The attempt to attract GOP support was the pretext which Democrats used to compromise continuously and water down the bill. But -- given the impossibility of achieving that goal -- isn't it fairly obvious that a desire for GOP support wasn't really the reason the Democrats were constantly watering down their own bill? Given the White House's central role in negotiating a secret deal with the pharmaceutical industry, its betrayal of Obama's clear promise to conduct negotiations out in the open (on C-SPAN no less), Rahm's protection of Blue Dogs and accompanying attacks on progressives, and the complete lack of any pressure exerted on allegedly obstructionists "centrists," it seems rather clear that the bill has been watered down, and the "public option" jettisoned, because that's the bill they want -- this was the plan all along.
So the only real question is: What was in the deal between the WH and the medical insurance complex ?
Should we get somebody to "follow the money ?" keep to the Fen Causeway
Should we get somebody to "follow the money ?"
The sad pathetic thing is that they probably wouldn't find anything.
In retrospect, Obama's election is a double sensation: not only the fact that the US elected a black president, but the fact that said black president would reveal himself to be an Eisenhower Republican.
In that context, we can deconstruct "Change we can believe in" as "Change within the bounds of Realpolitik".
Given that, it's no wonder he sold us out. What's more, he probably didn't even think to ask for his 30 pieces of silver. The fact is that what we're experiencing right now is a top-down disaster. -Paul Krugman
There was a time, barely remembered today, when the idea of bipartisanship really seemed reasonable. There was once a kind of Republican, now driven to the verge of extinction, called the "Eisenhower Republican." Today, the equivalent beast would be called a "Moderate Democrat." The Republican Party itself has largely purged itself of Eisenhower Republicans in its radical shift to the right. I have always been a Democrat. But even the earliest President I remember, Richard Nixon, though a crazy, paranoid, power hungry SOB, could be ideologically reasonable, as evidenced by his establishment of the EPA. But Nixon, probably unintentionally, began the decline of the Eisenhower Republican. Some of those he brought into government are the very same "barking crazy rightwingers" who have systematically been destroying our nation under Bush. That, combined with Nixon's spectacular and televised downfall, discredited the reasonable, moderate Republican
I have always been a Democrat. But even the earliest President I remember, Richard Nixon, though a crazy, paranoid, power hungry SOB, could be ideologically reasonable, as evidenced by his establishment of the EPA. But Nixon, probably unintentionally, began the decline of the Eisenhower Republican. Some of those he brought into government are the very same "barking crazy rightwingers" who have systematically been destroying our nation under Bush. That, combined with Nixon's spectacular and televised downfall, discredited the reasonable, moderate Republican
I just do not get this point of view. How is getting healthcare reform passed 'selling us out?' Maybe we can eventually make language a complete impediment to understanding. -Hobbes
There was a window there about a year ago where I think there was a real chance of getting Medicare for everyone.
I don't argue the current HCR will mean an improvement for millions. But it is still short of what was possible a year ago. And I believe the agreement with Big Pharma at the outset was an unnecessary concession that did a great deal to make the possible impossible. The fact is that what we're experiencing right now is a top-down disaster. -Paul Krugman
not call our leaders sellouts with bad motives when they can't achieve what we want.
If they try and fail, that's one thing. But I expect them to try.
In this regard, my disappointment with Obama goes beyond healthcare. The fact is that what we're experiencing right now is a top-down disaster. -Paul Krugman
I suspect that Obama genuinely failed to see what he could have achieved with his mandate.
Every bit of evidence I can observe from my perspective shows he's working to getting health care. This is a battle that's been waged for decades, for my whole lifetime anyway. I've seen it go down in flames often enough, and heard people on the left even, as recently as 5 years ago, parroting the consensus that 'everyone knows' it was 'impossible' in the US.
So everything I've seen indicates to me that this is a huge battle and no easy task and that this president seems to being on the brink of accomplishing something that no other president has. So why would I conclude that he's working against my interests and selling me out? Why brush aside the 'millions' that will be helped?
Right now, private industry IS our health care system. We've got NO significant public infrastructure. I see the evidence that Obama acknowledges this problem by what's in the bill - funding for building clinics and paying for health care workers' education.
