You should hope the Republicans and Lieberman filibuster it to death

[JackRiddler]

There's no definitive form of this thing yet, so I hope my assumptions of what will be in it are wrong, but consider the following:


A LAW
1) Mandating health insurance policies
+
2) No binding fee schedule for standard procedures and drugs

EQUALS
- Unparalleled profiteering opportunities for insurance & health sector companies
- Further bankruptcy of working class and poor people.


FURTHERMORE, A LAW
3) With a weak public option not available to all
+
4) Restricting availability only to the people insurance companies don't want to cover (i.e., the sick and at-risk)
and/or
5) Including state triggers or opt-out clauses

EQUALS
- Rigged game in which public option plans appear to fail in comparison to private insurance
- Republicans get a potentially winning issue for 2010.
- Reinforcement of the "Red America vs. Blue America" paradigm, just when it's on the ropes (right now it's more like everyplace vs. south).


IN ADDITION:

6) Too much complexity breeds endless loopholes for corruption and allows bad actors to use divide-and-conquer to sow conflict between economic and professional classes. Confusion is a breeding ground for demagogues.

7) The "Cadillac Plan" tax is an example of a misguided idea that will cause divide-and-conquer. The point should not be to punish those with good plans! We should want as far as possible to provide EVERYONE with a "Cadillac Plan."

In short, the insurance and health sector lobbies are still too strong relative to the movement. The monied-up Democrats are accordingly opportunistic and accommodating with false compromises. The lobbies are getting what they want and they even get to complain about it - keeping the cake and eating it too.


LUCKILY THE REPUBLICANS CAN STILL SAVE THE WORLD!

A) Let them filibuster and kill it. (Their victory celebrations will make for one sick polit-porn film.)

B) This will mobilize millions of people to march, lobby and fight for comprehensive, single-payer universal health care next year.

C) The Republicans suffer unprecedented losses for a midterm election and everyone knows it's because of A.

Then you can get a real single-payer health care program on the European model in 2011.

Or else: a strong public option that makes Medicare more comprehensive and offers it as an option to all citizens (including workers) without exception, with a binding universal fee schedule, rationalized premiums and subsidies for the non-working and poor. In the end, that would amount to the same thing.

[Captain Hilts]

1. YES!

[JackRiddler]

2. Thanks, Mookie!

Looks like I got my first unrecs inside a minute. Curious.

[Captain Hilts]

3. If congress critters aren't ashamed of their vote, then they won't mind going on record!!!

I don't 'get' the UNrecommends here at all!

Rooting for the Phils this go 'round:

[CrispyQ]

5. Dude, don't you realize Obama's playing chess & he's 10 steps ahead?

:eyes:

Like you, I hope what you summarized isn't what we're going to get, but I'm not holding my breath.

Great post. A hearty K&R from me!

[JackRiddler]

27. Ha! If he's really playing chess, then he should want to follow the above strategy...

imagine he gets blockaded until 2010 and parlays that into something almost unprecedented: mid-term election gains for the incumbent party.

Suddenly things beyond the "pragmatists" imaginations will become possible.

[rhett o rick]

54. If he is playing chess, he certainly has me fooled (that's actually not that hard). Looks like he

has lost some of his major pieces. Nancy will give us the bad news today.

[Bobbie Jo]

4. K&R

:kick:

[sabrina 1]

6. I agree. This is a terrible bill.

In your third list, regarding those the Insurance Industry doesn't want, the sick and dying, who will quailify for the weak PO. Won't the Insurance Corps profit from those people also? Does the payment for their care go through the middlemen also? Not sure if I read that right somewhere.

[JackRiddler]

29. Those are the people who actually cost money to the insurance companies...

so they get kicked out for "prior conditions" and such. Making a public option that doesn't allow the relatively young and healthy to join means it will run at ever-greater losses and become the dumping ground for the insurance companies who take premiums long as a person is healthy and then find an excuse to cancel coverage when they get sick.

[slipslidingaway]

7. knr - I was #7 n/t

[Ozymanithrax]

8. Both Medicare and SChip were weak to bad bills when first passed.

They were improved over time.

What we have now doesn't work and will just get worse.

Something must be passed.

All or nothing thinking here will just make things worse.

[slipslidingaway]

9. Medicare was open to everyone 65 and older, the government did not give subsidies

to people over 65 to purchase private insurance, therefore knocking out the competition.

