The President's Plan

By Big Tent Democrat, Section Obama Administration
Posted on Wed Sep 09, 2009 at 09:11:39 PM EST
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Here. The Progressive Block must do what President Obama did not, advocate for the public option in THE PRESIDENT's OWN PLAN, not belittle it as he did:

[The Obama Plan] [o]ffers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. The President believes this option will promote competition, hold insurance companies accountable and assure affordable choices. It is completely voluntary. The President believes the public option must operate like any private insurance company – it must be self-sufficient and rely on the premiums it collects.

The Progressive Block must fight for the President's own plan for a public option -- because he won't. In fact, he will fight to have it taken out (See Obama's "advocacy" for HIS public option plan on the flip.) UPDATE - I want to be clear on something - I hope and believe the Progressive Block should go out there and THANK the President for his ringing endorsement and unwavering commitment to the public option and promise the President they will never let him down by letting a bill pass that does not have the public option.

Speaking for me only

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I’ve already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

Despite all this, the insurance companies and their allies don’t like this idea. They argue that these private companies can’t fairly compete with the government. And they’d be right if taxpayers were subsidizing this public insurance option. But they won’t be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers. It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

It’s worth noting that a strong majority of Americans still favor a public insurance option of the sort I’ve proposed tonight. But its impact shouldn’t be exaggerated – by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

(Emphasis supplied.) A President committed to his OWN PLAN would not have said the things I highlight. He would argue for why a public option can help EVERYBODY. A President committed to a public option would not act as if whether it was in or out of his bill does not matter.

< Congressional Reaction to Obama's Health Care Speech | Sherrod Brown: Let's Pretend Obama Committed To The Public Option >

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The President's Plan | 51 comments (51 topical)

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Video of Republican yelling LIAR during speech. (5.00 / 2) (#1)
by kevsters on Wed Sep 09, 2009 at 09:17:35 PM EST

Here is a clip of Republican Joe Wilson yelling LIAR!!!

http://progressnotcongress.org/?p=2855

Label it the STD reform act. (5.00 / 3) (#2)
by jeffinalabama on Wed Sep 09, 2009 at 09:18:40 PM EST

after rogering about 300 million folks, he's got to have one.

Well, I wondered if poor leadership was better than none. I must say blue dog corporatist leadership is worse than poor leadership.

"Here's my plan. I don't really support it, so feel free to get rid of it. 'Cause I won't encourage it or ask congress to fund it."

Well (5.00 / 4) (#3)
by Ga6thDem on Wed Sep 09, 2009 at 09:22:30 PM EST

I dont think he's going to fight to have it taken out either. I just see it as more wimpishness where President Snowe has dictated that she doesnt want a public option and Obama is so desperate to pass something, anything he'll now be begging the PC to give up.

Isnt it odd that he always thinks that Dems shoudl be the ones conceding while the crazy GOPer's need to pacified? Of course, this is the beltway mentality so he's all into that.

Actually, I think it was an effective argument to (5.00 / 4) (#8)
by masslib on Wed Sep 09, 2009 at 09:32:01 PM EST

take it out. Not that I am buying the argument, but I think he was arguing it's expendable. Don't blow reform over this, progressives.


I think the compromise to get a bill (5.00 / 1) (#24)
by ChiTownDenny on Wed Sep 09, 2009 at 10:01:53 PM EST

on his desk is he has forgone "robust" public option, but not public option entirely. Incrementalism?


: I took from the speech (5.00 / 1) (#26)
by jeffinalabama on Wed Sep 09, 2009 at 10:06:37 PM EST

that incrementalism means cutting out completely. After I read the text, and watch the machinations of congress, if I see that the public option has to be self-supporting, limited to only five million, I will regard this as a throwaway. The Big Dog was today or yesterday talking about incrementalism.
I have the feeling that Obama wants a bill on his desk, and will then say that he's already dealt with health insurance reform, without any follow-up.

Again, I don't agree (none / 0) (#31)
by s5 on Wed Sep 09, 2009 at 10:34:19 PM EST

I think he's arguing that people should also read the rest of the plan, instead of focusing exclusively on the public option. I think he wants it, he will not bargain it out, and House Progressives must fight for it.

Look at what else he didn't issue a veto threat over. He didn't say, "I will veto any bill without an exchange". He didn't say "I will veto any bill without a mandate" or "I will veto any bill that doesn't cover routine check-ups". Yet he considers those all to be essential ingredients.

