I just watched Howard Dean on Meet the Press, and while he’s not supporting the health care bill, he’s no longer arguing that we should “kill the bill.”
Dean acknowledged that a number of improvements have been made the the Senate version over the past week, and he insists more improvements need to be made in conference. Many of his points might be attainable, so we can expect more improvements as the conference gets underway.
He doesn’t support the bill, and he may not support the final compromise, but his arguments are now much more constructive in how the bill can keep improving. He didn’t mention the reconciliation process once, and he refused to repeat his suggestion that Democrats should kill the bill.
He also explains why conservatives naturally hate it. It will, over time, lead to more government as the notion of universal coverage becomes expected by Americans.
Ezra Klein has made a name for himself during this health care debate. He’s one of the most sensible writers out there, and he’s great with the details and the big picture.
I still believe health care will look more similar than different when the day is done. A good bill will pass, if not a sufficient one. A sum of money will be appropriated, and a basic infrastructure constructed that will be, in the long-run, understood as a tremendous, even unlikely, political victory. The next steps will be easier, because $80 billion is easier to find than $900 billion, and because the argument over whether America has a universal health-care system and whether government provides some of the funding and scaffolding will be over. The money will be there. The scaffolding, too. The universal structure, built around the mandate and the exchanges and the subsidies, will be firmly in place.
At this point, an odd dynamic has developed, in which most all of the right, and some on the left, believe they’d be better served by the defeat of this bill. It is unlikely that they are both correct. But the right has had substantially more experience than the left opposing government initiatives before they can take root and grow into popular entitlements.
Look at the development of Medicare and Social Security, of Medicaid and S-CHIP, the Swedish and Canadian health-care systems, public education. Social Security was designed to exclude African Americans. Medicare didn’t cover prescription drugs. Medicaid was mainly for pregnant women and their young children. Canada’s system was limited to a single province. There was no University of California at Los Angeles.
It’s difficult to conclude that these things slip backward rather than marching forward. The $900 billion for people who need help, the regulations on insurers and the exchanges that will force them to compete, the structure that will make health care nearly universal and the trends that suggest more people — and more politically powerful people — will be entering the new system as employer-based health care erodes — it all makes this look even more like the sort of program that will take root and be made better, as opposed to the sort of common opportunity people should feel comfortable rejecting. It doesn’t feel like that now. But then, it rarely does.
Every liberal should read this. There’s a reason the Republicans are abusing every stall tactic they can muster in the Senate to delay this bill. They want to kill it all costs. It will lead to everything they despise, and everything liberals want. The details now really don’t matter. Once this is set in motion, they’ll never be able to turn back the clock.
In that context, it’s stunning to hear people like Howard Dean and Keith Olbermann play into the GOP’s hands by arguing that the bill should be scrapped. In one sense, as Kos pointed out, it’s healthy to have a real debate on the left. But Dean and Olbermann have taken it too far, risking everything.
I’m not suggesting that Obama policies alone are driving the stock market. Many factors, particularly earnings, drive the overall market.
But, many conservatives were quick to blame Obama when the market slipped in the spring, implying he was to blame as opposed to the economic crisis he inherited. Melissa Francis and some of the other conservative market worshipers at CNBC were just a few of the examples. Well, the market is now up, and we’re not hearing conservatives talk about it much any more.
Former Senate Majority Leader Bob Dole (R-Kans.) told a group of local Kansas reporters on Wednesday, that opposition to the president’s health care package had been driven by knee-jerk partisanship and urged Congressional Republicans to get on board a version of reform.
* * * *
“Sometimes people fight you just to fight you,” he said, according to The Kansas City Star. “They don’t want Reagan to get it, they don’t want Obama to get it, so we’ve got to kill it…
We’ve also seen an AP poll today that shows a rebound in President Obama’s approval rating and the approval for health care reform, along with a score from the CBO that shows the Senate Finance bill would actually reduce the deficit by over $80 billion, which would give plenty of negotiating room for liberals who want to expand certain parts of the bill.
