Why every progressive Senator supports this bill

[grantcart]

So Senator Saunders, Rockfeller, Feingold, Durbin, Kerry, Levin, Franken and Sherrod Brown all for it. Kennedy's family says he would have supported it.


In the House the Progressive Caucus the Black Caucus among many others saying they won't vote for a bill without the Public Option are strangely quiet.



Here's why:


Headline points already promoted


* Extend health insurance coverage to 31 million more Americans, including 14
million lower-income, working people through Medicaid
* Prohibit insurance company discrimination based on gender or pre-existing
condition -- and make sure you can't lose your insurance when you get sick
* End the upward, unsustainable increases in insurance premiums
* Increase funding for community health centers in 10,000 communities across the
country, enhancing primary care for more than 25 million people who have
traditionally been uninsured or underinsured
* Close the prescription drug "doughnut hole" for seniors
* Require insurance companies to spend at least 85% of their income on patient
care, not executive pay or profits
* Cut the federal deficit by $132 billion, according to the Congressional Budget
Office


In addition there are a laundry list of other health care projects that progressive would be happy about if they were offered on their own.

* Increaces CHIP
* Expands Health Care for Native Americans


Tackles the critical backassward incentives that have pushed US costs out of control

* Eliminates co pays for preventative care/tests so that more people will get earlier diagnosis and much cheaper treatments
* Pilot program to find a way to transition from "pay for services" to "pay for outcome".
* Modernize Medical record keeping to reduce costs

Controls gross margin, net margins and plan profits


Over the last week there has been a lot of discussion about the MLR and how advantageous it is to regulate private companies gross margin.

There is no question that the easiest way to do this is simply to have them compete with public options.

Many people have noted that increasing the gross margin does not necessarily lead to either price or cost controls. The question that was hanging in the air is what role is OPM going to have in setting the plans for the exchanges.

IT is good news that OPM's role is broader and stronger than expected. They will have complete control over all aspects of plans in the exchange for small groups and individuals. Every state will have a state exchange and they must include multi state plans approved by OPM.



Here is the text from the manager's ammendment

(q) Part IV of subtitle D of title I of this Act is
19 amended by adding at the end the following:
20 ‘‘SEC. 1334. MULTI-STATE PLANS.
21 ‘‘(a) OVERSIGHT BY THE OFFICE OF PERSONNEL
22 MANAGEMENT.—
23 ‘‘(1) IN GENERAL.— The Director of the Office
24 of Personnel Management (referred to in this section
25 as the ‘Director’) shall enter into contracts with

snip

7 (at) least 2 multi-State qualified health plans through
8 each Exchange in each State. Such plans shall pro9
vide individual, or in the case of small employers,
10 group coverage.
11 ‘‘(2) TERMS.—Each contract entered into
12 under paragraph (1) shall be for a uniform term of
13 at least 1 year, but may be made automatically re
14 newable from term to term in the absence of notice
15 of termination by either party. In entering into such
16 contracts, the Director shall ensure that health bene
17 fits coverage is provided in accordance with the
18 types of coverage provided for under section
19 2701(a)(1)(A)(i) of the Public Health Service Act.
20 ‘‘(3) NON-PROFIT ENTITIES.—In entering into
21 contracts under paragraph (1), the Director shall
22 ensure that at least one contract is entered into with
23 a non-profit entity.
24 ‘‘(4) ADMINISTRATION.—The Director shall im25
plement this subsection in a manner similar to the
56
BAI09R08 S.L.C.
1 manner in which the Director implements the con
2 tracting provisions with respect to carriers under the
3 Federal employees health benefit program under
4 chapter 89 of title 5, United States Code, including
5 (through negotiating with each multi-state plan)—
6 ‘‘(A) a medical loss ratio;
7 ‘‘(B) a profit margin;
8 ‘‘(C) the premiums to be charged; and
9 ‘‘(D) such other terms and conditions of
10 coverage as are in the interests of enrollees in
11 such plans.
12 ‘‘(5) AUTHORITY TO PROTECT CONSUMERS.—
13 The Director may prohibit the offering of any multi-
14 State health plan that does not meet the terms and
15 conditions defined by the Director with respect to
16 the elements described in subparagraphs (A)

This means that it will be the OPM who will be the gatekeeper for the multi state plans. OPM is well experienced in performing this as it performs this function for all federal and postal employees.

Here is how the same type of exchange currently being offered to federal employees: http://www.opm.gov/insure/health/search/plansearch.aspx

Over the last few days several people have written that the OPM is not equipped to match wits with controlling costs, prices with private companies. There are two ways to challenge that, the first is to click on the link above and see what they are doing. The other is to check the financial returns of private company's whose business is almost exclusively done on OPM based contracts.

Humana is a health provider that specializes in providing health care with federal contracts. Over 70% of its policies are those negotiated by OPM. As this analyst report shows Humana derives a 1.7% profit from its largely government based health care business and another 1.4% from profit from cash flow.

http://www.wikinvest.com/stock/Humana_(HUM)

* Medical Loss Ratio (MLR): The MLR is the ratio of medical expenses to income from premiums. In 2006, this was 84.0%.

Adding the two up, we see that without any investment, Humana would earn 1.7% profit on its premiums alone. Nevertheless, Humana does take advantage of the float, and it earned about 1.4% net interest income on the premiums, bringing its total profit margin to around 3% (ignoring taxes and other revenue sources). Income from investment can determine profitability, so Humana and other insurers can be sensitive to changes in the interest rate and to fluctuations in the bond market.

