The Baucus Health Care Proposal

KT:
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From the pdf of the plan:

Health insurance premiums would be allowed to vary based only on tobacco use, age, and family composition according to the following ratios:
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 Tobacco use – 1.5:1
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 Age – 5:1
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 Family composition:

o Single – 1:1
o Adult with child – 1.8:1
o Two adults – 2:1
o Family – 3:1

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Does this mean that Baucus is codifying age discrimination into insurance premiums at a 5:1 price ratio?
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…And he’s discriminating against families by proposing that premiums be written into law at a 3:1 price ratio?
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Are Max Baucus and the Democrats really proposing to pass a law allowing insurance companies to discriminate against seniors and families, KT?
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I wonder what Republicans will say in 2010…or 2012…What do you think they’ll say, KT?

SZ: You read faster than I do, but 5:1 is a broad band. Here’s a discussion of the issue and some perspective:
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http://www.kaiserhealthnews.org/Stories/2009/August/31/age-rating.aspx

Stuart: when you author a dumb plan it will contain dumb proposals.

That’s not a health care plan — its an insurance company handout that hides its true budget-busting nature by delaying implementation of its subsidies until 2013.

KT:
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From your linked KHN article:

Proposals approved by House and Senate committees would limit insurers to charging older people no more than double what younger people pay. Only nine states now restrict the range insurers can charge individuals based on age.
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But insurers want Congress to let them charge older Americans five times more than young ones.
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The industry trade group America’s Health Insurance Plans said in a July 16 letter to House leaders that anything less than that would force many young people to pay more to “heavily subsidize the naturally higher health care costs of older individuals.”

I wonder where Max Baucus got the idea to pass a law charging older Americans five times what other people pay for insurance…
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…thanks so much for responding to commentary, KT.
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(RE [You read faster...] That’s how I was able to post corrections quoting the relevant House bill to Joe Klein’s FISA column within some minutes of his having posted…I think I beat Greenwald to it, actually.)

Oh give me a break — I’m no fan of Baucus or this plan, but the idea that older people aren’t going to pay more when they are going to use the insurance more often than younger people is the foundation of insurance. Let’s not confuse our own inadequate understanding of actuarial science with a conspiracy to give sway to the insurance industry. The insurance industry has plenty to answer for, let’s not add the basic way insurance premiums of any kind our determined as one of them. Frankly, I’m surprised that they didn’t add obesity to the list, since it’s been this debate’s consistent whipping boy. But I guess it hasn’t yet reached the social stigma status that tobacco has obtained.

I must say I wondered about obesity as well, since as Dee says it has been a consistent whipping boy.

Overall, I must say I like it. But, I still do not see where you will get much Republican support.
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With that said, I will write (not email or call) my Congressman to vote for this bill.

“You can have my answer now Senator, if you like”

Bad policy and bad politics. Classic.

Your response tells me all I need to know!

Let’s not confuse our own inadequate understanding of actuarial science with a conspiracy to give sway to the insurance industry.
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Let’s also not confuse the House legislation that sets the ratio at 2:1 with the five times the price ratio offered by Baucus –and demanded by the insurance industry in their letter to Congress.

How much we are paying now? Because there are many of us out here that would prefer to pay double the price, but even at five times the price is better than what we have now. Let them argue about this in conference, it will end up somewhere in the middle, but if we go ballistic at every drip and drab we will accomplish only one thing — Giving KT and her brethren the emotional unrest they report on!

Of course, I’m sure that those of you who worship the ground she walks on don’t bother to notice that every time things seem to calm down she finds something else to add fuel to the fire.

I`m surprised Klein isn`t slobbering all over this plan and accusing anyone who does not agree with it of being an extremist.

Stuart, it’s called negotiation. The Senate will have five times and the house will have twice as much and in the end at conference they’ll meet somewhere in the middle. It just seems like now we’ve going from wanting Obama to act hyper partisan and emotional and dictate to congress like Bush did — to now we are acting like those on the right that go from zero to 60 with every media entry. Frankly, it doesn’t look good when they do it and we ought not to repeat that kind of knee jerk response mode — just a thought.

Rusty you know full well that no matter what is in this bill Republicans are not going to support it because anything that solves the problems of cherry picking, pre-existing conditions and purging plus lowers premiums through regulation will engender such loyalty that they won’t have a chance of being a majority party for a generation. Their words not mine. they will never give the Democrats credit unless they believe we will pass it on our own and then they will jump on at the end like they did with the Medicare vote and then they will try to claim their GOP amendments is what made the bill work — of course that didn’t work with Medicare either.

Dee, do you understand the idea of “community rating?”
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Seriously, how can you support a proposal that discriminates based solely on age but forbids discrimination based on the actual health of the person being insured.
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To me, that’s completely backwards, because charging someone who is older — regardless of how healthy they are — is just as invidious as charging someone more because they are black.

not only that. we’re getting state-based health exchanges. which, aside from not getting a public option is just the most mediocre idea out there. i was quite willing to sacrifice the public option to keep the general structure of the plan intact. But there is a point where not passing a plan becomes a better alternative, policy-wise.

I was under the impression that the exchanges would have the buying power of large group of people like the Federal government has and large companies.
This sounds to me like individual policies.

Do insurance companies price like this when they are bidding for the Federal employee insurance?

a 5:1 ratio?

Its called negotiation!

Wow.

Dee:
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It’s not knee-jerk response, it’s an examination of the facts as they happen to be, and in the order which they are presented. This proposal came out today, prior to Obama’s speech. It’s not hyperbole to quote from it, and to try to analyze and predict what its consequences will be both as a matter of policy and politics.
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it’s called negotiation
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You don’t say?
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It’s funny: Lately I’ve been noticing a slight problem with that skillset on the part of some…
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The Senate will have five times and the house will have twice as much and in the end at conference they’ll meet somewhere in the middle
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Or they won’t. Or they will. How do you know? Isn’t this the basis for “reform” that we’ve all been waiting breathlessly for? If the House Progressives lay down for the Blue Dogs, and the Blue Dogs are right there with Baucus, then there isn’t a middle in which to end up –we’re already there. There’s only worse.
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now we’ve going from wanting Obama to act hyper partisan and emotional and dictate to congress like Bush did
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I guess you’ve been reading the diaries at dKos from former Obama campaign field organizers about “emotional truth”, like the one called “The Public Option: A Promise Kept or a Promise Broken”
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http://www.dailykos.com/story/2009/9/5/777570/-The-Public-Option:-A-Promise-Kept-or-a-Promise-Broken
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but I assure you, just because thousands upon thousands of people will feel emotionally let down by Obama’s identification with centrist Senators instead of them does not mean that Baucus’ plan full of mandates and prices fixed at industry specifications is an insurance industry bailout. You’re right, that’s just an emotional reaction. I can’t wait until 2010!
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we are acting like those on the right
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That’s an extremely low bar these days, Dee. We haven’t actually said that the Baucus plan will enact government death panels into law, right? We’ve just said that it’s primarily an insurance industry bailout with some regulations thrown on top for appearances. Baucus isn’t an extreme, left-wing, fascist, communist, death-dealing Nazi, he’s just a politician from Montana who would like to retire with a lot of money, like Billy Tauzin.
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We’re angry, all right, but we’re not from outer space –I think.

first of all, you’re assuming that conference will be an even playing field between the senate and the house. clearly not the case.
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besides, costs will continue to grow. we all thought the National Health Exchange was settled policy. And here comes Baucus with a plan that will only allow state-based exchanges. Which isn’t much incentive for insurance cos to join in. And unless im mistaken, all the regulations aren’t like blanket regulations. they only apply to the exchange. So, there’s a strong likelihood that they’ll still drop people for pre-existing conditions if they don’t join in. And given the meager amount of people available in the exchange, it makes little sense for them to be joining it.