The untimely disappearance of Sally Marrari’s medical coverage goes a long way toward explaining why insurance companies are cast as the villain in the health-care reform drama.
“They said I never mentioned I had a back problem,” said Marrari, 52, whose coverage with Blue Cross was abruptly canceled in 2006 after a thyroid disorder, fluid in the heart and lupus were diagnosed. That left the Los Angeles woman with $25,000 in medical bills and the stigma of the company’s claim that she had committed fraud by not listing on a health questionnaire “preexisting conditions” Marrari said she did not know she had.
By the time she filed a lawsuit in 2008, she also got a diagnosis of pancreatic cancer and her debts had swelled beyond $200,000. She was able to see a specialist by trading office visits for work on the doctor’s 1969 Porsche at the garage she owns with her husband.
This outrageous behavior by insurance companies happens way too often in this country. It’s an outrage and it’s why we need reform. Insurance companies want to increase profits, so they screw over patients by canceling their policies when they need it most.
In the past 18 months, California’s five largest insurers paid almost $19 million in fines for marooning policyholders who had fallen ill. That includes a $1 million fine against Health Net, which admitted offering bonuses to employees for finding reasons to cancel policies, according to company documents released in court.
If health care reform implodes this year, the administration could ratchet up the pressure by having the Justice Department investigate these companies for fraud and potential RICO charges. There was a clear conspiracy to screw over patients, and they ought to be held accountable.
This also highlights why it’s important to pass reform with or without the public option. Insurance reform would benefit millions of Americans by protecting them from these practices.
This is a pretty useless interview conducted by Keith Olbermann with Markos Moulitsas of the Daily Kos. I respect that both of them strongly favor the public option. I do as well. I also understand the point raised by Olbermann that many polls show broad public support for the public option. Yet the entire discussion is cast in terms of whether Obama is abandoning his progressive base by looking for a compromise on this issue, and Olbermann never mentions the real obstacle – the fact that many moderate Democrats in the Senate will not vote for a bill with a public option.
Olbermann has addressed this before, so he’s clearly aware of the political stumbling blocks, yet he makes no attempt to engage Markos in a constructive conversation about where we might be able to go with this. The only point here seemed to be a progressive high-five session similar to the right wing backslapping that we get on lame shows like Hannity.
I’m still a fan of Olbermann, but too often he slips into an “all-or-nothing” approach to issues that justify the caricatures of Olbermann now coming from the right. Unfortunately, it takes away from the good work he often does on his show.
Any notion that sweeping health care reform that gets rid of pre-existing conditions, stops insurance companies from dropping customers, and makes health care accessible to millions of Americans who can’t get it, but doesn’t include a public option that pleases everyone, is somehow a failure by the Obama administration is just ridiculous.
Olbermann should consider this simple fact. Progressives do NOT have a majority in either the House or the Senate. Public opinion is important, but in the end that alone does not get you the votes you need to pass a bill. All those moderate Democrats might be pissing you off now, but they help provide the majority that makes this health care discussion even possible. The Republicans might talk a good game about reform, but we all know they will do nothing to achieve it. They didn’t even try when they ran the place.
That said, progressives should push as hard as they can for a public option, but killing a bill that doesn’t meet all progressive demands is a terrible option.
Fortunately, I don’t think most progressive members of Congress will turn their backs on Americans without insurance and vote against reform when they are faced with a final bill. Arms will be twisted, deals will be made, and this thing will pass if it gets that far.
Jon Stewart calls out Beck for grossly flip-flopping on the quality of U.S. health care. Beck has either lost his mind or is a total hypocrite. You be the judge.
Ezra Klein has an excellent summary of the health care debate and where it currently stands. He does a great job of separating the actual policy debates going on in Congress from some of the silly issues being argued by the public.
Many are extremely frustrated by the slow progress in the Senate Finance Committee, but it looks like one reason for the delay is the serious consideration by the committee for an excise tax on health insurance companies for gold-plated health care plans.
A proposal to tax insurance companies on their most expensive health-care plans may help lawmakers seeking a bipartisan solution for financing President Barack Obama’s $1 trillion health-care plan.
