Tuesday, July 7, 2009

Health Care Tuesday

Aravosis: MSNBC's David Shuster asks Dem. Senator Carper if he was bought by off by big pharma and insurance companies
Now that's journalism.

Baucus' troubling ties to anti- health care reform lobbyistsBaucus' troubling ties to anti- health care reform lobbyists
BarbinMD points out that it's no surprise that Democratic Senator Max Baucus (D-MT) is opposed to the public option. It seems his staff has been caught busily scheming away with big pharmaceutical lobbyists who just happen to have worked as Baucus' own chiefs of staff.

Conflict of interest much?

Plus ├ža change...
Sargent: Harry Reid, Meet Chuck Schumer

The other day I noted that Harry Reid was already downplaying expectations for what Dems could accomplish now that they’re within reach of 60 votes:

“We have 60 votes on paper,” Senator Harry Reid, the majority leader, said Wednesday in an interview. “But we cannot bulldoze anybody; it doesn’t work that way. My caucus doesn’t allow it. And we have a very diverse group of senators philosophically. I am not this morning suddenly flexing my muscles.”

Compare that with what Chuck Schumer told HuffPo’s Sam Stein in a new interview, namely, that now that Dems have 60 votes they don’t need to compromise, in particular on the cherished public health care option:

“If you did a consensus within the Democratic Party, you would find the level-playing-field public option to be the answer,” said Sen. Chuck Schumer, D-N.Y. “And now that we have 60 votes, it seems to me like we don’t have to turn it inside out for something we don’t like.”

Reid is narrowly right that it’s still an uphill slog to 60 votes, and Reid wasn’t talking policy specifics. But the difference in tone is instructive. It’s unclear why Dems would concede the possibility of failure in advance. Seems like it makes more sense to stake out a strong position, say you’re going to the mat for it, avoid conceding any ground, and make opponents grapple with how to deal with it, as Schumer is doing.

Think Progress: Senate Finance Committee may deny access to abortion.

As Sen. Max Baucus (D-MT) prepares to unveil the Senate Finance Committee’s bipartisan health care reform legislation later this week, several blogs are reporting that Republicans on the Committee are pushing legislation that would require insurers operating within the new Exchange to to deny coverage for abortion services. From Raising Women’s Voices:

The Senate Finance Committee has been writing a health care reform bill and struggling to create legislation that will have bipartisan support. Chairman Max Baucus (pictured left) considered several compromises to win Republican support, so they can claim it is bipartisan legislation. One of these potential compromises comes in the form of an abortion exclusion, which would prevent abortion services from being covered by some or all insurance plans in the Health Insurance Exchange. We fear that members of the Senate Finance Committee are considering such a compromise.

Should it pass, the Senate Finance version would be the only bill that specifically prohibits a medical service. As the Wonk Room points out, “if denying abortion services to women is the price of bipartisanship, then perhaps winning those one or two Republican votes isn’t worth the price of jeopardizing women’s health and well-being.”

  • digby: Packaging
    I've been meaning to post on this "packaging" problem confronting the Obama administration in their quest to find "common ground" on ... contraception. Yes, that's right. Now that the mushy abortion reduction crowd has convinced the Democrats that social conservatives will vote for them in droves if they will only stop treating abortion like a right and instead treat it as tragic female irresponsibility, it seems the right isn't altogether impressed. I know this will come as a shock to you, but while they are perfectly happy to have the government help women bring their unwanted pregnancies to term, they insist that any efforts to "reduce abortion" with birth control is unacceptable. Who'd have thunk, huh?

    As I said, I was going to write about this and was working on one of those boring posts about the "pincer" strategy and overton window blah,blah,blah, but when I came across this, by Charles Piece, I just decided to lift it:

    Matthew Y is a very smart young man, especially now that he apparently has given up on the Sisyphean task of explaining why the Washington Wizards ever will be any good. But this, alas, is unicorn-shopping at its most gullible. While I have no doubt that it is remotely possible that the nice lady across the street with the pro-life bumper stickers on her car may very well not give a damn who's buying condoms where, and how old the people are who are buying them, the organized political structure of the pro-life movement has been demonstrably anti-woman and anti-sexuality from the very first mailings it ever sent out. It has been financed and organized by religious organizations devoted to a truncated and joyless view of human sexuality. It has as its formal legal basis a philosophy for which the true target never has been Roe, but Griswold. It does not believe in a constitutionally guaranteed right to privacy in any sphere, abortion just being the most obvious and inflammatory one. And, most important, none of this will change. Ever.
    No it won't. Ever.

