There is No Drawing Board To Go Back To

I’ve heard several bobbleheads state that “liberals and progressives want to go back to the drawing board” with health care, and this is just ridiculous. There is no drawing board to go back to. Period.

The notion that they could just go back, rewrite the bill, and somehoe this time sneak in a medicare buy-in or public option is laughable, and there is no chance that, in an election year, Pelosi would be able to get the votes to get the bill we have now through the house again, let alone a more progressive one.

So it should be clear. If you are thinking that you can kill this bill and come back with a better one, you are fooling yourself. It is this, or it is nothing for decades, and that is why folks like Rockefeller and Sherrod Brown and Ron Wyden and other folks are sucking it up and still supporting the bill. Likewise, it is why that retrograde asshole Ben Nelson is still playing games with it- he doesn’t want the bill passed in any way, shape, or form, so he is back to his abortion BS.






252 replies
  1. 1
    valdivia says:

    John–little typo on somehow, you have it as somehoe. ;-)

    I totally agree. This post by Bennen gest exaclty to that point you are making.

    And this one by Ezra pretty much explains why calling this a bailout for the insurance companies obscures what is really going on.

  2. 2
    TR says:

    If you are thinking that you can kill this bill and come back with a better one, you are fooling yourself. It is this, or it is nothing for decades.

    Seriously. It’s now or never, folks. Lay the foundation now and build on it later.

  3. 3
    NobodySpecial says:

    If we go back to the drawing board, I want that guy from the UPS commercials.

  4. 4
    Tattoosydney says:

    This.

    (TUUUUUUUNCH!?)

  5. 5
    edmund dantes says:

    It’s funny, but does anyone else keep hearing the South Park Underpants Gnomes in their head every time someone says “we need to pass this now, then get real reform later”.

    1. Pass incremental bill
    2. ?????
    3. Real healthcare reform

    I’d just like to get a handle on what assumptions people are using in getting from Step 1 to Step 3 considering the roadblocks put their by Dems losing majorities, repubs stonewalling, “centrist” hostage taking, possibility of repeal if real affects aren’t felt by people before the next election and they toss Dems (thus scaring Dems against doing reform since they lost majority when they pushed it through), etc.

  6. 6
    SGEW says:

    I really don’t know what Howard Dean is thinking.

  7. 7
    brent says:

    Ben Nelson, you mean. Bill can also be a bit of a jerk at times but, as far as I know, he supports the bill.

  8. 8
    Will says:

    Let’s put a pin in this comment and revisit it in few years, after the many struggling uninsured 20-30 somethings realize that it means they have to fork over a significant amount of their already thin paycheck for health insurance that will still leave them bankrupt should they ever get sick. You mentioned earlier how the elites don’t get what is a good job, I’ll add that even the middle class don’t realize just how many people are scrimping and saving and still don’t have $10 to their names at the end of the pay period.

    I’m calling it. This bill is, as they say, how realignment happens.

  9. 9
    valdivia says:

    @edmund dantes:

    because this is what has happened every time with big legislation like this. it happened with social security and it happened with medicare and medicaid. Initially they were timid and limited and pretty sucky. Once you have created the basic legislation, tinkering with it, bettering it is much much easier. This is why the reps are dying to have this fail. No matter what.

  10. 10
    General Winfield Stuck says:

    Kevin Drum has a good piece on this.

    Personally, I think the grudge war against Bush and the GOP is vapor locking the brainworks of some on the left.

  11. 11
    Notorious P.A.T. says:

    @edmund dantes:

    That’s what happened with everything else: Social Security, Medicare, etc.

    In a few years we won’t have to worry about Holy Joe, which should make it easier to improve this.

  12. 12
    4tehlulz says:

    @SGEW: I’m hoping he’s just trolling to get Lieberman to vote for it.

    Otherwise I would be quite interested in his explanation for killing something that was better than the plan he ran for president on.

  13. 13
    amk says:

    A dkos refugee here. Thanks Cole for some sanity. Klein and Benen and Yglesias and Drum seem to get it unlike Markos.

  14. 14

    I sort of get Dean’s point, and at least he’s being somewhat realistic by saying we should take the House bill through reconciliation, but a couple of points

    1. Why is getting the House’s weak public option at the expense of the regulatory aspects of the bill better than getting the regulations without a weak version of the public option. The regulations are going to help more people by an order of magnitude.

    2. Why is everyone just sort of assuming there are 50 votes for a public option in the Senate. I know we keep hearing there are, but I’m not sure how credible that is. Off hand, my guess is that Lieberman, Lincoln, Landrieu, Ben Nelson, and Kent Conrad would oppose it, which takes you down to 55. How many Senators from this group would join them; Bayh, Pryor, Baucus, Bill Nelson, Carper, Feinstein, Tester and Dorgan?

  15. 15
    MikeJ says:

    This is why the reps are dying to have this fail. No matter what.

    They’ve admitted that they fear a program that makes things better. Any improvement in health care will make more changes possible.

  16. 16
    Notorious P.A.T. says:

    @valdivia:

    Howard Dean said this:

    “Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill.”

    But what I understand is, this proposal covers things that can’t be achieved through reconciliation, so there’s no reason why it has to be one or the other.

  17. 17
    edmund dantes says:

    Except Social Security, Medicare, and Medicaid all got expanded in different times in a different political era. Past results do not guarantee future investments.

    It’s good to know your contention for why this is a good thing is based upon it’s what happened in the past. Very sound planning.

    Edit — Look at the abomination that is Part D. It’s a massive drain. Huge giveaway to the Pharmaceuticals, and fails to really accomplish it’s job.

  18. 18
    Alien-Radio says:

    @edmund dantes:

    Given history the formulation is

    1. Pass Incremental reform
    2. 20 -30 years of struggle and incremental expansion
    3. Real healthcare reform.

    It ain’t pretty, but the US has never been good at this sort of thing.

    Once it’s passed a different set of political calculus comes in, because it’s part of the establishment, and congress always finds it easier to tinker with existing legislation that to pass new legislation, I’m guessing because of some sort of cognitive bias.

  19. 19
    Notorious P.A.T. says:

    I’m hoping he’s just trolling to get Lieberman to vote for it.

    That could very well be. Lieberman is such an a**hole that this might be what we have to do.

  20. 20
    amorphous says:

    PROTIP: Bobbleheads often say things they are just making up.

  21. 21
    valdivia says:

    Also–anyone who thinks reconciliation is a magic wand think again. Who is in charge of reconciliation–Conrad who chairs that committee. Is he a friend of the Public Option? No. It will be at the whim of the parliamentarian, who knows what he would decide (who knows who the fuck he is?). Also, it would grind any legislating to a halt. And delay things for months. Pass this now, this is it guys.

  22. 22
    Notorious P.A.T. says:

    Except Social Security, Medicare, and Medicaid all got expanded in different times in a different political era. Past results do not guarantee future investments.

    You’re right, but past results are also the best predictor of future behavior.

  23. 23

    But what I understand is, this proposal covers things that can’t be achieved through reconciliation, so there’s no reason why it has to be one or the other.

    In theory, you can pass the Senate bill for the regulatory aspects, then go to reconciliation to get the public option, Medicare buy-in, or whatever. It’s a great tactical idea, but I’m not sure how realistic it is. For one thing, I’m not at all convinced there are really 50 votes for a strong public option in the Senate. Secondly, the Budget Committee would be in charge of managing the reconcilliation bill, and the chairman of that committee is Kent Conrad.

  24. 24
    Fair Economist says:

    You can put through a Medicare buy-in via reconciliation. It got a lot of support even from fence-sitters in the Senate; I’m sure Pelosi can wrangle it through the House. That is a straightforwardly reconcilable, and very simple, bill. Then reintroduce the current bill – no changes necessary. Basically, Lieberman has just forced the necessary reconciliation vs. normal split.

    It’s not complicated. We just saw with the drug reimportation bill that the White House can twist the heck out of arms in the Senate if they so choose. If this bill fails, they still have to get some kind of healthcare reform; there will be no way other than reconciliation given Lieberman, so they will do some kind of public option via reconciliation and make it work.

  25. 25
    martha says:

    We all want exactly what we want, now. But that’s not how real, systematic change happens. At home, in a small business (like mine), a giant company, or a government. Sometimes you have to accept less than you want and then work to improve it. Sometimes it sucks to compromise, but if you don’t compromise, you may get squat.

    And thanks valdiva@1 for the links–both were great. Ezra’s been a great source lately. I’m just so tired of the hysterics. I switched to the cake show (the Charm City cake makers in Baltimore) on the Food Network last night instead of Keith (well, Lawrence). Much better for the blood pressure.

  26. 26

    Dantes:

    1. Pass incremental bill
    2. ?????
    3. Real healthcare reform

    Looks better than:

    1. Kill this bill
    2. Lose a bunch of seats in the midterms, including a few Senate seats
    3. ???
    4. Any kind of healthcare reform

    The fact is, even the incremental bill is a bigger step forward in terms of getting people insured than anything since LBJ. SCHIP would be the runner-up, and even this incremental bill is way bigger than SCHIP.

    And you can see what happened with SCHIP: once it passed, people wanted to improve on it. Even Republicans voted for this year’s SCHIP expansion in serious numbers, as they did in the last Congress with the bill Bush vetoed.

  27. 27

    @edmund dantes:

    Medicare was just expanded 6 years ago by a Republican President and Republican Congress.

  28. 28
    Jim says:

    as a commenter said last night, Lieberman (and his mini-me from Nebraska) is providing cover for at least four other Dems (Bayh, Landrieu, Lincoln, Pryor, Conrad). It’s a win-win, they fly below the radar, and Liebs is getting all the martyrdom stroking he gets off on from McCain, Hannity and all his other little friends. So as much as I’m grinding my teeth thinking about how stupid they were to give Lieberman his chairmanship in January, I don’t think anything would really be different if they had played hardball. My chief concern is that, while I accept all the realpolitik and historical arguments in favor of passing this legislation as a base for later improvements, I don’t know if Obama and his team get how badly this is playing with the base, and how badly he needs to pull a big fat Belgian giant rabbit out of his hat between now and November 2010.

  29. 29
    Hunter Gathers says:

    @Will:

    I’m calling it. This bill is, as they say, how realignment happens.

    I’m sure the young Hispanics and African-Americans who will get subsidized health insurance will go running into the open arms of the GOP, right after the GOP willingly gives up their “fuck the spics, ni***rs, and sand ni***rs” approach to electoral politics.

  30. 30
    Minionero says:

    Bill Nelson = Wishy-washy centrist Democrat senator from Florida who supports the HCR bill

    Ben Nelson = Wishy-washy centrist Democrat senator from Nebraska who may or may not support the HCR bill

  31. 31
    Fair Economist says:

    @valdivia: Conrad can easily be bought off by enhancing Medicare reimbursement in rural areas. Actually, given that educated, well-paid people like most healthcare providers have a lifestyle preference for cities, it’s a change justifiable on its own and not just a goodie for Conrad.

  32. 32
    Brian J says:

    I’m sure there’s a point at which the bill doesn’t become worth supporting, but I don’t think we are there yet. It’s frustrating that we had to do a lot of things we didn’t want to do in order to win the support of industry types. It’s downright infuriating that we keep trying to please doucebags like Lieberman and they keep fucking us over as they change the goal posts, but that can be unfortunate part of the process. I wish we had a strong array of options and strong cost controls, but what we have now isn’t bad, all things considered. There is talk that some of the provisions aren’t as strong as they need to be, which is something to be concerned about.

    The expectation that everyone deserves health care will be there. There will be more stringent regulations combined with subsidies to back them up. The regulations need to be stronger and the subsidies probably need to be bigger, but that can be changed in the future. Generally speaking, we’re getting closer and closer to establish a base from which we will not go back.

    If we don’t pass something now, we will still get another chance to pass something. But not for many, many years down the line. In the mean time, things will get worse and worse.

    On another note, I think people like Arrianna Huffington are wrong when they say that health care reform won’t help the Democrats avert major losses. It won’t be enough by itself, but it should do something to help Obama reverse the slump he’s now in. But if the economy keeps improving, even as slowly as it is now, he should be okay.

  33. 33
    robertdsc says:

    It’s too far to stop now. Pass it and move on to the next item on the list.

  34. 34
    Notorious P.A.T. says:

    @Brien Jackson:

    I agree totally. I’m just saying, it doesn’t have to be either or. In fact, your post shows why killing this bill and pinning all hopes on reconciliation is unwise.

  35. 35
    joe from Lowell says:

    Instead of scrapping the whole bill, they should pare it back to a Health INSURANCE Reform bill – and do a better job at that particular aspect than the current bill does – pass it easily, and take a victory lap.

    Then, pass a couple more incremental measures between now and 2010 – remember how popular S-CHIP expansion was – and run as the Party of Health Care in 2010. I’d recommend a bill to roll S-CHIP into Medicare. Old people, kids, and students, with just a hole in the middle to fill in. It’s a pincer movement.

    We were hoping we could take the city, destroy the enemy’s army in the field, and end the war in one big battle. It didn’t happen this time – but we can still take the city, deal them a big blow, and be in an even better strategic position. So, the war goes on. This ain’t over.

