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Will The Exchanges Become Like Medicare?

By Big Tent Democrat, Section Other Politics
Posted on Wed Mar 17, 2010 at 08:57:52 AM EST
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Ezra Klein writes:

For some time, I've been trying to find good polling from the passage of Medicare. According to Greg Sargent, though, the Democrats beat me to it [. . .] I wonder how many of the legislators who took the tough vote to move Medicare forward regret doing that today.

The problem with this analogy for me is this - where is the Medicare-like program in the health bills? Klein loves the exchanges - I venture to say that for him it was the one dealbreaker in the health bills. Klein imagines a future where employer-based health insurance is replaced by individual health insurance policies sold through the exchanges the current proposals set up. I do not think much of this reform approach and do not see it as the Medicare-like proposal that will become unassailable decades from now. In the end, when it comes to the "reform" that is being proposed, what you think about the exchanges will determine whether you believe this is "historic" legislation akin to Medicare. I don't think it is and I do not think this is "historic" legislation.

Speaking for me only

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    Will The Exchanges Become Like Medicare? | 119 comments (119 topical)

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    I saw Klein (5.00 / 1) (#2)
    by Capt Howdy on Wed Mar 17, 2010 at 09:05:21 AM EST
    on the tube last night and I thought he said an insightful thing.
    he said the democrats in tough districts should not be saying this was a terrible bill and the 11 page add on makes it something I will vote for.
    they should be saying that this is an important first step and we will be revisiting it every year until it is a healthcare system we can be proud of.

    that seems a much better argument to me.
    not surprisingly he also talked about the exchanges and about they could be improved over time.  I am not smart enough to have an opinion about that but I do believe it is an important and "historic" first step.
    the first step is a killer, as they say.

    The (5.00 / 4) (#3)
    by Ga6thDem on Wed Mar 17, 2010 at 09:13:12 AM EST
    only people taht would think that buying individual insurance thorugh exchanges is a great idea are people who've never had to purchase individual insurance. I pay for my own insurance and I see nothing of value coming to me from the insurance exchanges.

    the idea, (none / 0) (#4)
    by Capt Howdy on Wed Mar 17, 2010 at 09:17:22 AM EST
    or the hope perhaps, is that exchanges of millions of people will be more effective at bargaining that yours which is probably thousands at most.


    Parent
    What's the cost of the exchange? (5.00 / 1) (#22)
    by dead dancer on Wed Mar 17, 2010 at 09:42:18 AM EST
    So now you have an exchange that deals directly with millions of people. Is there a cost associated with this service? How much; and wouldn't that cost just be past on to the consumer? I don't see much cost control, or reduction happening.


    Parent
    I would (none / 0) (#23)
    by Capt Howdy on Wed Mar 17, 2010 at 09:44:45 AM EST
    agree with you.  I expect this is one of several thing that will be revisited.

    Parent
    Who runs the exchanges, and does (none / 0) (#26)
    by observed on Wed Mar 17, 2010 at 09:47:56 AM EST
    anything prevent insurance companies themselves from operating them?


    Parent
    Medicare (5.00 / 1) (#27)
    by waldenpond on Wed Mar 17, 2010 at 09:48:06 AM EST
    Good.  Now you and Klein can jump on the Paul Ryan 'Kill Medicare!' bandwagon.  After all, having two different models create inefficiencies (cost) in the market.  Vouchers for you!  Vouchers for me! Put Seniors in the market free!

    Vouchers for Everyone!!!!!

    Next up... more Republican job creation tax cuts like the bill just passed and the privatization of Social Security.  You and Klein need to keep that consistency going and take the private market approach to Social Security.  It's easily solved with a voucher system.

    You and Klein think the private free market approach with vouchers is the way to go.  You think a model making the Medicare model is superior.  Some of us disagree.

    Parent

    Models (none / 0) (#31)
    by waldenpond on Wed Mar 17, 2010 at 09:50:52 AM EST
    That last sentence was jibberish.  ha.

    You think a private free market system (vouchers in an exchange) is superior to a Medicare model.

    Again, you don't get both models because of the inefficiencies.

    Parent

    Nope (5.00 / 2) (#28)
    by Ga6thDem on Wed Mar 17, 2010 at 09:48:32 AM EST
    it's just more or less collecting in one place what we have right now.

    These aren't going to work because they aren't going to be regulated the way it needs to be done.

    Parent

    "Hope" (none / 0) (#11)
    by jbindc on Wed Mar 17, 2010 at 09:31:49 AM EST
    Hasn't really turned out to be a good deal, though, has it?

    Parent
    forgetting hope (none / 0) (#14)
    by Capt Howdy on Wed Mar 17, 2010 at 09:33:03 AM EST
    its a logical assumption

    Parent
    The insurance will not be cheaper (none / 0) (#99)
    by MO Blue on Wed Mar 17, 2010 at 11:38:10 AM EST
    taxpayers will just absorb the cost for more people.

    Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time. But don't look for a rollback. Instead, the main reason premiums would be more affordable is that new government tax credits would help millions of people who can't afford the cost now.
    ...
    The budget office concluded that premiums for people buying their own coverage would go up by an average of 10 percent to 13 percent, compared with the levels they'd reach without the legislation. That's mainly because policies in the individual insurance market would provide more comprehensive benefits than they do today.