The plan, offered by Democratic Senator John Kerry of Massachusetts, would impose an excise tax on insurers that could generate tens of billions of dollars. Making the companies pay may help break a deadlock in Congress over funding. Obama opposes taxing health benefits for middle-class Americans and many Republicans and Democrats have said they won’t accept a plan to tax the policies of the wealthiest.
“We’re taking an intense look at it,” Senator Charles Grassley of Iowa, the ranking Republican on the Finance Committee, said in an interview yesterday on Bloomberg Television’s “Political Capital with Al Hunt.”
The measure would help end “perverse incentives to over- utilize and have high-cost care,” said Grassley. “We’re interested in it as a discipline within health care.”
Senator Olympia Snowe of Maine, another Republican on the Finance Committee that is drafting health-care legislation, said she was also open to the proposal.
‘Practical Option’
“That may be a practical option, as a way of attacking future costs in health care and driving them down and creating disincentives for the most expensive policies,” Snowe said July 23. Earlier this week, Senator Kent Conrad, a North Dakota Democrat on the Finance Committee, said the idea is under consideration by the panel.
The Kerry proposal is similar to an amendment that Senators Bill Bradley, a Democrat, and John Danforth, a Republican, floated in the 1994 effort to overhaul health care. Obama has said he wants his plan to remake health care, which accounts for 17 percent of the economy, to have bipartisan support.
“It might be a way of accomplishing our goals,” Kerry said.
Grassley agreed. The proposal, he said, has “been a subject of discussion for two days of the last four or five” in the committee.
This is an excellent option given that any proposal to limit the health care deduction for individuals who have gold-plated plans went nowhere for political reasons. The delay must relate to the various ways this can be structured and the need to have it scored properly by the Congressional Budget Office. If the numbers work, this will go a long way towards getting a bill that can achieve broad support and even bring along some Republicans.
The insurance industry is up in arms over congressional proposals to create a publicly financed competitor in an effort to bring down health-care costs. That may be because it doesn’t have to face much in the way of competition now: Most regions of the U.S. are dominated by just one or two health insurers.
Each year the American Medical Assn. (AMA) surveys the commercial health-insurance landscape and finds little if any competition. Its latest report says that, out of 314 metropolitan markets, 94% are controlled by one or two companies, or fewer. In 15 states, one insurer has 50% or more of the entire market.
Such market concentration has become a potent argument for supporters of a public insurer, President Barack Obama among them. With no need to generate profits, a public plan could offer lower premiums, thus bringing competitive pressure to bear on the private insurers to do the same.
Ezra Klein makes a similar point in the Washington Post.
In the modern health-care system, there is no higher power than the insurance market. And the insurers who populate that market have grown all the stronger. The Justice Department judges an industry “highly concentrated” if a single company controls more than 42 percent of the market. By that definition, 94 percent of statewide insurance markets are highly concentrated. A recent study by the advocacy organization Health Care for America Now showed that in Indiana, WellPoint controls 60 percent of the insurance market; in Iowa, Wellmark accounts for 71 percent; and in Alabama, Blue Cross/Blue Shield holds 83 percent. In the past 13 years, there have been more than 400 corporate mergers involving health insurers.
Economics textbooks tell us that concentrated markets reduce the competitive behavior that benefits consumers and lead to outsize profits for the dominant firms. Predictably, health-care premiums shot up more than 90 percent between 2000 and 2007, while the profits of the 10 largest insurers increased 428 percent over the same period.
We have a system that is not sustainable. This isn’t capitalism – instead we have several large insurance companies practically stealing money from American taxpayers.
Right now, President Obama is trying hard to get a bill with the help of all the major players, including the insurance companies. Therefore we’ve seen him go after costs and premiums, but he has not taken on the insurance companies in a direct manner.
If the current effort at reform fails or stalls, expect to see a full-throttled attack against these companies that informs the American people just how much money they are making and the tactics they are using to deny coverage to pad profits.