NPR had an interesting piece on co-ops, pointing out that if they were that great, more would have been started up recently. They don’t have the negotiating power, since many insurance companies write into corporate contracts that they will not charge anyone else less than they charge… Additionally they don’t have the professional clout.

http://www.npr.org/templates/story/story.php?storyId=111966287

**But health co-ops as part of a nationwide health care fix are controversial. Robert Laszewski, who heads a Washington, D.C.-area consulting firm, says, “I think they’re the single dumbest idea I’ve heard in 20 years of being in Washington and working on health care policy.”

Laszewski says there’s no need to promote co-ops. They can already form on their own. As for the nonprofit advantage, he says there are plenty of nonprofit health insurers around, including many of the Blue Cross/Blue Shield plans. The only difference is that they’re run by board members who are appointed, rather than elected. Laszewski says any kind of new insurer will need a lot of cash on hand to line up doctors and hospitals willing to treat patients, and to set up health IT and billing systems.

“Actuaries have figured it will cost about $6 billion to establish the insurance reserve requirements that cooperatives will need, and 12 million people will sign on,” Conrad said in an interview with NPR on Monday.**

Perhaps plusiak you are the one who needs to gain some greater understanding. Age is always a factor in insurance whether its auto insurance that’s most expensive for males under 25 because they have the most accidents they don’t just charge those with accident the higher premium so no matter how careful you are if you are younger you’ll pay more. Similarly, if you are younger you are assumed to be healthier and you will not use the insurance you contribute to as much. this is why life insurance is cheaper as well because it is assumed that you won’t die anytime soon and life insurance for older individuals is much more expensive.
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Now we get to health insurance and despite your inflammatory racial bait that is too manipulative to discuss seriously, older Americans are going to use health care more regardless of how health they are. All of the preventive tests whether is mammograms, prostate, colonoscopy etc, begin to kick in at age 40, so even if you’re health you will be using more of the system overall.
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Now you’re suggestion is that charge people based on how sick they are. Hmm, so does that mean that populations that are more affluent, have had the benefit of better nutrition and access to information to create better health outcomes should continue to get all the advantages our society can muster. While, poor and minority communities, that disproportionately suffer from chronic diseases, obesity because of a lack of access to fresh fruits and vegetables in their communities, lack of information about nutrition or health, and documented health disparities should now be charged more for access to health care. Yeah, and you want to compare this to discriminating against blacks?
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Perhaps before you suggest that those least equipped to pay the higher prices, should take on all of the burden, you might want to pause and think. And Pluk — the next time you decide to call me out or try to manipulate me using a racial analogy don’t because you are way out of your league.

Ooooh, boy!!! A state ombudsman!!!!

That’ll keep those multibillion dollar insurance conglomerates in line! You betcha!

Here’s an idea: Institute tort reform maybe through KT’s “best practices” defense, but create a private cause of action for wrongful denial of benefits – including both consequential and punitive damages. Add a public plan trigger to keep the insurance companies from passing the costs along through higher rates, and I might start to feel better about the absence of an initial public plan.

Again Dee, so cynical. It is no wonder that Congress is bottle-necked to the hilt with things like this when we have people like you who will not compromise.
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If I were you, I’d be ashamed to even write such trash as you do.

Look let’s be clear, I am not defending this proposal. I’m just saying stop jumping to conclusions — this isn’t even the bill, it seems to me it’s a test case to see if Baucus could get Republicans to bite. Wednesday the President is going to tell them exactly what he wants. But in the mean time KT and the rest of the media is trying to get a rise out of you. Unrest and histrionics is all they are intersted in covering and whether its on the right or the left — they want you all to have a meltdown on cue. Now as far as knowing the conference isn’t a level playing field, that’s the way all law is made.
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The whole point of putting this out there is to see how many irate comments they can generate. You might be entertaining but you are not moving the debate forward. Frankly, I think its the most reprehensible activity that the media engages in. While it’s not quite the same thing as death panels or teabaggers or corporate faux grassroots shills, it’s on the same spectrum and I just hope you notice it before you react in a way that brings the opportunity for health care reform to an end.

Max needed 11 months to crap out this turdball? Good lord.

Thank ye Stuart! I be gettin’ ri’ tired o’ Dee’s willin’ness t’ bend o’er an’ take wha’ever th’ health “care” industry be plannin’ fer us – if we be goin’ t’ be talkin’ ’bout Nazis, I b’lieve it be high time we be startin’ t’ call out collaboraters, too!
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Yarr.

Why shouldn’t seniors (I am in that group) pay more based on age than younger?
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I believe it is equitable, and will keep it from going into a limitless pit of tax payer subsidies.
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I believe in fair representation of your individual situation. If I eat more, I pay more. If I use more electricity, I pay more. If I am old and go to the doctor or hospital more, then I should pay more for the insurance.
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I think most Seniors, who actually understand, will go along with this rather than scream “DISCRIMINATION”.

Just got off the phone with Jon Gruber at MIT. (Still reading, SZ.)
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The biggest burden here seems to be on people around 300% of poverty, or about $66,000 for a family of four. (Though worth noting they have an escape clause, and don’t have to buy if lowest cost premium exceeds 10% of their income).
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They could be spending $6,000 on out-of-pocket costs in addition to premiums costing up to 13% of income. That sounds like a lot of money — and it is — but is better than what they face now if they get really sick. (Also, remember we are talking about people who have to go out and buy insurance themselves, not those who are covered by employers and therefore are part of group coverage.)
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Gruber thinks that everyone should look at raising the deductible and lowering out-of-pocket limits. The actuarial value of a policy with a $600 deductible and $6,000 out-of-pocket limit is the same as a policy with a $750 deductible and a $3,000 limit. Not such a huge difference in deductible, but a big one in what you actually spend if you get sick
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Yes and one of the reasons that some corporations, although the government doesn’t do it will discriminate by not hiring people over a certain age if they can help it or people who smoke, or are over weight. Because all of these things can raise prices for group policies, it’s just as employees you are unaware of it until you go into the private market.

Look let’s be clear, I am not defending this proposal. I’m just saying stop jumping to conclusions — this isn’t even the bill, it seems to me it’s a test case to see if Baucus could get Republicans to bite. Wednesday the President is going to tell them exactly what he wants. But in the mean time KT and the rest of the media is trying to get a rise out of you.

KT is trying to get a rise out of me by saying: “here is the Baucus plan?”
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WTF.

