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Below is a reply I nearly submitted to Egnor’s smug little diary writing on the public policy disaster just enacted by the House. I decided it needed its own diary post. On the small scale, Egnor and Rosenbaum, and on the large scale, the Democratic Party and its constellation of "liberal" interest groups, need to all understand that they may have gotten away with committing one of the worst public policy catastrophes in modern America history, but we are not going to call it "victory", nor are we going to abide quietly by its proponents as they smugly pat themselves on the back for what they have done to us.
The people who caused this disaster need to understand that a lot of us will never forgive them, and never forget this, nor should we. We may not have been on the "right side of history" this time around but history is not just a process of making things better, but also sometimes of making things worse. We were on the right side of the issue and the bill’s proponents can answer to their grandchildren about "history’s right side".
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http://seminal.firedoglake.com/diary/36689
http://seminal.firedoglake.com/
Bullshit! There is not going to be any further "reform". The corporate tyranny that this legislation created is what we are going to be stuck with for a generation to come if not more. All that stuff in Jon Walker’s front-page list of what "isn’t delivered on"? Such as public option, drug re-importation, basic acknowledgement of womens’ control over their own bodies, some form of meaningful cost regulatory system?
You "activists" and your precious "progressive" Democrats are the ones who saw to it all these actual components of real reform were *DELIBERATELY* left out of the final legislation. Yes, *deliberately*. These actual components of real reform (not the now-institutionalized corporate tyranny) were left out of the legislation on purpose because the political "leadership" doesn’t want them. If they were left out yesterday, they will be left out for the next 30 years.
All this bill does is make the health insurance and pharmaceutical cartels more powerful.
All this bill did is prove that all the supposed "progressive" leadership of the Democratic party, and all the supposed "progressive" reform groups ranging from MoveOn.org, through NARAL, through HCAN, through OFA, all of these groups are really just partisan hack operations that exist to silence liberal dissent when the party’s corporate paymasters and the plutocratic buddies of the highest officials in the land decide they want to buy a law serving their interests and their interests alone.
I will never forgive the Democrats for this bill. I will never forgive supposed "progressive activists" and pressure groups for instituting this corporate atrocity. When I am signing my checks to Aetna because otherwise I can pay the IRS (I may just pay the IRS) I am going to think about the Democrats. I am going to think about Paul Krugman. I am going to think about OFA and NARAL. I am going to think about Nancy Pelosi. I am going to think about HCAN. I am going to think about Lynne Woolsey. I am going to think about Dennis Kucinich. I am going to think about Obama. I am going to think about Harry Reid, Joe Lieberman, Max Baucus, and the entire failed, ridiculous old plutocrats’ club called the US senate. I am going to think Bart Stupak, and his religious views that became a public policy requirement for the entire national health care system.
And I am going to resent the entire lot just named. With ever fucking fiber of my being, ever cent in the damn check to Aetna is going to signed away with my resentment, my anger, and my full knowledge of how broken this system is, who broke it, how it is broken, and just how egregious it is that in a Western World full of efficient, respectable single-payer systems, the US has instituted a tyrannical model that requires me to buy a private insurance product. This "wonderful reform plan" just passed is the ultimate proof that America is enterprise operated by the rich in their own interest, and if you work for a living, well, buddy, you just exist to make them richer.
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I mean, Christ, the only thing that the bill’s proponents can say they have really accomplished is “defeating dimwitted Republican opposition” or “having passed reform, showing that the Democratic Party can pass reform”. What have the Democrats done?
1) Institute a corporate tyranny, resembling the fascist economic model.
2) Directly assault the working people of the nation.
3) Show the world that the US cannot even follow when it comes to domestic economic and societal management on crucial issues. We just proved that European nations and Canada all are capable of showing the world how to have a functioning society, and to not follow in our footsteps.
4) Directly assault most or all of the Democrats grassroots constituencies: women, immigrants, union members, anyone with a worldview to the left of Joseph Lieberman.
And for what? To make a point that some sort of “reform” could be passed?
The first year I face an IRS penalty if I am not tithing Aetna is the first year that I will consult an attorney and in all likelihood submit a lawyer’s letter along with my tax return indicating why it is that the penalty sum for not paying tribute to Aetna has been subtracted from the total due, and how it is that I intend to sue if there is any attempt at collecting the “penalty” for not paying tribute to Aetna.
This is the US, and I have the right to not purchase the product of a private, for-profit corporation if I choose.
Oh, Seymour, don’t you get it? Our team, the Fighting Dems, has won! This is just like sports, get it?
Let’s celebrate and then fix those minor, pesky details, you know, the guts of this bill.
We can do it! Yes, we can! :)
Yes we can! We, the plutocracy, can buy and direct legislation serving us, from either party! Yes we can! We, the richest and most powerful, can exploit and attack those who are not rich, or powerful (or male) in order to insure that we have a political victory for its own sake!
Chris Hedges has a great article up at Truthdig with the wonderful title, “The Health Care Hindenburg Has Landed.”
Hedges says, “The bill is about increasing corporate profit at taxpayer expense. It is the health care industry’s version of the Wall Street bailout.”
Yes, and just like the Wall Street bailout there will be NO fundamental changes to this bill. It has ensconsed the private health insurance corporations in the role of feudal masters.
What can be more evident that the corporations call the shots in Washington? And we’re still talking about “fixing” this bill?