  36. 36
    FlipYrWhig says:

    @amk:

    A dkos refugee here. Thanks Cole for some sanity. Klein and Benen and Yglesias and Drum seem to get it unlike Markos.

    Yup. One thing this whole episode has really proved to me is which side _I’m_ on. I’m really recoiling from the posturing and antics of the Kos and Hamsher crowds, and I gave up on a bunch of other blogs in hopes of preserving my (self-diagnosed) sanity.

  37. 37
    truculent and unreliable says:

    @Will: This.

    We need a) an affordable insurance option available to young people and b) a mass student loan forgiveness program for this to work. Many, many young people have no fucking money to give, which is why they don’t have insurance in the first place. Many of us can’t afford decent food, much less save up to buy a house, or afford to have children. Now we’re going to have to buy useless health insurance? Fuck that.

  38. 38
    Senyordave says:

    Someone please tell me an end game where the Democrats and Obama looks like anything other than complete pussies. I mean they aren’t even competent asskissers.

    There are dozens of GOP house members and a few GOP senators willing to call out Democrats and even Republicans on issues, but the Democrats barely make a peep.

    Some Democrat senator should point out that Lieberman is married to a corporate whore for the drug companies.

  39. 39

    You can put through a Medicare buy-in via reconciliation. It got a lot of support even from fence-sitters in the Senate; I’m sure Pelosi can wrangle it through the House. That is a straightforwardly reconcilable, and very simple, bill. Then reintroduce the current bill – no changes necessary. Basically, Lieberman has just forced the necessary reconciliation vs. normal split.

    Small point of order; if you do reconcilliation first, Lieberman, and probably 3 or 4 other Democrats, will kill anything else going through the normal procedure.

  40. 40
    Notorious P.A.T. says:

    1. Pass incremental bill
    2. ?????
    3. Real healthcare reform

    When was the last time a government program shrank?

  41. 41
    dmsilev says:

    16 to 20 years seems to be the reset time for having another go at the problem after a failed attempt. That’s a long time to wait.

    -dms

  42. 42
    valdivia says:

    @Notorious P.A.T.:

    I agree I just think reconciliation is not something that happens easily and that guarantees things will go as we want. My thought–pass this now, if they want to do reconciliation later they can. as long as it is in the budget rules they can.

  43. 43

    @truculent and unreliable:

    I guess it’s a good thing it’s subsidized then isn’t it?

  44. 44

    The problem is that this moves us backwards. It is anti-reform.

    Remove the mandate, declare victory, let the Republicans whinge about how they were against the bill but weren’t able to stop it, and then that will be the real progress that they will be able to build upon later.

  45. 45
    TaosJohn says:

    Sorry, John, I don’t believe you. It isn’t this or nothing, because the current situation is untenable. In fact, that’s why I want to kill the bill: it doesn’t CHANGE the untenable situation…

  46. 46
    Notorious P.A.T. says:

    It’s too far to stop now. Pass it and move on to the next item on the list.

    Exactly. Even supposing this measure proves to be unpopular (which is debatable)–if the Democrats pass a good jobs stimulus bill, they still come out ahead.

  47. 47
    SGEW says:

    @Minionero: Both Nelsons voted for the Military Commission Act of 2006, for what that’s worth.

  48. 48
    Rhoda says:

    @SGEW: He’s not.

    The White House is taking it from all sides right now but if they get a bill that works decently, like Romenycare in MA (which Ted Kennedy helped pull through) we will have a foundation for further reform. This bill expands coverage. That is huge. It puts the costs of health care on the federal budget through these subsidies. That will push the envelope for more reform and it will likely begin with these exchanges.

    The biggest single issue is still the timing IMO. But otherwise, this is a first step. It’s not a great bill, but it’s a good bill. And that’s why Nelson is being an a-hole.

    I also think it could have been better if the FDLs of the world hadn’t freaked Reid into going and putting a public option in the bill. It alienated Snowe, which is why she has everything she wants and still doesn’t want to do this thing since Reid threw her out of the room on activists say so. And we need her now to circumvent Nelson. If Reid had gone with the game plan, done a triggered public option with the bill he did put together, kept Snowe in the room he wouldn’t have had drama with the democrats who don’t want health care. Lincoln wouldn’t have said boo.

    ITA w/Booman’s post here.
    Everyone was dumping all over the White House goal of get the bill through both houses and hash out the public option in conference. But now, here we are with no Public Option, no Medicare buy in, and nothing gained in the loss since this was a pure hold up.

    And now we have folks like Americablog saying Obama isn’t fighting and Bush got more done. HELLO: Ted Kennedy helped Bush do no child left behind, Max Baucus was there for Bush on the tax cuts as was Ben Nelson. There were democrats working to legislate not just saying no all the time. Obama has no Republican he can turn to but Snowe and Collins and every time he does the FDL/Americablog start carping on President Snowe, President Collins who are frankly more liberal than Nelson or Lincoln. And provide cover to folks like Bayh. It’s frustrating to watch; I can’t imagine actually having to govern through this mess when the 60 vote cloture rules are constant. The filibuster has paralyzed the senate and changed the game from just when Bush was here.

    The Republicans hung together through everything; the Left is getting set to recall their President. Or feeding Republican memes that are killing enthusiasm in the base.

    We have a democratic president who put out a liberal budget that he campaigned on. He went for health care his first year. He went for climate legislation. He went for financial reform. This is big stuff. And while we’re hitting other democrats, a 100 House Republicans have a prep rally with financial lobbyists and no one says boo.

  49. 49
    Hunter Gathers says:

    @Notorious P.A.T.:

    When was the last time a government program shrank?

    For the fucking win, right there.

  50. 50
    Napoleon says:

    I can’t see into Howard Dean’s head, or that guy who runs the progressive caucus in the House, but some of the “kill the bill” – “I can’t vote for it” I think is all posturing for other issues down the road so that they can say “hey you screwed us this time you need to take care of us” or “we really need this amendment to HCR considered in 2010/2011/2012 because this issue was not adequately handled originally.” Dean knows he can’t kill the bill at this point (that is not to say that it will pass, but if it does not it will not be Dean that stops it).

  51. 51
  52. 52
    Brian J says:

    @Senyordave:

    Interestingly, I read last night at the RBC that Lieberman’s wife is a lobbyist for Aetna.

  53. 53
    gwangung says:

    Except Social Security, Medicare, and Medicaid all got expanded in different times in a different political era. Past results do not guarantee future investments.

    Except a) this has happened in the US. This has happened in OTHER COUNTRIES. Given this, YOU need to man up and explain why this time is different.

    b) Devil’s in the details. A lot of crappiness in this bill are in details and funding, no? That’s stuff that can be taken care of by incremental steps, no? Why can’t that happen?

  54. 54

    @Andrew A. Gill, SLS:

    Would people stop with this “Drop the mandate” nonsense already? Look, I understand that the idea of the mandate really sucks, but it’s not something that’s there for no reason, it’s a vital aspect of the mechanics at work. To wit, if you guarantee that sick people will have access to insurance and on top of that you prohibit penalizing them for not having insurance before they got sick, then there isn’t any reason at all for non-sick people to get insurance. Which is a great deal if you’re not sick, but it also collapses the entire concept of insurance. After all, the entire point of getting insurance is to protect you against misfortune in the future, and the scheme works by having people who don’t need it at any given moment paying people who do. So while the mandates might leave a bad taste in peoples’ mouths, the progressive reforms everyone wants WILL NOT WORK if there isn’t a mandate for everyone to be covered.

  55. 55
    joe from Lowell says:

    @Andrew A. Gill:

    Remove the mandate, declare victory, let the Republicans whinge about how they were against the bill but weren’t able to stop it, and then that will be the real progress that they will be able to build upon later.

    Precisely: addition by subtraction. Dropping the worst provisions of this bill changes it from a crappy, but comprehensive, bill to a good, albeit smaller, bill.

    There’s no need to get greedy here. Grab a big chunk of enemy territory and set yourself up to grab some more later.

  56. 56
    valdivia says:

    @Rhoda:

    I too have been reading Booman and agree with his take. Reid threw a pass and failed. he thought he could do it and could not.

  57. 57
    Kryptik says:

    I’m honestly just so sick of the whole process right now.

    And I’m wary of hopes on returning to the legislation later down the line to improve it. People point out Medicare and Social Security as examples we can follow…but I’m honestly not so sure. MIght be lacking historical perspective here, but were there as many absolute obstinate stonewallers back then as there are now? We’ve essentially got 40 votes that are never going to be in play (and I’m counting Snowe and Collins here right now, because they’re playing the same moving the goalposts shit as ever right now), and a significant number of Dems who will flit off at the surest sign of trouble, as well as another chunk who might actually waffle out of honest to god genuine wishes for ‘bipartisanship’.

    And post 2010, that number doesn’t look to improve for us either. I’m afraid that we might have a Senate more willing to repeal the meager gains we get right now, rather than one willing to fine tune it and improve it.

  58. 58
    General Winfield Stuck says:

    Some days it is hard being a democrat. But what’s a body to do?

  59. 59
    Hunter Gathers says:

    @Napoleon: I think Dean’s out of his head at the moment. I watched him on the K.O.-less Countdown and he was having what looked like some sort of seizure.

  60. 60
    cleek says:

    if only Obama would use his magical powers to force the Senate to do his bidding!

  61. 61
    El Cid says:

    Although I do agree that as long as whatever ends up as the bill isn’t *completely* or *mostly* malevolent, it should be passed because no other attempt would be made for decades, you probably shouldn’t announce in the midst of negotiations that you will agree to pass whatever the most recalcitrant members want.

    Tends to undercut one’s negotiation position even further, even considering the horrendously weak starting position.

  62. 62
    truculent and unreliable says:

    @Hunter Gathers: It’s not just about voting for Republicans. It’s about losing interest in the Democratic party. It’s about being disappointed by the Democrats and thinking that your voice and your needs aren’t being met by the people who are supposed to be representing you. Obama was the youth candidate; he wouldn’t have been elected if it weren’t for the youth–not only young voters, but young volunteers. I don’t know if young people will be so eager to support him in 2012, especially after they’ve been forced to pay into a system that they’re not likely to see much benefit from.

  63. 63
    FlipYrWhig says:

    @Jim:

    I don’t know if Obama and his team get how badly this is playing with the base

    I’ve been duped before into thinking that the blogoverse is the same as “the base.” They overlap, but they’re different. I have a dim memory of having seen a recent poll result that self-described “liberals” were supporting the health care reform bill (which wasn’t at peak strength) something like 80-20 or even 85-15.

  64. 64
    General Winfield Stuck says:

    @Notorious P.A.T.:

    If they pass this health care bill, and a good jobs bill, the Democrats will be fine for the near future, and should be able to expand on what they’ve built.

    I am so glad to hear you say this, P.A.T. Really! :-)

  65. 65
    SFAW says:

    Huge giveaway to the Pharmaceuticals, and fails to really accomplish it’s job.

    Why do you assume that was not a key part of its job in the first place?

    Did the Clean Skies Act (or whatever Bush called it) intend to do that? Despite Teddy’s involvement, was No Child Left Behind really intended to do that?

    I’m not really into conspiracy theories (well, maybe a little bit re: the one about Pod People), but stuff like this happened enough during BushCo, that few giveaways to bidness are as unintentional as we would like to believe.

  66. 66
    Guster says:

    @Hunter Gathers: Deinstitutionalization.

    “”In 1970 there were 413,066 beds in state and county mental hospitals in the United States. By 1988, this number had decreased to 119,033. By 1998, it was 63,526 beds.”

    http://www.progressiveu.org/bl.....o-we-stand

  67. 67
    jwb says:

    I actually don’t think it’s this bill or we’ll get nothing for 10 years because I think the system is pretty close to insolvency and, if nothing passes, we’ll start to see the big corporations dropping their coverage in the near future—that’s when the shit is going to hit the fan and don’t for a minute think the voters will blame the goopers. The problem is that if nothing passes, the next bill is likely to be taken up in a much less friendly political environment and I wouldn’t be surprised to see Medicare and Social Security gutted in the process.

  68. 68
    Joey Maloney says:

    I’m perfectly willing to go back to the drawing board with Joe Lieberman.

    …provided that I can take him to the quartering board immediately afterwards.

    On another blog, someone is saying that the result of a House-Senate conference is not subject to filibuster. Straight up-or-down vote. So the Senate could pass a bill that says in its entirety, “Joe roolz and Harry droolz,” and the conference committee could replace it with the unaltered House bill, and then 51 votes pass it in the Senate.

    I’m not much of a parliamentarian, myself. Is this true?

  69. 69
    gwangung says:

    I’m honestly just so sick of the whole process right now.

    And this is why the Republicans and insurance companies have won, putting up so much crap that any mandate for reform will evaporate.

    Money for the insurance and health industries will always be there to oppose reform. Only way progressives can combat that is to remain just as engaged as they are in time and money.

  70. 70
    joe from Lowell says:

    @ Brien Jackson:

    So while the mandates might leave a bad taste in peoples’ mouths, the progressive reforms everyone wants WILL NOT WORK if there isn’t a mandate for everyone to be covered.

    I agree, and that’s why I was willing to swallow a mandate for a bill that included a public option, or Medicare buy-in, or Medicare-for-all.

