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Bob Cesca

Bob Cesca

Posted: December 16, 2009 06:02 PM

I'm Really Pissed Off About Health Care Reform

What's Your Reaction:

I'm pissed off.

I'm pissed off at health care reform. I'm pissed off at this endless process of emotional highs and lows and exhilaration and dejection and history and infamy.

I'm pissed off that President Obama "thanked" the independent senator from Connecticut even though the senator nearly killed health care reform this week.

To that point, I'm pissed off at Joe Lieberman. I'm pissed off at his childish, vengeful, opposite-day hackery. I'm pissed off at his giant pie-shaped head and his passive aggression. I'm pissed off that he enjoys government-run Medicare benefits while opposing government-run insurance for the rest of us.

I'm pissed off at the Senate. The whole Senate. The rules, the senators, the color of the walls, the fact that a doof like Chuck Grassley can actually be elected to it. Multiple times. I'm pissed off that even though we finally have a 60 seat supermajority, it's dysfunctional and Harry Reid is in charge of it. I'm pissed off that senators of both parties receive government-run primary care from the Office of the Attending Physician, while denying it to everyone else.

I'm pissed off at cable news and the establishment press for focusing more on The David Letterman & Tiger Woods Underpants Party than the substance of health care reform.

I'm pissed off at Rahm Emanuel and I'm pissed off at the "scary profane a-hole" mythology that's built up around him, and how he only seems to use his powers of intimidation to bully the left.

I'm pissed off at the Republicans. I'm pissed off at their ongoing self-contradictions and lies and bumper sticker sloganeering. I'm pissed off that around 55 Republicans are on Medicare, yet they oppose government-run health care for the rest of us.

I'm pissed off at Tom Coburn's bulbous Dirk Diggler haircut.

I'm pissed off at having to compromise while a handful of lopsidedly powerful conservadems get whatever they ask for.

I'm pissed off at the Senate health care reform bill. I'm pissed off at the House health care reform bill. I'm preemptively pissed off at the conference report, too, and I don't even know if we'll even get that far.

And I'm pissed off that my progressivism leads me to the unavoidable conclusion that if we don't pass health care reform now, innumerable bad things will continue to happen due to the fact that there's a very serious health care crisis in America. I'm pissed off that I can't, in good conscience, allow my anger to coerce me into believing that we should "kill this bill." I'm pissed off about that, too, because I know what could have been, and yet I have no other choice but to settle for what is. For now.

But being pissed off doesn't make this reality any less real.

While I clearly empathize with the dominant sense of rage spreading throughout the progressive movement right now, we've always taken pride in our ability to grasp the objective reality of both policy and politics. And the objective reality of this conundrum is that if health care reform dies here, it won't be back anytime soon.

I don't need to tell you that we've been outflanked on health care reform and so the whole affair has been tainted with the foul stink of compromise and bad faith, with someone as universally despised as Joe Lieberman absconding off with the smoking gun -- grinning from ear-to-ear across that jowly pie plate of his. That's what it feels like right now, and suggesting that it's an unpleasant sensation is vastly understating the rage.

Yet I can't help but to believe that killing reform will only heap an even larger failure on top of losing the public option, the Medicare buy-in and so forth. Only this time, it won't be a failure limited to an ideological or political routing. The failure of health care reform will invariably mean at least another decade (if not two decades) of a desperate health care system in crisis. Another decade or two of medical bankruptcies and deaths due to a lack of insurance -- exponential premium hikes and rescissions. You know the list.

If I stop being pissed off long enough to take a good look at what remains in both the Senate and House bills, there aren't necessarily fool-proof solutions to these problems, but there are regulations, subsidies and reforms that will ameliorate a significant chunk of the present crisis. For example, the Senate bill will reduce the cost of insurance for a family of four earning $54,000 from around $19,000 per year to around $9,000 per year.

Ezra Klein:

To put this a bit more sharply, if I could construct a system in which insurers spent 90 percent of every premium dollar on medical care, never discriminated against another sick applicant, began exerting real pressure for providers to bring down costs, vastly simplified their billing systems, made it easier to compare plans and access consumer ratings, and generally worked more like companies in a competitive market rather than companies in a non-functional market, I would take that deal. And if you told me that the price of that deal was that insurers would move from being the 86th most profitable industry to being the 53rd most profitable industry, I would still take that deal.