I think people are reading this wrong. He wants a public option, and he will get one. But he also wants people to stop fighting over the public option as if it's the only part of the bill. I think that's fair enough.

I'm not the gambling type but I'm willing to bet on this. Bill passed, public option, no trigger, no co-op, all before the end of autumn.


It depends entirely (5.00 / 1) (#33)
by gyrfalcon on Wed Sep 09, 2009 at 11:32:06 PM EST

on whether he's given up on structural reform of the health care system -- which he talked about extensively and passionately when he started this -- and is settling for relatively minor health insurance reform that will get rid of some of the worst abuses of the private insurance system.

That's what it sounds like to me, anyway, and if so, the public option is absolutely expendable. A PO under those constraints and which only 5 percent of people are likely to join will struggle just to maintain itself and will have little or more likely zero impact on private insurance practices.

I agree totally with BTD about the importance of even a crummy PO as a camel's nose under the tent, but at this point it's looking like if we get it at all, it'll be more like half a nostril.


What if the 5% number is wrong? (none / 0) (#42)
by FreakyBeaky on Thu Sep 10, 2009 at 12:57:17 AM EST

15% of the country is uninsured. Where do the other 10% go? Do they all find partially subsidized private insurance preferable? Do they all move to Canada? What if they choose the public option instead?

I'm thinking 5% turns out to be a low estimate.


Private insurance (none / 0) (#43)
by gyrfalcon on Thu Sep 10, 2009 at 01:12:46 AM EST

I think is the idea. I agree with you that it seems low.


: I too think private insurance is the idea (5.00 / 2) (#44)
by FreakyBeaky on Thu Sep 10, 2009 at 01:14:26 AM EST

I just do not see how that can happen though.

They have an effective "veto" over this (5.00 / 1) (#4)
by andgarden on Wed Sep 09, 2009 at 09:23:03 PM EST

So the question is, will they stand up against the President and the "any bill" crowd? I do not think they will. They will wilt, as always.

I agree (5.00 / 2) (#5)
by Ga6thDem on Wed Sep 09, 2009 at 09:24:55 PM EST

and the next two elections are going to be a blood bath.


I will say this (none / 0) (#6)
by andgarden on Wed Sep 09, 2009 at 09:28:05 PM EST

If we're going to have the Baucus plan, I hope it works.


You can (5.00 / 5) (#11)
by Ga6thDem on Wed Sep 09, 2009 at 09:35:21 PM EST

hope but the odds are that it isnt goign to do anything other than make people mad. When will forcing people to buy junk insurnace work in this lifetime? I dont see it.


+ don't forget the 35% co-pay in his bill (5.00 / 1) (#47)
by suzieg on Thu Sep 10, 2009 at 02:29:24 AM EST

Well, that's what's claimed about the MA system (none / 0) (#14)
by andgarden on Wed Sep 09, 2009 at 09:36:22 PM EST

But as I said the other day, the jury is still out.


Well, the jury isn't out on costs. (5.00 / 1) (#17)
by masslib on Wed Sep 09, 2009 at 09:44:56 PM EST

They have risen here faster than the national average, which has everyone arguing, well, it was really just an accessibility plan anyway. Now we'll need to deal with cost containment. And, 40% of the uninsured are still uninsured. 60% are not, I guess. However, the insurers are saying that many are "gaming the system". Singing up when sick, then dropping when well. Then there is the whole Connector thing, where a new study found people spend on average 4.5% of their premium costs on salaries for the Connector. Now the leg is worried about that too. I guess the jury isn't out, but then maybe we should wait to base an entire national plan on it.


I am familiar with your opinion (none / 0) (#18)
by andgarden on Wed Sep 09, 2009 at 09:46:08 PM EST

What does that mean? (5.00 / 1) (#20)
by masslib on Wed Sep 09, 2009 at 09:50:14 PM EST

There are volumes of reports about the shortfalls of the MA reforms. The legislature is talking about the shortfalls. My opinion is that I personally have no access to health care. But, this isn't about my opinion. It's a fact that the MA reforms need a lot of improving. Everyone acknowledges this.


None of this addresses (5.00 / 1) (#22)
by andgarden on Wed Sep 09, 2009 at 09:52:52 PM EST

whether it's better than what came before. THAT is what the jury is still out on, in my opinion. I lean towards yes.


