Yay! We passed the bill! No question about it, seeing the House pass the health reform bills, and watching the President sign one of them, felt like moments of triumph. Despite our many many reservations, so many of us have worked so hard over the last year to achieve this victory! From my own work with the remarkable network that has sprung up around EQUAL, and my colleagues at KPFA; to the hard work of women's groups, progressive organizations, and public health; to the members of Congress who took on enormous obstacles: we all have a claim to this step forward. Speaker Nancy Pelosi clearly deserved major credit for working the bill through the Democratic caucus.
But there are bitter disappointments. The public option failed though it was and is popular. Reproductive rights and immigrants' rights are under assault. Corporations are gaining legal as well as de facto rights. The rabid right, while possibly diminishing and cornered, is nevertheless frightening. The opposition leadership is fanning the flames of hate, divisiveness and willful ignorance, as they experience defeat for the first time in a decade. Members of Congress are heckling each other, the President and the public. One staff member described the atmosphere as “vicious.”
It’s not all over yet, even on the most pragmatic level. The Senate will debate all week, and Republicans will attempt every possible maneuver to derail the proceedings.
Both the President and Rep. Dennis Kucinich framed the victory as one that could begin to reverse 30 years of regressive Reagan-era policies. While the details of the bill are largely technical, and far from revolutionary, one has only to think back to the tsunami of corporate opposition that buried similar proposals in the Clinton era to appreciate the potential significance of this accomplishment.
The legislation itself offers significant improvements for health coverage for many, while ducking the most far-reaching controls on costs. The immediate benefits this year include a tax credit for small businesses that offer insurance, a ban on pre-existing condition exclusions for children, the elimination of copayments for preventive care, and a $250 rebate to Medicare beneficiaries who fall into the prescription drug plan’s doughnut hole. In 2014, 16 million people will begin coverage through Medicaid (called MediCal in California), and millions more will be able to buy insurance through pools created by new state-based exchanges. The plan will limit insurance plans’ ability to gouge sick enrollees in the small group market.
The public option would be a crucial factor in controlling costs and holding insurance companies accountable. Like Medicare and other public programs, the public option was envisioned as an entity with the clout to demand lower prices from health care providers, and also a real alternative for people seeking an escape from the predatory insurance industry. Its absence leaves a gaping hole in the program’s viability.
There’s no similar dispassionate analysis of the harm inflicted on women and immigrants. At best, the bills strengthen existing prohibitions on spending federal funds on abortion and for the first time intrude on the right and ability to buy abortion coverage with private dollars; and exclude tax-paying immigrants from health benefits others enjoy. These assaults are driven purely by vitriol.
The job for progressives is to rejoice in the prospects that may be opening up, and to stay angry about what we have lost, while taking a cold, hard look at the power dynamics that landed us here. A map of the House vote suggests a huge geographically-based divide in the U.S., with representatives from the more isolated middle of the country accounting for most of the Republicans, and the 34 Democrats who voted no. Can progressives win primaries against ConservaDems in those districts? A number of organizations are chomping at the bit to find out.
We have to come up with strategies to deepen and consolidate the public’s approval of Medicare as a model for a stronger public role in the health care system, and link state based and national campaigns to pursue it.
Challenging sexism, racism and homophobia will be problematic in an era of economic recession. But our communities are organized and articulate. Winning the power to defend and advance our interests is not an option; our opponents have their knives drawn, in some cases literally.
Quoting Rep. Dennis Kucinich:
“We're at a pivotal moment in American history, and in contrast to a crippled presidency, I have to believe that this effort, however imperfect, will now have a broad positive effect on American society, and make possible many things that might not have otherwise been possible. Once this bill is signed into law, more Americans are going to be aware of this as they ask, What's in it for me? And as they become more familiar with the new law, more people will be accepting this bill. The president will have a stronger hand in domestic and international affairs, and that will be good for the country.”
Is this President up for it, and up to it? Are we? The coming months will tell.
Showing posts with label public option. Show all posts
Showing posts with label public option. Show all posts
Wednesday, March 24, 2010
Monday, March 15, 2010
Thank You Dennis Kucinich
Let’s face it, politicians can be exasperating. Politicians who run for President get a level of exposure that would make most of us run for cover.
But Dennis Kucinich is taking a drubbing for doing what more progressives should be doing: standing up for a public option as part of the health reform bill, and demanding an ERISA amendment.
This is not a simple matter of getting the health reform bill passed. Passing a health reform bill is a bare minimum requirement for the U.S. to make progress towards an acceptable level of social justice and it should be done. Today’s “Hill” reports that the votes in play are - well, most of them. There are presently 114 Democrats declaring hesitation about the bill:
Firm No, Leaning No, Likely No (36)
Firm Yes (2)
Leaning Yes (5)
Undecided (71)
We’ll come back to this.
Last November, 219 Democrats voted to pass a health reform bill, 39 voted No. The bill included a public option, and also included odious provisions limiting access to abortions. Now the speaker needs 216 “yes” votes to pass a scaled back version of the bill, with fixes in the form of a budget reconciliation bill. That means she can lose 37 Democrats.
Some history
Congressman Kucinich voted for the House bill when it went through the Education and Labor Committee. That bill included a public option and an amendment he proposed to the Employee Retirement Income Security Act (ERISA), to permit states to implement single payer systems without facing a court challenge by employers.
Employers like ERISA, they like ERISA’s provisions that preempt state legislation on employment-related health care benefits, and they would be just as happy not to see any changes to it. Passing the amendment through the Committee was not an easy task, and it came about because Republican members of Congress joined some progressives to vote yes, doubtless alert to the fact this provision alone could swell Republican political contributions, and possibly sink the bill if it came before the full House. Nevertheless, the majority of the Committee voted to accept the amendment. Under normal circumstances, that would indicate it would show up in the bill that went to the House for a vote.
You didn’t see that amendment in HR 3692. That’s because in the interim the Chamber of Congress wrote to the House leadership and pledged to oppose the entire bill if it included the ERISA amendment. The House leadership crafted a bill they thought would pass, and that did not include any changes to ERISA. This was before the recent Supreme Court decision giving corporations expansive rights to influence politics. Mr. Kucinich voted “No” on the final bill.
Getting to the Public Option
Now Mr. Kucinich says he would like to discuss changing his vote to a Yes. He wants 2 things in the House bill: A public option. And the ERISA amendment.
Turns out the majority of Americans agree with him. The most popular part of the bill is the public option, and with good reason. Skeptical as we are of the government, allergic as we are to wonkitude, we have no doubt whatsoever about what lies in store for us if we have to start forking over our premiums to the private insurance industry without the option to vote with our feet. We’ll agree to pay up to get close to universal coverage. But we want a safe, affordable haven. The public option offers that, or at least the structural hope of something like that. Despite all that, we hear no end of excuses and proclamations from our elected leaders about why we can’t have it. Last week, a local health advocacy group picketed Kucinich in his district for threatening to vote No on a bill without the P.O.
Kucinich isn’t holding out for a boondoggle, or a minority vendetta. He’s staking a claim for a policy most people want. There are 114 votes in play. One of them belongs to a progressive. Let’s see about moving the other 113. Then we can come back and thank Dennis for voting Yes on a bill we actually helped to shape.
But Dennis Kucinich is taking a drubbing for doing what more progressives should be doing: standing up for a public option as part of the health reform bill, and demanding an ERISA amendment.
This is not a simple matter of getting the health reform bill passed. Passing a health reform bill is a bare minimum requirement for the U.S. to make progress towards an acceptable level of social justice and it should be done. Today’s “Hill” reports that the votes in play are - well, most of them. There are presently 114 Democrats declaring hesitation about the bill:
Firm No, Leaning No, Likely No (36)
Firm Yes (2)
Leaning Yes (5)
Undecided (71)
We’ll come back to this.
Last November, 219 Democrats voted to pass a health reform bill, 39 voted No. The bill included a public option, and also included odious provisions limiting access to abortions. Now the speaker needs 216 “yes” votes to pass a scaled back version of the bill, with fixes in the form of a budget reconciliation bill. That means she can lose 37 Democrats.
Some history
Congressman Kucinich voted for the House bill when it went through the Education and Labor Committee. That bill included a public option and an amendment he proposed to the Employee Retirement Income Security Act (ERISA), to permit states to implement single payer systems without facing a court challenge by employers.
Employers like ERISA, they like ERISA’s provisions that preempt state legislation on employment-related health care benefits, and they would be just as happy not to see any changes to it. Passing the amendment through the Committee was not an easy task, and it came about because Republican members of Congress joined some progressives to vote yes, doubtless alert to the fact this provision alone could swell Republican political contributions, and possibly sink the bill if it came before the full House. Nevertheless, the majority of the Committee voted to accept the amendment. Under normal circumstances, that would indicate it would show up in the bill that went to the House for a vote.
You didn’t see that amendment in HR 3692. That’s because in the interim the Chamber of Congress wrote to the House leadership and pledged to oppose the entire bill if it included the ERISA amendment. The House leadership crafted a bill they thought would pass, and that did not include any changes to ERISA. This was before the recent Supreme Court decision giving corporations expansive rights to influence politics. Mr. Kucinich voted “No” on the final bill.
Getting to the Public Option
Now Mr. Kucinich says he would like to discuss changing his vote to a Yes. He wants 2 things in the House bill: A public option. And the ERISA amendment.
Turns out the majority of Americans agree with him. The most popular part of the bill is the public option, and with good reason. Skeptical as we are of the government, allergic as we are to wonkitude, we have no doubt whatsoever about what lies in store for us if we have to start forking over our premiums to the private insurance industry without the option to vote with our feet. We’ll agree to pay up to get close to universal coverage. But we want a safe, affordable haven. The public option offers that, or at least the structural hope of something like that. Despite all that, we hear no end of excuses and proclamations from our elected leaders about why we can’t have it. Last week, a local health advocacy group picketed Kucinich in his district for threatening to vote No on a bill without the P.O.