Paul Krugman has been tough on Barack Obama at times, but he’s behind him on health care. Today he mocks the media for focusing on everything but the actual policy issues.
The talking heads on cable TV panned President Obama’s Wednesday press conference. You see, he didn’t offer a lot of folksy anecdotes.
Shame on them. The health care system is in crisis. The fate of America’s middle class hangs in the balance. And there on our TVs was a president with an impressive command of the issues, who truly understands the stakes.
Mr. Obama was especially good when he talked about controlling medical costs. And there’s a crucial lesson there — namely, that when it comes to reforming health care, compassion and cost-effectiveness go hand in hand.
Of course, the policy issues are too boring for our brain-dead media when compared to all the drama surrounding the process.
Krugman also focused on one of the most important policy developments over the past several days.
I don’t know how many people understand the significance of Mr. Obama’s proposal to give MedPAC, the expert advisory board to Medicare, real power. But it’s a major step toward reducing the useless spending — the proliferation of procedures with no medical benefits — that bloats American health care costs.
And both the Obama administration and Congressional Democrats have also been emphasizing the importance of “comparative effectiveness research” — seeing which medical procedures actually work.
So the Obama administration’s commitment to health care for all goes along with an unprecedented willingness to get serious about spending health care dollars wisely. And that’s part of a broader pattern.
Many health care experts believe that one main reason we spend far more on health than any other advanced nation, without better health outcomes, is the fee-for-service system in which hospitals and doctors are paid for procedures, not results. As the president said Wednesday, this creates an incentive for health providers to do more tests, more operations, and so on, whether or not these procedures actually help patients.
MedPAC was originally created by Republicans to look for ways to cut costs in Medicare and Medicaid, so you would think they would be openly in favor of this development of giving this panel real power, but most Republicans are too busy trying to kill the reform effort.
I’ve been following the Obama administration’s attempts to reform the defense procurement process and cut unnecessary military spending, so I was happy to see the Senate side with the President and kill the F-22 fighter program. Fred Kaplan explains why this is so important.
This is a big deal: The Senate today voted to halt production of the F-22 stealth fighter plane, and it did so 58-40, a margin much wider than expected.
Not only is this a major victory for Secretary of Defense Robert Gates, who lobbied strenuously (something he rarely does) to kill this program, and for President Barack Obama, who pledged to veto the defense bill if it contained a nickel for more F-22s. The vote might also mark the beginning of a new phase in defense politics, a scaling-back of the influence that defense contractors have over budgets and policies.
Then again, I might be dreaming. Surely things couldn’t be changing quite that much. Could they?
Kaplan explains how rare this is for Congress to kill a weapons program at the request of the White House. Hopefully a new level of seriousness will prevail on Capital Hill.
Of course, many Senators are still committed to old battles, and many Senators lined up behind the F-22 because of jobs in their districts. Defense contractors and their supporters at the Pentagon have known for years that the best way to preserve a program would be to sprinkle as many jobs around the country in as many districts as possible. As a result, many Democrats, including liberal Senators like Barbara Boxer, opposed the administration here and tried to keep the program going. On the other side, many Republicans who didn’t have a dog in this fight were willing to back the White House. Of course it helped that John McCain was a fierce advocate for killing the F-22.
One of the worst examples of putting politics over the national interest is Chris Dodd, who’s fighting for his political life as he faces a tough re-election campaign next year.
The floor debate was more transparently self-interested than usual. Dodd argued with intense passion that killing the F-22 would create a “dangerous gap” in America’s technical know-how. The next advanced fighter jet, the F-35, won’t enter production until 2014. The highly skilled workers who make F-22s can’t be expected to hang around four years; they’ll get different jobs, and they’ll be unavailable when the country needs them.
Levin took the floor to point out that production of F-35s actually starts next year and that the FY 2010 budget contains money to build 30 of them. In other words, Levin said, “There is no gap.” He wondered where Dodd got his information. Dodd replied that it came from the defense contractors. That’s where he probably got the whole speech, too.
We’re also seeing how important it was for Obama to keep Defense Secretary Robert Gates.
