Hey, can we strap Public Financing for Elections onto this thing?

Joe Lieberman isn't the only one to blame here. There's Nelson, and forty republicans as well. Not a one of whom votes against single payer if lobbyist money is out of the picture, especially after they see how much money single payer would save.

It's time to give Washington an economic enema. We all thought health care reform was the most important bill that could be passed in our time, but the more I think about it, the more lobbying and campaign financing reform overshadows it.

electing progressives sounds like a good idea. Not looking too likely for the near future though...

Also, Bob, since you are a chairman for your local Democratic Party, can you make a suggestion to someone that they should at least get a CBO report on what Single Payer would cost verses our current system?

Some people's ability to be manipulated is endless.

This bill is a piece of shit. A piece of fucking corporate-generated shit. If anyone wants support for this piece of shit so the poor can get a little something, then take out the mandate. I will never get behind a bill that forces me to fork over my money to a bunch of criminals. Never. Don't you dare hold up the poor to make people feel guilty for rejecting this god damn giveaway to these corporate criminals.

Also, Bob, since you are a chairman for your local Democratic Party, can you make a suggestion to someone that they should at least get a CBO report on what Single Payer would cost verses our current system?

Sorry about the double post.

Allen, of course it's corporate generated crap. What did you expect with a campaign financing system like ours, where lobbyists, and worse, PACs dominate the legislative agenda?

Do some work, and get behind your elected officials about getting lobbyist money and PAC money out of our elections. Until we do, we will always have our elected officials giving favor to their real constituents; the people who give them money.

Well, PPP, you're making a lot of sense now. Check out my post below on the bribery issue.

Bob, I am having trouble with this one . . .

"I don't know if the progressive movement would be best served as being responsible for stripping poor, working and middle class Americans of health insurance subsidies."

More taxpayer subsidies to the criminals that caused the crises? There has to be a better way.

Channeling:

Eric Cantor came out today explaining how government over-regulation caused the crisis we're in!

This is why Obama is right and we're wrong!

It's as simple as choosing one step forward or ten steps backward!

agreed.

I still feel like this particular incarnation is not real reform--it's a half measure on the very first rung of a long ladder leading to actual reform. It certainly has some good elements and many of the good elements are not politically sexy enough to get people worked up about, and that's probably a good thing.

I am ALL FOR working harder to push a more progressive agenda, getting more progressives elected, etc. I believe the efforts should be bold, but I'm damn tired of the teabaggers being the only voice of civil disruption out there.

How about we build an effigy of Lieberman made from 45,000 popsicle sticks; each one representing an American who died or will die this year from lack of health care. Then, we do what people do with effigies. Maybe the MSM would actually take notice.

Adding:

I've stated before but it bears repeating, this will only be changed on the state level.

I didn't get to vote for or against Lieberman nor did you get to vote for against Roberts!

As Democrats we must move our own states in the right direction, and no failure must be met with apathy!

Hielo & Co: What is your FIRST priority? Helping the American people or gutting insurance companies? Every single rant I saw mentions bringing the insurance companies to their knees more often than what to do to help the American people.

And this article is right and it's similar to what I said last night. You can sit and hope that the bill dies or you work on making the rest of it better. I mean, the bill is a piece of shit right?

I heard a good "fake" commercial from Allstate today.

"You're in good hands with Allstate...cuz we don't sell health insurance."

@Hielo:

>>>>>More taxpayer subsidies to the criminals that caused the crises? There has to be a better way.

With all due respect, I think the "giveaway to corporations" angle is weak.

What if we had single-payer? Who would it be "paying?" For-profit drug companies, for-profit hospitals, for-profit everything except the insurance cartel.

In other words, your same "taxpayer subsidies to the criminals" argument could be applied to single-payer. Actually, it's the providers (drugs, doctors, hospitals, etc) who are partly responsible for the high cost of healthcare right now.

no po=no mandate.

I just love the WH talking points, the big one is HEY IT WILL COVER 30M PEOPLE. They make it sound like a gift. NOT.

