The CBO finally scored the redrafted Senate health care bill, saying it will cost $871 billion over the next ten years. Not that anybody waited for the numbers before cutting a deal. This was never really about the numbers. It was about coming in below an arbitrary figure and passing the bill by an arbitrary date. It looks like both goals will be met.
The CBO Director's Blog writes that "(t)he changes with the largest budgetary effects include expanding eligibility for a small business tax credit; increasing penalties on certain uninsured people; replacing the 'public plan' ... with 'multi-state' plans ... deleting provisions that would increase payment rates for physicians under Medicare; and increasing the payroll tax on higher-income individuals and families."
In other words, the bill now has more breaks for business but harsher punishment for uninsured individuals, it eliminates the already-weakened public option, it pays doctors less - and it costs the Federal government $23 billion more.
Hey, what's not to love?
The idea of raising payroll taxes on higher earners is a good one. But if you take that new revenue, add the unfair tax on higher-cost benefit plans (studies demonstrate its unfairness), throw in the pay cut for doctors, and toss the higher individual penalties on top of that, it still doesn't offset the fiscal recklessness behind killing the public option.
Why would the public plan have saved the government money? Because, as the CBO puts it, "it was expected to exert some downward pressure on the premiums of the lower-cost plans to which those subsidies would be tied. " In other words, it would have made other insurance cheaper by creating real competition. If it's costing the government this much money to lose the public option, can you imagine what it's costing the rest of us as individuals?
Remember: the CBO score doesn't include the personal value of these policies for each of us. The Senate's new bill won't just increase the Federal budget.We'll also pay higher premiums because we lost the public option, and face more out-of-pocket payments because the excise tax stayed in. Wasn't it Oscar Wilde who said a cynic is someone who "knows the price of everything and the value of nothing"? One issue dividing progressives now is that some see pragmatism in this bill and others see cynicism.
If Joe Lieberman can single-handedly be credited with most of these changes, is it fair to call him the Twenty Billion Dollar Man? Maybe. But remember, it's easy to hate Joe Lieberman - and it's a distraction. The Administration and the Senate leadership made a series of choices that give him this power. In fact, some say that the public option was always doomed - that the Administration cut a deal in which they'd make a half-heated attempt to fight for it and would then let it die, placating the always-compliant liberal wing with another mantric repetition of the phrase "we didn't get everything we wanted, but ..." In that scenario Joe's the Bad Cop to the President's (and Harry Reid's) Good Cop. If Joe Lieberman didn't exist it would be necessary to invent him. "Hey, I wanted to help you out - here's a cup of coffee - but my partner here ..."
So progressives are torn between the Good Cop/Bad Cop Scenario and the String (of Blunders) Theory. The reality's probably somewhere in the middle: mismanagement and a back-room deal or two. (We know there was a deal with Big Pharma.) There's an easy way for the President and Sen. Reid to disprove the Good Cop/Bad Cop Scenario, of course: They can fight like hell to win concessions in the House/Senate conference, bringing final bill more in line with the House version. That would mean, at the very least, a public option and no excise tax.
Think they will? Me neither - but I think they should be pressed to do so. I expect that the House will be put under enormous pressure to cave and accept the bill as it is. I think the President and other party leaders assume the left can always be counted on to cave in for the good of the country. I also think that anyone who points out the flaws in this bill will be subjected to another round of scoldings from party leaders and their supporters, charged with not understanding how the world works. Wouldn't it be better to debate the tactics on their merits instead?
Because that last charge is the biggest miscalculation of them all. Many of the people being lectured over this bill are the same people who have been right about matters of both policy and politics for most of the last decade. (And about the politics - the Democrats are going to get killed if they pass this bill.) So it was particularly satisfying to see Markos Moulitsas respond forcefully to Chris Matthews for his wave-of-the-hand dismissal to those who saw the last decade's events more clearly than he did.