There’s a difference between realistic determination and outright folly. It is folly to think we can tranform this corporate give-away into it’s opposite – a healthcare system that pursues the common good. That ship has sailed.
I think you are reading the very worst possible scenario into this. What you say is a possibility, but there are other possibilities that are more likely. Now, I am an avowed and known optimist so I might be be too optimistic about the outcomes here. thats possible too.
What is most likely is some outcome in the middle. You act as though this is done, it isn’t. I am sorry if that comes off as smug, it is not intended to at all but the reality is there is always a way to change the programs this bill creates.
What you don’t address at all is the fact of the change of the frame. For all the bills faults (and I have never said they were anything other than legion) it does move us into a new way of thinking, namely that it is a legitimate purpose for the Government to work to assure access to affordable health care for all citizens. Even if that means creating taxes to fund it. This is a huge change that enables the chance for the changes you (and I) want.
That was the point of my diary. That we have made progress and we have. To merely be angry and strike out at the people who want the same things you want is counter productive. But I can also understand how it might be too soon to hear that.
In the end, I will keep working for better reform, and I hope you will be doing the same.
Cheers,
Fair enough. Come see me after hell freezes over and we’ll talk.
Carolyn, whats a real threshold that will work. I don’t give up on potential allies that easily. You and I want the same things, we just disagree on the methods. Surely there has to be some common ground we can find?
Potential allies don’t screw each other over. You Democrats have been using this game with us for decades. We on the left get election-year rhetoric, followed by off-year legislation and policies that stick knife after knife in our backs, followed by the ubiquitous addressing of our outrage with you positioning yourself as our “natural ally” or similar.
Tired of the football being pulled away at the last minute, Bill. Charlie may not play ball any more.
Bill, you use this word “we” as if it includes “you and I”. You say “we have made progress”. First off, I agree that progress is been made … if you want to prove America is only governable in the interests of the wealthiest members of society and that the rights and well-being of everyone else are just disposable assets to be configured and toyed with to produce the best outcomes for the richest.
Second off, as far as “you and I” are concerned sadly I don’t know that this a believe view at this point. What are people who understand what this legislation really represents to do about people who view our defeat as some sort of “step forward”? Certainly you can understand that there is now a gulf between proponents of this legislation – who are normally more partisan than they are populist – and people who opposed to this legislation on the left, who are populist before having party allegiance?
I get what you are saying. I still see you and me as a “we” in that we have the same end in mind. That you are angry and pissed at our politicians is understandable. I get it, but it is not the mode I operate in. I have been around and in politics my whole life. I have seen how many galling compromises happen before they add up to real change. I am an incramentalist in that way.
I also get we can seriously disagree as to whether this is progress or not, but it does not prevent me from understanding we are still on the same side over all.
What I can’t and don’t support is hammering people who are your allies. I have not and will not do it to you. I think your points are wrong, that does not make you a bad person or mean you should be left out of the debate. I would hope that people could extend the same thinking to me, but that is up to you.
We disagree here, fair enough. Where we agree is what we want, shouldn’t we focus on that and try to achieve it?
Can you understand that pushing for and enacting a bill that institutes a tyrannical economic model, and that sets up a SCOTUS challenge to Roe v. Wade, counts as *you* “hammering your allies”, Bill?
Do allies set up SCOTUS challenges to each other’s most dearly held court decisions? Do allies set up economic systems considered antithetical to each other’s understanding of basic social and economic justice?
Do you understand, Bill, that in this disaster, you fired the first shot at your “allies”? That you started the “hammering”?
Seymour, would you mind offering a couple of sentences outlining how this is going to challenge Roe?
I hadn’t caught that and am interested.
Thanks.
We did that in fact when we instituted a REAL reform Medicare 45 yrs. ago. This is a BS Corp. bail-out version of that and nothing else. Can we reform this reform? I don’t know maybe after this doesn’t work 20 yrs. from now. But by then the cartel will be even stronger and Corp. ownership of DC even deeper. It’s much stronger today then when I was in my teens back in the 60′s. We’ve lost the class war the right waged against us this last 40 yrs. and this bill shows just how badly we lost.
well put, The Loyalty to Party first seems to be the Staple for Egnor and Rosy.
Congratulations to the FDL community for being wise enough not to take the bait, the democratic machine is at work 24/7
I see. It can’t possibly be that there are more than a couple of ways to look at this situation. No, it couldn’t possibly be that people of good will who want the same thing can disagree on the methods. It all has to be some nefarious plot.
Good to know.
the bad of the individual mandate, to insurance companies, is so overwhelmingly wrong so unamerican. It is the reason you do not vote for dems anymore!!!
it is just that the facts demonstrate clearly that this was always intended to be a give away to big insurance.
It supports the worst elements of the system, locks us in!!
Your argument is change it later–Just think about that for a second
Bill: what tax besides the excise tax and the IRS penalty – both of which together target exclusively non-rich people – exist in this legislation under your rubric of “government demonstrated that it can tax to provide revenue to fund health care”?
Where is the tax on the plutocracy, Bill? Where does the bill provide revenue from the rich in order to benefit those who work? Instead of taxes that penalize people subject to the bill (subjugated to the health insurance corporations) who have a nicer policy, or people who cannot or will not pay tribute to Aetna?
