A few questions and thoughts

First, other than Baucus & the two Senators from Maine, which are the key senators that need to be pressured (certainly not the two from Massachusetts, where I am). A nice list at TPM of the dozen or so most crucial senate votes (the senate seems to be where the greatest problems lie) would be helpful.

Second, I don't quite get this issue of mandate. During the campaign, Obama argued for a mandate for ALL minors, while adults could opt out. That was trashed by many, I thought unfairly, as 'less progressive' than Hillary's approach, but in fact, forcing possibly millions of people to shell out significant sums for health coverage that (wisely or not) they choose not to have seems like a political burden.

What I have gleaned (correctly or not) is that the huge INTEREST groups (megacorporate health) stand to make more buckage if there is a broader mandate, even though millions of voters might be alienated, and therefore possibly members of Congress. Is it harder or easier to pass a bill with all the OTHER progressive provisions with or without a mandate on all adults to buy coverage? I suspect that it would be easier without a mandate, and that it is one provision that, unlike having public option or financing it by taxing the wealthiest from the start, w/o a mandate. I am also not sure about the employer mandate either, especially in hard economic times.

Single payer makes so much more sense than all of this *sigh*

Third, even if the tax on the wealthy is passed without dilution (and if elephants start flying out of my ass, all singing Mozart's Requiem), it seems that there will be more money needed to pay, especially for a really vibrant public option and allowing states to go single-payer. I think that the Kucinich Amendment is a key element that is more urgent than mandate -- mandate could be added later, as Obama argued during the campaign, reasonably persuasively.
The additional money needed could be gotten by taxing pollution (stuff like mercury emissions, even within legal limits). That would be the most politically palatable tax I could think of, and it would do some good (which is what makes it palatable)

What is the benefit to the average American to hlping implement a half assed insurance reform measure that won't actually do anything, anytime soon at least, to help reduce the costs all workers and businesses are having to pay the insurance predators? I just don't see any.

That's a very good point you make, freedomhasvalue. And here's another question for Mr. Reich:

Re key element #2, "a mandate on all but the smallest employers to provide their employees with health insurance or else pay a tax or fee (so-called "pay or play"),"

What would be the definition of "smallest employers?"

A few comments regarding cited issues. First, the public option is self-financing through premiums and requires no taxpayer money. In fact, it's a cost reduction mechanism through its ability to bargain with drug companies and compete with private insurers. That is why it is a critical element of the reform package.

Second, the mandates are essential to rectify current problems that leave millions uninsured. Some of these can't afford to pay when they get sick, and the public is stuck with the tab. Others are affluent and healthy. Their premium charges will equal those of individuals with illnesses or pre-existing conditions, and will therefore make it possible for all premiums to be more affordable. Equally pertinent, mandates are a prominent feature of effective health care in many European systems, all of which provide care for more citizens at lower cost, and with better health outcomes. They are well accepted, and serve equally well here. Low income families who find mandated premiums unaffordable will receive government subsidies to offset those costs. The level of subsidization is currently subject to contentious debate in Congress.

The bills are still in flux. Employer exemptions from some provisions refer to small businesses with fewer than 20 employees, but this may change.

Mandates are necessary to provide a basic level of care for everyone in the country. It's the human thing to do.

However, with or without a public option, mandates aren't going to reduce cost substantially. To say they're self-financing is deceptive, because the finance requires mandatory premiums and tax funded subsidies. Increasing the care delivered to today's uninsured, without taking steps to reduce the cost of that care, will logically drive total system costs upward. I think this is a key concern for the public now -- they see this extra cost and wonder who's going to pay for it.

Long and short, we as a decent society need universal coverage. We also need to take much more serious steps to reduce total cost if we're not going to be a bankrupt society in a few decades.

I don't understand why taxing peoples' existing health benefits is a preferable funding source than taxing rich people.

Two things.

1. This: "In other words, next fall we get something called "universal health insurance" that still leaves millions of Americans uninsured and doesn't substantially slow the meteoric rise of health-care costs. That would be a tragedy." ...was always going to happen, and is baked into even the House bill today, even with the four principles listed.

2. Reich calls for "(3) a requirement that every individual and family buy health insurance, coupled with subsidies for families up to 300 or 400 times the poverty level in order to make sure it's affordable to them." Anyone notice how both families and individuals are specified for being covered by the mandate, but only families are specified for subsidies? Significant or an oversight? Hard to say.

