Archive for the 'Health Care' Category

Google Translate says…

Aug 10, 2012 in Health Care

Sure, we Republicans want to take away health care made possible by Obamacare for millions, but don’t say we don’t care!

Democrats have been doing a better job of playing judo this election cycle, but they’re being a bit slow on this one. The health care stories are limitless, there are enough out there to cut a new ad every day. Problems with the Soptic story (because Republicans are super-concerned about accuracy, naturally)? There’s millions more.

-hw

Waiting until we hear this statistic from George…

Jul 10, 2012 in Clueless Conservatives, Health Care

In twenty plus years of arguing with rightwingers, it’s become no surprise that basic skills like reading comprehension or rudimentary principles of statistics are immediately thrown out the window when there’s propaganda at stake. If you can put some numbers on paper, it’s good enough for most of them, especially bottom-feeder king Drudge. Thus, the stat that 83 percent of doctors considered quitting over Obamacare ran all day, and was accepted as fact by millions of Republicans today. Fortunately, some light has been shed on the methodology:

The survey was conducted by fax and online from April 18 to May 22, 2012. DPMAF obtained the office fax numbers of 36,000 doctors in active clinical practice, and 16, 227 faxes were successfully delivered… The response rate was 4.3% for a total of 699 completed surveys.

Run with it!

But hey, let’s keep letting morons like that steer our country.

-hw

Watch out, Democrats!

Jun 28, 2012 in Clueless Conservatives, Crazy Tea Party People, Health Care

Republicans are going to run against Obamacare, declaring with fervent religiosity that now that they’ve failed to stop it in Congress, and they’ve failed to stop it in the conservative Supreme Court, they’re…going to take it back to Congress again! Because we can’t have this:

Gosh, that stuff really makes my blood boil.

-hw

Pre-statement statement.

Jun 28, 2012 in Constitution, Health Care

Our friend AJKamper has pointed out that there are arguably principled positions against the individual mandate that undergirds the provision of the ACA that forbids insurers from declining patients for pre-existing conditions. So be it.

But there are some important facts to note before we treat this as some kind of escape clause for a boob-stacked Supreme Court with one justice, Thomas, who stands to profit from striking down the ACA entirely and another, Scalia, who seems to be auditioning for Limbaugh’s replacement once the Oxycontin explodes his heart.

First, as I have repeatedly noted, the individual mandate was a Republican concept, invented by one of the bulwarks of the rightwing think-tank cottage industry, Heritage. It was proposed as a counter-idea to Bill Clinton’s efforts to reform health care in the 1990s, championed by people like Newt Gingrich only a few years ago, and actually implemented by a Republican governor, Mitt Romney (who’d like you to forget his best accomplishment that he advised Obama to copy because, well, Obama agreed, and Romney’s had his programming rebooted a few times since then).

Secondly, the actual case’s history in the courts has been somewhat split among conservative justices (of course, liberal justices don’t matter…). Republican appointed, conservative judges have noted 75 years of precedent and ruled accordingly that there’s nothing unconstitutional about the mandate. A few scored headlines by going the completely partisan route, but there would seem to be a very palpable divide among conservatives who are doing their jobs and those who are being activist partisans.

Ergo, one would expect a split among the conservative justices in the Supreme Court. Indeed, many predictions have even seen Roberts break off and join Kennedy, although I call that at about 20%. I haven’t seen much from Roberts to believe that, but it’s not difficult to believe he’s less slimy than Alito, Scalia, and Thomas. (Update: Apologies to Roberts, sad disappointment in Kennedy)

So in a few short minutes, we should see a favorable decision for the ACA, and for the millions of people who would be adversely affected by a lockstep partisan 5-4 decision against a plan that had every mark of conservatism imprinted upon it until the moment a Democratic president embraced it.

-hw

Just in case you ever believed a word Republicans said about Obama’s health care reform law.

Jun 14, 2012 in Clueless Conservatives, Health Care

It was always about team sports, about fearing Obama riding in on a wave of popular support for health care reform and then actually getting it done and getting applauded for it. It amazingly got passed, but the Republicans merely kept running against it, deliberately focusing on the one aspect of it that wasn’t very popular, the individual mandate, and turning it into The End Of Liberty.

And now that we’re days away from the Supreme Court, stacked with Republican hacks, potentially fulfilling that blatantly partisan quest, it’s starting to sink in for Republicans that they’ll, um, probably have to do something about health care reform, especially since it’s finally starting to sink in with voters that losing the mandate means that discriminating against people for pre-existing conditions will remain.

The Republicans’ solution?

The individual mandate.

How can anyone reward Republicans in the voting booth after the way they’ve carried on the past three and a half years? At every juncture, it’s been about nothing but sabotage, sabotage, sabotage. Anything that would help America, they were against if it meant President Obama would get credit for it.

That’s the genial version of what I have to say on this, as I’ve deleted about three different conglomerations of profanity and rage.

-hw

Republicans were always dirty fucking liars about Obamacare.

May 31, 2012 in Clueless Conservatives, Crazy Tea Party People, Health Care

The depths of cynical pandering: After spending three years railing on about the DEATH OF LIBERTY because of the Republican creation, the individual mandate, being the medicine that made all the sugar of the ACA go down, Republicans are starting to worry that voters will notice the sugar going away and, yes, they want to pander some more, sir.

I really don’t know how anybody considers Republicans to be any kind of fiscal conservatives, or responsible in any sense of the word. The mandate is what makes sure we have fewer free riders in the health care system. Republicans want to keep the provisions that protect people with pre-existing conditions? Then people have even more incentive to wait to purchase health insurance until they feel sick. Health insurance does not work when only sick people pay. It works when everybody pays the premiums, and then they get to go to the doctor when they need it.

But what they did was seize on the one aspect of the ACA that didn’t poll so well and make the entire program about that, whitewashing from history the fact that they invented the goddamn thing (and Mitt Romney signed it into law for Massachusetts, of course). As the ACA was designed to slowly roll out, people had little sense of the positive and only heard the negative. And those dumb Team Republican fuckers went all the way to their packed Supreme Court, just for the political victory against the object of their insanely irrational hatred, President Obama.

I swear, are they trying to get it dismantled so they can pass it again with their name on it?

Why do I feel like that’s a dumb question?

-hw

How conservative, non-activist judges might rule.

Apr 14, 2012 in Health Care, Politics

Once one descends a little deeper than Fox talking points about broccoli, the legal pathway is actually rather clear, conservative, and minimalist.

Limited Commerce Clause Holding:
Even assuming arguendo that Congress cannot require any and every purchase of goods or services under any circumstances (but cf. Judge Silberman’s “regulate”-includes-“require” argument to the contrary in Seven-Sky), Congress does have the Commerce Clause authority to control the means and timing of payment for goods and services that persons will consume, particularly so as to assure that the consumers do in fact pay for the costs of such goods or services. Thus Congress can at a minimum require everyone either (i) to maintain insurance for goods or services that virtually everyone will consume, that the government guarantees, and that many of the consumers will not otherwise be able to pay for (which would thereby shift substantial costs to the public at large); or (ii) to make a modest payment to the government (IRS) to help cover the costs the public will incur if and when the individual consumes services for which she cannot pay.

Such a formulation would not commit the Court to holding that Congress can require any and every purchase. Nor would it even imply that Congress can require a purchase whenever “non-purchase” has a substantial effect of any kind on interstate commerce–the principle that Randy assumes Justice Kennedy would have to accept in order to uphold the statute, and one that might justify a required purchase of GM cars since the failure to do so “causes” Detroit’s economic woes.

The key legal question, of course, is do we have five Republican politicians on the bench, rather than conservatives? Will a health care plan invented by, adopted by, and implemented by Republicans be rejected by the Court as soon as a Democrat decides to compromise and go along with the idea? We already know how Republican politicians have acted, but can we hope from better from the court? I suspect Kennedy will agree with the other conservative judges who have agreed with the Obama administration previously, but people holding out for a Roberts concurrence seem mighty hopeful to me.

-hw

Healthcare rope-a-dope?

Mar 12, 2012 in Health Care, Politics

Not only will Democrats not win running away from the ACA, it’s stupid to do so. The President can run ads like this from now until November, and it’s barely up and running yet. Just imagine how many more people’s stories Democrats will be able to tell, helped by their vote for healthcare reform that covers people who fell between the cracks of insurance company profit margins.

