Tweet
This morning the NYT reports President Obama’s ready to throw the public option under the insurance companies’ limousines.
According to The Associated Press, Health and Human Services Secretary Kathleen Sebelius is suggesting the White House is ready to accept nonprofit insurance cooperatives instead of a government-run public option in a health overhaul plan.
Speaking on CNN’s “State of the Union,” Ms. Sebelius says Mr. Obama still believes there should be choice and competition” in the health insurance market — but that a public option is “not the essential element.”
Without the public option, consumers will be left with a choice between purchasing insurance from the for-profits…or purchasing insurance from Kent Conrad’s imaginary friend, the co-ops….which are intended from the start to be unable to compete effectively against the for-profits we’ve all come to know and despise.
Of course, under Obama’s health plan we’ll all be under a Federal mandate to purchase insurance. Which means that, after the co-ops complete their auto-destruct sequences a few years out, we’ll all be chained to a lifetime of Federally enforced obligation to buy insurance from the same megacorps that make billions by denying us health care.
This outcome – a massive mandatory transfer of wealth from Americans to a few monopoly megacorps – is just what the doctor ordered….if the Dr’s Jack Kervorkian.
Or if the doctor is Robert Rubin: the fellow who used his revolving door detour away from looting and pillaging heading up the honorable banksters at Goldman Sachs and into Clinton’s cabinet as Treasury Secretary only to lead the successful war to destroy the Glass-Steagall barrier between retail banks regular people need and the investment banks that brought down our economy.
That Robert Rubin – he sure gets around. Why, just a few years ago he took time out from his busy bankster’s schedule (after leaving Treasury, he jumped over to head up Citicorp, one of the greatest winners from destroying Glass-Steagall) of looting and pillaging the useful portion of our economy to co-found the Hamilton Project. What’s the Hamilton Project? The Project’s the wholly owned creature of the "FI" sectors: the finance megacorps…and the insurance megacorps.
That Hamilton Project sure gets around, too. Why, the Project’s co-founder and very first executive director, Peter Orszag, got right into the White House – as Obama’s OMB director and one of his chief economic advisers. Maybe he caught Obama’s eye when the very ambitious Senator showed up to bend his knee at the spawning of Rubin and Orszag’s love child, the Hamilton Project.
Gee – and who will make billions from a health "reform" plan that compels us all to become customers-for-life of the insurance companies that make their money by denying us care?
Rubin’s owners, Orszag’s masters, and Obama’s patrons: the megacorps behind the Hamilton Project.
This outcome isn’t a bug: it’s a Rubinite feature. Signed, sealed, delivered – Obama’s theirs.
Without a public option, the only people Obama’s health plan will care for are the insurance CEO’s and the banksters who own pieces of their industry.
That’s why, without a public option, Obama’s health plan must die. So the rest of us have at least a fighting chance of living.
80 Comments
Outstanding post. The Progressive Caucus needs to tell Rahm there’s no reason to even talk about it and that he’s the one that will be looking for a job-not them. Deal breaker.
What about a pledge campaign for every progressive Congressperson who will vote the bill down unless it has a strong public option? $25.00 or $50.00 for each Congressperson?
Agreed the Progressives in the House and Senate must be willing to kill a bad deal forget the good is better than the perfect argument being used to force us to accept a bad bill by some *cough* Dems.
A bad plan is worse than temporary inaction on healthcare for without real cost containment healthcare is just shuffling a deck of marked cards.
Also we need to kill the deal with the drug companies we should pay what everyone else in the world pays for drugs. Why is the Media and the Dems ignoring this are Americans dupes? We are getting taken!
Also any healthcare plan will cost the tax payers less money if drug costs go down!
I feel ya!
Really, the PO thing has just been a big distraction and a failure of the progressive movement which always seems to be open to the siren song of some half-way intelligent folks who can come out with a cagey new idea. First, it was the kludgy program of Hillary Clinton and Ira Magaziner; now it’s the emasculated version of Jacob Hacker’s “smart Alec” idea of getting to Medicare for All without having to pass Medicare for All.
We need to do the obvious thing: First, Medicare for All to limit the role of the insurance companies and simplify the insurance part of it; then a quality management movement in Medical care to cut the Medical errors drastically and also cut costs. Both of these things can be done in five years, but we need to forget Obama’s gradualist approach and go back to the real and effective pragmatism of the New Deal.
I’m more for just copying the French Healthcare system completely and then after a few years adjusting it to our own circumstances once we got real world experience.
The French system works very well and they drink, smoke and eat fatty foods like we do.
There fat butter is better than the transfat we use and their sugar is better than our corn syrup healthwise but other than that they seem to have a system that works well for our vices.
amen.
at the very least we need a path to state/regional solutions (single payer, improved medicare for all)
Back to the drawing board: Medicare for All
Yes.
Everyone needs to call/write/email/fax their Congress Reps and Senators and tell them this, with no waffling, weaseling, or mushy stuff: Healthcare Reform = Robust Public Option. No public option — no healthcare reform. Period.
We just got out of an 8-year Administration filled with people who were willing to trade away our privacy, our freedom, the country’s reputation in the world, the safety and security not only of people in this country but also hundreds of thousands of people in Iraq and Afghanistan. Plus – drove the country’s economy into a ditch (and thereby dragged down the rest of the world with it)and gave away billions and billions of dollars of US taxpayer’s money to a bunch of liars in the banking and insurance industry AND through boneheaded insistence on delusional thinking about practically everything and focus on ‘what’s good for the Republican Party’, have put not only us but the entire rest of the world at risk.