    For most households, those added costs would be more than offset by the tax credits provided under the bill, and they would pay significantly less than they have to now. However, the budget office estimated that about 4 in 10 customers shopping for an individual policy would not be eligible for tax credits -- and would face higher premiums on average than without the legislation.

    The premium reduction of 14 percent to 20 percent that Obama often cites would apply only to a portion of the people buying coverage on their own -- those who want to keep the skimpier kinds of policies available today. link



    Parent
    that makes sense (none / 0) (#100)
    by CST on Wed Mar 17, 2010 at 11:44:42 AM EST
    If you keep your cr@ppy insurance, your premiums go down.  If you switch from cr@ppy insurance to good insurance and qualify for a credit, your premiums go down.  If you switch from cr@ppy insurance to good insurance and don't qualify for a credit, your premiums go up.


    Parent
    So, there (none / 0) (#103)
    by Inspector Gadget on Wed Mar 17, 2010 at 12:06:14 PM EST
    are price controls in the bill to keep the insurance companies from raising rates whenever they want?

    Parent
    I have no idea (none / 0) (#105)
    by CST on Wed Mar 17, 2010 at 12:10:11 PM EST
    I was just paraphrasing what that article said about premiums.

    Parent
    I thought (none / 0) (#107)
    by jbindc on Wed Mar 17, 2010 at 12:17:43 PM EST
    you've said you've read the bill?

    Parent
    Oh, jb - I think you are meant to (2.00 / 1) (#110)
    by Anne on Wed Mar 17, 2010 at 12:29:25 PM EST
    just go look at the website!

    [Now, why does that sound so familiar?]

    Meaning no disrespect to CST, it's just that that's how her answer struck me...

    Parent

    hah! (none / 0) (#108)
    by CST on Wed Mar 17, 2010 at 12:20:47 PM EST
    are you kidding me?  That's crazy talk, it's super long and super boring.  I have said on numerous times that the info people are looking for is in the bill.  And I have read numerous summaries, and a few sections.  But no, I don't have THAT much time to kill.

    Parent
    Actually, it's not (none / 0) (#111)
    by Inspector Gadget on Wed Mar 17, 2010 at 12:32:55 PM EST
    Big print, probably an average of 150 words per page.

    It's not boring. It is going to control your budget and health for a long time to come. Should be a page-turner for everyone.


    Parent

    If anything, I think there was a concerted (5.00 / 5) (#6)
    by Anne on Wed Mar 17, 2010 at 09:25:26 AM EST
    effort to stay as far away from Medicare as possible while designing the exchanges, lest the people get any ideas like, "hey - this is kind of like Medicare - wonder why they didn't just do something really historic, save a gazillion dollars on building something new and just open up Medicare???"

    I would actually be more worried that Medicare could become like the exchanges...since I am firmly convinced that Medicare and Social Security are the next targets for "reform."  

    Yup. (5.00 / 2) (#85)
    by Dr Molly on Wed Mar 17, 2010 at 10:34:37 AM EST
    All of this is a continuing march down the increasing privatization and deregulation paths IMO.

    Parent
    Medicare is the next target, (none / 0) (#104)
    by KeysDan on Wed Mar 17, 2010 at 12:09:59 PM EST
    sooner than later. The health care act that will emerge, in any final version, will "reform" Medicare so as to obtain "savings" sufficient to stabilize a Medicare program that we are told will soon be on the ropes, provide for advances in medical and surgical treatments, and  finance about half of the costs ($400 B) of the extension of insurance coverage. During the year-long debates, little attention has been given to this key aspect of either the House, Senate or WH versions (other than disingenuous Republican sound bites and salvos).  The ways and means of achieving "savings" of that magnitude have been detail-free, save for someone's good idea that "less care is better care", with restrictive lab test examples and reduced reimbursements to hospitals, all with no consequences. Politically, the bill offers the twin benefits of being unclear and having a delayed onset. However, as issues become apparent,  opportunities for corrections and remedies exist, such as occurred to the vastly unpopular Catastrophic Care Act of 1988.  However, the Medicare "reforms" needed to achieve projected "savings" are likely to be subtle and insidious.

    Parent
    I'm going to worry about (none / 0) (#106)
    by Inspector Gadget on Wed Mar 17, 2010 at 12:11:32 PM EST
    all the elements not being regulated for the insurance industry. The demands on what they need to provide for coverage really are limited. They are going to work this to their advantage as hard as they can for as long as they can get away with it.

    Parent
    Bob Dole proposed Exchanges 15+ years ago (5.00 / 4) (#9)
    by Dan the Man on Wed Mar 17, 2010 at 09:30:01 AM EST
    (in 1994) but called them purchasing groups.

    "The bill also encourages the creation of purchasing groups, including non-employer associations, to bargain for good insurance rates. But wisely, it does not mandate health alliances, or force- employers to pick plans for their employees."

    Of course, back then nobody called Dole's Exchange/Purchasing Groups an "historic" legislation akin to Medicare.

    Expect Absolutely Nothing (5.00 / 4) (#66)
    by kidneystones on Wed Mar 17, 2010 at 10:13:36 AM EST
    from Tim, Ben, Larry, and all the hard-ball Wall St players who've just stared down Dennis.

    I'm grateful, too, that nobody is cheering the bill on its merits, including Dennis, although I'm sure we'll soon learn that it's as historic as the hagiographers claimed.