-hw

Women’s health versus the patriarchy.

Feb 08, 2012 in Health Care, Women

I know which one I choose.

Let’s just keep things really clear, here: Catholics are generally pro-contraception. A clique of drag queens, perverts and pedophile-enablers who’ve never touched a woman sitting over in Italy has decreed that contraception is a sin. Dutiful priests and deacons in the U.S. follow the routine in sermons and have decided that to include contraceptive services in a health care plan is to give in to Satan.

All scientific research points towards responsible sex education and contraception as the best method of limiting unwanted pregnancies, teen mothers, and single-parent households. The public is overwhelmingly, staggeringly in favor of contraception, period. There’s a point where it’s simply a fundamental component of health care, and thus becomes an elementary component of any health care institution.

The question becomes then, how much are we going to let a tiny minority’s religious law designate the standards of basic health care? I confess that I do sympathize with their desire to maintain full control of their private organization, to have a liberty in how they choose to practice medicine. But what if a hospital concluded that its religious beliefs dictated heart patients must use a certain medication proven to increase risk of heart attacks?

So I go back to the original question and ask why this fight exists. And I’m left with the same answer: An out-of-touch patriarchy pimping a dogma that states some imperceptible “natural” law of God that says only man and woman must have sex, and it must be exactly as God designed our bodies to behave, with every sex act concluded to orgasm and deposit of semen within the vaginal cavity.

To me, that’s Lord Xenu territory. I choose women’s health and smart family planning in the hands of the family, not the corrupt and morally bankrupt Vatican. And guess what? Most Catholics agree. So I call it fair.

-hw

UPDATE: Just to be clear, yes, I expect the Obama administration will concede soon.

UPDATE II: You know, I was wondering if there wasn’t a way to get everybody what they wanted…churches want to not offer contraceptives, everybody else wants contraceptives available…so there simply needs to be another actor who provides that contraception coverage, and it seems the Obama administration has figured out a third way. This compromise sounds, on the surface, like a slightly wiser path that takes ammunition out of the religious right’s contraceptive-denying war.

The finest things you can do with money.

Feb 02, 2012 in Health Care, Women

I tip my hat to Mayor Bloomberg:

Billionaire New York City Mayor Michael Bloomberg pledged Thursday to give a piece of his own fortune to Planned Parenthood. The sizable donation– in which Bloomberg will give $1 for every new dollar Planned Parenthood raises up to $250,000– is in response to the controversy surrounding the Susan G. Komen Foundation’s decision to cease giving grants to Planned Parenthood for breast cancer screenings.

“Politics have no place in health care,” Bloomberg said in a statement, according to The New York Times. “Breast cancer screening saves lives and hundreds of thousands of women rely on Planned Parenthood for access to care. We should be helping women access that care, not placing barriers in their way.”

The Komen Foundation had been giving Planned Parenthood about $700,000 a year. In one 24-hour timespan since Komen announced that they were cutting funding, Planned Parenthood received $400,000 in donations. A Texas couple donated another $250,000. Bloomberg’s pledge raises the total to $900,000.

Amazing. The heat is coming down on the Komen charity. This is about saving lives, and a charity that places ideology above that is a fraud.

-hw

Out of touch.

Feb 02, 2012 in Clueless Conservatives, Health Care

In which another Republican politician asserts that a poor person in need is doing just fine:

Yes, drugs researchers need incentives. Let’s take half of our Pentagon budget and turn it towards health research, how about that? His pivot towards, “We either believe in markets or we don’t,” is a massive leap in logic. Better to say, “You either belief in the good health and safety of your citizens or you don’t.” Rick Santorum would gladly plunge this country further into debt and ruin starting a new war with Iran while slashing the taxes of the rich even more.

The answer? It certainly isn’t to tell me an ordinary everyday person like this lady can afford a million dollars a year for prescription medication. Please don’t lie to my face like that. Look for a solution that benefits most Americans, not just the wealthy interests funding your campaigns.

-hw

Santorum needs a hug.

Dec 08, 2011 in Clueless Conservatives, Health Care

Gosh, won’t someone just give him a chance? He’s trying so hard, and he really really super conservative and he’s against anything Obama-ish or Democrat-esque, he is a mighty rightwing warrior waiting to take off! He’s very much against Obamacare, for instance. Check out this withering attack:

If you don’t have to have insurance until you’re sick, why buy insurance? … How much would insurance be if only people who needed insurance bought it? The whole point of insurance is: healthy people buy it, sick people buy it, and those who are healthy support those who are sick…. But if insurance is only sick people buy it, well guess what’s going to be the cost of insurance. That’s why there’s a preexisting-condition clause.

Whoops, Rick Santorum just explained why either one has a mandate or else insurance companies just get to weed out anybody unprofitable. But he doesn’t seem to be aware, much like the other Republican candidates, just what the ACA is or what it’s already done for him.

Recently, Santorum has been openly discussing his three-year-old daughter’s illness, a rare and very serious chromosomal condition called Trisomy 18. “I had insurance under my employer,” Santorum told the students. “And when I decided to run for president, I left my job, I lost my insurance, I had to go out and buy insurance on the open market. We have a child who has a preexisting condition. We went out and we said, we left this plan, and we want to join your plan. Fine, we have to pay more because she has a preexisting condition. We should pay more. She’s going to be very expensive to the insurance company. That cost, while not the whole cost, is passed along to us…. I’m OK with that.”

You know what else the Affordable Care Act does? It bars insurers from denying coverage to children with preexisting conditions. Right now. Before the bill was signed into law last year, a parent in Santorum’s position could find his child denied coverage because of a preexisting condition. Is he OK with that too? Because if the Affordable Care Act is repealed, that’s precisely the situation parents like him — though mostly not former U.S. senators — would find themselves in.

I’m not sure how wealthy Santorum is, so perhaps he could have afforded any level of insurance, but the fact is that for 98% of Americans, having a little girl with Trisomy 18 could mean being denied healthcare under Republican rule.

Nearly everything about the Affordable Care Act is popular among voters, and the one snag that gave Republicans hope, the individual mandate, has steadily increased in popularity as people come to understand what no mandate means.

Weed out the sick, break the insurance companies, or have an individual mandate, what’s your choice? Although breaking the insurance companies could deliver us into the sanctuary of a single payer program, I don’t think many people would agree with such an outright attack on private insurance, so what’ll it be?

For Republicans, the answer is just keep hating Obama, but that won’t heal a sick child, will it?

-hw

Hat tip to Sullivan here.

Where it leads you.

Sep 13, 2011 in Crazy Tea Party People, Health Care

Allow me to distance myself from the people shouting YEAH!!! at the prospect of letting an uninsured person die in the hospital.

The Republicans have built their little boat and they’re sailing out to sea in it, searching for that pure libertarian paradise. My question is, can we keep these debates going forever, and can the audiences be entirely teabaggers?

-hw

Bizarro world update.

Sep 06, 2011 in Clueless Conservatives, Crazy Tea Party People, Health Care

Andrew’s back:

Perry’s Texas has 27.2 percent of its population without health insurance – the worst record in America. Massachusetts has an uninsured rate of 5.2 percent – the best. And yet Romney is still apologizing for this achievement.

But then he goes and asks a question that he seems to know the answer to:

Tell me: is it actually a Republican goal that people cannot have decent access to healthcare? Do they have any proposals to help? So far, the examples seem to be yes and no.

Now, in 2008 anything less than comprehensive health care reform was unacceptable, so McCain scrambled to pretend he had a universal health care plan just as good as Obama’s. Alas, voters could smell the difference, chose Obama, and Republicans proceeded to flip out because Democrats dared fulfill that campaign pledge. When it comes general election time again, You might see Republicans backslide a bit on that, but there’s no question what the GOP base believes: if you don’t have healthcare, that’s just God separating the producers from the leeches.

-hw

Medicare spending slowing…anticipation of ACA kicking in?

Aug 16, 2011 in Health Care

Another one of those links to information that Republicans can never acknowledge. Turns out that Medicare reining in costs, and ACA looks like the culprit!