PW(dw):
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it be high time we be startin’ t’ call out collaboraters
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Look, I know that you mean well, but…
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There’s really no reason at all to describe Dee’s differences with us on policy or politics as “collaboration”, as if she’s somehow in league with the insurance lobby or something.
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She’s got an honest difference of opinion largely (I’m going to speak for you for two seconds, OK, Dee? Sorry…) borne out of an honest desire to not have us f*ck up health reform for her and others.
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Would you please do me the greatest of personal favors and just very quickly take that particular characterization “collaborator” back, PW?
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We need to keep this heated disagreement out of Democratic Primary territory, IMHO. I’m sure that you weren’t really calling Dee a traitor, PW, but if you could just do the discussion some good and make it clear that you weren’t character assassinating Dee, I would appreciate that so much, and it would be the right thing to do.
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Please, PW(dw)…will you consider it?

Great stuff, KT.
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The details of this (and their implications) are really important to characterize fairly and accurately.
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Thanks so much as always for your fact-based contributions to this important public debate.

This is a very bland and un-radical bill that should get support from lots of Republicans. It won’t, but it should…

http://www.political-buzz.com/

So do you think Max just used Liz Fowlers’ computer for the bill or what?

http://emptywheel.firedoglake.com/2009/09/08/liz-fowlers-plan/

And, if you threw in Tort reform, the one thing missing from the Baccus proposal, you could eliminate the high deductibles and out of pocket expenses.
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Just saying

“Bad policy and bad politics. Classic.”
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Not to put to fine a point on it but this is what happens when you try to use insurance companies to deliver a national health care system. Age-related costs should be spread across the whole population (if we’re lucky and don’t get denied needed private insurance coverage and die, we’re all going to get there) and lifestyle-related costs (from smoking, diet, etc.) need to be reduced through other means. Higher insurance premiums aren’t a sensible public health policy.

Except there’s still no evidence tort reform has any effect except to increase insurance profit margins, no matter how often it’s suggested. The docs all think their malpractice carriers would cut them some rate slack, but experience in the many states that have adopted damage caps says otherwise.

KT:
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The Times sez:

Mr. Baucus’s plan, expected to cost $850 billion to $900 billion over 10 years, would tax insurance companies on their most expensive health care policies. The hope is that employers would buy cheaper, less generous coverage for employees, thereby reducing the overuse of medical services.

So even Max’s “cost conscious” plan will put us a trillion f*cking dollars more in the hole…after the bank bailouts…after the auto bailouts…after escalating in Afghanistan…after staying put in Iraq?
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OK, that last bit started to sound political, so I’ll back away from that for a second to ask you:
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If Baucus’ plan will cost the government nearly a trillion dollars in new spending, will that amount somehow be offset by savings to the economy? How will Baucus’ plan reduce the amount of GDP America devotes to health care spending (15.3 percent), and by how much?
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Currently we spend $7400 per person per year on health care, while Japan spends $3400. How much less than $7400 can we expect the cost of health care to be if Baucus’ plan were to be enacted, and by when? Could we see $4000 per person per year by 2013 if Baucus’ plan were enacted? $4500 by 2015?
How much will the Baucus plan reduce the cost of health care in America, and by what date (according to whom)?

Thank you, Stuart and I appreciate you asking permission to speak for me and not just assuming that it is okay.
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You’re right, as I have said several times, that I’m not defending this particular plan or any other yet. I am however, imploring Democrats not to draw lines in the sand. I know from experience how importqant it is to lay a foundation to build on. No matter what we get today, we are going to need to work on improvements and I don’t want the prfect to be the enemy of the good. I simply want to encourage folks not ro lose sight of the bigger picture because failure could mean waiting another eight years.
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My biggest critique was not of the plan it was of the media manipulation that I see. The invisble hand of the instigators who could have promoted the truth if they wanted to but chose to report on teabaggers protest that were in reality few in number, There wwere hundreds of town halls focusing on the pro-health care persepctive they simply ignored. Now they follow a bus that makes stops where only dozens show up and they label that the voice of the American people. They have labeled this intra party squabble as the a life or death fight for Obama and how likely the progressives in the party will take him down. NBC even changed the wording in their poll question so they could reduce the number supporting the public option.
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There is a concerted effort underway to take down this president. Yes, the right has set it in motion, but the media wants to cover it. But to do so they are forced to prop up the right by stepping on the scale.
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This is just one more episode in the side show and they are trying to find away to gin up resentment again. You see they fear that the overplayed hand of the school speech debacle threatens to put the right back on its heels. Followed by the president’s speech’s at the AFL and the nation’s school was a reset button that reenrgized the debate. They are trying to prevent him from taking back control of the debate tomorrow by fostering discontent today.
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Truth is that this Baucus plan is inconsequential, Obama is already writing his own plan. This crap today is nothing more than attempt by Baucus to remain relevant. Because he knows once the president lays down his speech tomorrow he will no longer be the subject of attention.
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Now pirate you can catagorize me any way you choose, because this is America and that’s how we roll. but I hope you keep in mind that it’s the conservatives that demand total allegiance to their point of view and it’s rusty, textee and freeinpa that call people enemies for not falling in line. Perhaps this all a misunderstanding and you didn’t mean to sound like you are the arbiter of who is a loyal member of the movement and who isn’t. I prefer to think that you misunderstood what I was saying or was just having a bad day — and I’ll leave it there.

Flown:
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I am not saying that Tort is the complete end all for the problems, but it is a start. I just question why Democrats are all opposed to Tort reform?
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http://www.newsbatch.com/vtarch-506malp1.html
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The last is a roll call vote on Cloture for Malpractice Insurance reform. Democrats voted “nay”.
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When auto-insurance went the way of Tort, the cost of the policy w/ tort went down dramatically. I remember as I was so happy to have relatively cheap auto insurance.

PW…
Dee isn’t a shill for the health insurance industry, she’s a shill for Obama (I know, a distinction with very little difference, but still…) Basically, Dee wants all of us to bend over and take it “for the Obama team” and Obama’s greater glory.
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I mean, Dee doesn’t understand what community rating means, and why age discrimination is completely antithetical to the idea of shared responsibility for health care costs.

“So even Max’s “cost conscious” plan will put us a trillion f*cking dollars more in the hole…after the bank bailouts…after the auto bailouts…after escalating in Afghanistan…after staying put in Iraq?”
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Never fear stuart, Obama’s here to the rescue. He will make this all budget neutral. He plans on TAXING your soda pop, buddy!!
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I swear they truly are stupid in Washington.

Y’all realize that – in one form or another – ‘tort reform’ has been done in a lot of states, like capping damage awards…
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One of those states – California – had the Medical Injury Compensation Reform Act (MICRA) pass in 1975. MICRA has a lot of the features we hear about when discussing ‘tort reform’…a cap for damages, which was frozen and not adjusted for inflation, for starters.
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Between 1985 and 1988, malpractice premiums in California rose 47 percent. It wasn’t until regulation of the insurance providers was enacted that rates dropped.
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[linky]
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So, whenever someone starts pis$ing and moaning about ‘tort reform’, please remember that a) It’s already being done and b) by itself, it has limited value in decreasing malpractice insurance premiums.
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Once again, the problem with the health care equation is the role and actions of the insurance companies.

From the comments at the “Hey, it’s something! Yay…” Yglesias post:

http://yglesias.thinkprogress.org/archives/2009/09/context-for-the-baucus-plan.php#comment-1662019
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mo Says:
September 8th, 2009 at 8:58 am
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Basically the problem is that if you just miss the subsidy cut, you are getting a new car-payment-sized monthly bill, with no new income to offset it. Also, because the means testing looks at assets, people who are consultants, artists, etc. and paid in occasional lump sums get screwed for having too much savings. People saving up to buy a house or do something else responsible get the shaft too. Hard to hear people who should be saving for kids college or retirement talking about having to spend their assets down to qualify for healthcare. Really nasty perverse incentives.

