The Finance Committee’s Work in Progress

The Washington Post’s Ezra Klein has gotten hold of an outline of the health care reform bill that the Senate Finance Committee is working on. It gives a clue to their direction, although it is certain to change–perhaps substantially–between now and the time the committee begins formally drafting the bill after the July Fourth recess. Here’s what Ezra thinks of it:

You could write this story a couple of different ways. The first is to note is the Finance Committee has substantially retreated in the face of the $1.6 trillion price tag the Congressional Budget Office affixed to its original submission. This version of the plan is, comparatively, quite diminished.

The numbers tell the story. In that plan, subsidies [KT NOTE: for helping the uninsured purchase health coverage] reached [those earning up to] 400 percent of poverty. In this plan, they’ve been cut to 300 percent. In that plan, Medicaid eligibility was as high as 150 percent of the poverty line. In this plan, it’s 133 percent for pregnant women and children, and 100 percent for childless adults. In that plan, the “gold” coverage was 93 percent of a person’s estimated expenses, and “bronze” coverage was 68 percent. In this plan, those numbers are 90 percent and 65 percent, respectively. That means people with a low-cost plan might be covered for only 65 percent of what they’re likely to need.

Another way of looking at the plan is that it remains a significant step forward. Subsidies to 400 percent of poverty would be nice, but subsidies to 300 percent of poverty are far beyond anything we offer now. Coverage that protects against 65 percent of anticipated costs is better than no coverage at all. The co-op idea isn’t a public plan, but with federal seed money to start new co-ops, it’s a good idea on its own merits. There’s an individual mandate, state-based health insurance exchanges, and a substantial health and wellness initiative. Insurers are barred from discriminating based on health history and Medicaid is sharply expanded.

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  • gysgt213

    KT-Have many elements of this plan been offered before?

  • trifecta55

    I am just so frustrated with this whole mess. Compromising with people who are paid to oppose health care reform is sausage making at the worst.
    .
    It would be nice if the American people could get a choice to have their say. Behind all the complications and details there is a philosophical divide. There are those who believe health care is a right, and those who believe it is a privilege that should be addressed by the free market.
    .
    This health care debate is going to end up with Broderian compromise which may end up being inadequate, and more expensive than a complete overhaul. I don’t know who came up with the dumb idea that compromise on basic principles is a great thing. You can compromise on priorities, but health care really is about your basic belief system when it comes down to it.
    .
    Would anybody accept a compromise on abortion that if you were pregnant with twins, you could abort one, and the other is given state protection?
    .
    I am deathly afraid that this compromise is going to cost a ton of money, still leave many people in a gap, and because it’s not going to be that effective, it will be used as an excuse later not to try fixing it again. Perhaps we can make the 2010 election a national referendum on the issue. Do you like it how it is, or do you want a change? Or maybe Joe Lieberman, Arlen Spector, and Olympia Snowe will come up with a Washingtonian compromise where if you make between $30,000-$40,000 a year, you qualify for your wound to be half sutured. Oye.

  • Karen Tumulty

    gunny: the elements are all pretty much what they have been talking about. it’s–for lack of a better word–the aggressiveness of those elements that is being scaled back. for instance, to save money, they are offering subsidies (presumably on a sliding scale) to those earning up to 300% of poverty (roughly $32,000 for an individual; $66,000 for a family of four). Earlier those subsidies would have been more generous, going up to 400%. What that means is that if you earn just over that level, you will be REQUIRED to purchase insurance, but the government won’t be giving you any help to do it. These subsidies are why health care reform is so expensive.
    .
    There is also a big expansion of medicaid (which is a public plan), but not as big as they had earlier been talking about.
    .
    And, of course, the coop is not the same as a public plan. but what I saw in that document was very sketchy, so I can’t really tell you how MUCH weaker it is.
    .
    Nor have they made any decisions about the employer mandate, except that firms over a certain size are going to have to pay some kind of penalty if they don’t insure their workers.

