The healthcare reform is exactly what one would have expected

[Phoebe Loosinhouse]

if the starting premise was:

A. How can we craft something that appears to be reformish BUT which really just tinkers around the edges and retains the profits of the insurers and the other "stakeholders" and thus our campaign contributions?

**************

Reform would have looked very different if the starting premise had been:

B.How can we bring real reform to the American healthcare system that will provide accessible, affordable, portable healthcare for the American people and bring our costs in line with the rest of the world?

*************

Don't you think that if they had started with premise B, we would have ended up with something totally different?

How many of you - bright-eyed and hopeful at the beginning of this process (like me) ever dreamed that we would end up with mandates to buy for profit health insurance, no public option, no cost controls, taxes on "cadillac" plans that will LOWER coverage for some(!),and that 20% of income would be deemed "affordable" by the powers that be for anyone not in an employer group?

It amazes me how many are actually grateful for this monstrosity of "reform" that will probably kill off the Democratic Party for years to come. The independent non-employer covered uninsured will most likely remain independent and uninsured, only poorer due to fines that they possibly could have put towards a check-up or self-help books or used dental tools on EBay.

I honestly wish that they would pass a stripped down bill that maintains the high risk pool for ill adults and children and that they would go back to the drawing board and produce something that isn't so obviously based on premise A and start taking a look at premise B.

This is the best they could do? Really? Cue Peggy Lee.

[ProSense]

1. "Don't you think that if they had started with premise B" No.

Example: Climate change.

As a matter of fact, health care.

They did start with premise B. What you need to explain is how Bayh, Nelson, Nelson, Lieberman, Landrieu, Carper, Conrad, Baucus and others could have been left out of the process?

[Armstead]

8. Did you read the post?

It addressed your question.

Even if there was such formidable opposition to meaningful things like expansion of Medicare, Obama and the Congressional dems could have AT LEAST focused on the things that are more widely accepted and which would be more easily passed, without imposing awful things like mandates to buy private insurance.

The end product does resemble Goal A (protect insurers). Maybe it wold not have been possible to advance Goal B significantly, but at least we should not have advanced the intrests of Big Insurance in a way that will make it much more difficult -- if not impossible -- to make the positive changes that are necessary down the line.

[ProSense]

9. Did you miss the debate?

Obama and the Congressional dems could have AT LEAST focused on the things that are more widely accepted and which would be more easily passed, without imposing awful things like mandates to buy private insurance.

Newsflash: The Senate wanted mandates. Several of those Senator supported them during the primary.

What are the "more widely accepted" things that everyone in the Senate would accept? Please list.

[Armstead]

12. The mandates with a public option is what was wanted

There are varying oipiniions on mandates. It is not a black and white position. There are good progressive legislators who believe in mandates, and others who believe that mandates without a public insurance alternative is wrong.

But the basic stated principle of most who supported mandates was to have them ALONG WITH the option of public insurance.

What could have passed? There are numerous things in the bill (or which could have been in the bill) that would have been acceptable to those all-powerful ConservaDems. In other words, the things that most agree wiuld help without locking us permanently into the extortionist private insurance industry.

Such as:

Deal with pre-existinbg conditions without mandates -- perhaps through subsidies for high-risk buyers.

Subsidies for those who are in the middle -- those who don't qualify for current low-income coverage but don't make enough to afford private insurance.

The creation of an "exchange" and pool to make affordable insurance available to the self-employed.

Expand medicaid funding and eligibility.

The cost controls of medical costs that most people agree make sense.

[Phoebe Loosinhouse]

13. Exactly - mandates were always in conjunction with a public plan

No one that I am aware of ever announced that our "reform" would consist of being forced to buy private plans with fines if we didn't.

[ProSense]

15. Who are they?

If they wanted a mandate with a public option, they would have voted for it.

[Armstead]

16. Now you're getting robotic and knee-jerk

Sounds like YOU missed the debate.

That statement sounds like you have not been near a newspaper or television set or news website all year.

[ProSense]

19. Now you're resorting to name calling because you can't answer the question:

Who supported mandates and a public option during the primary, and why didn't they vote for it?

[Armstead]

22. Hillary Clinton

And I was not a supporter of Hillary.

But if you look at her health care plan she made it clear that mandates AND a government health plan as an option plus vigorous regulations to ensure affordable basic private plans were a cornerstone of her platform.

Plus, throughout the 'debate" of this year, most legislagtors who supported mandates also triexc it into a public alternative and choice.