Your all heart. (5.00 / 3) (#25)
by masslib on Wed Sep 09, 2009 at 10:04:35 PM EST

For me, it clearly is worse than what came before. I am actually one of those uninsured everybody says they want covered.

I am for the reforms that expand medicaid, even offer more choices and subsidies for insurance. It may be a band aid, it may be costly. I'm ok with that. but I personally can not live with another mandate I can't afford.

But whatever. This isn't an academic discussion for me. It's life and death.


If you can't afford it (5.00 / 1) (#37)
by s5 on Thu Sep 10, 2009 at 12:02:04 AM EST

Then a subsidy or waiver would be available to you. At least, as the plan was described tonight.

As always, the devil is in the details. But I have a hard time believing that any legislator who cares about reelection would pass a bill that forces people to pay money they can't afford.

And if you're still worried about it, then call and write your representatives. We still don't have a final bill yet. Make sure the bad thing you don't want doesn't end up in the final product.


Well, the legislature in MA did just that. (5.00 / 2) (#39)
by masslib on Thu Sep 10, 2009 at 12:06:12 AM EST

Waivers are great, but it doesn't give me health care. I sort of hoped for that.

You know what, it's very uncomfortable arguing about my real life situation with people who seem to want me to clarify my personal position, or be happy with a waiver when I need health care.

I'm out of here. Enjoy your chat.


Well I hope a subsidy will be available to you (5.00 / 1) (#41)
by s5 on Thu Sep 10, 2009 at 12:23:32 AM EST

Your personal situation is your business, of course, and I hope they set up the math just right so some combination of subsidies and Medicaid will cover people who can't afford health care.

If they don't, give 'em h3ll!


: No, I'm not broke... (none / 0) (#53)
by masslib on Thu Sep 10, 2009 at 09:43:03 PM EST

That's why I don't fit into the subs or Medicaid. I'm make enough to not qualify for subs, and too little to afford the private insurance. I'm in the donut hole.

Why is it worse for you? (none / 0) (#34)
by gyrfalcon on Wed Sep 09, 2009 at 11:37:06 PM EST

Because you now have to buy insurance and you didn't have to before? That's by far the most vulnerable group, one to which I also belong. I flat-out dread the idea of being forced to spend money I don't have for crappy insurance that won't cover me for anything but a complete medical disaster.

But FWIW, a self-employed friend of mine was able to get better coverage for about 60 percent of what she had been paying for health insurance by digging through the options on the Connector. So for her, it's meant a pretty substantial improvement.


: I can't afford the premiums. (none / 0) (#38)
by masslib on Thu Sep 10, 2009 at 12:03:32 AM EST

That's great for your friend, my husband and I can't afford them. It would squash us like a bug financially. Obviously, now I am to pay a fine for not being able to afford insurance, so it is worse I had a lot of high hopes when MA passed their health reforms, and was appalled at the pricing once the Connector opened. I tried to get on the state plan and was denied. I'm happy for your friend, but that's not my situation.

Who? (5.00 / 1) (#7)
by mmc9431 on Wed Sep 09, 2009 at 09:30:22 PM EST

Who in the Progresive Block has the strength, the will, or the national microphone to fight Obama over this?

In spite of what Ezra and a few other's have said, Obama was the only one that could deliver real HCR for the people. Sadly this issue was never a priority for him.

He sure knows how to take the public out of (5.00 / 2) (#9)
by ruffian on Wed Sep 09, 2009 at 09:32:01 PM EST

public option. Does it get any government support at all, or is manning the claims center one of his new faith based initiatives?

Since Obama won't fight for a poor policy... (5.00 / 1) (#10)
by lambert on Wed Sep 09, 2009 at 09:34:21 PM EST

... why not fight for the best one?

Strategery?

You are fighting for no bill (5.00 / 2) (#13)
by Big Tent Democrat on Wed Sep 09, 2009 at 09:35:55 PM EST

I may end up there too.

Single payer is not possible to even discuss this year.

In a sense, you should be thrilled with Obama tonight.


: What a couple of pony haters (5.00 / 3) (#23)
by Militarytracy on Wed Sep 09, 2009 at 09:58:49 PM EST

I'm due a good pony

The only other ideas he wants... (5.00 / 7) (#12)
by Dadler on Wed Sep 09, 2009 at 09:35:34 PM EST

...are from Republicans. That is fact. Ideas from Progressives are less than not wanted, they are pre-emptively disregarded.

