So Now We See How It Is
It is looking more and more like the Executive and Legislative branches of the federal Government are going to cave on the public option. So the solution will be to give dump trucks full of money to insurance companies, with no cost controls.
Okay then; now I see how it is. The leadership of the Democratic Party will only represent the interests of rich people, and not my own. So, fuck the leadership of the Democratic Party. They have forgotten who they are elected to represent and defend: the little guy from the rapacious money powers (as FDR described them.) They have sold us mortals down the river for campaign money from rich insurance companies. Fuck 'em.
Digby said it best (as usual) a few days ago, in the context of a review of Michael Moore's new film:
Well, it looks like the leadership of the Democratic Party is incapable of "tak[ing] this on in direct, political terms." We're apparently far enough away from the searing memory of the last great economic and social crisis that no one of consequence in Congress or the executive branch has the basic courage to tell the money powers who pull their puppet strings, "Not this time, guys. There are people hurting terribly, and in order for us to help them we're going to require that you sacrifice some money and privilege for the greater good of living in a stable, just society."
I've come to the conclusion that the leadership of the Democratic Party is too corrupt to be redeemed. They are no longer represent "the peoples' Party" but rather a party that represents most faithfully a certain slice of the rich - the "creative class" Digby refers to.
More Digby, from today:
Again: I think the Democrats' problem, which the Republicans have ridden to success since Nixon, is they have forgotten who they represent.
In fact, I was visited by a guy with a long white beard and a greek accent recently, who asked me some questions about this:
Okay then; now I see how it is. The leadership of the Democratic Party will only represent the interests of rich people, and not my own. So, fuck the leadership of the Democratic Party. They have forgotten who they are elected to represent and defend: the little guy from the rapacious money powers (as FDR described them.) They have sold us mortals down the river for campaign money from rich insurance companies. Fuck 'em.
Digby said it best (as usual) a few days ago, in the context of a review of Michael Moore's new film:
It's extremely disheartening to see the administration and so many Democrats in congress completely ignore the political and policy ramifications of failing to engage in fundamental financial reform and fiery populist rhetoric at a time like this. This [tea party] movement is happening in a vacuum created by a lack of interest in this topic by liberals who are so enamored of being members of the new "creative class" and the like that they aren't paying attention to the cynicism and anger that's reaching critical mass among average working stiffs out there. It's easy to dismiss it, but very, very foolish. The issues Moore raises in this film will be answered on the right with authoritarianism, militarism, immigrant bashing and violence. It's a recipe for disaster unless the left takes this on in direct, political terms.
Well, it looks like the leadership of the Democratic Party is incapable of "tak[ing] this on in direct, political terms." We're apparently far enough away from the searing memory of the last great economic and social crisis that no one of consequence in Congress or the executive branch has the basic courage to tell the money powers who pull their puppet strings, "Not this time, guys. There are people hurting terribly, and in order for us to help them we're going to require that you sacrifice some money and privilege for the greater good of living in a stable, just society."
I've come to the conclusion that the leadership of the Democratic Party is too corrupt to be redeemed. They are no longer represent "the peoples' Party" but rather a party that represents most faithfully a certain slice of the rich - the "creative class" Digby refers to.
More Digby, from today:
This time there is a rather large group who, in the absence of an affordable public plan, are likely to be angry about health care reform and they will be aided by the large block of teabagging phonies and their industry allies in raising holy hell about it. These are people who are going to be forced to buy pretty expensive insurance policies from private insurers, and for whom the subsidies are just not adequate. They are average middle class people who are going to be told they need to find a way to now set aside nearly 50% of their discretionary income for Blue Cross insurance executives to make multi-million dollar bonuses. And that is from a very small amount of discretionary income.I would put it in far harsher terms: without a public option to control costs, this is going to be a disaster of epic proportions, something that will send more working people into the hands of the teabaggers, because we offer them nothing of substance.
[...]
I don't suppose that most of the people writing these plans have recently had to live with only a couple hundred dollars a week to spend among three people, but if they did, they would know that cutting that in half is impossible. I don't know how many people this affects, but it's obviously in the millions.
There's a reason why so many people are uninsured and it isn't only because they have pre-existing conditions. It's also because insurance is unaffordable. Unless this reform fixes that problem they haven't fixed it at all. They need to create a public plan that these subsidies can actually make affordable or these folks are all going to have to become criminals and defy the mandate. And if that happens reform fails.
I think you will see a terrible backlash if they don't get a grip on the political realities here. I hope that Hickey is correct and that they are, or this could be a monumental debacle.
Again: I think the Democrats' problem, which the Republicans have ridden to success since Nixon, is they have forgotten who they represent.
