Attention, “Fiscal Conservatives”

You would think that this would be the topic of some debate:

In a bid to wrangle concessions from the Blue Dog Coalition on healthcare reform, House leaders Thursday released CBO estimates for liberals’ preferred version of the public option that show $85 billion more in savings than for the version the Blue Dogs prefer.

Rep. Stephanie Herseth Sandlin, D-S.D., a Blue Dog co-chair, said any possible new momentum toward a public option tethered to Medicare rates is, in part, “because of the cost issue” and the updated CBO score.

The original House bill required the public plan to pay providers 5 percent more than Medicare reimbursement rates. But as part of a package of concessions to Blue Dogs, the House Energy and Commerce Committee accepted an amendment that requires the HHS Secretary to negotiate rates with providers. That version of the plan will save only $25 billion.

In total, a public plan based on Medicare rates would save $110 billion over 10 years. That is $20 billion more than earlier estimates, a spokesman for House Speaker Pelosi said.

You know, sometimes it almost seems like fiscal conservatives are full of shit, and it is just a ruse to get elected. Kind of like how the “fiscal conservatives” in the GOP have done a complete and total about face on Medicare.

I bet the folks at Reason could explain all this too me.

(via)

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126 replies
  1. 1
    Punchy says:

    Just wait until you see the robust public option we’ll get when the soon-to-be military junta is running things.

    /rubs hands in anticipation

  2. 2
    PaulW says:

    You have to remember these are Democrat numbers. Democratic numbers are socialist and can’t be trusted by patriotic God-Fearing AMERICANS WHO WILL RISE UP NON-VIOLENTLY TO SAVE OUR CORPORATE OVERLORDS. Ahem.

  3. 3
    Barbara says:

    Only sometimes? How much evidence do you need?

  4. 4
    JGabriel says:

    Barbara:

    Only sometimes?

    I’m with Barbara on this one. I think you could achieve greater clarity and less ambiguity in fewer words by cutting out the whole phrase, “… sometimes it almost seems like …”. Then it would read:

    You know … fiscal conservatives are full of shit, and it is just a ruse to get elected.

    Yep. That works.

    .

  5. 5
    Fwiffo says:

    To be fair, the blue dogs do have some parochial concerns about Medicare reimbursement rates screwing over rural areas because of cost-of-living formulas that many consider unfair. Of course, if they were honest about that instead of going on about “fiscal responsibility” and fetishistic centrism, then maybe something could be done about it and the debate would move forward. Can’t have that.

  6. 6
    Hunter Gathers says:

    Seems ‘death panels’ are conductive to lowering costs. Do we get a tax credit for delivering Grandma to the Euthanasia Clinic ourselves?

  7. 7
    monad says:

    OT, but I think the lexicon’s getting a little out of hand. Does there really need to be a definition for ‘Conservative’? Definitions for “LOL”, “WTF”, “FWIW”?

  8. 8
    Cerberus says:

    Well, sure it would be a hypocrisy, if fiscal conservatism wasn’t about concern trolling progress. At it’s most kind interpretation, fiscal conservatism is designed to look at great progressive ideas and go, tut tut, that would cost too much, silly libs.

    Though that isn’t fully true as the real interpretation is that fiscal conservatives are smart racists who know that supporting corporations and working against public amenities and programs for the poor will hurt the poor who are predominantly black or latin@. But by making it into some “ideology” with the concern troll facade above they can look like their political thought process is deeper than: “it’ll hurt people I hate? Great. Can we start monday?”

    See also fiscal conservative silence on the proven revenue drains of tax cuts for the rich, police and military costs, and anything republicans propose ever even if it works worse and is more expensive (see debate on health care).

    It’s about putting a principled facade over “I’m getting bribed and I hate n-“

  9. 9
    Bootlegger says:

    @Hunter Gathers: Cash for Elders?

  10. 10
    peach flavored shampoo says:

    OT:

    I smell a host of Darwin Award winners coming from this.

    Just wait until they lobby these things onto college campuses.

  11. 11

    So are you saying the plan is not only free, but it will save money too?

  12. 12
    Deborah says:

    I’d like to put in a good word for the CBO; unbiased analysis of how the numbers would play out given how things look today should be the first thing we want in evaluating government program suggestions. People forget, but a few years back Cheney was trying to abolish it to put in his own group, who would provide the correct numbers.

    I consider myself a fiscal conservative; based on Reagan, Bush 1, Clinton, and Bush 2, I don’t know why the hell Americans believe Republicans deserve that label.

  13. 13
    Napoleon says:

    Most of them are completely full of shit. They just run out the “fiscal conservative” meme when they want to vote against their constituents interest and in the interest of the lobbyist and corporate interest they whore for.

  14. 14
    John Cole says:

    @monad: I think you are right.

  15. 15
    BenA says:

    @Hunter Gathers:

    Seems ‘death panels’ are conductive to lowering costs. Do we get a tax credit for delivering Grandma to the Euthanasia Clinic ourselves?

    Why do I get a flash to the “Bring Out Your Dead” scene in the Holy Grail when I read this?

  16. 16
    r€nato says:

    @peach flavored shampoo:

    *sigh*

    as the picture in the story illustrated, most Arizona bar owners are not happy at all with this new law, they lobbied against it, and they will now be posting ‘no firearms allowed’ signs by the entrance to their establishments.

  17. 17
    asiangrrlMN says:

    @peach flavored shampoo: Just following the lead of the great state of Tennessee.

    Cole, while others are asking you to trim down the Lexicon, I want you to add to it–specifically the phrase, “I bet the folks at Reason could explain all this to me.”

    As for the fiscally-conservative GOP–ha, yeah, right.

  18. 18
    r€nato says:

    @John Cole:

    I agree, no reason to post common abbreviations like “LOL”. If your readers are not familiar with all internet traditions, they can be referred to urbandictionary.com

  19. 19
    SpotWeld says:

    You know, sometimes it almost seems like fiscal conservatives are full of shit,

    You can probably say the same about “compassionate” conservatives.

  20. 20
    Zifnab says:

    You know, sometimes it almost seems like fiscal conservatives are full of shit, and it is just a ruse to get elected. Kind of like how the “fiscal conservatives” in the GOP have done a complete and total about face on Medicare.