In Kerry's recent long explanation of the bill he included the often heard "American citizens should have the opportunity to buy the same health care plans that federal employees and members of Congress enjoy" is repeated and this is what they are talking about.

Every state exchange will also must have atleast one "non profit plan".

The alternative in having OPM negotiating plans for small and individual buyers is not as desireable as having a clearly identifiable Robust Public Option. It is probably better than the severly more limited Public Option that we was being restricted to a small population simply because it is an established option that can be introduced relatively easily.


States have significant options to use this HCR and make it even stronger, for example States can increase the MLR in their state, reducing the gross margins

page 9

‘‘(i) with respect to a health insurance
17 issuer offering coverage in the large group
18 market, 85 percent, or such higher per
19 centage as a State may by regulation de
20 termine ; or
21 ‘‘(ii) with respect to a health insur
22 ance issuer offering coverage in the small
23 group market or in the individual market,
24 80 percent, or such higher percentage as a
25 State may by regulation determine, except

page 10

1 that the Secretary may adjust such per
2 centage with respect to a State if the Sec
3 retary determines that the application of
4 such 80 percent may destabilize the indi
5 vidual market in such State.

The reason that all progressive Senators are signing on is that it is going to save lives and reduce costs but beyond that it puts the federal government in charge of approving the price, coverage, profit of plans that will be in every state exchange. Every state will have plans that must include a non profit plan and multi state plans negotiated by OPM.

We can and should be angry about how the bill has been negotiated, rolled out and explained. But this bill provides a floor of coverage and allows states to increase it. In Canada Tommy Douglas didn't pass a national health care act he passed the Saskatchewan Hospitalization Act. It took the other provinces 11 years to pass a national health insurance act in Canada. This bill gives a floor of federal government control for health care and allows states to improve on that, creating an opportunity to improve upon that. Reading this act and the pages cited above there is nothing preventing a state, like Vermont for example, from incorporating its own Public Option alternative to negotiate with OPM as an alternative plan in their state. Vermont State government would also have the opportunity to pass legislation increasing the MLR of the public plans.

For this reason and the fact that it will save lives and control costs all progressive Senators are going to vote for this bill.

We should agree to pass this bill and then immediately turn around (just like Teddy would do on minimum wage) and start pressuring for public options and increases in medicare. In states that have large progressive voters, expecially that are located closer to the Canadian border we should agitate for higher MLR and state government run "non profits" that would operate as a public option, in the same way Canada expanded public health care from a single province to all provinces.









Manager's ammendment text here http://democrats.senate.gov/reform/managers-amendment.pdf

[NJmaverick]

1. thanks

:hi:

[Armstead]

2. They are hardly enthusiastic and it is sad that they have to be supportive in defeat

This bill sucks compared to what could have been done -- realistically -- if it had been handled better from the start and throughout the process.

We could have done something that all liberals could have cheered. Instead we get this junky fig leaf.

[grantcart]

9. I think you are missing a key and yet unreported aspect of the bill

It provides a basic federal structure that will "save lives and money" and it will put the OPM in charge of not only negotiating the rates but the profit.

It also provides the opportunity for states to improve upon those numbers.

That means in states where we have stronger progressive majorities we can use this bill to pass even stronger legislation.

As I state in the OP - this is what happened in Canada - Saskatchewan started and others followed. After passage states could start immediately to build upon the federal bill to improve key features in their state.

[Armstead]

18. I hope it dioes accomplish those things

The bill does have good aspects. Never said it doesn't.

But I still believe elimination of a public option/medic are buy in and the mandates for private insurance will lock us into a bad system that is going to be very difficult to improve upon in the future.

This is not Canadian style healthcare, or any other civilized country. It leaves us with a lemon that we have to try to keep running.

[eridani]

33. Ask yourself what would happen if we regulated utilities in such an indirect half-assed way

Enron brownouts kill grandma when her respirator shuts down. But hey--thanks to a law stating that Enron must pay a certain percent of its gross toward actual electricity, the government determines that grandma is entitled to a rebate! Big whoop.

Mandated private insurance costs 100 euros/month/adult in the Netherlands, with NO copays, NO deductibles, and NO age rating. Anything much more than that is a sign of a law not worth having.

BTW, those of us 50-64 sure do appreciate being legally designated as disposable human garbage. Not.

[Armstead]

34. That question keeps crossing my mind...Why not really regulate them?

Listening to all of the so-called debate about this here and in the media and in Congress, I wonder why they don't at least do a straightforward thing and say "Healthcare is too important to leave to market forces. We must regulate private insurers, including setting basic rates."

If they are not going to allow a real public option/Medicare expansion, why the hell not at least do that?

It makes me think they really are bought and paid for.

[grantcart]

37. So your argument against giving OPM the power to negotiate

rates, coverage, and profit margins is that other countries regulate more?


Funny I think it makes the argument for passing the bill that adds the most power to the Federal Government for regulation and then to build on that.

[eridani]

45. Rates should be set at the front door, not enforced indirectly.

Why should I have to pay $450/month for shitty coverage where I am on the hook for 30% of costs, when in the Netherlands I'd have to pay only 100 euros which would cover 100%? That's real regulation by setting prices. We do it with utilities, and health care is just as much part of infrastructure as electrical power.