Yep.
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When it gets right down to it, that’s probably what Americans fear the most about letting liberals be in charge of government: “Really nasty perverse incentives” like not being poor enough to qualify for help with health care, therefore going broke anyway.

KT is trying to get a rise out of me by saying: “here is the Baucus plan?”
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WTF.
sy2d
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Yeah — isn’t that what happened? When ever you put out information without context that it is easily misconstrued it is a choice you’ve made. the chief complaint of the msm is that the Internet puts out information with no filter, not context and is too easily misunderstood and giving rise to drawing erroneous conclusions. Yet that’s exactly what continuously happens here. Now granted, she came back later with links to information that put some of the more immediate concerns in perspective. She could have just as easily put those links in at the same time she made the post but she didn’t’ — like I said it’s a choice. apparently she didn’t even read it first. I guess, if it had been a hoax, she could have been posting the pornographic guide to health care.

Saxby Chambliss (R-KKK), said on Fox a while ago that the president better not act too uppity when he addresses Congress tomorrow or the tea baggers are gonna com after him.

KT:
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One of the theories that I’ve seen floated around commentary at various wonky-lefty blogs is that the Gang of Six was Obama’s idea adopted by Baucus.
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Is that true?

The hope is that employers would buy cheaper, less generous coverage for employees, thereby reducing the overuse of medical services.
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this is a ridiculous statement. In general, the “gold plated” policies that would be taxed don’t encourage “overuse”, rather they cover more (like dental, glasses, hearing aids, etc), have lower/no deductibles and/or co-pays, and come with “bells and whistles” (like private rooms, etc.).
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(sigh) Like I was saying about not replaying the primaries, Paul…

Pluk you’re an a$$ but that’s beside the point. I’ve made no secret of my support for the President and you’ve made no secret of your disdain. But my motives are simple and I’ve stated them many times. I’ve lost my health insurance and I have a preexisting condition that prevents me from buy any. While I would never qualify for any kind of subsidy and I am over 50 years of age and would have to pay more than anyone else,I thank god I stopped smoking a year and a half ago or I would be taking on even more cost. My motives are simple, I speak for millions of us who need to get rid of the insurance companies prohibitions so that we can buy coverage. While today I can pay out of pocket for my doctors visits that cost me more than everyone else, and I can pay for my prescriptions, that cost me more than anyone else, I’m only one hospitalization away from complete ruin. No further conspiracy here!

That’s a new one on me.

Yeah — isn’t that what happened? When ever you put out information without context that it is easily misconstrued it is a choice you’ve made. the chief complaint of the msm is that the Internet puts out information with no filter, not context and is too easily misunderstood and giving rise to drawing erroneous conclusions. Yet that’s exactly what continuously happens here.

Why does the Baucus proposal need context? Is it poorly drafted? Did Max personally tell you that it was riddled with errors? Does the fact that the text of the Baucus proposal can be viewed on the internet without filter or Fox-like editorializing render it easily misunderstood by people unabled to read it?
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Check your meds, Dee. Check your meds.

stuart, you post great stuff so often, so how do you get many here, including KT and colleagues, to respond / engage in dialogues (I can’t)…and try to referee disputes too as above (#4+)? What the secret? Seriously, I’d like to know.

Thanks so much, KT, I’ll try to correct the record (demand more specific links and quotes than the “it’s implied” ones that have been provided thus far) wherever I see it.

shorter Dee…
I’m sick. I want everyone else to pay more for their health care because I’m sick. Nothing else matters as long as I get my problem paid for by everyone else.
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It ain’t about you Dee — and until you can get over yourself and start looking at the question of health care policy, and stop acting like an infant who thinks they are the center of the universe, you have nothing of value to contribute to the discussion.

KT, a very large chunk of the White House deal with PhRMA is enshrined in the Baucus plan (i.e. the 50% off name brand drugs in the donut hole provision is there — which is a gift to the drug companies, because they are still making massive sums of money with 50% off. Moreover, I didn’t see any provision that closes the donut hole, which means that for most seniors, their out of pocket expenses don’t go down — they just pay for more drugs before they reach the other side of the donut hole.)

deconstructiva:
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It’s our journalism: I’m just trying to do my part as an engaged news consumer like you.
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I don’t expect responses to me personally. If KT (and the other posters) responded to everyone but me with sufficient frequency and substance, I’d be more than happy.
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The point of post/comment/response/comment is to close the reporting/fact-checking/clarification/discussion-widening loop between the political press corps and news users, IMO. Karen Tumulty was an early adopter, so to speak, of this new technological formula for successful journalism, so she deserves and is given enormous credit for moving her profession (not a trade known for rewarding outliers) and her publication forward. Some people accuse me of sycophancy for being invested in the relationships between journos and users, but it’s just a closed loop to me. I think that the more that we try to understand journos as human beings, the better it will be for users tasked with analyzing and feeding back their product.
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As far as refereeing disputes goes, I’m not a referee, I’m an observer and a participant. I’m putting down my bat and yelling “That was a foul ball!” to anyone who will listen. A referee actually has the power of moderation, I don’t. I have good intentions, the possibility of persuasion, and nothing else at my disposal. I try to be honest and fair in my communications, and to maintain a good reputation –not for objectivity, but for having the best interests of the forum in mind when I speak.
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Thanks so much for the compliment on my posts, I really am trying to get the hang of this writing thing. I look at what Karen Tumulty writes, and I say to myself “Jesus, will I ever be as good of a writer as her? Man…“. Thanks for reading through my unnecessarily long commentary, deconstructiva, I’m working on making it more readable.

Thanks, stuart. Excellent point about journalists as human beings. I’m working on improving my feedback and however we can help the reporters here do their best, I’ll try.

Wow Pluk, that’s good you finally admit that you don’t give a crap about the 47 million uninsured, this is really all about you and your agenda. You claim I’m being selfish because I’m sick. Well I can pay for my doctors bills even though they are twice as much as those who have group insurance. I can pay for my drugs, even though I don’t have the luxury of only paying a co-payment. You attack me because I support Obama and you hate him. Perhaps you are a shill for the right because you consistently demonstrate a mean spiritedness that is so similar to rusty and friends.
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Now you want Dee shorter here it is in a nutshell. I want health care reform and I don’t want an intra party tantrum led by folks who either have health care or have time to wait a few years playing politics with the needs of 47 million people. Do you think for one second that given a second chance Hillary wouldn’t have negotiated and compromised to get her feet in the door knowing she would have a chance to make it better once she’s there?
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I haven’t advocate for any single plan or person, I’ve simply said let’s work smart instead of being manipulated by the media who just want drama to write about. Let’s work smart rather than help the conservatives do their work for them. Let’s learn from history so we neither repeat the mistakes of the past or fail to gain from our collective experience. If that makes me an enemy of the movement then so be it. I’ve never been one to enjoy the company of fools.
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You want to insult me, because I won’t walk in lock step. Well I thought that’s what being on the left was about. I thought it was about diversity of thought not just diversity of color. When I said some of you act like those on the right, I wasn’t talking about telling lies or death panels. I was talking about the tendency to demonize people, question their motives and their character if they don’t agree with the pack. Well that’s never going to be me. I don’t cow tow to the left or the right. and I’m certainly not going to cow tow to you.
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You don’t like my point of view move on, you don’t have to read it, but I’m not going to shut up just because you say so. I have been working to elect Democrats for a very long time and I didn’t just board this ship with Obama. But you ‘re right I do support the president, I worked just as hard if not harder to get him elected. I am an American and a loyal Democrat since I cast my first for Carter. How dare you act like I don’t have a right to my own point of view or that I’m some sort of shill because you don’t share it.
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Like I said from the outset politics is the art of the possible and sometimes that means compromise to live and fight another day. A line in the sand is best used to establish the perimeters of sandcastles not defining the parameters of debate.

