Why are so many people putting their hopes in fixing HCR later?

[Cleobulus]

I see this a lot with the HCR advocates, its not the best bill, but we can fix it later, etc.

Uhm, if a bill has to be fixed before it has even left Congress, doesn't this give you a clue as to how messed up the bill is? In addition, what assurances are there that it can or will be fixed later?

If the bill is just good enough to pass, but bad enough to have to be fixed later, why not take the good parts and pass them separately, like the community health center sections, removing preexisting conditions from coverage and claims denials, and medicaid expansion, and then just abandon the rest?

[mr715]

1. Politics.

The game. Winning or losing.

Media attention going into election season.

Considerations other than whats good for the people, but HCR is still better than nothing.

[SharonAnn]

93. There's really no other choice at this time or in the near future (1-10 years)

[uponit7771]

2. Wisdom is not letting the perfect or good be the enemy of adequate, this bill is better than nothing

...and less than what a lot of people want

[rpannier]

6. That's What Was Said About Kennedy-Kassebaum

That was a disaster

[Cleobulus]

8. Really, because from what I can see, a lot of people who advocate for it...

have no clue as to how it will work in the real world. As far as I can tell, I'm just as bad off with or without this bill, and a lot of people are going to be in the same boat, starting with all my fellow employees at work.

Hell, I have heard absolutely jack shit from the HCR advocates about how payments will work for paying for deducts and copays, you know, paying for actual health CARE, and yet I hear them harping on "coverage" as if that were some panacea where rainbows shoot out of people's asses and cure them of all ills.

[ecstatic]

13. You should probably abstain from it. It obviously won't help you

No plan would, not even the public option.

[Cleobulus]

16. No, the public option would help, and single payer would be great...

Its just ridiculous that people seem to completely disregard the cost of medical care in this country to individuals who CAN'T afford it.

[ecstatic]

18. The PO would still come with an annual deductible... sorry nt

[Cleobulus]

19. Would it be affordable or not?

Or put it another way, will it cost less than a quarter of my income, unlike the current HCR bill?

[ecstatic]

20. They never actually said a PO would be cheaper, just that it would

not be run by an evil, greedy corporation, and it would not exclude people with pre-existing conditions. Subsidies would apply based on income, just like in the bill they're about to pass now.

[Cleobulus]

22. The subsidies in the bill now as far as I can tell ONLY apply to premiums...

not to much else beyond that, will the government pick up the tab for my medical bills or not, that is what I want to know.

[grantcart]

52. lol it is increasingly obvious that you have not read the bill

There is no subsidy for any plan.

The subsidies will go to people based on their income.

Even if there was a public option it would receive no subsidy.

Here is a chart on the subsidies



Here you can read more about it

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x220570

Now the answer you asked in the OP has been answered. The reason that people are hopeful about improving the bill is because, like Sen Sanders and other progressives they have read the bill and know what is in it.

[Cleobulus]

57. Those are the subsidies for premiums, I already know about that...

I'm talking about subsidies for health care, in actually using a plan you are subsidized for based on income, you know, the out of pocket expenses, is there anything in the HCR bills that mitigate the cost of that to individuals or families?

[jeanpalmer]

92. The tendency from here on

because of the huge deficit, will be to cut back on social programs. And this health care bill will be no exception. It won't be improved, it will gradually be dismantled. Just like they're planning to do to Medicare and SS. Improving this program would require more money, but how likely is it that more money will be spent on this program while cutting SS and Medicare? Impossible. Many people here who are pushing the improvement angle are not dealing with reality. We have a $1.6 trillion deficits, $trillion deficits as far as the eye can see, we're not too far behind Greece in terms of financial problems, and people seem oblivious to it. They're focused on their health care pony and are not seeing the broader picture which is bleak.

The program is presented as revenue neutral, but that is only because of accounting gimmicks -- they're going to collect the revenue immediately while delaying paying the benefits until 1023-2014. But on an annual basis starting in 2013, the budget for this reform will have a $30-$40 billion deficit every year. That's a lot of money. They're going to find a way to cut this program down, because they're not going to raise taxes or let the program stay out of whack. That's when the real fix will surface -- a cutting of benefits/subsidies or an increase in premiums, or all of the above. I wouldn't be surprised if this thing weren't completely gutted by 2013. By that time, a new deficit reality will have set in and the political victory of HCR will be history. I think that's all they really want now is victory for victory sake. If the program becomes unwound in 2013 or 2014, what would they care? The goal of a political victory was achieved.

[golfguru]

76. By the same token, less of bad is better than more of bad!

[warm regards]

113. I wouldn't be so sure of that.

[AnOhioan]

3. Good question

The answer may be that the Democratic Party is now bought and paid for.

[pnwmom]

60. The answer is that we don't have 60 votes anymore, so the Repubs

will block anything we try to do, including banning preexisting conditions.