Zeke Emanuel, an oncologist and former special adviser for health policy to White House Office of Management and Budget director Peter Orszag, is certain that this is what is happening. When I spoke to him last week, Emanuel, said: “This is not mere chance: this is directly related to the initiation of health care reform.” It is not the result of reform, Emmanuel emphasized. The reform measures that will rein in Medicare inflation have not yet been implemented. But, he explained, providers are “anticipating the Affordable Care Act kicking in.” They can’t wait until the end of 2013: “They have to act today. Everywhere I go,” Emanuel, added, “medical schools and hospitals are asking me, ‘How can we cut our costs by 10 to 15 percent?’

One of the least touted features of the Affordable Care Act is that it implements several seed programs for cost controls…in fact, it features most of the cost controls anybody can imagine, sans the Republican plan of simply scrapping Medicare and offering fixed vouchers. It’s widely understood that fee-for-service, that wonderful method of charging you for every aspirin, racks up huge costs quickly, and that organizations like Kaiser Permanente (which insures my family) are showing the way ahead with salaried doctors and incentives for good care.

Fortunately, those in the medical industry are supportive of the Affordable Care Act, and being rather smart people they understand where the future is headed. Thus the initiative being taken in getting healthcare spending under control while maintaining standards of care.

-hw

Privatized tyranny.

Jun 14, 2011 in Clueless Conservatives, Health Care

While looking through the comments on Paul Krugman’s column I cited yesterday, I noticed a great insight:

If you stop and think about it for a while I think you will conclude the Republicans also want a single payer health care system. Their single payer would be a huge privately owned insurance conglomerate. This entity would exist because of a series of mergers and buyouts that Republicans would be loath to oppose. This insurance giant could make the kind of political donations that would effectively neuter congress and any future president who might want to break it up.

This single payer privately held company could protect its bottom line by denying benefits who don’t follow its recommended diet and exercise program. It could also insist that in utero testing be done to identify any fetuses that have a high risk of needing expensive health care during their lifetime and recommend either abortion or a life time of much higher premium rates. Those too poor or too sickly would be expected to die early.

Since this is a private company protected by a myriad of laws passed by a compliant congress the only option for the average citizen is to leave the country if he doesn’t like it.

Those who advocate giving away the power of government to the private sector should consider where this road leads. At some point any semblance of democracy ends and we like the Romans enter a new period of our history.

Precisely. The idea that power in private hands is always preferable to power in public hands is inane. Free market principles don’t work in delivering cheaper health care, and in Republican deregulatory paradise we’ll be left with fewer and fewer options, until all health care is under the pervue of a few major corporations, and it is doled out at their whim for one express purpose, maximizing profit. This is the case already, but in a free market it could get so much worse.

Whenever I say I’m a socialist libertarian, Republicans fall out of their chairs and their eyeballs do this sort of googly rolling-around bit, sometimes worse. It violates every bit of dogma they’ve been huffing for the past several decades, it makes no sense to them whatsoever. Yet it’s a simple principle: I’m against all forms of tyranny, and will not welcome it merely because, “inc.” appears after the name of the entity. In a post-Citizens United world, private entities more than ever are capable of bending the will of our elected representatives to represent them instead of the people.

Sure, it becomes sort of obvious, but that’s what Republicans are for. Through advertising, think tanks, rightwing radio, Fox, and the various loyal disciples lurking on the internets, you are told, “Be responsible, work hard, don’t whine, don’t be a parasite, be a Republican!” Money is speech (how come if I give a cop a hundred bucks while asking him not to arrest me I get arrested for bribery then?), and don’t you read the Constitution? It is a constant grift, but one that pays well…at the top.

-hw

Paying less in taxes excuses paying more out of pocket?

Jun 13, 2011 in Clueless Conservatives, Deficit, Health Care

Andrew Sullivan and his readers have been speculating about the precise moment where America became a decadent nation. The Lewinsky impeachment hubbub, Bush vs. Gore, torture legalized, etc. have all popped up. Let me nominate one, as much as I was happy with the result: “Read my lips: No new taxes.”

Now Bush I got rightly cornholed for getting caught violating a very explicit campaign promise. Except two things: He shouldn’t have made such an irresponsible promise, and the anger directed at him over lying to the public was transmutated into a dogmatic commandment on the far right that spread throughout the entire Republican party that taxes must never be raised, and whenever possible should be lowered ever further.

Today? Massive deficit spending because our political establishment has lost all will to adjust tax rates in any direction but down, while demand for government services remains the same or larger.

Republicans dogma constructs this as some kind of moral failure, where poor scumsuckers siphon off the wealthy heroes of capitalism to provide for them. All increased spending is intrinsically bad, while all lowered taxes are intrinsically good. Moral certitude has replaced accounting.

Yet health care spending is something nobody can get away from, and so it makes no sense to make a moral distinction between health care paid for with taxes vs. health care paid for with private dollars. Almost everybody, even the well off, pays for their healthcare out of a collective insurance program, whether private or public. The question is, which is a better use of the money?

The idea of Medicare as a money-saving program may seem hard to grasp. After all, hasn’t Medicare spending risen dramatically over time? Yes, it has: adjusting for overall inflation, Medicare spending per beneficiary rose more than 400 percent from 1969 to 2009.

But inflation-adjusted premiums on private health insurance rose more than 700 percent over the same period. So while it’s true that Medicare has done an inadequate job of controlling costs, the private sector has done much worse. And if we deny Medicare to 65- and 66-year-olds, we’ll be forcing them to get private insurance — if they can — that will cost much more than it would have cost to provide the same coverage through Medicare.

By the way, we have direct evidence about the higher costs of private insurance via the Medicare Advantage program, which allows Medicare beneficiaries to get their coverage through the private sector. This was supposed to save money; in fact, the program costs taxpayers substantially more per beneficiary than traditional Medicare.

Krugman nods to Bruce Bartlett, who notes that Americans have lower taxes but most of the benefit is really due to health insurance costs being handled privately. The article contains a lot of numbers, but this stood out:

The impact on the tax burden can be dramatic if one views family allowances as negative taxes. For example, in Luxembourg, an average married worker with two children pays a nominal income tax rate of 16.5 percent (including state and local income taxes), while an American in the same situation would pay 5.2 percent. But once family allowances are subtracted from the Luxembourg worker’s income-tax payment, the effective tax rate falls to just nine-tenths of 1 percent.

More importantly, almost every other country has some form of national health insurance that covers, on average, 72 percent of all health costs. The comparable figure in the United States is 46.5 percent, and almost all of that is accounted for by Medicare and Medicaid, which largely benefit the elderly and the poor.

Average American workers must pay for health care out of their pockets, or through their employers in the form of lower wages. Europeans prefer to pay higher taxes and get government health care for every resident in return.

Conservatives universally believe that whenever the government provides a service it will be vastly more costly than if the private sector does so. This is why they support the plan offered by Representative Paul D. Ryan, Republican of Wisconsin and chairman of the House Budget Committee, to essentially privatize Medicare. Conservatives believe competition will drive down health costs for the elderly.

But O.E.C.D. data show that Americans pay vastly more for health care than the residents of any other major country. In 2008, we paid 16 percent of G.D.P. in total health care costs, public and private combined. The people with the next heaviest health care burden were the French, who paid 11.2 percent of G.D.P. Indeed, at 7.4 percent of G.D.P., the governmental share of health spending in the United States is about the same as total health care costs in many other countries, including (as a percentage of G.D.P.) Luxembourg (6.8 percent), Israel (7.8 percent), Japan (8.1 percent), Britain (8.4 percent) and Norway (8.5 percent).

Indeed, the American experience in the last decade is best summed up as: Hey, nice tax cut! Hey, my health care costs doubled! Hey, I got fired and have a crappy job with no health insurance!

Americans are paying through the nose for health care. Why should they be happy to pay more in premiums than they would in taxes? Or pay the ultimate price by not being able to afford health care at all?

Are taxes inherently evil? Of course not. You’re either getting your money’s worth or you’re not, and few people have the luxury of feeling better about paying more just because it’s going to Aetna and not Uncle Sam.

-hw

It’s not privatization!

Jun 02, 2011 in Clueless Conservatives, Health Care

Republicans always have a difficult dilemma in front of them. Since they serve the rich and no one else, they have to devote extra time and attention to message control so that people who aren’t rich will vote for them. And since they serve the rich and no one else, their plans inevitably involve privatizing government social services and directing that money towards the rich while giving Americans the shaft. They start out talking about privatization with each other because to them privatization is a great word. Unfortunately, when their plan to privatize Social Security was unveiled by George W. Bush in 2005, the public hated the idea of privatization. The Republican solution? Demand people stop calling it privatization. Why? Who knows! It wasn’t polling well, that’s what mattered.

