House Bill Will Lack Robust Public Option

The Congressional Progressive Caucus has been furiously rounding up support for a "robust" public insurance option to be included in the health care bill that Speaker Nancy Pelosi (D-Calif.) is scheduled to unveil Thursday. House Democratic leadership has been part of the effort, whipping the caucus in an effort to find 218 votes to back it.

Leadership isn't confirming that a decision has been made, but all indications are that the progressives have lost this round and that Pelosi will include a public option that is required to negotiate rates with providers. Progressives prefer the robust version -- Capitol Hill code for a public plan that reimburses providers using Medicare rates plus five percent. [UPDATE: Leadership is now confirming they are indeed going with the negotiated-rate option.]

Rep. Raul Grijalva (D-Ariz.) has been pushing strenuously for a robust public option, arguing that tying it to Medicare rates gives it the best chance of competing against private insurers. The public option's intellectual father, Yale Professor Jacob Hacker, makes the same case.

Grijalva, in a statement to HuffPost, insists that he is not being rolled by leadership.

"I am not rolling over. I will insist on a Medicare+5 amendment on the Floor so that the full Caucus can vote on it. We are hopeful that the Rules Committee will allow this amendment, which has tremendous public support, to at the very least be voted on for the record," he said.

Grijalva, in pushing for an amendment rather than including the provision in the bill itself, is in conceding defeat in this round, while vowing to press forward.

Demanding an amendment, however, comes with its own set of problems, because conservative Democrats could then demand their own amendments related to abortion and other issues that would garner enough GOP support to pass.

On a policy level, the negotiated public option will cost taxpayers an extra $85 billion and is the favored choice of Blue Dogs and other conservative Democrats. Observers have noted the irony of the Blue Dogs -- who champion fiscal conservatism -- backing the the more costly public option. But such confusion misreads the Blue Dog Coalition, which is more properly understood as a bloc of Democrats who favor business interests. In the case of the public option, requiring it to negotiate rates means higher payments to providers -- hospitals, doctors and drug makers -- and less competition for insurance companies.

Leadership paved the way for negotiated rates on Tuesday evening, leaking Congressional Budget Office numbers showing that the bill including negotiated rates will cover as many people -- in fact, slightly more -- than the plan with a robust option.

House Speaker Nancy Pelosi (D-Calif.) will unveil the bill that will hit the House floor on Thursday morning.

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Comments

[kasv]

An absolutely brilliant play by PERRY. Cheney's endorsement is the "kiss of death" for many voters, even TX voters.

[hhayden]

Don't count on everybody ha'ting who you ha'te. Especially in Texas.

[Philclock]

Hey, Public Option lovers, I don't get it.

Want to control your health care with your doctor? Pick services you want, get the best customer service?

Won't happen with government monopoly. Anybody who's worked for the government or been in the military knows its customers aren't you and me, they are the politicians and bureaucrats that feed their budgets. Get sucked into the system, stand in line, it tells you what to do, what to buy, when you can buy it.

The free market got us here over the last 200+ years, best in history for prosperity, generosity, hope and realizing dreams.

Want ENRON running health care? Or government, or a self-appointed committee? Check out Fidel, Mao, Stalin, Pol Pot, Ho Chi Minh, Ayatollah Khomenei, Mussolini, Hitler for how well that works "for the people".

Government controls/mandates over half the health care market already through reimbursements by Medicare (bankrupt in 8 yrs, rife with fraud, underpays doctors and overpays for supplies) and government over-regulated "private" insurance companies (cannot compete across state lines, must write expensive policies-t­hat-cover-­everything insurance instead of inexpensive long-term catastrophic care policies only, coverage for "normal" care is expensive because it's used a lot, catastrophic infrequently). A big ponzi scheme!

LESS government involvement, MORE privatizing insurance companies, MORE support for my health savings account so I can pay cash for as much of my health care as possible, cash = better service, better deals.

Common sense!

[roscoeman]

Trolls, get back on the short bus.
Military has single-payer health care (VA) they love it.
Insurance company's control access and deny coverage.
There is no free market, get a grip
What are you on medicare?

[Philclock]

I have VA, it's a pain, must wait in line, I pay cash as much as possible and go to private docs/clinics, better service, usually get discount. Save VA for big stuff (kidneystone, so far).

[hhayden]

The government will deny coverage too - and there will be no recourse. This is not about first class health care for all - it is about the nanny state from cradle to grave. Why trade bad for worse?

[Mover]

I have to say that you are not telling the truth. I was in the US Army for 21 years and I recall their version “single payer” plan very well.

