I think mandates were just blown out of the water on Morning Joe

[Phoebe Loosinhouse]

They showed the clip of the Pres with Stephanopoulis where they debated whether the insurance mandate/penalty was a new tax and George pulled out his Miriam Webster. I have to say, I did not see that show yesterday except for the Round Table, so I missed that exchange. On the face of it, I would have to go with George and his dictionary. President Obama deflected, although not overly successfully in my opinion. Now -

Ok, so they have on Mike Allen from Politico, and he's all happy and gleeful as he reads from Baucuses' bill language that says that if someone does not purchase insurance they will be penalized in the form of an "excise tax". Then they all went nuts. They feel they have proved that mandating insurance is a form of a tax and that the penalty definitely is. I personally think the majority of Americans would agree with them.

So, I think, give it a little more time to be blasted from the rooftops and you will see the end of mandates. Many here have questioned their legitimacy/efficacy and I can't disagree. President O's first instincts to be against them as outlined by Hillary in the primary were on target and I think he needs to backtrack.

So where does that leave us? I think that any bill will HAVE to offer a low-cost public option - yes, MEDICARE, as a CHOICE and an alternative to mandated private plans. There is just no frigging way around it, no matter how hard they try to twist themselves into pretzels to avoid it.

I have one other thought - if we are so gung ho about free markets, competition, etc. - why don't we allow international health insurers from Germany, Sweden, the Netherlands (all countries held up as examples of public/private success) to market their plans in the US? They have already proved the ability to provide lower cost insurance with better outcomes than what we have here- no doubt because their citizens are too smart and informed to allow their companies to siphon off profit and funnel it to the execs at the expense of everyone else. American insurance companies will just have to do as well or die off due to their lack of competitiveness - they are no different than any other industry.

****************************************************************************************
edit to add name of Politco guy - thanks Babylonsister.

[babylonsister]

1. The guy was mike allen from politico. nt

[Phoebe Loosinhouse]

2. Thanks so much - I will edit my post to reflect the info.

Not a surprise it was Politico. He was so giddy with his discovery of the "excise tax" language I thought he was going to fall out of his chair.

[babylonsister]

12. The thing is, it's in the Baucus bill, but that bill hasn't been approved by

a long shot. Perhaps that part of his bill has been thrown out with so much of it by people with clearer heads.

Just because allen 'found' it there doesn't mean it will wind up in the final bill, so it's much ado about nothing imo.

[DrDan]

3. how about this - allow the purchase of pharmaceuticals from Canada?

oh yeah - already addressed and resolved.

Our brand of capitalism involves maximizing corporate profits, not providing "gooder services" at lower prices.

[Phoebe Loosinhouse]

4. Our capitalism has become a parasitic mutant that can't see it's bad to kill the host (consumer)

It's all about the unrestrained GREED that allows companies to just plunder and loot the consumer, their employees, and even their own stockholders as they transfer all profits to the upper tier of executives at the expense of everything and everyone else. Often the wretched excess kills off their own company, but they don't care, because they got theirs.

As to the re-importation of drugs - you say that's already addressed and resolved. How do you mean? Is that addressed in any single bill currently before Congress?

[DrDan]

5. it was a tongue-in-cheek comment

while you have a good idea re foreign insurers, it will not happen - similar to the pharm protection.

I would like to see it - look how it has forced our car makers into reality. But . . . we are bending over backwards now to placate these lobbyists - and money rules - as you say.

[BzaDem]

6. Hate to break it to you

but a mandate is a mandate, whether or not there is a public option. A mandate to buy health insurance when there is a public option available is still a mandate to buy health insurance. So all of your arguments against a mandate similarly apply to any healthcare reform bill with a public option. The truth is that if there is no mandate, there will be no healthcare reform bill. Not a chance in hell. You can't end discrimination on the basis of pre-existing conditions without a mandate. There isn't a single healthcare economist that I know of (liberal or conservative) that believes otherwise.

The truth is, you aren't really opposed to mandates at all. After all, your preferred approach (single payer) is one giant mandate, funded by an actual tax increase on the middle class (by definition). You really have no problem with mandates funded by taxes at all. You just aren't particularly thrilled about having to give money to a private company. That may be with very good reason. But that is really as irrelevant as it gets as to the issue of whether or not there is a mandate.

[Hello_Kitty]

7. You're right but at least a tax for single payer or a decent PO

Is a straightforward tax and not a compulsory purchase of a private product with little to no accountability.

[Captain Hilts]

19. As in Ontario. nt

[Phoebe Loosinhouse]

8. I don't actually disagree with you at all.

But I find the resistance is coming from people who feel that they will be compelled to purchase a private product that in all liklihood will STILL be unaffordable for them without a less expensive public option being offered or being offered to just a very few. All the figures/estimates I have heard bandied about are STILL crazy because the major emphasis coming out of our Congress is NOT - how do we as a country provide affordable healthcare? (The answer is obvious) The question being asked is - how can we sustain a specific private industry at the expense of the taxpayers, regardless of the ultimate costs?