Gates has slashed or killed a bevy of outmoded, over-designed, or unnecessary weapons systems in this budget. One or both houses of Congress have gone along with almost all of his swipes. Part of the reason for this compliance is Gates himself, who is almost universally respected; he’s known to be a hawk (a centrist hawk, but a hawk all the same), and he’s worked for Republicans as well as Democrats. In fact, he is a Republican.
Maybe it takes a Republican defense secretary to usher in a new era of defense politics. Are we in fact on the verge of such an era? There are many reasons to be skeptical (the annals of history among them), but what happened today might be a harbinger of something genuinely new.
In his speech at the NAACP, Barack Obama again stresses personal responsibility.
We have to say to our children, Yes, if you’re African American, the odds of growing up amid crime and gangs are higher. Yes, if you live in a poor neighborhood, you will face challenges that someone in a wealthy suburb does not. But that’s not a reason to get bad grades, that’s not a reason to cut class, that’s not a reason to give up on your education and drop out of school. No one has written your destiny for you. Your destiny is in your hands – and don’t you forget that.
The days of black leadership making excuses are over. Obama is delivering a message that all parents should be delivering to their kids – no matter what the obstacle, it’s your own fault if you make excuses and don’t try.
Anyone who wondering why health care premiums are exploding just needs to take a look at the insurance industry.
Schumer pointed to the profits of the 10 largest insurance companies — which shot up 428 percent between 2000 and 2007, from $2.4 billion to $12.9 billion — as a reason health care reform is needed.
The insurance industry has not been playing ball on reform, and now Senate Democrats are getting fed up.
With other industry groups pledging savings to help pay the cost of health care reform, Senate Finance Committee Democrats slammed insurers for holding out — and threatened to impose new fees on the industry that could cost it as much as $100 billion.
The Finance Committee members are currently hunting for hundreds of billions of dollars to help finance reform, and with the hospital and pharmaceutical industries having pledged $235 billion, the senators said it was time that the insurers paid their share.
“We need the insurance companies to step up to the plate and be part of the solution. Most of the negotiations so far, the insurance industry has been at the table but you can only sit there at the table with your arms crossed for so long,” said Sen. Chuck Schumer (D-NY).
Schumer and Sens. John Rockefeller (D-WV), Debbie Stabenow (D-MI) and Robert Menendez (D-NJ) pounded the insurers, who they portrayed as unwilling to help pay for reform even while they have enjoyed exploding profits.
“The insurance companies are the people who are just rapaciously, greedily and unstoppably making money by underpaying the patient, by underpaying the provider and by overpaying, therefore, themselves,” Rockefeller said.
We’re seeing a new urgency from the White House and other Democrats on the health care reform issue, and it’s refreshing to see them ratchet up the pressure on the insurance industry.
President Obama placed his political capital on the line Monday and reiterated his threat to veto a military spending bill unless the Senate removed $1.75 billion set aside to buy seven additional F-22 fighter jets.
Mr. Obama stepped up his campaign after liberal Democrats like Senators Edward M. Kennedy and John Kerry of Massachusetts said they supported the purchases, arguing that the program would retain high-paying jobs in many districts nationwide.
The F-22, the world’s costliest fighter jet, is the most prominent weapons system that Mr. Obama wants to cancel or cut in his plan to rein in military spending. A vote by the Senate to keep producing the plane would be an embarrassing setback for him.
Obama’s argument is simple – the military doesn’t need or want more of these planes. Ironically, one of his allies here is John McCain, who deserves credit for his never-ending battle against wasteful military spending.
From a purely political point of view, Obama might welcome this fight, even if an initial loss in the Senate occurs. Obama needs to show he’s willing to get tough on spending, and a veto here would send a strong message.
Health care month is here. President Obama wants the House and the Senate to both pass health care reform bills before the August recess. It will be very difficult to get his done, but the House made progress as the Democrats released their proposal yesterday.
The Process Is the Message: Three separate committees — Energy and Commerce, Ways and Means, and Education and Labor — have come together on one bill. This is an incredible achievement. If you read histories of the 1994 health-care reform fight, all of them have a substantial section on the committee crack-up: One passed a version of single-payer, another a variant of Bill Clinton’s reform, another went further to the right. There was no unity.
