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The Public Option Lives On
Tomorrow (Tuesday) is a critical day in the saga of the public option. Democrats Charles Schumer (New York) and Jay Rockefeller (West Virginia) are introducing an amendment to include the public option in the bill to be reported out by the Senate Finance Committee -- the committee anointed by the White House as its favored vehicle for getting health care reform.
Before you read another word, call and email the Senate offices of Democrats Max Baucus (Montana), Tom Carper (Delaware), Robert Menendez (New Jersey), Kent Conrad (North Dakota), Jeff Bingaman (New Mexico), John Kerry (MA), Blanche Lincoln (Arkansas), Ron Wyden (Oregon), Debbie Stabenow (Michigan), Maria Cantwell (Washington), and Bill Nelson (Florida) -- telling them you want them to vote in favor of the public option amendment. And get everyone you know in these states to do the same. Hell, you might as well phone and email Republican Olympia Snowe (Maine) and make the same pitch.
Background: Every dollar squeezed out of Big Pharma and Big Insurance is a dollar less that you'll have to pay either in healthcare costs or in taxes to cover healthcare costs. The two most direct ways to squeeze future profits are allowing Medicare to use its huge bargaining leverage to negotiate lower drug prices, and creating a public insurance option to compete with private insurers and also use its bargaining clout to get lower prices and thereby push private insurers to offer lower rates.
But last January, the White House made a Faustian bargain with Big Pharma and Big Insurance, essentially scuttling both of these profit-squeezing mechanisms in return for these industries' agreement not to oppose healthcare legislation with platoons of lobbyists and millions of dollars of TV ads, and Pharma's willingness to cut drug prices by some $80 billion over the next ten years. The White House promised these industries they'd come out way ahead -- getting tens of millions of new customers who'd be buying private health insurance policies and thereby paying for an almost endless supply of new drugs. Healthcare reform would be, in short, a bonanza.
Big Pharma and Big Insurance have so far delivered on their side of the deal. In fact, Big Pharma has shelled out $120 million in advertisements in favor of reform. Now the White House is delivering on its side.
Last Thursday, for example, the Senate Finance Committee rejected Ben Nelson's amendment to require Big Pharma to give some $160 billion in discounts to Medicare -- thereby reducing the bonanza Pharma would reap from the healthcare bill. Not surprisingly, all Republicans voted against the amendment. But it was defeated only because Dems Baucus, Carper, and Menendez voted with the Republicans.
Carper later explained to the New York Times why he voted with the Republicans. The amendment, he said, would "undermine our ability to pass" health care reform, because the White House had made a deal with Big Pharma by which the industry wouldn't oppose healthcare reform -- and White House officials had told him "a deal is a deal." The Times described the vote as a "big victory" for the White House.
Schumer voted for the amendment. He said he was "not at the table" when the White House and Big Pharma made their deal so didn't feel bound by it. But even if he had been at the table, he wouldn't be bound. No member of the Senate is bound to a deal made between industry and the White House. Congress is a separate branch of government.
Big Pharma and big insurance hate the public insurance option even more than they hate big Medicare discounts. And although the President has sounded as if he would welcome it, political operatives in the White House have quietly reassured the industries that it won't be included in the final bill. At most, the bill would allow the formation of non-profit "cooperatives" that wouldn't have the scale or authority to squeeze the profits of private industry, or a "trigger" that would allow states to form public insurance options eventually if certain goals for cost savings and coverage weren't met.
But the public option lives on, nonetheless. It's still in the Senate Health, Education, Labor, and Pension bill. It still headlines the House bills, and Speaker Nancy Pelosi says she's still committed to it. The latest Times/CBS poll shows 65 percent of the public in favor of it.
Now, Schumer and Rockefeller are introducing a public option amendment in the Senate Finance Committee. Carper, Menendez, Baucus, and other Dems on the Committee should vote for it, or be forced to pay a price if they don't.
Background: Every dollar squeezed out of Big Pharma and Big Insurance is a dollar less that you'll have to pay either in healthcare costs or in taxes to cover healthcare costs. The two most direct ways to squeeze future profits are allowing Medicare to use its huge bargaining leverage to negotiate lower drug prices, and creating a public insurance option to compete with private insurers and also use its bargaining clout to get lower prices and thereby push private insurers to offer lower rates.