In fact, I was visited by a guy with a long white beard and a greek accent recently, who asked me some questions about this:
Me: But Soc, ol' buddy, you're talking about The Repub's deluded base, here. You know, the people agitating for tax cuts for their boss's boss's boss? What possible use could they be to the Democrats?
Socrates: I can see I'm outmatched here, and must bow to your superior wisdom in this matter. I just have one or two questions, and I was hoping you could enlighten my ignorance.
Me: Sure, Soc. Shoot.
Socrates: Who are these people you call the 'base' of the Republican Party?
Me: Oh, you know...working stiffs...people in our society who are more or less powerless. People with stagnant wages, maybe just a high school education, who have little or no power in the workplace or the rest of society, and feel some vicarious empowerment when they hear Rush Limbaugh or Sean Hannity "speaking up for them".
Socrates: He speaks for them, does he?
Me: Well, of course. You know, against the dirty, heathen Liberals who want to turn all their wives into hairy-legged, baby-killing lesbians, or something?
Socrates (aghast): The Liberals want to do that?
Me: Are you serious?? No, of course not!
Socrates: Well, that's a relief. I just wonder then: why are they not voting for Democrats? They used to, in huge numbers, as I recall...
Me: I already told you - The Republicans have the wool pulled over their eyes.
Socrates: But I still don't understand: why did they stop voting for Democrats? I remember quite a long period when people like that voted overwhelmingly for Democrats, every single election, starting in 1932.
Me: Well, you know, that was a different time, then...
Socrates: Really? And how was it different?
Me: Well, to begin with, there was the Great Depression, which threw everyone out of work. The Republican response was: let charity take care of the indigent, and let The Market right itself. The Democrats had specific, concrete plans to help the people who were hurting...and so the Republicans just got killed in the '32 elections...
Socrates: Ah, so the Republicans learned their lesson, and sing a different tune, now? Me: Well, of course they...you know, come to think of it, no. They are pretty much saying and doing the same things now as they did then.
Socrates: Then I'm still confused - why are all those poor farmers and minimum-wage earners and economically hurting people now voting for Republicans?
Me: I already told you - the Republicans are appealing to their fears and prejudices! Socrates: Hmmm...if those folks voted Democratic, do you think the Democrats might do better in elections?
Me: I'm sure we would, but we don't want those people.
Socrates: Because...?
Me: Do I have to tell you again?? The Republicans have them all tied up in fear and prejudice.
Socrates: I see. Let me ask you: Have you ever experienced feelings of fear, and even prejudice, within yourself?
Me (thinking): Oh, sure. It's probably a universal human experience to some extent. Socrates: Did you enjoy it?
Me: What, feeling those things? No, I guess not - not deeply, anyway. Who wants to be afraid? Anyway, what's your point?
Socrates: Do you think the people who now are caught up in the Republicans' fear mongering and pandering to prejudices are enjoying the experience - I mean, really, deeply enjoying it??
Me: Um, probably not...
Socrates: Then why do they allow the Republicans to keep doing it?
Me: You lost me.
Socrates: As we've established already, not only are they powerless, but their prejudices and fears are only adding to their misery. Isn't that true?
Me: I've never thought of it that way, but yes, I guess you're right. What the heck is wrong with them?
Socrates: Do you remember the impassioned speech given at the 2008 Democratic National Convention - the one everyone remembers - where the speaker eloquently called for huge amounts of assistance for struggling family farmers, a living wage for all American workers, card-check legislation to help workers get some power in the workplace, and shooting barbs at the Republican rich, "lolling obscenely in their Opera Boxes"?
Me: Um...(thinking)...No, actually I don't.
Socrates: Neither do I. Do you want to help people who are trapped in economic stagnation, and are being exploited with fear and prejudice?
Me: Well, yeah, that's a large part of the reason I'm a Democrat.
Socrates: Well, how can you help them?
Me: Like I said, they are pretty much beyond help...
Socrates (now genuinely shocked): You don't really believe that, do you?
Me: Well, what can we do for those people?
Socrates: "Those people"? Didn't you describe them yourself as, "Working stiffs...people in our society who are more or less powerless. People with stagnant wages, maybe just a high school education, who have little or no power in the workplace or the rest of society?" Me: Yes, that's right: the Republican Base.
Socrates: We also went over how the Democrats gained a large and enduring majority in the past by coming up with specific, concrete plans to help people who were hurting, did we not?
Me (dawning realization): Uh, yes, I guess so. But what about the social issues - abortion, gay rights and so on?
Socrates: Think about this for a moment. How much does the status of gay marriage or the legal status of abortion increase their misery on a daily basis, in the course of living out their day-to-day existence?
Me: Actually, on a day-to-day basis...? Probably not much. Not much at all, really. Socrates: And how much does the fact that they are, in your words, "people in our society who are more or less powerless...with stagnant wages, maybe just a high school education, who have little or no power in the workplace or the rest of society" make their lives harder, on a daily basis?
