I really do admire President Obama for having the courage to make health care reform his top priority when he knew in advance how difficult it would be to pass. That took a lot of guts, and he should be congratulated for it. And I really do have genuine sympathy for White House staffers and Congressional leaders trying to work their way through the incredible complications on this issue to find the sweet spot for passing a bill. This is a massively complicated issue, with a new minefield around every bend. The fight over the public option has obscured all the rest of it, but health care reform is a monster of an issue: how do you make the subsidies for lower and middle class folks affordable without breaking the bank? How do you adjust Medicare rates and Medicaid formulas and provider reimbursements in a fair way? How do you re-structure financial incentives to encourage more primary care physicians without penalizing the specialists too much? How do you find a path through all the special interest roadblocks thrown in your way?
Questions like these, and a few hundred more, make the passage of any major health care bill as difficult as anything a President could ever take on -- it is just landmine after landmine. From what I can tell, the Obama team hasn't done a bad job of navigating their way through to a solution on many of those quiet but really important issues. Again, my congratulations.
In the end, though, health care reform will live or die on whether the White House, Nancy Pelosi, and Harry Reid can figure out a way around the massive barrier in the middle of the road, the public option. Progressives are demanding it, conservative Democrats don't want to do it, Senate procedural rules make it complicated, so it's difficult to figure out what to do. And I fully understand the political imperative to get something passed.
Here's where I get confused, though. We have always known that passing any health care bill would be tough, but it has become increasingly clear as we get closer and closer to an end game that the easiest, simplest, least painful path is to actually go ahead and do what the President has proposed, which is to pass a bill with the public option.
Look at the facts that we are dealing with:
Okay, stay with me now: ditching the public option would mean a massive, ugly civil war with House progressives, most of whom will be feeling very gun-shy about abandoning their written pledges to oppose any bill without the public option. Keeping the public option would require dealing with some unhappiness from some conservative Senators, and might require a procedural move or two that would be complicated.
Which approach sounds easier to get done?
But conventional wisdom insiders have been telling each other for a long time that there is no way to pass a public option, and that has made White House staffers and legislative leaders have a hard time seeing what is becoming the honest truth: passing a bill with the public option is not only possible, but the easiest way to a victory.
Maybe there is something I don't understand here -- it wouldn't be the first time. But as someone who passionately wants to help the White House pass a health reform bill, it seems pretty clear which way to go. I will admit it would not be simple or smooth, but that civil war scenario of dropping the public option would be a lot worse.
Let's get this train moving down the most direct path to victory.
He needs to look and BE in charge. If he repeats himself...just louder, we all lose.
Then you need to rethink your "admiration" as the cause is a mirage. Obama killed real health care reform before the debate began by attacking single payer. Instead he advocated a massive corporate welfare bill with extreme costs and low effect and no real change.
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I think that if the DLC continues to treat the progressives and liberals as expendable, they're going to find out just how hard it is to win elections when your only "allies" are Blue Dogs who have to appease their conservative constituents, and Republicans who wish you didn't exist.
That's why we progressives are playing this game of brinkmanship. We know how high the stakes are. We know what could be lost -- another chance at real reform in our lifetime -- and what could be gained, meaningful changes, not just in healthcare, but in the entire way government is run (is it for the benefit of the people, or for the benefit of Big Business?)
That's why we're willing to literally tear the party apart. Because, frankly, the issues at stake are more important than President Obama and his "legacy." They are more important than the Democratic Party. They are, at the core, whether or not the United States will still continue to be a functional democracy, or whether we will have officially just become subsidiaries of Blackwater, Wellpoint, and General Electric.
That's why we're drawing a line in the sand. If the President throws us under the bus on Wednesday, then things for the Democrats are going to start getting very ugly. You can't survive as a party when you abandon your base, and I'm very afraid that the Democrats are about to discover that.
The Obamaniacs will never allow this into their cult of personality, but there are more important things than President Obama's legacy or even re-election.
If he doesn't stand up and FIGHT, actively FIGHT, for the public health insurance option, then his Presidency isn't worth saving.
The Obamaniacs will cry "racism" or whatever they have to because they care more about the President's political career than the issues.
However, I care primarily about the people who cannot access the health care system. Without the public health insurance option to lower costs, people who cannot afford health insurance now are going to be mandated by law to buy overpriced, unreliable private insurance at extortion level rates, under penalty of taxation if they don't, with no increased health care dispensed, only more corporate welfare and bigger CEO bonuses.