I personally don't have any problem with a mandate OR a tax, as long as what is being mandated is reasonable and affordable to overwhelming masses of the people.

[Vinca]

9. That's my fear exactly: that whatever is mandated will still be unaffordable.

Affordable in Washington, DC, and affordable out here in the sticks are 2 different levels of affordability. For the most part, people enacting this legislation are very wealthy individuals and $1,000 a month is nothing more than pocket money for them. I don't think they understand the real world.

[BzaDem]

10. You fix that with subsidies. All bills limit health premiums to a certain percentage of income.

Some bills make that percentage too high, but that can be fixed with higher subsidies. Even a public option won't necessarily solve the problem without higher subsidies. The best case scenario at this point is probably a public option not tied to Medicare rates. This means that the public option will have to negotiate with doctors for rates, and the only leverage it will have is the number of people signed up for it. It is unlikely that this will be a huge number. This means that the actual costs of running a public option will be very high, even with profit and executive compensation taken out of the equation. The issue of affordability really comes down to subsidies.

[Phoebe Loosinhouse]

11. And you have stated every single reason why a new limited public option will not work

which almost everyone was aware of from the getgo. And which is why opening access to Medicare WILL work.

I agree that the answer lies in "how much subsidy?". I think that outlay should be capped at 5% of gross income, and I am not talking just premium - I am talking co-pays, drugs, out-of-pockets, etc. To me, that is a reasonable price to pay for healthcare and one that could be bearable for most people.

How much a percentage of our income should be shelter?
How much for food?
How much for utilities?
How much for transportation?

Those items above are NECESSITIES. You can't get away from them. Healthcare insurance/costs have to come from what is left.

AFTER the cost of healthcare then one gets to add education, entertainment, discretionary spending, etc.

How far do politicians think we can stretch? The median annual household income in the US for 2007 was 50K! That means half the households had a lower income!!

[BzaDem]

14. Opening access to Medicare is not even something that will pass the House.

In fact, it isn't even something that could get out of all three committees. The Energy and Commerce committee was deadlocked for two weeks, and it only passed a bill when Waxman agreed to tie the public option to negotiated rates.

Right now, people are being bankrupted over healthcare costs. In response to this, you are saying that we need to have something that is never going to pass the current congress. That is saying we shouldn't do anything if we can't limit it to 5% of one's income. I think that is ludicrous. Even Baucus's 13% limit (as bad as it is) is MUCH better than the status quo, where people end up going bankrupt and losing their house over healthcare costs. There is increasing support on Senate finance for lowering the 13% to something in the range of 6-10% (for premiums, not deductibles). If we get anything close to that, it will be the biggest change for the better to the American social contract in two generations. You are preparing to throw it all away because it isn't good enough.

[Bluenorthwest]

23. It should be the same percentage of income that Congress pays

not a portion of a point higher, and it has to have a wide open public option. The end.



It should be Medicare for all, Congress be damned for not doing it. And by damned, I mean replaced and sent packing.

[Lars39]

24. And if you're currently paying a huge percentage of your income on

past medical bills? Is that being factored in?

[Gravel Democrat]

13. The resistance might increase

when the thing about attaching "acceptable proof of insurance" to your 1040 starts
making people talk. Or maybe that will be kept off the burner till after reconciliation.
Then it'll be "too late to change" lol

For now? What enforcement? Shhhh..... 3 little letters.

[Bluenorthwest]

20. The American people hate the Insurance Companies

They are not simply 'private companies' they are greed happy private companies that have been treating people like shit for years on end, while they pile not just profits, but enormous profits gained by practices that are literally criminal in all of our peer Democracies.
It is like forcing people to buy from Manson or Dahmer.

[CTyankee]

21. The government already taxes us for Medicare and lays on a penalty

if, at age 65, you don't sign up for Part B, for which $95 per month is deducted from your SS check. The only exception is if you are covered for what Part B covers with a private insurer. If you don't sign up and later you have to, you are forced to pay a higher rate.

I agree completely that it isn't the mandate, it's the mandate for you to pay a private insurer and not the government, the way it is with Medicare.

[brentspeak]

30. "funded by an actual tax increase on the middle class (by definition)"

That's a grossly misleading, disingenuous statement since you're deliberately leaving out mention of the fact that any tax increase in a single-payer system is significantly offset by the elimination of premiums, deductibles, etc. The middle class would therefore be saving a great deal of money:

http://www.pnhp.org/facts/what_is_single_payer.php

Financing

The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated. Employers would pay a 7.0 percent payroll tax and employees would pay 2.0 percent, essentially converting premium payments to a health care payroll tax. 90 to 95 percent of people would pay less overall for health care. Financing includes a $2 per pack cigarette tax.

[flpoljunkie]

15. Perhaps these countries do not allow lobbyists to hold fundraisers for their legislators like we do.

Our system is truly 'legalized bribery.' Senator Durbin admitted as much when he said that 'banks frankly own the place.' The health care industry pretty much owns them, as well.

We have a fight on our hands to defeat their influence.

[greymattermom]

16. mandate to purchase=mandate to provide care?