No. Correct language would be GOVERNMENT FORCING PEOPLE TO BUY CRAPPY INSURANCE.

I'm broke, I'm unemployed and uninsured. DO NOT HOLD ME UP as a reason to pass this bill.

I'm with Bob and Allonfla.

We need to get this passed then keep working for the many things that need to be addressed. Killing the bill on principle conflicts with our principles of helping people who need this bill -- people who can't get insurance because of pre-existing conditions, small business owners who need an exchange, etc. There is more in this bill than we can get later and some of this we can get the second the bill is signed. We can keep moving forward. This bill doesn't stop progress, but killing it will.

When I look at this KFF attachment, I remember that reform isn't all about the PO and we only started talking the Medicare buy-in two weeks ago. Everything else has been here all along and isn't going anywhere. I do not want to throw all of this out the window for revenge or spite or teaching someone a lesson. Average Americans will suffer far greater from the "kill the bill" lesson than any politician will.
http://www.kff.org/healthreform/upload/housesenatebill_final.pdf

Jennifer

Allonfla

In my former life I was a trial lawyer and did a lot of business with the insurance companies. They are the most reprehensible shit weasels on this planet. If you think that putting money in their hands will help people with health issues, then you just do not understand who we are dealing with.

They will find every loophole to screw the insured (and taxpayers) that are mandated to pay for their garbage products.

We sued companies, got a big verdict with punitive damages, and they did not modify their conduct one bit. They just make too much money fucking people over.

If there is no real option for decent, honest coverage, there is no reform.

OK, Jan. I won't hold you up as a reason. I'll hold myself up: I want the end to pre-existing conditions NOW. I want to apply for health insurance without fearing I'll be denied, charged more or have a reason for anything in the past to be an excuse for not covering my needs.

The mandate thing concerns me without a PO BUT there are a lot of ways around that mandate. An unemployed person would qualify for an exemption and we have several years to work toward a PO or something similar before the mandate penalties even kick in.

Jennifer

@ Bob

I hate to say this because I value your opinions very highly. But, it does appear that you are getting a little desperate. For example . . .

"In other words, your same "taxpayer subsidies to the criminals" argument could be applied to single-payer. Actually, it's the providers (drugs, doctors, hospitals, etc) who are partly responsible for the high cost of healthcare right now."

This is not a good comparison. The insurance carriers are the primary source of health care costs. In addition to obscene profits and executive pay, they are huge, inefficient, quasi-monopolistic slugs that do not resemble competitive businesses. Not even a little bit.

Think of them as croupier dealers at the craps table. We put our money on the table and they rake off a big chunk for doing nothing more than just being there and handling the money.
The medical providers need to be reigned in and government insurance can do better. But the fly shit in the pepper is the insurance companies.

Simply stated, I do not feel that they can be regulated without an alternative, honest industry that people can go to. I know I sound a bit like the whiners busy defining the problem. But we have to take a stand somewhere. Reconciliation? Shit, what do I know? The way our bribe-infested government works does not provide me with a lot of hope.

@hielo, a significant amount of the unreasonable health care costs do come from providers--specifically from hospitals, more specifically, for profit hospitals. Hospitals lose 100s of millions of $ every year as a result of inappropriate ER visits and the uninsured. Those expenses are not just ignored. They are passed on to the rest of us through our insurance policies.

If more people had insurance and could be managed through a medical home, there would be less waste in ERs and hospitals in general. This may not remove the brunt of exorbitant expenses but it definitely helps to keep costs from skyrocketing year after year.

What if we had single-payer? Who would it be "paying?" For-profit drug companies, for-profit hospitals, for-profit everything except the insurance cartel.

True, but there is a difference. A mandate requires we buy private insurance or face fines. Single-payer simply taxes everyone and covers costs from general revenue as well as guarantees coverage. To that extent, mandates are more of a giveaway than, say, Medicare is.

I respectfully contend the insurance companies are a more significant problem than either drug companies, hospitals or doctors. Generic drugs and non-profit hospitals exist.

