By FireDogLake's David Dayen FDL
FDL Action is calling progressive House members to see if they’ll still hold to their written vow not to vote for a health care bill without a public option. You can see the real-time results of the call reports here.
The strategy for Nancy Pelosi appears to be to allow as many progressives as possible to vote against the final bill, hoping to pick up some Blue Dogs and more conservative Democrats with the framework of the Senate bill. So how is that process unfolding?
So far, we don’t know much. TPM is tracking the 39 House Democrats who voted against the health care bill the first time around. Of those, Bobby Bright (D-AL) has already stated that he’s still a no. The final bill will be less progressive-friendly than the bill which originally passed the House, so the two members who claimed to have voted against the House bill because it didn’t go far enough, Dennis Kucinich (D-OH) and Eric Massa (D-NY), can be reasonably expected to vote no again. And Mike McIntyre (D-NC) actually spoke at the “prayercast” put on by right-wingers to stop the health care bill, so I think we can put him down as a no as well.
So that’s four definite no’s. What about everyone else?
The reason I think most Blue Dogs in conservative districts will stay with their no votes is that they face the same basic political pressures. Dan Boren (D-OK) is a good example. This article describes him “fighting to keep his seat” in Congress by voting against practically every item in the Democratic agenda. Flipping on the health care bill at this stage would be completely out of character. Here’s another example of a Democratic Blue Dog and his Republican challenger sniping over how much they hate the health care bill:
(Republican challenger Josh) First also took aim at what he called a lack of leadership on Holden’s part. Although Holden voted against the House health care reform bill, First said Holden did not do enough to influence others to defeat the bill, such as hold town hall meetings.
The “no” vote was ultimately inconsequential, First said, because the bill had enough support to pass and his vote was not needed.
“It was election-year conversion. It was symbolic. It was meant to hoodwink the constituents in his district,” First said. “Tim Holden is a phony.”
Holden took issue with the accusation of political calculation, and pointed to an interview with Times-Shamrock Newspapers two days before the health care vote in which he announced his intention to vote against the legislation.
“If it was so inconsequential, why was the AFL-CIO just picketing me on Monday of this week for my vote against it?” Holden said, referring to a demonstration at his Pottsville office calling for him to rethink his health care vote.
Can anyone see Holden changing his vote at this stage?
This is not to say that no Blue Dogs will flip. Jason Altmire (D-PA) is openly talking about looking at that possibility, and Jim Matheson (D-UT) is talking up the Senate’s excise tax.
Still, while lots of House Blue Dogs say they’re keeping an open mind on the final vote, nothing has changed on the political landscape where the same people continually worried about challenges from their right and habitually unwilling to take stands on Democratic priorities and principles would suddenly change their worldviews. I would be surprised if more than a handful changed their vote. Which means that Speaker Pelosi will have a difficult job getting to 218, no matter what comes out of the conference committee.
UPDATE: John Boccieri (D-OH) looks like a no as well, given his comments at a meeting with constituents in his district.
Thursday, December 31, 2009
Health Care: The 10 Most Constructive Insights, Suggestions and Questions of 2009
By Naomi Freundlich and Maggie Mahar TCF
This year the rhetoric around health care reform reached historic levels. Barely a week went by without pundits dissecting some new fact, policy detail or wording change implicit in the various reform plans emerging from Congress. The result was a barrage of media reports, often conflicting, that heralded the demise or success of reform on a regular basis. Twisted facts, reactionary politics and just plain scare tactics have been pervasive.
Below, “The 10 Most Destructive Lies about Health Care Reform in 2009” and “ The Ten Most Constructive Insights, Suggestions and Questions.”
Heath Care Reform: The 10 Most Destructive Lies of 2009
1.)Seniors and the disabled "will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."
Sarah Palin made these comments on her Facebook page, responding to a provision in the House health care bill that would provide compensation to doctors who consult with patients about end-of-life care. The lie quickly spread—repeated at town hall meetings, tea parties, on Fox TV and throughout the Conservative blogosphere.
2) “You lie!” Joe Wilson’s angry shout-out to President Obama in the middle of his speech before the joint session of Congress made headlines this fall. Wilson was responding to Obama’s promise that health reform will not include coverage for illegal immigrants.
3) “Despite public statements by Pres. Barack Obama that ‘no federal dollars will be used to fund abortion,’ all of the major bills under consideration would put the federal government into the business of subsidizing elective abortion on a massive scale.” Minnesota Citizens Concerned for Life
“The Kennedy bill would result in the greatest expansion of abortion since Roe v. Wade.” according to National Right to Life Legislative Director Douglas Johnson
This charge, made by Conservative groups like the Family Research Council (which ran an ad with a distraught older man telling his wife that Medicare won’t pay for his back surgery because the government is spending too much on abortions) helped fuel opposition to reform.
4) “I have a message for you--You’re gonna die sooner!”
Dec. 1 2009 Senator Tom Coburn (R-OK) on the floor of the Senate warning senior citizens. Coburn was speaking about proposed Medicare cuts that could total billions of dollars. In fact, savings would come from removing the waste and over-treatment that plague the program.
5) “Health care reform will mean women won’t be able to get mammograms…”
Carly Fiorina, candidate for U.S. Senate from California made this statement during a weekly Republican address. She exploits her experience as a breast cancer survivor to make her case against health reform:
“Will a bureaucrat determine that my life isn’t worth saving?,” she asked before suggesting that the Senate health care bill would allow the Task Force to ration cancer treatments.
6) The Department of Veterans Affairs has "a manual out there telling our veterans stuff like, 'Are you really of value to your community?' You know, encouraging them to commit suicide." (Michael Steele)
7) "Take your AARP card, cut it in half and send it back. They've betrayed you," McCain told seniors after the group endorsed Medicare cuts. The Senator proposed an amendment that would “strip” the cuts from legislation—even though he had no intention of voting for the bill anyway.
8) "President Obama . . . wants to mandate circumcision." (Rush Limbaugh)
9) “Obamacare Could Kill You”. , writing in The Spectator, warns that, a Federal Health Board will be used to make life and death decisions based on cost-effectiveness -- deciding, for example when a drug’s expense has become too high to justify giving it to dying cancer patients.
10) A data-storing microchip "would be implanted in the majority of people who opt to become covered by the public health care option." (chain e-mail that found its way into the blogosphere)
Health Care: The 10 Most Constructive Insights, Suggestions and Questions of 2009
1) Maybe Washington Post columnists should have term-limits? Jamison Foser, County Fair, November 22, 2009, Jamison Foser.
2 ) The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”
3) “Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation.” Christopher, Hayes, writing in the Nation,” commenting on Rick Scott, the founder of Conservatives for Patients Rights who is best known as the former CEO of Columbia/HCA, the for-profit hospital chain that was forced to pay $1.7 billion to settle the largest health care fraud lawsuit in history.
4) “Most Americans would be delighted to have the quality of care found in places like Rochester, Minnesota, or Seattle, Washington, or Durham, North Carolina—all of which have world-class hospitals and costs that fall below the national average. If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next fifty years) would be solved. The difficulty is how to go about it.” Dr. Atul Gawnde
5) “If No Republicans Will Join, Why Should the Democrats Negotiate with . . . . Nobody?” asked Chris Matthews after grilling Republican Orrin Hatch on what it would take to get him to vote for health care reform.
“Would you sign on to any health reform bill this year?” Matthews queried. “Assume they dropped the public option and put in tort reform would you sign on? . . . or is this just a stupid negotiation? Are the Democrats just negotiating with themselves?”
6) “Name any stakeholder – hospital, physician, nurse, insurer, pharmaceutical manufacturer, supplier, even patients’ groups – every single one of them says, 'Oh, we need change! We need change!'But, when it comes to specifics, every single one of them demands to be kept whole or made better off.
“We are stuck in ‘the Tragedy of the Commons. The smart strategy for each person separately is not the best strategy for all people together. What is good for ‘me’ is not good for ‘us.’ Just like the villagers, health care stakeholders are eroding a common good by doing what makes sense for each of them, separately. In the short run, everyone wins. In the long term, everyone loses.” Dr. Donald Berwick, delivering the keynote address at Institute for Health Care I mprovement’s (IHI) 21st Annual National Forum on Quality and Improvement in Health Care,
7) Here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community has come to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.” Dr. Atul Gawande, commenting on over-treatment in McAllen, Texas in “The Cost Conundrum.”
8) Over the past year, “the profit margin for health insurance companies was a modest 3.4 percent. Among the large, for-profit health insurers, profit margins line up with the industry as a whole: UnitedHealthGroup, the biggest health insurer, had a 4.1 percent profit margin over the past 12 months. WellPoint, the next biggest, had a 4 percent profit margin. Aetna, Cigna, and Humana came in below that.”
By contrast, “Pharmaceutical companies have a profit margin of 16.4 percent,” seventh highest of the 215 industries that Morningstar tracks. . . The big money isn’t in the insurance industry.”(Rick Newman, writing in U.S. News & World Report)
9) “An Independent Medicare advisory commission of doctors and medical experts charged with identifying waste can help encourage the adoption of common-sense best practices by doctors and medical professionals throughout the system — everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.” President Obama, in a speech to Congress just after Labor Day
10) “Health Bill Alone Won't Stem Costs: White House” Reuters, reporting on White House Budget Director Peter Orszag’s comments on health care legislation. Orszag “indicated that other actions outside of Congress would still be needed to improve how medical care is delivered, including the Senate's proposed independent commission to oversee parts of Medicare.”
This year the rhetoric around health care reform reached historic levels. Barely a week went by without pundits dissecting some new fact, policy detail or wording change implicit in the various reform plans emerging from Congress. The result was a barrage of media reports, often conflicting, that heralded the demise or success of reform on a regular basis. Twisted facts, reactionary politics and just plain scare tactics have been pervasive.
Below, “The 10 Most Destructive Lies about Health Care Reform in 2009” and “ The Ten Most Constructive Insights, Suggestions and Questions.”
Heath Care Reform: The 10 Most Destructive Lies of 2009
1.)Seniors and the disabled "will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."
Sarah Palin made these comments on her Facebook page, responding to a provision in the House health care bill that would provide compensation to doctors who consult with patients about end-of-life care. The lie quickly spread—repeated at town hall meetings, tea parties, on Fox TV and throughout the Conservative blogosphere.
2) “You lie!” Joe Wilson’s angry shout-out to President Obama in the middle of his speech before the joint session of Congress made headlines this fall. Wilson was responding to Obama’s promise that health reform will not include coverage for illegal immigrants.
3) “Despite public statements by Pres. Barack Obama that ‘no federal dollars will be used to fund abortion,’ all of the major bills under consideration would put the federal government into the business of subsidizing elective abortion on a massive scale.” Minnesota Citizens Concerned for Life
“The Kennedy bill would result in the greatest expansion of abortion since Roe v. Wade.” according to National Right to Life Legislative Director Douglas Johnson
This charge, made by Conservative groups like the Family Research Council (which ran an ad with a distraught older man telling his wife that Medicare won’t pay for his back surgery because the government is spending too much on abortions) helped fuel opposition to reform.
4) “I have a message for you--You’re gonna die sooner!”
Dec. 1 2009 Senator Tom Coburn (R-OK) on the floor of the Senate warning senior citizens. Coburn was speaking about proposed Medicare cuts that could total billions of dollars. In fact, savings would come from removing the waste and over-treatment that plague the program.
5) “Health care reform will mean women won’t be able to get mammograms…”
Carly Fiorina, candidate for U.S. Senate from California made this statement during a weekly Republican address. She exploits her experience as a breast cancer survivor to make her case against health reform:
“Will a bureaucrat determine that my life isn’t worth saving?,” she asked before suggesting that the Senate health care bill would allow the Task Force to ration cancer treatments.
6) The Department of Veterans Affairs has "a manual out there telling our veterans stuff like, 'Are you really of value to your community?' You know, encouraging them to commit suicide." (Michael Steele)
7) "Take your AARP card, cut it in half and send it back. They've betrayed you," McCain told seniors after the group endorsed Medicare cuts. The Senator proposed an amendment that would “strip” the cuts from legislation—even though he had no intention of voting for the bill anyway.
8) "President Obama . . . wants to mandate circumcision." (Rush Limbaugh)
9) “Obamacare Could Kill You”. , writing in The Spectator, warns that, a Federal Health Board will be used to make life and death decisions based on cost-effectiveness -- deciding, for example when a drug’s expense has become too high to justify giving it to dying cancer patients.
10) A data-storing microchip "would be implanted in the majority of people who opt to become covered by the public health care option." (chain e-mail that found its way into the blogosphere)
Health Care: The 10 Most Constructive Insights, Suggestions and Questions of 2009
1) Maybe Washington Post columnists should have term-limits? Jamison Foser, County Fair, November 22, 2009, Jamison Foser.
2 ) The greatest threat to America’s fiscal health is not Social Security,” President Barack Obama said in a March speech at the White House. “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”
3) “Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation.” Christopher, Hayes, writing in the Nation,” commenting on Rick Scott, the founder of Conservatives for Patients Rights who is best known as the former CEO of Columbia/HCA, the for-profit hospital chain that was forced to pay $1.7 billion to settle the largest health care fraud lawsuit in history.
4) “Most Americans would be delighted to have the quality of care found in places like Rochester, Minnesota, or Seattle, Washington, or Durham, North Carolina—all of which have world-class hospitals and costs that fall below the national average. If we brought the cost curve in the expensive places down to their level, Medicare’s problems (indeed, almost all the federal government’s budget problems for the next fifty years) would be solved. The difficulty is how to go about it.” Dr. Atul Gawnde
5) “If No Republicans Will Join, Why Should the Democrats Negotiate with . . . . Nobody?” asked Chris Matthews after grilling Republican Orrin Hatch on what it would take to get him to vote for health care reform.
“Would you sign on to any health reform bill this year?” Matthews queried. “Assume they dropped the public option and put in tort reform would you sign on? . . . or is this just a stupid negotiation? Are the Democrats just negotiating with themselves?”
6) “Name any stakeholder – hospital, physician, nurse, insurer, pharmaceutical manufacturer, supplier, even patients’ groups – every single one of them says, 'Oh, we need change! We need change!'But, when it comes to specifics, every single one of them demands to be kept whole or made better off.
“We are stuck in ‘the Tragedy of the Commons. The smart strategy for each person separately is not the best strategy for all people together. What is good for ‘me’ is not good for ‘us.’ Just like the villagers, health care stakeholders are eroding a common good by doing what makes sense for each of them, separately. In the short run, everyone wins. In the long term, everyone loses.” Dr. Donald Berwick, delivering the keynote address at Institute for Health Care I mprovement’s (IHI) 21st Annual National Forum on Quality and Improvement in Health Care,
7) Here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community has come to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.” Dr. Atul Gawande, commenting on over-treatment in McAllen, Texas in “The Cost Conundrum.”
8) Over the past year, “the profit margin for health insurance companies was a modest 3.4 percent. Among the large, for-profit health insurers, profit margins line up with the industry as a whole: UnitedHealthGroup, the biggest health insurer, had a 4.1 percent profit margin over the past 12 months. WellPoint, the next biggest, had a 4 percent profit margin. Aetna, Cigna, and Humana came in below that.”
By contrast, “Pharmaceutical companies have a profit margin of 16.4 percent,” seventh highest of the 215 industries that Morningstar tracks. . . The big money isn’t in the insurance industry.”(Rick Newman, writing in U.S. News & World Report)
9) “An Independent Medicare advisory commission of doctors and medical experts charged with identifying waste can help encourage the adoption of common-sense best practices by doctors and medical professionals throughout the system — everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.” President Obama, in a speech to Congress just after Labor Day
10) “Health Bill Alone Won't Stem Costs: White House” Reuters, reporting on White House Budget Director Peter Orszag’s comments on health care legislation. Orszag “indicated that other actions outside of Congress would still be needed to improve how medical care is delivered, including the Senate's proposed independent commission to oversee parts of Medicare.”
Wednesday, December 30, 2009
Activists Calling Progressive Reps. Against the Individual Mandate
By FireDogLake's Brian Sonenstein FDL
At the moment, we have a House bill with a public option and individual mandate, and a Senate bill without a public option but with an individual mandate to purchase health insurance. As we move toward the conference process in which both bills are merged, the Senate has made clear its expectation that the House will not make any deviations from the Senate bill, and pass it largely as-is.
Such an expectation should make certain Members of Congress – 65 of them to be exact – a little bit uncomfortable. That’s because this summer, FDL captured evidence of 65 progressive Representatives pledging to vote against any bill that does not contain a public option.
With all of this in mind, one thing must be made certain: if there’s no public plan to compete with private insurers and provide coverage for those who can’t afford to pay private premiums, there cannot be a mandate for all to purchase insurance.
That’s why we launched a campaign this week to check in with those same 65 progressive members and find out where they stand on the conference process. Almost 100 FDL activists have already called progressive Members of Congress to ask them a simple, but crucial question: “Will the Representative oppose a bill with an individual mandate if it does not include a public option?”
We’ve set up a great tool that displays the call reports made by our activists in near-real time. Check it out here when you make your calls. Here’s a sampling of what folks are saying:
Susan tells us that Rep. Raul Grijalva (AZ-7) would “‘have a very hard time voting for something if it didn’t contain a public option’ unless ’some miracle’ was inserted that he does not yet know about.”
