Yeah, we don't need another Nader movement in 2010 or 2012.

Well said Bob. Pick your battles. We have the facts and the truth on our side. Truth will out as they say.

You're absolutely right Bob! I like Glenn a lot but, I think we're better off focusing on healthcare right now. As the saying goes "nothing succeeds like success. We'll battle one piece of legislation at a time. I suspect many of the Blue Dogs will be in quite a bit of trouble if we get a strong public option. They'll be even worse off if we don't. We'll then do all we can to pick their asses off and kick them out of our party!

After health care reform, the next battle will be cap & trade. That is Obama's chance to win the left for 2012. I'll have a bit to say about that battle in the coming days.

For extra credit, Obama can get EFCA passed by Spring of 2010.

I think it's much more important to hold the Dem's feet to the fire. We elected them because we wanted substantial change. I suspect that the Obama administration now has a pretty good idea of just what we were thinking when they tried to dump the public option. Those sliding poll numbers slid because of us...not the right wing loons who show up at the townhalls! If they screw us, it's only going to get worse!

This is our battle. Our first battle since the election. if we can't win this, we can't win energy or cap and trade or EFCA. There are huge lobbyists waiting in the wings for these issues.

We must win. We cannot have a crappy bill with mandates and no public option and 50M new customers handed over the the insurance companies like lambs being led to the slaughter. The very lives of our fellow Americans is at stake. This will set a precedent for the next year. If the rethugs roll us over on this, they will feel empowered and lie and get more violent and crazy than now. They will see it works.

Period. End.

I hope Stranahan is listening to this.

Jan's right and I ask:

Why did Obama seem strong, invincible, smart, clever, brilliant, strategic, impassioned, and, at times, angry during the campaign and now he seems waffly and more soft?

I realize, of course, that campaigning and governing are not the same thing: however some of his savvy and skills should have carried over to governing, no?

He accomplished the following as a campaigner:

1. Kept up an incredible tireless schedule of events
2. Shut down the Clinton machine and beat the much anticipated coronation of Hillary
3. Handled the press beautifully and stayed on message
4. Was a helluva fundraiser--- broke all sorts of $$ records
5. Got young people excited
6. Registered more Dems
7. TURNED RED STATES BLUE! (AMAZING FEAT!)
8. Had rapid response to attacks from the right
9. Had a streamlined, lean, competent team
10. Hit the nail on the head on the most of the issues
11. Got Independents, some Republicans, and other unlikely voters to vote for him
12. Over came his name and race challenges (huge!!)
13. Has a personal life that appears scandal free (no affairs, etc.)

We felt like we really had our guy! What an amazing man!

So why can't all these amazing strengths,, traits, abilities and cleverness translate to really sealing it when it comes to health care?

During the campaign --- he always seemed to pull out a victory when we were unsure and didn't know if he could do it --- then, he did.

What's going on?

Terri,

Have you done as much for health care reform as you did for Obama's election?

Have you knocked on as many doors, done a phone bank, or otherwise tried to propel public opinion?

I'm not trying to make this personal -- I'm just pointing out that WE *ARE* the campaign he needs.

Your last question presupposes that Obama isn't going to pull out a victory. He is. you are getting reform; I guarantee it.

He's not his own man now. The advisors, the bubble, Rahm, the press are all over him 24/7. I mean, there's an article out today bitching because he didn't have a helmut on while riding a bike with his daughters. Come ON. I think he just listens to these people and has forgotten or doesn't want to think for himself and remember his promises. And then his hang up with bi partisanship.
Lord knows he's heard from all of us. I know he's under alot of pressure BUT he wanted this. I just don't know what is in his head by wanting to ditch us and compromise on this bill. I don't mean to be a drama queen but people ARE dying everyday because of no healthcare or the insurance robbers. He's trying to walk the fence and keep everyone happy.

Maybe he just has to lose to wake him up.

I'm just pointing out that WE *ARE* the campaign he needs.

HE HAS THE BULLY PULPIT now. He's heard from us. WE got him elected. Time to step up. He knows what we want.

Hi Matt,

Yes I am putting personal effort forth for the health care reform I believe in: Sngle Payer.

I have not put effort forth for the Public Option as I don't support that.

My sense is that there will be *something* that will pass....but my hunch is that it will be watered down, weak, and still feed the for-profit insurance industry.

I am supporting Single Payer and I am very excited by the campaign by the citizen-doctors who call themselves the Mad As Hell Doctors (wwwlmadashelldoctors.com) who are strong advocates of Single Payer.

Meet the Mad As Hell Doctors, here:

http://www.youtube.com/watch?v=aX9VQZhlgwg

That is the health reform I can get behind -- and I like it that they are "mad as hell' doctors!

