?  What is the exponential cost "tail" to the system?


    Maybe I used the wrong word, (none / 0) (#35)
    by observed on Wed Feb 17, 2010 at 06:10:13 AM EST
    but there is no argument from anyone who writes on health care that many expensive tests and operations are overdone.
    How much someone goes to the doctor  is a factor so small its' not worth mentioning.
    What is important, according to many articles I"ve read, is arbitrary regional variation in medical practice.

    has some basic information and more links.

    Here's snippet:
    " Patients in high-cost regions have access to the same technology as those in low-cost regions, and those in low-cost regions are not deprived of needed care. On the contrary, the researchers note that care is often better in low-cost areas. The authors argue that the differences in growth are largely due to discretionary decisions by physicians that are influenced by the local availability of hospital beds, imaging centers and other resources-and a payment system that rewards growth and higher utilization."
    Not clear to me at ALL what "Cadillac" plans have to do with this problem.
    The link I provided also discusses Medicare reimbursement regional variations.

    A couple of examples of costly procedures which are overused in some regions: caesarians and heart catheterizations.


    Numbers, please (none / 0) (#40)
    by lambert on Wed Feb 17, 2010 at 08:03:35 AM EST
    This "too much care" argument does need to be quantified, right?

    Let's not kid ourselves that unnecessary (none / 0) (#43)
    by Anne on Wed Feb 17, 2010 at 08:57:40 AM EST
    procedures don't happen; they do, and it seems like the main reason is the most obvious one: money.  

    We have recently learned that a doctor at a local hospital, that has always had a stellar reputation for cardiac care, was implanting stents in people who didn't really need them; these people were told they had serious blockages when, in fact, they were as little as 10%.

    Was this out of an abundance of caution, concern for the patients, conservative medical practices?  No, it does not appear to be so.  It looks like this was all about having to make a ton of money in order to justify the expense of this division of the hospital.

    We have a lot of health care providers in this area; the choices available to us are abundant, but the competition for patient dollars is intense.

    So, yes, there are unnecessary procedures and tests, but it isn't because Joe and Jane Public are spending their days asking for these things, it's because the more of these Joe's and Jane's doctors send and subject them to, the more they can bill the insurance companies - including Medicare - the better their usage statistics look, the easier it is to justify expensive departments, equipment and salaries.

    What effect would single-payer have on this kind of situation?  I mean, if they're doing this to Medicare patients, I'm pretty sure they can do it to Medicare For All patients, too.  And how do I, as the patient, trust that I'm not being advised to get a stent I don't need - second opinions?

    It is a problem, that isn't being driven by patient demand; ultimately, unnecessary and arbitrary rationiong will be as harmful to the patient as allowing docs to do unnecessry procedures for financial, and not medical, reasons.  Do we accept the expense of these procedures in much the same way as we accept that in our system of justice, as a result of the protections afforded to all of us, sometimes the guilty go free?


    To double reclarify: patients (none / 0) (#36)
    by observed on Wed Feb 17, 2010 at 06:18:42 AM EST
    don't overutilize--doctors do.
    That's a fact. The theory is that Cadillac plans lead to doctors' choosing too many tests and procedures for patients. This could be true, although I haven't seen the link established.
    It certainly doesn't mean you have to hurt middle class people who are happy with their insurance.

    I'm not at all sure this is a function (5.00 / 1) (#49)
    by Anne on Wed Feb 17, 2010 at 10:26:11 AM EST
    of Cadillac plans - see my comment above - as much as it is a function of the bottom line - the providers' bottom line.

    Off the top of my head, here are the hospitals located within the Baltimore Metropolitan area:

    Johns Hopkins
    University of Maryland
    St. Agnes
    Franklin Square
    Greater Baltimore Medical Center
    St. Joseph
    Union Memorial
    Upper Chesapeake
    Carroll County General
    Baltimore Washington Medical

    I may have missed a couple, but you get the idea.  All of these hospitals, all with the latest technology, almost all of which have added beds, added a panoply of "specialty" centers - orthopaedic, heart, cancer, digestive disease, women's health, and so on - are all competing for the same patients.  The advertising is everywhere: TV, newsletters, seminars, lectures, free screenings - all designed to get you to go to their hospital.  They brag about their digital this and their minimally invasive that - it's like drug advertising, only worse.  The overhead is huge, and the only way to make money is to see as many paying patients as possible.

