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History's Judgment

Matt Yglesias writes:

Now that itís done, Barack Obama will go down in history as one of Americaís finest presidents. [. . . F]undamentally, heís reshaped the policy landscape in a way that no progressive politician has done in decades.

I guess anyone can call anything progressive, but I think E.J. Dionne is right that this is essentially a GOP (from 20 years ago) bill. I hope Yglesias is right and his thesis will be tested - Obama's (and Yglesias' and the rest of the Village Dems') vision is now law. My view aligns with Atrios':

Both on substance and politics, better to pass it than not. It does not do the important work of sowing the seeds of the insurance industry's destruction, leaving the skimmers in place, and only takes baby steps towards moving them to the regulated public utility model. It also doesn't get rid of their anti-trust exemption, leaving the effective monopolies in place. This leaves us open to continued abuses by the industry and fails to do the most important cost-cutting measure, cutting out the paper pushers who serve no useful purpose in the economy. But there is good in the bill, too, and one has to be a bit Hopey that over time demands by the public will make the bad and unpopular stuff less bad and less unpopular.

It is my view that the key to health insurance reform is public insurance. This bill does not forward public insurance. Thus, in my view, the health bills are not effective progressive reform. Hopefully I am wrong and Obama and the Village Dems are right. We'll find out for sure.

Speaking for me only

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    No (5.00 / 2) (#1)
    by Ga6thDem on Mon Mar 22, 2010 at 08:15:34 AM EST
    you're right. There is no reform in this bill. It's basically a mandated bailout of the insurance companies. There's no guarantee that the bill is even going to last very long. It is so open to abuse and poorly written that it could become a major campaign issue for the GOP in 2012. They are already planning to make it a campaign issue in the fall.

    the saddest thing is that none of this had to be. Women didn't have to be thrown under the bus once again and if Obama hadn't dithered and wasted literally months waving the white flag there could have been a much better bill passed last summer.

    And Matt's (5.00 / 7) (#2)
    by Ga6thDem on Mon Mar 22, 2010 at 08:19:24 AM EST
    statement reminds me of what people like Andrew Sullivan was saying after George W. Bush pranced around on the aircraft carrier proclaiming "mission accomplished". it seems that the cult of Bush has nothing on the cult of Obama.

    Parent
    I know (5.00 / 1) (#6)
    by SOS on Mon Mar 22, 2010 at 08:29:55 AM EST
    rather then an aircraft carrier landing and cod piece Obama needs to show up in surgery or something dressed in scrubs accompanied by House.

    Parent
    'Nuthin Accomplished' will be the legacy here (none / 0) (#166)
    by Ellie on Mon Mar 22, 2010 at 11:43:15 AM EST
    Women get doubly $crewed yet again, this time so fanboiz can pat themselves on the back for having a black BFF.

    What differs from the GWB chickenhawk years is that Obama's failures (and the Dem supermajority's) will be felt sooner and more viscerally in people's day to day lives, even if a lot of that is inherited blowback.

    November should be interesting.

    Parent

    The bill won't be repealed (5.00 / 3) (#3)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:22:28 AM EST
    But it won't be effective reform imo.

    Parent
    Probably (5.00 / 3) (#5)
    by Ga6thDem on Mon Mar 22, 2010 at 08:29:15 AM EST
    not but it is so ripe for abuse it's not even funny. The GOP can completely eliminate the subsidies so people are left being mandated to buy junk insurance. They can cut medicaid. Maybe the bill won't be repealed but it can be made to be a lot worse.

    Parent
    I agree, but (5.00 / 3) (#31)
    by Andy08 on Mon Mar 22, 2010 at 08:41:42 AM EST
    I also think many middle class and senior (Medicare cuts) will be worse off in terms of what their health plan cover and cost. On the other hand it gives access to some health care to many. But is this a good thing if it is at the expense of pitting one groups against the other? I do not think so.

    If Dems were going to pass a bill like the ended up doing ( Reconciliation and all Dems) they should have crafted a REALLY meaningful health INSURANCE reform bill.
     

    Parent

    I agree (5.00 / 1) (#35)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:44:47 AM EST
    I thought a 2 bill approach should have been the initial strategy.

    Parent
    Two bills meaning (none / 0) (#42)
    by Andy08 on Mon Mar 22, 2010 at 08:49:46 AM EST
    one extending coverage and one reforming the insurance monopoly? Could you refer me to where you explained this (I miss it). Thanks.

    Parent
    google the Schmer Plan (none / 0) (#51)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:59:19 AM EST
    Thanks BTD (none / 0) (#114)
    by Andy08 on Mon Mar 22, 2010 at 10:19:14 AM EST
    The irony (5.00 / 4) (#37)
    by Ga6thDem on Mon Mar 22, 2010 at 08:46:37 AM EST
    is that the parts that actually do help people could have been passed as a bill leaving the unpopular parts off the bill. Overall, the bill hurts more people than it helps. I went to the link in another thread that someone had put up and the bill is going to cost me an additional $5000.

    Parent
    Question? (none / 0) (#4)
    by MO Blue on Mon Mar 22, 2010 at 08:29:14 AM EST
    If the Republicans obtain majorities in Congress, is it possible that they could just not fund the program?

    Parent
    Yep. (5.00 / 1) (#7)
    by Ga6thDem on Mon Mar 22, 2010 at 08:30:32 AM EST
    Congress controls the budget and if they retake everything in '12 it's gone I would imagine.

    Parent
    Of course (5.00 / 3) (#8)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:31:18 AM EST
    And therein lies one of the major problems with this legislation - the "affordability" of it is beholden to political success.

    The comparisons to Medicare are not apt as there is no political constituency for any aspect of this reform.

    Parent

    I join my democratic friends (none / 0) (#10)
    by Capt Howdy on Mon Mar 22, 2010 at 08:33:45 AM EST
    in congress in daring the republicans to re-open the doughnut  hole and toss older children off their parents healthcare programs.

    Parent
    Silly (5.00 / 1) (#18)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:37:24 AM EST
    How about reduced funding for Medicaid and "affordability" credits?

    Parent
    I never understood why there was (5.00 / 5) (#69)
    by Anne on Mon Mar 22, 2010 at 09:21:18 AM EST
    not more concern for the (I think) all-but-certain possibility that continued increases in premiums will make affordability credits unsustainable at the levels they will need to be by 2014.  

    I will actually be very surprised if there is much of any of the delayed elements that are still in place and ready to go in 2014, and I'm not all that confident there won't be changes to the more immediate "reforms" if the composition of the 2011 Congress is redder than it is now.

    Parent

    fact check .org says (none / 0) (#22)
    by Capt Howdy on Mon Mar 22, 2010 at 08:38:23 AM EST
    not one penny come from reductions to benefits for seniors.

    Parent
    Not my point (none / 0) (#27)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:40:07 AM EST
    Try reading my comment again.

    Parent
    it is the only think (none / 0) (#30)
    by Capt Howdy on Mon Mar 22, 2010 at 08:41:32 AM EST
    people will care about

    Parent
    Which is bad for "reform" (5.00 / 4) (#36)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:45:37 AM EST
    such as it is. you make my point. There isno political constituency for most of this bill.

