mcjoan:

Senate [HCR] Bill has Loophole Allowing Coverage Limits

That was an easy catch. Just wait till the lawyers start in on the meaning of "is," "may," "shall," "notice," etc. Regulation of health insurance does not work in the United States.

Speaking for me only

This is quite the ethical lapse:

Sen. Max Baucus (D-Mont.), chairman of the powerful Senate Finance Committee, gave a nearly $14,000 pay raise to a female staffer in 2008, at the time he was becoming romantically involved with her, and later that year took her on a taxpayer-funded trip to Southeast Asia and the Middle East, though foreign policy was not her specialty. Late last Friday, Baucus acknowledged his relationship with Melodee Hanes, whom he nominated for the job of U.S. attorney in Montana, after it was first reported on the website MainJustice.com. [. . .] [Baucus] dismissed calls for an ethics investigation, saying, “I went out of my way to be up and up.”

I think Baucus misunderstands that his being on "the up and up" with an employee would be the subject of an ethics investigation.

Speaking for me only

In the season finale of "Curb Your Enthusiasm," Larry was supposed to do a favor ("F for Favor") for Mocha Joe, whom Larry had neglected to tip for doing him a favor. Mocha Joe asked Larry to pick up coffee beans ("C for Coffee") for Mocha Joe. Larry tried to get the beans, but arrived late and could not get the beans. The next day, Larry pleaded for an "E for Effort."

Mocha Joe (with an assist from Jerry Seinfeld) gave Larry an F for not completing the favor. Right now I am prepared to give the Democrats in Congress an E for Effort on their Health Insurance Premium Assistance Bill, but I still want a favor -- forget the pipe dream of 60 votes in the Senate and figure out what you can pass through R for Reconciliation.

Then they can all declare a V for Victory (S for Success?) and at least some less well off folks can get some insurance (C for Crappy?) paid for by wealthy folks (P for Progressive taxation?)

Otherwise, maybe we put Susie Essman on them.

Speaking for me only

I like that Ezra Klein wrote the post he just did. Because I think it illustrates precisely what is wrong with the analysis provided by the Village Wonks. Ezra writes:

Insurers seem evil because of the marketplace in which they operate. The healthy don't buy as much insurance as the sick. The sick aren't as profitable as the healthy. Insurers, like all private firms, are very simple: They pursue profit like a pig sniffing after truffles. It is up to society to train them, and we do that by setting rules.

Health-care reform will establish many, if not all, of those rules. The individual mandate will mean the healthy cannot hang back until they become the sick. Insurers, for their part, will not be able to discard the sick in favor of the healthy. Perhaps more importantly, risk adjustment -- which compensates insurers with sicker customers by taxing insurers who have cherrypicked healthier people -- will end the days when it is profitable to do so. As the exchanges open up -- if they open up, more to the point -- all of this will work better and more smoothly. This is how the Netherlands' health-care system looks, and few would accuse their insurers of being evil.

(Emphasis supplied.) We do not live in the Netherlands. If what Ezra prescribed actually worked, it would have worked in even one state in the US. Regulation would work. It has not. The Exchange has not worked in any state the way Ezra describes. The individual mandate has not worked in any state the way Ezra describes. The excise tax has not worked in any state the way that Ezra describes. Only one thing has worked to contain health care costs in the United States - government run insurance plans. Those are the facts. In ivory towers, you can build any Rube Goldberg contraption you want and claim it will work. In the real world, one program HAS worked. Only one. Medicare. Therein lies the problem with the Village Wonk. He lives in the Ivory Tower. The rest of us have to live in the real world. Right here in the good ole USA - where regulators do not effectively regulate health insurance; where exchanges do not work; where excise taxes will result in less health care for workers, not lower health care costs and increased wages.

Speaking for me only

Is it true that George Washington said "that the framers had created the Senate to "cool" House legislation just as a saucer was used to cool hot tea[?]" The question becomes then did George Washington and the Framers intend for the Senate to put the tea in the freezer.

A couple of days ago, I asked Senator Spector about our dysfunctional Senate:

I was on a call with Senator Specter yesterday. His office was kind enough to get me a transcript:

Senator Arlen Specter: Thank you all for joining us this afternoon the principle topic is the healthcare reform legislation, which has been highly publicized. There is some background activity on Jobs Bill. Climate control is pretty much on the backburner, for the moment, as is Wall Street reform and immigration and the Appropriation Bills are coming through, but I think it would be good to move right to the questions.

Q: Hi, Senator Specter. This is Eve Gittelson. I want to thank you, again, for graciously giving us your very valuable time. AS: Well, I’m pleased to do it, Eve. Thank you. [MORE . . .]

Chris Bowers argues that MedicAid expansion is the key provision in the health insurance premium assistance bill for progressives:

The largest public option in the health care bills is, and has always been, Medicaid. In terms of the number of people it covers, it dwarfs any other public option currently on the table in either bill. In terms of the type of people it covers, compared to the other public option expansions it includes a much higher percentage of Americans who are currently uninsured and a much higher percentage of Americans who are currently in poverty. [. . .] Providing 15 million low-income, uninsured Americans with public health insurance is also why so few House Progressives carried through on their earlier threat to sink any health care bill without a new public option program tied to Medicare rates. After all, House Progressives both want to help people in poverty, and they disproportionately represent districts that would have been impacted by the new Medicaid coverage.

