Reconciliation Fix Going Back To The House, Time For PO Amendment


Senate Republicans learned early Thursday that they will be able to kill language in a measure altering President Barack Obama's newly enacted health care overhaul, meaning the bill will have to return to the House for final congressional approval.

Because of this, there is no reason not to try and add a public option via amendment. Yesterday I was critical of David Sirota's campaign to have Senator Bennet offer such an amendment. This new development changes that. I'm with Sirota now:

Speaking for me only

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    My guess is (5.00 / 4) (#1)
    by Coldblue on Thu Mar 25, 2010 at 06:19:44 AM EST
    that since this development, the White House has been in contact with Sen. Reid whipping against any public option amendment.

    They could have used this opportunity (5.00 / 1) (#90)
    by MO Blue on Thu Mar 25, 2010 at 12:23:54 PM EST
    to fix the wording on pre-existing conditions for children. FDL is reporting that the Dems will offer no amendments so it looks they are not even going to do that.

    It wasn't a bug. (none / 0) (#102)
    by itscookin on Thu Mar 25, 2010 at 01:17:15 PM EST
    It was a feature.

    Although (none / 0) (#17)
    by robotalk on Thu Mar 25, 2010 at 09:15:11 AM EST
    he now has the perfect excuse--"well, I could never have foreseen this.  Sorry about the promises I made you, this is out of my hands now."

    Here's the dirty secret I mentioned (5.00 / 2) (#2)
    by andgarden on Thu Mar 25, 2010 at 06:25:23 AM EST
    last week: I don't think the House has the votes for a PO anymore. Sanders was quoted in an article yesterday as saying that it was possible that the could pass one through both chambers, but that he didn't think it was worth the risk of sinking the reconciliation package. And of course, that leaves open the question of expanded Medicare, which should be an easier sell.

    I could go either way on trying this.

    Then Pelosi should say so (5.00 / 1) (#7)
    by Big Tent Democrat on Thu Mar 25, 2010 at 07:30:42 AM EST

    Indeed (none / 0) (#8)
    by andgarden on Thu Mar 25, 2010 at 07:36:56 AM EST
    If the process (none / 0) (#21)
    by robotalk on Thu Mar 25, 2010 at 09:21:37 AM EST
    gets us accountability--simply members voting on the public option--it's still a plus. At least an explanation on how the po votes were lost.

    Doubt it will happen, though.  You already saw how easily the senate evaded taking a vote on public option.


    What changed? (5.00 / 1) (#18)
    by Faust on Thu Mar 25, 2010 at 09:16:12 AM EST
    Just curious what changed in the house that would cause the loss of appetite for the public option? Is it just that the 'cons successfully shifted the overton window and the conservadems can't go there anymore?

    Yes (none / 0) (#22)
    by ruffian on Thu Mar 25, 2010 at 09:22:15 AM EST
    With the help of the conservadems (none / 0) (#23)
    by ruffian on Thu Mar 25, 2010 at 09:22:57 AM EST
    I might add

    I dunno (5.00 / 1) (#20)
    by CST on Thu Mar 25, 2010 at 09:20:29 AM EST
    they should at least get that so-called "progressive" Lynch from MA who was oh so upset about the lack of a public option - I'd like to see this come through just to call that bluff.

    But in all seriousness, who in the house would dare change their vote at this time over something they have now passed twice?

    I think you are right, there are some who no longer want this, but I bet they can be shamed into voting for it.  It's too late for them to turn back now.


    Bingo... (none / 0) (#3)
    by masslib on Thu Mar 25, 2010 at 07:14:03 AM EST
    "I don't think the House has the votes for a PO anymore."

    But, no harm in trying I guess.


    What's the risk of failure? (none / 0) (#4)
    by observed on Thu Mar 25, 2010 at 07:14:20 AM EST
    The original Senate bill is now law, right?

    The reconciliation package is a genuine (5.00 / 3) (#6)
    by andgarden on Thu Mar 25, 2010 at 07:19:10 AM EST
    improvement in a number of ways. Not least of which is the increased Medicaid funding and the student loan modifications. The question is whether adding a PO would endanger final passage.

    Yes (none / 0) (#101)
    by Socraticsilence on Thu Mar 25, 2010 at 01:15:43 PM EST
    Reform is going through one way or another, this is just an improved form of it.

    it would be pretty ironic (5.00 / 2) (#15)
    by Capt Howdy on Thu Mar 25, 2010 at 09:14:15 AM EST
    if the republicans out smarted themselves (again) and got a public option for their trouble.

    I've been wondering (none / 0) (#36)
    by Manuel on Thu Mar 25, 2010 at 10:04:50 AM EST
    In the event the Supreme Court overturns the mandate, would some public option be a fix?  e.g.  You can buy insurance or you can buy into medicare.

    I have been reading (none / 0) (#40)
    by Capt Howdy on Thu Mar 25, 2010 at 10:09:56 AM EST
    even at volk that there is almost no chance that will happen.   unlikely they will even hear the case.

    It would not fix the problem (none / 0) (#42)
    by andgarden on Thu Mar 25, 2010 at 10:11:31 AM EST
    the Attorneys General claim to have with the penalty. It would be a good thing to do anyway, though.

    If that happens (none / 0) (#103)
    by Socraticsilence on Thu Mar 25, 2010 at 01:17:21 PM EST
    the Insurance industry will panic unless the overturn throws out the entire bill- without the mandate the bill basically destroys the insurance industry without leaving any system to take up the slack.

    Obama (none / 0) (#63)
    by TeresaInPa on Thu Mar 25, 2010 at 10:56:21 AM EST
    doesn't want a public option.  He promised his corporate donors in big medicine (insurance and hospitals) he would not propose one or let anyone else do it either.
    So there is no way, even if the republicans wanted to, for a PO to happen.

    In IA today someone kept calling for PO-Obama said (none / 0) (#120)
    by jawbone on Thu Mar 25, 2010 at 07:05:06 PM EST
    there were never enough votes for the public option.

    He didn't bother to add that he made damn sure there wouldn't be the votes by making sure there was never going to be a vote on PO (of whatever type, and absolutely never ever Medicare for All. Not St. Ronnie-fied enough.)

    Robert Reich wrote in TPM that Obama's bill was born in the Heritage Foundation conservative think tank. But he does feel it is indeed a big deal politically.

    So don't believe anyone who says Obama's health care legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama's health bill is a very conservative piece of legislation, building on a Republican rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option.

    The significance of Obama's health legislation is more political than substantive. For the first time since Ronald Reagan told America government is the problem, Obama's health bill reasserts that government can provide a major solution. In political terms, that's a very big deal.

     CJR's Trudy Lieberman, an excellent source of information and analysis on health care topics adds her take to his piece.

    Reich concluded: "Obama's health bill is a very conservative piece of legislation building on a Republican rather than a New Deal foundation." Perhaps this explains why Obama was lukewarm and equivocal about a public option--much too close to single payer and the Great Society-New Deal paradigm. Key elements of the law are right out of the conservative playbook.