It seems to me that if we are mandated to purchase insurance, the company can't then turn around and claim preexisting conditions and refuse to provide care. True or not?

[BzaDem]

17. True. Which is why every bill in question bans insurance companies from denying care due

due to pre-existing conditions.

[Phoebe Loosinhouse]

18. Perhaps their legislators simply have a higher sense of morality and ethics

than ours who have a group ethos lower than the James Gang.

Do you recall the huge uproar that the UK raised when their media reported about some expense report excesses, mostly involving landscaping fees, moat drainage, etc. and they had apologies and resignations almost immediately.

2 factors - a media that reports and treats corruption as corrupt, and a public that responds.

We have no media - right now they are sitting on a gigantic story involving Congressional blackmail by a foreign country and we have a populace that has excused the very highest forms of debauchery and corruption possible - fake causes for war and torture. In such a climate I think we are reaping pretty much everything we deserve for our lack of conscience, outrage and accountability - Which, I have to say, comes form the top when the "need to move forward" supersedes criminal accountability.

[Clio the Leo]

22. The President made George look like a fool....

.... toting in his little dictionary to try and prove his point as if they were in an 8th grade debate contest.

Watch thing whole thing for yourself and see....
http://abcnews.go.com/Video/playerIndex?id=8620606

And read our take on it....
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8663435&mesg_id=8663435

[Phoebe Loosinhouse]

25. I don't think that the Pres made Stephanopoulis look like a fool

The President rejected completely that the mandate was a tax despite the definition of "tax" being read aloud to him by George.

I think Obama should have said something like "Many have and will call it a tax. But it will have the opposite effect of what most of us think of as a tax since it will ultimately lower, not raise, your out of pocket expenses."

Instead he let himself get caught up in a discussion over semantics that he will ultimately lose. Most Americans feel that a government imposed mandate to purchase or contribute towards something is the exact equivalent of what the majority consider a tax. Mandate-mandatory-government-tax. Pretty simple.

Part of the issue is the constant Pavlovian fear of our politicians for the word "tax". They shrink and recoil and try to change the subject or discuss how something very taxlike is not a tax. Taxes are real, taxes are necessary. Own the discussion! Stop pandering to the infantilizing of the American public that swoons and faints dead away if someone attempts to have an adult conversation with them about why and how a tax increase is necessary and what the benefits will be.

Now, the second comment you made was "And read our take on it. . ."

I'm not seeing that there's a monolithic DU take on the discussion in that thread except for quite a few to see some illusory debate takedown by the President. I don't see it that way and some others also did not.

[Clio the Leo]

26. You're right. George made HIMSELF look like a fool.

And have you watched the clip yet? ;)

George looked like he was trying to trip the President up .... and that's a battle no one is ever gonna win against Barack Obama. It was foolish. He would have been better served if he'd simply pressed him on the matter and not acted like he was trying to score jounalistic points.

[Phoebe Loosinhouse]

27. Yes, I watched the clip.

I think STEPH was pressing him on the matter, and as I said in my first reply to you, I think the President is going to lose the war on semantics, but he could win the war on merits if he would cede the point that the mandate for all intents and purposes is a tax.
I am pretty sure there are polls out there that say that the majority of Americans want better healthcare and are willing to pay more in taxes to get it. He's picking the wrong fight.

He's also going to lose this bigtime because there's a lot of footage out there on Obama castigating Hillary over this very point. (And no, I was NEVER for Hillary)

This interview is a giant clue as to where the battle is going to go.

[Gravel Democrat]

28. Here are specific page numbers and a link to the HR3200 online detailing re-write of the tax code

Obviously no one cares but I've been on lonely roads before...
And I'm not going to shut up. Obama campaigned against mandates.
Now mandates and a re-write of the tax code. UnFRICKIN Believable.

Here's HR3200 online.

http://www.examiner.com/x-12837-US-Headlines-Examiner~y2009m8d10-Health-care-bill-HR-3200-read-it-online-now

Here are page numbers and section/division numbers:

Division A, Title IV on pages 167-215 called Amendments to IRS Code of 1986.
The expanded powers of the IRS in H.R. 3200 would empower the IRS to require
taxpayers to show proof of health insurance coverage

If this passes without any debate, well, I'm already speechless.

[slackmaster]

29. Miriam Webster?

The Christian singer?

[Phoebe Loosinhouse]

31. Ok, just got back from a doctor's visit where Fox plays in the waiting room

:puke:

For the scant 3 minutes I was there, the anchor (noonish) was making a big deal about "the President denies that the plan involves taxes, but right on page blah blah of the Baucus plan it clearly says that an excise tax will be charged blah blah. Doesn't anybody read these things?"

This is going down pretty much as I expected and we will all get caught up in a long pointless discussion about whether mandates or the fines for avoiding mandates are "taxes". We have been "wrongfooted" as they say with our initial responses.

This are they (mandates) or are they not "taxes" was highly predictable since this whole debate/scenario has already played out once in our own primaries. (Where, awkwardly for us, Pres Obama was on the opposite of his current side) I am disappointed that once again we are not controlling the debate and are in a defensive posture.