Bernie Sanders pushes for single payer healthcare.

Open thread below...

The Kucinich bill would allow states to form their own single-payer systems:

As reported earlier, House leaders have stripped the Kucinich amendment from the House health care reform bill. This amendment would help nullify legal challenges against efforts by individual states to enact their own single-payer systems.

[...] According to Tim Carpenter of Progressive Democrats of America, one avenue of appeal remains regarding these efforts:

Democratic House leaders can insert what is called a “Manager’s Amendment” into legislation, even when it is closed to any other amendments. The managers are the majority and minority members who “manage” debate for the bill on each side.

Today, tomorrow, and beyond, we need to call these “managers” and insist that the Kucinich Amendment is restored into the healthcare bill.

The “gang” that holds our future in their hands includes:

* Speaker Nancy Pelosi: Washington, DC, office (202) 225-4965; San Francisco office (415) 556-4862

* Majority Leader Steny Hoyer: Washington, DC, office (202...; Greenbelt office (301)...; Waldorf office (301)...

* Rep. Henry Waxman: Washington, DC, office (202) 225-3976; Los Angeles office (323) 651-1040

*Rep. Charles Rangel: Washington, DC, office (202) 225-4365; New York office (212) 663-3900

* Rep. George Miller: Washington, DC, office (202) 225-2095; Concord office (925) 602-1880; Richmond office (510) 262-6500; Vallejo office (707) 645-1888

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Look, I want single-payer, too. But this bill has a lot of things in it that will quickly offer substantial relief, and I'm not joining the wholesale condemnation. Even Howard Dean called it "real reform" tonight and said he'd vote for it.

There's some good things and some bad things. Actually, a lot of good - and you won't have to wait more than a few months for relief.

The bill keeps kids on their parents' insurance until age 27, there's a temporary insurance pool until the public option is operable, extension of COBRA benefits (still looking for details), steps to close the Medicare doughnut hole, a ban on lifetime coverage limits, and the end of rescissions, except in case of fraud. It also expands Medicaid.

The bill also adds a voluntary long-term care program (and if your parents have seen their insurance carriers crash and burn this year, you know what a blessing this will be). It also funds a temporary reinsurance program that subsidizes employers offering health benefits for retirees aged 55-64.

As Jane pointed out this morning, there's no requirement for generic versions of high-priced breast cancer drugs. In fact, the bill sweetens the pot for Big Pharma by extending patents on those drugs every time they make a minor change. (Like making an extended release formula.) Essentially, it's a monopoly in perpetuity. (And guess which netroots favorite voted for it? Rep. Patrick Murphy. He's got Big Pharma employing many, many voters in his district.)

Breast cancer survivors, organize! No one likes to be perceived as beating up on cancer patients.

Potentially bad: No Medicare+5. At first look, this means fewer savings - and thus, higher premiums. However, these rates will still be negotiated at a national level, and it does not preclude Medicare +5.

In a bill this complex and controversial, there are, of course, things that will make us swallow hard. From what I'm hearing so far, the subsidies are inadequate. As soon as I have concrete numbers, I'll put them up.

I'd say the subsidies are the single most productive focus for the netroots. Call your congress critter, tell him or her (or it) that the subsidies must be adequate - or else.

And if they say they have to respect the ceiling President Obama asked for, ask them why it doesn't bother them when they have to pay for wars - only health care. Tell them you will not pay more money for less coverage, that this is a deal-breaker for Democratic voters.

Send them a strong message.

UPDATE: Jamie at Intoxination cites Politico:

The House health care bill unveiled Thursday clocks in at 1,990 pages and about 400,000 words. With an estimated 10-year cost of $894 billion, that comes out to about $2.24 million per word.

I pulled out the calculator. How does this sound - $425.9 million per word? That's how much each of the 2,174 words in the authorization for the Iraq war has cost so far and the price keeps going up.

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October 28, 2009 MSNBC The ED Show

From Kucinich's office today: State Single Payer Cannot Be Ignored

Washington, Oct 29 -Congressman Dennis Kucinich (D-OH) today made the following statement after House Leadership announced the latest version of health care reform:

“Today, advocates of true health care reform were disappointed to learn that the Kucinich amendment was removed from the latest version of the health care reform bill. At the end of the day, states may be given the option to opt out, but won’t be allowed to opt into a proven system that provides all of a state’s residents with better health care.