Active duty soldiers, Sick Call:
1. Wait for an hour or two to see a PFC medic.
2. Add another hour to see a physician's assistant. (At Schofield Barracks the wait averaged 4 hours)
3. Wait months to see a specialist (I waited six months to see a cardiologist)
4. Surgical follow ups at VA hospitals also require you to wait many hours to be seen. When you are finally seen, there is a gaggle of students inspecting you.
5. If seeing the specialist requires travel, either you or your unit must pay for the travel and lodging.
6. When your doctor or dentist moves away, resigns to get a paying job or retires, you are back to square one and start the process over again. (a periodontist was reassigned at a point in one soldier's treatment when he was scheduled for surgery and the doctor's replacement canceled it saying "it isn't worth the time, trouble and expense”)
7. There are no malpractice lawsuits

Family members:
1. If you are within 40 miles of military clinic, VA or base hospital, you must use those facilities or pay for it yourself.
2. Treatment is "space available" only. You must go there and wait.
3. You can receive CHAMPUS (Google it) if the facility deems it as being cost effective.

[Mover]

More on the military version “single payer” plan.

Retired Coverage:
1. You must sign up and pay premiums for a VA subsidized insurance program called 6. TriCare Prime. The premiums are less than private sector insurance premiums but consider that when I enlisted, one of the benefits for staying until retirement included “free” medical coverage for life. Premiums equal Not Free.
2. I pay an insurance premium, co-pays and deductibles, and there is an annual limit to the coverage.
3. You must choose a “primary care manager” (PCM) through whom all appointments, labs, procedures and specialists, must be approved through.
4. You can only pick a PCM from a list provided by TriCare.
5. All labs, procedures and specialists must be on TriCare’s list of approved providers.
6. All referrals to labs, procedures and specialists, must be approved through TriCare and be on their list of providers. Your PCM refers you, you make an appointment, and then you inform the PCM who submits it to TriCare. So don’t make an appointment with the next week or so.
7. If you become disabled, such as being diagnosed with Multiple Sclerosis, and start receiving Social Security Disability Insurance (SSDI), you will lose most TriCare coverage after two years on SSDI and you forced into Medicare. You must sign up for Medicare Part B immediately or lose all TriCare coverage. TriCare at that point becomes a Medicare supplement program. The same thing happens when a military retiree reaches age 65.

[Cyndy Keith]

Still putting all your brainpower into those school textbooks, huh? Look at the world and what capitalism has done for us. Look at what will be in another 20 years if something doesn't change now. No one with jobs, or healthcare, no one to buy the products or services the big corporations are selling, how long will they stay on top, when no one can afford them anymore? Spreading the wealth around to the rest of the world through free trade has worked so well, hasn't it? Convincing people that they are in danger if they don't have insurance is a great scheme, but more and more people are finding out that it is just a scheme. I will be glad when everyone realizes how much better off we would be if we dropped our insurance.

[Philclock]

Capitalism = free association of people doing business as they wish, worked amazingly well for 200+ years, best in history!

Tired of making your own choices? Dismayed with private property? Try Fidel, Mao, Pol Pot, Hitler, Mussolini, any Arab country. 'Course might be some trade-offs if you're not the right gender, or thinking the right thoughts, or you're not part of the tribe that's more equal than the others.

Plenty of jobs but things move so fast the path tomorrow is different, can't stand still. today we're all independent contractors, no more 30 year jobs like my dad unless it's with the government or a really big corporation. Even high-demand nurses need specific experience or they have difficulty getting hired.

Health care like any other commodity is scarce, your choice what to buy with your resources. Government controls (medicare is 1/3) or mandates (private insurance companies aren't so private, cannot operate in every state, must write government approved insurance policies) over 1/2 of healthcare, doctors, hospitals and clinics don't deal directly with patients, but with big insurance or big government who negotiate & pay bills.

KEY: GET GOVERNMENT/BIG INSURANCE OUT OF THE WAY for everything BUT catastrophic & long-term stuff, the complicate expensive pre-existing condition problems. Handle "normal" everyday items by paying directly from tax-free Health Savings Accounts, deal directly with our doctor, clinic, better service, cheaper for all.

In behalf of my middle schooler, please don't give up on the US and capitalism!

[Patriot86]

The last eight have been pretty horrific really...maybe 30 years since the supply side was introduced by Reagan and of course fee market meant ship our jobs overseas...things are not good my friend. Do you have Medicare? My employer based health plan pays for less this year and cost more. I do not see how you righties think health care is good unless you are on Medicare-nothing more amusing then seeing Medicare users spout anti-public option talking points.

