The Private Option Wins!

I can see clearly now!

Are We at the Point of Accepting the Unacceptable?*

Health insurance coverage is only one aspect of the health care crisis that Americans are facing. The healthcare legislation passed by Congress mandates insurance for every citizen. But questions still remain regarding what will be covered and if it is affordable.

Marcy Wheeler at FireDogLake looks at how this legislation will affect a family of four making around $66,000 a year (three times the poverty line).

Here’s a version of one family’s total household costs under the plan: a middle class family with two cars and some child care costs. Note, in this scenario, I’m assuming the middle class family will pay 7.9% of its income for health insurance premium, significantly less than the 9.8% the plan assumes that family could pay to get the subsidies available. This, then, shows what a family would be required to pay (or incur a penalty) under the 8% opt-out rule.

301% of Poverty Level: $66,370

Federal Taxes (estimate from this page, includes FICA): $8,628 (13% of income)

State Taxes (using MI rates on $30,000 of income): $1,305 (2% of income)

Food (using “low-cost USDA plan” for family of four): $7,712 (12% of income)

Home (assume a straight 30% of income): $19,275 (30% of income)

Child care (average cost for just one pre-school child in MI): $6,216

Health insurance premium: $5,243 (7.9% of income, max amount before opt-out w/o penalty allowed)

Transportation (assume 2 cars, 12,000 miles each, @IRS deductible cost of $.55/mile): $13,200*

Heat, electricity, water: $1,500

Phone, cable, internet: $1,200

Total: $64,276 (97% of income)

Remainder (for health care out-of-pocket, debt, clothing, etc.): $2,091

In other words, assuming this family had no debt (except for that related to the two cars), no clothing costs, and no other necessary costs–all completely unrealistic assumptions–it would be able to incur just $6,970 of medical care out-of-pocket costs before spending all that $2,091 and going into debt (the opt-out is based on an insurance plan that provides 70% of costs, so this assumes the family will pay 30% of health care costs). Yet that family would be expected to spend up to $5,882 more out of pocket before the “subsidies” started picking up its out-of-pocket expenses. (If the family paid the full 9.8% of its income on premiums–at which point it would become eligible for subsidies under the plan–it would have just $825 left to spend on all other expenses, including health care out-of-pocket expenses.)

This family couldn’t even go through a normal childbirth without going into debt.

Nate Silver at Five-Thirty-Eight takes issue with Marcy's analysis. He believes the healthcare plan passed by Congress will be beneficial to most low or middle income families.

First of all, several of of Marcy's cost estimates are on the high side.

As Marcy points out, her assumptions may be favorable to this family in other ways -- her family doesn't have any debt, for example. Nor do I doubt that there are some families who would fit Marcy's template almost perfectly (although they should still be able to take advantage of the significant tax breaks that Marcy hasn't accounted for). But in general, this is significantly more than most two-child families will be spending on these services -- probably by a margin of $10,000 or so.

Nevertheless, that's not really the most important point. Rather, what is this family spending on health care now? ...if the family isn't buying insurance, their health care costs certainly shouldn't be figured as zero.

Frankly, unless they're living in New York or the San Francisco Bay or some other place where the cost of housing is very high, the family that Marcy draws from -- one which pays $1,600 per month for rent but does not buy health insurance for themselves or for their children -- does not have a reasonable and responsible gameplan to begin with. If they can't figure out how to squeeze out $430 per month in insurance premiums, what are they supposed to do in the status quo when somebody actually gets sick? You can object to the Senate's health care bill on libertarian/paternalism grounds, but it will leave the overwhelming majority of low- and middle-income families better off.

Yet Jonathan Cohn at The New Republic looks at what families can actually afford. He believes that the Senate bill is worth passing yet the reform is not good enough. He supports his position by acknowledging the dichotomy of his assessment.

Without reform, this family would either be uninsured altogether or paying high premiums for coverage that is, most likely, far less comprehensive that what the Senate bill would guarantee them. [...]

Families dealing with serious medical problems, particularly chronic diseases that require ongoing care, have enough problems without having to sweat out every penny. And even the best insurance policies leave people on the hook for expenses that fall outside of covered benefits and, as a result, don’t even count towards out-of-pocket limits.

Making those two arguments simultaneously is not easy. It's the political equivalent of walking and chewing gum at the same time. But if progressives can figure out a way to do it, the people that already stand to benefit from reform will benefit even more.

The sad part about all this analytic journalism is that if you need to pick through and parse out the benefits versus the disadvantages of the bill, then maybe the complexity is itself a detriment of this legislation.

For progressives, the answer lies in the clarity and simplicity of a single-payer, not-for-profit system. Of course, a public option or Medicare for all would be acceptable. No matter how many ways you look at it, this healthcare bill is not!

*UPDATE!!!