Why should we be willing to trade away anything at this point? Hmmm? I for one am not. Better to put a stake through the heart of this vampiric piece of garbage than to accept anything less than what is absolutely needed.
improved medicare for all.
see my comment @13. details here:
http://pnhp.org/facts/single_payer_resources.php
We need to hammer this point. We are fighting for healthcare so much we are not debating the details the devil is in the details.
It would help if we had more details we can research and debate stuff without bias much better than the Press or the lobbyists reading and writing the bills in congress but we need details.
http://firedoglake.com/2009/07…..ifference/
We are better at research and solving problems working as a group than the best and brightest. But the best and brightest are also ignored in this debate, we both can’t the inside details we need to really debate this.
Its the inbred dependent on rich connections rob the tax payer and the stockholder class writing the laws.
Trying to pull their old scams in the age of instant communication.
What I think folks need to realize is that, regardless future political situations (ie. even with a hammerhead majority in both houses and the WH), if you all lose on this one based on the ’successful’ use of the tactics used here….
Well.
You’ll never win.
.
(In Canada, we did not get Universal Healthcare because of the federal government of the day rammed it through…..Instead, we got it because a very vocal progressive minority pushed and pushed and pushed and pushed in just one province against all odds…..And guess what, the guy leading that minority was Jack Bauer’s grandfather!)
____
Amy Goodman talked about the KSutherland/TDouglas Connection recently here.
.
O Canada!
We need that story of how Canada got healthcare on national tv.
Have somebody with Hollywood clout in Hamsherland call Mr. Sutherland.
Now.
.
In fact…now that I think about it….Maybe the future need to call in the ‘Keifer Sutherland Is The Grandson Of The Father Of Canadian Healthcare’ chip is the real reaon that the Goddess put Ms. Garafalo on that despicable show….
.
I think we need to push for them to include wording that allows STATES to establish single payer systems. I think that is included in the House bill, that’s not enough. Maybe that is what should be focused on as an action, too.
duh. that’s why i was giving you push back (my “what public option?” etc) when you accused me of helping to kill your patients. there was, at that time, no public option on the table that would prevent what you are rightly railing against. (aside: kirk, i sent you an email after that post). a workable public option (or at least the one that had a chance of working) was already off the table (if it had even ever been on it) by that time.
on the other hand, i would not say that the current plan(s) must die – i think it is only right to say that the mandate must die. other reform measures — such as regulation to prevent rescission and to enforce community rating — will at least make insurance available, if only at the margins, for people with pre-existing conditions. this is what we had in MA prior to our 2006 reform. the down side is that making insurance companies actually pay for health care for sick people will raise costs on everyone. but the alternative is worse.
which brings us back to the real solution people like drs. himmelstein, woolhandler , mccanne have been advocating: hr 676 single payer (improved medicare for all):
they weren’t trying to kill your patients kirk, they were trying to protect them
Too bad these protectors never had the votes for their protection. 100% of nothing is still nothing.
do you know any of these people? have you spoken with nyceve about them? they’ve been working for years. never stopped after clinton care imploded. and you’re going to condemn them because even with all the progress they’ve made it wasn’t enough this year — when the majority of progressives pre-compromised away support for single payer and signed on to support the bogus (i write bogus because there was nothing more than talking points – no policy, no bill, no decent analysis) pro-corporate neoliberal “obama plan?’ that the dem leadership was pushing?
not me. they’ve done more than anyone to move us towards real reform. it’s easy to scapegoat them, but that doesn’t mean it’s deserved.
and i’ll just add that they are not quitting. they see their work as a long term effort.
the “condemnation” canard is a projection that would do Kodak proud.
The simple fact is that whoever these folks are, however fine they are (and I’ll stipulate they are all marvelous, for the sake of discussion) and however many years they’ve worked, this year there aren’t enough votes to get single payer passed.
100% of a completely virtuous proposal that doesn’t pass is still, sadly, 100% of nothing.
ok, i guess i misunderstood that when you wrote that you feared that single payer advocates would “put their own agenda ahead of my patients’ desperate needs.” that wasn’t a condemnation. my bad. but, you know, it doesn’t have to be about different agendas — it’s possible that people with the same goals can have different ideas about the best way to achieve those goals.
and that’s why they shouldn’t have be expected to drop everything they’ve been working on to support a policy that 1) didn’t exist and 2) from what they could figure out they didn’t think would work. maybe their thinking was that real reform would come quicker if they continued to work for what they believed in?
now, if you’ve got a convincing policy argument, one that addresses the issues they have raised, that’s a different story. but i haven’t see one from you or in fact from anyone else. so i fail to see why the current lack of votes for a workable policy should be reason to insist long time activists must switch to supporting a policy they didn’t think was workable just because the democrats in HCAN decided they should when HCAN had already ruled single payer off the table. and i will remind you — you couldn’t even describe to me the actual public option policy when i asked. repeatedly. and i actually wanted to be convinced.
so, it’s not about virtue. different people actually have valid reasons to support different policies. if you think the triangulation is a good way to convince people to change the policy they support — i’m here to tell you it’s done exactly the opposite with me.
i have no problem with people supporting public option in a multi payer system, co-ops or whatever. different strokes for different folks. my problem has been and still is with insisting everyone has to get behind your favorite policy when you won’t even 1) make the case for how it will work and 2) address the critiques that have been raised by people who have been studying the issue for years. on every other topic you’ve written about, you have been more than willing to do this — why not on this one?