The Post: Will you talk to Senate Democrats about your privatization plan?

THE PRESIDENT: You mean, the personal savings accounts?

The Post: Yes, exactly. Scott has been —

THE PRESIDENT: We don’t want to be editorializing, at least in the questions.

The Post: You used partial privatization yourself last year, sir.

THE PRESIDENT: Yes?

The Post: Yes, three times in one sentence. We had to figure this out, because we’re in an argument with the RNC [Republican National Committee] about how we should actually word this. [Post staff writer] Mike Allen, the industrious Mike Allen, found it.

THE PRESIDENT: Allen did what now?

The Post: You used partial privatization.

THE PRESIDENT: I did, personally?

The Post: Right.

THE PRESIDENT: When?

The Post: To describe it.

THE PRESIDENT: When, when was it?

The Post: Mike said it was right around the election.

THE PRESIDENT: Seriously?

The Post: It was right around the election. We’ll send it over.

THE PRESIDENT: I’m surprised. Maybe I did. It’s amazing what happens when you’re tired. Anyway, your question was? I’m sorry for interrupting.

Ah, gosh, if only we could have that guy back, right?

And now here we are with Paul Ryan’s plan to kill Medicare and give seniors vouchers that they must use to buy private insurance, if anybody will have them. The public is already strongly rejecting the plan, which actually only polls around fifty percent among Republians. Solution? Ryan, quickly turning into the whiningest whiny-baby in a party of whiny-babies, is demanding President Obama and the Democrats stop calling his voucher plan a voucher plan. Why? Who cares? The plan isn’t going well, and when things aren’t going well for Republicans, they call things different names. See the “Tea Party” for further evidence.

Here’s Ryan admitting that the only reason he doesn’t think it should be called a voucher is because the check is sent directly to the insurer, so you can’t go sell it or something. Because that’s why people oppose a voucher program, right? Of course not. The point is you get a lump sum, that lump sum is for buying insurance only, and it won’t work at delivering good care or even guaranteeing care.

Did I mention the worst part of Ryan’s plan? Yeah, the whole thing isn’t even designed to reduce the deficit, it’s designed to offset the costs of even more tax cuts which will, this time they SWEAR, send the economy through the roof. Just like those Bush tax cuts did…

-hw

“We don’t support rationing.”

May 24, 2011 in Clueless Conservatives, Health Care

Republicans who want to kill Medicare, hand seniors some vouchers and say, “Good luck out there in the private insurance market!” don’t want to staff a board that will oversee Medicare spending and make intelligent reductions while providing comparable service, because, says Orrin Hatch, “We don’t believe in rationing, nor do we believe in an unaccountable organization like that. I mean that’s crazy.”

Of course, private insurance companies who don’t want to touch sickly old people with a ten-foot pole are completely accountable, right? See, folks, you may not be able to have any kind of decent plan anymore, or one at all, but you’ll be free. But if a government board with members selected by Congress makes decisions about better spending, that’s unaccountable “rationing.” Yes, having this board allows some degree of tough decision-making, but don’t Republicans believe that Congress is generally ineffective at reducing spending by itself?

I just don’t know what to make of America anymore if it continues falling for this crap much longer. Republicans said DEATH PANELS at the prospect of Medicare balking on a heart operation for a 89 year old cancer patient, and then turn around and say, hey, let’s end that Medicare anyway, right?

Exactly how much more transparent do they have to be before people say enough?

-hw

They keep kicking the can, and we keep chasing it.

Nov 15, 2010 in Health Care, Politics

Wonder why Democrats passed a health care reform bill based on Republican ideas and Republicans ran against it as tyranny? Ezra provides a look back on Democrat efforts to cover all Americans since Truman:

In other words, Democrats have been willing to adopt Republican ideas if doing so meant covering everybody (or nearly everybody), while Republicans were willing to abandon Republican ideas if sticking by them meant compromising with the Democrats.

Better move to the right, President Obama!

-hw

Wait, health care reform is indefensible???

Nov 05, 2010 in Clueless Conservatives, Health Care, Politics

If anybody has been listening to Mitch McConnel ever, but more specifically since the election, it should be clear that McConnell is such a practiced liar that he would regard anybody who even expected him to tell the truth as naive. He says what he believes will serve his interests, and he will not be bothered by truthfulness.
Already McConnell admitted he pulled a good one by telling Republicans that he will get the “indefensible” health care bill repealed as soon as he gets a Republican Senate and President too.

But wait, what? Indefensible? What? I seem to recall shortly before HCR was passed Obama taking down a room full of Republicans on the issue, but furthermore, I’ve yet to hear what is so wrong about the HCR bill that Obama ran on passing in 2008.

I mean, I know the leftist problem with it: it’s not single payer, it doesn’t have a public option, negotiating prices is ruled out…concessions to business, to the right, to the “center.” But Republicans knew a successful HCR would be a potential death knell for them and a huge success for Obama. As Senator Jim DeMint urged, Republicans had to make HCR his “Waterloo.”

Well, they failed to do that legislatively. But dampened lefty enthusiasm left HCR with few avid defenders, so Republicans just kept up the intense assault and now have supposed 48% support for repeal among those who voted this week.

Yet the only thing Republicans have really rested their case on is the one part of HCR that doesn’t have majority support (surprise, people like all the good things it does), the individual mandate.

You know, that Republican idea from Heritage and Mitt Romney, that delivers customers to the insurance companies and allows them to stay afloat while covering those with pre-existing conditions.

So if you unplug the mandate, then all you get is insurance premiums skyrocketing even more than they did during the Bush years.

Republicans have attempted to sidestep this by going after the liberty angle. Because you’re a slave to the state if you get taxed extra for being irresponsible and not signing up for health insurance.

Um, yeah.

Of course, the way discourse in the media goes, leftist concerns don’t matter, and whatever Republicans say, no matter how extreme or nuts, must be taken very seriously. And so it goes that without many on the left really able to get super-excited by a super-compromised version of what they wanted, the anti-compromise right is getting close to establishing the meme that HCR is “indefensible.”

Oh, yeah, and Republicans love to point out that there were cuts to Medicare as part of the reform. Yeah, those spending-cutting fiscally responsible Republicans…

Against the squawking from the right, HCR is easily defensible. And considering the state of health care as it is, it is absolutely defensible, in fact it was mandatory.

I’m going to stand this ground, and break every Republican who tries to claim McConnell was remotely truthful. It is his claim that is indefensible, and I issue the challenge now.

Of course, right-wingers know they visit this site only to meet their doom, so don’t expect many challenges. Their attacks are to be spammed in venues where they think it can find purchase.

That’s what people who can’t make a case do.

-hw

Criticize the Republican “No” non-strategy, lose your health care!

Mar 26, 2010 in Clueless Conservatives, Health Care, Politics

For David Frum, anyway. After being canned by AEI for sounding like a sane Republican…

…the American Enterprise Institute has put Frum’s family into precisely the health care hell that Obamacare seeks to remedy. What many people don’t realize about the think tank world is that the policy types who serve as modestly paid fellows do so in large part for the health coverage. In our antiquated employer-based system, middle-aged wonks simply have to be attached to a group to be insurable. If you and your spouse have reached your 40s and have had even modest health bumps along the way, you’ll never be able to get coverage in the pre-Obamacare individual market (as my wife and I discovered and documented in this New York Times Magazine piece a few years ago).

It’s probably hard to overestimate how much this system leads to groupthink. Now for the sweet irony:

Luckily for the Frums, big government is here to save them…One existing government program, COBRA, assures that the Frums can stay on AEI’s health plan for 18 months, though they’ll have to foot the bill now for the full family premium (without AEI picking up the typical employer’s 70 percent of the tab). But the better news is that once Obamacare’s new insurance exchanges are up and running in 2014, the Frums – and the other 300 million of us – will never have to worry about being shut out of insurance coverage because AEI doesn’t like what we say. Of course, if the Frums move to Massachusetts, they can get coverage from Mitt Romney’s health-care exchange right away – thanks to the pioneering 2005 reform that Romney, consumed by presidential ambition, keeps trying, inexplicably, to disavow.

Talk about a two-fer. In one stroke, David Frum has become not only the poster boy for the Republican party’s incoherent tantrums, but for the need for Obamacare itself! It doesn’t get more delicious than this.