    Parent
    You should read (none / 0) (#38)
    by Andy08 on Mon Mar 22, 2010 at 08:47:01 AM EST
    the link that Jeralyn posted yesterday from the DailyBeast that has  a summary of the bill. There is a 500 Billion cuts to Medicare: how's that not ultimately taking anything from seniors?  

    Parent
    factcheck.org (5.00 / 1) (#41)
    by Capt Howdy on Mon Mar 22, 2010 at 08:49:01 AM EST
    False: Medicare Benefits Will Be Slashed

    The claim that Obama and Congress are cutting seniors' Medicare benefits to pay for the health care overhaul is outright false, though that doesn't keep it from being repeated ad infinitum.

    The truth is that the pending House bill extracts $500 billion from projected Medicare spending over 10 years, as scored by the Congressional Budget Office, by doing such things as trimming projected increases in the program's payments for medical services, not including physicians. Increases in other areas, such as payments to doctors, bring the net savings down to less than half that amount. But none of the predicted savings - or cuts, depending on one's perspective - come from reducing current or future benefits for seniors.

    The president has promised repeatedly that benefit levels won't be reduced, reiterating the point recently in Portsmouth, N.H.:

        Obama, Aug. 11: Another myth that we've been hearing about is this notion that somehow we're going to be cutting your Medicare benefits. We are not.

    Is he wrong? Not according to AARP, by far the nation's largest organization representing the over-50 population. In a "Myths vs. Facts" rundown, AARP says:

        AARP: Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.

    To be sure, Obama hasn't always thought that Medicare "savings" could be accomplished without actual cuts in benefits. Last fall, his campaign ran two television ads accusing Sen. John McCain of wanting "a 22 percent cut in [Medicare] benefits." The basis for the ads was a newspaper article in which a McCain aide said the Arizona Republican would cut Medicare costs. But the aide said nothing about cutting benefits, in fact quite the contrary. We called the claim "false" when Obama made it against McCain, and it's still false now when Obama's critics are making the same accusation against him.



    Parent
    From the CBO report (none / 0) (#53)
    by MO Blue on Mon Mar 22, 2010 at 09:02:20 AM EST
    Based on the longer-term extrapolation, CBO expects that inflation-adjusted Medicare spending per beneficiary would increase at an average annual rate of less than 2 percent during the next two decades under the legislation--about half of the roughly 4 percent annual growth rate of the past two decades. It is unclear whether such a reduction in the growth rate could be achieved, and if so, whether it would be accomplished through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care. CBO


    Parent
    other bold (5.00 / 1) (#63)
    by Capt Howdy on Mon Mar 22, 2010 at 09:12:00 AM EST
    It is unclear whether such a reduction in the growth rate could be achieved, and if so, whether it would be accomplished through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care.

    fact check. org seems to disagree

    Parent

    Fact check said that the bill (5.00 / 6) (#74)
    by MO Blue on Mon Mar 22, 2010 at 09:27:03 AM EST
    would not effect benefits. It did not address whether or not people would would lose access to care due to the reductions. You can have all the benefits in the world but you do not have care if hospitals and doctors refuse to accept you as a patient.

    President Obama last year praised the Mayo Clinic as a "classic example" of how a health-care provider can offer "better outcomes" at lower cost. Then what should Americans think about the famous Minnesota medical center's decision to take fewer Medicare patients?
    ...
    Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors. link


    Parent
    See my problem with this piece (none / 0) (#162)
    by Socraticsilence on Mon Mar 22, 2010 at 11:39:17 AM EST
    is when people argue that we should expand medicare and yet somehow doing so wouldn't result in an even higher rejection rate.

    Parent
    I actually think that is a good question (5.00 / 1) (#170)
    by MO Blue on Mon Mar 22, 2010 at 11:53:25 AM EST
    My guess would be that it would depend on the volume of people on Medicare. If the number was high enough to reduce their patient base substantially, then they would be forced to accept Medicare patients.

    The best way (only way maybe) to eliminate adverse selection by doctors and hospitals and control costs would be to have a single payer system.

    Parent

    True (none / 0) (#176)
    by Socraticsilence on Mon Mar 22, 2010 at 12:05:33 PM EST
    and I get this, but unless we lower the base cost somehow- wouldn't this just massively cut inot Health care providers margins- I mean at the moment many areas of specialization already complain that reimbursement is below cost.

    Parent
    Very few people claim that they are (none / 0) (#182)
    by MO Blue on Mon Mar 22, 2010 at 12:23:49 PM EST
    paid too much.

    A lot of ways that the base costs could be addressed if we had a single system and the willingness to tackle the multiple problems that cause us to pay 2 to 3 times more for health care and 35% to 50% more for drugs.  

    Parent

    And the amazing thing is (5.00 / 3) (#79)
    by jbindc on Mon Mar 22, 2010 at 09:34:28 AM EST
    This is the exact same thing John McCain proposed in 2008, only to be mocked by Obama.

    Glad we got Dems to push through Republican ideas!

    Obamacare is the new Romneycare!

    Parent

    the only person pushing republican (5.00 / 1) (#82)
    by Capt Howdy on Mon Mar 22, 2010 at 09:37:37 AM EST
    ideas is you

    Parent
    And the Democratic Congress (5.00 / 12) (#86)
    by jbindc on Mon Mar 22, 2010 at 09:39:57 AM EST
    and president.

    And you.

    Parent

    you should take a look around (5.00 / 1) (#88)
    by Capt Howdy on Mon Mar 22, 2010 at 09:42:10 AM EST
    I am agreeing with every elected democrat in congress (except of course the bubbas - gotta put that in there)

    you on the other hand are agreeing with every republican in congress.

    now who is doing what?

    Parent

    You can't help yourself, can you? (5.00 / 10) (#96)
    by Anne on Mon Mar 22, 2010 at 09:51:17 AM EST
    You have some weird inability to understand that the Democrats in Congress may be the determiners of what legislation gets offered and passed, but they are not the sole arbiters of whether what they propose and/or pass is "good;" there are hundred of millions of us who also get an opinion, and our opinions are not invalidated or superceded by what the Congress is doing.  If they aren't going to listen to us now, we will be able to speak in November, and the message sent may not be in line with your simplistic but-all-my-friends-are-doing-it-so-it-must-be-good attitude.

    Honestly, I think if the entire Democratic caucus were to march, lemming-like, over a cliff into the sea, I guess we'd have to hope you had your swim trunks on, wouldn't we?

    Wheeeeeeeeeeeeee!  Hope the water's warm!

    Parent

    I was accused of (5.00 / 1) (#99)
    by Capt Howdy on Mon Mar 22, 2010 at 09:55:34 AM EST
    pushing republican ideas by someone who constantly pushes republican ideas and talking points.

    not unlike yourself.  you guys may not like who you are agreeing with, you may wish yours was the democratic position but it is not, and at some point you will need to face it.


    Parent

    The Democratic p;osition (5.00 / 8) (#101)
    by jbindc on Mon Mar 22, 2010 at 09:59:39 AM EST
    isn't a Democratic position. Anne's right - if the Dems said we should all walk off a cliff, you'd think that was a good idea too.

    But don't let facts get in the way of your constant rants.