I understand why you want to pursue the relationship Stuart, just please let’s also consider that there is such a thing as allowing the pendulum too swing too far in the other direction. Just as we rightly pointed out to the village that their propensity to focus on access prevents them from telling truth to power out of fear of losing that access, we must stipulate the possibility that can be victims of this too. If we are going to acknowledge the humanity of journalists caught in this situation, then we ought to acknowledge our humanity to do the same.
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I’ve noticed that no matter what wrongs are discussed there are plenty of people who rush to KT’s defense. A scenario that does not exist for Mikey or Joe who rarely interact with commenters. So it begs the question does Karen get more of a pass because she provides that access or is there some other reasoning at play?. I am not calling into question your character or motives, I just want that aspect to be part of the discussion so that we don’t hold journalists to a standard that we cannot ourselves meet.

More bad news from the Baucus plan, this time for small businesses:

Small Business Tax Credits.
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In addition to the temporary small business tax credits provided in 2011 and 2012 and described above, the proposal also includes a permanent program to provide small business tax credits once the small group insurance reforms have been implemented.
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Beginning with tax years ending after December 31, 2012, small business tax credits will be available to new businesses and firms newly offering health coverage through an exchange once the exchange is established [meaning once whatever state the business is in gets around to setting up and exchange --however that works].
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Credits are again limited to firms with fewer than 25 employees and average wages below $40,000, and the maximum credit available would be 50%.

So, in addition to inexplicably segregating individuals and small businesses from one another in these combined risk pools in state (ugh) based “exchanges”, if your small business makes a middle class living for your employees, you’re out of luck.
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Once again, it’s a case of perverse incentives from Democrats in power. As with individuals, small businesses have to succeed at failing just enough to qualify for help under this plan…and by “failing”, Max Baucus means “failing to pay your average employee more than $40k a year without benefits”.

Senator John Barrasso just told Ed Schultz that people are traveling from Canada to Wyoming for health care. Does anyone believe that people are driving from Canada, through Montana, and into somewhere like Sheridan Wyoming for medical attention?
The segment ended before Schultz could ask him about it.
I don’t believe it for a second. Question is, who in the Versailles media would be willing to challenge Dr. Barrasso on his claim?

I agree stuart, I saw that one too. I am hopeful that it gets trashed with all the rest of the so-called “incentives”, which are really taxes in disguise for those hard-working individuals out there that basically do not have the funds in the form of profits to offer their employees even the basic of healthcare plans.
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But, I am hopeful that we shall see something of substance as it goes back to commmittee for further review. I think this is just a small bone to Repubs in hopes of garnering support. I’d rather see it as a “health-care voucher” program than this so-called subsidy and tax the business proposal.
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Have you looked at the cost to drug companies, DME suppliers yet? That is another good one. Baccus proposes to “charge” them fees in the billions of dollars, when all it will do is increase the costs to consumers in the end, it doesn’t lower any costs at all.

sy2d — I didn’t insult you and I would appreciate it if you afford me the same level of respect I’ve given you. You think implying that I’m a lunatic because I have a different point of view makes you the one in need of medication — and the fact that you called this trial balloon a proposal when it is clearly labeled a work in progress – a mere foundation of a proposal to see if he can garner any GOP interest because you know the debate is about to leave you behind, makes the case without me having to chime in. The fact that you are attacking me when I simply made it clear that this is media fodder — like that doesn’t happen every single day and KT has been driving this chicken little meme about health reform since the beginning, vindicates me not you.

ok. at some point dee, you just need to stop paying attention to this buffoon. he’s just inciting you and you’re not gonna convince him.
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Now i strongly disagree that a 1:5 ratio is alright. im quite convinced that the senate will have the upper hand if this ratio gets to conference. Furthermore, why the hell are the exchanges state-based?
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and i used to think that all we need to do is get the finance committee to freakin’ pass a bill. and move on to conference which actually is where real negotiations take place. But max baucus hijacked the plan and decided to conduct the negotiations out of his committee. so what you see is what you get, with minor changes, most of which will lurch to the right.
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im quite willing to let go of the public option if it means the structural integrity of the plan is kept. but max crossed a line here that i just wasn’t expecting by basically rewriting settled policy (exchanges).

Rusty:

Thanks for the fact-based response. It’s far more productive than some commenters’ habitual name-calling.

The diff with malpractice insurance is that the market is far more limited than that for auto insurance. We have empirical evidence… malpractice premiums were affected little if at all in states that have imposed jury award damage caps.
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About the only thing malpractice premiums correlate with is the insurors’ return on external (unrelated) investments – and the correlation is inverse. When the companies lose (or make less) money on their market investments, they raise malpractice premiums.

“I am not saying that Tort is the complete end all for the problems, but it is a start. I just question why Democrats are all opposed to Tort reform?”

Rusty-Let me first state that I have really, really appreciated your civil tone of late and the fact that you have seriously offered constructive criticism and ideas instead of treating everyone that disagrees with you as the enemy. I hope you don’t find the above comments condescending because I seriously do not mean them in that spirit.

I noticed though that you have really been pushing “tort reform” as being a major consideration in health care reform and I assume that it is an issue that is very important to you. I don’t necessarily disagree with you but, I wish you would also flesh out your position on this issue a little bit more so that one might understand where you are coming from.

Specifically, what are the upsides and downsides of tort reform? Who would see a benefit and who would tort reform adversely impact? Specifically what type of tort reform would you like to see.

Rustydog:
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Speaking of perverse incentives created by Democrats in power, I was actually wondering when you’d get around to asking “Does this plan create incentives for poor people to stay unmarried?“…

Health insurance premiums would be allowed to vary based only on tobacco use, age, and family composition according to the following ratios:
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 Tobacco use – 1.5:1
 Age – 5:1
 Family composition:

o Single – 1:1
o Adult with child – 1.8:1
o Two adults – 2:1
o Family – 3:1

Let’s see here, what’s the math… 1.1 (single) + 1.8 (adult with child) = 2.9, for a ratio of 2.9 to 1. Family (presumably two adults with child) gets a ratio of 3 to 1.
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Under this plan is it better for those folks (with kids) who are looking to save every dime to stay unmarried, and not combine incomes?
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Well, Rustydog?

KT-Are we back to having to put “.” to get paragraph breaks? I put 3 returns in my post and every is still run together making my post look like a bunch of run on garbage. WTF?

Stuart-Thanks for bringing the unmarried incentive up. I been meaning to do that all day, but I was at work at kept forgetting, because I was supposed to be um, working.