[grantcart]

62. Your payment in the Netherlands constitutes only 50% or less of the funding

Half or more of the funding comes from general tax revenues. When comparing apples to apples you would then have to include the differential you pay in additional taxes, or more to the point the average Dutch pays to offset federal support.

In any case the question isn't between your current plan in the Netherlands and what we have but between what we have and this first inclusion of federal power in the US in a universal medical plan.

When social security was first started in the US potential beneficiaries were less than 20% of the population. Now it is almost universal.

[eridani]

68. More than half our current health care spending is from the government

So I think the Netherlands analogy applies.

Including federal power after the fact (requiring reimbursements if insurance companies fail to meet mandated MLRs) is utterly ass backwards from the standpoint of people who need to NOT be fucked over in the first place, not merely compensated if they have been.

And Social Security did NOT start by forcing everyone to open mandatory retirement stock market accounts.

[grantcart]

70. "more than half our current health care spending is from the goverment

Everything you say is off point and without basis in fact.

In the US 46% of all health care spending is by the government but all of that is for medicare and medicaid and none of that is for employers and employees although some children of working poor. Moreover medicare funds are not derived from income tax but from payroll taxes for future use in a trustee account

You are employed in the Netherlands and the government is paying 50% of your premiums while you are still employed.


Comparing current US government expenditures in health care for the average employed worker to the single payer system in the Netherlands where 50% of the employees health care is paid for in a mandatory scheme is about the same as comparing apples to pineapples.

Your free to comment further but I simply don't have time for comments that are so bizzarly off the point.

[eridani]

94. Still, what is the point of after the fact regulation?

Nice to have the government review MLRs and decide that people get rebates, but why not just directly regulate and prevent them from being fucked over in the first place?

[Mojorabbit]

110. Can you explain

this further?
"Senate health version ensures that the unwashed masses are not part of the Senate risk pool:

...The details were revealed Saturday through a "Manager's Amendment," offered by Senate Majority Leader Harry Reid, D-Nev. The amendment specifies that OPM cannot reduce the staffing or funding which currently goes toward administering FEHBP in order to meet this new responsibility. It requires OPM to maintain seperate risk pools for FEHBP and the "multi-state plans," as they're called--which means that the legislation wouldn't affect benefits or premiums for FEHBP enrollees.

http://blogs.govexec.com/fedblog/2009/12/details_on_opm...

from
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7280876

Thanks,
mojorabbit

[pattmarty]

109. I will make this short. The Federal government will NOT be able............

,,,,,,to negotiate shit. The insurance monopoly has a gazillion dollars and a veritable fucking army of lobbyists. When this POS passes at that point it will be as good as it gets, and will just deteriorate from then on. Think what will happen when Republicans get in control again. They will GLADLY keep the all the shit parts and scrap the few crumbs actually in the bill that may have been acceptable (I didn't want to say GOOD, because very, very little is).

[kath]

125. +10!

[ImOnlySleeping]

105. in no way, shape, or form

is this what happened in Canada.

SK started a program on their own. But health care in Canada was nationalized due to a strong third party that forced a minority government to follow through with proper health care. They made the debate about the fundamental humanity of providing health care to all. The public backlash of not going through with it would have finished off the Liberal Party. So in essence, it's the exact opposite of what happened in Canada.

[cliffordu]

10. YOU cannot say that with any credibility:

"This bill sucks compared to what could have been done -- realistically -- if it had been handled better from the start and throughout the process."

Complete and utter conjecture.

The party of "no" and the sonsabitch bluedogs would have used the same asshole fucking tactics.

[Armstead]

23. Whatever. You won. Liberals lose. People lose. Who cares?

[cliffordu]

25. Well, you're right then.

:hi:

[grantcart]

35. I think that the rule is that who ever uses "whatever" first wins the argument

[Armstead]

36. I learned that from my teenaged neice.... Whaaaatttever

[mrcheerful]

54. That always meant that the teen had nothing else to say on whatever losing arguement

he was trying to get an adult to see things his/her way. Why can't I stay out until 4am, because 1) you need rest 2) you have to go to school at 7am 3)the police will pick you up, then call me or mom and we will have to go out of the house to deal with why you were out late. Teen, "whatever".

[cliffordu]

84. Whatever. Hoser.

[bread_and_roses]

111. yeah, that's about where I'm at too

let them keep putting lipstick on this - well, it's not even a pig, a pig is a good, useful animal - lipstick on a zombie, more like it.

[firedupdem]

3. Thanks for breaking this all down grantcart. Rec'd and bookmarked n/t

[CaliforniaPeggy]

4. Good.

K&R

[gratefultobelib]

5. I appreciate this. Thanks!

[OneGrassRoot]

108. +1. K&R n/t

[ShortnFiery]

6. Here's the SHORT answer = Because they're "corporate progressive" not "populist liberal."

It's all been a circus drama ... where everyone knew their parts in advance.

President Obama is, in essence, the Three Ring Circus Leader and the Insurance Cartel + Big Pharma are P.T. Barnum.


You and me ... and everyone in the LOWER 99% of wealth distribution?

... well as P.T. Barnum quips, "There's one born every minute." :grr: :nuke: :grr:

[stray cat]

7. Simply because they are not you....

and I know some of the senators be reputation better than I know your credentials or level of information.

[ShortnFiery]

11. No, when you GIVE THE POWER to the Insurance Cartel, it's not "rocket science" that

only our self acclaimed "intelligentsia" can discern ...