Medicare had a ready pool of subscribers which allowed them to negotiate prices with providers, the public option has no such ready pool as people can chose to purchase from a private insurance company.

Over 90% of seniors were enrolled in Medicare by the end of the FIRST year.

Obama says that just over 3%, according to the CBO estimate he quoted, would be enrolled in a public option by 2019.

The basic benefits were automatically available to everyone over 65 and financed by an increased payroll tax.

It did not have to be self-financed in contrast with the current public option bills.


http://www.politifact.com/truth-o-meter/statements/2009/sep/16/tom-price/medicares-history-public-option/

...Here's how an April 8, 1965, report in the New York Time's described the plan:

"As revised, the bill provides the basic hospitalization and nursing care benefits originally proposed by the administration while covering major doctor bills and many other medical expenses under a supplementary insurance program in which participation would be voluntary.

"The basic benefits, financed by increases in the Social Security payroll tax, would be automatically available to persons over 65. The additional coverage would be available to those over 65 who enrolled in the voluntary plan and paid premiums of $3 a month. Half of the voluntary plan's cost would be financed by federal subsidies of about $600 million a year from general tax revenues."

Johnson signed the Medicare law on July 30, 1965, and the program's aministrators began an intensive recruitment drive. At the end of the first year, participation was up to 93 percent of the elderly, according to The Politics of Medicare , a history by Theodore Marmor.

As we reviewed the history of Medicare, we noticed that legislators and policymakers drafting the legislation seemed to assume that Medicare participation would be very high. We could find nothing implying that Medicare coverage would compete with private insurers in paying for coverage...

This is markedly different from today's debate and discussion about the public option. Obama has said the public option would be one among many insurance proposals from which people could choose, and that it would be a backstop to keep private insurers honest. He also said it should not be subsidized by other tax revenues but pay for itself with customer premiums..."

[rhett o rick]

16. I dont agree. We have already compromised away from single payer. Compromise no farther.

A robust public option or nothing. If the Democrats cant do it with the public demanding a strong public option, it will never get done.

If the Democrats fail to give the public what they are demanding, the public will lose faith completely.

Draw the line in the sand. Force the republicants to kill the bill.

[bvar22]

38. The bad news is:

There is NO "robust" Public Option on the table.
The MOST Liberal Plan in Congress (HR 3200) includes only a "tiny sliver" (Obama) of a Public Option that isn't available to The Public.

As it now stands, HR 3200 IS a massive transfer of Public Money (Mega-Billions) to the For Profit Health Insurance Industry with a few crumbs (shiny object) thrown to the peasants for diversion.

[Ozymanithrax]

47. Compromise? .Single payer was never on the table, never part of a bill.

Never.

It would make sense, and be the best we could ask for, but single payer was never a contender in this process.

So your vote is another 50 years with nothing.

[John Q. Citizen]

57. So passing anything is the plan? Even something that will bankrupt us further and enrich private

insurance companies further and give them more control over our lives?

That is your plan?

No thanks.

Have you bothered to consider why that plan is "on the table" as you like to put it?


Your thinking process reminds me of how we got into Iraq.

Something had to be done, after all. And they did it! They did it to us and they did it to the Irquis and they did it to the whole world.

It was a shitty plan, but it was on the table.

[Ozymanithrax]

64. My thoughts are humanitarian. This plan will get insurance for more people...

That is what we need to do rather an continue to allow 40,000+ people to die every year. Cutting that number is an important humanitarian goal, even it it "Bankrupts us further." I will double or triple my taxes if we can cover everybody. Humanitarian needs not money should be the issue.

Actually, I've watched closely all the plans that have been put forth. No single payer plan was ever in serious contention. It was never going to happen. The best chance was to get some form of public option that could grow over time. Once a public option gets on the books not even Republicans will be able to kill it. We still have a good chance of doing that. The other thing that was critical, was to remove the anti-trust provisions from our law that allow Health-care insurance companies to create private monopolistic fiefdoms. There is a good chance that will happen in the final bill. Any bill they pass will cover more people.

If it costs a little more, well that is called civic responsibility.

[John Q. Citizen]

69. Iraq was humanitarian also, as I recall. Giving money to insurance companies isn't humanitarian,

it's greedy rip off, and that money doesn't go to health care it goes to enrich the few.

If you need a little bit of evidence, look at Massachusetts. They have some of the most expensive insurance in the country now, and they are cutting peoples benefits because it is too expensive.

