The Washington Post’s Steven Pearlstein echoes the Beltway’s self justification that Ted Kennedy’s success in furthering liberal causes occurred because he accepted anti-liberal compromises that the Beltway approved.
Thus it is that Pearlstein says "there’s a deal" to be had on a health reform bill if only the Democrats recognize that’s what Teddy would have wanted and embrace it.
But why is Pearlstein’s "deal" so familiar? Because it contains every element leaked out of the Senate Finance Gang of Six, including the Baucus/Conrad/Rahm bailout of the insurance industry.
Pearlstein’s "deal" would promise "universal coverage" but deliver instead a universal mandate forcing not quite everyone to purchase private insurance. There would be federal subsidies scaled down from levels in the HELP (Kennedy) Committee and House bills. And the "deal" leaves out strong rate regulation but shields the private insurance industry from any meaningful competition, unless you count an ineffective co-op, which Kennedy never supported, and which each state may or may not establish in your lifetime. Think Texas.
Pearlstein doesn’t tell us his deal is little more than a restatement of the unrepresentative "gang of six" rumors/leaks. Nor does he explain why a majority of Democrats, inspired by Ted Kennedy, should accept this, when they have already adopted stronger proposals in four Congressional committees that include measures like a public option supported by huge poll majorities.
So how can Pearlstein claim that Kennedy would somehow support this deal? Pearlstein’s history of Kennedy’s 1971 negotiations with Nixon notes that back then, like today, one goal was universal, affordable coverage for the uninsured. But he misses that the private insurance industy is dangerously more concentrated than it was then, has become relatively immune from weaker states’ regulations, and is now (if it wasn’t always) incapable of competitive behavior or efficient pricing.
As Wendell Potter and others have told us over and over, today’s industry is inherently dependent on screening out the sick, rationing coverage and denying claims, while remaining ineffective in disciplining provider rates.
There are many hydra heads of America’s health care disaster, but we know now that the problem that has to be solved in the "insurance reform" part is the for-profit insurance system itself. The anti-consumer incentives inherent in its for-profit structure and the relentless pressure from Wall Street investors to reduce "losses" are systematically pushing costs onto consumers and making meaningful insurance unaffordable for business and individuals.
Pearlstein’s deal — indeed, the hinted-at Obama/Gang of Six deal — is premised on "reforming" but preserving this destructive system. But it’s simply not sustainable, and it’s time to stop pretending otherwise.
Any worthwhile reform must therefore include some mechanism by which that system is directly confronted and replaced, either gradually but systematically or wholesale. There is no sustainable, affordable model that does not deal with that fact.
Perhaps that’s why a majority of Democrats, including Ted Kennedy, were willing to accept unattractive mandates that perpetuate an uncompetitive industrial policy in exchange for getting more people insured, but only if Americans had a choice that might — over time and under conditions yet to be defined — provide an escape and show the way out. Without that escape, nailed down and better defined, there’s little reason for Americans to embrace Pearlstein’s unworkable "deal."
More reactions:
Matthew Yglesias, Chasing Phantom Deals



52 Comments




What deal? Hasn’t Grassley made it pretty clear the GOP won’t even vote for the deal Perlstein recommends?
Steven Pearlstein and the Washington Post are the symbols of insufficient journalism.
Great point any GOP talk of a deal must include a majority of GOP votes. To borrow beltway logic the only way a GOP deal is possible is if they and the Blue Dogs have enough votes together to get it passed in the House and the Senate.
Right.
Both Baucus and Grassley are saying they want this thing to have 80 votes, but they’re talking about a different 80 votes. Baucus is thinking all of the Dems and 20 Republicans. Grassley is thinking all of the Republicans and 20 Dems. They’re not even speaking the same language.
Pearlstein seems awful confident he and all the other GOPers knew what Ted wanted lets hear from Ted’s wife and kids about what he really wanted I don’t trust GOPer hands on the Ouji board.
Enzi, too.
I noticed that there was some subtle pushback at this during Teddy’s funeral: http://blip.tv/file/2532618
The biggest gift ever made: $1.392 trillion to insurance companies. And I probably underestimated that figure by assuming that the population of single people is smaller than it actually is. The number is mind-boggling.