J. Lester Feder at the Nation has a review of the pro & cons of the Patient Protection and Affordable Care Act passed by the Senate. The Senate's draft of the bill must be merged with the much more progressive version passed by the House. Feder believes that despite very serious shortcomings of the Senate bill, it is necessary to pass healthcare reform now otherwise "another generation may pass before another chance will come to try again."

Despite these very serious shortcomings, however, the bill the Senate passed would reduce the number of uninsured Americans by 31 million by 2019. The Medicaid program will be open to new ranks of the country's poorest residents, and the near-poor and middle class will get subsidies to buy insurance. The Senate also advanced some important delivery system reforms that could chart a path towards reining in costs.

As disappointed as progressives are with the compromises Democratic leaders made to get this bill through the Senate--and as tempting it is to believe they may have gotten a better deal if they'd pursued a more aggressive strategy--they are on the verge of doing many other lawmakers have tried and failed to do. And if this effort fails, another generation may pass before another chance will come to try again.

Lester's view is common among people who feel defeated on the healthcare issue but who think this is the best that could be achieved. The attitude is "something is better than nothing."

Was that Ben Nelson's attitude when he fought against abortion funding? Was that Joe Lieberman's attitude or Max Baucus' position when they fought against the public option?

Hell NO!!!

They stood their ground and fought for the position they were espousing.

There wasn't one Senator that stood his/her ground on support of the public option. They all caved in. Do you really think any of the Representatives in the House will fight for 'The People'? Or will they allow the bullies of Congress to dictate from the moneyed corporate pulpit?

What We'll Get...

From Thom Hartmann's blog, Healthcare: First They Came For The Banksters

With apologies to Pastor Niemöller*:

First they came for the banksters, and showered them with money and put them in the Administration in a way that was not change we could believe in.

Then they came for the military industrial complex, and sent more and more of our children to die in faraway lands that had never attacked us in a way that was not change we could believe in.

And now they’ve sold out our hope for a national health care system not run by millionaire gangsters in suits. And who is left to speak for us?

President Obama is playing the Bill Clinton game of throwing people a bone and telling them it’s steak. Perhaps he’s doing it because he thinks it’s his only choice; perhaps it’s because he’s surrounded himself with Bill Clinton advisors (and Hillary as Secretary of State); whatever the reason, while it worked for Clinton, it won’t work for Obama.

It worked for Reagan, and for the first Bush, and even worked somewhat for George W. Bush.

But it won’t work anymore. Here’s why. [...]

He’s betting that he can do like Bill Clinton did to us with NAFTA and the World Trade Organization – hand us a turd and tell us it’s gonna blossom beautifully if we’ll just wait a year or three or five. Rahm’s betting that if he can “deliver health care reform” – even if the fundamental system of gangster corporations standing between us and our doctors while skimming 40 percent off the top for their mansions and private jets is intact – we’ll be all excited at his “victory” and elect more Democrats in 2010 and reelect Obama in 2012.

Ditto for cosmetic repairs of the banks, which is really just trickle-down Reaganomics on steroids. Rahm and his DLC buddies truly believe that this “change” brought to us by Bush’s man Tim Geithner or Clinton’s man Larry Summers is something we’ll “believe in.”

We don’t.

We oldsters of the Vietnam era, and the youngsters coming up who see how college loan banksters are screwing them as badly as their Clinton-era parents were screwed by the mortgage scammers, are all now fully awake.

President Obama, sir: Meet what is in large part your own creation – the High Information Voters of 2009/2010.

We’re awake, we’re mad as hell, and we’re not going to take it any more. Natalie Portman to Matt Taibbi to Arianna Huffington to Bill Moyers represent the span of our four awakened generations; generations who have figured out how the game is played. And don’t like it.

First Obama continued Bush’s policy of giving the banksters money, and we protested feebly.

Then he expanded Bush’s wars, and we protested more loudly.

Now he’s going to force us to give trillions to the gangsters who run the “health insurance” companies (while they promise to behave nicely in return) and thinks we’re going to go along with it and it’ll get him re-elected.

He’s wrong.

Please, President Obama, step up and lead. We’d like some that “change we can believe in” that’s actually the real thing.

Kill the bill.

*"First they came ..." is a popular poem attributed to Pastor Martin Niemöller (1892–1984):

First they came for the communists, and I did not speak out—because I was not a communist;
Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist;
Then they came for the Jews, and I did not speak out—because I was not a Jew;
Then they came for me—and there was no one left to speak out for me.

Weiner vs Varney

Rep. Anthony Weiner Debates Stuart Varney on Health Care

The Public Option Diluted

Robert Reich always has an uncanny viewpoint of events. His perspective on the Senate healthcare bill is direct and to the point in his article, Harry Reid, and What Happened to the Public Option [emphasis added].

First there was Medicare for all 300 million of us. But that was a non-starter because private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it was too much like what they have up in Canada -- which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)

So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.

So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.