I have consumed so much delicious news this week I’m going to defecate a pundit. That’s how they’re made, you know…

-hw

“Nothing succeeds like success.”

Mar 23, 2010 in Chomsky, Health Care

The public is positive. Any Democrat can turn our health care victory into a winning issue. Those who were afraid were always wrong.

While the press has tried a few, “Bad News for Democrats?” articles after this historic success, it’s not sticking well. For those of you unfamiliar with this inside joke, it’s conventional wisdom among the press that when Republicans win, it’s bad news for Democrats, and when Democrats win, it’s bad news for Democrats.

Well, this isn’t good news for Democrats…it’s fantastic news for Democrats. For those who doubted Democrats could ever live up to their promises in office, this is proof (although the public option shall not be forgotten, this bill made it more likely that we will have a public option one day, whereas failure would have sealed our fate for a generation). For those who felt that Democrats could never display any spine or organization, this bill could have passed no other way. For those who have ever uttered the familiar trope, “The Republicans and Democrats are just two wings of the same party!” the line in the sand is clearly drawn.

Moreso, the public can look at the behavior of Democrats and Republicans now and learn some instructive lessons. Shrill Republicans screeching at the top of their lungs about “totalitarian” tactics sound like sore loser idiots. Tea partiers yelling “Nigger” and “Faggot” at Congressmen reveal the level of pathological contempt boiling within. Those signing the Club for Growth petition to repeal the bill look like a cavalry of Don Quixotes preparing to joust a mountain. On the other hand, Democrats showed the country every last effort to compromise, to move towards the center, to negotiate, to debate, to put things out in the open for the public to see. Democrats fought bitterly for the public option but let it go in order to move forward. That is America. We strive, and fight, and we dream the grandest dreams. We dream of mansions, but if we find ourselves in a two bedroom house, we call it our home. And we get to work making it better so that it will be worth something to our children.

The Democratic Party has seen over forty years pass without a noteworthy display of strength against constant Republican warfare, beyond Clinton’s showdown against Newt Gingrich which earned a brief period of fiscal responsibility before the Republicans took power and squandered our wealth. With the ascent of Barack Obama, we have seen strength, cunning, flexibility and tenacity at work. I still look back and wonder why he couldn’t have been stronger at certain points, why he couldn’t have engaged in the full court press on the public option, if he mightn’t have helped Democrats along at one point or another. But then there is the trick of it all that I cannot deny. Today he signed a big fat piece of paper titled, “I Knew What I Was Doing All Along.” I may wish to cherish a bit longer the idea that it could have been handled a bit better, but the plain fact is that Obama had fooled me more than once, and I am humbled. He did what neither Roosevelt, nor Truman, nor Kennedy, nor Johnson, nor Carter, nor Clinton could do. Some of us may entertain the notion that a President Kucinich might have gotten us single payer health care, but it is a lazy fantasy shed of all responsibility or reality. And I say this as a person who fundamentally agrees with everything Noam Chomsky says here. Yes, I know the water is dirty, but I have come a long way through the desert, and now that I am stronger, I may set out once again.

-hw

One more time:

Mar 23, 2010 in Clueless Conservatives, Health Care

What everybody knows but the press can’t bear to say:

Obama is signing what was, until recently, a moderate Republican health care plan by every substantive comparison or definition. The unanimity of Republican opposition says more about Republicans than it does about the plan itself.

Republicans, determined to oppose the bill, have painted themselves into the corner of declaring that the government simply shouldn’t be “responsible” for helping everybody get health care. Their theory is that the threat of illness, injury or death works as an effective whip to keep the slovenly masses toiling away for minimum wage in the hope of becoming rich (reality check: 13 million middle class earners were uninsured in 2008, but don’t tell rightwingers…because they won’t listen anyway).

David Frum, on the other hand, is single-handedly trying to rescue the Republicans from their own shitstorm of stupidity, insisting the path forward for Republicans is to work to improve the bill through Republican-style ideas. Given that the bill is already an old school Republican bill, applying old school Republican ideas to it shouldn’t necessarily be that unpalatable to either party. He lists four ideas here. They’re debateable, which is more than could be said for the modern GOP’s STARTOVERWEPROMISETOWORKOUTADEALTHISTIMEYOUSOCIALISTFUCKINGCOMMIES!!! suggestion.

Well, that explains it…

Mar 21, 2010 in Health Care

It’s really Democrats’ fault that tea partiers were shouting “nigger” and “faggot”.

Rep. Devin Nunes (R-Calif.) came to the defense of the racists and bigots who shouted slurs at members of Congress Saturday. The Tea Party protesters shouted the ‘n’ word at African American members of Congress the ‘f’ word at an openly gay member.

Rather than condemn the anachronistic behavior, Nunes blamed the Democrats, saying that they make people do and say crazy things with their tyrannical behavior.

“When you use a totalitarian tactics, people, you know, begin to act crazy,” Nunes told C-SPAN’s Steve Scully Sunday morning when asked about the slurs. “I think that people have every right to say what they want. If they want to smear someone they can do it. It’s not appropriate–I think I would stop short of characterizing the 20,000 people protesting, that all of them were doing that.”

Yeah, totalitarian tactics like running on health care reform, getting elected, and then voting on it in Congress with a majority required to pass.

How is it Republicans lost this debate? It’s so weird because their arguments are so rational and sensible…

-hw

Hand in hand.

Mar 14, 2010 in Disappointing Dems, Health Care

It really isn’t that surprising that Bart Stupak being disingenuous about HCR funding abortions is shortly followed by news of Bart Stupak getting himself in ethical hot water, being another tenant in the Biblically subsidized C-street pad where mostly Christianist types of politicians have shacked up. Who pays the rent? Stupak won’t say. Rachel Maddow drives the nail in on the substance of the issue and the scandal of the man:

Visit msnbc.com for breaking news, world news, and news about the economy

It’s already settled that the Senate bill and the reconciliation package will not fund abortions. However, as usual with critiques that are ideologically rightwing, as Stupak’s is, par is that facts simply don’t matter. The right was happy to try pretending we’d be giving illegals health care too, even though the bill has explicitly stated the opposite. Even if Stupak tends to vote Democratic, on abortion he’s just over the edge of reason, so there’s little surprise he’s found some comradeship among the evangelical crowd. “If the facts are at variance with your claims, believe them harder,” is their credo, and one can only waste so much time talking to them. Your open hand won’t be returned.

Stupak’s ethical problems? More bonus, and symptomatic. Let’s move on…

-hw

Like I was saying…

Mar 06, 2010 in Health Care

NYT:

Reconciliation was intended to be a narrow procedure to bring revenues and spending into conformity with the levels set in the annual budget resolution. But it quickly became much more. The 22 reconciliation bills so far passed by Congress (three of which were vetoed by President Bill Clinton) have included all manner of budgetary and policy measures: deficit reductions and increases; social policy bills like welfare reform; major changes in Medicare and Medicaid; large tax cuts; and small adjustments in existing law. Neither party has been shy about using this process to avoid dilatory tactics in the Senate; Republicans have in fact been more willing to do so than Democrats.

Really, can anyone believe anymore that the Republican Party would let itself be restrained by the truth?

-hw

Is this the jiu-jitsu moment for Obama?

Feb 26, 2010 in Barack Obama, Clueless Conservatives, Health Care

Holy smokes. He’s allowed the Republicans to get behind the summit idea and got them in front of the camera again. Niiice judo flip.

If it was Obama’s intention to make clear to the public that the Republicans simply were not going to play ball at all, no matter what, then it qualifies as a cast-iron success.

Which suggest that Obama has learned the central method to handling rightwing talking points: Stick Republicans in a room and watch them sweat. Make them look for a retort. Exhaust their lines. Undermine their paradigms.

Look, folks, the only real critique of Obama is from the left. The GOP’s new star fiscal conservative is Paul Ryan, who voted for Medicare Part D. It’s rhetorical posturing that will translate into a party-line vote for the next Republican President.

The critique from the right is simply too staggered with money and propaganda to take seriously. America has to move forward.

As the Bush advisor said, “We’ll make history and you’ll be trying to analyze it, and just when you figured it out, we’ll make history again!”

And how can one do worse than Bush?