    Years ago, conservatives and their think tanks latched onto the individual mandate as the way to get health insurance to Americans. It was ideologically more acceptable than requiring all employers to provide coverage for their workers, and vastly more palatable than a single payer system. Tax credits, too, surfaced years ago, and gained some traction during the 2004 presidential race, when both John Kerry and George W. Bush embraced tax subsidies for families with lower incomes.

    At the time, Michael Chernew, then a health policy expert at the University of Michigan and now at Harvard, told The Nation that "the evidence suggests that subsidizing insurance premiums will be a relatively expensive way to encourage coverage, and relatively few people would respond." This year's version is still expensive, but Congress addressed the second part of Chernew's critique; the individual mandate with penalties will require people to respond.

    High-deductible insurance is now an integral part of the American health care model. Policies sold in the small group market, for example, will carry deductibles of $4000 for families and $2000 for individuals. As in Massachusetts, policies sold in the Exchanges will also carry high deductibles. The conservative think tank National Center for Policy Analysis--along with Patrick Rooney, then CEO of Golden Rule Insurance, which is now part of the giant UnitedHealth Care--pushed Congress to allow high-deductible health plans. They are quickly moving into mainstream insurance acceptability.

    A look at the history of the Massachusetts reform law, the model for national legislation, shows that the Commonwealth Health Insurance Connector--the state's name for its shopping exchange--was born at the conservative Heritage Foundation. A document circulated by the staff of Gov. Mitt Romney at the time called for a law reflecting "a culture of insurance" and "personal responsibility"--the latter a keystone of conservative ideology.

    The embrace of conservative ideas also helps explain why real cost containment didn't make it into the final product. Curbs on prices are anathema to American business, and perhaps that's why the president made a deal with the drug companies early on not to fight for negotiated prices in the Medicare program, a pledge he had made during his campaign

    Here is a link for Trudy Lieberman's work at CJR. She is very good and worth reading.


    Pat on the head goes a long way (none / 0) (#125)
    by good grief on Thu Mar 25, 2010 at 10:07:54 PM EST
    Obama doesn't want a public option.  He promised his corporate donors in big medicine (insurance and hospitals) he would not propose one or let anyone else do it either. (Teresainpa)

    In case anyone needs the smoking gun news report documenting this statement, here's the Aug 2009, NYT article.  When Ed Schultz discovered this tidbit of truth from the Aug 2009 Times (beyond the rumors we're heard of various deals) and brought it up on his show March 15 (over 8+ months after the deal with no reporting on this particular "no-PO" deal in the interim until just recently when it was too late), Ed tried to interest Adam Green in expressing some outrage. Mr Green, however, being a good progressive (head of something called BoldProgressives) and faced with the fact that this old truth rendered moot his efforts to lobby a PO into the HCR bill, and being loyal to the cause of protecting his dear president, curled up into a little ObamaBall and said benignly, "Now's not the time for finger pointing." Wow, that was a watershed moment.

    All this talk about "veal pens" and WH throwing progressives under the bus like poor Adam Green makes me wonder two things: 1) Isn't "throwing under the bus" a bit too deadly a metaphor and then they're gone? Why not just a pat on the head the way it used to be phrased, so they can be used again? 2) Was Green (and hundreds of other progressives) used by the WH to present a faux-campaign to whip the PO to pretend sincere energy that Obama could point to in showing his direction, only to quietly collapse at the end?  And then this guy Bennet? A whole system of "progressives" seemed to quietly and conveniently collapse.

    Now I'm trying to figure what happened to Ed Schultz who, after stumbling upon that odd response from Adam Green to the NYT article (as did Greenwald and Hamsher and others), himself didn't seem to do anything with it but instead folded up into a rather larger (than Green) ObamaBall and became the virtual official MC on MSNBC for the bandwagon leading up to the final vote, master of ceremonies of the "No PO, no dissent" parade to passage.

    Whatever the hell happened, it was hard to watch. I felt a pang of remorse missing the insights of George Orwell.


    Edit of above (typing too fast) (none / 0) (#126)
    by good grief on Thu Mar 25, 2010 at 10:28:40 PM EST
    Next to last par, "what happened to Ed Schultz" onward should read, "after stumbling upon the NYT article (as did Greenwald and Hamsher and others), and that odd response from Adam Green, himself didn't seem to do anything with it but instead folded up"  . . .

    It (none / 0) (#124)
    by lentinel on Thu Mar 25, 2010 at 08:20:51 PM EST
    could happen -- but it would require that the democrats wanted a public option which they clearly do not.

    It is a giant missed opportunity.

    P a t h e t i c.


    And (5.00 / 3) (#68)
    by DancingOpossum on Thu Mar 25, 2010 at 11:08:30 AM EST
    who has been vilified throughout this entire process?

    The same people we are now mandated by law to give our money to. Oh yeah, they really hate that!! They are fuming!

    No, what they were opposed to was any semblance, any shred, any faint whiff, of a "public option" or of "government-run healthcare," because that would be socialist, I mean, might cut into their profit margins. Well, they got their wish--and tens of millions of new customers forced to buy their product whether or not they like it, want it, or can afford it. (Oh yes, I know, you can always just pay a fine and deal with the IRS, an organization renowned the world over for its compassion and kindliness--of course you won't get any health coverage at all if you do that, but then again, since you aren't choosing to prop up the insurance companies, and by extension President Obama and the Congress, then your country doesn't need you anyway so your death is no biggie.)

    It's almost like, what was the term, "compassionate conservatism?" Maybe we need a new one: parasitic progressivism? Doesn't have quite the same ring. I'll work on it.

    "Parasitic progressivism" (5.00 / 1) (#87)
    by gyrfalcon on Thu Mar 25, 2010 at 12:03:40 PM EST
    is pretty darn good, IMHO.  Less sexy and non-alliterative would be Corporatist Progressivism.

    NOW says this reform bill is set back for womens (5.00 / 2) (#77)
    by fly on Thu Mar 25, 2010 at 11:25:43 AM EST

    read what Terry O'Neil says about this bill!

    Oh and she will be on Bill Moyers PBS show tommorrow night discussing this..oh and I called the contact person this morning to confirm that these are indeed facts..not Terry O'Neils opinions.( as has been accused by many in other places i posted this!) ....they are facts.


    Some of their facts are misleading at best- (5.00 / 1) (#104)
    by Socraticsilence on Thu Mar 25, 2010 at 01:24:27 PM EST
    "Gender-rating" for instance- yes the bill fails to prohibit it in some circumstances- however current federal law allows it in all circumstances (some states require gender equity- this wouldn't change).

    The part saying all public funds are now prohibited is way, way off- the bill wouldn't restrict state medicaid funds which are currently used (it doesn't alter Hyde with regards to public funding), and the two check solution while not ideal does make it possible for private insurance to still cover abortion via a rider.

    Finally, the part about not covering unregistered immigrants is true- but fails to mention the problems that doing so would pose politically ("illegals are getting your healthcare dollars!"), structurally (how do you impose a mandate if someone is living without valid tax and identification records), and financially (unregistered immigrants make up a significant portion of those currently uninsured- estimates run as high as 20 million of the approx. 50 million total).