    Parent

    I see (5.00 / 1) (#104)
    by Capt Howdy on Mon Mar 22, 2010 at 10:02:16 AM EST
    soooo
    the Republican position is actually the democratic position.

    Parent
    Yes, because being in favor (5.00 / 11) (#121)
    by Anne on Mon Mar 22, 2010 at 10:31:44 AM EST
    of single-payer, Improved Medicare For All is just so...republican...isn't it?

    I am not - and neither is anyone else here that I can discern - aligning with republicans on the issue of health care, and you know that.  

    For me, the bill was not liberal enough, for republicans, it was not conservative enough; there is no way they are coming closer to what I want, and I know I have no interest in helping them get what they want - they got too much as it is in this bill.  They opposed the bill because they could do so and still get a lot of what they wanted; I opposed the bill because I didn't get much of anything that I wanted: those are not the same thing.

    So, the only thing I have in common with republicans who were opposed to the bill is that I was also opposed to it.  One point of agreement does not make me a Republican any more than it makes them liberals - which is what you should be accusing them of being because of their opposition - and that doesn't make sense, does it?  Well, neither does the correlation you want to make.

    I am not in favor of vouchers for the purchase of insurance, or free-market health care, or tax cuts galore, or tort reform or health savings accounts, or any of the crap these people think will be good for the system.

    I know it's just been ever so much fun for you pushing our buttons, and doing that whole "you're an evil republican!" thing, but enough is enough.  You got what you wanted, so isn't your work here done?

    Parent

    um, yeah (none / 0) (#127)
    by Capt Howdy on Mon Mar 22, 2010 at 10:37:37 AM EST
    So, the only thing I have in common with republicans who were opposed to the bill is that I was also opposed to it.


    Parent
    Actually (none / 0) (#177)
    by jbindc on Mon Mar 22, 2010 at 12:13:18 PM EST
    You own post, that you are claiming as vindicating your position, also says so.

    AARP: Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.

    To be sure, Obama hasn't always thought that Medicare "savings" could be accomplished without actual cuts in benefits. Last fall, his campaign ran two television ads accusing Sen. John McCain of wanting "a 22 percent cut in [Medicare] benefits." The basis for the ads was a newspaper article in which a McCain aide said the Arizona Republican would cut Medicare costs. But the aide said nothing about cutting benefits, in fact quite the contrary. We called the claim "false" when Obama made it against McCain, and it's still false now when Obama...



    Parent
    Well no (5.00 / 7) (#90)
    by MO Blue on Mon Mar 22, 2010 at 09:44:00 AM EST
    Here is the ultimate paradox of the Great Health Care Showdown: Congress will divide along partisan lines to pass a Republican version of health care reform, and Republicans will vote against it. Yes, Democrats have rallied behind a bill that Republicans--or at least large numbers of them--should love. It is built on a series of principles that Republicans espoused for years. link


    Parent
    why do you think that emphasizing (5.00 / 2) (#92)
    by Capt Howdy on Mon Mar 22, 2010 at 09:47:15 AM EST
    the rightward shift of the country since Bob Dole makes your point?
    the point it makes is that we got what they could get because what we can get will be less tomorrow and the day after.

    Parent
    Hmm... (none / 0) (#112)
    by ruffian on Mon Mar 22, 2010 at 10:16:46 AM EST
    It is interesting that these were never mainstream enough Republican ideas to be enacted in the 14 years they controlled Congress.

    There are 25 or so Blue Dog House Dems that still thought this 'Republican bill' was too liberal. Don't know where they were during the Gingrich Revolution, but I imagine they would fit right in.

    Parent

    You shouldn't believe (none / 0) (#109)
    by Andy08 on Mon Mar 22, 2010 at 10:10:34 AM EST
    as "FACT" everything factcheck.org says...  They tend to parse things conveniently sometimes. Look at the budget numbers and what will be funded. Any decline in adjustment for cost of living and inflation is a CUT in future dollars.


    Parent
    Both measures could have been achieved (5.00 / 2) (#21)
    by Spamlet on Mon Mar 22, 2010 at 08:38:18 AM EST
    in separate legislation, without this bailout of a bill.

    Parent
    That's (5.00 / 1) (#26)
    by Ga6thDem on Mon Mar 22, 2010 at 08:39:33 AM EST
    not what they'll do. What they'll do is cut Medicaid and then eliminate the subsidies leaving the mandates intact.

    Parent
    I hope you realize that (none / 0) (#14)
    by MO Blue on Mon Mar 22, 2010 at 08:36:37 AM EST
    the donut hole won't be closed for ten years under this legislation.

    Parent
    let them try (none / 0) (#19)
    by Capt Howdy on Mon Mar 22, 2010 at 08:37:50 AM EST
    closing it

    Parent
    States do (none / 0) (#89)
    by waldenpond on Mon Mar 22, 2010 at 09:42:26 AM EST
    States cut their programs.  One state (AZ?) is cutting a large number of children and adults.  States maintain the right to cut those programs.  I'm not sure how that will work under a mandate... perhaps the subsidy to the private market will have to be legislated.

    Again, this is as easily a nose under the tent for a totally corporate for-profit system.

    Parent

    Or limit them, as in my "progressive" (none / 0) (#94)
    by Cream City on Mon Mar 22, 2010 at 09:48:24 AM EST
    state.  It just informed the state a few weeks ago that it could put no more people on its program for uninsured children and disabled adults.

    Have a baby or a bad accident the next day?  Sorry.

    Parent

    Never applied (5.00 / 1) (#102)
    by waldenpond on Mon Mar 22, 2010 at 10:00:46 AM EST
    It has always been an issue that those that qualify were never using the system.  A few would use out of pocket to conserve their meager savings.  I hope something is done at the federal level to adjust the means testing for medicaid before the mandate kicks in.

    Parent
    Uhh, wrong. The limits went on (none / 0) (#130)
    by Cream City on Mon Mar 22, 2010 at 10:44:06 AM EST
    because the state system was overwhelmed with far more applications -- and thus costs -- than were expected.  

    Don't know where you get your information; for mine, search madison.com.

    Parent

    Not wrong (5.00 / 3) (#141)
    by waldenpond on Mon Mar 22, 2010 at 10:55:27 AM EST
    Just additional information.  States stopping applicants because the State doesn't want to bear it's share of cost?  Obvious.  States reducing those eligible because their revenues have gone down?  Obvious.

    It is also true that not all of those eligible apply for medicaid.

    An expansion of Medicare would have been preferable to an expansion of means tested Medicaid.

    Parent

    doesn't this bill (5.00 / 2) (#150)
    by CST on Mon Mar 22, 2010 at 11:04:07 AM EST
    (or maybe it's the reconcilliation bill) also significantly increase the Fed part of medicaid funding?

    If I remember correctly, the fed will now be picking up more than 90% of the tab.  That should seriously help out cash strapped states.  I actually think the 5-10% they don't pick up is to easily allow the states that choose to to cover abortion services on medicaid.

    Parent

    Obama didn't dither (5.00 / 2) (#179)
    by lambert on Mon Mar 22, 2010 at 12:17:10 PM EST
    Bailing out the insurance companies was his preferred outcome. Why else do you think he:

    1. Took single payer off the table and censored its advocates, and

    2. Made a secret deal with hospitals that public option (so called) would never happen?)

    Everything to the left of what we got was deliberately destroyed, and by Obama. That's not "dithering."