Seymour it is coming. The tax on the highest earners is the only way to fund this correctly. You know it, I know it. The thing is you have to set the ground work. Right now we have a crappy tax that will go into effect in 4 years on the cost of insurance. It is the wrong thing to do, but it got the Senate to pass a bill.
We now have shown the acceptance that taxes are the way to pay for this, we just had to adjust the taxes that are used to do it. It is far easier to do that when you have achieved agreement that taxes are the way to go.
When is “it” coming, Bill? Care to make a projection? When, in the face of a perennial annual spending deficit for the last 20 years, were taxes raised on the rich for any reason? That’s right! 1993! 17 years ago! And all that amounted to was a slight reduction in the radical detaxation of the Reagan years.
At this point, we have got 2-4 wars going on, a multi-trillion dollar bank bailout, etc., and there still is not a murmur in the political leadership in DC about raising taxes on the wealthy. The richest Americans have been the beneficiaries of skyrocketing wealth inequality and still face the lightest taxation regime relative to their overall wealth seen anywhere in the Western World.
Care to speculate? When is “it” coming? A tax increase on the rich? Tell me how a Presidential administration that has turned economic management of the nation over to Goldman-Sachs, and that has only shown the willingness to spend lots of money on: banks, wars, and health/pharmaceutical corporations, is going to raise taxes on the rich.
Come on, Bill. The Democrats mustered an 18 billion dollar expenditure to create jobs in the worst economic crash since the Great Depression. They came up with trillions of dollars for the banks and passed a law that requires the broke middle class to buy private insurance, with protections for the revenues of pharmaceutical businesses.
Where is this government going to get the will to raise taxes on the rich?
I don’t believe you, Bill. And I am somewhat mystified by you: can you actually believe yourself? Can you actually believe what you’re writing? If you do, you’re deluded. If you don’t, you’re dishonest. And given that you are either deluding yourself, or just dishonest, where does that position us as “potential” allies?
Charlie may not play ball anymore, Lucy.
That’s sad. It has to come to name calling (dishonest, deluded). It can’t possibly be we are both wrong? One of us has to have the lock on the truth? I said above I might be too optimistic, just as I would hope you leave room for the possibility you are too pessimistic.
Oh now that’s just silly. I can suggest you are being dishonest without this being “name-calling” otherwise you’ve stricken most of the English language from our discussion that could ever be used to characterize the state of sentence’s subject. If you want to play that game, Bill, that’s fine, but again, it reflects on you, not me.
This isn’t about fluffy, nebulous, vague constructs like “optimism” and “pessimism”. Do you understand that something has actually happened? Do you understand that causing real things to happen (like legislation to pass) may actually have a justified, real, and long-term impact on people, and that some of these people may have a permanent change of disposition towards you for it? Some of us aren’t living in the land of vague gestures towards “flaws” and “faults”, and some of us aren’t living in the land of vague concepts like “progress”, “optimism”, and “pessimism”. Those vague constructs are really great in Obama’s speeches but some of us aren’t living in a Presidential speech.
Yeah, pretty seriously overblown. I’m more than willing to admit to the flaws in this bill, but you’re clearly not interested in seeing the real benefits as well.
And, for contrast, Jane’s much more balanced take on the whole thing:
http://fdlaction.firedoglake.com/2010/03/22/fdl-statement-on-the-passage-of-the-health-care-bill/
“Balanced” meaning “Jason gets exempted from being called out on what he has advocated”.
Understood – don’t worry Jason, this diary was the last time I am going to spend time trying to force you to be openly accountable for what it is that you have participated in. You’ll be comfy again shortly. Hope, change, etc. Yes we can!
I don’t recall you ever admitting the “faults” of this bill, and frankly, Jason, I find it a bit disturbing that what many are calling for example “the biggest attack on womens’ rights in 35 years” to you amounts to a “flaw”. You’re like Paul Krugman, who has made countless downplayed and trivializing gestures towards vague and unnamed “faults” and “flaws”, but who never identifies these “faults” and “flaws”, and never answers for them.
Some people (such as yourself) are clearly not interested in addressing the “faults” and “flaws”. That is because you would then be forced to acknowledge just the level of public policy disaster it is that you have pushed for. You’d be required to own what you have done. But you don’t want to do that. You want a comfy-hopey-changey “victory” or “progress” without having to look at the miserable crappy reality of what it is that you have caused to transpire.
I don’t think what I wrote is “overblown”, and, especially given that you have never in front of me, not once, acknowledged in any detail at all the “faults” and “flaws” you uncomfortably wave your hands at, I take your determination of “overblown” without any further justification as the lightweight airy summary dismissal of a man who will not allow himself to address the reality of what it is he has been advocate of. You just can’t do it, can you Jason.
Some of us are stronger than that, Jason. Some of us can look at ugly truths and point them out. Some of us aren’t so invested personally in seeing this public policy disaster enacted, because we are paid members of advocacy organizations pushing the disaster, that we can’t even in detail identify the dirty little “flaws” and “faults”.
Read my posts and comments, I think it stands for itself.
I’ve read your posts and comments, Jason. Lots and lots of them. And you always refer to “flaws” or “faults” as in “despite the flaws of the bill, this is really a good thing”.