But last January, the White House made a Faustian bargain with Big Pharma and Big Insurance, essentially scuttling both of these profit-squeezing mechanisms in return for these industries' agreement not to oppose healthcare legislation with platoons of lobbyists and millions of dollars of TV ads, and Pharma's willingness to cut drug prices by some $80 billion over the next ten years. The White House promised these industries they'd come out way ahead -- getting tens of millions of new customers who'd be buying private health insurance policies and thereby paying for an almost endless supply of new drugs. Healthcare reform would be, in short, a bonanza.
Big Pharma and Big Insurance have so far delivered on their side of the deal. In fact, Big Pharma has shelled out $120 million in advertisements in favor of reform. Now the White House is delivering on its side.
Last Thursday, for example, the Senate Finance Committee rejected Ben Nelson's amendment to require Big Pharma to give some $160 billion in discounts to Medicare -- thereby reducing the bonanza Pharma would reap from the healthcare bill. Not surprisingly, all Republicans voted against the amendment. But it was defeated only because Dems Baucus, Carper, and Menendez voted with the Republicans.
Carper later explained to the New York Times why he voted with the Republicans. The amendment, he said, would "undermine our ability to pass" health care reform, because the White House had made a deal with Big Pharma by which the industry wouldn't oppose healthcare reform -- and White House officials had told him "a deal is a deal." The Times described the vote as a "big victory" for the White House.
Schumer voted for the amendment. He said he was "not at the table" when the White House and Big Pharma made their deal so didn't feel bound by it. But even if he had been at the table, he wouldn't be bound. No member of the Senate is bound to a deal made between industry and the White House. Congress is a separate branch of government.
Big Pharma and big insurance hate the public insurance option even more than they hate big Medicare discounts. And although the President has sounded as if he would welcome it, political operatives in the White House have quietly reassured the industries that it won't be included in the final bill. At most, the bill would allow the formation of non-profit "cooperatives" that wouldn't have the scale or authority to squeeze the profits of private industry, or a "trigger" that would allow states to form public insurance options eventually if certain goals for cost savings and coverage weren't met.
But the public option lives on, nonetheless. It's still in the Senate Health, Education, Labor, and Pension bill. It still headlines the House bills, and Speaker Nancy Pelosi says she's still committed to it. The latest Times/CBS poll shows 65 percent of the public in favor of it.
Now, Schumer and Rockefeller are introducing a public option amendment in the Senate Finance Committee. Carper, Menendez, Baucus, and other Dems on the Committee should vote for it, or be forced to pay a price if they don't.
Before you read another word, call and email the Senate offices of Democrats Max Baucus (Montana), Tom Carper (Delaware), Robert Menendez (New Jersey), Kent Conrad (North Dakota), Jeff Bingaman (New Mexico), John Kerry (MA), Blanche Lincoln (Arkansas), Ron Wyden (Oregon), Debbie Stabenow (Michigan), Maria Cantwell (Washington), and Bill Nelson (Florida) -- telling them you want them to vote in favor of the public option amendment. And get everyone you know in these states to do the same. Hell, you might as well phone and email Republican Olympia Snowe (Maine) and make the same pitch.
Background: Every dollar squeezed out of Big Pharma and Big Insurance is a dollar less that you'll have to pay either in healthcare costs or in taxes to cover healthcare costs. The two most direct ways to squeeze future profits are allowing Medicare to use its huge bargaining leverage to negotiate lower drug prices, and creating a public insurance option to compete with private insurers and also use its bargaining clout to get lower prices and thereby push private insurers to offer lower rates.
But last January, the White House made a Faustian bargain with Big Pharma and Big Insurance, essentially scuttling both of these profit-squeezing mechanisms in return for these industries' agreement not to oppose healthcare legislation with platoons of lobbyists and millions of dollars of TV ads, and Pharma's willingness to cut drug prices by some $80 billion over the next ten years. The White House promised these industries they'd come out way ahead -- getting tens of millions of new customers who'd be buying private health insurance policies and thereby paying for an almost endless supply of new drugs. Healthcare reform would be, in short, a bonanza.