Me: I imagine it's a constant, grinding bummer...
Socrates: So, if you offered a whole list of ways to help them with those concrete, constantly-lived, ever-present miseries - in fact, if you organized your agenda around those issues, and hit the talking points constantly - do you imagine they might just consider giving your party a strong and enduring governing majority?
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Look, you have a point, but
First, as I relate everywhere else, my opinion is that when the dems are in, the oligarchy in control that owns 85% of every damn thing in this country gets 85% of the goodies handed out by Congress.
But when the repubs are in charge, that same oligarchy gets 99%.
Second, there is no final bill to bitch about yet although we must keep pressure on Congress throughout the entire process.
But this is an extremely fine exposition of argument and writing and it is extremely difficult to argue with your logic.
No, I am not upbeat about what is taking place, that is for sure.
October 19, 2009 5:56 PM | Reply | Permalink
Definitely rec'd! Digby's analysis is right on the money. I think the DLC really steps on its own dick this time if they fail to understand the depth and breadth of the ramifications of doing "just enough" to call themselves Democrats this time around.
But I don't hold out much hope the Emanuels et al will see this until it is too late, and I share your concern about the backlash and the opportunity it provides for the teabagging demagogues to ride this to new and outrageous political extremes.
Dangerous times.
October 19, 2009 6:17 PM | Reply | Permalink
when the dems are in, the oligarchy in control that owns 85% of every damn thing in this country gets 85% of the goodies handed out by Congress.
But when the repubs are in charge, that same oligarchy gets 99%.
Agreed. The thing is, though - if this continues, there is no reason to think this won't end in the grief that oligarchies everywhere usually end up in eventually: social instability, mounting unrest, maybe even revolution.
October 19, 2009 7:13 PM | Reply | Permalink
As a Yellow Dog Democrat (due mostly to lack of viable alternatives), I nevertheless have to recommend this comment.
I still think a flawed bill is better than no bill at all, as it will at least establish near-universal health care as a benefit provided by (or through, if you prefer) the federal government, and I'm sure that the trends will be towards making it more affordable and accessible as more people use it and/or want it. It will eventually become a political "third rail" like Social Security and Medicare, and politicians will be fighting to see who can be more of an advocate for more and cheaper health care. So getting a halfway decent bill is still important, and a huge achievement.
That said, if the Democrats are stupid enough to pass health care "reform" that imposes crippling mandates on working class families, yet does nothing to rein in the runaway inflation of health care costs, they will be banished to the political wilderness, perhaps permanently.
And they will deserve to be. Which is why my only reason for hoping we'll get a pretty good bill is that I can't believe that the Democrats are so beholden to the health insurance companies and Big Pharma that they will commit political suicide in order to please them.
October 19, 2009 9:18 PM | Reply | Permalink
Hi mftalbot - I understand some of the frustrations you express, but here I'll focus on only one - healthcare reform legislation that now looks likely to pass, but probably without the public option in its original form. That's not certain, but the odds are against it.
Please excuse my own frustration, as expressed below in the form of bolding for emphasis, because it's related to the almost innumerable repetitions I've been forced to engage in to point out that in terms of the proposed reforms, a public option is desirable but not essential. It's not central to the reform effort. A public option would achieve a modest reduction in insurance premiums, but would do nothing to alter the unsustainable trajectory of rising healthcare costs that threatens to bankrupt American healthcare in both the private sector and that part of healthcare already subject to a massive public option, Medicare. Insurance reform is important to ensure near universal coverage and to eliminate the inequities that deny individuals coverage or charge exorbitant rates based on health status. By itself, insurance reform can have only minor effects on cost, because cost excess resides within healthcare itself, not in the insurance sector.
Rather than repeat all the specifics here, I'll refer you to blog comments from a few days ago with links to relevant sources. I particularly recommend the link to the Dartmouth group studies that identify where the major cost excesses reside. It was in the first comment I made in the earlier blog, but I'll repeat the link here:
http://dartmed.dartmouth.edu/spring07/html/atlas.php
I also discussed the desirability but non-essentiality of a public option in an earlier blog of my own:
http://tpmcafe.talkingpointsmemo.com/talk/blogs/fredmoolten/2009/09/is-the-public-option-important.php
Current reform efforts, if passed, will represent a huge step forward with or without a public option, and if the latter is included, so much the better. There are some weaknesses in the bills - in particular, the Senate Finance Committee bill has only weak mandates and relatively stingy subsidies. The House bills and the Senate HELP Committee bills do better on both counts, and I hope the stronger mandates and larger subsidies find their way into the final legislation.