But, like so many others on your side of the gulf, you refuse to acknowledge these “faults” and “flaws” in any detail. You just don’t want to go there. You can’t go there. Arguing for the atrocity that just passed, taking into full, detailed account of the “faults” and “flaws”, in light of what little real gain is present (a bunch of broke people are now required to buy a private health insurance product that is priced and serviced on the company’s terms, with no meaningful regulation enforcer or competition mechanism) is a non-starter.
Some of us are stronger than that, Jason. Some of us can acknowledge the “gains” and “faults” together in detail. We don’t fail and hide from the downsides.
See above. There are real benefits and real flaws. In my estimation, the benefits outweigh the flaws, but it’s certainly not a view anyone else must subscribe to.
However, given the above comment, you’re clearly not so good at reading the words in front of your face. That’s ok, you’re allowed the disagree. But the personal nature of it takes away from your argument. You just seem angry, without a lot of direction behind that.
I just “seem angry” to you Jason, and those who agree with you. Many people who share my perspective find it easier to see more than “seems angry”.
I will acknowledge, however, as I have done before, that you remain comparatively civil, because that acknowledgement is due, even if I don’t believe that you should be acknowledged for having fairly characterized the issues at hand in front of your readers here.
cite the “Real benefits of the bill”
I’d like him to cite the “flaws” as well as he has never starkly identified them himself.
He is a paid member of an organization that was advocating for this legislation. I’d expect little from him.
32 million covered. 32,000 lives saves per year just because of that.
No denials for pre-existing conditions, charging more because you’re sick, selling junk insurance, caps on benefits, or raising rates with impunity.
85% medical loss ratio, as opposed to an average of 80% now.
35% small business tax credit on insurance costs, effective immediately.
Young people can stay on their parents’ plan until 27, effective immediately.
Closing the donut hole, starts immediately.
Huge expansion of public programs like Medicaid, SCHIP, and community health centers.
There’s probably more but that’s what I’ve got off the top of my head.
on the Donut hole. you can buy them cheaper on reimport than thru the the INCREASED SUBSIDIES for PHARMA you list as good–come on, you really dont get it
There are no increased subsidies to phrma. The Phrma deal, corrupt as it was, was about agreeing to only take a certain chunk out of their profits, not give them more.
look at the % increases in drug prices over the last year and the “tiny” concession givin by PHARMA–
Then compare it to reimport- your boys are screwing us, without good cause, other than serving the corp interests
repeat after me. there are no PHARMA subsidies, There are no PHARMA subsidies
Then cite the bad stuff– yea, pretty ugly
Flaws would include:
16 million new customers for the insurance industry, with an 8% increase in revenue because of it
Rollback of choice for women
Questions about whether the regulations and enforcement will be enough
Subsidies not enough for some income levels to make health care affordable
Undocumented immigrants left out entirely
Do you care to discuss the ramifications of an economic model for the national government in which any conceivable service the government provides is made to rely on private, for-profit corporations, Jason?
Let’ talk about the government refusing to pursue a health care model that does not first and foremost prize and protect the wealth and profits of the health insurance and pharmaceutical industries, as an over-arching requirement, Jason. Let’s talk about the ramifications there in a context in which there is a broad shift to the relying on private, for-profit companies to fight and kill people in the nation’s wars.
I stipulate to you that “progress” as defined in: “the supposed populist, liberal/left reform party in the nation has produced a health care model that prioritized private wealth as an overarching requirement, in a context of broader privatization including even the nation’s war fighting capacities” is not “progress” at all, but a sign that the US is degenerating into the kind of governance and regimes that characterize banana republics.
Care to address this? It’s a real concern.
Duly noted that you actually acknowledged the existence of a womens’ rights issue in an explicit sentence fragment, more than I have seen from you in the past.
In other words, Bill/Jason, I see your “progress” health care “reform” bill as a lot like a hypothetical bill that would require the US to pay Blackwater, Triple Canopy, and DynCorp to fight in covert military operations for us, passed because the figures at the top of these companies are wealthy and well-connected. Economically a bad idea, morally repugnant, but the same kind of “progress” that is fundamentally reflected in your “health care reform” legislation insofar as this real legislation is a statement as to how the US political ruling class believes that the government should provide its services, and as to what are the real priorities of the political ruling class.
I don’t think that’s where we’re headed, so not really interested in the slippery slope argument.
That was not a response, but more a demonstration that you cannot respond. Again, another airy summary dismissal from you. That isn’t how serious people address challenges, Jason.
Deals with Big PHARMA, Deal Not to negotiate Medi-care drugs- no cost curve ,Engrains insurance Companies, who make money NOT providing care, KEEPS anti-trust, precludes states from single player
on your 85% loss ratio, it is their accounting– stocks up double digits
what else should the gov MANDATE we buy Rosy
they could have passed pre-exist in a day–YOur also wrong here–they can charge up to three times as much in prems and more co-pay ect
No, you couldn’t. Can’t to pre-existing conditions without the subsidies.
lets see someone vote against pre-exist even the repubs supported that comeon, honest debate
You clearly don’t know much about the policy behind this. If you just cover pre-existing conditions, premium prices will skyrocket because your insurance risk pool suddenly becomes a lot sicker. That’s why you need subsidies, to offset the cost.
The better Question is why do you give Insurance Companies 1 out of three health care dollars. what value do they add? How do they make health care better? They Don’t!
To not address that problem in any way but perpetuating it is a simply fact that you need to avoid to make your argument.
