Another View of Healthcare

Roger Bybee says, "Health Insurers won the pot. Reformers need a new game." In his article, "Fixing the Big F*%#ing Deal," Bybee says that passing this comprehensive health plan legislation is a step forward. However, there is still much to do.

In a too-loud whisper to President Barack Obama, Vice President Joe Biden famously characterized the signing of the Patient Protection and Affordable Care Act as “a big f—-ing deal” at a triumphal White House news conference.

On a political level, the new law is indeed a “BFD.” But in terms of healthcare policy, many reformers believe that the law fundamentally reinforces insurers’ stranglehold on affordability and access. Consequently, the law will fail to restrain the market forces inexorably driving up healthcare costs, thereby forcing another confrontation further down the road as costs climb and coverage shrinks.

Still, America’s first comprehensive health plan represents a step toward establishing healthcare as a basic American right. The new law includes an extension of healthcare to 32 million uninsured people, some valuable protections against insurer abuses, and a badly needed expansion of Medicaid and community health clinics.

What about the pitfalls of the bill?

Whither single-payer?

Health Care for America Now!, a coalition of 1,000 organizations, views the Patient Protection and Affordable Care Act in distinctly positive terms. “First of all, the most important thing is that it establishes that people will get decent health coverage that they can afford, and that government has a responsibility to provide that,” HCAN Executive Director Richard Kirsch told In These Times. “That’s a fundamental transformation, from it being a privilege to a right.”

Kirsch ticks off some vital areas for improvement. “We will need to improve the affordability for many families in the exchange [a government-sponsored offering of insurance plans for the presently uninsured to choose from], especially those just above the Medicaid level and adding some more help for the upper-middle class.”

Insurance industry triumphs

Non-HCAN reformers are distressed by what they see as a fundamental defect with the new reforms: The new healthcare law enlarges and fortifies the throne from which for-profit insurers dominate the healthcare system.

Regardless of the policy differences among reformers, the law’s basic contours reflect the remarkable political power—exerted through campaign contributions, lobbying and television ads—of the for-profit insurance industry, according to Steffie Woolhandler of Harvard Medical School and Physicians for a National Health Plan, a 17,000-member organization advocating a single-payer or Medicare-for-all plan that would replace for-profit insurers with a single government entity.

“The big problem in this fight about trying to introduce the single-payer idea into the debate was actually the insurance industry and how they were allowed to write the bill and check the language of the bill throughout the process,” she told In These Times. Former WellPoint insurance company Vice President Liz Fowler, an “aide” to Senate Finance Chair Max Baucus (who ruled single-payer “off the table” early on in 2009), has been credited with writing much of the legislation.

Given the central role that the new law preserves for for-profit insurers, former Labor Secretary Robert Reich placed the new law in proper historical context when he cautioned in Salon.com: “Don’t believe anyone who says Obama’s healthcare legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama’s health bill is a very conservative piece of legislation, building on a Republican [a private market approach much like Mitt Romney’s] rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option.”

Consequently, the guiding logic of the current system—under which insurers maximize profits by minimizing care, and ever-expanding “provider chains” (hospitals, clinics and physician networks) seek to enlarge their revenues and market share without regard to health needs—will remain intact. “Most critically, the bill strengthens the economic and political power of a private insurance-based system based on profit rather than patient need,” says Rose Ann DeMoro, executive director of the National Nurses United union.

Is there a solution?

A single-payer future?

Developing a much stronger media operation to properly frame the healthcare players and issues will be just one of the challenges facing the reform movement. The upward trajectory of health costs and premiums may help to define the solution and to arouse a much broader swath of Americans in the next round of the healthcare reform fight. [...]

Some experts predict that the new law’s utter failure to rein in insurance premiums, trim the $400 billion dollar burden of insured-imposed administrative costs, and control the excess costs created by provider chains will ultimately make a Medicare-for-all or single-payer system unavoidable.

Writing in the New York Times , William F. Pewen, former senior health analyst for Sen. Olympia Snowe (R-Maine), put it this way: “When Congress next attempts reform, in a decade or more, health costs and the number of uninsured and underinsured will have escalated—and the likely outcome will be the single-payer system that Republicans most abhor.” 

Conflict over health care reform is morphing into the question of what system will work: a failed for-profit system or change in the form of not-for-profit health care. This article states that the "Patient Protection and Affordability Act falls woefully short of achieving the universality taken for granted in every other advanced nation." Hopefully real change will come in the form of a public option or a single-payer system.

Complete article is here.