So I have no idea if a 'deal' with pharma was necessary, but I'm certainly not going to jump to the conclusion that Obama has sold us out and that this was his motive based on that. For one thing, the drug-reimportation thing everyone's wailing about is really stupid policy -- why should we 're-import' drugs from Canada? Why shouldn't we just get the regulations in place then work out our own discounts when the government actually has the bargaining power brought about by the bill when it passes? Maybe we can eventually make language a complete impediment to understanding. -Hobbes
They should have started with single payer. I mean, even if they weren't going to get it, it is what most other western democracies have. It's the one program that makes sense. But okay, we live in a country that doesn't make sense.. But at least start with that. During the campaign, Obama said, 'If we were starting from scratch, single-payer would make sense.' Well then, let's start from scratch - that is kinda where we are in this country right now. And if they had started from that, then the fall-back compromise position would have at least been the public option. But they didn't even start with the public option - he didn't even defend that.
During the campaign, Obama said, 'If we were starting from scratch, single-payer would make sense.' Well then, let's start from scratch - that is kinda where we are in this country right now. And if they had started from that, then the fall-back compromise position would have at least been the public option. But they didn't even start with the public option - he didn't even defend that.
and as Dr Marcia Angell said to Bill Moyer
But if you look at it as a matter of policy, the President's absolutely right that the status quo is awful. If we do nothing, costs will continue to go up. People will continue to lose their coverage. Employers are dropping health benefits. Things will get very bad. The issue is, will this bill make them better or worse? And I believe it will make it worse. [...] BILL MOYERS: Well, you remind me 45 thousand people, as Wendell Potter said earlier, die every year for lack of health insurance. That should be-- they're-- MARCIA ANGELL: It's not lack of health insurance. It's lack of health care. There is a difference between health insurance and health care. You can have insurance offered that is too expensive to buy or too expensive to use. What good does it do?
The issue is, will this bill make them better or worse? And I believe it will make it worse.
[...]
BILL MOYERS: Well, you remind me 45 thousand people, as Wendell Potter said earlier, die every year for lack of health insurance. That should be-- they're--
MARCIA ANGELL: It's not lack of health insurance. It's lack of health care. There is a difference between health insurance and health care. You can have insurance offered that is too expensive to buy or too expensive to use. What good does it do?
But what if she's right. what if it makes things worse ? I don't know, I can't judge this situation. But the fact that something that should have been easy, a perfect do something unequivocally good has been so finessed and watered down that people of good intention can seriously question if it will make things worse, makes me think somebody at the top sold you out. And I think that's what dvx is saying. keep to the Fen Causeway
No, actually, that is not my stance. While true that almost anything would be better than what we have, I'm supportive of the bill because it's a good bill.
And, I'm sorry, but 'let's start with single payer' and 'start from scratch' isn't doable just because a smug libertarian comedian says so.
Contrary to what's being said on the blogs, this country is NOT all behind single-payer, tearing down the system, or killing the insurance industry. A small segment is, and it's gathering steam, but the vast majority are not. There's support for the public option, which would only require offering a service in the current 'market.' Single payer would require actually taking over the assets of the current privately owned infrastructure - there's not broad public support for that.
And 'what if the bill makes it worse' is simple fear. There's no evidence whatsoever that the bill will make things worse. All impartial evidence shows the bill will be an improvement. And I do have the experience and knowledge to be an informed judge of the situation. The bill addresses most of our immediate problems as well as laying the foundation to get to where we want to go.
It's not lack of health insurance. It's lack of health care. There is a difference between health insurance and health care. You can have insurance offered that is too expensive to buy or too expensive to use. What good does it do?
Marcia evidently has not read the bill, which specifically addresses the problems with junk insurance policies and puts annual caps on what individual's have to pay. In other words, it expressly prohibits these things she's worried about. And the 'health care not insurance' talking point is meaningless -- I'm to the point of ignoring anyone who repeats it.
Right now, insurance IS our health care. Almost our entire infrastructure is in private hands. The bill gives us access to the health care system we currently have in place and provides for building a public system, which is currently close to non-existent. I don't believe there's any way to get from 'private' to 'public' without taking these steps. The 'kill the industry' 'take out the middleman' sentiments are nifty, but isn't this a goal? How does one go about doing that right now, exactly, in one fell swoop? Maybe we can eventually make language a complete impediment to understanding. -Hobbes
Single payer would require actually taking over the assets of the current privately owned infrastructure
This statement is false.