  • gysgt213

    Thanks KT.
    .
    But here is the reason why I ask the question that I did. And the below is from November of 2008.
    .
    Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate
    .
    Washington, DC – Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate.
    .
    Under the new proposal, health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance.
    .
    Health plans also said that premium support for moderate-income individuals and broad spreading of risk was necessary to promote affordability and maintain premium stability in the individual health insurance market.
    .
    To ensure that all Americans can access coverage, health plans also reiterated their long-standing support for making eligible for Medicaid every uninsured American living in poverty and strengthening the Children’s Health Insurance Program.
    .
    “No one should fall through the cracks of our health care system,” said Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP). “Universal coverage is within reach and can be achieved by building on the current system.”
    .
    The announcement follows a nationwide listening tour conducted by AHIP as part of its Campaign for an American Solution. Concerns about coverage for pre-existing conditions, continuity of coverage for those between jobs and maintaining affordability for those with insurance were raised repeatedly across the country.
    .
    “AHIP’s Board of Directors is responding to the concerns of the American people by offering a workable solution to ensure that no one is left out of the health care system because of their health, age, income or employment status,” said Ignagni.
    .
    The new proposal builds on the series of comprehensive reform plans that AHIP’s Board of Directors began releasing in November 2006. Further reform proposals addressing the affordability, accessibility and quality of health care are anticipated in the weeks ahead.
    .
    Summary of AHIP’s Proposal to Guarantee Coverage for Pre-existing Conditions and Promote Affordability in the Individual Insurance Market:
    .
    *
    Guarantee-issue coverage with no pre-existing condition exclusions;

    *
    Establish an individual coverage requirement with an insurance coverage verification system, an automatic enrollment process and effective enforcement of the requirement that all individuals purchase and maintain coverage;

    *
    Promote affordability by: providing refundable, advanceable tax credits for moderate-income individuals and working families; and promoting tax equity whether coverage is obtained through an employer or the individual market; and

    *
    Ensure premium stability for those with existing coverage through a broadly funded reimbursement mechanism that spreads costs for the highest-risk individuals.
    .
    Background on the Individual Market and Guarantee Issue
    AHIP’s survey of the individual market shows that individually purchased health insurance is far more affordable and accessible than is widely known. The survey found that 9 out of 10 applicants undergoing medical underwriting were offered coverage. The plans commonly purchased by consumers provided substantial financial protection and a wide range of benefits, including coverage for behavioral health, prescription drugs and preventive services.
    .
    Some individuals are unable to purchase individual health insurance coverage in the private market because of their health status. One approach taken by states to address this issue has been the enactment of guarantee issue legislation requiring health plans to offer coverage to all applicants. These well-intentioned reforms have often resulted in severe unintended consequences, including significantly higher costs for all policyholders.
    .
    http://www.ahip.org/content/pressrelease.aspx?docid=25068

  • jcapan

    OT, or is it? Avi Lewis’ “Schwarzenegger’s Shock Therapy – Poor Pay For Sins Of The Rich” He says of CA: “the state is a Petri dish for some of the most virulent strains of American political culture,” which seem apt re: health care. And his Fault Lines documentary is great:
    ~
    http://www.commondreams.org/view/2009/06/18-14

  • Karen Tumulty

    all that stuff is in there, as it has been in every serious reform plan we have heard since the presidential campaign. because this bill has an individual mandate–which is what the insurance industry wants more than anything else, because it means tens of millions of new paying customers and a much broader spreading of risk–the industry is willing to make those other reforms, like getting rid of pre-existing conditions.

  • gysgt213

    “all that stuff is in there, as it has been in every serious reform plan we have heard since the presidential campaign. because this bill has an individual mandate–which is what the insurance industry wants more than anything else, because it means tens of millions of new paying customers and a much broader spreading of risk–the industry is willing to make those other reforms, like getting rid of pre-existing conditions.”
    .
    Are we talking about serious reforms to help the American people or the “insurance companies?”
    .
    Because what I get from what you just said is that we are beholden to the wishes of the industry and not to the American people. So, with all due respect to you and Ezra, this is a bunch of bullsh*t that gives into all the industry demands and none of the American people. Unless of course you work for a health insurance company.

  • trifecta55

    Will the top 3 health insurance company CEOs car pool their corporate jets on Thursdays in months that start with M though? They are sacrificing so much already. But maybe that little bit of effort will be a sign of good faith.

  • Mr. Nice Guy

    Gunny, don’t be so naive.

    > Because what I get from what you just said is that we are beholden to the wishes of the industry and not to the American people. So, with all due respect to you and Ezra, this is a bunch of bullsh*t that gives into all the industry demands and none of the American people.

    You don’t really think that Congress has We the People in mind, do you? Only marginally. We don’t fund PACs, or other lobbying agents, to pad the election war chests of influential politicians. Insurance companiess do. Therefore, of course they get greater consideration. When was the last time you heard of a “voters’ lobby” that got to sit in on meetings with lawmakers to draft new laws? Or, heck, just draft the laws themselves, and have it submitted by a Congress-person?