Sandra D contacted Rep. Sheila Jackson Lee’s (TX-18) office and reported,
Rep Sheila Jackson Lee had meet with several like minded Reps today and they are looking to host an event in the Houston area so the public can weigh in fully… Rep Jackson Lee fully supports the public option and healthcare for all.
Kevin contacted Rep. Nydia M. Velazquez (NY-12) and reported,
…Rep. Velazquez has NOT changed her position regarding her support for the Public Option. I expressed a a view that the Senate/”Mandate” bill should be killed if there is to be No PUBLIC OPTION.
We heard from two different callers, Thomas and David, that Rep. Jim McGovern (MA-3) wanted to pass health care reform, but also wanted the public option, or something that moves us closer to a public option.
These calls are key to determining the political landscape on the Hill. Thanks to your calls, we can not only make our voices heard, but we can find out where our Members stand. From our activist calls, we now know that Rep. Jackson Lee is meeting with other Houston members; we also know that Rep. McGovern is a likely candidate to bail on us.
Reports are still coming in, and we can always use more callers. They help keep us ahead of the action and are crucial to fighting for real health care reform. Click here and start calling progressive members of Congress to find out where they stand on health care reform.
At the moment, we have a House bill with a public option and individual mandate, and a Senate bill without a public option but with an individual mandate to purchase health insurance. As we move toward the conference process in which both bills are merged, the Senate has made clear its expectation that the House will not make any deviations from the Senate bill, and pass it largely as-is.
Such an expectation should make certain Members of Congress – 65 of them to be exact – a little bit uncomfortable. That’s because this summer, FDL captured evidence of 65 progressive Representatives pledging to vote against any bill that does not contain a public option.
With all of this in mind, one thing must be made certain: if there’s no public plan to compete with private insurers and provide coverage for those who can’t afford to pay private premiums, there cannot be a mandate for all to purchase insurance.
That’s why we launched a campaign this week to check in with those same 65 progressive members and find out where they stand on the conference process. Almost 100 FDL activists have already called progressive Members of Congress to ask them a simple, but crucial question: “Will the Representative oppose a bill with an individual mandate if it does not include a public option?”
We’ve set up a great tool that displays the call reports made by our activists in near-real time. Check it out here when you make your calls. Here’s a sampling of what folks are saying:
Susan tells us that Rep. Raul Grijalva (AZ-7) would “‘have a very hard time voting for something if it didn’t contain a public option’ unless ’some miracle’ was inserted that he does not yet know about.”
Sandra D contacted Rep. Sheila Jackson Lee’s (TX-18) office and reported,
Rep Sheila Jackson Lee had meet with several like minded Reps today and they are looking to host an event in the Houston area so the public can weigh in fully… Rep Jackson Lee fully supports the public option and healthcare for all.
Kevin contacted Rep. Nydia M. Velazquez (NY-12) and reported,
…Rep. Velazquez has NOT changed her position regarding her support for the Public Option. I expressed a a view that the Senate/”Mandate” bill should be killed if there is to be No PUBLIC OPTION.
We heard from two different callers, Thomas and David, that Rep. Jim McGovern (MA-3) wanted to pass health care reform, but also wanted the public option, or something that moves us closer to a public option.
These calls are key to determining the political landscape on the Hill. Thanks to your calls, we can not only make our voices heard, but we can find out where our Members stand. From our activist calls, we now know that Rep. Jackson Lee is meeting with other Houston members; we also know that Rep. McGovern is a likely candidate to bail on us.
Reports are still coming in, and we can always use more callers. They help keep us ahead of the action and are crucial to fighting for real health care reform. Click here and start calling progressive members of Congress to find out where they stand on health care reform.
Dear Sen. Harkin, These Are Terrible Materials For Building A Starter Home
By FireDogLake's Jon Walker FDL
Sen. Tom Harkin continues to refer to the Senate health reform bill as a “starter home” in a new entry on the Huffington Post.
Instead of that “partial loaf” analogy, I like to think of this bill as like a starter home. It is not the mansion of our dreams. But it has a solid foundation, giving every American access to quality, affordable coverage. It has an excellent, protective roof, which will shelter Americans from the worst abuses of health insurance companies. And this starter home has plenty of room for additions and improvements.
This bill has a terrible foundation. It is a starter home built with the equivalent of toxic drywall, lead paint, a poorly mixed cement foundation, and faulty electric wiring.
The bill is built on the extremely wasteful and inefficient private insurance system and contains one of the biggest rollbacks in decades of women’s reproductive rights. It, in effect, gives a permanent exclusivity to expensive biologics, and still denies Americans the ability to buy cheaper drugs from overseas. It has insufficient regulations and leaves the regulator enforcement purely up to the states, which have a poor track record enforcing the current regulations on their books. Regulation without enforcement is worthless. It throws good money after bad without fixing the underlying problems. The cost of the insurance will be too high and the quality of the insurance is too low. Funneling billions of dollars and forcing millions of Americans to buy a product that is frankly a terrible bargain is not a good foundation to build on. It is only a good foundation for the private insurance companies because it further enriches and entrenches them. Rewarding the failure of the private health insurance system with even more money and more customers is not how you want to build your “starter home.”
Harkin is definitely correct when he says, “a starter home has plenty of room for additions and improvements.” There are many, many, many problems with this bill that need to be corrected. Unfortunately, no one is going to want to put additions on a terribly built home, and no one is going to want to rehire the same contractor that so completely botched the construction of the home to build the addition. I would love it if this were a smaller home, but built with a sturdy foundation.
In reality, what we have is a massive corporate giveaway that will serve to discredit the “progressive” principles that Harkin falsely claims this thing is built on. Teddy Roosevelt was the progressive trust buster. It makes a mockery of the term “progressive” to claim a plan to force Americans to buy expensive, low-quality goods from insurance companies exempt form anti-trust laws (laws that Roosevelt championed) and subsidized with taxpayer money is in anyway “progressive."
Sen. Tom Harkin continues to refer to the Senate health reform bill as a “starter home” in a new entry on the Huffington Post.
Instead of that “partial loaf” analogy, I like to think of this bill as like a starter home. It is not the mansion of our dreams. But it has a solid foundation, giving every American access to quality, affordable coverage. It has an excellent, protective roof, which will shelter Americans from the worst abuses of health insurance companies. And this starter home has plenty of room for additions and improvements.
This bill has a terrible foundation. It is a starter home built with the equivalent of toxic drywall, lead paint, a poorly mixed cement foundation, and faulty electric wiring.
The bill is built on the extremely wasteful and inefficient private insurance system and contains one of the biggest rollbacks in decades of women’s reproductive rights. It, in effect, gives a permanent exclusivity to expensive biologics, and still denies Americans the ability to buy cheaper drugs from overseas. It has insufficient regulations and leaves the regulator enforcement purely up to the states, which have a poor track record enforcing the current regulations on their books. Regulation without enforcement is worthless. It throws good money after bad without fixing the underlying problems. The cost of the insurance will be too high and the quality of the insurance is too low. Funneling billions of dollars and forcing millions of Americans to buy a product that is frankly a terrible bargain is not a good foundation to build on. It is only a good foundation for the private insurance companies because it further enriches and entrenches them. Rewarding the failure of the private health insurance system with even more money and more customers is not how you want to build your “starter home.”
Harkin is definitely correct when he says, “a starter home has plenty of room for additions and improvements.” There are many, many, many problems with this bill that need to be corrected. Unfortunately, no one is going to want to put additions on a terribly built home, and no one is going to want to rehire the same contractor that so completely botched the construction of the home to build the addition. I would love it if this were a smaller home, but built with a sturdy foundation.
In reality, what we have is a massive corporate giveaway that will serve to discredit the “progressive” principles that Harkin falsely claims this thing is built on. Teddy Roosevelt was the progressive trust buster. It makes a mockery of the term “progressive” to claim a plan to force Americans to buy expensive, low-quality goods from insurance companies exempt form anti-trust laws (laws that Roosevelt championed) and subsidized with taxpayer money is in anyway “progressive."
Right & Left Agree: Mandates are the Road to Neofeudalism
By FireDogLake's Jane Hamsher FDL
There is tremendous fear rising on both the right and the left that the announced intention of Congress — to force every American to pay tribute to private corporations, with no government alternative — sets a dangerous and frightening precedent with implications far outside the scope of health care.
If the health care bill written by the Senate is passed, middle class Americans will be mandated to pay almost as much to private insurance companies as they do to the federal government in taxes, with the IRS acting as a collection agency for penalties of 2% of your annual income for refusing to comply.
This is just one of many recent measures that has brought liberal progressives and conservative libertarians together to join forces in opposition:
•Democrat Alan Grayson worked successfully this year with Republican Ron Paul to pass legislation to audit the Federal Reserve, with 317 cosponsors as diverse as Dennis Kucinich and Michelle Bachmann.
•On December 3, the liberal Campaign for America’s Future wrote a letter to the Senate opposing the reconfirmation of Federal Reserve chief Ben Bernanke until such an audit has been conducted. The letter was signed by James Galbraith, Robert Weisman, Chris Bowers and myself on the left, and Grover Norquist, Phillis Schlafly, and Larry Greenley on the right. Financial blogger Tyler Durden and young organizer Tiffiniy Cheng joined them.
•Also on December 3, conservative Jim Bunning joined liberal Bernie Sanders in placing a hold on the Bernanke nomination until the Fed had been audited.
•On December 15, CAF again sent a letter to the Senate Banking Committee, asking them to delay the vote on the Bernanke confirmation until Audit the Fed received a stand alone vote in the Senate. It was signed by Matt KIbbe of Freedomworks, John Tate of the Campaign for Liberty, and Grover Norquist on the right, and David Swanson of AfterDowiningStreet, Dean Baker and Robert Borosage on the left.
•On December 21, a letter was written opposing the mandate in the health care bill. It was signed by Bob Fertik of Democrats.com, Howie Klein of DownWithTyranny, Brad Friedman of Velvet Revolution, Tim Carpenter of Progressive Democrats of America on the left and Grover Norquist, Jim Martin of 60 Plus Association, Duane Parde of the National Taxpayers Union on the right.
•On December 23, Grover Norquist and I sent a letter to Attorney General Eric Holder calling for an investigation into Fannie Mae and Freddie Mac and White House Chief of Staff Rahm Emanuel’s conflicts of interest before the White House could lift the cap on the commitment to them from $400 billion to $800 billion with no Inspector General in place.
The individuals on both sides of the political spectrum who signed these letters agree on very little, but they do share both a tremendous concern for the corporatist control of government that politicians in both parties seem hell-bent on achieving.
In 2003, the Democrats railed in opposition when the Republicans passed Medicare Part D prescription drug coverage that didn’t allow for negotiated drug prices. And in 2006 when Democrats took over Congress, one of the hallmarks of their first hundred days was passing legislation allowing Medicare to do so, supported by both Rahm Emanuel and Barack Obama. Of course, it had no chance of passing with George Bush in the White House.
Candidate Barack Obama said the ability to negotiate for drug prices would save $30 billion a year in medical costs. Yet when President Obama got to the White House, one of the first things he did was negotiate a secret deal with PhRMA that prevented drug price negotiations in exchange for $150 million in political advertising to help vulnerable Democrats in the House and in support of the health care bill.
In the Senate, Tom Carper said that because PhRMA had paid for the deal with political advertising, they were obligated to abide by it.
Jeff Sessions railed against the corrupt PhRMA deal that didn’t allow for prescription drug price negotiation. He didn’t mention that he voted for the 2000 bill without it, and when he had the chance to vote for it in the Senate in 2006, he voted “no” himself. Both parties are equally blameworthy — the only difference is who is in power and taking PhRMA’s money.
The PhRMA deal is one of many negotiated by the White House this last summer which formed the underpinnings of the health care bill. From then on, it just became a matter of which member was going to extract what deals for their votes, and who was going to take the blame for cutting popular elements from the legislation that the corporate “stakeholders” didn’t want.
As FDL’s Jon Walker wrote recently, if the ability to cut health care costs hadn’t been auctioned off to private corporations in exchange for political patronage, there would have been no government subsidy necessary to make insurance coverage affordable.
We are ceding control of the government to private corporations, not figuratively but literally. When the Senate Finance Committee bill was released earlier this year, the “author” was a former VP of Wellpoint. Liberals, conservatives and independents alike are all justifiably alarmed at what this represents.
It is tragic that health care for the poor is being held hostage to the corporatist agenda, a fig leaf to buy public support and disguise this bill for what it is. As blogger Marcy Wheeler noted in a piece called Health Care and the Road to Neo-Feudalism:
I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.
Just as those on the libertarian right were demonized by the Republican establishment for opposing the Iraq war during the Bush years, so progressives on the left are being pilloried for “damaging the cause” by joining with Republicans to oppose these extreme measures. It’s ironic that the most virulent supporters of a President who ran on “bipartisanship” should reject it so vehemently when it becomes critical of the policies pursued by his White House.
This “right-left wraparound” is happening because politicians in both parties have become so unresponsive to popular sentiment: public support for stifling investigation of the bank bailouts just to protect the President are infinitesimally small, and fortunately Dennis Kucinich announced today that he would commence an investigation into the Fannie/Freddie bailout. But it’s a testament to the extreme nature of what is happening to our government that such traditional political foes could find common cause in opposing it.
It’s foolish to say that only those who agree with you on every issue are allowed to share your opinion when it comes to opposing something like the mandated bailout of Aetna — it isn’t necessary to achieve health care reform. As Jon Walker notes, removing the mandate would reduce the CBO score and its inclusion in the health care bill with no government alternative is unacceptable for moral, political and policy reasons.
Candidate Obama himself opposed the mandate. Keith Olberman and Howard Dean concur.
As Markos Moulitsas of Daily Kos said, “remove the mandate or kill this bill.” We’ve opened a “war room” at Firedoglake with information about calling your member of Congress to demand that this provision to bail out the insurance industry be removed from the health care bill before they agree to cast their vote in favor of it.
And nobody needs to pass an ideological purity test before they can use it.
There is tremendous fear rising on both the right and the left that the announced intention of Congress — to force every American to pay tribute to private corporations, with no government alternative — sets a dangerous and frightening precedent with implications far outside the scope of health care.
If the health care bill written by the Senate is passed, middle class Americans will be mandated to pay almost as much to private insurance companies as they do to the federal government in taxes, with the IRS acting as a collection agency for penalties of 2% of your annual income for refusing to comply.
This is just one of many recent measures that has brought liberal progressives and conservative libertarians together to join forces in opposition:
•Democrat Alan Grayson worked successfully this year with Republican Ron Paul to pass legislation to audit the Federal Reserve, with 317 cosponsors as diverse as Dennis Kucinich and Michelle Bachmann.
•On December 3, the liberal Campaign for America’s Future wrote a letter to the Senate opposing the reconfirmation of Federal Reserve chief Ben Bernanke until such an audit has been conducted. The letter was signed by James Galbraith, Robert Weisman, Chris Bowers and myself on the left, and Grover Norquist, Phillis Schlafly, and Larry Greenley on the right. Financial blogger Tyler Durden and young organizer Tiffiniy Cheng joined them.
•Also on December 3, conservative Jim Bunning joined liberal Bernie Sanders in placing a hold on the Bernanke nomination until the Fed had been audited.
•On December 15, CAF again sent a letter to the Senate Banking Committee, asking them to delay the vote on the Bernanke confirmation until Audit the Fed received a stand alone vote in the Senate. It was signed by Matt KIbbe of Freedomworks, John Tate of the Campaign for Liberty, and Grover Norquist on the right, and David Swanson of AfterDowiningStreet, Dean Baker and Robert Borosage on the left.
•On December 21, a letter was written opposing the mandate in the health care bill. It was signed by Bob Fertik of Democrats.com, Howie Klein of DownWithTyranny, Brad Friedman of Velvet Revolution, Tim Carpenter of Progressive Democrats of America on the left and Grover Norquist, Jim Martin of 60 Plus Association, Duane Parde of the National Taxpayers Union on the right.
•On December 23, Grover Norquist and I sent a letter to Attorney General Eric Holder calling for an investigation into Fannie Mae and Freddie Mac and White House Chief of Staff Rahm Emanuel’s conflicts of interest before the White House could lift the cap on the commitment to them from $400 billion to $800 billion with no Inspector General in place.
The individuals on both sides of the political spectrum who signed these letters agree on very little, but they do share both a tremendous concern for the corporatist control of government that politicians in both parties seem hell-bent on achieving.
In 2003, the Democrats railed in opposition when the Republicans passed Medicare Part D prescription drug coverage that didn’t allow for negotiated drug prices. And in 2006 when Democrats took over Congress, one of the hallmarks of their first hundred days was passing legislation allowing Medicare to do so, supported by both Rahm Emanuel and Barack Obama. Of course, it had no chance of passing with George Bush in the White House.
Candidate Barack Obama said the ability to negotiate for drug prices would save $30 billion a year in medical costs. Yet when President Obama got to the White House, one of the first things he did was negotiate a secret deal with PhRMA that prevented drug price negotiations in exchange for $150 million in political advertising to help vulnerable Democrats in the House and in support of the health care bill.
