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Chris Matthews is getting all hot and bothered because liberals in Congress and from the netroots are pushing hard to get a public option included in health care reform. That's called legislating, Chris. It's a long, hard process sometimes.

The Village really gets upset when dirty f*&king hippies get uppity and speak out on issues that matter. Villagers don't care that America voted in Obama with a mandate on health-care reform. Villagers don't care that America rejected conservatism, which practically caused the world to almost spin off its axis. It's getting to the point that Tweety is pulling stuff out of his pie hole because he hates us so much. And apparently Tweety forgot that "the left" was elected in droves in 2008. "The Left" is not a fringe teabagger, tax evading group, it dominates the House of Representatives. Here he is on Andrea Mitchell talking about Obama and Afghanistan and see where Tweety goes with it all.

Matthews: Everybody is doing their politics here. She represents San Francisco and she represents, I know the Speaker's role. you have to respond to the nosiest elements in your caucus, and the most passionate and apparently, I assume just knowing the Democratic House, the voices she's hearing from every single day are the left who want out. Now this president never promised to get out of Afghanistan. And he's not gonna...

He never promised to pull out, that was the good war, the necessary war. Oh, by the way he never ran on the public option. Somebody's got to tell these people on the left and the netroots and some of our colleagues, yeah, he might like the idea of a public option, he may prefer it. He didn't run on it. He didn't get elected for it. So this idea that he somehow betrayed a left wing mandate is nonsense.

Where to begin. Why is it OK to attack Nancy Pelosi for representing San Francisco? What did they ever do to Bill O'Reilly and Tweety? Aren't they part of the US of A too? That she is from the Bay Area somehow minimizes the fact that she's the Speaker. On Afghanistan, he's right. President Obama did not promises to withdraw from there. That's why we on the left have to put pressure on the administration or we could be there for decades.

But President Obama did campaign on the public option., It was part of his health-care plan that he unveiled in the primaries. I asked Ezra Klein to verify it for me and he did.

Berkeley's Jacob Hacker, who was the first to persuasively articulate it; to the Economic Policy Institute, which fleshed out the specifics; and to the Campaign for America's Future, which took the lead in selling it to advocacy groups and the presidential campaigns. John Edwards picked it up and made it central to his proposal, and the other candidates followed suit to protect their left flanks.

And I found that Paul Krugman has it also.

The idea of letting individuals buy insurance from a government-run plan was introduced in 2007 by Jacob Hacker of Yale, was picked up by John Edwards during the Democratic primary, and became part of the original Obama health care plan.

Tweety needs to apologize to President Obama, the netroots and the liberals in Congress who he just smeared in this clip. We are fighting for real health-care reform in America and not some mythical-bipartisan Beltway compromise bill that is completely useless to all the real working families that the Villagers like to pretend they speak for all the time.

(h/t Heather at Video Cafe)

Ho hum! Another Monday, another story of official indifference to the lack of affordable health care. In the words of Barney Frank: On what planet do these people live?

The affordability question vexing Democrats is whether those with moderate income will be able to afford health insurance, even with the subsidies the legislation would provide and all sorts of new rules aimed at controlling costs.

Because the legislation would require nearly all Americans to obtain health insurance, affordability is a potentially serious political issue. That is particularly so because most people would incur a financial penalty — payable along with income taxes — if they did not obtain coverage.

Senator Charles E. Grassley of Iowa, the senior Republican on the Finance Committee, last week attacked the requirement to have insurance, the so-called individual mandate, as potentially imposing a crippling penalty of $1,500 on a family earning as little as $25,000 a year.

“It’s a pretty heavy burden for low-income families,” Mr. Grassley said in committee debate.

You know it's bad when Chuck Grassley is the voice of the working poor.

Some liberal Democrats are already suggesting that the legislation may not be worth adopting if it will end up forcing Americans to buy health coverage they really cannot afford.

