Badfellas : How Rahm And My President Killed Health Reform
Do you remember how Joe Pesci got killed in Martin Scorcese's film Goodfellas? Pesci was told he was finally going to get what he'd always wanted and become a made man. He and his mother proudly picked out his best suit and got him ready for the big moment. He was picked up and brought to a house for the ceremony but just as he walks in the door, he sees a totally empty room. In an instant, he realizes what's really going on. He barely gets out a sound before a gun is put to his temple. He's shot dead and collapses in a heap on the floor.
That's how I feel about the current state of health care reform.
When I supported Barack Obama in 2008, two of most compelling reasons were his stand on health care reform and his strong opposition to the power of lobbyists in Washington. When he was elected, it was like we were all elected. Finally, we'd have one of our guys as the President.
When President Obama began he push for health reform months ago, I immediately began making a series of videos supporting his efforts. My videos focused on the issues that I thought President Obama would focus on, based on his campaign. I realized that the biggest danger to real reform was the corrupting influence of lobbyist money. I went after people like Senate Finance Committee chairman Max Baucus and Joe Lieberman, both of whom were getting millions from the insurance and drug lobbies.
Here's a video - one of about twenty I made back in June, doing what I thought Obama would be doing - fighting for the public option and connecting the issue to lobby money.
After several weeks, I noticed that President Obama wasn't really talking about lobbyists. He wasn't calling out people like Baucus and Lieberman. He wasn't rhapsodizing about a robust public option. In fact, the President wasn't saying very much at all.
This silence seemed odd to me. After all, President Obama had run as a reformer who was going to change the way the game was played in Washington. I expected a steady drumbeat of reasoned, compelling statements about the corrosive effect of all that money on our politics.
This wasn't just idealism. I expected Obama to lay the groundwork for health reform by making the case against lobbyists and the politicians they owned because it was smart politics. Speaking out against lobbyists would have tremendous appeal to independents and even some people in the Republican base. And Obama's extraordinary persuasive skills would allow him to subtly call out people like Baucus and Lieberman without even naming names.
If President Obama acted like the leader we'd elected and laid out the case for a robust public option, I knew supporters like me and the millions of others Obama voters would be right there to help him. And the press would pick up on Obama's hints about politicians who were playing the politics as usual game as start to shame people like Max Baucus in public.
So I kept working on my little videos and I kept waiting for the President to lead. I was ready for Obama and his lieutenant Rahm to deliver us reform. Finally. Time to pick out our best suit.
But as the summer wore on, I started to get a bad feeling. My stomach started to churn a little when I heard in August that Rahm Emanuel - in a rant that Joe Pesci could have delivered - said that groups making ads attacking Blue Dogs like Baucus was "f*cking stupid." That's exactly what I'd been doing, after all.
Then I learned about the backroom deal that the Senate made with PhARMA with the approval of the White House. The door opened and the room was empty. Everything clicked.
The White House didn't want real reform. They didn't want a a good bill. They wanted a win.
Rahm had said in August, "We're 13 and 0 going into health care." Sports talk from Rahm. This was a game. It wasn't about saving lives or even saving money. It was a game. Obama hadn't said anything about a robust public option because stating a position would mean a possible loss. Better to not stand for anything at all. Obama hadn't called out Baucus because he'd been working with him.
Click.
BANG. Get ready to pull the Trigger on an already weak public option.
BANG. A bailout to the insurance and drug lobbyists.
BANG. Selling out woman at midnight then cheering about it.
And there was nothing we could do. We had to sit still and take it. It was decided among the beltway insiders. It was real D.C. shit. They even shot Single Payer in the face so it couldn't be discussed.
They got us, all right. They got all of us. But Obama and Emanuel forgot one thing that they may remember in 2010 and 2012.
The dead don't vote.
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There is a philosophical difference between progressives and the blue dog and new democrat coalition combine. It is simply focus - progressives believe in paying labor fair wages and restricting immense accumulations of wealth. The opposition believes that business is the solution to all problems, and government has to be reduced so private companies can take control of roads, highways, libraries, Medicare, Medicaid, Social Security and the armed forces.
Unfortunately, Obama has surrounded himself with the anti-progressives, especially Rahmy. It is not just that these Third Way politicians want to win elections, they actually believe that the elite should rule, and the masses should follow.
Democracy has its origins in Ancient Greece. The original GDR demonstations has the slogan "Wir sind das Volk" (we are the people) to protest against the stalinist government that supposedly rules in the name of the people, but obviously didn't.
http://www.politik-web.de/
If you want to belong to a party that is based on calling its opponents names join the GOP. Why do people think "calling out" Baucus and Lieberman would secure their votes? Actions speak louder than words. Did anyone notice that the bill passed in the House includes an immediate mandated medical loss ratio of no more than 85% and the Secretary of HHS can set a higher mandate. For the first 9 months of 2009, even at the minimum of 85% this provision would wipe out about half of United Health Group's earnings and return the money as premium rebates. When the insurance lobby attacked the Baucus bill (which was the worst alternative of the five bills reported out of committee), the Democrats immediately responded by adding provisions to strip the health insurance industry of its anti-trust exemption. I don't know how you get tougher than that.
