I advocated killing the bill because I really, really resented the gift to insurance companies

[cali]

but I always recognized that killing it was killing any hope of healthcare reform for a years and years.

I think I was wrong. I think I let my anger over corporate control and influence, sway me to a point where I was reacting out of anger instead of reason.

Here's why I think I was wrong:

Yes, in many ways this legislation sucks. It is a gift to insurance companies, but it opens a long shut door. If this doesn't pass, it will be years before reform is taken up again in the Congress- no matter how bad things get. Or the repukes will regain power and pass thing like tax credits and medical malpractice "reform".


There are good things in this legislation:

The 10 billion for CHCs is a very good thing.

Insurance companies having to spend 80/85 cents of each dollar directly on care is a good thing.

There's leeway for the states to become laboratories- that could be good or bad.

Maybe all the critics are right and this legislation will make things worse for most Americans re health care.

I don't believe that. I believe that there's opportunity here. As Pema Chodron says, "start where you are". And where we are is with the almost certain passage of this legislation.

[Wardoc]

1. The bill is a net negative. But on the argument of a starting point, lets...

say that Republicans get back in power, strip out the few things you list as good things, implement tort reform in it, and we already have an entrenched bill?

Let's say they just get control of the House and refuse to fund the bill, but the requirements stay (namely, mandating insurance).

This is the danger with passing a bill that is marginal. You have no guarantee at all that all progress will move in your direction.

[cali]

2. there are never guarantees and there are always lots of what ifs

I don't know if the legislation is a net negative or positive and neither does anyone else.

[FrenchieCat]

3. I think that once people see the benefits,

Republicans will be crazy to try and gut it.....

If we make sure not to allow them to get back in power,
perhaps that is the answer.

[cali]

4. I don't know.

I hope the benefits outweigh the negatives, but really, we'll just have to wait and see.

[saracat]

12. What benefits? Forced mandates and abuse of women? The Nurses Union

apparently doesn't see the "benefits".outweighing the wrongs.

[Egnever]

18. Well the nurses union has its facts wrong unfortunately

So it makes their opinion suspect.

[madokie]

46. Perhaps that is the answer indeed

[Tom Rinaldo]

5. For better or worse

the mandates are the chain that will tie the performance of the private health insurance sector to the Democratic Party's neck for the next decade. If we were overly optimistic about the cost control elements of this bill, if we screwed up the regulartory oversight through one too many open or hidden loopholes, if Republicans return to power and appoint conservatives to the positions that monitor and regulate the private insurance industry, complaints about the results will land on the Democratic Party's desk.

[Egnever]

6. Well said

There are things to give hope though such as non profits inside the exchanges.

[cali]

8. I agree Tom.

[Egnever]

7. Nice post Cali

[saracat]

9. As it stands it is still a bad bill.And I would never support any bill that

contains either the Stupak Amendment or the Nelson version. Women are not lower class citizens as proclaimed in this bill.

[cali]

10. Yes, it contains onerous crap

but as I said, it opens a door that has been tightly shut for generations. A lot of bad stuff will come through that door, no doubt, but the possibility exists that a lot of good can come through. We don't and can't know whether the good will outweigh the bad, but we do know that this legislation will pass. All we can do now is start where we are and work to improve it.

[saracat]

11. Did you see this? The Nations largest Nurses Union says the Bill gives too much to insurers!

The 150,000 member National Nurses United, the nation’s largest union and professional organization of registered nurses in the U.S., today criticized the healthcare bill now advancing in the U.S. Senate saying it is deeply flawed and grants too much power to the giant insurers.

“It is tragic to see the promise from Washington this year for genuine, comprehensive reform ground down to a seriously flawed bill that could actually exacerbate the healthcare crisis and financial insecurity for American families, and that cedes far too much additional power to the tyranny of a callous insurance industry,” said NNU co-president Karen Higgins, RN.

NNU Co-president Deborah Burger, RN challenged arguments of legislation proponents that the bill should still be passed because of expanded coverage, new regulations on insurers, and the hope that it will be improved in the House-Senate conference committee or future years.

