We are getting to that gritty grimy disgusting part of the legislative sausage making on health care where the fight is less about what shining principles we will achieve, and more about the best possible negotiating strategy for getting the best possible details in the bill. On a wide range of issues -- including the public option, affordability for the middle class, who pays what in new taxes, how to lock in new cost savings, abortion, immigration- negotiators are still hammering out a wide range of details. Anyone who thinks either progressives or conservatives get a clean win on any of this is wrong, but anyone who writes the whole negotiation exercise as unimportant because we can't get clean wins is even more wrong. I have seen the effect of the details of public policy from both ends, as an organizer of poor and working class people and as a White House official, and I guarantee you that these details in real life.
We are now at a point where (a) the reconciliation option is virtually off the table for all kinds of political, timing, and procedural reasons (some of which I outlined a few days ago here); and (b) we are so close to getting a bill done that no one wants to be the person who stops it, making it likely to get passed. Where that leaves us is white knuckle negotiation time. The bill was never going to be everything progressives wanted: the question now is what percentage of what we wanted can we get.
Let's take the most publicized fight, the public option. We know for sure that it isn't going to look anything like Yale professor Jacob Hacker wrote up the public option idea a couple of years back, and all of us who have been fighting so hard for its enactment for the last 18 months are deeply troubled by that. But having fallen short of that, the details that are currently being discussed will matter enormously: will the new entity be national in scope or state by state? Will it be available from day one of a new system, or only if triggered? If there is a trigger, is it a trigger written never to trigger as the first Snowe trigger was, or is it a trigger that is more likely to be triggered, and triggered early on? Do anti-trust standards ever come into play in terms of the competitiveness of individual insurance markets? If the new entity is not exactly a public option, does it look more like the Tennesee Valley Authority in terms of its structure, or Fannie Mae (TVA is a whole lot better, because its board is appointed publicly and it is more accountable in general)? Are more people eligible for Medicare, Medicaid, and S-CHIP?
All of this matters a huge amount. These details have an enormous amount to say on whether there is any kind of real competition for private insurers, and on whether tens of millions have access to any kind of a decent public option, whatever it is called.
On every single issue, these kind of essential details are being worked through. It is essential that progressives negotiate together, and negotiate well, for us to end up with a decent bill. We can still make this a much better bill, but the process is as intense as it gets.
We do need to start over. Just a simple bill. Simple fixes. Think about it...why couldn't the Democratic party get a simple bill? Its clearly because they needed to add on tons of corporate welfare for each reform.
Its like smothering your veggies with gravy and thinking your eating healthy.
Obama
The Health Insurance Industry
The Pharmaceutical Industry
Big loss for:
The American people.
Progressives get a bill with NOTHING they wanted in it and the conservatives get to defeat progress once more time.
No matter how long it takes Women and pro-CHOICE men will run the Primary challengers against them so they NEVER use women's health as a weapon.
You are right. todd432, and I find it encouraging to see this much support for rejecting this garbage bill on this post.
We need a new Congress. Tell your legislators they're fired!
Otherwise this is all just corporate welfare, which it is all this bill is meant to be anyway.
What else can we expect from a Congress totally corrupted by corporate campaign cash and a President who gave away the store before negotiations even started, didn't show the character or courage to stand up and fight or draw a line in the sand for a robust public option, and threw his campaign pledge against a mandate to buy for-profit insurance under the bus?
This dog and pony show is fundamentally about one thing and one thing only. Trading an ocean of corporate campaign cash in exchange for a legal mandate to require people to buy for-profit insurance with no competition or cost controls.
Tens of millions of Americans who cannot afford for-profit health insurance now will see their standards of living lowered even further by being forced to buy for-profit health insurance at extortion level rates under heavy tax penalty if they don't.
And anyone with claim-denying, for-profit insurance will tell you from experience that having for-profit insurance coverage is not in any way the same thing as having access to the health care you need.
I hope Rahm Emanuel enjoys rolling around naked in all that corporate campaign cash the President will "deliver".
The one thing I really want to see -- and haven't yet -- is a move to accelerate the timetable so that people can start seeing the benefits of health care reform within the next year or to, rather than having to wait until 2014.
The other thing, of course, is that this whole crazy process is going to be repeated in Conference, assuming the Senate finally figures out a way to pass the damn bill.
Besides a health care bill the average and I mean average person can read understand and digest would be a good start Instead of this unfathomable 2000 page monstosity that most legal minds cant comprehend!
So unless this healthcare bill is written in simple form with concise truthful bullit points, I for one will not support it!
By the way what happened to Campaign promises of transparency!!
Seems like an awful lot of closed door sessions going on, with one thing in mind
to Ram a health care bill down our throats by hook or by crook
We shouldn't pretend there is nothing good in this bill. It proposes to insure some poor people and young people who can't now get insurance. So we've heard quite a lot of blinkered "Don't let the perfect be the enemy of the good" advocacy. But the bill as a whole isn't good, it's bad, a net loss.
The proposal now is to tax the middle class and cut Medicare to mobilize resources for the uninsured--while using an unprecedented mandate to deliver everyone into the hands of the private insurance industry as so many trussed up Christmas turkeys.
With a public option open to all, this reform would be a net plus, a weak but useful compromise in lieu of single payer healthcare. As it stands, it's political suicide for reformers, who will be blamed for making the problem worse in the name of reform.
Defeat it, and blame the lobbies and corrupt politicians who ruined it. Then campaign during the mid-term elections on healthcare reform. It's a winning issue. Ordinary Americans must make their opponents pay a continuing price until they give in.
Can someone tell me what we are getting out of this except guaranteeing a huge angry group of ex-democrat voters who are younger and financially struggling in a recession and will now have to pay for junk private insurance they don't need and who will also have been denied a public option and for whom the compromise of extending medicare to age 55 is a "so what"?
And small businesses? One of the last things that actually employs Americans vs.simply outsoucing? No public option means they get nothing out of this either. Fail.
Please Do not let progressives negotiate to "expand medicare" and call it a win unless you are covering both younger people and small business because those are the electorates that will matter most as the swings in 2010 and 2012.
Othewise vote this bill down, yes it looks bad however the election loses if it is passes will be enormous. Ironically it will eliminate the conservative democrats who suffer most in that election scenario.
Agreed this negotiating time is crucial. Say no to awful deals and make Obama do his job because he will then have no other choice and will finally put pressure on the conservadems dogs to heel.
A great resource for info and analysis of the health care plan put forward by the House is Dr. Marcia Angell from Harvard Medical School...
http://www.huffingtonpost.com/marcia-angell-md/is-the-house-health-care_b_350190.html