Really.

“…. that Republicans might support?”

two words come to mind.

Fuck them.

Believe in Magic

And Our Obama wants this to be a “bipartisan” effort — I guess to appease Fred Hiatt and the Villagers. Of course that means that we will be screwed standing sideways but it will be bipartisan!

to create a so-called “public option” that Republicans might support.

To be followed by a theory of evolution that Intelligent Designers might support.
And a theory of martial fidelity that Dave Vitter might support.
And guidelines to journalistic ethics that Judy Miller might support.
And …

Dean did an awesome job on Countdown… He completely debunked most of the Gooper’s TP’s… Baucus is a sleazeball that needs to be primaried out…!

republicans = democrats’ excuse for pandering to the insurance companies while pretending to fight the insurance companies.

I was under the – appearantly mistaken – impression that elections had consequences.

Good Morning all.
Rep Phil Gingrey on C-span says if the medical system ain’t broke why fix it. The party of stupid.

Here’s my public plan:

Rethugs get Blue Cross/Blue Shield, everybody else gets single payer.

how will a public plan lower costs to employers or decrease total health care costs?

i’m asking in all seriousness. all i’ve seen are talking points. no research, no detailed explanation.

Single Payer would resolve all those issues… That has been what Dean has advocated forever… However, he avoided saying those dreaded words…! 8-(

Well, they’re calling it an early nite here atop the mtn…! I bid ya’ll a fond adieu…!

I think the idea is that it would be more competition from an option that had very low overhead costs, a large risk pool, and massive bargianing power.

*thumbs up*

I don’t know how employers would fit into a public plan, assuming it’s an expanded Medicare-type thing. A cost savings would start with the administrative overhead. Medicare is under 10% while private insurance can be up to 30%. One of the reasons an aspirin costs upwards of $50 in the hospital is to cover the cost of treating uninsured, those who use the ER as a primary physician. It’s also reflected in insurance rates. We would see quite a jump in the Medicare payroll tax but I’m betting it would be drastically less than the monthly premiums folks are paying for private insurance.

i agree single payer would resolve all those issues, but i don’t think dr. dean has EVER been a single payer advocate. i like him a lot on many issues, but this is not one of them.

well screw a public plan then .. just give us the same coverage ..at the same cost that the house and senate members have ..

$10 brain surgery.. for a hundred a month …for the whole family ..

have there ever been a bigger bunch of hypocrites ?? they’ve all got primo coverage for themselves .. the wife and the kiddos for peanuts .. and “just don’t see there’s a problem” ..

and i agree ..screw the republicans .. as soon as franken gets aboard .. we don’t need a single damn republican vote .. and not in the house either .. it’s time to pass a universal coverage single-payer national health care plan .. and i don’t mind if the for-profit health-care insurers go slam out of business.. imo .. making a profit off other peoples’ health ..or the lack of it is obscene anyway .. if not immoral ..

the insurance folks make decisions everyday ..for the sake of profits .. which harm the health and well being of their “customers” .. they exist primarily to either deny .. or minimize “coverage” .. and people die because of it ..

we have simply got to wrestle our government out of the control of the capital corporatists…they are literally killing us .. on many fronts .. not just health care ..

that’s the idea, but i am EXTREMELY skeptical.

http://www.pbs.org/moyers/jour…..ript4.html

DR. DAVID HIMMELSTEIN: Well, most of the cost savings he’s talking about are really illusory, I think. And my research group has done most of the research work on administrative costs in health care. And the administrative costs he’s talking about saving are a tiny fraction of the potential savings under single-payer. ‘Cause hospitals have to keep their bureaucracy, if you’re dealing with hundreds of different plans. And doctors have to keep the bureaucracy in our office. You don’t actually get the streamlining that you get from having one payer that has one set of rules and can pay lump sum budgets to hospitals. But more than that, we’re worried that the public plan actually becomes a dumping ground for the unprofitable patients. As it’s happening in Medicare.

BILL MOYERS: What do you mean? How would that happen?