So would I, even though I'm pissed off about it. But it undeniably makes sense to take the deal. If progressives successfully convince enough Democrats to kill the bill, do we really want to be the group that plunged the last blade into the back of reform?

Do progressives really want to tell working-and-middle class families of that they're not allowed to get a $10,000 annual break on their insurance payments? If you're okay with that, I admire and respect your integrity, but I just can't be a part of it. Objective reality dictates that there's no other path at this point but to support the bill and to subsequently endeavor to fix it.

If we can holster our anger, check our pride, pin our noses and allow this thing to pass -- hopefully without further right-leaning compromises -- we have a decent enough infrastructure onto which we can attach additional reforms. There will be gaping loopholes to fill, and lots of areas to reinforce, but this seems like an easier mission than starting over from scratch.

And just imagine, for a moment, starting all over again.

At what point, and how many years from now will there be another center-left president with a Democratic quasi-supermajority in Congress? Certainly not after next year's midterms. But imagine the perfect storm happening again down the road. History has proved that health care reform is always weaker after a failed effort. So we start there. Then where to? The centrist Finance Committee? More watering down of the legislation? It's 2009 all over again, only weaker. Suffice to say, I can't imagine anything resembling Medicare for All being passed without an intervening health care reform bill.

America has always been governed by incrementalism, and health care reform is no exception. Health care reform was always going to be a work in progress -- we're just going to have to work a little harder to make up for a lack of a public option and the Medicare expansion.

Maybe our anger would be better channeled into fixing the bill than killing it. Amendments can be attached to budget bills and war spending supplementals. If you recall, the Wellstone amendment, forcing insurance companies to cover mental health, was passed in the stimulus bill last February. And there's no reason why the Democrats couldn't bring up the public option and Medicare buy-in as its own reconciliation bill. But SHH! Don't tell Joe Lieberman.

As pissed off as I am, I'm hopeful that we're going to be a part of achieving something good here. And perhaps the temporary loss of the public option and the other things will provide the political motivation to achieve a perpetual run of smaller victories as we help to shape this bill into something we can be happy about.

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07:13 PM on 03/02/2010
I think I am going crazy. First, I hear, publically, Republicans do not wish to borrow money (tarp-carp). Then they vote for millions as long as it is within their home state. The anti-debt, anti-bail-out, anti-clunk cashiers, anti-public health reform, anti-black president (Obama), anti-socialist, anti-jobs, anti-IRS employees, anti-harmless (guns r US) syndicate of jowl chinned GOP lawmakers seems like they attended basic training together. You know what is done in the latrine late night?
So I did this exercise in mime: With arms across my chest, a deep and foreboding look on my face, I started the transformation. I rumbled, moaned, swelled and spun to become The Metallic No-maton. I walked, talked, and shit as I said “no” loudly. I have been so transformed by this experience I am going to apply for citizenship in the GOP, the Tea baggers and the Oath Keepers. Saying no, nyet, nein over and over makes me feel like a two year old. And just like in a Day Care, nothing gets done, except for screaming and crying. Oh yeah, snacks and naps too.
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03:37 PM on 12/30/2009
Bob, you're not alone. One hell of a rant, too.

Russ Feingold is my senator and I don't expect him to be a martyr because President Obama has a pair of raisins when it comes to being the nations leader. The Pres put this as a priority, met with big Pharma and started giving out concessions before our congress even started working on it. Considering the obstructionist tactics of the conservatives, reconciliation is the only process in which we will begin to see any true reform.

Calling out Feingold, Sanders, and even Franken is reactionary, if not self-destructive for progressives. Although it may be the only option to be heard at this point, it's political cannibalism. 53 votes through reconciliation is enough to change Washington's grip on health care, progressives should be focusing on that option, not attacking their own.

This bill will pass, and it truly stinks of another bailout. Hopefully a public option remains on the table to be passed afterwards and the smell of this give-away dissipates. If not, President Obama may well be a one-term wonder.
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ginalee
Proud geek
08:05 AM on 12/24/2009
I feel your anger and pain.