“Those wishful statements ignore the reality that much of the expanded coverage is based on forced purchase of private insurance without effective controls on industry pricing practices or real competition and gaping loopholes in the insurance reforms,” said Burger.

Further, said NNU Co-president Jean Ross, RN, “the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the healthcare industry lobbyists and the lessons of this year in which all the compromises have been made to the right.”

“Sadly, we have ended up with legislation that fails to meet the test of true healthcare reform, guaranteeing high quality, cost effective care for all Americans, and instead are further locking into place a system that entrenches the chokehold of the profit-making insurance giants on our health. If this bill passes, the industry will become more powerful and could be beyond the reach of reform for generations,” Higgins said.

NNU cited ten significant problems in the legislation, noting many of the same flaws also exist in the House version and are likely to remain in the bill that emerges from the House-Senate reconciliation process:

1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.

2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.

3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.

4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they’d pass the higher costs to their employees.

5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:


* Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

* Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.

* Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.

* Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.

6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California’s largest insurers have rejected more than one-fifth of all claims since 2002.

7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.

8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.

9. Reduced reproductive rights for women.

10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.

“Desperation to pass a bill, regardless of its flaws, has made the White House and Congress subject to the worst political extortion and new, crippling concessions every day,” Burger said.

More: http://www.calnurses.org/media-center/in-the-news/2009/...

[azurnoir]

14. I would have to agree with the RN's

right now I live in a state that has certain protections regarding insurance such as your coverage cannot be canceled due to job if you or a member of your family is currently under going treatment for a medical condition, this is not COBRA the cost for your premium will remain the same.
Also my state had a single payer health plan that was the model to be used for a national plan it was an excellent plan that provided comprehensive coverage for adults and children that had either no other insurance or were undercovered by employer plans or could not afford their employer plans we did until a Republican governor was voted into office who step by step gutted the plan until it is almost useless now an adult without minor children can not be covered things such as testing supplies for diabetics are no longer covered and I believe adults can no longer receive dental care and the premiums have gone up to the point where it is no longer affordable for many,.
Still and none the less there are a number laws here protecting consumers were medical insurance is concerned and if companies can move out of state and still do business here they will

eta this Governor has been mentioned as a Presidential candidate for 2012 or 2016

[KrR]

44. The RNs dont work in the billing office like i used to...

Alot of the stuff on that list is true and some may be fixed and some may not. But the mandates are 100% necessary. When uninsured people get huge hospital bills and go bankrupt, we all pay it in the form of increased costs.

[Egnever]

17. Its not a glowing report from them but then they have their facts wrong

So I am not surprised they aren't happy.

Just some of the things I checked that they have wrong..

Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

This is wrong the bill permits discounts of up to 30% that can be raised to 50% if the secretary deems it appropriate for complying with a wellness program that encourages things like testing your blood sugar if you have diabetes. there is no failing because you have diabetes and there is no more than double charges. Why lie?

Insurers can charge four times more based on age

Again false it allows a ratio of 1-3 for the adult fees. Why do they exaggerate?

New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.

For this one they have to ignore all the stuff Bernie sanders put in concerning new clinics and training for nurses and doctors.

I appreciate them speaking out but i don't understand why everyone has to exaggerate to make their claims.

[NanceGreggs]

13. I have sometimes agreed with you ...

... and sometimes disagreed.

Through it all, I've always respected you.

Never more than right this minute.

Those who start from where they wanted to be (but aren't) accomplish little.

Those who start from where they demanded to be (but aren't) accomplish nothing.

Those who start from where they are (like it or not) and take up the fight from that starting point, achieve the goals that only such people can imagine.

[Prism]

15. It's not a door, it's a Pandora's Box

Ask yourself these questions, and think about them very honestly.

Do you believe American government can substantially reform any major industry at this point in time?

Think on the financial industry, the military industrial complex, the insurance companies, the corporations and their tax breaks, loopholes, and welfare.