“I am sympathetic, and I understand the concerns, and I appreciate as well the political volatility around the question of mandating or requiring coverage,” said Senator Debbie Stabenow, Democrat of Michigan, who is also on the finance panel. “The big question we have all grappled with is how do you make sure everybody is in, and that’s a tough one. It comes down to whether or not ultimately in this bill we can say this is affordable for people.”

Well, Debbie, I'd say the big question is: Who benefits? I don't doubt your sincerity, but I don't think everyone on the committee sees it the same way you so. Ultimately, is this a billion-dollar giveaway to insurance companies, a balm to the massive egos on the Senate Finance committee, or an actual solution to a very serious problem - namely, lack of affordable health care? I'm guessing the last is not all that important to the boys of the Senate Millionaires Club.

There are two obvious ways of making coverage more affordable, and neither is workable.

One would be to sharply reduce the cost of health care across the board, thereby limiting the cost of insurance. This is a chief aim of the Democrats’ bill, but it would require sweeping improvements in efficiency, including higher-quality, lower-cost treatment and better use of technology — all goals of the legislation, but not about to happen anytime soon.

The other obvious way would be to sharply increase government subsidies to help middle-class people buy insurance. Ms. Stabenow, for instance, has proposed capping the amount moderate-income Americans would have to pay for insurance premiums at 6.5 percent of income, with the subsidies paying the balance. The legislation now sets that cap on premium costs at 12 percent.

But President Obama has already sealed the top of the affordability box, telling everyone in his speech to Congress on Sept. 9 that he will not accept a health care bill that costs more than $900 billion over 10 years. And subsidies are already the biggest-ticket item.

Because after all, maintaining all those wars is expensive! Gotta prioritize here!

Some top White House officials, however, see a third way, a potential escape hatch: exempting more families and individuals on the basis of income from the penalty for failing to buy insurance, a fine that for families could run as high as $1,900.

The bill proposed by Senator Max Baucus of Montana, the Finance Committee chairman, would waive the penalty if the cheapest insurance, even with subsidies, would cost 10 percent of a family’s income.

Lowering the waiver threshold to 5 percent of income is a risky move, because limiting the threat of a penalty could leave more people uninsured, undermining a main point of the legislation.

Oh, come on. We all know the point of the current legislation as it stands. It's to put 40 million new victims on the insurance company rolls, thus ensuring massive quantities of campaign cash in the bank accounts of the cooperative politicians.

The Congressional Budget Office estimates that while there would be 29 million fewer uninsured people as a result of the legislation, a separate 25 million people would still be uninsured in 2019 — about one-third of them illegal immigrants.

Sparing more people from the penalty would certainly increase the projected number of uninsured, by tempting more people, particularly younger Americans, to continue going without insurance. But White House officials think the number of people willing to risk going uninsured would not rise by much, perhaps two million people. The budget office has not issued projections yet, and some Democrats warned that the erosion could be much worse.

Oh well! What's another two million college students who can't afford a doctor when they get the swine flu - a disease that has disproportionately fatal results in their age bracket?

And in the end, that may be the smallest price to pay to avert what could be a devastating political argument against the Democrats’ plan: that working-class Americans would be penalized heavily for not buying insurance they say they cannot afford.

Think of how amoral that argument is. People aren't really human, they're merely chips to be used in a high-stakes political poker game. Nice 'hope and change' there, President Obama.

Via Wonkroom, Grassley arguing strongly in favor of individual mandates in JUNE 2009:

On FOX News: "But when it comes to states requiring it for automobile insurance, the principle then ought to lie the same way for health insurance. Because everybody has some health insurance costs, and if you aren’t insured, there’s no free lunch. Somebody else is paying for it... I believe that there is a bipartisan consensus to have individual mandates."