Our mistake is to put faith in a political system that has apparently been hijacked by rich selfish people.
02:02 AM on 12/30/2009
I too feel his anger and pain although there were times when I couldn't help but laugh out loud at
his illustrative way of describing certain politicians. It was like orange juice mixed with castor oil!!
I think the problem is systemic and the President as well as some of our elected officials have realized just how powerless they are once they've joined that club. Our President has taken compromise to new highs and right now I'm not sure what he stands for.
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eztempo
12:20 PM on 12/22/2009
Regrettably, I have to agree with Cesca ... this go-around. But I have a short list of primaries I'm going to be targeting with "single-payer" donations to candidates not now in the House and Senate.
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QDP
disillusioned green architect
01:51 PM on 12/21/2009
US governed by incrementalism? Let's get real about being pissed off. It is the failure of leaders to lead. The constituency problem of our government is at the root of our evil ways. We voted THEM into office.

Sadly it is not just Obama who fails to lead here. It is all of Congress, all of the Senate and based on our voting, all of us who fail to meet the simple American ideal. Bob, you base your assumptions on the position that the American president has power.

The clear problem is within our governance system. Too many names, groups, associations, left, right, centrist, conservative, liberals, and none of it matters. The control over this legislative process is in the hands of leaders with a different agenda. 
You seek fairness when it is actually all about more profit.

Until we demand the right questions to ask, we will get the false answers we deserve.
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Roses
In a gentle way, you can shake the world.
12:07 PM on 12/22/2009
You're leaving one VERY large segment out of the object of your anger.

The way this government changes......really changes......is from the bottom up.
I never thought that we would have a brown (or any color but white) man for president in my lifetime.
I never thought we would have anyone who espoused values other than those of the people in power (you may quibble that he doesn't really believe them, but he did espouse them during the campaign).
I never thought we would have anyone in the presidency but a very rich guy and one who could not identify with the common people, but we do.

We do, because the people organized and worked very hard to get him elected.

I don't know about you, but I didn't see anywhere near the number of people out on the street or in our communities working for actual healthcare as are now complaining.

I am not only pissed at our legislative leaders for letting us down.......I am royally pissed at people in general for letting ME down......and then carping about it.
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QDP
disillusioned green architect
01:49 PM on 12/21/2009
This is why Copenhagen failed. The good news is America is back in negotiating sensible accords. The bad news is we are bankrupt. MONEY speaks. His (Obama’s) compromise and concession did not work with Chamberlain and won’t work now. A half loaf being better than nothing is the concession of weakness. Sadly, in this arena he has no other option. Appearing too needy for ANY accord is not the strong position we want to project in negotiation. By this behavior he has removed balance to bias and weakened our strengths.

" I realize he doesn't mean what he says -- or if he does, he just doesn't have the fire in his belly to follow through. He can't seem to muster the passion to fight for any of what he believes in, whatever that is." D.Westen blog on Obama.

Between Tiger Woods and Barack Obama there are amazing similarities. Both seem to have held bold, courageous, high ideals, marked by an extremely gifted talent, admired ability and persuasive potential content. Both have failed on their basic personal incapacity to understand the overriding moral value of their position, and by their action the consequences of such poor oversight and weakness. Sadly, when leaders fail, it is not just their constituents who lose, but all of us.

Your point: "Healthcare can now be saved by many new small reform initiatives". God, if there is something to be pissed off about, it is erroneous calculation.
08:48 AM on 12/21/2009
THis health care plan should be defeated. It is only a bail-out for the insurance companies, who don't need it, financed by the youngest of this country , who are struggling the most with the least. When they can't afford it, the government throws in cash to make sure the insurance companies make great big profits. That a family wwill save $10k suggests that the Co.s won't get together and decide that insurance should be $10k more expensive...legal without change to monopoly status. This bill should be defeated and single payer should go directly to the floor to be filibustered until it is over and a straight vote made...a waste of time, yes, but the only way to do this right!
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Melinda Gopher
A Progressive for an American Spring
10:54 PM on 12/20/2009
I dont know if you ever read this:

Single payer was viewed about a year ago---by Baucus and President Elect Obama---as not viable "because the public would not support it."

Thank you to Mike Dennison--he's great!

http://www.correntewire.com/montana_home_max_baucus_and_least_one_honest_intelligent_reporter
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Roses
In a gentle way, you can shake the world.
12:22 PM on 12/22/2009
I agree with President Obama's assessment.....it is not politically feasible......for the entire country not just California or the coasts. I think that President Obama made that estimation during the primary and campaign. Everyone should read his stand on issues then.
It is my opinion that President Obama had read the past universal healthcare suggestions that had failed.