“Many states are demanding single payer. Not only does it help people stay out of poverty and provide health care for all, but it would provide major relief for states facing budget difficulties. The Lewin Group’s financial analysis of the California single payer bill that passed the legislature twice found that “the net cost of the program to state and local governments is a savings of about $900 million” in 2006 alone. There are also strong single payer movements in Pennsylvania, New York, Illinois, Colorado, and New Mexico.

“If a state wants better health care than can be provided by the federal government in the health care bill we are seeing today, the federal government should not stand in their way. The removal of the Kucinich amendment constitutes yet another capitulation to the health insurance and pharmaceutical industries who are already reaping billions of dollars from the bill.

The Kucinich amendment had been added to HR 3200 in a 27-19 bipartisan vote in the Education and Labor Committee.

Transcript from MSNBC below the fold.

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From Face the Nation, Russ Feingold has to remind Bob Schieffer that the "public option" is not a "liberal" position on health care reform. It's a compromise. What liberals want is single-payer.

SCHIEFFER: Let’s talk a little bit about health care. Where do you think health care reform stands in the Senate right now? I know you want the public option, the government-run insurance program, like Medicare for older people. The majority leader now seems inclined to include that in the bill that he’s going to bring to the floor. Do you think that has any chance at this point of passage? Because for a while now, people have been saying the votes are just not there in the Senate.

FEINGOLD: Well, I want to give my majority leader, Harry Reid credit for seriously considering putting this public option in there. I think it’s very important. It’s a sign of strong leadership on his part that he has the guts to do that. Because the American people are for some alternative that will create some competition for the abuses of the insurance industry. So I believe that there’s a good chance it will be in the bill that comes before us in the Senate. I think we have some chance of prevailing in the Senate on it and if we don't I think there's a chance it will come through the House. So I’m becoming increasingly optomistic that we will have a health care bill that will not frighten the American people, that they'll be able to see as reasonable -- it's not a complete government take over health care, but will provide an option for those that don’t have health care or are unhappy with their health care to do something else and I'm frankly getting excited that we may have some momentum for something very positive.

SCHIEFFER: As I understand it, the liberals want the, want the public option. The conservatives don’t. Do you think there’s a possibility that this thing may just end up in a log jam, that liberals won’t vote for this plan without the public option and the conserves won’t vote for it if it includes the public option, and so we wind up with nothing instead of something?

FEINGOLD: Well, that could happen, but the truth is, what liberals want is a single-payer system. Medicare for everybody. So the idea of a public option is really a very moderate idea. Within the current context of a continuing private system, it’s a tough one to swallow for many people who want a single-payer system. So this is a very reasonable approach that I would think people who are both conservative and liberal and in the middle would say, let’s try this; let’s see if this can control and bring under some reason of measure that the insurance companies could finally improve their act.

That is exactly what -- what this is. It is not a liberal or left-wing concept at all.

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Rep. Anthony Weiner did his usual stellar job being the progressive voice on health care yesterday on MSNBC's Hardball with Chris Matthews. In typical Villager fashion, Matthews want to paint the public option as the "ultra liberal" position on health care, and Weiner helped set him straight:

MATTHEWS: OK, let me ask you this. What percentage, do you think, of Democrats in this country are liberals and what percent are moderates?

WEINER: I have no idea. I think...

MATTHEWS: Do you think most are liberals.

WEINER: I have to say...

MATTHEWS: Do you think most are liberals?

WEINER: No, here's what I think. I think when it comes to health care, the moderate position is choice and competition. I don't believe the public option is the liberal position. The liberal position is what I have, single payer for all Americans. This is the compromise position.

Of course, the whole point of painting the public option as the "far left" position is that, in Villagespeak, the liberal position is always doomed to being compromised by "centrist" Democrats. Which was the upshot of Matthews' interview -- namely, that liberals should be prepared to give up the public option to appease "centrists" in their own party.

Weiner had the perfect answer to that tripe:

WEINER: I think that we need to make the argument to my Democratic friends that this is an all-or-nothing strategy for us as Democrats. We run the country right now...

MATTHEWS: OK...

WEINER: ... House, Senate and the presidency.

MATTHEWS: OK...

WEINER: And if we can't do this (INAUDIBLE)

MATTHEWS: I've been talking around the Hill, talking to staffers and some members, and I've gotten to the point of disbelief. A lot of people like you believe that in the end, no good Democrat from wherever they are in the country is willing to be the man or woman who brings down the president's number one political ambition for this year, health care. And in the end, you folks believe that there'll be such tremendous pressure on all the Democrats, Nebraska, North Dakota, Arkansas, Louisiana, they'll still have to vote with the party. Do you believe that?

WEINER: Well, let me...

MATTHEWS: Do you believe that?