    But, you see, the progressive reforms everyone wants aren’t in the bill anymore. Put them back in, and I’ll support the mandates. Without them, they should drop the mandates, and quite a bit else of the “bad taste in people’s mouths” stuff.

  71. 71
    Will says:

    truculent and unreliable,

    Yup. These folks here really don’t get it.

    I was there a year ago, making $22k a year without health insurance while paying for rent, student loans, food, utilities and all. My car is old enough to go to middle school, my town has shit for public transportation and any number of problems would have broken me financially.

    You see all the folks hear banging the drum about how all those poor folks will love it because it is “subsidized.” From what I’ve seen, that subsidy means that a person will have to pay between 8 and 15 percent of their gross income in health insurance. Eight percent was only $133 of my old paycheck, but seeing as how I was lucky to have $5 in my bank account at the end of the month, that wouldn’t have helped much.

    And as these are private insurance products, I’m betting that the coverage, co-pays, deductibles and other gotchas are going to make it so shit that you’ll still be financially ruined if you have to use it.

    Remember when all the banks were graciously giving poor people accounts when the federal government went all direct deposit? Remember how they jacked up the fees on those accounts so much that they became a cash cow for the banks and a direct drain on the poor? This will be like that, but worse.

    The younger generation are going to fucking hate this.

  72. 72
    Notorious P.A.T. says:

    The Republicans hung together through everything; the Left is getting set to recall their President. Or feeding Republican memes that are killing enthusiasm in the base.

    I agree with what you wrote, BUT–it sure looks like the tea partiers are going to rip apart the Republican party. I know I suck at predicting the future, but if they keep doing what they did in that New York special election, they will hand 2010 to us. Then we get rid of Lieberman and improve this reform.

  73. 73
    Noonan says:

    I almost think Howard Dean is trying to give cover to the moderates before a final vote. The alternative is that Dean wants to push back reform for a generation so we can make another run at “perfection.”

    Also, the entire charade of trying to keep insurance companies profitable while insuring everyone is a huge waste of money. But that’s simply the best we can do with the Senate we have.

  74. 74
    Balconesfault says:

    @edmund dantes:

    Edit—Look at the abomination that is Part D. It’s a massive drain. Huge giveaway to the Pharmaceuticals, and fails to really accomplish its job.

    Yep. We’re in a different era – and it’s not easy to pull the iv pumping government money into the pockets of big corporations once the juice starts flowing.

    That’s what this bill does. It pumps government money into big insurance. To think that somehow this will result in a more progressive system seems naive.

  75. 75
    mr. whipple says:

    @Jim:

    I think you’ve nailed pretty much all of it.

  76. 76
    Jim says:

    @FlipYrWhig:

    I’ve been duped before into thinking that the blogoverse is the same as “the base.” They overlap, but they’re different.

    True, and count me as another refugee from the pure-o-verse (Eschaton). Kos had a poll last week or do that only 10% of self-described Democrats even read blogs. but this from TPM has me thinking the problem may be more serious:

    A Senate Democratic Chief of Staff weighs in …

    I don’t pretend to know Joe Lieberman’s motivation, but it’s working to perfection if his goal is to divide Party leaders (Obama, Reid, etc.) from the Democratic progressive base. I don’t remember seeing this level of outrage from movement progressives before,

    Now, maybe that’s a double-reverse multi-dimensional chess move, but these people look at detailed polls and party insiders, not the FDL comment threads. One reason I think the “back to the drawing board” crowd is so wrong is that to the larger public, the fabled “independents” who don’t get into the weeds of politics and policy, winners win and losers lose. If progressives force an abandonment of HRC at this point, the headline is “Obama dealt a major defeat by his own party….” Ask Bill Clinton how that plays.

  77. 77
    truculent and unreliable says:

    @Brien Jackson: It’s still money out of a lot of people’s paychecks that they may not be able to afford.

  78. 78
    amk says:

    I blame Hollywood (and Uma Thurman) for the “left’s” collective kill bill meme.

  79. 79
    jwb says:

    @Notorious P.A.T.: That Dean would have to come out against it in order to get Lieberman to agree actually makes some sense, because otherwise I really have a difficult time understanding Dean’s comments at this moment. (The only time to talk about killing the bill is after we see what comes out of conference.)

  80. 80
    Brian J says:

    @Notorious P.A.T.:

    I hope you’re right. My worry is that things go poorly enough for the Democrats that they give away far more seats than they normally would.

  81. 81
    Ash Can says:

    @valdivia: Thank you so much for those links. After reading through all the sturm und drang in these threads, it’s so nice to be reminded of the facts, and of why John’s most likely exactly right in this post.

  82. 82
    Balconesfault says:

    @Will:

    The younger generation are going to fucking hate this.

    That’s the point that I keep making.

    This will take the generation of 20-somethings who aren’t finding nice company provided benefits 40-hour work week jobs … but instead are scrambling from contract work to contract work … and teaching them that government is going to force them to pay money to big insurance for crapola.

    Thanks to the Democrats, over the objections of the Republicans.

    Who do you think they will become activists for in the future?

  83. 83
    Ella in NM says:

    My Drawing Board:

    Expand Medicaid assistance to the states to fully cover
    ALL members of a family qualifying by income

    Outlaw pre-existing illness exclusions, or premium increases or being dropped/refused renewal for the development of any illness during coverage;

    Allow adult children without coverage of any age to be included on family health insurance plans

    Subsidize alternate state health insurance plans (such as State Coverage Insurance in New Mexico) for the employed with sliding fee scales for premiums and coverage levels

    Close the Medicare donut hole.

    No mandates: just automatic enrollment and coverage under income sensitive/appropriate insurance or Medicaid options upon emergency admission to a hospital, limited to that admission.

  84. 84
    D-Chance. says:

    Since this subject has gotten boring beyond belief, we go to Radley Balko for this.

  85. 85
    Jim says:

    Well hell, here’s what that Dem COS had to say at TPM

    “PLAYING US FOR CHUMPS”
    A Senate Democratic Chief of Staff weighs in …
    I don’t pretend to know Joe Lieberman’s motivation, but it’s working to perfection if his goal is to divide Party leaders (Obama, Reid, etc.) from the Democratic progressive base. I don’t remember seeing this level of outrage from movement progressives before

    I don’t pretend to know Joe Lieberman’s motivation, but it’s working to perfection if his goal is to divide Party leaders (Obama, Reid, etc.) from the Democratic progressive base. I don’t remember seeing this level of outrage from movement progressives before

    I blame Obama for formatting problem. If he really wanted that to show correctly, it would have done.

  86. 86
    Notorious P.A.T. says:

    @General Winfield Stuck:

    Well, I suck at predicting the future, but what are the Republicans doing to improve their position?

    Did you hear about the latest teabagger protest? They were going to flood the Senate building and pretend to be people dead from government rationing. Here’s how it turned out:

    “Is this it?” some asked.

    The few dozen Tea Party activists who made it to upper Senate Park in Washington this morning were confused at the size of the crowd. The night before, some of them had attended a FreedomWorks-sponsored workshop about the day’s events–a “die-in” during which activists would pretend to experience the effects of government health care in Senate offices, and a 1:30 p.m. “red alert” rally outside the Capitol. Either everyone was waiting on the latter event or they were lost.

    http://washingtonindependent.c.....tle-die-in

  87. 87
    Kryptik says:

    @gwangung:

    It’s kind of hard to though when it feels like you’re throwing money and time at a brick wall.

    It’s hard to call for the fight when our leaders fail to fight in our stead.

  88. 88
    Brian J says:

    @Will:

    We can change the subsidy levels, among other things, if they aren’t sufficient.

  89. 89
    edmund dantes says:

    Yeah. It’s not like nothing has ever shrunk in the federal government. FEMA always grew and got the funds it needed. OSHA too, FDA, FCC, MSHA, etc.

    It’s weird having one side chastising another for magical thinking, but ignoring the past that shows it isn’t a given that this will be expanded and made better.

    I’d like to see the bill get passed, but I don’t see this rosy outcome of where it magically gets better down the road. I feel the people making that claim as to why you should pass it are being just as misplaced in their arguments as the ones that say kill it completely.

    Stop relying on that as a crutch as to why it should be passed. The bill needs to pass on its own merits now, not what it may or may not become down the road.

    And its merits now are the only thing that is going to matter come election time. Not what the bill is going to be in 5, 10, 15 years.

  90. 90

    @Brien Jackson:

    I’m not paying a bunch of fictional people for the privilege of living in the United States (and even then, it’s not like I have a choice, since I don’t have enough money to leave the country). That’s very much unAmerican, and fascist, in the true Mussolini corporatist sense. This bill moves us further away from freedom and into a sort of corporate serfdom.

    Also: I’m fully for a mandate if there’s a public option, or single payer, or even some sort of hybrid thing where there’s one alternative plan for those who can’t afford the others, but it’s run by a private company with massive government oversight.

    None of those things are in this bill. Kill it, or at least kill the mandate until there’s actually a real plan with a public option.

  91. 91
    MattMinus says:

    I, for one, welcome our new Alaskan overlord.

  92. 92
    mr. whipple says:

    @FlipYrWhig:

    Don’t know how reliable this polling group is, but I think this is what you might be referring to”

    “Little evidence of Democratic unrest
    Our new poll suggests that liberal unhappiness with Barack Obama is still largely anecdotal and not very widespread. His approval rating with liberal Democrats is 95%, with only 3% disapproving of him.”

    http://publicpolicypolling.blo.....nrest.html

  93. 93
    jwb says:

    @Jim: Yes, and this is why Rahm came down on Reid rather than Lieberman—Reid doesn’t come close to having the votes—and I also think Rahm’s visit signaled that Obama thinks Reid is basically through as majority leader.

  94. 94
    Joey Maloney says:

    @D-Chance.:

    That’s a fine bone china dessert plate of win drizzled with caramel-hazelnut awesome sauce.

  95. 95
    SFAW says:

    … Reid is basically through as majority leader.

    One can only hope.

  96. 96
    Notorious P.A.T. says:

    @Brian J:

    I worry about that, too. But the Republicans are such disorganized idiots right now. And the Democrats in Congress claim that they are ready for them, unlike 1994.

    That Dean would have to come out against it in order to get Lieberman to agree actually makes some sense

    Holy Joe actually said that he changed his mind about the Medicare buy-in after he heard progressive politicians speak in favor of it.

    http://www.washingtonmonthly.c.....021466.php

    Of course, Joe is a lying scumbag, so make of that what you will.

  97. 97
    Patrick says:

    Medicare Part D was a huge boondoggle, that didn’t really fix anything. It is almost a decade since that passed, and it hasn’t been fixed. Congress even changed hands, and it hasn’t been fixed.

    While stuff passed in the 30s and 60s, were amended in the 50s and 80s, where is the historical precedent that stuff passed in the current climate has ever been improved or expanded?

    Medicare Part D, no improvement.
    No Child Left Behind, no improvement.
    Superfund, passed in the 80s, funding killed in the 00s.
    Clean Air Act, only saved by the Supreme Court
    Federal Farm Program, impossible to change

    The recent history is that progressive stuff gets killed, and other stuff cannot be changed. Where are the improvements in the last three decades to anything?

  98. 98
    Will says:

    This will take the generation of 20-somethings who aren’t finding nice company provided benefits 40-hour work week jobs … but instead are scrambling from contract work to contract work … and teaching them that government is going to force them to pay money to big insurance for crapola.

    That was me a year ago. I’m far, far more leftist than the majority of the board, and I would have hated it.

    Why? Because I did not have that money. I was already paying more than 15 percent of my income in student loans, because Washington fucking loves that 15 percent figure. I had cut back to ramen and tap water, but still coming up short some months. And I was doing much better than a lot of my friends.

    This bill would have ruined me. I would either have had to moved back in with my mother, which meant leaving my job and moving back to a small town, or let the fines build up until I declared bankruptcy. I would not have been in the position to get the decent job I have now.

    And it will be much worse for some of my friends.

  99. 99
    Rhoda says:

    The senate bill will close the Medicare Doughnut hole. Not rationally, through the Dorgan amendment. But the AARP signed off on the senate bill after an agreement was reached and it’ll start in 2010 which will give Democrats something to run on.

    As for the mandate: it depends on the subsidies IMO. If they are high enough and insurance is affordable folks won’t mind. If they are not; then it’ll be a problem. MA seems to be doing fine and folks accepted the mandated health insurance. I wouldn’t hate it if they dropped that aspect; but I think it’s very important and folks will accept that if they get no recisions in return.

  100. 100
    azlib says:

    The one thing that makes the optics of this bill bad is the requirement to buy insurance without significant choice. I do not think people are going to be very happy when they are forced to buy insurance. I can hear the bleating now. Why do I need to buy insurance when I am healthy? I think that provision will be repealed in a heartbeat when people understand the impact.

    The Public Option was a way of making that at least somewhat palatable. Unfortunately, without the insurance mandate the whole house of cards comes tumbling down. We seemed to have managed to back ourselves into a corner with this bill. While it could very well be a place to build real reform, I am skeptical that it will be.

