Welcome to Firedoglake – great to have you here!

Thanks for coming by. I’m on your email list and really enjoyed seeing the following from you hit my inbox last week:

Without the public option, it will be like hitting our heads against a wall to cure a headache, and we all know that doesn’t work.

This battle for health care reform is about each of us and the quality of life that we, as Americans, deserve. We must encourage our elected leaders to join this fight and stand behind them. We must encourage them to work tirelessly, to remember each American, and to honor the work of so many like Ted Kennedy by finally passing real health care reform.

A public option is not optional.

Thanks.

Welcome!

Here are two questions for Jennifer Brunner:

1. As you know, insurance companies take 30 cents out of each health care dollar.

Can you explain what value, if any, insurance companies bring to health care transactions?

2. As you know, US health care costs are $7290 per capita (in 2007). France’s health care costs were half ours (at $3601) and they have better health care outcomes (their life expectancy is two years longer than ours). France uses a single payer system. Canada, which also uses a single payer system, has similar advantages.

Since single payer systems can be shown by evidence to save both money and lives, will you advocate for a single payer system in this country? If not, why not?

Welcome from Hilliard! What are some of the things you think you can do as a Senator to bring jobs back to Ohio?

Hello, everyone. I am online and enroute to Lorain County, Ohio on Lake Erie. I’ll get started on the questions asked.

Welcome to FDL this afternoon.

How do we make the President understand that giving a windfall to the insurance companies that created the mess we have today is like baling out all the major banks and then paying bonuses to the managers who created the mess.

Oh wait.

Nevermind.

But seriously, how do we assure everyone has access to health care without having to go bankrupt or die while waiting?

Thank you, Jennifer, for being here today. We hope everything is going well with the campaign.

Can you tell me how Democrats in Ohio are responding to your support of a public option? Since Ohio is a swing state, I’m sure your experience is going to be indicative of what many will face in 2010.

Welcome to the Lake, Sect’y Brunner.

How does your position on the Public Option differ from your primary opponent, Lt Gov. Fisher?

Why is it that there are three statewide elected officials (yourself, Fisher, & Brown) all fighting for the public option in the battleground state of Ohio yet DC conventional wisdom hasn’t realized the electoral importance of a good bill?

Welcome, Secretary Brunner.

Nate Silver is asserting that, if things go well, the Democratic Party stands to lose 10-15 seats in the House in 2010, whereas, if things go badly (no health care plan, a continuing recession, etc.), the House could lose as many as 50 seats. While I understand that you’re running for the Senate and not the House, I would like to hear your observation on Silver’s assertion. Specifically, what do you feel the Democratic Party must do now to hold onto the majorities in both the House and the Senate?

Tell us why it’s important to Ohio and the old boys’ club known as the US Senate to replace Mr. Voinovich with a progressive less beholden to Ohio’s remaining big businesses: credit card & banking companies and the insurance/medical services industry.

Secretary Brunner, do you concur that the acquisition of Diebold/Premier by ES+S is cause for anti-trust action?

Congratulations on your Profiles in Courage award. Your efforts at voting reform are greatly appreciated.

Do you foresee a paper ballot ever replacing electronic voting?

Gee, I wish we could put health reform to a public vote!

Welcome, Secretary Brunner.

Please support the public option. Personally, I think that it is in your best interest to support real healthcare reform. Failure to pass meaningful reform threatens the Blue Dogs, not the progressive caucus. Maybe someone should remind them of that?

Anyway, I am confident that we’ll get reform with the public option.

In the past, major medical insurance was nonprofit based (e.g. Blue Cross Blue Shield). In the late 1980’s I watched in even the Ohio legislature, as legislation enabled them to become for profit. It doesn’t make sense for health insurance companies to be for profit, since for profit, market-based business relies on the survival of the fittest–and that means cutting costs, like creating preexisting condition exclusions, larger and larger deductibles, copays and coinsurance requirements. I have stated before that a good health care system wants all people to have the best health care possible and to do all possible for all people to survive. For profit insurance cannot do this–and that is essentially why we are where we are today.

I support the aims of H.R. 676 offered by Congressman Conyers and believe that such a system will eventually work in our country. I have been vocal in supporting President Obama’s plan for a public option and see it as a needed first step toward the aims of Congressman Conyers’ bill. I do not believe that we will see any improvement in our current health care crises without a public option.

While I believe that a single payer system would work for the U.S., I do not believe the American public has been educated enough about how such a system would work in the U.S. and that Democrats must be more proactive in getting out the message of what even a public option in our health care system would do and how it would benefit individual Americans. We could have done a better job of that with explaining the benefits of a public option. It is tough when $1.4 million a day is spent in lobbying by the health insurance/health care industry to fight the critical and worthwhile efforts of the President.

