8.17.2009

How Many Votes Does the Public Option Have? How Many Does it Need?

Earlier I suggested that the public option probably does not have the votes to pass the the U.S. Senate. Let's examine this in a bit more detail.

Open Left's Chris Bowers lists 43 senators who as of last Wednesday, he believes based on official communications would vote in favor of a public option. This appears to be the best and most contemporary whip count of its kind.

There are at least two names on Chris's list of yea votes that I'd regard as less than certain: one is Ted Kennedy, who obviously supports the public option but might not be healthy enough to vote on it, and the other is Diane Feinstein, who has indicated that she's open to either a public option or non-profit co-ops -- wherein lies the whole debate. But let's give the Democrats credit for these two votes and start counting upward. What's their easiest path to 50?

There are five more senators who have either given signals that they'd support the public option or, when push came to shove, would be more likely than not to do so:

44. Tim Johnson (SD). Appeared to commit to the plan over the weekend. Should be regarded as a highly likely 'yes' vote.
45. Robert Byrd (WV). Has yet to take a position publicly, probably because he's been ill. But Byrd is generally pretty liberal on economic issues, and his colleague (Jay Rockefeller) is a vociferous supporter of the public plan. The potential barrier here, as in Kennedy's case, is likely Byrd's health rather than any philosophical concerns he has about the plan.
46. Amy Klobuchar (MN). Howard Dean's website lists her as a supporter. She's been decidedly more ambiguous in e-mails to constitutents, and Minnesota has lots of skin in the health care game in various forms. Still -- although Klobuchar is not as liberal as you might expect from a Minnesota Democrat -- this seems to me like an eminently whippable yea vote.
47. Ron Wyden (OR). Wyden's indifference to the public option is a little odd -- he's ordinarily quite liberal -- and may reflect his desire to promote his own health care alternative. Once it came time to vote on the actual, non-Wyden bill, I'd expect him to vote yes on the public option.
48. Herb Kohl (WI). Ostensibly supports the public option but with a lot of caveats: that it be "bipartisan", etc. Realistically, any public option that the Senate is considering is likely to be fairly watered down, moving Kohl into the probable yea vote category. But the co-ops concept might also be alluring to him.

Now, here are the senators that Bowers lists as maybes but who I think would be relatively unlikely to vote for the public plan. Not included here are Joe Lieberman and Susan Collins, who he lists as definite no's.

Mary Landrieu (LA). Other sources have her as a 'no'. She may be hedging a bit in constituent e-mails, but given a straight up-or-down vote on the public option, her vote seems highly unlikely.
Johnny Isakson (GA). Republican who is moderate on health care issues. Open Left lists him as a "maybe" based on what I think is a very optimistic read of a statement he made in June. Also, Isakson (along with all other Republicans but Olympia Snowe) sent a letter to the President stipulating his opposition to the public plan. Very little chance he'd vote for a public option.
Kent Conrad (ND). Given that he's probably done more than any other senator to hurt the public option, I don't really see him coming up big for the plan in the clutch.
Ben Nelson (NE). Generally the most conservative Democrat in the Senate, Nelson came out against the public option early on but has since hedged a bit. I don't know that Nelson would vote to filibuster a health care bill on final passage if it happened to include a public option. But, given the opportunity to take a straight up-or-down vote on the provision without bearing the burden of potentially killing health care reform (e.g. if an amendment on the public option had been proposed), I don't think a 'yes' vote is likely.
Evan Bayh (IN). Similar story to Nelson. He's been voting very conservatively (even relative to normal) this year.
Tom Carper (DE). Fairly conservative, and very corporatist Democrat. He takes a lot of money from the insurance lobby and there are also a lot of insurance jobs in his state. Seems to want co-ops instead.
Mark Warner (VA). Takes a ton of money from the industry. Our regression model regarded him as a very unlikely 'yes' vote. Has been somewhat ducking making a commitment on the issue, but some constituent communications suggest he'd much prefer the co-ops plan.

That leaves seven senators who I suspect are the true swing votes in a 50-vote environment. The Democrats would need at least two of these, and possibly as many as 4-5 depending on the health of Byrd and Kennedy and whether someone like Feinstein or Kohl ended up voting against the public plan.

Blanche Lincoln (AR). She's been all over the board on the public option. I don't know if anyone can say with confidence how she'd vote until they take the roll call.
Mark Pryor (AR). Been receiving less scrutiny than Lincoln since he's not up for re-election, but his position has been just as ambiguous.
Mark Begich (AK). Here's a guy who I suspect has fairly liberal instincts and doesn't take a lot of PAC money but is obviously in a very conservative/libertarianish state. Probably among the more gettable of the swing votes.
Jon Tester (MT). Largely the same story as Begich, although he's a bit more of a populist.
Max Baucus (MT). Public statements suggest he supports the public option in principle but he obviously hasn't done very much to move it along in practice. Common sense would dictate that he'd be unlikely to vote for a public option if it wasn't in the bill that came out of the Finance Committee. On the other hand, it's not out of the question that he'd want to save face with some of his liberal critics.
Bill Nelson (FL). "Not even his hairdresser knows," according to the Huffington Post.
Olympia Snowe (ME). Would probably vote for a public option that had a 'trigger' and vote against it otherwise.

But wait -- I've pulled a little trick on you. What's to say that 50 is the magic number of votes for the public option? It's far from clear that this is the case.

Suppose that the bill as reported out of committee to the Senate floor contains a public option. Opponents of the public plan could then try to pass an amendment to strip that provision. Proponents of the public option could try to filibuster voting on that amendement. But as I suggested earlier, I suspect that would probably be a mistake as even if the filibuster succeeded, it might encourage Democrats who are wavering on the overall package to filibuster everything else. So I suspect the public option needs at least 50 votes worth of support overall (with Vice President Biden potentially casting the 51st, tiebreaking vote as needed).

Alternatively, suppose that the bill that hits the Senate floor does not contain a public option. In this case, proponents of the public option could propose an amendment that included it. This amendment, however, would almost certainly be subjected to a filibster, meaning that a public option would need 60 votes to pass. It almost definitely does not have that many (even if there were a senator here and there who who was willing to break a filibuster on the issue even if they did not support the public plan itself.)

So for the public option to pass, it probably needs to be included in the initial, unamended bill that hits the Senate floor. This means that it probably needs to be supported by a majority of the Senate Finance Committee. But this is a little bit of a problem, since the public option only appears to have seven solid yes votes in the Finance Commitee when it will need 12:

Likely Yes (7): Rockefeller, Bingaman, Kerry, Schumer, Stabenow, Cantwell, Menendez
Probable Yes (1): Wyden
Swing (4): Baucus, Lincoln, Bill Nelson, Snowe
Probable No (2): Carper, Conrad
Likely No (9): Grassley, Hatch, Kyl, Bunning, Crapo, Roberts, Ensign, Enzi, Cornyn

If you could get a majority of this group of 23 senators to support the public option, then it would have better-than-even odds of being included in the bill that made it to the President's desk. Getting a majority of this group, furthermore, would probably mean that folks like Blanche Lincoln and Bill Nelson had voted in favor, meaning that the bill had at least 50 votes worth of support in the Senate overall.

On the other hand, I don't think a public option is likely to be included in a conference report if it hadn't already been approved in the bill passed by the Senate. This is the sort of thing that would make some senators very angry -- wavering Democrats who were looking for an excuse to vote against health care would have one, and could blame the liberal conferees for ruining their hard-earned compromise. Maybe liberals get really lucky with the conference commitee appointments and the Preisdent's approval has ticked back upward to 57 or 58 percent because of some good economic news or something; it's possible that you could add a public option at the conference stage. But it's just not very likely; there's too much risk that the conservative Democrats in the Senate will feel as though they've been baited-and-switched.

So, again, in order for a public option to pass, it probably requires the support of:
1. A majority of the Senate Finance Committee;
2. A majority of the Senate overall.
...and these two things are highly correlated; it is likely that either both are true or neither are.

When Kent Conrad says the public option does not have the votes, I suspect this means that (i) he himself does not want to vote for it; (ii) Max Baucus, the committee chair, is no more than lukewarm on it; (iii) senators like Carper and Lincoln have told him they'd prefer to vote on a bill without a public plan. If Conrad knows this, then the White House probably does too. There's some utility to them in pulling back on the public option now as (i) it signals their willingness to broker a deal while a deal can probably still be had and (ii) it prepares the liberal blogopshere to be let down gently, and perhaps to have rebounded by the time the bill comes up for final passage in the fall and their phone calls and door-knocks could be essential.

If the White House now says that Kathleen Sebelius "misspoke" in her statements on CNN this morning, they still have a lot of explaining to do. Did Barack Obama, Robert Gibbs, Bill Clinton, and Dick Durbin also misspeak when they hinted that it was time to move past the public option? Did they not know that they'd generate headlines like this one on the Drudge Report, headines that would take a lot of wind out of the public option's sails?

The White House had to know these things. This has not been a subtle hint. If they're hedging a bit now, it's probably because they're hoping to temper the reaction some in the blogopshere. I don't blame them for wanting to do so. And I don't blame the blogosphere for being angry -- the White House did not provide much in the way of leadership on this issue. But that doesn't mean it isn't the right time for the White House to (at least mostly) cut bait. There's likely going to have to be some sort of "regrouping" moment in September for health care to pass -- some sense of momentum that the White House can sustain for two, three, four weeks. If you'd waited until then to table the public option, such a moment would be less likely. There also probably has to be some effort to sell the public on the virutes of the plan as is -- and if the Administration can't convince the liberal blogopshere of that over the next 2-4 weeks, they almost certainly can't hope to do so to the general public.

118 comments

Bryce said...

We've been trying to get this for a century, and if we don't get it I think I might by physically hurt by the news. Obama has come so much farther than any president before him, Democrat and Republican(back when the Republicans made genuine efforts for positive reform too) that it will be a huge punch to the gut to fail now.