Absolutely. If we want to blame anyone, I think it’s Obama and his close associates. It was they who decided to take Medicare for All off the table. It was they who are most responsible for this failed strategy. Blame, is not itself so important. What is important is that people acknowledge their mistakes; and direct support of even Jacob hacker’s original public option as anything but a last minute compromise in case of inability to pass HR 676 was a mistake that people must not make again. If we can somehow arrange to pass a limited reform covering preconditions, rescissions, and insurance company actions to raise rates for those who have gotten sick, that would be meaningful reform which wouldn’t compromise our future efforts to get Medicare for All.
Alternatively…if we do end up with coops, what’s to say that the people in charge of each coop couldn’t get together and demand lower prices and better service, ultimately making it a public option?
Depends on the language of the bill, but maybe we can outsmart them.
(Good to see you selise, I was worried about you!)
(((loo hoo)))
thank you so much.
Same here, Selise, it wasn’t the same place without you.
(((Margot)))
wow, you both are so sweet! group hug!
p.s. i can always be reached by email (via gmail or the contact link in the upper right hand corner if you click on my name)
for anyone not yet reading the pnhp blog, here are few posts by kip sullivan (and old school friend of valley girl, long time fdler and i think the first mod) that are, imo, must reads for really good analysis:
Americans Support Single payer. Why Doesn’t Celinda Lake?
Bait and switch: How the “public option” was sold
Reply to critics of “Bait and switch: How the ‘public option’ was sold”
The Senate HELP Committee “public option” will be multiple “options,” and these will be run by insurance companies
In your opinion should this current effort simply be killed, or should we merely table it for now and be better prepared for battle next session. Or should we keep pressing now.
Just to butt in…the doctor who was on the Moyers’ program and is Editor (I think) of New England Journal of Medicine does think we should table and start over. Her recommendation is a progressive, by stages getting everyone into Medicare.
sorry, above was for revbev
re bill moyers: was that from this friday’s progam? i haven’t seen that one yet, but i’ve watched other programs on the topic. i remember especially the one with dr. david himmelstein (one of elizabeth warren’s coauthors!). will go look for the linkie…..
from bill moyers, transcript for May 22, 2009:
…….
BILL MOYERS: I want to get your thoughts on President Obama’s plan. As I read it, it’s very difficult, at this moment, to know the details of it.
DR. SIDNEY WOLFE: ‘Cause there aren’t any details.
BILL MOYERS: There aren’t any details. But he seems to be advocating a public option that would compete with the private insurance-driven sector, as a way of lowering the cost. What do you think about it? Is that- am I reading his plan correctly?
DR. DAVID HIMMELSTEIN: Well, most of the cost savings he’s talking about are really illusory, I think. And my research group has done most of the research work on administrative costs in health care. And the administrative costs he’s talking about saving are a tiny fraction of the potential savings under single-payer. ‘Cause hospitals have to keep their bureaucracy, if you’re dealing with hundreds of different plans. And doctors have to keep the bureaucracy in our office. You don’t actually get the streamlining that you get from having one payer that has one set of rules and can pay lump sum budgets to hospitals. But more than that, we’re worried that the public plan actually becomes a dumping ground for the unprofitable patients. As it’s happening in Medicare.
BILL MOYERS: What do you mean? How would that happen?
DR. DAVID HIMMELSTEIN: Well, the private insurers have all kinds of tricks to avoid sick patients, who are the expensive patients. So, you put your signup office on the second floor of a walkup building. And people who can’t navigate stairs are the expensive people.
DR. SIDNEY WOLFE: Get rid of the heart failure patients.
DR. DAVID HIMMELSTEIN: Or you have your signup dinners in a rural area at night, where only relatively healthy people are able to drive and stay up that late. So, there’s a whole science to how you sign up selectively healthier patients. And the insurance industry spends millions and millions of dollars on that. And would continue to as they’ve done under Medicare. Selectively recruiting healthier patients, who are the profitable ones, leaving the losses to the public plan.
And there’s really, despite regulations in Medicare that says you can’t do that, that’s continued to happen. And it means that every time a patient signs up with a private plan under Medicare, we pay 15 percent more than we would pay if that same patient were in the Medicare program.
BILL MOYERS: We the public?
DR. DAVID HIMMELSTEIN: We the public. But it’s not been efficient. It’s been effectively a subsidy. And that’s what we fear will happen with this public.
DR. SIDNEY WOLFE: Well, we also have some experience. Because in seven states, ranging from Washington to Minnesota, to other states, Maine, they have tried what amounts to a mixture of a private and a public plan. And it’s way too expensive as David mentioned. As long as you have private plans in there, everybody still has to do all the bookkeeping.
So, it has failed. I mean, as Einstein has said, the definition of insanity is doing something over and over and over again, and expecting to have a different result. We’ve seen the same unsatisfactory, unacceptable result, in state after state after state after state after state, why mess up the whole country with it?