I understand from my work as Ohio’s Secretary of State when I tried to move quickly to paper ballots with more than 50 of our 88 counties using touchscreen voting machines, how difficult it is to effect sweeping change. Despite my efforts, even with Democrats, I was only able to first make an incremental change with backup paper ballots before the November 2008 election, and it helped, as we continue toward the comprehensive change originally sought. Sweeping change can occur quickly in the face of devastating crisis. We are close to that in health care, and if the public option doesn’t pass, I believe we’ll next be looking at single payer as the the only option. It would be better for the health insurance companies to relent on public option and to allow changes to occur incrementally before too many more people suffer needlessly.

What can you do to persuade downstate conservatives, economically disadvantaged by their loyalty to the GOP and the manufacturers rapidly leaving your state, that their future depends on progressive, credible reforms of health care and consumer finance & bankruptcy?

Not SoS Brunner, but I do want to point out that the party that wins a presidential election typically loses around 10-15 seats in the midterm immediately following that win.

1998 was a big shocker because this failed to happen — in fact, the Dems held steady in the Senate (they lost a couple, but took out D’Amato and Faircloth) and picked up five House seats, all during a year when the GOP/Media Complex was saying that the Republicans would clean up big time in the wake of the Monica phase of CoupGate. (And if the American public had known ahead of time that the GOP was going to ignore the voters’ will telling them to cease and desist picking on Clinton and go ahead with impeachment anyway, they probably would have given control of Congress to the Democrats.)

one of my chief objections to a ‘public option’ is that

1. it still leaves the most expensive people [elderly, disabled] walled off into a high-risk pool [high-risk pools don’t work all that well, for a number of reasons] where we can point to them as THE drivers of health care spending [well duh, it costs money to treat sick people], and

2. it still leaves the poorest among us walled off into their own ghetto, where it’s easy to salve our consciences by providing them with some care.

both morally and economically it’s better to just extend medicare [or my preference, extend the vha] to cover everyone.

do you oppose or support extending medicare to cover everyone? [i see from your answer above that you’ve answered this question]

do ohioans in general oppose or support extending medicare to everyone?

While I believe that a single payer system would work for the U.S., I do not believe the American public has been educated enough about how such a system would work in the U.S.

Yeah, I agree with that. They’re freaking out over a little reform as it is.

You point out an important issue: how badly the Democrats craft their messages of reform and how poorly they combat the counter-messages so well marketed by the GOP. It is a national disgrace that will cost all Americans plenty, especially in Ohio.

What will you do in the Senate to better educate Ohioans on the need for reform?

Bravo!

Ohio is in an excellent position to develop a green initiatives strategy for manufacturing, distribution, marketing and investment. We have an amazing infrastructure for manufacturing that has been devastated by poor trade policies and poor government decision making. It takes a coalition of public and private effort with effective government leadership to bring the people and institutions together to stimulate growth of jobs in Ohio. It will take labor and business working together and effective leadership that can work with both sides. I understand that change can be difficult, but when a model of bringing all stakeholders to the table is used and allowing them to be a part of the process in developing the policy, amazing things can happen that are both responsive to communities’ needs and cost effective, because they are more apt to be accurately focused and less trial and error. I have this experience in starting a specialized docket to relieve the court system of individuals whose major reason for being there has been drugs, alcohol and mental health issues, and most recently, in collaborating with 88 bi-partisan boards of elections in reforming Ohio elections. There is no silver bullet for creating jobs. It takes good leadership helping people to work together. This is why I am in public service.

Just this once I would like very much for Nate Silver to be dead wrong. Seems a bit early to be making such predictions anyway.

I support the aims of H.R. 676 offered by Congressman Conyers and believe that such a system will eventually work in our country. I have been vocal in supporting President Obama’s plan for a public option and see it as a needed first step toward the aims of Congressman Conyers’ bill. I do not believe that we will see any improvement in our current health care crises without a public option.

Yup. If the public option was truly ineffective, the health-industry lobby wouldn’t be working so hard to kill it.

Exactly. If the economy improves markedly, so do Dem chances. One big reason — perhaps the biggest reason — that the public so strongly opposed Republican efforts to unseat Clinton in 1998 was because the economy was doing the best that it had in over three decades. For almost the first time since 1974, real wages went up consistently under his watch.