TommyReport said...

Nate,

It's over. All we're waiting for now is the next poll to show Obama below 50% in terms of approval (likely PPP(D) later this week but I guess that pollster is now persona non grata with the left).

MSNBC/WSJ and Quinnipiac won't be far behind. Your pals at ARG (which didn't miss one state this November) could show Obama sub-50 in its monthly poll soon as well.

Charles said...

Wow. As Bryce said, "it's a punch to the gut" reading Nate's assessment. 5 committees are for the public option, but the senate finance committee can (and likely will) stop it... And, with this one post, I felt the momentum unraveling. I can hear the spinsters reigniting the opposition on health care and other important topics. They will use the classic fallacy, "they lost, so we were right." A punch to the gut, and dreams of political bravura lost.

beavis said...

It is obscene and a disgrace that a party with control of the WH and both chambers did not do more to stop the lies of the nutbag right.

Other then the argument about cost, the right put up no legitimate argument. The cost argument, of course was overstated by the reichtards, and is not an insurmountable hurdle.

It is a fact that the cost of doing nothing is much, much higher then even the most liberal single payer plan possible.

It is shameful that the dems are so spineless. The only saving grace is that the GOP is so far down into the ratings sewer that they won't get anything positive for assisting pharma and the insurance companies to rip us off at the expense of our future.

Lack of reasonable health insurance is a big reason why the US is no longer a leader in business or technology. Of course, poor education, illustrated by the screaming trailer trash, is another reason. We are living in the fall of Rome brought to you by shortsighted corporations.

The ironic thing is that if it does go down, most of those celebrating are going to be hurt badly, but apparently their allegiance to corporations is more important to them then their alleged allegiance to America and their fellow citizens. Perhaps taking away their socialistic Medicare and Medicaid will drive the point home to these mental midgets.

Without the public option, the bill is nothing but a no-strings attached bail out to companies raking in billions.

Matthew said...

Nate,

Have you considered looking at ProgressivePunch's subset scores for Health Care to more accurately determine which congressmen will vote for the public option? If you look at these scores, you will see that despite all the money that Mark Warner has taken from PACs, he has a 100% rating for health care. I'd say that there is a decent chance he actually would vote for the public plan.

Juris said...

Before anyone concludes that the only acceptable healthcare reform must include the public option, consider the likely available alternatives and key goals: universal coverage, elimination of the "pre-existing conditions" out for insurance companies.

Yes, cost reduction and stopping the rip off of America by private insurance companies are also worthy goals -- ones that can best be achieved by including some kind of public option. But the stars do not seems to be aligned to assure either of these goals can be met. Big Insurance wins.

But there is something worth fighting for, as Krugman points out in his Op Ed on the Swiss Model.

Sean said...

I hope the rumors of the public options death are greatly exaggerated, as Mark Twain would say.

Seriously though this is why I get mad at Liberals, no spine, too cerebral, and beaten down so much they actually start to think they deserve it.

Senate finance may drop the public option from its bill, but it is in the 4 others. We can get a public option through conference, maybe not as strong as we like but better than nothing, and it can be strengthened later. The first step is often the toughest.

Truth is Obama is boned if he kills the public option, he'll lose some Liberal votes, and a lot of Liberal money and GOTV for the mid-terms, and even 2012. Health care is that serious to Liberals, and if he wants to be a corporate sellout, well then we might as well be honest and just vote Republican, or if you're like me and can't stand the thought of supporting those neanderthals, then just vote Green.

There is no way he does not know the sentiment of the Liberals on this issue, if he is thinking of scrapping the public option then he is hoping we are simpleminded enough to let him slide. I really don't think that is a wise gamble but we'll see what he does...

Saint Dude said...

A bit too early to be writing the obituary for the public option in my opinion.

However, even if the public option is off the table, it is still possible to construct a very good bill that will expand coverage to the millions of uninsured, make insurance more portable and less dependent on one's job, make insurance more affordable for those that are scraping by, and stop the insurance company practice of dumping sick patients or denying coverage to those with "pre-existing" conditions.

If the ultimate bill that comes to the floor of both chambers of congress lacks a public option, and no longer includes grandma firing squads, it is going to be all that more difficult for the GOP to pretend to be anything other than hyperventilating obstructionists.

Its come to Jesus time for the GOP.

All they had were lies, hyperbole, and hysteria, all of which are worth next to nothing once the things that they have been railing against are removed from the discussion.

Saint Dude said...

Oh, and while I think a public option is a very good idea, I do not think it is the whole ball of wax. I think the progressives posting here today are tad too emotional on the subject.

I suggest if you are this worked up over the issue, do something about it other than rant about how you will never vote for another democrat. As if the obstructionist republicans have lifted a finger to assist, or could give a rats ass, if we ever have meaningful health care reform.

Ideological purity on the left wouldn't be much prettier than it is on the right.

Glix said...

If the bill does not include a public option, the reform efforts will be a failure.

Consider this: If all we get out of this is some regulation of the insurance industry the next President could simply deregulate it. However, like SSI and Medicare, once a public option is in place it will be political suicide to try to rescind it.

If I can figure this out, so can our wicked smart President. He wants his legacy healthcare to be on a par with SSI and Medicare. Can't do that without the public option.

Saint Dude said...

Juris,

Thank you for pointing out the Krugman article. I have thought from the very beginning of this debate that the Swiss model was the best fit for the American politic.

whisper said...

I think Howard Dean is on the right track bu talking about primaries in 2010 for Democrats who don't support the public option. Democrats need to be reminded this is a popular issue for the people that elected them, and that there will be consequences if they do not support it.

Eric said...

Well, progressives have been trying for universal health care for a century now, another ten years won't hurt anyone. Except the uninsured, but they can take one more for the team.

J. Scott said...

You're wrong about this, Nate. The danger is not will we have a bill or won't we. The danger is, a large percentage of folks, especially young voters, voted for Obama and the dems to at least get a public option passed. If we don't do it, they won't vote next time. And there goes this great experiment.

President Obama and the dems need to stand firm for a strong public option. With or without a bill.

If they don't, look out below.

Maxwell said...

I've been slowly realizing how much Obama's wishy-washiness and weakness as a politician vexes me, and I do think a watered-down health care bill will be the breaking point for this voter. My bright light of hope, the actual president in office, has been stolen and passed on to the possibility of a 3rd party candidate finding some actual recognition given the general disappointment with democrats and circus sideshow-type behavior of the republican party lately.

bleepul said...

Yes ... look out below. Thank god this monstrosity is dying and people are finally waking up to the fact that Obama is another Jimmy Carter.

Can't these idiots out of office soon enough.

markymark said...

I think Nate may be painting an overly pessimistic picture here. I think there is a certain amount of hedging going on and a bit of game playing. But a few things, one Sen Kennedy I think would do his damndest to vote for the bill. Less so Senator Byrd perhaps, but I also think Kennedy has a big bat to swing on this issue somewhere along the line.

I wonder if some of the waverers are just looking to see how the wind is blowing on the matter. I personally would expect someone like Mark Warner or Evan Bayh to back a public option. I find it odd that the two Monyana Senators are considered so unlikely as well.

I wonder if sone of the hedging is a lack of 60 votes rather than a lack of 50, and whether a deal is needed to get to 60 or not?

I am still confident that a public option will be in the bill and that by hook or by crook that it will pass. Too many Democrats have too much invested in this now to not go down without a fight.

JWalker said...

I'm sorry Nate but your analysis is wrong. You see the public option will not be part of the orginial Senate bill. It will be added in conference to a reconcilation bill. Obama has alluded to this strategy repeatedly.

The public plan does not need a stand alone 50 votes in the Senate. A overall bill with a public option only needs 50 votes. To kill the public option 11 democratic senators must vote to kill health care reform completely. Wyden, Baucus, Kohl, Klobucher, Warner, Bayh, Tester, etc... will not kill health care reform just the spit the public option.

Daniel said...

There's nothing quite like screwing over the poor to rally the troops on the right!
You know, Medicare, Medicaid, and Social Security are all socialist programs. They're also horribly expensive. I think it's time to end those programs too. I mean, seeing as how most of the people who were making loud noises at the town hall meetings were on Medicare, it only makes sense. They obviously have a real issue with their taxpayer-funded health care.

Joseph said...

After 8 years of Bush the stars finally align for the Democrats, yet after less than 8 months, Democrats start running around like chicken little screaming that the sky is falling. It's no wonder Republicans call Democrats weak. We prove them correct with our panic. We also create our own self-fulfilling prophecy of doom if we give up on the public option because we "don't have the votes". Why not instead get off our asses and work like hell to get those votes?

And while you're getting the votes, we need to be telling everyone with all the confidence in the world that the Democrats are going to pass a public option and make the Republicans look like a bunch of losers and naysayers who are more interested in protecting insurance company profits than fixing the real problems of the country. The one thing Democrats could learn from the Republicans is that people are prefer confidence, even cockiness, to expertise or facts.

markymark said...

It seems to me that the people who need the public option are the uninsured. I don't think a lot of politicians will mind screwing them over because they are generally amongst those who don't vote! Of course they don't vote because government ignores them. Maybe it's time to break that particular viscous circle!!

Mike said...

This article and your last Nate seems incredibly premature Nate. And very out of character. For a site that I came to for incredible statistical analysis, this article and the last are pretty blatantly low on facts and statistics and strong on speculation.

I have to wonder at the Siblus(sp) quote too but there are explanations other then the one you are offering.

Regardless I just wish everyone would chill the hell out a little

GuyBella said...

My 29-year old daughter, who just days ago received her Ph.D. from one of the country's finest universities, wrote this piece yesterday that I'd like to share:

>>>
Ok - I've already outed myself as one who does not
currently have health care. It ran out as of Aug. 14. I suddenly feel an overwhelming sense of vulnerability on a fundamental level -- as if I could be forced to declare bankruptcy if I stumbled slightly on the stairs.