Mind you I'm with you. I think we're better off trying to work through the current bill than letting the opportunity slip for another 16 years, and I'm loathe to make the perfect the enemy of the good. But mandates are a huge issue for me.

It's getting to a point at which the political cost of passing this rancid turd will outweigh any self-congratulatory chest thumping about passing some nebulous shit-pile called "health care reform."

If the bill can be improved, fine. But if the President signs a bill into law that resembles the one currently wafting around the Senate, it will be a more profound albatross around his neck than the Tehran hostages were around Carter's. And deservedly so.

There are times when right and wrong are more goddamned important than winning or losing. I'm afraid you're losing sight of that, Bob.

I can hardly jump into this debate here.. I just want to add: myself, I'm really on the fence about all this. On one hand, where the hell's the cost control? isn't that a truly critical issue (that the so-called financially conservative are ironically blocking)? And on the other hand, America needs reform! not to mention we need help be able to afford modern health care!!

One things for sure- I fully support Chicken Man.

.. those in need of a little comic relief are advised to click on the above link ; )

Camel

What do you mean by "medical home"? I think (uselessly) of expanded Medicare as the place we can achieve true cost savings.

Yeah, I know. It doesn't matter. But we're talking cost factors here.

Woah, Chicken Man's got some chops!!

@Klaus:

>>>>Single-payer simply taxes everyone and covers costs from general revenue as well as guarantees coverage. To that extent, mandates are more of a giveaway than, say, Medicare is.

But those taxes are mandatory, right? I mean, what if I decide I don't want to subsidize for-profit providers. I can't decline to pay those taxes. With Medicare, you can technically opt out, but you're penalized by losing your Social Security benefits.

@ClayP-Being right isn't worth a can of cold bull piss in Washington D.C. If being right were a requirement of winning elections, Reagan and the two Bushes would have never reached 1600 Pennsylvania Avenue.

You gave an example of Jimmy Carter taking a hit with the Hostage Crisis in 1979-80. He was right, wasn't he? Didn't all of those hostages come home without military force executed? Killing the bill at this point and time might be the right thing now, but down the line when the seams on our health care system busts, they will look back on this President and blame him for not acting with any bill.

I hear there's a bill ramp up the war in Iraq that has a rider that increases the unemployment insurance to two years. Well, we'd all better get on board with ramping up the Iraq War. We don't want to be bad liberals and deny the unemployed a reasonable safety net. Come on now. Get on board. Quit complaining. More war is a small price to pay for giving the poor and working classes some peace of mind.

GOV

What do you think of the program where a good bill (Medicare Buy-In. . . say to age 27) emerges from committee and then letting the lying, bribed, cowards do there fucking filibuster?

I think the little shit hobbit from Connecticut would piss his pants.

Lieberman wouldn't care. Lieberman doesn't have a soul, this is a guy who dropped support for a plan simply because a liberal representative supported it.

We've already lost. Insurance companies win. Whether this passes or not, they're getting their profits either way. This bill basically forces the uninsured who don't want insurance to pay the health care costs of those who can't afford it. This is most preferable by single payer but we are nowhere near that. And there's certainly no reason a public option would hurt anyone. That's total bullshit, we all know that.

The fact is, even though we were progressive enough to elect a black man with a name that rhymed with Iraq Osama, the electorate didn't change as much as we thought, and most of us who campaigned for him kind of gave it all we got and aren't doing nearly enough this year. Obama was the face of our movement. Who is the face of this movement? We have no coordination and no coherent message, and I don't see that changing anytime soon. In the last few weeks, it's been all about Lieberman, Reid, and Obama. I haven't heard a peep from Rush or Beck. Starting now, we need to show the stark contrast between us and them. We obviously need to gain more seats. I haven't donated any money all year but I getting back in campaign mode, giving MoveOn a few bucks toward getting rid of Lieberman. The midterm campaign has to start now.

