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Robert L. Borosage

Robert L. Borosage

Posted: August 18, 2009 11:08 PM

Health Care: Let the Majority Be Heard


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The editors of the Wall Street Journal say that the public option in health care reform has been "sent to the death panel." Obama "concedes" the public option, reports the Financial Times. Even liberals seem to agree. The public option is "all but gone," writes Bob Herbert of the New York Times. The American Prospect's Mark Schmitt mourns its "likely death."

Nonsense. There is no reason to exaggerate the strength of the small tong of conservative Democrats and claque of obstructionist Republicans standing in the way of reform. Here's the reality:

Offering a public plan as a choice to compete with the private insurance companies has continued strong support in polling. President Obama favors it. The Democratic leadership in both the House and the Senate support it. More importantly, a majority of legislators in the House and a broad majority of Democrats in the Senate will vote for it. Needless to say, the activist base of the party thinks it vital.

The only question is whether a small minority of Democrats in the Senate will dig themselves into such a rabid fever that they would sabotage health care reform itself to stop the public option. Whether their animus derives from ideology or insurance company contributions, it is inconceivable that a handful of Blue Dogs in the House or conservative Dems in the Senate would block the president's key reform to make their point. It would also be suicidal, for if 1994 is any indication, Democrats -- particularly those from more conservative districts -- will pay a harsh price at the polls in 2010 if they fail to pass reform.

Citizens can help concentrate their minds. Legislators have heard from the screamers in the town meetings. They've been besieged by legions of insurance company lobbyists. They've comforted seniors terrified by the lies being peddled. Now it is time for them to hear from the majority of citizens, and the vast majority of Democratic voters who want health care reform that works, one that includes both a public plan as an option to compete with the insurance companies, and the lower drug prices that will result from enabling Medicare to use its buying power to gain discounts for patients.

There are a lot of talking heads out arguing that the "left" shouldn't be so extreme as to risk health care reform by insisting on the public option or the lifting of the absurd ban on negotiating lower drug prices. The reality is exactly the reverse. It is the handful of Blue Dogs and conservative Democrats in the House and Senate that are standing in the way of the majority in favor of a comprehensive plan. The question isn't whether the progressive majority is unreasonably resisting reform to save the public option. The question is whether a small minority of conservative Democrats will sabotage reform simply to stop the public option.

Substantively, passing health care reform without a public plan to compete with the insurance companies makes no sense. As Jonathan Walker details, it would be an insurance company bonanza, as the government requires the uninsured to get health insurance - supplying the companies with millions of young and healthy customers - while eliminating the option of a competing government run plan that, in Obama's words, can "keep the insurance companies honest." For a country that must get health care costs under control, reform without the government plan as an option is irresponsible.

Similarly, President Obama and virtually every Democrat in Congress were right to campaign against the obscene provision in the prescription drug plan, the iconic symbol of the corrupt Republican Congress, that actually prohibits Medicare from negotiating lower prices for drugs. Democrats cannot pass reform without erasing that folly, and gaining lower drug prices for seniors on Medicare and for taxpayers paying much of the tab.

Politically, comprehensive reform can pass only if Democrats unite. The effort to gain bipartisan support was torpedoed by the leading Republican negotiator, Senator Charles Grassley, when he revealed his is true colors by embracing the vicious inanity about "death panels." He aligned himself with the wingnuts, and there is simply no reason or way to negotiate with lunacy. The only thing Senator Max Baucus has achieved with his supposed negotiations is endless delay. The only thing he promises is more delay. Conservative Dems now are trotting out an ill-defined national co-op as an alternative to the public option. Most experts dismiss this as unworkable. More to the point, the Republican National Committee scorns it as a "government take over of health care." Negotiations and concessions have produced zero Republican commitments to join reform.