The only items we can pass now through the process of reconciliation are those that directly reduce the deficit -- not simple regulatory reform.

[Moochy]

4. Its the necessary dishonesty to get it passed

just enough dishonesty but not too much, the precise amount of deceit required is difficult, it's an inexact pseudoscience, like Alchemy, or Horoscopes.

[Cleita]

5. It's a game.

They will fix it because we will demand it. They think we won't, but we will make them. I promise.

[green917]

66. According to virtually every poll

a majority of Americans want, at the least, a public option. How are you going to make them do anything? We have majorities in both houses of Congress and the White House and still can't get what the American people, overwhelmingly, want. Unless you're going to start writing multimillion dollar checks to the crooks in office, they wont hear or listen to you.

[Cleita]

100. That's what we are going to have to fix, the way campaigns are financed.

This can be done on a local level. It already has been done in some localities. It will be a struggle, but I believe it will be the next big issue.

[grantcart]

7. Because it mirrors the way every major expansion of federal power has taken place

Social Security, Medicare, EPA, even the Civil Rights Act of 1964; all started with a much smaller version of what we now have.

Once the basic idea has been passed then the public stops buying all of the scare tactics and a much more sensible discussion of practicality takes place.

Also more people use it and it builds a constituency. This is also true with other countries like Canada. Now ever political party in Canada loves their health system and takes credit for it, in the same way that Republicans fought Social Security in the begining and now pretend to be the protectors of it.

Finally polling shows that the younger generation polls much more favorably for large extension of federal power while the oldest generation is the most suspicious. Simply changing the composition of the public through natural progression will give us an entirely different public in 5 years.

[Cleobulus]

10. That would only make sense if we had a public option in the bill...

Otherwise it sounds like you are extremely ignorant on how Canada built up its single payer system of today. It started with a PUBLIC program that was government run and that program was EXPANDED later. What relation does that have with forcing us to buy crappy insurance from PRIVATE insurance companies?

[phleshdef]

15. If private insurance is TRULY regulated and it results in coverage that gets people medical help...

...when they need it, then I could give less of a shit if private insurance is part of that equation or not.

[Cleobulus]

17. Where are the price controls, cost caps, etc.

There's a very vague regulation about needing to make sure at least 85% of premiums go to medical care, that's not reassuring.

[phleshdef]

23. Thats not a vague regulation at all. If I pay 100 bucks to an insurance company, 85$ is RESERVED...

...for coverage of medical expenses, PERIOD. And this bill does in fact create a regulatory agency that will be tasked with dealing with things like price control. Its the EPA for healthcare. Its not perfect, but its a damn good thing to have if we can't have anything else and its certainly a huge step beyond what we currently have.

[grantcart]

41. That is 100% incorrect OPM has control over MLR, Profit, coverage etc

Its obvious that your just repeating crap that you have heard and haven't read the legislation

http://journals.democraticunderground.com/grantcart/256


q) Part IV of subtitle D of title I of this Act is
19 amended by adding at the end the following:
20 ‘‘SEC. 1334. MULTI-STATE PLANS.
21 ‘‘(a) OVERSIGHT BY THE OFFICE OF PERSONNEL
22 MANAGEMENT.—
23 ‘‘(1) IN GENERAL.— The Director of the Office
24 of Personnel Management (referred to in this section
25 as the ‘Director’) shall enter into contracts with

snip

7 (at) least 2 multi-State qualified health plans through
8 each Exchange in each State. Such plans shall pro
9 vide individual, or in the case of small employers,
10 group coverage.
11 ‘‘(2) TERMS.—Each contract entered into
12 under paragraph (1) shall be for a uniform term of
13 at least 1 year, but may be made automatically re
14 newable from term to term in the absence of notice
15 of termination by either party. In entering into such
16 contracts, the Director shall ensure that health bene
17 fits coverage is provided in accordance with the
18 types of coverage provided for under section
19 2701(a)(1)(A)(i) of the Public Health Service Act.
20 ‘‘ (3) NON-PROFIT ENTITIES.—In entering into
21 contracts under paragraph (1), the Director shall
22 ensure that at least one contract is entered into with
23 a non-profit entity.
24 ‘‘(4) ADMINISTRATION.—The Director shall im25
plement this subsection in a manner similar to the
56
BAI09R08 S.L.C.
1 manner in which the Director implements the con
2 tracting provisions with respect to carriers under the
3 Federal employees health benefit program under
4 chapter 89 of title 5, United States Code, including
5 (through negotiating with each multi-state plan)—
6 ‘‘(A) a medical loss ratio;
7 ‘‘(B) a profit margin;
8 ‘‘(C) the premiums to be charged; and
9 ‘‘(D) such other terms and conditions of
10 coverage as are in the interests of enrollees in
11 such plans.
12 ‘‘(5) AUTHORITY TO PROTECT CONSUMERS.—
13 The Director may prohibit the offering of any multi-
14 State health plan that does not meet the terms and
15 conditions defined by the Director with respect to
16 the elements described in subparagraphs (A)



This is a massive expansion of federal power, obviously you haven't read the bill.