    There (none / 0) (#116)
    by Ga6thDem on Thu Mar 25, 2010 at 02:38:02 PM EST
    is not going to be a "two check solution" the reality is that even if you are paying the majority of the premium you aren't going to get abortion coverage due to the executive order signed by Obama and insurance companies are not going to be offering that solution because they are going to say it's not feasible due to overhead costs or somesuch. You probably could buy the coverage on the open market from someone like AFLAC who specializes in supplemental coverage but in reality it simply just isn't going to be offered in the exchanges due to the executive order.

    Obama's back alley signing of Coathanger Option (none / 0) (#115)
    by Ellie on Thu Mar 25, 2010 at 02:31:19 PM EST
    The WH already got the Nuthin' Accomplished propaganda they wanted. This was just a formality, fauxgressive men's burden and all that ...

    ... The Obama administration's decision to bar journalists from the signing of an executive order on abortion Wednesday drew fire from some in the White House press corps, who said it went against President Barack Obama's frequent pledges of transparency.

    The White House did not allow news reporters or photographers into Wednesday's Oval Office signing of the order reaffirming a ban on federal funding of abortion. Instead, it released an official photograph by White House photographer Pete Souza that some news organizations, including CNN and POLITICO, declined to use. [...]

    Nonetheless, reporters took their frustration out on the press secretary, Robert Gibbs, in Wednesday's daily briefing, after no pool reporters were allowed to cover the signing of the executive order [...]

    Sorry, Sweeties, better luck forty years from now.


    Not bloody likely... (5.00 / 1) (#95)
    by lentinel on Thu Mar 25, 2010 at 12:56:26 PM EST
    This bill got passed for two main reasons, imo.

    One was the sacrifice of women's reproductive rights.

    The other was Obama promising the Hospital lobby and the insurance industry that there would be no public option.

    This mess was reluctantly accepted by those who projected the thought that it was a first step, a starter home, a beginning...

    In my opinion, this is it.
    There ain't gonna be a step two.

    Too late (5.00 / 2) (#99)
    by andgarden on Thu Mar 25, 2010 at 01:03:17 PM EST
    Senate voting on final passage now.

    ha ha (4.00 / 3) (#64)
    by DancingOpossum on Thu Mar 25, 2010 at 10:59:56 AM EST
    The "facts" vicnadbx posted actually bolster Anne's point. LOL...you posted a letter from Wellpoint urging Obama to drop the public option and somehow this is evidence that there was no deal? I hope you are not a lawyer.

    What are you talking about? (5.00 / 1) (#118)
    by vicndabx on Thu Mar 25, 2010 at 02:56:20 PM EST
    I hope you aren't a lawyer either.  How does it "bolster Anne's point?"

    Why would a public campaign against something be needed if there was already a secret deal in place against it?  Oh I see, it was all for show.  Please.

    Some of you are truly amazing.  When you can't present a serious argument you resort to personal attacks - it's really sad.  


    What is the measure the Times refers to? (none / 0) (#5)
    by masslib on Thu Mar 25, 2010 at 07:14:40 AM EST
    The mandate?  

    No, it has to do with the student loan (none / 0) (#9)
    by Anne on Thu Mar 25, 2010 at 08:01:06 AM EST
    provisions that were included:

    A senior Democratic aide said one of the problematic items is a "hold-harmless provision," which was designed to prevent reductions in individual student grants if appropriated funds for Pell Grants declines. The second adjustment was described as "a conforming change, to strike obsolete language."

    "These changes do not impact the reforms to the student loan programs" contained in the health-care legislation, said the aide, who spoke on the condition of anonymity.


    oops - my comment was intended to (none / 0) (#10)
    by Anne on Thu Mar 25, 2010 at 08:03:54 AM EST
    be a reply to mass at #5; I guess it's going to be one of those days for me.

    Unions will not allow the house to throw in (none / 0) (#11)
    by Buckeye on Thu Mar 25, 2010 at 08:47:45 AM EST
    a public option.  If the recon bill does not survive, they are the big losers.

    What? (5.00 / 1) (#12)
    by inclusiveheart on Thu Mar 25, 2010 at 08:53:14 AM EST
    The unions would have been very happy to have had a public option - and specifically an expansion of Medicare to buy into.  It was only after it became clear that there was no public option to be had and that their benefits were going to be subjected to the "cadillac" tax that they had to go in a cut a better deal.

    The problem (5.00 / 1) (#13)
    by andgarden on Thu Mar 25, 2010 at 09:08:42 AM EST
    Is the risk of killing the reconciliation package.

    I understand that. (5.00 / 1) (#26)
    by inclusiveheart on Thu Mar 25, 2010 at 09:25:43 AM EST
    But they have an interest in a viable public option being enacted as in an expansion of Medicare - so if it would pass the House, I don't think they'd object.

    It already passed the house and died in (none / 0) (#29)
    by Buckeye on Thu Mar 25, 2010 at 09:36:49 AM EST
    the senate.  If the recon package dies, unions will eat the excise tax, which they hate.   They will not put that at risk.

    wtf are you talking about? (none / 0) (#31)
    by Salo on Thu Mar 25, 2010 at 09:46:55 AM EST
    I think you may have a point (none / 0) (#43)
    by Capt Howdy on Thu Mar 25, 2010 at 10:12:30 AM EST
    in that everyone is simply to exhausted to do it at this point.

    then they need to leave office (5.00 / 1) (#65)
    by TeresaInPa on Thu Mar 25, 2010 at 11:02:07 AM EST
    to tired?  Pathetic.   they are not nearly as tired as those people who support them and then get stabbed in the back over and over.
    Last night I hear Obama saying how they had done what generations of American have been waiting for in passing this health insurance protection act.

    I had to laugh, no this is NOT what we have been waiting for.  We have been waiting for real health care reform, not a give away to Insurance companies at the expense of the middle and lower classes.


    I wouldn't say tired so much (none / 0) (#105)
    by Socraticsilence on Thu Mar 25, 2010 at 01:26:43 PM EST
    as it being a bad bet for them- altering the excise tax is too important to their members for them to risk it on the at best 50% chance of getting the PO through.

    I doubt it will happen, but just (none / 0) (#53)
    by inclusiveheart on Thu Mar 25, 2010 at 10:30:31 AM EST
    for the sake of exploring this particular dynamic - if the Senate were to take it up and send it back to the House, there are reports that the House would have the votes to pass it.  The unions aren't going to stand in the way of a public option that benefits their membership that would pass - and it would never be introduced at this stage without everyone being sure that it would pass - which leads me back to my first point which is basically that I doubt a PO amendment would be introduced in the Senate at this point because it would be "too risky" - additional reports claim that the Senate will vote on the final today and then the House will vote right afterwards - wrapping it all up today - if that is the plan, chances are low that the leadership is going to introduce any new material, at all.