So the compromise that ended up in the House bill is to have a mere public option, open only to the 6 million Americans not otherwise covered. The Congressional Budget Office warns this shrunken public option will have no real bargaining leverage and would attract mainly people who need lots of medical care to begin with. So it will actually cost more than it saves.

But even the House's shrunken and costly little public option is too much for private insurers, Big Pharma, Republicans, and "centrists" in the Senate. So Harry Reid has proposed an even tinier public option, which states can decide not to offer their citizens. According to the CBO, it would attract no more than 4 million Americans.

It's a token public option, an ersatz public option, a fleeting gesture toward the idea of a public option, so small and desiccated as to be barely worth mentioning except for the fact that it still (gasp) contains the word "public."

And yet Joe Lieberman and Ben Nelson mumble darkly that they may not even vote to allow debate on the floor of the Senate about the bill if it contains this paltry public option. And Republicans predict a "holy war."

But what more can possibly be compromised? Take away the word "public?" Make it available to only twelve people?

What does Reich suggest?

I want every Senator who's not in the pocket of the private insurers or Big Pharma to introduce and vote for a "Ted Kennedy Medicare for All" amendment to whatever bill Reid takes to the floor. And if this fails, a "Ted Kennedy Real Public Option for All" amendment. Let every Senate Democratic who doesn't have the guts to vote for either of them be known and counted.

Let's hope our Senators get Reich's point so we don't get stuck with Reid's.

Read more here.

A Message for Congress

In his article for OpEdNews, Rob Kall wants you to Tell Congress To Go To Hell With Their Current Health Reform.

I know some of my words are not nice--crude, vulgar--but if you're not thinking something like them, you don't get it. And if you have been thinking them, but don't want to say them, send your legislator my article.

Just thinking. The current legislation that the Democrats have celebrated in the house is a pile of shit, an incredible insult. People are dying.

Tell your legislators in Congress what you think of their health reform.

Flipping Congress the bird collage by Rob Kall

People are enslaved in jobs they hate, abused by employers, because they can't afford to leave because they'd lose healthcare coverage.

What have they offered us?

-a four year wait for a plan that affects hardly any Americans.

-no controls on drug costs, and every likelihood that co-pays will go through the roof, since raising co-pay is one way to cut monthly insurance rates.

-We should expect rates to go up and benefits to keep shrinking.

-The current version is a horrific affront to women-- the 60+% of whom voted for Democrats-- that they would have rights to control their bodies and abortion rights. Disgusting. It's amazing Pelosi not only allowed the amendment to reach the house floor, but that she celebrates any legislation that cuts women's rights.

There are a handful of legislators who are calling for single payer. That is the only legislation worth talking about. The majority of the population wants it. America desperately needs it. I can't see myself voting for anyone who doesn't support it.

So, when the senate starts working with the house's bit of garbage health reform, let your senator know that anything less than single payer is an insult and a shameful failure to do what needs to be done.

Let him or her know that waiting four years is obscene.

Make it clear to all your legislators that what they've done so far is not enough.

There are teabaggers (see the wikipedia explanation of Teabagging) who oppose single payer. I can see legislators opposing it because they are whores who have sold out their constituents to health care companies. But the grassroots idiocracy is another story. These are the dumbest, most deluded, mislead lemmings in American history. They will be remembered as a movement of fools and idiots, dupes who bought the lies of Sarah Palin, Glen Beck, Fox News and the right wing echo chamber that was used by corporatists to take America from First to Third world status.

History does funny things. If the teabaggers win, which is possible, then they will be lauded as rescuing America. That will be history written in the US of Teabaggery. But outside the US, where truth may still see daylight, they will be seen as the moronic idiots that they are.

It's time to remember that health care is a human right, a civil right, and those who block it are no different than those who have engaged in blocking other human rights. It's time to remember that even after 40 years of equal rights for blacks, there are still tens of millions of racists. The toxic dregs of humanity don't go away. They linger, putting brakes on human progress. Now we face a new challenge to fight these dark forces. It will take the same kinds of strategies that freedom riders and protesters who supported Martin Luther King in the sixties south and those who supported the fighters against Apartheid in South Africa used.

Congress must be told that their best so far is not even close to good enough. The current incarnation of the public option is a sham. It will set back progress. Tell your legislators. Raise your voice. Let them know that they are not even close yet. Tell them to find their spines.

I agree! If you aren't completely appalled then you haven't been paying attention!!

Protesting with a Song

American's Health Insurance Plans (AHIP) is the powerful insurance lobby that spends 5 million dollars a week trying to kill health care reform. Billionaires for Wealthcare is a grassroots network looking to stop them - with song. •...



Rachel Maddow has info on Billionaires for Wealthcare and suggests that they are the antidote for the 9/12'ers. WATCH:

"Thank you for supporting the billionaires, woooo!" "We want the status quo!" "The status quo IS wealthcare!" they shouted.