    If this bill actually passes, expect a vomit-inducing avalanche of self-congratulatory adulation for every Dem connected to any part of this farce.

    This is an epic win for corporate America. Kucinich has delivered exactly nothing after all the fuss. No wonder folks think he's a wanker.

    They're right.

    Dennis caves (5.00 / 1) (#82)
    by DancingOpossum on Wed Mar 17, 2010 at 10:31:21 AM EST
    OK, well, that is one less Democrat I'm going to vote for (my list currently stands at about three). It had to be threats, bribery, or blackmail. This was not a principled switch based on logic, reason, or sudden realization of Obama's utter awesomeness. He caved, he gave in, he was beaten--for what reason? It doesn't matter in the end. He now joins a long list of "progressive heroes" who yap all day long about their high-minded ideals and then back it up by doing nothing, or worse (yes, I'm looking at you, Feingold and Grayson).

    Here's the scenario (5.00 / 1) (#86)
    by BTAL on Wed Mar 17, 2010 at 10:35:01 AM EST
    IF, the bill passes, the exchanges will be established.  The elimination of denial of coverage and pre-existing condition exclusions. Hooray!!! Hip, hip Hoooray!!!  The sick and poor are now safe. Says the left.

    Those who could not afford insurance in the past and those with pre-existing conditions rush to the exchange with their credit cards and some sort of subsidy deposited in their bank accounts.

    They apply, are accepted THEN the premium price and payment page is displayed.   OMFG, premiums are $4,000 per month!!!! OMFG, there's not enough balance on the credit card and the subsidy isn't enough to cover the difference.

    Hoooray!!! Says the left.

    Dennis (5.00 / 1) (#87)
    by lilburro on Wed Mar 17, 2010 at 10:35:43 AM EST
    woke up this morning and decided to vote for the bill huh?

    Must've been what happened.  Couldn't have had to do with the Obama rally or phone calls or anything.

    Cause the President?  He's irrelevant.

    <snark>

    I honestly (3.50 / 2) (#88)
    by Capt Howdy on Wed Mar 17, 2010 at 10:40:31 AM EST
    think it was the request from the hospital bed.
    at least in part.
    how could he ignore that?
    I also think he takes the rest of the Obama term seriously.

    Parent
    MA Exchange has nearly no buyers. (5.00 / 2) (#117)
    by masslib on Wed Mar 17, 2010 at 03:51:07 PM EST
    Almost all the newly covered are covered buy the Medicaid expansion, but keep dreaming, Ezra.

    it seems in a perfect world (none / 0) (#1)
    by lilburro on Wed Mar 17, 2010 at 09:03:51 AM EST
    where they work wonderfully that they would destroy Medicare, no?

    He may be right thatr more people (none / 0) (#5)
    by ruffian on Wed Mar 17, 2010 at 09:23:14 AM EST
    will be forced on to the exchanges, if only because this bill does so little to bring down insurance rates that many employers will be dropping insurance benefits in the next few years. I know my company is thinking dropping it. One more big rate hike might put many small companies over the edge.

    But that does not make them like medicare. Will there be further federal paycheck withholding to pay for insurance on the exchange? I doubt it.

    I suppose I should know this, but (none / 0) (#7)
    by observed on Wed Mar 17, 2010 at 09:26:05 AM EST
    how are the proposed exchanges different from what already exists? Comparative insurance shopping programs are all over the place.

    the number of people (none / 0) (#8)
    by Capt Howdy on Wed Mar 17, 2010 at 09:28:27 AM EST
    in the pool

    Parent
    Because of the mandate, you mean? (none / 0) (#13)
    by observed on Wed Mar 17, 2010 at 09:32:40 AM EST


    Parent
    I suppose partially (none / 0) (#17)
    by Capt Howdy on Wed Mar 17, 2010 at 09:34:14 AM EST
    because of the mandate but I would imagine mostly simply because of the scope of the plan.

    everyone is now involved.

    Parent

    But (none / 0) (#32)
    by Ga6thDem on Wed Mar 17, 2010 at 09:51:07 AM EST
    we're already in a pool. It's called the individual market pool. The exchanges make no changes on that account.

    Parent
    no (none / 0) (#34)
    by Capt Howdy on Wed Mar 17, 2010 at 09:53:51 AM EST
    you are in many different pools.  not the same thing at all.

    Parent
    No (5.00 / 1) (#38)
    by Ga6thDem on Wed Mar 17, 2010 at 09:56:38 AM EST
    we are all in the same pool as far as teh insuranc companies are concerned. It's called the "individual market". this does nothing to change that.

    Look be honest and admit that this really does nothing. All it does it make for one stop shopping but does nothing to change the actuarial tables that the insuranc companies have nor actually have any cost controls. We are bascially goign to get to look at the same insurance we have now in one place.

    Parent

    being in "the market" (none / 0) (#39)
    by Capt Howdy on Wed Mar 17, 2010 at 09:57:57 AM EST
    and being in a buying pool are not at all the same thing.

    Parent
    Yes (5.00 / 1) (#43)
    by Ga6thDem on Wed Mar 17, 2010 at 09:59:26 AM EST
    they are as far as teh insurance companies are concerned. You could call ti the individual pool then if that would help you understand it.

    It's nothing more than one stop shopping.

