You Can Go Your Own Way

Via Steve Benen, it looks like they have finally had enough of the Republican BS:

Given hardening Republican opposition to Congressional health care proposals, Democrats now say they see little chance of the minority’s cooperation in approving any overhaul, and are increasingly focused on drawing support for a final plan from within their own ranks.

Top Democrats said Tuesday that their go-it-alone view was being shaped by what they saw as Republicans’ purposely strident tone against health care legislation during this month’s Congressional recess, as well as remarks by leading Republicans that current proposals were flawed beyond repair.

Rahm Emanuel, the White House chief of staff, said the heated opposition was evidence that Republicans had made a political calculation to draw a line against any health care changes, the latest in a string of major administration proposals that Republicans have opposed.

“The Republican leadership,” Mr. Emanuel said, “has made a strategic decision that defeating President Obama’s health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day.”

The worst thing about the Republican obstructionism and nonsense the past month is the national conversation has been about death panels and angry blue hairs screaming about medicare and wingnuts carrying guns to townhall events and chants of tyranny. How many of you actually know what the Democratic proposals are? How many of you actually know what is being suggested? How many people can say, in a paragraph, what the difference between co-ops and the public option are? I’m trying to pay attention but I do not understand all the ins and outs. Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

Not only has this been a failure of leadership by the minority party, it has significantly dumbed down the debate.

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104 replies
  1. 1
    Maurs says:

    Please, please let this be true. Move forward without the Repubs. We don’t need ’em and they will NEVER negotiate reform in good faith.

  2. 2
    gyma says:

    Agreed, completely. CNN had a poll up recently asking whether people understood the debate and the overwhelming majority responded ‘no.’

    But this is exactly what the goons in Washington want, isn’t it?

  3. 3
    schrodinger's cat says:

    Why the media continues to give Republican politicians any credence after the epic fail of the last eight years is beyond me.

  4. 4
    gwangung says:

    Not only has this been a failure of leadership by the minority party, it has significantly dumbed down the debate.

    I’m reminded of the partisan who said, “This is going to lead us down the road to socialized medicine like Europe’s, and we know it failed there!”

    You have to say to these folks, “You are entitled to your own opinion. You are not entitled to your own facts. DO YOUR HOMEWORK.”

  5. 5
    gex says:

    Sadly, no amount of dumb is too dumb for today’s GOP. They are spending a lot of time in-fighting about who isn’t dumb enough to be in the coalition.

  6. 6
    nevsky42 says:

    Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    They’re also passing along the millions they’re spending in lobbying senators to our premiums…

  7. 7
    flukebucket says:

    This is a good first step. The Republicans have been given every opportunity to be a part of the process. They have decided against that. So move on. No big deal.

  8. 8
    cleek says:

    i agree it’s the right way to go.

    but get ready for the GOP to crank up the crazy another couple of notches, with much heavier emphasis on the “ramming it through Congress” and a whole lot more whining about Obama’s lack of bipartisanship.

  9. 9
    Elvis Elvisberg says:

    Not only has this been a failure of leadership by the minority party, it has significantly dumbed down the debate.

    As far as they’re concerned, that’s Mission Accomplished.

  10. 10

    Wasn’t it just this past Monday morning when I read the “public option is dead” and that the Democrats were caving to the Republicans?

  11. 11
    edmund dantes says:

    Not only has this been a failure of leadership by the minority party.

    I’m confused by the above. Do you mean the majority party? Was this a Freudian slip? I know it’s easy to confuse the Dems with a party in minority status by the way they act and govern, but I don’t see how this can be seen as a failure on the Repubs part. They’ve done a pretty good job demonizing, derailing, and gumming up the works on a policy they don’t want to see made law.

    I might not like them or their tactics, but I find it hard to see how this process has been a failure on their part so far.

  12. 12
    General Winfield Stuck says:

    They want their country back, after 7 months of dem control. What do they mean? What do you think they mean? Health Care, Smealth Care. Next it will be apoplectic shouts of liberal mind control over a dem proposal to name the Post Office in Bumfuck, Texas after Martin Luther KIng, or FDR, or Bullwinkle Moose.

    They are screwed electorally, and racially, and intellectually, and about every other way for the white man ruling class. And they know it, though likely not in higher brain functions loosely interpreted), but certainly in the lizard cortex region that makes their boats go.

  13. 13

    @schrodinger’s cat: It doesn’t matter how fact free an argument is; it just matters if it comes from the “other side.” Even when the “other side” has absolutely no merit and is based on nothing but mindless blathering. I believe that is the modern version of balance.

  14. 14
    Tom Q says:

    I know alot of people wanted this done months ago, and I won’t argue that this same gestalt existed then. But I think this timing works for the Dems. Obama is clearly seen as having gone the extra mile, which scores point with indies; the Pubs — personified by Grassley and Kyl — have unmistakably adopted Groucho’s “Whatever it is, I’m against it” as their credo; and we’ve had lunatics on TV for three weeks screaming about Hitler and making folks in the middle uncomfortable. It may be that Rahm/Obama have known for some time this day would come but they were waiting for the moment when they could do it without surrendering their “president of all the people” shtik (now amended to “president of all REASONABLE people”).

    I’m sure this puts me perilously close to the “Obama is a ninja chess player” mind-set, but, you know, till he actually loses a big one, I’m inclined to think he’ll get close to what he wants, whatever the initial noise (see: Cash for Clunkers, Sotomayor can’t be confirmed before Fall, etc.)

  15. 15
    jibeaux says:

    How do you link on this website these days? I can haz buttons yet or are we still at attack code reddish orange?

  16. 16
    General Winfield Stuck says:

    And btw, Michelle Barnard and to a slightly lesser degree, Dylan Ratigan, can blow it out their ass for the Union bashing stupidity I saw on my teevee this morning. But not Mike Allen, oddly enough.

  17. 17
    handy says:

    They want their country back, after 7 months of dem control. What do they mean?

    I’m gonna go with the Presidency and a Congressional Majority. Actually, strike that. Just the Presidency. Or rather, the likes of a Dick Cheney shacking back up at Number One Observatory Circle. I think that would pretty much cover it.

  18. 18
    Sloth says:

    I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    In theory, they could add positive value since they are motivated by the profit motive. Today, the profit motive is leading them to deny care and cherry pick only healthy people to insure. Which works great. For them.

    One could imagine that, with proper regulations (i.e., no pre-existing condition clauses, no lifetime cap, no rescission, guaranteed issue), that they might actually decide that the way to make more profit would be to actually, you know, lower their costs.

    And I suspect we’ll all get a pony too, but who knows.

  19. 19
    jibeaux says:

    @edmund dantes:

    I like to tell them that I will be able to relate to their pain at having lost their country, in just 89 short months. I will be very sympathetic and feel your pain. In 89 months.

  20. 20
    ChrisB says:

    You know who’s been really good on this? Anthony Weiner of New York. He absolutely kicked Joe Scarborough’s butt on Morning Joe yesterday. Scarborough had no response when Weiner asked him to name something of value that insurance companies provides. After several seconds of stunningly dead air, all Scarborough can muster was the lame “it’s not my job to answer your questions” line. You couldn’t have asked for a more forceful, cogent presentation.