Grassley bashing individual mandates YESTERDAY:

In addition, Grassley blasted an individual mandate to purchase insurance coverage, calling it "an intrusion into private life" that would require extensive new enforcement tools. While recognizing that there is "certainly a principle of personal responsibility that applies here," he contended that "individuals should maintain the freedom to choose whether to purchase health insurance coverage or not."

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I don't know that it matters how cleverly the president sidestepped George Stephanopoulos on this question: People are still going to view it as a tax increase, and they're angry about it:

STEPHANOPOULOS: You were against the individual mandate...

OBAMA: Yes.

STEPHANOPOULOS: ...during the campaign. Under this mandate, the government is forcing people to spend money, fining you if you don’t. How is that not a tax?

OBAMA: Well, hold on a second, George. Here -- here's what's happening. You and I are both paying $900, on average -- our families -- in higher premiums because of uncompensated care. Now what I've said is that if you can't afford health insurance, you certainly shouldn't be punished for that. That's just piling on. If, on the other hand, we're giving tax credits, we've set up an exchange, you are now part of a big pool, we've driven down the costs, we've done everything we can and you actually can afford health insurance, but you've just decided, you know what, I want to take my chances. And then you get hit by a bus and you and I have to pay for the emergency room care, that's...

STEPHANOPOULOS: That may be, but it's still a tax increase.

OBAMA: No. That's not true, George. The -- for us to say that you've got to take a responsibility to get health insurance is absolutely not a tax increase. What it's saying is, is that we're not going to have other people carrying your burdens for you anymore than the fact that right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that if you hit my car, that I'm not covering all the costs.

STEPHANOPOULOS: But it may be fair, it may be good public policy...

OBAMA: No, but -- but, George, you -- you can't just make up that language and decide that that's called a tax increase. Any...

STEPHANOPOULOS: Here’s the...

OBAMA: What -- what -- if I -- if I say that right now your premiums are going to be going up by 5 or 8 or 10 percent next year and you say well, that's not a tax increase; but, on the other hand, if I say that I don't want to have to pay for you not carrying coverage even after I give you tax credits that make it affordable, then...

STEPHANOPOULOS: I -- I don't think I'm making it up. Merriam Webster's Dictionary: Tax -- "a charge, usually of money, imposed by authority on persons or property for public purposes."

OBAMA: George, the fact that you looked up Merriam's Dictionary, the definition of tax increase, indicates to me that you're stretching a little bit right now. Otherwise, you wouldn't have gone to the dictionary to check on the definition. I mean what...

STEPHANOPOULOS: Well, no, but...

OBAMA: ...what you're saying is...

STEPHANOPOULOS: I wanted to check for myself. But your critics say it is a tax increase.

OBAMA: My critics say everything is a tax increase. My critics say that I'm taking over every sector of the economy. You know that. Look, we can have a legitimate debate about whether or not we're going to have an individual mandate or not, but...

STEPHANOPOULOS: But you reject that it’s a tax increase?

OBAMA: I absolutely reject that notion.

Ezra Klein talks about what everyone on the Hill knows: that the health-care deal will now get done by making it unaffordable for the people it's supposed to help. Only in D.C. is that considered a "victory." Well, I say it's spinach, and I say to hell with it!

The basic structure of the bill has three main planks working in conjunction with each other: The individual mandate creates a mechanism for a universal, or near-universal, system. A universal, or near-universal, system creates the conditions for insurance market reform. The subsidies make the individual mandate affordable for people to follow.

There are a few ways to destabilize this system. The most likely way is to reduce the subsidies so that the individual mandate isn't really affordable. That seems to be happening even as we speak. At that point, reformers have two options, both of them bad.

The first option is to reduce the value of the minimum insurance policy such that buying something the government considers insurance isn't very expensive. This means policies with high deductibles and co-pays, or policies that don't cover very much. But asking someone with a relatively low income to purchase a policy with a $1,500 deductible and significant co-pays is asking them to purchase something they can't really afford to use. So we're making them spend $7,000 or $8,000 a year on something they don't necessarily want and can't really take advantage of. That's a recipe for a huge backlash.

