home

Thursday Morning Open Thread

Has the Media tired of Joe Lieberman's antics? We know the Washington Post's Fred Hiatt, who engages in the same type of dishonest antics (heck even Ezra Klein called him out) will never tire of him, but Gail Collins writes today:

Somewhere between the time when it seemed as if Olympia Snowe was writing the health care plan and the moment when Ben Nelson grabbed the reins, it looked as if the bill was being written by Joe Lieberman. I don’t want to suggest that he is not still the central figure in this whole crisis because that could cause him to race over to Fox News and issue a new set of threats.

(Emphasis supplied.) Lieberman is a punchline now. But the hard question is for Democratic leadership - will they allow obstructionists to block health care reform? Or will they be willing to use reconciliation? Time will tell.

This is an Open Thread.

< Wednesday Night Open Thread | Why The Accused Have A Right To A Lawyer >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft


  • Display: Sort:
    Maybe the Dems are providing savings indirectly (5.00 / 6) (#11)
    by magster on Thu Nov 12, 2009 at 08:34:27 AM EST
    by keeping people from donating to Democratic campaigns.

    Let me say generally (5.00 / 2) (#16)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:51:24 AM EST
    That I was unduly harsh on jbindc and I want to apologize to her for my comments.

    That said, the reason I was harsh is because she operated from the premise that no one has been discussing the cost of insurance with considering the health care reform proposals.

    That is truly absurd. Lambert, for example, has been lambasting a lot of us because he (as do Kucinich and Massa) believes that the public option will NOT be an effective vehicle for cost containment, even over time. He believe single payer is the only way.

    Let me assure you that Evan Bayh and Doug Holtz-Eakin do not give 2 craps about cost containment in any sense.

    It galls me to see a progressive taken in by this ridiculous Politico article that quotes concern trolls using the very reason for the advocacy for government run health insurance and ignores the solution these weasels are fighting so vehemently against.

    On a full of hot air note (5.00 / 1) (#24)
    by CoralGables on Thu Nov 12, 2009 at 09:22:31 AM EST
    Helium dad takes the rap and takes the heat off balloon boy
     

    The Colorado parents who reported their 6-year-old son floated away in a helium balloon in what authorities say was a hoax to drum up publicity for a TV show will both plead guilty to charges in the case, the attorney for the boy's father said Thursday.

    Richard Heene, 48, will plead guilty to attempting to influence a public servant, a felony, his attorney David Lane said. Mayumi Heene, 45, will plead guilty to false reporting to authorities, a misdemeanor.

    Prosecutors have agreed to allow both to serve probation sentences



    A good father is an accountable father (none / 0) (#49)
    by Militarytracy on Thu Nov 12, 2009 at 10:43:25 AM EST
    The initial decision was not a good decision, but I have renewed faith in him as a father now.

    Parent
    Not unless and until he promises (none / 0) (#68)
    by Cream City on Thu Nov 12, 2009 at 11:50:52 AM EST
    as well to stop putting his kids, cute as they are, on Youtube mouthing awful lyrics and the like.

    The balloon fracas is only one of many ways this father, these parents, are using their kids rather than raising them.

    Parent

    He's done that too? (none / 0) (#70)
    by Militarytracy on Thu Nov 12, 2009 at 12:25:17 PM EST
    The bad lyrics on youtube?  I know little overall about him, I tried to avoid it.  He really does hope to be a reality program.  Perhaps Dog the Bounty Hunter can come and get him :)

    Parent
    Funny story... (5.00 / 1) (#30)
    by kdog on Thu Nov 12, 2009 at 09:43:42 AM EST
    out of Edinburg Texas...the police dept. donates fruit that they seized as part of a drug bust to the prison, but they miss 25 lbs. of reefer in with the fruit, and it gets sent on to the prison.

    And the prisoners turn it in! wtf?  Their fellow prisoners coulda used 25 lbs. of euphoria to pass around I'm sure...and think of all the Cup O' Noodles they coulda got in trade.  Bad form fellas, bad form...Red would not approve.

    The kicker...the wanna-be Ungers who turned it in got strip-searched for the trouble...that should teach 'em.

    Perhaps they thought (none / 0) (#37)
    by Steve M on Thu Nov 12, 2009 at 09:59:55 AM EST
    it was a set-up...

    Parent
    Good guess... (none / 0) (#42)
    by kdog on Thu Nov 12, 2009 at 10:18:36 AM EST
    or there was a screw right there when they opened the crate...those are the only reasons I can think of for turning it in...boy are they gonna hear it in the yard though!

    Parent
    I had hopes about the bill coming out of the House (5.00 / 2) (#32)
    by stoic on Thu Nov 12, 2009 at 09:49:21 AM EST
    "But the hard question is for Democratic leadership - will they allow obstructionists to block health care reform? Or will they be willing to use reconciliation?"