    Ya think?

    @Cerberus:

    At it’s most kind interpretation, fiscal conservatism is designed to look at great progressive ideas and go, tut tut, that would cost too much, silly libs.

    Not at all. Fiscal conservatism is supposed to look at great progressive ideas and go, “Ok, but seriously – how are we going to pay for that?” When JFK and Lyndon Johnson were crafting their Great Society, they had fiscal conservatives sizing up the budget to figure out how much Medicare and Medicaid would actually cost.

    When Clinton and Obama were developing their fiscal policies, they had guys like Peter Orzag calculating costs, setting caps, and determining new tax rates and income streams.

    We’ve got plenty of liberal fiscal conservatives who are also progressive leaders. But, just like “law and order” and “national security” got co-oped by the GOP, so did “fiscal” get co-oped by conservatives. That’s why we get boondoggles like Medicare Advantage and Plan D on the one hand while we have hard line opposition to a public option or single payer on the other.

    Blue Dogs aren’t “fiscal conservative” in the least. They’re just corporate cronies with cooler hats.

  21. 21
    David says:

    @Deborah: Just the other day I had to educate a so-called Reagan Republican waxing poetic about the 80s, when men were men, and presidents balanced the budget. Except they didn’t.

    There are definitely times when spending money saves money. However, the Republicans seem to think that gutting the Treasury for corporations is a good use of taxpayer money, mainly, it seems, because they get a finders fee for all proceeds into corporate coffers.

  22. 22
    J.A.F. Rusty Shackleford says:

    Fiscal Conservative = Tax Cuts for the Rich

    Don’t you remember, Reagan proved deficits don’t matter. What could be more fiscally conservative than maxing out the country’s credit card?

  23. 23
    Hunter Gathers says:

    @Bootlegger: We have a winner. HHS Sec. Sebelius will announce the plan next week. $3000 for anyone who delivers an elderly relative to your local Euthanasia Clinic for a night of “Bingo and Matlock”. Limit one per day.

  24. 24
    General Winfield Stuck says:

    And the irony overload is that the a large number of these patriotic commie hating freedom loving constituents of these rural Blue Dog districts call the quaking BD dems and rail on about gubberment takeovers, and sockalism, and Hitler, then hang up and go cash their SSI checks and the like.

  25. 25
    Mr Furious says:

    You’re like a pit bull on those Reason clowns, John. I’m enjoying it immensely. Also.

  26. 26
    Just Some Fuckhead says:

    How about the so-called fiscal conservatives adding 5 trillion to the national debt under Bush? Do we need any more evidence than that?

  27. 27
    Woody says:

    The wholly mendacious, venal, corrupt Congress/WhiteHouse do not give a rosey, red, rabid rat’s fat ass about saving money.

    What they care about, without exception, is who gets the money that’s spent. If the interests which send them money collect the bounty, they’re fine with ANY spending, on anything, anytime…

    Only if it is spent on the people do they scruple in the least…

  28. 28
    Mr Furious says:

    @Fwiffo:

    To be fair, the blue dogs do have some parochial concerns about Medicare reimbursement rates screwing over rural areas because of cost-of-living formulas that many consider unfair.

    Fuck that. They’re the one’s making a bullshit case, so they deserve no quarter. And I don’t believe for a second they give a shit about anyone but their contributors getting screwed.

  29. 29
    camchuck says:

    Fiscal Conservatism only amounts to reducing spending on poor, arty/academic or brown people.

    Spending that goes right to big corporations is exempt from “fiscal conservatism”.

  30. 30
    Woody says:

    Chris Floyd got it in a nutshell, yestiddy:

    The Reason for the Anger and Intractability of the Debate Over Health Care Reform in the United States:

    Written by Chris Floyd
    Tuesday, 29 September 2009 12:58

    One side is lying; the other side is not telling the truth.

    *

    Or to put it another way: One side is pretending that a wildly reactionary plan to further enrich rapacious corporations is really hardcore, gutbucket socialism from the Bolshevik trenches, while the other side is pretending that its “reform” is not really a wildly reactionary plan to further enrich rapacious corporations but something that will somehow, in some way, be good for some people at some point way down the line.

    *

    One often finds that dealing in such utter unreality makes it … difficult to achieve workable solutions to real-life problems.

  31. 31
    Bootlegger says:

    @Hunter Gathers: What’s the cutoff age and will a birth certificate be required? How distant must the relative be? I’m pretty sure my elderly neighbor is a an 8th cousin.

  32. 32
    JGabriel says:

    Kevin @ The Liberty Handbook:

    Obama is not a closet socialist, he’s a fascist. If you research fascism, you’ll note that he fits the mold perfectly.

    Kevin, you should check out this essay, The Rise of Pseudo-Fascism. You’d probably like it a lot.

    .

  33. 33
    JGabriel says:

    Kevin @ The Liberty Handbook:

    Obama is not a closet sociaIist, he’s a fascist. If you research fascism, you’ll note that he fits the mold perfectly.

    Kevin, you should check out this essay, The Rise of Pseudo-Fascism. You’d probably like it a lot.

    .

  34. 34
    Bootlegger says:

    @Woody: True that. If they cared about fiscal responsibility we’d cut the military budget to sane proportions of GDP and close our global military bases. Why the fuck do we have military bases all over the planet? And do we really expect everyone else to see this as a good thing?

  35. 35
    Highway Rob says:

    a complete and total about face on Medicare

    First time I read that, I saw “about farce.” I like mine better.

  36. 36
    GregB says:

    Fiscal conservative=Santa Claus, The Tooth Fairy, Easter Bunny.

    A mythical character that brings good things to those who are easily duped into believing anything.

    -G

  37. 37
    Bootlegger says:

    @GregB: So if I believe I get nice things? Yippeee!

  38. 38
    gnomedad says:

    @monad:

    OT, but I think the lexicon’s getting a little out of hand. Does there really need to be a definition for ‘Conservative’? Definitions for “LOL”, “WTF”, “FWIW”?

    To give due credit, RedKitten brought this up at abou 3am this morning. :) And I agree, with some exceptions that have a strong tradition or special context here.