This article suggests Democrats may finally be convinced they’ve earned the political cover. Will that be true? There’s a bizarre reverse effect where the longer this goes on, the worse it becomes for Democrats to turn on the bill. Though they keep trying…

-hw

What Republicans don’t want you to know about your health insurance premiums:

Feb 18, 2010 in Health Care

They’ve skyrocketed in the past ten years and they’re going nuclear soon:

California officials say 700,000 households face increases averaging 25 percent overall and as high as 39 percent for some.

The HHS report found that those numbers are in line with increases sought by insurers in other states – at a time of robust profit growth for the companies and a lack of competition in most states.

For example, Anthem in Maine was denied an 18.5 percent increase last year and is now requesting that state regulators approve a 23 percent rise. Maine is home to Sens. Olympia Snowe and Susan Collins, Republican moderates whose support Obama would like to have for his health care legislation.

Michigan’s Blue Cross Blue Shield plan requested approval for premium increases of 56 percent in 2009. And in the state of Washington, rates for some individual health plans increased by up to 40 percent until regulators cracked down.

Other states cited in the report were Connecticut, Oregon and Rhode Island.

I don’t know, do you think it could be the Republican plan to try getting back in office so they can pass essentially the same thing as the Democratic health care reform bill and take the credit? That if they actually had the power they crave so much, they’d be able to look at it and say, “Oh, wait, it’s already completely compromised to please us”? It’s already Mitt Romney’s Massachusetts plan with some cost control seed programs, so if he’s elected it shouldn’t be a big maneuver for him, should it?

Any way you come at it, the plane is diving into the mountain, and Republicans are fighting over how to properly fasten our seat belts. It’s already spooked several Democrats, including Diane Feinstein, into supporting the reconciliation deal with the House and getting reform efforts going.

Of course, watch those expected premium increases come along and then tune into BeckPalinLimbaughbots to hear how it’s all Obama’s fault. They got millions to make off the destruction of the middle class.

-hw

Assertions, assertions…

Feb 08, 2010 in Health Care

Say whatever you want about Fareed Zakaria, the man can generally lay pretense to being well informed. Then he writes something like this:

True, the Republican Party has decided to be utterly uncooperative (although on health care Obama never really reached out to them with serious compromises).

Great job paying attention, Zakaria. When’s the vote on single payer scheduled again? How’s that public option compromise doing?

-jb

Because Fox keeps you informed!

Jan 27, 2010 in Barack Obama, Health Care

When people actually find out what’s in the Senate bill, most of it tests positively. Nate Silver breaks it down, bit by bit. People don’t like the mandate or the overall price tag, but they like almost everything else about it, giving it an overall +22 net favorable rating. Unfortunately, Silver also reveals that rarely did over 50-60% of people even know about the provisions they liked so much.

Of course, the Democratic politician doesn’t think, “Wow, this bill has some great stuff people will like that I can sell without breaking a sweat!” They think, “Run away!!!” Obama’s State of the Union is well-positioned to course-correct here, but there ain’t a soul gettin’ their hopes too high. My forecast: 65% chance of reclaiming the baton, 35% chance of boilerplate that doesn’t change anything.

-jb

On the same page?

Jan 24, 2010 in Health Care

Robert Gibbs seems to understand things fairly well:

Putting aside some of his careful talk, it struck me how happy I was not to be seeing Ari Fleischer, Scott McClellan, Tony Snow, or Dana Perino on the screen lying to me constantly in support of a horrific agenda. Gibbs fundamentally gets it, and seems to be fully aware of the treacherous political landscape the Obama White House is finding itself in. He still throws in a few too many squishy qualifiers, but he appears to finally feel the fire under his ass.

His advantage, however, is that the ball is in the House’s court. The Senate can negotiate with 51 members willing to add fixes via reconciliation, able to offer the House a better deal than Joe Lieberman or Ben Nelson (and, of course, a big improvement on the GOP’s extended middle finger). I know not everything can be done via reconciliation, and I expect House members to know that as well.

It’s important that Democrats itching to retreat at this point see only bayonets behind them, charging forward. Retreat is simply unacceptable at this point, and would be one of the purest expressions of the term, “snatching defeat from the jaws of victory.” Democrats can win on the bill with one vote in the House, or face a political tsunami of rage and inconvenient indifference. Any American with hopes for repairing our broken system and who fears that they may one day slip through the health care cracks can feel somewhat reassured that the future won’t be so grim. Should the bill die, tens of millions of Americans will have little choice but to despair as the one party they’re supposed to trust on health care fumbles the ball on the five yard line.

-jb

OLIGARHY!

Jan 17, 2010 in Health Care, Politics

Protect the mafia!

You’re a social worker or a parish priest in a poor urban neighborhood that lives under the malignant, if stable, stewardship of an organized-crime protection racket. The small business owners all have to pay a protection fee, which most of them can afford, but a significant portion of bodegas and nail salons operating on razor-thin profit margins struggle to come up with the money. When they fall short (which is often) they are subjected to beatings, harassment, vandalism and other petty cruelties.

Now, it turns out that you can raise enough money through your organization so that you can reliably cover the protection fees for the struggling shop owners operating on the margins. Whenever they can’t come up with enough money, you can make up the difference. The improvement to residents’ lives would be massive: no longer forced to live in fear, they would be allowed to transact their business and go about their lives free from the constant, degrading fear of physical violence. But by taking this action you would also be channeling revenue into the pockets of the protection racket and, perhaps more insidious, further entrenching its power by conceding its central premise: that all local businesses must pay up in order to survive.

This is, of course, the solution to our health care problem forced on us because of the “centrists” and the Republicans. It’s a short term solution, and it gets the idea right of ending the beatings, but by forgoing price negotiations due to rightwing economic “principles” that have been absorbed by the centrist dipsticks, we give the health care mafia the right to jack up the prices whenever they feel like it.

There are some great cost control seed programs in the bill that can make a difference in the long run, but without price negotiating power, we’re leaving the back door wide open. Thank the Blue Dogs and the teabaggers for that one, folks. Having at least 55 Senators in favor of real change and a president willing to sign the bill doesn’t get jack squat done anymore.

-jb

Breaking news.

Dec 22, 2009 in Health Care

Bar brawl going on over at our friend Dana Pico’s Common Sense Political Thought site.

It’s interesting as we nurse the wounds of our compromise with the corporatists on the right in the Senate, to go over there and find out we just unleashed the Liberal Holocaust upon the country. As usual, the facts aren’t adding up in their favor, so somebody had to bring up Hollywood and who the real Americans are.

-jb

Two roads diverged in a yellow road, and sorry I could not travel both…

Dec 17, 2009 in Health Care

Unfortunately, my previous post puts me in the position of disagreeing with Howard Dean, but hats off to him for this:

Visit msnbc.com for breaking news, world news, and news about the economy

It’s amazing that I can agree with 99% of what he says, yet we part ways on the simple choice of whether to accept this heavily compromised yet still positive bill or let it all crash. I think that going forward will make further victories possible. Killing it will lead to certain suffering. The hostage takers of America’s uninsured win this round, but Liam Neeson kept coming after them therefore so should we. Landrieu should stop being so damn combative with Howard and acknowledge their commonalities instead of trying to dismiss him. He represents the base of the Democratic party more than she does. The two paths need to converge at some point.

-jb

More faux outrage from knee-clutching Republicans.

Dec 08, 2009 in Clueless Conservatives, Health Care

It’s a wonder soccer isn’t a more popular sport in America. The little I’ve watched illustrated a pattern of strategic drops to the ground clutching knees in order to get penalties against the other side. A team could nearly win on knee-clutching, and Republicans are intent on proving it can be done in politics.

Harry Reid dropped a little too much truth on the Senate floor:

Instead of joining us on the right side of history, all the Republicans can come up with is, “slow down, stop everything, let’s start over.” If you think you’ve heard these same excuses before, you’re right. When this country belatedly recognized the wrongs of slavery, there were those who dug in their heels and said “slow down, it’s too early, things aren’t bad enough.”

When women spoke up for the right to speak up, they wanted to vote, some insisted they simply, slow down, there will be a better day to do that, today isn’t quite right.

When this body was on the verge of guaranteeing equal civil rights to everyone regardless of the color of their skin, some senators resorted to the same filibuster threats that we hear today.

Call the Waaaaaaaahmbulance!