    No, see, even though we pay for their salary and benefits, that, by itself, does not mean that we get prime consideration. Nope. If you want the attention of a legislator, you need to pony up the gravy.

  • http://phd9.blogspot.com Paul Dirks

    Sigh…..
    .
    http://www.allaboutscience.org/first-law-of-thermodynamics-faq.htm
    .
    What is the First Law of Thermodynamics?
    .
    In its simplest form, the First Law of Thermodynamics states that neither matter nor energy can be created or destroyed. The amount of energy in the universe is constant – energy can be changed, moved, controlled, stored, or dissipated. However, this energy cannot be created from nothing or reduced to nothing. Every natural process transforms energy and moves energy, but cannot create or eliminate it.This principle forms a foundation for many of the physical sciences.
    .
    The First Law of Thermodynamics is one of the absolute physical laws of the universe. Everything in the entire universe is affected by this law, as much as time or gravity.
    .
    It might be really fun to bash Insurance companiy executives and make jokes about corporate jets, but the sad fact is that in order for people who currently can’t get Medical care paid for to be able to begin getting it paid for, someone has to put up the money.
    .
    To think that Congress can simply pass a law that will pay for coverage is to open yourself up to precisely the attacks that the Republicans like to depict as “Tax and Spend.”
    .
    We need to get past wishful thinking and actually count the money we have available to make this happen.

  • plukasiak

    Ezra’s willingness to make excuses for a bill that represents a betrayal of health care reform is how/why he got his gig with the Washington Post. (Froomkin’s refusal to play the “make the politicians/sources look good game” spelled his doom at the post.)
    _
    In other words, Ezra got his “peek” because he’s now a reliable conduit for the insurance lobby — why Karen continues to treat him credibly is a whole nother question….

  • gysgt213

    Gunny, don’t be so naive.
    .
    Sorry. I can’t help it. I still believe that there has to be someone that gives a sh*t about us all. Even though I’m proven wrong each and every day. Consistently.

  • shepherdwong

    “In other words, Ezra got his “peek” because he’s now a reliable conduit for the insurance lobby — why Karen continues to treat him credibly is a whole nother question….”
    .
    I’m persuaded that Karen is offering the glass-half-full viewpoint for our consideration but is just as “concerned” about the corporate ownership of the public policy as you or me. You just described why she can’t be more direct, or critical, and still keep her employer-subsidized health care.

  • shepherdwong

    “I still believe that there has to be someone that gives a sh*t about us all.”
    .
    It’s called the Progressive Caucus. It’s not much, I know, compared to the forces arrayed against us. Now I give campaign money here:
    .
    http://www.actblue.com/

  • pafro

    It is amazing how the 50% of the population that is worried about deficits are very important people who cannot be ignored, but the 70 or 80% of the population that wants a public counterweight to the insurance crooks literally does not exist. I keep saying that maybe they are really going to send a public option plan to get scored by the CBO one of these days and they want all the disappointing Lieberdem compromises out of the way prior to that, but I am just kidding myself right?
    I might just go down to a busy intersection one of these days with a sign that says “Honk if your Health Insurance Sucks” just to pass my time. It sure sounds more fulfilling than reading the cascade of reports about how more Democrats are pulling the ole Benedict Arnold every single day.

  • destor23

    I think this needs context. Karne, how does a bronze plan, under this legislation, compare to what our senators get in terms of costs and benefits? How about a gold plan? Anything that leaves my senator with better coverage than I have is unacceptable to me.

