How to lose in the health care debate. One sentence will do it.

[madfloridian]

Start putting a barrier between single payer and public option supporters...we all lose

[vaberella]

1. The most succint and truthful post, yet!!!

I've been saying this exact same thing on every thread discussing this. Everyone is up and arms over single payer...from the beginning of this debate, going back to the time of the health summit I've said that we need something different from single payer---because we'll lose the fight.

:kick: & Rec'd

[CBR]

2. I tend to agree. I have seen you debating ... do you have any

articles regarding the public option so I can compare the "single-payer only" ones being floated around?

[vaberella]

4. Try some of these...

I've posted it on this thread.

However I get my information from my Health economics books and classes added to my Public Finance class and books.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8402512&mesg_id=8402839

[madfloridian]

6. I have several in my journals.

.

[rockymountaindem]

3. I think a public option is the first step toward single-payer

It's not going to happen all at once, if it ever does happen. And, while I think that single-payer could work in the US, I'm willing to see if a public option within the existing framework will force the private plans to become more competitive. If it doesn't, then at least we will still have the public option for those who need/want it. Others can continue to do business as usual if they prefer.

[vaberella]

5. Exactly. Win the battle and you win the war. n/t

[snowdays]

38. Wrong. many hills taken but no war is won.

[nichomachus]

21. If you like the auto insurance situation, you'll LOVE the "public option"

[Sebastian Doyle]

28. Auto insurance is mandatory corporatism

at least it is in this state. That's the shit Hillary was pushing last year, and what Mittens did as governor of Massachusetts. That's not a "public option".

[nichomachus]

36. What we need is a "private option"

Just like we do with Medicare and like many countries do with their single-payer systems. Everyone gets basic health care. Yes, there will be some limits. Everybody can't have everything on demand. If you don't believe that, you need to grow up or at least get a good grounding in basic economics.

Those who can afford to do so can buy supplemental plans from private insurers to add certain coverages -- just like Medicare recipients do now. I have Medicare. I also have a supplemental plan that covers more than Medicare does. So, does everyone I know who is on Medicare.

[LiveLiberally]

48. I agree completely with you -- a robust public option WILL lead to a single-payer system

(just posted this on another thread....)

WHY??? Simple. The States. Right now as a state employee I have health benefits through my state -- at an annual cost of approx $12,000 for family coverage (and this doesn't count the monthly employee contribution). Unless a federal public plan is substantially more expensive ( extremely unlikely given its numerical clout), there will be no incentive for states to continue to manage their own health care systems. Union contracts will pose a barrier initially, but eventually -- particularly if salaries and other perks are increased -- the options for state employees will be negotiated down to a few catastrophic choices and the federal public plan. And where the states go the private sector will eventually follow.

So no, I don't really buy the argument that health reform will "allow me to keep my own insurance if I'm happy with it." If it is real reform, in the long run (or not so long run depending upon the robustness of the public plan) it won't.

And that is fine with me. I support a single-payer system. But it is no coincidence that every European single payer system was created in the immediate aftermath of a devastating world war; out of the ashes of economic collapse can come radical change. But I'm not about to wish such a scenario for us; I'm willing to wait IF the Administration is willing to stick to its guns and insist that a federal public plan becomes a viable, cost-effective option for uninsured and under-insured Americans. If it won't....then I will agree with the naysayers who fear that the Administration may be wasting a once-in-a-generation opportunity to ensure health care for all.

[FrenchieCat]

7. I agree.

[fadedrose]

8. If everyone would send this to anyone with a "voice"

it might work, but you have to shake the establishment a bit.



R..

[riderinthestorm]

9. When I called Baucus' office I simply asked why those two options weren't getting a fair hearing.

The woman was really hostile. If even questioning why either of these two options can't get a fair hearing (alongside the health care insurance industry recommendations) provokes such anger, I'm not sure the quibbling amongst ourselves that WE are doing makes a bit of difference.