Does the American government possess the fortitude to bring any major corporate industry to heel? If you believe this, what evidence can you present? (The auto industry doesn't much count here, as it was on its deathbed when the federal government intervened).

For me, I believe we've been watching the substantial weakening of American government in the face of corporate power. Could anyone have ever imagined Congress would be moved to repeal Glass-Steagall and President Clinton inclined to sign it? We have only moved further away from the reformist impulse in the ten intervening years.

Given the above, can you countenance chaining the American people to the private corporations? Do you trust the corporations enough to believe they will approach this "reform" in good faith? Does your conscience allow you to remove fundamental freedoms from the American people by enslaving them to private companies indefinitely?

More vitally, do you trust American government to come down hard on the insurance industry if they do not behave in good faith?

And finally, do you trust the Democratic Party to hold power until 2016 and beyond, before Republicans have the opportunity to weaken this legislation in any way?

I do not have positive answers to those questions. Too much history has passed, too many reforms and regulations weakened, too much proof our government will always bend towards the corporations instead of the people. There is too much recent, mountainous evidence.

I cannot in good conscience support the forcible taxation of American citizens on behalf of private corporations with the IRS as their collection agency.

If someone told me ten years ago the federal government would decree that a sizable portion of citizens' income goes to private corporations, I'd have thought it was some kind of paranoid lunatic left-wing delusion.

Now, it's about to become our reality.

I'm truly puzzled, and a little frightened, that all of this seems like not much bother. It's as if we've been utterly desensitized to what is now taking place. It feels like we've been abused into submission. Now we seek a smidgeon of light to justify the vast darkness we've invited into our government.

Something in us has broken, and I just want to know how it can be repaired. This legislation? Would be like bringing down a boot on the American people. This is just plain wrong.

[KrR]

45. Once again let me say...

The new insurance market will have a not for profit option. Also the house has also already passed major financial institition reforms.

[chimpymustgo]

49. Incredible, frightening, true. Thank you for your post. Fuck the HOPE, people. Deal with REALITY.

[girl gone mad]

16. Haven't you ever noticed...

that there's always an urgent need to pass whatever bad legislation they're trying to pawn off as "Help for the American People," coupled with vague promises that we can make it all better at some not too distant time in the future?

With TARP, for instance, Treasury, the Bush administration and congress warned us that if we didn't pass the bill the entire banking system would immediately collapse. Yet, after it was passed, they shelved it for a few weeks and then decided to do something entirely different with the money than implement the plan they had just sworn up and down absolutely had to be done the very next day.

We were also promised by the Democrats and the Obama campaign that as soon as Obama took office, he'd make it better. They said he would restore oversight and implement bonus restrictions and make everything transparent, etc.

I'm not falling for it anymore.

[cali]

20. As I keep saying, start where you are

this legislation will pass. the choice is either to work to improve it and implement it well or simply wash your hands of it. Granted, I live in a state where the gov't has demonstrated that it can work effectively for people and know that this legislation will help not hurt our efforts to expand accessible health care.

[Bodhi BloodWave]

21. thats wierd, i seem to recall Obama talking about that things would be hard

and that things would take time.

[pecwae]

19. Attention everyone who

still disagrees that this is the best our elected officials could do for us:

*You are wrong!
*You are acting out of anger
*You are unreasonable
*The Repukes will regain power!!!!!

[cali]

22. except that wasn't what I was saying. I was expressing MY opinion

I can respect people who believe this legislation is simply too flawed to be of any benefit. And who knows? They may be right. But whether they're right or not, this legislation is virtually a done deal, so my question to those folks is: Now what?

[OneGrassRoot]

23. Why did you post this? There are plenty of threads to insert these thoughts...

Why do so many DUers insert things like this in reasonable, respectful OPs -- and I say reasonable and respectful regardless of viewpoint, as I believe this is possible regardless of how one views the HCR bill.

Sorry to pick on you when there are plenty of others, but this post is representative of why this place is like a nursery school sandbox, full of bickering children who accomplish nothing through their antics.

I don't get it.