  • stuartzechman

    KT, commenters:
    .
    Read the outline.
    .
    It’s the worst of all health care reform worlds.
    .
    It’s welfare.
    .
    The mandates provide welfare for insurers, the subsidies are welfare for people who qualify through lack of income (most working Americans won’t qualify).
    .
    Non-profit Metropolitan Transit Authority-type “Coop” administration to supposedly create lots of little health insurance pools (for some unknown reason) –get this– by being granted loans to start up presumably non-profit health insurance groups that must be paid back to the government. No pooling via Medicare, no nothing. Ludicrous as a solution to current problems.
    .
    Presumably because the “Coop” is an inevitable failure, they provide for “Exchanges” which are State-by-State “groups” who share customer service telephone banks, enrollment forms and –I swear to God it’s really in there– “marketing”. “Exchanges” may be approved by HHS Secretary to “compete” after five years. What a timely solution!
    .
    Workers with employer-provided health care can’t get into bogus State-based “Exchange” unless they don’t make enough to afford their contributions to their current provided plans.
    .
    Increases in Medicare eligibility for (as they put it) “low income populations”.
    .
    Idiotic sales brochure language specifying “Bronze, Silver, Gold & Platinum Plans”…
    .
    It’s as if John McCain gave up on his idea of lifting the employer subsidy for employee insurance, but then wrote a plan anyway that was a little bit extra generous to its presumed welfare recipients.
    .
    This is a f*cking joke.
    .
    I won’t even insult your intelligence by describing their “Promote Personal Responsibility”-style “provisions” to Medicare that do nothing whatsoever to reduce the cost to the program in terms of adding people to the pool to negotiate lower health care provider fees and charges.
    .
    I swear to God if Obama gets up and makes a lofty speech about how “This is the fundamental reform the American people have been waiting for…and now they do not have to wait any longer for the health care they deserve!” to sell this abortion, i.e. adds insult to injury…I don’t know what I’m going to do, but it won’t be to give money and votes to Democrats, that’s for sure.
    .
    This is awful. This is something right out of the 1970s. It’s the kind of thing that most middle-class people won’t see a single benefit from. It changes nothing. It reforms nothing.
    .
    This isn’t “health care reform”, it’s the new “health care welfare” for Republicans to run against when we still don’t have enough money to keep Medicare running without raising taxes, and people are still going bankrupt from out-of-pocket expenses.
    .
    Remember when we voted for Democrats to end the Iraq war in 2006?
    .
    Remember what they did?
    .
    This is that, except in 2009 with a majority in both Houses and the Presidency.
    .
    We’re f*cked. I’m f*cked.
    .
    What if I don’t like my coverage? What if I make too much money to qualify for this outline’s subsidies, so I can’t leave my employer’s plan –even though I know from experience that they won’t actually cover the treatments I need, except they determine that retroactively, and left me with a 5 thousand dollar bill after I saw physical therapists?
    .
    What about the people whose spouses get sh*tty insurance through their employers, and so won’t qualify for their idiotic State Exchanges, or non-existent “Coops” with God-knows-what application processes?
    .
    Where are the choices? Where is the real alternatives for people who over 3 times the f*ckiing poverty line? How do we escape employer-based coverage by insurance companies that are out to f*ck us? Eventually my taxes are going to go up to pay for all of the absurd waste in our most expensive system in the world, and what I get for it is…this?
    .
    I’m trying to be calm about this, but it’s really difficult not to see this as betrayal.
    .
    How did we get here?
    .
    This can’t really be the outcome…no f*cking way.

  • stuartzechman

    Ezra writes:
    .
    Another way of looking at the plan is that it remains a significant step forward.
    .
    Yes…that certainly is “another way of looking at the plan”.
    .
    Another way to say that is:
    .
    It’s something, and it allows political leaders to say “Hey, we got something done!
    .
    It may do something significant…for some people.

  • 53_3

    What a bunch of carp. Look. There is a way to pay for it. I’m willing to pay more in taxes. I don’t think anyone, who is for real reform, is unwilling to do so.
    .
    This is a pointless low down dirty boatload of fecal matter.
    .
    Forgive me SZ, this is just an approximation off the top of my head, but most Americans later in life will be making medical decisions about life and death that can involve many hundreds of thousands of dollars under the current system.
    .
    Teetotal arfing bankruptcy. I have a brother in law who last year incurred a $550,000 medical bill. This is common.
    .
    And 65% of that is what? FYI, he was making $15 / hour. That is common too!
    .
    I call it a diarrhea splatter fart…

  • 53_3

    “I don’t know what I’m going to do, but it won’t be to give money and votes to Democrats, that’s for sure.”
    .
    And the GOP has better plans? They have nothing

  • 53_3

    By the way, Karen, how many calories does spin have?
    .
    Can I barbecue it? Can I slice and dice it? Will my wife eat it and like the way it tastes?
    .
    Is it really as nutritious as you say it is?

  • stuartzechman

    Update
    .
    Senator Chris Dodd just sent me a fundraising email:

    Dear Stuart,
    .
    One thing is crystal clear: you want substantial health care reform, and you want it now.
    .
    I’ve been reading through your ideas and comments about health care reform, and the common thread through virtually all of them is that you want a real solution to cover all Americans and reduce costs.
    .
    Many of you shared your personal stories highlighting the desperate need for real reform in our system. Here are just a few examples of the problems Americans are facing every day.