WEINER: Let me say yes but phrase it a different way. There's a divide here. Some people think a watered-down health care plan could be a success for us. Some, like myself, believe if we don't get this right...

MATTHEWS: OK...

WEINER: ... we're not going to get another chance for 20 years.

MATTHEWS: You're a good spokesman. Thank you, sir.

Blanche Lincoln, we hope you're listening.

Deleted scenes from Sicko (2007) showing the health care system in Norway.

Ever wonder why the single most sensible, economical and democratic way to provide health care to every person in the US was never really mentioned in the rhetoric whirlwind of public options, opt-outs, co-ops, triggers and free market embracing?

Part of the reason why is that the media refused to mention it:

The media analysis group Fairness and Accuracy in Reporting (FAIR) issued an action alert September 22 titled "NYT Slams Single-Payer" that described lopsided reporting in a New York Times article about "Medicare for all," a form of a single-payer health care system. FAIR noted that the article, titled "Medicare for All? ‘Crazy,’ ‘Socialized’ and Unlikely", laid out a list of arguments against single-payer while failing to include any balancing responses from the option's supporters.

Yeah, those nutty Norwegians, not to mention Canadians, Danes, French, Brits, Swedes, etc. etc. They're all just crazy for treating health as a human right, instead of a corporate profit opportunity. FAIR continues:

It's worth noting that thousands of doctors have voiced support for a single-payer system (see, for example, Physicians for a National Health Program's letter to Barack Obama), in part because they believe they spend too much on the administrative costs associated with private insurance companies. A survey of physicians published in the Annals of Internal Medicine (4/1/08) found that 59 percent supported government-sponsored national health insurance.

Seelye also wrote that Medicare for all "would almost certainly mean a big tax increase on the middle class," before noting in parentheses: "Supporters argue that a tax increase would be somewhat neutralized by the elimination of premiums that people pay now to insurance companies." Actually, single-payer advocates argue that a payroll tax on businesses (many of which currently pay for private insurance for their employees) and a small income tax increase that would likely amount to less than what most citizens currently pay out of pocket could fund a single-payer program. By calling a "big tax increase" a near-certainty and treating the savings on insurance premiums as a claim made by advocates, the Times told readers which side it was on.

Seelye cited Stuart Altman--identified as "a Brandeis economist who specializes in health care and who advised Barack Obama in his presidential campaign," but not as a director of a managed-care company that offers health insurance plans (WhoRunsGov.com)--to make a similar point about potential tax increases, and then went to "the other end of the political spectrum" to quote Robert Moffit of the conservative Heritage Foundation: "I don't see popular support for it beyond liberals.... It's a philosophical question: Do you want to give the government that kind of power?"

Of course, one might point out that public polling for years has demonstrated that support for single-payer is much broader than merely a liberal sliver of the population (FAIR Action Alert, 3/12/09); a July 2009 tracking poll from the Kaiser Family Foundation found 58 percent support for Medicare for all. But a piece detailing the deficiencies of a "crazy" single-payer system is an unlikely venue for that.

FAIR is asking that you contact NY Times Public Editor Clark Hoyt as to why they would run such an unbalanced and factually-challenged piece that hurts Americans by lying to them about their health care options.
CONTACT:
New York Times
Clark Hoyt, Public Editor
public@nytimes.com
Phone: 212-556-7652

I had to make a less compelling but similar choice several years ago, when one of my cousins, who also had PKD, asked us all to get tested for possible transplant donation. I was out of work and uninsured, and I knew if I had any complications, I couldn't afford treatment. Even though I felt really bad about it, I didn't get tested.

Isn't it horrible that we're making moral decisions on such immoral grounds? The more I see of the disgusting horse-trading going on over the public option, the more convinced I become that a national (and probably single-payer) health care system is our only sane option.

Nick Kristof:

So what would you do if your mom or dad, or perhaps your sister or brother, needed a kidney donation and you were the one best positioned to donate?

Most of us would worry a little and then step forward. But not so fast. Because of our dysfunctional health insurance system, a disgrace that nearly half of all members of Congress seem determined to cling to, stepping up to save a loved one can ruin your own chance of ever getting health insurance.

That wrenching trade-off is another reminder of the moral bankruptcy of our existing insurance system. It’s one more reason to pass robust reform this year.

Over the last week I’ve been speaking to David Waddington, a 58-year-old wine retailer in Dallas, along with his wife and two sons. I’d love to know what the opponents of health reform think families like this should do.