If Obama cowers on the public option and proves himself a fraud, then the Democrats in the House MUST vote down the mandate.
The Obamaniacs need to hear this in the marrow of their bones. Barack Obama's legacy and polticial career is not as important as the welfare of people he said he was running to represent.
If Obama doesn't FIGHT for the public option, then his Presidency isn't worth saving. If the Democrats don't vote down a mandate without a public option, then the Democratic Party isn't worth saving either.
Let's not forget: We have a public option. It is medicare, medicaid, etc. So when this blogger, Lux, asks "how do you make subsidies to lower and middle class folks affordable?" he is asking a question which doesn't make much sense because the system is already paying for these folks' medical care through unacceptable means wh ich we are all familiar with: Medicaid, bankruptcy, ER, etc.
Where will we "find the money"? where are we finding it now?
All O has to do is drop his "competition" and "lower costs" argument and say here is a bipartisan bill. HSA's for republicans financed through the existing IRA, 401-k system which repubs say is the way to lower costs and a public option operating on a non competing basis in the public sector with the power to negotiate with pharmas, salary doctors, etc., in order to wring cost savings out of the system so those who can't afford private insurance can still get quality affordable care by paying some percentage of their income as premium.
This wins the argument. The argument becomes: Won't that create a two tier system of health care where the poor suffer while the rich enjoy privileged care? However that is an argument we can welcome.
As for bipartisanship, Obama could let Republicans right the bill and they'd still vote against it. They want to sabotage Obama and regain the White House not pass healthcare reform
What are you going to do create two classes of citizenship, those who are allowed reasonably priced health insurance and those who must remain in bondage to insurers? Or what, if you have a decent job or make too much money we'll force you to subsidize some multi-billion dollar corporation by making you to pay more that you have to for health insurance?
And there's this little thing called the Constitution and Equal Protection, any public option must be available to the public. Any attempt to create official insurance serfs by denying people a choice (the only way to make a non-competing program) is totally unacceptable.
You're worried about paying for the uninsured? How about using the thirty percent of heath insurance premiums that go to marketing, administration and profits? The auto liability premiums for uninsured driver coverage? The home and renter premiums for liability coverage? -- In brief, use the waste, duplication and money siphoned off as profit to pay for the uninsured. -- Oh, and negotiate reasonable reimbursement, no two-hundred dollar aspirins.
http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-option%E2%80%9D-was-sold/
The first mistake was to think that a “public option” that merely took over a large chunk of the non-elderly market (as opposed to one that took over the entire market) could substantially reduce health care costs and thereby make universal coverage politically feasible.
Any proposal that leaves in place a multiple-payer system — even a multiple-payer system with a large government-run program in the middle of it — is going to save very little money….. First, any insurance program, public or private, that has to compete with other insurers is going to have overhead costs substantially higher than Medicare’s. (It is precisely because Medicare is a single-payer program that its overhead costs are low.) Second, the multiple-payer system Hacker would leave in place would continue to impose large overhead costs on providers.
It is no harder, and perhaps easier, to beat down the foes of health care reform with single-payer than with a watered down public option. The cost arguments are far stronger for single-payer anyhow, and that may sway a few “blue dog” types after appropriate debate in the media and education of the public on what single-payer really is.
Single-payer and the public option are unacceptable to insurers and pharma. But three-fourths of Americans want at least the public option. An up or down vote will clearly identify just who to target in reelections and freshmen, if we bounce incumbents, wanting more than a single term, will not commit hari kari to protect the healthcare industry.
Rock and hard place time for Congress. We may not get decent reform this time but we will get a hunting license. And even Republicans won't be secure if we don't irrationally rebound Republican in frustration but instead surgically target obstructionists, Dem or Repub.
Obama may not win us reform but he has won us the opportunity to get it, just perhaps not immediately and certainly not effortlessly.
The compromised Obama plan is a nationwide expansion of the system in Massachusetts. People in that state are finding that subsidies don't keep up with skyrocketing costs and they are being forced to buy insurance the can't afford or be punished by the government. Things will be even worse under Obamacare because most of the country is not as wealthy as Massachusetts, competition in health care is less, and the subsidies will be far less generous.
Obama wants low income Americans to go down in defeat so he doesn't have to. We can't let that happen.
If you're with the MSM, the impossible was somehow more likely than the difficult.
Odd, that. One would almost suspect they were carrying the water of corporatists.
Bound to continue.