    Agreed. Which is my point. (none / 0) (#60)
    by Buckeye on Thu Mar 25, 2010 at 10:46:14 AM EST
    If a PO thrown into the recon bill puts its passage in jeopardy, it will not get done if for no other reason, unions will push hard against it.  Would unions like a PO for their members?  Absolutely.  But if a PO places passing the recon bill in jeopardy (and it would), then they will push the dems in the house to not include it.  The stand alone senate bill is not acceptable to unions.

    I don't really think that the unions (5.00 / 1) (#66)
    by inclusiveheart on Thu Mar 25, 2010 at 11:03:14 AM EST
    or any other interest group really have a say in what happens with respect to procedure at this point.

    Really? Unions are the big reason (none / 0) (#89)
    by Buckeye on Thu Mar 25, 2010 at 12:18:02 PM EST
    we have a recon bill to begin with.

    Yes, but not today - not now. (5.00 / 2) (#91)
    by inclusiveheart on Thu Mar 25, 2010 at 12:34:45 PM EST
    They are in an internal process of moving the bill through the two houses right now.  They aren't taking calls outside of what it required to get the Senate vote done and the subsequent House vote - and all of that is internal having to do with the politicians who have the ability to vote.  Now if one or either is derailed over night, things could change, but the process is going to be largely focused on the Members and the votes for what is in play now - not anything additional.

    I would like to know that as well! (none / 0) (#83)
    by fly on Thu Mar 25, 2010 at 11:58:41 AM EST
    the uions should and would be happy with a PO or Medicare for all..the unions will be hit with the excise tax in 2018 is nothing is done..which will mean..Union workers will lose benefits..because the Unions nor employers are going to be willing to pay a 40% tax on the plans that exist today..this bill as is is a lose lose for the American worker!..especially union workers!

    Which PO plan would they throw in at this (none / 0) (#14)
    by ruffian on Thu Mar 25, 2010 at 09:09:33 AM EST
    late date? I guess it doesn't matter since it will not pass anyway. but sure, let's get everyone on the record.

    Would it be a separate amendment with a separate vote, or would killing it kill the whole reconciliation package?

    "A" public option? (5.00 / 1) (#16)
    by Anne on Thu Mar 25, 2010 at 09:14:54 AM EST
    "The" public option?  The original-and-barely-breathing House public option?  Something stronger?  A Medicare buy-in?

    For sure it has to be something that's already been written, because they don't have the time to put together something new if they are to recess on time for Easter.

    So, forget it; it's not going to happen.  The president can't betray the insurance companies he made private assurances to, the House isn't going to be the fall guy for the failure to pass the reconciliation "fix," so the votes for some kind of public option aren't going to be there.  

    It's not going to happen; that opportunity should have been there at the beginning of this 14-month endeavor, it should have been an equal part of the discussion and the public hearings, but it wasn't, and it won't be now, and we know why.

    Gives new meaning to the phrase, "that's how they roll," doesn't it?


    Yup (5.00 / 1) (#24)
    by ruffian on Thu Mar 25, 2010 at 09:24:45 AM EST
    The idea that anything is going to happen now seems pretty fanciful to me. I'll start watching for unicorns if it happens.

    This is wrong (none / 0) (#25)
    by vicndabx on Thu Mar 25, 2010 at 09:25:29 AM EST
    The president can't betray the insurance companies he made private assurances to

    Insurance co's don't like this bill - there's no cost control.  Oh I know the argument, "but, but, they're gonna get a bunch of customers!"  That's all well and good, but it don't mean much if those customers are costing much more than they put in.

    The promises were made to the providers of service - hence the reason why the large organizations signed on - PNHP notwithstanding.  None of the PO plans ever had cost controls in terms of reimbursement - the only thing the keeps Medicare cheap.


    The insurance companies don't like this bill (5.00 / 1) (#28)
    by ruffian on Thu Mar 25, 2010 at 09:32:05 AM EST
    but they would have hated one with a public option a lot more.

    You punch me in the face (none / 0) (#30)
    by vicndabx on Thu Mar 25, 2010 at 09:46:50 AM EST
    while someone else kicks me in the back.

    Doesn't mean I'd accept getting punched in the face because getting kicked at the same time will hurt more.  

    I don't really understand your point.  Ins Co's would've opposed it....more?  I highly doubt there were any deals - who has been vilified throughout this entire process?


    It's not a question (5.00 / 4) (#35)
    by gyrfalcon on Thu Mar 25, 2010 at 10:03:47 AM EST
    A couple of people who were part of the closed-door negotations between Obama and the ins. industry have come forward to report on the details.

    The biggie he promised was no public option if they'd mute their opposition to the rest of the ideas.  Obama was able to make this bargain with them because both he and they knew there was enough support in both House and Senate for a public option unless Obama personally stepped on the supporters and got them to back down.

    Which he did very effectively, while continuing to pretend to the public for months after that that he thought a PO was the best way to go.

    I should note that the White House has not denied the published reports of those negotiations.


    agreed (none / 0) (#38)
    by CST on Thu Mar 25, 2010 at 10:07:20 AM EST
    although we could have ended up with an accidental "11th demensional chess" move here.

    If they introduce the public option now, it's too late for the industry to effectively oppose the rest of the bill.

    Just a note - I don't think we will actually get a public option - because I don't think it will even be introduced.  But if the senate steps up here... it's possible.


    Not too late fot them to give all their (5.00 / 2) (#85)
    by MO Blue on Thu Mar 25, 2010 at 12:01:34 PM EST
    money to the Republicans for the 2010 and 2012 elections which may be the real reason for the deals.

    Well, (none / 0) (#82)
    by vicndabx on Thu Mar 25, 2010 at 11:44:52 AM EST
    the White House doesn't deny a bunch of stuff.  Doesn't mean lack of a denial makes something true.  

    I know they did meet, I remember the hoopla.  I remember the turn things took not long after also.

    Look, we can speculate all we want.  However, the only deals that have been reported were those reported in post 58.  As I noted in response, none involved Health Insurers.


    Yes, I think they would have (5.00 / 1) (#39)
    by ruffian on Thu Mar 25, 2010 at 10:09:48 AM EST
    opposed it more. I did not see any huge ad campaign against it, along the lines of the 'Harry and Louise' ads.

    They would have liked to keep the status quo. The WH pre-bargained with them on a number of issues - mandates in exchange for the tighter regulations, being one for sure, and no PO probably being another. They still opposed the bill, but I don't see that they unleashed the holy hell they would have had these deals not been made.


    I wonder if the way (none / 0) (#41)
    by Capt Howdy on Thu Mar 25, 2010 at 10:11:11 AM EST
    he stopped Harry and Louise is by telling them if they did that he would push for a PO.

    No doubt in my mind (none / 0) (#48)
    by ruffian on Thu Mar 25, 2010 at 10:21:08 AM EST
    He co-opted Harry And Louise. (none / 0) (#72)
    by Salo on Thu Mar 25, 2010 at 11:18:27 AM EST
    Very popular president (5.00 / 1) (#46)
    by ruffian on Thu Mar 25, 2010 at 10:18:36 AM EST
    (at the time) with a mandate for kicking you in the back and punching you in the face at the same time, comes to you and says he will fix your broken nose if you let him hit you in the face AND NOT kick you in the back at all if you just shut your trap and not protest too much...you wouldn't do it?

