John, Welcome to the Lake.

nyceve, Thank you for Hosting this Book Salon.

Welcome Eve, and welcome Dr. Geyman.

Thanks for all that both of you do.

Welcome to Firedoglake – glad you could join us!

I’m here. John

Hi everyone, you may know that I get to the meat quite quickly so I have two questions for our eminent guest.

1. Do we need to drive a stake through the heart of the for-profit insurance industry, is this the only solution to all that ails us?

2. What sort of reform do you think we’ll end up getting from this president and Congress?

Take it away, Dr. Geyman

welcome, Dr. Geyman, just asked you to respond to two questions.

Good morning. John

Welcome, Dr. Geyman.
Thanks for hosting, Eve.

Good questions. First, the private insurance industry is dying, is not sustainable, is pricing itself beyond what people can pay, and this book lays out all the reasons for that. So, yes we now need a publicly financed single-payer system with a private delivery system.

Insurance companies like UnitedHealth take millions in government subsidies (in form of Medicare Advantage pymnts), then turn around and spend millions lobbying against a public option. Short of the heavy lift of passing a law, is there a way to stop such behavior?

Gosh. I think you hit it. What else is there to ask? I only wish that we could drive a stake through the for-profit insurance business heart, but I am afraid they have Congress’s ear much more than we do. I must say that some of the things that Obama said in his presser last night did give me hope that he would “insure” that we got the best possible care bill out of a craven congress. (my words not his)

Thank you for being on our side, Dr. Geyman.

On the second questiion. That’s a big problem. Congress is shaping up a failed reformm bill for many reasons, but biggest is that it doesn’t even consider single-payer and is trying to “reform” the system by accomodating a failed multi-payer system.

Dr Geyman, what are your thoughts on single payer vs the option being discussed in congress? Will the “insurance exchanges” funtion in any meaningful way?

Hi, Gregg. I hope that the Administration will cut out overpayments to Medicare Advantage completely, but will be surprised it is that bold. Insurers are fighting for their lives against a public option, and so far are winning. As it looks now, it will be a very weak option, since the centrists and lobbyists don’t want it to get big and crowd out the private insurers.

I agree, Dr. Geyman, or as I like to say, they’re trying to fit a round peg into a square hole. It simply won’t “bend the cost curve”. We cannot have 30 cents of every precious hc dolar going to the for-profit insurance industry and think we’re reallt serious about reform.

Yes, I’m not reassured by the President’s talk last night that Congress will do much reform. The process is a charade, the rules in fine print very much favor private insurers, as one example you can’t change to the public plan if you’re insured by large employers.

Not a lot of detail yet as to how the exchanges will work. But we can be sure that it will be complicated and only some people can try to change. The idea of the public plan 10 years ago was for a bg one, maybe 120 million people – now the CBO is estimating only 10 million because of all the restrictions.

Stake through the heart?

WHAT heart?

Seriously, I’ve never heard anyone mention how medical malpractice suits would factor into the health reform issue.

Got any info,Dr. Geyman?

Welcome to the Lake, Dr Geyman.

You’re right. Malpractice liability isn’t being talked about much. It is often exaggerated as a big driver of health care inflation, but accounts for less than 10 percent of that problem.

thanks for Dr. Geyman coming here, and nyceve’s intro.

The restrictions on access to the Exchange, and through it, a “public option” are meant to (1) shield the private insurers and the employer-based system for a while and (2) limit the CBO/Budget impact, since only those purchasing through the exchange are eligible for federal subsidies. the House bill limits access in year 2013, eases it a bit in 2014, and then leaves it to the discretion of the Sec. HHS whether to open access to more/larger businesses.

Dr. Geyman — what do you think this scenario leads to? Will the public plan die from the beginning, or is it the seed for something larger over time.

Dr. Geyman, thanks for being here… I plan to read your book.

Do you think the Senate HELP committee bill is as flawed as the House bill?

Dr. Geyman: Any thoughts on the concept of state/regional co-ops? don’t they have a history of doing well locally, but not having much national impact?

Tragically, Dr. Geyman I agree again.

They must do “something” and they will call it refrom.