I have two teaching jobs next year, but neither gives me health care. (Universities, for those who don't know, function somewhat on the Walmart model: if they prohibit a certain population of employees from working full time, they're never obligated to give benefits.)

I will probably very shortly have access to health care, but *only* because DC has (gasp!) a PUBLIC OPTION for those in a certain income bracket. It's free, and they don't inquire about pre-existing
conditions. I could pay for private health care, but it might end up costing a fortune, depending on whether they think my migraines constitute a pre-existing condition.

I'm sure we all feel that this health care debate is personal, but for me, at this time of my life, it's *very* personal.

I'm not represented by a voting congressperson, but chances are, YOU ARE. Please do me (and not just me) a favor: call them and tell them to keep a public option on the table. We can't be cowed by crazies into giving up what's right and fair.

>>> So, please call your Congresspeople and urge them to do the humane thing and KEEP the public option! Thanks.

bleepul said...

I should subsidize your daughter's migraine medicine with my tax dollars because she can't afford it ... riiiight. With a PhD from an elite university? Holy crap you people are whacked in the end.

Tell her to nut up and pay the $150 bucks a months for the insurance. It's called responsibility.

GuyBella said...

To "bleepul":

Your comments are insulting and ignorant, but let me take the higher road: when your take-home pay is less than $1000/month and your health insurance premium would be $450/month, well, you do the math. My daughter IS doing the responsible thing by joining the public option. (And, by the way, are you not aware of the shrunken job market, which affects higher education, too, and forces Ph.D. recipients into the same dilemmas as other underemployed part-time workers?)

Bart DePalma said...

Nate:

Do you have any nose counts for the House? I suspect that the public option is in trouble there at least to the same degree as it is in the Senate.

Harper said...

This bill is dying because the administration has done a horrible job of explaining it. At best the Healthcare story is like the gnomes of SouthPark:

Step #1 - Steal Underpants
Step #2 - ?
Step #3 - Profit

The analog follows:

Step #1 - Pass Legislation with Public Option
Step #2 - ?
Step #3 - Lower Healthcare Costs

This is why the plan is dying a horrible death. Nobody understands the mechanics and nobody can explain it. Hence, the country suspects it is a load of B.S. I'm afraid of it, and I'm an ardent supporter of the public option.

At least Wyden Bennett can be explained in just a few sentences:
- Remove the employer tax benefit -> people aren't locked into jobs; unemployed people can still keep healthcare
- Universal Health coverage
- Medicaid people get enrolled autmoatically
- everyone is required to join at a "basic" level
- partially subsidized by a tax on employers

And I don't think there is a conservative dem or rep who wouldnt support it, if one commonsense measure was added:

- TORT REFORM

mdlewis said...

I liked both your posts on the headcounts.

Perhaps we progressives need a fall back position. Something to bargain for in exchange for dropping the somewhat disappointing public option in the bill now. And I certainly don't think co-ops are what we should fall back to.

How about reducing the age for Medicare over a period of time. I suggest one year each for the next 15 years. This combined with a modest increase in the Medicare tax might be attractive to some "conservatives". It takes older folks (myself now I admit) away from the private insurers who probably won't mind getting rid of them/us, gives employers incentives to keep/hire older workers and should reduce their costs, and builds support toward the ultimate goal of single payer...ok I admit my bias on that.

Since these numbers should be easy for the CBO in all sorts of various phasing in options and some go beyond the 10 year budget window I think it something that can be negotiated.

Naturally I would like to kill off the doughnut hole, throw in Medicare drug negotiating power, increase seats in med school, provide incentives to end fee for service, explore treatment costs and benefits, rationally explore malpractice premiums which might involve some tort reform (have no firm position on this but it should be studied). Might be best to keep this simple and haggle over dollars and cents with those few conservatives who might be willing to support Health Insurance Reform....

Thanks for your comments.

bruce m said...

Thanks, Nate, for an analysis that progressives need to consider. If health-care reform legislation fails in Congress because progressives oppose it for lack of the public option, we will not see another health reform bill for a decade or more. Republicans will be triumphant and the verdict of 2008 will be reversed. Progressives must be careful that they don't let their disappointment lead to their political destruction.

markymark said...

I wonder to what extent some of the Blue Dog types might vote for the public option as a firewall against a strong progressive primary challenge?

I would caution taking too much notice of what the administration says about what gets into the final bill at the moment. Obama has clearly ceded a lot of power about the contents of the bill to Congress, and I really haven't heard any definite negative soundings from those with actual power about whats in the bill. Vote counts on this type of issue are very very hard to get together, even when there is a final bill settled. Without a final bill, it is pretty much impossible, especially when the Senate is not even in session.

bleepul said...

To GuyBella ...

Wow ...PhD not worth much these days if she makes 12,000-15,000 a year. So what is that 6-8 bucks an hour? What is the minimum wage by the way and poverty line? You are full of BS and you know it. Counter help at Starbucks make twice this ... she should re-examine her career choices rather than have me subsidize them. This is more whiny, chain-mail, propaganda. Tax the rich, give to the poor PhD student wah wah wah.

The homeless I feel sorry for, the battered women, I feel sorry for, the developmentally disabled I feel sorry for ... it's because of people like you and your daughter who milk the system that this thing has to die.

I'm not paying for your daughters headaches ... sorry.

Walker said...

Notes from the Front!

Obama seems is in full retreat mode.

Obama is now going on vacation because he knows it’s over.

With this confused policy flip-flop and trial balloon chaos, Obama is spiking the bill to make it unpalatable to liberals and thus dooming it to an ignominious end.

This was a bloody Vietnam type war Obama walked into and his apparatchiks are looking for a graceful exit.

His strategy on this was worse than horrid, and he has made it worse the last week or two with the campaign events.

I have heard from more than one liberal friend in "the know" that they are mortified at the lack of depth and total amateurism.

Lest you think that this is just another right-winger piling on, I am equally dismayed at the Republican part. They have been content to just "wait for Obama to fail".

Basically, both parties are corrupt and controlled by the same special interests.

Reminds me of the old Who song: "Meet the new boss, same as the old boss".

I want to see at least two strong 3rd parties come out of the woodwork.

One could be left-leaning and one could be right-leaning.

What would unite them is a strong aversion to corporate interests and true grassroots populism.

Left Leaning 3rd Party: Green/Naderite

Right Leaning 3rd Party:
Isolationist/Libertarian

Bob Brigham said...

Why would liberals want to regroup and pass an insurance industry bailout bill?

It makes way more sense to let the senate be seen as killing the public option and make the midterms a referendum on corporate Dems sucking. Not only would we pick up senate seats with candidates forced to campaign on the public option, but we'd also lose a number of Blue Dog seats in the house.

Do it right in 2011.

mclever said...

bleepul,

If you think someone with migraines can get insurance for $150 on the open market, you are insane.

Like GuyBella's daughter, but like her I have migraines and was rejected by over 25 different health care providers for my "pre-existing condition."

After exhausting all of the health insurance options available in my state, the only plan that would accept me cost over $1000 per month, with a $10,000 deductible, and only covered emergency care up to $50,000.

Even if I'd been idiot enough to buy that policy, I still wouldn't have health care coverage. I'd have had minimal catastrophic care coverage, and if my bills ran above $50K, I'd still end up in bankruptcy court.

I make too much money to qualify for any sort of low-income plan, and can not get health care insurance at any price, because I got a headache once or twice in the past year.

That's just my own personal story of why our current health care system is MESSED UP!

I don't want you to pay for my headaches... I just want there to be an affordable insurance option that I can buy that's portable across state lines. The "co-op" plans are a bunch of messy paperwork and not portable enough. If there were a public plan available that I could buy for $200/month, I'd be all over it.

liberal_defender_of_freedom said...

Maybe Obama should forget about this and just pass the buck like the rest of the do nothing Presidents we've had and let the next administration tackle the difficult problems. Hopefully a Republican wins next term and we go into a death spiral because of unsustainable costs and China would have to buy America to keep us afloat.

Maybe that would make Republicans happy.

Josh said...

Don't these Democrats know who supports them? Don't they know who campaigns for them? Who donates to them? We (the involved) know that The Public Option is absolutely essential for any health care reform to be meaningful. We have to let these assholes know that we will not support them next time around if they are not on board.

Matoko Kusanagi said...

The religious left has just entered the fray
Will this change the equations at all?

Josh said...

Why does it seem like the Democrats are trying to win the votes of people who will never vote for them anyway instead of trying to make happy those people that actually campaigned for them, donated to them, and (of course) voted for them?

Any Democrat who votes against The Public Option should be politically crucified. I mean it. Just fucking shat upon. I want no part in any such "Democrat."

Davy said...

So lemme get this straight; for a filibuster, 60 people have to vote 'nay'. But if some people elect not to vote, you just need a majority (50 plus Biden). And what happens if Kennedy and Byrd (God forbid) leave an open seat and change the math of the Senate? And I suspect Kennedy would demand to be wheeled in on a stretcher for this one. Also, Wyden would be a yes. He is backing his own plan but if it came to the floor, he would never jump on a political grenade by voting 'Nay'.

markymark said...

Josh, your last point is another reason why people shouldn't get tooo carried away with all the talk of a losing out on a public option. I think guys like Warner or Baucus or Nelson know who vote for them, and know that this issue means something to those voters. For all the noise coming from Town Halls etc I think most of these guys know that the noisiest protestors have made their minds up about the politicians anyway.

The other interesting factor I would think about is whether any of these guys have any aspirations to higher office. Is, for instance, a Mark Warner or an Evan Bayh going to be able to run in a Democratic Presidential Primary having voted against a public option? Almost seems like a Republican coming out with a pro abortion stance and then running for President.

I certainly think there are at least 55 votes for the Public option around the Senate. Some might hold out for compromises or other stuff that they want in particular, but honestly, I really feel like Nate is being hugely pessimistic here.