Big Pharma and Big Insurance have so far delivered on their side of the deal. In fact, Big Pharma has shelled out $120 million in advertisements in favor of reform. Now the White House is delivering on its side.
Last Thursday, for example, the Senate Finance Committee rejected Ben Nelson's amendment to require Big Pharma to give some $160 billion in discounts to Medicare -- thereby reducing the bonanza Pharma would reap from the healthcare bill. Not surprisingly, all Republicans voted against the amendment. But it was defeated only because Dems Baucus, Carper, and Menendez voted with the Republicans.
Carper later explained to the New York Times why he voted with the Republicans. The amendment, he said, would "undermine our ability to pass" health care reform, because the White House had made a deal with Big Pharma by which the industry wouldn't oppose healthcare reform -- and White House officials had told him "a deal is a deal." The Times described the vote as a "big victory" for the White House.
Schumer voted for the amendment. He said he was "not at the table" when the White House and Big Pharma made their deal so didn't feel bound by it. But even if he had been at the table, he wouldn't be bound. No member of the Senate is bound to a deal made between industry and the White House. Congress is a separate branch of government.
Big Pharma and big insurance hate the public insurance option even more than they hate big Medicare discounts. And although the President has sounded as if he would welcome it, political operatives in the White House have quietly reassured the industries that it won't be included in the final bill. At most, the bill would allow the formation of non-profit "cooperatives" that wouldn't have the scale or authority to squeeze the profits of private industry, or a "trigger" that would allow states to form public insurance options eventually if certain goals for cost savings and coverage weren't met.
But the public option lives on, nonetheless. It's still in the Senate Health, Education, Labor, and Pension bill. It still headlines the House bills, and Speaker Nancy Pelosi says she's still committed to it. The latest Times/CBS poll shows 65 percent of the public in favor of it.
Now, Schumer and Rockefeller are introducing a public option amendment in the Senate Finance Committee. Carper, Menendez, Baucus, and other Dems on the Committee should vote for it, or be forced to pay a price if they don't.
Background: Every dollar squeezed out of Big Pharma and Big Insurance is a dollar less that you'll have to pay either in healthcare costs or in taxes to cover healthcare costs. The two most direct ways to squeeze future profits are allowing Medicare to use its huge bargaining leverage to negotiate lower drug prices, and creating a public insurance option to compete with private insurers and also use its bargaining clout to get lower prices and thereby push private insurers to offer lower rates.
But last January, the White House made a Faustian bargain with Big Pharma and Big Insurance, essentially scuttling both of these profit-squeezing mechanisms in return for these industries' agreement not to oppose healthcare legislation with platoons of lobbyists and millions of dollars of TV ads, and Pharma's willingness to cut drug prices by some $80 billion over the next ten years. The White House promised these industries they'd come out way ahead -- getting tens of millions of new customers who'd be buying private health insurance policies and thereby paying for an almost endless supply of new drugs. Healthcare reform would be, in short, a bonanza.
Big Pharma and Big Insurance have so far delivered on their side of the deal. In fact, Big Pharma has shelled out $120 million in advertisements in favor of reform. Now the White House is delivering on its side.
Last Thursday, for example, the Senate Finance Committee rejected Ben Nelson's amendment to require Big Pharma to give some $160 billion in discounts to Medicare -- thereby reducing the bonanza Pharma would reap from the healthcare bill. Not surprisingly, all Republicans voted against the amendment. But it was defeated only because Dems Baucus, Carper, and Menendez voted with the Republicans.
Carper later explained to the New York Times why he voted with the Republicans. The amendment, he said, would "undermine our ability to pass" health care reform, because the White House had made a deal with Big Pharma by which the industry wouldn't oppose healthcare reform -- and White House officials had told him "a deal is a deal." The Times described the vote as a "big victory" for the White House.
Schumer voted for the amendment. He said he was "not at the table" when the White House and Big Pharma made their deal so didn't feel bound by it. But even if he had been at the table, he wouldn't be bound. No member of the Senate is bound to a deal made between industry and the White House. Congress is a separate branch of government.