It's a SCAM for the Middle Class to be even further gutted by Insurance and Big Pharmacy.

Congratulations, you may look all cool and smart but you're being DUPED.

The American People are being PUNKED AGAIN. :grr:

[m448]

8. they

don't want to lose to republicans

[ShortnFiery]

15. Does that include you?

;)

[cliffordu]

12. We are eternally grateful that you are here to show us the One True Way,

:sarcasm:

[girl gone mad]

13. They get to bring home the bacon.

Our process is completely broken.

[Ozymanithrax]

14. You make a compelling argument, but the progressive left will not listen...

There is a teaparty sentiment, a feeling that they have been shat upon by the Democrats, just as the Teabaggers felt the they were subject to the ass wrath of the the Republican Party.

Obama is governing, an ugly process that requires a pragmatic approach to the world. The Democrats are passing the best health care bill they can. The nature of our system is evolutionary, elsewhere I've called it Incrementalism. Revolutionary change is neither acceptable nor desired. Because congress has chosen an evolutionary/incrementalist approach and created a bill that does good but will need strengthened, progressives have rejected it. The progressive left that has raged here wants neither pragmatism nor incrementalism, they want a revolution that will change the very nature of the nation to something more noble.

We will loose some of them, which is too bad because they carry a passion that is both refreshing and necessary for good to be done.

The progressive Senators and Congressmen are far more likely to be tossed under the bus than embraced for their wisdom.

[ShortnFiery]

17. Oh yeah, you are going to "loose" a hell of a lot of us progressives ... liberals too!

:evilgrin:

[Name removed]

Deleted message

Message removed by moderator. Click here to review the message board rules.

[Ozymanithrax]

22. I eccho your sentements.

My concern is for 50+ millon Americans dying at a rate of 45,000 a year because they have no health care.

[ShortnFiery]

29. You two put "the K" in Klassy. :-)

[eridani]

30. They won't get care after "reform" either

Just shitty insurance they can't afford to use.

[treestar]

47. How can one "not afford to use" insurance?

If you have it, it's there.

[eridani]

50. Your fucking insulin is NOT covered--only catastrophes n/t

[GreenPartyVoter]

52. Insurance doesn't cover everything. One can have insurance and still

not be able to afford hospital bills.

[treestar]

55. The deductible?

[bertman]

59. treestar, please let me explain how one can "not afford to use" insurance even if they have it.

If you have a deductible on your plan, YOU pay the deductible amounts. If you have copays, YOU pay the copays. If your treatment is not "covered" by your plan, YOU pay for it. In my case, I pay a $2500 deductible on myself plus my wife pays a $2500 deductible on herself. I am currently undergoing a treatment that I must pay for out of pocket to the tune of $150 per visit, which is about every two or three months.

[Skittles]

101. HUGE DEDUCTIBLES, BIG COPAYS

NO MONEY LEFT OVER AFTER PAYING THE PREMIUM

[druidity33]

104. wow, you're clueless. nt.

[Ozymanithrax]

24. If that is what it takes to help the 50+ million Americans without health care

Then it is a price well worth paying.

My concern is for those 50+ million Americans who are dying at a rate of 45,000 a year because they have no health care. This bill will help millions of them. Then we can go to work and find a way to make it better.

[Armstead]

19. THat's nonsense -- The core problem with the bill has not been fixed

Call it "teabagging" if it makes you feel good, but the same fundamental problem that applied at the start of this process has only been made worse.

All the happy talk inm the world won't change that.

And it is enlightening to see that you would rather do without those awful liberals.

[Ozymanithrax]

27. No, I don't think we should do without liberals. I believe in a big tent pary...

But I recongize that these differences of opinon may drive them out. Because my concern is for the people dying without health care, I put them first. This bill will help millions of people. Even the progressive Senators and Congressmen recognize that. They know that we do what good we can and work to make it better.

[Armstead]

31. Critics do not care about people dying ---

I got news for ya buddy. I currently do not have health insurance because there is noting left to pay it with after food, housing and other basics.

So fuck your arrogent "concern" for people dying.

[Ozymanithrax]

38. You know, I help pay my sisters health care, otherwise she wouldn't have any..

And I put money into health care for two of my older children.

The people hurt by keeping the current system isn't me, it is people like you who can't afford it, my sister, my children.

The Senate is passing the best bill they can against overwhelming attacks by the health care industry, Republicans, and Conservatives. Without this reform it only gets worse.

It is not a perfect bill. It won't be free or cheap. But we have to begin somewhere, and sitting on our duffs bemoaning the fact that single payer or a public option were the only way, so we destroyed the first real chance we had at getting some help since Johnson is wrong.

[Armstead]

43. Fine, Just don't claim that concern for uninsured is limited to supporters of the bill

[Ozymanithrax]

53. I do not claim that those with whom I disagree do not care...

But to me, it is more important to do some small good than to destroy everything because it isn't perfect.

There are no perfect bills. From my experience, liberals pass what they can and then work to improve things over time. Every significant advance we have had has come through slow change and evolution. The civil Rights Act of 1964, Medicare, Medicaid, Social Security. Conservatives fight constantly to destroy these advances, and sometimes they manage to do that. Deregulation under Reagan, Bush, and Clinton was a disaster for this country, and not just fiscally. Bush actually tried to privatize social security, as will the next Republican President.