[ProSense]

25. Hillary Clinton is in the Senate? n/t

[Armstead]

26. Now you are just being confusing -- On purpose?

I was originally referring to the "debate" this year, which i answered.

Then you said "during the primary" which I also answered. Now you say what Senators?

You are either trying to cause confusion deliberately or you need to take a break.

[Name removed]

20. Deleted message

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

[Name removed]

21. Deleted message

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

[Phoebe Loosinhouse]

10. ProSense - ever vigilant, ever alert

Right. They started with premise B.

That was in effect when single payer advocates were dissed and ignored. That was in effect when Pres Obama called all the "stakeholders" together for a confab. That was in effect when the White House "negotiated", as they jokingly call it, with Pharma, that was in effect as they put their heads to gether to figure out how to gut a public option and make it into a "level playing field" so that it wouldn't "unfairly" compete with the privates even though that was the whole point of a public option in the first place, that was in effect when they told the progressives to STFU.

I personally see no evidence WHATSOEVER that premise B was ever their starting point - particularly with the entrenched, elitist, completely-out-of-touch-with-their-electorate Senate.

As to what to do with the Bayhs and Nelsons and Conrads and Baucuses - that was the White House's job to figure out, not mine. I thought Rahm was supposed to be such a great enforcer.


As a rebuttal to you saying that they started with premise B - how could President Obama then say that he got "95% of what he wanted." He didn't want very much if that is the case.

Here is a revolutionary idea - the only "stakeholders" that count are the American people.

[ProSense]

11. Knew that was coming

"That was in effect when single payer advocates were dissed and ignored."

Do we really need to discuss this again?

"As to what to do with the Bayhs and Nelsons and Conrads and Baucuses - that was the White House's job to figure out, not mine. I thought Rahm was supposed to be such a great enforcer."

So you have no solution. You simply wanted Obama to wave a magic wand? As far as I can tell, he did figure it out. Now, exactly what were you expecting from Rahm, that Obama couldn't do?

[Armstead]

14. We need to "discuss that again" because that was where it went off the tracks

Single payer is a popular notion that most Democrats and others do support, whether as an additional option or as a replacement for free market coverage.

Maybe the starting point had to be modest (some Medicare buy-in or a public option) but that is the direction that most people (except those with a vested interest in the status quo) believe we should be moving.

The fact that even a modest starting point was yanked off the table says a whole lot about what this bill is really intended to do.

[ProSense]

18. "Single payer is a popular notion that most Democrats "

And it has little support in the Senate. What you are proposing is a battle that would have gotten nowhere.

[Armstead]

23. It is a matter of degree

There was widespread support for some form of single payer or a public option or expansion of Medicare among a great majority of democrats -- except for the comparatively small number of conservaDems and insurance industry lackeys.

The only difference was a matter of degree.

[Gravel Democrat]

41. "single payer advocates were dissed and ignored" and harassed and arrested

"Baucus’s Raucous Caucus: Doctors, Nurses and Activists Arrested Again for Protesting Exclusion of Single-Payer Advocates at Senate Hearing on Healthcare"
On Tuesday, five doctors, nurses and single-payer advocates were arrested at a Senate Finance Committee hearing, bringing the total number of arrests in less than a week to thirteen
http://www.democracynow.org/2009/5/13/baucus_raucus_caucus_doctors_nurses_and

Nurses, Doctors Arrested But Insurers Get a Seat at the Table
5 More Caregivers Arrested at Baucus Finance Committee on “Florence Nightingale Day Protests” for Guaranteed, Single-Payer Healthcare
http://www.calnurses.org/media-center/press-releases/2009/may/nurses-doctors-arrested-but-insurers-get-a-seat-at-the-tablenurses-doctors-arrested-but-insurers-get-a-seat-at-the-table.html

I'm going to remind everyone I can about this because Orwells history washers have been busy and efficient.

If Little Dumbyas administration had Doctors and Nurses *ARRESTED* what would be the response at this forum?

[Armstead]

2. You nailed it -- That is the crux of the problem

The fact that this bill was basically tailored to the wishes of Max Baucus, Ben Nelson and Joe Lieberman (all of them good servants of the insurance industry) is really all you need to know.

This would have been a compromise if, as you said, they focused on modest fixes that would have helped people now, without the onerous gifts to the insurance industry that will ultimately make things worse.

[chimpymustgo]

3. Monstrosity of reform: "appears to be reformish BUT...retains the profits of...campaign contributers

You have asked the damning question and answered it. This is EXACTLY what they set out to do.