Big Pharma and big insurance hate the public insurance option even more than they hate big Medicare discounts. And although the President has sounded as if he would welcome it, political operatives in the White House have quietly reassured the industries that it won't be included in the final bill. At most, the bill would allow the formation of non-profit "cooperatives" that wouldn't have the scale or authority to squeeze the profits of private industry, or a "trigger" that would allow states to form public insurance options eventually if certain goals for cost savings and coverage weren't met.
But the public option lives on, nonetheless. It's still in the Senate Health, Education, Labor, and Pension bill. It still headlines the House bills, and Speaker Nancy Pelosi says she's still committed to it. The latest Times/CBS poll shows 65 percent of the public in favor of it.
Now, Schumer and Rockefeller are introducing a public option amendment in the Senate Finance Committee. Carper, Menendez, Baucus, and other Dems on the Committee should vote for it, or be forced to pay a price if they don't.
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But last January, the White House made a Faustian bargain with Big Pharma and Big Insurance, essentially scuttling both of these profit-squeezing mechanisms in return for these industries' agreement not to oppose healthcare legislation with platoons of lobbyists and millions of dollars of TV ads, and Pharma's willingness to cut drug prices by some $80 billion over the next ten years. The White House promised these industries they'd come out way ahead -- getting tens of millions of new customers who'd be buying private health insurance policies and thereby paying for an almost endless supply of new drugs. Healthcare reform would be, in short, a bonanza.
I can't tell you how furious this makes me - not entirely with our government, which is forced to make such humiliating deals under these kinds of threats and extortion, but with the established economic interest who rule us. Somebody needs to put a stake through the heart of these "stakeholders". They apparently think health care reform is some kind of favor they will hand out to us on their own terms.
By the way,USA today reported today that "non-profit" Partners Health Care CEO James Mongan was paid $3.4 million in 2008!
If we can't get a public option in this package, I'm telling my members of Congress I want them to go nuclear and nationalize the whole stinking racket next year.
September 28, 2009 2:14 PM | Reply | Permalink
Yes, I feel similarly disgusted. My guess on why only 3 recommends (as I write) for one of the most popular commentators at the cafe is that folks want to think long and hard before advocating a course of action that would put a good part of the Democratic base in open opposition to the WH's apparent political judgment back in January that these were deals that had to be made to get to the best place it is possible to get to on health care this time around.
I find myself wondering what Ted Kennedy would be advocating on this matter--more to the point, whether this possibility was one that was on his radar screen before he passed and what his counsel would have been.
Maybe I can't get this information at the cafe and need to rely on Maggie Mahar or some of the other HC policy specialists--but I find myself struggling to understand how inclusion of the public option amendment as drafted would affect out-of-pocket health care costs for those earners making $15K, $25K, $35K, and $45K, especially.
Without knowing what those projections look like I find it difficult to form an assessment of whether the public option language being proposed would be likely to make a positive difference for these folks in particular, or whether there would likely be little or no difference and this is more about symbolism than substance.
I don't think one has to be a partisan Republican desiring political damage to this Administration or some probably well-to-do libertarian crank to think that mandating coverage for people who right now are really, really hurting, whether they would want to purchase it or not, raises serious equity issues for lots and lots of folks who hang out here.
If the argument is that everyone, no exceptions, has to be covered in order to reign in costs, I'd appreciate it if someone could offer a link to a plain-language, credible making of that case that includes cost estimates.
September 28, 2009 8:28 PM | Reply | Permalink
Either your post is missing a transition or you have confused the public option with the mandate. The theory behind the mandate is basically the theory behind insurance in general - spreading the risk acoross a large population. Without the mandate, many people opt not to buy insurance until they need health care. These are called free riders because the rest of us have to pick up the tab. There are good reasons to believe a mandate will lower actual costs - fewer ER visits for non-emergent conditions, etc. - but there is no question that it should lower the cost for the rest of us - the ones that are already paying.
The problem is that, without the public option - a government run insurance plan similar to medicare to compete with private insrance - or some other mechanism to control the health insurance industry, the mandate will just represent a bonanza of new customers for them to gouge. Others propose increased regulation, which would be fine with me however, I have a hard time imagining effective regulation being passed any easier than the public option. Plus, regulations are vulnerable to idiots waving chain saws in front of stacks of paper - as we saw with financial regs.