John said...

People who tell others (especially those who have pre-existing conditions) they should just purchase health insurance on the "open" market make me so mad. As others have pointed out, most insurance plans will not accept someone with even fairly common pre-existing conditions (e.g., migraines, chronic asthma, etc.) and those that will charge astronomical amounts to do so. Perhaps this is not a problem for the independently wealthy, but for most of us, it's simply not possible.

Underlying problem as I see it - many well-to-do people (or people who come from well-to-do parents) simply don't understand what many of us go through - their life experience does not encompass the idea that any item (health care, nice car / home, etc.) can be out-of-reach for a large number of Americans, through no fault of their own.

True story: one of my acquaintances expressed surprise the other day that I didn't live in a big, luxurious house, since I make well over six figures and am presumably financially stable. Answer? My parents are not wealthy - in fact, they are poor (my father is a minister and my mother has a chronic illness that has eaten up any "extra" money they ever had). After graduating from high school, I had to start from the ground floor: I bought my own clothes, I paid for my own college (100%), I bought my own cars, I saved up to make the down-payment on my townhome (an investment which has paid off handsomely, I might add), I bought all my own furniture, electronics, computer equipment, etc. In short, every cent I've ever made has gone to basic living expenses and a start toward retirement savings.

How did my acquaintance afford his big house? Mommy and Daddy *gave* him the money for the down-payment. In fact, he seemed surprised to hear that others don't get such a nice head start; likewise, amazed I had to buy my own car, etc.

Now in my 40s, I still have sizable debt, a small savings account, but decent retirement savings. I'd like to look for a better job, but I'm stuck with my current job because I have a spouse with chronic health issues and I need the domestic partner insurance benefits my employer graciously offers. If I leave the company (or am laid-off), I will *very* quickly be "hurting" for day-to-day living expenses and would not be able to afford medical insurance at all even if, indeed, I could find a private insurance company that would insure me and my partner with pre-existing conditions for any reasonable amount of money. An affordable public option would go a long way toward making people like me (and millions of others) more than a couple of paychecks from disaster.

Richard said...

Am I missing something, but isn't the "exchange" element in the bill more important to liberals than a public option? The exchange is the way the government (or, at least, the government's appointed commission) will regulate (i.e., control) what is offered and paid for in all insurance plans--private, co-op and public, if there is one.

As Paul Krugman points out, regulation and subsidy have been used to ensure universal coverage elsewhere, including the Swiss system and Massachusetts' system. My biggest problem with either a single provider of health care (i.e., British National Health Service) or single-payer of health care costs (i.e., Canadian system) is the fact that when you have one entity controlling everything it tends to stifle innovation. I also don't believe, philosophically, that it is a proper role for government to be the provider of private goods and services. In my opinion, health care is a quasi- public good (most of the benefit is provided to a private individual, but there are some benefits that the public as a whole receives from the good or service, yet do to certain externalities, a sufficient amount of the good or service is not provided in the aggregate) that should be regulated and subsidized by the government. I, therefore, strongly support the Swiss style of health care provision over the British, Canadian and even the current U.S. system.

bleepul said...

mclever ...

There are so many better ways of doing this.

So what happens when the government decides that your Zomig is too expensive to cover? You'll have NO choice then. Or do you think that AstraZeneca has no manufacturing costs and will just continue to produce an unprofitable product in perpetuity?

You situation is exactly why we should have consumer driven health care ... not the opposite.

mclever said...

bleepul,

If the public option won't cover what I want it to, then in your hypothetical utopia of private plans, I can just purchase the competing private plan that does cover what I want... Right?

Or, maybe I'll decide that the $200/month public plan plus the $100 once or twice a year for Zomig is better than the $250/month private plan that covers Zomig. (The private plans would now be more affordably priced, because of the competition with the public plan.)

But hey, if there's a low-cost public plan, then at least I'd get to make that choice!

As it is now, I have no choice but to pay for everything out of my own pocket, because no private plan will insure me, not at any price.

bleepul said...

mclever,

You make a good point in that currently you are screwed. I feel for you, I really do. It makes me hate the Obama administration for taking advantage of people like you and your individual situations. In a down economy everyone looks out for themselves.

But in the end this is about fixing the system ... for our kids and grand kids and nation. The government doesn't do ANYTHING well except maybe kill people. This public option is such a slippery slope. Improved care and lower costs? Great sign me up ... and I'll take the perpetual motion machine too.

See, there is no government mechanism by which such a thing can happen. One or another has to give over the long term. Ask the military vets how they feel about their care.

Anyway, my "utopia" is no insurance at all for costs less than say 10K a year. Catastrophic insurance after that. Give me back my $300 a month and let me spend it however I want (but on healthcare).

Medical costs are out of control because we have no idea what we consume.

mclever said...

John,

I agree with you... Even some of those who come from "well-off" parents are finding it difficult these days...

The challenge as I see it, is that many of those who spend their whole lives working for one employer, usually one that offers a good pension plan in addition to comprehensive health care coverage as part of their benefits, those people have no concept for what the job market is really like for the under-40 crowd.

The average 30-yr-old will have changed jobs four or five times. Because coverage is dependent upon employment, many younger people will be without coverage for significant gaps in time. COBRA costs are often too high for someone between jobs to pay for, and employees often aren't eligible for benefits until after six months or more.

Then, there are workers who have a job with coverage and are afraid to look for a new job, because then they might not be able to get health care ever again. If you or your spouse has ANY condition on their medical history in the past 10 years, then you can be denied. Even for a sprained ankle...

In order to help our workers be competitive, health care coverage needs to be portable and consistent, independent of one's job. In order for our businesses to be competitive in a global market, the burden of paying for health care costs must be reduced.

Universal public coverage (like universal Medicare) would obviously be the best solution for providing the most portable and cost-effective solution, but that is politically unpalatable. The next best solution is to have an inexpensive public option that gives people a choice between accepting whatever their employer offers or signing up for the public coverage. Then, for the mobile job-seeker, they'd have a choice for coverage.

The private market has already proven that they are not interested in giving consumers a choice.

mclever said...

bleepul,

You obviously want to make sure that everyone with a cold goes to the emergency room, rather than a private physician. In your world, the public will pick up the cost for the emergency room, but not the private doctor...

Brilliant way to make sure we ALL pay more!

A public plan would have less overhead, and thus lower costs. Currently, 30% of private costs are for overhead, while Medicaid manages on less than 3%. That's a pretty big savings, right there.

Why don't you just let me have the public option. If the public plan is SOOO horrible, then no one will sign up for it and it'll go kaput in a few years anyway.

bleepul said...

mclever,

You are wrong on almost all accounts. Look, I'm not a fan of insurance ... I'm taking issue with the basic assumption that we need it in the first place for non-catastrophic illness.


In MY world people think TWICE about going to the emergency room for a cold. I can't imagine if someone got a bill for an emergency room visit that they would ever go again for a cold ... don't know why you think I'd be for the public paying for that.

best lectures I ever heard:

http://drfd.hbs.edu/fit/public/facultyInfo.do?facInfo=bio&facEmId=rherzlinger

And on the last ... because I have to pay for it and government programs NEVER die.

markymark said...

Richard has done an excellent job concern trolling there.

First off, from my point of view, both insurance company regulation and the public option are vital. (many Dems I guess would prioritise but personally i say get both done!)

Insurance company regulation is important. American health insurance will have an important part to play for a goodly long while to come yet. It is important that the American Health Insurance industry plays ball. Actually in this case regulation will help the Health insurance industry because it will ensure the insurance companies are playing by the same rules as the government option.

But the public option is how you guarantee coverage for the uncovered. Its not a question of finding a method, its the moral issue here. Its just plain that in the richest country in the world people are left uncovered. The government, in my view, should have a role in guaranteeing coverage for everyone. To me it really is that simple. Yes the government has a moral duty to protect us with the army, but it also has a duty to ensure everyone is protected from health issues. Take for instance Swine Flu, its in everybodies interest that people are protected from it. Having 50 million people with no health insurance, and many more may decide not to go to the doctors when they are sick fearing that their insurance is unsatisfactory.

I know a lot on the right are playing a political game with this, but there are real issues at stake, that actually affect millions of people.

bleepul said...

markymark,

good points but the military isn't outside your house protecting it is it? No, CDC, FDA, EPA are more analagous. What exactly does everyone have a right to? A life-time of big-macs and then a free quintiple bypass? 2-liters of Coke per day and then 20 years of diabitic induced dialysis? There is a moral component but when are people responsible for their own well-being?

I prefer freedom and all the downside that comes with it.

Upon Further Review said...

The government doesn't do ANYTHING well except maybe kill people.

I laugh at that statement every time I turn on a water faucet.

Or drive on a freeway.

Or inhale breathable air.

Or eat food that doesn't kill me.

This line of thought has zero credibility and, as such, debating anyone who would put it forth is a complete waste of time.

KIC said...

I'm calling everyone under the sun I can think of to complain and offering that if they want angry mobs whipped to a frenzy to prove something we can probably do it, but quite honestly there is a reason there is a big (D) after their names, and that they had better start doing their job and stop waffling or there will be a big fat nothing next to their name soon. I can't fault Obama when his party *won't* support him for having to compromise.

KIC said...

It's not JUST about going to the ER for a cold. For God's sake there ARE things you have to go to the doctor for and it would be SO expensive to just do it ala carte out of pocket as things stand now, it's not doable. I don't know where you people live that say this, but when I look at my bills, if I didn't have insurance, I couldn't afford mammograms, pap smears, injuries, NOTHING. And that IS rationing and that IS unfair and that IS the status quo. IF you managed to get rid of insurance altogether, YES, maybe competitive pricing could bring down costs, but that has a colder chance in hell of happening than anything out there. Without that there is NO bringing down costs or coming any closer to a solution. This is insane! It should simply not be THIS expensive for basic care, let alone catastrophic coverage.