Maybe Pearlstein can explain why spending that kind of money on a bloated, broken system is a good idea.
mandates require either a public option or to regulate the health insurance industry like a utility, otherwise this “reform” is just a transfer of wealth to them.
currently, insted of sharing risk, the insurance industry is all about denying coverage to the risky.
so people go bankrupt if they get sick and insurance companies get obscenely rich.
now, if the goopers and some of their dimocrat enablers have their way, we are going to shift to mandatory coverage without either a public option or real regulation.
then we will see people paying a larger and larger share of income to pay their insurance rates. We will have to rely on the industry to not make that so high that people go bankrupt. I dont understand how the free market people see a free market in mandated insurance. part of the competition should come from those who DONT choose to buy.
I am calling Reps every day to say I want them to vote for the Conyers (with Weiner) HR Bill 676 Single Payer, Medicare for All, in the fall. The crap-less, everybody in, nobody out, citizen-has-a-right-to-good-health-care-bill-that-will-not-be-a-trillion-dollar-bill (not a bill that will sugar-daddy the health care and pharma industries who are vendors not constituents of our representatives in Congress, reps who should be earning their right to sustain their jobs there in future terms by doing RIGHT for us, not prostituting themselves and sacrificing the common good, the public trust yet one more time, continuing Bush’s Warren Harding administration). Hang media’s propaganda and the gamesmanship scoring of the pragmatic politicians and pundits.
If they can get any GOP votes in the Senate on this any GOPers willing to risk being Primaried by the Tea Baggers I will be surprised.
Its not only our side who will be calling out the Moderates on our side if they vote wrong. And that is the political reality the beltway bozos are not getting there is no compromise to be had from either side on this issue without consequences from either sides base.
Pearlstein and Jon McCain can talk about what they think Ted wanted but what are the GOP’s compromises the real compromises not the getting the Dems to bend over and give up compromises.
No real Compromise from the GOP then they don’t get a seat at the table. No GOP votes delivered no seat at the table. And by votes delivered I mean a majority of GOP votes.
We don’t need the GOP to pass this but if they were willing to help sell it to America and drop the Tea Baggers that might be worth something.
Pearlstein is just part of the noise machine. There is no “health”, “care”, or “reform” in healthcare reform. It is all about how generous our elites who are completely insulated from the issue by their wealth and access to gold-plated insurance plans want to be with the insurance companies at the expense of everyone else. All the rest, including the public option, is kabuki. To this day, none of us have any idea what such an option would contain. We only know what we would like to see in it. But as Pearlstein and the political interests he represents have shown again and again, what we want is not even up for discussion.
In this light, it would be better to ditch the “healthcare reform” package altogether and go for a smaller bill that would prohibit the worst industry practices, like rescission and prior conditions.
I love it that these great posts by The Amazing Jane and here, Scarecrow really lays the truth on the line. We do not need a delusional Potemkin Village of Idiots. All the WaPooP give us, is corporate lobbyists point of view. That is unless their neo-con masters tells them something else to believe.
It has to be Public Option or Nothing. If the Democrats fail to allow a Public Option vote, they will lose control of Congress for failing to even try keeping their promises. But do not worry, the lobbyists will still retain control. The present system IS the Conservative Health Care policy. The R’s want it and think it is GREAT. A few more years of the present shock doctrine medical care along with millions more people going bankrupt will bring down the system anyway.
But there is now a bigger issue. The neo-con thugs and goons now are waving their guns and making threats. If the D’s give in to these brownshirts we could get another decade of neo-con fascism.
The biggest gift ever made: $1.392 trillion to insurance ompanies.
But that “gift” was never made, right?
that would be OK as a starter, IF there were no mandates. But you would still have to regulate price and get rid of age and condition rating, cause the costs are going out of sight for individuals.
You cant get an affordable policy if you are a small business or an individual with a health history or over 55.
Great Speech is he thinking of making a go at Ted’s old job?
i went to healthcare conferences for 6 years ending in about 2006, and every time, every single time, every insurance company person talked about getting the free riders and the young invulnerables to buy into insurance.
without real rating reform and a public option, this program is their wet dream.
Does he even live in Massachusets
But this is the standard song and dance we have seen from the Obama Administration. Obama announces a big program using a lot of progressive rhetoric to describe it. But on closer inspection there is a lot less there there than meets the eye. He kicks it over to Democratic Blue Dogs and conservative Dems in the Senate who eviscerate it. Then in an effort at “bipartisanship”, Obama and/or Congressional Democrats make further concessions to the Republicans (who come in from their current base on planet Twylo) for this purpose. When all is said and done, we have a bill that is pure crap. The Republicans vote against en masse. The Blue Dogs and regular Democrats vote for it, and just enough “progressive” sellouts are pressured or bought off to make sure it passes. All this is so expectable you could almost use it to tell the time.