    Ahh, snappy rejoinders abound in my head (none / 0) (#57)
    by vicndabx on Thu Mar 25, 2010 at 10:38:14 AM EST
    but no.  I'm against domestic violence.  ;-)

    I have an argument to make as well.  All I have to ask is, how happy are you w/your insurance now.


    You started that analogy (none / 0) (#59)
    by ruffian on Thu Mar 25, 2010 at 10:45:55 AM EST
    I didn't like it either. ;-)

    Luckily for me I rarely use any health care at all. I don't like paying every month for insurance I never use, but I have no reason not to be happy with it aside for that. If I ever need it I will find out how good or bad it really is.


    tha is Obama's MO (5.00 / 2) (#69)
    by TeresaInPa on Thu Mar 25, 2010 at 11:09:24 AM EST
    he vilifies something in public and calls them off the record and tells them it is all rhetoric they shouldn't pay attention to.  He does it over and over.

    They are reasonably happy with this bill (none / 0) (#34)
    by Salo on Thu Mar 25, 2010 at 09:58:52 AM EST
    It could have been exterminated them.  Instead they get new customers and do not have to complete with a publicly administered plan.

    One of the biggest problems with the bill (none / 0) (#37)
    by andgarden on Thu Mar 25, 2010 at 10:05:38 AM EST
    is probably the the penalties for failing to comply with the individual mandate are too low. The reason I'm not complaining about that now is that there's no PO. If there were, I would probably have a different opinion.

    Yeah (5.00 / 1) (#51)
    by ruffian on Thu Mar 25, 2010 at 10:27:40 AM EST
    and I will not be surprised if they get lower before they kick in. But without a safety net for more people to fall back on, penalizing them a lot is onerous. The subsidies don't cover enough people.

    It's been pretty widely acknowledged (5.00 / 6) (#32)
    by Anne on Thu Mar 25, 2010 at 09:53:52 AM EST
    that Obama made assurances to the insurance industry that there would be no public/government option in the final legislation.

    What you seem to be suggesting is that - surprise! - the insurance industry wanted to have its cake and eat it too: they wanted a monopoly on new customers and the ability to keep more of the money they are charging for premiums.  They didn't get everything they wanted, but they got the promise of no public option, which is huge.

    Something tells me - maybe it's the big rate increases that are underway for those who are currently insured - that the insurance companies are not going to have any difficulty making sure they take in more money than their customers are "costing" them, and of making sure they have historical support for increasing that baseline between now and 2014.

    When the day comes when insurance companies do not report upper-level salaries and bonuses that are well into 7 and 8 figures, I will believe that they are upside-down in terms of receipts and expenditures, and the people being insured are "costing" more than they are contributing; until then, I will just keep calling BS and ignoring the industry's copious shedding of crocodile tears.


    You sure have got the talking points down. (3.00 / 2) (#54)
    by vicndabx on Thu Mar 25, 2010 at 10:31:55 AM EST
    I understand however, that's what works today, not the actual facts.

    If Insurance Co's were, as you put it

    upside-down in terms of receipts and expenditures

    they'd be breaking the law in most if not all states.  Rate-increases don't just happen, they have to be approved by the Ins. Comissioners of the state.  These Comissioners review data from hundreds of thousands if not millions of claims.  You seem to be suggesting these state officials are all shady.  I don't agree w/that, I doubt they would either.  Beyond that, you really believe salaries and bonuses is where a sizable portion of money is going?  Really?  Something so easy to prove if it were so?

    It's been pretty widely acknowledged

    Widely acknowledged by who?  I guess you are referring to blogger-regurgitated speculation.  You can't point to quotes from Ins. Co Executives and/or Adminstration Officials.  I understand we're on opposite sides of this issue.  You can continue to believe what you want, I will continue to point you to facts.  A sample:

    I write today to ask you to oppose the Senate bill if it is introduced in the House of Representatives. Any legislation that expands the role of government in the health care system, fails to address underlying health care costs or reduces our nation's financial security, should be considered the wrong kind of "reform". Instead, I hope that Congress reevaluates all of its options and starts over.

    Facts? (5.00 / 1) (#58)
    by lilburro on Thu Mar 25, 2010 at 10:38:30 AM EST
    Read the NYTimes.  Here is a HuffPo summary.

    There was a deal.

    Hopefully, that's changing. On Monday, Ed Shultz interviewed New York Times Washington reporter David Kirkpatrick on his MSNBC TV show, and Kirkpatrick confirmed the existence of the deal. Shultz quoted Chip Kahn, chief lobbyist for the for-profit hospital industry on Kahn's confidence that the White House would honor the no public option deal, and Kirkpatrick responded:

    "That's a lobbyist for the hospital industry and he's talking about the hospital industry's specific deal with the White House and the Senate Finance Committee and, yeah, I think the hospital industry's got a deal here. There really were only two deals, meaning quid pro quo handshake deals on both sides, one with the hospitals and the other with the drug industry. And I think what you're interested in is that in the background of these deals was the presumption, shared on behalf of the lobbyists on the one side and the White House on the other, that the public option was not going to be in the final product."

    Kirkpatrick also reported that White House Deputy Chief of Staff Jim Messina was aware of the existence of the deal.

    Lilburro (none / 0) (#61)
    by vicndabx on Thu Mar 25, 2010 at 10:46:59 AM EST
    This article talks about a deal w/the providers of service, Hospital Industry and other service providers, not Insurers.  

    That's a lobbyist for the hospital industry and he's talking about the hospital industry's specific deal with the White House and the Senate Finance Committee and, yeah, I think the hospital industry's got a deal here. There really were only two deals, meaning quid pro quo handshake deals on both sides, one with the hospitals and the other with the drug industry.

    I realize (5.00 / 1) (#74)
    by lilburro on Thu Mar 25, 2010 at 11:21:15 AM EST
    it is not specific to the insurance companies per se, but the for-profit hospitals and the insurance companies are in cahoots all the time.  Ex:

    Washington, DC - Facing the prospect of meaningful and comprehensive health care reform, two insurance industry front groups and the hospital lobby tried to make the case today that our nation's public health insurance plans are to blame for the insurance industry's own bad practices and greed.

    CEOs from America's Health Insurance Plans (AHIP), the Blue Cross Blue Shield Association, and the American Hospital Association backed a report claiming "inadequate Medicare and Medicaid payments" are why health care costs are so high, ignoring the reality that health insurers and hospitals themselves have the power to set prices high, and they do so to maintain enormous profits.

    And most pertinently, destroying a public option was a critical shared goal.


    Trust me, they're not in cahoots when it comes to (none / 0) (#84)
    by vicndabx on Thu Mar 25, 2010 at 12:00:04 PM EST
    the money....other than asking the gov't to pay something more in line w/what the private sector expects.  Shared goal - as we both stood to lose, yeah of course.  The issue was who the deal was with tho.  I prefer not to speculate, particularly since the Insurance Industry wasn't the biggest winner here.  Our status quo isn't still intact.