These doctors are a group of physicians (and retired physicians) who are leaving from Portland, OR on September 8 and are traveling across the country in a CARE-A-VAN to host educational town hall forums on Single Payer --- educating the public city by city.

Their final destination will be Washington, DC where they asked to meet with Obama, but he refused.

http://pdamerica.org/articles/alliances/2009-08-28-10-51-23-alliances.php

My efforts are going toward putting pressure on Obama to meet with the Mad As Hell Doctors.

I find it simply stunning that Obama invited (pro-actively extended!!) an invitation to Sergeant Crowley and Professor Gates for a contrived beer date on the White House lawn which was a televised photo op ----- yet, these men are spending days on the road for a good cause and he has refused to meet with them. Don't you think they will be thirsty, too, for a beer after that long, cross country trip and all that speaking? ;)

Obama is not really rejecting the men, personally --- he is rejecting Single Payer.

The doctors are working to build up support to get Single Payer front and center again --- now that IS something I can get fired up about!

Bob posted something earlier about Harry Reid trying to make the public option go private and keeping/inserting/ maintaining the profit-making nature of health care --- which is what we already have!

That is yet another danger of this Public Option -- it can be manipulated and twisted.

Both co-ops and the Public Option keep the profit-making nature in health care afloat.

There is NO WAY that can happen in Single Payer -- it is tight as a drum and a profit-making repellent. :)

My energy, efforts, support, and enthusiasm are with Single Payer and the Mad As Hell Doctors!

I do not support the notion of incremental or gradual change on this issue.

Obama may be a sell out: but we don't have to be too.

Many here know that Single Payer is the solution they want and like but they "settle" for the Public Option because "it's something" and "the only thing we can get" ....

Heck! Even Obama is for single payer!

In his own words Obama states, as a candidate: I am for universal single payer health care.

Watch for yourself.

http://www.youtube.com/watch?v=fpAyan1fXCE

I encourage progressives --- including Bob --- to stand tall on their values and don't compromise what you really want and what you really believe in.

Weenie leaders tend to make for a weenie followers: I will have none of it.

Terri

Terri,

When you declare the insurance companies out of business, what do expect the damage in the markets will be?

What about all the layoffs? Hundreds of thousands of people are employed by the industry.

How will you ramp up service infrastructure -- offices, call centers, etc. in time to take on a new-patient load of 150 million?

I'm all in favor of single-payer. The public option is the evolution toward single-payer. Half of America's health care spending is already done by taxpayers -- when it's 67%, or 75%, America will start to demand single-payer.

Matt,

First off, services would still need to be provided, so there would not be a shut down of services. The same people who need medical services now will need services regardless of what plan we have.

People would, therefore, still be working in this industry to provide.

The payment method, organization and administration of these services would be restructured.

Additionally, there would still be private providers for elective surgeries --- such as cosmetic services and such --- and or for those who wish to purchase something above and beyond (say, a private room or private duty nurse, or something to that effect).

What I would love to see happen is for Single Payer to pass and gain approval and the implementation be in stages; say for example, if we keep expanding medicare.

So if the age is currently 65 to receive benefits, by year X drop it to 60; by year X drop it to 50..etc and keep moving the bar down so that eventually the entire population is covered and we can unhook from the private pay and incrementally move to single Payer.

I strongly disagree with the graduated/ incremental move from Public Option to Single Payer.

We need to do this right and complete in one swoop -- Everybody in! Nobody out!

The most comprehensive website for Single Payer is this one:

http://www.pnhp.org/facts/what_is_single_payer.php

I think that progressives need to be a strong unified force for Single Payer and push Obama and the Dems in this direction.

Terri

From the site, regarding incremental reform:

What about incremental reform of the health system?

As a matter of policy, PNHP expressly opposes many so-called gradual steps towards single-payer. Many well-meaning supporters often push these bills as “feasible steps” to move us towards single-payer, but the history of these kinds of health reform efforts - Hawaii in 1974, Massachusetts in 1988, Oregon in 1989, Tennessee in 1992, Minnesota in 1992, Maine in 2003, etc. - shows that despite their claims of pragmatism, incremental reforms have consistently failed for more than three decades. Incremental reforms cannot garner administrative savings and redirect them to care. Hence they always founder on the shoals of cost. In addition, these reforms distract attention from the economically realistic, if politically challenging, option of single-payer reform.

Would a “public plan option” at least be a step in the right direction?

Answers contributed by PNHP Board members Dr. Andy Coates and Dr. Don McCanne

Answer by Dr. Andy Coates

I am not convinced that it is fair to call the “public plan option” (aka Jacob Hacker’s proposal) “a move in the right direction.”

In the best case scenario this proposal would, I believe, accelerate the trend toward two-tiered care in our country. But we should recognize first that MoveOn and its friends are suggesting scenarios, not backing a specific proposal. The “public plan option,” as yet, amounts to no more than talking points, with some therefore ungrounded assertions along the lines of the quotes by Dr. Dean. (Single payer advocates in contrast have been winning support for legislation — H.R. 676 in the house and now a bill in the Senate, introduced by Senator Sanders.)