The second option is to drop the individual mandate altogether. Obama, who didn't have a mandate in his campaign plan, might be amenable to this approach. But here, too, there are problems. The young, healthy risks will hang back from the system while the older, sicker risks will flood in to take advantage of subsidies and new regulations that stop insurers from discriminating against them. The risk pool will reflect that, and health-care insurance will become even more unaffordable for the people who need it. And because it's less affordable because of the presence of the sick, it will become even less attractive to the healthy.

The happy news is that the difference between a plan with decent benefits that's affordable for people and a plan that's not affordable for people and doesn't offer decent benefits is not that large. Optimally, you'd want to spend about $1.3 trillion over 10 years. You could probably do it for $900 billion to $1 trillion. But you can't do it for, say, $700 billion, which is a number I'm hearing fairly frequently.

The difference between doing this right and doing this wrong is, in other words, about $30 billion a year, or $300 billion over 10 years. To put that in perspective, many of the legislators who are balking at the cost of health-care reform voted for the Kyl-Lincoln bill to reform the estate tax at a cost of $75 billion a year, or $750 billion over 10 years. You can make health-care reform work at a price tag that legislators are, in theory, willing to bear, at least when the tag is attached to tax cuts.

Isn't it interesting? Because I never hear them talk quite the same about costs when it comes to war. For example: "We really want to stabilize Afghanistan - but it has to be revenue-neutral" or "Yes, we know we said it was important to stabilize Iraq, but we simply can't afford this anymore."

No, the place where they decide to draw the line is... our health. War is seen as the absolute necessity and health care is seen as optional. That's just crazy.

I hope President Emanuel changes his position on this important issue.

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Senators Orrin Hatch (R-UT) and John Kerry (D-MA) talked about the process of health care reform on Sunday :

STEPHANOPOULOS: These insurance reforms, you can't be denied health care if you're sick. You can't get thrown out if you're sick.

A lot of Democrats, Republicans say that maybe we should have this individual mandate, to require people to buy insurance, to couple that with reforms.

Bill Bradley points out today, I think it was in The New York Times, that, you know, maybe they should include some malpractice reform as well. Are they -- those three things the building blocks of a deal?

HATCH: Yes, they really are. You know, Democrats have been unwilling to take on the personal injury lawyers. And look, there are cases that really deserve huge rewards, huge judgments.

We've got to find some way of getting rid of the frivolous cases, and most of them are. Most of them are brought...

KERRY: And that's doable, most definitely.

HATCH: Yes, and that's doable. Most of them are brought to -- you know, to get the defense costs. They know that once they bring them, the insurance companies are going to have to pay their defense costs rather than take a chance at a runaway jury.

But it's not just that. It's the other elements you've been talking about too. Those are three very important...

Let's just wait one minute here. Bill Bradley? Although he has a reputation as a liberal's liberal, Bradley has never met a tax cut he didn't like. And when he starts talking about malpractice reform in exchange for healthcare reform, what he's talking about once again is ordinary people giving up another degree of security and protection against powerful forces to meet some politician's ideal of centrist compromise.

When approximately five percent of all doctors are responsible for 95% of all medical malpractice, how is that a legal problem? I'll accept limitations on malpractice awards when we have a national health care system that pays for every service someone needs to deal with with the outcome of bad medicine. Until then, I'll keep my torts, thank you.

STEPHANOPOULOS: And then if you add some subsidies to that that move towards covering more people...

KERRY: Yes, which I think we have some -- actually, I think we have some flexibility on as to sort of the rate and manner in which you do that. So I think that there are ways to do this, George.

As a member of the Finance Committee, I've been part of this discussion, though many of us would like to see it broadened in some ways. I'd like -- I mean, you know, my question to Orrin and to others is, you know, who is the Republican? Who are the Republicans, plural, who are prepared to step up and do as Ted Kennedy would have done here?