    We know, because you have shared (5.00 / 4) (#70)
    by Anne on Thu Mar 25, 2010 at 11:10:09 AM EST
    with us, that you work for an insurance company, and I'm sure if I did, I would be defending the industry's position, too, but at least acknowledge that in addition to whatever facts you have, you also have bias.  And talking points.

    Industry salaries and bonuses are not the whole story, but I imagine they are part of the roughly 30% overhead, no?  So, of the roughly $8,500 I send to CareFirst every year, they're taking $2,550 off the top and using it to cover overhead.  Overhead is inescapable, but if Medicare is any guide, it doesn't have to consume 30 cents of every premium dollar.

    Insurance companies are in business to make money.  The only way they make money is to take in more than they expend.  The less they expend on payments to providers on behalf of the people they insure, the more money they keep.  Now, before you deem rate increases acceptable because they have been vetted and blessed by the state-based Insurance Commissions, it might be instructive to know who sits on these commissions, where their interests lie, whether they are little more than industry-friendly, rubber stamps, whether they are being held hostage to threats to leave the state and thus strand hundreds of thousands of customers because they may be the only major insurer in that state, and how much clout they wield in being true advocates for the people.  Those are significant factors in whether rate increases are approved, and I think you know that.

    As for the back-room deals with the insurance industry, it has been pointed out that on-the-record acknowledgment has been made, and that there has been no denial of the deal from the president: don't you think he would have sent out his minions to deny it - and deny it himself - if it didn't happen?

    Insurance is a business.  The business model is weighted in favor of making money for the company.  There will always be pushback when that model is threatened in any way, but the muted pushback to this legislation tells an interesting story: that the legislation does not affect the business model in any appreciatively negative way, and the promise, via mandate, of a captive and large market is their reward for their minimal opposition.

    I think we know who comes out on top in this deal, don't we?


    One thing you and I agree on (none / 0) (#78)
    by vicndabx on Thu Mar 25, 2010 at 11:35:07 AM EST
    Is I do indeed have a bias.  Talking points no, other than those grounded in facts borne by years of experience in the industry.

    There is so much inflammatory BS floating around (no personal attack on you) that yes, I do find it necessary to defend the industry.  The fact of the matter is all insurance works exactly the same be it gov't provided or otherwise.  But hey, it's easy to attack the Private Insurance Industry.  Look over there!  They must be the villians!

    The problem no one wants to talk about is WE have to change in order for ANY health care and it's coverage to work and be cost effective.  Lilburro points out who got the deal - as I've been saying all along, suppliers of services.  While I'm not naive to enough say Insurers couldn't have fared worse, they/we definitely weren't the big winners here.  What sad is neither is the American public.


    I don't see how you can say (5.00 / 6) (#88)
    by Anne on Thu Mar 25, 2010 at 12:09:05 PM EST
    that the insurance industry is not the winner in the decision not to include any government-administered plan in the exchanges - or anywhere.  If a government-administered plan can offer the same coverage as a private plan, at a lower cost, who loses?  The private companies.  

    Providers have been setting their fees at artificially high levels for forever, because of the typical negotiated agreements that they will accept whatever the insurance company pays them.  I'm not sure anyone is paying the actual cost of anything, because this game that has been going on for years has made it impossible to know what the true cost of anything is.  The losers are always those in the individual market, and those without insurance - who don't get the benefit of negotiated rates, they pay based on the full-boat charges.

    This problem of cost is not going to be solved by telling individuals that they must self-ration their care, nor is it going to be solved by "managing" care in ways that make it more difficult to get the care.  If I am told that I need cardiac catheterization, and am then told I need a stent, how do I know whether I actually need it, or if the facility is under pressure to do more procedures to justify the cost of all their equipment and staff?  We had that situation here in a suburb of Baltimore, where a doctor at a local hospital's cardiac wing was implanting stents in people who had been told they had severe blockages, but who turned out to have blockages of 10% or less.  As a result, people who are now getting advice to be stented are being told to (1) demand to see the films and (2) get a second opinion.  Does that not drive up costs as well - and is it fair to blame the patient for "using too much care?"  I don't think so, and I think there is a lot of that kind of thing going on.  

    The problem is complex, but what is clear to me is that individuals cannot bear the total burden or the blame for what the business of insurance and the concurrent business of medicine have created.


    Bear the burden.... (none / 0) (#94)
    by vicndabx on Thu Mar 25, 2010 at 12:56:23 PM EST
    You're right, the average person can't recognize trends like that - that's where insurers come in.  They have tools to aggregate data and staff that review this stuff so you don't have to - and remove doctors from networks who don't appear to have your best interests at heart.  

    The gov't doesn't do this today and pays at a fraction of what we pay - hence your lower cost.  They are only just now beginning "studies" to figure out which providers do what, and who does it better.

    In your scenario, I fail to see where the insurer is causing the problem.  We don't tell doctors what to bill their patients.  That people don't have adequate options to group together in order to obtain insurance (be it gov't or private) is what you seem to cite as the issue.  Obtaining gov't insurance wouldn't alleviate the concerns you cite, unless, the doctor was prepared to take a hit on what he/she charged.  There was no evidence in any discussion on any Public Option that that issue was even raised.  In fact, Schumer's alternative (the closest PO proponents got) removed wording that tied providers to lower Medicare-like rates.  Providers would've had to negotiate just like they do w/pvt. insurers.

    I agree the average person can't handle this stuff and shouldn't have to.  Again, if people stopped thinking the insurer is out to get you, or is only after your money, there might be more opportunities to improve the healthcare experience.  Honestly, the folks who work at insurance co's aren't thinking up ways to give you a bad experience.  

    I also think however we need to be honest w/ourselves about the reality of the American Lifestyle also.  This stuff is just going to be expensive because of who we are and how we like to live.


    State regulation (3.67 / 3) (#62)
    by TeresaInSnow2 on Thu Mar 25, 2010 at 10:52:29 AM EST
    State insurance regulation is a JOKE.  I think you need to look into how this all works before you decide that it does anything to reign in insurance companies.

    In my state (Washington) the state insurance commissioner attempted to be strict with insurance companies.  The insurance companies retaliated by refusing to offer new individual plans in the state.  Now, they're back and getting the kidd gloves treatment from the regulators.


    try google (1.00 / 1) (#71)
    by TeresaInPa on Thu Mar 25, 2010 at 11:14:38 AM EST
    or are you only interested in being a white house apologist?

    what makes you think (5.00 / 1) (#73)
    by Capt Howdy on Thu Mar 25, 2010 at 11:19:27 AM EST
    the white house needs an apologist?

    You must have me mistaken for someone else (none / 0) (#75)
    by vicndabx on Thu Mar 25, 2010 at 11:23:37 AM EST
    Stick and stones and all that.  

    Understand something - I don't support the bill other than us taxpayers paying more to cover those who can't afford insurance, vis a vis Medicaid.

    You have a great day.


    What? no (5.00 / 1) (#67)
    by TeresaInPa on Thu Mar 25, 2010 at 11:07:00 AM EST
    the insurance companies love this bill.  The added cost is not going to be to them  Yes they have to take people with preexisting conditions, but they can charge what ever they want for premiums.  
    The insurance companies LOVE this bill.  You can tell by how their stock has increased since it was passed.  