But those taxes are mandatory, right? I mean, what if I decide I don't want to subsidize for-profit providers. I can't decline to pay those taxes. With Medicare, you can technically opt out, but you're penalized by losing your Social Security benefits.

Of course the taxes are mandatory, just like the income tax and the Social Security tax. As an employee, I can't refuse to pay because it comes out of my paycheck. I have no idea how it works now or would work for the self-employed. Still, we could extend that argument to supporting wars or anything else the government spends money on, yes?

As a person on single-payer (I'll call it Medicare), you could choose to go to a non-profit hospital. You get to choose your provider because (do correct me if I'm wrong!) everyone accepts Medicare.

Let's replace healthcare with retirement as an example. If Social Security were done away with, to be replaced by a mandate to invest with one of a handful of investment firms, would that be problematic? Efficient? Even of dubious constitutionality?

In short, you're quite correct that single-payer does result in a transfer of funds from taxpayer to government to provider. But the provider is at my discretion, versus an insurance policy's "network." The costs of single-payer are also lower, at least comparing the European systems.

To wrap up my rambling, everyone pays taxes to a government they have a voice in. I don't get to vote for the board of Aetna unless I own a boatload of stock. Forcibly transferring wealth to these companies that have a variety of methods to deny coverage is problematic.

I'm very angry right now and have been wishing death on a certain senator from CT all over the interwebs today. I think I should have a drink now and just chill out for a bit.

Hielo, unfortunately I think LIEberman is looking forward to a filibuster. He wants to be on the news 24/7. He DVRs it so he can watch himself later and wank what's left of his tiny shriveled and wrinkled little.....

I'm with Hielo: get some of the best measures from the house bill in there in Committee, and let Lieberman decide if he want's to derail the entire health care reform bill at that point. I don't think he's go the balls!!

sure, there'll be whining, but he's not going to block the entire thing, is he? losing HRC would rest squarely on his shoulders.. he would go down in history, all right!

@Jefe: laughing my ass off!!

Rox, you aren't the only one. I'm reading it all over the internet. LIEberman should seriously be worried about his safety. He is the most hated republican since Bush at the start of the Iraq War.

Le sigh...

As I've said mandates are problematic to me, but I think the larger point, at least in the short term, is getting pre-existing conditions and rescission. Just those two are pretty huge. Maybe that's me setting the bar low, but given the GOP and conservadems, what did we honestly expect?

I wish we could march on the Mall and get Canadian-style care, but we won't. And nothing gets out of the Senate without some combination of Lieberman, Nelson, Snowe, Lincoln, etc. Like it or not, that's what we have to work with.

It depresses me.

Don't be depressed, Gottverdamt. Just quit your job and become poor. Then your healthcare is free.

See? Joe really does care!

"You gave an example of Jimmy Carter taking a hit with the Hostage Crisis in 1979-80. He was right, wasn't he? Didn't all of those hostages come home without military force executed?"

The worst of examples! Carter did listen, unfortunately to the wrong people! Remember the choppers crashing into each other?

Major clusterfuck! Then Reagan got credit suppossedly because his mere presence scared the fuck out of the Ayatolla!!!!!!!!!!!!

Full of shit lately? Try colace!

On a serious note, is this bill going to create a class of people who are financially better off staying poor?

Just wondering...

@kansasdem-And thats my point. Reagan won, got the credit for the Hostage Crisis though Carter was instrumental in brokering their release.

Jefe and GOV

Maybe so. But with the bill that will most likely come out of committee, what do we have to lose by letting the public and 40 million uninsured watch the tragic spectacle put on by Lieberman and the GOPers?

Protests maybe?

At a minimum, a resolve to go this way could be a bargaining chip. No?

State by state! Mind by mind! Vote by vote!

kansasdem

You left off . . . "bribe by bribe!"

Klaus: >>>You get to choose your provider because (do correct me if I'm wrong!) everyone accepts Medicare.

http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

Corrected.