The industry execs and Congress are too closely wedded. I'm not sure it makes any difference where you fall on the healthcare debate scale - I believe "we're" going to lose anyway.

[vaberella]

11. Actually if we stood together to push O's plan then we're good to go.

The public option is the only thing I'm really standing by because I find the single payer something that basically undermines O's plan of, "if you like your insurance you keep it". Single payer doesn't allow that and it completely destroys any sort of compromise. However, a public option which is O's position and always has been opens the doors for talk and basically talks about the price set and all that. Both O and Sebelius and many Dems are single payer supports who are instead pushing and stand by a public option. However, if you take single payer and a public option...the easiest one to sell is a public option. That's without a doubt. It will later morph into single payer in years to come.

[riderinthestorm]

15. In all negotiating, you start by asking for everything.

And then you bargain and compromise.

We're compromising already at the very start and from the signals I see, it appears we're going to get fucked again on getting anything substantive at all. IF even asking for either of these two options to be considered is "too much" for these guys, then we're just squabbling amongst ourselves - you say tomay-toe, I say tomah-toe. Meanwhile the players are (again) laughing all the way to the bank.

I completely understand your position, and madfloridians. There's value in "standing together" on one or the other option. I just disagree that having a debate over public option or single payer will somehow "destroy" any chances for health care reform. You both are extremely sensible but I think we've met a very hardened corporate wall here. Healthcare reform is huge and shattering the "corporate" mindset, destroying the myths and fallacies of the great bogeyman of "socialized medicine" means hitting it with a sledgehammer. Or several sledgehammers. Now's our time and every voice/sledgehammer demanding reform is necessary regardless of where you fall along the healthcare reform spectrum.

[vaberella]

16. We did that in the 90s....and lost.

O has managed to win through proposing a compromise and he allowed them to fuck up. Now he has leeway to do anything he wants. Remember he can use reconciliation and no we definitely have Specter on our side. So we'll win. And O, Sebelius have pushed for what they want...and I say we back that to ensure we get it...not watered down. The compromise part is dealing with the watering down.

[riderinthestorm]

18. Honestly, I think we've lost anyway. Even a public option imho.

And it has nothing to do with the single payer v. public option debate since that debate isn't even getting any kind of a fair shot. THAT's my point. There is no real debate happening here - we're going to get 1.87% decrease in costs spread over the next 10 years (utterly unsupervised naturally) - hooray for change! and be expected to live with it as some kind of major reform. I don't see how you believe Obama has "allowed" anyone to fuck up. Our own side is against any real reform - they are bought and paid for by their corporate masters.

People who advocate for single payer are being told to shut up and unify with public option advocates to "get it done" when from my perspective, that means we're starting out from a much weaker negotiating position. Madfloridian believes this is some kind of "divide and conquer" thing that will defeat health care reform but I just don't see that. The corporate connection with Congress is extremely hardened - I think we can squabble amongst ourselves (there I said it myself), and still hammer at that wall together with some effect.

I think we lost in the 90s because healthcare costs weren't such a big horrible issue back then. While it was bad, there wasn't such a vast number of uninsured, the costs weren't so staggering, not THAT many people (cough) were driven into bankruptcy by medical costs.... Our (collective) healthcare situation is now so much more dire, it's impossible for the PTB to put off - the American public has finally said "enough!"

We own the Congress and the Executive branch but as Max Baucus demonstrates, their corporate masters are more important and powerful.

So why not ask for the whole enchilada? Honestly, I think we're going to get one unfried bean out of this reform after it's "watered down". I say again, I see you and madfloridian's point but the corporate interests could give a shit about any of it. They're farting in our general direction after eating the whole enchilada while telling us unfried beans are good for us.

[Hippo_Tron]

20. That's called the "door in the face" strategy

There is also the "foot in the door" strategy where you start by asking for something small and then escalate your request gradually. Both can be very effective negotiating tools.

[riderinthestorm]

26. Horse trader here (by profession)

So of course, I say start large.