In the Senate, Tom Carper said that because PhRMA had paid for the deal with political advertising, they were obligated to abide by it.
Jeff Sessions railed against the corrupt PhRMA deal that didn’t allow for prescription drug price negotiation. He didn’t mention that he voted for the 2000 bill without it, and when he had the chance to vote for it in the Senate in 2006, he voted “no” himself. Both parties are equally blameworthy — the only difference is who is in power and taking PhRMA’s money.
The PhRMA deal is one of many negotiated by the White House this last summer which formed the underpinnings of the health care bill. From then on, it just became a matter of which member was going to extract what deals for their votes, and who was going to take the blame for cutting popular elements from the legislation that the corporate “stakeholders” didn’t want.
As FDL’s Jon Walker wrote recently, if the ability to cut health care costs hadn’t been auctioned off to private corporations in exchange for political patronage, there would have been no government subsidy necessary to make insurance coverage affordable.
We are ceding control of the government to private corporations, not figuratively but literally. When the Senate Finance Committee bill was released earlier this year, the “author” was a former VP of Wellpoint. Liberals, conservatives and independents alike are all justifiably alarmed at what this represents.
It is tragic that health care for the poor is being held hostage to the corporatist agenda, a fig leaf to buy public support and disguise this bill for what it is. As blogger Marcy Wheeler noted in a piece called Health Care and the Road to Neo-Feudalism:
I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.
Just as those on the libertarian right were demonized by the Republican establishment for opposing the Iraq war during the Bush years, so progressives on the left are being pilloried for “damaging the cause” by joining with Republicans to oppose these extreme measures. It’s ironic that the most virulent supporters of a President who ran on “bipartisanship” should reject it so vehemently when it becomes critical of the policies pursued by his White House.
This “right-left wraparound” is happening because politicians in both parties have become so unresponsive to popular sentiment: public support for stifling investigation of the bank bailouts just to protect the President are infinitesimally small, and fortunately Dennis Kucinich announced today that he would commence an investigation into the Fannie/Freddie bailout. But it’s a testament to the extreme nature of what is happening to our government that such traditional political foes could find common cause in opposing it.
It’s foolish to say that only those who agree with you on every issue are allowed to share your opinion when it comes to opposing something like the mandated bailout of Aetna — it isn’t necessary to achieve health care reform. As Jon Walker notes, removing the mandate would reduce the CBO score and its inclusion in the health care bill with no government alternative is unacceptable for moral, political and policy reasons.
Candidate Obama himself opposed the mandate. Keith Olberman and Howard Dean concur.
As Markos Moulitsas of Daily Kos said, “remove the mandate or kill this bill.” We’ve opened a “war room” at Firedoglake with information about calling your member of Congress to demand that this provision to bail out the insurance industry be removed from the health care bill before they agree to cast their vote in favor of it.
And nobody needs to pass an ideological purity test before they can use it.
The Public Option Is Not Symbolic; It Is Foundational
By FireDogLake's Jon Walker FDL
There is a myth that the public option was only a tiny idea blown out of proportion for symbolic reasons. The public option was never going to be truly tiny, it was only going to be small at its inception. It is not because it was “weak,” it was just strongly caged in. But even the largest redwood tree starts out as a very small seed.
It is true that the CBO predicted that the negotiated rate public option in the House bill would only cover 6 million people, but that is because it was purposely restricted to a new exchange that would only be used by 30 million people at first. The CBO’s guess was that the public option would be selected by 20% of the people in this new marketplace. While I think their 20% estimate is low, it is important to put that in context–any company that can grab 20% of its market is a major player.
The public option was projected to be “small” because it would be forced to be a big fish in a very small pond. It would have major potential for growth. Progressives would have at their disposal multiple ways to increase the number of people who could have access to the public option. Dramatically expanding employer access to the exchange (something the Secretary of HHS could do without Congressional approval) is one idea. Expanding on Sen. Ron Wyden’s goal of giving people with employer-provided coverage the option of using vouchers to select their own plan on the new exchange is another route. The best solution might have been to attach a simple 12-word provision to the defense appropriations bill to allow the public option to sell outside the exchange. Any of these are very doable changes that could have completely changed the dynamics in only a few years.
If the public option was able to to sell to the entire private insurance market and just not the exchange gaining 20% of the market would have given it over 50 million customers. This would make the public option larger than Medicare, and one of the three largest insurance companies in America. Assuming the public option’s larger market share allowed it to negotiate much better rates (or even better, Congress decided to combine its operations with Medicare), it would probably be able to attract even more than 50 million customers.
The argument over the public option has never been symbolic or about what coverage a small group of Americans would or would not get. This health care fight is not about creating one new, static system that would remain in place forever. To argue otherwise is intellectual dishonesty put forward by many, including the Obama administration. The debate has been about the foundation on which we will build the future of our health care system, and whether the solution to our broken system is public or private insurance. Everyone from progressive activists to health insurance company CEO’s understood that this reform could grow, and only minor tweaks made later would make the public option a serious player. That is why the public option has been such a big fight on both sides. It was never about symbolism, but about laying down an infrastructure that could be quickly built upon.
The progressive demand that public health insurance programs must be part of the solution is based not on pure ideology, but overwhelming domestic and international evidence. The track record of private insurance is terrible, and no honest economist could look its performance compared to public insurance and think it a smart solution. The public option is not symbolic, it is foundational. Can the Democratic Party act in the best interest of our country by standing up to the health care lobbyists, or will they reward the private health insurance industry? This is not some metaphysical argument. There are literally hundreds of billions riding on this question, and possibly the future international competitiveness of the American economy. You may not agree with the methods that the supporters of the public option are using, but pretending that they are somehow fools chasing after symbolism completely ignores what the true stakes in the fight really are.
There is a myth that the public option was only a tiny idea blown out of proportion for symbolic reasons. The public option was never going to be truly tiny, it was only going to be small at its inception. It is not because it was “weak,” it was just strongly caged in. But even the largest redwood tree starts out as a very small seed.
It is true that the CBO predicted that the negotiated rate public option in the House bill would only cover 6 million people, but that is because it was purposely restricted to a new exchange that would only be used by 30 million people at first. The CBO’s guess was that the public option would be selected by 20% of the people in this new marketplace. While I think their 20% estimate is low, it is important to put that in context–any company that can grab 20% of its market is a major player.
The public option was projected to be “small” because it would be forced to be a big fish in a very small pond. It would have major potential for growth. Progressives would have at their disposal multiple ways to increase the number of people who could have access to the public option. Dramatically expanding employer access to the exchange (something the Secretary of HHS could do without Congressional approval) is one idea. Expanding on Sen. Ron Wyden’s goal of giving people with employer-provided coverage the option of using vouchers to select their own plan on the new exchange is another route. The best solution might have been to attach a simple 12-word provision to the defense appropriations bill to allow the public option to sell outside the exchange. Any of these are very doable changes that could have completely changed the dynamics in only a few years.
If the public option was able to to sell to the entire private insurance market and just not the exchange gaining 20% of the market would have given it over 50 million customers. This would make the public option larger than Medicare, and one of the three largest insurance companies in America. Assuming the public option’s larger market share allowed it to negotiate much better rates (or even better, Congress decided to combine its operations with Medicare), it would probably be able to attract even more than 50 million customers.
The argument over the public option has never been symbolic or about what coverage a small group of Americans would or would not get. This health care fight is not about creating one new, static system that would remain in place forever. To argue otherwise is intellectual dishonesty put forward by many, including the Obama administration. The debate has been about the foundation on which we will build the future of our health care system, and whether the solution to our broken system is public or private insurance. Everyone from progressive activists to health insurance company CEO’s understood that this reform could grow, and only minor tweaks made later would make the public option a serious player. That is why the public option has been such a big fight on both sides. It was never about symbolism, but about laying down an infrastructure that could be quickly built upon.
The progressive demand that public health insurance programs must be part of the solution is based not on pure ideology, but overwhelming domestic and international evidence. The track record of private insurance is terrible, and no honest economist could look its performance compared to public insurance and think it a smart solution. The public option is not symbolic, it is foundational. Can the Democratic Party act in the best interest of our country by standing up to the health care lobbyists, or will they reward the private health insurance industry? This is not some metaphysical argument. There are literally hundreds of billions riding on this question, and possibly the future international competitiveness of the American economy. You may not agree with the methods that the supporters of the public option are using, but pretending that they are somehow fools chasing after symbolism completely ignores what the true stakes in the fight really are.
Why Jane Hamsher and Howard Dean Can’t Be Wrong
By FireDogLake's Cenk Uygur FDL
Can Jane Hamsher or Howard Dean be wrong on the substance of policy issues? Of course!!! I don’t think they often are, but recently there have been many progressives who have thought so. These were reasonable disagreements and everyone was within their full right to think Dean or Hamsher might not have gotten the balance right on any particular issue.
So, why can’t they be wrong?
Because even if you disagree with them, they’re doing you a huge favor. If you’re a strong progressive and you think Howard Dean has gone out too far left in health care reform or Jane Hamsher has attacked President Obama too hard from the left -then, fantastic, you are now officially a moderate!
And more importantly, so is Obama.
Why is this so important? I’m not sure you particularly want to be moderate, and I’m certainly not sure you are one. But that’s not the point. The point is that the mainstream media loves people who they can call "moderates." If Joe Lieberman is somewhere between Obama and Cheney, no matter how far to the right he is, he gets to be called a moderate. Why? Because there’s someone to the right of him.
Now, you have someone to the left of you. Congratulations, you made it! You’re now part of the cool crowd in DC, the only people that the establishment media care about or give any credence to – moderates.
I get thrown into the Hamsher category because I believe in attacking hard from the left. Some have started to call this the Uygur Doctrine, which, of course, I love. The reality is I’m a political moderate who until about a month ago believed we should stay longer in Afghanistan and that single payer was not the way to go. But it’s not my positions that matter as much as my attitude. We have to, have to, have to attack Obama form the left. If we don’t, he is seen as the far left and the whole spectrum shifts even further right than it already is.
If Obama is seen as the middle that helps him. So, even if you think Jane is crazy to team up with Grover Norquist and her attacks have no merit (you would be wrong on that by the way), you have to send her a thank you note for making Obama look centrist. Rahm might not be happy about their target, but he has to be happy with how the politics of it plays out for the president.
But much more importantly, this isn’t about Obama. This is about moving the spectrum. If there is no real and credible left-wing that fights back, then the entire political landscape gets pushed down to the right. This has huge policy implications, as we just saw in the health care fight.
Besides which, what do we have to lose? We lost the public option. We’re going to lose on climate change (nearly a foregone conclusion at this point). Financial reform is terribly watered down and getting weaker by the minute. The war in Afghanistan has already been escalated, twice. Do I need to go on? This is what you get when there is no credible threat from the left.
Worst case scenario, Dean and Hamsher lose (I understand their tactics are entirely different, and in some ways I hate to lump them in together, but I do because they are among the few making real noise on the left), and they move the spectrum left and make other progressives look moderate. Best case scenario, they win! Dare we dream?
I know what some of you are thinking – that’s not the worst case scenario. The worst case is somehow their attacks on Obama help Republicans win. But if you buy into that, then you have to pack your bags and go home. That means you are never willing to forcefully challenge Obama out of the fear that it might somehow hurt him. While I’m sure he appreciates that, I can guarantee you that he will thank you by completely ignoring you (and your policy priorities). Asking politely is obviously not getting the job done.
Real political pressure by definition involves the possibility of real political pain. If you’re not willing to go that far, then in my humble opinion you are too risk averse to have any consequential role to play in current day politics. Politics is about power, if you don’t ever wield it, then you’re not really in the game.
The Young Turks
Can Jane Hamsher or Howard Dean be wrong on the substance of policy issues? Of course!!! I don’t think they often are, but recently there have been many progressives who have thought so. These were reasonable disagreements and everyone was within their full right to think Dean or Hamsher might not have gotten the balance right on any particular issue.
So, why can’t they be wrong?
Because even if you disagree with them, they’re doing you a huge favor. If you’re a strong progressive and you think Howard Dean has gone out too far left in health care reform or Jane Hamsher has attacked President Obama too hard from the left -then, fantastic, you are now officially a moderate!
And more importantly, so is Obama.
Why is this so important? I’m not sure you particularly want to be moderate, and I’m certainly not sure you are one. But that’s not the point. The point is that the mainstream media loves people who they can call "moderates." If Joe Lieberman is somewhere between Obama and Cheney, no matter how far to the right he is, he gets to be called a moderate. Why? Because there’s someone to the right of him.
Now, you have someone to the left of you. Congratulations, you made it! You’re now part of the cool crowd in DC, the only people that the establishment media care about or give any credence to – moderates.
I get thrown into the Hamsher category because I believe in attacking hard from the left. Some have started to call this the Uygur Doctrine, which, of course, I love. The reality is I’m a political moderate who until about a month ago believed we should stay longer in Afghanistan and that single payer was not the way to go. But it’s not my positions that matter as much as my attitude. We have to, have to, have to attack Obama form the left. If we don’t, he is seen as the far left and the whole spectrum shifts even further right than it already is.
If Obama is seen as the middle that helps him. So, even if you think Jane is crazy to team up with Grover Norquist and her attacks have no merit (you would be wrong on that by the way), you have to send her a thank you note for making Obama look centrist. Rahm might not be happy about their target, but he has to be happy with how the politics of it plays out for the president.
But much more importantly, this isn’t about Obama. This is about moving the spectrum. If there is no real and credible left-wing that fights back, then the entire political landscape gets pushed down to the right. This has huge policy implications, as we just saw in the health care fight.
Besides which, what do we have to lose? We lost the public option. We’re going to lose on climate change (nearly a foregone conclusion at this point). Financial reform is terribly watered down and getting weaker by the minute. The war in Afghanistan has already been escalated, twice. Do I need to go on? This is what you get when there is no credible threat from the left.
Worst case scenario, Dean and Hamsher lose (I understand their tactics are entirely different, and in some ways I hate to lump them in together, but I do because they are among the few making real noise on the left), and they move the spectrum left and make other progressives look moderate. Best case scenario, they win! Dare we dream?
I know what some of you are thinking – that’s not the worst case scenario. The worst case is somehow their attacks on Obama help Republicans win. But if you buy into that, then you have to pack your bags and go home. That means you are never willing to forcefully challenge Obama out of the fear that it might somehow hurt him. While I’m sure he appreciates that, I can guarantee you that he will thank you by completely ignoring you (and your policy priorities). Asking politely is obviously not getting the job done.
Real political pressure by definition involves the possibility of real political pain. If you’re not willing to go that far, then in my humble opinion you are too risk averse to have any consequential role to play in current day politics. Politics is about power, if you don’t ever wield it, then you’re not really in the game.
The Young Turks
Jon Walker v. Wendell Potter on Democracy Now!
By FireDogLake's Jane Hamsher FDL
Jon Walker debated Wendell Potter on Democracy Now this morning. “Debate” is the wrong word probably — Wendell said he agreed with Jon had to say about the Senate bill’s limitations, he just thought it should pass anyway:
AMY GOODMAN: And Jon Walker, of the sixteen demands, sixteen ways to fix the Senate bill, can you carry on with what you feel needs to be done?
JON WALKER: Oh, yeah. I don’t think the bill does anything to hold the insurance companies honest. And what we’re doing is we’re creating a mandate. We’re going to use the IRS to force people to buy a product, which is frankly a bad product, poorly regulated and not really worth the value of purchasing it. And that is a huge step for the government to give to the insurance companies, and it has not demanded enough concessions in return from them to justify that.
Wendell said he “would advise all progressives to really focus on the House bill over the next few days, next few weeks, to encourage and, in fact, demand that House leaders stand firm on the legislation that they have passed already.”
I have to wonder what negotiating position he thinks they have if Joe Lieberman is the only one drawing lines in the sand.
1 Comment to “Jon Walker v. Wendell Potter on Democracy Now!”
rach777 Wendell Potter came across as very weak kneed..He was feebly trying to justify why ANY bill should be put on the President’s desk to sign. At the outset, he decided to characterize the program as a “discussion” not a debate, because he couldn’t really hold to the talking points of his Huffington Post blog. Frankly, I was shocked by his capitulation to what is being sold as heath care reform, and he tried to slither out of what he wrote in Huff Post by reiterating his having gone through stages of grief about the bill. Who cares about his personal denial, anger and the rest as a reason for his coming to the conclusion that just about anything should be passed. I have lost respect for this so called whistleblower.
Jon Walker debated Wendell Potter on Democracy Now this morning. “Debate” is the wrong word probably — Wendell said he agreed with Jon had to say about the Senate bill’s limitations, he just thought it should pass anyway:
AMY GOODMAN: And Jon Walker, of the sixteen demands, sixteen ways to fix the Senate bill, can you carry on with what you feel needs to be done?
JON WALKER: Oh, yeah. I don’t think the bill does anything to hold the insurance companies honest. And what we’re doing is we’re creating a mandate. We’re going to use the IRS to force people to buy a product, which is frankly a bad product, poorly regulated and not really worth the value of purchasing it. And that is a huge step for the government to give to the insurance companies, and it has not demanded enough concessions in return from them to justify that.
