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Tag: "health care"

What’s Worth Voting For

[ 0 ] August 17, 2009 |

Yglesias:

Nominally at least that means that health reform is now in a legislative dead zone—there aren’t the votes in the House for a bill without a public option and there aren’t the votes in the Senate for a bill with them. If it comes right down to it and the senate is prepared to pass a bill that:

(a) subjects insurance companies to tough new restrictions,
(b) taxes employers who don’t provide decent health insurance to their employees,
(c) creates a new regulated marketplace in which individuals and small business employees can buy quality health insurance,
(d) expands Medicaid eligibility, and
(e) offers subsidies to ensure the affordability of insurance for middle class families

I have a hard time believing that House liberals will really kill the bill. But maybe they will.

It is certainly possible that a bill without a public option but with these kind of elements could emerge that would be enough of an improvement over the status quo that House progressives probably would and probably should vote for it. But:

  • A lot of the devil is in the details, especially with respect to (a) and (e). A bill with an individual mandate but that doesn’t require companies to supply good insurance and without sufficiently generous subsidies could well make things worse for many middle class working people despite the expense of the program. And the same insurance company lickspittles who are determined to remove the public option are likely to do everything they can to water down the regulatory restrictions on insurance companies too.
  • Consequently, it’s crucial that House progressives maintain the pubic option as a line in the sand, if only for bargaining leverage.
  • I’m not sure what to think about the possibility of adding a public option later on. I wouldn’t say it’s impossible, but I also certainly wouldn’t count on it. If a bill would only be acceptable on balance if a public option was added fairly quickly, I would say it should be rejected.

Points About the Indefensible American Health Care System That Need To Be Made More Often

[ 0 ] August 15, 2009 |

Yes:

Fun fact the media never tells you: as a % of GDP, the US has greater public expenditures on health care than the UK does. Not total expenditures, we know that. Public expenditures. More big government health care in the US than the UK.

And even the grossly underfunded British system doesn’t seem to produce demonstrably worse results than the American one with it extra-expensive layer of corporate looting.

Palin-LaRouche 2012! Or would that be LaRouche-Palin?

[ 0 ] August 12, 2009 |

Suzy Khimm offers some thoughts on the presence of LaRouchites along the midways of various health care town halls.

The LaRouchies’ logic seems virtually indistinguishable from the current right-wing fear-mongering. “Citizens are receiving Hitler-era ‘reasons’ for why they must accept drastic medical cutbacks, sickness, and death,” LaRouche writes on his site. “For example, you must forego what is called ‘wasteful, excessive treatment,’ during your end-of-life months.” The only difference between their agitations and the far right’s histrionics? Larouchies maintain that Obama and his cronies are in cahoots with HMOs and the insurance industry-and that the real solution to their fascistic agenda is a single-payer plan (which would presumably be rid of its Hitler-inspired leadership, though they don’t go into the details).

I suspect the LaRouchites would argue that once HMOs are abolished and placed on trial for crimes against humanity, their political enablers will join them in the dock — thus turning the American political system over to a new class of leaders who are determined at last to do battle against the English Crown.

Nuance aside, Khimm is obviously correct to point out the crossover between LaRouche and the Soylent Green Right; however, she fails to notice the most obvious (and literal) link in the axis. While Sarah Palin’s views on the Queen of England and her role in the international drug trade are, as yet, undisclosed, LaRouche has been a perennial advocate of a Land Bridge to Nowhere, connecting Asia and the Americas by tunneling under the Bering Strait. LaRouche’s ideas are custom-made for someone like Palin, whose “Drill, Baby, Drill” mantra could be easily adapted to support yet another federally-funded project to benefit a state comprised of independent, freedom-loving people who proudly reject federal funds except when, like, they prefer not to.

Dumber and Dumbest

[ 0 ] August 12, 2009 |

It has to be some sort of landmark in American political discourse when both Lee Siegel and Camille Paglia weigh in on American health care policy. Total combined knowledge of relevant policy area displayed: approaching zero.