In 1993 it took the Clinton administration until November 20 to get a bill introduced in Congress. The Obama administration got a bill passed in the House on November 7. The Clinton bill wasn't reported out of the last House committee until October 7, 1994, and never made it to the floor. It also never even made out of a Senate committee.
The bill was a huge accomplishment.
"Did anyone notice that the bill passed in the House includes an immediate mandated medical loss ratio of no more than 85%"
Is there an upper limit on the number that they can take 15% of?
It is limited by the size of the health care market less government administered health care (by 2019, an estimated 56 million Americans under age 65) and the newly imposed antitrust laws. The 15% they "take" is not profit, it includes all administrative, sales and management costs.
The way it works is the amount actually paid out to medical providers must be at least 85% of the total premiums the company collects. If it is less than 85%, the company must rebate the difference back to the premium payers. The 85% number is a floor. The Secretary of HHS can set the number higher, and will as administrative costs are driven down by other provisions of the bill.
In the case of UHG in the first nine months of this year they collected $59.586 billion in premiums. UHG paid out $49.248 billion in medical costs, which is 85% of $57.939 billion. That means they would have to refund $1.647 billion dollars in premiums. I did make a mistake in saying this is half their earnings. It is more than half their after tax earnings, but their taxes would also be reduced. $1.647 billion is about 38% of UHG's pretax earnings for the nine months.
I would think by now we would all know better than to believe the claims of the health insurers. Senator Rockefeller's committee says: "While the insurance industry has told Congress and the public that it spends 87 cents out of every premium dollar on health care, the actual medical loss ratio in the health insurance industry is significantly lower." Here's a link to the actual 2008 numbers for the five largest insurers:
http://commerce.senate.gov/public/_files/Nov2letterExh1.pdf
Unfortunately the voters who would have loved attacks on Baucus can't do anything about him until 2014. What you seem to be saying is forget health insurance reform, let's concentrate on changing the campaign financing system. Then eight years from now (it's too late to put finance reform in place for 2010) when we have a squeaky clean Senate the next president can get a better health bill. Maybe in 2016 the supporters of single payer will actually support a candidate who doesn't say over and over and over "Families and individuals should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan."
85% might be more impressive if it weren't two percent BELOW what the industry claims it's medical loss ratio is. Very corporate friendly.
President Obama ran against lobbyists and their influence on the system. It came up endlessly during the campaign. That means opposing politicians receiving massive amounts of lobbying money. No - Baucus wouldn't have liked it but the voters would have loved it. And putting an end to it would have been amazingly popular.
If Obama's plan was to fight lobbyists by helping bought off Senators negotiate deals with them, I wish he'd let us know about it.
I would think by now we would all know better than to believe the claims of the health insurers. Senator Rockefeller's committee says: "While the insurance industry has told Congress and the public that it spends 87 cents out of every premium dollar on health care, the actual medical loss ratio in the health insurance industry is significantly lower." Here's a link to the actual 2008 numbers for the five largest insurers:
http://commerce.senate.gov/public/_files/Nov2letterExh1.pdf
Unfortunately the voters who would have loved attacks on Baucus can't do anything about him until 2014. What you seem to be saying is forget health insurance reform, let's concentrate on changing the campaign financing system. Then eight years from now (it's too late to put finance reform in place for 2010) when we have a squeaky clean Senate the next president can get a better health bill. Maybe in 2016 the supporters of single payer will actually support a candidate who doesn't say over and over and over "Families and individuals should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan."
If you are concerned about having candidates who will fight for these progressive alternatives, then you must make sure that ballot access is available to third party candidates. It's very difficult for third parties to make it through, what in some states is, a very expensive gauntlet which the Dems and Repubs almost universally do not have to undergo.
The Greens have been beaten down by many of the Progressives for their early attenuation to this problem within the Democratic party, yet were bullied into a corner or otherwise ignored or blamed for Bushs' ascension. Had their been electoral reform (which requires at least one major party's support and that won't be the Republicans), then a third party could have entered without necessarily jeopardizing the progressive agenda. For example, we might not have "Blue Dogs" to worry about if Greens were allowed to run in those Bourban Democrat districts.
We also have to get on campaign finance reform. If your state is ready, start with your own towns or counties.
Then build strong community coalitions who will fight business-only interests. People and environment first agenda must take precedent and it must be through strategic measures taken at the ballot box.