Obama Makes a Deal

Barack Obama has had a hands-off approach in supporting a public option in the health reform bill. After the Democrats lost Kennedy's seat in Massachusetts, the public option seemed as dead as a door nail. But since a majority of the people want a public option, it is now being resurrected as a possibility through reconciliation.

So what is President Obama's position on the public option? Miles Mogulescu at The Huffington Post answers this question in his article, The Real Reason Obama'a Plan Doesn't Include a Public Option.

The reason Robert Gibbs gives for President Obama's health care plan not including a public option -- that despite majority voter support, it can't get 51 Democratic votes in the Senate -- doesn't hold up. The real reason is that Obama made a backroom deal last summer with the for-profit hospital industry that there would be no meaningful public option.

But Obama's deal with the for-profit hospital lobby to insure there would be no public option has, as best I can tell, only been reported in two articles in The New York Times. On August 13, The Times reported that while President Obama had presented himself as "aloof from the legislative fray," particularly in connection with the public option, "Behind the scenes, however, Mr. Obama and advisors have been...negotiating deals with a degree of cold-eyed political realism potentially at odds with the president's rhetoric." One of the deals reported in The Times article was the Pharma deal. The other was a deal with the for-profit hospital lobby to limit its cost reductions to $155 billion over 10 years in exchange for a White House promise that there would be no meaningful public option.

Throughout the process, the White House has given vague statements supporting the public option -- enough to keep liberals and progressive on board -- while repeatedly undermining the public option in practice. Jane Hamsher has written a useful timeline of White House efforts to undermine the public option.

There is no evidence that President Obama has ever twisted the arm of a single Senator to support a public option and plenty of evidence that he has assiduously avoided doing so, sending a message to Senators that he doesn't want a public option. When the Senate passed its version of the health reform bill, the reason the White House gave for there being no public option was that it couldn't garner 60 votes. But Joe Lieberman, who could have been the 60th vote, insists that the Obama administration never pressured him to support either a public option or a Medicare buy-in. And Sen. Russ Feingold blamed the demise of the public option in the Senate on the White House's failure to push for it.

Now the White House is saying they're not including a public option in Obama's plan because they can't get even 51 Democratic votes in the Senate. Does anyone really believe that if President Obama really wanted a public option -- if he hadn't dealt the public option away in a backroom deal with the for-profit hospital industry -- he couldn't get 51 out of 59 members of the Senate Democratic caucus to vote for it?

If this is true, then the change that we were to believe in has become the status-quo that Obama ran against. Also, the public option is not the answer to solve the health care problem. But it is certainly a better place to start.

Progressives and Democrats should join together and push for real change with a single payer health care system. Now that would be change that can be believed.

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?

A Message for President Barack Obama

David Sirota wrote a May 11, 2009 article for Open Left which is very relevant in light of the Health Care bill which just passed the Senate.

This is a must read:

In light of the White House's big hand-holding session today with the pharmaceutical and health insurance industries today, let me take this moment to note that a cynic - or, perhaps, a realist - might look at President Obama's statements on health care and see a politician moving farther and farther away from his progressive roots and closer and closer to the Washington/money Establishment.

David Sirota :: The Move Away from Single-Payer

In 2003, Obama said he supports a single-payer health care system, and that the only reason we "may not get there immiediately" is "because first we have to take back the White House, we have to take back the Senate, and we have to take back the House" - which, of course, we have:

"I happen to be a proponent of a single payer universal health care program...I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that's what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that's what I'd like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House." - Barack Obama, 2003

In 2006, I spent a day with Obama in the U.S. Senate, and he said he supports a "debate" on single-payer, but that he also had started having doubts, now that he was in the Senate:

I asked him to give me some specific examples of what he meant. Is a proposal to convert America's healthcare system to one in which the government is the single payer for all services revolutionary or reformist? "Anything that Canada does can't be entirely revolutionary-it's Canada," Obama joked. "When I drive through Toronto, it doesn't look like a bunch of Maoists." Even so, Obama said that although he "would not shy away from a debate about single-payer," right now he is "not convinced that it is the best way to achieve universal healthcare."

By last week, it became clear that Obama and his allies in Congress will use their legislative leverage to prevent even a debate about single payer. Here's the Associated Press:

Baucus and many others, including President Barack Obama, say single-payer is not practical or politically feasible.

"Everything is on the table with the single exception of single-payer," Baucus said.

My guess is that Obama still believes in what he originally says, because he knows the evidence about the supremacy of a single-payer system is irrefutable. But I'm also guessing that he's afraid of being attacked by moneyed interests that enjoy the status quo, and he's surrounded himself by Clintonites who, after the health care debacle of the early 1990s, aren't interested in antagonizing the insurance industry.