Mr. Waddington has polycystic kidney disease, or PKD, a genetic disorder that leads to kidney failure. First he lost one kidney, and then the other. A year ago, he was on dialysis and desperately needed a new kidney. Doctors explained that the best match — the one least likely to be rejected — would perhaps come from Travis or Michael, his two sons, then ages 29 and 27.

Travis and Michael each had a 50 percent chance of inheriting PKD. And if pre-donation testing revealed that one of them had the disorder, that brother might never be able to get health insurance. As a result, their doctors had advised not getting tested. After all, new research suggests that lack of insurance increases a working-age person’s risk of dying in any given year by 40 percent.

“At the time David needed a transplant, the people closest to him couldn’t even offer a lifesaving donation — for insurance reasons,” said Mr. Waddington’s wife, Susan.

Travis, who is living in New York and working toward a math doctorate, is anguished at having to weigh insurance obstacles against the chance to save his dad.

“Can you put a price on your father’s life?” he asked. “My brother and I talked it over privately, and agreed that we should both go ahead and get tested anyway. It seemed like the only course of action. We presented our plan to our parents, and of course Mom immediately shot it down, with Dad firmly behind her.

“We had to respect their right to want to protect us. But it was enraging to be in that situation, and to be completely impotent to do anything to help. I told myself a number of times that we would reconsider the issue of testing if Dad’s dialysis stopped working before he got a transplant.”

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Again and again, these issues arise that could have been solved by a straightforward push for a single-payer, government-run system. But that, of course, would have required a political system that didn't have corporate sponsors. It's painful to watch them tie themselves in knots, trying to rationalize the death-for-profit system:

Any health-care overhaul that Congress and President Obama enact is likely to have as its centerpiece a fundamental reform: Insurers would not be allowed to reject individuals or charge them higher premiums based on their medical history.

But simply banning medical discrimination would not necessarily remove it from the equation, economists and health-care analysts say.

If insurers are prohibited from openly rejecting people with preexisting conditions, they could try to cherry-pick through more subtle means. For example, offering free health club memberships tends to attract people who can use the equipment, says Paul Precht, director of policy at the Medicare Rights Center.

Being uncooperative on insurance claims can chase away the chronically ill. For people who have few medical bills, it is less of a factor, said Karen Pollitz, research professor at the Georgetown University Health Policy Institute.

And to avoid patients with costly, complicated medical conditions, health plans could include in their networks relatively few doctors who specialize in treating those conditions, said Mark V. Pauly, professor of health-care management at the University of Pennsylvania's Wharton School.

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So there I was, driving to my friends' house for dinner and babysitting last night when Howard Dean called me.

I'd been scheduled to talk to him after his appearance at the Philadelphia Free Library yesterday, but there was some kind of miscommunication and it didn't happen.

Anyway, he apologized for the mix-up and we had an interesting discussion. (Remember, none of this is verbatim. I was driving while we talked, and I've reconstructed as best I can.)

The first thing I said was, "Every single problem you described at today's talk, logistical and financial, could be solved with single payer."

His response was along the lines of "And your point is?" As in, let's deal with what we have in front of us, I suppose.

So then I asked him what he thought the strategy was behind the administration starting the debate with the public option instead of single payer. "I think it was a terrible mistake," he said. "I think they were worried it would be called socialism." (Naturally, I agreed.)

Let's see. What else? He said the reason the focus of the campaign is on the finances of health care is because Obama was actually put in the White House by the under-35 voters, and while they're socially liberal, they're very conservative on the deficit and are convinced they won't be able to count on things like Social Security.

"You don't have to tell me," I said. "My kids are Ron Paul fans." He laughed and said, "Then you understand."

"Tell them if this bill doesn't pass, their sick parents will have to move in with them. That ought to do it," I advised.

(And I said that while the under-35 votes may have put Obama in the White House, I suspected the bulk of individual contributions came from baby boomers and he might want to look into that.)

I said the real problem with the current health care system was a matter of human dignity. I told him about a friend who's struggling with brain injury and has been turned down three times for Social Security disability. "They keep telling her she can work, but who's going to hire someone who doesn't know ahead of time if she'll be too sick to work?" I said.

He said yes, there's no question that the present system was a nightmare for the chronically ill or handicapped.

I told him I was really hoping the bill's final version included lowering the Medicare age to 55, "since I turn 55 next week."

"I'd like to see it lowered to 50, that would make a lot of sense," he replied. We talked about how it would lessen the cost burden on employers and increase the chances of the over-50s getting rehired.

We also discussed the positive ripple effects we could expect from the public option - that it would lower the costs of auto insurance, and take work-related injuries out of the worker's comp system.