KIC said...

Obama explains it just fine. I listened to him this weekend and thought "why the hell can't senators and congressman make it this clear?" Mostly because THEY are the ones sitting back waiting to see what way the wind blows instead of SELLING the damn thing. This is THEIR fault EVERY time.

bleepul said...

KIC,

SOMEONE has to pay for those things ... now or in the future. All you are doing is spending someone else's money every time you have something done. And not just rich people ... but the people that sit next to you at work. You are spending THEIR money.

My wife uses probably 10X what she feeds into the medical system ... drives me nuts.

mclever said...

bleepul,

The biggest problem with providing coverage for catastrophic illness only is that the greatest cost savings come from having a good preventative plan. Part of the reason costs spiral out of control, is because people are afraid to go to the doctor earlier because they can't afford it. So, instead of getting their cholesterol checked and diet advice, they end up taking an ambulence to the emergency room with congestive heart failure... (or pick your favorite preventable disease.) Two $150 doctor visits and maybe an Rx are a lot cheaper than a $100,000 hospital stay. And if they're not covered, then the American taxpayer picks up the tab anyway.

That's the thing that most reform opponents don't seem to understand... The public is already paying for health care for the uninsured. But the current situation is the far more expensive route, both in terms of general public health and in terms of the national pocketbook.

And that's why we're ranked 37th in terms of quality of healthcare, despite spending almost twice as much per capita as anywhere else in the world.

Davy said...

Eric said,

"Well, progressives have been trying for universal health care for a century now, another ten years won't hurt anyone. Except the uninsured, but they can take one more for the team."

While I endeavour to abstain form unnecessary rhetoric, let me be clear on this particular topic: Fuck you conservatroll.

markymark said...

bleepul, my point was not to draw a perfect analogy, but rather to point out that their are things that people think the government should do, for instance providing an army. I happen to believe that making sure everyone has access to health insurance is one of them. And I happen to believe that the public option is the best way to achieve that.

I think that if the government reserves the right to draft people into the army, it should be prepared to do something for them in return.

bleepul said...

markymark,

Access to insurance SOLVES NOTHING. The cost drivers will still be the same. High demand, low supply. You people think that the insurance companies are sitting on hoards of cash disenfranchising you ... but they are just the middlemen. The major cost drivers are a) people consume healthcare without knowing what it truly costs and b) there isn't true competition at THE POINT OF CARE.

Obama has you hoodwinked into thinking this is about access to insurance because he wants to do away with it. It is about access to medicine in the end.

Anyway, most of you would be arguing the exact opposite if Obama told you it was the thing to do.

bleepul said...

mclever,

you are talking about preventative medicine which has little or nothing to do with access to insurance. What difference does it make if I pay the $150 out of my health savings account or I pay premium into a pool and then the pool pays for the same Dr. visit? None.

In fact, all the evidence on health saving accounts suggest they work very well and that people like them. If you have to pay for it you are more likely to take care of yourself.

markymark said...

bleepul, I for one would be arguing for a public health option, and for insurance regulation whatever anyone else said. And I believe most of the Democrats on the board would probably say the same thing. One might suggest you are arguing against them because Obama is supporting them??

Anyhoo, if it is true that costs are what is driving Health Insurance up, then how come health insurance PROFITS are rocketing.
http://blog.aflcio.org/2009/05/27/health-insurance-profits-soar-as-industry-mergers-create-near-monopoly/
428% rise between 2000 and 2007.

Noone has me hoodwinked into thinking this is about access to health insurance, perhaps save the 50 million who don't have health insurance.

markymark said...

(FWIW by the way, Obama hasn't talked enough about access to healthcare for my liking. That should be the driving force behind this, not cost, not profits, how do we make sure EVERY American can and does indeed have health insurance. Thats the ball game for me.)

bleepul said...

Markymark,

No, I used to think like you until I listened to Regina Herzlinger. I don't like Obama but am objective on this one ... it's not the right way.

You are quoting an AFLCIO so it's not exactly unbiased. The industry is notoriously cyclical, feast or famine, and I think entitled to a profit. Also, you need to keep in mind how this stuff works ... the money you put into a pool goes into an INVESTMENT which can be PROFITABLE on it's own. It's not like they keep a chunk and deny people medical care. Looks like the time the AFLCIO chose to report pretty correlated to the surges in equity and real estate markets.

Even so, that's a drop in the bucket and not the reason health care costs are surging.

markymark said...

bleepul, you at least insinuated that the health insurance companies were not doing great at the moment and struggling, BUT their profits have soared recently, for whatever reason. If part of the reason that profits have gone up is that investments have been doing well, why not pass those savings on to customers, in the way that the right is always telling government to pass savings onto taxpayers?

And its exactly like they keep and chunk and deny people healthcare.

bleepul said...

mm,

your thinking on all of this is too simplistic. In reality the whole system is HORRIBLY complicated as it is and I absolutely shudder the think of government involvement.

I would say be careful what you wish for but in this case it looks like it has died (hopefully). Don't give up hope though ... I agree with you, the poor and uninsured need some help. Get educated ... let's empower them while making the system better. Power to the people.

markymark said...

My issue, bleepul, is that the market is actually quite bad, when left to its own devices, especially in the field of health insurance. And just as I don't think the solution to the financial systems mess, partly caused by a lack of regulation, is less regulation, freer the market further is not going to help meet the twin tribulations of cost and access.

For instance how does a free market in health insurance help small business? The public option takes pressure off small businesses by giving them and their employees another option for health insurance. But just as the market doesn't have all the answers, neither does the state. Private health insurance will remain important in taking pressure off of the public system.

KIC said...

Bleepful,

Specious argument. THey are also spending mine. But the point is, though I have great insurance right now, I might not, probably won't, always if it gets too expensive for my employer. There is NOTHING out there to encourage lowering of costs if we don't have everyone on a plan. It's just BS that we have been working on this for 80+ years and it is the same song over and over.

Right now, we are paying through the nose for those uninsured and underinsured and the insurance agencies are laughing their way to the bank.

It just doesn't work to say that I or you will be paying for it because *we are paying for it now in a completely inefficient manner*. Why can't people GET that????? Only there is nothing in place to encourage the lowering of costs, or premiums or deductibles. It has to start NOW. There will be no reform if we sit around and wait because *that is how it works* once it's over it's over just like so many times before.

Go preach to your own corner because we ain't buying it here.

Crisscross said...

Um, I did a 10 second Google search and it costs less than $100 for a pack of Immigran migraine medicine or $12 a tab. I use this medicine regularly.

So cut the crap about how your PHD daughter can't afford it. Simply buy them yourself and stop asking the government or an insurer to baby you. Jeez.

bleepul said...

MM,

The market is enormously successful. Go to the supermarket and see how many choices you have. It should be the same way with healthcare. I still remember the images from eastern block supermarkets, prior to the fall of the Berlin wall, with bare shelves, one kind of meat, a few loaves of bread. Not worth the risk.

This is not to say government had NO role but it is in light regulation. You stifle innovation and competition we all lose.

I know, you are going to say this program enhances competition but that's not true. The government has unlimited pockets and can undercut "fair market" rates and play hardball with drug companies until their are only few giant conglomerates left. This is how they plan on cutting costs long term.

Free market would take the pressure off small businesses in the same way as the public option ... it's your money it's just your employer is spending it for you.

I know it sounds good to you now but it would be a huge mistake. Horribly, horribly expensive (you'll pay in taxes what you save in premiums though you don't believe that) and it will cripple future generations of Americans.

Health savings accounts instead. Let people shop for plans rather than employers looking for the cheapest. You'd see new insurance companies everywhere.

Crisscross said...

I'd also like to make a note about pre-existing conditions. If insurance companies are forced to take people with pre-existing conditions -- those people who did not have the foresight to take insurance out for the "condition" in the first place -- then what will happen is that most people will not take any insurance until they get sick. They will wait until they get sick and then buy "insurance". That is not insurance at all (more accurately a form of welfare) and it will drive up the costs for all the other people who were insured all along.

bleepul said...

KIC,

They are only spending yours if you don't consume more than you pay ... which it sounds like you are.

How in god's name does increasing demand lower healthcare costs? Emergency room visits are now "covered" is that it? Wow, did they have any economic classes in Art school? You think that because the government has lower rates the other companies will follow suit or that all of a sudden that mammogram machine is cheaper to manufacture? No, you'll still pay as there is no such thing as a free lunch. It will just be in higher taxes ...

I'm preaching to you in the hope you might find some sense.

MorgainLeFey said...

I surely hope they do not make the mistake of omitting the public option, I will not be voting for anyone who does not support this option. I am a progressive/liberal and I gave up the single payer for the public option, let the other side give something.

The Democrats need to "Grow a pair" and take a stand here.

bleepul said...

MorgainLeFey,

You can grow 10 pairs and take 20 stands and the outcome will be the same. Those of us who aren't liberal progressives (the majority) simply don't want it. Sorry.

markymark said...

bleepul,

First off, small business will not have to worry about healthcare costs with a public option, because it will be their come what may. A huge saving straight off for small business owners. But if they do want to provide private insurance for there workers, the new market place will allow them to do so more easily than before.

The public option will in fact force Insurance companies to be more competitive. Firstly, the government option will reduce the importance of health insurance as a bolt on (more on that in a moment!) and secondly, fewer people will need to buy health insurance, which will force insurance companies to be more competitive.

Competition in the supermarket works because costs and savings are easily compared and you can do something about it quickly. Walmart is charging more than you would like, go to someone else next trip. In health insurance its not that easy, and you know it. For a start, its your employer who is spending your money. You have little choice who with.

And all of this is because health insurance is a bolt on. Its not something you NEED to survive. (not until you realise you need it!) You need food, for instance, so competition works. (Though perhaps supermarket employees may not agree). Without health insurance being a luxury, But being a bolt on, almost paradoxically, gives the health insurance industry enormous power. It knows people will buy its services, given that they are important, but it knows people don't need to. Therefore it can pretty much charge what it wants.