However, let me just echo Ta-Neishi Coates who recently wrote that "while a good politician accomplishes what is possible, a great one expands the realm of possibility - he doesn't simply accept the lines of argument as they're drawn and hew to the side with the most soldiers, he tries to redraw those lines to benefit his ideals."

The whole idea that single payer is the best option but politically "impossible" is simply unacceptable. Last I checked, electing an African American president was politically "impossible"...until Barack Obama went ahead and got himself elected president. The entire notion of "politically possible" and "politically impossible" is a canard that justifies the status quo. So while it's certainly terrific that Obama is fighting for some sort of universal health care system, and one with a public option (which could ultimately become a single-payer system), let's just remember: Nothing has been politically "possible" until it actually happened - and so if that's the major argument against single payer, it's not just a poor argument, it's a fraud.

Fanning the Flames of Joe Lieberman

William Rivers Pitt has a truthout Op-Ed about, Joe Lieberman and the Health Care Train Wreck.

When last we heard from Sen. Joe Lieberman of Connecticut, he was throwing sand into the gears of the Democratic push for health care reform by declaring he would filibuster any legislation containing the so-called public option. "I feel so strongly about the creation of another government health insurance entitlement," said the senator back in November. "The government going into the health insurance business - I think it's such a mistake that I would use the power I have as a single senator to stop a final vote."

At the same time, Lieberman indicated his plans to actively campaign for GOP candidates during the 2010 midterms.

"There's a hard core of partisan, passionate, hardcore Republicans," he said at the time. "There's a hard core of partisan Democrats on the other side. And in between is the larger group, which is people who really want to see the right thing done, or want something good done for this country and them - and that means, sometimes, the better choice is somebody who's not a Democrat."

How did Democrats respond?

For some reason, these twin insults did not motivate the Democratic Congressional leadership to expunge this hypocritical cretin from their ranks. Lieberman kept his committee chairmanship and was not even mildly censured by his colleagues.

Biting back the hand that pats your head.

One month later, the decision to ignore his brazen disregard for his colleagues has come back to bite us all, for Mr. Lieberman has once again elbowed his way into the center of the health reform debate, and with a vengeance. "Mr. Lieberman threatened on national television to join the Republicans in blocking the health care bill, President Obama's chief domestic initiative," reported The New York Times on Tuesday. "Within hours, he was in a meeting at the Capitol with top White House officials.

Once again the Democratic response was to grovel at Lieberman's feet.

And on Monday night, Democratic senators emerged from a tense 90-minute closed-door session and suggested that they were on the verge of bowing to Mr. Lieberman's main demands: that they scrap a plan to let people buy into Medicare beginning at age 55, and scotch even a fallback version of a new government-run health insurance plan, or public option."

Sickening and Appalling

This turn of events is sickening and appalling on a couple of different levels.

First, of course, is the shameless reality that is Mr. Lieberman himself. During his 2004 presidential run, and again during his 2006 Senate campaign, Lieberman actively supported the public option's inclusion in any health care reform, and specifically supported the expansion of Medicare. As late as this past September, Lieberman continued to support such an expansion, as reported by The Connecticut Post. "As to how 47 million uninsured will afford coverage," said The Post, "Lieberman said only 12 million don't have insurance because they cannot afford it. By allowing citizens who are not eligible for Medicare or Medicaid to buy in for a rate below the private market, the government can extend coverage to more of those who are currently uninsured, he said."

That was then, and this is now. In one of the most astounding examples of political flip-floppery, Lieberman opened this week by declaring himself dead-set against the very health care reform policies he once championed, and once again announced his intention to don a Republican cloak and tear up the Democrats' legislative efforts. Again.

Why?

One would have to be deep into a severe state of personal denial to believe Lieberman has legitimate concerns about the impending health care legislation, given the fact that he very recently supported the exact provisions he now wants removed or destroyed. The only sensible explanation would seem to be that Lieberman is actively needling the Democratic leadership, and has become such an obnoxious obstructionist only to keep his name in the news. Josh Marshall of Talking Points Memo explains the situation, and what it means going forward:

The key issue senate Democrats now have in dealing with Joe Lieberman isn't his position on the Medicare Buy-In. They need to confront the problem that Lieberman isn't negotiating in good faith. No surprise that Republicans are giddy with what a problem he's creating for Harry Reid & Co. But in my conversations with them, it's as clear to them as it is to anyone else that he's now basically mocking his Democratic colleagues by moving the goal posts every time a new agreement is struck.