Now the next objection I get after posting this is that it is only eligible for a 'miniscule' number.

I'll skip that step and provide below the CBO report that shows that they project that it will have 26 million users.

http://cboblog.cbo.gov/?p=446

By 2019, CBO and JCT estimate, the number of nonelderly people who are uninsured would be reduced by about 31 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent. Approximately 26 million people would purchase their own coverage through the new insurance exchanges and there would be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law. Relative to currently projected levels, the number of people purchasing individual coverage outside the exchanges would decline by about 5 million. The number of people obtaining coverage through their employer would be about 4 million lower in 2019 under the legislation, CBO and JCT estimate.

The proposal would call on OPM to contract for two national or multi-state health insurance plans—one of which would have to be nonprofit—that would be offered through the insurance exchanges.

[Cleobulus]

44. So Insurance companies cannot deny too many claims, cannot make too much money...

and some of them have to be non-profit. So what will this mean for people who are enrolled in one of these plans?

[grantcart]

50. bottom line is that they will be able to buy the same kind of plans

that federal employees now get.

you can go here and see what OPM now does for federal employees:


You can go here put in your zip code and see what the exchange for federal employees have

http://www.opm.gov/insure/health/search/plansearch.aspx


What it doesn't address is the amount of subsidy people will get.

Also if a state were to establish an effective public option then that also could be included into the exchange for that state.

[Cleobulus]

62. Yes, subsidies estimates would be nice...

the Subsidy calculator doesn't help, it assumes a .70 actuary plan, these plans, after reading some of them, look to be .80 to .90 plans.

[Cleobulus]

75. Looking at the plans available, at my income level I have two choices...

Finding a plan with a high premium but low catastrophic annual limit, i.e. one I can't afford to buy for coverage, but can afford to possibly use (let's say 1,500 dollar catastrophic out of pocket limit), or I can choose the low premium plans that I can afford to pay for, but can never use to because the maximum out of pocket expense is catastrophically high, pun intended. Wow, color me shocked. I'm just wondering how much the government will subsidize the plan I can barely afford to use.

[eridani]

80. The less money you have, the shittier the plan you are stuck with

Platimum for Real People (TM) and Bronze for us disposable older human garbage.

[eridani]

79. Absolute bullshit. 15 states have already tried regulating insurance through MLRs

Abysmal failures, every single one.

[SPedigrees]

26. Other countries (Japan and one of the Scandinavian countries) have highly regulated private insur

cos. This system works as well as a public option.

[Cleobulus]

31. Yes, and our system under HCR bears exactly no resemblance to it...

They put in hard caps on costs, deducts, copay amounts, and are much more heavily regulated than our system, and they usually have a public option of one sort or another as well.

[rpannier]

70. But Japan has the political will to stand up and enforce those regulations

The US does not

[eridani]

81. Anyone who says this HCR is actually regulated is full of shit

In other countries using private insurance, the government DICTATES the costs and the coverage, and often provider rates as well.

[Lydia Leftcoast]

104. The key word is HIGHLY REGULATED in ways that Americans can't even imagine

Japan has private insurance AND a public option.

The premiums are based solely on income, not on age or state of health.

There are no deductibles, although there are modest co-pays.

If your co-pays reach a certain threshold, you can apply for a refund from the government.

If you suffer a catastrophic condition, the government picks up the full tab.

On one of my visits, I saw a state-of-the-art rehab hospital located on the campus of a health sciences university. The patients had had strokes or degenerative diseases, been in car accidents, etc. I asked who paid for their treatment, and my guide responded that almost all the patients were covered in full by the government because their conditions were regarded as catastrophic.

[grantcart]

33. No I actually know exactly how the Canadian system started and expanded

and you are guessing how it did.

I also know what is in the current bill and you obviously have not read it.


First on Canada


It was not until 1946 that the first Canadian province introduced near universal health coverage. Saskatchewan had long suffered a shortage of doctors, leading to the creation of municipal doctor programs in the early twentieth century in which a town would subsidize a doctor to practice there. Soon after, groups of communities joined to open union hospitals under a similar model. There had thus been a long history of government involvement in Saskatchewan health care, and a significant section of it was already controlled and paid for by the government. In 1946, Tommy Douglas' Co-operative Commonwealth Federation government in Saskatchewan passed the Saskatchewan Hospitalization Act, which guaranteed free hospital care for much of the population. Douglas had hoped to provide universal health care, but the province did not have the money.