I have been more vocal and unequivocal about it and have worked to encourage and incite others to step up and push for it with media releases and blog entries on Huffington Post and Daily Kos and will continue to be vocal about it. I also believe a single payer system will eventually work in the U.S., but that the public option is a first step to allowing the American public to experience (in addition to Medicare) that a government insurance system can work and will ultimately both save money for the government, businesses (especially small businesses–and I know about this, as my husband and I provided fully paid single and majority paid family coverage to our employees in our law firm, and he still does) and individuals and improve the well-being of millions of Americans and their families.

Jennifer:

Thanks for your lucid response to my real question in #1 ;-)

On question #2 (single payer) some followups:

In terms of your advocacy of an incremental approach to single payer from the public option:

1. The CBO has said that HR3200 as written will gain a maximum of 10 million enrollees (by 2019, IIRC). Do you believe that this is a large enough pool to compete successfully with private insurance?

2. Congress is now in the process of reducing subsidies for public option, and no doubt the insurance companies — as it is their fiduciary duty to do — are studying the legislation carefully to maximize their ability to cherrypick enrollees and deny claims. How would you address the concern that the public option plus the mandate forces people to purchase junk insurance that won’t cover them anyhow, and therefore amounts to a bailout for the insurance companies?

Secretary Brunner.

I’m from Minnesota so I hope you don’t mind. Did you happen to catch the video of Al Franken responding to critics that was making the rounds on all the blogs? It was a great performance. I hope that many other representatives will follow suit. I believe it is important to defuse the critics on the right, not browbeat them. Thanks.

Er no, PhoenixWoman. They’re simply pushing for the best deal possible for them. “Less bad” means “good” only in a world where all choices are binary.

When I talk to a plethora of people about a proposal that Medicare be extended to all Americans on an incremental basis, such as lowering the age eligibility for Medicare until all are covered, I don’t hear much objection, except as to cost. Democrats have to develop an effective way to show how Medicare costs less for the same services that would be provided by health insurance companies, and they do to some degree by comparing the costs of regular Medicare to Medicare Advantage. But we also have to show how the same services would be paid if through a completely private program (and also show differentials in cost of coverage by things like gender). In addition, we need to show how much is paid in insurance premiums versus taxation for Medicare and how businesses, especially small businesses, would save. There is an argument also for showing that employer provided health insurance puts the U.S. at a disadvantage on trade and job retention with other countries. In short, Democrats often take a backseat, hesitant role, frankly afraid of being called “liberal” instead of forging ahead, having courage and stating their position but being able to show why it is a good position, and that even if there is a cost, how, using good money management, it will have a long term net better effect in quality and cost. Let’s fact it, Democrats often have to come in and clean up Republicans’ fiscal messes (like right now). We’re better at government because we see value to government and how it helps maintain fairness, equality and respect in the lives of individual citizens.

One more question on single payer vs. public option:

Do you support the Kucinich Amendment to ensure that single payer at the state level is not outlawed (by ERISA requirements, for example?)

I’m in litigation with Premier and Diebold, having countersued Premier and Diebold (they sued first regarding Cuyahoga County’s claims against them in a preemptive suit) for the performance of its voting systems, especially the touchscreen system, so it’s probably premature for me to comment on this one.

Good afternoon, Ms. Brunner.

According to Matt Taibbi’s article in Rolling Stone, the bill that’s likely to come to the House floor will have its price tied not to Medicare, but to the prevailing cost of health insurance. He also alleges that access to the insurance pool will be limited to those whose employers don’t offer any insurance plan at all, without regard to how affordable or useful the employers’ plans are.

Do these strike you as features of a useful public option?

Thanks, understood. Good luck and wishes for a successful campaign.

I believe, as I seem to be hammering at again and again, that we need to better educate the public, including Democrats, about what a public option is and how it will benefit us individually and collectively. I often tell Ohioans that a public option is like Medicare and socialized medicine is like the Veterans Administration hospitals and campuses. Then they can visually picture it and are less threatened by the prospect of this kind of change (ironic, isn’t it that so many wanted change last year–seems they wanted everything around them to change, but to stay stationary themselves).

It makes me nervous when I talked to a Blue Dog Congressman who said that it seems like a public option might just work, and then commented on recent poll results that show that maybe the American public will favor it.

The media certainly is, but then they’ve been objectively pro-Republican since Nixon’s day. Woodward and Bernstein had to hammer their WaPo bosses to get them to run with their Watergate stories, and they were alone for months before the rest of the media started to pay attention, and only because the public was getting pissed off as the economy was starting to turn to shit thanks to Nixon’s wage/price controls and other ineffectual reactions to the OPEC production cutbacks.