    But they were dashed. This isn't a struggle between two ideologically opposing, equally balanced sides. This is one between what the voting majority of citizens want and what the private-interests-paying-off-Congress want. A solid no nonsense Single Payer bill could have easily been drafted and voted through Congress if we had people representatives but it ain't gonna happen with this bunch. The only question for the Democratic Leadership is what kind of bill can they fob off to their increasingly enraged constituency to pretend that tried to do their jobs and still keep the money flowing from the affected industries and trade groups.

    And don't get me started on the massive failure of leadership from Obama.

    Tweet or twit? (5.00 / 1) (#47)
    by MileHi Hawkeye on Thu Nov 12, 2009 at 10:33:32 AM EST
    Don't for a second, think Obama wants what is best for U.S. He is flying the U.S. Plane right into the ground at full speed. Let's Roll.

    State Sen. David Schultheis

    Threat to the POTUS or simple stupidity?  

    More from the good Senator...

    Schultheis voted in February against a bill requiring pregnant women to be tested for AIDS to prevent spreading the disease to the children. He said then that infected children would set examples for women against sexual promiscuity.

    The senator railed in January against public service announcements in Spanish encouraging people to fasten seat belts.

    Link

    Who does this guy.... (none / 0) (#53)
    by kdog on Thu Nov 12, 2009 at 10:55:33 AM EST
    think he is saying "lets roll"...Larry David?

    Larry: Alright, lets roll!
    Rabbi: What? "Lets roll"? What did you say?
    Larry: What?
    Rabbi: You knew my brother-in-law died on September 11th! How dare
      you say something like that!
    Larry: With all due respect, wasnt that just a coincidence?
    Rabbi: Oh, what the...
    Larry: Alright, poor choice of words...
    Rabbi: What the hell kind of a...
    Larry: Alright, thats long gone...
    Rabbi: You know, I dont wanna do this. Forget it. Forget it.
    Larry: Oh, I didnt know, I didnt know that if you, that if you, you
      died UPTOWN on 9/11 that it was, that it was part of it, uh... the
      tragedy.


    Parent
    Heh (5.00 / 2) (#64)
    by Steve M on Thu Nov 12, 2009 at 11:30:57 AM EST
    I was uptown on 9/11, and it would, in fact, have been a terrible tragedy if anything had happened to me!

    Parent
    Can anyone name (5.00 / 2) (#59)
    by lilburro on Thu Nov 12, 2009 at 11:08:11 AM EST
    an economic policy of Obama's that has yet turned out to be truly successful?  The stimulus is working sort of, but unemployment is up, we need another, etc.  The foreclosure plan is not working.  Healthcare is unnecessarily weak.

    My point is, when is the administration going to wake up and smell the coffee?  Their refusal to be bold is not paying off.

    I agree that the individuals quoted (4.50 / 4) (#18)
    by Anne on Thu Nov 12, 2009 at 09:00:31 AM EST
    in the Politico story are using concern for all of us Average Joes and Janes to mask their own interests, and it's true that if that concern were genuine, they would have been advocating for real reform and not this clusterf**kian, designed-to-be-complicated-because-that's-the-best-way-to-hide-who/what-is-really-going-to-benefit, Rube Goldberg-esque monster.

    But.  Regardless of whether their concern in real or as fake as fake can be, they are not wrong that neither Average Joe and Jane, nor Uncle Sam, are going to be saving any money.

    What bothers me is that Politico can dump that stuff in their article, and never ever push back and call anyone's bluff, along the lines of, "When asked why, if his concern is _____, the Senator has not been advocating for a Medicare for All plan, or insisting that the Senate include and listen to single payer advocates, he said...."

    Politico is taking dictation, as are a lot of other outlets: just dutifully write down what people say, and never ask the hard questions, or push for answers, lest you never, ever get to be in the presence of such eminence again, or ever get invited to another cocktail reception.  Oh, there's a little mild criticism of Obama in there, but nothing Obama cannot brush off like dirt from his shoulders.

    It's a terrible plan that is going to get worse before it ever - EVER - gets better, and is not worthy of the reconciliation process, because by the time it gets there, it will have been further whittled and watered down and compromised away - changes that will not be withdrawn before a reconciliation vote.  

    The patient that is the health care system came into the Congressional emergency room ten months ago, in need of courageous and principled treatment, and instead of emerging in better shape and on the road to recovery, has, thanks to the "efforts" of those treating it, flat-lined more than once, been given the wrong medications, been subjected to unnecessary surgery, had its most obvious symptoms ignored and dismissed as unimportant, had its chart mixed up with someone else's, and occasionally been lost in the bowels of the hospital while its doctors argue about the best way to treat the problems.

    Reconciliation may be able to shock this patient back to life, but it may create a much worse monster than what we started with.


    The issue is (5.00 / 1) (#21)
    by Big Tent Democrat on Thu Nov 12, 2009 at 09:06:18 AM EST
    whether you believe  in the "camel's nose under the tent" theory or not.

    If you do not, then you should oppose this bill.

    If you do, then the public option is reason to support it.

    I really think it is that simple.