You support giving them more, no matter how bad they have acted and will continue to act. this bill is a step backwards
Good diary Seymour, and good calling them out. The time for “well it’s not great but we’ll push really hard for change” is over. These people shilling for their little partisan advocacy groups are disgusting. They are on par with fake progressive politicians begging for money and then stabbing progressives in the back. Ugly truth is ugly.
Back up there Beaver. What group exactly am I shilling for? Hmm? Please don’t paint with a broad brush just because Jason and I tend to agree more than we disagree. I don’t do that to you.
Bill, I apologize if I unfairly painted you in with the special interest groups. You have always been civil, and my suggestion was unfair. Reading trolls on Jane’s post have got my dander up.
Thanks Beaver. I have been known to get there myself on issues I am passionate about. It shows you natural class that you are willing to back track when you get off the path.
Whats this “You Democrats” stuff? As much as I appreciate the thought, I am hardly the whole Democratic party. When I talk about potential allies, I men you and me. The party will have to take care of itself.
But I would make one point in defense of the progressives in Congress and their decision to get what they could from this fight. At a certain point there is a choice between complete defeat and progress. When the Clinton Administration was defeated on this issue, it took another 16 years before it came up again. This very likely would have been the case if this bill went down to defeat. Sometimes the best you can do politically sucks, but it is better than letting an issue die for another 15 or 16 years.
But if you are not willing to be allies with me, okay. I can’t and won’t make you. That does not mean I am going to give up on the goals that you and I share.
your just a good representative of the Democratic Party spewing democratic Talking points–you must expect some debate on that
I don’t believe the perfect should be the enemy of the good. I DAMN SURE DO BELIEVE, however, that “perfect” should be the standard by which “good” is judged.
This legislation simply doesn’t pass that test.
- so true. That’s the extent of it. That’s the reason Robert Kuttner and Howard Dean (when he eventually acquiesced), etc. gave for supporting it.
Where’s the American people in those calculations? It all sounds like it’s nothing, but a symbolic victory for a political party and a ‘sell out’ President — off the backs of hurting Americans.
I’m sorry, but mandating that people purchase crappy policies from price-gauging health insurance companies is not “covering 32 million more Americans per year” and most certainly is NOT “universal health care”.
The government gets to deem what is an appropriate subsidy for those who can’t afford it, and if it’s not enough, then those unfortunate, uninsured people will now have the IRS — like a mob enforcer — levying big financial penalties against them for not being able to afford expensive, crappy health insurance policies.
There will be NO celebration within my household until we have a robust public option, an ability to import cheaper medicines from other industrialized countries, and an end to the health insurance industry’s exemption from anti-trust laws.
Anyone who is celebrating at the passage of that piece of crap is all about party, and couldn’t give a rat’s ass about the people.
Genuine question for the mandate opponents:
Why does having a public option in there make it better? You’d still have subsidy levels defined by the federal government, you’d still have IRS enforcement.
I’m not saying public option is bad policy, on the contrary, it’s great policy. But saying public option or no mandate is kind of an incoherent stance, as the public option doesn’t actually make the mandate any less odious.
Because a public insurance policy would be operating at a break even point, and a government entity (with huge number of American policyholders has unbelievable bargaining power to negotiate/reduce costs downward).
It would not be operating off thick profit margins, and I’m sorry Jason, but 15% profit margins (which is allowed under this legislation) is HUGE by wall street standards. And that 15% margin comes only after the HUGE salaries/bonuses are awarded to their executives as expenses.
To use the obvious example — look how much other industrialized nations (with universal government insurance entities) spend on their health care: literally half what we spend. There’s a reason for that. Private ‘for profit’ insurance companies profit by the inefficiencies in the marketplace.
A government entity would have the people’s best interest at heart (in the quality of policies offered, the prices charged, and deals struck with hospitals, doctors, etc.), whereas a for-profit entity has only its own interest at heart, and it goes without saying those interests conflict in a disastrous way.
Right, I agree with all those things, those are the arguments for the public option. It would control costs, it would set the standard for the public interest. That’s why I think it’s crucial and it’s such a blow that it’s not in there.
But fundamentally, even with a public option, the mandate still forces you to buy insurance and still sends the IRS after you if you can’t. So the argument that a mandate is only ok with a public option doesn’t make sense to me. To me, a mandate is only ok if insurance is truly affordable to everyone, because that makes the mandate fairly meaningless.
I’m not sure why it doesn’t make sense. The health insurance industry has been operating as a predatory entity — profiting off the deaths and medical neglect of American citizens. They are exempt from ant-trust laws, so we can only assume they are colluding on prices (which would be illegal in any other industry).
If you don’t believe health insurance companies will pad their expenses to earn more, do a little research on the music or film industry to see how they pad expenses all the time to minimize having to pay royalties to artists and talent.
Now, we’re being mandated to purchase their crappy and expensive products, as they continue to find ‘work arounds’ to continue to gauge the public.
Aside from all the benefits of a public option in reducing costs, and ensuring the public interest benefits, being a government entity would allow it to levy premium expenditures in the same way it collect for Medicare and Social Security, albeit for the government run health insurance premium.
There’d be no fine, because it would be automatic for only those who could afford it. Employers would be mandated to contribute as they volunteer to do now with private insurance. Subsidies would be applied accordingly.
The government, under this bill, will mandate that people go out and purchase crappy and expensive policies from a predatory industry, and if they don’t then they will be levied penalties — while still remaining uninsured. You don’t see a problem with that?
