Posts Tagged ‘health care reform’

Oh no you dih-uhn’t!

November 9, 2009

David Frum:

Over time, the public option will grow, setting private insurance on the road to extinction – or at best to a tightly regulated new role as the health equivalent of public utilities.

Conservatives, are you sure you wanna go there?  Really?

Last I checked, electricity in this country was extremely safe and reliable, and available to effectively everyone.  Water in this country was extremely safe and reliable, and available to effectively everyone.  Phone service in this country was extremely reliable, and available to effectively everyone.

People like to complain about their public utilities for the same reason they like to complain about the weather: it’s always there, every day, without relent.  But that’s sort of the point with utilities, isn’t it?

If you want to hear some real howling, ask people how they feel about, say, their cable tv service — something that is run much more like the current health care system.

In short, I really don’t think the GOP wants to start people thinking about what life would be like if their health insurance were as reliable, automatic, and available as their electricity, no matter where they went.

Lieberman to Reid: You My B*tch

October 27, 2009

Remember a while back, when Joe Lieberman actively criticized and campaigned against the Democratic Party’s presidential candidate?  Called him unfit to be commander-in-chief?

I said at the time that if Harry Reid didn’t punish Lieberman in some way, he would make it very difficult to maintain discipline in his caucus.  (Similarly, with Ben Nelson.)  If actively campaigning against your own party’s* presidential candidate doesn’t get you disciplined, what could you possibly do that would?

Not to be all “told ya so” and everything, but…

Lieberman has now come out against the health care reform bill that Reid is sending to the floor for a vote.  He says he doesn’t like the bill, and is perfectly willing to help the GOP filibuster any bill he doesn’t like.

Because Reid did nothing before, he can now make no credible threat to Lieberman (or the more ambiguously wavering Dems, like Blanche Lincoln).  The only tool he’s got is trying to buy Lieberman off, which presents two immediate problems:  a) it’s tough to buy a senator when you’re bidding against the insurance industry, and b) whatever Reid has to give him, it’s going to be bad.

If you’d shown a little spine in the past, Harry, you’d have more options now; and Joe’s vote, if we can get it at all, wouldn’t cost us good legislation down the road.

(* Yes yes, I know.  But Lieberman still caucuses with the Dems and holds committee chairmanships as a Dem.)

The Semi-Public Option

October 26, 2009

The big news today is that Harry Reid decided to include a public option in the version of the health care reform bill that will come up for vote in the senate.  A big win.  Plus, the version he included is the “opt-out” public option — the one that starts as a national program, but individual states can opt out of if they’re stupid they have objections.  Also a win, relative to the “triggered” public option or “opt-in” public option.

Nevertheless, I think Josh Marshall gets carried away in this post:

But by making it an opt-out rather than an opt-in, you start with a truly national program. That’s the key. The default is everyone is in. Even if you had 1/3 or even, conceivably half the states (or half the total national population in however many states) opt out, you’d still have enough heft to make it have the desired effect. And presumably you’d have by far most of the population in the program.

I could definitely be wrong about this, but it is my understanding that the public option being proposed — whether it’s triggered, opted into, or opted out of — will not have everyone in by default, nor will it ever have anywhere near “most of the population” in it.

The public option being proposed is available only to those whose employers do not offer a private insurance plan, and who cannot afford to buy a private plan on the individual insurance market.  Even with all the states participating, it’s going to be quite small.  It will be a “national program” like Marshall says, but the default is not “everyone is in.”  Only a small percentage of people will even be allowed the opportunity to get in.

That’s a problem, because one of the keys to making a public option work is the ability to negotiate better rates with providers, and you can’t do that if you don’t have enough policyholders.

Am I wrong about the nature of the public option they’re voting on?  Is it available to the general public, or at least a bigger chunk of it?  Anybody know?

Brain Drain in the Offing

October 8, 2009

There’s a health care reform proposal floating around to include a public option, but allow states to opt out if they choose.  Politically it’s great.  In policy terms, it’s also probably good; gives you a chance to see a comparison between the states that have a public option and the ones that don’t.  Who’ll turn out to be right?  The GOP death-panelers, or the Dems?  Which will people prefer?  (OTOH, how good an experiment it is depends greatly on the nature of the public option included.)

The only downside I see to it, really, is that it’ll create another round of brain drain out of Southern and rural states.  Those are the places that will opt out.  And when they do, the more educated, higher income office workers and professionals will leave for states that didn’t opt out.  As will new college graduates.  And some of their employers will have to leave, too, to find the workers they need.

Those places need more of those people moving in.  Their problems will just get worse if the few they have start leaving.

Making the Bulldog Sleepy

September 9, 2009

I’m still at work, so I haven’t seen Obama’s big speech.  But according to TPM, this is the “key passage”:

Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care.

Wow.  That’s great, Mr. President.  You know what else now is the time for?  Ice cream that doesn’t melt or make you gain weight.  Cars that burn no fuel and cost no money.  Toilet paper that doesn’t delaminate.

Now is the time to bring together the best ideas of both the Russian mafia and the Sisters of Mercy on proper table manners.  To bring together the best ideas of the paranoid schizophrenic and the scientific community on the whole issue of laser-eyed elephant babies who lurk in soda cans.

Honestly, if that’s the key passage of Obama’s speech, health care reform — any health care reform — just got much, much less likely.  As did an Obama second term.

Somebody please tell me there was some substance in this speech.  That the president didn’t just call a joint session of congress and interrupt America’s primetime tv viewing to say, “Gee, wouldn’t health care reform be just be the dreamiest?!”