September 29, 2009 7:26 AM | Reply | Permalink
Just raising questions I have to try to understand the real-life (as distinct from the symbolic stakes surrounding whether there is a public option or not in the end) stakes, especially for the income groups I mentioned and on overall costs, of these three scenarios:
1. mandate with no public option
2. public option proposed in this amendment, with no mandate
3. mandate and the public option as proposed in the amendment
September 29, 2009 7:45 AM | Reply | Permalink
Quite a surprise, Mr. Reich, to see your upbeat assessment greeted with so little approval from the commentariat at TPM. They must be plotting an insurrection.
September 28, 2009 5:30 PM | Reply | Permalink
Was I caught Friday catnapping?
Maybe. Will somebody post a link so that I can boldly go where no link has taken me before:
Speaking quietly to treachery doesn't get it done for me here.
I am a primitive with a pipe craving reassurances.
The Thog part of my brain needs links...
September 28, 2009 9:20 PM | Reply | Permalink
Love that picture of Bertrand Russell - a great intellect!
September 28, 2009 9:24 PM | Reply | Permalink
FYI, the Nelson on the Senate Finance Committee is Bill Nelson (D-FL) not Ben Nelson (D-NE). Please correct, Mr. Reich, before people start pointlessly inundating that Nebraska insurance swine with pro-reform emails!
September 28, 2009 9:25 PM | Reply | Permalink
Sheila Jackson Lee
This is what we need to replace Speaker Pilosi.
She represents the new Obama Democrate Party.
She can speak over anyone and no matter what you ask her, she can talk for hours and not give a answers.
September 28, 2009 10:16 PM | Reply | Permalink
Keeping my fingers crossed and my phone busy.
But I keep thinking about poor Jon Kyl(R-AZ). If he is forced to pay for some poor woman's maternity care he will never be able to afford 7 houses like his buddy John McCain.
September 28, 2009 10:16 PM | Reply | Permalink
Eh, don't bother calling or contacting those reps unless you live in their districts. I'm sure staff will promptly put your message in the trash.
DO try to call people there to persuade them...to call.
September 28, 2009 10:18 PM | Reply | Permalink
I just sent a message to Sen. Mendez to express my support for a public option. Here is the link if anyone wants to do the same.
September 28, 2009 11:16 PM | Reply | Permalink
Edit: Menendez
September 28, 2009 11:34 PM | Reply | Permalink
No one has been able to leave a msg for Baucus for a couple of months now....his mailbox is always full. So he's not listening to any one in the public.
You can call but I don't think his staff really passes the messages on. I've called numerous times and the staff says "Yeah, OK".
September 29, 2009 9:27 AM | Reply | Permalink
Done (e-mails to all 11 on my lunch break, incl. John Kerry, my Sen.). Yes, they probably go in the recycle bin, but if they get a wave of them all pro-public option, that might make its way up the food chain.
I do think the public option will probably be more affordable than other private plans. First of all, the budgeting aspect would be transparent. And much less paperwork, no executive overhead to pay, no advertising budget. And you have the leverage of the US gov't in bargaining for drug prices, hospital stays, etc. Hey, if it turns out to be too expensive, I'm sure there will be private catastrophic-only plans with sky high deductibles ready to undercut the gov't. option with bargain basement insurance.
September 29, 2009 11:37 AM | Reply | Permalink
Public option would certainly be more affordable than any private plans...it's a critical component to this new health care reform. it needs to happen.
...but have they voted yet? bad or good news? i need to go look this up.
September 29, 2009 3:03 PM | Reply | Permalink
Excerpts, from the Grey Lady...
September 30, 2009 NY Times
Senate Panel Rejects a ‘Public Option’ in Health Plan
By DAVID M. HERSZENHORN
WASHINGTON — After a half-day of animated debate, the Senate Finance Committee on Tuesday rejected efforts by liberal Democrats to add a government-run health insurance plan to major health care legislation, dealing the first official setback to an idea that many Democrats, including President Obama, say they support.
All of the other versions of the health care legislation advancing in Congress — a bill approved by the Senate health committee and a trio of bills in the House — include some version of the government-run plan, or public option.
.....