I just firmly believe that when you are dealing with corporate special interest money that's this large, the "camel's-nose-under-the-edge-of-tent" won't work. There's too much money at stake and they are throwing it at these guys. Their greed is insatiable. Frankly, I'd even say it perhaps isn't even all about greed for some of these politicians - they MUST have insane amounts of cash to win an election.

They just can't afford to piss off their cash cow(s)- big pharma, big insurance, big AMA and others.

Obama has a chance here to change his place in history by doing the right thing on health care. I sincerely believe that but it's got to be real reform, dramatic reform that truly alters the present landscape. You don't do that with small baby steps imho.

[madfloridian]

23. What is starting here now is not a debate.

It is ridicule of those who support the public option for practical reasons.

That will destroy our chances of getting anything.

[riderinthestorm]

31. I can't say for sure. I'm late to this debate obviously.

Not late to caring about the issue but frankly I haven't been following a lot of the dialogue here or elsewhere on what the realities are going to be in the upcoming fight. Max Baucus's ejection of the single payer advocates is what woke me up to the problem in Washington - that any view outside of the corporate powers-that-be isn't even going to be heard or considered.

I think ridiculing anyone who wants either a public option or single payer is problematic. But not insurmountable and I certainly don't perceive that as a gamebuster because I'm not entirely certain that either has any chance. I wish that weren't so but unfortunately, I guess I'm not optimistic anymore.

After the Baucus hearings, I'm guessing we're back to an even more elemental problem than haggling over which plan we get behind - we're back to fighting for real change vs. "incremental" steps. Sucks and I hope I'm wrong. Hope I'm dead wrong. Would be thrilled if Obama gets behind a public option or (better yet) single payer and I get to issue a very public DU apology.

[northernlights]

50. I'm not sure Obama is compromising on public option

From what little I've read, public option is part of his health care plan.

Doubtless the insurance companies are trying to negotiate that out of the overall plan. If they succeed, that is one thing.
But if it's not a negotiable item, then it's not a negotiable item.

I doubt Obama is so naive as to think that they'll go through with $2t cuts or savings or whatever if he just drops the public option.

[Phoebe Loosinhouse]

10. While I prefer single payer, I am perfectly willing and even happy to see

a public option being the vehicle that introduces us to a government underwritten plan that provides coverage for all who want it.

My concern is that I see a concerted effort underway to gut the public option into something that is DESIGNED TO FAIL in order to protect the entrenched healthcare industry who has ill-served us lo these many years by choice.

I am not all or nothing, but I want at the very least a public option that is credible, not some charade or impression of one.

Schumer and Baucus are on my shit list because I do see them slanting the debate and discussion to exclude BOTH single payer and public option. Meanwhile we also have Sibelius saying no public option AND President Obama acting like a reduction of 1.5% over 10 years in the costs GROWTH is something to jump up and down about.

This is starting to look like the same incremental BS we always get while people are literally dying for lack of care.

[vaberella]

13. That's how most advocates for a public option think.

I do also see a move to destroy major parts of a public option by the insurance companies. I fear that the Republicans and some of those stupid "fiscal dems" are willing to allow the gutting that O did not support or write and that he's promoting. This is why I'm a bit pissed at the single payer people because they would be a great voice and unifying voice with those who want a public option to get this on the move. Instead we spend time bickering over public option and single payer which allows room for the insurance companies to butcher the public option all together. Schumer apparently added a bit of destruction already and Schumer is someone who mocked and helped Repubs in removing the 900 million needed for infectious disease vaccines. So writing health care reform is not his fortay.

[JimWis]

12. I will take either one. And I have stated that in my emails to

various representatives and the president. Single payer - public option, either one. But I can't help fearing that it might be neither one.

[madfloridian]

41. I have the same fear.

:-(

[HopeOverFear]

14. yep, divide and conquer

[madfloridian]

40. And get everyone angry at each other.

I was going to post a video of Dean today speaking of health care, but then I decided it was not worth it at all.

[OHdem10]

17. Does it really matter? Incrementalism is back. It is going to take

10 years to implement. It will end up a hodge podge. Forget it.