I hope and pray it’s more than just “something”. At bare minimum ther must be a robust public option, though I recognize, that will just be a bandaid.

Dr. Geyman, who would you say are the three or four folks on Capitol Hill that need to be pushed the hardest to get something approaching meaningful reform to happen? Particular committee chairs? Members of the leadership? “On-the-fence” members?

Only 10%, really? I was reading your book during a visit to my Dr., a pulmonary specialist (who graduated from U of Baghdad, btw), and that brought about a small discussion of what direction seemed right. He seemed to think the bulk of the problems would go a long way to being solved if they would deal with frivolous lawsuits that result in high medical malpractice insurance premiums, which evolve into many, many excessive tests and medical procedures that are basically just CYA attempts. I take it, you don’t agree?

Co-ops suck. Non starter. They are a gift to Max Baucus, Kent Conrad, Feinstein, Lieberman, other and the insurance industry. Period.

This is more of a legal question… but given that the lead Blue Dog Rep Ross owns 100% stock in a pharmaceutical business (that he sold in 2007)… is not that a clear conflict of interest?

Any way, in your opinion, to remove him from healthcare negotiations on that basis?

This is from Daily Kos.

It turns out the Republican Party has relied on and cited “policy analysis” from a “research firm” (the Lewin Group) that is wholly owned by a health insurance giant (UnitedHealth Group).

What can be done when one Party is determined to use smoke and mirrors and the other Party suffers from timid leadership?

Am working right now on a blog post (for PNHP and the Huffington Post) that looks at the public plan. Very complicated, but an excellent analysis by Kip Sullivan in Minnesota on yesterday’s PNHP site. Bottom line is public plan will be very small, limited to only some people (eg if uninsured or work for a very small employer), and will be wired to fail, including a lot of sicker people who the private insurers don’t want. Also the so-called “new regulations” of private insurers will apply to NEW private plans, not existing ones.

Welcome to the DC cycle.

It’s been a real eye opener being here. Since the US doesn’t actually MAKE anything any more, profits come from lobbying for a share of taxes. The profits recouped from that get fed back into lobbying for more.

When we were at the Ways & Means markup the other day it was like being on the floor of the Chicago Board of Trade — ask Eve. No wonder lobbyists are paying $3500 a seat. They’re fighting for their share of a $17 trillion a year industry, and everybody wants a piece of the pie.

The people who want to sit on the sidelines and take satisfaction from being “morally superior,” who don’t want to get their hands dirty by participating in the process, are IMHO just as culpable.

One of the many things that dismays me is the timeframe I hear talked about – no public option until 2013?!? I need it now. My husband is uninsurable and because of his medical condition can’t work for a big company full time in order to get insurance. I am not “employable” because of the time I have spent caring for him and the family. Why do we keep tying insurance to employment????

Not much real information yet on the coops. There are successful examples of coops as their own delivery systems — such as Kaiser and Group Health — but they need to compete also with the for-profits and took over 50 years to build. They also have specialists on salary, so can contain costs better than the investor-owned for profits. BUT, right here in Washington State, the Blue Cross plan just increased its premiums by 19 percent, and Group Health as I recall was up 12 or 12 percent.

How do you own 100% of something you sold?

I suggest Kip, who has commented here, get beyond the first year. Over time, the rules change. The phase in could help or hurt, but first you have to look at them. The application of “new regulations” kicks in for existing plans later. Perhaps it gets delayed, perhaps not, but all this means is that the regulation for existing plans is year x instead of year y. So isn’t the fair question: how soon should the regulations kick in? Or, are the regulations worth doing, or not?

All of us need to push our own leglislators. In Congress, push the committee chairs and members. Waxman needs a big push. Baucus doesn’t respond to pushes. Dodd seems insulated.

Just one example of conflicts of interest that pervade the whole political process. We don’t weed them out well. The revolving door swings often between K Street, industry and government

My rep and my senators are all Republican, so I feel absolutely powerless at that level. They are going to say no and protect corporate interests no matter what.

Jane is reporting no public plan in The Baucus Bill.

This is seriously bad news.