But overall, the changes have been for the good. We have fought off the worst of the attempts, and when Democrats come back into power, we have the chance to make small improvements, as we are now.

[treestar]

48. Then how can you be against the bill?

Plug in your information here.
http://healthreform.kff.org/SubsidyCalculator.aspx

[dflprincess]

74. And this bill will still leave 23 million uninsured

http://www.startribune.com/business/79720077.html?elr=KArksUUUoDEy3LGDiO7aiU

and millions more underinsured and still unable to afford care.

[MilesColtrane]

56. Indeed, it seems the whole purpose of the founders in creating the U.S. Senate...

was to prevent too much popular sentiment influencing the law of the land.

BTW this post wins for the term, "ass wrath".

:thumbsup:

[TheKentuckian]

128. BULLSHIT, I only ask for market based competion and choice of my mandated plan

That's not remaking the foundations of the fucking Earth. I'd prefer a government alternative, I think single payer is the only real answer, but I've been more than willing to compromise in long held acceptance that we can't go that far. That even a substantive public option was always the outside of the envelope but this is bulllshit. You can't tell me that market based reform and options is some unimaginable gulf to cross.

[cliffordu]

16. K&R

Nice work in spite of the signal to noise ratio here in never never land/.

[Cha]

20. Thanks grant, you've been

great in explaining the intricies of what's going on with this Health Care Reform Bill in the Senate.

[HughMoran]

21. Best post all week

Thank you so much for doing the work and posting this comprehensive piece here during this time of much confusion over what the deal is with this healthcare bill.

:yourock:

[JohnnyLib2]

26. Rec. with thanks.

I'm printing it out to have on hand.

[Undercurrent]

28. Thank you so much!

Rational, informative, and organized post. Excellent!



<after thought>
OMG! Where am I? Can this possibly be DU?

[AlinPA]

32. Thanks for your work on this post, grantcart. nt

[drm604]

39. K&R

Thank you! :thumbsup:

[cornermouse]

40. They're capable of having nuanced discussions?

Unlike us?... :eyes:

Then again, it might be as simple as the fact that none of them have to try to live on our income and some of them are trying to be loyal soldiers in spite of their personal reservations.

[hulka38]

41. One word - Pressure.

Money talks, now more than ever.

[Tx4obama]

42. K & R nt

[LastNaturalist]

44. Thank you! Enough said! This legislation is great for America and great for liberalism.

[McCamy Taylor]

46. Bill gives too much responsibility to the executive branch. Next GOP president will gut it like a

fish. A better bill would have been one like Medicare that was pretty much fool proof. W. tried to kill Medicare but he could not. W. would have no problem turning the current senate bill into an insurance industry feeding frenzy. He could tell his DOJ not to enforce the recently inserted part that keeps rates from rising too high. He could rubber stamp any limit as "reasonable". He could put poor folks in jail for not buying or being able to afford the fine.

I swear, the insurance industry crafted this one with the intention of driving Obama out of office in 2012 so that their own guy will be in place to use all the loopholes in 2014.

[grantcart]

57. The Manager's Report on the Ammendment does not support your concern

1) Key aspects of the bill are entrusted with non political agencies like OPM

2) Where the Secretary of HHS has significant power - for example setting the MLR it is only to increase it from the base that is established.

[boppers]

49. Good food for thought.

Thanks for posting it!

[ChimpersMcSmirkers]

51. This bill has a lot of problems, but you've done a nice job laying out the positives.

k&r

[customerserviceguy]

58. It's pathetic

to see the renewed defense of what is still labeled healthcare reform at DU.

We aren't even up to the conference committee, that is guaranteed to water it down even further. It will be interesting to see the arguments that "any HCR, no matter how little of a baby step" types will make for it.

[jefferson_dem]

60. Thanks grantcart.

:thumbsup:

Accept progress and keep fighting!

[Tx4obama]

61. And the Manager's ammendment includes the Consumer's Bill of Rights n/t

[grantcart]

63. and a lot lot lot more - lots of pilot projects that you could only guess from their

title.

[bertman]

64. It's pretty plain to see that the President and his sidekick Rahm have foregone applying any

"heavy" leverage against the extreme right wing of the party during this process, witness the control that Nelson, Landrieu, Bayh, Lincoln have exerted on the final outcome of the Senate version. So, for me, it is not hard to imagine that there is an immense amount of pressure being applied to the liberal side to conform or face the Wrath of Rahm.

I'm very cynical about how this is being handled. Plus, I've been around long enough to see liberal Senators vote for bills that they certainly regretted voting for--after the fact.

Bernie Sanders is very outspoken about why he's voting for it: the funding for community clinics. I love Bernie and respect his opinion highly.

Personally, I'm fed up with giving away the farm to get a bushel of corn and a chicken, and then calling it a step in the right direction.

[freddie mertz]

65. Russ Feingold is doing so reluctantly, and he placed the blame for loss of the PO

Directly on the president.

It's in a thread up here right now.

Inform yourself.

[grantcart]

69. And yet Russ is voting for this bill

Feingold does not explain how exactly we would get people who are determined to vote against to the PO to do so either than "exerting leadership".

Now concerning the question of "informing yourself" do you really want to go there given the OP?


Are you seriously suggesting that every Democratic Senator, including all of the progressive ones, are wrong in voting for this bill.

[Capn Sunshine]

72. And well he should have

because that aspect of it was true. The WH wanted to get a bill done. This was the path they chose. But pay attention here folks; RUSS IS VOTING FOR.