Still, tough as the competition is I’d have to say that the Paglia argument is decisively worse. Siegel is at least kind of crazy, making his bad arguments more original, and he does have an actual sensible point about the unwillingness of Dems to raise taxes embedded within the nonsense. Paglia, meanwhile, just re-heats especially stupid talking points (there will be “rationing!” Unlike the current system, where everyone has absolutely unlimited resources!), combined with apparently discovering for the first time that the United States doesn’t have a parliamentary system. I’m reluctant to say that a Paglia argument is embarrassing even by her standards, but…it is.

The Laws of Punditry

[ 0 ] August 5, 2009 |

There’s nothing a winger pundit can do to become discredited. Indeed, if your baldfaced lies help torpedo a major progressive initiative, they’re actually an asset. And, no, the damage can never really be undone.

The Wonders of Free Market Health Insurance

[ 0 ] August 3, 2009 |

Sarah Wildman on the glories of the individual insurance market:

Our six-month-old daughter cost over $22,000.

You’d think, with a number like that, we must have used fertility treatments—but she was conceived naturally. You’d think we went through an adoption agency—but she is a biological child. So surely, we were uninsured.

Nope. Birthing our daughter was so expensive precisely because we were insured, on the individual market. Our insurer, CareFirst BlueCross BlueShield, sold us exactly the type of flawed policy—riddled with holes and exceptions—that the health care reform bills in Congress should try to do away with.

[...]

Last fall, the National Women’s Law Center issued a report detailing exactly how women who want to bear children are derailed when searching for out-of-pocket health care. Only 14 states require maternity coverage to be included in insurance sold on the individual market, according to the Kaiser Family Foundation. In contrast, the Pregnancy Discrimination Act of 1978 requires employers with more than 15 employees to include maternity benefits in their health insurance packages. “We looked at 3,500 individual insurance policies and only 12 percent included comprehensive maternity coverage,” said Lisa Codispoti, Senior Advisor at the National Women’s Law Center. Another 20 percent offered a rider that was astronomically expensive or skimpy or both. One charged $1,100 a month; others required a two-year waiting period.

It’s definitely worth clicking through and reading in full. (Or, for those who prefer things in podcast form, she talks about it here.) This is one of the many things that an incremental reform package that keeps the private insurance system in place is going to have to regulate very, very carefully.

The Core

[ 0 ] July 29, 2009 |

Ezra objects to my post arguing that it might be better to reject a bill that sells out too much to the Blue Dogs:

But it’s also worth offering a more general reality check here: The public option is not now, and has not ever, been the core of the argument for heath-care reform. It is the core of the fight in Washington, D.C. It is an important policy experiment. But it was not in Howard Dean or John Kerry or Dick Gephardt’s plans, and reformers supported those. It was not in Bill Clinton’s proposal, and most lament the death of that. It is not what politicians were using in their speeches five years ago. It is a recent addition to the debate, and a good one. But it is not the reason were are having this debate.

Rather, what has kept health-care reform at the forefront of liberal politics for decades is moral outrage that 47 million of our friends and neighbors are uninsured.

I certainly agree with this, as far as it goes. Obviously, the core of the argument for health care reform is universal coverage. And, indeed, there are better ways of achieving this than a public option and employer mandates, although they’re not on the table. My concern is whether or not a compromise bill will, in fact, provide politically sustainable universal coverage, or anything close to it. If Ezra (and Kevin) are right that even compromise legislation will, in fact accomplish a lot, then I agree that it’s worth supporting, and I guess we won’t know until we have actual legislation on the table, and I’m willing to keep an open mind.

Ezra also outlines a criteria we should use to evaluate whether a bill is worth passing:

If reformers cannot pass a strong health-care reform bill now, there is no reason to believe they will be able to do it later. The question is whether the knowledge that the system will not let you solve this problem should prevent you from doing what you can to improve it. Put more sharply, the question should be whether this bill is better or worse than another 19.5 years of the deteriorating status quo.

I agree with this, to a point. Anybody who’s read the many nasty things I’ve had to say about late-period Ralph Nader knows I’m not a heighten-the-contradictions guy. If the proposed bill represents a substantial improvement and is constructed in a way that it will be politically sustainable, I agree that it merits support. However, there also has to be a point in which the two premises start to contradict each other. It’s true that there may not be many more opportunities to pass a good health care reform bill. It is likely, however, that there will be plenty of chances to pass incremental reform that is far too expensive because of the need to buy off vested stakeholders. (The 2003 Medicare expansion, after all, passed with the Democrats holding none of the elected branches, and pretty much fits this description to a T.) If the bill gets bad enough, it’s not clear how much is being risked by trying again, perhaps after mid-term elections likely to be favorable to Senate Dems.

