Time to get to work. Let's review there areas where there's near universal agreement at DU:

[Political Heretic]

The Bill has passed. I think there's near universal agreement that this is true (just a little joke to break the ice!)

:)

(It's ok to laugh)


But seriously, let's focus on the areas where we agree for a moment. As near as I can tell almost everyone here agrees that this bill does not go far enough. Many feel it is an excellent start, while others feel it sets up obstacles to future progress.

Regardless of who is correct on that, there seems to be agreement that more needs to be done after this legislation. I can't tell you the number of times I've heard strong supporters of this reform say that it's not perfect but we need to pass it and build on it.

So let's get serious about that build on it part?

We could continue the same fight about a bill that's already passed when the debate is over. My "side" lost. I would much rather star talking about what steps we can take to move forward with the cause of a quality health-care-for-all system that the American people deserve, that the rest of the industrialized world already has.

I think it would be really great if DU would be willing to engage in a serious "post-mortem" about the health care process, and critically analyze the actions of our own party. There are so many critical questions we should be asking such as:

-- how it is possible to pursue a more liberal/progressive direction when half of our party represents corporations and conservative constituents?

-- Can we go back and identify all of the deal making that various Democratic players were involved in with the Insurance industry, pharmaceutical industry, and financial lobby and how that effected the legislation?

-- Can we review the decision to completely take any discussion of single-payer of any form completely off the table from the very beginning? What if we had instead started from that position and negotiated from there? Better? Worse?

-- Why is it that Republicans, even when facing a seeming civil war inside their party can be counted on to vote in lock-step while Democrats have to deal with conservatives and corporate shills within their own party at every turn?

-- When does the answer to how to take steps forward include voting out conservative corporate shills from positions of leadership within our own Party? Ever? Or do we just keep bending over and taking it indefinitely due to fear of Republicans?

And most importantly:

-- When it comes to health care, what ARE the next steps?

[KILL THE WISE ONE]

1. demoralized base comes out strong in next election

then a public option or extend medicare to 55 plus then 45 then everyone

[readmoreoften]

3. No. No next election. This gets done now. The pushing has to start immediately.

And heads up--the base is still demoralized.

[Political Heretic]

4. What makes you think anyone has the political will to even put that on the docket?

The leadership made it pretty clear this time that it was a big fat "NO" to a public option.

You can't even said "we didn't have the votes" because it ended up that we DID...

So, why would there suddenly be a magic change of heart?

[nadinbrzezinski]

7. Because a few in DC have hinted that they will continue the fight

for PO... and more.

They know, just as I do, that this is the BEGINNING of the fight.

[Political Heretic]

8. Okay. Fair enough. So, the beginning of what fight, to what ends? Where do we want to go?

[nadinbrzezinski]

11. Look at Social Security for an idea

it's gone from a pos of a bill, to the third rail of American Politics. That didn't happen by accident. But you will not get Single Payer soon, that is not in the whip count.

[Political Heretic]

12. It took thirty years...

I don't think we can afford that kind of time-table.

You keep talking about whip-count. I was never talking about single payer, other than to acknowledge my compromise by still being willing to support insurance reform long after single payer was off the table (since it was never on the table.)

We never took a whip count on legislation with strong price regulations, or that addresses the chief was that insurance companies screw over policy holders (claim denials and accusations of fraud). And if you want to talk about whip-counts, the votes were there in the house for a public option, and the votes were growing daily - just five away - from there for PO through reconciliation. It was leadership that perpetually killed hopes of a PO. Not a lack of votes.

Had leadership been as ferociously behind a public option as there were just passing this bill, given the amount of fierce hardball they were willing to play - you have absolutely no ground to claim the votes weren't there. We never tried.

But aside from that, I was STILL ready to support insurance reform without a PO. But endless deals with industry and removal of nearly all regulatory oversight - none of that was tested by a whip count. It was just DONE. Most of it was done to appeal to Republicans, which we DIDNT GET.

You only care about whip-count. Great. Next time, let's fucking have one.

[nadinbrzezinski]

16. I am sure Clyburn and the leadership

looked to see what kind of votes they had.

That's what they do.

As is it seems the House went against the wishes of the WH on this.

And I just don't care about whip count. I just happen to know that without the votes, you go nowhere.

Until you change that...

[Political Heretic]

17. Regardless, we can't afford thirty years.

So we need to do more than just wait for wholly owned subsidiaries of the financial elite to count their votes...

[eridani]

23. Excuse me, but SS did NOT start out as a mandate to invest in Wall Street

--or have the IRS on your ass.

[eridani]

22. So what's plan B when every amendment gets put in the shitcan on the grounds

--that we already DID health care?

[ixion]

6. LOL...

yeah, riiiiight.