    Which if true (5.00 / 3) (#76)
    by CoralGables on Thu Mar 25, 2010 at 11:24:22 AM EST
    you'd have a point, but as I have noted here in the past, year to date the health care industry is just average as stocks go. Of the 12 stock sectors year to date, Healthcare is a mediocre 7th.

    In addition (none / 0) (#79)
    by vicndabx on Thu Mar 25, 2010 at 11:37:09 AM EST
    other than what we can do internally (improve processes so as to effect cost savings, obtain customers, etc.) we have NO control over the price of our own stock.

    All righty! (none / 0) (#86)
    by gyrfalcon on Thu Mar 25, 2010 at 12:01:46 PM EST
    (eyes rolling)

    See below. (none / 0) (#97)
    by vicndabx on Thu Mar 25, 2010 at 12:59:15 PM EST
    What? (none / 0) (#93)
    by waldenpond on Thu Mar 25, 2010 at 12:39:24 PM EST
    Uh....  You as an individual may not have a decision, but your company certainly has control over it's stock price.

    Stock repurchase?  Cut expenses?  Any business can.  Employees are expensive, advertising, training (entertainment) etc.


    You refer to the same stuff I do. (none / 0) (#96)
    by vicndabx on Thu Mar 25, 2010 at 12:58:44 PM EST
    Obviously indirectly we can affect the price, but the poster implied our stock price jumped after the healthcare bill passed because of something we did to the stock price.

    Did we do a buy back on stock over the last few days?  No we didn't.  Did a bunch of employees get let go?  Not that I'm aware of.


    Buy backs (5.00 / 1) (#100)
    by waldenpond on Thu Mar 25, 2010 at 01:14:15 PM EST
    Well, I believe they have been doing buybacks but no, stocks are not 'soaring' as some continue to argue.  The market seems to think the industry will adjust to it's new reality just fine... the stocks keep growing.

    Well, the idea that the (5.00 / 2) (#92)
    by Anne on Thu Mar 25, 2010 at 12:35:20 PM EST
    industry is collectively gnashing its teeth over the legislation:

    Industry Continues To Give Thumbs Up To Overhaul

    On Tuesday, "[p]rovider groups hailed the president's historic signing of the Senate's healthcare reform bill, which seeks to overhaul the healthcare system through the establishment of a new insurance marketplace, expansions to Medicaid and various insurance reforms," Modern Healthcare reports. The American Hospital Association president said, "While the path to universal coverage has been long, today we are closer than ever to reaching this important goal." The American Medical Association president said the bill means "32 million people will now have access to healthcare coverage" (Lubell, 3/23).

    Insurers waited until after legislation passed to reverse course on the overhaul, Time reports. "The health-insurance industry, which spent months campaigning against Democratic health reform, has shifted focus in the wake of its passage, pivoting from opposition to making sure the new law succeeds beyond most expectations." For instance, they joined a campaign called Enroll America that will promote the overhaul and find coverage for uninsured people. The reason? Health insurers want more customers to spread the risk in insurance pools (Scherer, 3/24).

    Meanwhile, "makers of medical devices ... may find the health care reform legislation signed Tuesday by President Barack Obama a bittersweet pill, for it both opens new markets and brings a new tax," NJBiz reports. "The legislation includes a proposal to introduce a 2.3 percent excise tax from 2013 on sales of almost all medical devices, excluding eyeglasses, contact lenses, hearing aids and everyday items bought at drug stores" (Shankar, 3/23).

    Overall, "U.S. stocks finished strongly higher on Tuesday as Wall Street relished more certain footing with health-reform legislation signed by President Obama," MarketWatch reports (Gibson, 3/23).

    This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations.

    Bold is mine.


    A tax on the disabled (none / 0) (#98)
    by Cream City on Thu Mar 25, 2010 at 01:00:46 PM EST
    is just abominable -- we have family members who need hearing aids, already so expensive.

    And the tax on eyeglasses, also so expensive, also hits home for me.

    Really, the more I hear -- because I can hear -- the more I wonder who came up with some of this cr@p.


    Excludes eyeglasses and hearing aids (none / 0) (#110)
    by Emma on Thu Mar 25, 2010 at 01:39:17 PM EST
    I think you're reading it wrong.  The tax doesn't apply to eyeglasses and hearing aids:

    "The legislation includes a proposal to introduce a 2.3 percent excise tax from 2013 on sales of almost all medical devices, excluding eyeglasses, contact lenses, hearing aids and everyday items bought at drug stores"

    What it does cover, if enacted, depends on how "medical device" is designed.  Pacemakers would certainly be covered, CPAP machines, too, for example.  But what about wheelchairs, for example?


    Whew, good. But yes, wheelchairs (none / 0) (#117)
    by Cream City on Thu Mar 25, 2010 at 02:53:09 PM EST
    also are needed by some in the family, among no doubt millions of others.  And I think that we can come up with lots of items not specifically excluded on that list, thus to be included under the tax.

    This misreading reminds me that I need a new prescription for these eyeglasses. Fast, before this exclusion somehow gets lost in the remix. :-)


    Hip and knee joint replacements would be taxed-- (none / 0) (#121)
    by jawbone on Thu Mar 25, 2010 at 07:11:34 PM EST
    Really! (Well, I read it...on the internets in an article from a real paper).

    I think (none / 0) (#27)
    by Capt Howdy on Thu Mar 25, 2010 at 09:28:28 AM EST
    you might be on to something

    would be? A lot of providers only currently accept medicare patients as a public service to force more on them would be a back-breaking imposition (both medicare and medicaid pay below cost rates for many procedures and drugs). I mean what happens if a medicare buy-in goes through and say 50% of those currently accepting medicare patients decline to accept anymore because its not fiscally responsible?

    Under your hypothetical, wouldn't (none / 0) (#109)
    by oculus on Thu Mar 25, 2010 at 01:38:08 PM EST
    medical care providers be short of patients if they refused those on public option?  

    In some cases yes (5.00 / 1) (#111)
    by Socraticsilence on Thu Mar 25, 2010 at 01:51:22 PM EST
    in others they'd simply shrink and fail- if rates are too low- as they are currently in a lot of cases- then doctors actually lose money on every medicaid/medicare patient they see(not just in terms of opportunity costs).

    Sometimes I think physicians do (5.00 / 1) (#114)
    by oculus on Thu Mar 25, 2010 at 02:19:02 PM EST
    protest too much.  

    Doctors and Hospitals Will Not Allow It (none / 0) (#19)
    by vicndabx on Thu Mar 25, 2010 at 09:19:55 AM EST
    They stand to lose too much $$ w/a public option.

    I just want to point out (none / 0) (#107)
    by Socraticsilence on Thu Mar 25, 2010 at 01:32:36 PM EST
    that its not just a greed thing- in many cases medicare/medicaid payment levels are so low that accepting them is a money-losing proposition- that is to say providers literally would be better off having less patients than accepting public option patients. Its like if all non-corporate legal services were suddenly pro bono- law firms would go out of business.