If these “public plan option” talking points are intended as a wedge for single payer against private insurance, we should see that they are also a wedge for private health insurance against single payer, the program of national health insurance that the large majority have been shown to want in poll after poll. Single payer has been dismissed by Dr. Dean and many other leading Democrats as “not politically feasible.” Indeed, the “public option” notion grew out of this very idea — the assumption that the insurance industry is too powerful, that we will always have private health insurance.

When Dean and others insist on the “choice” of insurer, they insist upon the “choice” of “keeping the insurance you have” — let’s keep the insurance business and its market, they assert. But the purpose of private health insurance and its market are the opposite of social responsibility — and individual responsibility too.

Choice of insurance companies only matters because it restricts choice in care. What matters for our health is choice among caregivers, choice in location of care. The very purpose of the insurance market is to restrict these choices and by doing so extract money from the health care system. “Adverse selection,” the name of the game of health insurance business success is a reason why we should abolish health insurance as a business. Keeping that market offers the industry plenty of what Jessica calls “protection.”

The insurance companies know all about how to keep the healthy and wealthy while showing the sick and the poor the “choice” of another plan. That is why the insurance industry lately has offered to move to community rating — if only the government will criminalize the uninsured and mandate the purchase of health insurance.

Getting back to one of the scenarios — the “choice” of buying Medicare, the “option” of paying health insurance premiums to a government entity (1) will not guarantee health care to all (as Dr. Dean asserts) and (2) will not be sustainable due to cost. Hundreds of billions of additional dollars annually will not be sustainable — on top of 2.5 trillion dollars, on top of spending that is twice what any nation spends per person. That is why Mr. Obama called $600 billion over ten years a “down payment.”

In another scenario, Senator Baucus, leader of the bipartisan “board of directors” who are working this out behind closed doors has suggested that the “public option” will be the chance to buy insurance through Federal Employee Health Benefit Program, something candidates Clinton and Obama discussed. These are (1) administered by the insurance industry and (2) way out of reach for the uninsured and underinsured, thus would at least require colossal government subsidy, way beyond the $600 billion “down payment.” Baucus also supports a “mandate” that criminalizes the uninsured.

The “public plan option” will not expand our choice of caregivers, will not be universal, cannot offer comprehensive care (and thus can not lessen disparities in care or improve quality) — and above all there will be no way to pay for it, especially as the economy continues to tank. We should conclude that it is not reform!

We should also recognize, with confidence in people to decide and act for themselves, that the single payer cause is growing into a mass movement for civil rights. We may not be likely to win single payer this spring, but as the only proposal for health reform that will save hundreds of billions of dollars annually, that is comprehensive and just and practical, our prospects will continue to brighten, no matter what inside-the-beltway compromise people like Dr. Dean ultimately recommend we make with the insurance industry.

Answer by Dr. Don McCanne

The option to purchase a public plan within a market of private health insurance plans would merely provide one more player in our inefficient, dysfunctional, fragmented, multi-payer system of financing health care, that is if the public option even survives the political process. It would leave in place the deficiencies that have resulted in very high costs with the poorest health care value of all nations (i.e., overpriced mediocrity in health care).

Those who believe that the people of this nation would have the wisdom to drop their private plans and join the government program are ignoring history. When Congress authorized private plans to compete with our existing public program, Medicare, many enrollees did just the opposite. One-fifth have left the traditional Medicare program and joined the private plans.

So why should we care? Why shouldn’t they have the right to choose private plans if they want them? We know that those private plans are wasting money, both in their own costs and the administrative burden they place on the delivery system, but what all too many don’t realize is that we are all paying for that waste because of the inherent structural deficiencies in our financing system. Plus we are being deprived of the reforms needed in our health care delivery system that our own single payer monopsony would bring us.

Single payer activists, don’t give up. As President Obama said in his press conference this week, “persistence!?

http://www.pnhp.org/facts/singlepayer_faq.php#incremental

Whatever method required, I'm glad Glenn Greenwald keeps pushing. There's no reason why he should relent. He just wants people to take things more seriously. They should.

But it's important to remember that there are some really good Democrats working on behalf of good ideas and progress, as well as some independent individuals in the media-- fact and humanitarian departments of America.

I'll put my all-star Dem/Progressive team up against the finest parliamentary leaders, statesmen, and activists in the world, and certainly against the whole damn GOP.

Think about your Dem/Progressive best.

There's a lot of positives to accentuate.

Terri, have you ever worked in a doctor's office? Because we're not talking about availability of care. We're talking about the reimbursement of physicians, hospitals, etc.