  39. 39
    gnomedad says:

    @gnomedad:

    at abou 3am this morning

    Ach, an’ I’m still lackin’ an edit button!

  40. 40
    Zifnab says:

    @Woody:

    The wholly mendacious, venal, corrupt Congress/WhiteHouse do not give a rosey, red, rabid rat’s fat ass about saving money.

    You’re about five years too late for this rant. Also, I’d love to see some link or at least a solid example of the current White House malfeasance. Do you have anything in particular you’re complaining about that isn’t Al Gore and death panels.

  41. 41
    Zifnab says:

    @Bootlegger:

    Why the fuck do we have military bases all over the planet? And do we really expect everyone else to see this as a good thing?

    Part of the reason is for troop deployment. If you want to get troops from the US to Afghanistan, you’re going to have to bunny hop them through Japan or Germany and mass them in India or Turkey.

    Having a network of military bases to move troops through saves you a lot of grief in international diplomacy.

  42. 42
    JGabriel says:

    monad:

    OT, but I think the lexicon’s getting a little out of hand. Does there really need to be a definition for ‘Conservative’? Definitions for “LOL”, “WTF”, “FWIW”?

    Maybe we don’t need a definition of Conservative (though it’s snarky fun to create our own), but I’d argue that, yes, we do need definitions for acronyms for like “WTF” and “FWIW”, as well as common nicks like “Tweety”, “The Mustache of Understanding”, and “Doughbob Loadpants”.

    I know that when my mother, for instance, first started reading blogs, she complained about all the acronyms and nicknames she didn’t know, how it made it difficult for her to follow the threads and understand what was going on.

    So, yeah, a lexicon that includes the nicknames and acronyms we use here, whether they be common internet memes or not, seems like a good idea. Given the number of other sites that have referenced it already, it might even become a resource for the liberal blogosphere in general, and increase the traffic for BJ.

    .

  43. 43
    Dean Wormer says:

    @Zifnab:

    “The time has come for someone to put their foot down. And that foot is me.”

  44. 44
    Stefan says:

    Part of the reason is for troop deployment. If you want to get troops from the US to Afghanistan, you’re going to have to bunny hop them through Japan or Germany and mass them in India or Turkey. Having a network of military bases to move troops through saves you a lot of grief in international diplomacy.

    But that doesn’t answer the question. Why, then, do we need troop deployment capabability around the world? It seems that there’s an assumption that the US just has to be a worldwide military empire, because….? Because, that’s why!

  45. 45
    Chad N Freude says:

    I posted this to the wrong thread (it’s still pretty early on the Left Coast).

    Slightly OT but sort of relevant: Fiscally conservative health care.
    Be sure to read the three short paragraphs below the video.

  46. 46
    Sly says:

    You know, sometimes it almost seems like fiscal conservatives are full of shit, and it is just a ruse to get elected.

    Sometimes?

  47. 47
    Paul L. says:

    Moonbat/Nutroots logic.
    Making Government bigger will save money and reduce the Federal Budget.

  48. 48
    Chad N Freude says:

    @JGabriel: Yesbut. The common abbreviations are easily found with teh Google. I think limiting the lexicon to the more obscure and BJ-specific terms with a referral at the top of the lexicon on the order of “If it ain’t here, Google it” would be A Good Thing(tm).

  49. 49
    David says:

    @Paul L.: Hmmm. “Fiscal conservatives” ran the show from 2001 through 2008.

    +5 trillion in debt? check.
    Made the government bigger? check.

    Don’t like the idea that corporate welfare queens might get squeezed out of the trough? You must really like getting screwed by insurance companies.

  50. 50
    gnomedad says:

    @Dean Wormer:
    ZOMG, I remember that! Complete with photo captioned “Dean Wormer says foot is himself.”

  51. 51
    Leelee for Obama says:

    Hi Everybody!

    Well, Mom passed yesterday afternoon and my Sister and I are going today to make the arrangements and begin to be daughters without a Mom. I’m so grateful she could get here in time and that Mom’s passing was a peaceful as I could ask for. The Hospice Staff are wonderful people and I’ll always think of them as friends.

    Hope to be back and being snotty in a few days, I can see how much nonsense there is to point at and snark, but I’m not in Political mode yet.

    Please know how much your good thoughts helped me-I feel like I have a huge collection of friends in the ether

    Talk to you guys soon.

    Leelee

  52. 52
    Michael says:

    They’ll apply some Cheeto dust, clap louder, and talk about the triumph of Conservatism.

  53. 53
    Svensker says:

    @Stefan:

    But that doesn’t answer the question. Why, then, do we need troop deployment capabability around the world? It seems that there’s an assumption that the US just has to be a worldwide military empire, because….? Because, that’s why!

    You and me, both.

    But it’s not “serious” to ask this question. Shut up, that’s why.

  54. 54

    @Leelee for Obama: My thoughts are with you and your family. I will be here waiting for your return.

  55. 55
    bayville says:

    Speaking of fiscal geniuses – Jim Cramer is at it again.

    http://www.zerohedge.com/artic.....-would-buy

  56. 56
    Bootlegger says:

    @Zifnab: Or, we could just not send troops overseas. One presupposes the other which was my point.

  57. 57
    Comrade Dread says:

    As someone who is more of a fiscal conservative, I would say that while the numbers look good now, we’ve seen plenty of programs that exceeded estimated costs once they’ve been created and they continue lumbering on often for years or decades before they are revisited by Congress.

    So I’m skeptical that the promised savings will ever really materialize.

    Then again, I’d be willing to trade off about 95% of the farm subsidies and about half the Pentagon budget so we’d have about 500-600 billion to play with.

    So, if you could do that, you can have a third to half of that for health care and use the rest to pay down the debt every year until we’re in the black, and then spend a few years using it to build up some infrastructure, then spend a couple of years building up a surplus, and then cut taxes accordingly, that would be great.

  58. 58
    Polish the Guillotines says:

    @Leelee for Obama: You have my condolences.

  59. 59
    Bootlegger says:

    @Paul L.: Yes. When you move the cost from one column, “emergency health care” to another, “normal health care”, and one is cheaper than the other, you save money. Seems pretty logical to me.

  60. 60
    Comrade Dread says:

    And, while I’m at it, if you could also send me a pony and a fire engine and make me look like Brad Pitt minus five years, that would be great too.