Wendell said he “would advise all progressives to really focus on the House bill over the next few days, next few weeks, to encourage and, in fact, demand that House leaders stand firm on the legislation that they have passed already.”
I have to wonder what negotiating position he thinks they have if Joe Lieberman is the only one drawing lines in the sand.
1 Comment to “Jon Walker v. Wendell Potter on Democracy Now!”
rach777 Wendell Potter came across as very weak kneed..He was feebly trying to justify why ANY bill should be put on the President’s desk to sign. At the outset, he decided to characterize the program as a “discussion” not a debate, because he couldn’t really hold to the talking points of his Huffington Post blog. Frankly, I was shocked by his capitulation to what is being sold as heath care reform, and he tried to slither out of what he wrote in Huff Post by reiterating his having gone through stages of grief about the bill. Who cares about his personal denial, anger and the rest as a reason for his coming to the conclusion that just about anything should be passed. I have lost respect for this so called whistleblower.
The New Robber Barons
By FireDogLake's bmaz FDL
Previously, Marcy Wheeler noted the unsavory blending of the private interests of health insurance companies with the power and hand of the US government:
It’s one thing to require a citizen to pay taxes–to pay into the commons. It’s another thing to require taxpayers to pay a private corporation, and to have up to 25% of that go to paying for luxuries like private jets and gyms for the company CEOs.
It’s the same kind of deal peasants made under feudalism: some proportion of their labor in exchange for protection (in this case, from bankruptcy from health problems, though the bill doesn’t actually require the private corporations to deliver that much protection).In this case, the federal government becomes an appendage to do collections for the corporations.
The reason this matters, though, is the power it gives the health care corporations. We can’t ditch Halliburton or Blackwater because they have become the sole primary contractor providing precisely the services they do. And so, like it or not, we’re dependent on them. And if we were to try to exercise oversight over them, we’d ultimately face the reality that we have no leverage over them, so we’d have to accept whatever they chose to provide. This bill gives the health care industry the leverage we’ve already given Halliburton and Blackwater.
Marcy termed this being “On The Road To Neo-feudalism” and then followed up with a subsequent post noting how much the concept was applicable to so much of the American life and economy, especially through the security/military/industial complex so intertwined with the US government.
Marcy Wheeler is not the only one recently noting the striking rise in power of corporate interests via the forceful hand of US governmental decree (usually at the direct behest of the corporate interests). Glenn Greenwald, expanding on previous work by Ed Kilgore, penned a dynamic description of the dirty little secret (only it is not little by any means) afoot in modern American socio-political existence:
But the most significant underlying division identified by Kilgore is the divergent views over the rapidly growing corporatism that defines our political system.
Kilgore doesn’t call it “corporatism” — the virtually complete dominance of government by large corporations, even a merger between the two — but that’s what he’s talking about. He puts it in slightly more palatable terms:
To put it simply, and perhaps over-simply, on a variety of fronts (most notably financial restructuring and health care reform, but arguably on climate change as well), the Obama administration has chosen the strategy of deploying regulated and subsidized private sector entities to achieve progressive policy results. This approach was a hallmark of the so-called Clintonian, “New Democrat” movement, and the broader international movement sometimes referred to as “the Third Way,” which often defended the use of private means for public ends.
As I’ve written for quite some time, I’ve honestly never understood how anyone could think that Obama was going to bring about some sort of “new” political approach or governing method when, as Kilgore notes, what he practices — politically and substantively — is the Third Way, DLC, triangulating corporatism of the Clinton era, just re-packaged with some sleeker and more updated marketing. At its core, it seeks to use government power not to regulate, but to benefit and even merge with, large corporate interests, both for political power (those corporate interests, in return, then fund the Party and its campaigns) and for policy ends. It’s devoted to empowering large corporations, letting them always get what they want from government, and extracting, at best, some very modest concessions in return. This is the same point Taibbi made about the Democratic Party in the context of economic policy:
The significance of all of these appointments isn’t that the Wall Street types are now in a position to provide direct favors to their former employers. It’s that, with one or two exceptions, they collectively offer a microcosm of what the Democratic Party has come to stand for in the 21st century. Virtually all of the Rubinites brought in to manage the economy under Obama share the same fundamental political philosophy carefully articulated for years by the Hamilton Project: Expand the safety net to protect the poor, but let Wall Street do whatever it wants.
One finds this in far more than just economic policy, and it’s about more than just letting corporations do what they want. It’s about affirmatively harnessing government power in order to benefit and strengthen those corporate interests and even merging government and the private sector.
Ms. Wheeler and Mr. Greenwald are correct, and the phenomenon is not just limited to the healthcare and military/industrial complex either; it is even more alarming in the ever more dominant and pervasive financial sector, home of the “too big to fail”. The phrase itself should terrify citizens, yet the country seems blithely oblivious to the implications. If there was even a vein of common sense among the people and leadership of this country, there would be immediate realization that an entity too big to fail is so big that it controls the government as much as the other way around. But the people are asleep, distracted by their own despair and desensitized over the years. The leadership, as both Wheeler and Greenwald describe have become symbiotic with the cause and, thus, are the part of problem not a source of solution.
Marcy Wheeler describes the concentration of power and wealth in corporations married to the hand of government as neo-feudalism; Glenn Greenwald and Kilgore posit it as corporatism. Both are worthy and descriptive terms, but the real ill goes a bit deeper if you also consider the accompanying rise in income inequality and transfer of wealth to the privileged and powerful few individuals that has paralleled what Marcy and Glenn describe. When you put it all together, the result is a situation that eerily duplicates the era of the robber barons existing in the United States 100 years ago.
The New Robber Barons
Robber Barons as a descriptor for the modern overlords came to me during a conversation with several colleagues a week or two ago on how to term the healthcare companies and their owners and executives. In writing this article, however, I have found I am far from the first person to realize how the old is new again in this regard to the rapacious class. Over a decade ago, Brad DeLong hit on the same precise thought, and he hit it hard and big:
“Robber Barons”: that was what U.S. political and economic commentator Matthew Josephson (1934) called the economic princes of his own day. Today we call them “billionaires.” Our capitalist economy–any capitalist economy–throws up such enormous concentrations of wealth: those lucky enough to be in the right place at the right time, driven and smart enough to see particular economic opportunities and seize them, foresighted enough to have gathered a large share of the equity of a highly-profitable enterprise into their hands, and well-connected enough to fend off political attempts to curb their wealth (or well-connected enough to make political favors the foundation of their wealth).
Matthew Josephson called them “Robber Barons”. He wanted readers to think back to their European history classes, back to thugs with spears on horses who did nothing save fight each other and loot merchant caravans that passed under the walls of their castles. He judged that their wealth was in no sense of their own creation, but was like a tax levied upon the productive workers and craftsmen of the American economy. Many others agreed: President Theodore Roosevelt–the Republican Roosevelt, president in the first decade of this century–spoke of the “malefactors of great wealth” and embraced a public, political role for the government in “anti-trust”: controlling, curbing, and breaking up large private concentrations of economic power.
…
And whatever the causes, the period since the mid-1970s has seen wealth concentration in the United States increase more rapidly than ever before–even during the heyday of industrialization in the last decades of the nineteenth century. Aggregate measures of wealth concentration today are greater than at any time since the election of Franklin D. Roosevelt in the Great Depression, and are within striking distance of the peak in wealth concentration reached during the Gilded Age (see Wolff, 1994).
…..
It is striking how closely numbers of “billionaire” match shifts in aggregate wealth inequality: when the frequency of billionaires in the labor force is high, wealth concentration is high. A simple linear regression predicts that the frequency of billionaires would drop to zero should the share of wealth held by the top one percent drop to twenty percent or so–and, indeed, we find no billionaires back when wealth concentration was so low.
…..
These causes of immense wealth have nothing to do with the determinants of the relative supplies of skilled and unskilled workers, or with the technological requirements of production. It makes me think that the overall level of wealth concentration is much more a “political” and a “cultural” phenomenon than an “economic” one: that we through our political systems and our attitudes have much more to do with the concentration of wealth than does the dance of factor supplies and technology-driven factor demands.
DeLong’s piece is a comprehensive thesis that describes both the history of the earlier American robber barons and modern day versions, at least as of the time he penned his work in 1997-98. Brad noted disturbing trends at the time, but did not reach hard conclusions as to the overall effect of the phenomenon on the health of American society.
So if there is a lesson, it is roughly as follows: Politics can put curbs on the accumulation of extraordinary amounts of wealth. And there is a very strong sense in which an unequal society is an ugly society. I like the distribution of wealth in the United States as it stood in 1975 much more than I like the relative contribution of wealth today. But would breaking up Microsoft five years ago have increased the pace of technological development in software? Probably not. And diminishing subsidies for railroad construction would not have given the United States a nation-spanning railroad network more quickly.
So there are still a lot of questions and few answers. At what level does corruption become intolerable and undermine the legitimacy of democracy? How large are the entrepreneurial benefits from the finance-industrial development nexus through which the truly astonishing fortunes are developed? To what extent are the Jay Goulds and Leland Stanfords embarrassing but tolerable side-effects of successful and broad economic development?
DeLong knew what the issues were, but did not have firm conclusions and answers as to the potential detriment or benefit of such unequal wealth distribution. However, the decade plus that has elapsed since Brad wrote his version of the robber barons, and especially the last two, has put a far different patina on the situation. It is not just the difference between the rich man and poor man, it is the vanishing middle class coupled with the ever grosser arrogance, recklessness and impunity which makes the New Robber Barons such a dangerous and destructive force. There is no longer need to describe what the downside of the insanity could be; we know, we are living it as we speak and have been over the past two years.
The question is where we go from here with respect to the New Robber Baron overlords. Just mosey along status quo as the Obama Administration appears to envision, not looking back with anger, accountability and real change; or do we plow the harder, but ultimately more fertile ground of curbing the irrational and destructive accumulation of wealth and power through Teddy Rooseveltian anti-trust programs, return of Glass-Steagall protections separation of banking and investment functions and tax and social programs to rebuild the evaporating middle class.
Healthcare is the current flashpoint, and it is rightfully a big one. There is no question but that the US needs “reform”; but there is a real question, still to be answered, whether there will be something produced which benefits the masses of citizens both now and in the future or just an illusory pile of junk that benefits the ruling classes of politicians and health industry robber barons.
As Marcy Wheeler and Glenn Greenwald have persuasively argued, however, it goes much, much deeper than merely healthcare; the battle is over the root ethos of what this country is and is going to be. The incontrovertible trend is toward an unholy blending of the robber barons with the government itself. Not just the usual influencing of government policies through lobbying and monetary control of individual politicians to seek favorable policies, but where the federal government becomes an appendage to do collections, enforcement and expansion for the corporations. The best time to rethink and reverse this trend is now, it will not get easier as the trend becomes more ingrained and pervasive with time.
As long as this post is, the surface of this topic has barely been scratched. It is my hope to peg this phenomenon with a term simple, descriptive and instantly understandable by all, and to start a discussion both in comments to this post and in subsequent posts here and by others across the spectrum. Time is wasting at an alarming rate.
Previously, Marcy Wheeler noted the unsavory blending of the private interests of health insurance companies with the power and hand of the US government:
It’s one thing to require a citizen to pay taxes–to pay into the commons. It’s another thing to require taxpayers to pay a private corporation, and to have up to 25% of that go to paying for luxuries like private jets and gyms for the company CEOs.
It’s the same kind of deal peasants made under feudalism: some proportion of their labor in exchange for protection (in this case, from bankruptcy from health problems, though the bill doesn’t actually require the private corporations to deliver that much protection).In this case, the federal government becomes an appendage to do collections for the corporations.
The reason this matters, though, is the power it gives the health care corporations. We can’t ditch Halliburton or Blackwater because they have become the sole primary contractor providing precisely the services they do. And so, like it or not, we’re dependent on them. And if we were to try to exercise oversight over them, we’d ultimately face the reality that we have no leverage over them, so we’d have to accept whatever they chose to provide. This bill gives the health care industry the leverage we’ve already given Halliburton and Blackwater.
Marcy termed this being “On The Road To Neo-feudalism” and then followed up with a subsequent post noting how much the concept was applicable to so much of the American life and economy, especially through the security/military/industial complex so intertwined with the US government.
Marcy Wheeler is not the only one recently noting the striking rise in power of corporate interests via the forceful hand of US governmental decree (usually at the direct behest of the corporate interests). Glenn Greenwald, expanding on previous work by Ed Kilgore, penned a dynamic description of the dirty little secret (only it is not little by any means) afoot in modern American socio-political existence:
But the most significant underlying division identified by Kilgore is the divergent views over the rapidly growing corporatism that defines our political system.
Kilgore doesn’t call it “corporatism” — the virtually complete dominance of government by large corporations, even a merger between the two — but that’s what he’s talking about. He puts it in slightly more palatable terms:
To put it simply, and perhaps over-simply, on a variety of fronts (most notably financial restructuring and health care reform, but arguably on climate change as well), the Obama administration has chosen the strategy of deploying regulated and subsidized private sector entities to achieve progressive policy results. This approach was a hallmark of the so-called Clintonian, “New Democrat” movement, and the broader international movement sometimes referred to as “the Third Way,” which often defended the use of private means for public ends.
As I’ve written for quite some time, I’ve honestly never understood how anyone could think that Obama was going to bring about some sort of “new” political approach or governing method when, as Kilgore notes, what he practices — politically and substantively — is the Third Way, DLC, triangulating corporatism of the Clinton era, just re-packaged with some sleeker and more updated marketing. At its core, it seeks to use government power not to regulate, but to benefit and even merge with, large corporate interests, both for political power (those corporate interests, in return, then fund the Party and its campaigns) and for policy ends. It’s devoted to empowering large corporations, letting them always get what they want from government, and extracting, at best, some very modest concessions in return. This is the same point Taibbi made about the Democratic Party in the context of economic policy:
The significance of all of these appointments isn’t that the Wall Street types are now in a position to provide direct favors to their former employers. It’s that, with one or two exceptions, they collectively offer a microcosm of what the Democratic Party has come to stand for in the 21st century. Virtually all of the Rubinites brought in to manage the economy under Obama share the same fundamental political philosophy carefully articulated for years by the Hamilton Project: Expand the safety net to protect the poor, but let Wall Street do whatever it wants.
One finds this in far more than just economic policy, and it’s about more than just letting corporations do what they want. It’s about affirmatively harnessing government power in order to benefit and strengthen those corporate interests and even merging government and the private sector.
Ms. Wheeler and Mr. Greenwald are correct, and the phenomenon is not just limited to the healthcare and military/industrial complex either; it is even more alarming in the ever more dominant and pervasive financial sector, home of the “too big to fail”. The phrase itself should terrify citizens, yet the country seems blithely oblivious to the implications. If there was even a vein of common sense among the people and leadership of this country, there would be immediate realization that an entity too big to fail is so big that it controls the government as much as the other way around. But the people are asleep, distracted by their own despair and desensitized over the years. The leadership, as both Wheeler and Greenwald describe have become symbiotic with the cause and, thus, are the part of problem not a source of solution.
Marcy Wheeler describes the concentration of power and wealth in corporations married to the hand of government as neo-feudalism; Glenn Greenwald and Kilgore posit it as corporatism. Both are worthy and descriptive terms, but the real ill goes a bit deeper if you also consider the accompanying rise in income inequality and transfer of wealth to the privileged and powerful few individuals that has paralleled what Marcy and Glenn describe. When you put it all together, the result is a situation that eerily duplicates the era of the robber barons existing in the United States 100 years ago.
The New Robber Barons
Robber Barons as a descriptor for the modern overlords came to me during a conversation with several colleagues a week or two ago on how to term the healthcare companies and their owners and executives. In writing this article, however, I have found I am far from the first person to realize how the old is new again in this regard to the rapacious class. Over a decade ago, Brad DeLong hit on the same precise thought, and he hit it hard and big:
“Robber Barons”: that was what U.S. political and economic commentator Matthew Josephson (1934) called the economic princes of his own day. Today we call them “billionaires.” Our capitalist economy–any capitalist economy–throws up such enormous concentrations of wealth: those lucky enough to be in the right place at the right time, driven and smart enough to see particular economic opportunities and seize them, foresighted enough to have gathered a large share of the equity of a highly-profitable enterprise into their hands, and well-connected enough to fend off political attempts to curb their wealth (or well-connected enough to make political favors the foundation of their wealth).
Matthew Josephson called them “Robber Barons”. He wanted readers to think back to their European history classes, back to thugs with spears on horses who did nothing save fight each other and loot merchant caravans that passed under the walls of their castles. He judged that their wealth was in no sense of their own creation, but was like a tax levied upon the productive workers and craftsmen of the American economy. Many others agreed: President Theodore Roosevelt–the Republican Roosevelt, president in the first decade of this century–spoke of the “malefactors of great wealth” and embraced a public, political role for the government in “anti-trust”: controlling, curbing, and breaking up large private concentrations of economic power.
…
And whatever the causes, the period since the mid-1970s has seen wealth concentration in the United States increase more rapidly than ever before–even during the heyday of industrialization in the last decades of the nineteenth century. Aggregate measures of wealth concentration today are greater than at any time since the election of Franklin D. Roosevelt in the Great Depression, and are within striking distance of the peak in wealth concentration reached during the Gilded Age (see Wolff, 1994).