    Parent

    I don't disbelieve in the theory, (5.00 / 3) (#25)
    by Anne on Thu Nov 12, 2009 at 09:26:59 AM EST
    in and of itself, but before embracing the theory as applied to this reform effort, I think it's important to make sure (1) that it's a nose and not some other body part, (2) that if it is a nose, that the rest of the animal is, in fact, a camel and (3) if it is a nose, and the rest is a camel, whether there is anything else outside the tent that the camel might be bringing with it.

    I am not convinced that it is the camel's nose, or that it's a camel, or that there isn't more outside the tent that we would be unhappy to see inside it.

    But, you knew that already.

    Parent

    Well (5.00 / 1) (#29)
    by Big Tent Democrat on Thu Nov 12, 2009 at 09:30:39 AM EST
    You are familiar with the provision for a public option. What part of it are you unclear about?

    As for the rest of the bill, I am not sure that there is anything so bad that having the public option in is not worth accepting it.

    Parent

    As far as I know, the Senate has (5.00 / 6) (#56)
    by Anne on Thu Nov 12, 2009 at 11:01:07 AM EST
    not even decided if their bill will have a public option, have they?  I think they're still "leaning" in that direction, but that's as far as it's gotten.

    Kind of hard to say you think having a public option is worth whatever not-so-bad provisions are in the rest of the bill when we don't know what the final public option will look like.

    That being said, we do know what the House bill looks like, and I will let John Geymann, from PHNP.org speak to that bill and the public option in it; this was written the Thursday preceding the House passage of their bill:

    After all of the political compromises along the way that have led to the introduction of the new bill (HR 3962), on the positive side we can say that it will introduce some limited reforms to the health insurance market, expand health insurance to some of the uninsured (primarily by expansion of Medicaid and by often-inadequate government subsidies to individuals and small employers for the purchase of private insurance); and help to address some other problems, such as the growing shortage of primary care providers.

    But the negative side far outweighs the positive:

    • Although supporters of the new House bill claim that it would expand coverage for as many as 30 million uninsured, we are actually likely to see an  increase in the number of uninsured in coming years for these kinds of  reasons--as costs keep going up, many Americans will be forced to drop  their present coverage because of inability to afford rapidly rising costs of  premiums, deductibles and co-payments; there is no guarantee that the  uninsured will be able to afford new private coverage (even with subsidies, which won't kick in for another four years); and expansion of Medicaid will  not take place until 2013 (many states are already pushing back with  concerns that the their recession-strained budgets will not allow them to pay  their share in adding to their Medicaid programs, potentially leaving millions of the poorest Americans uninsured.

    • There are no effective cost containment mechanisms built into the bill, either for the costs of health insurance or for health care itself. As it whines about weakening of the individual mandate that will likely limit some of its big increase in the insurance market, the health insurance industry is already warning that sharp premium increases will result. The most the bill will do is to require disclosure and review of premium increases, without any regulatory teeth. Although the bill would set up a Health Benefits Advisory Committee to recommend a minimal essential benefits package (with four tiers), insurance industry lobbyists will argue for the most minimal levels of coverage, and we can anticipate an exponential growth in underinsurance. Moreover, there are no price controls to be applied anywhere in the system, except perhaps in authorizing the government to negotiate drug prices with manufacturers. But that provision will almost certainly not clear the Senate, where we can expect even less concern for affordability and prices.

    • Although the public option has been the target of intense controversy, it will play a negligible role in health care reform. The CBO has concluded that it would cover no more than 6 million Americans, just two percent of the population, in 2013, and will cost more than private programs, mostly due to adverse selection in attracting sicker individuals and its inability to set reimbursement rates for physicians and hospitals as is done by Medicare. Moreover, middle-income families may be required to spend 15 to 18 percent of their income on insurance premiums and co-payments.

    • HR 3962 will not result in making health care more affordable, despite allocating some $605 billion over ten years for subsidies to low- and middle-income Americans to buy insurance on Exchanges. We can count on continued increases in the cost of health insurance as far as the eye can see, together with less actuarial value of coverage.

    • Buried in the fine print of this monster bill are many provisions that will benefit corporate stakeholders in the medical industrial complex on the backs of patients and their families. These examples make the point:

    • Although medical loss ratios (MLR) (the proportion of premium revenue actually spent on medical care) are specified at a minimum of 85 percent, this loophole has been added-"while making sure that such a change doesn't further destabilize the current individual health insurance market." By way of comparison, the Senate Commerce Committee has found that the average MLR for the largest insurers in the individual market is only 74 percent, with 26 percent of premium revenue going to marketing, administrative overhead and profits.

    • Although the bill would create a much-needed Center for Comparative Effectiveness Research, it would have no say over reimbursement and coverage policies. As the bill says, it "contains protections to ensure that research findings are not construed to mandate coverage, reimbursement or other policies to any public or private payer."

    In sum, this $1.055 trillion plan over ten years will not fix the major problems of cost and affordable access to health care in our deteriorating system, will add new layers of bureaucracy and complexity to the present system, is not fiscally responsible, and is not sustainable.

    Given the negatives of this particular public option, one has to ask whether we would be accepting a bad public option in exchange for mininal improvments that are in the rest of the bill, instead of, as you framed it, accepting the maybe-not-so-bad aspects in the rest of the bill in order to get the public option.


