"we're about to pass a $900 billion bill to help low-income Americans afford health-care coverage"

[Clio the Leo]

Size matters



Harold Pollack does the math:

By 2019 when the reforms are fully implemented, the Senate bill would provide about $196 billion per year down the income scale in subsidies to low-income and working Americans.

Even policy wonks have trouble getting their heads around such a big number. With due allowance for the back-of-the-envelope nature of this calculation, $196 billion exceeds the combined total of federal spending on Food Stamps and other nutrition assistance programs, the Earned Income Tax Credit, Head Start, TANF cash payments to single mothers and their children, all the National Institutes of Health, and the Department of Housing and Urban Development. (I admit to some uncertainty about that last one. We may have to leave HUD behind…)

Some progressives have decided that they cannot support this imperfect bill. We have 196 billion reasons to disagree.

Gawker had the best take on this, headlining the post, "News of First Major Progressive Legislation in 30 Years Enrages Liberals." And make no mistake, this legislation is major, and as Pollack points out, quite a bit more so than people realize.

To avoid the psychologically scary $1 trillion price tag, the bill doesn't kick into action until 2014, the fifth year of the 10-year budget window. If the bill's price were actually being measured over 10 years, it would be well over a trillion (and still paid for, to be sure, just as the bill grows in the second 10 years, but continues cutting the deficit). In 2013, for instance, the subsidies are ... no dollars. In 2019, they're almost $200 billion. And because they grow each year alongside health costs, it's a safe bet they're above $2 trillion from 2020 to 2029.

That's why so many of the folks who focus on the subsidies are so scared of seeing this opportunity slip away. Democrats haven't been close to getting anything even comparable to this in decades, and there's no reason to think they'll have another chance anytime soon. I mean, we're about to pass a $900 billion bill to help low-income Americans afford health-care coverage, and that's wildly low-balling the true size of the subsidies!

http://voices.washingtonpost.com/ezra-klein/2009/12/size_matters.html

[Beetwasher]

1. The Most Important And Significant Part Of This Legislation Will Be The Implementation Of The SYSTEM

And the foundational structure that it creates. Once in place, it will be near impossible to remove.

People don't realize the significance of this. It's huge, it's monumental and it will have it's own, irreversible inertia once in place.

[Cha]

38. They got their orders..

"KILL THE BILL" & "WE WILL MARCH WITH THE TEABAGGERS!"..that's really all they need to know.

[paulk]

43. characterizing opposition to this bill as "marching with the

tea baggers" is insulting and disingenuous.

Of course, it fits right in with the general run of swill you post.

[DJ13]

2. If they had used an increase on income taxes instead of mandates

There would have been an immediate fund to buy insurance for low income people, with no subsidies needed, and no need for any additional cash outlay by those same low income people.

These mandates suck.

[phleshdef]

9. The difference between a tax increase and a mandate is not as large as everyone lets on.

At the end of the day, people with an income are still required to pay into the pool. The mandate means they pick a private pool to pay into whereas a tax increase means everyone pays into the same public pool. If the end result is that there is enough wealth generated in the pool to adequately cover everyone, then I really don't care how they achieve that.

[RaleighNCDUer]

12. Bullshit.

It is, as you said, about private pools. And the mandate means people are buying private pools for health insurance execs, not to mention cars, houses, and Harvard educations for their kids.

There are no cost controls down the road, and all the mandates do is feed the beast.

[phleshdef]

18. "buying private pools for health insurance execs", BS, the bill requires 85% of intake for CARE.

Considering that health insurance companies will be REQUIRED to spent an immense majority of the money in the pool for health care and will only have 15% for operating costs, the point you just attempted to make just fell flat on its face.

There ARE cost controls for all the companies that participate in the exchange, which is where most people are anticipated to go for their healthcare, given that plan actually works, then we will be all right, if people DON'T use the exchange, then thats a different story.

You and others really need to learn more about this bill before you run your mouth any further though. The uninformed, knee jerk anger is embarassing.

[RaleighNCDUer]

21. And how, pray tell, is that 85% benchmark going to be monitored

when there are virtually NO controls, no regulation, no oversight?

You think that these organizations which do nothing but think about money, all day every day, can't figure out how to turn that 85/15 on its head?

