Wednesday, September 16, 2009

Health Care: Killing Crystal Edition

Think Progress: Real-life ‘Norma Rae’ dies of cancer after her health insurance refused to cover her medications.
Crystal Lee Sutton, whose courageous efforts organizing Southern textile mills inspired the award-winning 1979 film “Norma Rae,” passed away on Friday after a long battle with brain cancer. Sutton’s story is particularly tragic because after fighting her whole life for rights of working Americans, her health insurance wouldn’t cover the medications she needed:

She went two months without possible life-saving medications because her insurance wouldn’t cover it, another example of abusing the working poor, she said.

“How in the world can it take so long to find out (whether they would cover the medicine or not) when it could be a matter of life or death,” she said. “It is almost like, in a way, committing murder.”

Although Sutton eventually received the medication, the cancer had already taken a toll on her.

Tim F.: Do You Live In Montana?

Call your Senator to thank him for giving Republicans a critical bonus month to whip up lies and hate over health care. Make sure to mention how you appreciate his crippled compromise bill that netted the same zero Republican votes that single payer would have done.

If you do not live in Montana (i.e., a constituent) or run a health insurance firm (i.e., a supervisor) then Baucus does not care what you think. Call your own Senator and yell at him or her about something else.

  • from the comments:


    No one lives in Montana, Tim. One of the most frustrating things to me lately is that the fate of hundreds of millions of people is being held up and manipulated by people from places where very few people live.

  • Kryptik

    If you do not live in Montana (i.e., a constituent) or run a health insurance firm (i.e., a supervisor) then Baucus does not care what you think. Call your own Senator and yell at him or her about something else.

    You sure about that one, Tim?

    Because I’m pretty sure pubilc opinion on the option in Montana actually supports the Public Option. So I really doubt it’s a case of listening to constituents there.

Senate Finance Committee Chairman Max Baucus (D-Mont.) seemed to think he could thread the needle. He'd offer a right-leaning reform package that could pick up some Republican support, and keep Democrats more or less satisfied. His plan isn't working.

This afternoon, shortly after Baucus said there's a "very good chance" he'd get bipartisan support for his proposal, Senate Minority Leader Mitch McConnell (R-Ky.) said Baucus' plan still isn't conservative enough to get GOP votes.

And what about progressive, pro-reform Democrats? The ones Baucus refused to include in the bipartisan negotiations? Baucus may have hoped his Democratic colleagues would simply go along, figuring his plan is better than nothing. Today, however, Sen. Jay Rockefeller (D-W. Va.), a strong supporter of a bold, ambitious reform package, was unambiguous.

"There is no way in present form I will vote for [Baucus' proposal]," Rockefeller said. "Therefore, I will not vote for it unless it changes during the amendment process by vast amounts."

Jonathan Cohn puts this in the larger context.

A little over a month ago, right before the August recess, I spoke with Rockefeller at some length. And he was clearly wrestling with how to position himself.

No living senator has done as much to promote health reform as he has. It's the cause of his life and, for the first time, the goal is within reach. He admitted that voting against a package, even a flawed one, was difficult to imagine.

But Rockefeller also made clear his frustration with the compromises Baucus was making, whether it was replacing the public plan with a co-op or gradually reducing the subsidies to help people pay for insurance. He was particularly incensed about the changes to Medicaid and CHIP, programs on which he's worked closely over the years.

It seemed like he was still on board, if only to help get a bill out of the Finance Committee and onto the Senate floor. But you got the feeling -- well, I got the feeling -- that was near the breaking point. Clearly, he's now hit it.

The next step is some pretty intense wrangling. There'd be less, if only Baucus had bothered to talk about the proposal, even a little, with the Democrats on his own committee.

The Dems enjoy a 13-10 edge on the Finance Committee, suggesting Baucus doesn't have a lot of leeway -- if even a few Dems break ranks and reject his flawed proposal, Baucus would need some Republican votes to make up the difference, and as McConnell explained, that's not likely to happen.

A few things to keep an eye on: how many (and what kind of) changes Baucus is willing to make to keep Dems on board; whether the leadership tells Rockefeller to pass Baucus' plan now and they'll fix it when it's being reconciled with the HELP bill; whether Rockefeller gets Democratic allies to force Baucus' hand (and how many); whether Snowe gets on board with Baucus' plan; and whether Harry Reid considers just circumventing the Finance Committee altogether, moving the HELP bill to the floor with a bunch of amendments.

After months of negotiations, debate, and partisan wrangling, Senate Finance Committee Chairman Max Baucus (D-Mont.) will unveil his health care reform framework today. Baucus, who delayed the entire legislative process for months, simply so he could work with Republicans on a bipartisan solution, has managed to garner a grand total of zero GOP votes for his proposal.

CNN has learned that -- barring some unforeseen change -- Democratic Senate Finance Chairman Max Baucus will unveil a health care proposal Wednesday without the support of the three Republican senators -- Charles Grassley, Mike Enzi and Olympia Snowe -- he's been negotiating with for months.

...Wednesday, when the Senate Finance Chairman unveils his bill, all indications are he will be doing it without the support of Republicans he has spent hundreds of hours negotiating with.