This puts the Democrats in an extremely difficult, politically untenable position. Yes, they need 60 votes. But they're not going to be able to hang on to Lieberman's vote long enough to get the bill passed. That now seems unquestionably clear. People who say that the Dems should just move to reconciliation don't necessarily realize the difficulties involved - either procedurally or politically, in terms of losing even more Democratic votes. Personally, I'd like to see them try it. But I don't know if it's possible.

Until a couple days ago I was close to certain a health care bill would pass. I still feel relatively confident one will simply because the Dems just don't have any choice but to pass one. Once it is passed, if it is, it's definitely time for the Democratic caucus to strip Lieberman of all the benefits he receives as a member of the Democratic caucus. But that doesn't accomplish anything at the moment. The only path I can see for the Dems is that they need to try to put 60 votes together with Sen. Snowe. Yes, that sounds crazy to me too. But I think she actually has a set of policy priorities that could be met. I don't think that's true with Lieberman. So further negotiating just means more game-playing.

The Solution?

The solution to all this, one would think, would be for the Democratic leadership in Congress to wrap Lieberman in bright red wrapping paper, slap on a bow, and ship him across the aisle to his ideological compatriots in the GOP as an early Christmas present. Strip him of his leadership position, show him the door, and publicly denounce him as nothing more than a stinking chunk of cholesterol clogging up the arteries of progress.

But no.

Of course that isn't going to happen. Instead, Democrats appear poised to once again knuckle under to this fraud and further denude what has already become a half-a-loaf bill. According to several sources, Rahm Emmanuel and the White House are actively pressuring the Democratic leadership in Congress to give Lieberman whatever he wants in order to pass some form of health reform legislation, no matter how ragged, damaging and useless the final product may turn out to be.

What about Joe?

The Senate won't vote on health care reform until next week, and the process has changed course two dozen times already, so the outcome of this latest idiot eruption is far from certain, but the writing does appear to be on the wall this time around. Joe Lieberman doesn't give a tinker's damn about the people he represents, the party that coddles him, his own positions on key issues or anything else beyond getting his mug in front of television cameras in the guise of someone who actually matters.

What about the Obama Administration?

The Obama administration is once again moonwalking away from doing the right thing on this issue, and the jellyfish pond that is Congress appears poised to do what jellyfish do: float, flop, flounder and drift with the scum in this rising tide.

In short, this whole thing is about to become a train wreck of galactic proportions. Stay tuned.

This isn't an issue of politicians standing up for the issues that they believe in. Once again we have a politicians acting on behalf of their own interests rather than the interests of the people who voted them into office and who they were elected to represent. This reality includes Lieberman as well as Obama and his administration.

Gaming the System

The Democrats want a public option. The Republicans don't. In an attempt to ridicule the public option, two Republicans, Senators Tom Coburn (R-Okla.) and David Vitter (R-La.), sponsored an amendment (SA 2864) to the healthcare bill which would require all members of Congress to use the Public Option, if it is included in the Senate Health Care bill.

Via Crooks and Liars:

Sherrod Brown explains to David Shuster why he decided to co-sponsor Tom Coburn and David Vitter's amendment which would require members of Congress to enroll in whatever version of the public option ends up being passed in the health care bill.

Brown: Yeah, you often find out about amendments going on on the Senate floor and if my staff and I like one of the amendments we'll call an office and say, Republican or Democrat, I'd like to co-sponsor. We do that as a matter of course it happens across party lines all the time, hundreds of times a day. We did that with Sen. Coburn, nine times we said we wanted to co-sponsor--usually it takes once and they say yes--I've always accepted that. So has everybody I know in the Senate. Nine times we asked to co-sponsor and their office either just said we'll get back to you or ignored our calls and our emails because it was all a sham.

They don't, they clearly don't like the public option. They were making fun of it. Their whole game is to delay and deceive and to play political games. And when they offer an amendment saying sign up for the public option to force--tell members of Congress they have to join the public option--I think I should. I think we all should but they don't evenn like it themselves. And so it's just a little partisan game they're playing, and this is too serious for them to play those kind of games.

The bottom line is that all the compromises that the Republicans and blue-dog Democrats want made are really shams and create an ineffective the public option.

From Salon's War Room--Coburn, Vitter plan to ridicule public option backfires:

Now, as the Senate's debate over its version of reform legislation kicks into gear, two Republicans -- Sens. Tom Coburn and David Vitter -- have picked up that theme and are running with it. The two authored an amendment they want attached to the bill; it would require members of Congress to enroll in whatever version of the public option the final legislation creates, if it includes one.

Both Coburn and Vitter are vehement opponents of the public option, and they're hoping to prove themselves right by showing that no senator who's in his or her right mind would want their healthcare covered by it. They've gotten a surprise, though: Genuine support for their amendment from someone on the other side of the aisle -- and a proponent of the public option, at that -- Sen. Sherrod Brown, D-Ohio.

