Bait and Switch on Public Option? No, The Sky Really Isn't Falling
One of the things I've learned from my many years in journalism (and yes, even my short stint as a political staffer) is that when legislation is first proposed, people throw a bunch of crap on the wall and duke it out over the details. You know why they say it's like watching sausage being made? Because it's stomach-churning.
Several bloggers linked to this. They're taking the article in good faith and assume it's accurate in its conclusions (that the public option has been gutted and the idea of "reform" amounts to a bait and switch), and I just don't believe that.
The author doesn't even seem to understand how legislation is made. It's kind of like judging the way a finished room will look by painting a stripe on the wall: It's not the whole picture.
The bills are usually weakened at this point in the process - but they're fixed later in committee. One of the reasons it still works like this is so politicians can say, "I voted against that!" if part of a bill becomes controversial in his or her district. (Remember the thing with Kerry, where he said, "I actually did vote for the $87 billion before I was against it"? He's right. All politicians do it.) Some of the same politicians who are screaming on the teevee against this will be a lot more reasonable once the cameras aren't running. The final committee work is what counts.
So really, the sky isn't falling. I would tell you if I thought it was. I mean, I'm not exactly known as Obama's biggest booster, am I?
I'd rather ward off the attacks from the insurance companies and the Blue Dogs instead. It's no secret that I think single payer is the best solution - but I'm not going to try to poison this compromise bill to prove a point.
The next best thing to single payer is structural change that really makes people understand and support the concept that health care can and should be accessible to everyone. This bill will do that, and we can improve from there.
I'm actually shocked to find the more I look at the long-term strategy here, the more I like it. The fact is, it will be a lot more politically difficult for members of Congress to vote against those future incremental improvements than to vote against the entire plan now. Once it's in place, and constituents start calling their elected officials with complaints about flaws in the bill, they're going to have to fix those problems - or at the very least, not get in the way of the solution.
Remember: Social Security only covered about half of the people when it first passed. It took almost 10 years to get there, but you couldn't take it away now. The voters would be furious.
We won't get there overnight, but this bill will at least be a decent start.
Thanks Susie for your comment. I want single payer too and have argued against a public option many times. However, I understand that we must get something moving which involves getting the legislation out of subcommittees.
Keep fighting!
that cheese looks good
get in line?
... after all it's the second mouse that gets the cheese!
in any event. Exactly how big does he have to fail to lose his job??
and how big does he have to be to be too big to fail?
"Government by organized money is just as dangerous as Government by organized mob"
-= Franklin Delano Roosevelt =-
The "fight" this Democratic "leader" put up for the President was shameful. He's gotta go...only the Republicans will miss him.
don't let the ruling class and the wing-nuts out-shout us. The congress will cower to the ruling class if that's all they hear from.
easy as pie...
"Government by organized money is just as dangerous as Government by organized mob"
-= Franklin Delano Roosevelt =-
One of your best, Ms. Madrak. Given current circumstances, I couldn't add more.
If the democrats were not worried about what they putting in the health bill , then they would give the American citizens the details as they developed. I don't believe a word which comes out of the mouth from these republican democrats..
The White House announced an agreement with three associations representing the hospital industry to cut Medicare and Medicaid payments by $155 billion over ten years to help finance efforts to extend health coverage to all Americans. The payment reduction agreement would take effect only if it is part of successful health reform legislation.
But lets not bring back the tax on the upper income level which Bush's administration gave to them..
Of course this is another campaign that Obama made and now is not keeping..
Face it we no longer have any democrats in the government that are working for their voters or American citizens. Democrats like Kucinich are censored and when their election comes up the democrats even try to find someone to replace him like they help Lieberman win over Lamont in the senate race in 2006.
Democrats wish to replace all progressive democrats with centrist democrats and they are doing a good job of this..
Then Obama claims they will cut unnecessary tests.. Claims doctors have too many tests.. The Doctors most of the time do not know a d... thing without a test..
Obama also claims we will be forced to buy the high prescription drug from American which are at least Twice as much as they are in other countries..