I understand that these are not affected by single-payer. That is not the point.

HOW do they get paid? THAT is the point.

What number are nurses going to call with a billing problem?

Where's the single-payer formulary list for pharmacies?

There is a tremendous amount of human and organizational infrastructure involved in this question. That infrastructure already exists.

Yes, the for-profit model is too expensive. But to go directly to single-payer, you'd either have to (A) nationalize the insurance industry, or (B) spend many billions to get a program of the ground quickly.

Like any project this big, you can have it done right, you can have done fast, or you can have it done cheap. You can have any two.

I'll tell you one way we ought to be emulating the right, is by not crapping our pants in terror at the idea that we might be criticized for standing up for our views. Here's the thing: this notion that we'd better not speak out too loudly or too strongly for fear of being seen as "whiners" is a construction of the right that we've bought into out of our own lack of self-confidence.

Take the public option issue, for instance. It's been described so often and so loudly as a "left of the left" issue, that a lot of progressives believe it and think, "gee, well maybe we need to scale this back." But guess what? AN OVERWHELMING MAJORITY OF THE COUNTRY WANTS A PUBLIC OPTION. Yet this is still being treated as a "liberal" issue.

The problem with the hand-wringing over whether we're being "self-destructive" by being loud and activist is that it assumes progressives are a small fringe in this country. That's a lie the GOP created that most of the country has bought into. Yet on an issue-by-issue basis, progressive causes actually enjoy wide support in the mainstream of the country. If there was ever truly such a thing as a "silent majority" in this country, it's the left. The problem is, we're too so intimidated by the corporate media to assert our strength.

The problem with the left is not that we're too loud or too aggressive, it's that we seem to have no clue as to how to effectively communicate our ideas. When we speak out and it doesn't work, we assume it's our ideas that are flawed, not our message. What we never seem to understand, that the right perfectly understands, is that it's not always about ideas. Most of the time, it's about engaging people's emotions. People respect strength. And we don't project strength, in large measure because we spend so much time with this self-conscious hand-wringing about how we're going to be portrayed in the media, rather than standing firm on what we believe in.

Sorry, but I'm with Glenn Greenwald on this one. What we're seeing right now is that this pursuit of victory at the cost of our convictions is useless when it creates the pathetic spectacle of a Democratic supermajority that somehow manages to be completely hamstrung. What's the point of a supermajority if we can't do anything with it? I'd frankly rather see Democratic losses if it results in a stronger, more robust, more disciplined party. Contrary to popular belief, I think this would give us more victories in the future, not fewer, because it would mean we were finally working from a position of strength and confidence instead of fear and insecurity.

"Part of the problem with healthcare is not the republicans but the democrats, including the democrats telling progressives to sit down and shut up." Bill Moyers

______

The progressives should be speaking up! Bob, I ask you to be a voice to have the progressives speak u and not to tamp down!

As I have said a thousand times, there's a difference between constructive criticism and complete defeatist and non-productive attitudes.

I have hardly heard or read any constructive criticisms. Most of the stuff that I have been reading and hearing has already placed Health Care Reform as defeat, when there isn't anywhere near a final bill. The bills that have circulated all have a public option, but none of that is repeated. What's repeated at ad nauseam is how Obama is giving away the public option, when he has been saying the same things since the beginning. Even Ezra Klein pointed that out. This has been one of the craziest August news cycle ever.

It's amazing to me that Obama's supporters have fell for all of this political theater hook, line, and sinker. I have spoke to several people(co-workers, friends, family) who don't read blogs and have a completely different opinion of the President, than supposedly well informed political blog readers. These are all Obama supporters who support him, and won't make any concessions about who he is and what type of leader he is for a while. Their overall consensus is that it way too early. But amazingly, they all feel we will get health care reform with a public option.

I like Glen Greenwald, but personally I think he is saying all of this, because criticzing the President gets him more clicks and links to other blogs. It's just attention. Unfortunately, it's shameful.

I'd frankly rather see Democratic losses if it results in a stronger, more robust, more disciplined party.

Bring this up again after we have publicly-financed campaigns. Non-corporate candidates of either party will be as rare as Sasquatch without it.

That single issue is bigger than all the other "problems" with the party put together. It makes primary challenges all but impossible, and immediately ties any winning candidate to his corporate benfactors.

I wish a Democrat would reach office and then flip corporate interests the bird, knowing that serving his constituency and the public good will keep them in office as long as they wanted—no matter who outspends them.

Perhaps Franken?

Thank you, Da Bomb. I'm not sure who is worse -- the left or the right with all of the hand wringing and bunched up bloomers. If Obama could have accomplished all that they think he should have (forget about he's not been in office a year yet), then he would truly be the messiah. He's one man, folks, most likely doing the best he can. Just because you folks don't see it happenin' doesn't mean that it isn't.