[Warren Stupidity]

24. me too.

This is about the third or fourth about face for me on this issue. I continue to be stunned and outraged by the blatant foul corruption that is manifest in this bill, but it is simply nakedly obvious here. The corruption is pervasive in washington. We have a republic by and for large corporations.

And then there is the fact that this bill will do some good. And the fact that defeat again here and now will put off reform efforts for another half generation and hand a revived Republican Party a victory of huge proportions. That Republican Party is now even more far right than the one that seized power in 2001.

We once again have little choice but to fall in line and support this bill.

[cali]

25. thanks for putting it so well.

it's been a nasty roller coaster ride for sure.

[Egnever]

26. I understand the frustration

There is a lot of good in both the house and the senate bills many wont admit to at this point.

[SmileyRose]

27. I still advocate killing it.

The 10 billion for CHCs is a very good thing. --- spending a 1000 Billion and only 10 Billion may or may not be good spending? - Not a good trade IMHO.

Insurance companies having to spend 80/85 cents of each dollar directly on care is a good thing. - Medicare's overhead is 2 or 3%, yes? If we wanted to be serious we'd be mandating insurance spend 95% on direct care, not 85%.

There's leeway for the states to become laboratories- that could be good or bad. I live in Georgia. Not all that excited about being put to the whims of the nutjob crowd.

[cali]

30. let me repeat: it's effectively a done deal.

so what are you going to do now that killing it isn't a possibility?

[SmileyRose]

41. I'm still alive and the windmill is still there.

somebody find me a horse! :)

[Douglas Carpenter]

28. I 100% agree!!

[cali]

31. thanks doug, that means something to me coming from you.

[earth mom]

29. Quit trying to sell DU shit on a silver platter.

Hopefully most DUers are smart enough to not fall for this kind of bullshit.

Saying the health reform ripoff is "better than nothing" and "opens doors" that go fucking nowhere is a piss poor way to excuse the most massive theft from the American people this country has ever seen. :puke:

[cali]

32. I'm not trying to sell anyone anything. I'm expressing my pov

don't like it? go eat...

you are as always completely dripping with it.

[earth mom]

33. Telling people to enjoy the shit sandwich that Obama & Congress are about to serve up is b.s.

Your "POV" is really a "Talking Point" that reeks to high heaven.

But no surprise because you are so full of b.s. it ain't funny.

[cali]

34. your bullshit doesn't become true, honey, just because you repeat it .

Goddamn I'm sick of stupid.

go eat it.

and sod off.

[earth mom]

35. If you're so sick of stupid quit looking in the mirror. nt

[cali]

36. gad, you really are pathetic

I can't help but pity you. I'll leave you your last lame word.

[KrR]

48. Its a good bill what is your problem with it? n/t

[CreekDog]

37. I came around to support the bill for the same reasons

Expect to be called lots of names. You've been called them before, you know how it works.

It doesn't matter if you thought carefully and came to this position, well, not to some people.

But doing what is right and supporting what you believe in on the basis of evidence is more important than being liked for doing so.

:hi:

[cali]

38. sure, I'm used to it

but I'm a fuck of a lot better at it than they are. A dubious achievement, I grant you.

[Vinca]

39. It's a lousy bill and there's no way to pretty it up.

All we can hope is the House will make it more palatable. In the meantime, we might as well look at investing in health insurance stocks.

[Mimosa]

43. Who has money to invest in health insurance stocks?

My health insurance premiums are too high to leave me any money. :(

[Surya Gayatri]

40. Courageous position, cali, given the

prevailing sentiment for blood letting around here. SG

[KrR]

42. Anyone on the fence because of mandates

please realize that yes it will lead to more customers for the ins companies. But the only way to bring down costs is to get more people insured... It is not intended as a 'corporate giveaway' and a NON-PROFIT plan will be included in the new Insurance market.

[DailyGrind51]

47. We might have to wait another generation for anything better to materialize.

We have Congressional majorities now, but that can change in an election, leaving us with the
unacceptable status quo.