    Parent

    Which already exists. (5.00 / 2) (#48)
    by observed on Wed Mar 17, 2010 at 10:01:24 AM EST
    My guess is that the exchanges will be yet ANOTHER vehicle to give money to the insurance companies, who will actually run the exchanges---after all, they have the expertise, right?

    Parent
    you clearly (none / 0) (#47)
    by Capt Howdy on Wed Mar 17, 2010 at 10:00:52 AM EST
    do not understand the concept of a buying pool.


    Parent
    No (5.00 / 1) (#54)
    by Ga6thDem on Wed Mar 17, 2010 at 10:03:50 AM EST
    you clearly do not understand what is going on here. I've been in insurance for almost 20 years. there is nothign that changes teh actuarial tables on which policies are priced is there?

    This is more or less just one stop shopping. There is nothing to lower the price. There is nothing to change the problems. It is nothing more than one big insurance agency.

    Parent

    Choice (5.00 / 2) (#64)
    by waldenpond on Wed Mar 17, 2010 at 10:13:17 AM EST
    It might make shopping a little easier.  You will have the choice of going with the company that is going to raise your rate $290 with a 1% increase in co-pay rather than a rate increase of $300 and a .9% increase in co-pay.

    I don't get how people don't see this does nothing for cost.  Insurers just spiked their rates and dumped people in the middle of this debate and somehow this bill is going to stop the monopoly from continuing.  The denial is strange.

    I believe 'cost' has been removed from the list of Dem talking points.

    Parent

    That's (5.00 / 1) (#77)
    by Ga6thDem on Wed Mar 17, 2010 at 10:23:06 AM EST
    pretty much my point. It makes shopping more convenient but that's about it. But when it comes to raising to rates, you usually don't get that information until you've already got the policy. So yeah, you can shop every year for a new policy but it's likely that there's going to be very little difference in the rates.

    Parent
    Not important (4.00 / 3) (#68)
    by jbindc on Wed Mar 17, 2010 at 10:15:10 AM EST
    This isn't about saving people money or helping them - this is about making Obama look like a strong president who fights for the little guy.  This has never been about the people.

    Please update your talking points.  Some around here have already gotten their copy - did yours get lost in the mail?

    Parent

    Obama is aahhwsome (4.00 / 4) (#74)
    by waldenpond on Wed Mar 17, 2010 at 10:20:57 AM EST
    Obama is aahwsome.  Progressives ruuuule.  :)

    I can't get past my position that health care is a right not a privilege and that cost efficiencies should provide actual care.  I suck!

    Parent

    personally (none / 0) (#72)
    by Capt Howdy on Wed Mar 17, 2010 at 10:18:31 AM EST
    I never said it will do much to contain costs expect for the fact that the larger the buying pool the more leverage pool has.
    thats a fact.

    Parent
    When (5.00 / 1) (#79)
    by Ga6thDem on Wed Mar 17, 2010 at 10:25:50 AM EST
    it is a large corporation you are correct but not the way that this is set up. This is no different than going to an agency and picking your policy. You are still going to be medically rated on age just like you are right now. As a matter of fact, people in their 50's will proabbly pay MORE with these exchanges.

    And frankly, what's the piont if it does nothing for costs?

    Parent

    What leverage will the buying pool have? (5.00 / 4) (#89)
    by nycstray on Wed Mar 17, 2010 at 10:50:39 AM EST
    We HAVE to buy insurance. There is no competition to give us any leverage is there?

    Parent
    The mechanism for cost reduction is (none / 0) (#91)
    by observed on Wed Mar 17, 2010 at 10:59:01 AM EST
    completely different. Cost containment is supposed to happen by driving people out of the insurance plans they like into HMOs.

    Parent
    Kucinich Sells Out (none / 0) (#10)
    by kidneystones on Wed Mar 17, 2010 at 09:30:24 AM EST
    Looks like 'progressives' are going to look for a new messiah.

    Wonder what they offered Dennis. Hope he got more than Nelson.

    He says that it's: (5.00 / 1) (#15)
    by andgarden on Wed Mar 17, 2010 at 09:33:14 AM EST
    "very important the the potential of the President not be destroyed by this [vote]."

    Along the lines of Bob Kerrey's vote for Clinton's budget in 1993 (roughly 'I will not destroy this President.') Except that this time it's from the left.

    Parent

    the is a very smart (5.00 / 1) (#18)
    by Capt Howdy on Wed Mar 17, 2010 at 09:35:04 AM EST
    and very democratic response.  and excuse.
    I believe I posted a comment to that effect yesterday.

    Parent
    he also said this (5.00 / 1) (#29)
    by Capt Howdy on Wed Mar 17, 2010 at 09:48:34 AM EST
    "I know I have to make a decision -- not on the bill not on the bill as I would like to see it, but as it is."

    the voice of reason.

    Parent

    Arguably, that was true (5.00 / 1) (#42)
    by andgarden on Wed Mar 17, 2010 at 09:58:59 AM EST
    in passing the first bill. I think the better argument is that when your party really needs your vote, you're pretty much obligated to either give it or resign. (At least, that's the parliamentary model).

    The same applies for John Barrow, BTW, who is in no real danger and should be an easy yea, but will likely vote no.

    Parent

    This is my instinct too. (5.00 / 1) (#92)
    by dk on Wed Mar 17, 2010 at 11:04:38 AM EST
    The reality is that Democratic party is now moved firmly center-right.  The choice for someone like Kucinich is either to accept that and work for little victories here and there, or leave the party.  