Kucinich isn’t holding out for a boondoggle, or a minority vendetta. He’s staking a claim for a policy most people want. There are 114 votes in play. One of them belongs to a progressive. Let’s see about moving the other 113. Then we can come back and thank Dennis for voting Yes on a bill we actually helped to shape.
Friday, March 12, 2010
Three Things Worth Fighting For: A Public Option. Women’s Rights. Single Payer.
It was tempting to think that the Bush presidencies were an error from which we’ve now recovered. It’s increasingly apparent that there are deep structural fissures in our society that, like the earthquakes in Chile, have not played themselves out. Unlike that force of nature, we can do something about it – but it will take some work. Here are three tests that demand our commitment:
1. The public option. Americans want an alternative to the predatory insurance industry. They aren’t ready to mandate turning the whole apparatus of paying for health care over to the government, and we’re not going to talk them into it this year. But they damn well want a safety valve from corporate insurance.
Now, the public option is a new entity. We can predict with certainty that it will have lower administrative expenses and won’t pay profits or million dollar bonuses to executives based on denying needed care. The finer points are less certain.
But critics on the left who have consistently contended that the public option could never work seized with relish a 10-page memo dashed off by the Congressional Budget Office to House Ways and Means Chair Charles Rangel on October 29, 2009, stating that the public plan would likely enroll only about 6 million of 30 million newly covered lives. This estimate itself rested on some questionable assumptions. The House bill (in Sec. 213) tightly constrained the grounds for variation in premiums. In Sec. 322, it also limited the amount the public plan could pay to providers. Nevertheless, CBO said the public plan would have higher premiums than other plans in the new Exchanges:
That estimate of enrollment reflects CBO’s assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges.
In addition CBO stated that:
The public plan would have lower administrative costs than… private plans but would
probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees. (The effects of that “adverse selection” on the public plan’s premiums would be only partially offset by the “risk adjustment” procedures that would apply to all plans operating in the exchanges.)
These unsubstantiated assumptions were not repeated in CBO’s extensive (167-page) examination in December, 2009, of the factors involved in speculating on the effects of possible reforms.
We need a public option. Progressives should fight as hard as we can for the most robust possible public plan. A new public entity that could enroll up to 31 million is estimable, next to 25 million in the Veterans Affairs system, 45 million in Medicare, 49 million in Medicaid, and millions more in other federal programs. It is just a step, but it is potentially a step forward.
2. Women’s rights. Abortion restrictions were voted down in the Senate, 54 – 45, scant days before Nelson bludgeoned them back in. But the House does not have a reliable pro-choice majority. The state of Utah has criminalized miscarriages if there is a claim that they are related to an attempted abortion.
I repeat: The state of Utah has criminalized miscarriages if there is a claim that they are related to an attempted abortion.
The attack on reproductive rights is not, it turn out, a side show in health reform. It is a major shot across the bow. The assault is serious, it is not going away, and progressives are going to have to fight about it, hard.
3. Single payer. Unlike the abortion issue, health reform is not a step backwards for state single payer efforts. Employers have been using ERISA (the Employee Retirement Income Security Act) for decades to block state reforms that would make them pay up for health insurance. Crusading Dennis Kucinich could still fight to get his ERISA amendment in the final bill, opening an important new avenue for states, and eliminating likely long court battles.
Happily, progressives are figuring out that if we want a progressive Congress, we need to run progressive candidates. Challengers are showing up in Democratic primaries against Bart Stupak and other pretend Dems, and organizations are springing up to support them. It will take more than the election of November, 2008, to recover from decades of neoliberal politics and corrupt economics. Passing health reform is the step we can take in the next few weeks. Fighting to make it work will be one of the projects we dig in for over the next few years.
1. The public option. Americans want an alternative to the predatory insurance industry. They aren’t ready to mandate turning the whole apparatus of paying for health care over to the government, and we’re not going to talk them into it this year. But they damn well want a safety valve from corporate insurance.
Now, the public option is a new entity. We can predict with certainty that it will have lower administrative expenses and won’t pay profits or million dollar bonuses to executives based on denying needed care. The finer points are less certain.
But critics on the left who have consistently contended that the public option could never work seized with relish a 10-page memo dashed off by the Congressional Budget Office to House Ways and Means Chair Charles Rangel on October 29, 2009, stating that the public plan would likely enroll only about 6 million of 30 million newly covered lives. This estimate itself rested on some questionable assumptions. The House bill (in Sec. 213) tightly constrained the grounds for variation in premiums. In Sec. 322, it also limited the amount the public plan could pay to providers. Nevertheless, CBO said the public plan would have higher premiums than other plans in the new Exchanges:
That estimate of enrollment reflects CBO’s assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges.
In addition CBO stated that:
The public plan would have lower administrative costs than… private plans but would
probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees. (The effects of that “adverse selection” on the public plan’s premiums would be only partially offset by the “risk adjustment” procedures that would apply to all plans operating in the exchanges.)
These unsubstantiated assumptions were not repeated in CBO’s extensive (167-page) examination in December, 2009, of the factors involved in speculating on the effects of possible reforms.
We need a public option. Progressives should fight as hard as we can for the most robust possible public plan. A new public entity that could enroll up to 31 million is estimable, next to 25 million in the Veterans Affairs system, 45 million in Medicare, 49 million in Medicaid, and millions more in other federal programs. It is just a step, but it is potentially a step forward.
2. Women’s rights. Abortion restrictions were voted down in the Senate, 54 – 45, scant days before Nelson bludgeoned them back in. But the House does not have a reliable pro-choice majority. The state of Utah has criminalized miscarriages if there is a claim that they are related to an attempted abortion.
I repeat: The state of Utah has criminalized miscarriages if there is a claim that they are related to an attempted abortion.
The attack on reproductive rights is not, it turn out, a side show in health reform. It is a major shot across the bow. The assault is serious, it is not going away, and progressives are going to have to fight about it, hard.
3. Single payer. Unlike the abortion issue, health reform is not a step backwards for state single payer efforts. Employers have been using ERISA (the Employee Retirement Income Security Act) for decades to block state reforms that would make them pay up for health insurance. Crusading Dennis Kucinich could still fight to get his ERISA amendment in the final bill, opening an important new avenue for states, and eliminating likely long court battles.
Happily, progressives are figuring out that if we want a progressive Congress, we need to run progressive candidates. Challengers are showing up in Democratic primaries against Bart Stupak and other pretend Dems, and organizations are springing up to support them. It will take more than the election of November, 2008, to recover from decades of neoliberal politics and corrupt economics. Passing health reform is the step we can take in the next few weeks. Fighting to make it work will be one of the projects we dig in for over the next few years.
Friday, February 26, 2010
The Health Care Summit: Fight On!
First of all, kudos to Lynn Woolsey, Barbara Lee and the Progresive and Black Caucuses for presenting just the right statement on the public option; to HuffPo for giving it (and us) space; and to the 1.2 million people who stood up in one day(!) around the country yesterday for comprehensive reform. All this certainly paved the way for final statements by Murray and Pelosi on the public option.
The upshot? Obama's timeline - up to 6 weeks - to resolve all this was worrisome, if he meant to suggest this could drag on through Easter recess.
But on the whole, I think it was a careful and methodical dismemberment of every Republican argument and proposal. After both sides agreed that it was imperative to do something about the health insurance crisis, and almost 5 hours of discussion, Boehner retreated back into the standard Republican tropes and misrepresentations. It left the President sounding like the soul of reason and consideration in stating that he could not settle for a Republican plan that made no progress and would at best cover 3 million of the 45 million uninsured. He outlined places where the Democrats had already compromised (no public option, allowing insurance companies to trade across state lines, within the context of a national exchange), and offered a few weeks for the Republicans to consider if they had actual compromise proposals. But he made a firm commitment to move forward if the two sides could not agree soon. It made the reconciliation process, with a 51 vote majority, seem like a desirable process, and perhaps one the country would do well to rise up and demand.
It is clearly the moment for the public to continue the drumbeat.
(see live blog at Huffington Post: http://www.huffingtonpost.com/2010/02/25/health-care-meeting-exper_n_474978.html)
The upshot? Obama's timeline - up to 6 weeks - to resolve all this was worrisome, if he meant to suggest this could drag on through Easter recess.
But on the whole, I think it was a careful and methodical dismemberment of every Republican argument and proposal. After both sides agreed that it was imperative to do something about the health insurance crisis, and almost 5 hours of discussion, Boehner retreated back into the standard Republican tropes and misrepresentations. It left the President sounding like the soul of reason and consideration in stating that he could not settle for a Republican plan that made no progress and would at best cover 3 million of the 45 million uninsured. He outlined places where the Democrats had already compromised (no public option, allowing insurance companies to trade across state lines, within the context of a national exchange), and offered a few weeks for the Republicans to consider if they had actual compromise proposals. But he made a firm commitment to move forward if the two sides could not agree soon. It made the reconciliation process, with a 51 vote majority, seem like a desirable process, and perhaps one the country would do well to rise up and demand.
It is clearly the moment for the public to continue the drumbeat.
(see live blog at Huffington Post: http://www.huffingtonpost.com/2010/02/25/health-care-meeting-exper_n_474978.html)
Saturday, February 20, 2010
Plots
The public option, declared dead on a regular basis, is still supported by aboout 60% of the public, and probably a majority of Senators, who are piling on to a ststment of support initiated by Sen. Bennet of Colorado. Ask your senators to join in, or thank them if they did.
For contact numbers and a script, see the PCCC/DFA/Credo public whip count here:
http://whipcongress.com
Read the letter here:
http://whipcongress.com/letter-senate?source=med
The intention is to seek a nationally administered plan as part of the national exchange that will be available to individuals and small employers. It will be more effective if it is open to more enrolleess. Large numbers are the only way any health insurance scheme can work. As recently as December, Senator Rockefeller and others pushed for a PO that everyone could choose, including employees of large firms. This formulation did not prevail. It will have to remain on the agenda for the next round, as will single payer.