    Parent

    Someone is finally asking the question (none / 0) (#1)
    by jbindc on Thu Nov 12, 2009 at 07:51:07 AM EST
    After all this showboating about "health care reform", when it comes right down to it, is this plan really going to save anyone any money?

    Barack Obama ran for president on a promise of saving the typical family $2,500 a year in lower health care premiums.

    But that was then.

    No one in the White House is making such a pledge now.

    It's one of the most basic, kitchen-table questions of the entire reform debate: Would the sweeping $900 billion overhaul actually lower spiraling insurance premiums for everyone?

    No one really knows.

    And in fact, for all the ink spilled on the effects of health care reform, no independent group has taken a comprehensive look at how the legislation would impact premiums for the 170 million Americans who receive insurance through their employers - a population that would receive little direct financial assistance under the various congressional proposals.

    For small businesses and individuals who purchase their own plans, economists remain sharply divided over the impact on premiums.

    "This town continues to miss what is going to be the real issue," Sen. Ron Wyden (D-Ore.) said. "The real lodestar, the thing people are focusing on at home, is all premiums, premiums, premiums. All you have right now is what the insurance industry has said."

    At a recent Senate health committee hearing, two health care rivals - Douglas Holtz-Eakin, an economic adviser to Sen. John McCain's presidential campaign, and Jonathan Gruber, an economics professor whose work is cited often by the White House - agreed comprehensive, objective evidence wasn't available for small and large businesses.

    "It's insane," Holtz-Eakin said.

    The lack of data prompted Sen. Evan Bayh (D-Ind.) to request a broad analysis from the nonpartisan Congressional Budget Office on premiums, which he said was "a basic, bottom-line question that we have to have answered before we can decide if this is an intelligent thing to do."

    Aides expect to see the report ahead the Senate floor debate on health care, which is causing anxiety among Democrats because of the uncertainty of what the famously cost-conservative CBO will produce. The possibility that congressional scorekeepers will conclude that premiums won't flatten out or decrease would make centrists even more leery of reform, forcing adjustments to the bill just as Senate Majority Leader Harry Reid (D-Nev.) is already scrambling to meet a Christmas deadline.

    Obama was the one who raised expectations of lower premiums. From one city to the next, and during the presidential debates, Obama made the pledge almost as often as he vowed to remove troops from Iraq: "We estimate we can cut the average family's premium by about $2,500 per year."

    He has barely uttered it since taking office. The last recorded mention by Obama was in May, when he announced that six health industry groups agreed to lower the growth rate in health care spending by $2 trillion over 10 years, resulting in a savings of $2,500 per family "in the coming years."

    Campaign advisers sought to make Obama's plan tangible to voters. But the $2,500 estimate was controversial, even among progressive health care economists. First, the figure represented not simply a family's share of premiums, but also savings that would accrue for employers, Medicare and Medicaid. Second, experts did not expect the savings to materialize for many years.



    Citing Evan Bayh and McCain (5.00 / 1) (#2)
    by Big Tent Democrat on Thu Nov 12, 2009 at 07:54:58 AM EST
    is pretty ridiculous.

    If they REALLY cared about lowering premiums for "average Americans," they would be for Medicare for All.

    Your link is ridiculous. Simply ridiculous.

    Parent

    Don't you mean "insane"? (5.00 / 2) (#3)
    by andgarden on Thu Nov 12, 2009 at 08:04:50 AM EST
    Well (none / 0) (#5)
    by jbindc on Thu Nov 12, 2009 at 08:12:31 AM EST
    You need to read it again - they didn't cite McCain.

    At a recent Senate health committee hearing, two health care rivals - Douglas Holtz-Eakin, an economic adviser to Sen. John McCain's presidential campaign, and Jonathan Gruber, an economics professor whose work is cited often by the White House - agreed comprehensive, objective evidence wasn't available for small and large businesses

    And as you see - an Obama consultant is also mentioned as agreeing with the sentiment.

    I don't think it's a silly question to ask if after all this, are people going to save money, or if it's going to cost us more. So it actually seems that your comment is the absurd (and "insane") one.

    Parent

    As for whether it is a silly question (5.00 / 1) (#8)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:19:24 AM EST
    Of course it is not a silly question.

    But to quote people like Bayh and McCain's man Holtz-Eakin for the proposition is ludicrous concern trolling.

    As you well know, I have argued about cost containment at length at this very blog.

    It is the essence of why I have written time and time again that the only worthwhile reform is the public option.

    I have written time after time about the myth of the exchanges, the ludicrous idea that requiring insurance companies to insure person with pre-existing conditions WITHOUT premium caps is absurd and that the ONLY proven method in the United States for controlling costs, premiums and otherwise, is through government run insurance.

    The reason is quite simple - the government has a strong incentive to control health care costs and premiums. No other actor in the industry does.

    It is like you have not been paying attention to the debate.  

    Parent

    That's pathetic of you (none / 0) (#7)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:14:55 AM EST
    Douglas Holtz-Eakin was, of course, McCain's economic point man during the campaign.