Text of H.R. 676 (pdf) 30pp
Single-payer is a benefits financing proposal to be funded by premia collected through existing state and federal tax facilities and administered by CMMS et al. The objective of combining Medicare and Medicaid coverages and eliminating enrollment eligiblity according to age is to capitalize bargaining power of insureds in the open market for medical goods and services. Diversity is the key to economic and political evolution.
damn - wrong there, too! that sentence is all fucked up. I meant, detrimental to people and to the benefit of the industry... or something.... obviously I don't re-read or self-edit much before hitting the post button... Maybe we can eventually make language a complete impediment to understanding. -Hobbes
Contrary to what's being said on the blogs, this country is NOT all behind single-payer
Attitudes may have changed since 2006. You will recall at that time Mr Bush implemented a nationwide consultation steered by a DHHS commission, Citizens Healthcare Working Group, pursuant to the Medicare Prescription Drug, Improvement and Modernization Act of 2003, Sec. 1014.
Following this nationwide citizen engagement, the Working Group is required to prepare and make available to the public this interim set of recommendations on ``health care coverage and ways to improve and strengthen the health care system based on the information and preferences expressed at the community meetings.'' Following a 90-day public comment period on these recommendations, the Working Group will submit to Congress and the President a final set of recommendations. The law specifies that the President shall submit a report to congress on the recommendations within 45 days of receiving them, and designates five congressional committees that will hold hearings on that report and the recommendations: the Committee on Finance of the Senate, the Committee on Health, Education, Labor and Pensions of the Senate, the Committee on Ways and Means of the House of Representatives, the Committee on Energy and Commerce of the House of Representatives, and the Committee on Education and the Workforce of the House of Representatives. Following are the interim recommendations of the Citizens' Health Care Working Group, along with descriptions of how we conducted our work and what we heard from participants in community meetings, respondents to our Web polls, and citizens who wrote in to tell us their views. These recommendations outline a vision and a plan for achieving broad-based change in health care in America. We recognize that the issues involved are complex and challenging, and that it will take time and a great deal of technical expertise, as well as political will, to make the changes we think are necessary. Over the next three months, we will continue to actively pursue public input as we deliberate and further refine these proposals. During this process, we will provide greater detail and explanation of our recommendations, as well as further analysis of what we are hearing from the American people before issuing the final recommendations to the Congress and the President.
Following are the interim recommendations of the Citizens' Health Care Working Group, along with descriptions of how we conducted our work and what we heard from participants in community meetings, respondents to our Web polls, and citizens who wrote in to tell us their views.
These recommendations outline a vision and a plan for achieving broad-based change in health care in America. We recognize that the issues involved are complex and challenging, and that it will take time and a great deal of technical expertise, as well as political will, to make the changes we think are necessary. Over the next three months, we will continue to actively pursue public input as we deliberate and further refine these proposals. During this process, we will provide greater detail and explanation of our recommendations, as well as further analysis of what we are hearing from the American people before issuing the final recommendations to the Congress and the President.
Some Daily Kos bloggers reported their experiences in local focus groups. I just now attempted to access Citizens Healthcare Working Group survey results, "Dialogue with America," published August, 2006, by the Bush WH, ironically. That data has been SCRUBBED. Fortunately, I copied a few data points.
Calitics: Interesting Finds on Health Care in the LA Times Poll
Extending Medicare to cover all Americans, creating a government-run system: 53% yes, 36% no
It's not public opinion that is the main obstacle - it is the vast wealth of the insurance industry, which has made both Congress and the White House reluctant to take on more fundamental and more useful reforms.
That decision can be defended. But let's be clear about what drove DC Democrats' decisions on this. It wasn't public opinion. And the world will live as one
To call either him as an individual or The Democrats as a singular entity a sell out, to make accusations that the industry wants this bill, that it's a bailout, that they're all engaging in kabuki and serving their 'masters' is really destructive, imo, as well as being generally stupid.
What good does it do? How does it help us reach our goals?