@hielo, medical home is just a term for the place a person goes for their care. It has broad implications for the future with electronic medical record keeping but for now think of it as your primary care provider or whoever manages your care. People without insurance are essentially medically homeless. Because of that, there is no consistent and effective management of their care. Having a medical home keeps people out of the ER for non-urgent care. It also helps people manage chronic conditions better. Those things save huge amounts of money.

There's enough loopholes in the Senate bill to drive a truck through. Yeh, they'll take you with a pre existing condition- at DOUBLE the regular premium. Yeh, you'll get insurance with huge deductibles and co pays. Dependng on income, you could pay up to 17% of your income efore the subsidies kick in.

So whatEVER.

"kansasdem

You left off . . . "bribe by bribe!""

I'm talking bottom > up!

We do decide who represents us!

Thanks for the empathy eljefejeff! I'm in much better "spirits" now!

@Rogect8

Thank you for the link! Holy crap - annual physicals aren't covered by Medicare?

I didn't know about the concierge doctors either. I know that quite a few people go to India or Thailand for treatment, because even out-of-pocket it's less expensive than in the US.

Camel54

Re: "Medical Home". Got it. As it should be.

If anyone wants support for this piece of shit so the poor can get a little something
The bill doesn't help the poor - the poor qualify for Medicaid! geez. It helps people who can't get insurance at all or who are in danger of having their policies rescinded or who are paying insanely high premiums. Does the proposed bill do everything we want? no. Does it still help people? most certainly. Do we know what's in it? not yet. Is it final? NO.

@ceu, poor people don't by default qualify for medicaid. It depends on the state they live in and how poor they are, how many assets they have, how many family members, whether they are already on medications or not and how much per month those meds cost. For example, a couple of empty-nesters with a home/land they own on little or no medication can make enough money to not qualify Medicaid easily even though they may not make enough money to pay their utility bills, grocery bills, etc.

Medicaid can be a nightmare to navigate, and though this bill won't change that, giving people access to case managers will help significantly.

@ Klaus - Yeah, I know...it's absolute insanity. Btw, I totally agree with the sentiments you've expressed in the comments here (you're making so much damned sense that I had to go back to a previous post from a few days ago b/c I remembered getting into an extended argument w/ you, but I honestly couldn't remember what it was about).

The entire healthcare system has become so rotten to its core that it boggles my mind just to think about it. That's actually what concerns me most about this whole healthcare debacle - even the solutions that have been proposed along the lines of "Medicare buy-in" or "public option" are riddled with problems.

That article highlights just a few of the issues with Medicare, but I don't think even mentions the fact that the entire program is quickly headed towards insolvency, and is badly in need of some reforms of its own (I'm sure Congress will get around to that in a jiffy....)

And having received government healthcare on countless AFBs as a child, and later getting my health insurance through TriCare (the DOD's health insurance for military personnel and their dependents), I'm also wary of the public option. I'm not as well-versed in how that version of government insurance would actually operate, but if it's anything like other forms of government-sponsored health insurance, it will be accepted NOWHERE, or by only the worst of the worst healthcare facilities.

I guess that's why I'm so gung-ho about just getting SOME SORT OF BILL passed - with or without the public option. The system as-is is so bad that almost any change will be a positive one; especially if it's aimed at regulating private sector insurance providers. Hell, even if we only knock out a couple of the problems (like you mentioned, pre-existing conditions and rescission are two big ones), it's at least something we can build upon.

But like you pointed out - the current version of the bill includes those pesky mandates; which is a huge issue for me, because I simply can't afford to get health insurance through the private sector right now (we broke-ass students are a notoriously uninsured bunch). I understand the logic of the mandates, but as a practical matter, I'm not convinced there are enough cost-reducing measures in place (yet) for mandates to be a good idea. And of course, as a purely moral matter, I don't want to give my money to companies like BCBS anyway. And even if I didn't have any moral qualms about it, any insurance they can offer me is so ridiculous in terms of high premiums and deductibles, it's basically the equivalent of me saying - "I'll bet you guys that I get into a car accident and have to spend 2 weeks in the ICU," and them responding "You're on. We bet that you don't." That would be the extent of my coverage.