No, not this week, but this week was very good. And Moyers was really engaged; he liked the discussion. The one I mentioned was about 2 weeks ago, I think.
i think it’s the bill moyers program i linked to @49? anyway, thanks for the recommendation re friday’s show! i will check to see if the podcast is downloaded into itunes and give it a listen tonight.
i don’t know.
what i would really, really like is an open, thoughtful, discussion (policy and politics) with everything on the table, everything within the circle of legitimate debate (per jay rosen). what was it that al gore used to say when i liked him (2002-2006)?
let us reason together.
well sure–but given where this thing is tactically, wtf should be done now?
will try to expand on my “i don’t know” …
some stuff i’m sure of, but most i’m not.
here’s what i’m sure about:
1) no triangulation. that means showing support for the long time single payer activists even if that’s not what you want to work on right now. (attempting to persuade with evidence and argument is always ok in my book). and for single payer advocates, no calling pro public option or pro co-ops folks sell outs. honest disagreement about how best to move healthcare reform forward is to be respected. solidarity with all who do not attempt triangulation or limiting honest discussion (no church of the savvy putting popular ideas into the circle of deviancy — as per jay rosen)
here’s what i’m not so sure about:
1) regulatory reform to prevent rescission, to enforce community rating, maybe even to implement risk adjustment (all to try to control/limit insurance competition via adverse selection, etc). seems to me to be worthwhile as a stop gap measure.
2) fixing medicare (part d, advantage, etc) seems like a good idea even if done as a stand alone reform
3) more $$ to provide for care for those who can’t afford it (this can be done via any number of programs and doesn’t have to go through private insurers) is always good.
4) it’s the mandate that is, imo, the really difficult one. first because i don’t like the idea of making the insurance companies even more powerful and second because i think people will hate it and that could end up making the dems loose the after reform argument (when the republicans accuse them of supporting big gov programs that don’t work). would a public option make this acceptable? if so what kind of public option? i just don’t know about this one but would be willing to support the earlier hacker proposal (see bait and switch link in my comment @25) with strong regulation and enforcement as a compromise. but that doesn’t seem to be on the table any more than single payer hr 676 is.
… ..
what do you think?
Breaking that down–on your first point–my Rep. Doggett says that single payer is simply not possible. There is zero chance. To me, it’s less a matter of not bickering among progressives than it is not diluting the limited amount of power we have. This was doublewide’s point here a few days back in her post, if I remember correctly.
Oh hey Selise- you found that last one by Kip about the Senate HELP bill. I was gonna post it, but thankfully skimmed comments first.
Despite some claims, the “public option” now on offer (both Houses) is worse than no public option at all.
It took me quite a while to even get a clue about the health care debate, because “single-payer” is not exactly a self explanatory term. Medicare for all- (especial thanks to letsgetitdone for pushing that phrase) works much better. Just by chance, bec. his name was mentioned in a comment on an FDL thread (Feingold talking about “robust public option”) I tracked Kip Sullivan down, and started to understand very quickly what was what.
And, interestingly PNHP’s site traffic has tripled in the past few months, so I was told by the webmaster.
hey VG!
i’m glad to know that pnhp’s traffic is up. i’ve been linking to it a lot in the comments, i hope that has helped. kip’s posts are a real treat — like i said above, the best analysis i’ve seen anywhere. imo they are must reads for anyone interested in this issue.
re single payer, medicare for all. it’s tough because some public option advocates have been calling it medicare like (even if it is no such thing). and hr 676 is really an improved version of medicare. but this is a great time, while the issue is front and center, to educate ourselves and each other about the various policies being advocated.
Selise is right… and (IMHO) the passing of the “public option” is merely the equivalent of withholding care from the “health care reform” patient who is now brain dead as a result of malpractice. What passed for a “public option” in HR 3200 was a joke anyway — and the significance of the sellouts to the parasites that created 3200 pale in comparison to the difference between the “public option” in 3200 and “co-ops”.
holy crap. paul and i agree.
gotta go look out the window, maybe pigs are flying today too? *g*
To repeat myself….at the meeting here at the TX Medical Association, the loudest complaint was against insurance companies and the most unified voice (not saying unanimous) was for a public option. An intelligent, well-moderated discussion.
Has Doctore Murphy been sleeping the last year??
If he doesn’t think that once health care is paid for by taxpayer money that the taxpayers are not going to feel the right to look over his shoulder at the amount of money he and other other fellow doctors are making, he is nuts. Look at the new pay czar for companies that took public money.
I hired a medical doctor into my company in China recently. I couldn’t understand why he would want to work for me instead of being a doctor. Reason: very little salary. Pressing work conditions.
Would that happen here? NO, but I wouldn’t want to leave my life subject to politicians–especially when the political winds can blow in a different direction at any time.
The public option is ONLY there to run private companies out of business. How stupid do you think the public is?
Better, let all 1300 health insurance companies compete nationally, not state by state as it is now. There is no competition because government rules make it so there is none.
Also, get the lawyers OUT of health care. Then, the costs will also be lower.
But I thought it was the free market in operation? If the insurance companies are so bad off that they can’t compete with a public option, then isn’t it the free market mantra that they should be allowed to go ahead and die?
Or is that only for when it can work in their benefit?
Because truly, if they can’t compete with a public option, then maybe they should go out of business.
re competition. wigwam has, imo, a must read diary:
But, With Single-Payer, There’s No Competition!