The insurance industry today diverts 30% of its premiums income away from healthcare. They are masters at it. Now, with millions more people pouring money on their heads, you think they can't figure out how to siphon off an equal amount?

You seem to equate health insurance with health CARE. They are completely different critters. Always have been. Always will be.

This will not, CAN not, control spiraling healthcare costs. All it does is increase the pool of people paying into the system, with NO guarantee of reciprocal pay out.

[phleshdef]

28. The claim that there are no controls, regulation or oversight exposes your ignorance of the bill.

I could list every single GOOD regulation and cost control measure thats in the bill (as many DUers have over the past week) and you would continue to ignore it because you would rather believe your "corporate sellout" fantasies.

The rule is established that they have to spend 85% on care and there ARE in fact some stiff penalties for not doing so. If they find ways around that, then we will do what we ALWAYS do and find ways to seal those loopholes. Any kind of industry regulation whether it be healthcare or some other entirely unrelated industry entails an ongoing job to regulate and keep honest.

If we listened to every person like you that foams at the mouth with negativity at attempts to be successful in such endeavors, we would have to shut every industry down and simply not allow people to run businesses because of the chance they might find ways to skirt regulation.

[Milo_Bloom]

45. They already have gotten around it.

It's actually quite easy.. just reclassify job titles.

This silly little 85% has already been tried and FAILED.

There are no cost controls in this bill because all the companies have to do is act in concert, as they have done in the past.

It is a shame that people can have such a lack of understanding of this industry and how it has worked in the past.

[DJ13]

24. Taxes are income based

That would solve the issue of affordability for those who presently cannot afford to buy insurance (since the lower income brackets pay little or no income taxes), and it would have ended this hodgepodge BS about subsidies that only confuses the issue of insuring everyone.

[T Wolf]

3. You mean that the government will now take even more money and give it to the corps

that exist to deny medical care to people who need it.

And they will get that money from the rest of us.

And the level of medical care that these supposed beneficiaries will actually get will be somewhere between none and little while those of us who may have something currently will certainly see increased costs and lessened care.

Just think how much medical care that money could provide without the insurance corps draining their vigorish off the top...

[NJmaverick]

4. Classic progressive values

[freddie mertz]

5. Is this intended as irony?

There is precious little that can be called truly progressive in this bill, least of all the corporate mandate and the taxation of existing health benefits to pay for it.

[Vincardog]

6. There is precious little that can be called REMOTELY progressive in this bill,

[Nicholas D Wolfwood]

15. You must not be a progressive if you can't identify them. (nt)

[Vincardog]

17. Please list the top ten "progressive" elements of this bill that cannot be subverted by the

Parasitic Insurance Companies.
They can not deny you for "preexisting conditions" They can raise your rates
You make the list

[Nicholas D Wolfwood]

19. Those lists are all around you.

Do yourself a favor and read.

[Vincardog]

22. You can't defend your position with more than 6 words? Really lazy

[Nicholas D Wolfwood]

23. I'm lazy, but there are lists both for and against all around you and you refuse to read them.

I think that makes you the lazy one.

[Vincardog]

29. OK so you can NOT list 10 progressive things in the senate bill.

[Nicholas D Wolfwood]

32. Ok, so you're utterly incapable of reading. (nt)

[NJmaverick]

7. More like a reminder to those who have forgotten

[freddie mertz]

8. Forgotten what?

I'm not forgetting any time soon, believe me.

[NJmaverick]

10. That it's about helping people

[freddie mertz]

11. Helping corporations to people's money.

[NJmaverick]

13. So you claim

although from where I sit, you haven't made a compelling case to back up that assertion.

[Nicholas D Wolfwood]

16. Who do you work for?

If you're currently unemployed (and my sincerest apologies if that's the case), who did you work for?

[freddie mertz]

20. None of your business.

[Nicholas D Wolfwood]

25. I'd just like to know which corporation you're helping shovel money into.

That's all.

[freddie mertz]

31. WTF are you talking about?

You make no sense.

The shovel is the bill, the corporations are the insurance companies.