    I do feel badly for him, in a way, since it's not like it's his fault that the choice is what it is.

    Parent

    its not his fault (4.00 / 3) (#93)
    by Capt Howdy on Wed Mar 17, 2010 at 11:07:49 AM EST
    it not our fault.  but "to accept that and work for little victories here and there" is better than taking your marbles and going home.

    Parent
    Well, that's a matter of opinion, I guess. (none / 0) (#94)
    by dk on Wed Mar 17, 2010 at 11:12:24 AM EST
    Also, I don't think there's one "right" way to deal with the reality.  I think there's room for some people to work in the system, and some to work from outside the system.  From my life-observation, I personally think both are probably required.

    Parent
    I agree (5.00 / 2) (#96)
    by andgarden on Wed Mar 17, 2010 at 11:19:02 AM EST
    We all have different standards about when we're willing to wheel and deal.

    I'll tell you what, though: Kucinich has made himself more powerful by finally, at long last, being willing to say yes to something. If he's a gettable vote, he's worth talking to.

    Parent

    Actually, I don't think this had any (none / 0) (#118)
    by dk on Wed Mar 17, 2010 at 06:36:00 PM EST
    effect on Kucinich's power.  Yes he proved himself loyal to the Democratic leadership, but he also did it without extracting anything in return.  So, probably a wash.

    Parent
    You know, insisting that (5.00 / 3) (#45)
    by observed on Wed Mar 17, 2010 at 09:59:55 AM EST
    only people who agree with you are "reasonable" makes you anything but the voice of reason.
    Not to mention saying that people who oppose the bill don't want sick people to get care.
    You know, if there's Medicare for all, this woman will get covered too, and probably at a lower cost. Are you against seeing a poor sick woman get affordable treatment?
    Do you kick babies too?

    Parent
    and if frogs had wings (none / 0) (#50)
    by Capt Howdy on Wed Mar 17, 2010 at 10:02:01 AM EST
    they wouldnt bump their a$$ when the hop around

    Parent
    And this is what he said on Sunday (5.00 / 1) (#49)
    by jbindc on Wed Mar 17, 2010 at 10:01:54 AM EST
    Link

    Unfortunately, the president's plan, as it currently stands, leaves patients financially vulnerable to insurance companies. It requires all Americans to buy private health insurance policies, while failing to ensure those policies do what they are supposed to do -- protect people from financial catastrophe caused by injury or illness.

    Comprehensive health insurance is a matter of economic security. While many Americans don't have health insurance at all, many more Americans have health insurance that doesn't pay for care when they get sick or injured. When that happens, illness can lead to economic ruin. Half the personal bankruptcies in America occur because health insurance companies refuse to pay medical bills.

    Unfortunately, if the president's plan becomes law without substantive change, you would still be only a major illness or injury away from personal bankruptcy, except the federal government will have required you to buy a private health insurance policy.

    SNIP

    Absent a strong public option or legal protection for states that wish to pursue single payer, the bill that the president is proposing is a step in the wrong direction. Even with the few modest improvements in the bill, the insurance companies will still have dozens of loopholes to deny care and continue to find ways to leave Americans with the unpayable bill.

    It's obvious his seat was threatened and he felt he had to cave.

    Parent

    please (none / 0) (#52)
    by Capt Howdy on Wed Mar 17, 2010 at 10:02:53 AM EST
    tell me what, exactly, you think the "threatened" him with?

    Parent
    Let's see (none / 0) (#55)
    by jbindc on Wed Mar 17, 2010 at 10:05:00 AM EST
    Money flowing from the DNC to help his re-election campaign?  Whatever is left of the shell of OFA to campaign for him?

    Just for starters.

    You actually think he's so altruistic he cares about "saving Obama's presidency"?  Puh-leeze.

    Parent

    I think Kucinich is an a$$ (none / 0) (#59)
    by Capt Howdy on Wed Mar 17, 2010 at 10:06:43 AM EST
    but a progressive a$$ with a conscience.  I absolutely believe he is smart enough to know, as the NYTimes said yesterday, that if this doesnt pass he is crippled.

    Parent
    The NYT (5.00 / 2) (#60)
    by jbindc on Wed Mar 17, 2010 at 10:09:54 AM EST
    also said that those that believe this will kill his presidency are speaking in hyperbole.

    Parent
    maybe not, but it would (IMO) (5.00 / 3) (#63)
    by andgarden on Wed Mar 17, 2010 at 10:11:57 AM EST
    dramatically increase the probability of a Republican Congress.

    That might be ok with you, but it's not with me.

    Parent

    Are you (5.00 / 4) (#69)
    by Ga6thDem on Wed Mar 17, 2010 at 10:15:20 AM EST
    kidding? With 57% of the country against this bill how is passing it more likely to keep dems in office?

    Frankly it's a lose/lose proposition. If he doesnt pass it he looks bad but if he does pass it he still looks bad. I guess this is what you get from no leadership.

    Parent

    I think that kind of polling is unreliable (5.00 / 2) (#73)
    by andgarden on Wed Mar 17, 2010 at 10:19:52 AM EST
    and in this instance not quite relevant: midterms are about base turnout, and all of the polling says that the Dem base is HEAVILY in favor of passing healthcare.  