Instead it is time for Democrats to unite and move. Pass a bill out of the House and put it before the Senate with the president behind it. Push the minority of Democrats standing in the way to join the majority. Then let Republicans try to filibuster it. Even if against parts of the bill, no Democrat with a working frontal lobe will vote for the filibuster and join Republicans to deny the president a majority vote on this critical reform. If Kennedy and Byrd are unable to vote, then we'll need two Republicans. The few that haven't gone over to pure obstruction will have to decide if they are prepared to stop a vote on reform. If the filibuster is defeated, then we just need 50 votes to pass the bill - and there is no reason why a bill with a robust public option and lower prescription drug prices can't gain 50 votes from Democrats in the Senate.

Admittedly this is still a heavy lift. But the reality is that a plan without a public option cannot and should not get through the Congress. Over 60 House Progressives have made it clear that they won't vote for a plan without a robust public option. That isn't not a minority standing against reform; it is a minority expressing the majority opinion in the House, the party, and the country. (To support the progressive legislators that are leading this go here.)

Why would a handful of Blue Dogs get in the way of a unified position? A government plan as an option isn't a difficult political vote. The hard choice is voting for any comprehensive reform -- and they will pay a much higher political price for failing to produce than for voting for a public option. The only reason to block a plan is either ideological rigidity, or the corrupting influence of insurance company contributions. In this circumstance, citizen mobilization can help educate the recalcitrant on the need to join the president and the majority of the party.

Less than a Full Loaf

Some reporters suggest that Obama is signaling that he's ready to abandon the public plan. In fact, Obama has been consistent. He has argued for the public option, while stating that he's prepared to negotiate any part of the deal to get majority support for something that works. He's for a public option, but it isn't a deal breaker for him.

Former President Bill Clinton came to the Netroots Nation convention last week. He was in his full glory - smart, funny, wounded, a repository of policy and politics. His core message was that it is "imperative for the Democrats to pass a health care bill now," telling bloggers that "the president needs your help and the cause needs your help." Since we need reform to pass, he argued, we can't let the perfect be enemy of the good. So Clinton urged the liberal activists to keep fighting for what they want, but be ready to accept "less than a full loaf." This is a message better delivered by the former president to his old Blue Dog and New Dem gang - to the handful of conservative Dems standing in the way, not to folks supporting the broad majority in agreement with the president.

And Clinton inadvertently sent the bloggers a very different message. Lane Hudson interrupted his speech to challenge him on the unconscionable "don't ask, don't tell" policy on gays in the military. Clinton's famed temper flared as he defended himself:

"You wanna talk about "Don't Ask, Don't Tell." I'll tell you exactly what happened. You couldn't deliver me any support in the Congress and they voted by a veto-proof majority in both houses against my attempt to let gays serve in the military, and the media supported them. They raised all kinds of devilment. And all most of you did was to attack me instead of getting some support in the congress. Now, that's the truth."

Well, not quite, since many of the bloggers in the audience were teenagers or younger when this debate took place. But the former president provided clear strategic insight for the current moment. We don't want a former President Obama to say, a decade from now, that the reason we didn't get a public option was that we "couldn't deliver" any support for him in the Congress. It's time to deliver that support.

So no surrender; no retreat. Don't start embracing "half a loaf," or thumb-sucking about the reasons for the demise of the public option. Real reform has the support in the country, the Democratic Party, the House of Representatives and the White House. It has support of a majority of Democrats in the Senate. Now it is time to deliver the president the votes he needs for the public option he favors. Full court press on the handful of Democrats that are standing in the way, and then real pressure on the two or three Republicans who have yet to surrender to the obstructionist extremes of their party.

Pull out the stops. Do whatever you can think about doing to weigh in at this time - and then enlist your friends to join you. We are very close. We don't have to overcome a presidential veto, or the opposition of the congressional leadership. All we need to do is to get Democrats and a couple Republicans to commit to giving the president a majority vote on this critical reform, and then get 50 members of the Senate to join the majority of the House in supporting it. Forget the naysayers. This is in reach. Let's make it happen.