Why and how could it work? It's true that large numbers are the centerpiece of effective insurance plans.
It will likely have a higher enrollmenr than the original hastily written and brief CBO projecction, which predicted that the PO would charge higher premiums than the average plan, something that is expressly forbidden in the language of the bill itself.
Is it an attempt to put the risk of expensive cases on the public sector, while leaving the profitable business to the private sector? Death spirals - where healthy people quit and only people with expensive health conditions remain - are a problem now for publicly sponsored high risk pools, and the excuse for Anthem Blue Cross raising its rates by 39%. The difference is that the public option will be one choice for people who are all going to buy insurance anyway. Healthy individuals buying insurance are just as likely to choose the public option as a private one - probably more likely.
Where does something like this work now? While not the definitive case study, in California counties where public plans compete with private plans for enrollees in the State Children's Health Insurance Plans, the public sector does very well in enrollment and cost.
Some single payer supporters have not only retreated from support of the public option, they actively organize opposition, calling it "puny" and a plot that would destroy prospects for single payer in the future.
A great deal has been writtn about the PO, including in hours of Congressional testimony, all online. So just a few comments here:
The public option just isn't an insurance industry plot. Activists are fighting to make it a nationally administered alternative that will be as effective as possible. AHIP's opposition to the public option is a matter of public record, and their payments to the Chamber of Commere to oppose it were reported in the NY Times. If advocacy for the PO is also really an insurance industry plot, surely there would be some evidence somewhere - ?
It's not as good as a single payer, which is not attainable now. It is a placeholder that can be used and improved over time. The alternatives are no bill, or a bill without a public option.
Think about these statements, and then go look up tautology:
The public option could never work; the insurance industry will never let it work; the public option is a plot by the insurance industry to destroy the single payer movement.
You can't trust the government to do anything right; look at how the government mishandled Katrina.
As one commentator noted: "You know who else passed laws? Hitler."
For contact numbers and a script, see the PCCC/DFA/Credo public whip count here:
http://whipcongress.com
Read the letter here:
http://whipcongress.com/letter-senate?source=med
The intention is to seek a nationally administered plan as part of the national exchange that will be available to individuals and small employers. It will be more effective if it is open to more enrolleess. Large numbers are the only way any health insurance scheme can work. As recently as December, Senator Rockefeller and others pushed for a PO that everyone could choose, including employees of large firms. This formulation did not prevail. It will have to remain on the agenda for the next round, as will single payer.
Why and how could it work? It's true that large numbers are the centerpiece of effective insurance plans.
It will likely have a higher enrollmenr than the original hastily written and brief CBO projecction, which predicted that the PO would charge higher premiums than the average plan, something that is expressly forbidden in the language of the bill itself.
Is it an attempt to put the risk of expensive cases on the public sector, while leaving the profitable business to the private sector? Death spirals - where healthy people quit and only people with expensive health conditions remain - are a problem now for publicly sponsored high risk pools, and the excuse for Anthem Blue Cross raising its rates by 39%. The difference is that the public option will be one choice for people who are all going to buy insurance anyway. Healthy individuals buying insurance are just as likely to choose the public option as a private one - probably more likely.
Where does something like this work now? While not the definitive case study, in California counties where public plans compete with private plans for enrollees in the State Children's Health Insurance Plans, the public sector does very well in enrollment and cost.
Some single payer supporters have not only retreated from support of the public option, they actively organize opposition, calling it "puny" and a plot that would destroy prospects for single payer in the future.
A great deal has been writtn about the PO, including in hours of Congressional testimony, all online. So just a few comments here:
The public option just isn't an insurance industry plot. Activists are fighting to make it a nationally administered alternative that will be as effective as possible. AHIP's opposition to the public option is a matter of public record, and their payments to the Chamber of Commere to oppose it were reported in the NY Times. If advocacy for the PO is also really an insurance industry plot, surely there would be some evidence somewhere - ?
It's not as good as a single payer, which is not attainable now. It is a placeholder that can be used and improved over time. The alternatives are no bill, or a bill without a public option.
Think about these statements, and then go look up tautology:
The public option could never work; the insurance industry will never let it work; the public option is a plot by the insurance industry to destroy the single payer movement.
You can't trust the government to do anything right; look at how the government mishandled Katrina.
As one commentator noted: "You know who else passed laws? Hitler."
Tuesday, February 2, 2010
What's At Stake
Most people in this country would like to get the health insurance industry off their backs, given a choice.
There is an increasingly polarized clamor from the left and the right claiming that the modest but effective incremental proposals coming from Congress are leading us down the path of tyranny and corporate control.
Let’s be clear about who is controlling what.
Corporations exist to generate profits. They want them now and they don’t want a lot of guff about it. People (other than corporate executives) get to have a bit of the wealth if we fight for it. (It helps motivate us to produce and consume the goods and services that generate profits.) If corporations don’t need us any more and can figure out how to do it all with machines, they will. If they can go somewhere else where the population is under tighter political control, they will.
The government isn’t static. It protects corporations and corporate rights. It also protects people and the rights of people and communities. It can strengthen or weaken organizations (like unions) and rules that protect us. It depends on who’s in charge of the government and who is pushing them.
As corporations face a global meltdown, our communities are experiencing wrenching losses – of jobs, income, housing, education, social services.
The Democrats’ institutional and financial base includes corporations, as well as organizations and individuals committed to limiting corporate power. Some Democrats are reliable allies. Some are not.
Corporations have an unequivocal political voice. It is the Republican party.
The last 8 years of Republican rule brought us direct cash transfers from our taxes to corporations. That’s why we have a deficit. All that money went somewhere. A lot of it went to the war industry and finance capital. The recent clamor from “independents” about the deficit is not only misdirected, it is perfectly misdirected.
We also got a wholesale incursion on our civil liberties and attacks on our rights, in the name of combating terrorism. The right now complains about a lack of debate after a year of televised hearings – on C-Span!! – while their acolytes invade town hall meetings and derail debate.
If the Republicans regain control of Congress in November, the filibuster rule will go down the drain in the first month. I shudder to think what they’ll do in the second. I’ve never lived in a fascist state, I’ve only read about it, and talked to people who have.
How can we protect our rights and challenge corporate power?
We can support laws that rein in the power of corporations to take our money and do whatever they damn well please.
The health reform bills would do that.
They establish that we Americans have the right to get health care, a principle accepted all over the rest of the world. We’re Americans so we say you have to pay in to claim the right. But the bills take a giant step in the right direction.
Not a small, insignificant step. A giant, major step.
They say that once you pay, you have to get what you paid for. The Mafia elements of the health insurance industry are under attack. Will the new laws be strong and effective enough? They could be. We have to pass them and then we have to fight to make them work. This is possible. We can do it this year. Here’s what else we would get:
1. Health care availability for most of those left out now.
2. A requirement that employers also contribute to the cost of health insurance.
3. Premium credits help make insurance affordable for incomes up to 400% of poverty.
4. A national health insurance exchange, the first step towards a national plan.
5. Coverage for comprehensive benefits
6. Ban on insurance industry abuses like pre-existing condition exclusions, rescissions
7. Payment incentives and other measures to improve the quality of care, including moving away from specialty care to preventive care to address our critical public health needs.
8. Negotiated drug prices through Medicare.
Canada had years of doctors’ strikes after passing universal coverage. But they stuck with it, fought for it, and made it work. (No, just passing the law wasn’t the end of it. They still had to fight. They still do.)
We can pass laws that strengthen the power, funding and authority of the public sector vs. the private sector. The public option would do that.
The better route would, of course, be to get corporations out of health care. Let’s talk about why no one who believes that made a serious effort in 2009 to make it happen:
We don’t have the power to do it. We don’t have the movement. It will take massive, determined grass roots mobilizations to make it happen.
The American public might get there some day. It might or might not be about health care. But we’re generally pretty healthy, and the health care system is complex and amorphous.
People are getting educated about “single payer” proposals. This is great. Some assert that the American public is already in favor of single payer, and is being restrained from achieving it because the Democrats haven’t proposed it. This is an inspiring belief. There have been about 30 people arrested nationwide in support of single payer. Maybe 100. This is a good beginning. Expanding Medicare for some or for all is a popular proposal, and we can continue to fight for it.
Is it a ruse that the corporations oppose health care reform? Not according to them. The Chamber of Commerce and American’s Health Insurance Plans joined forced to kill the pubic option. The NY Times (Jan. 31 p. 21) quotes Chamber chief R. Bruce Josten on the fact that “Despite the Democratic majorities in the House and the Senate, they have not been able to muster support for a single final bill [on health reform]. ‘We had a good year. I have no regrets.’”
Are they just fooling? Were their lobbyists all over the Committees writing the bills, just in case something passed? You bet. When they thought it was inevitable and unstoppable they were there getting their licks in. They are, perhaps, rethinking. Do they want the package to pass? No they do not.
The Democrats need to take another look at who’s voting for them and why. They need to go back and pass a bill that expands union organizing rights, as well as a jobs bill and small business tax credits. They need to go through the reconcilation process to pass a health reform bill, and they need to do it soon. They should also change the Senate rules so that they need 52 votes for cloture (or whatever number they reliably have).
Then progressives can get back to work pushing the reforms further, and mobilizing our communities to fight for our rights and our stuff. We’ll be able to do it because we’ll be living in a country that is dominated by corporations but still respects democratic rights, one that plays out daily the tensions between capital and people.