The reason I feel a need to keep emphasizing these points is that the Administration needs all the support it can get to achieve the best reform package possible, and a misconceived emphasis on the importance of the public option may undermine that support if it appears such an option will be absent from the final package.
Finally, if you want additional quantitative data you can't find in the referenced sources (e.g., insurer profit margins, overhead, sources of healthcare excess, comparison with other nations, etc.), I'll be glad to provide what I can.
October 19, 2009 11:11 PM | Reply | Permalink
Fred, God Bless your wonkish soul, you really just don't get it. It isn't about money Fred. Not for most of our people anyway. They don't care about that anymore than they care about the phantom of bipartisanship.
The whole point of this post was to highlight the problem of ignoring the needs of the vast working and middle classes. If we don't provide publicly funded, Medicare style health insurance as an option to anyone who wants it, these people are going to go berserk and rightfully so. This whole absurd dance of keeping the insurance and other parasitic corporate interests profits sacrosanct prevents us from focusing on what we really need to focus on which is providing health care to all our citizens and providing relief to those that are being robbed at present by the insurance companies by paying ever higher premiums for less medical care in order to increase annual profits. The little people are not so stupid and docile they won't realize they are getting screwed by the assinine, unfair and larcenous madated insurance approach. Take off your accountant and good policy wonk hat for a minute and think about this as a very real, personal, human, political problem that needs to be solved. As pointed out so well by Digby in the quotes above, if Democrats ignore the needs of the vast working and middle classes we will have a political disaster on our hands of huge proportions. Obama and the other corporate centrist Democrats are completely tone deaf to this and, like their other massive mistake of sucking up to Wall Street, they seem to be the only ones being fooled by their approach. Everyone else understands that the special interests are the ones being served first and foremost, not the interests of the people.
October 20, 2009 1:32 AM | Reply | Permalink
Great points, oleeb! This issue has really ranged beyond the basic effort to reform health care. The pretzel-twisting effort to appease the Insurance Industry and other Washington Masters has made this a needlessly complex task. And the contortions to which Obama and Congress have committed themselves to avoid the public option has really highlighted a concern among all as to who it is they are working for - their voting constituency or their paying constituency.
I appreciate almost everything I've read from Fred on the HCR issue. And I believe he is right on his "take" that the public option need not be included in the present legislation for the reasons he states - mainly because this does lay some degree of reform in place, and the "public option" simply will not be denied.
But Fred misses the political realities here. HCR is a populist notion. Obama was elected by the Dems and a wide swath of Independents who voted for HCR. Virtually every one of them held a concept in their mind of a government run health care system when they so voted. (Do you really think these people entered into this with the idea that Universal Health Care & Health Care Reform meant subsidizing the insurance industry with hundreds of billions of dollars for them to provide universal INSURANCE coverage?)
Digby makes the case very well that there is a populist "revolt" on the horizon. People are angry and scared, and the teabagger movement has grown out of that and channels that emotion in dangerous directions.
The Dems have the right issue in HCR to righteously acknowledge the populist discomfort that is so with us today and to efectively give it opportunity to vent. The Insurance Industry has acted out its role as a fat, ambitious, greedy, cruel, and parasitic scourge of the working class. There is opportunity here to offer some degree of satisfaction to those who feel so powerless by sticking this bloated beast in the neck. Gaining some backbone in support of the public option is only one way this can be accomplished.
Instead the message from Emanuel and Baucus and the rest is "We'd get you the public option you want if we can, but we gotta' see what the insurance lobby will allow first."
They proceed down that road at their peril, and when pitchforks are raised they will be found wanting when asked "Which side are you on?"
And Glen Beck, Limbaugh, Gingrich, and the rest will only be too happy to pick up the pieces.
October 20, 2009 8:47 AM | Reply | Permalink
I've already provided factual data (or more accurately, references to factual material) indicating that the public option, while desirable, would not address the main problems facing U.S. healthcare today, and that any expectation that this option, or for that matter, insurance reform alone, would make healthcare affordable is destined to be shattered by the realities facing the healthcare situation.
Important insurance reforms are already in each of the bills, and would extend coverage to most (Baucus) or almost all (the other bills) who currently lack it. It would make insurance more equitable. These are reforms of enormous importance.
None of these, including the public option, would solve the basic problems of increasing healthcare unaffordability, and to turn a blind eye to that reality is to forfeit the opportunity to make the necessary reforms within healthcare - something the proposed bills take baby steps toward achieving.
Insurance costs contribute only slightly to healthcare cost excess, and reducing those alone without tackling healthcare itself will do little to help the middle income or lower income individuals achieve adequate coverage and therefore adequate health. That is a reality. Insurance profit margins are quite low, and consistently so - about 3-4 percent (less than 2 percent of total healthcare costs), and while their overhead is excessive, the excess is modest, and its reduction to levels in single payer nations would have only slight impact on healthcare affordability. A public option would squeeze costs even further within insurance, but would not address the far larger problems within healthcare.