We can see how Cheney was denied tests when he was in office.. Cheney carried his personal doctor a arms length all the time..
Can't not say they sleep together ,, cause Cheney carry a shot gum with him at all times.
None
and it involved drug costs. I said I would research the cost of a drug for high blood pressure named ramipril (2.5 mg.), which is the generic for Altace. I instantly discovered that the cost for this drug, per pill, was between .16 cents to $1.58 through mail order. How can this be? Which price will you be charged if the purchase of drug coverage becomes mandatory? If a drug can be sold (by Costco) for 16 cents per pill, what justification does any other company have for selling it for $1.58 per pill. WTF?
Good. You found your answer. If I recall, you pay for your drugs with cash. Are you able to get those 16 cent pills? I hope so.
And welcome to the world of for-profit health care.
Your question is a bit silly. What is the justification of the store down the street charging $2.99/pound for hamburger when Costco sells it for $1.99/pound?
Seems to be the way to engage. Heaven help we face up square against vested HMO's, or worse yet, move to Frayance!!
Good to read something that isn't totally depressing on this subject, for a change.
There are only a few fundamental constants that ring true from the beginning of this country to the present.
1. Working people have to fight for justice. No one gave freedom to the captives, or let women vote, or blessed workers with the right to organize. People had to die to get justice.
2. Human life comes in second to business interests. Especially minority and female life.
3. American politicians respond to direct pressure. If enough people make a racket they will respond. No matter how corrupt and hateful they are, their political survival comes before EVERYTHING!
Medicare, which is single payer, went into effect eleven months after being signed. Having this purported 'public option' start AFTER two election cycles, in 2013, is flim flam in and of itself.
I am a aghast at the inclination expressed over and over again on this page to accept such a completely LAME bill.
Single payer is the only way. We are the only 'advanced' country without it.
---
As for HOW legislation is written, it is written BY the corporations FOR the corporations.
This government is for sale, CHEAP.
statusquObama, change you can only pretend in
This is a lot like software development. It will take a long time to write and debug the legislative program, because they have to see how it plays with all the other factors. It will be FULLY implemented by 2013.
But in the meantime, some very good things will go into effect immediately - like the prohibition against rejecting people for preexisting conditions. That will be a lifesaver for so many people.
The reality is, we have a Democratic president, House and Senate who are HIGHLY unlikely to support anything that's openly radical. To them, this compromise is radical enough.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
I am not buying it.
statusquObama, change you can only pretend in
in ultra slow motion.
.. that I don't think anyone has considered yet: it will remove some of the incentive for companies to replace full-time workers with part-timers and self-employed contractors. Because after all, if they were honest they'd admit that they hire that way to avoid the cost of benefits.
I believe it will greatly improve efficiency in the workplace to have people who have been on the job long enough to know their way around the shop. The way it is now even the full-time workers are often in jeopardy of dismissal under pretext soon after they qualify for full benefits. There's even a euphemism for such experienced employees: those who have "exceeded the company's expectation of loyalty."
"In theory theory and practice are alike. In practice they are very different."
In order to understand what Americans face when they purchase health insurance in the individual market, Families USA surveyed all state insurance departments and compiled information on the laws that each state has in place to protect consumers. On page 4 there is breakdown by states.
http://www.familiesusa.org/assets/pdfs/failin...
Here are the highlights of the report:
In the vast majority of states, insurance companies are permitted to reject individuals for coverage based on their health status, occupation, or even their recreational activities.
- Only five states prohibit all insurance companies from cherry-picking the healthiestconsumers and excluding everyone else.
- If an insurance company does accept an individual’s application for coverage, few states significantly limit how much an insurer can increase an individual’s premiums based on what the insurer deems to be health risks (which can include anything from cold sores to hobbies to below average height)
- In 35 states and the District of Columbia, there are no limits on how much insurers can vary premiums based on health status. An additional six states have limits that still allow dramatic variations in premiums.
- Insurance companies will not necessarily provide coverage for the very health services individuals need when they sign up for a policy.