Continue reading...

Senators Franken, Dodd, and Mikulski also joined Sen. Brown in co-sponsoring the amendment. Here's Sen. Franken weighing in on the Senate floor.

If members of Congress don't want to receive the healthcare that they are voting on, why should we. A robust public option is necessary and and this stunt shows that anything less is not acceptable.

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.

Republicans in Congress Think the Public Option is OK for them...

...but not anyone else!

Did you know that 151 members of Congress already have a "public option" for their healthcare services.

Yup, they “currently receive government-funded; government-administered single-payer health care — Medicare” according to Rep. Anthony Weiner’s (D-NY). His office released an internal study .

Of those 151 members, 55 are Republicans who also happen to be “steadfastly opposed [to] other Americans getting the public option, like the one they have chosen.”

Included on Weiner’s list are anti-public option crusaders Senate Minority Leader Mitch McConnell (R-KY), Sen. Chuck Grassley (R-IA), Sen. Jon Kyl (R-AZ), Sen. John McCain (R-AZ), Sen. Orin Hatch (R-UT), Sen. Richard Shelby (R-AL), Sen. James Inhofe (R-OK), Sen. Mike Enzi (R-WY), Rep. Virginia Foxx (R-NC), and Rep. Peter King (R-NY).

This morning on C-Span, Weiner explained the idea behind the project:

WEINER: It’s more another way of looking at this debate, this discussion about the public option, to put it in focus. We went, just out of curiosity, looked at how many members of Congress get the public option. And I know a lot of people have said, “Well under the new bill, how many of you members of Congress would choose the public option?”

Well there already is one; it’s called Medicare. And we found 55 Republicans and 151 members of Congress are on Medicare right now. So they’re already getting the same type of public option that we’d like people who are without insurance to be able to get. And I guess the purpose of this list was to kind of point out some of the hypocrisy of this debate.

“You have members of Congress thumping their chest how they’re against government health care,” Weiner noted, adding, “and yet when it’s time for them to accept Medicare, they’re like, ‘Sign me up!’” Watch it:



Back in July, Weiner offered an amendment that would eliminate Medicare, saying at the time that it was “put-up or shut-up time for the phonies who deride the so-called ‘public option.’” Of course, no one voted for the measure.

“Even in a town known for hypocrisy,” Weiner said in a statement today releasing his study, “this list of 55 Members of Congress deserve some sort of prize. They apparently think the public option is ok for them, but not anyone else.

A Healthy Choice as American as Apple Pie

Actress Heather Graham shows how a healthy public option is good for competition.

Getting on the Progressive Side

What will it take for President Obama to get resounding progressive support? Mike Lux, the founder of Progressive Strategies, speaks to this issue in his article, Fighting for Regular Folks.

If progressives, and regular working Americans, see Obama pick a side- our side- and really fight for it, no matter what happens over the next 3 years, we will stick with him and fight for him, too.

Right now, President Obama needs to pick the side of a public option in healthcare and he needs to "really fight for it." He will then see progressives as well as "regular working Americans" joining him in his support of a public option.

I bet his ratings will go up too!

The Insurance Industry Blood Suckers

In Congress, the politicians are trying to decide what should be included in a healthcare package. One possibility is a public option. The argument against the public option is that it will cost too much money and that the insurance companies are better at controlling healthcare.

Glenn Beck, Rush Limbaugh, Fox News and other GOP talking points pundits are quick at diverting attention to the real issues of insurance reform.

But the following article by Robin Marty proves that we shouldn't leave all of our eggs in the insurance industry basket. As a matter of fact, the for-profit insurance industry is the last place to go to lower costs for healthcare.

Having our first child was one of the greatest moments of my husband’s and my life together. Once we adjusted to being parents, we knew that at some point we would want to expand our family. When we found out 7 weeks ago that we were expecting again, we couldn't have been more excited.

The longer we have been parents, the more we have become planners, especially financially. I made a goal of paying off my student loans before our first was born, literally writing that last check two weeks before her due date. That payment quickly became a 529 account. We became frantic savers, opening online accounts, IRAs, anything we could sock our money into. When we decided to try for a second child, we made sure to first set aside the $3000 it would cost us out-of-pocket to pay for the birth, $1500 out-of-pocket max for me, and $1500 max for the new baby.

This weekend my husband broke the news to me -- his company would be switching to a new health insurance plan starting in January. As we looked through the brochures, it jumped out at me immediately that our out-of-pocket expenses were skyrocketing. Instead of the $3000 family out-of-pocket maximum we were preparing for, we were now expected to pay $6000 for the full family, a 100 percent increase.