It should be viewed as a desirable policy, not a religion.
You speak of populist revolts, but that is an illusion reinforced by the incestuous nature of blogs of like-minded individuals who talk mainly to each other. The nation, when polled, is about evenly split between those who say that reform proposals don't do enough and those who state they do too much. The large majority of individuals, including many who favor the public option, are pragmatic enough to comprehend the significance of proposed reforms with or without the public option, and I can pretty much guarantee you that any "revolt" will be limited to a small fraction of those who favor reform.
It does, however, trouble me, when I read here an acknowledgment that what I say may have legitimacy, but that people are going to "revolt" anyway despite the lack of a basis for it (at least when it comes to the specifics of healthcare reform). That would be unfortunate, but I'm confident that intelligent people will eventually calm down and appreciate the gains that are to be made, rather than refusing to take yes for an answer.
In the meantime, continued pushing to include a public option sounds like a good idea to me.
October 20, 2009 10:56 AM | Reply | Permalink
Politics driven by wonks with no connection to the people creates unsustainable, unpopular policies that don't do what the wonks claimed because everyone hates the policies. Many Democrats fall prey to becoming the disconnected wonks who end up being the very unpopular and distrusted folks who show up saying "Hi! I'm from the government and I'm here to help!"
Ignoring the reality of what is going on amongst the majority of Americans is foolhardy at best. The populist anger that is building is not a myth or a simple creation of the blogosphere Fred. You're a doctor right? A researcher right? Like most of the wonkosphere, you are living in a world vastly different from that of the ordinary people of this country. They are fed up by seeing a nation where there's one set of rules for the little people who are required to follow all the rules no matter what while working their asses off all their lives as their standard of living deteriorates yet the rich and powerful have a different set of rules that don't have to be followed unless they are favorable to the rich and powerful and any mistakes they make are taken care of by the government and paid for with the little people's money. It is extraordinarily clear that since the depression first hit us last year at about this time that the elites, especially the Democratic elites are completely out of touch with the people, their needs, their problems and their wishes. The atrocious idea of mandating everyone buy rotten private insurancea t inflated prices but offering nobody any alternative to private insurance could well be the last straw. Everyone expects the Republicans to whore themselves to the special interests, but when the Democrats do it as they so clearly are doing on healthcare insurance reform it is another thing altogether.
October 20, 2009 3:26 PM | Reply | Permalink
But, as is increasingly clear, we deal not just with a corrupt Republican Party but also with a corrupt Democratic Party Leadership that gives lip service only to the people's interests and instead does the bidding of their wealthy, corporate paymasters. And so despite having this issue with which we could rally the people we see no appropriate leadership coming from our most important leaders. Our dedicated group of liberal/progressive Democrats who are actually committed to the things that most Democrats are in favor of, persist, but they do not have enough weight to force the corrupt Democrats (moderates/centrists/bluedogs, etc.) to do the right thing or even to posture appropriately on important issues like healthcare reform. We need to clear out the DINO's from the Democratic Party. It will take a legion of Grayson's and that sort of real Democrat to force the DINO's out.
October 20, 2009 4:02 PM | Reply | Permalink
I don't think you help your case, oleeb, by writing comments laden with accusations and dogmatic assertions, often of a general nature, but deficient in confirmable evidence.
So as not to become enmeshed in an interminable exchange, I think anyone interested should instead go back and read what's already been written, including my comments above. If I've made any misstatements, they should be corrected, but I think I've gotten most things right.
The proposed healthcare reforms constitute a major advance, with or without a public option. A public option would be a desirable addition, but is not central to reform. It would not dramatically constrain costs, nor are excessive costs attributable primarily to the insurance industry. The main weaknesses of the bills, as I see them, is that they take only small steps to address the most important obstacles to future affordability and quality of American healthcare - the excesses that lie within the healthcare system itself (see the link I gave earlier to the Dartmouth group). The public option is a policy, and should be viewed as such, not as a religion. Most Americans are likely to be pleased eventually with the outcome of proposed bills, including those who favor a public option, even if that option is absent, although I expect some variant of it may survive.
Oleeb or others - if you have factual data to refute any single sentence in the above paragraph, please provide that evidence, and we can take the discussion from there. Accusing me of being out of touch with ordinary Americans is not a substitute.
Finally, in saying all the above, I'm addressing only healthcare, and not other inequities, such as unconscionable bonuses to executives on Wall Street in firms that contributed to the financial collapse we faced earlier this year. There is plenty to complain about, but please don't confuse that with the public option.