A public option would ensure that everyone gets insurance. This mandated private insurance plan doesn’t ensure that. It merely penalizes those who can’t afford it and leaves them uninsured.
So, this was your argument above against the mandate:
With a public option, you might solve the problems in the first paragraph, but not the ones in the second. You see what I’m getting at here? The no public option/no mandate stance is a bit off, because the public option doesn’t actually solve the problems with the mandate.
Again, Jason, the public alternative plan idea does certainly take steps towards addressing the concerns with the mandate, at least in the minds of anyone who has a fundamental grasp of representative democracy:
1) Government is on fair ground imposing compulsory requirements on the citizenry when the government is elected and therefore accountable through representative democracy, at least in principle,
2) When government requires the public to spend individual household money, the government is in effect leveraging public money as tax revenue. The government can use its enforcement arms to compel these households expenditures when it is the government’s plan and administration, answerable to the people, that holds and expends the revenue.
This is public administration 101.
What we are seeing with the “reform” plan emerging from the Democrats (and which you are advocating) is something a lot more along the lines of a Shock Doctrine approach to profiteering off the illnesses and injuries of people in a context of government power co-opted by private interests. The role of a public administration is not to simply hand over the administration role to a private, unaccountable, for-profit entity, to allow the entity to serve its own interests, while the public administration acts as the entity’s enforcement arm.
You should be able to understand basic concepts like these if you wish to advocate for polices, Jason.
Ok, I like that argument. It’s a bit different from the one theCallUp is making, but it makes a lot more sense. Government is allowed to force you to give up your money (see: taxes), corporations are not. I agree with that principle.
His point is not really so different than the point I was making if you read my comments.
I mentioned that the government could collect premiums in the same way they collect SS and Medicare which would mean that there’d be no place for penalty and everyone gets insured, and that the government is representative of the people, for profit corporations are somewhat predatory.
This bill that just passed penalizes people who can’t afford insurance, while leaving them uninsured. That in itself makes it dramatically different than a mandate with a public option.
I guess I read it differently, but ok. Still, for me, the argument against the mandate is more about affordability. In fact, I’d rather if there was no mandate. If health care was affordable to everyone, you wouldn’t really need one.
SO mandating that people buy from a ‘for profit’ industry doesn’t bother you? Your concern is only about affordability?
I would suggest that those two things are incompatible: achieving affordability through a predatory ‘for profit’ industry exempt from anti-trust laws.
The economics in health care are not the same as other goods and services.
Their interests run counter to ours, and yet we’re mandated to purchase from them. It’s illogical and wrong.
Well, for me, the arguments for the public option are less about the mandate and more about the other things we’ve discussed. I want the public option, think it’s necessary, because of cost control and because it would serve the public interest.
Honestly, that’s the stupidest and most out of touch thing I’ve heard Jason say about HCR. Being forced by the government to pay a private company for anything, much less something as critical as health care, is odious in the extreme. Being forced to pay the very insurance companies who have created this for-profit system in which they exist only to deny care and make their stockholders happy, just adds insult to injury. Accepting a for-profit model in the first place (a model which is illegal in many countries), much less turning it into what amounts to a public utility with an antitrust exemption, is Machiavellian. The comparison to Blackwater is certainly apt. I’m one of those people who will have to be dragged off to jail before I pay one dime to a private insurance company.
I’m sorry, what? OK, I just reread it, what? OK, I’ll just repeat it so I’m sure I read you correctly:
If health care was affordable to everyone, you wouldn’t need a mandate.
So the healthcare isn’t affordable, so we have to force those who can’t afford it, to buy insurance???!??! Is it me, or is that not the stupidest thing I’ve ever heard/read? And you have said in the past that your organization supports helping poor people get insurance/healthcare. Holy schmolly. Yikes.
“If a mandate was the solution, we could try that to solve homelessness by mandating everybody buy a house. The reason they don’t have a house is they don’t have the money.”
– Candidate Barack Obama
Video of him stating this.
I can’t believe anyone cannot understand this. Good intentions or not, you have to have one damn serious disconnect to not grasp how dumb that really is.
*shaking my head in complete disbelief*
Which helps to underline their ‘strategy’.
By legislating a health care mandate, they get the health insurance industry to happily back them (reward them), AND they can now disingenuously add “this insures $32 million people who otherwise wouldn’t have had insurance” to their talking points.
It’s a completely dishonest, rhetorical game they are playing with the American people, while they actually enrich the entrenched interests who line their pockets.
I have absolutely no confidence left in this government. It rapes and pillages its own, and with a lie and a smile. Disgraceful!
The actual amount of new customers that the insurance industry will get because of this is 16 million, not 32 million.
I wonder how much they’re anticipating making in penalties from all the non-insured who won’t (or can’t afford to) bite into this garbage?
The government? That’s in the CBO report I think, but I forget the figure offhand.
Last I saw it was $17 billion. Yep, that’s right. With a “b.”
Nice tidy little sum to make available for another bailoout down the road, dontcha think?
Something tells me that they think they’re going to make money hand-over-fist in the future, otherwise Cigna wouldn’t have given their ex CEO 110 MILLION Dollars
http://www.huffingtonpost.com/2010/03/20/cigna-gives-1109-million_n_506974.html
That’s not quite what I meant. I meant that if health care was really really really affordable, or, say, free, a mandate isn’t necessary. But if it’s a serious economic decision, then you may need it.