So, why not just pass MedicAid expansion then? Hell, throw in the subsidies to purchase private insurance too if you want. Use the House funding mechanism (the very popular "tax the rich" approach) and voila - we have a good progressive bill. Are there not 60 votes in the Senate for that? No problem. As was contemplated in 1997 for S-Chip, pass it through reconciliation:

Via TPMDC, the Communications Workers of America commissioned a poll:

[N]ew polling, commissioned by the Communications Workers of America and conducted by Anzalone Liszt Research, finds that voters overwhelmingly oppose taxing high-cost health insurance plans as a way to help fund health insurance reform, but support raising taxes on the wealthy to accomplish the same goal. The Anzalone poll surveyed 2,200 likely voters in 10 states including seven with 2010 frontline Senate races (Arkansas, Colorado, Connecticut, Delaware, Louisiana, Nevada and North Dakota). Also polled were Indiana, New Mexico and Virginia.

We are through the looking glass. The public supports a public option but it must go. The public opposes the excise tax, but it must stay. Democracy in action.

Speaking for me only

Booman writes:

In any case, I find it absurd that anyone would seriously believe (or ask others to believe) that Obama has wanted to weaken the public option all along. In fact, I think that is just stupid.

I agree. I do not think the President has lifted a finger, pro or con, regarding the public option. He has been the Bystander President regarding the SUBSTANCE of "health care reform." Some attribute this to the political impotency of the Presidency itself. In my opinion, that is an absurd and stupid view. Others think the President and his team are focused on "success" (apparently defined as passage of a bill, any bill. I fall into that camp.) Others rightly question why that definition of success should be accepted by progressives and activists.

In any event, absurdities abound.

Speaking for me only

In a way, it is stunning to me that someone like Matt Yglesias, who has spent the year pooh poohing the public option and arguing that it be dropped by progressives would write this:

[I]t’s important to understand that [Medicare's] low reimbursement rates are a feature not a bug. [. . .] [O]n the one hand, that funding levels are high. But it also means that there’s a reasonable amount of interest in getting as much health care services per dollar as possible. Consequently, providers are paid enough to make it worth their while to see Medicare patients, but much less than they’d like to make. The result is not a perfect program (far from it) but this particular aspect of Medicare is an example of big government at its best—serving clients’ interests rather than those of providers.

I have written it a million times - here is one million one - the one tested and proven method of controlling health care costs is Medicare. Health care reform that creates a program that COULD become like Medicare is the only proven reform that has been proposed. The wonks will tell you all about the wonderful "bending the curve" provisions like the Exchange, and the excise tax and all the rest. What they do not tell you is that none of that - absolutely none of it, has been proven to work in any setting ever. Only one program has been proven to work to cut costs - the government run insurance program known as Medicare.

Speaking for me only

John Cole writes:

I understand that things are not moving the way many people want them to and with the speed that some desire, but as far as I am concerned things are a HELLUVA lot better than last year. I think in all the doom and gloom, we forget that our President can now speak in full sentences, has not invaded Russia, and is not ducking shoes everywhere he goes. [. . .] [T]here is no chance in hell I am going to be demoralized come November 2010. I’ve been watching the wingnuts- we need to keep them as far away from power as is legally possible. They are dangerous, and this Obama fellow, despite some letdowns, ain’t half bad.

I think Cole is conflating two different issues. What you want from your representatives and the choices you make on election day are not the same things. I think everyone is more than a little demoralized with the Obama Presidency and the Democratic Congress (even me, who worried incessantly about Obama's political style.) They just are not doing as much as they could. At least imo. It seems a strange argument to ask people not to be demoralized because Obama is not as bad as the worst President in history. I get that it would be crazy to vote for the GOP in 2010. I doubt anyone who is demoralized is planning on that. By the same token, I doubt many in the base are enthused with the idea of keeping the Dems in office based on their performance in the last year. And, as the old saw goes, off year elections are base elections.

Speaking for me only

Ezra Klein generally has the best sources on the health insurance bill and he writes:

The deal looks pretty much like it's looked for the past few days: The Office of Personnel Management will shepherd national, non-profit plans into existence. Medicare will open to folks between 55 and 64 who are eligible for the exchange. If the national non-profit plans don't materialize, then there appears to be a trigger that will call a public plan into the market, but that seems pretty unlikely. All of this, of course, is contingent on CBO giving it a good score.

The camel's nose here is the expansion of Medicare eligibility to a group beyond those 65 and over. That group is defined as persons between the age of 55 and 64 who qualify for the Exchange (stevie makes a great point in comments - if dependents can be covered in a Medicare buy-in this becomes a more meaningful provision - progressives should demand that concession.) It's a start. Lowering the eligibility age now becomes an acceptable concept. Now there needs to be a tweak to all of this imo - the individual mandate must be limited to those persons who will be eligible for the Exchange AND who qualify for the new Medicare expansion and/or the new Medicaid expansion. To wit, you are only mandated to purchase health insurance IF you are eligible for a public insurance plan (Medicaid or Medicare.) I would also support mandating coverage for persons who make $200K a year or more. I also prefer the House funding mechanism.

If the bill can end up in that final form, I would support it.

Speaking for me only