In my experience political and social change are hard, take consistent, intelligent work, strategic engagement with influential actors including the public, an analysis of where power lies, an understanding of the role and life cycles of organizations, including the ones that govern us and those that might create change. Atheist that I am, I have been impressed with my friends in the faith community. They are not health policy wonks, but they learn what they need to know, they identify their targets, they figure out what it will take to move them, and they do it. They attempt to analyze reality, engage with the reform proposals as they are and to try to influence them.
We need to pass the health reform bill, and keep the email lists and the relationships we’re building in the process. It’s going to be a bumpy few years, and we’re going to need each other.
There is an increasingly polarized clamor from the left and the right claiming that the modest but effective incremental proposals coming from Congress are leading us down the path of tyranny and corporate control.
Let’s be clear about who is controlling what.
Corporations exist to generate profits. They want them now and they don’t want a lot of guff about it. People (other than corporate executives) get to have a bit of the wealth if we fight for it. (It helps motivate us to produce and consume the goods and services that generate profits.) If corporations don’t need us any more and can figure out how to do it all with machines, they will. If they can go somewhere else where the population is under tighter political control, they will.
The government isn’t static. It protects corporations and corporate rights. It also protects people and the rights of people and communities. It can strengthen or weaken organizations (like unions) and rules that protect us. It depends on who’s in charge of the government and who is pushing them.
As corporations face a global meltdown, our communities are experiencing wrenching losses – of jobs, income, housing, education, social services.
The Democrats’ institutional and financial base includes corporations, as well as organizations and individuals committed to limiting corporate power. Some Democrats are reliable allies. Some are not.
Corporations have an unequivocal political voice. It is the Republican party.
The last 8 years of Republican rule brought us direct cash transfers from our taxes to corporations. That’s why we have a deficit. All that money went somewhere. A lot of it went to the war industry and finance capital. The recent clamor from “independents” about the deficit is not only misdirected, it is perfectly misdirected.
We also got a wholesale incursion on our civil liberties and attacks on our rights, in the name of combating terrorism. The right now complains about a lack of debate after a year of televised hearings – on C-Span!! – while their acolytes invade town hall meetings and derail debate.
If the Republicans regain control of Congress in November, the filibuster rule will go down the drain in the first month. I shudder to think what they’ll do in the second. I’ve never lived in a fascist state, I’ve only read about it, and talked to people who have.
How can we protect our rights and challenge corporate power?
We can support laws that rein in the power of corporations to take our money and do whatever they damn well please.
The health reform bills would do that.
They establish that we Americans have the right to get health care, a principle accepted all over the rest of the world. We’re Americans so we say you have to pay in to claim the right. But the bills take a giant step in the right direction.
Not a small, insignificant step. A giant, major step.
They say that once you pay, you have to get what you paid for. The Mafia elements of the health insurance industry are under attack. Will the new laws be strong and effective enough? They could be. We have to pass them and then we have to fight to make them work. This is possible. We can do it this year. Here’s what else we would get:
1. Health care availability for most of those left out now.
2. A requirement that employers also contribute to the cost of health insurance.
3. Premium credits help make insurance affordable for incomes up to 400% of poverty.
4. A national health insurance exchange, the first step towards a national plan.
5. Coverage for comprehensive benefits
6. Ban on insurance industry abuses like pre-existing condition exclusions, rescissions
7. Payment incentives and other measures to improve the quality of care, including moving away from specialty care to preventive care to address our critical public health needs.
8. Negotiated drug prices through Medicare.
Canada had years of doctors’ strikes after passing universal coverage. But they stuck with it, fought for it, and made it work. (No, just passing the law wasn’t the end of it. They still had to fight. They still do.)
We can pass laws that strengthen the power, funding and authority of the public sector vs. the private sector. The public option would do that.
The better route would, of course, be to get corporations out of health care. Let’s talk about why no one who believes that made a serious effort in 2009 to make it happen:
We don’t have the power to do it. We don’t have the movement. It will take massive, determined grass roots mobilizations to make it happen.
The American public might get there some day. It might or might not be about health care. But we’re generally pretty healthy, and the health care system is complex and amorphous.
People are getting educated about “single payer” proposals. This is great. Some assert that the American public is already in favor of single payer, and is being restrained from achieving it because the Democrats haven’t proposed it. This is an inspiring belief. There have been about 30 people arrested nationwide in support of single payer. Maybe 100. This is a good beginning. Expanding Medicare for some or for all is a popular proposal, and we can continue to fight for it.
Is it a ruse that the corporations oppose health care reform? Not according to them. The Chamber of Commerce and American’s Health Insurance Plans joined forced to kill the pubic option. The NY Times (Jan. 31 p. 21) quotes Chamber chief R. Bruce Josten on the fact that “Despite the Democratic majorities in the House and the Senate, they have not been able to muster support for a single final bill [on health reform]. ‘We had a good year. I have no regrets.’”
Are they just fooling? Were their lobbyists all over the Committees writing the bills, just in case something passed? You bet. When they thought it was inevitable and unstoppable they were there getting their licks in. They are, perhaps, rethinking. Do they want the package to pass? No they do not.
The Democrats need to take another look at who’s voting for them and why. They need to go back and pass a bill that expands union organizing rights, as well as a jobs bill and small business tax credits. They need to go through the reconcilation process to pass a health reform bill, and they need to do it soon. They should also change the Senate rules so that they need 52 votes for cloture (or whatever number they reliably have).
Then progressives can get back to work pushing the reforms further, and mobilizing our communities to fight for our rights and our stuff. We’ll be able to do it because we’ll be living in a country that is dominated by corporations but still respects democratic rights, one that plays out daily the tensions between capital and people.
In my experience political and social change are hard, take consistent, intelligent work, strategic engagement with influential actors including the public, an analysis of where power lies, an understanding of the role and life cycles of organizations, including the ones that govern us and those that might create change. Atheist that I am, I have been impressed with my friends in the faith community. They are not health policy wonks, but they learn what they need to know, they identify their targets, they figure out what it will take to move them, and they do it. They attempt to analyze reality, engage with the reform proposals as they are and to try to influence them.
We need to pass the health reform bill, and keep the email lists and the relationships we’re building in the process. It’s going to be a bumpy few years, and we’re going to need each other.
Tuesday, January 5, 2010
The Public is Right About the Public Option
This article appeared on page A - 8 of the San Francisco Chronicle, January 6, 2010.
The insurance industry hates it because it would ding its profits. Democratic leaders fear it could kill passage of health care reform. But reports of the death of the public option have been greatly exaggerated.
Poll after poll shows that Americans want to be able to choose a public insurance plan, and for good reason. It would be tragic to lose this pillar of health care reform to cynical inside-the-Beltway political horse trading. Here's why we need the public option:
It can really deliver on the benefits. The proposed bills would outlaw common and perverse industry loopholes such as pre-existing condition exclusions, which exclude sick people from buying insurance as individuals, and rescissions, which let companies deny treatment retroactively for people they already insure. While outlawing these rules will help, private insurance plans have demonstrated that they are willing to challenge patients' rights to the grave and beyond in the interest of clinging to the premium dollar.
We've witnessed a heartbreaking parade of insured patients trooping to corporate headquarters to plead for lifesaving treatments that were denied, even though the benefits are covered in writing. In contrast, no one at the government-run Medicare program gets a bonus for turning away sick people. We need to be able to choose a plan in which the financial incentives to provide needed care line up with the proposed new laws, and that can only happen in the public sector.
It will drive down costs. Health care reform will cover millions more Americans - a great achievement. But we need to use the increased buying power of this newly covered population to control costs, a job at which private insurance companies consistently fail. Some companies can't reduce premiums because they're too small to hold leverage in negotiations with private hospital chains and big drug companies. Or if they do save a buck, they put it back in their own pockets in the form of profits and executive bonuses.
In Massachusetts, large nonprofit insurers recently testified that they had negotiated sweetheart deals that benefited certain employers and hospitals - and confidentiality agreements that kept the details secret. When the Veterans Administration negotiates lower drug prices, the savings buy more drugs for veterans, and the transactions are all transparent. We'd like to be sure that the change we voted for turns into change we save on reduced premiums, which is possible only in a public plan.
It will allow us to re-engineer how we deliver and pay for care. How? By coordinating with Medicare initiatives that will bolster quality while lowering costs, like financial incentives that promote primary care and better coordination of medications. The public plan will be most effective if it starts right away and is available to everyone - policies we can continue to fight for. But the projection that the public option would offer savings too small for too few, or would be too expensive, is off the mark.
It's democratic. Most Americans know this in our bones. The majority of the House voted for it, including many in our powerhouse delegation from California. The majority of senators expressed support for it - including committee chairs Max Baucus and Tom Harkin. We're tired of arcane rules that let minorities of one hijack the public's interest.
There will be efforts to leverage the public option for other benefits. One benefit of that debate would be if the antitrust exemption for health insurance companies were revoked so they can be regulated by the Federal Trade Commission. But we need a real institutional alternative to the present system. Americans want - and need - a public option. Don't let your representatives trade it away.
Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/01/05/EDNG1BDU6L.DTL#ixzz0boXMcwU1
The insurance industry hates it because it would ding its profits. Democratic leaders fear it could kill passage of health care reform. But reports of the death of the public option have been greatly exaggerated.
Poll after poll shows that Americans want to be able to choose a public insurance plan, and for good reason. It would be tragic to lose this pillar of health care reform to cynical inside-the-Beltway political horse trading. Here's why we need the public option:
It can really deliver on the benefits. The proposed bills would outlaw common and perverse industry loopholes such as pre-existing condition exclusions, which exclude sick people from buying insurance as individuals, and rescissions, which let companies deny treatment retroactively for people they already insure. While outlawing these rules will help, private insurance plans have demonstrated that they are willing to challenge patients' rights to the grave and beyond in the interest of clinging to the premium dollar.
We've witnessed a heartbreaking parade of insured patients trooping to corporate headquarters to plead for lifesaving treatments that were denied, even though the benefits are covered in writing. In contrast, no one at the government-run Medicare program gets a bonus for turning away sick people. We need to be able to choose a plan in which the financial incentives to provide needed care line up with the proposed new laws, and that can only happen in the public sector.