Plus if I may add, deconstructive. Being courteous, and not calling your adversary on some topics of discussion a “racist” helps. Stuart defines courtesy as a behavioral trait on this blog. He may use the F word on occasion, but I will forgive him on that one. But, I have as yet to see him belittle someone for their views. Plus he is a great suck-up so far as “thanking” KT, Joe, Michael, et al for taking the time to respond, even when it is not responding back to his specific comments or questions (I’m just kidding you now stuart, so don’t “FU”, rusty.
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But seriously, we can all have our opinions and views, I for one wouldn’t want it any other way. But being totally disrespectful will never bring opposing sides even close to an agreement to disagree, and let it at that. Statements like “all the Republicans want is to destroy Obama’s Presidency” is so 3rd grade. I do not want to see him fail, because doing so would simply set our country backwards, not forwards. Do I agree with all of his policies and ideas? Absolutely not, more not than agree with him in general. But, policies can be changed. That is why we have elections and can vote them out of office. I am even hopeful one day I shall see term limits in place for all elected officials. Not just the President.

T’ say I be havin’ a bad day wi’ regard t’ this health insurance “reform” be puttin’ it mildly – it be frustratin’ th’ p*ss out o’ me (an’ considerin’ th’ copious ‘mounts o’ scotch it be takin’ t’ keep me blood pressure fr’m explodin’, that be quite a haul o’ p*ss t’ be irritated)!
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I understands ye be wantin’ “somethin’”, bu’ b’lieve yer view be shortsighted an’ just wha’ th’ insurance corporations be hopin’ fer.
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Ye castigate those o’ us who be insistin’ on th’ pubic option fer drawin’ a line in th’ sand an’ causin’ th’ downfall o’ reform, yet ye don’t ‘ave a word t’ say ’bout th’ insurance an’ other “health”: corporate interests who be first drawin’ a line by refusin’ t’ consider single payer, an’ now be movin’ the line by refusin’ th’ public option.
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Th’ bill wi’out a real public option be a sell-out!
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Ye’ll be havin’ no fallback once th’ premiums start risin; ’cause th’ deal will be “done”, an’ th’ Congress’ll be havin’ no stomach t’ be revisitin’ it again any time soon.
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Ye don’t understand tha’?
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Ye seems t’ be wantin’ “somethin’” so bad, ye’re willin t’ be settlin’ fer wha’ ‘mounts t’ nothin’, an’ helps no one bu’ th’ health “care” industry.
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I be knowin’ me language be colorful, bu’ really – th’ Vichy govt were assumin’ th’ Nazis were comin’ anyway an’ were b’lievin th’ best course fer everyone would be t’ just go ‘long an get as best they could fr’m ‘em – look ‘ow tha’ worked out.
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Ye be talkin’ li’ th’ pr’gressive position be th’ stubborn minority, when in reality we be havin’ th’ support o’ th’ majority o’ Americans in this.
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If ye be so pro-Obama, ye need t’ be tellin’ ‘im t’ grow a pair an’ do wha’ ‘e said ‘e’d do when ‘e were runnin’ fer office, an’ tell th’ democrats in Congress t’ do th’ same an’ represent th’ American People instead o’ corporate health interests! This grumblin’ ’bout pr’gressives sinkin’ th’ “deal” be helpin’ no one bu’ those who be countin’ on makin’ a lot more profit, an’ continuin’ t’ find newer an’ better ways t’ deny coverage once this battle be o’er!
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If ye don’t be wantin’ an inter-democrat battle, quit urgin’ us t’ be wavin’ th’ white flag o’ surrender, an’ start supportin’ th’ position of th’ majority of th’ American People!
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No “reform” wi’out th’ public option!

Pafro-Ed could have countered with the fact that Americans are traveling to foreign countries for operations.

Actually, I did wonder about why it was set for married w/ children at 3:1. I guess I thought they would do away with SCHIP, and if you had one or even more children they would be covered, but you would only be charged at the 3:1 rate. But the current proposal in no way clearly defines this at all. But, I think you confuse me with the other conservatives that do not believe in birth control. 1 to 3 children are plenty, especially in this day and age.
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But, I think just going for the 5:1 for seniors will end this proposal right off the bat. When seniors figure out they are going to pay 5 times more for their insurance than the average under 63 year old currently, and 65 in the next few years, the townhalls will not be peaceful demonstrations, but full scale riots.
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Obama also has to get passed his statements for the 500 billion in cuts to Medicare Advantage. I see this as a major obstacle as well. Which is elusively contained in this proposal too, in the waste, fraud etc section.

…stuart, my #21 should’ve been 20.1, so much for click on “reply”, oops, but Dee, maybe the reporter engagement matters. It can open them up to us as real people. At least I need to see that. Similar too, rusty, for your comments on courtesy. I try never to be rude to KT, Amy, or Jay. I see that at my other regular sites from CNBC to select Huff Post writers (specifically Cenk Uygur and Shannyn Moore) – now that’s a diverse world view – the more the reporters engage us the better the feedback they often get.

gysgt213:
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First let me give credit where credit is due. stuart has changed my opinion for most of the liberals on this site. When I first started to post comments, I was attacked each and every time. Then one day I was defended by stuart for my opinion and I believe my right to post on here. Plus, stuart is always respectful, a trait I am not good at sometimes. But, I am trying to change that which I think is what you are observing. There are still a few “wing-nuts” however on here that do increase my blood pressure and I will probably attack them right back with their own, perverse statements. But, thank you for recognizing my changing behaviors. But, I shall always remain a dyed in the wool conservative, and hold those values and ideals strongly. I will defend them as best I can from further attack or erosion, it is just who I am.
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So far as tort, is it a personal issue. No, but I have some family and many friends that it is a major issue. Mainly for the cost of malpractice insurance, which is driving out all of the “good doctors” in the area I live in here in Pennsylvania. Because we are a small, rural area to attract a good Physician to this area, is all but impossible. Putting on the high cost of malpractice insurance almost insures we will never get someone with good credentials because it just doesn’t pay to practice in this area. That is my main goal in promoting tort reform.
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The second purpose is greedy lawyers. Not to single out John Edwards alone, but the reason he became a Senator and later a Presidential candidate and could afford to do that was because of his days as a trial lawyer. Alot of the representatives in Congress are also former trial lawyers. They are a strong and powerful lobby group in Washington, and control much of what is done in the Democrat Party. Because, trial lawyers are one of the biggest campaign contributors to the Democrats. So they sleaze away money from frivilous law suits, increasing the overall costs of insurance for what gain? Their own personal gain. I just believe they can make sufficient dollars to support themselves and their families without sucking the blood out of the rest of us who have no vested interest in their lawsuit.
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Downfalls to tort, possibly more class action lawsuits will be filed as a result. But, I do not see that as all bad. Potentially it would help with further reform so far as changing out-dated practices and treatments. So I am really on the fence as far as that is concerned.
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But, again I’ll repeat. Tort reform in and of itself is just a part of the entire reform package. I just know that most Democrats I know do not want to touch it due to their lobby friends, the Trial Lawyers. I call it the third rail of Democrat politics. If our Democrat friends in congress would put this up as a condition, they would quickly gain not only my support, but a major part of the support of conservatives. For the good of the people, but in this case it would be to their own loss as a candidate for re-election.