October 20, 2009 4:22 PM | Reply | Permalink
If you can wrap your head around this Fred, please do. This thread isn't about your numbers. It is about people. You are not getting it at all. You are simply not in touch with what this thread is about. It's as though you are Spock unable to comprehend emotion. Try for a minute to put your calculator aside.
October 20, 2009 7:48 PM | Reply | Permalink
Unfortunately, no time. Gotta get to work.
Encountered two more people today who received notice of foreclosure on their homes yesterday. One of them was cut back to 30 hours work per week for the indefinite future (15 years on he job), which cost him his benefits including health insurance.
To ignore the populist rage that is building is crazy. These people need a victory against the oligarchs, and the public option is a litmus test to determine just whose side are the Dems on. So far, all the contortions committed to "pretend" they are in favor of the public option "if only it were possible" provides a pretty indefensible answer.
Apples and oranges arguments between "Fred the Wonk" and "oleeb the populist" in this thread that probably won't be reconciled.
October 20, 2009 6:11 PM | Reply | Permalink
I agree with you completely. But, as you are no doubt aware, the bad news of this new depression has only just begun to hit. Things are going to get much, much worse for the average American. We are in a period of history where we desperately need real progressive leadership from the Democrats and for the first time in our national history it isn't there. It's gonna be a rough ride.
October 20, 2009 7:51 PM | Reply | Permalink
Socrates is right, as usual. Look, the FDR coalition fell apart for a simple reason - The Democratic Party, with a few exceptions, has ceased to be the party of FDR's policies and ideals. There is a mass strike ferment out here in the hinterlands. It is mis-directed into silliness like teabagging and birtherism. Some of it is potentially usefull (like Ron Paul's Audit the Fed Bill). It could be coopted by Dems if they truly threw off the Banksters, the Health Insurance indusry, Big Pharma, etc., and fought for working people's interests. Certainly, the GOP will never do that. If the Dems also continue to refuse to stand with us, the country's diminishing productive will shrink further, with devastating effect on working people. Where will they turn in that event? Whatever form it takes, it will be a totally demoralized, nihilistic movement. It will be the death of the Republic. There isn't an option any longer, if there ever was, to be Republican Lite. Either we become again the party of FDR in word and deed, or the Economic Royalists will finish looting the country and move on like locusts to greener pastures, leaving us a burnt out husk.
October 20, 2009 11:23 AM | Reply | Permalink
Sadly, you are correct. Where will America be when the last 20 rich guys decide this is a nation of diminishing financial returns, and leave for their nesteggs in Switzerland? We're bankrupt as individuals as well as nationally. Where do we go from here? China owns us. Now what?
October 20, 2009 11:57 AM | Reply | Permalink
Sorry, "the country's diminishing productive capacity..."
October 20, 2009 11:28 AM | Reply | Permalink
When I add the amount my employer pays into my healthcare, the total I pay each year into healthcare is over 30% of my income! This is in good years, when our family is lucky and has no doctor visits. This number is projected to raise to 40% in the next decade. I avoid the doctor because of the co-pays and the deductibles, which I cannot afford. If that isn't a form of "rationed healthcare", I don't know what is!The middle class is getting squeezed like never before and I find it rediculous to be squabbling over the seperate bills. It should be obvious to anyone with an eye for partisanship, these guys (the R's and the D's) have to be in bed together! The democrats need to find the intestinal fortitude to stand up for the lower and middle classes! If they don't, is anyone else ready for a 3rd party?
October 20, 2009 11:47 AM | Reply | Permalink
One of the biggest problems in America is that so many people don't care about ANYTHING until it is their ox getting gored, THEN they raise holy hell, and not a minute sooner.
I am not suggesting that we give up on the public option just to prove a point, but until insurance premiums go up to the point where what is left of the middle class can no longer afford them, they prefer the status quo.
October 20, 2009 11:49 AM | Reply | Permalink
If you think this "business rebellion" is something nasty, take a look at this:
http://carnival-of-anarchy.blogspot.com/2008/01/smedley-butler-and-business-plot.html
I want to know...
When did the interest of the corporation become more important than the Individual American? Why are more people not ready to fight for this? Are we really so lazy, that we will simply roll over and ask for Vasoline?
October 20, 2009 11:53 AM | Reply | Permalink
Probably doesn't help that the site has the word "anarchy" in it, but you MUST read it. It is so relevant in the Wall Street Scandal as well as the Health Care Debacle (I mean debate.)
October 20, 2009 12:01 PM | Reply | Permalink
truth is it is not a matter of being abused if this fails. We are already being abused. It's simply and detestably, a matter of whether we can stop it, or mitigate it. Obviously the tea baggers with the MSM did a better job of getting people on the Mall then any healthcare reform crowd. Do the people not care? No, the people cared enough to elect Obama and now, in their disappointment in his fabricating a contest where he holds a majority, they are doubtful they can do anything more at this time.