It will drive down costs. Health care reform will cover millions more Americans - a great achievement. But we need to use the increased buying power of this newly covered population to control costs, a job at which private insurance companies consistently fail. Some companies can't reduce premiums because they're too small to hold leverage in negotiations with private hospital chains and big drug companies. Or if they do save a buck, they put it back in their own pockets in the form of profits and executive bonuses.
In Massachusetts, large nonprofit insurers recently testified that they had negotiated sweetheart deals that benefited certain employers and hospitals - and confidentiality agreements that kept the details secret. When the Veterans Administration negotiates lower drug prices, the savings buy more drugs for veterans, and the transactions are all transparent. We'd like to be sure that the change we voted for turns into change we save on reduced premiums, which is possible only in a public plan.
It will allow us to re-engineer how we deliver and pay for care. How? By coordinating with Medicare initiatives that will bolster quality while lowering costs, like financial incentives that promote primary care and better coordination of medications. The public plan will be most effective if it starts right away and is available to everyone - policies we can continue to fight for. But the projection that the public option would offer savings too small for too few, or would be too expensive, is off the mark.
It's democratic. Most Americans know this in our bones. The majority of the House voted for it, including many in our powerhouse delegation from California. The majority of senators expressed support for it - including committee chairs Max Baucus and Tom Harkin. We're tired of arcane rules that let minorities of one hijack the public's interest.
There will be efforts to leverage the public option for other benefits. One benefit of that debate would be if the antitrust exemption for health insurance companies were revoked so they can be regulated by the Federal Trade Commission. But we need a real institutional alternative to the present system. Americans want - and need - a public option. Don't let your representatives trade it away.
Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/01/05/EDNG1BDU6L.DTL#ixzz0boXMcwU1
Saturday, December 12, 2009
The Senate Compromise: Does it Help?
The Senate compromise seems to be this:
For the slice of the population age 55 - 64 that would have gone into health exchanges with subsidies – uninsured, self-employed – let them instead buy in to Medicare. Except without subsidies.
The Medicare Part B premium is now means-tested – that is, based on annual income. It covers 25% of the cost of the program. Individuals earning less than $85,000 a year pay no premium; going up from there from about $44 a month to about $353 a month. Buying in to Part B alone could presumably cost 4 times those amounts, or between zero and $1400 a month. Plus the $155 deductible.
Offer the same group, under age 55, the choice of 2 nonprofit health plans, administered by the federal Office of Personnel Management.
No public option.
Til now we’ve heard that Congress would abolish lifetime caps on what the plans would pay. Now we’re hearing the caps may be back. (After which you’re on your own.)
The great thing about Medicare is that it has the clout of 40 million beneficiaries and the federal government when it comes time to negotiate with Sutter Health. So sure, add more folks in over there.
But. If they’re the oldest and sickest, and everyone under 55 is still left to the depredations of the private insurance industry…Well. Perhaps at least a few more of them will be covered.
And rumor has it that the Senate would also require the companies to spend 90% of the premium dollar on actual benefits (a big hike from the 70% or so that some plans spend now).
Ok marginally a little better than nothing. But so diluted from the House bill, in terms of a stepping stone to the future: less public involvement than any proposed public option (so less cost control), less affordability, less coverage. Makes you think that maybe the regular legislative process has some advantages over the Gang of 10 system.
Painful as it may be, and tempting as it is to go for expanding Medicare by any means necessary, it’s looking like getting something through the Senate, to be followed by a conference with the House’s better bill, is our best hope.
For the slice of the population age 55 - 64 that would have gone into health exchanges with subsidies – uninsured, self-employed – let them instead buy in to Medicare. Except without subsidies.
The Medicare Part B premium is now means-tested – that is, based on annual income. It covers 25% of the cost of the program. Individuals earning less than $85,000 a year pay no premium; going up from there from about $44 a month to about $353 a month. Buying in to Part B alone could presumably cost 4 times those amounts, or between zero and $1400 a month. Plus the $155 deductible.
Offer the same group, under age 55, the choice of 2 nonprofit health plans, administered by the federal Office of Personnel Management.
No public option.
Til now we’ve heard that Congress would abolish lifetime caps on what the plans would pay. Now we’re hearing the caps may be back. (After which you’re on your own.)
The great thing about Medicare is that it has the clout of 40 million beneficiaries and the federal government when it comes time to negotiate with Sutter Health. So sure, add more folks in over there.
But. If they’re the oldest and sickest, and everyone under 55 is still left to the depredations of the private insurance industry…Well. Perhaps at least a few more of them will be covered.
And rumor has it that the Senate would also require the companies to spend 90% of the premium dollar on actual benefits (a big hike from the 70% or so that some plans spend now).
Ok marginally a little better than nothing. But so diluted from the House bill, in terms of a stepping stone to the future: less public involvement than any proposed public option (so less cost control), less affordability, less coverage. Makes you think that maybe the regular legislative process has some advantages over the Gang of 10 system.
Painful as it may be, and tempting as it is to go for expanding Medicare by any means necessary, it’s looking like getting something through the Senate, to be followed by a conference with the House’s better bill, is our best hope.
Wednesday, December 9, 2009
The Senate: Getting to the Public Option
It is important that health reform continue to move forward through the Senate. The most recent announcement offers some elements that sound attractive. As a whole, though, the package seems to leave a lot of gaping holes, that the Senators will need to address, or that will be resolved in conference.
What the proposal is, as far as we can tell:
Opening up something like the Federal Employees Health Benefits Plan (FEHBP) to the public, through the Office of Personnel Management.
Offering some or all people age 55-64 the chance to buy in to Medicare.
A trigger to create a public option in the future.
Progressives need 3 things:
1. An expanded role for the public sector, in order to effectively control the charges by health care providers: drug companies, hospitals, medical supply companies, hospitals. Doctors too. Private insurance companies have no stake in controlling prices and are often too weak to bargain successfully with organized providers.
2. To the extent there will continue to be private for-profit insurance companies in the mix, they need to be strictly regulated, so that the uninsured will have a fair shake at getting covered, and the insured and underinsured have a fair shake at getting our claims paid.
3. Subsidies to make insurance affordable, and to put some pressure on the government as prices rise.
Increasing enrollment in Medicare for seniors, while expanding coverage for middle age/middle income people, would be a great step forward.
But marginally opening up Medicare selectively to a subset of seniors does not accomplish these objectives. It likely will not increase significantly the number of beneficiaries; and they will be the most expensive to treat.
FEHBP has the same inflationary insurance spiral as any other set of private insurance plans. It does function somewhat like the proposed health insurance exchanges. It is not a public option. A trigger needs to be pulled now.
The Illinois Campaign for Better Health Care proposes this:
"It is NOT an either or - we demand a strong public option, strong insurance reforms, and expanding access to Medicare to all individuals 55 and older. Better yet, let everyone join Medicare."
Call your U.S. Member of Congress at 1-888-801-4426. Tell them:
For Democratic reps: "Stay firm on the public option plan on which you have already voted yes and on expanding Medicare eligibility."
For Republican reps: "Quit playing politics with my and my family's life. Support the American people and support health care reform."
What do you think?
What the proposal is, as far as we can tell:
Opening up something like the Federal Employees Health Benefits Plan (FEHBP) to the public, through the Office of Personnel Management.
Offering some or all people age 55-64 the chance to buy in to Medicare.
A trigger to create a public option in the future.
Progressives need 3 things:
1. An expanded role for the public sector, in order to effectively control the charges by health care providers: drug companies, hospitals, medical supply companies, hospitals. Doctors too. Private insurance companies have no stake in controlling prices and are often too weak to bargain successfully with organized providers.
2. To the extent there will continue to be private for-profit insurance companies in the mix, they need to be strictly regulated, so that the uninsured will have a fair shake at getting covered, and the insured and underinsured have a fair shake at getting our claims paid.
3. Subsidies to make insurance affordable, and to put some pressure on the government as prices rise.
Increasing enrollment in Medicare for seniors, while expanding coverage for middle age/middle income people, would be a great step forward.
But marginally opening up Medicare selectively to a subset of seniors does not accomplish these objectives. It likely will not increase significantly the number of beneficiaries; and they will be the most expensive to treat.
FEHBP has the same inflationary insurance spiral as any other set of private insurance plans. It does function somewhat like the proposed health insurance exchanges. It is not a public option. A trigger needs to be pulled now.
The Illinois Campaign for Better Health Care proposes this:
"It is NOT an either or - we demand a strong public option, strong insurance reforms, and expanding access to Medicare to all individuals 55 and older. Better yet, let everyone join Medicare."
Call your U.S. Member of Congress at 1-888-801-4426. Tell them:
For Democratic reps: "Stay firm on the public option plan on which you have already voted yes and on expanding Medicare eligibility."
For Republican reps: "Quit playing politics with my and my family's life. Support the American people and support health care reform."
What do you think?
Thursday, November 19, 2009
Real Health Reform: Positions for Progressives
What Now
It has been both an exhilarating time for progressives and a bumpy one: the House passed a bill (yay) with a public option (yay). These are victories for progressives, inside and outside of Congress: we made this happen.
But House leaders caved at the last minute to an anti-abortion spoiler, the Stupak-Pitts amendment, and dropped a popular provision proposed by Rep. Dennis Kucinich to protect states that opt for single payer systems from lawsuits under ERISA.
Many of us who both support and desperately need health reform are still trying to make sense of the news of the last week. Advocates and the public need to be unified and energized for the final push to get the best possible bill through the Senate and back through the conference committee with the House.
Here’s what we think all Senators need to hear, and why:
1. The House bill is a major achievement. Preserve and expand on its strong points, including the public option.
There is a lot here for access, quality, affordability and cost control, in fact more than there was in any of the bills that passed through the House Committees. The public option is likely to be more robust than the Congressional Budget Office’s preliminary projection.