You’re right. We should also abandon the employer-based system. It is failing more all the time. Look at the increasing divide in the business community — especially small vs.big business. Cost of coverage is making business much less competitive, but private insurers want that market to continue and be more subsidized

The Republicans — with a big assist from ConservaDems — scored an early victory making us all a prisoner of a CBO score. It’s going to take time to unwind, and wedge the coalitions that were necessary for initial creation of a public program in future legislation.

For instance, one of the “buy-ins” critical for passage of the House bill was the AMA, because doctors give a lot to members of Congress. But holding health care costs down is something that could be achieved by giving nurse practitioners the right to practice independently, which was taken away because doctors fought for it. So the big lift is getting a government plan set up at all — it’s going to take years to get it to where it needs to be by passing something like this that could reduce the CBO score and bring costs down.

I am really sorry about your husband GdP. I know many are suffering and this is sadly not going to be all it needs to be soon enough.

I wish the Obama team would get in there and tell the idiots who are protecting the insurance companies what they will accept in a plan, instead of allowing a lot of nonsense sausage to be made – sausage that will never get past the president’s desk, at least according to what he said last night.

Not surprised. I didn’t expect much from the Senate, and doubt that a strong public option will emerge from the House.

Waxman is probably the person who is more responsible than anyone for making sure we have a public plan at all. If he hadn’t “dug his heels in” it would be all over right now.

He doesn’t need a push, he needs help.

Specifically what did he say last night about what will get past his desk? I didn’t hear it.

welcome Dr. Geyman, it is heartening to see your perspective given more prominence here!

Agree. But the Administration has hardly been bold. It has waffled on the public plan, and keeps reassured private insurers that it won’t kill them. But it’s already obvious that we won’t get a level playing field when all the fine print gets written — it will be tilted in favor of private insurers.

Nor did I.

Thank you. John

Thanks for your input.

Good point

Private insurers should have the exact same standards as the public option, otherwise it becomes the dumping ground.

I just got dumped from my insurance for seasonal allergies and mild osteopenia.

This is not a joke.

My state has a plan for people denied coverage, and as a self-employed person, I am in a big pool for the first time. I don’t normally see doctors, so I don’t know how well I am actually covered, but it is affordable for me for the first time ever.

I spent a sabbatical year working with my State’s Human Services Department on Medicaid and related issues. One of the things I learned while I was there is that no matter how bad you think our kludged-together system is, it’s really worse than that.

If you are correct about what we will get out of Congress, we’re putting band-aids on abrasions and ignoring the blood gushing from the arteries. What’s going to happen? Are we going to have to let the kludge fail completely, and then start from scratch?

I don’t have the transcript, but it was in an answer to one of the questions about one version of the bill. He basically said if the final bill that reaches his desk is not to his liking, he will not sign it. That gave me hope that he knows exactly what he wants and that he is letting Congress “play” at being all powerful, but in the end it will be his bill. I just wish he would be more assertive on that front instead of every morning making me read about another “dumbass” idea to preserve the status quo. Thank you Jane for all you are doing on this front.

WaxMan has been a very useful and effective AxMan.

Pity he doesn’t get the kudos he deserves….

Hello Dr. Geyman. thanks for coming to the lake.

I asked our pediatrician (who has pretty strong opinions and is quite jaded, frankly) what he would like to see in health care reform. His response:

First we don’t have a health care system.
Second the politicians will do nothing, nothing. They’ll make a big noise and do very little.
Third, his suggestion was to go with what we already have (medicare) and expand it to include pregnant women and children 0-6. Then expand it more later, and more later, etc etc.

Any thoughts on his strategy?

Everyone should be checking Campaign Silo at least a half dozen times a day for updates, action, people who need to be contacted. etc.

Do you have a feel for where physicians fall out on healthcare reform? Primary care vs. specialists. Independents vs. HMOs and other partnerships, etc.

Exactly, we need it now! Why it isn’t obvious that basing it all on employent is nuts, I can’t imagine.
I’m beginnig to think the onlly way anything real willl happen is if the Congress abruptly gets all its health insurance cancelled. (I can fantasize, can’t I?) They just don’t get it.

And people who think they are insured, until something happens to them and they find out about getting denied, getting delayed, getting the run-around, etc. etc.

Oooo-weee,wait till the insurance companies get hold of all your PAST medical and pharmaceutical records via e-health records.