That’s right! He’s right! Remember how the introduction of public schools saw the sad ending of private schools? Remember?…what’s that, it didn’t?
Oh. Well never mind, then.
by all means, butt away. I’m just trying to figure out where we are and where we need to be going.
If Obama’s government forces us to buy insurance, but only from private insurers who have de facto control over state regulators that fail adequately to regulate insurance contracts, he will be using taxpayer dollars, the power government and the intimidation of the law to guarantee private markets and private profits. The cost will be bankrupting millions of Americans and making criminals of those unable or unwilling to buy the false assurance of the “insurance products” that private insurers offer.
Mr. Obama would be laughing in the faces of 76% of Americans, while turning the myth of “private” enterprise and market theory on its head. Obama couldn’t do more to invite tens of millions of Americans to commit civil disobedience if he tried. The civil disobedience of 1968 might pale in comparison.
I guess that’s what Barack Obama means by change: giving private corporations more unfettered control over our lives and pocketbooks. Freedom and choice, it seems, only apply to the Fortune 500.
re: If Obama’s government forces us to buy insurance, but only from private insurers who have de facto control over state regulators that fail adequately to regulate insurance contracts…
Yes, a lot of the provisions are bad, but this one seems like a disaster (I agree with Selise, who phrased this more politely).
A question that has been niggling me since the get go on this is- if this passes, how soon will it be challenged in court? And would such a challenge have merit? Requiring auto-insurance, well, driving is a privilege, so okay. But this is a different kettle of fish (or whatever) imho. INAL. Any lawyers out there who might be able to educate me on this?
WHen I saw the headlines today, I wanted to scream, screw Obama and Rahm and the whole adminstration that would conclude that public option is off the table. The bills as they now exist, as I think I understand them (tho God help me, that is only incredibly superficially, it’s all so incredible complex) resolves way too little of the crass and gross problems of American health care. If the insurers and Pharma are calling all the shots, then the people will be totally screwed, just as they are now. There is no substantial reduction in costs and little likelihood there ever will be under the present proposed frameworks. Obama’s goals are being whittle away, piece by piece and if that’s the only way to get a bill, then I say, perhpas it’s best to kill it and that leaves me in despair.
I’m preparing a letter to my Rep (the one and onlyblue dog who has supported reform under present HR 3200 and has been a long time advocate for health care improvements/expansions and some levels of reform. That he has received nearly 3/4 million dollars in med industry may have led to his support of portions of the Ways and Means bills I would dispute (but I don’t know the details on that), I can nevertheless wonder what he really means when he says he sees a place for the private sector. So do I, under very real restrictions; and while he says cost reductions is essential, he’s not willing to go the way of “medicare for all” which seems to be the only way to really cut costs and begin to provide access equity.
I need to come to terms with where I am vis a vis his statement of commitments, versus what I would like to see, because I have committed to share his statement sent to me with some 200 neuropathy patients in his district. They need to know where he stands as a positive beginning place, they need to know the limitations of the present proposals, they need to know what I believe is needed v s a vis health care for all, and of a particular amendment for Medicare neuropathy patients who need help with a particular problem in gaining better and easier access to IVIG treatments, an amendment that has been stuck in committee, going nowhere (HR 2002, by Rep Steve Israel, D-NY and John Kerry is sponsor of 3701 on the issue nd it too is going nowhere.)
I pray for wisdom on what to say, what to do. I’m sick of the dilemmas that confront us all. I’m sick of the sausage of legislation. I’m sick of Dick Armey and his minions. I’m sick of the slick games of Obama and company. I’m sick of the American political process. So, FDL folks, what shall I do?
Blessings,
marchan1940 – i don’t have any answers, just wanted to say thank you for everything you do.
Bless your heart. Selise, thanks and back atcha.
I’m very weary of it all and my bod isn’t happy, whatever the hell that means, but I’m very weary. So I truly salute those who do no weary…..
Blessings,
Gosh, it seems someone thinks that public schools are a paragon of excellent management. Personally, I think opponants should drop comparisons to the post office or DMV regarding health care. If you really like the way schools are run, then you will love government run health care. Didn’t you think your school was run wonderfully when you were there?
Do you think some different group of bozos are going to run health care than the schools??
Heck, I don’t even think teachers think schools are run all that well.
Most private schools are far better than most public schools.
But, that is not the point. The goal of the public option insurance WILL be to run private insurance companies out of business so that the prayed for single payer system can come into being. If you think the public doesn’t get that, then, I’ve got some ocean front land for you. The movers behind this may have thought they hid their intentions well under a smoke screen of “competing” and “driving down costs,” etc. But, it is too obvious.
The venom in this forum regarding private insurance companies ensures that the intent behind the public option is destructive.
The proof that this isn’t any kind of serious reform effort is that nothing is being done to solve one the the biggest causes of high health care costs: lawyers and their junk lawsuits. It’s like the elephant in the room no Democrat will talk about. The AMA calls it “defensive medicine.” Everyone knows about it, its not a big secret, but the Democrats have no part in their plan to handle it.
I know that my medical bills are generally about twice what they ought to be because of tests and procedures I know are not really needed. They never show anything, they never solve anything, but they are there only in case some lawyer shows up in the future.
So, it really isn’t any kind of serious reform being proposed. Its a joke.