Mandatory insurance coverage is the worst possible of all ideas.
The bobbleheads on Tee Vee can keep repeating all lies (drop in support for public option being the biggest, IMO), and we have to take to the streets.
There is no way unless a robust public option.
I want change.
If we got rid of the current bill, mandates would be dead. A smaller bill would not address cost containment but let’s face it neither does this much larger monstrosity of a bill in any of its various manifestations. So yes, the system will remain unsustainable but that’s a given.
National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of the gross domestic product (GDP). By 2018, national health care expenditures are expected to reach $4.4 trillion—more than double 2007 spending.
The National Coalition
on Health Care
304,059,724 – Jul 2008
Source: U.S. Census Bureau, Population Division
I think 2.5T divided by 304M is 8222.
That’s $8000 for every man woman and child in the US.
We could cover everybody on a public plan if only every family of 4 would be willing to pay an extra $32,000 a year in taxes.
Of course 85% of us already have insurance, so if only 47M are uninsured as I’ve heard earlier, the tax for every man woman and child to cover them would be $1271.
Even if 1/3 of them are undocumented that Obama said he wouldn’t cover, and a third are young healthy people that don’t think they need insurance, it still seems like a bargain for only $5000 added to every families tax burden to make sure every one is covered under a public plan.
When you go to a casino it should be the object to have a good time because the house is going to win. Buying insurance is in many ways the same, the house is going to win. When the house skims off 30% off the top your odds of winning go down. Is it a gamble to buy insurance or to not buy insurance.
The Republicans have become like the screaming brat throwing a tantrum in the grocery store.
The question now is whether the Democrats are going to be the cowed parent that continues to placate the whiny, sniveling child that will not be placated, or removes the baby from the room so the civilized people can get on with the business of their lives.
I don’t disagree, but it’s not very original. Maybe we can move beyond name calling.
Well, let’s cut to the chase, ‘eh?
Corporate America is the current religion, so let’s not bother with incremental steps and instead, institute a mandatory tithing. 10% (to start) of all gross income goes to a Corporate Pigout, which the US government distributes according to the best performance in the lobbying effort. No returns to us, just take and take more.
Which is the gist of Kristof’s NYT column today.
I understand the purpose of the public option and agree with it. Could the same be accomplished by robust regulation that would treat health insurers like utilities? Would that be an easier to sell?
Heh. Limiting it to 10% would be a big improvement over what we’ve got now.
Absolutely not. You want something like the SEC in charge when another Bush becomes president.
If the regulating boards were made up solely of Elliot Ness clones — maybe. Otherwise, a prescription for massive corruption. And lobbyists would have a much easier time targeting.
This is over and above your usual income tax burden.
We got crumbs from Bush. Now we are begging Obama for croutons.
What makes you think the public option will not be subject to the same forces? It will just be a two-step regulation.
Once we gave up on single payer, for me it is hard to get all hot and bothered for one damn contraption over another.
Current proposals eliminate state insurance control, with the idea that there will be more competition if insurance companies can cross state lines (perhaps to excape stricter state regulation?). The co-op proposal, on the other hand, would be limited to individual states. One has to ask why co-ops shouldn’t be national, also. And there should certainly be more outrage at the idea of a mandate to purchase private, for-profit insurance, with its 30% overhead. The idea that the government wants to tax income that is spent on something mandatory, first at the 15.3% payroll tax rate, then again at the income tax rate, should make us all scream bloody murder!
Yes, the loss of single-payer was huge.
Sounds like he got spanked by Fred Hiatt for his smackdown of Steele et al. earlier this week. I wondered how long it would take.
Yes, Kristoff has done two excellent columns on health care this week. Today’s is wrenching.
no, I think they would just say we are trying socialism and trashing the free market system.
Easier to sell to whom? I can’t imagine the insurance industry would accept this. Nor do I believe the US is about to set up a federal regulatory system capable of dealing with this powerful, highly-concentrated industry. There are a few states large enough to oversee instate insurance companies with limited success, usually achieved by politically ambitious Attorneys General — or not. If you start thinking of insurance being nationwide, with mega companies controlling most of the market, you need a mega regulator. We don’t have such an institution and the bills do not create one. The premise is that if you set up an Exchange and adopt a rule that everyone selling in the exchange must avoid prior condition exclusions, rescissions, that will be mostly self-enforcing with a little bit of prodding from HHS. Having worked in a state utility regulatory paradigm, I’m very skeptical this could work — we on the ”public interest staff” side were always outgunned by the utilities. Always. And then there were the politically appointed commissioners who made the decisions, with whom I worked for many years. Regulating massive monopolies well is very difficult.