>>>"It depresses me."

I hear you on that one. Hell, it's not just old people who are turning to India or Thailand for treatment. SWIM has to get any prescriptions he needs from less-than-reputable generic overseas pharmacies for Christ's sakes. He doesn't want to; it's just so much cheaper than the alternatives that he doesn't really have a choice.

"Best healthcare system in the world".... my arse.

@ Rogect8

Indeed, you remind me of another problem (and why I understand but hate mandates) - if the private firms are obligated to not drop people and cover even pre-existing conditions, they may be unable to succeed as businesses. Not that I'd lose sleep over that in itself, but they have to be able to cover their overhead. I'm not convinced they can. Which means they'd end up turning to the government, which would bail them out. And we continue to pay more for crappier service.

You're right, the system is fundamentally wrong. This bill may make things better for a while, but it will have to be revisited.

I still wonder if mandates would pass Constitutional muster. States mandate insurance for drivers, but one can opt not to drive. One can't necessarily opt not to live (there's suicide, but if you fail then the state just locks you up for a while). I'm sure there's some tortuous rationale for it, just one I don't know. "General welfare" seems silly, since that has to do with Congress raising revenue, not telling me how to spend my money. But then I'm an odd liberal in that I tend towards Jeffersonian views on the Constitution ;)

@ Klaus - It's funny that you'd bring up the Constitutionality issue. I'm off to take my "Constitutional Law II" final in a couple hours. The most important thing I've learned is that ours is a results-oriented Court - and certainly not as apolitical as they'd like us to believe (Bush v. Gore settled that argument once and for all - Scalia suddenly in favor of expanding the scope of the equal protection clause, but just this once? Rrrrrriiiiiiiiight.....). If the majority is in favor of mandates as a matter of policy, they'll find a way for them to pass constitutional muster.

Actually, if you go here: http://law.wfu.edu/ , and click on the 3rd bubble under the main graphic, there's an interesting video of a few law professors discussing this very question (though I'm not sure the link is still working; I'm having trouble getting my computer to play it). If I remember correctly, they all seem to think that mandates would indeed be constitutional, though for the life of me I can't remember any of their rationales.

My guess would be something to do with the Commerce Clause, just because the Court has never really figured out what that does or doesn't allow Congress to regulate. It was interpreted VERY broadly from the 1930's until about 1995, but since then they've started to reign it in a bit, so who the hell knows. Since it's constitutional for the government to force you to automatically pay into a health insurance program that you may or may not live to take part in (Medicare), I'm sure they have lots of precedent to work with. It's probably a short leap from Social Security and Medicare to mandates.

Also funny that you'd mention Jefferson. I have a statue of him in my living room (though admittedly, my admiration for Jefferson has less to do with his views on the Constitution and more to do with my animosity towards people who try to turn our government into an offshoot of their religion).

I actually do know that, Camel. (hanging head) I was a bit irritated when I wrote that comment. Bottom line, tho, is that this piece of proposed shit will still help people by doing more than giving subsidies to "the poor".
They need to drop the mandate, tho. It just makes no sense without a low cost alternative.

Healthcare tourism, I'm serious, if you need healthcare, call a hospital in Canada or Europe, ask for an estimate of how much the bill will be for the care you need, stop paying insurance, put your money in a high interest account and bypass the insurance companies, it happens all the time in the UK, we always have people in for operations and treatment from overseas, who ask for estimates of cost, its not as expensive as you may think, and if enough people do it, the HC insurance firms will soon take notice.

Subsidies...this is our collective tax money going to help pay the bloated rates insurance companies charge individuals, in part to fund their lobbying and legal teams, right?

I get that the subsidy is for the person, but where does all the money end up? In the coffers of the companies who love and lobby for the status quo.

The more subsidies we provide, the more powerful and entrenched we let these bloodsucking companies become.

If subsidies to the insurance companies is the best part of the bill, I think we're stuck.