We've yet to be given full information, such as if his monthly payments will be increasing as well (something I'm worried about, as the preliminary paperwork shows no sign of his company continuing to contribute monthly, instead offering a $1000 HSA account). Assuming that his payment per month is the same and the company is indeed offering $1000 on top of that, he will still be paying over 10% of his pre-tax income just to pay our family's health care costs. If they have pulled their monthly assistance, that could go up to as much as 20%.

We recognize that we are lucky people. With two incomes and no real debt, we should have no major difficulties saving the additional $3000 we might need for our new arrival in May. But we know that many people aren't in our situation. Having a child should be a joyous occasion, not a time that can potentially plummet a family deep into debt.

According to the new insurance company, your health care costs should never be much as long as you are making "healthy lifestyle choices." My question for the insurance industry is, when did wanting to add to your family become an unhealthy lifestyle choice?

I will put my money on the public option for lowering health care costs. Let's hope the politicians in Congress have the courage to come to the same conclusion!

It's Time to Realize Something About the "Blue Dogs"...

...they are not Democrats!!!

They look like Democrats, the smell like Democrats but they don't act like Democrats.

So what are they?

They are a hybrid species that have fallen to the right of center and have huge control issues.

As an example, just examine the difference between the blue dog estimate of the number of votes in the House of Representatives for the 'Public Option' versus the progressive whip count.

According to Chris Bowers at Open Left:

Anonymous Blue Dog aides told Politico that Progressives had found only 145 votes for the robust public option during this whip count. This morning, Greg Sargent reports that Progressive Caucus Co-Chair Raul Grijalva's office is claiming a much higher number, around 180:

"I am confident that we have the support of over 70% of the Democratic Caucus," Grivalva said in a statement emailed my way. That means according to him, around 180 of the 256 Dems in the House are prepared to back the robust public option right now.

Sargent is correct, not the anonymous Blue Dog aides. I know this, because I have the actual numbers. As of Friday, here is where the whip count stood:

Progressive Caucus Whip Count on Robust Public Option
Democrats only, 217 needed for passage
Yes: 183
No: 22
Undecided: 20
Not Whipped: 31

All 22 of the no votes are Blue Dogs. Every single one.

It is time for true Democrats to join with the Progressive wing of the party and vote out of office all Blue Dogs who are merely obstructionists and vote with the Republicans.

Healthcare and Insurance Reform are issues that are extremely important to the majority of Americans...and the majority wants a Public Option.

Consider an Important Number

Daily Kos has the story:

For all those people obsessing about the U.S. finishing fourth in the 2016 Olympics sweepstakes, here's a number that ought to be a little more troubling.

We rank last among 19 comparable industrial countries in preventable deaths.

The data which has been around a few weeks was reported again this morning in the Washington Post.

Are Americans dying too soon? The answer is yes. When it comes to "preventable deaths" -- an array of illnesses and injuries that should not kill at an early age -- the United States trails other industrialized nations and has been falling further behind over the past decade.

Although the United States now spends $2.4 trillion a year on medical care -- vastly more per capita than comparable countries -- the nation ranks near the bottom on premature deaths caused by illnesses such as diabetes, epilepsy, stroke, influenza, ulcers and pneumonia, according to research by the nonpartisan Commonwealth Fund published in the journal Health Affairs.

How the US Stacks Up on Preventable Deaths

1. France -- 65

2. Japan -- 71

3. Australia -- 71

4. Spain -- 74

5. Italy -- 74

6. Canada -- 77

7. Norway -- 80

8. Netherlands -- 82

9. Sweden -- 82

10. Greece --84

11. Austria -- 84

12. Germany -- 90

13. Finland -- 93

14. New Zealand -- 96

15. Denmark -- 101

16. UK -- 103

17. Ireland --103

18. Portugal --104

19. US -- 110

The U.S. ranks at the bottom of 19 industrialized nations in the number of preventable deaths by conditions such as diabetes, epilepsy, stroke, influenza, ulcers, pneumonia, infant mortality and appendicitis. The number at the right represents the number of preventable deaths per 100,000 population in each country in 2002-2003.

Source: Commonwealth Fund, Health Affairs, World Health Organization

Everyone should be in favor of Insurance Reform and the Public Option which is necessary to take profit out of the healthcare system.

What Are We Waiting For?

The Daily Kos put together this synopsis of various Democrats commenting on the Baucus Report.

Nancy Pelosi briefed reporters today and reiterated that she, and the House, support the public option in healthcare reform:

"I fully support the public option. The public option will be in the bill that passes the House," Pelosi (D-Calif.) said purposefully.