That could prove a field day for denying coverage, in some cases, alleging a pre-existing condition-or am I wrong on that?

Yes, private insurers are expert at limiting their enrollments to healthier people, cherry picking the market, denying claims, and cancelling coverage. My book goes into many ways. Then they tell us that we need them. Premiums along are going through the roof, and that doesn’t include our total costs of care. Many of us don’t know what our real coverage is until we need it. The insurance industry needs to replaced by a solid not-for-profit financing system, as my book goes into at some length.

Ooops… should have said “100% of the stock in a company he sold in 2007″… solly.

If I may jump in, just anedotally, the doctors in our area are trying to survive the insurance companies too. One internist doctor’s wife I know says all the docs they know are “numb”.

No.. not in Baucus plan, but there is a very strong public option in the HELP bill… or so I’ve been told by a legislative aide in a coversation yesterday.

That was the intent of the people who got Medicare through Congress in 1965. They expected to expand Medicaid up (in both income qualifications and age) and Medicare down (in age) and eventually we’d all be covered by a de facto single payer system.

We see how well that worked out. The first significant expansion of Medicaid came with the SCHIP program, which raised the income qualification for kids, but didn’t raise the coverage age.

One of the big problems with the SCHIP program is that it covers kids but not their parents. Studies have shown that in that situation children tend to miss out on some necessary preventive care.

From the transcript:

I won’t sign a bill that doesn’t reduce health-care inflation so that families as well as government are saving money. I’m not going to sign a bill that I don’t think will work.

And my measure of whether things work or not are listening to the American people, but also listening to health-care experts who have shown that in some communities health care is cheaper and delivers a better result. I think we can achieve that.

Then near the end was this on the Public Option:

Steve Kaufman (sp), the Cleveland Plain Dealer.

Q Thank you. Just to follow up on Jake’s question earlier, sir: So many Americans are concerned that this plan, particularly the government insurance, the public option, would lead to reduced benefits or reduced coverage. Two questions.

One, can you guarantee that this legislation will lock in and say the government will never deny any services, that that’s going to be decided by the doctor and the patient, and the government will not deny any coverage? And secondarily, can you, as a symbolic gesture, say that you and the Congress will abide by the same benefits in that public option?

PRESIDENT OBAMA: Well, number one, not only the public option, but the insurance regulation that we want to put in place will largely match up with what members of Congress are getting through the federal employee plan. That’s a good example of what we’re trying to build for the American people, the same thing that Congress enjoys, which is they go, there’s a marketplace of different plans that they can access depending on what’s best for their families.

Now one of the plans that we’ve talked about is a public option, and part of the reason we want to have a public option is just to help keep the insurance companies honest. If the insurance companies are providing good care — and as it is, they’re going to be more regulated so that they can’t deny you care because of a pre-existing condition or because you change jobs or because they’ve decided you’re too sick and not a good risk. You know, if — with regulation, there’s already going to be some improvement in the insurance industry.

But having a public plan out there that also shows that maybe if you take some of the profit motive out, maybe if you are reducing some of the administrative costs, that you can get an even better deal, that’s going to incentivize the private sector to do even better. And that’s a good thing. That’s a good thing.

Now, you know, there have been reports just over the last couple of days of insurance companies making record profits, right now. At a time when everybody’s getting hammered, they’re making record profits, and premiums are going up. What’s the constraint on that? How can — how can you ensure that those costs aren’t being passed on to employers or passed on to employees, the American people, ordinary middle-class families, in a way that over time is going to make them broke? Well, part of the way is to make sure that there’s some competition out there.

So — so that’s the idea.

Aren’t we ALL glad Bill Frist is no longer in the picture?

Unfortunately, the incremental “reforms” being built into bills in Congress are just rearranging the deck chairs on the Titanic. Costs will continue to go up by three or four times the cost of living or incomes, more people will be uninsured and underinsured, and more will forego needed care and have worse outcomes. Social justice is a myth in this supposedly civilized country.

Yes indeed… the revolving door between K Street and government…

I realized as I called Baucus’ office and left him a vitriolic voice message re his holding all Americans hostage so he can be the “healthcare” industry spokesperson… that my threats are hollow because if he’s not re-elected, he will make even more money in the private sector… so there is really nothing to hold their feet to the fire.