That doesn't necessarily make them right today, of course, but I think they are. Debates over motives don't even matter in the end, since the tactics should be the same either way. And speaking personally, I'm not talking about "killing the bill" here - I'm talking about getting a better bill. I believe it will take a credible threat from the left - a "fear factor" - to get that done. Sure, we'll be told this is the best we can expect, that it's this bill or nothing, but it's too soon for that. When it really is take-it-or-leave-it time, I and many others will agonize over the decision. But most of all, I think now is the time to press the case against the Senate draft. The odds may be long but the struggle for a better bill is still worth pursuing.
The battle is lost but the war isn't over.
(UPDATE: I talk about the bill with Cenk Uygur on The Young Turks; video here.)
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RJ Eskow blogs when he can at:
A Night Light
The Sentinel Effect: Healthcare Blog
Website: Eskow and Associates
Follow Richard (RJ) Eskow on Twitter: www.twitter.com/rjeskow
failure, stay piss poor, so I can qualify for the Medicaid plan.
No need to try getting ahead while being slapped down and called CRIMINAL to boot.
We have a few years to adjust to subsistence living, which many live in now since the banks
and wall st took those failed money making risks and we were presented with their bill.
I'm no longer a member of the Democratic Party. Bye-bye. I'm going to remain Independent, vote for Dems when there is no other possible progressive option, and focus on Democratic Socialism as my new political value system.
I must have missed that speech, where Big Biz wins,scams,
pays off , bribes, lobbyist spewing money, and screws us doing it.
We all know SINGLE PAYER is the only answer.
"To keep them honest", now that's a joke.
To keep a CORRUPT INDUSTRY honest, who are they fooling!
We will not forget this sham or vote for a president who sold us into being
indentured to the corrupt Insurance Cartel.
Rahn thinks we will just bend over again, if we are thrown a progressive crumb.
It leaves me wondering why Rham is so willing destroy Obama's base?
Cause him to loose the next election.
It has to be the payoffs.
He is being foolish, and will cause Obama to be a one term Prez.
Maybe then we can vote in someone who does not support the Corrupt ways of Washington. Someone who really has the peoples interest in mind.
I think he didn't push hard for single payer or a public option because either option would radically negatively impact 1/6th of our already deeply suffering economy - and may well have pushed us over the edge. We're still teetering even now, and predictions aren't good for our immediate future..
We will end up with a bill that the CBO passes, add desperately needed improvements to our HC system, and will have something to work on in the future.
Senator Whitehorse. Democrat. RI
He too voted for the bill. And he called all Americans who opposed the bill on economic or other grounds, none of them having to do with the president, any number of names. All of us right wing milita, tea baggers, religous fanatics, and FREE AMERICANS shall remember him and all the others who voted for this bill against the will of the majority of the nation. Hang on, justice grinds slowly, but it grinds exceedingly fine. It is eleven months until November 2010. Wrongs shall be righted then.
I'm voting third party next time.
Focus on this: The bottom line, no public option, no deal. Without a public option no mandate to purchase, no special deal for Ben Nelson and Nebraska, no concessions to Lierberman and Connecticut. And the antitrust provision gets removed for the insurance industry no matter what, as punishment for interfering with the will of the people. That is how you negotiate for your constituents and protect the American people. You do not let others who wish to keep you from attaining your objectives dictate to you on your ground, in your back yard.
Vote for progressives, they care about us.
We are sick of the corruption of our government.
I'm so disgusted with the Dems right now - but is this any different than it's ever been? The second most capitalistic organization in the world: The Democratic Party.
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.
THIS IS WHY.
1. Demand for health care is INELASTIC meaning you will pay any price to get it particularly when your life is at stake, therefore the law of supply and demand CANNOT work.
That is why pricing is regulated in civilized countries and profiting from basic care is outlawed.”
2. Competition apparently does not work for private health care insurance companies in the same way that it does for others marketing other goods and services. Health care spending is mostly non-discretional and therefore the law of supply and demand in the marketplace really does not function.
3. If the insurance is paid for by the employer but used by the employee, that also changes things.
4. Finally the insurance company has financial incentive of denying claims thus marketing an inferior product.”
I would like to add, if this Senate bill is not corrected in Conference, the cost of health care in this country is doomed to increase exponentially.
If the rule is that private enterprise results in the marketing of better goods and services for the public than the government could provide, private health care companies are the exception that proves the rule.””