    You really are arguing Holtz-Eakin's analysis is independent of politics here? Really?

    Sheesh.

    Parent

    An article quoting (5.00 / 1) (#4)
    by lilburro on Thu Nov 12, 2009 at 08:06:16 AM EST
    Wyden, "Mr. Exchange," a conservative economist, and a knuckleheaded showboat centrist Senator, does not give me confidence that this question is truly being asked.  I mean, Evan Bayh, who is married to someone in insurance, actually cares about this question?  Of course not.

    Plus you did not excerpt this

    Gruber, the favorite economist of the White House, said the bill "really doesn't bend the cost curve."

    "But I think this bill starts us down the road to the point where we can do that," Gruber said. "The alternative is doing nothing. Relative to doing nothing, I think we are a lot closer to bending the curve."



    Parent
    Yes, of course (none / 0) (#6)
    by jbindc on Thu Nov 12, 2009 at 08:13:24 AM EST
    that's what the WH is going to say.

    The point is - NO ONE ACTUALLY KNOWS.  

    Parent

    The White House? (5.00 / 1) (#9)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:24:51 AM EST
    Wait, weren't you touting Gruber just a second ago?

    BTW, the reason a lot of people are insistent on the public option is precisely because they believe it is the only cost containing reform in the entire plan.

    Village Wonks believe the excise tax is the cost containment. They once even argued the exchanges would provide cost containment. But at this point, everyone paying attention knows that the public option is the only road to cost containment.

    Citing a Politico piece with "concerns" from anti-public option Senator Bayh and an advisor to anti-public option Senator McCain is the very definition of concern trolling.

    If these people REALLY were concerned about cost controls, they would support not just a public option, but a robust public option (Medicare +5) with wider availability.

    The fact is they do not care.

    A much more convincing link that would demonstrate a sincere concern about whether this bill can work over the long haul would be to Kucinich and/or Massa.

    Bayh and Holtz-Eakin? Puhleeeeeaze.

    Parent

    and of course (none / 0) (#13)
    by lilburro on Thu Nov 12, 2009 at 08:39:23 AM EST
    the cherry on top being that the only PO sympathetic Senator quoted is Wyden, who as we all know mostly believes in the exchanges more than anything else.

    Parent
    The real gall is (5.00 / 2) (#17)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:53:49 AM EST
    the ignoring of the fact that the robust public option is clearly the most effective cost containment proposal that was considered.

    The very proposal vehemently opposed by Evan Bayh, "champion" of concern here.

    It's not like Bayh is going to look at a study (BTW the CBO already did a study of the RPO and it showed it did the best job of cost containment) and then say 'Ok, now I am for a public option.'

    He is a lying snake.

    Parent

    Right (5.00 / 1) (#19)
    by lilburro on Thu Nov 12, 2009 at 09:01:16 AM EST
    the only people asking the question, contrary to what jbindc says, are the progressives in favor of a very strong public option.  They are the only people who care.  

    Now, progressives in Congress need to own that and of course I would love for Obama to do that but he seems to find the FDR model irrelevant.  That's an issue, but the question being asked at all is not the issue.  As you say that was always there, and I don't think you were unduly harsh on jbindc - I think this was clearly a disingenuous article.

    Parent

    Well no. (none / 0) (#33)
    by Samuel on Thu Nov 12, 2009 at 09:54:39 AM EST
    A lot of people that aren't "progressives" have expressed concerns over cost.  


    Parent
    If that's the case (none / 0) (#31)
    by Samuel on Thu Nov 12, 2009 at 09:49:15 AM EST
    then can we get a public option food distributor?  ...save us all some money.  Haha.  You see the private food companies are screwing us at the register - but the government can negotiate those prices right down.  

    Seriously though - what actual evidence is there that creating a taxpayer funded insurance policy available for anyone to join at anytime is the best approach re "cost containment"?  


    Parent

    One of these days (5.00 / 4) (#34)
    by Steve M on Thu Nov 12, 2009 at 09:55:04 AM EST
    libertarians will discover the concept of market failure, and all 12 of them will have their lives turned completely upside down!

    Parent
    Heh (5.00 / 1) (#35)
    by Big Tent Democrat on Thu Nov 12, 2009 at 09:57:25 AM EST
    Haha (none / 0) (#38)
    by Samuel on Thu Nov 12, 2009 at 10:02:27 AM EST
    Yea and you can fall off a bike while riding it.  I take it that you're backing some type of "failureless" system.  Anyway, answer the original question.  Thanks.  

    Parent
    Will that be the same day... (none / 0) (#41)
    by kdog on Thu Nov 12, 2009 at 10:16:25 AM EST
    big govt. libs discover the concept of central planning failure?

    Sh*t, all the theories of governing economies are disasterous if taken to the extreme...the rub is to find the right balance and borrow from all of 'em...and I hope we find the right balance!

    Parent

    Come now (5.00 / 1) (#44)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:20:37 AM EST
    Steve N makes the point that the health insurance "market" has failed. something that not only libertarians fail to acknowledge, but mainstream Democrats.