They require mandatory coverage. They ended pre-existing conditions and instituted modified community rating.
The insurance companies love it. Just like they love the Obama plan. People are getting less and less coverage.
That's not humanitarian.

If it costs more, that is called more rip-off. Don't try to piss on my leg and tell me it good because the drought is ending.

Blackwater loved going into Iraq. So did Lockeed. It wasn't because they are humanitarian.


You may be one of the people Lincoln was referring to when he said, "..You can fool some of the people all of the time.." but I'm not part of that group.

[Ozymanithrax]

71. I call allowing people to die for political gain un-humanitairan.

There is no perfect bill possible in this political climate.

So the question is, do we help more people or just continue let the problem get worse and allow more to die.

Humanitarian needs must come first. We get more people some kind of health insurance, even if it is more expensive, and we pay for it.

[John Q. Citizen]

78. Yep, that's exactly what bush said about Iraq. And a lot of people believed him.

See, just like Iraq, it's always cast as "somethiung has to be done right now, and the something is this!

Well something does have to be done. But lets not do something that will make our problems worse.

That's what we did in Iraq.

This health care bill, as written, is bad public policy. It wastes resources that are needed to help people.

For one thing, it has no cost containment.

Cost is why people go without health care. It's already too expensive and this bill will make it even more expensive. Even more people will have to go without health care when you drive up the cost.

Sending tax money to the mafia isn't humanitarian. Subsidizing criminal oirganizations, like the health insurance companies isn't humanitarian. It's criminal.

[cascadiance]

80. That IS the problem! "Capitalism" simply doesn't work for areas where people HAVE to have a service

... or product to survive in a meaningful way. It is those areas (like health care, energy, food, fire protection, law enforcement), etc. that simply can't be "traded" based on a supply and demand curve like traditional capitalism can be used for other goods and services. For capitlism to work, there needs to be a price point where people can say "Nope, too expensive for me. Not for me." That doesn't work when you have things they HAVE to have to survive. Especially if there are monopoly protections for things like health care services.

We learned a while ago it didn't work for fire and police services, and moved those to the socialist model of being provided by the government. We have to look at health care the same way. It's affected us with privatizing our military too, which has also lead to heavy efforts of profiteering there as well, where you don't have true supply and demand curve at work for governing what kind of business takes place.

We need to stop this NOW or it will only get worse. And instead of the people now being the only ones that die with the current status quo, the newer bill will swallow more people up in to the debt mess by requiring them to hand over more of their money to the elites running the country and its just a matter of time before everyone is either dead broke or dead physically of health problems.

I think that we need to start pulling off the gloves and say if they are going to play hardball with us, it's time for us to play hardball with them.

Perhaps now we should be looking around the country for our local court systems to see if we can find some that have both prosecutors and judges that are sympathetic to the notion that these "corporate persons" are the primary culprits for people dying from lack of health care, etc. and are prepared to rule on cases to help fix this problem.

Then if we can find a prosecutor for example in L.A. to charge CIGNA as a "corporate person" with the crime of murder for someone like Natalee Sarkisiyan, and then we get the judge to get them found guilty and sentenced as a "person" to death.

Now if it goes up the appeals ladder, and they try to invalidate it, if the court case decision is written well enough, perhaps it can be used to either:

a) force CIGNA to be broken up as part of the "death penalty", or some other very nasty punishment that other insurance companies won't want to have pushed on them.

or better yet

b) force a higher court to dismiss the notion of "corporate personhood" as it doesn't apply in this case, in order to preserve a company like CIGNA, and basically strike it down as unconstitutional interpretation of the law.

So in either case we win. Either we start killing off companies that are killing our people with these practices, or we kill off the notion of "corporate personhood" and perhaps with it things like "corporate free speech" that can help us reform our election system to go to public campaign financing or something better to take these corporate lobbyists out of the loop in shaping our future legislation and perhaps help us "clean out" congress of the bribery loving crooks.

If we can't find courts within L.A. that might do this in the case of Natalee Sarkisiyan, surely there are other locales where similar egregious insurance company behavior has occurred that has led to the death of other individuals where we might have a friendly court to do this.

[JackRiddler]

85. Are you really going to take out that moral cudgel?

Support health reform, even if it's not reform, or you will be killing people!!!

This is right out of the Bush propaganda playbook. You should be embarrassed to try silencing criticism with that kind of sledgehammer.