    Of course, later in the day, I think it was Chuck Todd who noted how unhappy the White House must be with how forcefully Weiner was making his argument.

  21. 21
    Stephen1947 says:

    John says: Not only has this been a failure of leadership by the minority party, it has significantly dumbed down the debate.

    And I chime in in agreement, pointing to the NBC poll that’s making the rounds this morning “proving” that support for public option in particular and health reform in general is withering. But it also demonstrates that most of those against it don’t know jack about what’s actually in it and “know” a lot of other stuff that is demonstrably untrue.

    Thing is – we’ve all got to get in the habit of referring to Publicans as liars, and get our Dem reps to say the same over and over. If the reps say it enough, the corporate media will hafta start reporting that it was said, and who knows what kind of truth might grow outa that?

  22. 22
    wilfred says:

    “The Republican leadership,” Mr. Emanuel said, “has made a strategic decision that defeating President Obama’s health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day.”

    The coroolary of this must have something to do with the Democratic leadership but I just can’t seem to put my finger on it.

  23. 23
    chopper says:

    part of me thinks this was the idea all along, to get the GOP to go full-retard and then have an excuse to walk away. put the moderates in a vice, either be part of the fix or with the deathers.

    after all, obama is known for being a good poker player.

    but really it seems more like the WH didn’t think they’d get such an earful from liberals about dropping the public option, and wants to act fast to avoid falling into the same trap clinton did.

    the GOP is good at this move, the so-called moderates argue up and down to get you to water the bill down (which pisses off your base), and then turn around and vote against it when it comes up so you get punked two ways. you lose on your big bill and look the fool and your base gets pissed off.

    its a crappy move to pull and the WH will certainly never trust those ‘moderates’ again but the damage would be done. if its done at the right time over the right issue it can hurt the president enough and invigorate the GOP base enough to change the political landscape. see 1994.

    obama knows this i think. the GOP is trying to stab him in the back.

  24. 24
    satby says:

    @edmund dantes:
    I can’t speak for what John means, but to me it’s a failure of te Republican leadership to offer an opposition based on actual policy differences, or a coherent alternative, or to keep their party from continuing down the path of irrelevence to any sane human.

  25. 25
    charlied says:

    It’s about time. You can only get punked so often before you only have yourself to blame for getting punked again.
    I think that John has it right when he says that insurance companies add nothing to the health care system. but lets take that further, what have the banks added to our financial system? They skim money in fees from deposits and credit cards while making reckless investments that need to be bailed out by the taxpayers. In fact our reliance on corporate america to move us forward has left us with a decaying electrical grid, a fleet of inefficient autos that hurts our national security, and telecommunications and internet connections that are years behind Europe and Japan. It’s time to talk about the many failures of the marketplace, and the corruption of corporate america.

  26. 26
    General Winfield Stuck says:

    but get ready for the GOP to crank up the crazy another couple of notches

    There is a law on diminishing returns on most things humans do. That might go double for those who bet the farm on “death panels” “Nazism” and the like.

    So crank it up wingnuts, bring it on, bring them in dead or alive, and get them on the run. Stupidity is on the march.

  27. 27
    Martin says:

    Let’s see the result before we say whether it’s a failure of leadership. Now is when Democrats can speak to Democrats and Independents and ignore Republicans. We’ll see if they bother to do it.

  28. 28

    After letting the opposition score a couple of layups the administration has slowly, but steadily, ratcheted up the pressure game. The Obama team is pushing the ball up court and applying a full court press to these guys:Michael Smerconish, a Philadelphia-based conservative talk show host, will broadcast his nationally syndicated program from the White House Diplomatic Room alongside the president. OFA is gearing up for an online healthcare forum and you now see prominent Democrats everywhere in the news. The Republicans and teabaggers you see on the news have one thing in common: they all appear unhinged. The narrative has slowly evolved over the past couple of weeks. But it does appear that the GOP allowed the message to be dumbed down to the point that they look like freaks and idiots to even the casual observer of the news.

  29. 29
    satby says:

    @charlied:
    Yes, this too.

  30. 30

    Now I have Fleetwood Mac running through my head. Thanks for nothing, John.

  31. 31
    Richard says:

    So what you are saying is that real reform is “SINGLE PAYER!”

  32. 32
    T. O'Hara says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all.

    I can’t figure out how protesters could ever get the idea the actual goal was to get rid of private health insurance. Must be unAmerican evil-mongers.

  33. 33

    @The Grand Panjandrum: Rats! My blockquote html disappeared. This is what should be blockquoted:

    Michael Smerconish, a Philadelphia-based conservative talk show host, will broadcast his nationally syndicated program from the White House Diplomatic Room alongside the president.

  34. 34
    gwangung says:

    but really it seems more like the WH didn’t think they’d get such an earful from liberals about dropping the public option, and wants to act fast to avoid falling into the same trap clinton did.

    Um, no. I think it’s more like the White House was hoping they didn’t have to play games with their constituency and that the left would organize for reform on their own without having to make public hints about dropping desired options.

    Reform was not going to pass without liberals getting off their ass and being as active as the wingnuts. That means getting organized, being in the public eye and getting down and putting pressure on their Congressman. Anybody who thought it would pass without this kind of activity from the left is an idiot.

  35. 35
    someguy says:

    This is a great move by the Democrats. They should put through whatever they think is right. Matter of fact, I think they should up the ante, and let the teatards opt out of the public option right fucking now. Doesn’t mean their tax dollars aren’t going to pay for it, just if they don’t want it, they can sign a paper, and opt out now and forever. No death panels, no nazis, no nothing.

    If you’re going to raise the stakes, might as well go all in and call their bluff.

  36. 36
    Michael says:

    Remember when conservatives talked about the “moral hazard” inherent in handing TARP money to banks (something I didn’t disagree with totally, by the way. I wanted to see an RTC sort of buyup and an unwind of BAPCA 2005 as it related to forcing most bankrupts into 13s)?

    I’d like to see the debate switch to the following:

    1. Talk about the absurdity of having 1/6 of our economy be sucked up into the provision of health care services.

    2. Talk about the moral hazard inherent in a system where an organization profits by denying treatment, considering that it adds no value to that treatment.

    3. Remind folks that we did plenty fine without all the economic sucketry of for profit hospitals.

    4. Ask people why a 5 minute session with a medical provider should be accounted as costing as much as it does.

  37. 37
    Rommie says:

    Oh boy, we get to hear about the Tyranny of the Majority for the next few months. I wonder if the White House waited as long as they could to cross the Reconciliation River because of the inevitable reaction and the increase in Teh Krazy.

    If the Wingnuts start wearing Che Guevara T-Shirts, the Irony Meter will be broken permanently.