And of course it’s only got worse since then.

Thank you for being here, SoS Brunner and thank you for your stand on the public option. I can see from your comments that you understand very well how the many parts of this problem (and others) must be worked together to create solutions. I appreciate that sophistication.

The lies have to be met with force AND truth. How can we lose this battle to lies???? It’s incomprehensible but it is happening.

And add me to the list of people who do not understand how something 70% of the people want is considered too extreme for our Congress to pass. It’s nuts. And clearly that this is a voter’s issue in Ohio is another manifestation of this. But in Washington, it’s the lobbyists who run the show … and we are NOWHERE near solving that problem.

It’s really discouraging that for Dems on Capitol Hill money counts more than people who vote.

Well, if you agree that the insurance companies add no value to the transaction, then the 30 cents on every dollar you save with single payer goes a long way — $350 billion a year (minimum) according to study in the (refereed, gold standard) NEJM. In fact, given savings like that, a program that’s merely revenue neutral is a fail — given, again, that we spend almost twice as much per capita as the next country for worse outcomes.

In terms of educating the public then, would you support that the CBO perform a “full analytical study” of all the policy choices, comparing each them, as oppposed to the “scoring” approach currently used?

And of course it’s only got worse since then.

I remember those times. Sometimes I almost miss Nixon. Only not really.

now this is a seriously good question, Bob.

I will work with leadership in the Senate, the DSCC, the DNC, the Ohio Democratic Party, leaders at all levels of Ohio government, the labor and business community, the nonprofit and civic community and activists in them, and will work in the netroots community to help craft simple, effective explanations and messages of what it is we are trying to do and will employ an effective staff in Ohio to be my liaisons, as well as personally hold public meetings to listen to the public and convey our messages. A collaborative approach, involving the public, has worked well for me at all levels of elected service. I have lived in Ohio all my life and have roots in southeast and western Ohio rural areas, as well as having grown up in Columbus, to help me understand the views and concerns of individuals in a diverse state such as Ohio, and to communicate effectively with them. Again, no silver bullet for getting this done, just effective communication again and again, and when you think you have said it enough, communicating some more. (This also requires a lot of listening.)

Well, not to be too harsh, but public option is not really “like” Medicare except insofar as public option is a government program, like Medicare is as well.

Medicare is not one option among many — like public option is, by definition. Medicare is the option; it’s single payer for over-65s.

So I’m greatly concerned that conflating the Medicare brand with public option is going to degrade Medicare in the public’s mind — as Bush’s “Medicare Part D’ (also a subsidy) has done. Degrading the Medicare brand is one of the risks of the incremental approach, is it not?

Lambert, if they really wanted the public option, why are they still fighting, to the tune of $1.4 million a day, to keep it out of any bill that hits Obama’s desk?

They’re not saying “we hate single payer but will take the public option”. They’re saying that they hate both, because as SoS Brunner and others have stated, the public option is seen as leading to single-payer.

This is excellent. I like this.

If you will reread the original question, you will see that the answer already lies therein.

Simply, yes. In Ohio, the previous Republican-controlled government abolished its Legislative Budget Office. In July, my office released “Better Lives, Better Ohio,” which is a social health index of indicators of the quality of life in Ohio, with 300+ indicators, that can at least start to replace what has been lost in effective public policy and budget decision making in Ohio. When we develop “best practices” on which government policy relies, we need good analysis and data to support it. If you want to take a look at the Ohio index, you can find it here: http://www.sos.state.oh.us/SOS/betterLives.aspx

It’s a heartwarming feeling to hear anyone say “I’m in litigation with Diebold.” ;-)

You make a very good point. For seniors, Medicare is single payer, except when it comes to Medicare Advantage. Many older Americans have private insurance to supplement their Medicare. Perhaps my analogy is oversimplification for those more sophisticated in the health care debate, but it helps people see that it is not some foreign concept we can’t trust.

Okay, you are cheering me up … and that says a lot!

I really like these messaging approaches. Carry on!

It would if the public option were actually unpopular. Yet poll after poll after poll shows that it is in fact quite popular and has been for some time.

Welcome to Firedog Lake Secretary Brunner,
My Congressman in Michigan has your typical republican banter in reply
to my calls for health care reforms, and won’t reply about single payer. (I
say they’ll save money if its even 3.6 trillion over the next ten years),
the republicans can’t wait to get back in office and start more false flag
wars costing atleast that, and spreading terrorism ( so they can protect us from it). So, I supported Rep. Kucinich this last election cycle too, we need more legitimite honest politicians who understand their servitude role, like him. Also, would you support his Department of Peace Legislation?