  101. 101
    jwb says:

    @dmsilev: This would be true if the system wasn’t close to crisis. And the system will only last so long as the big corporations continue to pay the medical coverage of their employees. Without reform, I only give that a couple of years. And once one company drops medical coverage, you’ll see an avalanche. No, if nothing happens now, we’ll be revisiting this within five years and the politics will be much more hostile.

  102. 102
    Hunter Gathers says:

    @truculent and unreliable: I’m only 34, don’t even make 10 bucks an hour, and I can still afford the $300 a month premium for me and my wife. That’s more than a week’s pay. You know how I do it? I DON’T SPEND MONEY ON USELESS CRAP. I don’t need a fancy new cell phone every 6 months. I don’t need to eat out all the fricking time. I don’t waste money at the bar. I don’t have a car with expensive insurance, because I want something that looks cool and goes fast. If I could go back in time and kick the shit out of my 24 year old version for being a stupid wasteful fuck, I would. Memo to the young – “There will be subsidies.”

  103. 103
    Notorious P.A.T. says:

    It’s not like nothing has ever shrunk in the federal government. FEMA always grew and got the funds it needed. OSHA too, FDA, FCC, MSHA, etc.

    Aren’t those administered by the executive branch, rather than Congress? It might not matter, though. /shrug

  104. 104
    Will says:

    We can change the subsidy levels, among other things, if they aren’t sufficient.

    Who is we?

    I’ve been watching the student loan “reform” process over the last couple years. Banks don’t want to lose money, Congress has no fucking idea what money means to the average citizen in this economy and the entire system is wired to punish people for being poor.

    Same thing will happen to the insurance reform. Do you really think that the insurance companies aren’t going to lobby to retain that new profit, or that the politicians in Washington are going to balk them?

  105. 105
    Balconesfault says:

    @Ella in NM:

    Allow adult children without coverage of any age to be included on family health insurance plans

    Isn’t this a matter of contract, and not of regulation?

    In other words, I don’t think there are any laws against my companies healthcare provider expanding their service to cover my son after he graduates college in a couple years … there just isn’t a marketplace that demands that, and it’s cheaper for my insurance company (and thus my employer) not to provide it.

    And what the hell – my son, graduating in a couple years, could start contracting services in competition with my company, and not buy coverage. Why should my company end up paying to cover him in that case?

  106. 106
    jibeaux says:

    I’m making my peace with it, although the LieberRage has not subsided. This I consider a mark of sanity, however. But in what Benen calls the activist/ progressive wonk divide, I pretty much always find myself on the wonk side, and there I am again. What can I say, I hate slogans and signs and shit.

    @edmund dantes:

    Try looking at it this way. What is the path from:

    1. Kill this bill
    2. Dem morale collapse, gleeful Repubs, midterm elections brutal to Democrats
    3. ????
    4. Single payer health care

  107. 107
    The Raven says:

    What is going to happen when the mandates hit the middle class? There will be millions screaming for Democratic blood. And more and more people will be in the independent plans; employer health care is fading away. You hominids already have something to build on: it’s called Medicare. You’re going to have to solve the health care problem in less than “decades,” so Congress will be back at it, regardless of what happens to this bill.

    Lots of food for corvids, if you pass it, though.

    And Ben Nelson still hasn’t weighed in on abortion. Young people and women: could just be a voting bloc.

  108. 108
    Notorious P.A.T. says:

    Reid is basically through as majority leader

    Too little, too late. He tried at the end, but it was always foolish to have a conservative as the leader of the Democratic wing.

  109. 109
    valdivia says:

    @Ash Can:

    happy to share some sanity. :-)

  110. 110
    FlipYrWhig says:

    @Jim:

    One reason I think the “back to the drawing board” crowd is so wrong is that to the larger public, the fabled “independents” who don’t get into the weeds of politics and policy, winners win and losers lose. If progressives force an abandonment of HRC at this point, the headline is “Obama dealt a major defeat by his own party….”

    I’m in total agreement. Nobody much likes seeing Obama look “weak” by caving in to Lieberman-for-Lieberman. But if taking that hit for weakness keeps other aspects of the agenda alive (if gasping for breath), IMHO you kind of have to do it. Because if projecting “strength” by standing up to Lieberman (or whatever) means no bill, you’ve just created a _much bigger_ story about your “weakness.” “You’re so weak you let Joe Lieberman push you around” is embarrassing. “You’re so weak you spent a year on a bill and got nothing” is catastrophic.

  111. 111
    Tom Hilton says:

    What John said.

    I got this e-mail this morning with the subject line “Don’t let Joe Lieberman win!” And as much as I loathe (and have always loathed) Joe Lieberman, I think this is just a completely irrational, short-sighted, childish way to look at it. It’s playing Lieberman’s game, but in reverse (“don’t let the DFHs win!” says the voice in Holy Joe’s head). Shooting down reform (imperfect, weakened, compromised as it is) because Lieberman enrages you is just criminally callous and irresponsible.

  112. 112
    Will says:

    Hunter Gathers,

    Where do you live and what do you pay in rent and utilities? Do you have student loans? What do you do when that old car breaks down?

    Because if you are making $20k a year and still have $300 extra every month that you won’t miss, you are either living in shithole USA or at your parent’s. Or you are getting money from said mommy and daddy.

    Or stupid enough not to realize that you’ll be paying money that you can’t afford on a policy with high deductibles that will ruin you if you ever have to use it.

  113. 113
    Jack says:

    @TR:

    How do you build on this “foundation”? What’s the basis for faith in individual mandates + sunset/sunrise clauses + captive consumers + no cost controls providing the useful ground for anything approaching comprehensive health insurance coverage?

    Or are we just glad handing over the general categories, “universal health care” and “legislative win”?

  114. 114

    @joe from Lowell:

    So because there’s no public option we should forget about banning discrimination against pre-existing conditions?

  115. 115
    PeakVT says:

    @Joey Maloney: A conference report can be filibustered but not amended.

  116. 116
    truculent and unreliable says:

    @Will: I know that I would have been fucking angry as HELL if this had passed when I was struggling when I was 22-26. As it is, I am still really fucking pissed. It’s going to affect a lot of my friends. And I know that people in power are more than happy to spend trillions of dollars on sending my generation to war, but are unwilling to provide us with decent health insurance and expect us to subsidize the expense of insuring older people.

  117. 117
    jwb says:

    @Brien Jackson: While I agree with you on policy grounds, the mandate is a political killer. That’s not saying I think it should be stripped out of the bill; it’s just pointing out that from a political point of view, the mandate is going to be very, very costly to the Democrats.

  118. 118
    valdivia says:

    @mr. whipple:

    PPP have been very reliable. so this poll is very good news.
    The only thing is PPP sometimes asks crazy questions (birtherism stuff) in their polls in NC, Georgia, Alabama, etc. so we get very dramatic headlines but they are a very pro polling outfit.

  119. 119
    georgia pig says:

    I don’t see how you wouldn’t be in an even weaker position if you fail to pass this bill. It’s easy to posit that the insurance cos will find ways to circumvent the regs, and they very well may, but I’m not sure they can and, if they do, that’s just a reason to push for more regulation or a public option. This requires a patient, multi-stage legislative strategy, not a high-stakes gamble.

    Dean seems to be driven more by concerns about cost control than achieving universal coverage, because he probably fears that will give Republicans political fodder if the costs run amok. A legit concern, but this may not be a very useful tool for the Republicans, because folks getting these benefits will be motivated to go out and vote if the benefits are threatened. Think Medicare – even Teabaggers support it and Republicans have been forced into the incoherent position of defending it in spite of years of anti-Medicare rhetoric.

    Think of this as the liberal equivalent of the Grover Norquist strategy, i.e., get the programs (instead of tax cuts) in place and then let the “paying for it” aspect take care of itself. People will either be invested in the idea of universal health care, or they’ll be apathetic and allow the programs to be cut. If the latter happens, well, you’re screwed anyway, i.e., you can lead a horse to water etc. What you want is a broad agreement that the government has an obligation to provide a certain basic level of health care, which we are close to getting with this bill.

  120. 120
    jibeaux says:

    @Will:

    I can think of something that would’ve been worse. Getting seriously ill, finding out about a chronic pre-existing condition, or being in an accident.

    Look, I sincerely hope that the mandate doesn’t take anyone from water and ramen to something less. God forbid. But we really do all need health care.

  121. 121

    @truculent and unreliable:

    Who? Medicaid is expanding to 133% of the poverty level, and the subsidies go up to 400% of the poverty level on a sliding scale. Who is going to suddenly be hit with a massive bill they can’t afford?

  122. 122
    truculent and unreliable says:

    @Hunter Gathers: Then I’m guessing you live somewhere that has a low cost-of-living and you don’t have to pay $600 a month in student loans.

  123. 123

    @jwb:

    Yeah, I think it probably will be something Democrats take a political hit over, maybe a big one. But you don’t win elections for the sake of winning more elections, you win them for the sake of making policy. And if the Democrats have to take a political hit for the cost of creating a better regulatory scheme that guarnatees sick people won’t be shut out of the insurance/healthcare market, I can think of worse things to take a hit over.

  124. 124
    Jack says:

    @Patrick:

    This.

    There’s just too much belief in a number of unquestioned assumptions – that the Democrats are good faith players, that the Republicans won’t take back the House or the White House, that the Senate is full of populist do-gooders, that Obama wants anything else, that the Afghan Escalation won’t destroy Obama’s presidency, that the commercial real estate collapse won’t happen, that the Bush-Obama Permanent banking insurance program won’t further eviscerate the commons…etc. ad naus. ad inf.

  125. 125
    jwb says:

    @truculent and unreliable: Welcome to the disenchanted world of politics, where everything isn’t a melodramatic battle of good and evil. Seriously, I’m pretty fed up with people who suffer a disappointment and so throw in the towel because things aren’t going their way. Yeah, that will do a lot for the poor and uninsured.

  126. 126
    Tom Hilton says:

    @Will: the bill allows people to stay on their parents’ insurance until the age of 26. Just saying.

  127. 127
    Guster says:

    @jibeaux:

    1. Accept this bill.
    2. Activist morale collapses. Midterm elections brutal.
    3. Get stuck with a bill that, while it includes some positives, does more to keep the current system on life support for a long long while.

    1. Kill this bill.
    2. Rank-and-file morale collapses. Midterm elections brutal.
    3. Get stuck with the deeply flawed status-quo until the healthcare system collapses under its own weight, and hope that we still have a majority at that time.

    1. Encourage Harry Reid to schedule an adequate bill for a vote, by threatening to support his challenger in his reelection bid.
    2. Encourage Harry Reid to vow that he’ll use reconciliation for a stronger bill if his ‘adequate bill’ is filibustered.
    3. Focus activist rage on defeating Reid when he fails to come through, and accepts this bill.
    4. Defeat Reid, allowing progressives to claim a victory of sorts.
    5. Get stuck with a bill that, while it includes some positives, does more to keep the current system on life support for a long long while.

  128. 128
    joe from Lowell says:

    @ Brien Jackson:

    So because there’s no public option we should forget about banning discrimination against pre-existing conditions?

    No no, you misread my comment. Once again, from my original comment at #35:

    Instead of scrapping the whole bill, they should pare it back to a Health INSURANCE Reform bill – and do a better job at that particular aspect than the current bill does – pass it easily, and take a victory lap.

    They should pass a smaller bill that focuses on things precisely like banning discrimination against pre-existing conditions.

    I’m saying, because there’s no public option, they should forget about the individual mandates.

  129. 129
    jibeaux says:

    O/T but damn do I hate the Nation. Got it as a gift, they sold my name to every left wing group under the sun and several under Alpha Centauri, now they’re sending me freakin’ emails called “The Winter of our Discontent” about what a major disappointment the failed Obama presidency is and can you please give us $250. Since Paul Newman died, I guess they’re pretty desperate, I don’t know if they were in the will or not. I literally only read Calvin Trillin in that thing. I’m a pretty decent liberal, they just rub me the wrong way at every turn. I’ve unsubscribed now. Carry on.

  130. 130

    @joe from Lowell:

    I think we’re in complete agreement here.

    I don’t know that that needed to be said, but I’m saying it anyway.

  131. 131
    Will says:

    jibeaux,

    So the bill’s going to eliminate co-pays, deductibles and medical costs to those who are mandated to pay? Because otherwise, I don’t see much difference in being bankrupted for $40,000 over $200,000.

    It’s all money people don’t have.

  132. 132
    Kryptik says:

    @Patrick:
    @Jack:

    This is my worry as well. We seem to have a Republican party who’s perfected the monolithic stonewall, and that seems poised for gains in both houses, and we have a Democratic party that seems to take away the exact opposite lesson from any particular fight that they should.

    I’m seeing more likelihood of the next Senate wanting to force through a repeal like Republicans have been threatening rather than any attempts to fine tune and fix health care legislation.

  133. 133
    Rick Taylor says:

    Except for Howard Dean, I haven’t heard anyone talking about going back to the drawing board; I think it’s pretty well understand it’s this bill or nothing. As for Howard Dean, he might be coming out in opposition just to keep Lieberman from finding some other principle that compels him to veto the bill.

    All in all though, this was handled very badly. It’s been one long exercise in humiliating progressives who were arguing in good faith. If they didn’t have the votes, there was no point in going through this charade, having senators waste their time hammering out a compromise when Lieberman was just going to dictate the outcome anyway.