    Central planning is a Communist policy, not a liberal policy.

    You sound like Joe McCarthy or Rick Perry.

    Parent

    I acknowledge... (none / 0) (#50)
    by kdog on Thu Nov 12, 2009 at 10:46:43 AM EST
    the healthcare market has failed some of the consumers, if not most...for others it has suceeded, like congresspersons and millionaires.  Like a rigged market should:)

    If central planning is communist-only policy, our government must be overrun with commies who just call themselves libs.  I mean isn't that what we've been talking about for months? How much of our healthcare system should run through Washington?  aka be centrally planned?


    Parent

    Indeed (none / 0) (#55)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:58:31 AM EST
    You make the point that the argument for central planning of health insurance is what some have been arguing for.

    It has never been a seriously considered part of the debate.

    So unless you are prepared to argue that liberalism means Kucinich, Weiner, Massa, and Sanders and nothing more - then you will have to rephrase your statement.

    Parent

    But aren't there degrees of central planning? (none / 0) (#61)
    by kdog on Thu Nov 12, 2009 at 11:18:03 AM EST
    Totally centrally planned right down to state-run hospitals, central planning of payment processing only like single payer, option of centrally planned coverage a la the "public option"?

    Parent
    You say that as though (none / 0) (#63)
    by Samuel on Thu Nov 12, 2009 at 11:28:47 AM EST
    health care and health insurance are not already two of the most heavily regulated industries in this country.  

    Central planning is the alternative to allowing a price mechanism to allocate goods and services.  Current "liberal" policy seems to favor abandoning the price mechanism and replacing it with bureaucracies.  Saying that the free market is ill-equipped to provide goods demanded relative to a centralized distributing bureaucracy whose funding is non-voluntary has to sound a little communist...come on.  

    Saying kdog sounds like Joe McCarthy sounds like Joe McCarthy.  


    Parent

    "Steve N makes the point that" (none / 0) (#73)
    by sarcastic unnamed one on Thu Nov 12, 2009 at 02:02:35 PM EST
    Steve N makes the point that the health insurance "market" has failed.
    And both he and you are assuming facts not in evidence, but, if you say it's "failed" enough times, I'm sure more and more people will believe it...

    Parent
    Big government doesn't fail (none / 0) (#43)
    by Steve M on Thu Nov 12, 2009 at 10:19:28 AM EST
    it's just that it's never really been tried!

    Parent
    In the health care market (none / 0) (#45)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:21:17 AM EST
    this is certainly true.

     

    Parent

    State debt financing has been around (none / 0) (#66)
    by Samuel on Thu Nov 12, 2009 at 11:35:12 AM EST
    1000's of years.  It never works out.  This plan guarantees 1.2 trillion over 10 years, which can be assumed to be minimum of 4 trillion (look at other budget projections).  We do not have that money.  This is a power grab.  

    Also that reasoning is questionable: "hey should we spend 4 trillion dollars?"  "yea, i mean one has ever tried and the results will be unrecoverable so why not?".  

    Parent

    I'm not touting anything (none / 0) (#14)
    by jbindc on Thu Nov 12, 2009 at 08:42:56 AM EST
    My point was that in this whole debate, between soundbites, and abortion amendments, and death panels, etc., this seems like a fundamental question - if we pass this bill, is it actually going to save people money?  The fact that no one knows the answer (even Obama's advisors) is troubling.  I'm not saying I'm surprised by this, but this is the story that should be headlining every newspaper, not, as you seem to be suggesting, that I agree with Evan Bayh and John McCain and I want to kill HCR, or as andgarden suggests, that I agree with "insane" premsises,  blah, blah, blah.

    No, I want more people asking this question, because frankly, history has shown us, that those who make the laws, don't really ask this question enough, and end up passing legislation that doesn't really help the American people.  We need health care reform - we aren't really getting that in what's been presented (and passed in the House) thus far. So, yeah, I'm a little hesitant to be all rah-rah for something I know will look good on paper and is going to be a complete and utter disaster, and I'm not going to apologize for applauding when someone asks the question, "Is this really going to help?" Even if it comes from Evan Bayh or John McCain.

    Parent

    You touted that article (5.00 / 1) (#15)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:46:59 AM EST
    And the entire raison d'etre of the single payer/public option is to make health care more available and affordable, for everyone.

    Honestly, did you really miss that part of the debate?

    Parent

    Oh, I think someone has been asking (5.00 / 4) (#10)
    by Cream City on Thu Nov 12, 2009 at 08:31:05 AM EST
    that question for a while now.

    The American people.

    For one, they must have been asking it even in the campaign, or why would Obama -- in a cautious and carefully strategized campaign, have given that answer?

    Now, I would not necessarily trust an answer from Bayh or others noted here.  But that does not negate that it is a good question, and I will look forward to an answer from the CBO.  (Or are some here saying that the CBO is stupid? biased? Or ?)