It is truly “the best democracy money can buy”… but I digress…

I want to thank you very much for doing the hard work in digging out the details and writing this book…

I am chronically healthy. I take a prescription occasionally in April/May for mild seasonal allergies. I have mild ostoepenia, the likelihood of a bone break in the next 10 years is 11%. I have taken one of the bone-preserving meds for a year or so. That is all.

I had single coverage with this company, kept the same company in a small business plan (3 people) and tried to switch back to the single coverage with them when the business plan was costing over $600/mo.

I was with them from 2003-2009 and never had a “covered event,” only an occasional pap and mammo and 2 bone scans. I was a cash cow.

That still doesn’t help.

How does he OWN (present tense) 100% of the stock in a pharmaceutical company he sold (past tense) in 2007?

fyi -per Jane’s Silo post:

Once a bill passes the Finance Committee, it’s up to Harry Reid to reconcile it with the HELP bill. Because Reid knows there aren’t enough votes in the Senate to pass a public plan, he will not include that part of the HELP bill

I still call that bogus – if you own 100% of the stock, you own the company.

It sounds to me like the company was converted from private ownership to stock company, and the private owner/”seller” got all the stock.

Still an owner. No matter how you look at it, of course it’s a conflict of interest. But, no requirement for congressfolks to recuse themselves or keep quiet….that’s supposed to be the job of the “4th estate”, to point out that stuff. …..oh well.

My sister is a PC physician. She is in a market that is dominated by two providers – Medicare and one private for-profit. At this point, she prefers Medicare patients because Medicare pays promptly and causes less paperwork. She pulls her hair out over the private insurer because of all their delaying tactics. I, too, wonder why Medicare cannot be expanded. If they lowered the age limit by five or ten years a lot of us uninsurables could get coverage.

What, he’s not a registered lobbyist? Even if he isn’t, bet he’s talking to his old buddies.

Am I too cynical?

thanks for the informative reply BC.

Insuerers only want to insure those who are least likely to use it-and charge them top dollar for it!

Insure the long shots,reject the sure shots…the ones who need it most./

Insurance-Casino Capitalism.

We hear your fear.

Thanks Peterr. That is it.

Jane, just reported that Reid says no bill until after recess.

I say, Nah I can’t print what I say.

One of the things that has disturbed me about the current healthcare debate is how little debate there has been about healthcare. It has all been about various insurance schemes.

When I think about healthcare reform I think about serious debate on
Trade-offs between various kinds of treatments, between acute care and preventative care
About the numbers and kinds of physicians we are training and how we are training them, even who we are encouraging to enter the profession
Drug costs, lack of original research, emphasis on “me-too” drugs
Skewed research funded by industry
Maldistribution and redundacy of healthcare resources throughout the country
Reduction of administrative costs and billing generally
Better and more reasonable “best practices” standards nationally
Better outpatient care and follow up, home nursing, and hospice care
More sanctioning of problem physicians
More honest and better reproductive healthcare

I have seen almost no discussion of any of these things.

And note that Ross’s wife works for them.

Agree with his first two comments. But not the third. All the heat and division over this year’s reform attempt, which at best will be a bandaid on bigger problems, shows that we need to put the main fix on the table and confront the medical-industrial complex head on. Otherwise we may wait another 5 or 10 years for another reform opportunity. We have Democratic control now of Congress and the White House. That may be as good as it gets, so we should have done it this year, but many of the Democrats are divided and too few are progressives. So the real choice,and next step, is to automatically enroll everyone in something like H.R. 676.

TOO cynical-what’s Too ?

When dealing with lizard lobbyists, you can’t be cynical enough,imho.

I had better head out to get some of my “real” work done, (I am self employed) before I blow my stack reading things like that. It seems like the Dems don’t like having one of their own in the POTUS seat. They want to run the weak and meek show! GRRRRR!

Obviously a Republic said “Boo!” to Reid.

I am starting to wonder if it might actually be BETTER to not have insurance…? I am self-employed and have BC/BS insurance… it is a state plan in NM… but I am fairly certain it would qualify as junk insurance and if I ever got sick I would be purged.