    Last week, my mother had some sort of episode - she started shaking as she was making her coffee, and she pulled the emergency cord in the apartment she lives at the retirement community.  Her blood pressure was through the roof, and because she has a history of stroke and TIA, the doctor on call wanted her taken to the hospital.

    Within a 24-hour period, she had the standard blood and urine labs, plus an EKG, a CT scan, an MRI, a Doppler of her carotid arteries and an echocardiogram.  Some of this she had in the ER, and some after she was admitted to the neurology unit.  She had a heart monitor, the automatic compression gear for her legs and an IV.

    She's on Medicare, with supplemental BC/BS.  

    Am I glad to know she's fine?  Of course.  Was all of it "necessary?"  Maybe, with her history, it was - who am I to judge?

    My point is that while some of this is a function of not wanting to be sued, and some of it is a function of needing to make money, and some of it is a function of standard of care, the patient is not the one driving the bus.  This is still going to be true even if we have a single-payer system, if my mother's experience is any indication.


    I agree with your comment completely (none / 0) (#51)
    by observed on Wed Feb 17, 2010 at 10:34:18 AM EST
    So, we should cut back on health care... (none / 0) (#41)
    by lambert on Wed Feb 17, 2010 at 08:04:38 AM EST
    ... based on a theory?

    Why not look at the evidence of the success of other countries, and do what they do?


    Look, you're not reading (none / 0) (#42)
    by observed on Wed Feb 17, 2010 at 08:24:22 AM EST
    what I'm writing!
    Its' not a theory that there is overuse of some tests and procedure---it's a fact that all experts agree on. Furthermore, when patients get too many tests and procedures, they are NOT getting good health care; in fact, their mortality rates increase.
    That said, I'm all in favor of socialized medicine, personally.

    I've never seen (none / 0) (#46)
    by gyrfalcon on Wed Feb 17, 2010 at 09:38:50 AM EST
    maybe you have and can point me to it, a detailed analysis, point by point, of why, say, France (or pick a country) spends so much less per capita on health care.  I've never seen anything more than guesses and assumptions.

    The over-surgicalization, so to speak, of women's reproductive health problems in this country is notorious, but that's gradually declining and can't account for more than a small portion of it.

    Do our docs really do vastly more tests than French docs do, for instance?

    What part of that expense is a result of the fact that we pay physicians, particularly specialists, a great deal more money than other countries?

    What part of it is a result of our system having degraded general practitioners/internists to the status of the school nurse, with superficial 15-minute appointments and referral to a specialist for anything more serious than a hangnail?

    And something I've never seen addressed even once, how about the effect of pharmaceutical advertising, which convinces people they have all kinds of odd illnesses and conditions, drives them to their doctors and requires a fair amount of testing to prove they really don't?

    What part of it is the result of the chaos that prevails at many of our big urban teaching hospitals, where each patient is attended to by a literal horde of interns, residents, attendings, specialists, nurses and technicians in training, etc., to the point where nobody has a coherent overal picture of the patient's condition and status?  (My mother once spent 11 days instead of the normal 3 for a routine procedure in a major, famous Boston hospital renowned for its credo of "patient-centered care" as a result of multiple minor screw-ups and lapses, and then required 2 months in a rehab facility just to get back on her feet.)

    The vast majority of these additional costs, as far as I can tell, are a result of U.S. medical culture itself and the pernicious structure of our health care "system" and can't be dealt with without addressing those core issues.


    Here's a quick line (none / 0) (#53)
    by lambert on Wed Feb 17, 2010 at 03:23:56 PM EST
    Overview: Thirty cents of every health care dollar goes to insurance companies in profits, administrative overhead (that is, the denial of care) and profit. As Anthony Weiner has asked: What value do the insurance companies bring to the transaction? And there's no answer.

    So, from the pragmatic perspective, I regard the focus on "too much care" as (a) a diversion from the central problem, which is health care for profit, and (b) dangerous, because in a system of health care for profit, it won't be unneeded care that is cut, but unprofitable care.

    * * *

    As far as why is France doing so much better, I would presume it's because they have different incentive structures than we do, right?

    NOTE "The vast majority of these additional costs"... Evidence?