    Btw, the American people must have had another question in the campaign, because they also were repeatedly told that their coverage would not change.  That they would have the same doctors, the same conditions covered, etc.  A lot of the concern lately from some of them, including some in the House, appears to be about whether that answer changed -- in recent votes they cast.

    Personally, to make a good (repeat, good) health care bill happen, I could give up a bit of coverage, if I could choose which part I give up.  I could even be willing, despite my pay cut, to pay more for others to get more care or care at all.  But I want to know which conditions I will pay for out of pocket now, and I want to know how much it will cost me and us all.  These are not bad questions.  After all, they were good campaign promises.

    Parent

    The CBO is certainly not expert (5.00 / 1) (#12)
    by Big Tent Democrat on Thu Nov 12, 2009 at 08:34:53 AM EST
    on effects outside of government expenditures and revenues.

    Economic modeling is an interesting field, but certainly not precise.

    It is particularly imprecise in an area of untested assumptions.

    We do have some real world evidence on the effect of exchanges on premium prices and the effect of government run insurance on health care costs.

    The evidence is overwhelming that exchanges do not lower premiums and that government run insurance does lower health care costs.

    It is the essential argument that surrounds the public option/single payer issue.

    Parent

    We will hope that Bayh knows that (none / 0) (#69)
    by Cream City on Thu Nov 12, 2009 at 11:59:23 AM EST
    and at least the CBO would be providing its sense of part of the answer, the government-expenditure part.  And then we will hope that others we trust will factor in that and come to the fore with a fuller answer.  And then, if these are good answers in the public opinion, the polls will show a rise in support again for a health care plan.  And then the Dem pols may do it.  

    Parent
    Here is (none / 0) (#20)
    by Steve M on Thu Nov 12, 2009 at 09:06:03 AM EST
    one part of the bill that I'm pretty sure will save money.

    Parent
    That is begging for (none / 0) (#22)
    by Big Tent Democrat on Thu Nov 12, 2009 at 09:09:04 AM EST
    regulatory capture.

    I find that provision to be rather a joke to be honest.

    Parent

    I cannot find (none / 0) (#36)
    by Steve M on Thu Nov 12, 2009 at 09:58:29 AM EST
    the provision in this bill that is immune from regulatory capture, but I think that provision might be less prone to it simply because consumers are directly affected.  In other words, no one really cares when a Republican appointee loosens regulations on a given industry, but if people would be getting a monetary rebate but for a particular loosening of the rules, that's an issue a politician could actually run on.  I believe there would be accountability at the ballot box.

    Parent
    The public option (none / 0) (#54)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:56:15 AM EST
    is the provision not susceptible to regulatory capture.

    Parent
    First 40 pages or so (none / 0) (#65)
    by Inspector Gadget on Thu Nov 12, 2009 at 11:35:08 AM EST
    Text of HR 3962 starts at page 3.

    From what I can tell, the restrictions on premium increases begin Jan 1, 2010. Private insurers who want to raise premiums must file a request and justify the need.

    I wish I had time to study it.

    My congressman, Jay Inslee, sent me a long email describing his role in the design of the bill and his confidence in its value. I trust him. He and Jim McDermott gave Nancy Pelosi a tour of Seattle's Swedish Hospital on Monday to show her the model they are using. Personally, I think people will be happy with this bill as a first step.
     

    Parent

    Justification (none / 0) (#71)
    by waldenpond on Thu Nov 12, 2009 at 12:33:54 PM EST
    Just as the banking industry.... a few insurers own the majority of the market.  The justification for increased premiums is they, as the banking industry, are too large to fail.  They will get every increase they demand as investors would bolt if the investors did not get an increasing return on their investment.  This country operates as a corporate oligarchy.  It's the politicians job to protect the market.

    Parent
    Gail Collins writes silly stuff (none / 0) (#23)
    by Militarytracy on Thu Nov 12, 2009 at 09:13:51 AM EST
    Jon Voight and Hannity don't get to vote in the Senate.  And Bob Kerrey can't ban you from Nebraska.  His first wife is a member of my family. If saying bad things about Bob Kerrey could get you banned from Nebraska my family would be in deep deep trouble.  Especially Uncle Ben who is a Conservative and NEVER liked him, and documented every stupid thing Bob ever did when he was drinking.......or say investing with partners :)

    BTD (none / 0) (#26)
    by Jlvngstn on Thu Nov 12, 2009 at 09:27:30 AM EST
    Do you not believe they will push it through reconciliation if they cannot get the votes?  Perhaps i am naive but I think Barack Obama needs a victory here (despite his arms length distance) and will have to make sure it passes one way or the other.

    A year long battle with a major loss combined with a crappy economy will surely cripple him and damage the party as a whole.  Am I naive to believe that it is not about the greatness of the bill rather the need to pass something?

    I guess that is why i believe that Jlieber knows it will go through recon because politically it has to......

    I think they will jettison the public option (5.00 / 6) (#27)
    by Big Tent Democrat on Thu Nov 12, 2009 at 09:29:00 AM EST
    And I think the progressives in Congress will cave.

    I hope I am wrong. But that is what I think will happen.