People are dying in this country because of a health care system with skewed priorities, and therefore you shouldn't support any proposal that may serve to keep the priorities skewed for many more years to come.

[JackRiddler]

28. "Something must be passed" = "All or nothing thinking"

For counter-examples to the idea that "something," even if terrible, is better than "nothing," look to the history of "campaign finance reform." Each phase of it has made an even greater Beast out of money-power's stranglehold on the political system. All along, only public financing and free media access for all candidates could possibly loosen it -- which is why such ideas though normal in many countries are defined as utopian, and we are suckered every decade with a new set of "reforms."

[John Q. Citizen]

58. Very good points. You can fool some of the people all of the time, apparently.

[Nay]

87. My fear is that a crummy bill will be passed, and not only will we be

stuck with a crummy bill that further enriches the health ins companies, but then we'll have to listen to the RW yowling forever after about how "gubmint socialist healthcare doesn't work," thus dooming any robust plan in the future.

[John Q. Citizen]

55. Medicare wasn't weak, at all. CHIP is gov subsidized private health insurance

Your thinking is poor. It isn't rational, and it isn't factual.

Poor thinking leads to poor outcomes.

Please study up and please try and think clearly.

Thank you.

[Fading Captain]

93. Insurance industries fuck us over. Solution: Law requiring us to give money to insurance companies

That;s fucking brutal.

[mike_c]

10. agreed 100 percent....

Single payer in 2011 would be WAY better than any of the current turkeys that are likely to come to a floor vote in the House or Senate EXCEPT HR676, which would establish single payer reform. The half-assed measures the Senate is likely to vote on would be a set-back, not progress. Let the republicans and blue dog democrats exhaust themselves fighting against the current of public opinion by blocking the current reforms, then replace them, and enact real progressive reform in 2011.

Right ON!

[laughingliberal]

11. I like the scenario but I question that millions will mobilize next year.

More likely we won't see reform attempted again until the premiums and costs of health care double again.

[JackRiddler]

31. I don't know that either but it becomes possible ...

assuming the Republicans kill the bill and then the reform movement and the Democrats push for public mobilization next year.

But if a bad bill passes and it becomes common wisdom that it sucks, what do you think will happen in 2010?

[GreenPartyVoter]

40. Agreed on both counts.

[slipslidingaway]

12. Drum Roll ... House Health Care Bill To Be Unveiled Tomorrow

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8720226&mesg_id=8720226

October 28, 2009 2:20 PM

Speaker Nancy Pelosi couldn't get the votes for the "robust" public option she prefers, but she is ready to roll out a health care bill.

Karl_2 ABC News’ Jonathan Karl has the story:

After weeks of intense, closed-door negotiations with House Democrats, Speaker of the House Nancy Pelosi plans to unveil her health care bill tomorrow.

The roll-out is tentatively scheduled for 10:30 am on the West Front of the Capitol building. This is the bill the House will debate and vote on – probably next week.

According to sources familiar with Pelosi’s plans, here are some key elements of her bill:

- It includes a public option, but it will not be the Medicare-like public option she wanted. The government-run insurance company created by her bill would negotiate payment rates with health care providers just like private insurance companies. Pelosi simply could not get the votes to pass the “robust” version she prefers..."

[rhett o rick]

19. So Rep Pelosi failed us. nt

[quiet.american]

22. The bill still has a public option - not "Medicare for All," but it has it.

No "failure" there. The government would still have the power to negotiate rates with the insurance companies.

[rhett o rick]

33. And those rates will include profits for the insurance companies. This is not a win. nt

[quiet.american]

45. The government will be negotiating directly w/doctors & hospitals - not the insurance co's.

In my earlier post, I initially misunderstood the info, but if I understand this quote correctly --

The government insurance plan would negotiate rates with doctors and hospitals, as private insurers do.

http://www.nytimes.com/2009/10/29/health/policy/29health.html?hp

It really becomes clear why the insurance companies are terrified they'll be put out of business -- if they are to seriously compete, sooner or later they're going to have to lower their prices.