    Link, not line, which I forgot (none / 0) (#54)
    by lambert on Wed Feb 17, 2010 at 03:27:21 PM EST
    One quick answer is price controls. The government sets most hospital fees.

    Do you think..? (none / 0) (#45)
    by jbindc on Wed Feb 17, 2010 at 09:28:50 AM EST
    That some of that is also, as we are told, that some doctors are afraid to be sued, so they order unnecessary tests for CYA purposes?

    I know when I was in law school, one of my doctors jokingly told me he wouldn't treat me anymore if I decided to practice medical malpractice.  I've heard of other doctors tell their lawyer patients that, but they weren't kidding.


    There's an article in today's (none / 0) (#50)
    by observed on Wed Feb 17, 2010 at 10:33:49 AM EST
    NYtimes which answers this very question.
    According to a study in Florida, CYA medicine MIGHT be 5% of costs. The expert interviewed in the article was skeptical, saying 2.5 % is more likely. Also, it's not clear that what doctors consider CYA practice is bad medicine.

    Sure, "some" (none / 0) (#55)
    by lambert on Wed Feb 17, 2010 at 03:29:43 PM EST
    But it's also a winger talking point pushed to screw the trial lawyers. So I take it with a grain of salt.

    The number to watch is the 30 cents of every health care dollar that goes to health insurance companies for administrative costs (ie, denial of care), CEO salaries and bonuses, and profit. And not one single penny of the 30 cents adds values. All this other stuff is tinkering around the edges which is why, of course, Versailles likes to talk about that and not the central problem.


    So, what will get thru to Obama and ConservaDems (5.00 / 2) (#8)
    by jawbone on Tue Feb 16, 2010 at 06:59:21 PM EST
    to make them understand that the only system which saves money and covers health CARE for all is single payer?

    Medicare for All...with a robust private option.

    Oh, yeah ---  it's hard to make someone understand something when his job depends on not understanding it.  Or his donations and support from corporations and other top money makers depend on this not "understanding" it....

    How can we get them to listen to us? The MCM will amplify the rantings of Tea Partyers (well, as long as they tend to sound conservative, right?).

    IIRC, albeit I was off line pretty much due to the death of my PC, the physicians who made a cross country auto trip to DC, with stops in many large cities, got very little coverage.  Their message didn't fit with the Corporatist president's message or with that of the BHIPpers (Big Health Industry Players).

    Millions in the streets? We lefties know that when we go to march or protest, we just get ignored or ridiculed.

    Tea Partyers? Not so much.

    They got good local coverage (5.00 / 1) (#32)
    by lambert on Wed Feb 17, 2010 at 12:35:01 AM EST
    (I subscribed to a news feed on the Mad as Hell Doctors) but no coverage from Versailles. I firmly believe that it's local, local, local, local efforts that have kept single payer alive to this day, and will win. It's a movement, not part of the 11 dimensional chess game.

    leave it to obama and the vichy dems (none / 0) (#18)
    by pluege on Tue Feb 16, 2010 at 08:07:53 PM EST
    to come up with exactly the wrong solution to the problem. Of all the problems and all the possible solutions, they do exactly the wrong thing - every time - its as assured as death and taxes.

    And don't be expecting nuttin from the big bipartisan HCR show. With obama starting with a pre-compromised crappy republican bill, it can only get crappier...just another opportunity for obama to suck punch progressives, get them soiled with his resurgent republicanism topped off with an obligatory kiss of his ring.

    Public Option (none / 0) (#26)
    by WS on Tue Feb 16, 2010 at 09:14:44 PM EST
    is a cost saver.  Use that instead as the solution or part of the solution.  

    No, public option is NOT a cost saver (none / 0) (#33)
    by lambert on Wed Feb 17, 2010 at 12:35:54 AM EST
    The CBO estimates 6 million enrollees. That's not enough to put pressure on the insurance companies to keep costs down.

    The excise tax (none / 0) (#38)
    by Abdul Abulbul Amir on Wed Feb 17, 2010 at 07:39:25 AM EST

    The excise tax is only  the excuse of the moment.  The reason neither bill will pass is that they are underwater by double digits.  That and most members of Congress don't want to be booted out of office this November.

    If it wasn't the excise tax it would be the Medicare cuts, if not the Medicare cuts, then something else, etc., etc.