…and, yes, progressives are going to have to use threats if there’s any chance that the bill will be worth supporting. If only conservatives (in both party caucuses) are threatening to torpedo the bill it’s going to be bad.

[X-Posted at TAPPED.]

A Health Care Bill Is Not Necessarily Health Care "Reform"

[ 0 ] July 28, 2009 |

I think it’s pretty obvious that a health care bill with no public option and no employer mandate is worse than no bill at all.

Not the Onion

[ 0 ] July 28, 2009 |

Math is hard!

Health Care Reform Prospects

[ 0 ] July 20, 2009 |

This is certainly right on the merits:

For Gingrich and his allies, the health care debate wasn’t really about health care: it was about destroying the power of a Democratic President.

It’s not surprising that the Republicans have remembered that lesson, but it’s disappointing that the “centrist” Democrats have forgotten it. This bill is make or break for the Democratic Party, and Harry Reid ought to enforce party discipline on the cloture vote. No on cloture should mean no subcommittee chair, no pork, and no money from the DSCC.


Alas, I’m also inclined to think that Benen is right on the politics:

It occurs to me, then, that there’s at least a possibility that “centrist” Democrats — Blue Dogs, New Democrats, Lieberman, et al — might not see failure as such a horrible option here. In other words, they may realize that coming up short on health care, letting this opportunity slip away, and hurting millions of Americans in the process may be devastating for the Democratic majority, but these same “centrist” Democrats may prefer a smaller majority, or perhaps even a GOP majority to “balance” the Democratic president. They may very well disagree with the party’s leadership on most issues, and think the best course of action is taking away their power by undermining the party’s agenda.

It seems odd that these “centrist” Democrats would forget the lessons of 1993 and 1994. But alternatively, are we sure they have forgotten those lessons, or have they learned those lessons all too well?

Alas, I think this is right. It’s not that Blue Dogs don’t know that defeating health care would be a major blow to the Democratic Party, it’s that they don’t care. And while I’d like to think that Reid would apply enough pressure to alter the incentives a little, well, I’d like to think that the Mets could remain competitive while fielding 6 or 7 replacement level players and 1 proven starter, but they’re about equally likely.

B-Day Addendum

[ 0 ] July 17, 2009 |

So, as some of you knew and others surmised, today was supposed to be the day in which the wife and I enjoyed a Blessed Event, and introduced spawn into our happy home. For a variety of reasons too complicated to go into, we and our doctors had agreed four months ago to schedule a C-section for this morning at 7am. Thus, when I started my “D-8″ series, I was aware of the possibility that the spawn might arrive early, but had psychologically excluded the possibility of a late arrival.

So…. it turns out this morning that, in the midst of preparation to engage in the aforementioned C-section (IV was in), our doctors noticed that the procedure ran afoul of a previously unknown hospital policy. Bureaucrats arrayed themselves for battle, and in the end it was determined that the birth would be delayed for an additional six days. Spawn remain healthy, but still trapped in the wife. Wife remains uncomfortable, grouchy, irritable, and litigation-prone. I have seen July 17, 2009 change from Momentous Life Changing Moment Day to Day that Something Remarkably Irritating Happens, which doesn’t really distinguish it from any other day.

DJW has the last word:

With an evil, government bureaucrat-run health care system like they have in Europe, you’d just be put on a waiting list and they probably wouldn’t be born until November.

The Idiocy of Beltway "Centrism"

[ 0 ] July 16, 2009 |

Yep:

In other words, [red-state Blue Dog Democrats are] concerned that the bill (a) costs too much overall and (b) will increase the deficit. And their proposed solutions to this are to (a) increase the cost of the bill by neutering the public plan and (b) decrease the quantity of revenue by fiddling with the employer mandate. Under the circumstances, it’s no wonder that Ross didn’t want to go into detail with CNN about how he’d propose changing the bill. Maybe Harry Potter knows a spell that could untie this mess of contradictions.

I think it’s time for another Michael Lind column about how urban liberals are preventing the Democrats from supporting economically progressive policies…

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