…..
It is striking how closely numbers of “billionaire” match shifts in aggregate wealth inequality: when the frequency of billionaires in the labor force is high, wealth concentration is high. A simple linear regression predicts that the frequency of billionaires would drop to zero should the share of wealth held by the top one percent drop to twenty percent or so–and, indeed, we find no billionaires back when wealth concentration was so low.
…..
These causes of immense wealth have nothing to do with the determinants of the relative supplies of skilled and unskilled workers, or with the technological requirements of production. It makes me think that the overall level of wealth concentration is much more a “political” and a “cultural” phenomenon than an “economic” one: that we through our political systems and our attitudes have much more to do with the concentration of wealth than does the dance of factor supplies and technology-driven factor demands.
DeLong’s piece is a comprehensive thesis that describes both the history of the earlier American robber barons and modern day versions, at least as of the time he penned his work in 1997-98. Brad noted disturbing trends at the time, but did not reach hard conclusions as to the overall effect of the phenomenon on the health of American society.
So if there is a lesson, it is roughly as follows: Politics can put curbs on the accumulation of extraordinary amounts of wealth. And there is a very strong sense in which an unequal society is an ugly society. I like the distribution of wealth in the United States as it stood in 1975 much more than I like the relative contribution of wealth today. But would breaking up Microsoft five years ago have increased the pace of technological development in software? Probably not. And diminishing subsidies for railroad construction would not have given the United States a nation-spanning railroad network more quickly.
So there are still a lot of questions and few answers. At what level does corruption become intolerable and undermine the legitimacy of democracy? How large are the entrepreneurial benefits from the finance-industrial development nexus through which the truly astonishing fortunes are developed? To what extent are the Jay Goulds and Leland Stanfords embarrassing but tolerable side-effects of successful and broad economic development?
DeLong knew what the issues were, but did not have firm conclusions and answers as to the potential detriment or benefit of such unequal wealth distribution. However, the decade plus that has elapsed since Brad wrote his version of the robber barons, and especially the last two, has put a far different patina on the situation. It is not just the difference between the rich man and poor man, it is the vanishing middle class coupled with the ever grosser arrogance, recklessness and impunity which makes the New Robber Barons such a dangerous and destructive force. There is no longer need to describe what the downside of the insanity could be; we know, we are living it as we speak and have been over the past two years.
The question is where we go from here with respect to the New Robber Baron overlords. Just mosey along status quo as the Obama Administration appears to envision, not looking back with anger, accountability and real change; or do we plow the harder, but ultimately more fertile ground of curbing the irrational and destructive accumulation of wealth and power through Teddy Rooseveltian anti-trust programs, return of Glass-Steagall protections separation of banking and investment functions and tax and social programs to rebuild the evaporating middle class.
Healthcare is the current flashpoint, and it is rightfully a big one. There is no question but that the US needs “reform”; but there is a real question, still to be answered, whether there will be something produced which benefits the masses of citizens both now and in the future or just an illusory pile of junk that benefits the ruling classes of politicians and health industry robber barons.
As Marcy Wheeler and Glenn Greenwald have persuasively argued, however, it goes much, much deeper than merely healthcare; the battle is over the root ethos of what this country is and is going to be. The incontrovertible trend is toward an unholy blending of the robber barons with the government itself. Not just the usual influencing of government policies through lobbying and monetary control of individual politicians to seek favorable policies, but where the federal government becomes an appendage to do collections, enforcement and expansion for the corporations. The best time to rethink and reverse this trend is now, it will not get easier as the trend becomes more ingrained and pervasive with time.
As long as this post is, the surface of this topic has barely been scratched. It is my hope to peg this phenomenon with a term simple, descriptive and instantly understandable by all, and to start a discussion both in comments to this post and in subsequent posts here and by others across the spectrum. Time is wasting at an alarming rate.
Hard Is The New Evil
By FireDogLake's Eli FDL
It’s no secret that Barack Obama frustrates the hell out of me. At a time when we need bold transformational leadership, he gives us cautious incrementalism. Where we need moral courage, he gives us compromise and expedience.
Ironically, the character trait that makes him so infuriating is the same one that makes him the opposite of George W. Bush. Where Bush made political decisions based on his distorted sense of Right vs. Wrong and Good vs. Evil, Obama makes them based on Easy vs. Hard. Dubya’s moral compass pointed due South, while Obama’s points to the path of least resistance.
As John Odum puts it:
[M]ore progressives have come to realize (based not only on the health care struggle, but virtually every other political hot potato from the Afghan War and civil liberties to Presidential appointments): that this administration will seriously consider no policy to the left of the Senate’s most conservative Democrats.
Or, alternatively, as I put it back in August:
Need to slash greenhouse emissions to prevent the ice caps from melting? You have to do it without hurting the energy companies.
Need to rescue the economy and reform the financial system? You have to do it without hurting Wall Street.
Need to make healthcare affordable and available to everyone? You have to do it without hurting the insurance companies.
It’s not that Obama doesn’t want to do good, but if doing the right thing involves taking on corporations or the religious right (in the always-helpful guise of their Rahmocrat proxies), he’ll happily settle for doing good enough, and sometimes not even that.
Assuming I haven’t misoverestimated Obama and he’s not a misogynistic corporatist homophobe at heart, he’s probably rationalized his conflict avoidance as a Very Pragmatic Strategy to woo corporate money and fundie manpower so that he and the Democrats can keep winning elections and continue to do… good enough. And who knows, maybe a few hundred years of good enough would eventually add up to something meaningful.
But we don’t have a few hundred years. People are getting sick and dying now, our financial system is out of control now, the climate is heating up now, women and gays are seeing their rights rolled back now. And that’s without mentioning how absurd it is to expect that any agenda that corporations and fundies have veto power over would stay even good enough for very long.
Sadly, it’s not just Obama who consistently takes the easy road; large chunks of the Democratic and progressive worlds have adopted the same approach. Harry Reid doesn’t want to take on Obama or the Lieberman Caucus by pushing the public option through reconciliation. The progressive orgs in the Veal Pen don’t want to oppose Obama because he might choke off their donations. The unions don’t want to oppose him because they’re afraid he won’t back EFCA (although why they think he’ll lift a finger for EFCA based on his track record so far is beyond me).
So not only do we have a president who always follows the path of least resistance, but we have a Democratic/progressive establishment that’s willing to cave in where Republicans and Rahmocrats are not, thus ensuring that the path of least resistance will always bend to the right.
And that, in a nutshell, is why Jane and FDL continue to fight, kicking and screaming, even enlisting unlikely allies like Grover Norquist: We are trying to move the path of least resistance back to the left, by making corporatist corruption and religious intolerance politically painful, by pressuring progressive politicians to use their power – because it’s the only way to make Obama and the Democrats do the right thing instead of the good enough thing.
It’s no secret that Barack Obama frustrates the hell out of me. At a time when we need bold transformational leadership, he gives us cautious incrementalism. Where we need moral courage, he gives us compromise and expedience.
Ironically, the character trait that makes him so infuriating is the same one that makes him the opposite of George W. Bush. Where Bush made political decisions based on his distorted sense of Right vs. Wrong and Good vs. Evil, Obama makes them based on Easy vs. Hard. Dubya’s moral compass pointed due South, while Obama’s points to the path of least resistance.
As John Odum puts it:
[M]ore progressives have come to realize (based not only on the health care struggle, but virtually every other political hot potato from the Afghan War and civil liberties to Presidential appointments): that this administration will seriously consider no policy to the left of the Senate’s most conservative Democrats.
Or, alternatively, as I put it back in August:
Need to slash greenhouse emissions to prevent the ice caps from melting? You have to do it without hurting the energy companies.
Need to rescue the economy and reform the financial system? You have to do it without hurting Wall Street.
Need to make healthcare affordable and available to everyone? You have to do it without hurting the insurance companies.
It’s not that Obama doesn’t want to do good, but if doing the right thing involves taking on corporations or the religious right (in the always-helpful guise of their Rahmocrat proxies), he’ll happily settle for doing good enough, and sometimes not even that.
Assuming I haven’t misoverestimated Obama and he’s not a misogynistic corporatist homophobe at heart, he’s probably rationalized his conflict avoidance as a Very Pragmatic Strategy to woo corporate money and fundie manpower so that he and the Democrats can keep winning elections and continue to do… good enough. And who knows, maybe a few hundred years of good enough would eventually add up to something meaningful.
But we don’t have a few hundred years. People are getting sick and dying now, our financial system is out of control now, the climate is heating up now, women and gays are seeing their rights rolled back now. And that’s without mentioning how absurd it is to expect that any agenda that corporations and fundies have veto power over would stay even good enough for very long.
Sadly, it’s not just Obama who consistently takes the easy road; large chunks of the Democratic and progressive worlds have adopted the same approach. Harry Reid doesn’t want to take on Obama or the Lieberman Caucus by pushing the public option through reconciliation. The progressive orgs in the Veal Pen don’t want to oppose Obama because he might choke off their donations. The unions don’t want to oppose him because they’re afraid he won’t back EFCA (although why they think he’ll lift a finger for EFCA based on his track record so far is beyond me).
So not only do we have a president who always follows the path of least resistance, but we have a Democratic/progressive establishment that’s willing to cave in where Republicans and Rahmocrats are not, thus ensuring that the path of least resistance will always bend to the right.
And that, in a nutshell, is why Jane and FDL continue to fight, kicking and screaming, even enlisting unlikely allies like Grover Norquist: We are trying to move the path of least resistance back to the left, by making corporatist corruption and religious intolerance politically painful, by pressuring progressive politicians to use their power – because it’s the only way to make Obama and the Democrats do the right thing instead of the good enough thing.
The Incredibly Stupid Politics Of Delaying Benefits
By FireDogLake's Jon Walker FDL
If there was any one single completely terrible political decision made by Democrats during this health care debate, it was to “save money” by delaying the start of reform. This is an act of political foolishness so profound, I’m, to this day, at a loss for words. Making the bill appear $100-300 billion cheaper simply is not worth the medium term political damage that delaying reform will do to the Democrats.
Paul Krugman thinks it is a very bad politics for Republicans to run on repealing the bill. His evidence is even though reform is not very popular in Massachusetts, repealing it is even less popular. But this is a pretty worthless comparison. Reform is already in place in Massachusetts. People can see who it helps and who it hurts. They know how it works, and can make an informed decision about it.
If this Senate bill is passed into law, it will do very little until 2014. For the 2010 and 2012 elections, the health care reform bill will mainly be a far away promise (or impending threat). Votes in 2010 and 2012 will not be anywhere nearly as informed as the people in Massachusetts are. Even if it is impossible for Republicans to get the seats necessary and summon the desire to spend the political capital needed to actually repeal the whole reform package, that does not mean it will be a bad campaign issue. I can picture many Republicans in 2010 and 2012 pointing to high premiums and people still uninsured as proof that Democrats “failed.” If you expect Republicans to be honest about reform during a campaign, you have not been paying attention.
I think about the fate of Ben Nelson in Nebraska. Recent polling shows his vote for health care has hurt him in Nebraska, but he is not up for re-election until 2012. Now, it is possible that by 2012, health care will have dropped off everyone’s radar, but it will definitely not be something Nelson will want to campaign on. He will have made a big vote three years prior for a bill that will still have almost no tangible benefits (but some tangible pain in the form of taxes and Medicare advantage reforms) to show for it.
If Democrats were a sensible political party, they would have started reform as soon as possible (probably about 6-12 months from now for most of it). That way senators like Ben Nelson would have the program in place serving people for a full two years before his election. If it succeed he could run on it. If it failed, well politicians deserve to lose for passing bad legislation.
I don’t know if Democrats primarily delayed the start of reform until after the 2012 presidential elections because they know it would not be popular to implement, or because of a terrible political calculation based on their insane fetish with the CBO. I still have not decided which scenario would give me a less negative impression of the party.
If there was any one single completely terrible political decision made by Democrats during this health care debate, it was to “save money” by delaying the start of reform. This is an act of political foolishness so profound, I’m, to this day, at a loss for words. Making the bill appear $100-300 billion cheaper simply is not worth the medium term political damage that delaying reform will do to the Democrats.
Paul Krugman thinks it is a very bad politics for Republicans to run on repealing the bill. His evidence is even though reform is not very popular in Massachusetts, repealing it is even less popular. But this is a pretty worthless comparison. Reform is already in place in Massachusetts. People can see who it helps and who it hurts. They know how it works, and can make an informed decision about it.
If this Senate bill is passed into law, it will do very little until 2014. For the 2010 and 2012 elections, the health care reform bill will mainly be a far away promise (or impending threat). Votes in 2010 and 2012 will not be anywhere nearly as informed as the people in Massachusetts are. Even if it is impossible for Republicans to get the seats necessary and summon the desire to spend the political capital needed to actually repeal the whole reform package, that does not mean it will be a bad campaign issue. I can picture many Republicans in 2010 and 2012 pointing to high premiums and people still uninsured as proof that Democrats “failed.” If you expect Republicans to be honest about reform during a campaign, you have not been paying attention.
I think about the fate of Ben Nelson in Nebraska. Recent polling shows his vote for health care has hurt him in Nebraska, but he is not up for re-election until 2012. Now, it is possible that by 2012, health care will have dropped off everyone’s radar, but it will definitely not be something Nelson will want to campaign on. He will have made a big vote three years prior for a bill that will still have almost no tangible benefits (but some tangible pain in the form of taxes and Medicare advantage reforms) to show for it.
If Democrats were a sensible political party, they would have started reform as soon as possible (probably about 6-12 months from now for most of it). That way senators like Ben Nelson would have the program in place serving people for a full two years before his election. If it succeed he could run on it. If it failed, well politicians deserve to lose for passing bad legislation.
I don’t know if Democrats primarily delayed the start of reform until after the 2012 presidential elections because they know it would not be popular to implement, or because of a terrible political calculation based on their insane fetish with the CBO. I still have not decided which scenario would give me a less negative impression of the party.
Controlling Costs On The Backs Of The Middle Class
By TalkLeft's Big Tent Democrat TalkLeft
Rather than just copping to the fact that the policy he favors does indeed impose a stiff cost on middle class workers, Ezra Klein argues:
[Herbert] doesn't really argue that the excise tax is bad policy. Instead, he argues that there will be losers. Workers who will see higher deductibles. Union members who will find a portion of their policies taxed.
Actually, Herbert's argument explains why he opposes the excise tax - it would enact cost control by making the middle class pay for it. In Herbert's view, and mine, that is bad policy. In Ezra Klein's view, that is good policy. Remember that the competing financing mechanism presented by the House bill is to tax persons making 500k/yr. Ezra is saying he prefers a policy that punishes middle class workers to one that places the burden on the wealthy. you can call Ezra's position many things, but certainly not progressive. But of course not every good policy has to be progressive in nature. what is Ezra's argument for this non-progressive policy?
Cost control is based on precisely opposite premises, in fact. First, more insurance is not always better. Health-care outcomes in Canada and England -- both of which have strong pressures against overuse -- are not worse than those in America.
Fascinating that Ezra chooses England and Canada for his counter-examples. As we all know by now, both England and Canada have implemented a public insurance reform to their health care systems. Neither uses an "excise tax." Of course, neither England or Canada could as neither use a private insurance/employer based system. Ezra writes:
There is no way to sharply cut costs in a fifth of the economy without there being losers.
Assuming this is true, I am not comfortable with a policy that puts the pain on the middle class as opposed to the wealthy. Ezra urges such a policy. All in the name of "cost control." Ezra writes:
Those who would kill this attempt should think really hard about what their counter-policy is, and who will lose from that policy, and why that is preferable, and whether it can actually pass, and where we're left if it doesn't, and who loses from that.
(Emphasis supplied.) Ezra well knows that people who oppose the excise tax almost universally favor a public insurance reform. He argues that "it can't pass." And of course, as we all knew, it can not pass with 60 votes. But it could pass through reconciliation. Of course, what Ezra will not discuss is that he prefers the fanciful "exchanges and regulation reform" which can not survive the reconciliation process to the public insurance reform that actually has a proven track record of working in the United States.
That is certainly his right, but it is long past time for him to come clean and discuss these issues honestly.
Bob Herbert objects to the policy that Ezra endorses - the excise tax - which is cost control at the expense of the middle class. This is bad policy and bad politics according to Herbert (and me.) Herbert prefers that we enact universal insurance (at least the idea of it) in the manner the House bill prescribes - by taxing the rich. Ezra opposes that. It seems clear which position is the progressive one.
Speaking for me only
Rather than just copping to the fact that the policy he favors does indeed impose a stiff cost on middle class workers, Ezra Klein argues:
[Herbert] doesn't really argue that the excise tax is bad policy. Instead, he argues that there will be losers. Workers who will see higher deductibles. Union members who will find a portion of their policies taxed.
Actually, Herbert's argument explains why he opposes the excise tax - it would enact cost control by making the middle class pay for it. In Herbert's view, and mine, that is bad policy. In Ezra Klein's view, that is good policy. Remember that the competing financing mechanism presented by the House bill is to tax persons making 500k/yr. Ezra is saying he prefers a policy that punishes middle class workers to one that places the burden on the wealthy. you can call Ezra's position many things, but certainly not progressive. But of course not every good policy has to be progressive in nature. what is Ezra's argument for this non-progressive policy?