October 20, 2009 1:52 PM | Reply | Permalink
As the linked article states, this extraodinary plot against the incoming FDR is forgotton history. It's there for all to see if one digs, however it certainly has been buried. I discovered this for myself maybe 5-6 years ago, which led me to buy and read Gen. Butler's book.
What we are going thru today is not exactly the same as 1932, but it is similar enough that if we take steps akin to those FDR did, we could survive and re-start economic growth. There is not one prominent politician I see out there who is smart and courageous enough to even suggest it.
October 20, 2009 3:53 PM | Reply | Permalink
Excuse me in advance for offering what is probably a ridiculous and overly simplistic idea, but what if, the government simply took everyone with a pre-existing condition, and offered to put all of them on Medicare? Wouldn't that reduce medical costs paid by Insurance companies and thus lower premiums for everyone else?
It would, in effect, be a public option, but only for people with chronic conditions. Medicare would then cover the millions who need coverage the most, and the resulting reduction in the cost of private insurance would allow many of those that currently can't afford insurance to get it.
Combine that with strict regulations to prevent the Insurance companies from making a profit more than a certain percentage above cost, and voila, real health care reform.
(The secret twist would, of course, be that everyone has a pre-existing condition, so everyone would be eligible to be covered. hahaha)
Or is that too simple?
October 20, 2009 4:38 PM | Reply | Permalink
Smitty - Your suggestion may be simplistic but it's not ridiculous. Medicare is funded primarily by payroll taxes (plus about $100/month premiums for part B). To cover the chronically ill would require a significant payroll tax increase, which might be difficult politically, unless some other revenue source could be identified. It would mean that working Americans would end up paying more for a plan for which many would be ineligible. I doubt whether the plan would impact private insurance costs for individuals without pre-existing conditions, since currently, individuals with those conditions are charged higher rates than those without or are excluded (unless they are part of an employer group plan). Therefore, those who can't afford private insurance would still need government subsidies, and many who would benefit from insurance might end up without it. In addition, we would still need the proposed insurance reforms that prohibit any residual cherry picking, caps on total coverage, recissions, inadequate benefit packages, and the like.
Defining who is or isn't eligible would be difficult.
I still think it's an interesting idea, but not likely to be as effective or equitable as a reform plan that attempts to cover all or nearly all Americans. In fact, though, if your plan also included mandated coverage, it would turn out not to be radically different from current reform efforts, with the main difference residing in the source of revenue to pay for those with low incomes or poor health status.
October 20, 2009 5:23 PM | Reply | Permalink
Will you PLEASE get off the insurance bandwagon!!!! All your "facts" and "numbers" are just offered as reasons why we should just deal with insurance. It hasn't always been this way and it doesn't need to be this way. You just keep arguing that everything is just peachy, and insurance companies don't really make obscene profits, and this reform is going to be great, and everyone keeps telling you that you don't get it.
Here it is in simple terms: your spouse lost her job, your own hours have been cut back, your kids can't find work, and the government is now going to mandate that you MUST buy a new GM car every year! And maybe if you are truly in abject poverty the government will kick in a few hundred dollars towards the purchase.
October 20, 2009 10:28 PM | Reply | Permalink
Insurer profits are small - about 3-4 percent consistently (less than 2 percent of overall healthcare costs). The problem with private insurers is that they treat people inequitably, not that they make obscene profits. Their profit margins are quite low, and their overhead, while somewhat excessive, adds only a small part to the excess costs of healthcare. The problem with affordability lies mainly outside of the insurance industry.
October 21, 2009 11:23 AM | Reply | Permalink
Fred, 3-4% is misleading. The insurers have a huge incentive to make the whole cost higher (because 4% of a larger number is better then 4% of a smaller number).
Fee for Service is the structural problem. None of the bills address this in any meaningful way. All your fearmongering of rising costs due to unnecessary waste and replication of services will continue unabated. Save now thanks to mandates, the only issue you consistently push, insurers will have a much larger pool of cash to make there 4% off of.
We need Structural reform that changes 'fee for service' Single payer does this. Medicare for all does. Instead we will have this expensive bandaid that makes things better for poor at the expense of the middle class (those too rich for subsidies, but still struggling). This may be better morally but it does NOT make economic sense.
October 21, 2009 12:00 PM | Reply | Permalink
Not true, Sal. Insurers have conflicting incentives. To attract subscribers (particularly to attract employer group insurance subscriptions), they need to keep premium costs low. To acquire contracts with hospitals and physicians, they need to offer high reimbursements, thereby raising costs. The fact remains, therefore, that rather than insurers artificially raising costs in search of profits, cost increases within the private insurance market have been only slightly higher than in Medicare, and insurer profit margins have been consistently low. This is true despite the fact that competition has been inadequate in some regions, while adequate in others.