The idea, again, Jason, with a mandate in the face of a public alternative plan is that the public alternative plan allows the people to, at least in principle, have some say in our health care costs via the election processes.
I don’t understand how you don’t seem to get the contribution that basic representative democracy stands to make in health care provision, or why it is that you cannot see the difference between compulsory holding of health care policies as a plan with vs. without a major constituent of the plan that a) allows the public some voice in the management of the public health care system beyond turning it over to private corporations and that b) hugely reduces the shared economic burden of any such plan.
I agree with the bulk of your argument. However, I believe the 15% profit you cite does not account for the overhead. I believe overhead is included in that 15% (or at least I hope so!) It seems to me that if you include rent or purchase of buildings, payroll for personnel, utilities, etc., in some cases, maybe even medical equipment, you wouldn’t get to 15% for profit alone. Jason, TheCallUp, clue me in if I’m wrong. Incidentally, the gov’t also has overhead….
I stand corrected on the Medical Loss Ratio according to Ezra. It appears they will be forced to pay 85% on claims.
Not sure though if that 85% includes the processing of those claims, or the salaries of those who process those claims, or what exactly…
I’d like to read the fine print of the bill, before I give them the benefit of the doubt on that.
Government overhead is nothing compared to private insurance industry. The government won’t have financial incentive to lose claims that hospitals and doctors fax to them, etc. The private health insurance industry creates overhead for itself to avoid paying claims.
If you want to know how the 85% medical-loss ratio requirement will be utterly gamed by private-insurers; I present you with the “Special Purpose Entity.”
These pseudo-corporations will almost certainly be established, and arranged, to manipulate the appearances of revenues and payouts to subvert the regulatory framework. If you’re the CEO of a for-profit insurance company, and you don’t do it, you’re an idiot, and you’re leaving money on the table.
At least in principle a competing alternative plan with rates set by the government gives the public interest a lever in forcing downward marginal prices on coverage via the competition that a public alternative plan can in principle offer. Furthermore, government is famously cost efficient relative to the bloated, self-serving insurance companies and as been hugely enumerated a real public alternative plan will reduce dramatically the shared economic costs of providing health care. The fact that you can’t understand why people find the individual mandate – basically government serving as a collection agency and enforcer for private, for-profit businesses – with no alternative and no way for the public to protect itself (no public alternative plan) makes clearer that you are so out of touch with the thoughts and sentiments being presented to you hear. It’s odd that you have remained so out of touch.
Right, I agree, but that doesn’t solve the problems with the mandate. See above for what I’m getting at.
Before agreeing, see my above comments about the contribution that representative democracy might be able to make, if it was really part of the health care system moving forward under your plan. The mandate is much less odious if it includes an option to buy into a publicly administered the plan the terms and conditions of which are directly created by public administrations answerable to figures that the public can elect or throw out of office. A public administration or governing body is on fair ground using compulsion in order to levy taxes to provide public services. This is how public single-payer is premised, and we can all agree that public single-payer is the system we really should have, anyway. The “public option” is just away of saying that individuals have a right to pay an added tax burden to the government to get health care. The problem with the mandate emerges, Jason, when the public administration or governing entity decides that it will create a permanent situation in which the public is re required to buy from a private, for-profit entity, largely on that entity’s terms, with the public administration simply committing itself to be an enforcement arm of the private entity. That is what *your* plan does.
No theoretical public option could use its funds to lobby Congress against private insurance.
Consider this hypothetical scenario: a low income person happens to have financial commitments (let’s say he’s got child support, car payment, mortgage or rent, and he lives hand to mouth).
He looks on the exchange, and even with his subsidy he realizes he can’t afford anything. Now he will have the IRS extorting a financial penalty from him, diverting money from his kids’ mouths.
Another scenario (same guy, same situation): with subsidy he can only afford this crappy policy on the exchange that has a $10k deductible. It will really set him back, as he lives hand to mouth. He goes ahead, but now he still can’t afford to get the medical help he needs, because of the deductible. And yet, Obama is claiming political victory by putting this guy on the “now insured” list.
But realistically, he’s hardly insured. He could NEVER afford that $10k deductible, so he’ll avoid getting medical attention like the plague.
The winners: Barack Obama and Democratic Party for “passing universal health care reform” and the insurance industry who now collects premiums from 30 million more people who still can’t afford medical attention.
This is an immoral sham.
Well, we’ll have to put numbers on this. For one, high-deductible plans are banned from the Exchange, so no 10k deductible for anyone. Now, how much does this hypothetical low income person make?
What’s the highest deductible permitted under this bill? “High” is a subjective term.
As far as that hypothetical low income person’s take home, it could be whatever you want, … :)
The cap is a sliding scale based on income, and it includes all out of pocket costs. So, on the high side, for someone making 400% of the poverty level (about $77,000 per year), the cap is about $10,000, but that’s deductibles, co-pays, prescription drug costs all together – everything out-of-pocket. For folks at the lower level, that cap is much much lower.
Does “out of pocket costs” include premiums?
Assuming “out of pocket costs” doesn’t include premiums, that’s an extortionate deductible. $10k for someone making $77k?
Whether you include copays, and prescription drugs doesn’t change a thing. That guy does not have access to medical attention assuming he’s bogged down in expenses (mortgage, car payments, kids, etc.) like the rest of us.