    Parent
    I think its bigger than (5.00 / 2) (#9)
    by Capt Howdy on Mon Mar 22, 2010 at 08:32:40 AM EST
    health care.  it show democrats can actually do something.  something pretty big.  

    I actually think the psychological aspect actually doing somthing pretty big this may end up being the best and most consequential thing about it.

    Democrats proved they could do (5.00 / 11) (#11)
    by MO Blue on Mon Mar 22, 2010 at 08:34:59 AM EST
    something "big" with TARP. They now have proved that they can do something "big" for the health care industries.

    Parent
    Stephen Lynch. (5.00 / 3) (#143)
    by itscookin on Mon Mar 22, 2010 at 10:55:58 AM EST
    Democratic congressman from South Boston, real Democrat-not a Blue Dog, said this morning on NPR, "We have paid the ransom, but the kidnapppers still have the hostages."

    Parent
    so glad (none / 0) (#15)
    by Capt Howdy on Mon Mar 22, 2010 at 08:36:40 AM EST
    about your tiny minority view

    Parent
    You are kidding yourself (5.00 / 8) (#20)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:37:59 AM EST
    This bill is hardly popular.

    Parent
    It is popular now, but as the realities (5.00 / 10) (#43)
    by inclusiveheart on Mon Mar 22, 2010 at 08:50:35 AM EST
    of the legislation set in, it will become less and less so.

    Many of us will probably be on Medicare by the time the second round of the private insurers' abuses build to the point where the public demands change again.

    The question of defunding the subsidies, however, may raise a red flag earlier.  Although, the constituencies that typically receive subsidies do not hold tremendouns political power in this country.  I always thought that the subsidies should have been inextricably linked to the mandate.  Meaning that I thought that if the subsidies were defunded or reduced below a certain threshold, that should trigger a moritorium on the mandate.  That would have ensured that the private insurers who will surely like that easy cash would advocate strongly in favor of keeping the subsidies and keeping them high.

    But never mind.

    Between the financial industry and the private health insurers, I feel like carion today and it seems that there isn't a thing I can do about it.

    Parent

    Vouchers (5.00 / 4) (#91)
    by waldenpond on Mon Mar 22, 2010 at 09:47:09 AM EST
    If this legislation is successful, you won't have Medicare.  You will have a voucher (subsidy if needed) to purchase insurance through the exchanges.  This model is the Republican free (cough) market system.  The Dems have decided the free market system can best deal with the cost abuse.

    It's a completely different philosophy.  Progressive:  health care is a right and cost is best managed under single payer and other govt programs.  Conservative: free market competition and financial incentive on the individual (pricing people out of the market) will control cost.

    Parent

    Yes, I know. (none / 0) (#161)
    by inclusiveheart on Mon Mar 22, 2010 at 11:37:22 AM EST
    I didn't really want to think about that at the time that I posted, so I just skipped it.  Too depressing to ponder.

    Parent
    It's not popular now (none / 0) (#50)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:58:51 AM EST
    I don't know anyone who doesn't (5.00 / 1) (#60)
    by inclusiveheart on Mon Mar 22, 2010 at 09:06:19 AM EST
    like the concept.  But most of the people I know really do not know what is in this bill right now.  That was my point.  I should have made that clear.

    I haven't really had the heart to burst all of the bubbles that have floated in my direction in the past week.  Lots of happy, hopey people who would like to believe that their President did right by them.  But they'll figure it out eventually because we can rely on the private insurers to push it to the limit and probably beyond in continuing to abuse their customers.

    Parent

    it will grow (none / 0) (#23)
    by Capt Howdy on Mon Mar 22, 2010 at 08:38:58 AM EST
    on people

    Parent
    What parts? (5.00 / 1) (#25)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:39:31 AM EST
    are you serious? (none / 0) (#29)
    by Capt Howdy on Mon Mar 22, 2010 at 08:40:58 AM EST
    do I have to find the list of benefits?

    Parent
    It's a question (none / 0) (#34)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:43:47 AM EST
    what parts? My point is the parts that are NOT on your list will of course be vulnerable.

    Parent
    Please, patronizing (none / 0) (#44)
    by Andy08 on Mon Mar 22, 2010 at 08:52:54 AM EST
    people is hardly a winning strategy....

    Parent
    Um (5.00 / 6) (#13)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:36:24 AM EST
    okay. As long as it is "big," whether it works is irrelevant?

    Parent
    no its is not irrelevant (5.00 / 1) (#16)
    by Capt Howdy on Mon Mar 22, 2010 at 08:37:04 AM EST
    want it imagine a world where it did not pass?

    Parent
    What's that have to do with anything? (5.00 / 3) (#24)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:39:13 AM EST
    It is this incapability to understand that  "not passing it" will not be on the ballot and is now officially irrelevant.

    What WAS passed is what will be judged.

    Parent

    I agree. (5.00 / 1) (#28)
    by Capt Howdy on Mon Mar 22, 2010 at 08:40:21 AM EST
    I think it will be judged very differently than it has for the last few months.
    just in the last couple of weeks popularity has risen double digits.

    Parent
    Rally round the flag (5.00 / 5) (#33)
    by Big Tent Democrat on Mon Mar 22, 2010 at 08:42:52 AM EST
    is what that was about. Sort of like you.

    The results will be the issue now.

    In other words, whether Obama is remembered as "one of our finest Presidents" will depend upon whether ths "reform" in this bill works.

    I think it will not. If you think it will, then you should be happy, as Matt and Ezra and the Village Dems are.

    Parent

    there are a lot of (5.00 / 1) (#39)
    by Capt Howdy on Mon Mar 22, 2010 at 08:47:26 AM EST
    happy people this morning.

    I did not use that phrase but many people are.  and I dont necessarily disagree with it.

    Parent

    I'm (5.00 / 1) (#45)
    by Ga6thDem on Mon Mar 22, 2010 at 08:53:12 AM EST
    willing to bet that those people think there's going to be affordable insurance available tomorrow. What happens when that doesnt occur? Just like the stimulus, there might be temporary euphoria but if the bill doesnt work like the stimulus then there's going to be heck to pay. And as someone who has years in the insurance industry, I can tell you right now that this bill does notthing to increase affordablity. Usually the insurance companies start sending out their notices to the businesses in the fall. Mark my words this is what they are going to do: they are going to raise premiums prices and they are going to say it was because of this bill. This will probably happen right before the November elections.

    Parent
    Yes, I'm getting emails of joy (5.00 / 4) (#47)
    by Cream City on Mon Mar 22, 2010 at 08:55:40 AM EST
    from young nieces and nephews, saying yay! we have a new health care system! and yay! we have national health care! and etcetera.

    Poor things.  But they will learn, as we did, when we yelled yay! we changed the world!

    That was just before the historic conservative ascendancy, of course.

    Parent

    you are not alone (none / 0) (#78)
    by Capt Howdy on Mon Mar 22, 2010 at 09:34:09 AM EST
    no its is not irrelevant (5.00 / 1) (#17)
    by Capt Howdy on Mon Mar 22, 2010 at 08:37:13 AM EST
    want it imagine a world where it did not pass?