In 1950, Alberta created a program similar to Saskatchewan's. Alberta, however, created Medical Services (Alberta) Incorporated (MS(A)I) in 1948 to provide prepaid health services. This scheme eventually provided medical coverage to over 90% of the population.<30>

In 1957, the federal government passed the Hospital Insurance and Diagnostic Services Act to fund 50% of the cost of such programs for any provincial government that adopted them. The HIDS Act outlined five conditions: public administration, comprehensiveness, universality, portability, and accessibility. These remain the pillars of the Canada Health Act.
By 1961, all ten provinces had agreed to start HIDS Act programs. In Saskatchewan, the act meant that half of their current program would now be paid for by the federal government. Premier Woodrow Lloyd decided to use this freed money to extend the health coverage to also include physicians. Despite the sharp disagreement of the Saskatchewan College of Physicians and Surgeons, Lloyd introduced the law in 1962 after defeating the Saskatchewan Doctors' Strike in July.

The Saskatchewan program proved a success and the federal government of Lester B. Pearson, pressured by the New Democratic Party (NDP) who held the balance of power, introduced the Medical Care Act in 1966 that extended the HIDS Act cost-sharing to allow each province to establish a universal health care plan. It also set up the Medicare system. In 1984, the Canada Health Act was passed, which prohibited user fees and extra billing by doctors


It twenty years to go from an initial limited public funding to a universal single payer system and another 18 years before the Canadians stripped the private health providers the power to charge for fee for service.



The Congressional Budget Office projects that 26 million Americans will take advantage of the exchanges which will have OPM controlled plans and must include not for profit options. Those options could, of course, include state public option plans.

You can go here and actually learn the facts:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x225498#225638

[Cleobulus]

36. Wow it looks like it started in Canada with Public Municipal programs...

the Provincial run Public Corporations and then expanded even further from there. Wow, you really showed me up. :eyes:

[grantcart]

43. You really have a reading problem

1946 was the start of the first Provincial wide coverage of health care

I didn't make bold the entire paragraph but here is where it started

In 1946, Tommy Douglas' Co-operative Commonwealth Federation government in Saskatchewan passed the Saskatchewan Hospitalization Act, which guaranteed free hospital care for much of the population. Douglas had hoped to provide universal health care, but the province did not have the money

"It wasn't a municipal program it was a province wide free hospital care for much of the population"

Where I really show you up is in reply 41 above where I quote directly from the bill showing that OPM will have radically expanded powers that will control not only the MLR but also the profits of the providers, and MUST INCLUDE A NON PROFIT, which presumably could also include any state run public options.

Now you say that it doesn't do that so please quote the part of the bill that supports your POV because I don't think that you have even read it.

[Cleobulus]

45. OK, did Tommy Douglas require Canadians to buy catastrophic coverage with subsidies...

from private companies? No, then stop comparing the two.

[grantcart]

51. lol the point was it started small and in one province

There is nothing stopping a state from doing the same thing.

Bottom line this is a major expansion of federal power, it is much larger than the initial steps that Canada started that was only provincial.

Canada only went to a national system when they saw that it was working effectively in that province, and even then it was extremely limited.

Canada did not do what you are suggesting that we should be able to do, namely go from a theoretical system of universal coverage in the US to a complete system in one move.

In Canada one province and then another did it with limited coverage. This is exactly how every other massive increase in federal power has taken place in the US.

I defy you to give an example of another situation where there was a massive increase in federal power that did not start with a very limited version of its present scope.

You can't because it doesn't exist.

[Cleobulus]

56. "Limited version of Present Scope" so we expect an even larger expansion of mandates...

because that is the present scope, the present foundation of HCR, American Style.

[eridani]

82. So, let's start out in CA with single payer, which they have passed THREE TIMES

Except the fucktards pushing this shit on us won't grant an immediate ERISA waiver.

[SPedigrees]

24. Thank you for stating what I was about to write. nt

[flamingdem]

30. +1

[Cleobulus]

32. The flaw in your reasoning is that the basic idea is a bad one, that we be required...

to buy private insurance by law. That is the idea you want to expand on, and its a horrible idea.

[rpannier]

71. Allow me if I may to play Devil's Advocate

We did pass Health Care Reform... in 1996.
It was called the Kennedy-Kassebaum Bill (Also Known As Health Insurance Portability and Accountability Act)

It provided the following:
1. The bill limits preexisting condition exclusions
2. For the first time makes the regulation of private health insurance a federal responsibility

On the other hand
1. It does not extend coverage to the uninsured, and while it prohibits insurance companies from refusing to renew coverage, it sets no limits on what they can charge

It didn't work out so well, because they regulatory agencies were weakened through defunding, lack of oversight and n political will on the part of the federal government to make sure the rules are being enforced.