- In all states, insurance companies are not obligated to cover pre-existing conditions for most people for at least the first six
months that an individual has a policy.
- In 21 states and the District of Columbia, insurers can exclude coverage for pre-existing conditions for more than one year.
- In eight of those states and the District of Columbia, insurers can exclude coverage for pre-existing conditions for the duration of an individual’s policy.
- Not every state ensures that premiums are reasonable by reviewing premium rate increases before insurers impose them. And few states require that at least 75 cents of every dollar collected in premiums be spent on medical services rather than administration and profit.
- In 20 states and the District of Columbia, insurers can set and raise premiums without adequate oversight.
- In 45 states and the District of Columbia, insurers can spend less than 75 cents of every premium dollar on medical services.
- In the majority of states, insurance companies can move to limit or revoke an individual’s policy long after it was purchased by claiming that the policyholder did not adequately
reflect his/her medical history on the application. Oftentimes, this leaves individuals with huge medical bills that must be paid out of pocket and no recourse.
- Insurers in 29 states and the District of Columbia are allowed to look at a policyholder’s medical history and perform medical underwriting months, or even years, after they issued the policy.
- In 44 states and the District of Columbia, insurers can revoke an individual’s health insurance policy without advance review by the state.
You will not get a bill that everyone likes, but at least by getting a bill you start the process and this the most important factor. Like in Massachussetts you try to get everyone covered, which may increase the costs, but then because no one will want to lose their coverage you have set-up a system were there is a huge much larger incentive to pound down costs.
Krugman also makes the point that the $1 trillion cost over 10 years only represents 4% of expected total healthcare costs over the period. You then have the other 96% of the costs which you should be able to pound down to make up for the extra 4% of costs to cover everyone.
For much of the 20th century, Sweden had a single-payer system of health care in which the government paid almost all health care costs. Like other nations with a single-payer system, Sweden has had to deal with the problem of ever-growing health care expenses causing a strain on government budgets. It has dealt with this problem by rationing health care - instituting waiting lists for medical appointments and surgery.
..and frankly I don't want our health care system to pay for everything, no questions asked.
For instance:
One thing we're often criticized over is wait times for things like MRI and PET scans. But here's the thing; those very expensive scans are not therapeutic or curative, they are diagnostic procedures with no real health benefits. They MAY help your doctor determine a course of treatment, but a lot of the time (and way more of the time in your system, where there are a lot of malpractice lawsuits) they are ordered by physicians more as a CYA than anything else - they merely serve to confirm what the doc already knows.
"In theory theory and practice are alike. In practice they are very different."
I worked in the medical imaging industry and manned booths at RSNA for 4 years. "Scans" are officially called "modalities", but many radiologists called them "scams", for exactly your reason: they are vastly overused, and oversold, e.g. GE Medical's exhibit at RSNA cost $4M for 4 days exhibit on a show floor.
I worked in high tech for 30 years, went to a lot of computer conferences, but I never saw big money until I worked in medical. I assume defense would be even bigger and more wasteful, but I avoided that. I know where your medical dollars are going, and to be quite honest I got some of them from stock options when my company was acquired. So medical "been very, very good to me."
Social Security is in trouble
Pensions are in Trouble
Health Care is in Trouble
The Economy is in Trouble
Jobs are in Trouble
never mind I'll be here all day at this rate.
If there is one thing Barack Obama has is his ability to put words together to motivate, inspire, and look good while doing so. He has been front center on the American stage since he's been in office. Six months in the honeymoon is over and the issues are consistently complex and at times filled with negative attacks unrelated to the issue being addressed. In short, the pressure is on. Yet, Obama, like all others, is only human.
First off, why would the president continue to be so predictable the media becomes critical when they don't get what they have been talking about for most of the day prior to the president's televised appearance? At some point, just to avoid being attacked on his attempts to solve our nation's issues, it might not be the best idea to broadcast his intentions to the Republicans and the right-wing media.
This president is not America's "song and dance man." He does not have to thrill, impress, and pour his heart out every time he speaks to the American people. At some point, he must conserve his efforts for the 4 or 8 year hull. I am surprise this president has held up this long without trying to pace his efforts.