[closeupready]

59. If it's not robust (and it's not), it's a failure.

n/t

[quiet.american]

66. Set rates (Medicare rates) were the "robust" part; costs will still be lower.

Public option is still in and government-negotiated rates (directly with doctors and hospitals) will be lower:

Interesting reason given, though, for the Speaker relenting on set rates:

The government insurance plan would negotiate rates with doctors and hospitals, as private insurers do. Payments would not be based on Medicare rates, as Ms. Pelosi had wanted. Democrats from rural areas balked at the use of Medicare rates, saying they were so low that hospitals could not survive on them.

http://www.nytimes.com/2009/10/29/health/policy/29health.html?sq=pelosi%20rural&st=cse&scp=1&pagewanted=print

[JackRiddler]

63. If it's an "option" can anyone in the "public" choose to take it?

[quiet.american]

67. 96% of Americans will be covered, according to what was said today.

http://prescriptions.blogs.nytimes.com/2009/10/29/pelosi-unveils-house-health-care-bill/?hp

<snip>
The House speaker, Nancy Pelosi of California, on Thursday unveiled a $894 billion health care package that would provide insurance to up to 36 million people by broadly expanding Medicaid, the state-federal insurance program for the poor, and by offering subsidies to moderate-income Americans to buy insurance either from private carriers or a new government-run plan.


<snip>
Mr. Dingell went on to say that the House bill meets the goals set by Mr. Obama of being deficit-neutral and providing coverage for 96 percent of Americans.

“This bill offers everyone, regardless of income, age, sex and health status, the peace of mind knowing they will have access to real quality health insurance when they need it,” he said.

[JackRiddler]

72. Will 96 percent of Americans have the option of the public option?

And what will this plan offer? The bill is 1,990 pages long. Confession: I probably won't read the full text, but I will read the legal expert summaries when these become available in the next few days. Let's see then what these claims are based on.

[quiet.american]

74. What's most important to me is coverage - and that almost all will be covered.

If I am able to have health insurance, whether it comes through the public option or another part of the bill, that's what's most important to me. However, I am very pleased that the public option is still included; this is what I expect to find in the plan - not everything, but a good portion:

The Obama Plan:
http://www.whitehouse.gov/issues/health-care/plan

If You Have Health Insurance

Ends discrimination against people with pre-existing conditions.

Limits premium discrimination based on gender and age.

Prevents insurance companies from dropping coverage when people are sick and need it most.

Caps out-of pocket expenses so people don’t go broke when they get sick.

Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money.

Protects Medicare for seniors.

Eliminates the "donut-hole" gap in coverage for prescription drugs.

If You Don't Have Insurance

Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.

Provides new tax credits to help people buy insurance.

Provides small businesses tax credits and affordable options for covering employees.

Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice.

Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. For those Americans who cannot get insurance coverage today because of a pre-existing condition, the President’s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.

For All Americans

Won’t add a dime to the deficit and is paid for upfront.

Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality.

Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.

Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.

Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform. Under the President’s plan, large businesses – those with more than 50 workers – will be required to offer their workers coverage or pay a fee to help cover the cost of making coverage affordable in the exchange. This will ensure that workers in firms not offering coverage will have affordable coverage options for themselves and their families. Individuals who can afford it will have a responsibility to purchase coverage – but there will be a "hardship exemption" for those who cannot.

[JackRiddler]

75. I would not want to be forced into a particular form of coverage.

I don't want to give insurance companies a 10 percent margin to feed their executives and auditors (coverage deniers). Although that is currently the case, as it is my only option. If the public option is available to everyone regardless of employment or where else they may be categorized within the plan, and if it covers in the same way as Medicare plus, then I'm for it.

[quiet.american]

77. If buying health insurance lowers rates for others, I'll do it.

Health insurance for me right now is a "luxury" and not an urgent necessity. However, I'm very aware that for others in this country, health insurance means the difference between life and death, a house or no house, or extreme stress vs. peace of mind.

If I don't qualify for the public option, so be it. My perspective is the glass half-full one -- that others will be able to have the insurance they need because we're all participating.

[slipslidingaway]

24. You mean Medicare rates plus instead of negotiated rates ....

http://firstread.msnbc.msn.com/archive/2009/10/28/2111291.aspx

"...And it looks like the "robust" public option is a bust: The measure is not expected to include the reimbursement rate to medical professions based on Medicare, plus 5%. Instead, it will include a public option based on rates negotiated region by region..."

Last month...

Pelosi To Allow Public Option To Use Medicare-Like Reimbursement Rates In Final House Bill

http://wonkroom.thinkprogress.org/2009/09/22/pelosi-medicare-public/

[rhett o rick]

34. I mean we need single payer and settle for a government operated (not insurance co. operated) plan

that would have low operational expenses like Medicare. If the insurance companies get to operate the "public option" they will have higher prices because they will include a profit. Worse than nothing to me.