[freddie mertz]

114. To think, you used to be a strong Dean supporter.

What happened?

[Zomby Woof]

130. That's fucking insulting

You're accusing a sincere Dean supporter of turning back his support because he doesn't meet YOUR Dean supporter purity test.

I wish more Dean supporters on DU were like Capn Sunshine. Not because of the HCR debate or bill per se, but because he knows Governor Dean's sincerest, strongest, and best supporters are independent thinkers who can see the big picture, and that it isn't always a pleasant state of affairs in the political world. Plus the important fact that it is okay to differ with the good doctor on some points of argument without being tarred a 'sellout' or implications of betrayal.

No real supporter of a political personality would demand absolute fealty and fidelity to that political personality's opinions or agenda. It's wrong when Obama's supporters do it, and it's equally wrong when Dean's supporters do it. Or Kucinich's, etc. It's antithetical to democracy, something you're supposed to be in favor of, from what I read on here.

And I say this as someone in general agreement with Obama, Dean, AND Kucinich about many, many (but not all) issues and policies.

[WI_DEM]

118. Oh my Russ is reluctantly voting for it. If he is so opposed why doesn't he vote against it?

because he knows that doing nothing is not the answer.

[Colobo]

66. It's good to see something get done.

I'm sure it will be improved in the future.

[dflprincess]

75. Just like NAFTA and NCLB have been improved

I don't know if I would call selling us out to the insurance companies "getting something done".

[kath]

127. +1

[JimWis]

67. Thanks.

[grantcart]

71. welcome

[Clio the Leo]

73. gotta get in on this one. NT

[Truth2Tell]

76. Every Democratic Senator,

progressive or otherwise, supports this bill because to do otherwise would be political suicide. It has nothing to do with the policy outcomes. It's political.

Unrec. Because you know better.

[grantcart]

80. lol glib ideological claptrap that doesn't worry about facts

1) save more lives
2) save money
3) more preventative care
4) more outcome based care

there are people in my family whose untreated diabetes it will help. you can be against the bill but your patronizing tone is pathetic and out of touch.

[Truth2Tell]

92. Really?

Dragging out the tired and beaten-down argument that my opposition to this bill harms your family? :eyes:

My reply wasn't regarding the merits of the bill. It was regarding your assertion that yes votes can be interpreted as support for the policies laid out by the bill. But we both know that people vote yes or no for a variety of reasons in legislative bodies, often with little regard to the merits of policy. Some liberals may hate this bill, but may vote for it because this is their President's landmark first-year legislation. Some blue dogs may do the same. For all you or I know some of the earliest votes may have been locked up with promises completely unrelated to healthcare or the merits of this bill.

I think reasonable people can disagree about whether this bill does more good or more bad. But to claim that everyone who votes yes on the bill agrees with the policy? Based on your demonstrated level of political sophistication, I have a hard time believing that you really believe that.

I take it as an honor to be accused of a patronizing tone by the undisputed master. The irony is strong with you.

[eridani]

93. Forcing people to buy shitty catastrophic coverage saves lives?

The CBO only cares if the government saves money. Fuck saving money by taking out of the hides of older people.

No one is going to be helped for untreated diabetes. That is exactly the kind of ordinary medical expense that catastrophic coverage does NOT pay for.

[jeanpalmer]

77. "End the upward, unsustainable increases

in insurance premiums." How does it do that? There's nothing in your post that indicates an "end" to premium increases. Your post says the Director can "negotiate" premiums on a small number of plans. What's the Director to use as a guide? Whose interest is he to look out for? Where's the limitation on premium increases? There isn't any. The 85% loss ratio actually gives insurance companies an incentive to jack up revenues/premiums. For every extra dollar they take in, they get to keep 15 cents. If their profit margin gets too high then, they simply pay higher executive bonuses to bring the margin back down. Where is the limitation on executive compensation? Also, since the new system won't start to operate until 2013, what's to stop premium increases between now and then?

Is there any requirement that the people administering this system and making decisions about premiums represent the people, and not the insurance companies? Are industry people excluded from holding these jobs? Will they regulate the insurance industry like SEC regulates Wall Street?

This bill looks like bullshit thrown heavily at the public so they can't understand what's going on. I thnk you're throwing a WH pr release at us that tries to cover up for its failures. An efficiently run health care system shouldn't be this complicated. The fact that it's so complicated tells you it's not efficient. And it explains why after this system is implemented, the US will still be paying twice as much for health care as the rest of the world.

[grantcart]

81. So Krugman and Klien are both idiots and we should listen to somebody

named jeanpalmer who can't follow somevery basic points. The CBO has scored the bill and confirmed that it will save hundreds of billions, now because the total amount of care is given expenditures in the begining will continue to increase as we move people from emergency room and no care situations to start getting regular care.

Average costs will attacked along many different lines

1) By increasing the pool of risk both risk and costs are amortized.
2) Creates a move from pay for service to payment for outcome. This is no
3) Eliminates any barrier or copay for preventative test or treatmets. This alone will save hundreds of billions.


OPM's record is well established and I deal with thousands of federal employees who use it. The unions who use it love it including the APWU, the AFGE, TEIU the MailHandlers Union

so old JP name one Nobel Economist Laureate that says that it will not save money.

Name one union leader that says OPM doesn't do a good job,

Name one progressive Senator that doesn't want this bill to pass.