There are always a 'Devil in the Details'
In the present bill before Congress, it does not prevent Insurance companies from denying people with pre-existing conditions, it fines them. If the fine is less than the cost of the care the Insurance Company will simply pay the fine and be done with it.

One last thing on the Kennedy-Kassebaum Bill (from Paul Star)
"Better than nothing" was the sentiment heard frequently among the former health reform staffers.

link:
http://www.princeton.edu/~starr/articles/signing.html

[Sebastian Doyle]

78. Those things also all happened before Satan and his son Al From created the DLC

Democrats were Democrats then. Not all of them perfect, by any means. But they weren't corporate prostitutes like the DLC'ers/Blue Balled Coward false "Democrats" of today are.

NAFTA was a DLC project that they claimed they would "fix later". Not only did they not do so, they came up with several other shitty "trade" agreements to go along with it.

They have no fucking intention of ever speaking of REAL reform again, once everyone is forced into corporate insurance coverage. I'd tell you to take that to the bank, but odds are you're bank will fail on some Friday in the near future.

[Marsala]

9. Past history

Social Security and other entitlements were greatly expanded from their initial, inadequate forms. The addition of a public option would be a simple thing to push for once the bill becomes law and is accepted.

[Cleobulus]

11. How does one follow the other, did Social Security start out as forcing people...

to open savings accounts?

[sabrina 1]

54. No, and it didn't start by forcing people to pay protection money

to a corrupt private industry either. The foundations are rotting and that is what this bill builds on.

[eridani]

83. The inadequate forms were 100% GOVERNMENT PROGRAMS, period!

No horseshit about making people invest in the stock market for retirement and sending the IRS after them if they refused.

[Ozymanithrax]

12. Check out U.S. History. That is how we do things in this country.

[Cleobulus]

14. Really, and this is supposed to be reassuring, how?

If that were true then I imagine that in 20 years there will be one private insurance company covering everybody, let's call it Aetna-BCBS-Humana-Kaiser, or ABHK for short and with very few regulations you would have to buy their crappy insurance and you will like it dammit.

[Ozymanithrax]

49. No, over the next 20 years they will be reduced in their power.

But really, check out the history of legislation in this country. Making adequate bills better is what we do here.

[Cleobulus]

63. Who said this bill is adequate? I certainly didn't, and I don't see how we can reduce...

the power of the medical insurance industry through this bill when we just keep adding to their risk pools, through the force of law no less.

[depakid]

35. Unfortunately, you've moved in the opposite direction of where you needed to go

to address the root causes of the problem(s).

Instead of making progress- all you've done is address a few of the more egregious symptoms, while further enriching and entrenching the source of the malady- making it that much harder to fix!

Kinda reminds me of the various attempts to deal with slavery- the Missouri Compromise, the Fugitive Slave Act, the Kansas-Nebraska Act being analogous to the present reluctance to address the the salient issues of your fragmented, inefficient- and unsustainable health care financing system.

[Bluenorthwest]

90. US history. I checked out Manzanar and post Katrina

New Orleans to see how we do things in this country. We leave children stranded on rooftops in this country, apparently.
All snark aside, you have nothing to draw on because the US has not, nor has any other nation, ever mandated the purchase of private for profit products. It has never happened in the past. Using the law to force people to buy products is an Obama era innovation. It is brand new, never been done, and considered a crime by our peer nations.

[ShortnFiery]

21. I don't know? It worked swimmingly with NAFTA.

:nuke:

[Luciferous]

46. lol

[Lil Missy]

25. Politics is chess, not checkers

[Cleobulus]

27. That makes absolutely no sense, unless you are talking about sacrificing pawns. n/t

[depakid]

42. DUzy

[stevenleser]

28. Doesnt matter what would be passed. It would need to be modified or "fixed"

In case you haven't noticed, there is no such thing as a perfect healthcare system anywhere in the world. The top rated health system, that of France, is constantly being modified (lately, that means paring back services) and it still has problems of sustainability.

[Cleobulus]

29. True, but shouldn't we start with a base that can be built on first...

The very foundation of our Health Care Reform is flawed, it has a huge crack in it, and we don't even have so much as rubber cement to fill in that crack, it will only get worse as time goes on.

[Warren Stupidity]

37. We will not get a redo.

The majorities we have now will not exist next January. This is it. There is no do-over.

[Cleobulus]

38. So the country is fucked? Is that it?

[Warren Stupidity]

47. Well yes that also is true.

But I remain of the opinion that this flawed bill is much better than our having wasted another two year window and done nothing.

The bill is not all bad, and the bad in the bill does not result in or cause (this) country (to be) totally fucked. The bill, even the Senate bill as is, would do considerable good, even as it bakes in profits for the insurance cartel.

[Cleobulus]

72. I guess saying we'll be totally fucked isn't really true, my situation, for example...

won't change, I still won't have access to medical care, but with HCR I get to pay for the privilege as well.