But then, I guess if you have no insurance with serious illness, your treatment options are severely limited… at least in NM… I think there would be one university hospital in ABQ who would take you.

Lord, how has our country come to this…

I am quoting from a FDL article about Ross… they said he sold the pharmaceutical company but he and his wife own 100% of the stock.

I am a scientist/artist not a financial guru… only relating what I read here.

The AMA represents only about a quarter of U.S. physicians. A recent national study of 2200 physicians found that 59 percent support single-payer, including more than 50 percent in all but three specialties. Most primary care physicians want single-payer

You’re welcome. A really good reference on the status of things through about 1966 is Harris, A Sacred Trust. It’s permanently out-of-print now, but most of the material appeared in articles Harris wrote for The New Yorker.

Someone needs to update Harris. If I were a grad student in History, I think that’s what I’d take on.

Thanks. I know it’s our best shot. I guess I’m feeling cautiously pessimistic, even with dems in the majority. sorry to get moody on our guest!

It is like being poor – if you are sick, you deserve it. It is yer own damn fault. *fume* Now I had really better go.

How’s about we get the good Doc to team up with the Cigna whistleblower that was on Moyer’s last week,and book them on KO,Maddow AND Moyers?

Now THAT would be “Must see TV!”

How’s about it,Jane,Doc?

Honestly, the main reason I bought “health insurance” is because I had a friend who died, uninsured, from cancer. The hospital was able to seize her assets (property) to cover the bill.

I did not want that to happen to me. I bought insurance to protect my real estate. That is still the main reason I have it. Besides that, I do believe that having insurance does open the door to health care. Of course that is the risk. . .will they cover me if/when I have a “catastrophic illness?”

I posted a comment in Christy’s thread on that passage. It is the only time Obama mentioned a public option last night, in answer to Steve Koff’s question. That is telling. He did not speak to the public option on his own. His answer by the way makes no sense. If the public option can deliver the same or better care at a lower price, why do we need to keep the private insurance industry honest? Why would we need them at all?

Yeah, I saw that – I think that meme “sold” is shorthand for something else — see my #73.

There is not going to be a public option the way supporters envision it. I don’t know what about that reality you don’t understand? This is a moderate country not an extremist one and that holds true for the right and the left. You can curse at the Blue Dogs all you want; the reality is that they genuinely represent the constituencies of moderate to conservative districts and states.

“Whether the subject is health care reform, climate change, or pay-as-you-go budgeting rules, almost everyone, it seems, suddenly wants to talk with the Blue Dogs. President Obama’s White House meeting with members of the fiscally conservative Democratic coalition earlier this week is but the latest indication that the Blue Dogs — 52 members strong — have deftly turned themselves into a key voting bloc at the nexus of power”.

To keep people from accusing the president of being a socialist.

Thanks to all at FDL and the good Doc for the informative interlude.

Yes, and you see from the Ross return that he or she or they are collecting more than $100k but less than $1M even though she is not being “paid.”

Agree. It is a long list of important issues that don’t get a hearing in the health care debate. The debate gets over-simplified and intentionally distorted by dysinformation from warring special interests. Corporate media also part of the problem. Leader of Gallup poll yesterday acknowledged how polls are biased by catch words and how questions are asked. We have a corpocrasy,not a democracy.

Thanks, that’s what I thought but I wanted to get it out there. Most physicians I have known would rather do medicine than deal with administrative issues about billing and what they can and can’t order for a patient.

Hugh,

The problems you cite are issues, and need to be addressed. But the biggest problem is the finance problem. I wish people would stop referring to this sturm-und-drang as health care reform and call it health care finance reform. But I’ve always preferred for things to have accurate labels.

As we come to the end of this lively Book Salon,

John, Thank you for stopping by the Lake and discussing your new book and the healthcare industry with us.

nyceve, Thank you very much for Hosting this great Book Salon.

Everyone, this is a good book about the healtcare industry, if you haven’t bought this paperback book yet, here is a link.

Thanks all.

That sounds like Madoff Math.