  134. 134
    geg6 says:

    Nothing, nothing I have read or seen or heard about this bill makes it worth the paper it will be printed on. Nothing.

    Status quo is better than whatever this will end up being. I’m sorry to sound like some sort of Jane Hamsher of the Left, but advocating for this is advocating for shit. And perhaps you, John, are perfectly happy to shovel millions of dollars down the throats of the insurance companies and Pharma, but I’m not. I have a sister, 55 years old, who has never had health insurance since the age of 18. She makes too much money to get Medicaid. She is single. Here’s what the Senate bill originally provided as a subsidy according to the Center for Budget and Policy Priorities:

    The bill strengthens affordability by improving the premium subsidies in the Senate Finance Committee bill for the millions of households with incomes between 154 percent and 400 percent of the poverty line — that is, between $28,200 and $73,240 for a family of three. Unfortunately, the new bill reduces the subsidies in the Finance Committee bill for near-poor households at the bottom of the subsidy range, which already were less than adequate. A family of three with income of $27,465 (150 percent of the poverty line) would have to pay $1,250 for premiums, or over $400 more than under the House bill. Many families with incomes this low already struggle to pay the rent and utilities and put food on the table and could have difficulty paying this much for health coverage.

    She makes approximately what is the lower end quoted here for a family of three. Again, let me say, she is single. How much subsidy do you think she’ll get? And how much do you think her premiums will be considering her age and her pre-existing conditions of hypermenorrhea and endometriosis?

    And this is the best case scenario for her at this point. And, as we’ve all noticed, they aren’t done cutting shit to keep Joe and Nelson and Snowe happy.

    It will be cheaper for her to pay the fines. Which she will also have trouble paying.

    Yeah, this is just great shit here. Just great.

  135. 135
    Tattoosydney says:

    For god’s sake, who do I have to fuck to get an Open Thread around here?

  136. 136
    Jack says:

    @jwb:

    You imply an either/or (either support this or the poor and uninsured aren’t helped) to condemn an either/or (either support bad legislation or throw in the towel) . Funny, whether or not you intended the irony.

  137. 137
    jwb says:

    @Notorious P.A.T.: Thing is, I doubt a new majority leader will be much more liberal because even under the most optimistic scenarios you still need 51 votes for anything to go forward.

  138. 138
    Will says:

    And for all the “you liberal” folks, I’m simply looking at what this bill would have done to me and will do to my friends. It will fucking ruin them, and I don’t think that’s going to do much for their voting habits or your progressive future.

    And for the record, I’m 35. Most of my friends are over 26 and a lot don’t have health insurance. In fact, that age bracket has one of the highest rates of being uninsured, because insurance already covers people until 25 if they are still in school.

    I mean, I know you folks are all ready to lump us into the category of acceptable casualties, but don’t be shocked when it comes back to bite you hard.

  139. 139
    jibeaux says:

    @Guster:

    I’m not entirely sure I understood all those chains, but I will just say that I don’t think progressives have a lot of sway over Reid. Reid is from Utah and his survival to a Republican is already very much in doubt. If the hundred or so progressives in Utah decide to back a challenger, they’re making a bad situation slightly worse, but one thing they are definitely not doing is electing a more liberal Utah Senator. Maybe that’s a “victory of sorts” in your book, I don’t know, but one thing it’s not is a vote for health care reform.

    I also don’t really think of expanding coverage to the vast majority of people here legally and vastly expanding subsidies for coverage, constitutes “the current system on life support”, but potato, potahto, I guess.

  140. 140
    Jim says:

    one of the main reasons Harry Reid is Majority Leader is because no one else wants the job

  141. 141
    Tom Hilton says:

    @joe from Lowell:

    I’m saying, because there’s no public option, they should forget about the individual mandates.

    You don’t get the no-pre-existing-condition part without an individual mandate. Period. In a system where only (or primarily) sick people are insured, premiums have to be at a level so high that it isn’t even really insurance any more. Like it or not, you have to have healthy people paying into the system or it’s unsustainable.

    (And yeah, I would rather have a single-payer system where we all pay taxes to cover it instead of some ‘individual mandate’, but single-payer is a pipe dream here.)

  142. 142
    joe in oklahoma says:

    i am sick and f’ing tired of people saying that this is our only chance to reform healthcare for at least the next 20 years! why would that be? are Dems planning on losing Congress and the White House? ’cause if they aren’t, they should be able to revisit this at any time.

  143. 143
    Tom Hilton says:

    @jibeaux: Nevada, not Utah. But hey, I understand–to us folks out West, all those Eastern states (Michigan, Florida, New Jersey, Iowa–all of them) look alike.
    ;-)

  144. 144
    Will says:

    Basically, this country is unwilling to nut up and tax the wealthy or have government take over the responsibility for this mess, so you are shoveling it onto the not-quite-poor. And then, you’ll yell at the critics for not supporting this great plan.

    That’s going to work out real well.

  145. 145
    Jack says:

    @Kryptik:

    I’ve retired all claims to predictive powers, so I won’t speculate on what the next Senate might or might not do, with or without more Republicans.

    I think, though, that the general problem with the lesser-evil approach is the idea that “anything good” (banning recision and pre-existing condition exclusions, community rating) justifies the “plethora of bad.”

    It may be very good that your neighbor gives you a chocolate cake, but it doesn’t change the fact that he punched you in the nose, gut and groin twice before and once after he gave it to you.

  146. 146
    truculent and unreliable says:

    @Brien Jackson: You have to spend 2-12% of your income in order to get those subsidies. If you’re making $20,000 (which is about 200% of the FPL for one person), you will have to pay about $80 a month to meet those numbers. For a “silver” plan, which isn’t really worth the paper it’s printed on. I live in a smaller Midwestern town where the cost-of-living is fairly low, and I can tell you that $80 a month would be pretty hard to manage on a salary of $20,000 a year, especially with student loans.

    @jwb: I know it sounds like I’m throwing in the towel, but I’m really not. I’m just trying to explain how this will come off to young people.

  147. 147
    gwangung says:

    i am sick and f’ing tired of people saying that this is our only chance to reform healthcare for at least the next 20 years! why would that be?

    Because it’s true.

    Think about it. You bring up a bitter divisive measure and you lose. NOBODY will bring it up again in the next few years unless you bring even more firepower to bear—and that’s not gonna happen BECAUSE YOU LOST.

  148. 148
    Meyer says:

    You don’t need to be a genius to see how this plays out. I’ve been involved, as an employer, with HC purchasing for several years. We’re fucked, and by “we”, I mean this entire country. So:

    The dems accept this bill and pass it. This is actually a good thing for the country – a major step forward, it greatly benefits a lot of people. It really, truly does.

    I expect this to happen.

    However.

    Without a public option OR sufficient cost controls in there, and unless I’ve missed something, they are not in there, (except maybe an extremely weak “90% of premiums must be paid out”, which amounts to an accounting game if passed and which I do not expect to pass), without controls, the insurance companies are going to fuck over the dems. They are going to raise rates, they are going to point fingers (gently – but firmly), and the dem party is done for at least a generation. Over. We are going to see a near collapse of our HC system and the dems are going to own it, rightly or wrongly. Frankly, this collapse is happening anyway, unless a good bill is passed, but I don’t think they will pass it and they now own the issue.

    The republicans will sweep to power, it’s wingnut central, and we’ll see the final stages of a bloodless corporate coup take place. HCR will see full free-market “reforms”. This won’t work either, but hey, so what.

    If I were a dem politician, I’d dump this load of toxic shit ASAP and let the states work it out. It’s the only path to survival, and it’s the only path that doesn’t have Sarah Palin or equivalent running this country.

    As Yoda said, do or do not, there is no try. This bill is a “try” and, like trying to jump a car over the grand canyon, the consequences of not making it all the way are disastrous and fatal.

    Walk away. Lick your wounds. Move on to the next thing. Blame the people who torpedoed this, work for 2010 and 2012.

    But for the love of all that is holy, do not pass a bill without strict cost controls, or you have fucked yourself, and this country, over like it has never been fucked before.

  149. 149
    Hunter Gathers says:

    @Will:

    Where do you live and what do you pay in rent and utilities? Do you have student loans?

    Eastern Illinois, and about $550 for everything, including student loans. My wife only works part-time, only bringing in about $100 a week.

    What do you do when that old car breaks down?

    Um, I fix it. Contrary to popular belief, auto repair is not complicated. Especially on older cars. Your average $10 set of rachets can work wonders.

    Because if you are making $20k a year and still have $300 extra every month that you won’t miss, you are either living in shithole USA or at your parent’s.

    I haven’t received a dime from my parents since 1996. One man’s shithole is another’s paradise.

  150. 150
    PTirebiter says:

    @joe from Lowell:

    Aren’t some of the reforms pretty much contingent upon having mandates?
    I didn’t appreciate how risky all of this was for Obama, and I think it explains his low key approach from the start. They saw the snakes in the grass and the need to temper unrealistic expectations.

  151. 151
    Jim says:

    i am sick and f’ing tired of people saying that this is our only chance to reform healthcare for at least the next 20 years! why would that be? are Dems planning on losing Congress and the White House? ‘cause if they aren’t, they should be able to revisit this at any time.

    Where do you see either an end to the filibuster or sixty votes for stronger HRC coming from?

  152. 152
    jibeaux says:

    @Will:

    Will, dear, let’s say you find out you have a brain hemangioma and no health insurance. Your problems are far, far, far greater than $200k in bankruptcy. We all need health care. Your essential beef with that is no, we actually don’t all need health care because it costs money, or is it just that the subsidies aren’t enough?

  153. 153
    truculent and unreliable says:

    @Meyer: DING DING DING DING!

    I have been discussing the perception of this, but really, there’s a whole other layer of toxic bullshit that makes this legislation a nightmare.

  154. 154
    jibeaux says:

    @Tom Hilton:

    Right, sorry. It was, literally, the Mormon thing. I always think he’s from Utah because of that. Not the square-state thing.

  155. 155
    dmsilev says:

    @Will: I spent 6+ years as a grad student only a few years ago, with a (gross) stipend that topped out at $18K, and I was able to save a small amount of money on that meager income. How? No car, for starters. Simple tastes in living and entertainment. Living in a relatively inexpensive city (Baltimore). Etc. We had insurance through the school, so premiums were taken out of the pre-tax pay.

    Now, there’s no way I could have made the numbers work if I had a dependent. Some of my classmates did have children, and either they had a spouse with a Real Job or they scraped by with the help of things like food stamps.

    -dms

  156. 156
    Guster says:

    @jibeaux: Well, it’s not just a couple hundred votes. It’s a couple hundred dollars from me, and you–and all the Jane Hamshers of the Left. What I’m suggesting is that we can threaten to undermine Harry Reid unless he does what I suggested: tell Senators that unless they vote for a weak public option, he’s gonna pursue as strong public option via reconciliation.

    And if our threat is strong enough–if we’re willing to lose his seat to a Republican (I’d suggest that our message be, ‘Don’t vote for Reid’, not ‘vote for a more-liberal challenge’, because one doesn’t exist)–then what’s he gonna do? Either make a credible threat of using reconciliation, or give us a target. If the former, great. If the latter, that’s better than where we are now: because instead of destroying all activist enthusiasm, we can claim a (lame-ass, but still) victory when he goes down. Which could be a short-term defeat, but a long-term victory. I know that progressives don’t like to think in terms of making a sacrifice right now to flex muscles that we’ll use later, but I think this one time it might be worthwhile.

  157. 157
    joe from Lowell says:

    @ Tom Hilton:

    In a system where only (or primarily) sick people are insured

    Sure, and I get that, and I’m not even opposed to an individual mandate as part of a good-enough bill, but your concern about “only (or primarily) sick people” having health insurance plans is not going to happen. Between government programs and the private sector, something like 88% of Americans have health insurance. Throw in some S-CHIP expansions and other incremental movements towards universal coverage, and that goes up over 90%.

  158. 158
    jwb says:

    @Jack: No, on this point, I don’t really see it as an either/or in terms of supporting the bill (you can be against the bill without disengaging). What I do see as completely counterproductive is stomping off in a huff, saying the Dems and the goopers are just the same, etc. because the Dems aren’t doing what you want them to do. The implicit threat is an all-or-nothing gamble, and the surest way to ensure that you have no political influence.

  159. 159
    Rick Taylor says:

    From Booman:
    __

    Just a couple of reminders here. The Senate bill is not the final bill. It’s borderline retarded to openly advocate for killing the Senate bill right now. All that matters, and all that ever mattered, is what is in the Conference Report. Even though things look predictably (from my point of view) grim for the Conference Report, the time to reject passage of an unacceptably shitty bill is when it is actually about to be made into law. For progressives, the goal right now should be to try to make improvements in the bill in Conference. While some much needed changes won’t be possible, others will be.

    __
    And Atrios

    Attributing Opinions To Me That I Have Not Expressed
    __
    I’ve never said the bill should be killed. There isn’t even a bill to kill at this point.

  160. 160
    joe from Lowell says:

    I’m opposed to single payer.

    I think people should be able to buy supplemental insurance for hangnail and boob job coverage from Aetna, on top of the coverage they get from a universally-accessible, tax-funded health insurance system, if they want to.