It is beyond naive, and into the realm of mental incapacity, to believe the insurance industry is going to stop making their excessive profits without being forced to.

Period.

: That part is nuts (none / 0) (#16)
by Militarytracy on Wed Sep 09, 2009 at 09:38:20 PM EST

I'm okay if he said it to make a point about how effing nuts they all are. Okay, we all saw how nuts they are. But that smack needs to be over with now!

The winger heads on the tube all vowed to (5.00 / 6) (#15)
by Militarytracy on Wed Sep 09, 2009 at 09:36:48 PM EST

go home and prove how the public option is going to cost us tons and tons of money and finish bankrupting the country. They just need to pass this now, be done with it. Ram it right down their throats and eff it. Do the reconciliation thing with 51 votes. It isn't going to get better. Someone wrote into CNN that Bush would have done it in a heartbeat. The more he courts Republicans the more they lose it, hold up bills with code pink style lettering on it, scream at him that he's a liar. It's pathetic.....just do it before someone shows up in all this fricken whacko winger crisis building with a gun and really hurts someone!

The Irony Is (5.00 / 5) (#21)
by BDB on Wed Sep 09, 2009 at 09:52:41 PM EST

that Obama's plan, which has no cost controls that I can see, will cost tons and tons of money. It just won't cost the government the money, it will cost the people the money - but instead of paying taxes to the government for actual coverage of their healthcare costs, they'll be paying taxes to insurance companies for questionable coverage of their costs.

And, of course, there's still the issue of whether the Democrats are really so politically stupid (read: owned by their corporate overlords) that they are willing to tax current health insurance plans to pay for the subsidies to the uninsured.

Hey, the GOP, some of the most power hungry people on the planet were willing to follow their corporate masters until it led to political disaster. So far, I've seen no evidence - based on the bailouts and now healthcare "reform" - that the Dems aren't willing to follow in the GOP's footsteps. I'm beginning to wonder what happens in two years when the Dems are just as discredited as the GOP is - what will rise from the ashes of Versailles?

Because this is starting to look very much like a system collapsing in on itself.


: It is (none / 0) (#40)
by cal1942 on Thu Sep 10, 2009 at 12:14:55 AM EST

starting to look very much like a system collapsing in on itself
It is collapsing and probably nothing will stop it from falling completely apart.
Expect a smaller and smaller percentage of eligible voters to go to the polls. A smaller and smaller number of people will decide elections.
Because of the money in and media coverage of politics don't expect a viable third party and don't expect a new party to be built on the ashes of a crumbling major party.
There is simply too much self-interest built into maintaining the status-quo no matter how damaging the status-quo.
There is a complete separation of elites from everyone else.

Passing (none / 0) (#19)
by Ga6thDem on Wed Sep 09, 2009 at 09:46:39 PM EST

the plan isnt going to stop them. They'll just get madder and madder and then there's going to be antoher OKC or some other horrible tragedy. Only then will they be chastised enough to go away.


ahahaha (5.00 / 3) (#27)
by s5 on Wed Sep 09, 2009 at 10:18:38 PM EST

I love the update to this post, BTD. Brilliant. Yes, that is exactly what House Progressives should do.

House Progressives own the public option now. Whether it passes or fails depends on them.

Does individual mandate survive? (5.00 / 1) (#30)
by NealB on Wed Sep 09, 2009 at 10:25:12 PM EST

At some point (I'm guessing it'll be the last minute), the reality of a bill with mandates and no public option is going to dawn on Democrats in Congress and they'll see that it's a bigger mistake than nothing at all; right? Of course right.

Without the individual and employer mandates, the whole thing unravels. Everything else that's in the bills depends on the mandates. Forcing insurers to accept everyone regardless of pre-existing conditions depends on the mandates. Forcing insurers to end recissions depends on the mandates. Lowering costs depends on the mandates.

But the bottom line is that employers and individuals that can't afford health insurance now won't be able to afford it whether there's a mandate or not; so they won't buy it. If Congress passes a bill with mandates it will fail.

Unless that's the plan from the outset and I've been an idiot to think it was something else. Obama and our Democratic friends are going to finance health insurance on those of us least able to afford it. Why aren't Republicans cheering for this plan?

I'm sorry; I just find myself, still, with (5.00 / 2) (#32)
by Anne on Wed Sep 09, 2009 at 10:49:57 PM EST

more questions, and as I start to formulate them, I get lost in the weeds of other things he has said.