Your limp arguments are surpassed only by your intellectual laziness. Its obvious you didn't even bother to read it.

[jeanpalmer]

87. I read every word of it

although there's not much there except WH pr. It was hard to wade through all the bullshit. You've been taken in by a bunch of liars and bought off politicians.

I'm not impressed with titles. You can't let yourself be spoonfed this bullshit by titleholders. Think for yourself man. A Nobel peace prize to someone who escalates a war a week before accepting the prize? Take your prize and stick it. You're not fooling anyone.

You note all the people who might gain under this system. Who loses? Because someone has to pay for it. Who is that? You're like GWB telling us about all the great things invading Iraq would bring us. But like him, you fail to mention the costs. And who is going to pay for it? Isn't it the young and the healthy who will be funding this scam? If a young healthy person is forced to pay $5,000 a year for insurance that is overpriced, he's a loser imo. And that's what's happening.

The 2013 start date should have tipped you off. If this system were so great, they'd be starting it tomorrow morning. The reason they put it off til 2013 is to put off as long as possible the consequences of a bad decision.

Ask yourself this question: does this bill reduce overall health care costs in the US so that we're not paying twice as much as people in other countries? If you're honest with yourself, you'll answer no. They're merely moving pieces around the board. Obama originally promised health care reform. He later changed that to health insurance reform. Why? Because this is not HCR.

My God man, don't believe everything they tell you.

[Demeter]

100. That Does It. Your Personal Attack on Jean Gets You a Big IGNORE

I'm ashamed to say I followed your posts.

[Bluenorthwest]

113. I see the respect and humanity in your faith based words

Those who make personal attacks where reason and logic should be are those who are arguing a weak position.
If you have to get personal, you got nothing. I note that all the 'lay down and take it' posters wind up with the name calling and emoticons and all the most sincere forms of communication.
Maybe if you shout meaner words even louder, they will become true!

[Demeter]

99. don't worry, it won't end increases

just ask Massachusetts, where Romneycare is is already unaffordable and unavailable, less than four years out.

[jeanpalmer]

103. It's my understanding Mass is experiencing

real cost problems. And lack of funding. I've read some articles about it lately and I'm amazed that their experience hasn't been brought up in the discussion of the current bill. Their experience seems very relevant.

Regarding grantcart, he's a pretty good poster. I read his posts too. I didn't take his reply as an insult, just someone who feels very strongly about his position. And I didn't mean to come across to him in my reply as insulting. Maybe he thought so. Anyway, I'm just going to forget about it.

[johnaries]

78. Maybe not what we wanted, but a very good and important step.

KnR.

[AVID]

79. K & R

[cliffordu]

82. I'm gonna make sure you are the first one sent to jail for

not paying your premium.

:rofl:


Oh, yeah, for the humor challenged...

:sarcasm:

[grantcart]

88. on the way for 30 unrecs lol

[cliffordu]

120. Sigh...

:eyes:

These children....

[saltpoint]

83. grantcart. Nicely done indeed. Recommended.

[usregimechange]

85. Good work, k/r

[impik]

86. Facts, facts. Who need them?

[FrenchieCat]

89. Not I, said the person who said they read the bill, but then said

they couldn't find it to read.

So for those folks, the answer is....Not I!

[saltpoint]

90. By god I'm kicking this again. It's a keeper.

thumbs up, a brass sextet, and butterscotch pie.

:thumbsup: :hi:

[Kind of Blue]

91. Thanks, grantcart!

I have to admit that your posts have really helped me to understand a lot of the bill that causes my eyes to blur and glaze over. I can get the rundown and then some from you before going back to reading. Very much appreciated :thumbsup:
KnR

[LittleBlue]

95. They support it because it's better than nothing? Wow, that's really outstanding change!

Change we can believe in! I wish he would have run on that campaign: better than the right, better than nothing.

"* End the upward, unsustainable increases in insurance premiums"

OP = joke with that one. How can you type that with a straight face?

[rpannier]

96. You mean like Sen Sanders

who said it's not a great bill

or

Sen Feingold who said he's voting for it in hopes it can be changed in committee

That's not exactly enthusiastic support

One of this reform bills biggest flaws is the inept way the Democratic Senate and White House has handled the process
They couldn't stay on message.
They made bold assertions about what they were going to do, then changed
They did a crappy job of explaining the positives in the bill

As such...They are being lambasted for it. And in all honesty rightfully so

[Demeter]

97. Bad Bills Are a Result of Bad Policy

And Obama's policy is as bad as any...the only thing worse would be to dismantle what little is left of the "safety net" and public welfare state.

It's a kluge. It will almost immediately break down because of its internal conflicts and contradictions. It will be tinkered with for years, trying to make this abortion of a bill functional, by some, and gut-able, by others.

A GOOD bill withstands all challenges, broadens public support for itself, and doesn't enrich the greedy. This is anything but a good bill.

We deserve a good bill.

[Skittles]

98. we deserve better than this

that is for DAMN sure

[JTFrog]

102. K&R

[PHIMG]

106. Keep drinking the coolaid

Anyway progressives don't matter. It's the NELSONS and the LIBERMANS's and even REPUBLICANS LIKE SNOW who matter.

Progressives can always be rolled. And they roll.

BIG INSURANCE wrote this bill. 30 million new customers. that's all you need to know. And follow the money.