There is unity now. And if it holds — if the House of Representatives manages to pass this plan with a substantial majority of enthusiastic Democrats — that significantly strengthens the House’s hand in its eventual negotiations with the more fractious Senate. That’s a big “if.” But so too would have been the idea that three separate committees could cooperate on a bill of this size.
The House proposal includes a tax surtax to help pay for the bill.
If I’m reading this correctly, about half is paid for through $500 billion or so in savings from Medicare and Medicaid. The rest comes from a surtax on the richest 1.5 percent. The surtax is 1 percent on income between $350,000 and $500,000; 1.5 percent on income between $500,000 and $1,000,000; and 5.4 percent in income above $1,000,000. The surtax can vary if the bill is less or more expensive than initially anticipated. There are also revenue expectations from the employer and individual mandates, though they’re relatively modest ($200 billion over 10 years is one estimate I’ve heard).
I’m not a big fan of this part of the proposal, though it’s important to get something on the table. Obama’s proposal to limit charity deductions for high-income taxpayers made more sense. A small surtax in the neighborhood 1% would be fine, but going up to 5% seems like a bad idea.
I would much rather see a tax on soft drinks. Liberals don’t like it because it’s regressive, but as we’ve seen with cigarette taxes an increase in price does affect consumption, and the American people are getting way too fat. That alone contributes to our soaring health care costs, so a tax on sugary drinks, just like taxes on alcohol and cigarettes, makes sense when we’re considering ways to fund health care reform.
Perhaps a compromise can be struck where we include a much more modest surtax along with a soda tax.
In November 2007 Prince George’s police raided the wrong home of a couple in Accokeek. Though the couple presented the police with evidence that they were at the wrong address, the police still detained them at gunpoint, refusing even to let them go to the bathroom. The couple asked the police if they could bring their pet boxer in from the backyard. The police refused. Moments later, the police shot and killed the dog.
In June 2007 police in Annapolis deployed a flash grenade, broke open an apartment door, and kicked a man in the groin during a mistaken drug raid. When they later served the warrant on the correct address, they found no drugs.
Most victims of these mistaken raids experienced the same callousness and indifference from public officials that Calvo did. When police in Montgomery County conducted a mistaken 4 a.m. raid on a Kenyan immigrant and her teenage daughters in 2005, the county offered free movie passes as compensation. When police in Baltimore mistakenly raided the home of 33-year-old Andrew Leonard last May, the city refused to pay for Leonard’s door, which was destroyed during the break-in. When Leonard called the city’s bulk trash pick-up to come get the door, no one came. Days later, city code inspectors fined Leonard $50 for storing the broken door in his backyard.
This stuff didn’t get exposed until a SWAT team mistakenly raided the home of a mayor. What a joke. Decriminalize the stuff already.
With the opening statements from Senator Leahy and Senator Sessions, we might be looking at an ugly fight in the confirmation hearings of Judge Sotomayor. Leahy basically called out those who are trying to twist her words, and Sessions shot right back, basically alleging in his opening remarks that Sotomayor is not an impartial judge.
Given the colorful history of Senator Sessions, I’m wondering how many Republicans and conservatives will cringe when hearing some of his statements.
Of course, it’s up to Sotomayor to explain her philosophy, but Sessions seems to be itching for a fight, regardless of what she might say in these hearings.
“I wanted to prove it wasn’t torture,” Mancow said. “They cut off our heads, we put water on their face…I got voted to do this but I really thought ‘I’m going to laugh this off.’ ”
The upshot? “It is way worse than I thought it would be, and that’s no joke,” Mancow told listeners. “It is such an odd feeling to have water poured down your nose with your head back…It was instantaneous…and I don’t want to say this: absolutely torture.”
“Absolutely. I mean that’s drowning,” he added later. “It is the feeling of drowning.”
“If I knew it was gonna be this bad, I would not have done it,” he said.