  38. 38
    Jennifer says:

    FWIW, I attended a town hall yesterday in the unenlightened state of Arkansas, and was pleasantly surprised. No teabag protests. No shouting down or chanting. Sure, a few ill-informed people made it to the microphone – they were answered, rebuffed, etc. Many, many more who made it to the microphone were adament in their support for public option and it was clear that the majority in attendance were in agreement. For reasons I can’t understand, our rep, who I’ve known personally for 15 years and who is himself a doctor, continued to say he wasn’t generally supportive of a public option, didn’t think it mattered that much, but that if the final bill contained it he would vote to support it.

    I never got a chance at the microphone (perhaps because he knows me and that I wouldn’t ask a bullshit question!) so I never got to ask what their plan is for controlling costs absent a public option, since we all know the health insurers will be there day in and day out throwing around tens of millions of dollars (if not hundreds of millions) to chip, chip, chip away at whatever reform we get and to try continually to shape things to their own advantage. That’s the problem with not having a public option – there’s no way to control costs, because the insurers will simply lobby their way around whatever reform is imposed. They can’t lobby around a public plan that provides the same services for less – their only choice in that scenario is to compete with it.

    If you’re writing to your representatives or senators, please be sure to make that point. Health care costs in this country not only need to be controlled, they need to be rolled back. We pay twice as much as the French do, and they have the best health care system in the world. We aren’t going to get that kind of result as long as we have private insurers predominating in the health care market, but at the very least, we should try to match the costs of the second-most expensive system in the world in Switzerland, which has private insurers but prohibits them from profiting on basic care plans. I think they’re allowed something like 5% overhead and profit on basic care plans. They are allowed to profit on supplemental plans, and somehow, they’ve managed to survive.

  39. 39
    maye says:

    This is a failure of the White House communications team. No one could have predicted the wingnuts would lie and disseminate propaganda? Please. Gibbs, et. al., had no plan for August. Sending Obama out to a few town halls was too little, too late. They should have been ready to launch a national campaign featuring ordinary Americans telling their healthcare horror stories – with the cameras rolling 24/7. PR is not brain surgery.

  40. 40
    jenniebee says:

    @General Winfield Stuck:

    They want their country back, after 7 months of dem control. What do they mean? What do you think they mean?

    They want a country that they believe agrees with them about the importance of socially conservative issues like abortion, gays, and anti-communism (even if the horrible “elites” are persecuting them by not legislating their agenda). Their main upset is that they took it personally when they were repudiated at the polls.

  41. 41
    Sasha says:

    I suspected it was heading this way.

    Sure Democrats have made concessions, but the narrative of the last few weeks will be that Republicans not only couldn’t compromise or offer up their own ideas for reform, they have no interest in allowing *any* kind or reform. Grassley’s recent comments about not voting for a bill, even if it had everything he wanted, all but prove that.

    Add the bullying, hectoring manner of the protestors and the dishonest arguments by conservative personalities and you got a perfect formula for “Look, we tried being bipartisan, but the GOP isn’t offering or suggesting anything in good faith. What else can we do but go it alone?”

  42. 42
    jimBOB says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all.

    I could say much the same about the current opposition party.

    Generally, the idea behind an opposition party is that they can point out flaws in the majority’s policies and work to keep things honest. An opposition that works through blatant serial dishonesty has no reason for being, at least from the point of view of the society as a whole.

  43. 43
    David Eoll says:

    Not only has this been a failure of leadership by the minority party, it has significantly dumbed down the debate.

    I agree with Edmund, this makes no sense as written, since dumbing down the debate has always been part of the GOP’s strategy on any of their legislative objectives. On that point their party’s leadership has scored yet another win. Not a failure.

    The failure of leadership has once again been on the part of the Democrats. For all of the reasons that are mentioned.

    How many of you actually know what the Democratic proposals are?

    Precisely.

    Maybe it was a slip on John’s part. They certainly act like the minority party even though they have the strongest majority in recent history. Idiots.

  44. 44
  45. 45
    Ash Can says:

    @T. O’Hara:

    I can’t figure out how protesters could ever get the idea the actual goal was to get rid of private health insurance.

    By being paranoid, and by being ignorant of what the reform proposals actually were.

    You’re welcome.

  46. 46
    Calouste says:

    @schrodinger’s cat:

    Why the media continues to give Republican politicians any credence after the epic fail of the last eight years is beyond me.

    Why people still expect that the media, which mostly consists of and is owned by old rich white people and the children of old rich white people, in other words the natural constituency of the GOP, would do anything else but suck up to Republican politicians is beyond me

  47. 47
    jenniebee says:

    @Jennifer:

    [Switzerland] has private insurers but prohibits them from profiting on basic care plans. I think they’re allowed something like 5% overhead and profit on basic care plans. They are allowed to profit on supplemental plans, and somehow, they’ve managed to survive.

    Yow, no way would profit caps, even as an alternative to a public plan, ever get passed in this country. Shoot, restrictions on paying executive bonuses with taxpayer bailout money were “controversial” and led to accusations about the money only being offered with strings attached so that… government takeover! Soc1alism! Soc1alism! Lalalalala I CAN’T HEAR YOU!

  48. 48
    brent says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    I agree with the sentiment here but I don’t think its exactly right. That is, health insurance, like all insurance, is a service one pays for to manage risk. Its also (theoretically) a way that consumers can pool resources and use their combined purchasing power to lower the cost of health care. So, if its done properly, then its a helpful service. That is the value that it can provide.

    The problem is that right now, the power balance between consumer and the corporations that provide the insurance is tipped heavily in the favor of the latter. I do think there is a reasonable argument to be made that changing that balance would go a long way to fixing the significant problems that we have with health care and its costs. Not that Republicans are making that argument or willing to accept anything that inconveniences the insurance companies in any way but in the larger context, if we were having this debate in a sane world, I can see a scenario in which insurance companies could provide value and offer some advantages over single payer.

  49. 49
    Bisquits says:

    Our small firm of 5 people pays 40k a year for group health. Our monthly premiums are half as much as our payroll. At some point in the near future, doing right by our employees will mean shortchanging my family with less income. This is a horrible choice. I think our situation is the norm for small businesses. It’s just not sustainable.

  50. 50
    Ella in NM says:

    “I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.”

    Other than being a major corporate player in our economy, nothing. Which is everything to the Republicans who matter in this country (aka, the ones REALLY in charge, not the gun-totin’, Death Panel fearin’ racist rubes who they have set loose on the nation like a pack of Michael Vick’s fighting dogs). Which is why they–Insurance, Big PhARMA, etc– should have never been allowed to get this filthy-frigging rich and monopolize our system in the first place. Health care should have been declared a quasi-public business and heavily regulated and structured by our government a long time ago. But NOOOOOOO! Every thing has to be for profit in this country!

    Now we will, unfortunately, have to deal with job losses in this sector which will be created by any cost saving changes to a totally wasteful, for-profit way to provide health care. A lot of administrative and claims personnel–and hopefully marketing agents– will definitely be out of work in a better, more efficient system.

    For a nation that prides itself on old fashioned values of frugality, practicality and financial conservatism, we’re awfully generous to the corporations that are literally robbing us blind, aren’t we?