My point is that for some industries, the market is fine. But for others the market, frankly, sucks at providing a good deal for consumers. Given the importance of health insurance, and its unique characteristics, a public option for health insurance, in my view, is absolutely necesary.

bleepul said...

MM,

It's a huge savings for small business because they get to cut your salary. It's just in a different form. They hate healthcare because they have to indirectly give you a raise every year to cover it. Problem with your thinking is that you don't see your healthcare as part of your compensation which it is. If more people saw it that way and had to buy insurance out of their "take-home" pay there would be higher demand for different types of insurance plans.

I think it would be great to see small clinics specializing in different diseases and health problems such as migraines (imagine a migraine therapy session like a massage). I'd like to spend my health-care dollars at the gym or an acupuncture clinic or a spa. I'd like to be able to save it for hospice when I'm 90. I'd like to take healthcare vacations where I get a hernia fixed in the quiet countryside.

You are putting us on a road to cement bunkers with overworked and underpayed Drs./nurses, archaic medical devices, and old medicines.

It sucks now and you have to think about yourself I get it. I urge you to think about the world you want your kids to live in.

bleepul said...

MM,

Look, I make vaccines for the developing world. That's my job. We have to BEG for money because no one will pay much for the R&D effort.

Do you know what it takes to get a vaccine or drug fully developed? 10-20 years and over a billion dollars (mostly navigating the FDA and clinical trials). Companies undertake this only in cases where they can expect to pay for these costs and make enough money to invest in new projects.

The government cuts both ways ... it's good as a huge buyer (large market) but bad as it drives down prices to a level of minimal profitablity. When the latter happens companies drop the more risky development projects because they can't hope to recover the costs. Same is true for medical devices. You lose innovation, you lose the collatoral benefits.

jmscalisi said...

Obama fans and waffling Obama fans - Please remember that this guy is a master strategist.
Have you considered that Obama is not abandoning his base, but igniting it by putting some shading on his support for the public option?
He has said repeatedly that insurance companies need competition and the best way to provide it is a public option not only for the sake of healthcare in this country, but for the sake of our entire economy.
So far, the public option supporters haven't been ignited. Now they are. Good strategy, and a typical Obama trap of the kind we saw many examples of in the campaign.

bleepul said...

jmscalisi,

"Obama fans" says it all. This has less to do with honest healthcare decisions than the tribe not wanting to see their guy suffer defeat.

markymark said...

And bleepul all you want to see is Obama lose. genuinely I believe the Dems are far more interested in getting policy right rather than winning at the moment. I think Republicans just want to beat Obama. Why else throw terms like Obamacare around?

bleepul said...

MM,

I don't care about Obama. If he were pushing what I outline in all my posts I'd be completely behind him. Sure the Republicans want him to fail but they are not advocating this horrible idea so I'm with them for the moment.

ydef said...

Bleepul,

You claim that you do not like Obama, but that you stance against him is objective. Yet, you don't extend such support for others that have stated repeatedly that their stance on health care would stay the same whether Obama came out against healthcare altogether or not.

What gives?

If you think that others are for it just because they are mesmerized with Obama and he is for it (and you somehow can't fathom those that don't agree with you as capable of thinking independently) then why not at least be honest about your stance against Obama being your primary motivation?

You ask that we take your word for it, but you refuse to extend the same respect to others. Jmscalisi's absurd address was to the fictionalized 'Obama fans' that somehow would put Obama's opinion over being 'public option fans'. If you're going to extrapolate what one user says and stereotype an entire group of public option supporters with it, you should at least be honest and stop trying to claim that your hatred for Obama is not what's driving your opinion against health care.

It's also quite easy for you to say that those that can't get health insurance and suffering because of it should think of their children when you aren't a member of that unfortunate pool of people.

Also, please explain how a tax on those making a million bucks or more annually to fund a public option will somehow affect our children's wealth in the future.

Nodak Brian said...

The health care system is very complex and it will be difficult to fix. But I believe that the first step is to provide serious competition for the Health Insurance giants who now have a chokehold on the marketplace and can do pretty much whatever they want in terms of prices, services and in how to process claims. Conservatives have one goal and that is to kill the reform movement. They want NO REFORM WHATSOEVER. They will tell you that's a strawman argument, but it's the truth. They are in the back-pockets of the Insurance giants and will do their bidding. I do have some reservations on the public option and I do think that cooperatives might work if they are done right the first time. Once the Blue Dogs and the Congressional leadership reach an agreement, the right-wing extremists won't be able to stop reform from happening. And I will love every minute of it.

bleepul said...

ydef,

Even the CBO knows that the tax the rich scheme won't be anywhere near enough to pay for it. The rest is from "projected savings" which is a lot like Bush's war cost projections ... rosey to say the least.

I mean we can't even meet the obligations of old entitlement programs. Medicare is toast in 2017 and social security is done in 2037 (http://www.nytimes.com/2009/05/13/us/politics/13health.html). What makes you think a program 10-100X bigger will fair any better? Hope?

And as for the rich ... well, capital will move somewhere else.

More than anything it's not the wealth of our kids and grandkids that I'm worried about ... but the health. You think you are doing them a favor but they will be worse off than we are now.

JF Isher said...

@Nate

Howard Dean just called you one of the smartest political analysts in the country (while appearing on MSNBC).

:D

I agree.

bleepul said...

ydef,

And since I have to go I'll respond to what I know you are going to sat, which Obama's plan is meant to deal with the Medicare crisis and control medical costs.

So I ask you, how exactly is this cost control going to take place? All I ever hear is about affordable options, or insuring those currently without insurance, or things about emergency room visits ... nothing that really explains how COSTS are to be controlled. And by COSTS I mean the cost of a drug, what the doctor charges, a hospital's purchase of a new MRI machine, an outpatient's visit, malpractice insurance. THIS is what is out of control ... the insurance companies just pass these costs along to you in the form of increased premiums. HOW DOES THIS PLAN CONTROL FOR COSTS?

You can't answer it but you know the truth and you haven't admitted it to yourself. You believe it's all in the administration and profit of insurance companies ... that somehow the government could do it better and cheaper.

When the government disappoints you, as Obama and the Democrates have now, you can't say you weren't warned. They've failed you on this very simple promise ... why would you believe what they say on something so much bigger? The rest of us have figured it out ... you should too.

Michael said...

The sheer number of lies about the pre-existing condition problem pisses me off.

I have something that qualifies as a pre-existing condition. I don't require medication, and it won't have any health complications down the road... but it means that if I buy health insurance, that is money thrown away ... because if I ever cost the company more money than I've paid them, I will be retroactively dropped.

If I get hit by a bus, because I have a "pre-existing condition", my coverage would be dropped.

That is the problem.

And that is the problem with people with migranes. It's not that they want insurance to cover their "headache medicine" (and calling it that proves you have never known anyone with migranes, because they are literally crippling), it's that they cannot get insurance for anything else.

If you have ANY kind of health condition, you cannot get insurance for ANYTHING ELSE.

Which means if someone with controlled diabetes gets hit by a bus ... the ER has to take care of them, and has to eat a loss when they declare bankruptcy, because they couldn't pay for it because they didn't have insurance.

Or if someone with migranes has an I-Beam dropped on their head, again, the ER has to do the work and eat a loss.

Or if a bipolar person has a heart attack ... again, the ER eats a loss, and they declare bankruptcy.

Or do you people honestly believe that people who have one health problem should be completely unable to get insurance for any others?

JonTheLyrik said...

Bleepul, you seem to think many pro-reformers don't have their eyes on SS and Medicare. Both of them are sinking ships, nobody is doubting that. Personally, I think wealthy non-payers into the system should be taxed. It may be unfair, but it sure will seal up a lot of the leakage.

gk22 said...

So Baucus' attempt to strip out the public option will cost us all $150 billion according to the CBO.

That's $1100 per person!

What would you have done with your
BaucusBucks (TM)?

DCM in FL said...

MICHAEL

you got it right. I have been frustrated at the ignorant LIES & intentional truthiness that the GOOPers & health insurance industry are spewing. especially about 'pre-existing conditions'...

I am forced to 'pretend' on paper that I still live in CA because otherwise I must forfeit my Blue Cross health insurance since I moved to FL [except on paper].

I have paid premiums to several BC's for over 30 years [started back in the day when they were affordable & good coverage & non-profits...

BUT about 5 years ago I got a nasty case of Lymes Disease from a tick bite that due to poor medical care [thanks to BC] ended up damaging my liver almost to the point of liver failure & close to needing a transplant.

Fortunately with proper meds & time my liver was able to 'recover' & become functional again & all at minimal cost to BC [since I had 5K/7.5K deductibles...

BUT I am not able to get any other health insurance now because they all tell me that no one will write a new policy ANYWHERE in the USA without exempting ANYTHING to do with my liver in the future [pre-existing condition].

Now, how can I take that chance & get a policy for coverage in FL ??? I cannot since the liver is so vital to all health concerns for me in the future. I did not cause the liver failure, and it has recovered completely - no thanks to BC who refused to even allow my Dr to test me for Lymes since I lived in SoCal at the time & people there 'do not get Lymes Disease' so no test was warranted - until my liver shut down & nearly killed me...

So I am forced to pretend to still reside to CA for health insurance purposes. I go back at least once each year for my annual medical exam + I have to keep a amiling address in CA for billing purposes or I will lose my coverage [which is $400/mo for 'nothing'].

In the meantime, I cannot go to a Dr in FL without fearing I might lose my policy so I am forced to go without preventative care except for once a year...

None of that is my fault - but I have NO OPTIONS due to pre-existing conditions ruling out a FREE MARKET. I am locked out without a public option & true transportability & deleting the pre-existing conditions exemtions that only line the insurers pockets.