Here's Sherrod Brown:

SNYDERMAN: ...If we really talk about Medicare expansion as being that "public option," can you find enough votes to say, you know, bipartisanship doesn't matter as much as reform does, and push this through?

BROWN: Absolutely.... We have an overwhelming majority of Democratic Senators, as we have an overwhelming majority of House members who support the public option, and more importantly, as you know Dr. Nancy, a recent survey showed that 70 percent of physicians in this country support a public option, and a comparable percent of the public supports a public option. So it's the right way to go. It's simply a choice that will make the insurance companies more honest and help us, because of competition, bring prices down.

Here's Anthony Weiner:

What we're saying to the United States Senate, to the Gang of Six, is "thanks, but no thanks." Any health care proposal that does not have the competition and cost containment that can only be achieved via the public option will be considered dead on arrival....

What we're finding is that after months of talk, the Senate plan came out and actually took several steps backwards in important things, made it less affordable for the middle class and actually provided less competition for insurance companies.

The Baucus debacle might just end up being the kick start the Democrats needed to reinvigorate them for the fight for a public option. If that's the case, it'll be the only real good to come out of the thing.

Why did it take the Baucus Report to stir this response? The Republicans have been consistently against any meaningful change to health insurance and health care reform.

Now, I am waiting to hear President Obama say that he supports a Public Option in the Insurance Reform Package, 100%.

Public Option is "Change We Can Believe In"

PETITION TO PRESIDENT OBAMA: "We worked so hard for real change. President Obama, please demand a strong public health insurance option in your speech to Congress. Letting the insurance companies win would not be change we can believe in."





"We have been told we cannot do this by a chorus of cynics. It will only grow louder. We’ve been asked to pause for a reality check. We’ve been warned against offering the people of this nation false hope. But in the unlikely story of America, there’s never been anything false about hope." -- Barack Obama

GO HERE to Sign Petition ƒor the Public Option

Healthcare Inusrance Financial 'Bonanza.'

In the fight to keep our healthcare system as a single payer system, the health insurance industry have mobilized 50,000 employees to lobby Congress to defeat the public option.

That's right. We do have a form of single payer healthcare system!

For most people, the insurance companies are the only option for health insurance that we have.

And the insurance companies desperately want to kill any form of a public option. Because a public option would give the American people a choice. We all know that choice brings competition and therefore lower prices.

According to the Los Angeles Times, healthcare insurers now have the "upper hand" in dictating healthcare legislation.

Already, the health insurance industry has flexed its muscle to water down reform. After spending millions on lobbying, advertising, and direct contributions to lawmakers, the Senate Finance Committee made a major concession allowing insurers to reimburse only 65% of medical bills (down from the 76% proposed requirement).

Most group health plans cover 80% to 90% or more of a policyholder's medical bills, according to a report by the Congressional Research Service. Industry officials urged that the government set the floor lower so insurers could provide flexible, more affordable plans.

Think Progress has reported that "AHIP — the multimillion dollar lobbying juggernaut for the health insurance industry — is one of the most effective stealth lobbying firms."

AHIP’s grassroots lobbying is being managed by the corporate consulting firm Democracy Data & Communications.

Although AHIP has made grandiose promises of self regulation, many insurers have recently broke promises made by AHIP President Karen Ignagni. On June 16, despite Ignagni’s pledges of commitment, insurance executives from UnitedHealth Group, Assurant, and WellPoint specifically refused to “commit” to ending the controversial practice of rescinding coverage after an applicant files a medical claim.

With DDC’s stealth lobbying assistance, AHIP may well kill the public option too.

So what does this mean for the health insurance industry?

The half-dozen leading overhaul proposals circulating in Congress would require all citizens to have health insurance, which would guarantee insurers tens of millions of new customers -- many of whom would get government subsidies to help pay the companies' premiums.

"It's a bonanza," said Robert Laszewski, a health insurance executive for 20 years who now tracks reform legislation as president of the consulting firm Health Policy and Strategy Associates Inc.

Rep Anthony Weiner [D-NY], has succinctly stated:

To insurance company lobbyists and – from the sound of it – nearly every Republican, the public option is more a confirmation of their fear that the Obama administration is out to nationalize another industry. They argue that the public option would soon become the only option because it would have too many advantages in the marketplace.

Without acknowledging it, both sides seem to agree with the argument for a single-payer system.

But the arguments for a public option do leave you wondering why you would need or want a private insurance plan. We know that insurance companies rely on a formula to provide as little health care as possible for each dollar they take in. This isn't because they are uncaring. It is because they are good business people.