[eleny]

2. With the last bit of strength tonight in my typing fingers, I'll give you a Rec for spirit

Unless of course you're a smarty pants who in anticipation had this all ready to post as early as last week. :D

[Political Heretic]

5. Hahahahaa! No, I didn't. :)

[jotsy]

9. Addressing the likelihood of success using an employer based system

with unemployment on the rise.

Reduce systematically and often the potential for profits going to the irrelevant middlemen the health insurers are bit by bit. Poison what meat is left on the bone, and maybe they'll go away.

The shot gun wedding style of the mandate is (IMO) suspect in terms of treading the waters of the constitution, tattered as it is. I see the logic in a mandate for auto insurance, if premiums are too steep you can opt out of the market by choosing not to drive. Not a choice available when it comes to your very existence.

The mission statement that precedes the constitution and what I see as something of a foundational fabric for the American expression calls on upon the here and now of us to continue pursuing that perfected union through a promotion of the general welfare.

[Political Heretic]

20. Excise taxes are not unconstitutional.... ?

I really don't think this argument that mandates, which are in effect excise taxes I believe, are unconstitutional is going to go anywhere, but if you do give me some more details.

[jotsy]

25. You caught me, I don't gots 'em.

I'm just a hotheaded over the hill idealist who doesn't want to believe it could be legal to require a citizenry to do business with a particular lot, at a particular rate, for a particular kind of service and then establish a penalty for an unwillingness or inability to comply with such a policy. Add to that the despicable, greedy and homicidal selfish nature the industry has displayed and tell me that is likely to strike anyone else as effective governance.

I'm really not trying to be argumentative, I think your OP is a great way to put to good use of that euphoric energy of success.

I like to think we're smart enough as a species to know too much to let material baubles rule us so. To give in to those that think it should and does, keeps us from being a deeper and more detailed reflection of our potential. The rest is smoke, mirrors, parlor tricks and games to provide cover for the sake of what they covet. It's disappointing enough on some occasions to shed the depth of my hope for those who are asked to endure this farce from further down the chain of humanity.

Where we are is nowhere near where we might be; all we have to let go of is the idea we have to have more than all around us to feel validated and valuable.

The language of a tax might have been more palatable, but I can't come to terms with the practice of medicine being about profit.

[RoyGBiv]

10. Bookmarking ...

I'm posting to bookmark this and address it later.

I've been up since about 5am, spending much of my day going back and forth between here regularly for the first time in quite some time and working phones.

But I did want to take a moment to acknowledge this. I think it's a good faith attempt to start building a bridge, and I would like to address it in some detail with a clearer head.

[ScreamingMeemie]

13. Back to square one. Real, true reform. Affordable healthcare for EVERYONE

with no penalties and no sellouts.

The next steps are the first real steps.

[Political Heretic]

19. This implies that just passed legislation serves as an obstacle rather than a foundation...

...no?

[ScreamingMeemie]

21. It does serve as an obstacle. But it's not what it says it is.

So we've really just got to start over.

[Swamp Rat]

14. k&r

[New Dawn]

15. The Individual Mandate must be revoked, and single-payer implemented.

"Health" insurance companies should not even exist.

[Political Heretic]

18. Great. How do we do that?

[inna]

24. If this bill were a step forward, we would support it

http://pnhp.org/blog/

by Margaret Flowers, MD

If this bill were a step forward, we would support it.

If we believed and evidence indicated that this bill could be “tweaked” into something better, we would support it.

But this bill is a step backwards, a step away from single payer. This bill further cements the privatization of health care, further enriches the industries that are the problem.

We are seeing the same scenario play out at the national level that has played out at the state level for decades. People see the suffering because it is very real. They are told that we must do something and that this all they can get. So the people accept this believing it is an incremental step towards reform. And guess what – it is not a step in the right direction. This type of reform has failed every time. This is why we continue to be in a health care crisis.

As this passes, the public will be told it is a solution. They will be told to wait and see how it works when it is implemented in 2014. In the meantime, people will continue to suffer, go bankrupt or die of preventable causes. This is unacceptable.

We want health CARE reform. Health insurance reform makes no sense. Health insurance is very regulated but they are rich enough and clever enough to evade regulation. We will not support health insurance reform: it is a waste of time, money and human life.

If we want real reform, it isn’t going to be pretty. It can’t be brought in through the back door or by tweaking. We will have to take on a very powerful industry that currently owns the White House, Congress and the media. But work for anything less is a waste of time. The smallest increment of change that will be effective is to change to publicly funded health care.

It is not going to be another 10 years or 50 years before we get real reform if this bill fails. The single payer movement is growing. We can organize and push for real reform. But we must stand strong and united on our principles. We must put single payer on the table. It won’t happen any other way.

Dr. Margaret Flowers, a Maryland pediatrician, is PNHP’s Congressional Fellow.