    Parent
    not correct (5.00 / 1) (#75)
    by Capt Howdy on Wed Mar 17, 2010 at 10:20:58 AM EST
    NBC/WSJ poll might bring it back. In the survey, the public is split on whether Congress should pass the health-care bill (46%-45%), on President Obama's approval rating (48%-47%), and on which political party would do a better job handling the economy (31%-31%). In the short term, the partisan divide could end up helping Obama and the Democrats, especially on health care.


    Parent
    And it's still early (5.00 / 1) (#78)
    by jbindc on Wed Mar 17, 2010 at 10:24:50 AM EST
    People who want the bill passed, don't necessarily know things like, costs probably won't be contained and they'll be required to buy insurance and any help won't come for years.  That may change their attitudes come November.

    Parent
    it's not early (5.00 / 1) (#80)
    by CST on Wed Mar 17, 2010 at 10:29:34 AM EST
    in this debate anymore.

    And the fact is, the support dropped like a bomb and now it's turning the other way.  Which kind of indicates that the more people learn the more they like the bill - not the other way around.  Considering the amount of negative press the bill has gotten, that's saying something.

    Parent

    Uh - It's not ealry in the debate (none / 0) (#95)
    by jbindc on Wed Mar 17, 2010 at 11:12:34 AM EST
    But is IS very early in an election year. Pretty much all legislation will stop in about 10 weeks - it's campaign season.

    You really think they'll pass this bill, chalk it up as a huge bill, and then ride that wave into more sweeping reform of things before then?

    Hardly.  Right now, every Democrat who hates this HCR bill as much as Kucinich, but is resigning themselves to vote for it (under party pressure), is hoping that a miracle takes place and all hard  and soft copies of this bill are magically destroyed and that voters get amnesia until Thanksgiving Day.

    Parent

    hmm (5.00 / 1) (#98)
    by CST on Wed Mar 17, 2010 at 11:33:11 AM EST
    I thought we were talking about early in terms of forming opinions on the health care bill - especially since you said "it's still early - people will find out more about the health care bill and hate it" or whatever.  I do not think the American public has been sold a pie in the sky bill in which they will be disappointed.  I think at this point in the health care debate, most of the news has been negative, and the fact that the numbers towards it are increasing means that people who learn more about the bill like it more, not less.

    In this next post you've changed the metric.  I never said anything like this in my post.

    I think they'll pass this bill and then defend it on it's merits.  And hopefully pass other legislation in the mean time since that is their job.

    Parent

    With all due respect, and keeping (5.00 / 4) (#109)
    by Anne on Wed Mar 17, 2010 at 12:25:22 PM EST
    in mind that this is just my take on it, I think "pie in the sky" is pretty much all the American public has been sold, especially in the last month; I mean, have you watched any network news lately that wasn't predomimantly a clip of Obama or one of his surrogates repeating the mantra of "30 million insured!" followed by a clip of the usual Republican saying what Republicans always say?  Have you considered how desperate some people are for relief, for health care, who watch this stuff and are willing to just believe what the president is saying - even if it isn't accurate?  

    What concerns me, aside from believing that this reform bill is not going to accomplish what those who support it claim it will, is that once people are confronted with the reality of how the legislation will affect them, what they will and won't be eligible for, that it is unlikely to save them money, there is going to be anger at a level we haven't seen in a long, long time - which is not going to translate into Democratic victories because this thing is owned lock, stock and barrel by the Democratic Party.  The anger will not just be for what they won't be getting, it will be for the realization that those who made it happen knew the truth from the get-go, and that's why so much of it isn't going to happen right away.  And I fully expect we will be hearing about more side deals made behind closed doors, and none of those deals will be for the benefit of the people.

    We disagree on whether this is the first step on the road to a better system, or is just pouring the cement around our feet, locking us into this pernicious and rapacious private insurance system for years and years to come.

    For people like me, who are on the cusp of being eligible for Medicare (so close - and yet so far!), the future we have is not going to be long enough for the kind of incrementalism younger people may feel is possible, and we fear that the quality of the future we have left will be significantly reduced not just due to this legislation, but to expected changes in Medicare and Social Security, and the fallout from the market crash that saw many of our planned supplemental retirememt funds take a big dive - we don't have the same kind of time to build our future as you do.

    What things look like has a whole lot to do with where you are looking at them from.

    Parent

    You thought wrong (none / 0) (#102)
    by jbindc on Wed Mar 17, 2010 at 11:53:06 AM EST


    Parent
    if you think (none / 0) (#97)
    by Capt Howdy on Wed Mar 17, 2010 at 11:19:11 AM EST
    all legislation will stop I think you are misguided.  again.
    from what I have been reading I dont think that is the plan at all.

    Parent
    You're (none / 0) (#101)
    by Ga6thDem on Wed Mar 17, 2010 at 11:44:42 AM EST
    skipping the part where 57% disapprove of Obama's handling of healtcare. How does that help him or dems?

    And if it's tied as being for and against then I woudl say that does not help the Dems when you consider the enthusiasm gap. I dont think that people are all of a sudden going to beome enthused about a crap bill. How many of those people for it are in the "better than nothing" category?

    Parent

    Good point (none / 0) (#114)
    by kidneystones on Wed Mar 17, 2010 at 01:24:12 PM EST
    I also suspect few Americans are actually deeply invested in 'seeing this president succeed', if that success means passing bad bills and granting Dems a free pass on jobs.