DR. DAVID HIMMELSTEIN: Well, the private insurers have all kinds of tricks to avoid sick patients, who are the expensive patients. So, you put your signup office on the second floor of a walkup building. And people who can’t navigate stairs are the expensive people.

DR. SIDNEY WOLFE: Get rid of the heart failure patients.

DR. DAVID HIMMELSTEIN: Or you have your signup dinners in a rural area at night, where only relatively healthy people are able to drive and stay up that late. So, there’s a whole science to how you sign up selectively healthier patients. And the insurance industry spends millions and millions of dollars on that. And would continue to as they’ve done under Medicare. Selectively recruiting healthier patients, who are the profitable ones, leaving the losses to the public plan.

And there’s really, despite regulations in Medicare that says you can’t do that, that’s continued to happen. And it means that every time a patient signs up with a private plan under Medicare, we pay 15 percent more than we would pay if that same patient were in the Medicare program.

BILL MOYERS: We the public?

DR. DAVID HIMMELSTEIN: We the public. But it’s not been efficient. It’s been effectively a subsidy. And that’s what we fear will happen with this public.

DR. SIDNEY WOLFE: Well, we also have some experience. Because in seven states, ranging from Washington to Minnesota, to other states, Maine, they have tried what amounts to a mixture of a private and a public plan. And it’s way too expensive as David mentioned. As long as you have private plans in there, everybody still has to do all the bookkeeping.

if it’s so great why isn’t it working with medicare or in any of the states that have tried something like it?

last year it was universal mandates that was supposed to bring down costs. ok, i thought, that sounds reasonable. only now we know, NOT (see massachusetts reform).

i remember when “managed care” was going to bring down costs.

are we just being fed another line in order not to face taking the private insurance companied out of the picture entirely? right now they soak up about $400 billion dollars annually and add nothing.

Obama knows very well that there will be minimal Rethug support for any plan with anything close to a public option. This is all Kabuki theatre, just like the stimulus bill. He opened the door, they shut it in his face, and then he went ahead anyway. It will be the same this time, too.

When it comes to universal health care, put me down in the column for “glum and frustrated”.

President Obama is going to get his political epiphany in the next six months. Should he eventually sign-off on the public option, he will find himself for being labeled as a Neo-Lib. Currently, Obama’s problem is that he has to make nice or peace with ‘privatization’ and America’s “racial and ethnics” will quickly realize that Obama snuggly fits the square hole that the Clintons’found themselves back in 1993. And perhaps, history will repeat itself?

If so, Obama will have gotten his political comeuppance in less than a year, and consequently, his Legacy for either the next three or seven years, will consist of his hanging on by his fingernails, and with nothing much to show for it despite all the hard work attempted by Team Obama and with considerable input by the Neo-lib and DLC cabal. To wit, he self-imploded.

And for America’s “racial and ethnics” Obama didn’t deliver on a medical delivery system disconnected from the Employer, and the ‘blame’ if any will laid at the doorstep of white Democrats. Thus, Democratic coalitions should also be recognized as fragile political entanglements.

Jaango

my impression was that the “public plans” being proposed would be stand alone from medicare. am i wrong on that?

i remember when “managed care” was going to bring down costs

What they didn’t tell us was that the costs being brought down were the insurance companies’, not ours.

i also think it’s kabuki meant to score political points off the republicans.

and i actually have no problem what so ever with that. fuck the republicans.

what irks me no end though, is that the faux “lets work with the republicans” kabuki serves as a cover for the dems to write legislation that panders to the right while pretending to fight the right.

i want better policy. especially when it comes to stuff like health care and climate change.

wow. of course.

i hadn’t thought of that. but of course, you are exactly right. thanks for the insight.

Last figures I saw were under a nickel per dollar for Medi-Care and between 30 and 40 cents on the dollar for private insurers administrative costs.

The suggestion that private insurers be protected is so offensive that it makes me ill and it would help a lot if Senators would get off of that. The cost for my family of 3 for private insurance last year was over 13 thousand dollars. Thats right, $13,000.00. Between the 3 of us, for the year there were 4 office visits and 5 perscriptions. Total, under $500.00. How in the fuck is that affordable health care? $12,500.00 for uninsured? Bullshit!