[eridani]

84. Speak for yourself . It totally fucks me over nn/t

[Warren Stupidity]

34. I subtract 1993 from 2010 and I get 17.

The last time we had a Democratic congress was 17 years ago, and that was the last time we tried and failed to pass anything at all. I'll take this crummy bill as is, hope that reconciliation fixes up the worst parts, and hope that we can move forward from here. That is indeed a lot of wishful thinking. On the other hand I am rather certain that if we fail now to pass anything we will not have another chance for at least another decade.

[rpannier]

67. We did Pass Health Care reform in 1996

Kennedy-Kassebaum

[mkultra]

39. because the country marches left

it will get better

[Cleobulus]

40. How is this an indication that the country is moving left, it looks like a rightward turn to me...

or, perhaps more accurately, a "muddled middle" move.

[mkultra]

106. i didnt say it was an indication

i asserted that the country is marching left. if you consider were we came from i think its undeniable. This country certainly wasn't MORE liberal in the past.

[Dinger]

48. You Know What They Say . . . "There's Always Hope . . . . As Long As It Stops There (nt)

[Skittles]

53. because they are fucking deluded

[LibDemAlways]

94. It will get "fixed." Repukes in years to come will strip it of any

good it may do while leaving mandates in place. The rose-colored glass wearers on this site are in for a big disappointment.

[rhett o rick]

55. For the same reason they put their faith in Obama standing to change. It's all we have. nm

[Lord Helmet]

58. It will be improved just as Medicare and Social Security were improved.

[rpannier]

69. I hope your right, but I lack your certainty

Last year the insurance companies raised the fees on what retired federal employees pay on their retirement insurance. This change affected Congressional Reps, their staff and all Federal Employees

What did they do?
They called up the execs, whined, pissed, moaned and did nothing else.

If they won't aggressively defend their plans I have little faith they'll defend someone elses

[eridani]

85. Those were FUCKING GOVERNMENT PROGRAMS!!!!!!!!!

It is not possible to improve private insurance except by the kind of regulation congress refuses to do. If they were willing to do it, then single payer would also be feasible, but they will do neither.

[Lord Helmet]

98. !!!ELEVENS!!!!!!

Improved as in moving toward a hybrid system with Medicare buy-in. Grayson has a bill calling for just that.

[eridani]

115. Except that the people who need that can't afford it. A hybrid system would just lower the age.

One of the aims of HCR is to destroy Medicare.

[pnwmom]

59. We don't have the votes to pass anything separately that can't be justified through

reconciliation. Removing preexisting conditions, for example, has nothing to do with deficit reduction (a requirement for using reconciliation). We were able to pass a bill last year in the Senate removing preexisting conditions, despite Republican opposition, because we had 60 votes for it -- which we no longer have.

Now, we are amending the Senate bill through reconciliation, but we can't include any items that don't reduce the deficit -- and most regulatory reform doesn't fall in that category.

[alcibiades_mystery]

61. Why are so many putting their energy into killing it now?

[stevenleser]

64. Bingo!

You nailed it.

[Cronus Protagonist]

65. lol

They've told you why a thousand times over and you still don't see it? Pearls before swine and all that.

[Cleobulus]

68. The language I'm using in the OP is the same that many supporters of the bill use.

Yet we IMPROVED medicare, social security and other programs over time, yet this one, for some reason has to be fixed, not improved. Indeed at some point most parts of it will have to be replaced if we wish to have a system that covers all Americans fairly.

[LibDemAlways]

95. eridani's point is well taken. There is no new government program here

to be fixed, improved, or whatever. The government is attempting to regulate private corporations, telling private businesses in detail how to operate and what they can and can't do.

This entire mess is going to end up in the courts, and the litigation will drag on forever.

A single payer health insurance program - medicare for all or a public option administered by the federal government- could be tweaked by the government. I'm confident the insurance companies will weigh in with their lawyers on this bill and any attempts to "fix" it.

[ProgressOnTheMove]

73. Mostly because the movement for single payer most likely won't end here...

There were moments in the last 8 years it seemed the Iraq war would never draw down and one would start in Iran. People kept moving and pushing and now we're here. This is where the coporation will have to relent as the people striving for better are never giving up. In NYC Bloomberg spent a fortune to get elected and only won by a small margin Romney and Giuliani spent oodles of cash and lost. The supreme court decision is desperation people are working it out.

[Cleobulus]

74. That would involve scrapping this bill sometime in the future and...

replacing it damn near wholesale.

[LibDemAlways]

96. When the R's get their hands on Congress & the Presidency the

bill is toast. They will leave the mandates in place. Anything that remotely does anybody any good will go. That's if the courts haven't already declared parts of (or the entire bill) unconstitutional.