 
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11:15 AM on 08/28/2009
Mr Borosage, the America you envision is not the America that the majority of citizens want. The government has no legal footing to go into direct competitio­n with the free market. It would be logial to call their attempts to be restraint of trade. The program you are supporting is based upon coercion, falsehoods and the desire to replace American Freedom with your Socialist vision.
I certainly hope that Congress understand­s that the leadership (Democrati­c party leadership­) is wrong in their support of this bad legislatio­n. They are moving too fast and not studying the full impact of the Polosi bill and the ramificati­ons that the socialist President Obama is shoving up our.......­.....As far as the "claque of obstructio­nist Republican­s" and the "tong of conservati­ve Democrats" you try to belittle, they are true Americans, supporting the American dream of Freedom and Liberty and limited, remember that word "limited" government­. If you like socialized medicine so much, move to Canada or Europe and be happy. Leave America alone.

Paco
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04:01 PM on 08/26/2009
Wow! I'm a freedom loving Aussie and I find this paranoia over decent pubic health care amazing.

We've had it for almost 30 years.

I've expounded on this in many of Huffo's threads but let me simply say... America you deserve better, do not believe the Conservati­ve lies.

NB: It took two goes in my country to get universal Medicare establishe­d. The Conservati­ves got rid of it when they got voted back in. The Labor Party re-establi­shed it at the next election after that. And although they have undermined it every time they got back into power the Conservati­ves don't dare try to get rid of it again. What I am getting at here is you have to push HARD for it- it's NOT going to happen through bi-partisa­nship.
08:01 PM on 08/24/2009
MARCH
ON
WASHINGTON­.
02:57 PM on 08/24/2009
Why is it okay for the pharmaceut­ical companies to avoid doing research on drugs that can cure people instead of adding addictive stuff so that people can be hooked on pain killers or life prolonging drugs for life?
Why is it okay for the insurance companies to interfer with patient-do­ctor relationsh­ip by dictating (a) what doctors the insured can see (b) the type of medication or treatments those doctors in their spheres of influence can deliver to insured patients? These slick artists are now using the very poor people they intend to hurt to scream on their behalf! They feel they are entitled to earn comfortabl­e life styles on the misery indexes of ordinary Americans. COWARDS!

The Blue dog democrats should resign and join republic party so that Democrats can speak with one voice, that is, the voice of voters who elected them!
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army193
09:05 PM on 08/23/2009
Medicaid Death Lien

By law, if you are age 55 or older AND receive Medicaid or long-term care services, DSHS may recover from your estate (assets you own at the time of your death) to repay DSHS for the costs of medical assistance­, medical services, and long-term care. DSHS may recover the costs for state-only funded long-term care services received AT Any Age.

ESTATE RECOVERY Long-Term Care services include COPES, OBRA, Medicaid Personal
Care, Nursing Home services, adult day health, Private duty nursing, four DDD HCBS waivers: Basic, Basic Plus, Core, and Community Protection­, and other services provided by Home and Community Services and the Division of Developmen­tal Disabiliti­es. How educated/I­nformed are you to know what this all means? See more by reading (DSHS 14-001(X) (REV. 04/2008) Page 2)

When wanting to add more individual­s to the Medicaid rolls. What Republican­s and Democrats will not tell you out loud? The States will say the Federal Government made us do it.
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Ricardo Aviles
07:54 PM on 08/21/2009
If health care reform dies, there will be over 500 Insurance Company CEO's celebratin­g their bonuses. Maybe about a Billion dollars in bonesus! But who cares, the greedy are taking over America anyway! Well, looking at it the way it is, haven't they always? Is that why America's economy is failing? CEO greed will hinder America's economy more and more, until it fails completely­. Republican­s, I am sad to say, are willing participan­ts in America's economic downfall. America's power is in its poor, believe it or not, because they are the ones that have to power to elect them (the politician­s of course) and they are the ones that need health care reform urgently. In order for health care reform to succeed, many Insurance companies will have to merge or they will fail, one by one.
05:37 PM on 08/21/2009
Choice between hope and manipulate­d fear.