  61. 61
    Patrick says:

    @comrade: while you are right about killing gov’t programs once begun, the difference here is that the gov’t program already exists. It is called Medicaid, and it is already lumbering us towards bankruptcy. Getting people who use Medicaid into an actual pooled insurance system is what saves the money.

    @John Cole: Keep tweaking the Reason idiots. They are libertarians when Republicans are in control, but soon as Dems are in control they become corporatist shills. The religious right is used by the GOP, but they are not smart enough to see it. The “libertarians” are smart enough, but choose not to see it. How can you look at the fiscal record of Dems and Repubs since 1980 and conclude the GOP is the party of fiscal conservatism?

  62. 62
    JGabriel says:

    Leelee for Obama: My condolences on your loss. We’ll be here when you return.

    .

  63. 63
    Svensker says:

    @Leelee for Obama:

    So sorry to hear that and glad for all of you that she had a peaceful passing. My mom died 17 years ago and, while the sharp pain is gone from my heart, I still miss her something awful.

  64. 64
    Ash Can says:

    @Leelee for Obama: My sympathies to you, your sister, and the rest of your family at this difficult time.

  65. 65
    Mr Furious says:

    @Leelee for Obama: My condolences to you and your family for your loss.

  66. 66
    gronald says:

    Hi,
    Having a public option at Medicare rates will save money. However, if a larger portion of the paying public pays at those rates, many hospitals, docs, and providers could go out of business. In fact, I think that this is so true (and so acknowledged by people in health care) that the chances of a public option that pays Medicare rates is zero.

    Currently, Medicare is subsidized to a large extent by private payers. This may be inconvenient for simplistic arguments for a public option, but it is true. (I support a real public option, btw). Having more people covered in a new system may help providers by decreasing the amount of indigent (read: free) care they provide, but it might not. In any event, people should realize that the notion of more people paying Medicare’s really low rates is terrifying for some providers. If you want to stick it to the man, and support thes low rates anyway, just realize you might be sticking it to your own doctor. Chuck Schumer’s version of the public option seems more reasonable for now.

    My personal opinion is that simple fee-for-service has to go, eventually. The incentives are just perverse. The current cycle is: 1) reduce reimbursement 2) do more services to make up for it. This will not work (and is not working now). There needs to be real incentive for the providers to do things more cheaply, and oustide of certain systems (e.g. Mayo), this does not exist. I think this is the 1 trillion dollar gorilla in the room.

    regards

  67. 67
    slag says:

    I bet the folks at Reason could explain all this too me.

    I know some of us wonder why you keep saying stuff like this, but personally, I find it highly gratifying. It’s like someone else looking up and saying “The sky is blue” after a very long time of everyone else swearing up and down that it’s magenta. I value the rare realization that they’re the crazy ones and not me.

  68. 68
    ThatLeftTurnInABQ says:

    @Stefan:

    But that doesn’t answer the question. Why, then, do we need troop deployment capabability around the world? It seems that there’s an assumption that the US just has to be a worldwide military empire, because….? Because, that’s why!

    OK, I’m going to put on my I’m a liberal so I can argue both sides of just about any policy question hat and try to take a crack at this one, since apparently we don’t have any sane conservatives hanging out in these parts.

    1 – We inherited the British Empire when it started to collapse under the combined fiscal and geopolitical strain of two world wars and the collapse of European colonialism after 1945. Actually we didn’t so much inherit it as that we forclosed on the mortgage the Brits took out to pay for it using our money, when they couldn’t keep up with their payments.

    2 – Historical precedent suggests that once a country acquires an empire it does not willingly give it up until forced to do so by a mix of internal decline and external competition. We seem to be working on the internal decline bit. Stay tuned for external competition sometime in the next couple of decades.

    3 – This may not be as bad a thing as we think it is. Past periods when a single hegemonic power has dominated a large part of the globe have often been characterized by economic growth and cultural flowering. Periods of heightened competition between geopolitical rivals have often been worse for everybody, both elites and common folks. So empires may be wicked and immoral, but the alternative can be worse. Personally I’d happily give up our imperium if I knew the world was ready to maintain a geopolitical balance by consensus, but I’m not too keen on the idea of experiencing the 21st century equivalent of the Napoleonic Wars.

  69. 69
    Brick Oven Bill says:

    The Obama Administration is dishonest. The 35% bracket used to bring in $600 billion annually, before the economy collapsed. Raising this to 39% would only bring in, assuming revenues would not have fallen with the collapsing economy…

    0.04 times $600 billion equals $24 billion.

    This is zero point eight percent of the federal budget; or
    One point three percent of this year’s budget deficit.

    But people still have become convinced that raising the top rate will pay for these programs.

    Nope, won’t work. This government funds its operations by using the good name of previous generations of Americans to print and sell money.

    A rage for paper money, for an abolition of debts, for an equal division of property, or for any other improper or wicked project…

    The lesson to be learned here is that government welfare cannot exist for any length of time without strict control of the borders of a nation. This is because most of the world pays wages of between $1 and $3/day/worker, and food stamps pay $10/day/person in the US.

    Now these politicians want to give away more free health care. The whole goal is to lower the price of labor and concentrate wealth and power. I don’t think President Obama is capable of comprehending this, but perhaps he is in on it.

  70. 70
    liberal says:

    @Comrade Dread:

    Then again, I’d be willing to trade off about 95% of the farm subsidies and about half the Pentagon budget so we’d have about 500-600 billion to play with.

    Yeah, but how are we going to have the wherewithal to attack Iran and a bunch of other neocon targets if we do that? /snark

  71. 71
    Zifnab says:

    @Paul L.:

    Moonbat/Nutroots logic.
    Making Government bigger will save money and reduce the Federal Budget.

    Make government bigger save money? That’s unpossible!

    Here, let me show you how to really save money.
    http://blog.prospect.org/blog/.....bchart.jpg

    Victory, Whiskey, Sexy! Our philosophy cannot fail, it can only be failed!

  72. 72
    IndyLib says:

    @Leelee for Obama:
    Condolences, Leelee. Sending good thoughts to you and your family.