I talked about the strange Beltway bubble and asked if people working there really understood what was at stake out here.

He said no, it wasn't my imagination, the people in the Beltway really do live in a different universe - "especially the Senate. It really is like a club," he said. He corrected himself: "No, it is a club. And they're most concerned about their personal relationships with the other Senators, and then everything else. It's very strange."

Don't they understand how angry everyone is out here? I said. "If they put us in a position where we're paying more money for less coverage, it's going to be war." He said no, they really don't - although he keeps trying to tell them. He said we're looking at a real political disaster if they screw this up. "Because I'm on the outside, I get to say those things," he said.

Dean says not to worry about the Baucus bill, that the final version won't look anything like it "but everyone's sort of tiptoeing around, no one wants to say it out loud. They have to pass a bill out of Finance first, and then they'll change it."

I told him the perception from here is that the Baucus bill was the one that had the White House approval, and he said, "I can understand why you have that perception, but I don't think so at all."

I told him many of us despaired of any real change, and he reacted immediately. "You absolutely shouldn't be thinking that way," he said. He believes there's a "95 percent chance" of a real public option, and if there isn't one, the bill shouldn't pass.

No point to throwing billions of dollars to the insurance industry if we don't get the public option, he said.

"Do you think the people working on this bill actually understand that?" I said. "Maybe I'm being cynical here."

"Yes, they do," he said. "The bill was basically written by the insurance industry. I do think they know [it's a giveaway]." He said it was written by two former insurance industry lobbyists, they knew what they were doing.

But the good news is, he really does believe there's going to be an affordable public option, and all this will be a moot point.

I told him a lot of us were counting on him, and if he told us to support the final bill, I'd feel okay about supporting it.

Here's hoping.

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Real Time's New Rules for Sept. 25, 2009.

Maher: And finally if America can't get off its back and get something done it must lose the bald eagle as our symbol and replace it with the You Tube video of the puppy that can't get up. As long as we're pathetic, we might as well act like it's cute.

One constant theme which needs dealing with is the idea that the country is more conservative than liberal and that centrists are needed to hold off horrible conservative things from happening.

More than that, this is an argument for oligarchy. What I see is that the majority of people, in poll after poll, want single payer. A huge majority want the public option, yet odds are decent you won't even get that.

When people talk of left-center coalitions the center part include a large number of Senators (like Diane Feinstein) who won't do what the majority of their constituents want them to do. At this point centrist = captured by monied interests.

Odds are if Obama wanted single payer, the House could pass it. It'd be close, but they could get it done. The House is the more representative body of the two bodies, the Senate is deliberately retrograde.

When I look at the US what I see is a banana republic, because it doesn't act like a democracy. I see people who think that the Senate, or even the House, actually does what the American people want. Again and again, Congress does things that the majority disagree with. In 2006 the Dems were elected to end the war in Iraq, for example, and refused to do so (though again, the House at least went through the motion, the Senate didn't even make an effort). Oh, Congress will sometimes do what the majority want—when that's what it was going to do anyway.

The plan to fix this is simple enough and always has been.

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John Conyers draws a line in the sand for his vote on the health care bill.

Conyers: Well, we should be doing single payer, but we've compromised on that and what we're doing now is that we're stepping back. But this cannot be called reform of health care if a public option isn't on it and so this is down to the crunch time...

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While discussing with Ed Schultz whether there is going to be a public option in the final health care bill once everything is said and done, Shultz reads off John Boehner's response from the Republicans saying that the Democrat's plan is a "government takeover" of health care. Schakowsky points out that Boehner's statement is of course complete bunk since no one is proposing single payer (sadly IMO) and they've already compromised with Republicans, so they've already got a bipartisan bill. She goes on to make one more really great point on the media's lousy coverage of this debate.

Schakowsky: Let me just say one other thing Ed about the news media. When myths are, or lies are told, it is not just he said she said. I like what you said. It is not true. It is simply a lie that this is a government takeover and I think that it really ought to be up to the media too, not to just report well this is what the Republican said then this is what the Democrat said and this is what the President said. They're telling lies! And I think they need to be called on it.

Amen sister.

h/t danieljbmitchell:

In 1971, President Nixon proposed a national health insurance plan built on heavily employer private coverage. Senator Ted Kennedy proposed what would today be called a single-payer plan. In 1974, the debate had morphed into Nixon vs. Kennedy-Mills vs. Organized labor. Despite the prediction in the second clip shown, the result was stalemate rather than passage in 1974 or 1975.