Dr Geyman, do you think that the strtegic mistake was that the Dems took single payer off the table from the outset? Had that not happened, then it seems intutive that the compromise would have become the public option.

I think single payer activists were correct all along, single payer should have been the demand, with public option as the compromise.

What a damn tragedy.

Potter and Bill Moyers did a great job. Just sent then a copy of the book. We need more of those programs.

oh no, Bev, it’s just getting exciting!

Wealth care .

That is one of the talking spinning points of Obama and the no change people. People are happy with their present insurance. More and more they are worried, if they are awake, … will it be there when we need it. All those cashed premium checks and yet more and more people dumped by insurers once they actually need support.

We got crumbs from Bush adm. and now we are begging Obama administration and Congress for croutons.

The ceo of Mayo Clinic was dissing Medicare on Charlie Rose and saying the way to cut costs is to pull back on end of life care. Make the elderly comfortable as they die. Okay, I am sure he has a point in terms of over-proceduring, but it was chilling to hear. The elephant in the room is healthcare and big pharma industries profiteering and he’s talking putting elderly citizens on a benign ice floe to save the system.

Obama last night talking about one willful rogue stray uninsured person who will cost us money when he has an injury. That is how he deals with the uninsured his advocated program will overlook? He is so not a reformer and protector of the citizenry.

We’ll never have a leader apparently who will even acknowledge the plight of the homeless.

Crumbs from Bush. Croutons from Obama if we are lucky?

We need more docs like you!

LOTS more.

I have concluded that Democratic control of Congress is merely an illusion… with the centrist DINOs who are actually Republican holding everything up… Dems do not have a majority…

We have to get rid of all the DINOs (some of whom our friend Rahm Emmanuel helped to get elected) before we have a true majority.

Conclusion: We are screwed.

I researched best places in the world for healthcare a couple of days ago … and France, San Marino and Italy were at the top of the WHO’s 2000 list (WHO no longer compiles the list due to its complexity)…

But I don’t think one can easily move to one of the top 10 countries and get a work visa.

For the love of God, don’t we deserve SOMETHING for bailing out WallSTreet?

Wasn’t that about their ” health”?

So which Senators (besides Baucus) do we need to be hammering on this? Should we be writing letters to the editors of their hometown papers, as we’re currently doing for the Blue Dogs in the House?

ummm… because they own Congress?

Yes, that was a huge mistake — to surrender in advance by allowing the opposition to keep single-payer off the table. And that also divided the Democrats, centrists from progressives, etc. The public option has distracted the debate, and real reform is being lost because we won’t get a strong enough public plan.

That is one of the talking spinning points of Obama and the no change people. People are happy with their present insurance.

I am sure people are just tickled to death when they get that notice in the mail that their rates are jumping and their benefits are going down.

The consensus seem to be that there will be no meaningful reform.

First, the majority of politicians who are responsible for our welfare, are uninterested. They are interested only in the money they receive from the health care system. They do not care if the system collapses, as long as they can collect money from the system in the near term.

Second, a public option on health care strikes at the American Dogma, and it its a religious dogma, that “free enterprise” is always the preferred solution. The concept of a public heath care system is attacking the keystone of this dogma. What next, a public car & house insurance system? A public option on banks?

Third, the removal of single payer was the death of reform, as there is no meaningful option that includes “insurance” and “claims”.

I fear we wil have deformed health care as opposed to reformed health care.

Actually, Russ Feingold is now saying that Our Pressure Is Working.

Thank you, Bev and Eve. I enjoyed this program. Appreciate the help. All the best. John

Thing is, they want us to give up. If what Feingold says is true, we’re a lot closer to victory than the GOP/Media Complex is letting on. Keep up the pressure!

From an e=mail I just received

P.S. Health insurance reform is a complex issue and many of you have questions about what it means for you and your family. To help get you the answers you need, White House Health Reform Director, Nancy-Ann DeParle, is holding a live video chat through Facebook and WhiteHouse.gov. Join the chat today at 3pm ET.

That Free Enterprise sysytem has cost us dearly-”bailout”.

Wall Street didn’t mind big government THEN. Socializing their risk-then privatizing their ill gotten profits,on OUR uninsured backs.

WHATs free about that?