1. reform junk lawsuits
2. get lawyers out of medicine and from inbetween patients and doctors
3. let all insurance companies compete nationwide.
4. give some subsidy to those whose poor status makes insurance out of the question.
5. Similar to the auto insurance fund for those who are high risk, set up a similar fund for those with high risk conditions who cannot get insurance.
THAT is real reform that gets coverage to those who need it, lowers cost for the rest of us and keeps our percentage of patients waiting for surgery more than 4 months to from 1/5 to one tenth of the waiting times for Canada, England, Portual, France and Spain (OECD study done for the Canadian government).
And it doesn’t involve some massive, rube goldberg “reform.”
You and your mantra of tort reform is really quite tired, even without considering the fact that it is total Bullshit. Malpractice lawsuits are not a major driver of the costs of Healthcare. Doctors, in fact, have not seen the promised reductions in premiums in locales after tort reform was enacted. Studies clearly demonstrate that Malpractice Insurance premiums are based on competition within the Insurance Industry, not on factors such as the enactment of Tort Reform.
But what has happened is that Americans have seen their rights further compromised, leaving them with little recourse when they are injured by a bungled medical outcome, which is far more common than either you or the Medical community care to admit. Of the people thus injured, only a small portion even take steps to go to court, few being aware of their rights to redress, and of that portion, most settle out of court.
The stories of massive settlements are the exception, rather than the rule. The loudmouths spin any story to try to make themselves appear to be the aggrieved party, to hear the American Chamber of Commerce tell it, the poor Health Insurers are barely getting by and as for the Doctors, walk by Physician’s parking at any Hospital. It will make it clear how tough the financial climate is for them…
It’s obvious that the solution is to strip the consumer of their rights! Make them spend their bottom dollar on a service and when they inadvertently cut off the wrong thing, deny the chump the right to legal redress. Why can’t you just be honest and admit that this wouldn’t even be a consideration if trial lawyers overwhelmingly donated to the Right?
Texas passed tort reform several years ago, with Dem support in state leg. As far as I can tell, tort reform has (unsurprisingly) had no impact on the cost of healthcare generally, or the rate of insurance premium increase specifically.
As you said, it’s bullshit.
Well, considering the “cost reductions” promised by nearly every program passed by Democrats has only produced cost increases, I’d say a reform which only produced a neutral result was pretty good.
Does Canada allow junk lawsuits? I don’t know the answer, does anyone? I doubt they do.
The cost savings is not in the malpractise insurance premiums. The huge savings is dropping the defensive medicine. That’s something I can see each time I visit a doctor and when my wife has had procedures and surgery. The bill is stuffed with things that really were not necessary and whose only purpose was to be able to say at a later day, if needed, that “well, yes, I did try that.” It is easy to see.
Why are you afraid of it?? Why are you so afraid of this reform? If it is neutral, as you say, then why not put in the bill to get further support? Me thinks you might have another motive.
But, since I can see it in my bills, I don’t buy your “doesn’t make any difference.” Especially if applied nationally, and not just in one local area.
But, again, it isn’t reform you want, it is free health care.
No, my friend, I’m a disabled Veteran you’re supplying me with “Free Healthcare” for the rest of my life, it’s not necessarily “free”, as you people are just soooo worried someone might get something for nothing. I say your just a bunch of selfish jerks, but that’s just me, calling it as it appears.
I do care about stripping people of their right to access the Judicial system when they are harmed by malpractice! What are YOU afraid of? People should have the right to monetary compensation to provide for their needs when they are irrevocably harmed through carelessness, human error, or for whatever reason. Obviously you feel that we of the lower classes have no such right, just as the esteemed Mr. Bork so emphatically championed, right up until he was harmed, when he immediately sued.
I couldn’t have said it better.
Today my daughter graduated with her masters in nursing. He father was an internist. I believe in single payer, universal, socialist health care. We are a medical family and we care about our fellow human beings. It is the civilized way to behave.
Hi Mary-
I posted this on wigwams diary but in light of what you’ve said, worth reposting the link. http://seminal.firedoglake.com…..ment-64444
wigwam- I’d add this to your list- the efforts of health insurance companies to try to maximize profits- each by setting up their long lists of can do/ can’t for doctors is a huge burden on doctors who really are trying to do the best by their patients. This is the best piece in terms of what it’s really like “on the ground” that I’ve read. A look inside a GP’s office.
http://riverdaughter.wordpress…..-part-one/
snip-
~~A medical practice may be contracted with 150 or more different insurers (via their patients), all of whom have different coverage, with different requirements, that shift again as fast as you can figure out what they will/won’t allow. One day you realize that as much time is spent getting (or trying and failing to get) treatment approved than you spend actually treating the patients. It’s out of control. This isn’t working.~~
I was astonished at the number of Doctors from the clinic which I went to (until my COBRA expired) who eventually ended up working at the VA. I remember how resentful many Doctors were of the ridiculous and repetitive paperwork that not only my insurer, but my employer subjected these people to. Many of my STDI benefits were dependent upon much of it, much more so than the Physician’s reimbursement. Common decency demanded that I to offer to pay for their time, as it was only proper, most of them wouldn’t accept.