Cost control is based on precisely opposite premises, in fact. First, more insurance is not always better. Health-care outcomes in Canada and England -- both of which have strong pressures against overuse -- are not worse than those in America.
Fascinating that Ezra chooses England and Canada for his counter-examples. As we all know by now, both England and Canada have implemented a public insurance reform to their health care systems. Neither uses an "excise tax." Of course, neither England or Canada could as neither use a private insurance/employer based system. Ezra writes:
There is no way to sharply cut costs in a fifth of the economy without there being losers.
Assuming this is true, I am not comfortable with a policy that puts the pain on the middle class as opposed to the wealthy. Ezra urges such a policy. All in the name of "cost control." Ezra writes:
Those who would kill this attempt should think really hard about what their counter-policy is, and who will lose from that policy, and why that is preferable, and whether it can actually pass, and where we're left if it doesn't, and who loses from that.
(Emphasis supplied.) Ezra well knows that people who oppose the excise tax almost universally favor a public insurance reform. He argues that "it can't pass." And of course, as we all knew, it can not pass with 60 votes. But it could pass through reconciliation. Of course, what Ezra will not discuss is that he prefers the fanciful "exchanges and regulation reform" which can not survive the reconciliation process to the public insurance reform that actually has a proven track record of working in the United States.
That is certainly his right, but it is long past time for him to come clean and discuss these issues honestly.
Bob Herbert objects to the policy that Ezra endorses - the excise tax - which is cost control at the expense of the middle class. This is bad policy and bad politics according to Herbert (and me.) Herbert prefers that we enact universal insurance (at least the idea of it) in the manner the House bill prescribes - by taxing the rich. Ezra opposes that. It seems clear which position is the progressive one.
Speaking for me only
Whose Interests Is the White House Representing in the Senate-House Health Reform Conference?
By FireDogLake's Scarecrow FDL
After the Senate passed its version of the health reform bill, the White House was quick to announce that the President and his aides will be actively involved in helping to guide the process of reconciling the Senate and House bills.
Nothing wrong with that; it’s what we’d expect from any White House in pursuit if its own agenda and legislation affecting the public interest. But something’s missing, something important.
What the announcement left out is any statement about whose interests and what positions the White House would represent. While I realize that criticizing the White House in dealing with Congressional realities is something that, in civilized Villages at least, is just not done, I seem to recall instances in the past when Presidents actually took public positions on matters important to them by, uh, you know, telling us what they wanted Congress to do or not do on specific issues.
Even completely despicable Administrations, which shall go unnamed, usually let us know what was really important in their perspective on the public/private interest; we always knew what they were demanding be included or taken out as legislation moved along. Why, some even said they’d veto a bill that didn’t have something they thought important.
We now have two different bills, with lots of overlap/common features but also dozens of important differences that affect the public interest, some profoundly so. Does this President have a view on any of these? And if so, would it be too much to ask, Your Majesty, that your Ministers give us a hint, this being a democracy premised on governmental accountability and all? I mean, you don’t have to put it on C-SPAN (though what’s wrong with that?), but maybe your COS could leak it to Jake Tapper, or someplace safe like Meet the Press? For example, consider this list from yesterday’s Times editorial:
AFFORDABILITY Under the more generous House bill, low-income people would pay substantially less and get better benefits than under the Senate bill. The House bill has far better subsidies to help lower-income Americans with premiums and cost-sharing. The Senate bill offers better subsidies for middle-income people. House staffers calculate that a family of four earning $33,000 a year would pay $1,521 in premiums under the Senate bill, which is $530 more than under the House bill. The same family would be exposed to as much as $4,100 in cost-sharing under the Senate bill, which is $3,100 more than under the House bill. Affordability is probably the most critical issue in winning popular support. The Senate needs to agree to more subsidies.
MEDICAID The House bill would expand Medicaid coverage to higher-earning people than the Senate bill does. It would raise Medicaid’s low payments to doctors in one crucial respect — paying primary-care doctors the same that Medicare pays. That would make it more likely that poor patients could find a doctor willing to serve them. The Senate should follow the House lead.
EMPLOYER MANDATES The House bill imposes higher penalties on employers who fail to offer coverage, a prod estimated to increase the number of covered workers by six million in 2019. The Senate bill has weaker penalties that would allow more employers to opt out, reducing by four million the number of workers covered. Under the House bill, employers would have to pay most of the premium and meet minimum benefit levels; the Senate has weaker requirements. The House bill is superior.
INDIVIDUAL MANDATE The House has stronger penalties on individuals who decline to buy insurance and would exempt fewer individuals on grounds they could not afford to buy coverage. Given that the reforms would work best with the greatest number of people insured, the House provisions should prevail.
I make this humble request, because there seems to be confusion among your subjects the citizens about whose interests your aides will be representing. Will it be big PhRMA, or AHIP/insurers and the hospitals with whom you reportedly cut secret special deals to protect their interests? Or will you side in protecting the public interest in controlling the prices and market power and limiting the public money these groups receive with no safety valve/alternative to continue corrupting Congress and, uh, forgive me, your own Administration?
After the Senate passed its version of the health reform bill, the White House was quick to announce that the President and his aides will be actively involved in helping to guide the process of reconciling the Senate and House bills.
Nothing wrong with that; it’s what we’d expect from any White House in pursuit if its own agenda and legislation affecting the public interest. But something’s missing, something important.
What the announcement left out is any statement about whose interests and what positions the White House would represent. While I realize that criticizing the White House in dealing with Congressional realities is something that, in civilized Villages at least, is just not done, I seem to recall instances in the past when Presidents actually took public positions on matters important to them by, uh, you know, telling us what they wanted Congress to do or not do on specific issues.
Even completely despicable Administrations, which shall go unnamed, usually let us know what was really important in their perspective on the public/private interest; we always knew what they were demanding be included or taken out as legislation moved along. Why, some even said they’d veto a bill that didn’t have something they thought important.
We now have two different bills, with lots of overlap/common features but also dozens of important differences that affect the public interest, some profoundly so. Does this President have a view on any of these? And if so, would it be too much to ask, Your Majesty, that your Ministers give us a hint, this being a democracy premised on governmental accountability and all? I mean, you don’t have to put it on C-SPAN (though what’s wrong with that?), but maybe your COS could leak it to Jake Tapper, or someplace safe like Meet the Press? For example, consider this list from yesterday’s Times editorial:
AFFORDABILITY Under the more generous House bill, low-income people would pay substantially less and get better benefits than under the Senate bill. The House bill has far better subsidies to help lower-income Americans with premiums and cost-sharing. The Senate bill offers better subsidies for middle-income people. House staffers calculate that a family of four earning $33,000 a year would pay $1,521 in premiums under the Senate bill, which is $530 more than under the House bill. The same family would be exposed to as much as $4,100 in cost-sharing under the Senate bill, which is $3,100 more than under the House bill. Affordability is probably the most critical issue in winning popular support. The Senate needs to agree to more subsidies.
MEDICAID The House bill would expand Medicaid coverage to higher-earning people than the Senate bill does. It would raise Medicaid’s low payments to doctors in one crucial respect — paying primary-care doctors the same that Medicare pays. That would make it more likely that poor patients could find a doctor willing to serve them. The Senate should follow the House lead.
EMPLOYER MANDATES The House bill imposes higher penalties on employers who fail to offer coverage, a prod estimated to increase the number of covered workers by six million in 2019. The Senate bill has weaker penalties that would allow more employers to opt out, reducing by four million the number of workers covered. Under the House bill, employers would have to pay most of the premium and meet minimum benefit levels; the Senate has weaker requirements. The House bill is superior.
INDIVIDUAL MANDATE The House has stronger penalties on individuals who decline to buy insurance and would exempt fewer individuals on grounds they could not afford to buy coverage. Given that the reforms would work best with the greatest number of people insured, the House provisions should prevail.
I make this humble request, because there seems to be confusion among your subjects the citizens about whose interests your aides will be representing. Will it be big PhRMA, or AHIP/insurers and the hospitals with whom you reportedly cut secret special deals to protect their interests? Or will you side in protecting the public interest in controlling the prices and market power and limiting the public money these groups receive with no safety valve/alternative to continue corrupting Congress and, uh, forgive me, your own Administration?
Why Can’t Bill Supporters Say “Affordable”?
By FireDogLake's emptywheel FDL
Like Nate, I appreciate having a discussion based in facts and details. And Nate says several of the cost estimates I used to show why the health care bill is unaffordable for middle class families “are on the high side.” I appreciate him checking my numbers–as I have said on several versions of the post I have done on affordability, I’d like to have a real discussion about these costs.
Nate’s numbers are too low
Nate uses a different method than me; rather than building costs up from individual estimates as I did (indeed, Nate never shows what my hypothetical family’s budget would look like), he looks at BLS data, and argues that either, “this is significantly more than most two-child families will be spending on these services — probably by a margin of $10,000 or so,” and/or my hypothetical family, “does not have a reasonable and responsible gameplan to begin with.”
Now, Nate hasn’t actually shown that. Instead, his primary source of numbers shows what the average family in this income bracket ($50,000 to 69,999) would spend. And that family is older (average adult age of 47) and smaller (2.7 people, with just .7 kids) than the family I was discussing. That’s significant in ways that make his costs too low on several counts. For example, over a fifth of the people in the BLS estimate own their home outright. A significant portion are single or couples. Adding older home-owners and singles needing smaller homes into his consideration almost certainly means Nate’s housing costs are too low for a family of four or even three. Similarly, Nate’s figures for food expenses are low by $1,324 (and his average family eats out, which USDA assumes my average family of 4 does not for its calculations).
Plus, Nate doesn’t point to the places where my estimates (based on real expenditures) are quite low, according to the numbers Nate uses. I said this family spent $1,500 a year on heat, electricity, and water; his numbers say the average 2.7 member family would spend $2,823. I said this family would spend $1,200 for all telecom services; Nate’s data says this 2.7 member family would spend $1,253 on telephone services alone, with cable, at least, presumably included in the $1,141 of audio and visual equipment and service. So, accepting Nate’s numbers for these services would mean both my costs and probably his, too, for utilities and telecom are still too low for a 4-person family.
And the BLS data Nate uses appears to not account for child care at all (please correct me if I’m wrong here). Nate points out rightly that, “not all families will have a pre-school aged child. The typical child spends 3-4 years in pre-school, but then 12-13 years in the public school system,” but doesn’t account for the fact that I used costs for just one kid in child care, and not the more expensive infant or toddler rates. Also, if these kids were school aged, it would mean the family would spend $1,353 more on food because of the growing kids’ higher calorie requirements. Also, note these costs don’t necessarily have to include child care. Unmanageable college loan debt, unplanned major house repairs, existing medical debt, or credit card debt could all get my middle class family into the same plight without any child care costs and without, necessarily, making this family at all unusual or frivolous.
And then there’s the most ironic place where Nate’s calculations–finding my estimates $10,000 too high–are themselves too low: health care. The BLS data Nate uses shows this family of 2.7 spends $3,229 yearly on health care. Yet, the majority of this pool would get health care through work, a significant number are single, and some (though not many) are on Medicare.
Even Nate’s numbers show this plan is unaffordable for a middle class family
But what’s remarkable is that, even assuming Nate’s numbers are correct and mine are high, those numbers still show that this plan is unaffordable for a family of three paying some child care.
Nate’s numbers show the average income in this bracket is $59,319, with $58,610 left after taxes (note, a family of 3 at 301% of poverty would make $55,131, so this hypothetical 2.7-member family would still fall into the same income bracket I used in my original post). This average family would spend $50,465 a year. So to show what happens when this average family has to pay child care and spend 7.9% of its income on mandated insurance, I’m going to take out the BLS health care costs and add in the 7.9% this family would have to spend under the mandate. And because I argued earlier that these families aren’t spending all that much on entertainment (and therefore couldn’t save money by cutting entertainment expenses), I’m going to back out entertainment costs too. And because Nate said my estimates for taxes were too high, I’m going to take out those, too (though not FICA, which this family would have to pay).
$50,465 (total expenditures)
-$3,229 (less health care expenses)
-$2,936 (less all entertainment costs)
-$709 (less income taxes)
$43,591 (Nate’s numbers less health care, entertainment, income taxes)
+$4,686 (7.9% of $59,319 in income–or the amount paid before opt-out became possible)
+$6,216 (child care for just one four year old in MI)
$54,493
$4,826 (total income less total expenses)
In other words, this family would have just $4,826 left to spend on entertainment (what Nate originally said this family could cut back on) and out-of-pocket health care expenses.
That says a family expected to pay 30% of out-of-pocket health care expenses would blow their entire discretionary budget after $16,086 in medical costs. More than what my other hypothetical family might spend, but still not a catastrophic medical event. And this hypothetical family would have to go $3,147 in debt before government subsidies would pick up the rest of their out-of-pocket expenses. And that’s assuming the family just misses the ability to opt-out. Supposing this family pays the 9.8% the government asks them to pay before subsidizing premiums, the family would spend $5,813 on premiums, blow through their discretionary funds after $12,330 in medical costs, and go $4,274 into debt before out-of-pocket subsidies kicked in. And even if this family got a tax credit of $1,243 for child care rather than paid nothing in income taxes (as I’ve figured here), this family would still go into debt under this plan.
Note, the biggest differences between Nate’s numbers and my earlier scenario are 1) his doesn’t account for all the people in my average family, and 2) his doesn’t account for child care costs.
So let’s look at child care costs. I used data from an industry group–which, since it pushes for tax breaks, may have an incentive to push those costs higher (though mothers in threads say those costs were realistic some years ago). But calculate those costs another way: while this number came from costs for day care for one four-year old in 2005, assuming this family had two children, it would mean a family would spend less than $60/week per child care per child ($120 total). Which even assuming some of them were school age and just needed after school care, wouldn’t be unreasonable amounts.
So even using Nate’s amounts, this family would go into debt because of a significant, though not catastrophic health event; in addition, this family would go into debt before the government subsidies for out-of-pocket expenses kicked in.
Now, Nate says my analysis is “painting an incomplete picture — and somewhat missing the forest for the trees.” You might say of his that he misses the struggling individual middle class families for aggregate data that includes singles and seniors not facing some of the challenges that middle class families are facing. Or you might more charitably say that Nate and I are just talking about totally different things.
But there is one thing that Nate still doesn’t address: affordability of care. He doesn’t use the word “affordable” in his entire post. He does suggest this family–which would go into debt to pay for care–would avoid the problems of such middle class families now.
Marcy is basically treating the $5,243 per year as though it’s a tax hike. That’s not what it is — at all. It’s a deeply discounted — albeit mandatory — service that they’re purchasing. And it’s saving them a lot of money: it either saves them a lot of money every year if they’re already buying insurance, or a lot of money on average if they’re not buying insurance.
And in either case, because of the caps in out-of-pocket expenditures — it also provides them with a lot more certainty in forecasting their income stream. It allows them to come up with a reasonable gameplan.
But he still assumes something that–the MA experience shows–is not true in all cases: that this family will be getting a service in exchange for the 7.9% or 9.8% of its income spent on insurance premiums. 21% of those surveyed in MA said they still couldn’t get the health care they needed because they couldn’t afford it–precisely the situation this hypothetical family would be in. That is, they would have paid for a service–health insurance, but not health care–but still face the choice between going into debt or forgoing necessary care, even with the insurance.
And that’s the complaint. It’s one thing for the IRS to serve as the insurance industry’s collection agency (still allowing the insurance companies 20% in profit and marketing expenses) if, in exchange, you guarantee that health care won’t continue to put middle class families into debt. But for middle class families that have any of a range of fairly typical middle class challenges (like child care costs or leaky roofs or exploding ARMs or college debt), this plan doesn’t do that.
I’m grateful that Nate is beginning to look at how this plan will interact with other middle class expenses. I’m happy to revise these numbers if he or someone else provides more detailed costs for such a middle class family. Perhaps the next conversation we should have is what happens to middle class families like these who–predictably, given the costs involved–will opt out because the plans are too expensive.
But the point I’m trying to make is that this plan does not solve the health care debt problem middle class families are experiencing now–and will still experience under the Senate plan. This plan is not affordable for the middle class. And since we’re talking about mandating these costs, we ought to be having a discussion about what is affordable.
Like Nate, I appreciate having a discussion based in facts and details. And Nate says several of the cost estimates I used to show why the health care bill is unaffordable for middle class families “are on the high side.” I appreciate him checking my numbers–as I have said on several versions of the post I have done on affordability, I’d like to have a real discussion about these costs.
Nate’s numbers are too low
Nate uses a different method than me; rather than building costs up from individual estimates as I did (indeed, Nate never shows what my hypothetical family’s budget would look like), he looks at BLS data, and argues that either, “this is significantly more than most two-child families will be spending on these services — probably by a margin of $10,000 or so,” and/or my hypothetical family, “does not have a reasonable and responsible gameplan to begin with.”