Sen. John McCain, R-Ariz., for one, has demanded an apology from Reid. Sen. Tom Coburn, R-Okla., said he’s “personally offended.” Republican National Committee Chairman Michael Steele, too, says Reid should apologize — and that Democrats should strip the majority leader of his post if he doesn’t.

Oooh, yes Sir, Mr. Steele! We’ll get right on that. Does that man ever listen to his own words?

So the Republicans, always the true victims in America, cried and whined and threw their temper tantrum, and we’re supposed to forget that Reid was right. Our nation’s history has been riddled with great strides forward that were fought against by ignorant badgers who gleefully used tooth and claw to make sure we stayed in the Dark Ages. Indeed, today’s Republican Party was borne of the Civil Rights Act and the migration of the Dixiecrats hearing the whistle of Nixon’s Southern Strategy. Discontent and outrage, over equal voting rights for non-whites.

40,000 Americans die every year and nearly twenty times more go bankrupt and Republicans tried telling us we had the best health care in the world. They’re on the wrong side of history again. No amount of tear-squirting is going to undo that.

-jb

The elephant in the room.

Nov 26, 2009 in Clueless Conservatives, Disappointing Dems, Health Care

Gosh, somebody besides a crazy liberal hippie is noticing that Republicans have overseen the massive inflation of the filibuster, transforming the Senate into a 60 vote body rather than the foreagreed majority vote requirement.

According to research by UCLA political scientist Barbara Sinclair, there was an average of one filibuster per Congress during the 1950s. That number has grown steadily since and spiked in 2007 and 2008 (the 110th Congress), when there were 52 filibusters. More broadly, according to Sinclair, while 8 percent of major legislation in the 1960s was subject to “extended-debate-related problems” like filibusters, 70 percent of major bills were so targeted during the 110th Congress.

The Republicans don’t have a leg to stand on here. They’ve abandoned all restraint, even to the point they would lobby the charge right back at Democrats if they reinstated restraint.

The fact is, the health care reform bill would pass if it cleared the filibuster, which is why the filibuster has become so important. The country has already elected the number of Senators in favor of health care reform to make it possible. They just forgot to make sure there weren’t enough Republican Senators willing to torpedo reform and leave our system broken.

As for Lieberman, who’s been a pro-health care reform guy his entire career, who used to look favorably upon single-payer care, the voters clearly got swindled.

Surrendering to that because Democrats don’t want to be called rude for ending or curtailing the filibuster is cowardice, ignorance, and abettal.

-jb

More on the mandate.

Nov 19, 2009 in Health Care

The incomparable Ezra Klein:

But what’s the alternative? No one wants an individual mandate. But the folks who spend all their time trying to solve the first problem Ross describes have concluded that you can’t do it without an individual mandate. After all, why do people get priced out of insurance? The answer, aside from “they’re poor,” is that they’re bad risks. They’re older, or they’re sicker, or they’ve been sicker at some point in the past, or they work at a dangerous job or a job associated with chronic injuries.

If reform simply forces insurance companies to sell to these people, then prices skyrocket for everyone, as the sicker or the older rush into the market, while the young and the healthy hang back. In that scenario, you’ve not solved the problem of pricing people out. You’ve arguably worsened it. If you want to solve the problem of pricing out but you don’t want an individual mandate, you need to think of an alternative to it.

Moreover, it’s simply not true, as Ross says, that the people paying the $750 individual mandate penalty get nothing in return. Far from it, in fact. For one thing, they get access to emergency care, as happens now. For another, they get the chance to come back into the system when they actually need insurance. Someone who puts off purchasing coverage and then tries to buy Aetna’s plan the first time they collapse unexpectedly will not be sold a plan. Having chosen not to buy insurance when they didn’t need care, they can’t buy it now that they do need care. They become the priced out or, in some cases, locked out.

Under reform, these people get the chance to come back into the system when they need coverage. They can’t be discriminated against.

People would probably realize this if they weren’t busy trying to make sure the Democrats didn’t have a legislative success.

-jb

Ain’t no rush if you’re doing it right.

Nov 18, 2009 in Health Care

May Congress follow the lead of Blizzard Entertainment, and vote on the health care bill “when it’s ready.” Ezra Klein, who’s essential reading on health care reform, points out some of the cost control measures being considered.

The first comes from the excise tax on high-cost health insurance plans. The idea here is simple enough: you’re taxing any growth in health-care premiums that’s faster than the rate of growth in GDP plus one percentage point, which is going to make people a lot less accepting of premium increases and unchecked growth. This is, in the simplest sense of the term, a cost control. In theory, it controls costs by taxing one of the drivers of cost growth into submission. It is, by far, the policy economists are most united on, and the one that works in the most straightforward and blunt way.

The second comes from the newly formed Medicare Commission, which is a lot stronger than people realize. The idea isn’t simply that a panel of experts gets to dream up interesting reforms to try out in Medicare. It’s that they are charged with making sure that Medicare hits certain growth targets, and their package of reforms has to achieve that goal. Those reforms are then sent to Congress, where Senate debate is limited to 30 hours, and amendments must be both budget neutral and “germane.” This report, in other words, is exempt from the filibuster. So far as anything is ever easy to pass, this is easy to pass. If Congress cannot manage action even within this streamlined process, then it simply cannot cut health-care costs at all, and our federal government will go bankrupt.

The third is the delivery-system reforms. The House bill has these too, though they’re a bit weaker. They key alchemy, however, is the interplay of the delivery-system reforms and the MedPAC commission. The Senate builds in a lot of pathways by which an idea that starts in Medicare through the commission and proves successful can be brought to pilot and then brought to scale across the health-care system. Medicare serves as the laboratory, but other institutions created in the bill serve as the factory.

All three of those stories make sense, and any of them, on their own, would represent the most significant effort at cost control in a generation, if not ever.

We really have no choice but to take our time to truly address cost control as part of health care reform. The long term costs of health care demand it. Our current system is fundamentally broken.

Within the next fifty years, medical technology is going to advance to levels that we simply cannot properly gauge in 2009. Life expectancy will, barring interference from energy and climate issues, increase, perhaps significantly. By the time I am eighty years old, it is entirely conceivable that I may have access to technology that will allow me to live to 150, or 200 years. To live indefinitely is not out of the question. What we have come to understand in the last ten years will pale next to what we will have mastered by then.

Very likely then that the same kinds of research will yield benefits on how to keep us healthier longer. At eighty, I may have strengthened bones and more muscle mass than I possess now. Nano-tech may be cleansing my blood. Yet, despite all these measures, an extended life creates a bigger window for costly life-threatening issues, and simply persisting may be a hugely expensive undertaking itself.

In such a world, notions of when we should retire will face upheaval. Working 47 years and living another 150 simply won’t be feasible. More than ever, sustainability will be a part of our vocabulary. If you’re 100 with the body of a 50 year old, you will be expected to work. The very concept of retirement may become drastically altered or largely obsolete, reserved for the wealthy.

Addressing long-term costs isn’t merely a panacea for teabagging fools who suddenly woke up to the deficit the day George W. Bush left office. Sustainability must remain a constant concern, whether the subject is health, energy, or preserving our Constitutional rights.

Let Congress work on it, and make real cost control part of the final bill. The cries of the foolish will diminish, and we will see who is dedicated to solving difficult problems responsibly.

-jb

“There’s no advantage achieved by all this fuss.”

Nov 07, 2009 in Clueless Conservatives, Health Care

Republican representatives mutate into town hall screamers, trying to drown out voices of opposition instead of challenging them.

-jb

Dana Pico, you are compelled!

Nov 07, 2009 in Health Care

The Catholics endorse the health care reform bill.

The United States Conference of Catholic Bishops delivered a critical endorsement to House Speaker Nancy Pelosi on Saturday by signing off on late-night agreement to grant a vote on an amendment barring insurance companies that participate in the exchange from covering abortions.

“Passing this amendment allows the House to meet our criteria of preserving the existing protections against abortion funding in the new legislation,” the Bishops wrote in a letter to individual members. “Most importantly, it will ensure that no government funds will be used for abortion or health plans which include abortion.”

The group goes on to say, “The Conference will remain vigilant and involved through this entire process to assure that these essential provisions are maintained and included in the final legislation. With this important step forward we hope the House can come together and finally move forward essential reform which truly will protect the life, dignity, conscience and health of all. We also hope the Senate will follow the example of the House and include these essential safeguards in their version of health care reform legislation.”