Most Canadians are starving to death too, which is why millions of them line up everyday to try to get into the US. Don’t believe any of the studies that say they are happier than the US with their health care system. It is all lies. North Koreans are better off than Canadians.

Interesting language in the Baucus plan for individuals:

Individual Responsibility. Beginning in 2013, all US citizens and legal residents would be required to purchase health insurance or have health coverage from an employer, through a public program (i.e., Medicare, Medicaid, or CHIP), or through some other source that meets the minimum creditable coverage standard.
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An exemption from the penalty is permitted if coverage is deemed unaffordable – defined based on a circumstance where the lowest cost premium available exceeds 10% of a person’s income.
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For taxpayers with incomes above 300% of poverty, the penalty for failing to obtain coverage is $950 per year with a maximum penalty per family of $3800.

Here is a link to 2007 numbers on percent above federally-defined poverty level: http://www.taxfoundation.org/research/show/22471.html
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So based on that data, if you’re a family of four, and you and your wife each make over $31,000 at your jobs ($61,950.00 declared together on your joint tax return) , you won’t face a penalty if you can’t find insurance for less than $6195.00/year.
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That’s good! There’s no such thing as a policy for less than $6195.00/year (“the average family premium was $12,680” from http://www.kff.org/insurance/7672/index.cfm), except obvious junk insurance.
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But how does that work out for people who were making, oh, say $127,000/year (before taxes, of course), where the late 40-something year-old husband and wife have been running a dry-cleaning store for the past 18 years, and now pull in around $64,000 each –a nice, not wealthy, not terribly affluent, solid middle class family? Now, in addition to insurance premiums being a huge drag on their incomes (knock that $64k down to $57k), they are faced with having to prove that they are purchasing insurance to the federal government. They don’t qualify for subsidies, they don’t qualify for an exemption, they make enough to be subject to penalties, but aren’t failing enough (yet) to get any help with these still horrifying costs.
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Who will be more likely to be unperturbed by this plan in practice? Who will be more likely to be angered by it?
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Democrats would do well to think about these sorts of fault lines between how different families will experience reform created by their proposals. The difference in experiencing the role of federal government in folks’ lives between the haves and the have-nots won’t really be as severe as the that between have-somethings and the have-a-little-more-than-somethings.
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Creating divisions in the middle class doesn’t seem to be terribly good strategy for Democrats, does it? Shouldn’t the experience of health care reform be uniformly good for all Americans? Isn’t health reform that effectively penalizes any segment of the shrinking American middle class be anathema to the Democratic party?
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Didn’t we just run (and take the White House) on a middle class tax cut for %95 of Americans?

Rusty: (22.4) This doesn’t hit seniors. They have Medicare. It hits near-retirees, people in their 50s and early 60s, I think.

Sorry, that’s “Shouldn’t health reform that effectively penalizes any segment of the shrinking American middle class be anathema to the Democratic party?“

Can I be the first to say it …
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“Max Baucus 2016″
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And OT, but SZ I did manage to get back to you (link). Absolutely no need to respond. I’m sure I was rambling by that pt. in the day anyway.

Markos Moulitsas Warns Obama On Health Reform: ‘Public Option Is Our Waterloo’

I’ve never been on his site but this may be the time to join. I just hope he isn’t kidding when he says this is the Left’s Waterloo. If Obama and his centrist cult want a war with the Left, go ahead and drop the public option.

Rusty-Thanks so much for responding. And with all due respect to Stuart. You are the one who changed, you didn’t have to. But you did. And its great because now when I read a Rusty post, I might just learn something.

As are as your position on tort reform. I would remind you that some of those same greedy trial lawyers provide defense on mal practice claims and they get to bill the client they defend and not work on a contingency fee (fronting the cost of the litigation) like the plaintiff attorneys. Are there abuses. You betcha.
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But one of the downsides of tort reform is that if you are poor and there is no clear imediate liability and no way to prove economic loss it means that you can’t find any trial lawyer to take your case. Even if in the end there really does exist liability.
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Another thing I don’t think you consider is that mal practice insurers will not passed on any savings from reform to the doctors. Not to mention that congress will find a way to fu*k up any type of reform.

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Gunny:
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with all due respect to Stuart. You are the one who changed, you didn’t have to. But you did. And its great because now when I read a Rusty post, I might just learn something.
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Amen, brother, amen.
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You’re completely right, all I did was talk to Rustydog like Barack Obama said we were supposed to speak to fellow Americans. Rustydog’s done all of the hard work of thinking things through, examining the facts, and putting them out there with a minimum of invective –so that the forum benefits.
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It’s interesting, since I’m not an Obama supporter, that I would say that, but it’s true. I mean, I voted for the guy in both the primary and the general, but I did so out of largely out of fear of the other candidates, not hope. But sometimes the guy says things that make beautiful sense when actually applied, and I’m trying them out.
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What’s so great about Rustydog’s changing contribution is that he’s not hiding anything about his movement conservatism, he’s representing himself and his philosophy truthfully, but there’s a genuine interest in contributing to the debate that some trigger-happy, invective-prone liberal commenters here (my cursing self included too, sometimes) could do well to better emulate themselves. I must admit that I’m a bit relieved that the “conservative = troll” meme that was going around commentary at Swampland –over which I nearly quit this place– can perhaps be put to rest in the minds of some regulars here.
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Amen, brother, amen.

Oregon JC:
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I read your excellent commentary, and I’ve been considering it well, but I’ll just briefly say this:

…god knows I’ve spent enough time in seminars and faculty meetings to know how destructive and toxic leftists can be. That said, if there is hope for humanity, it’s my contention that the answer lies in deconstruction—a hybrid of democracy, capitalism and socialism. God, is that centrist?

No, Oregon JC, I believe that’s “liberal”.
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It’s the political philosophy that I despised and mocked in 1992 when I was heavily considering political affiliation with the long-dead Situationist movement of 1968 France (you’re aware of it, I’m sure).
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LOL
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It’s funny how similar you and I are, although we differ so much in style. Perhaps it’s a function of you and I being in the same age group.

I’m ashamed to admit that I’ve never seen Escape from NY

Yes, that is to your everlasting shame, Oregon JC.
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For God’s sake –FOR GOD’S SAKE– see this f*cking film, my friend. Let’s talk after you see it about that strange place and time in American popular culture that you and I were around to experience, and from which we might get our fundamentally post-apocalyptic-esque perspectives on hope for humanity (and politics). I’ll say it once more, Oregon JC, FOR GOD’S SAKE SEE THE F*CKING FILM.

The 3:1 for families is kinda odd – usually families are double of individuals for most employer provided insurance plans, sometimes they have a seperate category for employee+spouse but not always

Anyway the difference between 2.9:1 and 3:1 is minimal, I dont think anyone is going to stop getting married because of $300 a year, especially since they are going to be hit hard if they earn separate incomes as individualsas compared to married filing jointly !!

DK has kinda gone off the deep end on this topic – there is a smattering of sanity there nowadays but usually it s a lot of people promising to do a lot of things (all of them very bad) to Democrats and Obama if the public option doesnt pass. F

Funnily I’ve asked question after question about the public plan specifics i.e. premiums, out of pocket max etc., the only response I got was the 5000/10000 max out of pocket which actually looks suspiciously similar to the Baucus plan !! Its about 900/1800 different – it’s kind of amazing that people want to “draw a line in the sand” and threaten to dump health care reform over $900/1800 per year !!! Just Amazing !!