I’m with you, SoDrag, in that I believe the tax hike from some sort of universal plan could not possibly be anywhere near even half of the current cost to me and my employer for private insurance.

Good Morning Now Joe Scarbrough speaking “for” the Republican party..Lost it’s way 8 years ago.

No. What I envision, eventually, is a Medicare-type plan for all, a single payer plan. Not to expand Medicare into the “public plan” would be folly, imo. Obama may want this now but I’m thinking we have a better chance after 2010. This could/should be a major issue in 2010. The Rethugs can put all the lipstick on the private insurance pig they want, the public knows how much they’re paying for health insurance. The Rethugs can’t lie that away.

That’s half my annual salary. JHFC.

for anyone who didn’t hasn’t read BargainCountertenor’s diary on the single payer bills now in crongress (at the moment being ignored by D party leadership even though one of them has 78 cosponsors), here it is:

http://oxdown.firedoglake.com/diary/4557

Look at statements from authority from your standpoint, then look at them from their standpoint. Day and night. When one walks in another’s moccasins one must also see with another’s eyes.

Question Authority. Always.

By the way, I still have an original Question Authority poster from the anti-nuke power days in Oregon in the 70s.

1) It would eliminate the requirement for profits. A significant part of the problem with the current system is that insurance companies, like every other for-profit business, must make a return on investment for their share holders. In health insurance, the only way they can maximize their profits is to deny any and all care that they can get away with denying. Having a public option would remove the profit motive from the mix (unless it was rigged to keep costs high – as in a “competitively priced plan” that someone was batting around last week).

2) If everyone is eligible to join, and wealthier “customers” subsidize poorer ones (income-tied costs to patients), then there would no longer be a need for over-charges for the under- or un-insured. Everyone has coverage, so there are no longer losses to cover through other means.

3) Since everyone has coverage, no one has to use the emergency facilities for primary care, so overall costs are reduced. Preventive care through a regular physician would be available to all insured (just as it is now), and so treatment for medical conditions wouldn’t have to be delayed until it was an emergency, thereby reducing total cost of treatment.

4) Allowing employers to offer the public option to employees would give small businesses the option of offering a company subsidized option to their employees when they would otherwise not have insurance. This helps reduce the cost to subscribers as well as to providers.

Admittedly it isn’t a good as single-payer by any stretch of the imagination, but it could help reduce or contain the costs overall. This, naturally, supposes that the public option would be open to anyone who chooses to enroll (as opposed to a plan I heard about that would only allow enrollment in the public option if your income was below a certain level or you were otherwise uninsurable – sort of like “County Mutual” auto insurance in TX).

I believe that the Republican “plans” are primarily intended to prevent people from opting for any public option, and then requiring everyone to buy insurance, thereby enormously expanding the pool of people that the insurance companies have as clients (and magically reducing the costs to everyone somehow), but the fundamental problem with this is that it does nothing to reduce the cost of that insurance to the consumer.

Insurance companies have no motive to reduce costs to consumers, only to maximize ROI for investors. The public option has no such motivation, so cost control and affordability would be their sole motivations.

Mornin’ All,

couldn’t help but daydream a little during Dr Dean’s segment ’bout what our family could do with that $$$

i hope you are right about 2010. the thing is though, if the current reform is a failure then the dems won’t have the political capital, to go for single payer 2010. and why should they given all the money they get from the insurance companies?

right now, while people are thinking about health care reform imo it’s important to keep bringing up single payer as a viable and better alternative. so if the current private / public plan thing is not successful in bringing down total costs or covering most of us (and i don’t see why it should be) — people will remember that the private / public plan approach is not the only alternative.

You got it in one. What the “they’ll increase your taxes” people don’t tell is that while universal single payer may involve a new tax, the old tax of health insurance through a private plan would be eliminated. The costs would at worst be equal and a far more likely scenario is that they would be reduced significantly.

If the Rethugs sabotage the public option the Dems will have all the political capital they need for the 2010 election. Folks are pissed. And broke.