STEPHANOPOULOS: You were part of the negotiations earlier this year but then stepped away. Are you ready to come back?

HATCH: Sure. I've always been ready to do that. But look, you talk about an individual mandate. The problem with an individual mandate is that the people who are really hurt the most are those on the lower end of the wage spectrum.

They either lose their jobs, a cutback in pay, or the company goes overseas. Once you start doing that -- because the theory behind that is that you've penalized the company if they don't provide insurance for their people by having them have it surcharged.

And look, let's just be honest about it, it's a very difficult thing to do. There are some ways we could do this, none – both sides...

KERRY: Actually, Orrin...

HATCH: Both sides are arguing for insurance reform. That's not the issue. The issue is, how do we put all of these elements together?

Paul Waldman in the American Prospect:

"Illness doesn't care where you live," the narrator says sympathetically, "or if you're already sick, or if you lose your job. Your health insurance shouldn't either." The ad ends with the hope that "the words ‘pre-existing condition' [become] a thing of the past." So say the people who won't insure you if you have a pre-existing condition and who will cut you off if you get a serious illness. It's kind of like a gang of home invaders expressing the fervent hope that people will get better alarm systems and stronger deadbolts.

What's going on? In simple terms, they cut a deal. It may not be written down on paper, but it goes like this: If the government imposes an individual mandate, forcing all Americans to buy health insurance – and thus guaranteeing us millions of new customers – we won't stand in the way of new regulations curbing some of our worst abuses. And this is their defense when those abuses are brought up. We've already agreed to those new regulations, they'll say, so why do we need to talk about it anymore? Let's just make sure there's no public option people can choose, because that would just be a step too far.

But here's a question: If the insurance companies have finally come to understand that it's wrong to kick people off their coverage when they get sick; and it's wrong to deny coverage to people who have previously been sick; and it's wrong to hide lifetime limits in the fine print, forcing people into bankruptcy if they face a serious illness; and it's wrong to discriminate against pregnant women and their families; why don't they stop doing these things? Like, how about today? Why are they waiting for Congress to outlaw their most abominable practices?

Continue reading »

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(h/t Heather.)

Former CIGNA PR chief Wendell Potter is very, very angry over Obama's movement away from true healthcare reform:

Not only is Obama clearly ready to throw the public option overboard, he is embracing the requirement that we all be forced to buy insurance from private insurers. That means your tax dollars and mine will be used to pay subsidies to the big insurers to provide coverage to people who can't afford to buy their policies, because the big insurers charge far more than they should because Wall Street investors demand that they do.

One of the people who undoubtedly talked Obama away from the public option and into supporting this mandate is his new BFF, Aetna CEO Ron Williams. Williams, who made $65 million off of Aetna's policyholders' premiums over the past two years and who was the mastermind behind Aetna's shedding of eight million members a few years ago to meet Wall Street's demands, is the insurance industry's leading champion of requiring us all to buy insurance. And, of course, without a public option, we'll all be forced to buy coverage from Aetna or one of the other private insurers.

According to a recent article in Forbes, Williams has been to the White House a half a dozen times recently to advise the president and his staff on health care reform. That same article quoted a Wall Street analyst as saying that Aetna likely will dump about 600,000 policyholders during the coming months to satisfy its investors' unrelenting profit demands.

During his speech in Montana, Obama talked a lot of trash about the insurance industry. Don't be fooled by that tough talk. It's all part of a strategy to try get us to believe we'll get the reform he promised during the campaign. Industry leaders are in fact delighted he's denouncing their behavior, because they believe most of his supporters -- who were hopeful the stars might finally have aligned for real reform -- will be fooled into thinking the reform bill that reaches his desk will benefit them more than the special interests with their armies of lobbyists. And they know the nonprofit cooperatives Sebelius and Gibbs are now trying to sell us on don't have a prayer of succeeding. The big for-profits will never let them get off the ground in any meaningful way.