Now, Nate hasn’t actually shown that. Instead, his primary source of numbers shows what the average family in this income bracket ($50,000 to 69,999) would spend. And that family is older (average adult age of 47) and smaller (2.7 people, with just .7 kids) than the family I was discussing. That’s significant in ways that make his costs too low on several counts. For example, over a fifth of the people in the BLS estimate own their home outright. A significant portion are single or couples. Adding older home-owners and singles needing smaller homes into his consideration almost certainly means Nate’s housing costs are too low for a family of four or even three. Similarly, Nate’s figures for food expenses are low by $1,324 (and his average family eats out, which USDA assumes my average family of 4 does not for its calculations).
Plus, Nate doesn’t point to the places where my estimates (based on real expenditures) are quite low, according to the numbers Nate uses. I said this family spent $1,500 a year on heat, electricity, and water; his numbers say the average 2.7 member family would spend $2,823. I said this family would spend $1,200 for all telecom services; Nate’s data says this 2.7 member family would spend $1,253 on telephone services alone, with cable, at least, presumably included in the $1,141 of audio and visual equipment and service. So, accepting Nate’s numbers for these services would mean both my costs and probably his, too, for utilities and telecom are still too low for a 4-person family.
And the BLS data Nate uses appears to not account for child care at all (please correct me if I’m wrong here). Nate points out rightly that, “not all families will have a pre-school aged child. The typical child spends 3-4 years in pre-school, but then 12-13 years in the public school system,” but doesn’t account for the fact that I used costs for just one kid in child care, and not the more expensive infant or toddler rates. Also, if these kids were school aged, it would mean the family would spend $1,353 more on food because of the growing kids’ higher calorie requirements. Also, note these costs don’t necessarily have to include child care. Unmanageable college loan debt, unplanned major house repairs, existing medical debt, or credit card debt could all get my middle class family into the same plight without any child care costs and without, necessarily, making this family at all unusual or frivolous.
And then there’s the most ironic place where Nate’s calculations–finding my estimates $10,000 too high–are themselves too low: health care. The BLS data Nate uses shows this family of 2.7 spends $3,229 yearly on health care. Yet, the majority of this pool would get health care through work, a significant number are single, and some (though not many) are on Medicare.
Even Nate’s numbers show this plan is unaffordable for a middle class family
But what’s remarkable is that, even assuming Nate’s numbers are correct and mine are high, those numbers still show that this plan is unaffordable for a family of three paying some child care.
Nate’s numbers show the average income in this bracket is $59,319, with $58,610 left after taxes (note, a family of 3 at 301% of poverty would make $55,131, so this hypothetical 2.7-member family would still fall into the same income bracket I used in my original post). This average family would spend $50,465 a year. So to show what happens when this average family has to pay child care and spend 7.9% of its income on mandated insurance, I’m going to take out the BLS health care costs and add in the 7.9% this family would have to spend under the mandate. And because I argued earlier that these families aren’t spending all that much on entertainment (and therefore couldn’t save money by cutting entertainment expenses), I’m going to back out entertainment costs too. And because Nate said my estimates for taxes were too high, I’m going to take out those, too (though not FICA, which this family would have to pay).
$50,465 (total expenditures)
-$3,229 (less health care expenses)
-$2,936 (less all entertainment costs)
-$709 (less income taxes)
$43,591 (Nate’s numbers less health care, entertainment, income taxes)
+$4,686 (7.9% of $59,319 in income–or the amount paid before opt-out became possible)
+$6,216 (child care for just one four year old in MI)
$54,493
$4,826 (total income less total expenses)
In other words, this family would have just $4,826 left to spend on entertainment (what Nate originally said this family could cut back on) and out-of-pocket health care expenses.
That says a family expected to pay 30% of out-of-pocket health care expenses would blow their entire discretionary budget after $16,086 in medical costs. More than what my other hypothetical family might spend, but still not a catastrophic medical event. And this hypothetical family would have to go $3,147 in debt before government subsidies would pick up the rest of their out-of-pocket expenses. And that’s assuming the family just misses the ability to opt-out. Supposing this family pays the 9.8% the government asks them to pay before subsidizing premiums, the family would spend $5,813 on premiums, blow through their discretionary funds after $12,330 in medical costs, and go $4,274 into debt before out-of-pocket subsidies kicked in. And even if this family got a tax credit of $1,243 for child care rather than paid nothing in income taxes (as I’ve figured here), this family would still go into debt under this plan.
Note, the biggest differences between Nate’s numbers and my earlier scenario are 1) his doesn’t account for all the people in my average family, and 2) his doesn’t account for child care costs.
So let’s look at child care costs. I used data from an industry group–which, since it pushes for tax breaks, may have an incentive to push those costs higher (though mothers in threads say those costs were realistic some years ago). But calculate those costs another way: while this number came from costs for day care for one four-year old in 2005, assuming this family had two children, it would mean a family would spend less than $60/week per child care per child ($120 total). Which even assuming some of them were school age and just needed after school care, wouldn’t be unreasonable amounts.
So even using Nate’s amounts, this family would go into debt because of a significant, though not catastrophic health event; in addition, this family would go into debt before the government subsidies for out-of-pocket expenses kicked in.
Now, Nate says my analysis is “painting an incomplete picture — and somewhat missing the forest for the trees.” You might say of his that he misses the struggling individual middle class families for aggregate data that includes singles and seniors not facing some of the challenges that middle class families are facing. Or you might more charitably say that Nate and I are just talking about totally different things.
But there is one thing that Nate still doesn’t address: affordability of care. He doesn’t use the word “affordable” in his entire post. He does suggest this family–which would go into debt to pay for care–would avoid the problems of such middle class families now.
Marcy is basically treating the $5,243 per year as though it’s a tax hike. That’s not what it is — at all. It’s a deeply discounted — albeit mandatory — service that they’re purchasing. And it’s saving them a lot of money: it either saves them a lot of money every year if they’re already buying insurance, or a lot of money on average if they’re not buying insurance.
And in either case, because of the caps in out-of-pocket expenditures — it also provides them with a lot more certainty in forecasting their income stream. It allows them to come up with a reasonable gameplan.
But he still assumes something that–the MA experience shows–is not true in all cases: that this family will be getting a service in exchange for the 7.9% or 9.8% of its income spent on insurance premiums. 21% of those surveyed in MA said they still couldn’t get the health care they needed because they couldn’t afford it–precisely the situation this hypothetical family would be in. That is, they would have paid for a service–health insurance, but not health care–but still face the choice between going into debt or forgoing necessary care, even with the insurance.
And that’s the complaint. It’s one thing for the IRS to serve as the insurance industry’s collection agency (still allowing the insurance companies 20% in profit and marketing expenses) if, in exchange, you guarantee that health care won’t continue to put middle class families into debt. But for middle class families that have any of a range of fairly typical middle class challenges (like child care costs or leaky roofs or exploding ARMs or college debt), this plan doesn’t do that.
I’m grateful that Nate is beginning to look at how this plan will interact with other middle class expenses. I’m happy to revise these numbers if he or someone else provides more detailed costs for such a middle class family. Perhaps the next conversation we should have is what happens to middle class families like these who–predictably, given the costs involved–will opt out because the plans are too expensive.
But the point I’m trying to make is that this plan does not solve the health care debt problem middle class families are experiencing now–and will still experience under the Senate plan. This plan is not affordable for the middle class. And since we’re talking about mandating these costs, we ought to be having a discussion about what is affordable.
If This Were Germany, Denmark, Belgium, or France, We Would Not Need Affordability Tax Credits
By FireDogLake's Jon Walker FDL
Our health care system is unbelievably more expensive than any other first world nation. On a per capita basis, we spend over 50% more on health care than the second most expensive nation, Norway. As a nation, we spend more than twice as much per capita on health care than first world countries like Germany, Denmark, Belgium, France, Sweden, the UK, or Australia. If we actually got real health care reform that brought our health care costs down closer to the rest of the industrialized world, their would be no need to grant affordability tax credits on the new exchange.
In 2016, the Senate bill will spend $76 billion on affordability tax credits in the new exchange. The CBO says in 2016,
The majority of nongroup enrollees (about 57 percent) would receive subsidies via the new insurance exchanges, and those subsidies, on average, would cover nearly two-thirds of the total premium
Using this data, I can estimate that roughly $210 billion will be spent on premiums in the non-group market in 2016. Of that $210 billion, about 36% ($76 billion) will by paid for by the government in the form of tax credits, and about 64% ($134 billion) will be paid directly by individuals.
If we had a health care system as cost effective as Germany, Denmark, or France, that $134 billion paid by individuals would be more than enough to cover everyone in the non-group market with several billion left over. If we could truly reform our broken health care system and bring its costs in line with the rest of the industrialized world, there would be no need for large government tax credits on the exchange. Think about that for a moment. Even with the government picking up about 36% of the cost, individuals in the new exchanges would still be dramatically overpaying for health insurance compared to the rest of the world.
What this bill does is expand something called “coverage” and adds some new regulations to insures. It is not real health care reform. Because Obama cut sweetheart deals with the hospitals, doctors, and drug companies, true cost-controlling reform became impossible.
Some supporters of the Senate bill have pointed to all the money going to middle class families to help them afford insurance as a great thing. The help is nice, but it only points to how terrible the underlying problem really is. It is simply a strategy of throwing good money after bad. Middle class families should not need government subsidies to afford health insurance. What middle class American families really need is for our government to rein in the different industries ruining our health care system, not pass a bill that will only enrich and empower them further.
Our health care system is unbelievably more expensive than any other first world nation. On a per capita basis, we spend over 50% more on health care than the second most expensive nation, Norway. As a nation, we spend more than twice as much per capita on health care than first world countries like Germany, Denmark, Belgium, France, Sweden, the UK, or Australia. If we actually got real health care reform that brought our health care costs down closer to the rest of the industrialized world, their would be no need to grant affordability tax credits on the new exchange.
In 2016, the Senate bill will spend $76 billion on affordability tax credits in the new exchange. The CBO says in 2016,
The majority of nongroup enrollees (about 57 percent) would receive subsidies via the new insurance exchanges, and those subsidies, on average, would cover nearly two-thirds of the total premium
Using this data, I can estimate that roughly $210 billion will be spent on premiums in the non-group market in 2016. Of that $210 billion, about 36% ($76 billion) will by paid for by the government in the form of tax credits, and about 64% ($134 billion) will be paid directly by individuals.
If we had a health care system as cost effective as Germany, Denmark, or France, that $134 billion paid by individuals would be more than enough to cover everyone in the non-group market with several billion left over. If we could truly reform our broken health care system and bring its costs in line with the rest of the industrialized world, there would be no need for large government tax credits on the exchange. Think about that for a moment. Even with the government picking up about 36% of the cost, individuals in the new exchanges would still be dramatically overpaying for health insurance compared to the rest of the world.
What this bill does is expand something called “coverage” and adds some new regulations to insures. It is not real health care reform. Because Obama cut sweetheart deals with the hospitals, doctors, and drug companies, true cost-controlling reform became impossible.
Some supporters of the Senate bill have pointed to all the money going to middle class families to help them afford insurance as a great thing. The help is nice, but it only points to how terrible the underlying problem really is. It is simply a strategy of throwing good money after bad. Middle class families should not need government subsidies to afford health insurance. What middle class American families really need is for our government to rein in the different industries ruining our health care system, not pass a bill that will only enrich and empower them further.
Criticizing The President On Health Care
By FireDogLake's Jane Hamsher FDL
There’s a very slick PR letter posted online that’s being furiously retweeted by DC political operatives. I wasn’t going to address it, but the editor of the Nation Katrina vanden Heuvel started pushing it. It becomes widely disseminated based on her role as a validator within the progressive community, and that necessitated a reply.
The letter says:
I do not doubt that you genuinely feel that your very vocal opposition to the Senate health care bill is in the absolute interests of the American populace and progressive politics. I honestly believe that you feel that the administration has let you and other progressives down by not publically pushing harder for elements in the bill that we all hoped would survive the legislative process.
What I doubt is that your actions will ultimately serve the advancement of the progressive agenda that you obviously care so much about. I believe in fact, that quite the opposite will be the result. Pushing for the very best bill that we can get through this congress is laudable, attacking the administration for dealing with the reality that is congress is not.
You can argue that this bill helps people and is therefore progressive. I would argue that it forces the middle class to pay almost as much to private insurance companies as they do in federal taxes, weakens the coverage of those who have employer-based insurance, and is a Shock Doctrine attempt to raid the public sphere of unprecedented magnitude. I come down on the side of Marcy Wheeler, wrote an important post entitled “Health Care on the Road to Neofeudalism“:
I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.
But the truly creepy thing about the letter being pushed by Katrina (in addition to all the manipulative Orwellian language), is that it doesn’t argue the bill itself is progressive. Rather, it says “attacking the administration for dealing with the reality that is congress” is not “laudable” and hurts the “progressive agenda.”
It is manifestly untrue that the bill is the handiwork of Congress, for which the President bears no responsibility. The White House negotiated this bill with lobbyists starting early in the year. As Marc Ambinder reported shortly after the inauguration, the official White House strategy would be to deflect responsibility for anything unpopular onto Congress.
But Rahm Emanuel’s need for self-promotion keeps stepping on that plan. The New York Times is just one of many places that has reported that he has been running the show all along:
Rahm Emanuel, the chief of staff, runs the campaign out of his West Wing office. A former congressman, he knows how to count votes. (It was Mr. Emanuel, for instance, who suggested Mr. Orszag reach out to Ms. Collins.) Aides say he does not host a regular health care meeting, but rather summons his team several times a day, typically with e-mail messages ordering colleagues to drop everything and show up right that minute.
On October 5, I wrote “Countdown to Lieberman,” saying it was only a matter of time before Joe stepped in and we started hearing that old song about “60 votes” again. And Brian Beutler reported that when it came time to deliver a bill to the Senate and yank the public option on October 25, Obama didn’t want to take credit for Rahm’s handiwork:
Reid wants Obama to do it to give cover to his caucus, Obama wants Reid to do it so he’s not the bad guy on the public option, and can still walk away with a win with reform, with bipartisanship, and with a card for everybody running for re-election.”
The Obama White House has been working furiously to pass an enormous transfer of wealth to the insurance companies from the start. I don’t see how reporting this constitutes “attacking the administration,” or why it “hurts” the “progressive agenda” to do so. So, I was very surprised that Katrina would promote and give the imprimateur of the Nation to a blog post encouraging me not to be critical of the administration on health care, and to accept the fiction that this bill is the fault of Congress. I asked her why she was doing this, and she replied:
Big tent. Divisions within progressive community can’t be wished away. Respect your views; worth respecting others’ views.
It’s not such a big tent when you’re promoting something that tells someone to stop criticizing the president’s role in crafting the health care bill, nor does it “respect” the views of anyone who disagrees with that contention on the basis of well-documented evidence. Yet the editor of the Nation is granting its legitimacy to a post which attempts to stifle criticism of the president and dismisses it as “Naderite,” equating the “progressive agenda” with “what’s politically advantageous for the President.”
Recently, Glenn Greenwald wrote in a post entitled “White House as helpless victim on health care“:
Of all the posts I wrote this year, the one that produced the most vociferous email backlash — easily — was this one from August, which examined substantial evidence showing that, contrary to Obama’s occasional public statements in support of a public option, the White House clearly intended from the start that the final health care reform bill would contain no such provision and was actively and privately participating in efforts to shape a final bill without it. From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House — hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama’s campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN). Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn’t pass it. The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party — rather than the GOP – will continue to be the prime recipient of industry largesse.
Glenn was indeed roundly attacked for asserting that this bill is the handiwork of the White House, even though as he says “the evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives.” And Russ Feingold backs him up:
“This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth,” said Feingold. “I think they could have been higher. I certainly think a stronger bill would have been better in every respect.”
Despite this evidence, there is an orchestrated, active, full-court press to discredit and silence anyone who tries to point out the responsibility the president bears for crafting this bill. I’m surprised that the editor of the Nation would take part in it.
There’s a very slick PR letter posted online that’s being furiously retweeted by DC political operatives. I wasn’t going to address it, but the editor of the Nation Katrina vanden Heuvel started pushing it. It becomes widely disseminated based on her role as a validator within the progressive community, and that necessitated a reply.
The letter says:
I do not doubt that you genuinely feel that your very vocal opposition to the Senate health care bill is in the absolute interests of the American populace and progressive politics. I honestly believe that you feel that the administration has let you and other progressives down by not publically pushing harder for elements in the bill that we all hoped would survive the legislative process.
What I doubt is that your actions will ultimately serve the advancement of the progressive agenda that you obviously care so much about. I believe in fact, that quite the opposite will be the result. Pushing for the very best bill that we can get through this congress is laudable, attacking the administration for dealing with the reality that is congress is not.
You can argue that this bill helps people and is therefore progressive. I would argue that it forces the middle class to pay almost as much to private insurance companies as they do in federal taxes, weakens the coverage of those who have employer-based insurance, and is a Shock Doctrine attempt to raid the public sphere of unprecedented magnitude. I come down on the side of Marcy Wheeler, wrote an important post entitled “Health Care on the Road to Neofeudalism“:
I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.
But the truly creepy thing about the letter being pushed by Katrina (in addition to all the manipulative Orwellian language), is that it doesn’t argue the bill itself is progressive. Rather, it says “attacking the administration for dealing with the reality that is congress” is not “laudable” and hurts the “progressive agenda.”