[hhayden]

The last eight years weren't "horrific" at all. Things were perking along pretty well until the subprime loand demanded by democrats came home to roost. Remember that three of those fingers are pointing right back at you. The government option is only designed to further control the public.

[Mover]

High taxes, the EPA and unions drove jobs overseas, not Reagan's lower taxes.

If you know people who lost their job, you can refer them to the US Congress: the root cause of the current recession.

[hhayden]

Democrats never let common sense get in their way. They are dreamers and will follow anyone who li'es to them if they like the li'es.

[Philclock]

Delusional.

[BWToppel]

Hey my fellow progressives, take a deep breath and think for a few minutes. The right appears to be self-destructing with Palin, Cheney and their brand of negative lunacy splitting off from the old style lunacy of Gingrich, etc. Let's not be so quick to cut the less enlightened members of the Dems out of our party. If the Democratic Party can maintain a span to the middle, we can maintain power. The fact that we are going to see comprehensive healthcare reform with any public option is a huge step forward from what seemed possible four years ago. It's far from perfect and yes there is a bit of a stench, but it is still a victory. Couple with it the positive news about the economy and President Obama is looking like an 8 year President. I think we will see his popularity rising and his ability to sway congressional elections on an upswing by the 2010 cycle.

[mjeffn]

It's not over yet.

[hhayden]

I don't think a victory that st'inks is much of a victory. It may be a victory for oppressive government, but it's no victory for the people. I take some solice in that you will be suffering along with the rest of us ultimately.

[Philclock]

A few questions for the curious...

What's a "progressive"? What's a "public option"? What's the "right"? What's the difference between "negative" vs "old style" lunacy? What's an "enlightened member"? What is "comprehensive health care reform" and how is it a "huge step forward"? How will we know when it is "perfect"? How is "it" a "victory? What is "positive news" about the economy? If we haven't yet had a congressional election, how will we know his ability to "sway" is on the "upswing"?

[hhayden]

I would like to know what the difference is between a sc'rew job and a "robust" sc;rew job.

[Wisconsin Dave]

BLUE DOGS ---- CAPITALIST DIRTY DOGS

Paid actors surely, a smoke screen actually, as they help to lock
government in darkness so that capitalists may compete against
those elss intelligent and enrich themselves upon the misery of
those less fortunate.

[MarcusT]

Big Pharma Declares Victory in Deal With White House
Thursday, 06 August 2009

Essentially PhRMA won the right to continue bilking the beleaguered American taxpayer--a concession won under the Bush Administration which prohibited Medicare to negotiate prescription drug prices.

Neither health care reform nor cost cutting is possible when the Obama administration strikes a deal with Big Pharma accepting industry's demand not to enact any measure that would allow the government to negotiate drug prices with drug manufacturers.

The New York Times report is cognizant of the fact that: "The new attention to the agreement could prove embarrassing to the White House, which has sought to keep lobbyists at a distance, including by refusing to hire them to work in the administration. The White House commitment to the deal with the drug industry may also irk some of the administration’s Congressional allies who have an eye on drug companies’ profits as they search for ways to pay for the $1 trillion cost of the health legislation."

So, how is the Obama Administration's approach to the nation's economic crisis and health care crisis different from that of the Bush Administration?

[Patriot86]

You can fix some stuff later...get it done.

[hhayden]

The idea will not to fix it later, the idea will be to make it worse once they have their foot in the door.

[mjeffn]

Pass a robust PO or don't knock on my door come 2012.

Don't think you are like the neocons in power and I am like a witless christian who mindlessly follows your rhetoric.

Be progressive or I will work to elect someone who is.

[MarcusT]

Did you vote for Nader?

[mjeffn]

No I didn't. I think his writings about the real lack of difference between the parties is correct but, I feel his involvement threw the 'election' to Bush. That he doesn't see this is disingenuous at best.

I believe we need a strong Progressive Party in control whether the Democratic Party becomes controlled by progressives or it ultimately goes where it looks like the Republican Party is headed, to extinction. I believe momentum in the country is headed in a far more progressive direction and it may turn out that the Republicans become extinct, the Democratic Party takes their place and there will be a new populist party created around liberal progressive ideals. It could happen.

I'm old enough to know that money talks and BS walks but, Obama created a monster in the last election that will be increasingly difficult to control by saying what it wants to hear during an election and behaving differently once in office. There is a lot of non-corpor­ate/lobbyi­st money out here that will become just as demanding in holding politician's feet to the fire and, as ruthless as the 'business interests' are today when they don't get what they paid for.