  73. 73
    jibeaux says:

    @gronald:

    This sounds right. Most of that crazy spending in McAllen, TX, that Atul Gawande wrote about what Medicare spending, not that they were over-reimbursing per procedure, since we all know their rates are low, but the system was just “overused”, too many procedures and too many tests that wouldn’t be considered necessary elsewhere, and so it doesn’t deliver any better care but it can cost twice as much. I think this is part of what they’re getting at when they talk about reforming the delivery mechanisms, and also when they talk about the dearth of primary care providers as opposed to specialists. Medicare reimbursement rates encourage specialization and procedures as opposed to looking at the whole picture. I hope that this kind of thing will get consideration in reform, because honestly it seems like it is a rather bigger deal even than the public option in terms of holding down costs. (I think the public option is pretty important for other reasons, though, including symbolic.)

  74. 74
    jibeaux says:

    This sounds right. Most of that crazy spending in McAllen, TX, that Atul Gawande wrote about what Medicare spending, not that they were over-reimbursing per procedure, since we all know their rates are low, but the system was just “overused”, too many procedures and too many tests that wouldn’t be considered necessary elsewhere, and so it doesn’t deliver any better care but it can cost twice as much. I think this is part of what they’re getting at when they talk about reforming the delivery mechanisms, and also when they talk about the dearth of primary care providers as opposed to [did you know that if you write spec i a lists you go to moderation for the c word?]. Medicare reimbursement rates encourage specialization and procedures as opposed to looking at the whole picture. I hope that this kind of thing will get consideration in reform, because honestly it seems like it is a rather bigger deal even than the public option in terms of holding down costs. (I think the public option is pretty important for other reasons, though, including symbolic.)

  75. 75
    ThatLeftTurnInABQ says:

    @Leelee for Obama:

    You have my condolences, sympathy and support. Thank god for hospice folks; having lost both parents some time back, I can say from personal experience that the people who provide hospice care are some of the nicest folks I’ve every met.

  76. 76
    IndieTarheel says:

    @Comrade Dread:

    and make me look like Brad Pitt minus five years

    Is that -5 years in normal space-time, or as seen in The Curious Case of Benjamin Button?

  77. 77
    jurassicpork says:

    Right about now we ought to be asking ourselves “Where will the next Fort Sumter Be?”

  78. 78
    Xecky Gilchrist says:

    Moonbat/Nutroots logic.
    Making Government bigger will save money and reduce the Federal Budget.

    Meanwhile – reichtard logic = paying 1000 people a living wage is not as cost-effective as paying one CEO 100,000 times a living wage.

  79. 79
    Koz says:

    “I bet the folks at Reason could explain all this too me.”

    I’m sure they could but that would require you to open your brain a little bit. Personally I’m not from Reason so I can make this really simple.

    There’s no prominent bunch of Democrats or liberals (the Prez, the Blue Dogs, Henry Waxman, whoever) with any plan where the proponents can clearly show that their plan is better than the status quo. Of all the things we’ve learned in the health care debate since the beginning of July, that’s the clearest.

    Heck, most of them can’t even explain in complete sentences what their plan does.

  80. 80
    Mark S. says:

    @Leelee for Obama:

    I am sorry to hear that. Best wishes to you and your family.

  81. 81
    Mark S. says:

    Whenever I hear some Congress critter talk about how he or she is a fiscal conservative, I think “This is someone who understands nothing about macroeconomics.” My favorite is when they compare a family’s budget to the federal budget.

  82. 82
    Bourbaki says:

    As I think BOB just pointed out “Fiscal Conservative”=”Numerically Illiterate”

    Unfortunately the later group is an extremely large demographic.

  83. 83
    Bourbaki says:

    As I think BOB just pointed out “Fiscal Conservative”=”Numerically Illiterate”

    Unfortunately the latter group is an extremely large demographic.

  84. 84
    NR says:

    Unfortunately, it seems that “Fiscal Conservative” includes Obama.

    Rockefeller disappointed Obama didn’t push harder for public option.

    The public option was doable even in the Senate Finance Committee if Obama had pushed for it. But he didn’t, and now it’s an open question as to whether we’ll get it at all. If we don’t, it’ll be Obama’s fault.

    I guess he’s saving his political capital for another bank bailout?

  85. 85
    tc125231 says:

    @JGabriel:

    You know … fiscal conservatives are full of shit, and it is just a ruse to get elected.

    Amen, brethren!

  86. 86
    Davis X. Machina says:

    How can you look at the fiscal record of Dems and Repubs since 1980 and conclude the GOP is the party of fiscal conservatism?

    Fiscal conservatism means making sure someone from your tribe gets the boodle. If there were a fourteenth-amendment friendly way to deliver government-run health care only to the melanin-deficient, it would have passed when Truman proposed it.

    My personal opinion is that simple fee-for-service has to go, eventually

    It’s started to go in Massachusetts — the Blues are going to capitation payments.

  87. 87
    Ed Drone says:

    Or, we could just not send troops overseas. One presupposes the other which was my point.

    The problem with troops is, what do you use if you don’t have them? In cases where violence is needed (and no, I don’t think the last administration even considered whether not using violence was an option), you have about three choices — diplomacy, troops, or bombing from the air.

    Without troops, you go directly from diplomacy to bombing. Remember the flap during the election campaign about Obama’s “our troops just bomb them” statement? THAT’s why we have troops, and need to have them movable. It’s like a disagreement going all the way from “Oh, yeah?” to “10. 9, 8, …” in one step.

    As bad as using troops is, it’s better than using a Daisy Cutter or “Little Boy.” We’ve been there, done that, and it stinks.

    Now, if you want to discuss how to MINIMIZE the use of troops, I’ll probably agree with you on many fronts.

    Ed

  88. 88
    tc125231 says:

    @Zifnab:

    Blue Dogs aren’t “fiscal conservative” in the least. They’re just corporate cronies with cooler hats.

    Nice detective work. Amazing how many people will believe that the median sky color is chartruese, isn’t it?

  89. 89
    Midnight Marauder says:

    @Koz:

    There’s no prominent bunch of Democrats or liberals (the Prez, the Blue Dogs, Henry Waxman, whoever) with any plan where the proponents can clearly show that their plan is better than the status quo. Of all the things we’ve learned in the health care debate since the beginning of July, that’s the clearest.