    ;-)

  161. 161
    jwb says:

    @Will: Would the bill make things worse for you?

  162. 162
  163. 163
    The Raven says:

    I think this bill is going to make matters worse than the status quo by:

    – lowering the quality of employer-provided insurance; the CBO is estimating that this will affect 19% of employees

    – hurting the middle class at the low end, by requiring people who do not currently carry insurance to buy poor-quality insurance at high prices

    – encouraging the insurance companies to continue to raise prices and cut services

    – funneling more money to the insurance companies so that they can lose it in speculation

    All of which adds up to slo-mo disaster for the Democratic Party. Perhaps, maybe, once there’s been a few years of pain, Congress will be persuaded to fix things, but I bet they won’t fix the bankruptcies.

    And it’s going to get worse. As Digby puts it, “I think we have a way to go before this bill is bad enough for [Lieberman] and his cronies to allow the Democrats to commit political suicide with it.”

  164. 164
    John S. says:

    This will take the generation of 20-somethings who aren’t finding nice company provided benefits 40-hour work week jobs

    Right.

    Look, I’m 32 and I haven’t had a fucking employer pay for my health insurance IN EIGHT FUCKING YEARS. And I have been employed full-time 7 out of 8 of those years. This is nothing new.

    But unlike some of my friends in a similar situation, I have carried my own policy. Yes, it hurt me at times, but at least I took responsibility for myself as best I could. That is in stark contrast to my ultra-liberal friend who ended up with very bad pneumonia and had to have open-lung surgery and be in the hospital for 2 weeks and stuck the rest of us with his bill.

    Because in his mind, he was young and invincible so he didn’t need no stinking health insurance. Until he needed it, didn’t have it and made everyone else pay for it.

    I suspect that at some point or another, a lot of those 20-somethings will grow the fuck up and stop rolling the dice every chance they get. Because it’s great to take chances when you win, but it fucking stings like hell when you lose.

    I’m simply looking at what this bill would have done to me and will do to my friends.

    Me too, and I’m drawing a different conclusion than you. I’m married, pay for my family’s health insurance on my own – without subsidies – my wife has been unemployed for over a year, we have one child and another on the way that I have to pay for OUT OF POCKET because individual HSAs do not cover maternity costs. I don’t make six figures, not even close, and somehow manage to get by.

    I have a really hard time looking at my friends my age who aren’t married, have no mortgage, no kids and no real responsibilities other than themselves and feeling sorry for their plight if this bill passes. This notion doesn’t come from any feeling of FYIGM, it comes from a notion of “If I Can Manage, So Can You”. And while there are a whole pantheon of people that simply cannot do that, 20-somethings with a college degree and a $30k per year job absolutely fucking CAN.

  165. 165
    Balconesfault says:

    Why not just Reid putting up the bill including the public option at this point … and allowing Republicans and Joe the joy of maintaining a public filibuster for a few weeks?

    This will change the story line from “Democrats can’t agree on healthcare” (or worse yet – Democrats pass shit sandwich healthcare) … to Republicans obstruct healthcare.

    If 50 Dems aren’t willing to show up every day to force a Repub to stand at the podium to block something that most Americans are in favor of … we deserve to have our asses kicked in the next election.

    And if during the filibuster, the polling reverses and people start saying they don’t want a public option, you pack it up.

    But at least try to create some heat. There are states where 50+% of voters support the public option with Republican Senators. Let’s make the explain why they supported the filibuster during the next election.

  166. 166
    inkadu says:

    @Jim: If this is our only chance to reform health care, what makes you think this is something we can build on in the near future?

    I understand the “build” argument. But the first political effect of this bill will be to make government the problem and make Republicans look sensible.

    The big question is how the mandates will play out. Republicans probably won’t kill the mandates. What they will do is lower government subsidies, shifting the costs directly back onto the consumer, OR lowering/eliminating the fines. This is the GOP that made a run at social security.

    I didn’t get a chance to participate in last nights megahyperthread about it, but I didn’t read any convincing case that there was much incremental meat behind this bill, nor that it created any program that couldn’t be rescinded, nor that it wouldn’t slaughter Democrats for a decade and make health care reform just as radioactive as if this thing had failed.

    AND nobody’s explained to me why any smaller programs in a single bill would fare any better…

    I’m undecided and depressed.

  167. 167
    khead says:

    I mean, I know you folks are all ready to lump us into the category of acceptable casualties, but don’t be shocked when it comes back to bite you hard.

    Sorry, but you were an acceptable casualty before this bill.

  168. 168
    Amaliada says:

    I’d sure like to believe that something more than requiring people to buy insurance with no caps and no more coverage is possible.

    But I don’t believe it. I’m sure the bill will pass and I’ll be in the same boat – unable to afford it, unable to get the knee operations I need (pre-existing conditions), and now being a criminal because I refuse to buy something I can’t use.

    Sorry, if this is the best that can be done with these kinds of majorities in both houses of Congress, thinking that something better is coming along in 20 or 30 years is wishful thinking – and how many of us will still be here in 20 or 30 years?

    I’ll just have to wait until I’m old enough for Medicare to return to the US to live.

  169. 169

    @joe from Lowell:

    But it just won’t work like that. You can’t guarantee equitable access to sick people without also guaranteeing healthy people stay in the system. If healthy people respond to the obvious incentives by not getting insurance until they’re sick, then you’ve just blown up the entire mechanism of cost-sharing. Basially, sick people can get insurance, but if only sick people have insurance, there’s no one to disperse cost across, and you might as well just be paying the bill out of pocket.

  170. 170
    Meyer says:

    Why not just Reid putting up the bill including the public option at this point … and allowing Republicans and Joe the joy of maintaining a public filibuster for a few weeks?

    Yup. That’s the way to dump the bill. Nice and clean.

    This is exactly what they should do. And then start pointing fingers, worry about the next election, and wait for things to get truly shitty for the american people, shitty enough that they simply will not stand for tea baggery and stupidity and Lieberman.

    Best possible outcome at this point.

  171. 171
    PTirebiter says:

    @Will:

    I know you folks are all ready to lump us into the category of acceptable casualties…

    That’s just a load of crap.
    And which progressive policies created the currently swelling class of “not quite poor” Americans?

  172. 172
    Balconesfault says:

    @Brien Jackson:

    You can’t guarantee equitable access to sick people without also guaranteeing healthy people stay in the system.

    I don’t mind a mandate that people buy insurance.

    I only mind a mandate that people buy insurance from private companies that spent tens of millions of dollars to prevent government competition.

    I think people can be convinced why mandating buying into a public option is reasonable. I can’t see where mandating people paying money to Aetna will resort in anything but disaster for the people who crafted the mandate.

  173. 173
    Tom Hilton says:

    @joe from Lowell: okay, I phrased it somewhat inartfully. Let’s try this: a system in which sick people are more likely to have insurance than healthy people is unsustainable.

  174. 174
    Tsulagi says:

    It is this, or it is nothing for decades

    More than likely.

    Agree with Dean that what’s being pushed is not much more than a big expansion of the current system, the one that is already chewing up a big chunk of GDP. That interests that helped kill HCR would only become more entrenched with that expansion. Can see his suggestion to harvest the stem cells from this abortion, the few good things, and push them through.

    But come back in two years for real HCR? Not gonna happen. Plus he’s assuming within those two years the Dems would grow a spine and change the dom/sub dynamic they have with the Rs. Yeah, right.

    This was fail, but looking forward to the Mission Accomplished banners.

  175. 175
    Brendan says:

    All of this “I scrapped moss off of rocks and drank rainwater as a grad student, and I survived just fine” stuff is the left wing equivalent of over-entitled Republican pricks’ “I got into Yale and made a million on Wall Street just fine, what’s everyone else’s problem?” In both cases it boils down to a complete inability or unwillingness to even try to understand that other people’s situations may be radically different from theirs, even despite superficial similarities. It’s profoundly egotistical.

    More importantly, let’s say your austerity stories are all true and widely applicable- it remains bad politics to force austerity unto a large swathe of the population, and ridiculous social policy to base sweeping legislation on the idea that you can force everyone to walk an extremely narrow and hard to negotiate path between two dangers. It’s fantasy-land stuff. You can’t assume the best case scenario for behavior or circumstances across wide demographics.

  176. 176
    John S. says:

    and wait for things to get truly shitty for the american people, shitty enough that they simply will not stand for tea baggery and stupidity and Lieberman

    What color is the sky on your world?

    The shittier things get, the more people blame the PARTY IN POWER. It doesn’t matter how irrational or misguided that belief is, hell, barely a year after the fiasco that was the Bush presidency plenty of people are already blaming Obama and the Democrats and forgetting the Republicans were ever in power.

    And you think making things WORSE will magically get the public behind progressives and a real reform effort and abandon the Teabaggers and douchebaggery? Talk about wishing for ponies…

  177. 177

    @Tom Hilton:

    I think what you don’t understand is that most people do want insurance. They don’t simply buy insurance because they know they’ll get sick.

    As an aside, my health insurance is awesome. I recently had a medical bill which was sent to me as less than $200 self-pay when they thought I didn’t have insurance. Now that I’ve submitted it to my insurance, I’m looking at over $400 because the insurance company doesn’t like to pay for things. I hope the billing company realizes the stupidity of this and it results in a net lowering of my bill, but otherwise, I have no clue where I’ll get that sort of money.

    Health insurance reform won’t be enough when health care providers give better discounts to self pay than insurance coverage, but simply mandating that I buy that exact same plan won’t help, and encouraging more people to buy that plan will actually hurt.

  178. 178
    Brian J says:

    @inkadu:

    There are plenty of military or sports-related metaphors I could use here, so I’ll skip that. Let me just say that if you establish a firm line in the sand now, it’ll be pretty much impossible to go back from that. This is one reason why Republicans, back in the early 1990s as well as now, are so scared of the bill passing. They know that unless the system is an absolute horror show, they can never take it away. They will be forced to work within the confines of a new system, one that will go against much of what they stand for. They will be forced to adapt.

    It’s not impossible for a base to be established in the future and for reform to then move forward, it’s just harder. Instead of spending the next few years improving the reforms, we’ll be forced to spend it trying to gain enough momentum to pass reform in the first place. Failing to pass anything now is a pretty big step backwards.

  179. 179
    geg6 says:

    @Meyer:

    I’m all for that. Sign me up.

  180. 180
    Jim says:

    @Jim: If this is our only chance to reform health care, what makes you think this is something we can build on in the near future?

    One of the reasons this plan is so hard to pass is that people are generally scared b/c of the bad economy. Passing smaller bits of a plan is less scary to those independents who think “deficit” and “recession” are somehow synonymous. Letting the bill fail would feed into the idea that Democrats are losers and can’t get anything done, so you should vote Republican. Again, “independents” don’t get into policy details. You can’t win them over with charts showing that the Bush tax cuts are causing most of the deficit increase or that deregulation caused the Wall Street meltdown. You win them over by showing them that Democrats passed a less than perfect bill that made things better for some people, and now they want to pass another bill that will make things better for them.

  181. 181
    joe from Lowell says:

    @ Brien Jackson,

    You can’t guarantee equitable access to sick people without also guaranteeing healthy people stay in the system.

    I agree with you.

    When we have a bill that guarantees equitable access for sick people and poor people, I will support adding an individual mandate.

    But not for this.

    Brien, Tom Hilton, I get what you’re saying about the need for universal buy-in being part of a comprehensive system that includes universal access. I agree with that point.

    But why should I support it as part of a bill that doesn’t create a comprehensive system that includes universal access?

  182. 182
    Belafon (formerly anonevent) says:

    Why don’t we all pool our money together and start an insurance company that plays by the rules that we’re talking about? What if every member of the insurance was considered to be one big pool, rather than per company like even my insurance is doing? What if it were a private version of single payer?

  183. 183

    @Balconesfault:

    You can put through a Medicare buy-in via reconciliation. It got a lot of support even from fence-sitters in the Senate; I’m sure Pelosi can wrangle it through the House. That is a straightforwardly reconcilable, and very simple, bill. Then reintroduce the current bill – no changes necessary. Basically, Lieberman has just forced the necessary reconciliation vs. normal split.

    Well that’s a bummer, but I’m not worried about the political consequences, I’m worried about the policy outcomes. And those are obvious; if you guarantee sick people access to insurance and guarantee they won’t be discriminated against with regards to price, a lot of healthy people who don’t understand how insurance works (and there are more of them then you might think, especially amongst people under 30) are going to assume there’s no reason to get insurance before they get sick. After all, they can just go get it when they do get sick and the insurance company can’t charge them extra right?

  184. 184
    Balconesfault says:

    @John S.:

    The shittier things get, the more people blame the PARTY IN POWER.

    Again – the point here is to show that thanks to the filibuster, and the lockstep Republicans, and Joe Lieberman – the Democrats ARE NOT IN POWER.

    The majority of Americans want the public option. By some polls, a supermajority of Americans want the public option. In many Republican states, at least a plurality … in some case a majority want the public option.

    Do you want to be the party that did everything it could do to get the public option passed … while the other party did everything in its power to stop the public option?

    That’s where I’d like to be going into the 2010 midterms, if I can’t be the party that passed the public option.