Thanks for having me today. As all of us can see, health care is a topic that engages us intensely. I will continue to fight for a public option in our current reform efforts. Someone said to me that health care reform will probably be solved by the time I would get to the Senate. I don’t think so–not by a long shot. As we begin to implement reform, like we do with so many other attempts at making things better, we find actions and changes that we know could make it better. We, as Progressives, are focused on making improvements in the lives of our fellow citizens, so there will always be more to do. Thanks again.

i live in a very rock-ribbed republican part of florida, but when i talk to people individually about medicare for all, i’ve used john conyers’ suggested 4.75%/4.75% payroll tax as a starting point for talking to people in general, and even used bernie sanders’ proposed 8.7%/2.2% payroll tax. i’ve found that about 2 out of 3 people that i talk to, including small business owners, would be agreeable with this.

You raise an important issue; see here.

Thanks for coming, it was nice to get to know you this afternoon. Good Luck!

This is one of the best guests and threads on the health reform issue,imho.

Thanks to ALL here who helped to help me understand the issues better.

Lambert, your original question was a way to try to avoid answering my question by reframing it to one more to your liking.

But since you won’t answer that one, here’s another one for you: Why is it that the sponsors of single-payer legislation backed it when it wasn’t going to get voted on, but are running away from it now that it’s set for an actual vote?

Except that public option is so ill-defined that the polls are meaningless. GIGO is GIGO, no matter how often repeated.

That’s also why it’s critical not to confuse the public by equating Medicare with “public option.”

A “public option” program with only 10 million enrollees is at best not certain to succeed, and if — some say when — it fails, it could take the Medicare brand down with it, severely impacting future reform efforts, even incremental ones.

my guess: because the democratic party leadership is leaning on them to back hr 3200 instead.

I’m don’t claim telepathy, unlike some, so I can’t speak to motive. I envy your prowess in that regard! I’m simply here to advocate forcefully for what all agree is the best policy on offer — single payer — and I couldn’t be less interested in the “Inside Baseball” of the day to day maneuverings of our elected representatives — any more than an advocate for abolition was interested in tracking bills to make the chains of slaves less comfortable to wear. YMMV, and, apparently, does.

That said, I’ve discussed this matter with others, and one view we came up with is that some of the backers peeled away precisely because the vote for HR676 — now that Pelosi has promised one — had actually become less symbolic and more meaningful.

If the public option is able to piggy back on Medicare than it really would be like Medicare. Early ideas like Rockefeller’s proposal was to make the public option simply buying into Medicare for the first few years. If the public option is a Medicare buy in than it is not 11 million people but part of a 60 million person network.

CBO guesses about how many people would sign up for the public option is just that, a pure guess. Expanding what size companies can use the exchange should be relatively easy (as written now would not take an act of congress) and would expand the reach of a public option.

The incredible amount of money that is going into killing the public options I think is proof in itself that the industry knows even a weak public option would still be very popular.

[In reply to Jon Walker @ 62]

This has always seemed the most sensible form of such an option. Instead of creating an entirely new bureaucracy, it would just expand one that already exists. It would have the same bargaining power and a large ”customer” base in place already. I’d pay money for Medicare coverage. I haven’t seen anything coming out of Congress lately that’s worth paying for.

I’d pay money for Medicare coverage.

so would i. in a heartbeat.

Hi Ms Brunner. What are your feelings with regard to the previous administration’s use of torture?

THANKS FOR SAVING OHIO FOR US:)

Well, now that our guest has left, I can explain again, more directly: The trump card you seem to think you are playing, is that if the insurance companies are spending money to run ads against the bill, then the bill must be good. It’s equally likely that they know that some sort of bill is inevitable — after all, the midterms are coming — and they’re running the ads to make sure that the bill that does pass works against they’re interests are little as possible. I’d expect a telepathic strategerist to be able to see the distinction, but binary thinking does take a toll.

1. No matter what, you’re going with a guess, since the only option on offer that can be shown to work is single payer.

2. “If the public option is a Medicare buy-in…” Well, if ifs and buts were candy and nuts, every day would be Christmas. Where’s the legislation on offer that has that provision?

3. As far as the idea that if my enemies spend money against something, that something is good… How does that work out for you in RL?

Book Salon a couple of flights upstairs with Thom Hartmann’s Threshold: The Crisis of Western Culture hosted by Mommybrain

Sorry I missed this one; I certainly wanted to find out what steaming piles of doo-doo Blackwell left for her to clean up that we don’t know about.