    Parent
    That's a big leap of faith (5.00 / 1) (#12)
    by Andy08 on Mon Mar 22, 2010 at 08:35:34 AM EST
    It also doesn't get rid of their anti-trust exemption, leaving the effective monopolies in place. This leaves us open to continued abuses by the industry and fails to do the most important cost-cutting measure, cutting out the paper pushers who serve no useful purpose in the economy. But there is good in the bill, too, and one has to be a bit Hopey that over time demands by the public will make the bad and unpopular stuff less bad and less unpopular.

    that's utopian in politics and imo the first part of this paragraph is a very very serious flaw and we'll pay a huge price for it.  

    and now that this is over (5.00 / 1) (#32)
    by Capt Howdy on Mon Mar 22, 2010 at 08:42:21 AM EST
    I have work to do.

    have fun
    and congratulations to everyone who saw something good happen last night.


    That sums it up (5.00 / 13) (#46)
    by Spamlet on Mon Mar 22, 2010 at 08:55:29 AM EST
    congratulations to everyone who saw something good happen last night

    Not "congratulations" to legislators who passed meaningful health care reform.

    Not "congratulations" to citizens who wrote and called their representatives and demanded that they pass meaningful health care reform.

    No, those citizens got punked.

    Instead, it's "congratulations" to "everyone who saw something good happen," regardless of whether anything good actually happened.

    In other words--you said it--"congratulations" for seeing something good, regardless of whether it actually is good.

    "Congratulations" to everyone who clapped the hardest and waved the biggest pom-poms and pulled off the real magic trick: convincing themselves that "something good" rather than something embarrassing happened last night.

    Now I understand your vehemence over the last few days. I get that way at tailgate parties, too.

    Party on, dude.

    Parent

    "Your work here is done?" (5.00 / 11) (#87)
    by Anne on Mon Mar 22, 2010 at 09:40:29 AM EST
    We can only hope.

    Like I said last night, glad you're happy, glad you feel victorious, but now the real work begins.

    If the Democrats, who own this legislation lock, stock and barrel, cannot deliver in line with the expectations they set, they are going to get the blame, as well they should if there is blame to be handed out.  Should it turn out to be the best thing since sliced bread, they will also get the credit, but delaying so much of the implementation means they have to hope they can stem the tide of confusion, disappointment and anger that will be bubbling up as people realize that help is years away.  

    They also have to deal with women, specifically pro-choice women who found out just how little this president regards their rights and freedoms, and that the conviction of the pro-choice caucus is meaningless.  Whether there is actual damage to those rights as a result of the executive order, the perceptual damage may be all that matters.

    We will soon see in rather stark and real terms whether this legislation represents the action of a government that places the quality of the lives and rights of its citizens ahead of the quality of the corporate bottom line; given everything else we've seen in the last 14 months, well, let's just say I'm not confident that we, the people, will be coming out on top.

    Parent

    Obviously (5.00 / 8) (#40)
    by SOS on Mon Mar 22, 2010 at 08:48:39 AM EST
    a lot of well to do feel good liberals are happy about it. I don't know whats worse these days the lunatic right or the sneering left anymore.  Getting hard to tell them apart.

    We have sneering (5.00 / 2) (#54)
    by Spamlet on Mon Mar 22, 2010 at 09:03:18 AM EST
    I don't know whats worse these days the lunatic right or the sneering left

    We have a lunatic right, and we have plenty of sneering. What we don't have is a left.

    Parent

    And a lot of poor liberals (none / 0) (#165)
    by Socraticsilence on Mon Mar 22, 2010 at 11:41:42 AM EST
    you know those who are covered under the medicaid expansion.

    Parent
    They (none / 0) (#188)
    by Ga6thDem on Mon Mar 22, 2010 at 12:43:50 PM EST
    are still not going to get care in a lot of places. Here in Ga medicaid is privatized with teh worst HMO imaginable. There's a lot of GOP governors out there who hate the program and will do everything to make sure that it is an inefficient and terrible as possible. You can't find dctors that will take it.

    So yes, make yourself feel good that these people will have coverage but it's bascially junk that doesn't do them a whole lot of good. It's catastrophic but that's about all.

    Parent

    The mandates make public anger (5.00 / 3) (#48)
    by Militarytracy on Mon Mar 22, 2010 at 08:55:48 AM EST
    something to fear.  The public has a hard time getting its anger all together on healthcare because we are all scattered over a huge spectrum.  So I look forward to being able to get angry with a lot more friends standing with me now :)  That has some potential to change what must be changed.

    Is there a cap on the % rates can rise? (5.00 / 4) (#61)
    by katiebird on Mon Mar 22, 2010 at 09:09:10 AM EST
    Is there anything to slow the rise in rates over the next 4 years?  -- If not, premium rates could double (or more) as the mandates take effect.

    I can't imagine how a family just outside the 400% of poverty mark can absorb the cost of this and have anything left.

    I don't get the joy.  This is more like fantasy-health-care (insurance) -reform.

    Parent

    no caps that I'm aware of (none / 0) (#70)
    by Militarytracy on Mon Mar 22, 2010 at 09:21:25 AM EST
    They have thrown us to the wolves but we have been thrown together now....whether we are buying junk insurance, paying fines for refusing to buy junk insurance

    Parent
    mandates will create anger (none / 0) (#52)
    by diogenes on Mon Mar 22, 2010 at 09:00:45 AM EST
    With every other insurance, they advise that you carry the highest deductible possible.  With these mandates, you have to carry straight insurance (no more catastrophic insurance policies); the people with ten thousand dollar deductible policies will pay thousands which will subsidize the others.  

    Parent
    Yes, we will demand our money's worth (none / 0) (#56)
    by Militarytracy on Mon Mar 22, 2010 at 09:04:09 AM EST
    And our demands will be meaningful.  We will all be very much on the same page.

    Parent
    I have a huge problem with getting (none / 0) (#58)
    by Militarytracy on Mon Mar 22, 2010 at 09:05:19 AM EST
    insurance denials, that group anger can now make that something that must be dealt with.

    Parent
    Does the bill take care of that? (none / 0) (#95)
    by nycstray on Mon Mar 22, 2010 at 09:50:00 AM EST
    I know they can't deny you insurance or drop you if you get seriously ill, but what about the routine treatment denials?

    Parent
    It does nothing to address (none / 0) (#137)
    by Militarytracy on Mon Mar 22, 2010 at 10:52:37 AM EST
    the denial scam that in my opinion has any teeth.

    Parent
    mt (5.00 / 1) (#151)
    by CST on Mon Mar 22, 2010 at 11:07:55 AM EST
    is the denial scam about what they say they will cover?  Or is it about them saying that you lied about health conditions?

    There was an article recently about an insurance company that repeatedly cancel anyone who was diagnosed with HIV - basically saying they had "lied" about it on their application - despite the fact that they were diagnosed after the fact.  

    Is this related to that type of fraud or something else?  If they say they don't cover it because of fraud on your part - that may be mitigated - since they are no longer allowed to change policies due to health condition anyway.  If it is something else I'm not really sure how it will work.