  185. 185
    inkadu says:

    @John S.: You’re paying for your own baby’s delivery and you think you have health insurance?

    Also, you say that the kids that have college degrees and make 30k should be able to make it. What does the college degree have to do with it?

  186. 186
    Et Tu Brutus? says:

    Hmmm,

    Mandated buy -or -be fined;

    insufficiently funded subsidies;

    no real cap on insurance premiums;

    no real cost containment measures( no PO, no Medicare buy-in, no cheaper drug importation).

    Yes indeed, the senate should pass this, and send it on to be merged in committee with the house bill; surely the result will be far better. And folks are wondering why Dean is having a stroke? No surprise as too why Dean was never seriously considered for Sec of Health, eh? As Greenwald points out, this type of excrement is what Obama/Rahm/Healthcare lobby wanted all along; all the rest, including Liebermann, has been Kabuki theater of the first order.

  187. 187

    @joe from Lowell:

    But why should I support it as part of a bill that doesn’t create a comprehensive system that includes universal access?

    There’s no reason you should, if you don’t want to. But you can’t have your cake and eat it too, so to speak. No mandate means most of the insurance reforms don’t work in practice. If you’re unwilling to accept a mandate without a public option, then you should also be willing to accept the cost of losing the possibility of ending discriminatory practices in insurance.

  188. 188
    Meyer says:

    Again – the point here is to show that thanks to the filibuster, and the lockstep Republicans, and Joe Lieberman – the Democrats ARE NOT IN POWER.

    Bingo. The dems need to have at least 50 senators sitting in that chamber trying to pass a good bill from now until 2012, if need be. The whole fucking time. The need to make it clear that this system is collapsing, that without strong price controls it is doomed and they need to be open to serious proposals to make it better.

    But it must be CRYSTAL clear who is obstructing and who is trying to make it better.

    Straight up or down. No more bullshit.

  189. 189
    inkadu says:

    @Jim: I understand the financial inching up argument. But what about changes that would costs the government $0? Medicare buy-in is a free bill, but we can’t get it. I feel like if we broke up this bill into its constituent parts, every one of them would have led to a year-long tussle.

    Eh. I think I’m leaning towards supporting this bill, but only because I take some sort of sick car-wreck pleasure from it.

  190. 190
    NobodySpecial says:

    @jwb:

    I can speak for Will, although I’m in a slightly better position than he is. Yes, it is worse. Because it will force me to buy a crappy insurance plan (trust me, no one will give us a good one. That might cost them money.) or pay a fine. I don’t have the money for the crappy insurance plan now, or can I use the subsidy to pay the fine? Because either way, you’re saying the lower middle-class who makes too much for the Medicaid bump and too little to afford a good premium after life hits (and I have an aside about that for later) are screwed, screwed, screwed, and oh, by the way, complaining is really not wanted, so take your medicine and STFU. And vote for us in ’10.

    The aside – I love the way some Joe Rednecks on this board instantly assume that making X amount of dollars means you could obviously afford health insurance, and you don’t because you spent it all on quality weed and tofurkey, or you bought a bigscreen with the savings. Sounds an awful like some other people, except they’re better about calling it by less polite names, like welfare queen.

  191. 191
    geg6 says:

    @Brien Jackson:

    No mandate means most of the insurance reforms don’t work in practice.

    What fucking reforms? There are none. The pre-existing condition language is a joke. Some numbnut was here last night arguing that the language is standard contract language and so it protects people and will be needed. Stupidest shit I’ve ever seen because ALL insurance policies are contracts and always have been. So what, exactly, will change the insurance companies’ ability to claim pre-existing conditions? If these people can’t afford insurance, how are they supposed to afford the attorney to fight this for them? And the subsidies? Right. A family of 3 with income of $30,000 will have to come up with about $1200 a year for their share of the premiums. Please explain to me where this family gets this kind of money. And that’s assuming that the subsidies aren’t lowered even further than they already have been or cut out altogether.

    Please point me to what, exactly, is reforming about any of this.

  192. 192
    Jim says:

    @Jim: I understand the financial inching up argument. But what about changes that would costs the government $0? Medicare buy-in is a free bill, but we can’t get it.

    CBO scores show teh House bill lowers the deficit. Non-partisan, even-handed truth-teller David Broder (okay, you probably just threw up in your mouth a little reading that, as I did while typing it, but among a lot of politically engaged people–including probably a good half of self-identified Democrats, they believe that like they believe the sun rises in the East) says it will explode the deficit and create a terrible burden for our children and grandchildren. Likewise, Medicare is bankrupt and the only solution is to cut benefits. This is the field we’re fighting on. People are easier to scare when unemployment is at an all time high (again, not true, but I’d bet 70% of people would agree with it if asked by a pollster).

    Specifically on the Medicare buy-in, I think it was brought in too late, which made it easier for Lieberman (et al) to troll. Maybe if Dems start pushing it now, emphasizing the “buy-in” part, they can use it to build momentum into 2012. It’s not going to come unless people demand it. Fortunately, unlike the young and the poor, that large demographic, including a lot of people who would change careers but for insurance, votes.

  193. 193
    Jack says:

    @geg6:

    …never mind ERISA limitations placed on settlements.

  194. 194
    matt says:

    NO, NEVER, NO WAY!

    They want to fuck us over for ins co profits, let em, they will never get another dime or vote, and I’ll go out of my way to spit on any who pass this POS

  195. 195
    scudbucket says:

    @geg6:

    What fucking reforms? Exactly right.

    Please explain to me where this family gets this kind of money.

    The bill also includes a mandate that poor people buy a new pair of boot straps.

  196. 196
    Jack says:

    @geg6:

    Brien’s argument appears to be “you cannot get the stuff you want from the people in power” so “settle for a wee concession or two while they make things worse.”

    FWIW, he’s not the only BJer making the argument, but at least he’s a lot nicer about it then the sneering “centrists” and “pragmagists” on the other threads…

  197. 197
    Rick Taylor says:

    Another point, regardless of whether they eventually intend to pass the bill or not, progressives in congress have to say they are on the verge of killing it. The so called centrists are playing hardball, threatening to filibuster any bill that’s not just perfect from their point of view. It is nonsensical that with the medicare expansion that he’d supported until recently supported, the bill is so awful it must as a matter of principle not just be opposed, but filibustered so it never comes up for a vote, but without, it’s so good Lieberman would support it!

    Since centrists are demonstrating that by being willing to kill the bill, they can get anything they want, progressives have to use the same tactics, or accept politically neutered (even as their views are supported by the majority of the congress and the great majority of the Democratic party). If that means pretending they believe there will be other opportunities to do health care, so they’re not inclined to be rushed into supporting this bill, so be it.

  198. 198
    Jack says:

    @geg6:

    Brien’s argument appears to be “you cannot get the stuff you want from the people in power” so “settle for a wee concession or two while they make things worse.”

    FWIW, he’s not the only BJer making the argument, but at least he’s a lot nicer about it than the sneering “centrists” and “pragmatists” on the other threads..

  199. 199
    MNPundit says:

    Strip out the mandates and I will shut up about the bill.

    It’s trash, but if you strip out the mandates, then I can keep it down without vomiting in your face.

  200. 200
    geg6 says:

    @MNPundit:

    Strip out the mandates and I will shut up about the bill.

    This.

  201. 201
    truculent and unreliable says:

    @MNPundit: I could live with it, too.

  202. 202
    Hooters against Healthcare says:

    The opposition has been creative. You can’t say the Chamber of Commerce doesn’t know how to play to the base. How long till they trot out “Titties For Tea Parties”?

    http://thinkprogress.org/2009/.....alth-care/

  203. 203
    Bobby Thomson says:

    It’s not complicated. Dean was arguing for the reconciliation pathway, which requires only 50 Democratic votes. Getting 50 Democratic votes is exponentially easier than getting all 58 Democratic votes, Sanders, plus one Republican vote.

  204. 204

    Brien’s argument appears to be “you cannot get the stuff you want from the people in power” so “settle for a wee concession or two while they make things worse.”

    I’m not sure that’s what I’m trying to say. Basically, you can be of whatever opinion you want and prioritize things however you want to. That’s everyone’s right, and if the public option is the most important thing to you, well I disagree, but I’m not going to tell you you’re wrong to think that (at least until you start trying to tell me what I voted for or what my unisurable friends and family members really prioritize anyway, but that’s another subject). I just want people to understand the way te policy mechanisms work, and understand what giving up various things mean. I really have talked to people in the last month who have no idea how insurance works in practice. Two of them thought that the insurance company took your premiums and put them in your own personal accounts to save until you needed them. I don’t know if they’re representative of many people, but there are a lot of dumb people out there, so it wouldn’t surprise me. So yes, I imagine that a lot of people would decline to buy insurance if they thought they were guaranteed to get it at the same price as everyone else if they waited until they were sick. And that would mean fewer healty people to disperse cost amongst, which defeates the entire purpose of insurance.

    I’m not trying to tell people how they ought to think about that, or what way they should come down on the question. I just want them to understand the interconnectedness of the mandates to universality, fair practice, community rating, etc.

  205. 205
    Jack says:

    @truculent and unreliable:

    It would still be awful. But it wouldn’t be truly, deeply, unforgivably awful.

    Of course, it would also make the whole project of reform, with this particular patchwork of legislation, a giant waste of time.

    For the plan to work as it’s so far cobbled together (even badly, and to the benefit of existing private carriers, as well as the very disadvantaged who will gain some actual relief), everyone must buy in.

    If everyone doesn’t buy in, the liability pool is too small to prevent decoherence (my apologies for borrowing and hamhandedly retooling a physics term).

  206. 206
    Jack says:

    @Brien Jackson:

    See the post directly below your response. I understand your argument, and I still think it resolves to: some of the good stuff requires you to swallow a whole lot of awful.

  207. 207
    danimal says:

    My $0.02 for progressives unhappy with the bill.

    1. Clearly identify the sections of the bill that you don’t like. Contact your elected representatives about changing those sections.STOP being obsessive about optics or generic feelings. They don’t care about who’s winning and losing, Joe’s influence on the process, Blue Dogs, etc. That won’t determine their vote at this point.
    2. Support the bill grudgingly.
    3. Use your passion and motivation to push for legislative improvements in this session and in future elections. For example, if this bill isn’t fair to younger workers, develop a bill that improves the ability of younger workers to obtain affordable insurance. Most of the “wonks” actually want the same things you want, and will be your allies.

    Everyone would like a bill that solves the entire issue in one fell swoop. It just doesn’t happen that way.

  208. 208
    chiggins says:

    @jibeaux: If it’s that important, then we blow away the insurance companies once and for all, make it a fucking public utility, and we pay for it as a tax out our paycheck.

    If I want a cellphone, I have to deal with some company that’s going to fist me whenever it gets a chance if there’s a buck in it for them. But I don’t have to get a phone. If I want to own a car, I have to deal with some company that will gladly kick-fuck me out of the money I give them month after month, but I don’t have to own a car.

    However, a law that thrusts me, by virtue of my existence and citizenship, into the maw of these uncle-fucking shit-eaters without providing me with a publicly administrated alternative is a 100% guaranteed way to get me to spend the rest of my life throwing the biggest wrenches I can find into any political machine that was involved in creating this abomination.

    Remember where Republicans came from, Democrats and Whigs not getting abolition done. If we’re gonna do healthcare for everyone, then let’s do it. And if neither side can get it done, then they both need to burn for it. But the very idea that what’s coming out of this process is gonna cut it is disgusting, and I’m not gonna be a fucking pawl in the Rightward Ratchet anymore. Fuck that.

  209. 209
    Jack says:

    @chiggins:

    Fist bump for the SMBIVA reference.

  210. 210
    Olly McPherson says:

    @danimal:

    So, dedicate myself to being a congressman, except with more impotence and no pay? No thanks.

  211. 211
    Jack says:

    @danimal:

    That “fell swoop legislation” is largely mythical does not prove that “guaranteed incremental improvement” is any less a chimaera.

  212. 212
    Bobby Thomson says:

    @Brien Jackson:

    If you’re unwilling to accept a mandate without a public option, then you should also be willing to accept the cost of losing the possibility of ending discriminatory practices in insurance.

    This bill doesn’t do that. It expressly allows the continuing practice of rescission. While it doesn’t allow insurers to refuse to sell you any policy because of a pre-existing condition, it also doesn’t prevent them from pricing it so high that it is out of your reach, anyway.

    It allows insurers to set annual limits on payments, after which people have to declare bankruptcy, after which they go on Medicaid.

    It allows insurers to charge WTFTW, which basically makes consumers a conduit for payments from federal tax revenues directly to insurers, until they figure out that the insurers are raising premiums by more than the subsidies cover, at which point, they say, “Fuck it. I’ll just pay the fine those Democrat assholes put in.”

  213. 213
    Bobby Thomson says:

    @geg6:

    This.