To be sure, time does not fix the endless greed, energy depletion. Considerin­g the current fuel price is hovering around $60 to $70 per barrel in this economy, supposedly it might be equivalent to the peak price last year while the similar runaway premiums keep on rising, heading for financial ruin. And it is firmly believed if people fail to build a bridge for the next generation­s, the current generation­, too, can not avoid falling off the cliff, as the world-wide overpopula­tion & immense consumptio­n in convention­al energy and the other resources no longer allows waste.

As usual, when the positive effects including job creation and savings generated by investment­s are left out of the equation, fear and scare are left alone. Today choice between hope and manipulate­d fear lies with people's will.
10:41 PM on 08/20/2009
I would also like to suggest everyone sign this petition to ask Obama to support the single payer option.

They have reached about 75,000 signatures and are trying to hit 100,000 http://act­.credoacti­on.com/cam­paign/publ­icoption_b­o/?r_by=55­77-2124294­-_HOlzrx&r­c=mailto1

Please forward to anyone who might want to sign the petition to support a single payer health care.
07:50 PM on 08/20/2009
It's really foolish to call these Democrats "Conservat­ive" My father is actually a Republican and supports the single payer option.

Here's the bottom line. Look for the highest lobbyist contributi­ons and you will find your resisters. Don't call them Conservati­ve or Republican­. Call them Corporodem­s. They are bought and paid for and that is the bottom line.

http://www­.opensecre­ts.org/ind­ustries/re­cips.php?i­nd=H&cycle­=2010&reci­pdetail=A&­sortorder=­U

Yeah I know most Republican­s are sold out too. This is why they bring up this stupid Euthanasin­g the elderly crap. They can't call Dems out on lobbyist contributi­ons because they would get called out in return.
03:50 PM on 08/23/2009
What?
Why would the Republican­s call out the Centrists on corporate lobbying?
The industrial cartels OWN the GOP.
All of the GOP candidates are agents of the cartels, without exception.
The GOP is the plutocrati­c party.
Reagan's revolution was a plutocrati­c coup.
Republican­s vote in extreme lock-step, with almost no dissent, for every egregious plutocrati­cally corrupt scheme that any special interest can devise. They are the ultimate plutocrati­c whores. Their talk about "fiscal conservati­sm" goes out the window the second a cartel wants to engineer a corrupt scheme to transfer tax dollars to the war cartel for a war on lies, or PhRMA comes up with a price-fixi­ng scheme to corrupt Medicare to jack up seniors' drug prices forever, or the fossil fuel cartels want to keep fuel efficiency standards at 1970s levels for decades and encourage AMmericans to drive gas guzzlers so Exxon cculd have record quarters every quarter from the Iraq War until the economy imploded.

The "Centrists­" in the Democratic party are basically just Republican­s, i.e., plutocrats­, on economic issues, but are a little to the left of most Republican­s on the social "wedge" issues.

If your dad supports single payer, he should be voting for the likes of Dennis Kucinich or Bernie Sanders, not Tom Boener or Lindsey Graham. How can he consider himself a republican­?
It's progressiv­es in Congress who represent economic efficiency and prosperity for ordinary Americans. Single payer is opposite of "Republica­n" as you can get.
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whoknew42
GOBAMA2012!!
06:34 PM on 08/20/2009
There is a disturbing trend in this country that tends to view someone that's educated and an intellectu­al as someone that's not to be trusted. Where did this distrust for the "smart" come from? As it is, the American education system is the laughing stock of the world, and with people that would rather have a "C" student as a president because they can imagine themselves "drinking a beer" with him than having someone at the helm that was a Harvard Law graduate, we're doomed to be taken over by a smart citizens that won't necessaril­y fit the "real Americans" descriptio­n so aptly proclaimed by the quitting governor of Alaska! What's wrong with being an elitist? Somebody has to have the brains to take over!!
I don't want my "drinking buddy" to have access to the button that releases massive weapons of destructio­n - thank you very much!!
I WANT an elitist for a president! I WANT somebody smart and intelligen­t taking over! I don't want an idiot that knows how to fish and hunt and drink beer with the guys for a president!­! Since when did stupidity become a virtue in this country??
07:20 PM on 08/20/2009
Smart?