Tell me how the market will correct for this & my case is by no means a fluke - it happens everywhere every day. people forced to keep bad policies or lose coverage completely & rely on the ER at public expense.

It is a travesty in that health insurance is not truly even available except to PROFIT a few big monopolistic insurers...

Dennis said...

Obama is still holding OFA listening tours across the country. I suggest going and giving them an earful I know I will.The Democrats are the party of wimps 1st Bush's tax cuts 2nd Iraq or worse Nader was right after all. No P.O. no more door knocking, phone banking donations nada! I'm so upset I dont know whether to scream or cry.
P.S. Did anyone notice since last night they now require a word verification to post on website

Nosimplehiway said...

My mom is 61. She has rheumatoid arthritis. She was employed for decades, except for brief breaks to raise my brother and me. The whole time she (or my father) had dutifully paid the insurance premiums.

Last year she was fired from her job, working in accounts receivable for a construction supply company. They claimed she had been late for work too often. Over a period of a year she had been late three times, twice by under a half hour and once by an hour. That last time was during a foot deep snow storm, and she was still among the first employees there. The owner of the company called off entirely that day, as did her immediate supervisor. For this she was fired?

But she found out differently when she spoke with a friend who worked in HR, who spoke on condition of anonymity. Turns out the same week another woman at the company was also fired. The other woman was a breast cancer survivor. The company was firing the most expensive people to have on their healthplan. The insurance carrier had told them if they didn't reduce their payouts pronto, the company would either double their premiums or drop coverage altogether. My mom has heard that they have since fired several more people in a similar way, including a guy with hepatitis and a guy who has five kids.

She hired an attorney when the company tried to deny her unemployment. She has gotten unemployment and is paying for her health insurance with COBRA. It costs her $1200 per month. That's right. It costs $14,400 per year. It has a $5,000 deductible and a 20% copay, which is almost no coverage anyway.

Do the opponents of a public option really think this can never happen to them?

How is an unemployed person supposed to afford that?

How can we live in a country where that is an okay thing to happen?

How can her company afford to lose skilled employees because the health insurance company wants higher profits?

This system we have is craziness, and it needs to be fixed now!

Medicare for All. We need it. Now.

Paul from Santa Fe said...

As usual I'm late to the conversation, and bleepul said s/he had to leave, so these are probably wasted words. But it strikes me as incredible that the die-hard opponents to health care reform and the public option produce all these theoretical arguments about how it can't possibly work, while ignoring the plain fact that it does work, and works well, in pretty much every other advanced country in the world. Sure, they produce some disgruntled types from Canada and the UK who complain about their systems, but it's well established that the systems are enormously popular, and politically as untouchable as social security in the US. Different countries have different systems, as has been made clear during this debate, and that gives us the opportunity to pick and choose the features that are best for the US. But to pretend that this is something strange and unworkable is simply willful ignorance.

DCM in FL said...

pay for rational singlepayer health care [not subsidized private health insurance] with a VAT or national sales tax on EVERYTHING including food & basics.

sure it may be regressive - but that is OK in this instance since perhaps those hit hardest are the ones who will benefit most & EVERYONE would contribute.

for this one tax, a majority of voters would back it imho. it would relieve the pressure on property & local taxes to raise the funds to cover un-reimbursed ER expenses that everyone agrees are a total waste of resources & bad health services providers

ehggfc said...

Thank you, Nosimplehiway and Paul from Santa Fe. What I find so shocking in following this thread is the lack of knowledge about the cost of health care to many ordinary people right now. Many migraine meds don't just cost "$100" -- they cost upwards of $300/400 a month without insurance. And pre-existing conditions aren't things that one can just avoid simply by eating well and exercising. Type I diabetes is hereditary, incurable, and very expensive to treat. Good luck finding an insurance company that will cover you if you have it. I sincerely hope those who hate the public option never find themselves unemployed and in ill health.

neroden@gmail said...

"some utility"?

There is "some utility" in taking the Republicans in the Senate and horsewhipping them until they vote for a public option. The rest of this is just crap.

There is no "let down gently". If there's no public option, then I am going to be lobbying my Senators to vote against the health insurer bailout bill. And so will my friends.

neroden@gmail said...

'Before anyone concludes that the only acceptable healthcare reform must include the public option, consider the likely available alternatives and key goals: universal coverage, elimination of the "pre-existing conditions" out for insurance companies.'

I'm going to shoot this down, again. We have all that in New York. Insurance costs $1100/month.

So, no, not a useful change by itself.

neroden@gmail said...

"Tell her to nut up and pay the $150 bucks a months for the insurance. It's called responsibility."

You're an idiot, because the insurance costs $1100 per month in some states. LOOK IT UP.

neroden@gmail said...

'How about reducing the age for Medicare over a period of time. I suggest one year each for the next 15 years. This combined with a modest increase in the Medicare tax might be attractive to some "conservatives".'

This would be ideal to most of us liberals. If you just reduced it by one year each for the next 65 years, you'd be done.

neroden@gmail said...

"The government doesn't do ANYTHING well except"

....build roads, run the police, run the fire departments, build and run the water piped into your home, manage the national parks, keep the air clean, keep the water clean, prevent your food from being contaminated with unlisted poisons, make sure restaurants don't give you food poisoning, run the subway systems, vaccinate people against polio, smallpox, et cetera, prevent child labor abuses,.....

Seriously, I get so tired of this bullcrap. There's a buttload of things the government does excellently, and most of them are things the private sector does really, really, really, appallingly terribly. Fire protection is the classic example.

neroden@gmail said...

"I urge you to think about the world you want your kids to live in."

It's called "Canada". Or "The UK". Or "France". Or "Germany". Hint: all have effectively government-run payment for the vast majority of health costs, one way or another. And they have absolutely no trouble developing new medicines or doing research, either, to shoot down that piece of crapola.

grinder said...

Nice try with the propaganda, Saint Dude. But if the public option isn't in the bill, then health care reform is a joke and Obama will be the quickest lame duck in American history.

R.I.P., Democratic Party. It wasn't murder, it was suicide.

Richard said...

Interesting article on health care reform in the Atlantic (See here: http://www.theatlantic.com/doc/200909/health-care), which is a pretty liberal magazine. The writer argues for a guaranteed single-payer system for all, with manadatory coverage (poor would be given sufficient subsidies), but only for catastrophic illnesses (the writer argues for insurance to cover health care costs exceeding $50,000, with a lower threshold for chronic conditions). Other, routine health care costs would be paid out of Health Savings Accounts ("HSAs). I think the best question the article poses is: Aren’t we also likely to get worse care in any system where providers are more accountable to insurance companies and government agencies than to us?"

I think the other tone that comes from this article, and that I think will become prominent in future political debates, is for individuals to become more responsibile for their own health care. Of course, I'm sure the uberliberals here won't like this idea because it doesn't require the healthy, wealthy and employed to subsidize those who aren't. As Margaret Thatcher said: “The problem with socialism is that you eventually run out of other people's money.”

nybrian said...

From what I understand the only people who will really benefit are the insurance companies. All people will be mandated to have insurance, and the insurance companies will prosper.

And hopefully Obama will understand that there's no way to even start a conversation on medicare or social security---wait til 2016 for a Republican to take the heat on those programs. He can't win on those---the same crackpots will come out. So again, do NOTHING on any of the other programs and then let the republicans take all of the heat when it comes time to either cut benefits or raise taxes......

Amar said...

The Repubs always fell in line on their big issues. Why? The Hammer Tom DeLay threatened to cut off RNC corporate lobbyist-provided funds to deviants, as the lobbyists themselves requested.

The Dems never fall in line. Why? There are no pro-people lobbyists forcing them to fall in line.

It's that simple.

Crisscross said...

ehggfc: Many migraine meds don't just cost "$100" -- they cost upwards of $300/400 a month.

Is this really so difficult? Search Google for "Buy Immigran". Click the first link: http://www.pillsforstress.com/Imigran.htm

$139 for one month's supply. Less if you buy more. Even less if you do some comparison shopping.

This demonstrates clearly that cost savings come from taking personal responsibility for your health care decisions and competition between a multitude of suppliers in the free market.

John said...

"ehggfc: Many migraine meds don't just cost "$100" -- they cost upwards of $300/400 a month.

Is this really so difficult? Search Google for "Buy Immigran". Click the first link: http://www.pillsforstress.com/Imigran.htm

$139 for one month's supply. Less if you buy more. Even less if you do some comparison shopping.

This demonstrates clearly that cost savings come from taking personal responsibility for your health care decisions and competition between a multitude of suppliers in the free market."

Please don't spout off about that which you know nothing. Imitrex (the brand name in the US) is a *prescription* drug and is not available legally over the Internet. It is also *not* the only migraine medication (nor even the preferred medication for some sufferers). My mother has had migraines all her life and Imitrex stopped working for her *years* ago. So she can either spend her life in unbelievable agony or can use some much more expensive (but effective) drugs partially paid for by insurance.

Anandakos said...

@Juris,

Any "regulations" about pre-existing conditions and rescission will either be written to be circumvented or if strong be overturned by the Supreme Court's activist wingnut majority.

The reasoning will be: since a majority of the States ban health insurers from other states practicing within their borders, the Interstate Commerce Clause is not operative in health care provision. Therefore Congress has no right to pass regulations over it.

But the mandate that everyone get at least some minimal coverage will stand, because it's a tax law.

So what we'll end up with is the worst of all possible worlds: 45 million people will be forced into the maw of the HealthCareBeast® which will deny them coverage when they need it with the same leering smile they use today.

Anandakos said...

@Richard,

I am 1000% for individuals to become more responsible for their own health care. And I'm sure you'd call me an "ultra-liberal".

I expect that given the proper incentives we could replicate our success with smoking for obesity. But, to do that is much more difficult that simply telling people they need to get thin. You'd need to take on agri-business and the food industry in a big way, and frankly I expect that if you mess with peoples' Coke fixes, you'll get the shouters right back.