I think, given the political environment in general and the makeup of the current congress in particular, the bill is a really great start that will help millions. How are we going to build on that if we keep tearing down those who've helped make it happen? Maybe we can eventually make language a complete impediment to understanding. -Hobbes
abolishing the private health insurance industry
This is an AHIP fallacy repeated to undermine popular support for public financed insurance as described in H.R. 676. That bill does not compell enrollment in the public plan; nonetheless everyone is eligible to apply for coverage. The bill does not compell persons to terminate private insurance coverage, nor does it prohibit persons from purchasing private insurance. H.R. 676 does prohibit beneficiaries duplication of coverages as do all commercial insurers; all policies contain a coordination of benefits provision to prevent over-insurance i.e. duplicate payments of claims. Diversity is the key to economic and political evolution.
As was noted back in 2007;- "It was Matt Taibbi who first identified the real problem with Barack Obama, that he is a largely self-satisfied exponent of the status quo." keep to the Fen Causeway
the pretext which Democrats used to compromise continuously and water down the bill
that's the bill they want -- this was the plan all along.
Yes, because the democratic party is all acting in unison, planning on fooling the public into thinking they're working towards health care reform, all the while working on behalf of industry. They're... what? well-coordinated evil geniuses?
I suppose the evidence of this is... health care reform that gives access to millions is on the brink of passage? passing reform that regulates the industry and restricts profits was secretly what the industry wanted?
I'm not following the logic. Maybe we can eventually make language a complete impediment to understanding. -Hobbes
no, it's not a conspiracy theory so much as wondering why nobody in the WH even tried to go for the best solution. The one that gave Americans actual healthcare instead of an insurance that might or might not buy them any healthcare whatsoever. Why was that not tried ? That's where the questions come. Why did they move past gold standard healthcare (single payer) or even silver (public option) without even trying them out. What is coming may or may not be good, but it's not in the foothills of what was needed, let alone wanted. This, the only solution even tried, is the very least of all possible bills. keep to the Fen Causeway
I don't know why there seems to be this assumption that the rest of us are too stupid to have thought of and through these arguments for ourselves.
But even setting all that aside: Let's assume the hypothetical that everybody ran on a single-player plan. Now let me explain the problem.
This "They should've gone to the table with single-payer" thing sounds great, until you realize: This entire effort was dependent on a handful of senators who didn't give a rat's ass if it passed or not. There was always this behavior as though the House was the equal to the Senate on this bill. It wasn't.
There were always enough people committed to the issue in the House. There weren't in the Senate. Because if the House said, "We won't agree to what you're proposing," the Senate would've said, "Okay, piss off then."
But people on the blogs seemed to think they could just put their fingers in their ears and pretend this wasn't so. "The House has to have leverage!" The House never had any fucking leverage, because the Senate didn't give a shit if it passed.
As for the silver option, given that up until...yesterday, I think...there was still an effort underway to push a public option, despite it being proclaimed dead about 700,000 times, why do you assume nobody in the White House pushed for it?
It isn't even that I disagree with the view. I share it, actually. But why is it simply assumed to be true? Conservatives want live babies so they can raise them to be dead soldiers. - George Carlin
Edwards Gets It Right
"Health Markets", coops, exchanges... MOAR CHOICES baked in the goshdarn senate cupcake, baby....
Like Mr. Schwarzenegger, Mr. Edwards sets out to cover the uninsured with a combination of regulation and financial aid. Right now, many people are uninsured because, as the Edwards press release puts it, insurance companies "game the system to cover only healthy people." So the Edwards plan, like Schwarzenegger's, imposes "community rating" on insurers, basically requiring them to sell insurance to everyone at the same price.
BWHAHAHAHAHAHAHA uniform pricing? BWAHAHAHAHAHAHA
Finally, some people try to save money by going without coverage, so if they get sick they end up in emergency rooms at public expense. Like other plans, the Edwards plan would "require all American residents to get insurance," and would require that all employers either provide insurance to their workers or pay a percentage of their payrolls into a government fund used to buy insurance. But Mr. Edwards goes two steps further. People who don't get insurance from their employers wouldn't have to deal individually with insurance companies: they'd purchase insurance through "Health Markets": government-run bodies negotiating with insurance companies on the public's behalf. People would, in effect, be buying insurance from the government, with only the business of paying medical bills - not the function of granting insurance in the first place - outsourced to private insurers. ahahahahahahahaaaa Read MORE....