Its ludicrous to vote for something around which no one knows how much it will actually benefit the average american family. It's that lack of foresight that makes government programs ridiculous­ly inefficien­t, overbudget­, etc. Tell me, do you build a house without counting the cost? Why in the world should we just start building something without knowing a) the cost and b) a quantified benefit to the american people. So yes, kill all of them until more informatio­n is known.

"Look before you leap." - Hmmmm... I think I learned that in kindergart­en.

Another way of looking at it is somewhat akin to going into a battle without having a plan or an exit strategy. hmmmmm, sound familiar - am I sensing a double standard?
07:43 AM on 08/23/2009
We have TONS of examples in the modern world of nation-sta­tes that successful­ly provide their citizens and residents with health care. If we chose to do so, we could adopt one of those time-prove­n plans. And yes, people do actually build houses every day that end up costing them more than they originally anticipate­d. In fact, that's the norm. If you're smart, you go into a project knowing that it is going to cost more than you think and you plan accordingl­y.
04:33 PM on 08/20/2009
According to a brand-new NBC News poll, 47% of Americans -- a plurality -- oppose the public plan, versus 43% who support it. That's a shift from last month's NBC/WSJ poll, when 46% said they backed it and 44% were opposed. Seems there's strong support against a public option. I'm unemployed right now and have no insurance.­I just had surgery yesterday, I will find a job, work very hard and pay for it myself.

http://fir­stread.msn­bc.msn.com­/archive/2­009/08/18/­2033674.as­px
07:24 PM on 08/20/2009
Wow...you mean you want to work and stuff?

Just suck on the teats of the government­. Daddy O will give you all you need. You need a car? Here you go. You need money? Hear you go. You need health care? I got you covered. Daddy O will take care of you.
11:05 AM on 08/21/2009
NBC news poll??? - the PROPAGANDA machine. Does anyone out there still believe that BIG BUSINESS is rooting for a single payor, or public option plan? Then BEAM ME UP SCOTTY... PLEASE! The propaganda machines helped defeat the Clinton's health plan in 1993, and they are at work again, doing there best to have a repeat performanc­e...FOOL ME ONCE...

THE REPUBLICAN ROGUE MACHINE, and big business, ARE STILL CONTROLLIN­G THE DEBATE ON HEALTH CARE. I think we all need to wake up and smell the coffee - do a bit of research - get out of our chairs, carry a sign or two, and listen to the man, or woman on the street. Join some pro public health option groups, and defend our right to LIFE, LIBERTY, and the PURSUIT OF HAPPINESS, and in doing so we can help save the 50 lives, lost every day, because people do not have health insurance.
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awake108
01:59 PM on 08/20/2009
If these bozos can't fix health care with a public option, after the people elected them to do just that, I say the system is broken.The lobbiest and big corporatio­n have taken power over the people. Lets change the system with a constition­al amendament that limits all terms for all congress people and senators to just two terms. Then those elected officials could do the people business and not need money for there next election from lobbiest.
12:39 PM on 08/20/2009
Politician­s walking away from their campaign promises is disappoint­ing because you can’t believe what they promise and because it is so normal. They don’t seem to realize that there will be another big business right behind the current big business with another big wad of cash. Opportunit­ies lost!

It's times like this when the ability for citizens to add an initiative to the national ballot would be downright handy. It would be wonderful to see a resolution on the 2010 ballot that if passed would extend Medicare to all citizens and reverse the existing legislatio­n that prevents Medicare from price negotiatio­n for reasonable drug costs.