so put single payer back on the gd table when they vote on HR 676 in the fall. where is the collective OUTRAGE!!! not intellectual gamesmanship.
single payer cuts through the Gordian knot of corruption. Do you think it is naive, unsophisticated, unpragmatic to ask for that? Bobby Kennedy encouraged us to ask “Why not” not just “Why”. Why are we enabling the enablers of our rapists, i.e., the administration and the Congress???? Don’t be too inconvenienced with your vote. We will settle. We know we live in a corrupt America so let us all tiptoe out of the quicksand. You can’t tiptoe out of quicksand. Don’t join them in it.
Our whole gd country recognizes the level of corruption and we are circling the bowl in terms of financial and moral bankruptcy.
So progressive leadership with obama thinks glacial backpedaling out of the corruption is the best strategy. Talk strategy. Forget morality? Leave the gun. Take the cannoli. Pulllllleeeeeezzzzzze. Fight for justice and unalienable human rights. Not pragmatism.
Well, frankly, I am skeptical about it working to a degree I would find acceptable. But, it might be a step forward and better than nothing.
And, I am skeptical of virtually any
damn contraptionplan, other than single payer, working to a degree I would find acceptable.Anyone else struck by the physical resemblance between Pearlstein and Cheney? Brrrrrr.
Libby, I think your argument is more with Article II of the Constitution than with Obama.
Let’s be honest. Any Bill that gets a single Republican vote is a Bill that is not worth anything, will harm the country, enrich the healthcare industry and betray the whole reason for reform. Perhaps Vicki will speak out in the days ahead. Already, I am sick of hearing pundits and cretin legislators putting words in Ted’s mouth.
Its becoming clear that we must kill this bill and let nature take its course. In a couple of years insurance rates will have doubled and so will the percentage of uninsured. Then the populace may be a little bit more agreeable to doing something.
Tell me more or are you talking about the cannoli line?
They say, lie down with dogs get up with fleas. Our president and representatives have done that with the corporate lobbyists.
The Repubs have done that.
Please, progressives, don’t do that! No fleas.
Okay, I’ll shut up now.
That would be me, one infinitesimally small part of the ‘percentage,’ come October 1st, when I have to let my insurance (such as it is, with its $7500 deductible) lapse because I can’t pay for it anymore.
No telling how “nature (will) take its course” with me. I only can hope there will be some people in health care who will be willing to partner with me for very little monetary compensation.
OK, the office of POTUS is by Constitutional design, particularly in domestic matters, a weak office. Now, I happen to agree with the Founders wisdom in this regard. But, recognizing this to be the case, I am less willing than others to blame Obama for not delivering health care reform in the manner I would prefer.
Is anyone else getting the sinking feeling that Baucus, Conrad, et.al., are getting there marching orders from the White House?
A sham health care reform bill could bring Obama, Rahm and the Democratic Party the mother of all payoff money deals.
Just a thought.
you sound like a malthusean….
or maybe a russian revolutionary, praying for worsening conditions to foment unrest.
what about the people who will suffer?
Thanks.
But there is something weird about Obama and the single payers. He did not allow them at the table where he invited all other viewpoint reps. Summarily dismissed the single payer people from the get go. That is hypocriical IMHO and reveals a very anti-populist agenda to me and some inappropriate flexing of his authority or at least personal power.
Again, I think just because the president and our reps took legalized bribes from the lobbyists to our detriment, we should pushback on this and not enable the betrayers and settle passively. Yes, I feel it is that — betrayal … in this accountability coma culture — they all know they betrayed. It reached critical mass at long last. We should not just eat sh*t and grimace.
If Obama can’t help us single payers, at least don’t get in our way of addressing OUR viewpoint to the granted corrupt Congresspeople — if he is being detached as a leader. 1000s are working on this and many who have up close and personal knowledge of health care dysfunction and what is more efficient in fixing.
Obama’s behavior is not about a democratic detachment. It is silencing a part of the citizenry, serious and earnest people. Same way media edges out and disenfranchises legitimate candidates and puts their thumb on the scale for the rush to judgment they make.
Obama didn’t rush to judgment on single payer. He and cronies trashed it faster than the speed of light from the get go. Its sanity and efficiency would illuminate all the crap that is going on with the deal making and graft and fraud and monopolistic controls.
Thanks for responding.