The work is at the local level because the head is corrupt.
Ask the Republicans how much third party access helped in the 23rd CD of New York. They backed the Conservative and the Democrat won. If we support Greens in Bourbon Democratic districts, we won't have "Blue Dogs" to worry about; we will have Republicans instead. Remember that's how George W. Bush got close enough in 2000 to take the election. In light of subsequent events who was the true "green" candidate, Nader or Gore.
Campaign finance reform almost always favors incumbents and cripples third parties. We have a public financing system here in Connecticut that has been found unconstitutional by a Federal District Court judge because it "acts as an impermissible subsidy for major party candidates", "artificially enhances the political strength of many major party General Assembly candidates" and "qualifying criteria for minor party candidates are so difficult to achieve that the vast majority of minor party candidates will never become eligible to receive public funding at even reduced levels".
Very well put Sir.
I'm a 60 year old Liberal with a disabled wife, caused by a 'rich-f%#K-up' who CYA'ed past destroying us financially.
I have worked since the 5th grade and watched 'the root of all evil' turn our country from the 'role model' that inspired masses of 'flag wavers' in every country to idolize the USA to a country whose atheletes dare not display their country of origin, the United States, while abroad, for fear of being 'retaliated' against. On 9/12 the WORLD stood behind us in support and the 'idiocracy' pi$$ed it all away and emptied our treasuries.
The Republican Party at its best!
And these are the 'people' the Administration compromises with while telling US on the Left to tamp it down?
Progressives are the REASON the Middle Class in this country EXISTS!
The Milton Friedman,Chicago economics BS is starting to stink up the place!
Barack the 'politician', too bad..........time for a Progressive Labor Party. Make more than 100grand a year and you can't be in this Party.
Power to the People!
Oh I'm gonna vote all right. Third party ticket. Anyone else who doesn't feel particularly excited about the choices available should do the same. Put the fear of G-d into the conservatives.
I am unfortunately going to have to agree, sir.
We have been had.
"the dead dont vote" exactly right, obama has killed the spirit that elected him and the voters who made the difference in 2008 wont show up the next time.
Rahm and Obama are trying to call our bluff. They are betting that we will go with them because the alternative is worse. Mr. President ... beware of an ally scorned. You play the other side, you don't get a bill and you don't get re-elected.
"They even shot Single Payer in the face so it couldn't be discussed." REAL SHAME! And as always Democrats compromised ! You will think they wouldhave learn from the party of "NO".
Great article, Thank you!
If anyone wanted single payer they should have elected someone other than Barack Obama (maybe Dennis Kucinich). President Obama said over and over and over that his health plan would be private insurance based. It is true that he backed away from one of his campaign positions. His plan would not have mandated individual participation.
It is amazing that so many people are surprised that Obama does not support same sex marriage or single payer health care and has escalated the wars in Afghanistan and Pakistan. This are all exactly what his campaign positions were. This is what the Democratic National Platform said: "Families and individuals should have the option of keeping the coverage they have or choosing from a wide array of health insurance plans, including many private health insurance options and a public plan." Obama has kept saying this.
The platform said "We will send at least two additional combat brigades to Afghanistan".
The platform said "We support the full inclusion of all families, including same-sex couples, in the life of our nation, and support equal responsibility, benefits, and protections." That's code for domestic partnerships or civil unions not marriage equality.
I wasn't surprised that President Obama didn't support Single Payer. As you said, that's not what he ran on.
But for a while I was shocked that he didn't support it being put on the table for discussion because it's a basic negotiating tactic - you ask for more than you expect to get. By framing the debate with Single Payer, it puts the Public Option as moderate position.
So, for a while - this confused me.
Then I realized - click - that the Public Option WAS the 'more than they expected to get position'. In other words, the PO was always a bargaining chip and a way placate the liberal base....because the President will say he 'prefers' the public option.
So, no - I'm not going to let you reframe the discussion as so many Obama apologists do; by trying to say that Obama supporters had expecatations that were unrealistic. Taking the candidate at his own words, there's only one conclusion - we were betrayed. Hoodwinked. Bamboozled. Led astray. Rahm Emanuel landed on US.
Yeah. When he said he'd be a "fierce advocate", we all knew he meant that he would fiercely advocate something other than what we want.
"If anyone wanted single payer they should have elected someone other than Barack Obama (maybe Dennis Kucinich). " HOLD ON, please! Kucinich ( whom -BTW-I supported from the beginning) was not only totally disregarded during the debates but dismissed at the end. So, let me ask you this: Do you believe voters can/would elect a candidate who is not on the ballot? And whose decision was this?
That was some very powerful imagery !!! Great job !!!!
Great analogy, Lee. This is how it feels for so many of us.
WOW!
Took the word right out of my mouth.
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