    This is a joke, right? Surely, you jest in writing this drivel? Almost anything being debated on the Democratic side (that did not originate with Baucus or Conrad) is lightyears better than the status quo.

    And if that’s the “clearest” thing you’ve learned since July, the only thing that’s clear is that you haven’t really been paying attention to anything.

  90. 90
    Original Lee says:

    @Leelee for Obama: My sincere condolences to you and your family.

  91. 91
    jibeaux says:

    @Midnight Marauder:

    You’re so crazy, when the Republicans release their plan it will be so much more awesomer than the stupid dimmocrats. It will be out any day now. I’m going to put my tooth under my pillow tonight so that will help.

  92. 92
    Koz says:

    “Surely, you jest in writing this drivel? Almost anything being debated on the Democratic side (that did not originate with Baucus or Conrad) is lightyears better than the status quo.”

    No. Of course I’m being serious. As much we can know anything in the current environment, we know as a stone cold fact that none of the plans are “lightyears better than the status quo.”

    And we know that because there’s nobody eg, Henry Waxman or Nancy Pelosi or you, who can go on the Sunday talk shows or anywhere else and say in a reasonably coherent way, “This is what my plan does. This is why it’s better than current law.”

    This is why 90%+ of the debate on the Left, here and elsewhere, is about political maneuvers. “If we can’t get a bill through, the progressives will be demoralized and the Republicans will take over again.” or the usual song and dance about reconciliation as a countermeasure against a filibuster. None of this would be important if the D’s had anything legit to sell to the public.

  93. 93
    FormerSwingVoter says:

    @Koz:

    There’s no prominent bunch of Democrats or liberals (the Prez, the Blue Dogs, Henry Waxman, whoever) with any plan where the proponents can clearly show that their plan is better than the status quo

    How so? Because you said so just now? Because the conservative media that tells only the pure unadulterated truth told you?

    They’ve explained – multiple times – what the basis of their plan is, and how it would be better. They’ve explained how the status quo is untenable. Your insistence that they have not does not make it so.

    My, the trolls are out in force today.

  94. 94
    FormerSwingVoter says:

    @Koz:

    And we know that because there’s nobody eg, Henry Waxman or Nancy Pelosi or you, who can go on the Sunday talk shows or anywhere else and say in a reasonably coherent way, “This is what my plan does. This is why it’s better than current law.”

    O HAI! I CAN HAZ REALITY CHECK PLZ?

    http://www.whitehouse.gov/issues/health_care/

  95. 95
  96. 96
    Koz says:

    “They’ve explained – multiple times – what the basis of their plan is, and how it would be better.”

    Oh bullshit. First of all, “their plan” is a misnomer because the legislative process has lots of iterations and all of them have a separate plan from the last one.

    We know for sure that they can’t explain why “their plan” is better than the status quo because to date they can’t explain what their plan is. This applies to you too, btw. I defy you to pick out any of the iterations we’ve seen over the last ten weeks or so and explain to a comprehensive first-order approximation what it does (in, say, 200 words or less).

  97. 97
    Midnight Marauder says:

    @Koz:

    No. Of course I’m being serious. As much [as] we I know anything in the current environment, we I know as a stone cold fact that none of the plans are “lightyears better than the status quo.”

    Fixed that for you.

    And we know that because there’s nobody eg, Henry Waxman or Nancy Pelosi or you, who can go on the Sunday talk shows or anywhere else and say in a reasonably coherent way, “This is what my plan does. This is why it’s better than current law.”

    So we’ve now officially established that you clearly haven’t been following any of the debate or discussion in regards to HCR. Because people from all across the spectrum have gone into great detail about all of the Democratic plans for HCR. This has been happening for months, on television, on the internet, in print, in town hall meetings, on informational tours that have gone from coast to coast. Just because you haven’t heard it or don’t understand it, does not mean that it has not been happening.

    This is why 90%+ of the debate on the Left, here and elsewhere, is about political maneuvers.

    None of this would be important if the D’s had anything legit to sell to the public.

    These two points have nothing to do with one another. The reason you hear so much about political maneuvering is a result of Obstructionist Assholes in both parties desperately doing whatever they can to prevent any meaningful reform from happening.

    That you are so ignorant as to think that if Democrats had “something to sell” none of the teabagger/town hall madnes would have happen is simply evidence of how intellectually shallow your perspective on the situation really is.

  98. 98
    tc125231 says:

    @gronald: This is a thoughtful and informative post.

    Thank you.

  99. 99
    Fulcanelli says:

    You know, sometimes it almost seems like fiscal conservatives are full of shit, and it is just a ruse to get elected.

    You can stop there, John.

    I know you “read these idiots, so we don’t have to” and for that I’m kinda grateful that you and DougJ have stepped up to be the canaries in the villager coal mine because my mental health couldn’t take it.

    Be mindful however, that there is a strong imbalance in the force these days and you might go into wingularity remission if you spend too much time at places like Reason, NRO and others, and who knows what might happen if you spend too much time at Sully’s.

  100. 100
    jibeaux says:

    Just because you don’t *understand* them, koz, don’t mean they haven’t been explained. You might not *understand* why women won’t date you, either, but I’m sure they’ve told you why one way or another. And *this* little turd:

    None of this would be important if the D’s had anything legit to sell to the public.

    is the stupidest thing I’ve heard all day. Does the phrase “representative democracy” mean anything to you? How about “most of us are represented by ass clowns?” Seriously, is there anyone else in this entire freaking country naive enough to believe that all there is to passing federal legislation is popular approval?

  101. 101
    Koz says:

    “Because people from all across the spectrum have gone into great detail about all of the Democratic plans for HCR. This has been happening for months, on television, on the internet, in print, in town hall meetings, on informational tours that have gone from coast to coast. Just because you haven’t heard it or don’t understand it, does not mean that it has not been happening.”

    No, no, no. You may think have deluded yourself into believing this, but it’s plain wrong.

    Nobody can follow every last blogpost or cable show, but I’ve seen way plenty. And basically, the talking points on the Left get boiled down to 1. “We hate Republicans.” and 2. “Insurance companies suck.” That’s the way it is here, from Ezra Klein, Ed Schultz, digby, Matthew Yglesias, whoever. There’s not a one of you who’ve got any legit message at all. If you had we’d have heard it by now.