  51. 51
    Eric U. says:

    Before Reagan screwed things up, insurance companies simply pooled risk. That is a reasonable role. But since the ’80s, cost management has grown. Initially it was used to control costs to employers, now it’s used to scrape money from the system. The fact that we will pay a lot of money not to die was the elephant in the room that the insurance companies could not ignore because of their fiduciary responsibility to their shareholders. So now we’re rapidly heading towards the situation where we cannot get sick or we will die or, if we’re lucky, survive but be unemployable. Kerry’s idea of government funded catastrophic care might have delivered us from this problem, but of course he probably couldn’t have passed that either.

  52. 52
    dom says:

    Not only has this been a failure of leadership by the minority party, it has significantly dumbed down the debate.

    Is this a joke? The failure to put together and pass a piece of legislation by a government completely controlled by one of two political parties is the fault of the minority party? Legislation, mind you, which is the crown-jewel of the center-left coalition that allegedly “helped” Democrats regain power in Congress and the White House? And it’s the Republicans fault?

    This is epic fail on the part of the Obama administration and the Democratic leadership, not the Republicans. There was never any coherent message on healthcare reform from the White House and the Democratic caucus. Instead, we have ambiguous statements from the leadership about how “reform will cover uninsured Americans”, etc., etc.

    Real reform is going to come about by explaining to the American people the sacrifices that will have to be made in any meaningful legislation. Not once has the administration spoken about the potential costs, which will be astronomical. Not once has the administration laid it out and said “look, this will cost us in the near term”, in other words….taxes. Because the plan as currently structured will require as much, as it essentially is a new entitlement program, which requires funding.

    If the President truly believes the nonsense he says about the willingness to be a one-termer, then lay it all out there. Because the higher taxes to be paid plus the notion that this is in fact, another bureaucratic-laden entitlement, will cost the Democrats in 2010 and possibly Obama the White House.

  53. 53
    jenniebee says:

    @someguy: I’ve been wondering, the way things are right now, if someone calling themselves “centrists” proposed expanding Medicare as a “compromise” couldn’t get a whole lot of people believing that that was actually a compromise position. After all, Medicare is such a known and liked element, and the right has done such a good job of making people nervous about Democratic proposals primarily because they’re unknown and exotic, I think most Americans right now would embrace the expansion of something they know and like rather fiercely.

  54. 54
    T. O'Hara says:

    By being paranoid, and by being ignorant of what the reform proposals actually were.

    Obviously. Here’s another look at that Scarborough video being cheered above:

    S: But you are making the conservatives’ point. You are making the point of the people at the town hall meetings who say this is Barack Obama’s opportunity to get rid of private health care and turn it completely over to the government. I’m sitting here stunned, saying Oh My God, you’re making the point of the health care protesters.
    W: If Barack Obama doesn’t want to do it, I want to do it.

  55. 55
    Alan says:

    @gwangung:

    I’m reminded of the partisan who said, “This is going to lead us down the road to socialized medicine like Europe’s, and we know it failed there!”
    You have to say to these folks, “You are entitled to your own opinion. You are not entitled to your own facts. DO YOUR HOMEWORK.”

    I’ve been waiting nearly 30 years for western Europe to go completely bankrupt due to the “socialization” of their economies. Who woulda thunk it took our free market capitalistic banking system to do it for them. Very strong is the Right’s cognitive dissonance.

  56. 56
    williamc says:

    @John Cole up top

    I don’t understand the confusion on the co-op/public plan proposals, but I will give it a shot…

    It seems simple: in the public plan scenario, the government will operate an insurance company nationwide (let’s call it Americare). People who own small businesses, people who are self-employed, people that are too sick or too poor to afford the premiums of private insurance will be dumped there. The cost controls come in the ability to negotiate drug prices due to the large size of the group (which it seems the White House may have bargained away), and the reimbursement rate that Americare negotiates with the hospitals (maybe Medicare rates + 10%). Private insurers will have to match that low rate or exceed it to compete with Americare.

    In the co-op scenario, there are two options, national co-op and regional/state co-ops. In this scenario, the co-op (let’s call this one Blue Cross/Blue Shield) will be set up by the states, hospitals, doctors, and any mixture of interests which will in turn set up administration to form their own insurance companies. I call them BlueCross/BlueShield because in some states, BCBS is already operating in the mode of what some are describing as “co-ops”.

    The problem with the co-ops is that even a national one will take years to set up, will involve lots of government seed money and really not do anything to bend the cost curve downward because to administer the co-op plan will cost just as much as private insurance, and doctors, hospitals, and other medical concerns have no interest in designing a program that will not pay themselves on the high end. And don’t forget the state run co-op in this: it will leave the co-op open to state legislators taking insurance industry money and designing these co-ops to be less competitive to the industry.

    I’d welcome any correction to my thinking on public option vs. co-op, but that is my understanding of the issues…am I mistaken?

  57. 57
    Olly McPherson says:

    Despite right-wing chicanery, I agree that the failure has been one of communication on the part of Obama and Dems.

  58. 58
    Zach says:

    A government plan would be run out of the executive branch a la how Medicare is run out of HHS. A cooperative could take a few forms ranging from being like the SSA (independent government agency w/ Presidential appointments of commissioners serving 6-year terms and bipartisan boards) to being like Fanny/Freddie (although it’s doubtful proponents will make that comparison) to just being an independent non-profit started with seed money from whatever bill passes playing on the same field with the private insurers. It’s somewhat ironic that the latter is considered the least intrusive since without government oversight there is no way to hold those responsible for its management accountable.

  59. 59
    The Other Steve says:

    Isn’t the purpose of the Republican party to dumb down the debate so they can pass tax cuts?

  60. 60
    The Other Steve says:

    @williamc: I don’t think the public option is where people are dumped. If this was in fact the case, the insurance companies would not be against it.

    Rather what is more likely the case is that the public option would define the minimum, a standard for paperwork and so on, and it would be expected the private companies adhere to that. Which is why they are against it.

  61. 61
    Chad N Freude says:

    A failure of leadership indeed, but certainly a failure to lead by the majority party. I wish I could agree with those among us who see Rahm E as the second coming of Machiavelli, but — call me a jaded cynic — I think it’s just a dropped ball, and the we’re-gonna-get-tough-now rhetoric is an attempt to pick it up again. Pushing a metaphor beyond all rational bounds, I think the ball may now be completely deflated.

    @Alan:
    Very cool observation.

  62. 62
    Shalimar says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    Exactly. That is the perfect summation of my feelings about insurance companies. The first two are actually a pretty good summation of contracting government work to private companies that was so popular under Bush too.

  63. 63
    Violet says:

    How many of you actually know what the Democratic proposals are? How many of you actually know what is being suggested? How many people can say, in a paragraph, what the difference between co-ops and the public option are?

    This has been my argument all along. It’s very difficult to find out and understand the Dem proposals. The crazies have dominated the debate.