It is manifestly untrue that the bill is the handiwork of Congress, for which the President bears no responsibility. The White House negotiated this bill with lobbyists starting early in the year. As Marc Ambinder reported shortly after the inauguration, the official White House strategy would be to deflect responsibility for anything unpopular onto Congress.
But Rahm Emanuel’s need for self-promotion keeps stepping on that plan. The New York Times is just one of many places that has reported that he has been running the show all along:
Rahm Emanuel, the chief of staff, runs the campaign out of his West Wing office. A former congressman, he knows how to count votes. (It was Mr. Emanuel, for instance, who suggested Mr. Orszag reach out to Ms. Collins.) Aides say he does not host a regular health care meeting, but rather summons his team several times a day, typically with e-mail messages ordering colleagues to drop everything and show up right that minute.
On October 5, I wrote “Countdown to Lieberman,” saying it was only a matter of time before Joe stepped in and we started hearing that old song about “60 votes” again. And Brian Beutler reported that when it came time to deliver a bill to the Senate and yank the public option on October 25, Obama didn’t want to take credit for Rahm’s handiwork:
Reid wants Obama to do it to give cover to his caucus, Obama wants Reid to do it so he’s not the bad guy on the public option, and can still walk away with a win with reform, with bipartisanship, and with a card for everybody running for re-election.”
The Obama White House has been working furiously to pass an enormous transfer of wealth to the insurance companies from the start. I don’t see how reporting this constitutes “attacking the administration,” or why it “hurts” the “progressive agenda” to do so. So, I was very surprised that Katrina would promote and give the imprimateur of the Nation to a blog post encouraging me not to be critical of the administration on health care, and to accept the fiction that this bill is the fault of Congress. I asked her why she was doing this, and she replied:
Big tent. Divisions within progressive community can’t be wished away. Respect your views; worth respecting others’ views.
It’s not such a big tent when you’re promoting something that tells someone to stop criticizing the president’s role in crafting the health care bill, nor does it “respect” the views of anyone who disagrees with that contention on the basis of well-documented evidence. Yet the editor of the Nation is granting its legitimacy to a post which attempts to stifle criticism of the president and dismisses it as “Naderite,” equating the “progressive agenda” with “what’s politically advantageous for the President.”
Recently, Glenn Greenwald wrote in a post entitled “White House as helpless victim on health care“:
Of all the posts I wrote this year, the one that produced the most vociferous email backlash — easily — was this one from August, which examined substantial evidence showing that, contrary to Obama’s occasional public statements in support of a public option, the White House clearly intended from the start that the final health care reform bill would contain no such provision and was actively and privately participating in efforts to shape a final bill without it. From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House — hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama’s campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN). Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn’t pass it. The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party — rather than the GOP – will continue to be the prime recipient of industry largesse.
Glenn was indeed roundly attacked for asserting that this bill is the handiwork of the White House, even though as he says “the evidence was overwhelming from the start that the White House was not only indifferent, but opposed, to the provisions most important to progressives.” And Russ Feingold backs him up:
“This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth,” said Feingold. “I think they could have been higher. I certainly think a stronger bill would have been better in every respect.”
Despite this evidence, there is an orchestrated, active, full-court press to discredit and silence anyone who tries to point out the responsibility the president bears for crafting this bill. I’m surprised that the editor of the Nation would take part in it.
Tuesday, December 29, 2009
Health INSURANCE Is Not The Same As Health CARE
By The Left Coaster's Turkana TLC
A common misunderstandings drives much of the online debate over the health insurance bill. It is the difference between health care and health insurance. They are not the same, yet defenders of the various and increasingly compromised iterations of the health care bill frequently argue as if they were.
As previously diaried, the most obvious example of this fundamental difference comes in the literally deadly form of denial of treatment. Insurers sometimes refuse to pay for the expensive treatments that could save the lives of policy-holders. Without again going into the details, this Los Angeles Times article gives a concise explanation. So does this Philadelphia Inquirer article (h/t aravir). So, with this in mind, it's worth revisiting some of the arguments made by defenders of the health care bill, to elucidate how this fundamental misunderstanding obfuscates very real problems with the bill. The defense of the bill will be italicized. The response will follow.
Some 30 million more people will be covered.
This is the classic misunderstanding, because being covered means having insurance, it does not mean the insurance has to pay for expensive treatments. There is no defined rule to ensure that the newly insured will receive adequate health care.
But insurers won't be able to refuse people with pre-existing conditions.
Insurers will be forced to take money from people with pre-existing conditions, and give them insurance policies. But because there is a difference between providing coverage and providing care, this doesn't mean insurers will be required to pay for the expensive treatments those pre-existing conditions require. Some people with pre-existing conditions will be forced to buy policies that simply won't meet their medical needs. A nice lose-lose for people suffering from chronic and/or severe health conditions.
But people will be able to shop for different policies, on the exchange.
Why do you think the antitrust exemption is so important to insurers? It gives insurers impunity to collude with each other to ensure that options on the exchange are limited. Nothing is to prevent all insurers from agreeing that certain expensive treatments are not worth paying for, and that people with the conditions requiring those treatments won't have any good alternatives. Once again, they will be forced to buy policies that won't meet their medical needs.
But there are mechanisms that allow people to appeal denials of treatment.
And such mechanisms exist, even now. But there are no strict guidelines as to how such appeals are to be resolved, and there are no strict guidelines as to how long the appeals can take. In some cases, those appeals run out the clocks on people's lives.
But there are mechanisms that prevent insurers from stopping coverage during the appeals process.
But once again, this confuses health insurance with health care. The insurers won't be able to drop people from being covered, but that doesn't mean they will be forced to pay for the treatments. During the appeals process, the policies will remain intact. But treatments can still be refused.
But insurers will be required to spend 90% of their premiums on patient care.
Not only are there are no enforcement mechanisms, but because insurers can own providers, that 90% of premiums that supposedly goes to care can be whittled down as the profit margins of those owned providers. Don't be surprised if this bill is followed by waves of corporate consolidation.
Once again, it's not complicated. Semantics. A deliberate confusion that will take many people by surprise. But the insurers themselves won't be surprised. They know better than we what loopholes will be protected in the new health insurance laws. And they already know, very well, that the new health insurance laws will not be health care laws. They understand the difference between health insurance and health care, even if many supporters of the bill do not. And do not for a moment delude yourself into believing that they aren't already planning how to exploit those loopholes.
A common misunderstandings drives much of the online debate over the health insurance bill. It is the difference between health care and health insurance. They are not the same, yet defenders of the various and increasingly compromised iterations of the health care bill frequently argue as if they were.
As previously diaried, the most obvious example of this fundamental difference comes in the literally deadly form of denial of treatment. Insurers sometimes refuse to pay for the expensive treatments that could save the lives of policy-holders. Without again going into the details, this Los Angeles Times article gives a concise explanation. So does this Philadelphia Inquirer article (h/t aravir). So, with this in mind, it's worth revisiting some of the arguments made by defenders of the health care bill, to elucidate how this fundamental misunderstanding obfuscates very real problems with the bill. The defense of the bill will be italicized. The response will follow.
Some 30 million more people will be covered.
This is the classic misunderstanding, because being covered means having insurance, it does not mean the insurance has to pay for expensive treatments. There is no defined rule to ensure that the newly insured will receive adequate health care.
But insurers won't be able to refuse people with pre-existing conditions.
Insurers will be forced to take money from people with pre-existing conditions, and give them insurance policies. But because there is a difference between providing coverage and providing care, this doesn't mean insurers will be required to pay for the expensive treatments those pre-existing conditions require. Some people with pre-existing conditions will be forced to buy policies that simply won't meet their medical needs. A nice lose-lose for people suffering from chronic and/or severe health conditions.
But people will be able to shop for different policies, on the exchange.
Why do you think the antitrust exemption is so important to insurers? It gives insurers impunity to collude with each other to ensure that options on the exchange are limited. Nothing is to prevent all insurers from agreeing that certain expensive treatments are not worth paying for, and that people with the conditions requiring those treatments won't have any good alternatives. Once again, they will be forced to buy policies that won't meet their medical needs.
But there are mechanisms that allow people to appeal denials of treatment.
And such mechanisms exist, even now. But there are no strict guidelines as to how such appeals are to be resolved, and there are no strict guidelines as to how long the appeals can take. In some cases, those appeals run out the clocks on people's lives.
But there are mechanisms that prevent insurers from stopping coverage during the appeals process.
But once again, this confuses health insurance with health care. The insurers won't be able to drop people from being covered, but that doesn't mean they will be forced to pay for the treatments. During the appeals process, the policies will remain intact. But treatments can still be refused.
But insurers will be required to spend 90% of their premiums on patient care.
Not only are there are no enforcement mechanisms, but because insurers can own providers, that 90% of premiums that supposedly goes to care can be whittled down as the profit margins of those owned providers. Don't be surprised if this bill is followed by waves of corporate consolidation.
Once again, it's not complicated. Semantics. A deliberate confusion that will take many people by surprise. But the insurers themselves won't be surprised. They know better than we what loopholes will be protected in the new health insurance laws. And they already know, very well, that the new health insurance laws will not be health care laws. They understand the difference between health insurance and health care, even if many supporters of the bill do not. And do not for a moment delude yourself into believing that they aren't already planning how to exploit those loopholes.
Monday, December 28, 2009
New Year's Resolution: Don't Apologize for Democrats
By The Huffington Post's Jeff Cohen Author and Media Critic The Huffington Post
For the new year, let's resolve: Don't defend Democrats when they don't deserve defending. And that certainly includes President Obama.
Let's further resolve: Put principles above party and never lose our voice on human rights and social justice.
When we mute ourselves as a Democratic president pursues corporatist or militarist policies, we only encourage such policies.
If it was wrong for Bush to bail out Wall Street with virtually no controls, then it's wrong for Obama. If indefinite "preventative detention" was wrong under Bush, then it's wrong under Obama. If military occupation and deepening troop deployments were wrong under Bush, then they're wrong under Obama.
Imagine if McCain had defeated Obama in 2008 and soon tripled the number of U.S. troops in Afghanistan. I have little doubt that activists would have mobilized major opposition, denouncing the reality of more U.S. soldiers in Afghanistan and Iraq combined than even Bush had deployed.
But as Obama goes about tripling the troops in Afghanistan, with more U.S. soldiers in war zones that Bush ever had -- and proposes the biggest military budget in world history -- many activists have lost their voices.
When Obama's West Point speech on Afghanistan paid lip service to benchmarks and a timeline (as even Bush learned to do on Iraq), how did the once independent MoveOn react? Its leaders sent out a muted petition urging -- benchmarks and a timeline. The email might as well have been written by Rahm Emanuel in the West Wing.
Taking cues from the Obama White House, liberal groups went quiet on Wall Street bailouts and bonuses -- thus helping rightwing teabaggers and corporate-fronts to pose as populist saviors of the middle class.
By going soft on the White House or Democratic Congressional leaders, most netroots groups have undermined genuine progressives in Congress -- on issues from Iraq and Afghanistan to Wall Street and health care.
Instead of launching their health care reform efforts behind an easily-explained, cost-effective "Enhanced Medicare for All" bill co-sponsored by dozens of progressive Congress members, netroots leaders meekly made a "public option" their starting demand and pretended not to notice when Rahm Emanuel began signaling last spring that the White House had no intention of pushing for it.
Predictably, we've ended up with corporate-enrichment legislation that forcibly delivers tens of millions of customers to big insurers and big pharma -- with almost no cost controls because of private deals cut in the White House . In the New York Times before Christmas, beneath an accurate header "Corporate Glee," a news article asserted: "The insurance companies were probably among the merriest of industries last week . . . But the drug companies were certainly joyful, too." Insurance stocks are soaring on Wall Street.
It's tragically ironic that netroots forces joined Democratic leaders in killing Medicare for All as an unrealistic starting demand and now are belatedly urging "kill the bill."
I'm old enough to remember that when Democrats are in majority power -- controlling both ends of Pennsylvania Avenue -- they are capable of horrific policies. With Lyndon Johnson in the White House, most Democrats in Congress went along with Vietnam escalation. And with President Clinton, some leading Congressional Democrats joined mostly Republicans in backing the anti-worker, anti-environmental NAFTA.
The good news -- during the eras of Vietnam and NAFTA -- is that large numbers of progressive activists stood fast to their principles and vocally opposed those wrong-headed Democratic policies. They didn't follow Democratic leaders over the cliff or pretend that Democratic presidents are automatically "on our side" or well-intentioned.
And back then we lacked the most awesome tool ever invented for independent grassroots mobilization: the Internet.
The Net has helped unleash a golden age for independent media -- and for journalists unafraid to challenge leaders of both parties: folks like Glenn Greenwald, Jeremy Scahill, Arianna Huffington, Matt Taibbi and Amy Goodman, to name a few.
Thanks to the Internet and independent media, progressive activists are more fully and more quickly informed about national and global issues than ever. Yet many activists are poorly represented by national netroots groups that often function as appendages of the Democratic leadership.
While independent progressive media are booming on the Internet, the largest netroots political-action groups are sorely lacking in independence.
Be it resolved: In 2010, we will not apologize for indefensible Democratic policies, and we will no longer support netroots groups that fail to resist such policies.
Jeff Cohen is director of the Park Center for Independent Media at Ithaca College and a former board member of Progressive Democrats of America .
For the new year, let's resolve: Don't defend Democrats when they don't deserve defending. And that certainly includes President Obama.
Let's further resolve: Put principles above party and never lose our voice on human rights and social justice.
When we mute ourselves as a Democratic president pursues corporatist or militarist policies, we only encourage such policies.
If it was wrong for Bush to bail out Wall Street with virtually no controls, then it's wrong for Obama. If indefinite "preventative detention" was wrong under Bush, then it's wrong under Obama. If military occupation and deepening troop deployments were wrong under Bush, then they're wrong under Obama.
Imagine if McCain had defeated Obama in 2008 and soon tripled the number of U.S. troops in Afghanistan. I have little doubt that activists would have mobilized major opposition, denouncing the reality of more U.S. soldiers in Afghanistan and Iraq combined than even Bush had deployed.
But as Obama goes about tripling the troops in Afghanistan, with more U.S. soldiers in war zones that Bush ever had -- and proposes the biggest military budget in world history -- many activists have lost their voices.
When Obama's West Point speech on Afghanistan paid lip service to benchmarks and a timeline (as even Bush learned to do on Iraq), how did the once independent MoveOn react? Its leaders sent out a muted petition urging -- benchmarks and a timeline. The email might as well have been written by Rahm Emanuel in the West Wing.
Taking cues from the Obama White House, liberal groups went quiet on Wall Street bailouts and bonuses -- thus helping rightwing teabaggers and corporate-fronts to pose as populist saviors of the middle class.
By going soft on the White House or Democratic Congressional leaders, most netroots groups have undermined genuine progressives in Congress -- on issues from Iraq and Afghanistan to Wall Street and health care.
Instead of launching their health care reform efforts behind an easily-explained, cost-effective "Enhanced Medicare for All" bill co-sponsored by dozens of progressive Congress members, netroots leaders meekly made a "public option" their starting demand and pretended not to notice when Rahm Emanuel began signaling last spring that the White House had no intention of pushing for it.
Predictably, we've ended up with corporate-enrichment legislation that forcibly delivers tens of millions of customers to big insurers and big pharma -- with almost no cost controls because of private deals cut in the White House . In the New York Times before Christmas, beneath an accurate header "Corporate Glee," a news article asserted: "The insurance companies were probably among the merriest of industries last week . . . But the drug companies were certainly joyful, too." Insurance stocks are soaring on Wall Street.
It's tragically ironic that netroots forces joined Democratic leaders in killing Medicare for All as an unrealistic starting demand and now are belatedly urging "kill the bill."
I'm old enough to remember that when Democrats are in majority power -- controlling both ends of Pennsylvania Avenue -- they are capable of horrific policies. With Lyndon Johnson in the White House, most Democrats in Congress went along with Vietnam escalation. And with President Clinton, some leading Congressional Democrats joined mostly Republicans in backing the anti-worker, anti-environmental NAFTA.
The good news -- during the eras of Vietnam and NAFTA -- is that large numbers of progressive activists stood fast to their principles and vocally opposed those wrong-headed Democratic policies. They didn't follow Democratic leaders over the cliff or pretend that Democratic presidents are automatically "on our side" or well-intentioned.
And back then we lacked the most awesome tool ever invented for independent grassroots mobilization: the Internet.
The Net has helped unleash a golden age for independent media -- and for journalists unafraid to challenge leaders of both parties: folks like Glenn Greenwald, Jeremy Scahill, Arianna Huffington, Matt Taibbi and Amy Goodman, to name a few.
Thanks to the Internet and independent media, progressive activists are more fully and more quickly informed about national and global issues than ever. Yet many activists are poorly represented by national netroots groups that often function as appendages of the Democratic leadership.
While independent progressive media are booming on the Internet, the largest netroots political-action groups are sorely lacking in independence.
Be it resolved: In 2010, we will not apologize for indefensible Democratic policies, and we will no longer support netroots groups that fail to resist such policies.
Jeff Cohen is director of the Park Center for Independent Media at Ithaca College and a former board member of Progressive Democrats of America .
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