But Mr. Edwards goes two steps further.
People who don't get insurance from their employers wouldn't have to deal individually with insurance companies: they'd purchase insurance through "Health Markets": government-run bodies negotiating with insurance companies on the public's behalf. People would, in effect, be buying insurance from the government, with only the business of paying medical bills - not the function of granting insurance in the first place - outsourced to private insurers.
ahahahahahahahaaaa Read MORE....
... which brings me back to my realpolitisch deconstruction of "Change we can believe in" upthread. The fact is that what we're experiencing right now is a top-down disaster. -Paul Krugman
Your assessment of the bill as being 'the least of all possible' bills is based on what I believe is a flawed interpretation of 'possible.'
I don't see any realistic way single payer could be accomplished right now. The public option was supported by the WH, but didn't make it through congress which, as we all know, is full of not only wingnut R's but also D's in name only. Seems to me there's a disconnect with people who can acknowledge there's sellout D's but somehow then think they're not a problem for progressive D's when it comes to passing legislation. Obama's election didn't magically make congress cooperative with his agenda. Contrary to popular belief, congress still makes the laws in this country. Maybe we can eventually make language a complete impediment to understanding. -Hobbes
Its brilliant that lots more people will be covered, but I think a lot of people are sitting and thinking that this example of "Change we can believe in" is yet an another example of what appears to be a paucity of imagination on the part of the administration.
As for as a conspiracy, I don't see that this is any more likely as a conspiracy than any other 9/11 or vaccine lunacy Any idiot can face a crisis - it's day to day living that wears you out.
As for as a conspiracy, I don't see that this is any more likely as a conspiracy than any other 9/11 or vaccine lunacy
Really? Is the proposition "When the WH and the Democratic leadership said that they favor a public option they lied." really so far fetched? Wait this is important. Someone is wrong on the Internet.
you'd have to believe that Obama somehow wants to help the insurance industry
If he was always a consensus guy he might be concerned to include the insurance industry in the consensus. So his "compromises" with Big Pharma and the Medical Insurance Industry were driven by principle, however repugnant that may seem, rather than being a conspiracy. It is just that we should have examined rather more closely the nature of the pig in the poke during the primaries. As the Dutch said while fighting the Spanish: "It is not necessary to have hope in order to persevere."
That still doesn't make sense -- do you think the industry wants to have itself regulated and its profits restricted and that Obama is looking out for their interests over the people's? Maybe we can eventually make language a complete impediment to understanding. -Hobbes
Perhaps it's escaped your notice, but he has been confronting them -- they're currently fighting this bill and have been since the start. Funny way to go about avoiding confrontation...
I don't know for sure. But if he is strongly consensus driven and he accepts the medical insurance industry as a legitimate player he may well have sought to balance their interests with those of the public.
Or... perhaps he simply recognizes they're currently pretty much the only player right now, and is seeking to balance the interests of the 300 or so million people they're currently covering with those of the 50 million or so they're not. "Consensus" doesn't have to be the motive here.
And, yes, I remember the 'sharp' conversation -- it was in the context of a criticism. It doesn't make them 'friends.' Maybe we can eventually make language a complete impediment to understanding. -Hobbes
Perhaps it's escaped your notice, but he has been confronting them
That still doesn't make sense -- do you think the industry wants to have itself regulated and its profits restricted and that Obama is looking out for their interests over the people's?
well this is where the kabuki element comes in to play.
they are sorta faking the fight against hcr, because actuarily speaking they know too that the present system is economically inefficient, and will fail eventually, but it's in their interest that it fail slowly, so they can continue their fiduciary duty (barf) to maximise short term shareholder profit.
they have the money, they have the lobbyists, so they'll use them as powerfully as they can to keep their monopoly profits rolling in, but inside they know it's a holding action, because america cannot go on in this wasteful, uncompassionate modus operandi.
meanwhile they will continue to have the power, the same power they used to have the most important elements of hcr gutted before negotiations even started, namely the ability to bargain down drug prices, and the single payer and public options.