    The blame lies at the feet of the Republicans, for pushing this sort of behavior, the Democrats for not having better messaging and also anticipating this nuttiness, and the media for focusing on the idiots instead of doing their job. But hey, it’s a ratings game. They’ll always focus on screamers. Dems should know that and be prepared. It’s not like that is new information.

  64. 64
    Xenos says:

    The for-profit insurance companies were supposed to bring the magic of competition and aggressive cost controls. However, their only competition are the Blue Crosses, which may be public charities but are run like business, at least in as much as they pay their executives ridiculous amounts of money.

    There never was price competition between the companies, and it was easier to spend their money on politicians to arrange for monopolies rather than trying to control prices. Epic fail for a misbegotten experiment. Privatized, shareholder-owned health insurance is a monstrosity that would never have been allowed to exist for most of American history, or in much of the rest of the world. Reform unavoidable means putting them out of business.

  65. 65
    Chad N Freude says:

    @Violet:

    the media for focusing on the idiots instead of doing their job

    Focusing on idiots seems to have become the media’s job.

  66. 66
    Anoniminous says:

    Conservatives have, up to now, taken control of the discussion in their usual inimitable fashion: lie and scream.

    Anyone who has bothered to pay attention over the last 30 years would have known they were going to lie and scream since that’s what they’ve been doing over the last 30 years.

    Expecting them to do anything but lie and scream is an exercise in stupidity.

    From this it follows President Obama, Rahm, and the other elected leaders of the Democratic Party have up to this point been stupid.

    Conservatives, through their usual media channels, have taken control of the discussion and created the areas in which the discussion is talking place. Until and unless the Obama administration goes full court press with their own media campaign and shifts the discussion to something approaching reality even if they win in the short term, they lose in the long term.

    OK, why?

    THE crucial issue of the day is not this or that particular piece of legislation. It’s the Conservative mindset, writ large, that deems the Public Good does not exist except as an emergent property of individual action(s). They are ignorant of the fact the Public Good is an state variable of the Fitness Landscape in which agents and actors – act. (To lapse into jargon.)

    Over the past year we’ve seen the results of the Public Good being devalued and then shrunk through actions guided by Neo-Classical economics and Conservative political and social theory. The results have been discussed on BJ many, many times and I feel no urge to recapitulate It All.

    Suffice to conclude: The System she be Broken.

    Postulating the current leaders of the Democratic Party, who rose to their positions within The System, have as their primary concern to ‘tweak’ The System under the impression that will cure the problem the actions of the Democratic leaders becomes clear; so does their surprise at the actions and reactions of the Progressive Caucus – writ large – of the Democratic Party who maintain more than a ‘tweak’ is needed.

    Interestingly:

    Rahm, as long as the GOP, is a solid Nay, cannot pass anything in the House without the Progressive Caucus. The votes, by my count, aren’t there. As long as the Progressive Caucus stays solid at least.

    Speculation: this is why Rahm went all twitterpatted recently when he finally realized this.

    IF true we’ve got a situation where the Party of No is giving their political enemies – the Progressive Caucus – control of the Obama administration’s legislation. Meaning those who would prefer to ‘tweak’ The System are being forced to move to The Left. IF this is the case the ‘Tweakers’ are going to be forced to conduct an all out media offensive to convince enough of the American electorate to support the Public Option so the ‘Tweakers’ won’t get destroyed in the 2010 elections.

    OK, there’s a lot of “IF”s running around in the above analysis© but I submit it gives some ground to explain the shift of the Obama administration to a more aggressive stance regarding the Public Option.

  67. 67
    Jennifer says:

    “I can’t, for the life of me, figure out what value the insurance companies add at all.”

    Well, that hits on two different points.

    The first is that some activities just aren’t suited to a for-profit business model. In any situation where someone stands to profit by allowing someone else to die, people will be allowed to die. Human nature being what it is, this is an eternal truth.

    The second is this notion hatched by the Republican-corporate axis some 30 years ago that profit is the only motive that drives the economy. There is some truth to that, in that profit is one of the major, if not the major, motives driving the economy – but it’s not the only one. Trade exists so that people can obtain the products and services they need. Profit is incidental to trade, because trade can exist in other forms – barter, etc. By the end of the 80s, profit as everything had been embraced by the Democrats as well. The problem is, this belief got twisted into the idea that unless profit is involved, certain goods or services cannot or will not be available. And this, of course, is patent bullshit, but it explains the mediocrity of much American business today.

    Back in the day, profits of 5% – 10% were considered good returns for many types of business. But once this “profit is the only goal” mentality was embraced, suddenly ALL types of businesses were expected to produce profits of 15%, 20%, 30%…instead of the old understanding which was that, for example, investment in a newspaper would return 5% per year while investment in an oil exploration company could return 40% (or conversely, nothing at all), American business has tried to shoehorn all types of commerce into a formula where everyone produces 20% profit annually. And, things just don’t work that way. Some activities by their very nature can’t fulfill their basic mission (the product or service they are ostensibly in business to provide) while producing that profit margin. Media, for example. It’s gotten more profitable, and as it’s done so, it’s become increasingly worthless. That’s a direct result of cutting staff, which cuts back on actual reporting, which supposedly is the reason media organizations are in business. Except for these days, it’s not. Like all else, media organizations are in business to produce profits. It’s what the shareholders demand, and as long as the money flows, the shareholders couldn’t give two shits about the quality of the product or service the company produces. And it’s that way across the board, with any type of business you can name.

    In this, health insurers are the norm, not the exception. They know what their mission is – it’s the same as any other type of business – generate profit, the more the better, however you can do it. The fact that a few thousand people die as a result every year doesn’t enter into it at all.

  68. 68
    SpotWeld says:

    It’s wierd how the health care debate is playing out like a fight with your HMO.

    You’re doctor tells you that you need an MRI to see if you have a certain condition which will direct him for effective treatment.

    Your HMO says that it’s more cost effective if you get an X-ray first, and wait an see if that tells your doctor what he needs to know.

    Your doctor says an X-ray is uneeded because of reasons 1, 2 & 3. The HMO says, no, we won’t pay for an MRI without a conclusive X-ray first.

    So you either pay for the MRI yourself, continue being treated on less certain diagnosis or get the X-ray and just waste time and money.

    GOP wants us to either pay for our healthcare without any insureance, continue health care under a shakey private industry solution or take up a “co-op” option (which will probabaly be just HMOs rebranded) until that proves to be a failure and we just waste time and money before it becomes even more obvious we need a public option.

    Argh

  69. 69
    Mike G says:

    How many of you actually know what the Democratic proposals are? How many of you actually know what is being suggested?

    It’s a feature, not a bug. The Repigs have to throw up a constant cloud of gorilla dust to distract the public from realizing that this legislation would benefit most people.

    They can’t run against the actual bill on a “defending insurance company profiteering” platform, so they fight against fictions like ‘death panels’. The Repigs kick the shiny ball and the shallow whore media, like six-year olds playing soccer, run after it no matter how far off into fantasyland and transparent cynicism it goes.