You like this?
Let’s assume he’d be paying $8k a year in premiums (for family).
That guy will take home about $46k after taxes.
deduct $8k for premiums (for family).
== $38k — assuming guy has wife and kids this is what he’s got to put towards mortgage, car payments, schools, living expenses, etc.
And he’s gonna have to front the first $10k of his medical expenditures after paying premiums all year long?
That guy is gonna run for the door the moment his doctor tells him he needs an expensive MRI. This isn’t health care we can believe in.
So we can stop guessing at numbers, take a look at these charts:
http://hcfan.3cdn.net/46590729111c307ccc_lom6b3a6r.pdf
The ones you want are on page 8.
What the reconciliation bill does is essentially take the lower income numbers from the House bill and the higher income numbers from the Senate bill, so we’ll get an idea of what we’re talking about.
So, under reform, a family making $77,000 dollars per year would pay, on average, $11,000 per year for health care – that’s total costs, premiums and out of pocket included. That’s about $900/month.
Jason, thanks for the link.
These numbers make me sick! So someone making $73k will have to pay a maximum of between $15k and $19k per year in all out of pocket medical care expenses?
That’s between 20% and 26% of that family’s gross salaries (before they even pay taxes). This is worse than I thought. And this is mandated by the government to be transferred into the pockets of private predatory companies?
And Obama thinks this is going to sit well with the American middle class? My question to Obama would be this: Are you fucking nuts?!
So, the way these numbers are calculated, the maximum is only in a year when, say, two of your family members get hit by a bus. It’s not typical, the average is calculated on normal use, which includes getting sick every once in a while, or having a chronic condition.
However, there are problems with the affordability equations. Specifically, in the middle of the spectrum 200%-300% or so, that’s where I feel subsidies fall most short. So it’ll be a battle to make this more affordable in the future, that’s for sure.
However, two points on this. First, those 400% families who already have insurance they like can keep it if they want, so they don’t have to get an exchange plan if they don’t want to. And second, it’s not like people spend $0 per year on health care already, so it’s not like a family has to shoulder a new $10k burden.
Even the typical (average) to be spent annually — between $11k-$13k — for a family making $73k is extortionate.
On average Americans making $73k per year are to be spending between $11k-$13k per year (between 15% to 18% of their annual pre-tax earnings).
That’s A LOT of money for someone grossing $73k per year in salary.
No wonder this won’t become law for another four years. Americans will crucify the Democratic Party when they finally figure out what’s been cooked up for them at the behest of the special interests.
I guess Dems intend to parade around this ‘HCR victory’ knowing full well the only ones who should be celebrating are the health insurance industry and big pharma. By the time the public finds out, Obama will already be re-elected.
Given what the average family who doesn’t have employer sponsored insurance now is spending, this is a huge improvement. But I’m with you on the fact that the subsidies aren’t adequate for everyone. They’re much better at the lower end of the income scale.
The real trouble with the “we’ll fix it later” crowd is that they fail to acknowledge the real harm that will come about if these fixes are not implemented. I’d also like to point out that the excise tax is the only show in town, the tax the rich idea was floated and deemed politically unworkable ( really? 1% of the population is more important than the middle of the bell curve ?) so anyone throwing that one around is not being realistic about what this congress has the will to do. Where the harm is is that we’re now equating having an insurance policy with having access to actual healthcare. As someone who has run the gamut of health insurance ( from no insurance for me, to bad insurance, mediocre to then good insurance ) equating insurance with actual access to care is a bad idea ™. Expending money to buy insurance that provides little or no coverage is a bad thing ™ and actually wastes MORE money for the affected family than if they’d had no insurance at all ( premium plus bill for actual service ).
So i could go on, but i won’t. It depresses me. I wished far better for my fellow human beings, apparently it wasn’t to be.
To Bill and Jason,
1. Is it O.K. to lie to people for their votes?
“Now, under any mandate, you are going to have problems with people who don’t end up having health coverage,” Mr. Obama said during a debate with Clinton on Jan. 31, 2008. “I think we can anticipate that there would also be people potentially who are not covered and are actually hurt if they have a mandate imposed on them.”
2. Is it O.K. to lie to people for their votes?
“That’s what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are,” Mr. Obama said during his Jan. 31, 2008 debate with Clinton. “Because part of what we have to do is enlist the American people in this process. And overcoming the special interests and the lobbyists who — Senator Clinton is right. They will resist anything that we try to do.”
3. Is it O.K. to lie to people for their votes?
In the Jan. 31, 2008 debate, Mr. Obama said, “If a drug company — if the drug companies or a member of Congress who’s carrying water for the drug companies wants to argue that we should not negotiate for the cheapest available price on drugs, then I want them to make that argument in front of the American people.”
4. Is it O.K. to lie to people for their votes?
During the campaign, Mr. Obama said his plan would “Allow consumers to import safe drugs from other countries” because “some companies are exploiting Americans by dramatically overcharging U.S. consumers.”
5. Is it O.K. to lie to people for their votes?
“Insurance companies, drug companies are gonna have to be ponying up, partly because right now they’re receiving huge subsidies from folks.”
Guess what? The subsidies…just got millions of times bigger.
This is a strange argument for not passing the bill, but if you’re talking about how shitty the politics were around this, then sure, you’re right.