-edit-

How can we craft something that appears to be reformish BUT which really just tinkers around the edges and retains the profits of the insurers and the other "stakeholders" and thus our campaign contributions?

-edit-

KILL THIS BILL.

[juajen]

4. Going back to the drawing board is advisable and preferable

Why is it that common sense has flown out the window of government? Can we start a Common Sense Party?

[chimpymustgo]

6. How about an "I'm NOT STUPID Party?

[Armstead]

17. "Not Stupid" is too radical

How about "Just Somewhat Stupid" for a start?

[Hippo_Tron]

37. Because we live in a democracy

This that are common sense to policy wonks are not common sense to politicians because politicians are primarily concerned about being re-elected. This is what Churchill meant when he said democracy is the worst form of government except for all of the others.

[Cronus Protagonist]

5. It's health INSURANCE reform

And not munch of it either, as you pointed out.

[donco6]

7. And even before that, bigger questions:

Like, What is the purpose of the US Government? To ensure corporate profits, or benefit the people?

When your purpose for existing is A, the best thing to do is pass NO laws whatsoever!

[unblock]

24. i knew we were screwn the minute i saw all those insurance ceos standing behind obama

early in the process he gave them "a seat at the table".

translation: anything we do will ensure your profitability for years to come.

[DisgustedInMN]

27. If there's one thing I hate worse than being screwed by Republicans..

... it's being being screwed by DINOs...

And I DON'T forget.

[bvar22]

28. That is the phrase that DAMNS the Democratic Party:

"We did our BEST."

If they "fought hard" and this is "the best" they could do,

I have no more use for this Party.

[shadesofgray]

29. K&R.

[Vinca]

30. I'm still trying to figure out why the Republicans are opposed to it.

The bill pretty much preserves the corporations and the profit motive at the expense of the ordinary citizen. Big insurance seems happy - no commercials in weeks - and the flow of money to politicians will most likely continue unabated.

[glitch]

34. They foresee their own obsolescence.

Corporations no longer need them.

[Phoebe Loosinhouse]

38. I know.

and you are very right about the telltale silence of the commercials.

[glitch]

31. Proposition C: How can we begin the process of completely privatizing Medicare?

And permanently lock out the dangerous possibility of expanding Medicare into the full blown entitlement of Single Payer Health Care?

Remember, entitlements to anyone but the existing elite (military/fossil resources/financial/insurance sectors) = BAD.

http://www.huffingtonpost.com/zeke-emanuel/sustainable-health-care-r_b_114788.html?view=print

(and before anyone says Huffington Post, phooey, this article was written by President Obama's advisor on HCR, Zeke Emanuel)

...
A good test of reform proposals is whether they address both sets of problems. If a reform addresses either financing or delivery system problems but not both, it is not credible or sustainable. Incremental changes will not fix these problems and are not sustainable.

The Guaranteed Healthcare Access Plan proposes to repair the health care system by giving all Americans a voucher to select a standard benefits package offered by insurance company. In most areas, American will be able to choose between 5 and 8 insurance companies. And the insurance companies will be required to enroll anyone who wants and cannot exclude coverage for pre-existing conditions. The standard benefit package is based on what Congressman and Senators receive, and is more generous than what most Americans currently have through their employers or government program. Americans will also decide if they wanted to buy additional services, say wider selection of doctors and hospitals, more mental health benefits, or coverage for alternative medicines.

The Guaranteed Healthcare Access Plan will be administered by a National Health Board and regional boards modeled on the Federal Reserve System with fiscal, administrative, and political independence to make tough decisions based on the merits, not special interest lobbying. There will also be an Institute for Technology and Outcomes Assessment to assess the effectiveness of new drugs, devices, procedures, and other interventions. It will also assess and make publicly available data on the clinical outcomes of patients in different insurance companies. This will permit comparative shopping based on real quality results.

No one receiving Medicare, Medicaid, or any other government program will not be forced out, but there will be no new enrollees. People who turn 65 will simply stay in the Guaranteed Healthcare Access Plan. The special tax benefits related to employer based coverage will be eliminated and most employers will stop offering health insurance.
...

[Phoebe Loosinhouse]

32. And, Zeke Emanuel wrote that just a year and a half ago.

It's not sopme youthful term paper. He wrote that when the prize was in sight. How good does it make you feel to know that this guy is the President's advisor on HCR?

Vouchers for private insurance to replace Medicare - the single most efficient, effective program we have going. How do you feel about that America? Medicare operates with a 3% administrative overhead, something that will NEVER be duplicated in the private sector.