  70. 70
    bayville says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    Post of the Year on the internets. This should have been the frame supplied by health reformers since day one.

    AIG vs. The People.

  71. 71
    MBSS says:

    @ChrisB:

    weiner is a great presenter of single payer. he’s a democrat who talks and acts like he’s not actually ashamed of his beliefs. amazing!

    otoh, i recently found out that he is quite the zionist, and refers to the I/P issue as a “local affair.”

    but, i am totally behind him on health care.

    i still haven’t watched the scarborough debate. i’ll have to check that out. the schadenfreude is too delicious for me to avoid.

  72. 72
    IndieTarheel says:

    @Maurs: This is their neogtiating model.This video should be played back every single time the GOPosauruses trot out another lie.

  73. 73
    Anoniminous says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all.

    The basic value insurance companies provide is to take the collective (EEK! Teh $ociali$m!) payments of their clients, invest them in some manner to maintain a healthy reserve, and pay-out, based on the insurance contract, to individual clients.

    That’s the THEORETICAL BASIS of insurance.

    In practice, under the Neo-Capitalist idea of maximizing gain, insurance companies have been taking the payments but not paying out.

    So, right now, the insurance companies are not adding value they are actively stripping value from their customers.

  74. 74
    MBSS says:

    my view on rahm “tiny dancer” emmanuel is this:

    fuck him.

    he was the 1st appointment of obama, and he set the tone early. the tone sounds like this:

    coooooooorrpppppppoorate bbbbuuuuuuulllllllsssshhhhhiiittt

    he is in there because his beliefs line up with the president’s, and he is seen as an effective person. he is a corporate dem to the bone. he is DLC to the bone. he is clinton 3rd way to the bone. and the people he has been arm twisting lately are people like me, and the progressives on the hill.

    and after he leaves washington he will funnel right back into making millions on wall st, or as a lobbyist, just like everyone else.

  75. 75
    williamc says:

    @the Other Steve

    Thanks for the correction. I figured as much.

    You are dead on with the “Isn’t the purpose of the Republican party to dumb down the debate so they can pass tax cuts?” That’s what Rush and Beck are for…

  76. 76
    JHF says:

    Going their own way? No. :-) The White House is denying the premise of this post. The fix is still in.

  77. 77
    MBSS says:

    what value do the insurance companies add to the nation as a whole?

    nothing, nada, zip, zilch, zero.

    private insurance companies, like wall st., suck the life blood of america. and exist as a tick, swollen with our blood, about to burst. they don’t burst because they funnel much of that blood to offshore accounts, for safe keeping.

  78. 78
    someguy says:

    @ Jenniebee: to stop being a snarky asshole for just a second, I think to the extent that there’s a valid objection to single payer, it’s that you’re putting health care in the same hands that brought you Katrina, the mortgage mess, and innumerable f***ups before that.

    A compromise is possible, but it would have to have several things if you wanted effective, long-lasting change. I apologize for the length, but you asked. I would:
    1) Expand Medicare to cover more of the uninsured 47 mill. Make payments reasonable – 70% of market rate or something. Otherwise our insurance premiums are in part a hidden tax to cover the losses from absurdities like a $7 reimbursement to doctors from a Medicare patient visit. Try to police up doctor fraud a little better too, and consider premium payments to get doctors to go into general practice. Loan forgiveness?
    2) Require those who are not medicare eligible to have catastrophic care coverage, which is not terribly expensive but which would lower the cost of insurance for everybody by bringing people (primarily younger healthy people) into the system, and ensuring they can pay when they do have a car accident or get cancer or something major. This along with Medicare expansion should put a crimp in rising insurance prices, since a 20-something with a major injury will have coverage, instead of walking away from the bill (resulting in a charge off the rest of us have to pay for through higher premiums or taxes).
    3) Make it difficult for insurance companies to offer “first dollar” policies that cover everything or nearly everything. These policies are insanely expensive, and they encourage doctors to over-practice and over-prescribe. Instead, incentivize the hell out of FSAs and HSAs, up to $2 or $4k. (I worked for a company that switched to a system where you paid out of an FSA up to $2k, didn’t pay any of the insurance premiums, and got matching dollars for your FSA contributions. Once the FSA was exhausted, insurance kicked in with first dollar coverage. Physicals, kid visits, and maternity visits were free, along with a couple different types of screenings and vaccinations. We were pretty happy with it and the company liked it because people stopped going to the doctor for head colds, and it saved the company an enormous amount of money on premiums, cutting them by more than half because the ins. co. didn’t worry about the employees seeing the doc over little problems that you probably shouldn’t go to the doc for).
    4) Require insurance companies to create risk pools into which small businesses, the self-employed and the not-employed can enter. The size of small business insurance premiums makes me think they are being used to subsidize coverage at larger companies, which have the power to refuse to pay high premiums.

    Anyhow, yes, I’m sure we could find a compromise between government single payer and the status quo that would leave most people happy and probably better off than we are now. But that would require courage by the Dems to walk away from a long held position (single payer) and would require the Repukes to walk away from their long-held position (that the government-sanctioned oligopoly works better than the government could). Good luck on that.

  79. 79
    chopper says:

    @Anoniminous:

    In practice, under the Neo-Capitalist idea of maximizing gain, insurance companies have been taking the payments but not paying out.

    So, right now, the insurance companies are not adding value they are actively stripping value from their customers.

    mostly because thanks to deregulation, insurance conglomerates have invested their money in all sorts of crazy parts of the market and have watched their money vanish into thin air. so they make up for this by dropping people, cutting coverage and raising rates, all while coming up with lame excuses about ‘tort reform’.

  80. 80
    chopper says:

    @someguy:

    I think to the extent that there’s a valid objection to single payer, it’s that you’re putting health care in the same hands that brought you Katrina, the mortgage mess, and innumerable f***ups before that.

    that’s my issue as well. as long as we have GOP presidents from time to time we’re going to have administrations who don’t believe the government can do anything right and go out of their way to prove that by screwing with and defunding this sort of stuff behind the scenes.

    thing is it’ll be the same issue with a public option.

  81. 81
    WereBear says:

    I’m a bit puzzled myself. After all, Obama & Company had a whole Keating Five website ready to spring on McCain, yet this time, perhaps because they now have government websites? perhaps the target is too diffuse? they had no bombshell ready to be lobbed back.

    And while we can argue if he’s playing dimensional chess or not, if they are capable of pivoting to an opening, that’s just as good in some situations.

    And, you know, as much as I’ve seen of Republicans these past few years, the stupidity lately is simply breathtaking. I would never have thought they would be pushing that “death panels” thing. So I wouldn’t have come up with a website to refute it.

    The big thing is that this plan sounds good to me. At the end of the day, I’m all about whatever works.

  82. 82
    PanAmerican says:

    Before Reagan screwed things up, insurance companies simply pooled risk.

    IIRC they were much more co-op in origination and structure. The BC/BS system was substantially not for profit. Some combination of the “greed is good” mantra and tax code changes set the industry on the current path of self destruction.