i think obama's attitude has been a little lukewarm because if this doesn't pass, he can be seen not to have put too many eggs in that basket, and because if there had been stronger populist pressure for single payer or p.o. he would have been well placed to ride that wave all the way into the history books.
if... and notwithstanding the considerable pressure, it has not been enough for him to see congress/lobbyists fazed, and there are not enough kucinich's or sanders to really push very serious change, not to mention the dino's, blue dogs and a million bucks a day of lobbyists against any change at all, even with the writing on the wall.
obama is nothing if not canny. i suspect he's going for a 30% change on many fronts, finance regs, climate change legislation, EPA, guantanamo, torture, troops wound down, to name but a few, while having to keep the status quo mollified with the slowness of the changes, which though ultimately inevitable, can still be much delayed through obstructionism and pig headed greed, milking the last drops from the cow.
people want him to really put his ass on the line for any and all of these super important issues, and risk his political capital an an all-or-nothing assault, a media drama, but he's trying to plug a lot of holes with his fingers, counting on that as being better, wiser and more longterm than trying to deal with any one issue balls to the wall, and possibly flaming out and losing his one-in-a-century opportunity to be the truly great reformist his campaign rhetoric encouraged so many to believe and emotionally invest in.
like any pol, he wants to land on his feet whichever way the wind blows. unlike many, he may just be intellectually perceptive and politically nimble to have a chance of pulling it off, but he'll fall way short if he can't unite enough public opinion behind him.
he has some, but his awesome initial momentum has been dealt several severe body blows, much of his most vociferous base is bitterly disappointed at his inability to be more of a statesman reformist, and yet he shrugs us off because he knows that we have failed to enlighten the average fox news low info voter that they are being gulled twice over, first by the insurance companies, and secondly by palinesque propaganda.
so many nuts, so few hammers. ~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~
You'd have to think that the industry could live with the contents of the bill and was either sufficient scared of public pressure or of the opinion that it could find a way to twist the bill into being a net plus.
Is a lot different from what you said earlier:
A conspiracy that just demands that nothing is done needs very few people. Write the public option in the bill and let it die peacefully
And neither one leads to this:
And Obama would have to value the industry's party contributions over a better bill.
It's the assigning of motive to Obama, that he's working for insurance and against people, that's the part I'm questioning. I don't see any evidence in his actions which would indicate this.
If he wanted to maintain the status quo, there were much easier ways. He could pass an unfunded piece of shit bill like the Medicare D one -- a corporate giveaway with bipartisan support -- or he could insist on a 'perfect' bill, say a very liberal single payer one that would be impossible to implement, and let congress take the fallout when they stomped it to death. Maybe we can eventually make language a complete impediment to understanding. -Hobbes
This: You'd have to think that the industry could live with the contents of the bill and was either sufficient scared of public pressure or of the opinion that it could find a way to twist the bill into being a net plus. Is a lot different from what you said earlier: A conspiracy that just demands that nothing is done needs very few people. Write the public option in the bill and let it die peacefully
The claim was that the WH was against the public option and the bill as it is now is basically what they want. I don't see a contradiction. Wait this is important. Someone is wrong on the Internet.
He could pass an unfunded piece of shit bill like the Medicare D one -- a corporate giveaway with bipartisan support -- or he could insist on a 'perfect' bill, say a very liberal single payer one that would be impossible to implement, and let congress take the fallout when they stomped it to death.
i personally think the latter would have been much more heroic and great leader-y, and ultimately more revealing of the actual shark tank health care situation.
but he doesn't want to risk too much capital in one issue, methinks.
there are others as important, imo, the most compelling to completely change, no revolutionise the corporate ag/food inc. ripoff, as unless this is done there will have to be so much more ill-health care.
the further up the causal river the clean up, the more efficient the change.
if you have a dead pig rotting upstream, you're going to have to do a lot more water filtering down the line.
i'm surprised, as he's so smart, that he doesn't seem to get this.
it's the fastest way to better, more self-aware society, imo, and starting where it should, the betterment of each individuals relationship with their own -and their habitat's- health.
right now all the argument is about what kind of filters are going to be used, and the dead pig rots away.
go to the source, obama! why spill milk with hand and mop with the other? ~"When an inner situation is not made conscious, it appears outside as fate." Karl Jung~