Although I agree that fee for service is part of the problem, it's not correct to say that the bills don't address this - in fact, they explore a number of alternative payment mechanisms, although to a more limited extent than I would like. Medicare for all is does not solve the payment mechanism issue, since traditional Medicare is now based on fee for service.
Single payer is not a feasible consideration for economic reasons in the midst of a recession, politics aside, nor does it necessarily address the fee for service issue.
The fact that insurers stand to benefit from insuring the uninsured does not negate the fact that the uninsured stand to benefit from insuring the uninsured.
October 21, 2009 1:14 PM | Reply | Permalink
Also, Sal, it may even more relevant than the 3-4 percent profit figure for insurers as a fraction of their own budgets to point out that insurer profits constitute less than 2 percent of overall health expenditures. If they disappeared completely, costs would decline only minimally. Reducing insurer overhead would have a larger effect, but would still make only a slight difference.
October 21, 2009 1:40 PM | Reply | Permalink
Single payer is not a feasible consideration for economic reasons in the midst of a recession,
Really? An existential crisis seems like a great time to fundamentally reform the economy. In fact it is usually the only time it happens. I see these things tied, look no further then Japan to see where will be in a decade without an economic restructuring but I suppose I will leave that alone. I think you mean to say 'political reasons'
Nice try Fred, but 4% of a larger pool of money is more then 4% of a smaller pool. Period. Nothing you say disputes that. Sure there is minor competition among coveted corporate pools but not much. Costs have been rising 10 to 15% a year across the board. Now employees pay copays. There is not that much competition and small guys like me (self-employed formerly with 1-4 employees). have no choices. Most insurers have regional monopolies and no incentive to reduce costs.
4% of more money is more!!!
The bills pay lip-service to exploring other options from fee for service. But not much. You are right about medicare but we could reform that easily too. Plus we could open the vast medicare database up for some real evidence based cost savings (currently banned by law).
Private insurers hid the true costs of health care procedures from doctors, pharmacists, and patients. Pretty much everybody. Why keep it? What value does it bring to the equation. Nothing.
All that said I accept how limited our political imaginations may be, however I strongly object to the current proposed structure to pay for it. The mandates will soak non corporate employed middle class twice over (once because of taxes for subsidies, 2cd time for more expensive insurance to cover more). We continue to pretend that employers pay for it but most employers are small businesses and that money comes straight out of wages.
Anyway also just to reiterate that 4% of more money is More!! That is the private insurers incentive, and thats why they love strong mandates.
October 21, 2009 2:25 PM | Reply | Permalink
Thanks Fred. It was just a thought that kept rattling around in my head. Your reply makes sense.
October 20, 2009 5:57 PM | Reply | Permalink
Awesome! You pay premiums until you get sick, then you are referred to the government for treatment. So the companies have nothing but profits to manage. They can cut their staff by 95% without ever lowering premiums. We are getting so that only the top 5% are going to have any money anyway. This makes things much simpler. If anyone objects to that, they just hate capitalism. No need for the government to decide who gets thrown off the roles. That's a private matter! It's a business decision. The government should not interfere in a business matter.
October 20, 2009 7:37 PM | Reply | Permalink
Well, that wasn't quite what I meant, but I see your point, GregorZap, hence the need for strict industry regulations.
As I said, it was just a thought, and perhaps not a well-enough thought-out one.
October 20, 2009 10:24 PM | Reply | Permalink
MrSmith!, I apologize. There probably is a way for your suggeston to be implemented that is not a complete rip-off of the American people. There might be ways to structure a market with a specific risk pool and leave it to private industry to participate within those perimeters. In essence, it would relieve the government of having to develop a structure to include those individuals within the low risk pool. And it might be a manageable solution to the disintegration of private insureres who can take the profits and redirect their organization so it and many of its mployees survive the transition. I was just thinking of how a Wall Street would consider the proposition since they have no intention whatsoever of providing any service if they do not have to work for it. They are only interested in their own profits, and to hell with anyone else. I know that is not your sentiment at all and you wish to find an answer that works for the most people as can be served. Having irreverant and sarcastic tendencies I went off on the idea, but I meant no ill will toward you.
October 21, 2009 2:41 AM | Reply | Permalink
No apology necessary, Gregorzap, I understand and share your concerns about what I call, excessive capitalism; the vultures/wiseguys who will take any situation and through loop-holes and gerry-rigging will reap unseemly benefits at the expense of the rest of us.
I also share your irreverent, sarcastic tendencies, so I know how easy it is to indulge them when given an opening.
October 21, 2009 12:31 PM | Reply | Permalink