    Senator, I have been a registered nurse for 30 years, predominantly in the mental health field. One of the biggest problems I saw was the fact that virtually none of my patients had insurance. This precluded them from having a choice in providers. -Carl
    .
    The health insurance premium through our small business for my family of three is so high monthly that we forgo regular check ups and preventative care. What’s wrong with this picture? -Jane
    .
    My wife and I have two children ages 4 and 3. I’m self-employed. Health insurance is by far my biggest business expense, and, as an individual, I have little to no buying power or leverage with the insurance company…. To create a 21st-century American economy that fosters innovation and entrepreneurship, a public health-insurance option is absolutely critical. -Andy
    .
    What happens if my sister, who is battling ovarian cancer, can no longer work? She is 48 years old, and the waiting period for Social Security and Medicare typically takes a couple of years. I pray that she will beat this, but even with good coverage, she has already incurred enormous out-of-pocket costs…. I can only imagine that millions of American stories are even scarier than ours. There is nothing American about inadequate health care! -Connie

    I’m committed to real health care reform for these families, for yours, and for millions more all across America.
    .
    Your commitment to this issue is vitally important as we move forward with reform legislation. Yesterday, the Senate began its historic work to make comprehensive health care reform a reality for all Americans. As we continue our work, input like yours will make a big difference.
    .
    I will keep you updated regularly with progress reports and more ways you can help.
    .
    Thank you for your support,
    .
    Chris Dodd

    …There’s a huge yellow “DONATE” button, of course.
    .
    Really, Senator, how does “Andy”‘s statement “To create a 21st-century American economy that fosters innovation and entrepreneurship, a public health-insurance option is absolutely critical.” square with the inadequate proposal currently under consideration by health insurance lobbyists…excuse me, your colleagues in the Senate?
    .
    How dare you ask me for money that will soon go to out-of-pocket expenses, Senator Dodd?
    .
    Until it is actually “crystal clear” to you and the rest of your fellow Senators that I want “substantial health care reform, and I want it now”, you’ll get less than nothing from me, and I suspect that a few other people may feel the same way.

  • stuartzechman

    53_3:
    .
    And the GOP has better plans?
    .
    This is the GOP’s “plan”. That’s the problem.
    .
    This is John McCain’s plan without the taxing of employer health insurance benefits.
    .
    This is a plan that seems designed to get at least 10 Republican votes in the Senate.

  • 53_3

    “This is a plan that seems designed to get at least 10 Republican votes in the Senate.”
    .
    I know, Stuart, it was a rhetorical question, and the big, big, big question is why?
    .
    We have the tools to do real reform. The ‘reconciliation procedure’ that was adapted in the budget. Why in pluperfect hell are we even doing this charade.
    .
    One thing that Baucus did get right was that this is a Rube Goldberg contraption. But that is the only thing anyone has gotten right.
    .
    Think of the burden lifted from businesses! Their playing field would be much more level with the rest of the world knowing they don’t have to provide it. The jobs Americans don’t want to do? They don’t, partly because many of them are shopping for health insurance as well as a job, because they need both.
    .
    And the 1.6 trillion spent? What about the money saved, and the enormous boost to business?

  • 53_3

    FYI Stuart, I saw an article on CNN news a couple days ago referring to the benefits to business, but I can’t find it.

  • pafro

    If we wanted the Republican plan, maybe we would have voted for more Republicans.

  • stuartzechman

    53_3:
    .
    Well, there are temporary small business tax credits (whoopee) for those with employees making under 40k…and more temporary tax credits (whoopee) for new businesses that sign up with their own State’s “Exchange”…
    .
    …and there’s no employer mandate to cover anybody, unless their employees get Medicaid…
    .
    Employers with an employee in the State “Exchange” have to pay the equivalent of the worker’s tax credit (whoopee) subsidy, though.
    .
    Benefit? The whole idea of “Anti-Crowd Out” seems to be to leave businesses with private insurance largely as is. That’s apparently why they’re proudly proclaiming that it’s “Anti-Crowd Out” –they apparently believe that keeping employees tied to the insurance corporations that practice “rescission” is a benefit.
    .
    Unbelievable.