Every day that goes by without a vote in the House or Senate on universal health care makes it less likely that major reform will occur, because (1) opponents have more time to stir up public anxieties about it; (2) Democrats up for reelection next year come ever closer to the gravitational pull of the midterms, and grow increasingly worried about voting for a bill that could be a political liability in a year when unemployment may well reach double digits and the electorate is restless and unhappy ...

Well, if this is true then it seems to me that the whole health care reform effort is suffering from some fundamental strategic and public relations failures.

First, why isn't it the opponents who are worried about stirred-up anxieties? Shouldn't the proponents of health care reform be able to make the case that people's premiums and co-pays are going to go up, along with the risks of losing their coverage altogether, unless reform is enacted? The proponents of health care reform should be capable of being at least as successful as their opponents in scaring the bejeezus out of people.

Similarly, why should voting for health care reform - something that is good for the country and good for most of the individuals in the country - be a political liability? Shouldn't the opponents of reform be the one's that are cowering about the political liability that comes from failing to enact reform?

If progressives can't figure out how to sell people on the idea that health care reform is an urgent national need, and in most Americans' own damn interests, then why are they even trying?

The mandate won't work in California. Since illegals will be ineligible for insurance that would leave somewhere between 6 and 8 million without it. Without the Kucinich amendment making it through intact with the bill, this will mean California will be even more screwed than it is now.

Unless Speaker Pelosi keeps the House in session into next week, there will not be a vote on health reform this week. The committees are still working on the bills so the timeframe makes it virtually impossible to have a vote by Friday (I say this as a former Hill staffer who worked on the Clinton health reform effort in 1993-94).

I am definitely nervous about health reform. However, I see positive signs, particularly Henry Waxman's decision to call the Blue Dog's bluff last week by threatening to not have an Energy and Commerce bill. THe Blue Dogs quickly caved because they know Energy and Commerce is their only chance to influence the process. It is by far the most conservative committee of the 3 House health committees and it was the only one that could not produce a bill in 1994.

If Waxman gets a bill out, as now seems likely, that will be a very positive sign in the House.

"Every day that goes by without a vote in the House or Senate on universal health care makes it less likely that major reform will occur, because (1) opponents have more time to stir up public anxieties about it;"

While I see your point, this is a bit of a self-fulfilling prophesy -- this bill is dead if we have an August recess! The logner we wait, I agree, it is harder, but August per se was a bit of an arbitrary deadline.

Nate Silver has pointed out it could go either way -- and give us a break from the current media pileon against health care. In a few weeks, the narrative might change as they tire of he story of Obama's troubles" and move on to a new story line.

So while I support your call for pressure pols, I don't think we should be pessimistic. That only gives aid and comfort to the enemy.

I'm worried about the affordability of the mandate. 300-400% of poverty sounds OK until you look at how low an income that really is and consider how high the deductibles are likely to be on the "affordable" policy and how it may only cover very basic medical care.

The bill is going to be underfunded. The Blue Dogs will guarantee it. Why do Blue Dogs hate Americans?

The current House bill cuts off all subsidies at $43,000 for an individual.

So if you make $44k or more, and you don't have insurance through some other means, you will be required by law to purchase a policy at full price - with no cap on the premiums, no limit on the deductibles, no definition of minimum coverage. Where I live that's something like $800/month or more a month for catastrophic insurance, which does NOT cover routine and preventative health care.

$800 a month is more than half of my post-rent, post-taxes monthly income. Yet I'm in that no-subsidy group.

How the hell am I supposed to afford that? And if I'm still left to pay out-of-pocket for normal medical care on TOP of that huge monthly mandated bill, how am I really better off?

People are going to be very surprised and very pissed off. And this is the GOOD plan.

I see two problems that appear unlinked but might be an opening to a longer term strategy to outmaneuver the "centrists"(read corporate lackeys).
The first problem is that there is almost no stimulus money going where it's needed most, to the unemployed who will most definitely spend it as soon as they get it, providing real stimulus to the economy.
The second problem is that all attempts to get single payer included in a universal coverage bill will almost certainly be smothered under the millions of dollars of corporate dirty tricks and purchased congressfolk.
My thought is that we need to go hard after extensions to unemployment benefits as the right thing to do and include coverage under medicare and SCIP for health benefits for those same families. Certainly these would be folks who otherwise would not be able to get any medical coverage, who have obviously been productive workers until the economic depression, and who would provide a backdoor way to expand single payer coverage (medicare) that would be much more difficult to block; think, golden parachutes for bankers and execs and congresspeople, but nothing but rags for hard working Americans?