Here in FL Gov “Bulldozer” Crist signed a bill rammed through by developers that gives them more access to wetlands, etc. In 2010 this will hurt the Rethugs here no end. The only people happy with the bill are developers. Counties are already moving to make impact fees so high the developers won’t bother. We can have that same momentum in 2010 if the Rethugs keep playing their private insurance game.

thank you for the detailed reply.

1) agreed.

2) & 3) disagree. the private / public plans are NOT universal coverage.

hr 676 (the single payer bill with 78 cosponsors) IS universal.

4) i think i agree.

…..

the problem i have is that in the real world usa near examples it has been a subsidy for insurance companies (because they can select for low cost “customers” and the public plan gets the more expensive, sicker, people.
that’s why i’m looking for some research or detailed analysis to make the case.

Road King.

This is all Kabuki theatre, just like the stimulus bill. He opened the door, they shut it in his face, and then he went ahead anyway. It will be the same this time, too.

Agreed.

I actually think the public option is a side door approach to single payer, since a true public option would be flooded with participants; I can think of 50 million new ones off the bat.

Once that toothpaste got out of the tube, the private insurers would have to cut costs to stay competitive, which would cause many of them to go out of business (boo hoo).

That’s why this battle line is being drawn so sharply in the GOP sand.

Mornin’ Tiger Man,

Gov Bulldozer is learning impaired – apparently forgetting the rather precipitous/instantaneous drop his JAR took over off shore drilling – a whole 12 months ago

really good report from commonwealth fund comparing the increased coverage and costs of various plans before congress a couple of years ago.

http://www.commonwealthfund.or…..erage.aspx

take a quick look at figures ES-2 (number of uninsured people newly covered) and ES-4 (change in national health expenditures).

the stark (americare) plan is the one to look at — the most people, by far, covered. and the least total cost, by far.

those two figures tell a powerful story.

This legislative session which just ended was an absolute disgrace.More so than in any of the 5 years I’ve been down here. I expect next year’s to be worse.

well, I was thinking more along the lines of tuition . . .

p.s. Heartbreaking News this morning, we have lost Luke Cole

in addition to his work on behalf of us all, he was one of those all round great guys – met him birding once with Rich Stallcup – David and I ran in to him 3 years later owling in Cave Creek, AZ . . . kinda guy who remembered our names

truly tragic

I actually think the public option is a side door approach to single payer, since a true public option would be flooded with participants; I can think of 50 million new ones off the bat.

i hope so. but don’t see how it could be done without massive gov subsidy. and that will give the republicans ammo to say gov plan is too expensive (wasteful governement program, and other standard republican bs)

Now Joe Scarbrough speaking “for” the Republican party

Until that untidy business of the dead intern crops up.

No, he’ll lay in the weeds and sell his books and lob GOP stink bombs from the comfort of his morning show, then beg off any serious political overtures in the name of quality time with the family.

BTW, did anyone else catch his book launch cocktail party at Margaret Carlson’s DC home?

Whitest thing I’ve seen since the last GOP convention.

Way too young.

mornin’ selise

your link says “Page Not Found”

You should see the Texas legislature. Vomit inducing.

fingers crossed.

i’m just going to keep bringing up single payer universal healthcare in every conversation on health care reform.

Cindy Sheehan will be in St Pete next week. I can’t wait. Tigers is gonna get fed an early din-din on the 17th.

Off to swim in the great (bwahahahahahahaha) capitalist cesspool.

Be good to yourselves, and all other living things.

Namaste

damn. sorry about that. maybe the link is too long.

trying again – commonwealth report

good morning to you too!

….

edit to add: that didn’t work either!

here’s a tiny url:

http://tinyurl.com/psdthw

That’s the way it will get done. The pols certainly don’t have the cojones. Chapter and a half left of Secrets.

both work fine – thankee

An Analysis of Leading Congressional Health Care Bills, 2007-2008: Part I, Insurance Coverage

First link at 48 worked for me, if this is the right title

damn you’re good. way a head of me!

cbl2 and SD – perhaps some nice mod fixed my link for me (thank you mods!).

i’m off….. great day to all!