[madfloridian]

19. The split has begun right now.

And it is unfortunate.

Ridicule of those who support the public option as realistic....it has begun.

[Hippo_Tron]

22. Personally, I want a system like the French have

But I know there's a snowball's chance in hell of that passing. Public option is probably the best thing we can get.

[bvar22]

24. DEMAND Single Payer....

...Settle for the Public Option.


Demand The Public Option, and you will have to Settle For Much Less....like voluntary cost cutting by the Insurance Corps while they reap $Billions in Taxpayer Subsidies.

MF, you are correct in calling for Unity, but we should unify behind demands for Single Payer.

Support HR 676 (MediCare for All).
I do.
It has 93 co-sponsors in the House.
FORCE the Corporate Owned Democrats to Vote it Down, and then hang it around their necks while we Settle For the Public Option.

BTW: If HR 676 has 93 co-sponsors in the House, don't you think we should be hearing something about it from our OverLords in the Senate and White House?

[Hippo_Tron]

25. Demanding more than you actually want only works if your demands are credible

Demanding more than you actually want is called the "door in the face" strategy of bargaining. It works very well when what you demand is very credible forcing your opponent to settle for fear of something worse. In this case I don't think the demand for single payer is credible, mostly because the major players (President Obama, etc.) have already stated that they aren't going to seriously push for it.

An alternative strategy of bargaining is the "foot in the door" strategy. This is where you start with a small request and then gradually escalate that request. This is the strategy that they seem to be using in this case.

[bvar22]

33. Foot in the door ....

...seems to be the strategy they are using?

I don't think so.
Complete Capitulation to the Rich and Powerful Campaign donors and then calling it reform looks like the strategy they are using.
Wall Street Banker Bailout redux.

If you could point to an actual case of the Democratic Party successfully using the "foot in the door strategy" in the last 30 years, then your supposition might have some credibility.

OTOH, I CAN point to many actual cases of Complete Capitulation to the Rich and Powerful Campaign donors.

[dgibby]

43. Thank you. You said that so much better than I could have.

Sticking your foot in the door with these characters is dangerous. Either side could slam the door and there you'd be---broken foot and no insurance.

[vaberella]

27. Imagine how far we'd be if those medical officials screamed Public Option.

They'd be more unsettled because the Presidents plan is so welcome.

[snowdays]

39. I like your way of thinking on this.

[fadedrose]

29. Hey mad, a request here

How about a SEPARATE post, not buried somewhere under another OP, entitled "Differences between "single payer" and "public option" - for dummies like me.

I would appreciate it. Most posts have too many links and meander around the topic so that the essence is lost...

thanks, as usual

[madfloridian]

30. Here would be my explanation.

Single payer would mean a government run option only, with the insurance companies on the sidelines in many ways.

Public option in my mind means a government run option along side the private options. It would be there for those who are without insurance or those who would prefer it. Like opening Medicare up to those under 65 or jobless.

Realistically the votes are not there for single payer. The other day I posted that only 21 Dem senators support a public option.

The Senate is where any single payer would bog down.

Our country has given the insurance companies so much power for so many years that it will hard to overcome their power.

There are a lot more details, but that is just a quick summary.

[vaberella]

35. I believe...

Your definition for single payer is half right...the insurance companies are not on the sidelines they just don't exist or are entirely eliminated for the government plan only. Public option works in a similar way to the UK version which allows private insurance with government option still being a focal players. However, ultimately they are over run through crowding out---forcing government public option being the dominant force even though they are players on a much smaller sphere.

The rest is right. Senate would destroy single payer.

[backscatter712]

32. I mentioned we have to use Overton Window strategy to get somewhere on this.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5639025&mesg_id=5639025

We have to be pulling from both the moderate left and the radical left.

That means we need Public Option advocates, but at the same time, we need Single Payer advocates, and we need to look further. I think that in order to really solve the problem with inflated health care costs, we need to look at nationalizing some of the health care industry - nationalize some hospitals and clinics, because if they're left to be run for profit, they'll continue to overcharge and gouge.