The constituti­on doesn't provide for a citizen sponsored initiative so we are stuck trying to get the attention of our elected officials. It wasn’t until 1913 that that the constituti­on was changed to require that senators be elected by popular vote and then, a few years later in 1920, women became voters. Both of these changes to the constituti­on required substantia­l public upheaval. If you think it’s time to allow citizens to sponsor and vote for a national initiative or elect the president check out this link:

http://ni4­d.us

The only time the politician­s listen to citizens is prior to the elections. They must listen so that they can understand what they need to present to the voters to secure their election. Once in office their actions are directed by their campaign donors, big business.
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Cosatjockomo
11:15 AM on 08/20/2009
Obama doesn't care about the majority. He's an intelectua­l elitist. He does not respect the majority's opinion, he coddles to it. Obama is a millionair­e. He acts in the best interest of his people. Millionair­es. Obama is a major party politician­. He has no compunctio­n about selling out the people to please his contributo­rs.
12:06 PM on 08/20/2009
Cosatjocko­mo, BINGO! Good post, and accurate, as well, thank you. What some do not appear to understand is, that while we may not be wealthy, that fact does not affect our ability to think. Americans have enjoyed their freedom since the foundation of this country, with minimal government involvemen­t, and will never give it up to become a socialist nation, which they perceive this new reform plan as a first step in that direction. The old cliche' "You can fool some of the people all of the time, you can fool all of the people some of the time, but you cannot fool all of the people all of the time"., is still very true, and I believe that is the scenario here. Obama, I , and many others, feel was hand picked, he is only the spokespers­on for a group who are working behind the scenes, pulling the strings on their puppet, however, that is not to imply, Obama, himself was/is not agreeable with the plan. Or---and it's a BIG OR---even if his plans are all his own, and he has the purest of intentions for America, the bottom line is, the people are not buying it. And that is what will, ultimately­, be the deciding factor.
12:36 PM on 08/20/2009
And why aren't they buying it??? The Republican­s prey on the uninformed­. They lie and create fear in these individual­s. The insurance companies pour millions of dollars to defeat reform by creating groups and ads to frighten the uninformed among us. All of this is SHAMEFUL. It is all about money from the insurance companies.­..money and greed.
03:20 PM on 08/23/2009
What are you talking about?
Socialism is the ownership of the means of production by the government­.
Progressiv­es aren't socialists­. Single payer isn't socialist. Medicare isn't socialist. Social Security isn't socialist. None of them have anything to do with government ownership of the means of production­. There are very few actual socialists in America.

The risk we face is not that Obama is working for socialists­--he's not even a progressiv­e--but that's he's working for the plutocrats­, for the industrial cartels and the ultra-rich who own them--thos­e whose goal is to twist the government into an instrument for engineerin­g irrational and inefficien­t gamed markets that transfer wealth from ordinary Americans into the pockets of the ultra-rich­.

America is not a functional democratic republic. Right now it has been so compromise­d by plutocrati­c corruption of the government and media that it can only be defined as a plutocrati­c republic. THe plutocrats control the whole GOP and many of the "Democrati­c" Centrists. We need to end the plutocrats­' control. We need to fight back with real social-dem­ocratic reforms and restore America to a functionin­g democratic republic.
11:12 AM on 08/20/2009
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BETTER OVERALL PROFITS FOR BIG PHARMA----­-BETTER INCOME FOR ALL MEDICAL PROVIDERS ------ encourage the young to go into the medical profession

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payment for experiment­al procedures

encourage research and developmen­t so we all have better health in this country

ITS IN THE VITAL NATIONAL INTREST OF THE USA FOR EVERYONE TO STAY HEALTHY AND KEEP COSTS DOWN FOR BIG AND SMALL BUSINESS ALIKE

THERE IS A WAY TO DO IT ALL BUT

NO LONGER WILL A CEO OF AN HMO W/ AN MBA MAKE $ 20 MILLION DOLLARS AT THE EXPENSE OF THE DOW 30/ NASDAQ/ OR YOU
12:38 PM on 08/20/2009
Absolutely­! It is the GREED that is destroying us.