[asjr]

14. The more I learn the less I know. There are

so many stories going around. There are so many voices heard but not the ones that matter. I am coming to the conclusion we have been had. So many polls (which I don't trust all the time) are saying we want public option, we want single payer, we want REAL health care reform--we are not being heard at all. Do the insurance companies come out on top? Do we really have to pay more in premiums? All this crap I hear about 60 votes, 50 votes. Is that just a ruse to make us believe they are working in D.C. So, I don't understand any of it because too many involved are telling different stories and of course the Republicans are sitting back, slapping us in the face and waiting until it all breaks down. I give up.

[Armstead]

26. One Simple Question -- Instead of funneling all those "subsidies" into Private Corporations....

Why not direct it into an expended version of Medicare or some other single payer public plan?

[ClarkUSA]

27. Sen. Bernie Sanders said it would be the biggest expansion of primary care in this country's history

Senator Harkin said it's not the end of the public option, either. On the contrary, he said they'll achieve the public option
in the future because Congress will be able to tweak it every year, year after year.

Senator Sherrod Brwon said it would cut the deficit by $150 billion in 10 years and save trillions in the 10 years after that.

Source: Live MSNBC interviews yesterday

[DJ13]

30. he said they'll achieve the public option in the future

When will our party once again have this kind of majority in this imaginary future to get a PO?

[MichiganVote]

33. Well that's the biggest crock of baloney I've heard yet. Next year's Christmas children!! Believe us

[golddigger]

36. Sanders and Leahy also said:

"This is a "BIG FAT GIVEAWAY" to "HEALTH INSURANCE" and "PHARMA" companies!

[gorfle]

34. But it doesn't do SHIT for me.

So this is just another welfare project where I have to pay for other people but can't take advantage of the program myself.

[dpbrown]

35. Taxes going to corporations

Another corporate victory over democracy.

[eridani]

37. Worthless shitty coverage that only "covers" 60-70% of actual COSTS

Why not use it for health care?

[Jeff In Milwaukee]

42. And your basis for those numbers?

[eridani]

46. It's in the bills

http://www.hewittassociates.com/_MetaBasicCMAssetCache_/Assets/Legislative%20Updates/2009/House_Passes_Sweeping_HC_Reform_Bill.pdf

Notice the moral values implied by having four tiers available, only the shittiest one being eligible for subsidies. That's for us disposable human garbage. If all you can afford is shit, then you ARE shit. If you have money, you deserve better health care.

[Tippy]

39. Klein...was on Maddow's show last night...

I really didn't understand what point he was trying to make...I know I don't want to see this opportunity slip away...I know I've said before "something is better than nothing". This bill may make our "Health Care" the best in the world...Good Lord I hope, I'm right. That bunch on C Street will be praying for bad things to happen to all Progressive/Democrats.

[mcablue]

40. What about the middle class?

I heard our savings in premiums will be a sad $100 to 300 dollars a year.

[ShortnFiery]

41. If our rulers continue to gut the middle class, their propaganda and disinformation

efforts will be more fruitful. Democracy DIES without a vibrant Middle Class.

R.I.P. while health care "reforms" GUTS the middle class: If, God forbid anyone in your family gets a serious illness your rates will sky-rocket ... it won't be long before you will have to "declare bankruptcy" so you can qualify as POOR and get the freebies in order to get well.

No more Middle Class.

Welcome to Fascism, Neo-Liberal Style! :nuke:

[paulk]

44. what I don't understand - if we, the taxpayers, are going to

subsidize the health insurance industry anyway, why not go with a single payer plan. It seems a more effecient way of spending our money, where a much higher percentage will actually go to healthcare rather than lining the pockets of some CEO.

[Phoebe Loosinhouse]

47. ding! ding! ding! ding! A Winner!

You sir or madam have cut to the heart of the matter.

We will be sending by express mail a family sized tub of "Poppycock" popcorn, the nut and caramel coated treat enjoyed by Americans for generations.

[paulk]

48. it's been fascinating, in a way, to watch this trainwreck

if single payer, where the government subsidizes its citizens, is "socialism", what do you call a system where the government
subsidizes an industry, guaranteeing a profit for that industry?

There is a word for that, and that word is "fascism".

hyperbole?

This legislation is a sea change for the Democratic Party.