  83. 83
    CalD says:

    “…How many of you actually know what the Democratic proposals are?…”

    Well, there’s this:

    http://www.whitehouse.gov/blog.....ral-Email/

    Also this:

    http://www.whitehouse.gov/realitycheck/

  84. 84
    Comrade Kevin says:

    @T. O’Hara:

    I can’t figure out how protesters could ever get the idea the actual goal was to get rid of private health insurance. Must be unAmerican evil-mongers.

    So, John Cole wondering about the value of private insurance companies == Democratic President and Congress want to outlaw private insurance?

    Troll FAIL.

  85. 85
    Roger Moore says:

    @someguy:

    I think to the extent that there’s a valid objection to single payer, it’s that you’re putting health care in the same hands that brought you Katrina, the mortgage mess, and innumerable f***ups before that.

    Yes, this is the biggest objection. Once you have single payer, it will no longer make sense to vote for Republicans, because they’ll screw it up the same way they screwed up FEMA, bank regulation, and everything else they could get their hands on. This is absolutely, 100% the reason that Republicans are so terrified of any solution to the health care mess that requires the government to do a good job for the system to work.

  86. 86

    […] this, (via Atrios), does the best job of illuminating how worthless corporate health insurance is: Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. […]

  87. 87
    Martin says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    The biggest problem with the insurers now is that state insurance laws largely force state-level monopolies to happen. Let’s look at Missouri with a single insurer providing 75% of the policies in the state. There might be 3 million potential customers there for a competitor, but 2 million of them either need no insurance because they have Medicare, or are low income and either can’t afford a policy or are unwilling to spend money on one. The remaining million customers need to provide enough revenue to justify creating policies that comply with MO law, working out agreements with all the care providers in the state – hospital, doctors groups, etc. It turns out that it’s barely worth the effort to do that because even if you did all the work, there’s a company with most of the customers that can almost certainly afford to undercut you. And if you do all the work to get established in MO, it doesn’t help you in the slightest if you want to bleed over into a neighboring state, with different insurance laws, different commissioners, etc. so trying to capture the residual market in Kansas isn’t a realistic option.

    Now, there’s only two alternatives to this problem – either move the standards to the national level so any insurer can compete in any market without worrying about a whole new set of laws to comply with, or eliminate all of the laws. We know which side each group is on, but if we went with a set of federal laws, insurers would actually become somewhat useful again. There’d likely be real competition in every market after a while and they do provide a benefit in negotiating prices downward that the government is unlikely to be better at (may not be worse at it either, though).

    My discussions with family members are centering on these two issues:

    1) The health insurance marketplace is fucked because of the sheer number of competing laws and controlling authorities, and its driving the marketplace to form into 50 little monopolies. Unfortunately, none of the insurance companies trust the Feds to impose a single set of laws – they like their little monopolies. But they also know it needs to change and there’s real uncertainty about the best way to do it.

    2) The pricing model that the public option/Medicare adopts scares the fuck out of them. They are large enough to drive prices below what any insurer can match because the feds mandate that you cannot dump patients out of your area – so doctors are forced to adopt the public pricing models, at least to a degree. They make those costs up by refusing to lower prices when negotiating with other insurers. So the fed pays $100 for a $120 treatment and Aetna pays $140 to make up the difference. If the public option followed Medicare, it really would drive consumers away from private insurers. Insurers already have this problem because of regional differences in the cost of living. It’s hard to set one price for a procedure when some of your doctors work out of Manhattan and the others out of Oswego, or some out of Newport Beach and others out of Blythe. Magnify that problem by 50 and that’s the problem the oversight commission faces in addition to deciding what will/won’t be covered under the public plans.

    Further, consider the makeup of the commission in light of Bush’s appointments to, well, everything. Without the politicization of the Atty Gen office, I wouldn’t be worrying so much, but you get a commission made up of John Yoos and Heckava Job Brownies and I worry. It’d be nice if the Senate *actually* confirmed appointments, but they’re too inclined to rubber stamp everyone.

    I’m all for Obama’s plans here. As far as I can tell, we already have more than a few dipshits running insurance companies, so I don’t see that this will get any worse, but there are valid concerns in all of this. We’re not hearing any of them, but there are concerns there.

  88. 88
    Jinchi says:

    How many of you actually know what the Democratic proposals are? How many of you actually know what is being suggested? How many people can say, in a paragraph, what the difference between co-ops and the public option are?

    It’s not just the national conversation. You’ll have a hard time finding the answers to these questions on any of the major liberal, pro-health care reform blogs (including Steve Benen’s).

    All the talk is focused on Max Baucus, Republican obstruction, Nazi references, Joe the Plumber, etc.

  89. 89
    Ruckus says:

    John
    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

    Don’t know why you ask and answer your question at the same time. That’s all any insurance company does. Take money and skim off all the cream they can. It doesn’t matter if it’s health, auto, home, business or whatever. It’s a rigged game and they are the house. Always have and hold the percentage. The only time they loose that is when government regulates them and makes them pay. Friends lost their house in the 94 Northridge earthquake. Lost it to fire that occurred after the quake. All the insurance co’s tried to deny coverage because the cause of the fires was the quake. The insurance commissioner forced all of the insurance co’s to pay for fire loss. Friends got a new house. Which is what they paid for.

    It’s why I’m for single payer. And I don’t even call it insurance. Because the very definition of insurance any more is not to pool money from the “good times” to pay for the bad, it’s to take a lot from everyone and give to those not in need.

  90. 90
    Xenos says:

    Martin – Insurance is regulated at the state level, not the federal, for fairly good reasons. Federalizing insurance regulation is pretty radical, although not as radical as eliminating all regulation… I doubt even republicans would think you could have an effective insurance industry without any regulation at all.

    There is no reason, historical or legal, why insurance companies should ever be run in such a way as to provide a profit to shareholders. It is indefensible. Such companies have no right to exist, and their existence today derives from radical policy errors and accidents of history.

    A true left wing political movement would be taking the fight directly to these companies, getting their corporate charters pulled.

  91. 91
    Chi-city says:

    I think Obama’s biggest issue so far (and it goes back to day one) and is his desire to open up the floor to fair debate from both sides. To look at all options and to make educated decisions that appear to leave no one out. The Repubs have come to the debate with empty binders again and again. No budget, lies and distorted truths. By not having a crisp message at the outset Obama has been hurt on the health care debate. There are a few mantras that have been espoused: lower costs, can’t proceed on the same trajectory, for-profit 3rd party payer systems don’t work for all, coverage for all, but the solution to meet those mantras are still unclear. Now that the bills have been drafted, now is the time that Obama needs to craft his message and plan. Repubs are not going to vote for any bill. So nothing to see here, move on.

  92. 92
    Sasha says:

    @Ruckus:

    It’s why I’m for single payer. And I don’t even call it insurance. Because the very definition of insurance any more is not to pool money from the “good times” to pay for the bad, it’s to take a lot from everyone and give to those not in need.

    Hey, we may be a Christian country but let’s not go overboard here!