So, Obama now has a plan, is that right? Is this something that has to go through committees first? And can anyone tell me why it has taken this long for him to actually have a plan - assuming that I am right that he has one? Oh, nevermind - I guess I am supposed to be grateful that he came up with something he was willing to put his name on.

In parts of the speech, I felt like he was speaking to the insurance industry - I got a really weird vibe from all the disclaimers about how small and weak the non-profit option would be - but at the same time, it felt like he was attaching a kind of stigma to the public option to keep it a last-resort option for those too desperate to care what people think about them.

And I am completely lost in the concept of the public option having to be self-sustaining - how do subsidies fit into this picture? Am I nuts or would the public option be one of the few things government is involved in that is required to be self-sustaining?

I suppose I fear that even if the Dems could take up a collection and cobble together a spine, could call Obama's bluff on his (less-than-tepid) support for a public option, Obama would simply announce that he never said what he is on record saying, or that it didn't mean what we thought it did - he's done it too many times for anyone to have any level of trust that he can be a man of his word.

I don't know; nothing about this makes much sense to me anymore.

: No plan, no (5.00 / 1) (#36)
by gyrfalcon on Wed Sep 09, 2009 at 11:50:26 PM EST

This isn't a plan, it's a list of things he wants to see in the final legislation. It's still up to Congress, he's just consdescended to be a bit more specific in the goals he's setting out for them.
Re subsidies and the public option, my understanding is that whatever subsidies are going to exist will go to individuals depending on income, whether they choose insurance from the private system or the public plan. That's a separate issue from the PO being "self-sustaining" since the subsidies are for individuals and enable them to purchase private or public insurance as they choose.

Managing expectations, face it:: (4.80 / 5) (#35)
by RonK Seattle on Wed Sep 09, 2009 at 11:47:56 PM EST

Real health care reform was never in the cards in an Obama administration - so what's the point in getting upset about it now?

The speech was Obama on his 'A' game, and it might have revived the potential reform that was in play - a minor but significant race of insurance reforms (coupled with some largely illusory cost containment proposals).

For what it was, it was a great speech.

For what is was not, those horses left the barn and wandering in the desert until they died a long time back.

The one line that pissed me off:

I am not the first President to take up this cause, but I am determined to be the last.

He hasn't taken up the cause, and the fight isn't over.

He declares when it's over (5.00 / 1) (#45)
by BrassTacks on Thu Sep 10, 2009 at 01:47:52 AM EST

Period.


: See below. (none / 0) (#52)
by RonK Seattle on Thu Sep 10, 2009 at 09:41:33 AM EST

First you write (none / 0) (#48)
by weltec2 on Thu Sep 10, 2009 at 05:33:44 AM EST

"Real health care reform was never in the cards in an Obama administration"

Okay, that's Greenwald's argument as well. Is it true? I don't know. I suspect it is. But then you write

"He hasn't taken up the cause, and the fight isn't over."

Huh? Obama is the POTUS. If it was never in the cards, as you say, then the fight is over, isn't it? In fact, the fight never even got started because the final outcome had already been determined.

Aaah questions of determinism versus free will. No... we the public have no free will. That is, we cannot force him to do what he never intended to do in the first place.


: It's pretty much over for Obama (5.00 / 1) (#50)
by NealB on Thu Sep 10, 2009 at 09:09:59 AM EST

He'll sign whatever Congress manages to pass, if anything. But as a post-partisan (meaning conservative), Obama won't fight for a liberal cause like health care reform.

: Obama won't even start. Other P'sOTUS ... (5.00 / 1) (#51)
by RonK Seattle on Thu Sep 10, 2009 at 09:40:27 AM EST

... will start the fight for world-class health care, in another opportune moment, probably after a dormant period of more than a decade.
Obama's interest is in tangential problems of private insurance regulation, and cost containment within the health care industry.
Whether he succeeds or fails in these mild initiatives, that leaves teh ext generation with a system centered on private health insurance, largely employer-based, with a stronger-than-ever private health insurance industry (and lobby).

How are mandates enforced? (none / 0) (#46)
by BrassTacks on Thu Sep 10, 2009 at 01:50:11 AM EST

My unemployed son is going to have to buy insurance, whether he wants it or not. How will the government make him do that?

: The way it works in MA (none / 0) (#49)
by CST on Thu Sep 10, 2009 at 08:45:06 AM EST

is that if you don't have insurance, you pay a fine when you file your state taxes.