2. We need to advance reproductive rights, not retreat.
The anti-abortion amendment is a real threat and a wake-up call.
We can beat it. Many members who voted “yes” on Stupak are on record as pro-choice.
Pro-choice energy can propel reform forward.
3. Protect single payer states from ERISA lawsuits.
It is important to continue to point this out and to organize for single payer, and against the for-profit private insurance industry States will be a far cry further in the march toward single payer if we can win waivers from federal obstacles including ERISA.
The House is still in play; they will be involved in the conference with the Senate, and will vote again on final passage. Our messages to House members depends on how they voted. (See Tables on p. 8):
1. Voted Yes on the bill and No on the Stupak Amendment (178 Democrats): Thank you! You’re the progressive Democratic majority. Help us win the ERISA waiver, and keep what we’ve won.
2. Voted Yes on the bill and Yes on Stupak: Stick with the bill and stick up for women. [For those historically pro-choice: Shame on you for voting Yes on Stupak]
3. Voted No on the bill and No on Stupak: Thanks for opposing Stupak. I’m asking you to stand up for health care reform now and support the bill.
4. Voted No on the bill and Yes on Stupak: We need health care reform now, and need our member of Congress to stick up for women. Will you change your vote and stand up for health reform and for women? [For those historically pro-choice: Shame on you for voting Yes on Stupak]
(for full statement and to see how Menbers voted go to: http://www.centerforpolicyanalysis.org/id62.html)
It has been both an exhilarating time for progressives and a bumpy one: the House passed a bill (yay) with a public option (yay). These are victories for progressives, inside and outside of Congress: we made this happen.
But House leaders caved at the last minute to an anti-abortion spoiler, the Stupak-Pitts amendment, and dropped a popular provision proposed by Rep. Dennis Kucinich to protect states that opt for single payer systems from lawsuits under ERISA.
Many of us who both support and desperately need health reform are still trying to make sense of the news of the last week. Advocates and the public need to be unified and energized for the final push to get the best possible bill through the Senate and back through the conference committee with the House.
Here’s what we think all Senators need to hear, and why:
1. The House bill is a major achievement. Preserve and expand on its strong points, including the public option.
There is a lot here for access, quality, affordability and cost control, in fact more than there was in any of the bills that passed through the House Committees. The public option is likely to be more robust than the Congressional Budget Office’s preliminary projection.
2. We need to advance reproductive rights, not retreat.
The anti-abortion amendment is a real threat and a wake-up call.
We can beat it. Many members who voted “yes” on Stupak are on record as pro-choice.
Pro-choice energy can propel reform forward.
3. Protect single payer states from ERISA lawsuits.
It is important to continue to point this out and to organize for single payer, and against the for-profit private insurance industry States will be a far cry further in the march toward single payer if we can win waivers from federal obstacles including ERISA.
The House is still in play; they will be involved in the conference with the Senate, and will vote again on final passage. Our messages to House members depends on how they voted. (See Tables on p. 8):
1. Voted Yes on the bill and No on the Stupak Amendment (178 Democrats): Thank you! You’re the progressive Democratic majority. Help us win the ERISA waiver, and keep what we’ve won.
2. Voted Yes on the bill and Yes on Stupak: Stick with the bill and stick up for women. [For those historically pro-choice: Shame on you for voting Yes on Stupak]
3. Voted No on the bill and No on Stupak: Thanks for opposing Stupak. I’m asking you to stand up for health care reform now and support the bill.
4. Voted No on the bill and Yes on Stupak: We need health care reform now, and need our member of Congress to stick up for women. Will you change your vote and stand up for health reform and for women? [For those historically pro-choice: Shame on you for voting Yes on Stupak]
(for full statement and to see how Menbers voted go to: http://www.centerforpolicyanalysis.org/id62.html)
Sunday, November 1, 2009
Is 2% Worth It?
Now we’re hearing that the public option is too puny to work. Is it true?
Let’s back up a minute, and look at the choices before us right now.
1. No change.
2. A reform bill with no public option.
3. A reform bill with a public option.
The insurance industry thinks #1 and #2 are just grand. (Despite what they say in public.) They’d like us to believe that #3 is so useless that we should settle for #1 or #2. Here’s why they are wrong:
The existence of a public option creates a wedge for the public sector. The public sector already covers people who are over 65, low-income, in the military, and others. Now it will start slicing into working age Americans. It will have the most bargaining clout to pay lower rates to providers – drug companies, hospitals and doctors - if it includes most of us right away, and can base reimbursement rates on Medicare, plus 5% for wiggle room.
Nancy Pelosi tried to get that. She came up short of the 218 votes needed. After a week of “whipping,” she proposed 2nd best: a public option that will negotiate rates with providers. It won’t save as much money as “Medicare plus 5%” version. Not a great performance by our elected members of Congress, who could’ve sided with the voters who use health care services instead of the industries that provide health care, or by the President of Change, who kept his elegant neck tucked in on that subject.
The Congressional Budget Office and Joint Tax Committee did some pretty quick math:
“By 2019, CBO and JCT estimate, the number of nonelderly people who are
uninsured would be reduced by about 36 million, leaving about 18 million
nonelderly residents uninsured (about one-third of whom would be
unauthorized immigrants). Under H.R. 3962, the share of legal nonelderly
residents with insurance coverage would rise from about 83 percent
currently to about 96 percent. Roughly 21 million people would purchase
their own coverage through the new insurance exchanges, and there would
be roughly 15 million more enrollees in Medicaid than the total number
projected for Medicaid and CHIP combined under current law. (Under the
bill, CHIP would no longer exist in 2019.) Relative to currently projected
levels, the number of people purchasing individual coverage outside of the
exchanges would decrease by about 6 million, and the number obtaining
coverage through employers would increase by about 6 million.
“Under the proposal, certain employers could allow all of their workers to
choose among the plans available in the exchanges, but those enrollees
would not be eligible to receive subsidies via the exchanges (and thus are
shown in Table 2 as enrollees in employment-based coverage rather than as
exchange enrollees). CBO and JCT expect that approximately 9 million
people would obtain coverage in that way in 2019, bringing the total
number of people enrolled in exchange plans to about 30 million in that
year. Roughly one-fifth of the people purchasing coverage through the
exchanges would enroll in the public plan, meaning that total enrollment in
that plan would be about 6 million.
“That estimate of enrollment reflects CBO’s assessment that a public plan
paying negotiated rates would attract a broad network of providers but
would typically have premiums that are somewhat higher than the average
premiums for the private plans in the exchanges. The rates the public plan
pays to providers would, on average, probably be comparable to the rates
paid by private insurers participating in the exchanges. The public plan
would have lower administrative costs than those private plans but would
probably engage in less management of utilization by its enrollees and
attract a less healthy pool of enrollees. (The effects of that “adverse
selection” on the public plan’s premiums would be only partially offset by
the “risk adjustment” procedures that would apply to all plans operating in
the exchanges.)”
This is a possible scenario. CBO and JCT are about as smart as anyone, and we need a guidepost in all this, Lord knows. But honestly. We know for sure the public plan will have lower administrative costs and no profits. Will it engage in less utilization management (read, frivolous denial of claims) compared to private insurance plans? We hope so – and we damn well plan to stop the insurance industry from that deadly business plan, too. Will it enroll fewer people, therefore be more expensive, therefore enroll sicker people, therefore be more expensive and enroll fewer people, etc.? Beats me.
Here’s what I’m pretty sure about. I don’t like Options #1 and #2. The public doesn’t either.
I think Option #3 gets us to the next step: coming out of this battle with a victory, and going back to the states to fight for single payer.
Some on the left meet up with the right on this point: they prefer Options #1 and #2. They say the House bill (Option #3) gives more money and power to the insurance industry than they have now. True. But so do Options #1 and #2. In fact, the only way the insurance industry gets less money is to get rid of them. A single payer program funded entirely by the government would accomplish this. We haven’t won the public’s support for that yet, and it’s not just because Max Baucus wouldn’t hold hearings on it.
A bill with Option #3 gives more power to the public sector, and arguably will save some money. It includes the following important benefits for people:
For the first time, most employers will have to contribute to the cost of health insurance. We’re the only system in the world that relies primarily on the workplace to get insurance, but we also have no requirement on employers to actually offer insurance or help pay for it. Right now about 130 million people get insurance through work, but another 27 million workers do not.
It requires individuals to buy insurance, but it provides subsidies to low- and middle-income individuals and families, so they can afford it. Is it affordable enough? Probably something to fight about.
Insurance company abuses will be prohibited: They won’t be able to exclude people with pre-existing conditions, or stop paying for your treatment once it turns out your sick. They’ll have to spend 85% of our premium dollars on actual health care, not executive bonuses and administration.
Costs: gives the government the authority to negotiate for drug prices.
Access: Many more people will qualify for Medicaid, the federal-state program for low-income people. The feds pick up most of the tab. People with COBRA can keep it until the new exchanges kick in, in 2013, and young people can stay on their parents’ plans til age 27. We still need it to start sooner.
Quality: Reform Medicare to encourage better quality of care, eliminate copayments for preventive care, and increase the number of primary care providers.
Is any old thing ok then? I think the victories so far on the public plan are important. We have to fight hard to keep it and strengthen it on the House side, and make sure it gets into the Senate bill in conference. And let’s hold on to each others’ email addresses. We’ll need them for the state single payer fights.
Let’s back up a minute, and look at the choices before us right now.
1. No change.
2. A reform bill with no public option.
3. A reform bill with a public option.
The insurance industry thinks #1 and #2 are just grand. (Despite what they say in public.) They’d like us to believe that #3 is so useless that we should settle for #1 or #2. Here’s why they are wrong:
The existence of a public option creates a wedge for the public sector. The public sector already covers people who are over 65, low-income, in the military, and others. Now it will start slicing into working age Americans. It will have the most bargaining clout to pay lower rates to providers – drug companies, hospitals and doctors - if it includes most of us right away, and can base reimbursement rates on Medicare, plus 5% for wiggle room.