Can barely put it down. Biggest impediment the last 3 weeks is Maste wanting attention. Can’t sit down without him jumping into my lap then wants to lie on book so he can get his head rubbed. He is definitely a daddy’s tiger. Follows me around like a puppy.

Dean’s plan and Kennedy’s plan are looking a lot like the Massachusetts’ plan. There’s an exchange where people can shop for private insurance; everyone has to buy insurance or is penalized; a public plan is nominally available but is of no use because it is not mandated to regulate the price of provider services. Better no reform than false reform as I have just pictured.

I have had enough kabuki from the Democrats. They are on the take from private insurers. Moderate Democrats are lining up with Republicans and Blue Dogs to nuke anything that might deviate from private insurance.

The high cost of treating the uninsured is a canard. It is like blaming the poor and minorities for the financial crisis in the banks. The reason the price of a hospital aspirin is so high is because of greed and a lack of regulatory control.

Whenever they frame the need for healthcare reform as due to an economic crisis, your alarms should go off. Health care is a right, not a commodity. When changes are predicated on the false premise of reducing spending, health care takes a second place position relative to how much you spend. That’s how HMOs were created to ration care; it was to save money and to make money by denying care. Denying insurance due to preexisting conditions, denying payments due to high use of medical care, denial of needed tests based upon claims for efficiency, denial of access to real doctors and sidelining patients to nurse practitioners to save money………they reduce insurance companies’ expenses and increase their profits. Your premium keeps going up and your medical care keeps decreasing like the proverbial shrinking candy bar with the big wrapper on it.

It is past time to get free enterprise and for profit businesses out of health care. The only non-profit entity available to tackle this reform is a central government program which can set uniform costs for services and drugs. I want Single Payer health care via HR 676. Only Single Payer can control the price of services and drugs. You should pay 98 dollars for that MRI because that’s what it costs to use the machine and to pay the operator and the interpreter of the MRI. Doctors should decide what it is going to be: Are you here for medicine or to be a millionaire? Hospital administrators making six and seven figure incomes need to decide: Are you here to heal or to be well-heeled??

Well, you’re correct that 2 & 3 only work if coverage is mandated (which seems to be the direction things are taking). The difference between Ds & Rs right now appears to me to be that Ds want to require coverage and support a public plan of some sort, while Rs simply want to require everyone to get coverage.

That’s why we need to not just keep up the pressure, but increase the pressure to unprecedented levels. Get Franken seated and forget about bi-partisan.

We know most Dems in congress are spineless, that’s why we need to create so much pressure they have to buckle to us rather than the lobbyists. Otherwise we’ll get faux reform that will then eliminate the chance for real reform for another decade or so.

Best option is national single-payer.

The next best option is a public option, but as many people here fear, the devil is in the details of this. One implemented right, could indeed be a precursor to national single-payer since for-profit companies just wouldn’t be able to compete with it. However, it Republicans and Blue Dogs manage to hamstring the private option so it can’t be implemented to run at it’s ideal efficiency, it will kill the publicly-financed healthcare option for a generation.

I think we have a shot at this one, but only if people rise to the occasion, by “people” I mean “We the People” not those morons up on Capitol Hill.

It would appear the more immediate concern is how to keep the Obama team onboard through some compromise that satisfies their uppermost goal of preserving the existing for-profit system rather than how one might appease the so-called loyal opposition who are, after all, major stakeholders in said for-profit system.

Dean did an awesome job on Countdown… He completely debunked most of the Gooper’s TP’s… Baucus is a sleazeball that needs to be primaried out…!

Baucus needs to be constantly reminded of the results of the six or so town hall meetings recently held by his staff in his home state, where over 50%, maybe 60% of the attendees were for single payer.

Being a rural state, Montanans tend to have long memories when it comes to non-responsive elected officials.

to go along with the commonweath report, i should have included this diary:

http://www.dailykos.com/story/…..-Proposals

see especially part 8)