[boppers]

77. Two Words: Social Security

One word: Medicare

We don't get the perfect, we get a start. Same as it ever was.

[eridani]

86. Two words: GOVERNMENT!!!!!!!!!!!!!1 PROGRAMS!!!!!!!!!!!!!!

Not requirements to invest in the stock market for retirement or be docked by the IRS.

[PA Democrat]

116. Except I don't remember a huge infusion of corporate money to run ads

to defeat Social Security and Medicare legislation. Add in the fact that the filibuster was historically never abused as it is by today's Republicans.

If we are to get any real improvements I think it will be very difficult and nearly impossible without reforming campaign finance as well as Senate rules.

In the meantime, the health care profiteers are furiously working on every angle to get around the current proposed legislation. There are huge amounts of money to be made and they will do everything they can to maximize their take.

[quaker bill]

87. Because

it is the only place available?

[marshall]

88. Because they want to be re-elected

The folks who are against it but who normally would be on Obama's side have their asses on the line. They'll lose their cushy jobs if they anger their constituents.

In my opinion we're screwed either way, because this has dragged on so long and turned into an all out fiasco. But the main person who would lose if it were NOT passed is Obama. What his advisors need to do to get this thing passed is figure out a way to make the possible swing votes coincide with the interests of Obama and passing the bill.

[WCGreen]

89. If you can assure me and all the other people who have been fighting

for some kind of health care reform since President Truman that president Obama will have the political will or the political support to jump right back into the breach and try again even though he will appear to the strong on the other side weak and that his presidency is in effect over, then yea, I agree...

Otherwise, take what is on the table and come back to fight from a position of strength.

If you have nothing in your hand, no tangable position to bargan from, what makes you think you will get another chance.

[Hippo_Tron]

91. Not passing the bill means handing Congress to the Republicans for a decade at least

I like the odds of making fixes under Democrats compared to doing nothing for another decade.

[Cleita]

102. Whatever half of them call themselves, those Democrats are no better than

Republicans IMHO. We need to replace them and change how our elections are financed. We also need to take the ability to rig elections out of the equation too.

[Hippo_Tron]

103. No, they are better than the Republicans

Even if you want to make the case that they are center right, center right is better than lunatic fringe right (which is what the Republicans are).

[NorthCarolina]

97. What we should be asking is "why couldn't they get it right in the first place?"

Good luck with your "fixing it later" plan.

[Proud Liberal Dem]

99. There is little reason IMHO for it to NOT be improved upon later

Like other people have already posted, other programs such as Social Security, Medicare, etc. all grew over the years once their much limited versions were enacted plus they became impervious to repeal once the benefits of both of the programs became well established to everybody and only the most ardent (fringe) conservatives remained opposed to them and committed to their repeal. Once HCR passes and people notice that the sky hasn't fallen, the seas haven't started boiling, and the sun hasn't turned to sackcloth(?), people will be less reluctant to tinker with health care and will advocate to enhance it, mostly because like with Social Security, Medicare, etc. almost everybody will be affected by it. Plus, nobody can ever fully account for all possible outcomes of legislation and people will invariably notice flaws in the new system over time that will need to be corrected and, presumably, the President and Congress will respond- but not knowing everything that MIGHT happen because of the legislation is not sufficient reason IMHO to start over, particularly when the prospect of getting something better now (i.e. single payer, public option) or especially after the upcoming midterms seems virtually impossible.
The bottom line, really, is that I can really only see about two outcomes: Either the legislation is going to be helpful/successful and people will accept the new changes and consider other changes as we go along (It is NOT likely to be forgotten or left alone if it is a success). If, however, people come to the conclusion that the current legislation is indeed a horrific trainwreck and really become pissed off at the private insurance mandates, well, I guess we'll get voted out of office and Republicans will have a real mandate to repeal the changes and take us back to the status quo although I don't really believe that many people honestly believe that the status quo is better than what is currently winding through Congress and voting Republican will NEVER get us to Single Payer or even a Public Option.
Also, if you want to be REALLY technical about it, HCR is ALREADY going to be "fixed" by the time it comes out of Congress because the final product is NOT going to be the flawed "Senate Bill" that people are most upset about- though I concede it does still retain many elements objectionable to progressives.

[Cleobulus]

110. Stop comparing this bill to Social Security and Medicare...

Neither one of which required us to buy or invest into private companies, the base, the mandates, are severely flawed, and if you want to expand on them fine, I don't, I want them scrapped.