Nancy Pelosi tried to get that. She came up short of the 218 votes needed. After a week of “whipping,” she proposed 2nd best: a public option that will negotiate rates with providers. It won’t save as much money as “Medicare plus 5%” version. Not a great performance by our elected members of Congress, who could’ve sided with the voters who use health care services instead of the industries that provide health care, or by the President of Change, who kept his elegant neck tucked in on that subject.
The Congressional Budget Office and Joint Tax Committee did some pretty quick math:
“By 2019, CBO and JCT estimate, the number of nonelderly people who are
uninsured would be reduced by about 36 million, leaving about 18 million
nonelderly residents uninsured (about one-third of whom would be
unauthorized immigrants). Under H.R. 3962, the share of legal nonelderly
residents with insurance coverage would rise from about 83 percent
currently to about 96 percent. Roughly 21 million people would purchase
their own coverage through the new insurance exchanges, and there would
be roughly 15 million more enrollees in Medicaid than the total number
projected for Medicaid and CHIP combined under current law. (Under the
bill, CHIP would no longer exist in 2019.) Relative to currently projected
levels, the number of people purchasing individual coverage outside of the
exchanges would decrease by about 6 million, and the number obtaining
coverage through employers would increase by about 6 million.
“Under the proposal, certain employers could allow all of their workers to
choose among the plans available in the exchanges, but those enrollees
would not be eligible to receive subsidies via the exchanges (and thus are
shown in Table 2 as enrollees in employment-based coverage rather than as
exchange enrollees). CBO and JCT expect that approximately 9 million
people would obtain coverage in that way in 2019, bringing the total
number of people enrolled in exchange plans to about 30 million in that
year. Roughly one-fifth of the people purchasing coverage through the
exchanges would enroll in the public plan, meaning that total enrollment in
that plan would be about 6 million.
“That estimate of enrollment reflects CBO’s assessment that a public plan
paying negotiated rates would attract a broad network of providers but
would typically have premiums that are somewhat higher than the average
premiums for the private plans in the exchanges. The rates the public plan
pays to providers would, on average, probably be comparable to the rates
paid by private insurers participating in the exchanges. The public plan
would have lower administrative costs than those private plans but would
probably engage in less management of utilization by its enrollees and
attract a less healthy pool of enrollees. (The effects of that “adverse
selection” on the public plan’s premiums would be only partially offset by
the “risk adjustment” procedures that would apply to all plans operating in
the exchanges.)”
This is a possible scenario. CBO and JCT are about as smart as anyone, and we need a guidepost in all this, Lord knows. But honestly. We know for sure the public plan will have lower administrative costs and no profits. Will it engage in less utilization management (read, frivolous denial of claims) compared to private insurance plans? We hope so – and we damn well plan to stop the insurance industry from that deadly business plan, too. Will it enroll fewer people, therefore be more expensive, therefore enroll sicker people, therefore be more expensive and enroll fewer people, etc.? Beats me.
Here’s what I’m pretty sure about. I don’t like Options #1 and #2. The public doesn’t either.
I think Option #3 gets us to the next step: coming out of this battle with a victory, and going back to the states to fight for single payer.
Some on the left meet up with the right on this point: they prefer Options #1 and #2. They say the House bill (Option #3) gives more money and power to the insurance industry than they have now. True. But so do Options #1 and #2. In fact, the only way the insurance industry gets less money is to get rid of them. A single payer program funded entirely by the government would accomplish this. We haven’t won the public’s support for that yet, and it’s not just because Max Baucus wouldn’t hold hearings on it.
A bill with Option #3 gives more power to the public sector, and arguably will save some money. It includes the following important benefits for people:
For the first time, most employers will have to contribute to the cost of health insurance. We’re the only system in the world that relies primarily on the workplace to get insurance, but we also have no requirement on employers to actually offer insurance or help pay for it. Right now about 130 million people get insurance through work, but another 27 million workers do not.
It requires individuals to buy insurance, but it provides subsidies to low- and middle-income individuals and families, so they can afford it. Is it affordable enough? Probably something to fight about.
Insurance company abuses will be prohibited: They won’t be able to exclude people with pre-existing conditions, or stop paying for your treatment once it turns out your sick. They’ll have to spend 85% of our premium dollars on actual health care, not executive bonuses and administration.
Costs: gives the government the authority to negotiate for drug prices.
Access: Many more people will qualify for Medicaid, the federal-state program for low-income people. The feds pick up most of the tab. People with COBRA can keep it until the new exchanges kick in, in 2013, and young people can stay on their parents’ plans til age 27. We still need it to start sooner.
Quality: Reform Medicare to encourage better quality of care, eliminate copayments for preventive care, and increase the number of primary care providers.
Is any old thing ok then? I think the victories so far on the public plan are important. We have to fight hard to keep it and strengthen it on the House side, and make sure it gets into the Senate bill in conference. And let’s hold on to each others’ email addresses. We’ll need them for the state single payer fights.
Saturday, October 24, 2009
What Do Progressives Want?
What progressives want is the same thing the President wants: to build power for a majority in Congress and the country that will support our issues, and will perceive us as powerful; and to win the best possible health reform.
So far the President has played a pretty smart game. He kept the insurance industry at bay long enough that even the mainstream pundits are willing to say publicly that the industry has no credibility.
But it’s time to cut the cord.
Progressives need to play a smarter hand.
It’s important to sit in at insurance companies. But here’s the thing: 1. Insurance companies have no shame. They really don’t. 2. Even Republicans were willing to throw them under the train back in February. 3. They don’t vote.
Here are some people who vote: Senators Mary Landrieu, Louisiana; Blanche Lincoln, Arkansas; Joe Lieberman, Connecticut; Evan Bayh, Indiana; Ben Nelson. Nebraska
Take Mary Landrieu. She says she won’t support a public option because it would force the country to go bankrupt.
Now Mary Landrieu is not a stupid person. She knows that the CBO says a strong public option saves more money than negotiated rates or no public option.
She’s been elected twice in a Republican state, including in 2008 when Obama got only 40% of the vote.
Is she in the pocket of the insurance industry? The Center for Responsive Politics says she gets virtually no money from health interests, and raises half her money in-state. She’s the 47th least wealthy person in the Senate.
Does Louisiana need health reform? Here’s some information about Louisiana:
Second highest rate of female poverty in the US
Highest rate of black poverty
63% white
4th highest rate of uninsured for ages 0–64 (22%), 3rd highest for ages 19-64
One of the highest recipients in the country of federal Medicaid funds, one of the lowest in per capita Medicaid spending
35% of population live in primary care shortage area, 3rd highest % of population who didn’t see a doctor in the last year because of cost (18%)
In 2008 Obama lost to McCain, but Landrieu won among the same demographics that voted for Obama:
Women
Younger people
African Americans
Among the 9% of voters who said health care was their most important issue, Landrieu got the widest issue-based margin over her opponent: 72% voted for her.
Why can’t a populist organizing campaign rile up some voters in New Orleans and environs to communicate with Senator Landrieu? And in Arkansas, Connecticut, Indiana and Nebraska; and the holdouts in the House. Harry Reid and Nancy Pelosi have signalled they're ready to play. Are we paying attention?
So far the President has played a pretty smart game. He kept the insurance industry at bay long enough that even the mainstream pundits are willing to say publicly that the industry has no credibility.
But it’s time to cut the cord.
Progressives need to play a smarter hand.
It’s important to sit in at insurance companies. But here’s the thing: 1. Insurance companies have no shame. They really don’t. 2. Even Republicans were willing to throw them under the train back in February. 3. They don’t vote.
Here are some people who vote: Senators Mary Landrieu, Louisiana; Blanche Lincoln, Arkansas; Joe Lieberman, Connecticut; Evan Bayh, Indiana; Ben Nelson. Nebraska
Take Mary Landrieu. She says she won’t support a public option because it would force the country to go bankrupt.
Now Mary Landrieu is not a stupid person. She knows that the CBO says a strong public option saves more money than negotiated rates or no public option.
She’s been elected twice in a Republican state, including in 2008 when Obama got only 40% of the vote.
Is she in the pocket of the insurance industry? The Center for Responsive Politics says she gets virtually no money from health interests, and raises half her money in-state. She’s the 47th least wealthy person in the Senate.
Does Louisiana need health reform? Here’s some information about Louisiana:
Second highest rate of female poverty in the US
Highest rate of black poverty
63% white
4th highest rate of uninsured for ages 0–64 (22%), 3rd highest for ages 19-64
One of the highest recipients in the country of federal Medicaid funds, one of the lowest in per capita Medicaid spending
35% of population live in primary care shortage area, 3rd highest % of population who didn’t see a doctor in the last year because of cost (18%)
In 2008 Obama lost to McCain, but Landrieu won among the same demographics that voted for Obama:
Women
Younger people
African Americans
Among the 9% of voters who said health care was their most important issue, Landrieu got the widest issue-based margin over her opponent: 72% voted for her.
Why can’t a populist organizing campaign rile up some voters in New Orleans and environs to communicate with Senator Landrieu? And in Arkansas, Connecticut, Indiana and Nebraska; and the holdouts in the House. Harry Reid and Nancy Pelosi have signalled they're ready to play. Are we paying attention?
Saturday, October 17, 2009
No Excuse for Apathy
Eva Chrysanthe is my health care hero.
Back in January Senator Dianne Feinstein's staff were telling us she wasn't sure about her position on the public option because she was hearing a lot of opposition from people calling in from southern California opposing it. They seemed to be responding to talk radio shows.
A lot of people wrote articles about Dianne Feinstein's campaign contributions. She kept talking about what she was hearing from voters.