    Parent

    That's what I thought . . . (none / 0) (#149)
    by nycstray on Mon Mar 22, 2010 at 11:02:39 AM EST
    It is my understanding (none / 0) (#62)
    by MO Blue on Mon Mar 22, 2010 at 09:09:22 AM EST
    that some people (younger set) will be allowed to purchase catastrophic insurance policies. Also, that 60% actuarial policies will be available on the exchange.  

    Parent
    I was not aware of younger people (5.00 / 1) (#73)
    by Militarytracy on Mon Mar 22, 2010 at 09:25:54 AM EST
    being able to get away with cheaper catastrophic insurance.  If so their voices are not with us then.  A sixty percent policy just isn't going to cut it for most of us though after we've paid that damned premium.  Who can actually afford to pay premiums and also come up with 40% when they get sick?  What a rippoff

    Parent
    Yes (none / 0) (#83)
    by jbindc on Mon Mar 22, 2010 at 09:37:53 AM EST
    the under 30 set.

    Parent
    I join the sentiment (5.00 / 1) (#49)
    by andgarden on Mon Mar 22, 2010 at 08:57:09 AM EST
    Glad it passed; don't think it will do much.

    A small significant step (5.00 / 1) (#64)
    by Manuel on Mon Mar 22, 2010 at 09:13:18 AM EST
    Obviously there is a ton of work left to do but overall this is a win for health care consumers.  A defeat yesterday would have been disastrous.  I hope the doubters on the left are wrong about their fears.  In any event, it will be a struggle to hold even this shaky ground but it should be manageable.  The battle for the center goes on and the Republicans may have handed the Democrats some good arguments.  For example, David Frum thinks the Republicans overreached in their monolithic opposition and missed an opprtunity.

    It's not clear how much it benefits (5.00 / 1) (#67)
    by observed on Mon Mar 22, 2010 at 09:18:45 AM EST
    consumers at ALL.
    The main benefit is the political one of destroying the Republicans (hopefully).

    Parent
    No (none / 0) (#84)
    by Ga6thDem on Mon Mar 22, 2010 at 09:38:03 AM EST
    it is not a win for healthcare consumers. It is a loss.

    Parent
    More regulation (5.00 / 1) (#107)
    by Manuel on Mon Mar 22, 2010 at 10:05:03 AM EST
    How is that a loss?  Look, I get it that this isn't anyone's ideal for change but I think it is a stretch to claim that it isn't a net positive, however small, even if you don't think it is worth the price.

    Parent
    Do (5.00 / 3) (#110)
    by Ga6thDem on Mon Mar 22, 2010 at 10:11:51 AM EST
    you really think the regulation is going to be enforced? I understand that a large part of the regulation was removed from the final bill.

    Parent
    It is (5.00 / 3) (#111)
    by Ga6thDem on Mon Mar 22, 2010 at 10:13:40 AM EST
    not a net positive. It is a net negative. If you look at the people that it's goign to hurt (the majority) vs. the number of people it's going to help (a minority) that equals a loss. Forcing people to subsidize a private corporation or be harrassed by the IRS is hardly a win for your average citizen.

    Parent
    You could say the same thing (5.00 / 1) (#116)
    by Manuel on Mon Mar 22, 2010 at 10:23:21 AM EST
    about any minority rights legislation including civil rights.  Hwever timid, this legislation advances the notion that health care is a right and not a privilege.  Yes the funding could be a lot better but funding can be tweaked in the future.  Establishing the principle is important.

    Parent
    Oh (5.00 / 3) (#119)
    by Ga6thDem on Mon Mar 22, 2010 at 10:28:12 AM EST
    please the civil rights comparision makes me mad. Civil rights was about giving people freedoms. This bill is about taking them away. There are no freedoms gained in thsi bill. Some people will qualify for medicaid but then that's left up to the states and it's privatized here in GA with the worst HMO imaginable so people still dont get healthcare. People with preexisting conditions will be able to get coverage if they can afford the premium and the rest of us just ahve to take it on the chin it seems.

    Parent
    I am not saying they are equivalent (5.00 / 1) (#132)
    by Manuel on Mon Mar 22, 2010 at 10:45:46 AM EST
    I am pointing out an example of a law that benefits the few at the expense of the many that you would agree is just.  Obviously there are several implementation problems but this law does advance health care as a right and not a privilege.  We should turn now to figure out how to improve it and build on it because we should not want to go back.  I can understand it if you want/fear that the whole system will collapse and we can start from scratch (with single payer preferably).  For my part, I don't have the stomach for the kind of suffering that would entail so I remain hopeful that we will continue to make progress inch by painful inch.

    Parent
    This (5.00 / 5) (#152)
    by Ga6thDem on Mon Mar 22, 2010 at 11:10:49 AM EST
    bill actually sets things back in a lot of ways. It doesnt make healthcare a right like single payer would. How are you going to define this as a right when if you dont purchase it the IRS is going to hound you?

    This is not even a step towards reform. It is nothing other than a subsidy program for the currently uninsured, currently unisurable and the insurance companies. Nothing more, nothing less.

    PS. I'm not one that thought single payer could happpen this time. I think the Dems totally screwed the pooch by constanly raising the white flag to the GOP everytime they talked about opening up Medicare etc.

    Parent

    I'm still not seeing it.... (5.00 / 3) (#154)
    by ks on Mon Mar 22, 2010 at 11:13:59 AM EST
    How exactly does this bill "advance health care as a right and not a privilege" when it's largely based on the existing health insurance for profit model?  Why would we have to tolerate "suffering" and start from scratch with single payer when we could simply transition from the current model to single payer?  

    But the big flaw in your argument is this stubborn notion I see in some circles that "we can make it better".  This view never seems to take into account that it's just as likely, if not more,  that it will be made worse by the Repubs and points out one of the big flaws in this process as BTD and others have pointed out.  Namely, the effectiveness of this bill depends on the whims of who is "control" of Congress especially the budgetary process.

    Parent

    Recission is one way (5.00 / 1) (#158)
    by Manuel on Mon Mar 22, 2010 at 11:25:37 AM EST
    When I get sick, the health insurance company will not be able to cancel.  A child with pre existing conditions, will be able to get coverage.

    Of course this does not end the debate, it merely continues it.  A defeat yesterday would have silenced the debate for a long time.

    BTW Kudos are due to Pelosi for sticking with this.  I thought for sure this thing was dead.  I remain hopeful that this will show the country just how unresonable the Republicans have become.  It should be easier to hold this new ground than it would be to try to take the single payer mountain.

    Parent

    That's a terrible comparison (5.00 / 3) (#128)
    by ks on Mon Mar 22, 2010 at 10:39:52 AM EST
    The civil rights struggle was not about granting rights to a minority at the expense of the majority.  It was about extending the rights the majority enjoyed to minorities.  It was an expansion of rights.  Anyway, the idea that this legislation advances the "notion" that health care is a right or principle is pretty dubious especially when this is way more about health insurance $$$$$$$$$ than health care..  