  • rose83

    Maybe the most interesting thing about this “plan” is that it shows how little power both ordinary Americans and traditional (i.e. non-financial) businesses have. Other than Wall Street and the health insurance industry, most of the elite economic interests would actually be helped by a real plan that reduces overall costs, like single-payer.
    .
    I’m not saying they want lavish single-payer – which is still cheaper than the current system – but a basic single-payer like the NHS was before the latest round of investments would undoubtedly be good for them.
    .
    It’s like how the auto industry has to beg for bailouts while Wall Street easily gets vastly larger bailouts, even though they’re the ones that started this whole mess in the first place.

  • stuartzechman

    Chris Bowers has a pre-leak action post up from Wednesday called “Put an End to Backroom Health Care Deals“.

  • FlownOver

    Gutless weasels. GØ∆ ∆åmn gutless weasels.
    .
    And here I thought there was something going on about “change.” Guess there’s no fool like an old fool.
    .
    Note to DSCC – If you clowns pass this weak crap just save your postage. Stick your campaign solicitations up your ∂∫∫. Forever. You can get your happy ending from the the Republicans and the insurance companies.

  • stuartzechman

    Digby weighs in:

    It’s a good day to be an insurance company CEO. An mandate from the government forcing people to buy your product and no serious competition from anybody but your monopolistic buddies in the industry, all of whom look after each other very, very well.
    .
    Start looking at new yachts and vacation homes in Gstaad, CEOs. The party’s back on!

  • pafro

    rose83, I think you are right that we are seeing the power of the elite companies who pay for good health care for their companies and don’t want the platinum plans taxed, but that is COMBINED with the companies who base their business plans on disposable unskilled labor and slim margins. The bottom feeders don’t want to pay benefits of any sort, but are willing to listen to any ideas that might throw around a little corporate welfare.

  • stuartzechman

    Dr. Steve B at Kos poses the obvious question for people with greater than mosquito-brain memories:
    .

    Does anybody else remember when Obama ran on Yes to public option and No to mandates?

  • stuartzechman

    Tim Noah over at Slate asks a very interesting question:
    .
    Will Seniors Kill Health Reform?

  • http://teacherreaderwriter.wordpress.com/ Shakespeare in GA

    SZ: thanks for the link. Sent my e-mail. I live in Georgia, though, so I’m not sure my Republican senators will bother replying. But one can hope.

  • stuartzechman

    Matt Yglesias points out the key problem with the premises behind this joke of a “plan”:

    The big problem, politically speaking, with health care is that you basically have people on the left arguing both sides of the question.
    .
    On the one hand, insofar as your plan is “big government” that’s left-wing. But insofar as your plan is expensive, that’s also left-wing. Which is because people normally think of big government programs as expensive.
    .
    But when it comes to health care, heavy-handed government intervention is actually way cheaper than private sector alternatives. Consequently, every time you try to make the plan more “moderate” by, for example, curbing the influence of a public option you actually wind up making the plan more “left wing” by needing to raise more taxes. And if you want to make the plan cheaper, while still actually achieving its goals, then you need to make it more left-wing not more moderate.
    .
    But in the United States, ideological correctness and special interest politics prevents us from admitting this.

    Baucus and Grassley have truly given us the worst of all worlds:
    .
    These Senators responded to CBO, the Republicans and the health care industry by proposing a less solution-oriented, yet more expensive plan in terms of the necessity of future taxes to pay for the problems it won’t solve.
    .
    Sometime later, economic necessity and political reality will combine the way that they have now in California, and we’ll be right back where we started…and the “At least it’s something!” tax credits for lower income folks will get rolled back during the next “End Welfare as We Know It” cycle.

  • apr2563

    For over 10 years I worked for a 3rd party administrator of a health insurance pool for California for small businesses. The first couple of years were encouraging. We covered about 200,000 people. There was no underwriting and plans offerred with no pre-existing conditions. Then the insurance companies got together and systematically destroyed the pool by withdrawing after their demands were not met. This was after the state removed itself from oversight.
    Iowa and Florida initiated basically the same plan. They to were destroyed due to politics and special interests.
    Never doubt the power of the health insurance industry. They have purchased Baucus and others who now give us an half-assed reform that will cost us more and solve very little.

  • FlownOver

    When does the current Baucus term end, and is there anyone running against him? I don’t even care about party. No point having a Democrat who sells out as Baucus has done; if you have a Republican at least the sellout wouldn’t be a surprise, and maybe the loss would send a badly needed message to other Democrats.