  102. 102
    Sly says:

    We know for sure that they can’t explain why “their plan” is better than the status quo because to date they can’t explain what their plan is. This applies to you too, btw. I defy you to pick out any of the iterations we’ve seen over the last ten weeks or so and explain to a comprehensive first-order approximation what it does (in, say, 200 words or less).

    Shorter: If you can’t explain something in thirty seconds, it doesn’t exist. Or, if it does, it’s too complicated to be worth debating.

    How very Cable News producer-ish of you.

  103. 103
    Midnight Marauder says:

    @Koz:

    Nobody can follow every last blogpost or cable show, but I’ve seen way plenty. And basically, the talking points on the Left get boiled down to 1. “We hate Republicans.” and 2. “Insurance companies suck.” That’s the way it is here, from Ezra Klein, Ed Schultz, digby, Matthew Yglesias, whoever. There’s not a one of you who’ve got any legit message at all. If you had we’d have heard it by now.

    These trolls just keep getting worse and worse. You are a fucking joke.

    There is nothing even remotely factual in anything you have posted thus far, and for you to try and claim that Ezra Klein’s writing on HCR can be simply reduced to “Insurance companies suck! Down with Republicans!” is the final notice that your trolling here today is exceptionally failtastic.

    Good day.

  104. 104
    jibeaux says:

    @Koz:

    Dude, if you are reading Ezra Fucking Klein and his graphs, charts, studies, links, proposals, interviews, analyses, congressional reports, think tank outputs, comparisons to foreign countries, and legislative proposals and you think it boils down to “hating Republicans” and “insurance companies suck”, then you are dumb enough to pay money for Sarah Palin’s book. And I mean, I hate to go there, I hate to say that kind of thing about someone, but dayum.

  105. 105
    Demo Woman says:

    Your snark is missed. My thought are with you and your family, also. Please take care.

  106. 106
    AkaDad says:

    Q. What’s the difference between public and free-market health care?

    A. Free-market health care has death panels.

  107. 107
    Koz says:

    “Seriously, is there anyone else in this entire freaking country naive enough to believe that all there is to passing federal legislation is popular approval?”

    No, but even most low-information liberals know that’s why, for the moment at least, their health care dreams are crashing against reality.

  108. 108
    FormerSwingVoter says:

    @Koz:

    We know for sure that they can’t explain why “their plan” is better than the status quo because to date they can’t explain what their plan is. This applies to you too, btw. I defy you to pick out any of the iterations we’ve seen over the last ten weeks or so and explain to a comprehensive first-order approximation what it does (in, say, 200 words or less).

    Except that there are consistent recurring themes in every iteration that you insist do not exist only because you want to believe what you want to believe. Self-delusion is not synonymous with logic or reason.

    Here’s a summary of themes we’ve seen in every single plan:

    1.) Insurers cannot drop people from coverage when they get sick. Insurers cannot risk-select, offering insurance at reasonable rates to only those who are healthy. Insurers can’t set annual or lifetime caps on payments that force the very ill to pay for the majority of their care out-of-pocket.

    2.) The healthy will be encouraged to buy insurance, either through an individual mandate or an employer one (or both). This will spread the risk over more people and keep costs down.

    3.) Subsidies will be provided for those who can’t afford insurance, and Medicaid will be expanded to include more people.

    4.) Those without insurance can choose from several different plans on an online exchange, which may or may not include a “public option”. These users will be pooled together to negotiate rates with insurers with similar economies-of-scale that large employers can.

  109. 109
    b-psycho says:

    @NR: …and that surprises you how?

  110. 110
    tripletee says:

    @Koz:

    There’s not a one of you who’ve got any legit message at all. If you had we’d have heard it by now.

    To be fair to Koz, having your head irretrievably wedged up your ass does make it difficult to hear things clearly.

  111. 111
    Jody says:

    …in all fairness to Koz, I DO hate Republicans, for the train wreck they’ve made of this nation, and our for-profit insurance companies DO suck, for a multitude of reasons, some personal, some cultural.

  112. 112
    Koz says:

    “Here’s a summary of themes we’ve seen in every single plan:…..”

    This is great as far as it goes, but unfortunately that’s not very far. The first thing to get is, a summary of themes is not a plan.

    A plan offers some measure of accountability, ie other parties get the chance to evaluate the pluses and minuses and have their say. Of course that’s the death knell of D-style health care “reform” which is why Obama and the various Congressional Democrats are playing their hide-the-ball games. When your team is going back and forth between the public option, single payer, co-ops, triggers etc., it’s pretty clear the whole bunch of them have nothing but the vaguest idea of what they’re trying to do and no idea at all of how they’re supposed to do it.

  113. 113
    WereBear says:

    @Woody:

    do not give a rosey, red, rabid rat’s fat ass about saving money

    Dude, I’m so using that in future. ‘Tis a thing of beauty.

  114. 114
    WereBear says:

    @Leelee for Obama: I’m so sorry. It’s great that you have family to be by your side.

  115. 115
    FormerSwingVoter says:

    @Koz:

    Well, you wanted a summary in less than 200 words. There is specific language in each of the three bills addressing these points – the House bill, the Senate HELP bill, and Baucus’ Mark that is currently under debate. You can look at these bills and see the words that are in them. This is not a hypothetical. These are not a series of vague ideas that exist only in some cloud of mythological ether. The plan consists of the parts of the legislation that are the same across all bills. Your blind insistence that there is no plan is completely and indisputably false.

    Insurers have to cover you if you’re sick. Subsidies if you can’t afford insurance. An exchange where you can shop for a plan if you don’t have one. The fact that the different committees can’t seem to agree whether subsidies should stop at 300% or 400% of the poverty line is irrelevant. Whether there is a public option immediately or after a particular trigger occurs is mostly irrelevant. There is a plan. They have repeated – over and over – what this plan is. Your claims that there is no plan just because it would support your point are without merit.

  116. 116
    Midnight Marauder says:

    @Koz:

    When your team is going back and forth between the public option, single payer, co-ops, triggers etc., it’s pretty clear the whole bunch of them have nothing but the vaguest idea of what they’re trying to do and no idea at all of how they’re supposed to do it.