If this president is going to stay on his own schedule, he has got to stop reacting to the press or conservative media.
More to Come
Joseph
I'd rather have single payer, too, but the public option is perhaps a gradual move toward it. If it works as well or better than private insurance at a lower cost, it will certainly give lie to those who LOVE to claim that government cannot possibly administer a health plan effectively or efficiently. They say it even when Medicare and Medicaid are the examples in the US to look to, never mind other countries.
I've also been involved in the legislative process as a health-care advocate. My experience has always been that you lead with more than what you expect. That's the only way that you're going to wind up with something that you can accept.
The Democratic "leadership" knows how to play politics. Since they forced single payer off the table from the get go, maybe they're actually just fine with a lousy plan. What do you think the health care industry pays them for? "It isn't surprising that politicians can be bought, it's that they can be bought for so little."
I agree with you. There are many, many people still harping over single payer. I would love single payer, but I am realistic, it is hard enough trying to get this passed through, forget single payer. Unfortunately, too many people equate single payer to socialism.
There is no way, we will get everything with the first health care bill, but there has to be a beginning. Then as with all bills, as time passes it can/will become better.
agreeing to this before they know what is in it? I do not understand this!
Thank you. A thousand thank yous. We've never been closer to getting a huge start on real health care in this country, and people are willing to throw in the towel because Reid caved to the August deadline or because the public option MIGHT not be there the way we want (I'm praying it will be).
I esp love your reminder about social security. Hard to believe in only covered half the people for the first decade. We are not going to get everything we want, not even close. But we are going to be further along the continuum than ever.
How's that? What is in the public option that you like?
That's easy, it's like going to the Post Office. You know you that your money is being used reasonably efficiently, meaning none of it is used to make profit, to pay rich investors and overpaid CEOs.
Better yet, without the profit motive, the Post Office is not trying to overcharge you; there is not motivation to do so, profit is not part of their "mission statement".
Similarly, without a profit motive, unlike all private insurers, a public plan will not have staff whose job it is to deny you coverage.
The only reason the U.S. doesn't have a Single-Payer Health Care system is...Link
Call Congress and the White House and demand,
MEDICARE/SINGLE-PAYER TYPE HEALTH CARE FOR ALL NOW!
I am pledging $1000 toward any fund that works for the passage of a public option; see below. I welcome others to pledge their own amount, and use the below as you like. If there is such a fund, or you're legit and you want $1000 to start such a fund, let me know.
I am 59 and a resident of Massachusetts who is forced to buy for-profit health insurance; the last paragraph is real.
I have emailed this pledge to my Congress reps, but most others will not accept email from outside their district, so feel free to email this or your pledge to your representative.
I do not expect a public option to pass, but I demand that the Dems bring it to a vote. We can then get up enough money to defeat the vulnerable who opposed it and try again, and again after that if needed. Citizens' money beat corporate money in the last Presidential election, and it can do it again. You have to "fight fire with fire", and that means our money versus theirs. Believe it or not, we still have more, for now.
=============================================================
Fact: Medicare is a "government-run", single-payer, national health insurance plan.
Those who oppose offering a similar plan to non-seniors must secretly favor abolishing Medicare, or feel Medicare is adequate for seniors but not others, or support Medicare because it covers seniors, thereby allowing corporations to profit by insuring only those younger, with lower health expenses.
Our Constitution states the United States was formed to "promote the general welfare", right after "provide for the common defence" and before "secure the Blessings of Liberty to ourselves and our Posterity". There is no mention in the Constitution or the Bill of Rights of a right to make a profit.
Therefore, not only is our government entitled make law that benefit its citizens at the expense of corporate profits, it has a Constitutional obligation to do so.
I hereby pledge $1000 to any fund that works to defeat, in future elections, elected officials who oppose or obstruct the inclusion of a "public option" option in any health insurance bill, or who fail to vote in favor of such legislation.