The committee on Tuesday afternoon voted, 15 to 8, to reject an amendment proposed by Senator John D. Rockefeller IV, Democrat of West Virginia, to add a public option called the Community Choice Health Plan, an outcome that underscored the lack of support for a government plan among many Democrats.
Mr. Baucus voted no, as did Senators Thomas R. Carper of Delaware, Kent Conrad of North Dakota, Blanche Lincoln of Arkansas, , and Bill Nelson of Florida, joining all 10 Republicans in opposition.
Senator Charles E. Schumer, Democrat of New York, who voted in favor of the proposal, said supporters of the public option would keep on fighting. He has offered a separate amendment to establish such an option.
“We are going to keep at this and at this and at this until we succeed, because we believe in it so strongly,” he said.
.....
Aides to the majority leader, Senator Harry Reid, Democrat of Nevada, say that he will not include a provision for the public option when he combines the measures coming out of the finance and health committees.
.....
September 29, 2009 3:51 PM | Reply | Permalink
But, but --
The Public Option Lives On
On life support.
September 29, 2009 7:44 PM | Reply | Permalink
What's with Carper? The other Democrats I can explain to myself in terms of geography, small state, rural state, retireee state, but New Jersey? Eastern, urban Jersey? I know it has screwy politics, but I just don't see where Carper is coming from. Any theory would be appreciated.
September 29, 2009 8:03 PM | Reply | Permalink
He's Delaware, isn't he? Word has it he was floored when he told a town meeting Obama really is a US citizen and therefore is the legit prez and got hooted by the attendees. Maybe he's spooked, I don't know.
September 29, 2009 8:34 PM | Reply | Permalink
Ooops. My bad. Where did I get the idea he was from New Jersey. (hangs head in shame).
September 29, 2009 9:30 PM | Reply | Permalink
Aw, heck, we've all been there, amike. I really enjoy the stuff you write here, BTW.
September 30, 2009 9:52 AM | Reply | Permalink
I can't tell you how furious this makes me - not entirely with our government, which is forced to make such humiliating deals under these kinds of threats and extortion, but with the established economic interest who rule usbuy steroids. Somebody needs to put a stake through the heart of these "stakeholders". They apparently think health care reform is some kind of favor they will hand out to us on their own terms.
September 30, 2009 9:07 AM | Reply | Permalink
Are we out of the !@#$%^& Senate Finance Committee yet?
Most here probably know that, ordinarily, a bill must be voted out of each committee to which it was referred in order eventually to be voted on by the full chamber, in either the House or Senate.
If the bill had been voted down or simply not been brought to a vote in Senate Finance, under the ordinary rules and understandings, that bill would have been killed. Those who want to kill legislation do their best to get bills referred to as many Committees as possible for that reason, decisions which are made by the Parliamentarians of each chamber upon bill introduction.
Plenty Enough Suck to Go Around.
September 30, 2009 10:18 AM | Reply | Permalink
American Dreamer--
To answer your question about the public option:
Someone earning $45,000 (individual) isn't going to be eligible for a subsidy (tax credit) from the government to help pay his premiums.
Unless he has an employer helping to pay for his insurance, he's on his own--and required to buy insurance (which really is a good idea---even should be insured if at all possible) or pay a penalty.
The public option will help him because the public insurance should be at least $1,000 less expensive (for an individual) and $2,000 less
expensive (for a family) just because it's administrative costs will be lower (no lobbying, or huge marketing and advertising expensens; ho need to deliver profits to shareholderse; no huge executive salaries.)
The public option also should have the clout to negotiate better rates from drug-makers and some brand-name hopsitals that are over-charging insurers.
So the savings could be greater than the $1,000 to $2,000. And very likely the coverage will be better. It's more likely to be based on medical evidence showing which treatments are most effective for most patients.
October 4, 2009 1:43 PM | Reply | Permalink
Thanks, Maggie. Much appreciated as always. Really wish you were contributing regularly to help us all understand the implications of the various decisions Congress is making.
BTW, your book Money Driven Medicine is currently displayed prominently at the Barnes and Noble at Tyson's Corner, Virginia. I was glad to see that.
Best,
AD
October 4, 2009 8:15 PM | Reply | Permalink