[mjeffn]

No.

[Conservoprogressive]

[[I am like a witless christian who mindlessly follows your rhetoric]]

Do you slam ALL religions, or just mine?

[hhayden]

Liberals think that any other religeon is fine. They only ha'te Christianity because ti reminds them of how bad a society they are building.

[hhayden]

Liberals are giving the word "progressive" a bad name.

[LemonMeringue]

2010 looms, Congressmen.

If you get this wrong you will be replaced, until Congress gets it right.

[hhayden]

Look for new candidates. Liberals are determind to get things as wrong as they can.

[Oldwave]

Yeah! Like ending slavery, Civil Rights, Medicare, Social Security, women's right to vote, black's right to vote, 40 hour work week, child labor laws, minimum wage and on and on and on...what good have conservatives ever done for this country?

[PBMac]

Somehow when everything is all said and done Congress just can't get it right. It always has to capitulate to big pharma, the insurance companies or any other corporation that happens to come along that has an interest in separating the American people from their money.

[MarcusT]

Sunday, August 09, 2009
How the White House's Deal With Big Pharma Undermines Democracy

I'm a strong supporter of universal health insurance, and a fan of the Obama administration. But I'm appalled by the deal the White House has made with the pharmaceutical industry's lobbying arm to buy their support.

Robert Reich

[stevendedalus3]

And in separating the American people from reality-- too often voting against their own interests.

[hhayden]

What does it matter who is stealing your money if it ends up being gone? The government will not be happy until it has total control over every aspect of our lives.

[braytjr]

It is time to demand something for negotiated pricing. First thing I want is to lower the age for Medicare to 45 and put all children up to age 25 in S-CHIP. We start by demanding everyone have the option to go into Medicare then we work our way to my plan. Instead of providing up $750/month to help people with their COBRA payments, they would automatically go into Medicare until one year after they got employment. Include all of this with the 150% of poverty to get into Medicaid.

This will let the health insurance companies keep the relatively healthy 26-44 year olds (excuse me while I throw up). Also, this put those pro-lifers between a rock and a hard place since it would be the liberals and progressives who are actually doing something to save children. And for God Sake, close the stupid dough nut hole and start negotiating drug prices for Medicare.

[mjeffn]

That would get my vote!

[FirstShirt]

It won't happen for years. It won't cover all people.

It will cost close to 1 trillion dollars and still not cover everyone.

[LemonMeringue]

Single payer is the only cost-effective solution that will cover everybody.

$400 billion is taken by insurance companies every year. That money could be better spent.

[Conservoprogressive]

Agreed, but can you understand the hesitancy of those who have seen what government can do when they get their hands on a program? The lobbyists would be right there, making sure it benefited them somehow, and the politicians would beg and grovel. It often feels like "would you like the guillotine or the electric chair?"

[mjeffn]

I am putting my faith in the Progressives. If it is good enough for them, I will accept it. I'm tired of the whole thing and no longer want to invest any energy in it until it is created at which point I will judge what was able to be accomplished. If the PO is weak then, I would like the Progressives to deny the administration its bill and let the goopers and Ins. co.s win. Their position is unsustainable anyway and, ironically the 'market' will make them as obsolete as a buggy whip manufacturer. If the progressives hold strong they will become an undeniable force that the Administration will have to address or even become strong enough to primary Obama/Biden.

Lieberman was our darling just a few years ago and look who he really turned out to be. I'm reconsidering some of my opinions about this administration. I am not interested in Republican lite and have no reason to want to continue propping them up.

[hip dibler]

BETRAYAL, plain and simple.

[clutchkill]

If the progressive public option isn't passed I will never sent another dime or support another democrat. I will however, give what I can directly to true progressives. Not another dime to the DNC.

[forty8r]

The simple fact is this bring a strong public option. If it is defeated then make it a referrundum in 2010 midterms. So what if it passes in spring of 2011 than the winter of 2010? I am tired of these backwards Southerners and corporate elitisit minority obstruct progress.

[PaxEterna]

Single Payer - which Our President Took Off the Table at the Getgo - would be simpler, cheaper, and more effective.

Go figure . . . another "brilliant" administration cowtows to the power elites.

[WhiteDelyte]

i hope the progressive caucas an stay strong. if there is no strong public option than kill the bill like they had threatened earlier. remind obama who was out knocking on peoples doors during his campaign. we got him elected and now he wants to leave us behind.

[Melissa]

I doubt whether she will even get this one.