What I think you can criticize President Obama for is that he had said that he would allow EVERYONE a "seat at the table" during decisions. He didn't.
Perhaps because the WH agreed to keep 'hands-off' during negotiations and Max Baucus made the decisions and he was indebted to the insurance interests. But I can only assume.

THAT was what I disagreed with him about. I think everyone should of had a say.....I think it could have changed some minds. It was a good way to present negotiations.
06:58 PM on 12/20/2009
I see not use for the Senate anymore whatsoever. We should get rid of it, and come up with some knowledge and integrity standards for the House. We have the technology to do secure direct polling, and we can ensure that these elected Representatives vote as their constituents truly want.
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Roses
In a gentle way, you can shake the world.
12:25 PM on 12/22/2009
You're right, but good luck with that.

The Senate has always been the representatives of the upper class, and they will 'not go quietly into that goodnight'.
exmate
Life is about playing a poor hand well.
05:53 PM on 12/20/2009
Private for profit health care insurance should not exist. There are basic differences between them and other business enterprises that produce and market goods and services. Unlike the latter where the profit motive, usually produces BETTER goods and services, when health care insurance companies are run for profit the result is a WORSE product
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joanno
Think before speaking...
05:17 PM on 12/20/2009
Time for reason to re-assert itself. The bill gives exactly what candidate Obama promised: healthcare similar to what governemnt types get, actually expanded to many more people than he suggested then. That occurs in the healthcare exchange where highly regulated private and nonprofit companies will provide national policies to a large number of folks which will drive down premiums and which the federal government will negotiate. The exchange creates such favorable conditions for gov't workers precisely because the companies that offer insurance there are under tight federal control and the gov't negotiates for a huge number of consumers. There are a number of positives about this bill. Is it everything we might want? Of course not. No bill that must go through the tortuous super majority process in the senate will ever be perfect for anyone. To expect otherwise represents a level of naitivity progressives should stay away from if we really want to have a hand in molding public policy for a while. All this talk about progressives being disheartened and staying home next year is also foolish. Politics is a raw game, not for innocents who freak out every time they don't get their way. Only the tough prevail so we will have to decide are we whiners or contenders?
09:33 PM on 12/20/2009
The bill coming out of the Senate does not contain the "tight federal" controls you mention with regard to the exchanges. That is something that is not currently in this bill... a governing body overseeing the exchanges (like private utilities). Without that, all it does is invite collusion between the few insurance companies that exist. I agree with Howard Dean that going down the path of universal health coverage by way of private entities is a very dangerous path for us. We will be forced to pay all of this money into these private companies who in turn will take all of these increased profits and use them to lobby against any additional reform. Anyone who doesn't see THAT coming is truly naive!

I should have the right as an American citizen to not have to pay a profit every year to a private company, period.
04:59 PM on 12/20/2009
This health care bill is a disaster. The democrats will push anything thru just to claim victory.
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06:11 PM on 12/20/2009
One step @ a time..
08:49 AM on 12/21/2009
Even a step backwards???
02:23 PM on 12/20/2009
Well, Bob... you've articulated my feelings on the whole subject quite nicely. And from what I can tell -- a large portion of the American public are so mad at both parties they'd as soon piss on the leadership as yell at them.
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masher
software engineer
02:18 PM on 12/20/2009
You want a bill that forces all Americans under penalty of law to buy a corporations products?
You want a bill that hands away billions to corporations in hopes they will be so fat with cash they can't raise rates? Does that make any sense at all?

This deal is so perfect for corporations they will seek to keep it permanent. If you think the military industrial complex is bad then wait for this bill to become law!
01:50 PM on 12/20/2009
Not only that, but in a couple of years, they are springing GridPoint all encompassing utility monitoring and command of your residence in the name of national security and conservation. Monopoly private utility control of your home.

See, we get this crap in increments. Our democracy dies a death of a thousand cuts. But the bastards that think this stuff up lay plans for years. And us sheeples just keep moving along.

This should be up to each state. Say "Enough!" to more centralized federal/private boondoggles.

The military is now mostly privatized. Health care is now privatized. Banking, by virtue of stealing all our money is private but federalized for its behalf - not ours, and utilities are about to be ubiquitous data centers that control our ability to live and move around.

Wake up.
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06:36 PM on 12/20/2009
Got that all just about right. Nice!