  • jcapan

    What’s that Tracy Chapman song, “If not now then when”?
    ~
    Somehow, I think dirty hippies on the left are going to be getting some company soon. Af-Pak-Iraq policies, stiffing the gay or civil libertarian communities is one thing, abdicating all responsibility and once again throwing their supporters under the f’ing bus, on the seminal issue of the day, not to mention representing the corp patrons’ interests–well, that’s quite another.
    ~
    All our energy and donations from this day FWD should be going exclusively to Accountability Now. And I’ll double down, Obama can start showing some proverbial cajones, or I’d love to see him challenged come next primary season.
    ~
    I’d answer Chapman that without consequences “then never”

  • FlownOver

    O/T:
    Sun-Times reports Walter Cronkite is gravely ill. He’s 92.

  • spob

    Read and weep, guys:
    .
    http://michellemalkin.com/2009/06/19/the-obamacare-horror-story-you-won%e2%80%99t-hear/
    .
    Seems Michelle didnt like urban folks in her hospital . . . .

  • jcapan

    Spob, I just wanted to tell from the bottom of my heart how touching I found your link above, you know, by Ann Coulter’s fascist little sister. It’s a great gesture, that on a day when we’re far more frustrated with our own party’s failings, in despair really, that you have the warmness of heart to try to make us feel a little less (sniffle, gasp!) depressed … allowing us to see (imagine voice rising in tone to a hysterically moved pitch) what truly advanced batsh!t crazy farts could be running the f’ing country!
    ~
    I simply didn’t think you had it in ya, but man-hug across the pond bro. If we can simply rise to the graciousness of your engagement, re-sorting ourselves into our partisan places, screaming at the media and you killer GOP blokes and folks, well, it’ll be ever so much easier to face the day.
    ~
    “I know this steak doesn’t exist. I know that when I put it in my mouth, the Matrix is telling my brain that it is juicy and delicious. After nine years, you know what I realize? Ignorance is bliss.”

  • Karen Tumulty

    destor (#17): When your senator (or President) gets really sick, he can go to Bethesda Naval Medical Center, which is (cough!) single payer.

  • Karen Tumulty

    speaking of which, when i was diagnosed with thyroid cancer many, many years ago (i’m fine now), i went to get treated at the national institutes of health, right across the street from bethesda naval medical system. no special pull here; anyone can be treated there if you are unfortunate to have a condition they are studying. anyway, also single payer. cutting-edge treatment for seven or eight years–and i never once saw a bill.

  • Karen Tumulty

    Malkin story does hit a legitimate point raised by Grassley (though she somehow can’t resist making it look like Michelle Obama is responsible for this problem), which is the number of elite non-profit hospitals that don’t take their share of charity patients. m.d. anderson in houston has also been hit on this as well, and i blogged about it here:
    .
    http://swampland.blogs.time.com/2009/04/21/a-health-care-disgrace/
    .
    and grassley is right to call attention to it. it is a scandal.

  • Paul-no not that one

    This is beyond bad, for reasons sz lists @18.
    .
    If this is the plan, and these things tend to get worse from the public’s perspective as bills are negotiated, BHO and Congress are seriously misreading the the country on this.
    .
    And it is not republicans who will pay at the polls.

  • Paul-no not that one

    I read the outline, and maybe I haven’t had enough coffee yet, but is there anything in there that addresses spiraling costs that fuel this “healthcare reform” desire?
    .
    I don’t think it is coverage for the uninsured that has people angry, as important as that is, it is the ever increasing premiums.

  • fedupwithswampland

    An individual mandate to purchase insurance that only covers 65% of expensese?!?!?!?!

    Are you F***** kidding me?!?!?!

    Hey American Middle Class. You just got hosed.

  • Karen Tumulty

    fedup (#49) health care economists says there is an argument that people, even poor people, should have to pay at least part of their health care costs themselves. that encourages them to spend more wisely. however, the figure that i have seen them cite (jon gruber at MIT is my go-to guy on this stuff) as making the most sense is more like 15%.

  • Paul-no not that one

    KT, why would those of us in the middle class get behind this?
    Is it a “greater good” argument?

  • http://teacherreaderwriter.wordpress.com/ Shakespeare in GA

    KT, I understand the reasoning behind believing people should pay something into health care, or anything really. I support that thinking–people take more ownership of something they’ve bought into, etc. But 15% sounds about right. 35% for something this weak? Seriously?
    .
    Compromise is necessary and even works on many issues. But if this is the best that compromise can bring us on health care, then let’s double-down and fight for something meaningful or back up and go home.