I further recognize that when I or my employer make payments to a private insurer, we thus fund corporate lobbyists who work against a public plan in order to stifle competition, subverting the will of American people for their greater profit. "We the people" have the right, through our government, to band together and jointly insure our own health care. It is the same as the right to form credit unions without interference from banks.
I therefore further pledge to disobey any federal or state law, including the current law of Massachusetts, that mandates that I purchase health insurance without the inclusion of a public, non-profit plan. I reject any government mandate that I fund and reward investors, lobbyists and overpaid CEOs, who not only profit from human misery, but often increase that profit and misery by refusing to pay for needed medical treatment.
I'm with Alice X. Simply change the Medicare eligibility requirements to any resident of the US for over six months. Then tax the businesses at a rate of about 75% of average of what they were paying for their regular health insurance premiums. Slap an increase on Medicare taxes for those making over $250K/yr to pay for the other uninsured people. These are ballpark numbers. But the basic premise is so simple.
How many of the 50 million uninsured are going to wait another 3 years for coverage they will end up being forced to pay for, but STILL, STILL cannot afford?
The people of privilege will always risk their complete destruction rather than surrender any material part of their advantage." J.K. Galbraith
More than likely you will be waiting at least 3 years anyway. Everyone is talking as if we have a health care system today. We do not have a health care system and have never had one. If we did have a system, we would have been able to pinpoint exactly what was wrong with it and discover the inefficiencies. This is the start of a long process that will take alot of tweaking.
Ye of nil facts, we have a system, Medicare, it has 3% overhead and it works perfectly well.
statusquObama, change you can only pretend in
Susie, I haven't any idea how many years you have in journalism, but it doesn't seem like many when you write criticism without any substance. You said:
"The author doesn't even seem to understand how legislation is made. It's kind of like judging the way a finished room will look by painting a stripe on the wall: It's not the whole picture.If you can put together an article half as knowledgeable or half as well written about health care policy or how legislation is passed, I'd like to see it. "It's like sausage," Is neither informative or original. It's lame, really.
Here is the some of the writing and political experience of the person you decided off the cuff to do a hatchet job on. I personally think you owe him an apology or at the very least you might attempt some actual critical analysis of his piece. Did you study journalism, or are you self taught. Do you know what critical analysis is?
About the Author of Bait and Switch
Tell me this Susie; Have you read HR 3200 now that it's been voted out of the three committees? What do you like about the bill (if you have read it) and what don't you like about it? Or have you even read it? Thanks
Steve W
It's really not all that difficult to look at this problem and say, "Here's what needs to be done." The really challenging part is to develop a coherent political strategy that will actually make it happen.
It's much like being an architect. You can design an amazing building - but if the client doesn't see your vision, he'll want something else. Either you quit, or you come up with something else until the client's happy.
That's the legislative process: coming back to the common denominator.
So Kip Sullivan went to Harvard Law. So he's a health care activist. So tell me: what long-shot legislation has he ever shepherded through the entire process to victory?
What possible difference does the content of his bill make if there aren't enough votes to get it through the full House and Senate? Politics isn't about right or wrong. It's about votes, and the horsetrading that goes on to get them.
This is what you don't seem to understand: Really wonderful bills die after being voted out of committee all the time. They're created with the best of intentions and the highest of ideals (well, not really - politicians like to brag they supported something popular when they know there's no chance it will pass.)
But they don't become law. Wishing won't make it so. Hard-nosed strategy will.
If you can't get the votes, the point is moot.
Now, if the members of the Senate are digging in their heels over this relatively mild and pretty damned conservative health care plan, what on earth makes you think they'll wake up one morning and vote for HR3200 instead?
Under what possible scenario will this become law? SHOW ME THE VOTES.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
Didn't mean to say HR 3200.
A former award-winning journalist and lifelong class warrior, keeping a jaundiced eye on the Washington elite.
Those are the people you would be listening to in public hearings to formulate legislation.
Instead in our CAPTURED government, legislation is written behind closed doors by the lobbyists.
It is a done deal before it ever gets to public hearings.
statusquObama, change you can only pretend in
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