[Bluenorthwest]

107. And it discriminates against my family. So of course the

faith and personality crowd adores it, because they are pro discrimination at their core.
And tell me. These Senators who are voting for this crime. Which of them has refused to meet with Insurance Industry lobbyists? Any of them? Which of them has rejected 'donations' from the Insurance Industry? Or is the fact that they all have drunk deeply from the money stream? Have any of them rejected any donation from Pharma or the AMA?
Seems to me they don't really like it but claim to be voting for it for reasons that amount to 'we got paid'. Let me be blunt with you. I have never taken a dime from any Health Industry 'donor'. Have your list of those who you claim are personalities to pattern after?
So they are tainted by monies and personal agendas. They are politicians. Some voted for Iraq War, as well. Were they right about that?
And the bottom line is this. They can vote for it. I don't have to vote for them.

[fedupinBushcountry]

112. K&R

Thanks for this post it needs to be seen. A wise DUer (TayTay) recently said in our group: " Democracy is compromise". This is the beginning of healthcare reform, many changes will be made down the road. I know everyone of those progressives will still fight for a public option or better yet medicare for all. This is a process, change is hard, Social Security, etc. were not what they are now when they were first passed. We need to take a deep breath and keep fighting cause this in no ways is over yet.

[tekisui]

115. I have arrived at a similiar perspective.

Namely, that the bill is going to pass, so the next question becomes where to go from here?

The public option and medicare expansion should be the next fight. And, it should be fought for strongly.

Railing on and on about how it is a weakened or worthless bill doesn't do anything for us now. It is time to move forward and renew our push for the eventual realization of Single-Payer Universal Health Care.

[HughMoran]

116. keeping this kicked

need to appreciate good research here...

[WI_DEM]

117. I'm glad to see there is still some sanity on DU

[grantcart]

122. well with 35 unrecs we are trying to beat it into oblivion lol

[Tigermoose]

119. Thanks for the information.

Whining gets tiresome.

[autorank]

121. When does the bill go into effect? n/t

[SandWalker1984]

123. Mandates to buy insurance is NOT health care coverage

They LIE: Mandates to buy insurance does not = insurance coverage. Members of Congress keep stating that this bill provides coverage to 93 percent of Americans.

No, it doesn't. Both bills in Congress do not guarantee coverage for 93% of Americans -- they MANDATE that Americans buy private, for profit health insurance. There is a huge difference between PROVIDING coverage and MANDATING you BUY coverage.

Most people that do not have health insurance are going without because they cannot afford the monthly premiums, especially if they are over 49 years of age or have pre-existing conditions OR family members that have/had pre-existing conditions. (Try buying insurance in the open market if you have 2 immediate family members that have battled cancer and you will know what I am talking about.)


It is a lie to say these bills will be successful because most Americans will have health insurance.

It is a lie to call this health care reform because these bills will not reform the cost issues that are prohibiting many Americans from getting health CARE.

It is a lie to call it health care reform when failure to buy the for profit insurance (that will not be sufficiently regulated) will result in FINES or PRISON.

It is a lie when they say we can pass this bill and fix the issues later. IT WON'T HAPPEN. Look at NAFTA. Remember that when we were sold NAFTA by Clinton, Gore & corporate media, we were told it could be renegotiated and fixed in 6 months if it wasn't working out. It's now 15 years later and NAFTA wasn't fixed or renegotiated and it has devastated Detroit. In just the past few weeks Whirlpool and Electrolux have moved almost 2000 more jobs to Mexico. Never mind that NAFTA has destroyed the value of our dollar and helped destroy our middle class economy.

And it is a lie when Democratic members of Congress jump on the insurance bandwagon while telling us how great this "reform" legislation is going to be.


The very corporations that have created the need for health care reform will be rewarded immensely for their bad past behavior. That is not the real reform we were promised or deserve.

Health care reform must include a strong public option that allows ALL Americans that want to participate access. It's key to controlling costs, expanding coverage, and forcing big insurance corporations to compete. Without it, we'll end up with a national health care system controlled by a handful of large corporations accountable neither to American voters nor to the market.

This legislation as currently stands is totally dysfunctional
and I cannot support it.

Nor should any thinking person, especially progressives.

We need to let Congress know we will not accept an insurance corporation giveaway as health care reform.

Passing this Corporate Health Insurance Profit Protection Act will be disastrous for Americans and for Democrats.

KILL THIS BILL NOW, before it destroys us thru corporate mandated slavery.

[grantcart]

126. Krugman and Klein disagree

BTW no one will be mandated to purchase for profit private health care.


There must be atleast one non profit plan in each state exchange.


Your other factual mistakes are simply too numerous to detail but you are free to join the 40 other unrecs who stand firmly against every progressive Senator, (and every progressive economist).

[usregimechange]

124. kick

[cliffordu]

129. Kick - Can I see 100 UNRECS?????

[HopeforChange]

131. They are not extending healthcare to millions ... they are imposing a health insurance tax on ALL !

Why do people keep saying this bill will extend health care coverage to millions.

It is not extending anything.

It is a health Insurance Tax on every single American Citizen !

At a time when 10% are unemployed !

SHAME ON OBAMA FOR ALLOWING A GOVERNMENT PENALTY FOR PRIVATE INTERESTS !

[Billsmile]

132. Max Baucus Thought Medicare Coverage Should Be Available...

To some folks in his state.

http://www.nytimes.com/2009/12/21/health/policy/21healthcare.html?_r=2&emc=tnt&tntemail0=y