Sadly, I believe the fat cats are winning and that the bill Congress sends the president will be one that gives an industry with an unsustainable business model a new lease on life and a guarantee of unprecedented future profits.

So I hope the president's aides are buying lots of lipstick. He'll need all he can get to put on that pig of a bill.

Okay, let's see if I'm following this. The administration is talking about lending money to small businesses because the banks to which they've already funneled billions didn't do the thing all that money was supposed to do: make them open up the taps and lend working capital to businesses.

Are we clear now?

The Obama administration is developing an initiative to take money from the $700 billion program for the banking system and make it available to millions of small businesses, which officials say are essential to any economic recovery because they employ so many people, according to sources familiar with the plan.

The new effort -- which would represent a striking shift from the rescue program's original mandate -- would direct billions of bailout dollars toward a program that aims more at saving jobs than righting the financial system.

A proposal being floated by senior Treasury Department officials calls for using the bailout funds to expand an existing government program that helps small companies borrow money from banks a low rates to keep their businesses going, the source said. These "working capital" loans would come with few restrictions and could be used for buying inventory, holding onto employees and paying off short-term debt.

The initiative would expand a Small Business Administration lending program called 7(a), the agency's most popular lending program. Lines of credit for small companies could greatly increase in size. If the firm failed despite receiving this help, the government would cover most of the losses on the federal loan, perhaps as much as 90 percent. Lines of credit act like the credit cards for companies -- short-term revolving debt used to pay a variety of immediate expenses.

Discussions about the plan have reached the highest levels of the administration. In a meeting at the White House last week, Treasury Secretary Timothy F. Geithner expressed support of his staff's proposal, while National Economic Council director Lawrence Summers was more skeptical. Neither has made up his mind, officials said.

"Larry has supported every small business idea we have implemented so far," said Gene Sperling, a counselor to Geithner, who has been working on small business issues. "When we have a brainstorming session on new ideas, Larry as always asks the toughest questions in the room."

The debate over the proposal has centered on whether taxpayers would be protected and whether banks that make these loans would lower their standards if the government promises to cover most of any loan losses, according to participants present or briefed on the discussions. The spoke on condition of anonymity because the conversations were considered private.

On one hand, administration officials want to prevent healthy small businesses from closing their doors and adding their workers to the growing ranks of the unemployed. But small companies have poorer record of repaying loans compared to large corporations and would be the riskiest investment made under the bailout program to date.

The officials said the discussions are in the early stages and that no plan is expected before the fall. Ideas currently on the table may evolve or be scrapped altogether, they said.

Anything that creates or maintains jobs is good, but I wonder if this will really do that. I think too many of those small businesses are already gone.

It's real simple. If President Obama doesn't include a vibrant public option in health care reform, he will lose the left and will never recover. Is that what he wants? Does he want to be a one-term president? Does he want conservatives and teabaggers to control Congress?

I'm sick and tired of hearing his representatives tell me that Congress is writing the bill. He won a mandate to reform health care. John McCain's plans for health care were rejected by Americans. So why is he involved in a kabuki dance with all the weak-kneed Democrats like Blanche Lincoln, DiFi, Ben Nelson, Kent Conrad and all the rest of the corporate Dems? And why does Sen. Grassley matter at all? They don't care about American families and what's been happening to them.

Doesn't his team look at the polls? Americans are willing to be taxed for health care reform. What more does he want? There's a 20-point jump in the belief that the government can run health care, which is amazing. The polls aren't lying so what is President Obama doing?

Protests should be breaking out all over America about health care before it's too late. July 4th would have been a great day to have one.

President Obama wants a bill to sign in October. Great. But it has to be a good bill with a vibrant public option or health care will never be reformed and President Obama will see his popularity rise in Republicanland. I'm sure they'll all turn out to vote for him in 2012. The problem is that nobody else will.