Also I keep asking them to show me the votes – they’ve gotten to about 45 in the senate, they keep pointing me to a website that list Johnny Isaakson (R-GA) as a maybe on the public option !!! Totally insane.

And there’s some crazy person out there from FDL that keeps posting daily about how they’ve got 65 votesfor the public option in the house – yup that’s 65 out of 435 definite yeas !!!

gysgt,
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Again it is a case of agreeing to disagree. You said,
“Another thing I don’t think you consider is that mal practice insurers will not passed on any savings from reform to the doctors. Not to mention that congress will find a way to fu*k up any type of reform.”
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Perhaps this link will provide you with some insight to what I am saying about tort reform. Tort reform with “caps” or limits on damages an individual can get for their loss.
http://www.mlmonitor.com/WIP/site/August-Sample%20Issue1.pdf
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In particular it says this: “States with caps in 2000 included Alaska, California, Colorado, Hawaii, Idaho, Indiana, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Missouri, Montana, New Mexico, North Dakota, South Dakota, Utah, Virginia, West Virginia and Wisconsin. However, Alaska was excluded because factors that affect a decision to locate
there are likely to be different from other states.
In malpractice cases, most of these states limit payments for noneconomic damages(pain and suffering), but a few limit both economic (medical expanses and lost wages) and noneconomic damages, according to the study.
States that had caps that were declared unconstitutional were reported as states that had no caps. The study said that states with relatively high caps were less likely to experience an increase in physician supply than states with lower caps. This finding seems to support arguments of tort reformers that the higher the cap on noneconomic damages, the less effective it is.”
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I have read other reports that contend that the “cap” does nothing to affect rates charged, but I believe these “studies” are supplied and funded by the law lobby groups.
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Common sense also dictates that caps on the amount of the loss, would or should lower the cost of the insurance. There are other studies that show actuary rates are higher in those states without caps.
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Other studies try to show it as a cyclical phenom related to the economic times during any specific year. IE: when times are good, and investments by the insurance company affords them the opportunity to lower premiums, when bad economic times are prevalent, then premimuns go up. I’m not discounting this, as I believe with or without tort reform, this would occur anyways.

Karen:
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I’ll have to re-read the Baccus proposal, but if my memory serves me right, there were no “ages” specified, only that “seniors” will pay at 5:1. One can assume either, 63 and over or as you did, under 63.
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I am thinking in order to “crack open Medicare”, and be able to make this budget neutral they will have to include anyone over the age of 63. Meaning they will pay higher premiums or have more money taken out of their social security checks paid towards Medicare.
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But, it is not clear and we will have to wait and see what they define as “Seniors”.
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Obama has promised 500 BILLION in cuts to Medicare, I can’t believe he is going to find all of that cash in fraud, abuse or duplication of tests.

Alright, not bearing the shame for a moment longer, I’ve learned that our version of Blockbuster, Tsutaya, has it. It’s known here as:
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ニューヨーク 1997 (“New York 1997″)
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Also realized it wasn’t released in ’88 but ’81. Sh!t, man, I was only 11–my moms wouldn’t even allow cable in the house!
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And ’92! You beat me to the radical left by a couple of years. A freshly coined uni rube, I got my first gig on cap-hill that year.

jcapan:
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Is 2016 the year that most of the middle class realizes just how badly they got screwed by Baccus, and they decide to literally like Sadam Hussein, hang him?
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Just curious is all.

No, RR, I’m seriously saying Balk-Us has my full support for the presidency in 2016 (mind you, this is after Obama is defeated in ’12 and Sarah F’ing Palin goes to war with Russia, personally manning a windboat across the Bering Straits (dressed in a faux fur and leather get up).
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As Matt Taibbi said of the relative cojones of our former president: “Can you imagine Bush and Karl Rove allowing themselves to be paraded through Washington on a leash by some dimwit Republican Senator of a state with six people in it the way the Obama White House this summer is allowing Max Baucus (favorite son of the mighty state of Montana) to frog-march them to a one-term presidency?”
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But, really, reassessing, I like your idea better, but let’s all skip the preliminaries. Got rope?

If I’m understanding any of this, & perhaps I’m not, it sounds as if Sarah Palin was sort of right. Rather than instituting “death panels” as Palin claimed, Baucus has engineered “slow-death panels”: as you age, paying for health insurance becomes more & more costly. At the point when they need health insurance most, many people will be priced out of it & just give up & die.

Am I getting it right? Tell me I’m not.

The Constant Weader at http://www.RealityChex.com

I didn’t insult you and I would appreciate it if you afford me the same level of respect I’ve given you. You think implying that I’m a lunatic because I have a different point of view makes you the one in need of medication — and the fact that you called this trial balloon a proposal when it is clearly labeled a work in progress – a mere foundation of a proposal to see if he can garner any GOP interest because you know the debate is about to leave you behind, makes the case without me having to chime in.

The fact that you do not believe that anyone can understand source material unless you explain it to them is not respect; its delusional. Get a grip.

I don’t know if anyone is still reading this thread but just wanted to say “ditto” — the contributions here from Stuart, Rusty, and several others have been very informative and thoughtful.
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It’s great to see a vigorous but substantive debate here. I feel that I learn more from the comment threads, often, than from the original posts.

dee, your verbosity doesn’t mean you make sense, its just a case of piling the bullsh*t higher.
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I do care about the uninsured — I care about all aspects of health care policy. That’s unlike you, who focuses solely on providing insurance to YOU yourself.
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You’re comfortable with Obama making deals to enrich drug companies, insurance companies, and for-profit hospitals AS LONG AS YOU GET CHEAP HEALTH CARE. The fact that EVERYONE ELSE pays more is irrelevant to you.
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I take a different approach. I want a system that provides care to everyone at the lowest price. That means a single payer system — one that eliminates the costs of running an insurance industry (and which actually saves $400 billion a year while insuring everyone.)
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And its a single payer system that is the bar against which I measure all other proposals. Your bar is your own bank account. I look at policy, you look at your own wallet.

You my friend have it EXACTLY correct!!

The status of the American health care system is a symptom, not a cause of our problems. No matter how we ‘reform’ it, with our general attitudes and culture unchanged, the end results will in most cases remain the same.
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Lawyers will find new loopholes. Politicians will cut new deals. Regulators will fail to enforce certain laws upon certain entities. And most importantly, individuals will still look for the quick and easy answers that inconvenience them the least, which facilitates those other things to occur in the first place. The “American way of life” shall continue until it wounds itself so severely that pure necessity (vice logical free choice to prevent future tragedy) forces it to change.
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This is human nature. This is history 101. It is a sad conclusion, but it is NOT a cynical one. It is the predictable result based on 2 millenia of written history and observable modern day trends. Be encouraged however. We always overcome once all options to procrastinate have been removed. And we are usually just a tad bit better than we were before for the experience, albeit at great cost.

[...] the public option, and yet downplayed it. The package that he described is about the size of the framework released yesterday by Senate Finance Chairman Max Baucus–$900 billion, which is the lower limit of [...]

[...] the public option, and yet downplayed it. The package that he described is about the size of the framework released yesterday by Senate Finance Chairman Max Baucus–$900 billion, which is the lower [...]