    Parent
    Extending rights (5.00 / 1) (#146)
    by Manuel on Mon Mar 22, 2010 at 11:00:27 AM EST
    For many, this legislation is about extending access to health care that a majority of our citizens already enjoy (however poor the service).  For better or worse, a decision has been made that will keep the private insurance model of health care delivery in place.  I would agree that is not the right decision but that is no excuse for not trying to expand access.

    Progressive radical change became impossible the moment single payer or a strongg public option were taken off the table.  The whole process was a cake cutting exercise with Obama doing the cutting and carving out the smallest piece that proressives would accept.

    Parent

    Actually, the civil rights struggle (5.00 / 2) (#195)
    by Spamlet on Mon Mar 22, 2010 at 02:46:34 PM EST
    was not about extending rights. It was about ending the systematic violation of the civil rights that African American citizens already had. That's one reason why the original analogy between the civil rights legislation and this insurance bailout is so wrong, not to mention distasteful.

    Parent
    Dangerously Weak Enforcement (5.00 / 1) (#124)
    by MO Blue on Mon Mar 22, 2010 at 10:35:18 AM EST
    There are some good new regulations, but regulations are only as good as the strength of the agency tasked to enforce them. This bill is dangerously lacking in this area, leaving enforcement mainly up to the same state insurance commissioners that now often lack the will, funding, or power to hold the private insurance companies honest. Only a national exchange and a federal insurance commissioner would have the power to make sure the new regulations are more than over-hyped window dressing. link



    Parent
    Good points in that list (none / 0) (#164)
    by Manuel on Mon Mar 22, 2010 at 11:40:56 AM EST
    I agree with the list although I might have some quibbles with soe of the details.

    One overlooked advantage of the new regulations is that it levels the playing field so that new, not for profit, Vanguard style institutions, might enter the market and be competitive.

    Parent

    And Adam Lambert is one of the finest (5.00 / 1) (#66)
    by observed on Mon Mar 22, 2010 at 09:15:17 AM EST
    singers in history!
    If there is something historic about this bill, it is that it may lead to a sea-change in voting attitudes, thusly: when the choice comes down to a Republican(R) and a Republican(D), voters may choose the Republican(D) now. Woohoo!

    Given that it goes the opposite direction (5.00 / 2) (#68)
    by ruffian on Mon Mar 22, 2010 at 09:20:13 AM EST
    from what I wanted...maybe it's not all bad.

    I'm trying to evaluate it on its merits rather than comparing it to what was never going to happen. The Atrios/BTD position sounds about right.

    I sure wish my crystal ball were good enough to see how this would play out down the line for 20 or 30 years. I think given all the variables it is impossible to say right now. Both sides seem a lot more confident of their prognosticating abilities than I am.

    I'll add... (5.00 / 1) (#71)
    by ruffian on Mon Mar 22, 2010 at 09:24:44 AM EST
    to agree with BTD, whatever this is, it is not Progressive reform. It does not slam the door on Progressive reform in the future, but just barely.

    Parent
    Real (5.00 / 1) (#85)
    by Ga6thDem on Mon Mar 22, 2010 at 09:39:48 AM EST
    reform is going to happen this bill or not. This bill does nothing to stop the skyrocketing costs and actually will probably make people even angrier about our health care system than they already are.

    Parent
    Ah well, to paraphrase BTD: (5.00 / 9) (#72)
    by Cream City on Mon Mar 22, 2010 at 09:25:44 AM EST
    Insurance companies will be insurance companies.

    That is, just like pols who will be pols, they will screw us.  We just don't know when, we don't know where.  But we know they will.

    The best thing in it might be (5.00 / 1) (#76)
    by ruffian on Mon Mar 22, 2010 at 09:28:35 AM EST
    the non health care related part about bringing student loans back under government administration.

    heh (5.00 / 1) (#123)
    by CST on Mon Mar 22, 2010 at 10:34:29 AM EST
    it is a little funny.  While we don't have a "government takeover of healthcare" we do have a "government takeover of student loans".

    And none of the wingbats even noticed.

    I'll take it.

    Parent

    they noticed it (5.00 / 1) (#126)
    by Capt Howdy on Mon Mar 22, 2010 at 10:36:04 AM EST
    they are just being completely drowned out

    Parent
    Are those (none / 0) (#136)
    by jbindc on Mon Mar 22, 2010 at 10:52:20 AM EST
    only on new loans?  In other words, does that affect anyone who's already graduated and is paying on student loans?  

    Parent
    it says (5.00 / 1) (#148)
    by CST on Mon Mar 22, 2010 at 11:01:05 AM EST
    if you have an existing loan, and have begun paying it back (read - graduated) you can still switch to a federal loan.

    So no, it's not only on new loans.

    Woot woot!

    Parent

    And this takes place.....? (none / 0) (#159)
    by jbindc on Mon Mar 22, 2010 at 11:29:01 AM EST
    when?

    I'll fill out the paperwork as soon as he signs the bill, if that's the case.

    Parent

    I have been very critical (none / 0) (#153)
    by MO Blue on Mon Mar 22, 2010 at 11:11:24 AM EST
    of the health insurance legislation. Only fair to say that from what I've read about bringing student loans back under government administration, I do like this legislation.

    Parent
    Paper towel, Matt? (5.00 / 4) (#80)
    by lambert on Mon Mar 22, 2010 at 09:34:33 AM EST
    Jeebus.

    LOL!! (none / 0) (#81)
    by Spamlet on Mon Mar 22, 2010 at 09:36:26 AM EST
    Basically (5.00 / 4) (#93)
    by TeresaInSnow2 on Mon Mar 22, 2010 at 09:47:29 AM EST
    they passed a tax increase on the middle class last night to be funneled directly to insurance companies.  Many families of four still won't be able to afford the insurance.  Even with the subsidies, their out of pocket premiums portions will be too high.  Many people will be paying the fine instead of paying for some doctors visits out of pocket.  Healthcare will reduce.

    Case in point: My SIL is a single mom who currently has no dependents because they're both over 21, but is at the threshold of not getting subsidies, while still not being able to afford insurance. Besides owning a house upside-down that is a money pit, she just put two kids through college  and is paying off loans for private colleges for the next decade. (She's a bit of a sucker in regards to private versus public colleges.)   While she looks like she's okay financially on paper, she's dirt poor.  She plans to put the money she would have paid toward getting herself some healthcare every year toward the tax.  She doesn't plan to insure.

    How many people out there are like her.  I'll bet it's more than a few.  And when premiums rise ridiculously because no cost controls exist but we're forced to buy insurance from a monopoly, then even more people will drop off.  I will drop off because it makes more sense to pay the tax and self-insure.

    The Democrats have written their own path to destruction.  Was it the plan all along?  Do even they prefer one-party Republican rule?  Personally, I think it's kind of obvious that they do. Dionne might think so now too.

    My fate is sealed.  I will never vote for a Democrat again.  They aren't better than Republicans in any meaningful way.

    Surreal, Orwellian even. (5.00 / 6) (#117)
    by Dr Molly on Mon Mar 22, 2010 at 10:24:57 AM EST
    Now that it's done, Barack Obama will go down in history as one of America's finest presidents. [. . . F]undamentally, he's reshaped the policy landscape in a way that no progressive politician has done in decades.