I was reluctant to go to the VA as long as I had good Health Insurance (this was 2001) and so many Veterans were having difficulty getting into the VA. I was already in the VA System and could go back anytime basically by reappearing and the Gulf War Syndrome was providing a bad time for many Vets. Hell, Bush II was a bad time for many Vets as they constricted the VA financially.
Hi nonplussed-
One quick question- I tried to figure out what you meant by STDI by googling, but unclear.
I sent that riverdaughter link to friend of mine who blogs at PHNP (see Selise’s comments). One of his biggest concerns is how demoralizing the current situation (and the current “solution”/ NOT) will be to doctors and nurses. He added that it is really hard to find such detailed accounts of this, tho he was making a file. And, your comment adds another dimension to this. And yes, totally understand what you are saying about pressures on the VA.
The details are really important in understanding/making the case as to how patients as well as docs and nurses are being run into the ground, because otherwise the personal connection with the words doesn’t happen, even tho people can grasp the general.
I’m in no position to say “do a diary” on this, bec. I speak w/o knowing what goes on behind the scenes at FDL, but one way or another, I’d much like to know more about the details of your experience.
Sorry for the use of the acronym. It is Short Term Disability Insurance, which pays your salary for the six months that you are allowed under the Family Medical Leave Act (FMLA). After that you go onto Long Term Disability Insurance (LTDI), which is where they really try to take you to the cleaners. Nothing quite like suddenly denying a person’s claim when they are at their most vulnerable.
But, again, it isn’t reform you want, it is free QUALITY health care.
i think this one must be the one revbev was looking for. from wikipedia
….
bill moyers: transcript from July 24, 2009
TRUDY LIEBERMAN: They’ve been finessing since the very beginning. They’ve been finessing since the campaign. During the campaign, he was not even willing to be pinned down. He had a whole list of things that he would like to do. But so did Hillary Clinton and John McCain. And in some ways, they really weren’t all that far apart, except on the issue of long term care.
That is another time bomb that is awaiting America and nobody has talked about it. But aside from that, I see an Administration that is trying to keep this playbook going as long as possible. And to commit as little as possible until the 11th hour. And by then, it’s going to be too late for the American people to know what’s going to await them. And as a journalist, whose job it is to explain to the average person on the street what all of this means to them– that’s not happening. And as a journalist, that troubles me. The press has not dealt with the issue of how this is going to affect the auto mechanic on Main Street. Or the babysitter. Or–
MARCIA ANGELL: We don’t know what this is.
TRUDY LIEBERMAN: But we know the outlines enough. We know about the individual mandate. We sort of know that if there’s a public plan, it might be this tiering arrangement that has a bronze, silver, and gold kind of arrangement. And you can pay more if you have more. Which still perpetuates the problem that we have. We know enough so that journalists can write the story.
BILL MOYERS: Do I hear you both saying, in effect, what Bill Kristol, the Republican strategist said this week? “Kill this bill. Kill this proposal that Obama is pressing and start over?”
TRUDY LIEBERMAN: Well, not in fact.
MARCIA ANGELL: Not exactly.
BILL MOYERS: You’re hesitating.
MARCIA ANGELL: I’m hesitating. Because I don’t think he’s grasped the nettle. And I don’t think that even the best of the proposals that he is considering are going to be effective. And I worry about even the public option, because–
BILL MOYERS: You’ve been skeptical of the public option.
MARCIA ANGELL: I’m skeptical of that, because the power of the insurance industry is so great that I believe that they would use their clout in Congress to hobble the public option in some way. And have it become a dumping ground for the sickest patients, and then cream off the profitable ones for themselves. And then what people would decide is that the public option was no good. That the public couldn’t do any– the government couldn’t do anything right. And that would be the wrong lesson to dwell on.
TRUDY LIEBERMAN: That’s what some people fear will happen to Medicare. That it will be privatized in some way, …
…. snip…..
MARCIA ANGELL: Well, the plan is not for all the reasons we’ve said. It leaves the bad guys in place. And it tries to kind of make concessions. And what the Clintons found out is they too wanted to keep the private insurance industry at the table. And maybe regulate them a little. And what the private insurance industry decided was, “Why should we take half a loaf when we can have the whole thing?” And that’s what I’m seeing happen. Happening now.
TRUDY LIEBERMAN: We are having the same debate, almost, that we had in ‘93-’94. And it’s something I’ve written about for the Columbia Journalism Review. It’s actually the same debate we’ve had decades before. And it’s the unwillingness to look at what we could learn from other systems. Single payer, multiple payers, as they have in Germany and Japan. Or even in the Netherlands, where there are private payers. What’s really happening there?
So, I think there’s an unwillingness on the part of politicians– on the part of advocacy groups, some advocacy groups, to really educate Americans on what the possibilities are. And we at C.J.R. have been saying we really have not had a vibrant discussion about other possibilities.
MARCIA ANGELL: I think we have to start all over on this. I really do. I think we have to go for a single payer system. You could institute that gradually. You could do it state by state. You could do it decade by decade. You could improve Medicare. That is, make it nonprofit. But extend it down to age 55 and age 45 and age 35. It would give the private insurance industry a chance to go into hurricanes, earthquakes or something. To get out of the health business. It could be done gradually. I think that has to be done. And it’s the only thing that can be done.
I don’t understand.
What do I pay voluntarily?
What do I pay involuntarily?
What do I get?