  • http://teacherreaderwriter.wordpress.com/ Shakespeare in GA

    …that’s pack up. Sorry–morning coffee hasn’t kicked in yet.

  • 53_3

    KT:
    .
    Does anyone really believe that they can pay 15% of $550,000 after losing a job paying $15 / hour?.
    .
    Do you? Really? Is this “ownership”?
    .
    I call it something else.
    .
    “Bankruptcy”

  • 53_3

    “I support that thinking–people take more ownership of something they’ve bought into, etc. But 15% sounds about right.”
    .
    See above.
    .
    Ownership. Like owning the heavy ball and chain around your ankle?
    .
    Believe me. This is a common occurrance for anyone later in life.

  • gysgt213

    “fedup (#49) health care economists says there is an argument that people, even poor people, should have to pay at least part of their health care costs themselves. that encourages them to spend more wisely.”
    .
    KT-I think what these health care economists really mean is that they want people to seek out less health care.
    .
    Has anyone asked these health care economists where people even poor people are supposed to get the information they need to spend their money wisely when dealing with the health care industry?

  • http://phd9.blogspot.com Paul Dirks

    want people to seek out less health care.
    .
    It’s easy to forget that Medicine as a field is fraught with wishful and/or magical thinking. Between people who seek treatment for every twitch or people who insist that their herbalist knows better than their doctor there are lots of bad decisions available to those who insist on making them themselves. Add to that the amount of uncertainty contained with ‘mainstream’ medicine and we are forced to realize that there’s not necessarity a single ‘right’ answer to every question.
    .
    People on both the left and right exploit the uncertainty. The example from the left that forcing people to pay will result in inadequate care is balanced on the right by the insistence that actually confining payment to treatment that can be shown to work is some totalitarian conspiracy.
    .
    There are no easy answers and,as I keep harping on, the people who are concerned about where the money is supposed to arrive from have legitamate concerns that need to be addressed.

  • Karen Tumulty

    53_3 (#4/#54): My understanding is that all of these benefits packages would have out of pocket limits.

    gunny: (#6/#56): yes, less care. but that is in the context of people who HAVE coverage, not those who don’t.

  • Karen Tumulty

    Guys: Just put up a new health care post. Really, really recommend you read the story I linked to. (It’s not mine.)

  • afguy

    Sun-Times reports Walter Cronkite is gravely ill. He’s 92.
    .
    MSM is also gravely ill (and has been so for quite some time now).

  • spob

    KT, but Michelle Obama did seem to help the hospital offload some of its charity cases. Seems to me that Malkin’s not off-base here.

  • spob

    “Spob, I just wanted to tell from the bottom of my heart how touching I found your link above, you know, by Ann Coulter’s fascist little sister. It’s a great gesture, that on a day when we’re far more frustrated with our own party’s failings, in despair really, that you have the warmness of heart to try to make us feel a little less (sniffle, gasp!) depressed … allowing us to see (imagine voice rising in tone to a hysterically moved pitch) what truly advanced batsh!t crazy farts could be running the f’ing country!
    ~
    “I simply didn’t think you had it in ya, but man-hug across the pond bro. If we can simply rise to the graciousness of your engagement, re-sorting ourselves into our partisan places, screaming at the media and you killer GOP blokes and folks, well, it’ll be ever so much easier to face the day.
    ~
    “‘I know this steak doesn’t exist. I know that when I put it in my mouth, the Matrix is telling my brain that it is juicy and delicious. After nine years, you know what I realize? Ignorance is bliss.’
    .
    I am so touched by your warmth. People with whom you disagree are “fascists” etc. etc. You know what I love–I am taking a page out of Alinsky’s book. Hold the other side to its rules. Michelle Obama obviously had some role here. I guess it’s all good, since she rolls with you.
    .
    Calling Michelle Malkin “fascist” doesn’t really cover that up.

  • http://teacherreaderwriter.wordpress.com/ Shakespeare in GA

    53_3 quoted me above: “I support that thinking–people take more ownership of something they’ve bought into, etc. But 15% sounds about right.”
    .
    See above.
    .
    Ownership. Like owning the heavy ball and chain around your ankle?
    .
    Believe me. This is a common occurrance for anyone later in life.

    .
    .
    53: talk about my coffee really not kicking in yet. I was thinking the 15% was the amount of the premium that lower-income folks would be expected to pay.
    .
    In general I think it’s a good idea that people pay something for services, when possible–again, back to that ownership idea. Though I’m not an ideologue about it.

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