[slipslidingaway]

37. I agree about SP - the Dems will not even get an estimate from CBO...

maybe they'll give a figure a few days before Weiner offers his amendment.

:(

[Jakes Progress]

13. Given what the bill looks like,

that could be our best hope and the only chance the Democrats have of salvaging this mess.

[Name removed]

14. Deleted message

Message removed by moderator. Click here to review the message board rules.

[rhett o rick]

17. Nice talk Yavin4. nt

[Name removed]

18. Deleted message

Message removed by moderator. Click here to review the message board rules.

[rhett o rick]

20. I didnt read it that way. I believe that if the Democrats pass a piece of crap

we dont WIN, we lose. I read the post as saying that Democrats should only take credit for passing a good bill. Let the republicans defeat a crappy bill.

But apparently you dont want a dialog.

[dionysus]

23. amazing, isn't it? the failers have gone 'round the bend...

[rhett o rick]

35. We have the momentum. 70% of the public is behind the public option. Why give that up

and settle for a piece of crap that will piss off everyone in a year or two. We have compromised way to far already.

[dionysus]

39. i still have faith we'll get a decent PO. if i'm wrong i'll acknowledge you guys were right.

[rhett o rick]

43. I certainly hope you are right. nt

[no limit]

15. Yeah, the same democrats that cant legalize pot

Can't regulate wall street. Cant get us out of Afghanistan or Iraq. Can't stop torture. Can't close gitmo. And can't do a bunch of other things americans largely support will get you single payer system.

Keep dreaming. Me personally? For now I'll be happy with a public option and the inability for them to deny me care for preexisting conditions or drop me when I get sick. Its not perfect but its a start and I will fight for it; I hope you do too.

[Parker CA]

30. +1 especially the preexisting conditions/dropping care when sick part. ;)

[John Q. Citizen]

60. Kind of like a guaranteed pension from a major corporation? Ha ha ha ha

some people will fall for anything even as the evidence is right in their faces that they are being had.

Sure, the criminal insurance companies are going to stop behaving like criminals, if we bribe them enough!

Do you really believe that? I mean really?

[quiet.american]

21. Why would I root for that? Obama already has 80% of what he wants.

And here's what he wants: (But why would I even want to root for Obama to fail on such an important initiative anyway? -- which is the basis of what you're saying)

The Obama Plan:
http://www.whitehouse.gov/issues/health-care/plan

If You Have Health Insurance

Ends discrimination against people with pre-existing conditions.

Limits premium discrimination based on gender and age.

Prevents insurance companies from dropping coverage when people are sick and need it most.

Caps out-of pocket expenses so people don’t go broke when they get sick.

Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money.

Protects Medicare for seniors.

Eliminates the "donut-hole" gap in coverage for prescription drugs.

If You Don't Have Insurance

Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.

Provides new tax credits to help people buy insurance.

Provides small businesses tax credits and affordable options for covering employees.

Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice.

Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. For those Americans who cannot get insurance coverage today because of a pre-existing condition, the President’s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.

For All Americans

Won’t add a dime to the deficit and is paid for upfront.

Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality.

Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.

Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.

Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform. Under the President’s plan, large businesses – those with more than 50 workers – will be required to offer their workers coverage or pay a fee to help cover the cost of making coverage affordable in the exchange. This will ensure that workers in firms not offering coverage will have affordable coverage options for themselves and their families. Individuals who can afford it will have a responsibility to purchase coverage – but there will be a "hardship exemption" for those who cannot.

There would be no "win" in this for the Democratic Party if this bill is defeated by delay and filibuster. And I disagree that it would "mobilize" people. More likely it would demoralize them, and rather than marches, etc., what is more likely to happen is a big increase in shoulder-shrugging cynicism. Single payer by 2011 by way of defeating this bill? Just don't see it happening that way.

Even eighty percent of the above would be a damn sight better than 100% of what will happen should the Repubs/Lieberman succeed (which they won't).

[Vinca]

25. Harry and Nancy should cook up a Medicare Part E bill to

run through with 51 votes if the current scheme fails because Lieberman and his Republican friends filibuster it.

[rhett o rick]

53. Actually they should have run that up the pole first. Give the republicants lots to filibuster.

The public will get tired of it and mite demand they behave. I doubt it, but nice dream.