    Really? Exactly how has he done that?

    just want to say (5.00 / 5) (#118)
    by CST on Mon Mar 22, 2010 at 10:27:11 AM EST
    I'm glad it passed, I think it will help people.

    But let's not forget there's a long way to go still.

    I honestly see this as the beginning not the end.  Private insurance is not a sustainable model.  This bill will help the most vulnerable in the short term, but I also believe it will help expose the fact that there is no true reform based on the private model.

    Basically in my mind the best case scenario is - the people who are most vulnerable get some assistance, and this bill sets up a system where in the future we can now say "we actually tried to reform the private model, it wasn't enough, time to go public".

    Was public insurance possible at this moment in history - I think yes, but we didn't get it.  So I'll take what I can get, and lets continue working.

    Also - Nancy Pelosi is really something.  Of all the players in this match, she has impressed me the most - perhaps I should say, she's the only one who's impressed me.

    chris bowers gets it (5.00 / 2) (#122)
    by Capt Howdy on Mon Mar 22, 2010 at 10:34:24 AM EST
    Personal reactions:

    I feel relief that the most difficult aspects of this specific fight are over.  This was just an utterly grueling fight.

    I feel grateful to everyone who participated in this fight, even to those on the left who opposed final passage.

    I feel determined, in that this is just a step in the right direction.  There is a long way to go before we achieve universal health care in this county.

    I feel sad that it came at the cost of throwing reproductive rights under the bus.  Any win that means hurting some of your friends is not a full win.

    I feel frustrated, because I know we could have won the public option campaign, but it didn't happen.

    It feels good that Democrats did something with their majority.  I hope it works out well, and provides the benefits its strongest supporters say it will.



    Parent
    Chris Bowers channels (5.00 / 3) (#131)
    by Anne on Mon Mar 22, 2010 at 10:45:45 AM EST
    Stuart Smalley: gosh darn it, he's good enough, he's smart enough and people like him!

    Parent
    Maybe J will put up (5.00 / 3) (#134)
    by ruffian on Mon Mar 22, 2010 at 10:47:59 AM EST
    'Feelings' for us later.

    Parent
    and I agree completely (5.00 / 1) (#125)
    by Capt Howdy on Mon Mar 22, 2010 at 10:35:28 AM EST
    about Nancy.  she lived up the the worst boogie woman fantasies of the right.


    Parent
    The problem is (5.00 / 2) (#129)
    by nycstray on Mon Mar 22, 2010 at 10:43:23 AM EST
    how many people will be adversely effected to prove the private model is not sustainable? And how long will it take to reform it and at what cost?

    Parent
    well (5.00 / 2) (#145)
    by CST on Mon Mar 22, 2010 at 10:58:59 AM EST
    I know people are adversely affected by health insurance companies all the time under current law, but I don't think the expansion of health insurance in this bill will adversely affect people.  People will be hurt by what the bill doesn't do, not by what it does do.  And I've tried to judge the bill by what it does rather than what it doesn't do, because then I can decide whether I think it's better than the status quo, not whether I think it's the best bill possible (it's not even close).

    How long?  I don't know.  But I actually think we are closer today because of this bill, rather than further.  If only because we now have a federal model that says everyone should be covered.

    I will add, I know people are worried about the mandate and how that will hurt the middle class, but from my personal experience with the MA bill - most people who can't afford insurance DO want it (even those under 30).  And I don't think younger people or middle class people will choose to "opt out" and pay the mandate.  In fact, one problem we had in MA was that more people signed up than were expected to.

    Parent

    Well (5.00 / 9) (#120)
    by Emma on Mon Mar 22, 2010 at 10:31:34 AM EST
    this:

    [. . . F]undamentally, he's reshaped the policy landscape in a way that no progressive politician has done in decades.

    is certainly true.  1)  He's publicly reshaped the Dem party into a moderate Republican party and 2) as part of #1 he's taken abortion off of the political table by creating a more-or-less anti-choice Democratic party.

    At the least he's certainly reshaped the abortion debate and the Dem platform.  He's very effectively served notice that, so long as Roe remains technically intact, Dems will happily enact anti-choice policies in service to other political ends.  

    It seems very clear that "choice" is no longer a policy goal for Dems.  As far as Obama and today's Dem party is concerned, the status quo is the apotheosis of Dem efforts on women's reproductive rights and women's health care needs.

    It remains to be seen whether this will mean anything to american voters, particularly women on the left.  My prediction:  No.

    Thread cleaned of (5.00 / 1) (#201)
    by Jeralyn on Mon Mar 22, 2010 at 11:40:01 PM EST
    personal snipes and one-line insults. It's staying closed.

    This is incrementalism, (none / 0) (#75)
    by Realleft on Mon Mar 22, 2010 at 09:28:02 AM EST
    for better or worse.  The politics of the day pull for calling it some kind of sweeping reform, when it's really not, to the disappointment of many.  But its passage is also the disappointment of many others.  For myself, I agree that many aspects could have been handled and framed better, but I also think this should never have been put forth to dominate the year's agenda.

    He supports the President (none / 0) (#98)
    by waldenpond on Mon Mar 22, 2010 at 09:52:33 AM EST
    Capt supports the President and the legislation the Dems pass.  It is not possible that Capt will feel a 'loss.'

    yes (5.00 / 1) (#106)
    by Capt Howdy on Mon Mar 22, 2010 at 10:04:48 AM EST
    I confess.  I support the president.  AND the democrats.  get out the tar and feathers.

    as far as supporting the legislation, I think I have been pretty clear about my feelings about the legislation.

    Parent

    That was not an insult (5.00 / 2) (#133)
    by waldenpond on Mon Mar 22, 2010 at 10:46:44 AM EST
    Not an insult Capt.  You have legitimate and reasoned thoughts on why you support the President and his legislation (I've told you this before.)  I don't think you have to 'twist' to do it either.

    We agree on some points and (flat out) disagree on others. :)

    Parent

    fair enough (5.00 / 1) (#139)
    by Capt Howdy on Mon Mar 22, 2010 at 10:52:54 AM EST
    I salute you.  you do good work here.


    Parent
    Kind of like (3.00 / 2) (#193)
    by Spamlet on Mon Mar 22, 2010 at 02:41:18 PM EST
    this?

    That's pretty much who Obama most reminds me of, though of course Obama's health care plan is quite a bit farther right.

    Parent

    Sher, care to compare (none / 0) (#198)
    by Spamlet on Mon Mar 22, 2010 at 03:01:07 PM EST
    Obama's health "reform" with the one that Richard Nixon and Ted Kennedy were discussing? Do you even know anything about it?

    Or would you prefer to lurk in the shadows and troll-rate people who don't praise Obama unconditionally?

    Parent

    The Kennedy-Nixon (none / 0) (#200)
    by Socraticsilence on Mon Mar 22, 2010 at 06:51:03 PM EST
    bill was farther left than Clinton's not to mention Obama's- but then again with the exception of Carter, you could argue Nixon was the most left-wing economics president since 1968- rationing, price-fixing, healthcare etc.

    Parent
    Anyone not anything (none / 0) (#105)
    by waldenpond on Mon Mar 22, 2010 at 10:03:34 AM EST
    Just a note... I think Yglesias is saying the President is progressive not the legislation.

    Which would also be incorrect.