Eva networked with people inside Organizing for America and found 1200 people in the Bay Area who thought Dianne should represent us. They demonstrated, set up meetings, flooded her office with letters, petitions and emails. Dianne finally wrote a very long treatise on health reform, indicating that she was open to a public option; or maybe not. She heard about it from the voters.
Last week, Senator Feinstein was one of 30 senators to sign Sherrod Brown's statement supporting a public option. Period. Eva brought the staff a carrot cake.
Let's not get googly eyed about what we can accomplish. We're talking about a political system trying to manage an economy in deep crisis. The President, a charismatic figure who is well-informed about the health care issue on both the policy and personal levels, campaigned on expanding coverage for children.
But lookit, they're going to pass something here. How come no one knows that the public option as written doesn't start til 2013 and won't be open to most of us until years later, if ever? Are we expecting the media to do this job? The corporate owned media exist to manipulate our emotions between commercials so that we will feel sufficiently inadequate or bored to want to buy whatever the sponsors are selling, and definitely sufficiently cynical, apathetic and confused that we will not consider taking political action.
Some progressives also seem generally to think that dismissing and ridiculing the emerging proposal passes for analysis and agitation. Willingness to consider how we might influence the bill to set the stage for future progress has been compared to compromising on slavery (a great analogy, really - all they had to do in that case was stamp their feet and reframe the struggle as a fight for human rights, and by golly that was that).
Expanding Medicare to cover more people would've been a great thing to do. Max Baucus thought so. He proposed it in a Finance Committee document in January. It wasn't single payer for all, just for people over 55. Wimp. Must be due to his campaign contributions. Wonder how Baucus, the present obstacle to the public option, and the 4th poorest member of the Senate, stacks up against Sen. Rockefeller, the 4th richest:
Baucus
Cycle Source of Funds, 2009-2010, Campaign Cmte only
Individual Contributions $5,989,921 52%
PAC Contributions $4,872,291 42%
Candidate self-financing $0 0%
Other $640,654 6%
Rockefeller
Cycle Source of Funds, 2005-2010, Campaign Cmte only
Individual Contributions $3,756,635 63%
PAC Contributions $1,963,331 33%
Candidate self-financing $0 0%
Other $260,341 4%
Cycle Top vote-getting candidates Election Results
2008 Max Baucus* Amount Raised $11,602,479 Amount Spent:$9,305,359 Reelected
Bob Kelleher $0 $0
2002 Max Baucus* Amount Raised: $6,719,728 Amount Spent: $6,795,547 Reelected
Michael A. Taylor Amount Raised: Amount Spent: $1,839,020 $1,839,020
Cycle Top vote-getting candidates Election Results
2008 Jay Rockefeller* Amount Raised: $5,972,208 Amount Spent: $5,979,250 Reelected
Jay Wolfe Amount Raised: $123,862 Amount Spent:$123,720
2002 Jay Rockefeller* Amount Raised: $3,045,338 Amount Spent:$2,889,425 Reelected
Amount Raised: Jay Wolfe $136,373 Amount Spent:$136,373
Turns out they both raise most of their money out of state (Baucus 90%, Rockefeller 75%), virtually no one runs against them, and they spend most of what they raise to get re-elected. Why do they take different positions on the public option? Interesting question. In casting his vote, Baucus said that the public plan had a lot to recommend it, but it was his job to get the bill out of Committee. Sound like he's been getting calls from the White House?
It's great that people are sitting in at insurance companies. For the 3% of Americans who still thought health insurance companies had any legitimacy, aside from employees of the industry and their friends and relatives, it's probably a revelation. For the rest of us, a worthwhile way to spend time this week will be strongly suggesting to our friend in the White House, and our leaders in Congress, that they must cough up a program that is going to benefit people pretty quickly or else people will notice.
We need a strong public plan, that bases reimbursement on Medicare rates and uses Medicare providers so that it's affordable and viable. It should be a choice for each of us, in 2010. And we need an ERISA waiver for single payer states, so that they can convert to single payer without a lawsuit. For example people could cut and paste the following:
LETTER TO THE PRESIDENT, Senate Majority Leader Harry Reid, House Speaker Nancy Pelosi:
The Senate Finance Committee drama has concluded. The American public will not long remember whether or not any Republican voted for health reform. We do want to know if we'll get more affordable, reliable health care coverage, that provides relief soon. It's time to tell the President, House Speaker Pelosi and Senate Majority Leader Reid:
We need a public plan option with affordable premiums, that pays hospitals and doctors Medicare rates +5% and includes Medicare providers - and all of us want to have that choice in 2010! Put that up for a vote and we'll support you!
And the bill must include the state single payer option, proposed by Rep. Dennis Kucinich.
http://www.whitehouse.gov/CONTACT/
http://speaker.house.gov/contact/
http://reid.senate.gov/contact/index.cfm
Back in January Senator Dianne Feinstein's staff were telling us she wasn't sure about her position on the public option because she was hearing a lot of opposition from people calling in from southern California opposing it. They seemed to be responding to talk radio shows.
A lot of people wrote articles about Dianne Feinstein's campaign contributions. She kept talking about what she was hearing from voters.
Eva networked with people inside Organizing for America and found 1200 people in the Bay Area who thought Dianne should represent us. They demonstrated, set up meetings, flooded her office with letters, petitions and emails. Dianne finally wrote a very long treatise on health reform, indicating that she was open to a public option; or maybe not. She heard about it from the voters.
Last week, Senator Feinstein was one of 30 senators to sign Sherrod Brown's statement supporting a public option. Period. Eva brought the staff a carrot cake.
Let's not get googly eyed about what we can accomplish. We're talking about a political system trying to manage an economy in deep crisis. The President, a charismatic figure who is well-informed about the health care issue on both the policy and personal levels, campaigned on expanding coverage for children.
But lookit, they're going to pass something here. How come no one knows that the public option as written doesn't start til 2013 and won't be open to most of us until years later, if ever? Are we expecting the media to do this job? The corporate owned media exist to manipulate our emotions between commercials so that we will feel sufficiently inadequate or bored to want to buy whatever the sponsors are selling, and definitely sufficiently cynical, apathetic and confused that we will not consider taking political action.
Some progressives also seem generally to think that dismissing and ridiculing the emerging proposal passes for analysis and agitation. Willingness to consider how we might influence the bill to set the stage for future progress has been compared to compromising on slavery (a great analogy, really - all they had to do in that case was stamp their feet and reframe the struggle as a fight for human rights, and by golly that was that).
Expanding Medicare to cover more people would've been a great thing to do. Max Baucus thought so. He proposed it in a Finance Committee document in January. It wasn't single payer for all, just for people over 55. Wimp. Must be due to his campaign contributions. Wonder how Baucus, the present obstacle to the public option, and the 4th poorest member of the Senate, stacks up against Sen. Rockefeller, the 4th richest:
Baucus
Cycle Source of Funds, 2009-2010, Campaign Cmte only
Individual Contributions $5,989,921 52%
PAC Contributions $4,872,291 42%
Candidate self-financing $0 0%
Other $640,654 6%
Rockefeller
Cycle Source of Funds, 2005-2010, Campaign Cmte only
Individual Contributions $3,756,635 63%
PAC Contributions $1,963,331 33%
Candidate self-financing $0 0%
Other $260,341 4%
Cycle Top vote-getting candidates Election Results
2008 Max Baucus* Amount Raised $11,602,479 Amount Spent:$9,305,359 Reelected
Bob Kelleher $0 $0
2002 Max Baucus* Amount Raised: $6,719,728 Amount Spent: $6,795,547 Reelected
Michael A. Taylor Amount Raised: Amount Spent: $1,839,020 $1,839,020
Cycle Top vote-getting candidates Election Results
2008 Jay Rockefeller* Amount Raised: $5,972,208 Amount Spent: $5,979,250 Reelected
Jay Wolfe Amount Raised: $123,862 Amount Spent:$123,720
2002 Jay Rockefeller* Amount Raised: $3,045,338 Amount Spent:$2,889,425 Reelected
Amount Raised: Jay Wolfe $136,373 Amount Spent:$136,373
Turns out they both raise most of their money out of state (Baucus 90%, Rockefeller 75%), virtually no one runs against them, and they spend most of what they raise to get re-elected. Why do they take different positions on the public option? Interesting question. In casting his vote, Baucus said that the public plan had a lot to recommend it, but it was his job to get the bill out of Committee. Sound like he's been getting calls from the White House?
It's great that people are sitting in at insurance companies. For the 3% of Americans who still thought health insurance companies had any legitimacy, aside from employees of the industry and their friends and relatives, it's probably a revelation. For the rest of us, a worthwhile way to spend time this week will be strongly suggesting to our friend in the White House, and our leaders in Congress, that they must cough up a program that is going to benefit people pretty quickly or else people will notice.
We need a strong public plan, that bases reimbursement on Medicare rates and uses Medicare providers so that it's affordable and viable. It should be a choice for each of us, in 2010. And we need an ERISA waiver for single payer states, so that they can convert to single payer without a lawsuit. For example people could cut and paste the following:
LETTER TO THE PRESIDENT, Senate Majority Leader Harry Reid, House Speaker Nancy Pelosi:
The Senate Finance Committee drama has concluded. The American public will not long remember whether or not any Republican voted for health reform. We do want to know if we'll get more affordable, reliable health care coverage, that provides relief soon. It's time to tell the President, House Speaker Pelosi and Senate Majority Leader Reid:
We need a public plan option with affordable premiums, that pays hospitals and doctors Medicare rates +5% and includes Medicare providers - and all of us want to have that choice in 2010! Put that up for a vote and we'll support you!
And the bill must include the state single payer option, proposed by Rep. Dennis Kucinich.
http://www.whitehouse.gov/CONTACT/
http://speaker.house.gov/contact/
http://reid.senate.gov/contact/index.cfm
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