And it will be all about "deficits" and "forcing the cost curve downward" (even though private copanies do the opposite.) And how we'll go "bankrupt" unless we do something quickly.


With the kind of "reform" we have seen so far in both finance and healthcare, entitlements are the next step.

I'm starting to appreciate that I was completely wrong when I thought of the New Democrats, the Blue Dogs and the DLC as "Republican Lite".

[glitch]

33. Definitely not "Republican Lite"

I am with you, we were mistaken in thinking them lite. Sure, less knuckledragging (who isn't) but no less intent on "change" and far more effective at producing it.

And they have the nerve to call us impractical idealogues, straightfaced.

[IndianaGreen]

35. A full blown Republican program, in disguise as a Democratic plan

The corporatists hate Medicare and will do what they can to gut it.

[rockymountaindem]

40. Jeez... I wish I hadn't read that

What a cockamamie idea. I don't think I ever understood what "Third Way" really meant until this debate started. At first I thought "how is it different from regular conservatism?" Now I realize: it's not about reducing government so business can just do mostly whatever they want. It's about using taxpayer money to PAY these corporations to do what they want. Yay :(

[JoeyT]

42. Yeah, that pretty much sums it up.

And we have a word for that, but people get all sorts of offended if you use it.

[Hippo_Tron]

36. Everybody is self interested, that is what you have to realize

Ben Nelson doesn't care about the future of the Democratic Party, he only cares about his own re-election in 2014 and thus his campaign contributions. Obama probably started with premise B but reverted to premise A as soon as it became clear that he couldn't get 60 senators to go for premise B.

[ProgressOnTheMove]

39. If Krugman is for the bill, then ultimately this bill will help folks so it must pass.

[ima_sinnic]

43. but Obama swore any bill he signed MUST have a public option! would he lie?

why didn't he fight for it, if it was so important to him?

or is "must" a relative kind of thing now? It "must have a public option" only if Lieberman says it can? So why did Rahm get everyone to bend over for Lieberman?

So many unanswered questions, so little time to be fleeced by liars and con artists.

By the way, the next time Obama "promises" something, I'll take it about as seriously as I did bushspeak.

[oreo3leg]

44. We will know one way or another for sure the day he signs the bill.

[ima_sinnic]

45. I really do want to be proven wrong (nt)

[Phoebe Loosinhouse]

46. He has already clearly stated that he WOULD sign without a PO

http://www.pbs.org/newshour/bb/white_house/july-dec09/obama_12-23.html
Interview with Jim Leher December 23

PRESIDENT OBAMA: Right.

PRESIDENT OBAMA: You know, look, I've been in favor of the public option. I think the more choice, the more competition we have, the better.

On the other hand, I think that the exchange itself, the system that we're setting up that forces insurance companies to essentially bid for three million or four million or five million people's business, that in and of itself is going to have a disciplining effect.

Would I like one of those options to be the public option? Yes. Do I think that it makes sense, as some have argued, that, without the public option, we dump all these other extraordinary reforms and we say to the 30 million people who don't have coverage, "You know, sorry. We didn't get exactly what we wanted?" I don't think that makes sense.

JIM LEHRER: So it is not - that's not a deal-breaker for you in any - any way, either way.

PRESIDENT OBAMA: I think - I think, right now, that the Senate and the House bills - if you look at their overlap, the 95 percent that they agree on - if that bill was presented to me -

JIM LEHRER: You'd sign it?

PRESIDENT OBAMA: - I would sign it.

So there's your answer. This is the interview where he said he got 95% of what he wanted - so he must have a pretty good idea of the finished bill. The whole interview should be read if you have not already.

[oreo3leg]

47. yes, now I recall that interview. sad sad sad.

[Phoebe Loosinhouse]

48. Oh, oh. In reading that I noticed Pres O only mentions "lifetime" caps

so I would guess they are going to keep the undefined "reasonable" annual caps. (Too bad if you hit that, you must be one really sick bastard!)

Also, I noticed he only mentioned "children" being excused from prior condition bans as soon as the bill is signed. I hope they're not about to bargain away the Nation High Risk pool that was supposed to take care of sick adults until the exchanges were set up. That was supposed to be in effect within 90 days of bill passage.

[TheKentuckian]

49. How about I split the difference and say they had good intentions as long as nobody's profits take

a hit?

Probably C is the most likely but I'm trying to be optimistic.

[cornermouse]

50. kick