    Agreed (none / 0) (#113)
    by vicndabx on Thu Mar 25, 2010 at 02:08:09 PM EST
    They're running a business and have to support it.  They've got employees to pay, lights to turn on. Totally understand it - and don't mean to seem like I'm against a doctor or other providers.  I can appreciate their issues as well.  

    Well (none / 0) (#33)
    by Ga6thDem on Thu Mar 25, 2010 at 09:55:14 AM EST
    I guess we can all "hope" but since Pelosi pretty much in effect announced that they are all too exahusted to do any more "serious business" then I sure wouldn't bet any money on it.

    If the PO gets put back in and becomes law (none / 0) (#44)
    by magster on Thu Mar 25, 2010 at 10:12:30 AM EST
    I will no longer laugh at the 11 dimensional chess claim.  Who knew Obama actually engineered Scott Brown winning the Senate race? <snark>

    you know (5.00 / 2) (#45)
    by Capt Howdy on Thu Mar 25, 2010 at 10:15:14 AM EST
    I actually think Browns win may have helped the bill get passed.
    it eliminated the "60 vote majority" illusion and allowed them to do what they probably intended to do all along without needing to explain why they had to when they have "60 votes".  
    which of course they never really had.

    sort of (5.00 / 1) (#52)
    by CST on Thu Mar 25, 2010 at 10:28:26 AM EST
    except the senate did actually pass a bill with 60 votes before he was elected.  Although it did open the door for them to "fix" the bill with 50 votes.  I don't know that they would have gone there otherwise.

    On a gut level I really hate the idea that Brown might be a benefit.  But... I can't really say that you're wrong.

    I am curious to see how he plays his cards.  He seems to be buddying up to the pres quite a bit.  He had lunch with Biden today, and has been very carefull not to sound like a right-winger so far.  I think he wants to be the next pres. Snowe - and he's got a decent shot at succeeding.


    Made reconciliation the (5.00 / 2) (#55)
    by ruffian on Thu Mar 25, 2010 at 10:33:10 AM EST
    only way in objective reality. They couldn't pretend there was another way. At the same time it made it clear Dems were in big trouble electorally if they didn't have something to show for the last year.

    WellPoint's 39% (and higher) premium increases at (5.00 / 1) (#122)
    by jawbone on Thu Mar 25, 2010 at 07:21:27 PM EST
    a crucial point in the Congressional negotiations did play a big role in changing the momentum toward passage.

    Leslie Fowler, senior aide to Max Baucus, had left Baucus's staff for a two year stint as VP (managing Congress and PR) for WellPoint and returned to Baucus's staff to oversee the writing of the Senate bill.  

    Nice, cozy relationship there, eh? And Baucus's chief of staff (with emphasis on health insurance) went to the WH as an ass't chief of staff (with emphasis on health insurance).

    Very smooth communication and coordination set in place.

    Importantly, Obama did not bring a staffer from Ted Kennedy's staff to the WH to work on health insurance reform.

    Karen Ignani, presdient of AHIP, said in an interveiw on C-Span that the predictions were for high increase in health insurance premiums if nothing were done, and now, she said pointedly, the high increases from WellPoint in CA show this is not just hypothetical any longer.

    What excellent timing! And WellPoint taking the point man's place, drawing fire, but getting the job done. Insurers wanted those mandates very, very much. They were killing off the ability of too many of their customers to afford their products -- so they desperately needed new, less tapped out hosts to suck dry.


    No doubt (none / 0) (#50)
    by magster on Thu Mar 25, 2010 at 10:24:38 AM EST
    without it, there'd be nothing.

    IMO, the ship for that sailed (5.00 / 5) (#47)
    by andgarden on Thu Mar 25, 2010 at 10:21:03 AM EST
    when they didn't put a PO in the reconciliation package in the first place. Not even Medicare buy-in.

    I think the PO (5.00 / 1) (#49)
    by ruffian on Thu Mar 25, 2010 at 10:22:25 AM EST
    flew off with Santa Christmas Eve when the Senate voted.

    I hate to keep harping on this (none / 0) (#108)
    by Socraticsilence on Thu Mar 25, 2010 at 01:34:12 PM EST
    but can someone tell me how a medicare buy-in would have worked in a way that prevents the denial of service to medicare patients from skyrocketing.

    Why does it seem like we (5.00 / 4) (#112)
    by Anne on Thu Mar 25, 2010 at 02:05:55 PM EST
    are the only ones in this whole scenario whose choices are severely limited?  We HAVE TO have insurance, we WILL be fined for not having it, but the providers get to pick and choose and summarily accept or reject us.  Ho-hum.  Free enterprise.  

    All of which takes us back - or me, anyway - to single-payer: if doctors spend less time on the bureaucracy that comes with accepting private insurance, can cut overhead accordingly, and those currently employed to push paper in the back offices of medical practices can be placed in jobs with a CMS-type emplyer, shouldn't costs come down for everyone, and shouldn't there not be a hardship for providers?  Every study I have seen or heard about suggests that this is exactly what would happen.

    This whole thing about costs is circular, and until we stop the loop, it's never going to come under any kind of control.


    They would (none / 0) (#128)
    by Socraticsilence on Fri Mar 26, 2010 at 04:42:17 PM EST
    the primary problem in the US with transitioning would be controlling malpractice costs (or rather malpractice insurance- it would likely take unpalatable capping ala Britain and Canada), and loan forgiveness (no other country has comparable student loan debts- essentially if we give every young Doctor in America 200 grand to accept Medicare patients it would work- otherwise they don't have huge options until age 40 or so as their shackled to loans and frankly need the money).

    Do you know anyone on Medicare? My elderly (none / 0) (#123)
    by jawbone on Thu Mar 25, 2010 at 07:25:55 PM EST
    neighbor gave a celebratory party when she was Medicare eligble and could get out from under her HMO (various HMO's because her employer kept changing plans, trying to keep the cost down, and she had to keep changing doctors which was difficult as she had several chronic conditions).

    She could chose her own doctors, chose among specialists. She had freedom for the first time in years to do so.

    Now, she may have had some things turned down, but it was never anything she complained about. She loved Medicare!

    Are you sure those denials aren't simply coding errors?

    Links to your sources? Thnx!


    My husband is on medicare and cannot (none / 0) (#127)
    by suzieg on Fri Mar 26, 2010 at 01:44:41 AM EST
    find a primary care physician who accepts medicare patients - he's  found  a clinic which does, but can only be seen by their interns.

    Best government (none / 0) (#56)
    by SOS on Thu Mar 25, 2010 at 10:36:15 AM EST
    money can buy.

    Anyone know if any of the 33 Dem. (none / 0) (#80)
    by oculus on Thu Mar 25, 2010 at 11:37:16 AM EST
    Representatives who voted "no" did so because they were holding out for some type of public option?  NY Reps. for example.

    that's what (none / 0) (#81)
    by CST on Thu Mar 25, 2010 at 11:41:32 AM EST
    Steven Lynch - MA said