    Again, the only thing that’s clear here is that you have no understanding of the debate taking place regarding HCR, and moreover, not the slightest inkling as to the history of the legislative process over the past few months in the effort for meaningful HCR.

    This game you’re trying to play here is getting even more boring and lame than it was when you first started it.

  117. 117
    Chad N Freude says:

    @Koz: I suppose that explains why the Kaiser Family Foundation could not put this together.

    Oh, wait, they did.

  118. 118
    Koz says:

    “Your blind insistence that there is no plan is completely and indisputably false.”

    This isn’t supposed to be complicated. I didn’t say (and I’m not saying now) that there’s no plan. I said you (or anybody else) can’t summarize what it does in any detail, as opposed to generic handwaving describing want it to accomplish. And let’s note, you haven’t done it so far.

    The point being, something has to be relatively fixed so that we can talk apples to apples. In this case, it probably ought to be a plan or a bill, but in any case it’s gotta be something. Otherwise, you get to the situation we’re in now, wherein Obama and various D’s try to pretend that there’s a “consensus” on the big picture and things like subsidies up to 300% or 400% of the poverty line are second-order details for Congressmen and staffers to clean up.

    When in fact, it’s plain to any good-faith observer that a big-picture consensus is exactly what we don’t have. Furthermore, your team is completely unwilling to build one, mostly because your team is reading the tea leaves and sees that the customers don’t want to buy what you have to sell. Instead, your team is putting its energy into thinking up political maneuvers like reconciliation and blaming other parties when they don’t work.

    Get this above all else. It’s not “them”, it’s you.

  119. 119
    Demo Woman says:

    @Leelee for Obama:
    My thoughts are with you also. Please take care and I expect you to be as snarky as ever when you come back.

  120. 120
    asiangrrlMN says:

    Must not feed the trolls. Must not feed the stoopids. Must not must not must not because then they never go away.

    Ok. Better now.

    @Leelee for Obama: Leelee, I am sorry to hear of the loss of your mother. I surround her with a white light in order to guide her on her journey to the other side. My deepest condolences to you and your family. I have missed your snark, and we are eagerly awaiting your return.

  121. 121
    ThatLeftTurnInABQ says:

    @Koz:

    This isn’t supposed to be complicated. I didn’t say (and I’m not saying now) that there’s no plan. I said you (or anybody else) can’t summarize what it does in any detail, as opposed to generic handwaving describing want it to accomplish. And let’s note, you haven’t done it so far.

    Moving the goalposts much? First you say you want a brief, succinct summary. You even specified a word limit – 200 words. Then when presented with precisely that, you change your tune and say you don’t want a summary, you want details. Why should any of us bother debating with you when you do such a fine job of arguing with yourself?

  122. 122
    Midnight Marauder says:

    @Koz:

    This isn’t supposed to be complicated. I didn’t say (and I’m not saying now) that there’s no plan. I said you (or anybody else) can’t summarize what it does in any detail, as opposed to generic handwaving describing want it to accomplish. And let’s note, you haven’t done it so far.

    Several people have already addressed this nonsense at length. There are several explanations of the common traits of each of the proposals making their way through the system currently, as well as links that explain the general intent of Democratic plans for HCR. Your continuous wanking does not change that. And moreover, there isn’t any ONE plan right now. There are four or five of them currently in the mix, so why you think there would be a “consensus” when there still isn’t a final plan to begin with–not to mention that we’re just now hitting the portion of the debate where an actual, tangible “consensus” is formed–just shows again that you have no clue what you’re talking about. Or that you’re a moron. Or both.

    Speaking of which…

    When in fact, it’s plain to any good-faith observer that a big-picture consensus is exactly what we don’t have. Furthermore, your team is completely unwilling to build one, mostly because your team is reading the tea leaves and sees that the customers don’t want to buy what you have to sell. Instead, your team is putting its energy into thinking up political maneuvers like reconciliation and blaming other parties when they don’t work.

    Well, there’s the giveaway that you have no idea what you’re talking about. I mean, of all the trolls who have passed through here recently, none have exhibited the incredible lack of awareness, knowledge, and critical thinking skills that you have when discussing HCR.

    Once again, good day.

  123. 123
    jibeaux says:

    @asiangrrlMN:

    I know, I’m sorry. Sometimes it’s tough to resist. I’m still saving up for that “can’t fix stupid” tattoo I plan to get across each knuckle.

  124. 124
    Cain says:

    @Leelee for Obama: \

    My condolences on you and your family’s loss.

    cain

  125. 125
    Lurker with a Preexisting Condition says:

    I shouldn’t feed the troll, but what the hey.

    I’ll tell you what’s “lightyears better than the status quo.” End discrimination against preexisting conditions and end rescission.

    All of the competing plans in Congress right now seem to do that. So, for me, Congress’ current plans are “lightyears better than the status quo.”

    Just give me a *chance* to buy my own health insurance. That’s all I want.

  126. 126
    Koz says:

    “There are several explanations of the common traits of each of the proposals making their way through the system currently, as well as links that explain the general intent of Democratic plans for HCR. ”

    Oh bullshit. There may be link to this explanation or that somewhere on the web, but the point is you don’t them. Considering you want Congress to vote some variant of this into law, you shouldn’t blame Chuck Grassley or Glenn Beck or whoever for “obstruction”.

    “Moving the goalposts much? First you say you want a brief, succinct summary. You even specified a word limit – 200 words. Then when presented with precisely that, you change your tune and say you don’t want a summary, you want details.”

    Not at all. The things in some of the bills, health care exchanges, co-ops, public options etc. are so far outside what our previous health care experience is in America, I defy anybody supposedly in favor of them to demonstrate any clarity on what these things are.

    “There are four or five of them currently in the mix, so why you think there would be a “consensus” when there still isn’t a final plan to begin with—not to mention that we’re just now hitting the portion of the debate where an actual, tangible “consensus” is formed—…..”

    No, no, no. I say there’s no consensus in health care reform, which apparently puts you and I both in opposition to the Prez (and the liberal blogs) who asserted there was in his speech to Congress a few weeks ago. If there were a consensus we’d have seen it by now.

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