Keeping tax dollars away from abortions certainly angers some, including our own Thomas Tallis. However staunchly pro-choice I am, I still understand and perceive the moral repugnance of the actual deed. I oppose restrictions on women’s rights, but that doesn’t translate into an entitlement of cash to do them. People have a say in how their tax dollars are spent, and I think ultimately it’s fair to grant people the right not to have their tax dollars spent on something they abhor so much. If that concession brings the Catholic Church on board with everything else, I think it’s a valid compromise that respects and balances everybody’s rights.

-jb

UPDATE: Comments thread has shifted my thoughts somewhat. When you look at the fine print, it’s a horrible deal that holds trillions of private dollars hostage. Can’t lose it fast enough, and it isn’t going to change anybody’s vote about the final bill.

They wanna filibuster?

Nov 05, 2009 in Health Care

Alan Grayson shows how to counter.

-jb

Pillars of reason

Nov 05, 2009 in Clueless Conservatives, Disappointing Dems, Health Care, Politics

It is my contention that were we dealing with a genuine opponent in Republicans, instead of a gang controlled by the know-nothing musings of the Beck/Palin/Limbaugh Idiot Trinity, this piece by the Brookings Institution may carry some weight.

The proposal starts from the conclusion that the standard short-term measures to address rising costs, like reducing prices, are not sufficient to succeed. Instead, legislation must support necessary changes and improvements in health care by reforming payment systems, regulations, and institutions that currently prevent patients from consistently getting the best quality care at the lowest cost.

This strategy consists of four interrelated pillars. First, as a foundation for improving value, all stakeholders in the system need better information and tools to be more effective. Second, provider payments should be redirected toward rewarding improvements in quality and reductions in cost growth, providing support for health care delivery reforms that save money while emphasizing disease prevention and better coordination of care. Third, health insurance markets should be reformed and government subsidies restructured to create competition and improve incentives around value improvement rather than risk selection. This step requires near-universal participation in insurance markets to succeed. Finally, individual patients should be given greater support for improving their health and lowering overall health care costs, including incentives for achieving measurable health goals.

Also appreciated would be more Democrat politicians who win on grassroots power instead of big money donations they curiously vote in line with.

While we are potentially looking at a likeable bill, endorsed by the AMA and AARP and a number of other big players, it’s important to remember that there are still numerous concessions being made in the name of political expediency and big donor waahbabiness. Or waahbabitude, although I feel that imaginary word to be a little too positive for the desired effect.

While I remain personally optimistic that a series of bills in the future may be able to ferret out some of the absurdities and inch us closer to the idyll most of us realize needs to be manifest, that shouldn’t lie in the way of this current bill, which is by any analysis a huge step away from the barbarisms of past decades.

-jb

Fine, today is Beltway Servant Day.

Oct 30, 2009 in Health Care, Politics

The Dean Lord of Washington CW, David Broder, come up with a unique angle to attack the opt-out public option and Harry Reid: Nobody should be denied health care based on where they live!

Then maybe no goddamn states should opt-out, should they, Broder? Why is Harry Reid being blamed for trying to find a compromise with the Senators who have been trying to kill the public option altogether?

Broder suggests liberals stand against the compromise…and then? Retired to Magic Candy Land and write fan fiction about a universe where the Public Option exists, with Unicorn Coverage included?

Forty Republicans and Joe Lieberman are defying the national will, and will try to refuse to even give states the public option at all.

Why need such explicit and unfortunate facts go unconsidered?

-jb

We forgot there are 41 Republican Senators.

Oct 27, 2009 in Disappointing Dems, Health Care, Politics

It’s not so much betrayal as being plain wrong on the public option. But that doesn’t stop Joe Lieberman, who acted like a Republican until Obama came into office, minded himself, and waited for the perfect moment to declare himself the most powerful person in the country.

Lieberman doesn’t have a response to the facts, in that the public option will save money according to the CBO. He’s got his “gut,” on this, so there’s little arguing. The press is already lying down, with a few exceptions:

Lieberman has said he opposes a public option because of the potential burden it could place on taxpayers. However, Democrats have crafted a public option that would be financed by premiums rather than federal funds.

I suspect that he has his committees and seniority threatened, and Obama promises him he’ll say nice things about him. Going down in history as the Democrat who became the party of himself and killed real health care reform (and voting for the bankruptcy bill still isn’t forgotten) is just a recipe for losing his seat for real next time. Time and time again, the voters of Connecticut have been shown the folly of trusting Lieberman’s centrist cooings and assurances when he ran against the winner of the Democratic primary, Ned Lamont.

Make no mistake: Everybody supporting health care needs to be ready to make sure no filibuster gets pulled off by mere threats. This is a pivotal moment in our country’s history, and if the Republicans and Joe are going to demand the debate keep going, by all means they should be forced to debate.

-jb

One step closer.

Oct 26, 2009 in Health Care

However it was done, the public option (with opt-out) is in the bill. Holy smokes.

Harry Reid may have sensed that the only way forward for him was to get strong on a popular bill. If it took an electoral threat to put some steel in his spine, may the GOP try harder every time he’s up for re-election.

More of the usual jiu-jitsu from the WH, trying to swear at the last minute that it was all about the trigger, but Congress boxed him in on the public option! Well, that’s not the official statement, that’s the conveyed image. Obama has been repeatedly open about his desire for a public option, but then all of a sudden he developed a huge crush on Olympia Snowe. That moment of weakness gave some ownership to Congress. Now Baucus is going along, after he was a dramatic foil. It was annoying as fuck, but the bill got out of the Finance Committee.

Whatever the case, here is the bill, and Harry Reid is ready to take on any filibuster attempt. How the hell did that happen?

Oh, wait, yeah…Democrats won in 2008 running on health care. Shh…it’s a conspiracy.

-jb

The fraudulent effort to pretend Republicans have a plan.

Oct 05, 2009 in Clueless Conservatives, Health Care

They have some crappy bills their leaders don’t care about, because if Democrats incorporated them, the GOP would still vote “no.” And then their whole goddamn ruse would be exposed.

It’s about that simple. Had McCain won, health care reform wouldn’t be on the table at all. And the dead would continue piling up, while America got sicker and more broke (Grammar correction thanks to Group 2012, his only useful offering of the day/week/month/year) every day.

-jb

The public option is in.

Sep 25, 2009 in Health Care, Politics

We win the elections, we win the argument, we get the public on the side of health care reform.

Nobody’s told Rahm Emmanuel yet, but the teabaggers are turning off Americans. It became a battle of Glenn Beck vs. Obama, and America made a rather simple and obvious choice. Intellectual conservatives started defecting, and once again we’re looking at those low-30s Bush-style approval ratings for the GOP. That same crowd is staying stubborn, just staying Republican because they hate their liberal cousin who’s a pussy literature major.

Suddenly, we think we can tackle the filibuster, because scaredy cat politicians are starting to come out of their shells. “Did the Republicans stop saying mean things about us?” is their first question, but right before they crawl back in their holes they start hearing voters clamoring. “It’s okay to stand up for what we believe?” is the second question.

So to all the latecomers, the answer is, yes, it will be okay. You will win re-election because of the public option. If you’re Olympia Snowe, you will win re-election because of the public option. No Democrat in a red state will lose a race because of the public option. The policy has a firm grounding. The answers are easy to give. The opposition will still be talking about Commies. Serious retardation required to lose that election.

-jb

Wait a second…

Sep 23, 2009 in Health Care, Politics

On the possibility that some Democrat might be a chickenshit and join the filibuster:

“People have lost seats on procedural votes,” said Tad Devine, a long-time Democratic strategist. “That is what happened in the 1994 election, when President Clinton’s economic package went into law and a number of Democrats in the House lost their seats… But if you are talking about one or two people who are well established, they can oppose legislation on the merits but allow it to come to a vote and I don’t think that’s enough to cost them a seat.”

News flash: No Democrat could lose an election over providing health care. I’m glad it looks good to clear a filibuster, but any Democrat scared of losing his seat over a yes vote on the public option is a goddamned pansy.

Still, 51’ll do, pig.

-jb

Harry Reid again claims to have a pair.

Sep 22, 2009 in Health Care, Politics

Watch out with those threats, Harry! Republicans might say mean things about you!

If you don’t mean it, Harry, then hand over the reins.

-jb