Implicit in the Democratic plan – and the Republican opposition to it – is a tacit recognition that single-payer health plans like Medicare are the best way to go.

Rep. Anthony Weiner: A Very Sane and Sensible Voice

How About the 'Kennedy Public Option Plan'

Joe Conason at Salon notes that, Ted Kennedy wanted the public option.

Forty years ago he began the quest for universal healthcare that became the cause of his life when he introduced his first bill outlining that goal. His final bequest to the Senate is the Affordable Health Choices Act, his version of the Obama administration's reform proposals, which was passed by the Health, Education, Labor and Pensions Committee last month. Republicans now say that if Kennedy had not been forced by illness to relinquish the chairmanship of that committee, he would have negotiated away the strongest provisions of that bill to win passage.

Kennedy's Republican friends should not make that disingenuous argument in his lamented absence. Lest there be any doubt about what he truly wanted, his bill includes a robust public option along with all the insurance reforms and cost controls that the president has endorsed since this process began.

How would he have handled the intransigence and dishonesty of the Republican opposition? We know that he could shout as well as whisper — and that he could be partisan as well as bipartisan. He believed that the time for incremental changes had passed. He was ready to fight. The tragedy of his death is not only that he didn't see the triumph he had dreamed, but that he fell before he could lead the nation to that final victory. Now that victory will have to be won in his name.

David Waldman from Daily Kos suggests that we, Name the Public Option After Kennedy, Not a Watered Down Bill.

The temptation to name the health care reform bill after fallen health care champion Sen. Ted Kennedy (D-MA) is as understandable as it is overwhelming. But with the bill currently still at the mercy of players who are, shall we say, not as clearly dedicated to a product that offers the kind of help Kennedy envisioned, I suggest that we not offer them the opportunity to attach his name to anything less than a bill he would have fought for.

So while it's undoubtedly in that spirit that the Progressive Change Campaign Committee and others have begun their drive to honor Kennedy's memory by demanding that the HELP Committee's bill be passed and named after him, I suggest that it serves us and the Senator's memory better if our essential element -- a strong public option -- carries his name instead.

With the Kennedy Health Care Plan intact in the bill, there's no reason the legislative vehicle that creates it cannot also bear his name. But while there's still a fight ahead about just what will be in this bill, if we're going to lend Ted Kennedy's name to something, let it be done in a way that keeps him in the fight to fulfill his vision right to the last, and which keeps his name on people's lips when they are finally able to take their families to the doctor without fear of financial ruin, saying, "We're covered by the Kennedy Plan."

Possibly there are a few Republicans who have guts to join Democrats in order to pass a Healthcare bill which includes a the 'Kennedy Public Option Plan'.

The Benefits of Single-Payer Health Care

The Republicans have equated single-payer healthcare with "socialism". The insurance companies are trying to kill any system where they are not the sole insurer. The Democrats are afraid of raising the issue of a single-payer system. The Blue-Dog Democrats are joining forces with the Republicans on the issue of insurance reform. The "gang of six" really wants the status quo.

We know that our present healthcare system of private insurance doesn't work. Now Rep. Anthony Weiner of New York has even gotten Morning Joe, Joe Scarborough, to admit that a single-payer system of healthcare has virtues.

As Weiner acknowledges, there two powerful forces against change are the status quo and the insurance lobby. The real question is "why we do we have a private plan."

The Nation's Leslie Savan has noted:

Something rather remarkable happened on Tuesday's Morning Joe. Rep. Anthony Weiner of New York pointed out that the health insurance industry has no clothes, and Joe Scarborough, after first trying to spin it some gossamer threads, broke down and said, By God, you're right, this emperor is a naked money-making machine!

Well, he didn't use those exact words, but Joe did seem to finally get that America has granted insurance companies the right to create bottlenecks in the financing of healthcare in order to extract profits out of the suffering of ordinary people--without providing any actual healthcare whatsoever.

"Why are we paying profits for insurance companies?" Weiner asked Scarborough. "Why are we paying overhead for insurance companies? Why," he asked, bringing it all home, "are we paying for their TV commercials?"[...]

"It sounds like you're saying you think there is no need for us to have private insurance in healthcare," Joe asked at one point.

Weiner replied: "I've asked you three times. What is their value? What are they bringing to the deal?"[...]

Maybe the real turning point came when Weiner asked, "How does Wal-mart offer $4 prescriptions?"

Watch these 2 videos of the show:

Rep. Anthony Weiner Discusses Public Option Health Care Reform on Morning Joe - PT 1


Rep. Anthony Weiner Discusses Public Option Health Care Reform on Morning Joe - PT 2