    Parent
    What is the difference between a (5.00 / 6) (#81)
    by Anne on Wed Mar 17, 2010 at 10:30:18 AM EST
    Republican Congress and a Democratic president that thinks the GOP is chock-full of good ideas, and a Democratic president with a Democratic Congress that will not stand up for itself and knows only one trick: roll over?

    Not much that I can see, frankly, so I am d-o-n-e wetting my pants over Dems losing in November; they did this to themselves and all we are doing by saving them is perpetuating the extreme dysfunction that is helping no one.

    And please, spare me the horror stories of what the future holds: I'm already horrified at what the present holds and that's WITH Democrats in the majority.

    Parent

    I don't care to relive the 90s (5.00 / 1) (#83)
    by andgarden on Wed Mar 17, 2010 at 10:31:27 AM EST
    There's too much work left to do, all of which has some chance with a Dem Congress, and none with a Rep one.

    Parent
    I'm not much interested in re-living (5.00 / 4) (#90)
    by Anne on Wed Mar 17, 2010 at 10:50:50 AM EST
    my childhood, either...except I'd have to go back a bit farther than the 90's to do it.

    I'm glad you still have some confidence that (1) the Dems are capable of actually addressing the issues that face us, and (2) if they can rustle up some functionality, how they address thes issues will not be along the lines of what they have done here, selling out piece after piece of anything resembling a left-leaning agenda.

    I don't share that confidence, and the lesson of this health system clusterf**k doesn't do much to inspire any.

    Parent

    How old were you? (none / 0) (#115)
    by itscookin on Wed Mar 17, 2010 at 03:36:25 PM EST
    10? Many of us who were adults then would happily return to the Clinton years.

    Parent
    Why Stop There? (5.00 / 1) (#116)
    by squeaky on Wed Mar 17, 2010 at 03:45:19 PM EST
    No nostalgia for the garden of eden? From what I can tell healthcare was free back then.

    Parent
    If you did (none / 0) (#119)
    by Rojas on Wed Mar 17, 2010 at 07:42:54 PM EST
    do you think you'd notice the rug being pulled out from under you?

    Parent
    let me be on the record (none / 0) (#84)
    by Capt Howdy on Wed Mar 17, 2010 at 10:32:06 AM EST
    as hoping you continue to be horrified in 2011.


    Parent
    You think (none / 0) (#65)
    by jbindc on Wed Mar 17, 2010 at 10:13:22 AM EST
    We AREN'T going to have a Republican Congress?

    Parent
    I think the polls are pretty close (5.00 / 2) (#71)
    by andgarden on Wed Mar 17, 2010 at 10:18:10 AM EST
    one factor that would break in favor of the Dems is "getting stuff done."

    Parent
    Dear Dennis: (5.00 / 5) (#40)
    by Dr Molly on Wed Mar 17, 2010 at 09:58:16 AM EST
    "It's not about whether the president 'is destroyed' or not.

    It's about whether the american people continued to get fleeced by the insurance industry."

    What did they threaten Dennis with?

    Parent

    I think his explanation is believable (5.00 / 3) (#46)
    by andgarden on Wed Mar 17, 2010 at 10:00:21 AM EST
    He won't be the person who sinks this Presidency. He made it pretty clear that he didn't get any specific concessions.

    Parent
    Yes, I can understand that I guess. (none / 0) (#51)
    by Dr Molly on Wed Mar 17, 2010 at 10:02:34 AM EST
    But it's still focused on the wrong thing - the President, instead of the people.

    Parent
    what you are unwilling to understand (3.50 / 2) (#53)
    by Capt Howdy on Wed Mar 17, 2010 at 10:03:38 AM EST
    is that the presidents ability to pass progressive legislation effects the people.

    Parent
    Progressive legislation??? (5.00 / 7) (#56)
    by observed on Wed Mar 17, 2010 at 10:05:32 AM EST
    Not funny.

    Parent
    perhaps. but what you are unwilling to understand (5.00 / 6) (#57)
    by Dr Molly on Wed Mar 17, 2010 at 10:05:38 AM EST
    is that the president is not passing progressive legislation. not currently, and therefore, probably not in the future.

    Parent
    Dennis killed any chance (5.00 / 1) (#70)
    by kidneystones on Wed Mar 17, 2010 at 10:18:02 AM EST
    of any progressive legislation ever being passed by this conga line.

    If Dennis votes for it, it must be progressive.

    Parent

    Let's see (5.00 / 3) (#58)
    by jbindc on Wed Mar 17, 2010 at 10:05:49 AM EST
    some progressive legislation for starters.

    Parent
    you should really try (none / 0) (#44)
    by Capt Howdy on Wed Mar 17, 2010 at 09:59:41 AM EST
    reading his actual statement.

    Parent
    I know this is naive (3.50 / 2) (#12)
    by Capt Howdy on Wed Mar 17, 2010 at 09:32:18 AM EST
    but you think it could have been the request from one of his constituents from here hospital bed?


    Parent
    The one (5.00 / 1) (#16)
    by jbindc on Wed Mar 17, 2010 at 09:33:27 AM EST
    Who qualifies for financial aid and has a personal assurance from the Cleveland Clinic not to put a lien on her home?