[angrychair]

111. you beat the same drum

over and over again. Yet you have not offered another viable option. You fight for the status quo as if your life depended on it. A bill is imperfect. Laws are imperfect. We spend year, even decades, tweaking and twisting to get some things right. I can't make you feel better about this effort because you never will. First, NOTHING in real life works like that. In real life you have to take the im-perfect and make it work. You aim high and take the best you can which hopefully is somewhere in the middle or better if your lucky. Second, bills are RARELY the final say on an issue. Equal rights for people of color and women and those with disabilities were not perfect when they were first written or passed. Yes, the HCR bill is unique in how it works and no its not the same as SS or MC but the CONCEPT is the same. They were worked and re-worked over the years, ALWAYS a little better than the last. WHY WHY WHY do you think the re thugs fight so hard to prevent the bill even coming up for a vote?? Because once it becomes law-it is law-and there is NO take back. Second, the bill, even once it becomes law IS NEVER the final destination, it is only the first step of the journey. Relax, take a deep breath and SUPPORT THE HCR bill and keep fighting for your cause for better, cheaper universal health care. I and many others will be right there with you every step of the way.

[brentspeak]

101. It's all one big con

Nothing about it will be fixed later. Our tax dollars AND our paychecks will go straight into insurance execs' bank accounts. And all for privilege of unaffordable premiums and deductibles that won't even cover the ever-increasing cost of health care.

[fredewir]

117. I Agree! They are stuffing their wallets!

I never write in these things. This is my first time.
However, I cannot believe more is not being said 
about the fact that this entire issue ("Heath Care
Bill") is only 
to support the insurance companies and their stockholders.
By making it mandatory that people pay for health-care or be
fined;
By taking away Medicare from those who need it; 
By all the stupid things the government is making the tax
payers pay for;
It worries me to no end!

I am a permanently disabled man. Yes, I am on Social Security.
And, Yes I get Medicare. And to the skeptics, yes I did work
from the age of 11 till I became disabled.

We live in a house that has floors sinking in the ground,
walls cracking around us. And our car is being held together
with twisty-ties.
We (my wife and I) have to sit down and figure what medicines
we can to do without  to buy groceries.(We make $10 too much
to qualify for food stamps.)

So, anyone who would believe that people who are on Social
Security don't deserve the support they get; Or those who
believe people on Social Security, and Medicare WANT to be on
it; I say to you ppthhh!

If my wife and I had not worked, nor put money into the
program, sure!
But WE DID!

So please think of the people who live 300% below the poverty
level, and the people who don't WANT to be, but Have to be on
it! You may be in the same, 
or similar circumstances someday. 

I am not telling you all this to beg for money or help! You
wouldn't know who I am anyway!
I am telling you this to let you know the people who are being
hurt, are real!

Thank you for your time and consideration.

Me in Tennessee

[Dappleganger]

105. Because of Canada. nt

[stranger81]

107. Gullibility, pure & simple. [n/t]

[timo]

108. oh they WILL fix it

just like they promised to fix nafta !!!

[Orsino]

109. Same reason we put our hopes in fixing everything else later.

Since fixing them now has been ruled out, and the time machine to let us fix it then hasn't been invented.

All the myriad woes facing our country are moving targets, and no bill every fixes everything. Ergo, we should always be looking hopefully to the future.

[dkf]

112. They are deluded.

So sad.

[JustABozoOnThisBus]

114. The bill is the bill. Anything else is "starting over"

and the little common-sense "good parts" will get a lot of smiles and nods. And then the Republicans will threaten a filibuster, or raise an objection, voting "no" in a disciplined bloc.

Might as well take this small improvement, pass the stupid thing, and then pursue fixing it. Unfortunately, this administration will simply declare victory and not bother to attempt any fixes.

Maybe in 2012 we can elect a liberal.

:hi:

[Bodhi BloodWave]

118. While not a very good analogy this question might work halfway

If you are going to build a house(proper health care) would you have an easier time doing so with a foundation(this bill) or without a foundation?

That's how I see it anyhow, this is just laying the foundations upon which the rest will be built; and I think most would agree its usually easier to make something if you have a firm foundation or frame to build within.

[FrenchieCat]

119. You put the word in your OP.....it's called HOPE....

the difference is that some think HOPE is a given. It's not. One must work for it.
In otherwords, we elected a President because we had hope. Well, we still had to
work for that. Now he needs our help getting things done, and that will be work too.
Nothing just "happens" cause we want it too. We have to fight for it.
We may not win every battle, or get everything we want,
but if we get something, we build on that, and so on and so forth.

Those who sit on the laurels and expect everything to be handed to them,
will never gain what they want, and if they do, it will be pure luck,
not necessarily by design.

The upcoming elections are a great example.
Either we can work to give ourselves an even bigger majority,
so we can get even more done, or we can sit around and complaint
and hope that someone hears us and act on our behalf...although I can
tell you that whatever you get may fall short of what you wanted,
if you weren't truly willing to get out there, and make it happen....
and again, you still may not end up exactly with what you want....
but that's the way it works, in this country, at this time.

Reality is what we are dealing with here.