And I don't think that you can fairly base premiums on "lifestyle". For one thing, how would you measure it? You can't use body mass index because you'd just be giving naturally thin people an undeserved bonus. Some folks are just chunky by nature, but still aren't unhealthy.

And anyway, obese people and smokers die earlier than normal weight non-smokers, so it's not clear that the "bad" people do actually use more health care over their lives.

What actually is non-normally distributed is cancer and other horrible wasting diseases such as ALS and Cystic Fibrosis. These cost millions to treat even over the typically shortened lives of the sufferers, but they did nothing to contract the condition. That is true of most cancers, as well, with the exception of mouth and lung cancers from tobacco use and toxicity induced illnesses from work environments.

So by all means, lets work to ban idiocies like high-fructose corn syrup and Nutri-Sweet that play havoc with the body's sugar metabolism system leading to Type II diabetes. Make food stamps be worth more for fresh vegetables and bulk foods and less for CocoaPuffs. Set up government subsidized outlets for those more healthful foods in poor areas where for most people the only food sources are convenience stores.

But don't glibly blame the obese for their plight when the entire food distribution system is biased toward over-consumption of useless calories and fats.

Spend some money educating people and make certain that they have access to foods that support a healthier lifestyle.

And while you're at it, spend some money on public transportation. The walks that are almost always necessary -- even if only from the far edge of the Park'N'Ride lot to the bus stop and from the stop to the office building -- are valuable health builders.

Anandakos said...

@Richard,

By the way, I forgot to mention that I agree with the idea of a shared pool for catastrophic and genetically based lifetime conditions. That's where we should be focused.

However, $50,000 per year for the cut-in is way too high. Paying that much as a deductible would bankrupt many families, and avoiding that is the reason for catastrophic coverage.

So I'd look more to the $5,000 to $10,000 range for the cut-in -- or maybe some percentage of taxable income for the previous year? -- and believe that would keep the premia low enough that most people could participate on their own dime and the subsidies affordable for the rest.

I'd love to have some sort of law outlawing "discounts" for in-network patients, but the Supremes would probably overthrow it using the same logic as other regulations.

Anandakos said...

@bleepul,

Medicare and Social Security are not "toast in 2017" and "not done in 2037". (The actual dates have been moved up because of the recession, but no matter.) The dates are when the money coming into the Trust Funds in a given year are less than the benefits paid out during that year. But there will still be trillions flooding in annually.

The "Trust Funds" hold trillions of dollars of special Treasury Bonds that they will start cashing at that time. Unless the US Government wants to default on those bonds -- which have the same "full faith and credit of the United States" backing that ordinary Treasuries do -- they will raise taxes, cut benefits, or do some of both at that time.

The reason for this is not "waste, fraud, and inefficiency". For Social Security it's entirely the result of the radical drop in childbearing in America (a good thing considering the environmental burden of each and every American). There are fewer young workers to support seniors each decade for the next three until the baby boom has completely worked through the snake.

For Medicare it has the additional element that the designers of the system had no inkling that medical technology would progress so rapidly, cost so much, and be so effective when they introduced the system. People live much longer and use much more expensive technology than projected in 1965. The deduction should have been 4 to 5% of wages instead of 3%.

Richard said...

Amandakos,

By responsibility I was referring to having people pay the costs of their bad health decisions, not necessarily dictating to everyone what they should and should not do with their lives. For instance, if someone is obese or is a smoker and gets diabetes or lung cancer respectively, they should have to pay the costs of treating those diseases, and not have their costs subsidized by society. I do agree with you,however, that we should "[S]pend some money educating people and make certain that they have access to foods that support a healthier lifestyle." Education is extremely helpful when it is lined up with proper incentives (i.e., get a Bachelor's Degree and you will earn more money during your life; live a healthy lifestyle and you will save a ton of money on health care costs).

With regard to the $50,000 limit on catastrophic care insurance, I probably would agree with you that that figure is a bit high. The writer does explain, however, that we would have a great deal more money in our pockets if we didn't have to pay all the taxes for Medicare and Medicaid and if our employers provided those health care benefit cost directly to us in income. Whether that is accurate is debatable. As you indicate, a $10,000 cut off would probably be appropriate. I'm sure that even this is tough to fathom, given the exhorbitantly overpriced costs of certain health care goods and services now, but I believe the writer does a good job of explaining that health care costs should greatly decrease if we had to pay them directly ourselves.

Patapsco Jones said...

I think people are misreading the statement from Sebelius and the rest of the Democratic leadership to a large degree. This past weekend's comments from the HHS Secretary, President Clinton, Majority Leader Reid and President Obama himself look to be a very big weather balloon to gauge the reaction of liberals. Liberals have spoken loud and clear and with none of the hemming and hawing we're hearing from the leadership. They will not vote for a plan without the public option. Period.

If it comes down to a choice between 60 votes in the House and making Max Baucus, Kent Conrad and Chuck Grassley happy, the White House has no choice but to yield to the House progressive caucus.

I have no doubt it will be a tough fight in the House. But Pelosi and Hoyer can get the votes provided the progressive caucus is on board. If the progs are not on board then they can forget it. The bill is dead and the fight is over without those 60 votes. However the votes of Baucus, Conrad and the other Conserva-Dems are not necessarily needed to get the bill out of the Senate provided this stretches past October 16th and Reconciliation kicks in. Then a public option plan needs 50 votes plus Biden to Win in the Senate. It wil be a tough fight too, but Democrats can win it. This wouldn't be the first time it took 50 votes + a Tie Breaker to win a hard fought vote in the Senate. NAFTA and the Bush Tax Cuts both only got 50 votes. As long as progressives stick to their guns and don't fall into the trap of being rolled on and taken for granted they can force this scenario...and it's a scenario where they can win.

Dr Zen said...

bleepul, money is just a way of sharing society's resources. Of course you feel you are entitled to more than the next guy -- you feel, as most of us do, that you are extremely important. It's just a pity your parents never taught you why sharing is a good thing for you as well as those you share with.

As for the Blue Dogs, don't you guys even have a whip? There is no way a government in the UK or Australia, with a majority, no matter how slender, would fail to whip in a major reform, because it would remove the fucking whip rather than allow even one member to vote against it. It would be as simple as that: "you vote against the public option, you stop being a Democrat, end of discussion". I know American politics doesn't work like that, but let's face it, the Republicans were able to create a unified party that voted as a bloc, so hey, it can be done even there.

Dr Zen said...

"This demonstrates clearly that cost savings come from taking personal responsibility for your health care decisions and competition between a multitude of suppliers in the free market."

How do rightards even think they can get away with nonsense like this? America spends way more on healthcare than other developed countries, with worse outcomes. I happily allow the government here to take care of my health care decisions. It does a fucking good job of it and that costs me 1.5% of my taxable income in a year. (I'd have to pay extra for migraine meds but not a cent for treatment.) A bargain compared with the fleecing you guys get not to be treated. I also have private insurance. You'd cry if you knew how little it costs and how much I get for it.

nicvera211 said...

I read through this thread (quickly, yep) but didn't see this point addressed.

A poster ( who is obviously against it) said regarding the Public Option:

"I don't want to have to pay for it [or for you to have it]"

Then another poster who is in favor mentioned why they feel okay about paying for it...

FOLKS

The Public Option is NOT going to be underwritten by our taxes.

There will be start up expense, yes -- but then it operates just as private insurance with premiums and co-pays. I have not seen this, but I imagine the money paid in will also not just sit there waiting to be spent, but be invested in order to grow -- again, just like private insurance entities.

**********

The fault here IS in the President and the Democrats seeming refusal to EXPLAIN this clearly.

They are letting the right wing and their corporate financiers win the Perception War.

This is where I am starting to get my hackles up --- I worked my ass off for the results in Nov 2008, I donated money for the first time ever, I thought it mattered -- and NOW these folks can't even speak up FOR ME!

They can't put the information and facts out to counteract the lies and misinformation?

Did you see the NBC poll... the percentage of those respondents that STILL have the facts all wrong.

Dang.

I hope Mr. Obama knows what he's doing... and then... I really hope he decides to SAY it!

Richard said...

Dr. Zen,

Sharing is when people decide to give freely what they have to others. The government taking your money to give to others is beuraucratically referred to as "redistribution," but, if it were anyone else doing it, the practice would be called "theft." I think you have it backwards. The people who think they have the entitlement are the ones who do not contribute to society but want top of the line health care.

As for those in other countries touting their superior systems, I quote from Clifford Asness' article on RCP (http://www.realclearpolitics.com/articles/2009/07/23/health_care_mythology_97552.html) "Those touting socialism's success have never seen a world without a relatively (for now) free US to make or pay for their new drugs, surgical techniques, and other medical advancements for them. When (and I hope this doesn't happen) the US joins in the insanity of socialized medicine we will see that when you remove the brain from the body, the engine from a car, the candy from the striper, it just does not work....To put it simply, right now the US's free system massively intellectually and financially subsidizes the world's unfree (socialized) ones. That sucks. The only thing that would suck worse is joining them without anyone to subsidize us all."

Randomizer said...

Ha, Ha, Ha, Ha cough sputter!!!

Richard:

You do know that most of the new drugs are marginal improvements over existing treatments or worse yet "me too" drugs designed to evade patent monopolies. The U.S. has long since been the intellectual and financial engine of the world economy. The EU has a bigger economy and how can a debtor nation be a net financial subsidizer.

But lets assume your argument has any merit -- you are arguing that it is important not to provide affordable medicine to Americans because of our noble duty to subsidize countries that have a social contract?

Lets get real -- what Americans are subsidizing is an obscene standard of living for a small number of health insurance company executives and owners. That's why the overhead in the U.S. is many times higher than anywere else.

I thought conservatives were supposed to want efficiency and low overhead -- you know, like medicare (the rumoured death of which continues to be greatly exaggerated).

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