So which Senators (besides Baucus) do we need to be hammering on this?

All of them, with the exception of Ted Kennedy and Bernie Sanders.

Hey, if you aint pissin somebody off you aint doin your job.

Personally,I’m tired of the Repubes peein’ on my leg and tellin me its rainin’.

Dems have to learn you can’t substitute a wishbone for a backbone.

The US is the leading manufacturing nation. As of 2004 the US nearly produced more manufactured goods than the next two nations combined.

Manufacturing in the US is still growing, China’s is growing faster.

Free Enterprise is when big business is free to prey on consumers in whatever way they deem most profitable.

@127

Damn right it’s free-some other poor schnook ALWAYS gets stuck with the check!

Where’s the JOBS to match up to that stat?

Maybe its considered American manufacturing-but actaully assembled in Mexico?

Source: Washington Post

Research Firm Cited by GOP Is Owned by Health Insurer
By David S. Hilzenrath
Washington Post Staff Writer
Wednesday, July 22, 2009; 6:46 PM

The political battle over health-care reform is waged largely with numbers, and few number-crunchers have shaped the debate as much as the Lewin Group, a consulting firm whose research has been widely cited by opponents of a public insurance option.

To Rep. Eric Cantor of Virginia, the House Republican whip, it is “the nonpartisan Lewin Group.” To Republicans on the House Ways and Means Committee, it is an “independent research firm.” To Sen. Orrin Hatch of Utah, the second-ranking Republican on the pivotal Finance Committee, it is “well known as one of the most nonpartisan groups in the country.”

Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation’s largest insurers.

More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician’s group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the “usual and customary” doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.

Read more: http://www.washingtonpost.com/…../20…

except you are pressuring for the wrong thing – passage of a flawed, kludged, inadequate bill that tinkers around the edges a bit, but does nothing to address the fundamental flaws that make health care in this country so costly, wasteful, and unfair.

so if they pass something, anything, Obama and the congresscritters have a big signing ceremony on the south lawn and preen and make florid speeches and create the impression that ‘reform’ was accomplished, and all the pressure for real reform is dispersed, which was the real goal of all this.

as the good Dr. Geyman says:

Unfortunately, the incremental “reforms” being built into bills in Congress are just rearranging the deck chairs on the Titanic.

Manufacturing jobs have been lost to higher productivity. This shows up in higher profits… it should also show up in higher wages for manufacturing workers, but that hasn’t happened.

Gee,give the serfs decent health care and next thing they’ll be unionizing!(Snark)

At my age, protecting my teeth is a great concern. Any comments on the coverage of teeth in the proposed plans. I would like to see some sort of a menu, if necessary; say choosing to forgo alcoholism clinic or mental therapy to get coverage that you care about.

Working to do what? Resuscitate the insurance companies?

Nancy Ann DeParle? Say, has she fixed the health care forum that was censored to eliminate the mention of single payer? The question was asked of her by Dr. Jess Fiedorowicz, so I assume she followed through…

Re the bandaid metaphor:

Am I not right in thinking that a bandaid over an infected wound will seal in the infection and make it worse?

Wait ’til you’re forced to buy junk insurance with a mandate…

Victory? You mean single payer, which is how the main players on this thread define victory?

And Kucinich, who introduced an amendment allowing states to conduct single payer experiments.

Ya know, that would be something to whip for that might actually make a difference…

I couldn’t agree more. That’s why it’s especially unfortunate that progressives with big megaphones were on the sidelines so long. Now a lot of us are going to be saddled with inferior policy.

”Indeed, when sales revenues (gross output) that are earned by the manufacturing sector are used to measure the size of output, China will grow to outrank the United States as early as 2008.”

http://www.finfacts.ie/irishfi…..0305.shtml

There are many empty industrial buildings in the state where I live. We have bled manufacturing jobs, so I really don’t know where this growth in U.S. manufacturing is occurring (some stats on this, please, and whether the stats reflect gross output or value-added figures).

Our official unemployment figure is over 10%, but that doesn’t take into account those who were forced into early retirement, have given up looking for work, or are minimally employed. Taking these last three into account, I would estimate our real unemployment figure to be at least 20%.

(This is meant to be a response to comment 126)