    Parent

    thanks (none / 0) (#28)
    by Jlvngstn on Thu Nov 12, 2009 at 09:30:20 AM EST
    i was afraid of that....

    Parent
    At the risk of getting my head bit off, (none / 0) (#40)
    by HenryFTP on Thu Nov 12, 2009 at 10:12:36 AM EST
    what I don't understand is why the House bill version of the public option is so timid. I understand (even if I don't agree) with the arguments about Medicare + 5% rates being "unacceptable" to rural health providers (highlighting the utter lack of true concern in the Village about health care costs), but the real driver on cost containment was always going to be good old-fashioned competition, given that the public plan would start with a 15-17% edge over private plans in costs. But the House bill sabotages the ability of the public plan to compete by severely restricting enrollment. Surely there is no policy or even "optical" reason to prevent employers from choosing the public plan or, in cases where employers offer cafeteria choices, making the public plan one of those choices. A good place to start would be the Federal Employees Health Benefit Program, with its 8 million participants.

    Given that the public plan now will have to negotiate rates like any other plan, why should employers be barred from contracting with it? With an "open enrollment" approach, no one can complain that the "Government is taking away my health plan".

    Is there any reason Congress isn't permitting the public plan to compete on a level playing field other than protecting investors in investor-owned insurance companies?

    Parent

    Didn't have the votes for it (none / 0) (#52)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:55:31 AM EST
    This is simply not true (none / 0) (#39)
    by vicndabx on Thu Nov 12, 2009 at 10:07:53 AM EST
    The reason is quite simple - the government has a strong incentive to control health care costs and premiums. No other actor in the industry does.

    Larger point about costs is, the only reason the public option would work is it creates a reimbursement ceiling and forces that upon providers.  The hope is providers accept this by nature of the fact that there's no other means to get money in their coffers.

    The fact is, the gov't can come up w/a reimbursement scheme that doesn't involve them offering their own plan and see the same results -lower costs for all involved.

    It simply Is true (none / 0) (#46)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:23:59 AM EST
    Medicare holds down health care costs.

    The reason is the government does not want to raise taxes nor does it want to cut services.

    Your "only reasons" are driven by the government's incentives to hold down costs.

    Finally, "a government reimbursement scheme" that does not involve a government insurance plan? What would they be reimbursing pray tell?  

    Parent

    You're right it does (none / 0) (#48)
    by vicndabx on Thu Nov 12, 2009 at 10:42:02 AM EST
    Medicare holds down health care costs

    by reimbursing at rates substantially lower than private insurers (coincidentally, this is the reason why you need Medicare +5 - to entice providers onto the PO plan's network.)  It also does this by not doing any review whatsoever of whether services rendered are applicable/necessary/warranted.  Hence the term "fee for service."  There's less staff looking at what is actually getting paid and why.  Surely you don't expect this to continue under HCR.

    By government reimbursement scheme, I was referring to expanding the scope of what CMS already does in determing both covered services and reimbursement fee schedule.  Extend it to/include private insurers.  Why can't insurers do your Medicare +5 w/o the gov't?  They do Medicare +15-20 now.  They have the leverage in terms of subscribers now you hope will accrue to the PO later.  

    Parent

    Why indeed? (none / 0) (#51)
    by Big Tent Democrat on Thu Nov 12, 2009 at 10:55:03 AM EST
    The fact is they do not.

    Parent
    They do not (none / 0) (#57)
    by vicndabx on Thu Nov 12, 2009 at 11:05:38 AM EST
    for the same reason we are now talking about bills that have negotiated rates instead of Medicare +5.

    Parent
    Not clear what you mean (none / 0) (#58)
    by Big Tent Democrat on Thu Nov 12, 2009 at 11:07:04 AM EST
    The current system (none / 0) (#60)
    by vicndabx on Thu Nov 12, 2009 at 11:14:02 AM EST
    gives providers a lot of leverage - you want them in your network so you can offer savings to your customers in terms of reduced out of pocket expenses.  Didn't the Senate committee produce a bill w/Schumer's negotiated rates?

    Parent
    Not necessarily true. (5.00 / 1) (#62)
    by MileHi Hawkeye on Thu Nov 12, 2009 at 11:24:13 AM EST
    Individual providers lack any significant clout in the negotiations with Health Carriers.  If they don't accept the contractual terms, they don't get the patients.  No patients, no $.  

    This is especially true in areas where the market is controlled by one or two carriers.  

    Parent

    Well, I can't speak to what the rates are (none / 0) (#67)
    by vicndabx on Thu Nov 12, 2009 at 11:36:11 AM EST
    specifically, but you would agree they are higher than what Medicare reimburses, yes?  They can also just charge the patient up front and tell the patient to get reimbursed from their insurance company - whatever that may be.  A more accurate statement would be they don't get the negotiated rate patients - which may or may not work out to their benefit.

    Parent
    21st Century Justice.... (none / 0) (#72)
    by kdog on Thu Nov 12, 2009 at 01:11:12 PM EST
    the Facebook alibi...maybe this social networking stuff ain't all bad, it sprung this innocent man from Rikers.