[JackRiddler]

76. See now this is the idea - make the debate about something good and simple...

extension of Medicare to all as option, for example. Then there are clear battle lines and the disinformation is minimized.

[Occam Bandage]

26. Yes, because (B) and (C) happened after the Repukes defeated Clinton's health-care bill, right? nt

[JackRiddler]

32. That's not how I remember it.

Clinton's proposal also sucked, if that's what you mean.

But there's no comparison as far as relative support in the public. The teabaggers can march in their tens of thousands, fact is the million millions are not buying the propaganda this time around. People have become highly aware of how insurance companies and the health care system fucks them up every day.

Neither "single payer" nor "public option" were in that debate, and if they are today, it's because of the overwhelming public support. The process back then was driven by the "findings" of HRC's study board, Obama's been smarter perhaps not to go that route - although the Congressional process today is amounting to the same pretense as back then, that the problem's too complex, and then letting the insurance companies bastardize the proposals further.

I'm saying, rather than killing reform by passing a fake version of it that fails, let the Republicans block it for a year more against the wishes of the American people, and let the people vote out the miscreants who did that.

PS - Thanks for reading. I mean that seriously, at least you got to B and C.

[DefenseLawyer]

36. There is iron in your words of death for all DU to see. n/t

[JackRiddler]

44. Um, what does that mean? Are you agreeing?

It's a quote from Outlaw Josey Wales, but I never saw the movie.

[tiny elvis]

50. so there is iron in your words of life

defenselawyer just cracked me up
he was being positive, surely

[DefenseLawyer]

79. You should watch it.

Every entertaining. The quote means you aren't bullshitting. I am agreeing.

[JackRiddler]

94. Thanks, Dude!

[Bonn1997]

41. Do you really think the Republicans would be blocking a bill that would lead to "Unparalleled...

profiteering for the insurance companies"? I'm not saying you're wrong; I'd just have trouble understanding the scenario you're describing.

[JackRiddler]

42. Weirdly enough, I think even the insurance companies would do so...

They're already sitting fat. Why should they want any kind of shakeup? That means new rules, new winners and losers. They're scrambling to get their provisions in. But what's the big picture with mandates and without a universally available public option or fee schedule? It amounts to forcing new business on them!

As for the Republicans, they're hardly rational right now. Everything's ACORN, you know? But if the plan passes and proves to be a bust, they benefit most if they opposed it.

[John Q. Citizen]

61. Follow the money. Right now the Dems are getting far more insurance/health care money than the Repos

are.

[TorchTheWitch]

90. When it's Dems that will be getting the campaign loot absolutely

Repubs have only ever cared about bowing to big business because they got big campaign dollars from big business for doing so. Dems started doing the same because they believed they couldn't compete with Repubs without big campaign money from big business. Repubs want this to fail because instead of them getting big campaign dollars from Big Ins. now Dems are going to get those big campaign dollars.

ALL that matters to politicians anymore is getting big campaign money to either get a seat in power or keep their ass in that seat. This is exactly why until we change how we do campaign financing big corporations own our government on both sides of the aisle lock stock and barrell. The wishes of big corporations will cease to matter when they can't buy politicians.

[Lydia Leftcoast]

46. Have to agree with you

Having no reform would be better than the corporate welfare plan that seems to be gaining traction in the Senate.

[Overseas]

48. K&R. //nt

[pnwmom]

49. Dream on. n/t

[TheeHazelnut]

51. "This will mobilize millions to march next year" -- Based on what evidence?

Most people are too busy fighting to feed their families.

[JackRiddler]

62. My assumption is that there are real fighters in politics who would mobilize it.

That's often been the case, including - no, especially - in times of the greatest distress. It should be a real embarrassment to the Democrats who think they're effecting change that the teabaggers had the biggest demonstration in Washington this year (at a "whopping" 40,000 or whatever pathetic total it really was). But all these supposed liberal organizations are in "shut down, e-mail, wait for Obama" mode.

What you're saying is kind of absurd in the context of every revolution or upheaval in history, where people who had to "fight to feed their families" were the first to fight to change that condition. If there had been no pressure from below, the New Deal would have died too. Given the treatment Americans are currently getting from the economic overlords, every other country in the world would be seeing large protests in every form. Are Americans the only people content to be milk cows?

[SammyWinstonJack]

52. K&R!

[chimpymustgo]

56. K & R. This "reform" SUCKS.

[BrklynLiberal]

65. I have this sinking feeling that you are 100% correct...

I only hope that you are right about the huge mobilization that iwll occur and that we WILL get single payer coverage.