Update (8:50 pm): Since I posted this, TPM put up some new posts about the rest of the president’s speech.  Not being where I can watch the speech, I thought it was over when their first live-blogging post stopped getting updated, ending with the “key passage” bit I quoted.  I’ll withhold judgment until I’ve had a chance to see the full speech, myself.

Quid Pro Quo?

September 9, 2009

When Sen. Kennedy died, the chairmanship of the Senate HELP Committee came open.  Everyone assumed Sen. Chris Dodd, who’s next in seniority and has been running the committee during Kennedy’s illness, would take over.

In a surprise move today, Dodd declined to do so.

That means Sen. Tom Harkin will take over.  And here’s where things get interesting.  Because Harkin’s plate is already so full, he’ll have to step down as chairman of the Agriculture Committee.  So who’ll take over Agriculture?  Why, Sen. Blanche Lincoln.

Here’s why I find that interesting.

As a Democrat from a deep red state, Lincoln is very vulnerable in 2010.  Recent polls have shown her running behind both of her likely GOP challengers.  Suddenly becoming the chair of the Senate Agriculture Committee could do wonders for her re-election chances in a fundamentally agricultural state.

Lincoln has been one of the Dems most vocal about her disinclination to vote for any health care reform legislation that includes a public option.

So my question is this: did the Senate leadership make a deal to get Lincoln’s vote on health care reform in exchange for giving her a chairmanship that’s worth its weight in gold back in her state?

It’ll be interesting to watch Lincoln’s rhetoric over the coming few weeks, and, ultimately, her vote.

Not Feeding the Bulldog

September 9, 2009

According to TPMDC:

According to Politico‘s Mike Allen, in his speech tonight, President Obama will stick to his longstanding game plan of endorsing the public option, but not demanding it, and leaving himself enough wiggle room to get on board with some sort of compromise.

If that’s what the president does, I suspect he’s not going to like America’s reaction to it.  Everybody’s been waiting for the president to step up and say — specifically and forcefully — what he wants, what he expects, what he will and will not accept.  Everybody’s expecting this speech to do that.

If all he does tonight is repeat the same vagaries he’s been repeating for months, in order to continue avoiding taking a firm position, people are going to be pissed.  And I don’t just mean progressives or Democrats or Obama voters.  I mean people in general.

People have been waiting for you to lead, Mr. President.  If you duck that responsibility again, in a spotlight like the one you’ve created for yourself tonight, your poll numbers are going to drop so fast you’ll get vertigo.

You’ve called everybody together.  You better show up and lead.

Deep Stupid

August 27, 2009

Today I bring you Senator Mary Landrieu, of Louisiana.  At a town hall in her state, Sen. Landrieu had this to say about the public option in health care reform:

I’d like to cover everyone — that would be the moral thing to do — but it would be immoral to bankrupt the country while doing so.

She could not have gotten more things wrong in one sentence if she’d tried.

The public option has nothing to do with universal coverage.  They’re two distinct things.  The health care reform legislation currently under consideration has two goals: universal coverage, and reducing health care inflation.

The public option is aimed at the latter, not at universal coverage.  If you think it’s immoral to bankrupt the country while providing universal coverage, the public option should be the thing you insist on keeping in the bill; not the thing you insist on stripping out.  Passing universal coverage without the public option (or a similar cost-control measure) is what would break the budget.

Saying you want to keep the country from spending too much on health care and therefore  you’ll filibuster any health care bill that includes a public option (a threat Landrieu implicitly makes elsewhere) is like saying you want to keep the country safe from enemy bombers and therefore you’ll filibuster any defense bill that includes money for the Air Force.

It couldn’t be any more stupider.

A Really Rotten Summer to be a Celebrity

August 26, 2009

As you’ll probably have heard before you read this, Senator Ted Kennedy died overnight.  Much will be said.  Much more than is really necessary or even appropriate.

My first thought is of health care reform, something Kennedy championed for decades and would be championing today, if not for his illness.  It’s hard to know how this will affect the current debate.  Kennedy was hated by conservatives, but loved within the senate by just about everyone, regardless of party or ideology.

There was a time when a death like this, coming at a time like this, would speed health care reform legislation along; make it more progressive, as Kennedy would have wanted.  That time, however, is probably past.  What we’ll probably get instead is more partisan spleen, including commentary about how Kennedy would have died months ago under “socialized medicine,” because a “death panel” would have declared his case not worth the expense.

And that’s just sad.

Products and Losses

August 25, 2009

The second largest health insurance company in the country is United Health Care.  The health insurance industry supposedly supports Pres. Obama’s goals for health care reform.  Yet UHC is encouraging its employees to show up to anti-reform rallies and town halls; even providing them with talking points.

UHC happens also to be my insurance provider.

Normally, when a business I patronize does something I find deeply offensive, I take my business elsewhere.  It might be Kroger or Domino’s or GM or Disney or whomever.  If they do something I don’t like, I can penalize them by taking my money elsewhere; I might or might not do it, but I have the option.  So does everyone else.  That gives those businesses an incentive not to piss people off.

But health insurance markets aren’t structured that way.

I don’t have any control over who gets my health insurance business.  My employer makes that decision.  So there’s nothing I can do to hold UHC accountable for jumping into the political process to oppose something I favor, all the while pretending to favor it.  They’ve got my business, and there’s nothing I can do about it.

This isn’t limited to me, of course.

Consumers have extremely limited control over insurers, and therefore the insurers in this country have very little incentive to behave themselves.  Overwhelmingly, their customers are the businesses that buy group insurance and provide it to their employees at a subsidized cost.  The transaction is between an insurer and an employer, not between an insurer and an insuree.

What’s the problem?

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