    Parent
    as far as aid they say this: (5.00 / 1) (#19)
    by Capt Howdy on Wed Mar 17, 2010 at 09:36:40 AM EST
    Health officials say cancer patient `will most likely be eligible' for Medicaid

    that doesnt sound all that certain to me.  and how nice they are not going to put a lien on her house.
    I would imagine that also was not always obvious.


    Parent

    God, I hope Kucinich ... (5.00 / 1) (#33)
    by Yman on Wed Mar 17, 2010 at 09:52:35 AM EST
    ... is smarter than that.

    Basing a public policy decision on the desires of one sick woman rather than logic seems more than a bit silly, and that's assuming this plan would help her, if she survives the next four years, if she doesn't qualify for the current assistance programs, if she has any assets after four years, etc., etc., etc.

    Parent

    and btw (5.00 / 1) (#37)
    by Capt Howdy on Wed Mar 17, 2010 at 09:55:08 AM EST
    its done.
    he is not "smarter"

    Parent
    yeah (3.50 / 2) (#36)
    by Capt Howdy on Wed Mar 17, 2010 at 09:54:45 AM EST
    you made clear you dont care about her yesterday.

    perhaps he means other people like her.  hum?


    Parent

    No, I made it clear ... (4.40 / 5) (#61)
    by Yman on Wed Mar 17, 2010 at 10:09:55 AM EST
    ... that it's a foolish way to make public policy that affects the entire nation.  Humm?

    BTW - I have no idea if he "means other people like her", or if her individual desire was even part of his decision.  But since we're playing the mind reading/maybe/future predicting game, maybe he should vote against a plan that will leave her stranded for another four years, on that basis alone.  Maybe he should vote against a plan that does virtually nothing to control health care costs.  Maybe he should vote against a plan that includes no public option and will destroy the chance of getting one for the forseeable future?  Maybe, if he votes for this plan, he just doesn't care about her, huh?  Maybe those who support this plan hate apple pie, puppies and the American way of life!

    Heh, heh ....

    Heyyyyyyyy, .....

    ... that is easy.

    Parent

    oops (none / 0) (#41)
    by Capt Howdy on Wed Mar 17, 2010 at 09:58:16 AM EST
    He continued, "His visit to my district underscored the importance" of this debate.


    Parent
    So? (none / 0) (#62)
    by Yman on Wed Mar 17, 2010 at 10:11:56 AM EST
    Assuming to take it at face value, as opposed to face-saving value), what's that supposed to mean?

    Parent
    it means (none / 0) (#67)
    by Capt Howdy on Wed Mar 17, 2010 at 10:14:04 AM EST
    he is not "smarter than that".


    Parent
    No it doesn't (5.00 / 2) (#76)
    by Yman on Wed Mar 17, 2010 at 10:21:34 AM EST
    Your conclusion is based on the assumption he voted for the bill because of the plight of this woman.  There's simply no evidence of that.

    My point is, I certainly hope that's not the case.  He'd have to be a simpleton to do that..

    Parent

    I hope not (none / 0) (#20)
    by kidneystones on Wed Mar 17, 2010 at 09:38:03 AM EST
    The idea that hc costs are going to go down in a big hurry is a pipe dream.

    We're in an Obama closed Gitmo moment. The troops are all home from Iraq. Wall St does not control the WH and 16 million un-employed is the new standard of doing a 'decent' job on unemployment.

    Dennis is one vote. Others may well follow. We'll know soon enough.

    Parent

    others will follow (5.00 / 1) (#21)
    by Capt Howdy on Wed Mar 17, 2010 at 09:41:29 AM EST
    and it takes the wind out of the "killers from the left"

    Parent
    If Kucinich is in, (5.00 / 1) (#24)
    by andgarden on Wed Mar 17, 2010 at 09:46:00 AM EST
    then I cannot foresee a single no vote from the left.

    Parent
    Rosa Park's journey (none / 0) (#25)
    by kidneystones on Wed Mar 17, 2010 at 09:47:32 AM EST
    depends on it.

    Good call on 'saving the presidency'. Blow enough smoke and Dennis falls in line.

    All Dennis has to do now is translate his surrender into a winning position on the public option.

    Parent

    I dont know if you joke (none / 0) (#30)
    by Capt Howdy on Wed Mar 17, 2010 at 09:49:19 AM EST
    but we need him on our side.  for exactly that reason.

    Parent
    Kucinich Saves the WH! (5.00 / 1) (#35)
    by kidneystones on Wed Mar 17, 2010 at 09:54:22 AM EST
    He can pin the headline next to his mirror. And got....in return.

    Dennis is a rock.

    Parent

    One aspect of his switch that shows some honor (none / 0) (#112)
    by Inspector Gadget on Wed Mar 17, 2010 at 12:54:42 PM EST
    is that he is returning donations he received for his promise to vote NAY on anything that didn't include a public option.

    Parent
    I can't see any opponents (3.50 / 2) (#113)
    by kidneystones on Wed Mar 17, 2010 at 01:20:56 PM EST
    of this bill seeing Dennis as anything but a flake glorying in his fifteen seconds of fame. I'm intensely pleased he's confirmed beyond any doubt his lack of scruple and his giddy self-love.

    He's destined to join Edwards in the pantheon of legendary frauds.

    Dennis 'the Joke'.

    Parent

    Will The Exchanges Become Like Medicare? | 119 comments (119 topical)

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