[riderinthestorm]

34. Oh my lawd, exactly what I think but you said it much better!

:hi:

I hate that madfloridian (et al) now believe this is some kind of furious fight. That may be correct, and would be unfortunate, but that doesn't mean it would necessarily doom all healthcare reform efforts.

As I said before, I think they are doomed already. The Baucus hearings are a pretty ominous shot across the reform bow so this entire discussion is probably moot. Not that I've given up. Watching the hearings only galvanized me to finally take real action.

[vaberella]

37. I strongly believe and I mean admantly...

that ALL public option advocates are single payer focused people. Because anyone who understands the economics will see that Public Option will dominant---as long as it remains the way the Pres describes it. So it's not mutually exclusive as some people think. I happen to be a single payer advocate who is a pragmatist. That means single payer will not happen now the way the political climate is...so public option will because it allows choice. Single payer completely and utterly removes the idea of "choice" which unsettles people...especially those who may be terrified of big government and that's a reality if your a Dem or a Repub.

[madfloridian]

42. And we need them all without any insults toward the other.

It can be done, but there must be respect for those of us who decide to support the public option....no implied idea that we are undermining anyone.

[backscatter712]

44. Exactly.

By supporting the public option, you're helping out single-payer, and by supporting single-payer, you're helping out the public-option.

[madfloridian]

45. Yes, thank you.

:hi:

[Jakes Progress]

46. Maybe you're right.

So everyone here at DU should start supporting single payer.

Sorry, bout that. The problem is that I don't trust the insurance industry. They will lie. They will cheat. They will outlast us and our desires. What we see as a foot in the door, they see as stalling. Stalling until they hire more senators. Stalling until they figure out loopholes. If you think that any of Pharma or Insurance is going to do the right thing because it is the right thing, you are deluded.

Now if you mean a true public option, one that works like single payer if anyone wants it, that would be fine. But the public option that we will get is the public option like the Senior drug plan. You get to choose which Insurance Corporation gets to take your money and decide your fate. The insurance companies will never let a government plan happen. What company would continue to pay for any insurance at all if that were an option?

We will get a bastardized, wet-kiss for big Insurance and Pharma. Count on it.

[madfloridian]

47. I do support single payer. I also support a public option.

I agree that they will try to negotiate us out of anything fair at all.

And that is a sad commentary on the Democrats in control.

:hi:

[Jakes Progress]

51. Yep.

I think the term that is nebulous is Public Option. I've read a couple of meanings. One is the one I think we are talking about - government run option - no insurance companies. The other is a version of the medicare drug program. My mother is caught in that one. She will hit her ceiling in about two months, then be on the hook for thousands. Meanwhile the government is buying from the limited list of drugs available at profit plus for the pharmacy companies all while the insurance companies are taking their rake of the top. Not negotiating for price was built into the deal. Our taxes go for top dollar price gouging. Places like Costco and some of the drug chains get to bargain and can get the stuff cheaper than the government. But since she signed up for the government/big insurance "help", she is not allowed to use those sources and plans.

That is what we get when the drug and insurance companies "cooperate". I would like to think when the president stood there smiling and shaking the hands of the insurance and pharma leaders, congratulating them for their good works, that he knew what they were doing and it was all for show. We will know if he did when we see the bill. If it offers a million "options" like senior drug coverage, either he was fooled or we have been screwed.

Given Public Option A (no insurance companies), I will support this first step. If we get Obion B (insurance/pharma wet kiss) I cannot. No one at DU should.

[firedupdem]

49. Agree. n/t

[Peacetrain]

52. Bingo!

[Faryn Balyncd]

53. Agreed.

[madfloridian]

54. It's still going on....the dividing that is.

Dean is advocating a public option...a Medicare for all option.

Some who are advocating single payer will say that is unacceptable.

That is how we lose.

One is a compromise to get to the other after years of insurance being in total power.