I don’t want mandatory health insurance. This year, with income near zero, I had to cancel my personal health insurance (while keeping my wife’s). It is a budget decision, and that’s one we just have to make. I don’t want the mandate telling me that I must decide to spend $300 or more per month, when I need that money for food. And sure, there will be “financial” exemptions or subsidies, but if it takes a year or more to prove that I’m not making enough to afford health insurance, it may be too late. Lose the house, the bank account, go bankrupt, all to support the health insurance companies (who are doing quite well, thank you).
Yes, this version forcing people to buy insurance from the parasite insurance companies would make life worse- and crikey “failure to pay” could lead to really bad outcomes.
Contra that, I don’t see the (off the table) idea of “Medicare for all” or “Improved medicare for all” doing that. That’s my aside- not a direct response to what you said- so don’t take that as a negative comment.
medicade-for-all .. medicade-for-all … that should be the next plan .. scrap this ongoing bait-and switch clusterfuck called HB 3200 ..
i’m with dr. kirk 100% ..
The stinking pile in the room is the Insurance Industry and the “toadies” throwing marlarkey around the Halls of Congress and the public airwaves. If the money that currently funds the obscene profits of the Insurance Industry (currently funding the ad agencies and ads against the public option) went into a plan that actually provided health care, the competition would force a realization that the “free market” also means that the consumer has choices.
Medicare is not perfect, tort reform is overdue as well as the actual monitoring of impaired physicians and providers engaged in criminal activity and fraud. A realistic fee schedule would help to recruit the physicians and other health care providers of the future. State regulation of insurance companies is an issue but don’t fall for federal oversight without a commitment that adequate supervision of insurance companies would take place and that the states with the highest standards would set the standard.
If we can keep the “State Innovation” amendment alive, we’ll be just fine.
When this plan fails, I hope that Obama and others will recognize the real reason it failed. It was the same reason Hillary’s plan failed. Obama tried to avoid the problems with Hillary’s actions, but didn’t excise the one that was most important.
Obama thought the problem was Hillary issuing a back room deal from the White House, so he solved by having a back room deal issue from Congress. Wrong move.
As with Hillary, the health care proposals both in the House and the one being worked on by the Senate were (and will be) presented on a here’s what we think you should have basis. Meaning, done entirely behind the scenes and presented as done.
If you want this to pass, Congress needs to conduct open, honest, well publicized and full hearings into all aspects of any hoped for ideas with a full vetting by experts of the pros and cons of that aspect.
By doing this, they will bring the public along and involve the public and engender broad public support for whatever comes out of it.
A few insiders might think this has been debated ad nauseum, but actually, there have been no extensive hearings on this. To John Q. Public, these proposals appeared out of nowhere. Kind of like the climate change bill. You heard absolutely nothing about it, and then, voila!, a bill appears.
That is the grown up approach as opposed to trying to sneak something by for fear if you don’t, it will be rejected. Forget the deadlines. Thoroughly vet it. It the long run, it will be most successful.
It may turn out that single payer is the system the hearings expose as the best way to go and the public, due to being informed and involved along the way, will support it.
I’m shocked that I agree with you! And here I thought I was going to disagree with you on everything on this thread
BTW, about your comment at 48, malpractice suits are capped at 250k (non-economic) in California, which would not seem to support your theory (at least in Cali)
Thanks. I do want reform, but I want real reform. Reform the lawyers, the insurance companies, the rest of it.
Regarding California, I agree it is a difficult problem. Once the lawyers got into the system to milk it, the mental orientation toward defensive medicine will be very difficult to put back in the tooth paste tube. It is possible it is ruined for quite some time. In the conversations I have had with my doctor and others, there is no question it adds a lot to the bill with very little benefit.
I do think there should also be an assigned risk fund for pre-existing condition people.
The difficulties I have some systems and proposals are:
Why should the taxpayers pay for the junk lifestyles of a good percentage of the population who don’t eat right, don’t exercise and walk around doing unhealthy things. Why should we all pay the bills of smokers for example? They’ve been warned for years, why should we pay to cover the cost of their bad habits?
In any event, a completely open, comphrehensive set of hearings would enable the public to absorb what is being done and why. When people feel they have had something sprung on them–and this is undoubltedly like that since there weren’t any publicized hearings–they are going to have a negative reaction to it. Hiding things because you fear what the opposition will do if they find out is plain stupid. Because, in this country, the opposition will always find out one way or the other.
Bush found that out but good.
To John in Sacremento
And would you support paying for the disease of those unfortunate to have to live within the radius of the toxic fumes spewed by oil refineries?
Why don’t the refineries have to pay their medical bills? Very poor people have few options for a healthy place to live, right?
I know a woman who died of lung cancer because of undetected Radon gas in her home. Btw, it was a very nice home in a very upscale neighborhood. Who should have paid her medical bills?
These days I think we all live in glass houses. It’s difficult to live a pure life, even if we try. There is just too much pollution and some are more sensitive than others.
I see your point about smokers, but if they are separated how about the drinkers? The fast food eaters? The sugar holics (cancer LOVES sugar)?
LIke Medicare, one size fits all. All in. We must demand Medicare for All and stop pointing fingers at those with problems, in my opinion.
You must have me confused with someone else, and I wish I had the smallest idea what you were talking about, so that I could help you
This is what I said to cregan
Which was the only comment I made on this thread other than this one, as far as I remember