    :)

  93. 93
    chopper says:

    @Roger Moore:

    Yes, this is the biggest objection. Once you have single payer, it will no longer make sense to vote for Republicans, because they’ll screw it up the same way they screwed up FEMA, bank regulation, and everything else they could get their hands on. This is absolutely, 100% the reason that Republicans are so terrified of any solution to the health care mess that requires the government to do a good job for the system to work.

    this. look at the damage the GOP’s attempt to privatize social security did to their brand among older americans. there are a lot of older people who think the GOP is out to ruin what they consider a great thing. now imagine instead of SS its a service that affects pretty much every voter.

    yeah, the GOP is scared as hell of the government succeeding in health care. for this reason as well as the fact that such success over the current system drives a stake in the heart of the whole ‘the market always does things better’ meme.

  94. 94
    Deborah says:

    In terms of understanding what’s on the table:

    I can’t give you a one paragraph summary. But then I can’t do that for any other health plan–Taiwan, France, Canada, Australia. Any good plan (or bad, or iffy) is going to be massively complex to try and address all the issues that should be addressed. So in this case I’m hiring someone.

    I want single payer. That’s not on the table. So I want real reform that will move us in the right direction, and have visible changes–people who aren’t terrified to call an ambulance after a car crash lest it wipe them out financially, for example. What we have isn’t working, and we need to try something new. So what gets through needs to look like it is something new. I will trust Barney, or Ezra, or Nate, to parse out the details and let me know if what’s on the table looks better than what we have now in a substantial way. But don’t spend a ton of political capital to move the ball 8 inches down the field.

    And if you as a congresscritter gave any love and comfort to the “death panel” or “nazi” or “Freeeeeedoooooooom” sloganeers, you’re not serious and I don’t want Dems to waste any time ‘negotiating’ with you. Shoo.

  95. 95
    Throwin Stones says:

    @CalD: Just got this one via email today:
    http://my.barackobama.com/page.....gtherecord

  96. 96
    Daulnay says:

    <blockquote cite = “Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.”

    Insurance companies used to operate honestly. They figured out the liklihood of an event happening, estimated the cost of that event, and calculated the payments they would need to make a decent profit on top of the expected payouts. People would buy the plans, and if a policy holder was unlucky, the insurance companies would pay out, but still make a profit on the remaining policy holders.

    Some time in the last 30 years, some of the less honest operators realized that they could cheat, in several ways. The cheats would allow them to charge less, yet still make more profit. And so the dishonest insurance companies have driven the honest ones out of business or into dishonesty.

    The cheats, which you are probably familiar with are:

    Delaying payments or coverage with red tape. Having people jump through procedural hoops delays the payment (allowing the insurance company to get the interest on the money for a couple more months), and also discourages policy holders from filing claims at all. This reduces the number of smaller claims (people fight harder when a lot of money is at stake).

    Denying coverage of particularly expensive procedures as ‘voluntary’. One of my co-workers with breast cancer was told that her chemotherapy was ‘voluntary’, and withheld coverage. By the time she’d fought them and got the therapy covered, it was too late, and she died of the cancer.

    Invalidating the policies of the people who develop really costly illnesses. These are less than 1% of policy holders (the rest of us pay the companies more than we cost), and are main targets of this cheat.

    These three cheats all invalidate the original model of insurance coverage – pooling the risk. Instead, the company takes our money, and gives us headaches, and bankruptcy or death if we’re really unlucky. So there is no rational reason to support the continuation of private health insurance. The companies no longer honestly provide actual risk pooling.

  97. 97
    matoko_chan says:

    But…Dr. Cole….
    the republicans are fighting for their political lives.
    ANY healthcare reform is going to push them further into rump status.
    Like Bill Kristol said.

  98. 98
    DougL (frmrly: Conservatively Liberal) says:

    @cleek:

    Combining your quote of “ramming it through Congress” and mentioning Obama in one sentence gave me a visual that made me laugh my ass off.

    I am sure that any wingnut reading the same would have subconsciously clenched their butt-cheeks.

  99. 99
    kay says:

    Did anyone else’s view of banking, credit and insurance change as a result of the financial crisis (or whatever we’re calling it)?

    Because mine did.

    I went from vaguely mistrustful but mostly ignoring them while trying not to get screwed by them, to open hostility.

    I had instances talking to people who were really damaged by Wall Street recklessness, where I felt something close to rage. That’s gone now, mostly, but just ’cause I got inured to it.

    So that’s where I started on health care reform. Not in a mood to negotiate with these folks. Maybe that’s where some of the strong feelings on this come from?

  100. 100
    Martin says:

    Insurance is regulated at the state level, not the federal, for fairly good reasons. Federalizing insurance regulation is pretty radical, although not as radical as eliminating all regulation… I doubt even republicans would think you could have an effective insurance industry without any regulation at all.

    I agree that federalizing insuarance regulation is pretty radical. I also agree that most republicans don’t want regulation to go away. But the local monopoly problem is strongly driven by the status quo, and the local monopoly problem is why health care doesn’t function anything like a proper marketplace.

    What I’m saying is that this situation *could* be improved (not fixed, but improved) solely in the private sector if there were other kinds of reforms, but nobody seems to be able to embrace those reforms as being any less radical than a public option. The GOP should be all over alternatives, but I don’t think they see any as possible and so they just jump to the ‘don’t touch anything’ option.

  101. 101
    Phoenician in a time of Romans says:

    Hell, I can’t, for the life of me, figure out what value the insurance companies add at all.

    Back in the old days, there used to be graverobbers and those who would loot battlefields. They’d go over dead bodies pulling gold fillings, stealing boots, cutting off rings, that sort of thing.

    The beauty of the American insurance industry is that now they don’t wait until you’re dead.

  102. 102
    Bender says:

    Rahm Emanuel, the White House chief of staff, said the heated opposition was evidence that Republicans had made a political calculation to draw a line against any health care changes, the latest in a string of major administration proposals that Republicans have opposed.

    Democrat President.

    Democrat House of Representatives.

    Democrat Supermajority in the Senate.

    Blame Republicans for being obstructionist rather than admit you are failing with your own party members?

    Fuck Rahm Emmanuel. Fuck all the media talking heads repeating his nonsense. Fuck ’em all sideways with a belt sander. You lose.

  103. 103

    […] By Jove! The Man Has a Point. Posted by mjbrinkman under Uncategorized Leave a Comment  John Cole at Ballon Juice says, Hell, I can’t, for the life of me, figure out what value the insurance companies add at […]

  104. 104
    Koz says:

    I shouldn’t be that hard to figure out why you’re losing this issue. The Demo message on health care is “We hate Republicans.” Small wonder it’s not selling.

Trackbacks & Pingbacks

  1. […] By Jove! The Man Has a Point. Posted by mjbrinkman under Uncategorized Leave a Comment  John Cole at Ballon Juice says, Hell, I can’t, for the life of me, figure out what value the insurance companies add at […]

  2. […] this, (via Atrios), does the best job of illuminating how worthless corporate health insurance is: Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. […]

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