    And this common ground effort is designed to advance socially conservative policy, period.
Sargent: Despite Obama’s Demand, Outside Groups Will Keep Pounding Dem Senators

President Obama may have issued a private demand that groups allied with the White House stop hammering moderate Democratic Senators with health care ads, but those groups have no intention to listen to him.

In fact, not only do the groups plan to continue their ads, spokespeople for the groups tell me, but one is actually increasing its buy.

Over the weekend, the Washington Post reported that Obama had privately told Congressional Dems he’s concerned about TV and online campaigns hitting moderate Democrats for not getting fully behind the public health care option. “We shouldn’t be focusing resources on each other,” Obama reportedly said.

The response from the groups: That’s nice, but we ain’t stopping.

A spokesperson for the Progressive Change Campaign Committee, one of the groups Obama reportedly complained about, confirms to me that the group is upping its buy with a new round of ads attacking moderate Dem Senators like Ben Nelson and Mary Landrieu this coming week. “If congressional staffers are complaining to the White House, that shows they are nervous and what we’re doing is working,” PCCC’s Stephanie Taylor says. “So we should just keep doing what we’re doing.”

Meanwhile, a second group, Change Congress, has not dropped plans for a coming campaign of ads attacking the Senators for taking contributions from health care special interests, Change Congress spokesperson Adam Green confirms. He urged the White House to consider a “good cop, bad cop approach,” suggesting Obama could hold positive rallies in the home states of moderate Dem Senators while Change Congress goes ahead with its ads.

Meanwhile, there are no indications MoveOn plans to drop its pressure campaign. If Obama did indeed complain about the efforts by outside groups, it’s unclear why. Obama himself has strongly backed a public option, and it seems obvious that pressure from the left on Dem Senators not to waver on this priority can only help the White House.


Update: Jane Hamsher reports that a third group, Democracy For America, won’t pull its ads, either.

Update II: It doesn’t look like Americans United for Change will refrain from targeting moderate Dems, either. From AUC spokesperson Jeremy Funk: “We will be encouraging everyone in Congress to support serious health care reform as outlined by the President.”

Update III: Still more: Blue America is forging ahead with ads targeting Senator Blanche Lincoln.

Grassley's dubious health care solution July 6: GOP in Exile: Guest host Alison Stewart talks about Sen. Chuck Grassley's, R-IA, advice to get good health care (just add 75 million new government employees!).

digby: Here We Go
I'm surprised he didn't whisper this one to Ceci:

It is more important that health-care legislation inject stiff competition among insurance plans than it is for Congress to create a pure government-run option, White House Chief of Staff Rahm Emanuel said Monday.

"The goal is to have a means and a mechanism to keep the private insurers honest," he said in an interview. "The goal is non-negotiable; the path is" negotiable.

His comments came as the Senate Finance Committee pushed for a bipartisan deal. To help pay for the package, the committee planned to announce an agreement Wednesday with hospitals and the White House for $155 billion over a decade in reductions to Medicare and charity-care payments for hospitals, according to a person familiar with the agreement. That will help pay for the legislation, expected to cost at least $1 trillion over 10 years.

One of the most contentious issues is whether to create a public health-insurance plan to compete with private companies.

Mr. Emanuel said one of several ways to meet President Barack Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.

Mr. Obama has pushed hard for a vigorous public option. But he has also said he won't draw a "line in the sand" over this point.

Using the prescription drug plan as an example is brilliant. Pharma loved it. And they really loved Billy Tauzin, the man who rammed it through. Good times.

Dday wrote about the "trigger" in this post:

A trigger mechanism is simply absurd. The insurers have had decades to provide decent coverage and have demurred every time. They have shown themselves to be untrustworthy that entire time, including just last month, when they backpedaled on the cost controls they vowed to offer. Mike Lux, who has seen these battles up close, senses that this is the big proxy fight right now.

The insurance lobby has had multiple tactics for stopping the public option idea, which they despise because they know if regular folks have choice to go to a public option, insurance companies won't have the same ability to treat their customers like garbage when they get sick. The first tactic was just to try to kill the public option outright, and the good news is that they appear to have failed at that. This so-called trigger proposal is the second tactic: the idea is to write a "trigger" that will allow for a public option only under certain conditions, but write the legislation so that those conditions would never get met in the real world. It's a classic DC tactic, right up there with calling for a commission to study something. Olympia Snowe is carrying the insurance industry water on their trigger proposal, proposing triggers that would only get tripped in some fairyland none of us have ever visited.

The great thing for the insurance companies in a tactic like this is that it gives "centrist" Senators (centrist in Washington, DC usually means those who have taken massive amounts of campaign contributions from the affected industry) an excuse to help the insurance industry while looking like they are open to the public option that their constituents have been demanding.

It's always possible that Emanuel is playing 45 dimensional chess. Gosh I sure do hope so.

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