  214. 214
    Elie says:

    @valdivia:

    Totally agree. And though I cannot cite specific examples, I know that in my industry (healthcare information), many times large changes within a company take time to implement and are tweaked many times in the process…

    This is a huge change to our system. No way it could be made perfect the first go round. Pass it the way we can and lets keep working…

    Thanks also for your great links

  215. 215

    @Jack:

    That’s fair, but I guess I think it comes down to what you prioritize. Myself, I think banning discrimination, communtiy rating, etc. is one of the more important aspects of the bill. Those are my highest priorities. So I guess I don’t really consider the mandates a concession in that sense, it’s just something you have to have to make what I want work. The public option would be the concession here, and on balance I guess I’m mostly ok with that because I prioritize the regualtory reforms over the public option. But I’m sacrificing the public option to get those reforms, the mandate is just something that has to be there to make the other regulatory aspects of the package work.

  216. 216
    Elie says:

    @geg6:

    Some of that will be addressed during the regulatory process that comes after the bill is passed. Those details that you cite, which are tremendously important to the validity of “reform” will be fought through the regulatory process as well, I am sure, but that is when that detail is placed in how this will be implemented.

  217. 217
    Jack says:

    @Brien Jackson:

    What you or I prioritize doesn’t matter, unless we are actively engaged in the process itself. Our priorities don’t determine the enforcement of clauses or the consequences of policy.

    At what point, then, do we ask “Who benefits?” about the existing legislative drafts?

  218. 218
    Rick Taylor says:

    While it doesn’t allow insurers to refuse to sell you any policy because of a pre-existing condition, it also doesn’t prevent them from pricing it so high that it is out of your reach, anyway.

    This is something I’d like to get a clear answer on. I’ve heard some people say that the bill would make insurance companies give the same policies at the same price to those with pre-existing conditions as anyone else; they can only price policies based on age and similar factors. I’ve heard others say it wouldn’t. If what you’re saying is true, this would be a deal-breaker for me.

  219. 219
    Jack says:

    @Elie:

    This presumes an unwarranted faith in any number and combination of non-predictable variables.

  220. 220
    geg6 says:

    @danimal:

    Well, I really don’t need lectures about how these things work, so you can shove that.

    As for your points:

    1) Who is writing or calling them about optics? I don’t know anyone who is, nor am I. I’ve writing and calling for the past 6 months with very specific criticisms about what sucks and praise for what was good. It netted me two form letters thanking me for contacting them about the “very important” issue of health care and to tell me that they support “reform.” This would be 2 Dem senators and 1 Dem congressman. And the only one who has stated support for a real reform bill is the Democratic senator who was a Republican a year ago who supported reform even as a member of the GOP.

    2) I refuse to support a piece of shit, grudgingly or wholeheartedly. So forget this.

    3) I’ve been a passionate, committed Dem who has worked tirelessly to get Dems elected and has donated more than I can afford to Dems for over 30 years. This is a foolish thing to say to someone like me.

  221. 221
    Snark Based Reality says:

    It really sickens me all you fuckers whining about kos and such and missing the point they are trying to scream out loud:

    Having a Mandate without the public option is SUICIDE.

    You are forcing people who don’t get insurance from work to run out and buy a plan whose cost WILL GO UP as Insurance companies exploit all the loopholes to increase rates. You will be giving lots of people age 18 to 65 the choice between being fined by the government or dumping money into overpriced under delivering insurance.

    Stupid fuckers whining about losing a few seats in 2010 when you should be more worried about all the shit hitting the fan when Mandates kick in and people realize how fucking immoral and horrid the whole arrangement is.

    It’s not just about 2010, jesus fucking christ. Stop being stupid. It’s not about passing ANY bill, it’s passing a BILL THAT DOESN’T MAKE THINGS UNDENYABLY WORSE IN 4 TO 10 YEARS.

    And that Nate Silver graph is pure fucking fantasy. The guy should stick to polling because he talks out his ass on everything else as much as some random guy on DKOS does.

  222. 222
    geg6 says:

    @Elie:

    Sorry, but you’re nuts if you believe that.

  223. 223
  224. 224
    Snark Based Reality says:

    Mandates as currently implemented will be the death of the Democratic party for the next 8+ years. You can COUNT ON IT. And they will deserve every freaking lost vote. In fact if this shit passes as currently proposed I’ll be having my own reverse John Cole moment and switch from Dem to Independent. This is fucking bullshit.

  225. 225
    scudbucket says:

    @Rick Taylor:

    That’s similar to my worry as well. From what I’ve gathered from the intertoobs, policy price would be fixed (I think) but lifetime cap, co-pay, deductibles and out-of-pocket can all vary. Anyone know for sure?

  226. 226
    joe in oklahoma says:

    @Jim: step 1: introduce a good bill, step2: vote it up or down, step 3: if it loses, the American people see clearly who is opposed to health care, make their obstruction part of the mid-term election in order to replace bad dems with good ones, step4: bring up a new stronger bill

  227. 227
    Jack says:

    @geg6:

    Perhaps “you’re nuts” is unfair. Maybe instead: “…a whole lot of conviction that national ‘Democrats are good faith players, that the Republicans won’t take back the House or the White House, that the Senate is full of populist do-gooders, that Obama wants anything else, that the Afghan Escalation won’t destroy Obama’s presidency, that the commercial real estate collapse won’t happen, that the Bush-Obama Permanent banking insurance program won’t further eviscerate the commons.’ “

  228. 228
    Nellcote says:

    I just feel sad that Dean’s soundbites will be used by the goopers against the dems.

  229. 229
    burnspbesq says:

    @edmund dantes:

    I think step two in your three-step plan is “more and better Democrats.”

  230. 230
    Jack says:

    @scudbucket:

    This is what came up in an initial search, re. annual dollar limits:

    http://help.senate.gov/BAI09A84_xml.pdf

  231. 231

    @Jack:

    What you or I prioritize doesn’t matter, unless we are actively engaged in the process itself. Our priorities don’t determine the enforcement of clauses or the consequences of policy.

    Well I guess not, but if you want to go that route, then there isn’t really any point to us discussing it is there?

    At what point, then, do we ask “Who benefits?” about the existing legislative drafts?

    You should always ask that.

  232. 232
    Jack says:

    @Brien Jackson:

    Well I guess not, but if you want to go that route, then there isn’t really any point to us discussing it is there?

    Our discussion has no bearing on the policy, but that doesn’t mean we should stop trying to understand or inform.

    You should always ask that.

    So, cui bono, Brien?

  233. 233
    Makewi says:

    You could go back to the drawing board. You could scrap the idea that attempting such a broad change at this point is a good idea, and focus on each of the problems with the current system individually. I think it would work.

    I’d start with a risk pool system to cover the uninsured, where any company that wants to provide health insurance in a given state must accept their share of those who meet the qualifications. That would be one bill.

    At the same time, I’d work on a fund to cover those that get screwed by recission, or denial, or any other thing that causes a catastrophic health concern to break them. This fund would be created by payments from taxpayers, insurance companies, pharmaceutical companies and a fee levied against those who come to this country for health care. That would be another bill.

  234. 234
    lol says:

    Can we get a reality check on reconciliation here?

    There aren’t 50 votes.

    You lose Lieberman, Nelson (NE), Lincoln, Landrieu, Conrad,
    Bayh, Baucus, Byrd, and Feingold more or less off the bat with Feinstein, Pryor, Nelson (FL) and I think one or two others waiting in the wings.

  235. 235

    @Snark Based Reality:

    I really shouldn’t, but I find this highly amusing:

    And that Nate Silver graph is pure fucking fantasy. The guy should stick to polling because he talks out his ass on everything else as much as some random guy on DKOS does.

    Ok, so show your work. But just screaming “nuh-uh!” when you don’t believe someone else’s math isn’t any different than Lieberman running around saying the public option will increase the deficit even tough every scoring says the exact opposite. If you think Nate Silver’s math is wrong, then demonstrate how it’s wrong. But running around refusing to accept the results of actual research on the matter because you just don’t believe it is right up there with wingnuts insisting tax cuts can increase revenues because shut up that’s why!

  236. 236
    jibeaux says:

    @Guster:

    If the “long-term victory” is making Harry Reid go deal cards in a cas-ino or whatnot, then sure, it’s a victory. If you actually want to pass health care reform, then, no, it’s not a victory. It’s just redoubling your effort while you lose your aim.

  237. 237
    Jim says:

    @joe in oklahoma:

    You have enormous faith in the ability and willingness of the American people to follow and understand our political system. See 2000, 2004, and your own two Senators.

  238. 238
    Snark Based Reality says:

    @Brien Jackson:

    He cherry picks a scenario and makes assumptions about the actions of the players in the scenario. The scenario works because of subsidies which I guaran-fucking-tee you will get swallowed up when insurance companies spike rates. And it’ll all be covered and OK by conviently valid cost increases elsewhere in the market. It’s a “best case scenario” being used to further the “anything is better than nothing” when the premise is FALSE.

    This shit happens all the time in the educational sector. Increase financial aid and lo-and-behold tuition, fees, textbook prices, etc spike. As someone who works in the sector all I can say is… If you want to contain the cost of a college education stop increasing financial aid.

  239. 239
    geg6 says:

    @Brien Jackson:

    Nate’s analysis is based on fantasy. The math may be correct (and I have no doubt it is), but RJ Eskow pretty effectively skewers the assumptions behind it and the political context Nate is completely missing.

    I would never take Nate Silver’s numbers as the gold standard for political or policy questions. About polling, football games, fantasy leagues, post-election voter demographics…yes. Strategy, tactics, and prognostication of the political landscape…no.

  240. 240
  241. 241

    @Jack:

    I guess I just don’t care about “tactics, strategy, and politics.” If HCR is political suicide in the medium-term, then so be it. If we start worrying about what’s political suicide at the margins, we’re never going to get anything. See the Civil Rights Act. If 3 or 4 Senators hadn’t decided that the moral imperative of the bill was more important than their next election, the bill wouldn’t have had the votes. And yeah, they lost their next elections, and Democrats handed Republicans a political strategy that lasted a generation and got us Nixon and Reagan. But they lso passed the Civil Rights Act, and the Voting Rights Act thereafter.

  242. 242
    Guster says:

    @jibeaux: I’m not sure how we achieve long-term victory without ever imposing short-term consequences.

    But maybe you’re right. Maybe a consequence-free Senate will decide to do the right thing.

  243. 243
    inkadu says:

    @Jim: Everything I’ve read about the negotiations is that the longer a progressive provision is in the bill, the more likely it is to be stripped out. In fact, the only way to protect provisions is to sacrifice other provisions…

    But back to your point… if ANY bill proposed will suddenly be a budget buster, regardless of reality, then your “incremental financing” argument doesn’t hold.

  244. 244
    Jack says:

    @Brien Jackson:

    This “moral imperative” to pass “HCR” benefits whom, Brien?

  245. 245
    licensed to kill time says:

    I’m so sick of this whole process.

    Thank FSM for Balloon Juice – it’s the only way for me to stay informed w/o going entirely insane.

  246. 246
    JenJen says:

    @Rhoda: I’m with Booman all the way.

  247. 247

    […] honorable, admirable, and astute John Cole posted a warning about the Health Care Reform bill working its way through the legislative lower intestine we call […]

  248. 248
    Will says:

    Just to note, as of a year ago, I got mine. I’m a state employee with insurance and benefits and, as such, I’ll be covered long after the private sector plans go tits up and all of you are buying your insurance on the private market.

    But that was not true a year ago and it’s not true for a lot of my friends. And as someone who donated money to our current president, I wasn’t expecting the end result to be “reforms” that pay for bankers to get billions in bonuses, refuses to raise taxes on the wealthy, while imposing a huge new tax on people who are already struggling.

    As I said, I’m a leftist. If I was in Europe, I’d be a committed democratic socialist. And it’s a bit of an eye-opener to watch so many American Democratic moderates and progressives calmly consign their poorer neighbors to privation in pursuit of some better future.

    Sacrifice comrades! The bankers need the sweat from your brow to gold plate their iPhones!

  249. 249
    Jennyjinx says:

    @geg6:

    A family of 3 with income of $30,000 will have to come up with about $1200 a year for their share of the premiums. Please explain to me where this family gets this kind of money

    I know this is kind of an old thread, but I just wanted to say that my husband and I had a combined income of $28,156 last year (according to our tax return). We paid $300 a month for our health insurance (through his job). $300 * 12 = $3,600. He’s subsequently lost that insurance.

    $1,200 a year would be a HUGE savings for us.

  250. 250
    geg6 says:

    @Jennyjinx:

    Well, I’m glad for you. But I know dozens of families that I interact with every day who can’t afford either your current insurance or the $1200 for the subsidized premiums. They are going on nothing and praying no one gets sick. I have had several who simply said they’ll file for bankruptcy if they do.

    Are you sending children to college? In your financial situation, then $1200 is too much in my area. Are you struggling with an ARM? Then $1200 is too much, if you are.

    Don’t think that everyone’s situation is similar to yours, even in the same income bracket. Because I can assure they aren’t.

  251. 251
    Fritzie says:

    Does anyone here (or elsewhere) know how the MANDATE will work? And how much it will cost if you rebel? (I’ve heard 2000-7000 per person.) And how it will be enforced? And how the subsidies will work and at what income level they will begin?

    I don’t think anybody does know, now really, do they.

  252. 252
    Fritzie says:

    http://www.commondreams.org/further/2009/12/15-1
    This Health Reform Bill Is Political Suicide

    http://www.dogcanyon.org/2009/.....ck-comedy/
    Did I Wake Up in a Black Comedy?

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