[Nikki Stone1]

68. I rec'd because it's interesting,

..

[freddie mertz]

70. K & R. This bill sucks and deserves to die.

Not to mention the disaster its passage will likely inflict on the Democratic party.

I hope enough progressives refuse to support it so it dies.

[slipslidingaway]

73. kick - even more so since they stipped out the Kucinich SP amendment...

negotiated prices per region with providers etc.

[cascadiance]

81. Any comments from Howard Dean yet on this?

He was confident we'd get a "good" public option in a bill before December. If he's disappointed, he should be leading the charge to help us say "NO!"

[andym]

82. The house bill has one VERY important effect that may be worth passing

It strips the anti-trust exemption from the insurers.
That will have profound effects on their business model and allow federal trust-busting if needed (and it is).

[Libertas1776]

83. I hope this garbage fails

I hope this garbage fails. I hope this garbage FAILS.

The bill must die.

[Myrina]

84. Too late to Rec, so here's a KICK!!!

:applause: THANK YOU! :applause:

[JackRiddler]

86. kick!

[CTLawGuy]

88. This is where you're mistaken

You say it only covers the sick and high risk and is not available to everyone, so therefore the PO is bad.

The bill makes the PO available to anyone who

1) is unemployed OR
2) whose employer does not offer health insurance.

Effectively, unless you can get health insurance through your employer, you can sign up for the public option.

That includes, yes sick and at risk people (heaven forbid they should be covered!), but also healthy young people possibly in grad school who are not on their parents' insurance or young people in school whose parents don't have insurance. Also, self employed people presumably could sign up, small business employers and employees where the small business cannot afford insurance could also sign up.

Furthermore, there will be no trigger, and no state will actually opt out. Too many people want the PO. Tell me which state whose governor blustered about refusing the stimulus money actually refused the stimulus money? You couldn't.

So your bleak assessment is not altogether accurate.

[JackRiddler]

92. We'll see - however note the OP was written before the Pelosi rollout of yesterday

Thus the conditional, if/then statements.

First of all, your words, "sick and at risk people (heaven forbid they should be covered!)" are a blatantly unfair characterization what I said. Rather than taking it as a provocation, let me be clear: of course I want everyone covered. That's the point.

However, a public option shouldn't be a place where insurance companies dump the people they don't want to cover any more. It's the insurance companies who have been pushing out the sick and at risk (who are also disproportionately represented among the unemployed), and rather than reinforce this practice, a truly robust public option allows the general population to join, leading to a robust financing model.

Can an employer offer the PO?

All of which emphasizes something important I forgot to add to the OP:

If the PO isn't allowed to all people, not just as you say those without employer insurance, then it doesn't compete directly with employer private insurance and therefore acts as no brake on the rise of patient premiums or co-pays. (As you phrase it, the PO would compete directly with private insurance only for the group who are employed but have no employer plan.)

The law can of course introduce a variety of proscriptive measures, such as profit limits on overall insurance business (something the insurers will look immediately to circumvent through the kind of creative accounting that is routine); premium tables or bans on denying insurance or ending due to "prior condition" (something that can work, but encourages premium and copay rises). All of this invites the insurers to find more ways to game the system.

Why add layers of complexity? Clearly, it's to accommodate the loophole needs of the insurers and health sector businesses. Why not a straightforward offer of strong PO for all, with no copays, universal fee schedule (on standard procedures) and the same premiums across the board, premiums set to cover overall costs and no more, employer option to pick up 1/2 of the payments (or obligation for businesses above a certain size)? Add $30 billion a year to finance research and development in the health sciences, offer a decent federal malpractice insurance so the doctors shut up about "tort reform," and voila.

[Rockholm]

89. FOLLOW THE MONEY......

Watch the stocks today of the big insurance companies, Big Pharma, hospital corporation, and any associated company, anything that has a hand in providing health care, coverage, etc.
If they spike, then the game is rigged and they show their hand. If they are in overwhelming support, then that means they benefit. Big time.
Jack, your assessment is chilling. I just read about the sweetheart deals BigPhara is getting regarding non-compete with generics. Truly frightening.

[TorchTheWitch]

91. I absolutely agree

This repulsive gift to the health insurance industry that won't bring down costs and won't actually help anyone but a minute percentage if that needs to die.