Gang of Six members reportedly chatted again last night, but agreed to nothing.

So, in the span of a half-day, Baucus' reform package was rejected by one of the Finance Committee's leading Democrats (Jay Rockefeller) and all of the Finance Committee's Republicans. An inauspicious start, to be sure.

All eyes have been on Maine Sen. Olympia Snowe (R), the Senate's most moderate Republican and the only GOP lawmaker on the Hill who seems sincere about wanting a reform bill. She no doubt disappointed Baucus when she concluded that his bill just isn't good enough.

But let's not lose sight of why Snowe balked at the Baucus framework. For one thing, she's concerned about the financing mechanism, which she believes would hit Maine hard. But just as importantly, Snowe also believes (as I do) that Baucus' plan offers weak and inadequate subsidies. "The affordability question is crucial," Snowe said. "It's a central component, because at the end of the day people have high expectations they will have access to affordable health insurance."

In other words, one of the leading Republican negotiators on health care reform believes Baucus' plan is too conservative.

So, does this mean Dems will have no choice but to go it alone, probably through reconciliation? That's probably premature -- Snowe isn't going for Baucus' plan, but Baucus' plan isn't the final bill. It's about to be amended a whole lot in committee, and then has to be reconciled with the HELP bill.

Snowe may still be able to support a reform package -- just not the one Baucus will formally present today.

As for the committee chairman, this has to be pretty embarrassing. He invested months and countless hours in this, holding up health care reform with painful delays. Indeed, don't forget that the Finance Committee was supposed to be the first committee to pass reform.

Baucus, it appears, has very little to show for his efforts.

Sargent: Grassley: I Can’t Back Bill Now Because Dems Might Do Bill Without Me Later

The evidence that GOP Senator Chuck Grassley isn’t serious about negotiating a bipartisan health care compromise is beyond overwhelming at this point, but here’s still more.

As you may have heard, Grassley announced in a statement last night that he can’t support the health care bill that is expected from the Senate Finance Committee today, citing concerns about abortion and illegal immigrants. But I wanted to focus on this amusing nugget from Grassley’s statement:

“On top of all that, there’s no guarantee that a Finance Committee bill, even if it becomes bipartisan, will stay that way after it leaves the committee. An overriding issue for some time has been the fact that members of the Democratic leadership haven’t made a commitment to back a broad bipartisan bill through the entire process.”

Grassley’s position really appears to be that a key reason he can’t back the bill now is that Dems haven’t sworn a blood-oath not to do a bill alone later if no bill emerges that can get “broad” Republican support. This amounts to asking Dems to promise in advance to do nothing at all in the event that a “broad” number of Repubicans don’t agree to get behind some kind of compromise bill.

By this standard, in order to satisfy Grassley’s definition of true bipartisanship, Dems quite literally must cede all their power and leverage in advance, even as Republicans are refusing en masse to back any proposal that can reasonably be called a compromise. That really is Grassley’s position, with no exaggeration.

Update: To be clearer, what this really means is that in order to meet Grassley’s definition of bipartisanship, Dems must effectively hand over to Republicans total veto power over health care reform. It’s that simple.

Ezra Klein: Kent Conrad and the 'Annie Hall' Theory of Health-Care Reform

Kent Conrad is chairman of the Senate Budget Committee and one of the chamber's loudest, and most powerful, deficit hawks. On Tuesday, for instance, he directed the Congressional Budget Office to score the impact of health-care reform over a 20-year time frame, rather than the traditional 10 years. This is a tougher fiscal test than any bill has had to pass in memory.

You could see this as a good thing. Reformers sometimes argue that health-care reform's true impact on the cost curve will be seen over the long term. If CBO's scores reflected that, Conrad's demand could be a boon to reform. But Conrad doesn't appear to believe the scores will reflect that. He called the CBO's scoring of the bill's cost controls "stingy," and predicted that "the savings will be greater than CBO is showing."

In other words, he thinks the CBO is underestimating the savings that reform will deliver, but he wants to see those savings underestimated over a longer period of time, which will make the total gap between the revenues the CBO predicts and the savings it misses appear larger. It's a bit like the restaurant review from "Annie Hall": The food was terrible, and such small portions!

The end result is likely to be a new hurdle for health-care reform: a CBO report that makes the bill's total cost sound higher, as it's measured over 20 years, and its savings seem smaller, as they're underestimated over 20 years. The Huffington Post caught up with Conrad and asked him whether this would kill the reform effort. "No," he replied, "but it makes it more challenging." The question is why Conrad wants to make health-care reform more challenging.

One explanation is that Conrad is a stickler for deficit reduction, even at the cost of health-care reform. After all, the CBO's acid test might be overly difficult, but perhaps a high bar is warranted for a reform of this magnitude. "We've got to have somebody that we give this responsibility to and that we follow," Conrad explained. That would be more credible if not for two data points.

The first came earlier this year when Conrad modified Obama's first budget. Obama had eliminated a couple of Bush-era gimmicks that made the deficit appear smaller than it really was. Bush, for instance, shortened the budget window from 10 years to five, so the total deficit sounded smaller. Obama's budget returned it to the traditional 10. And then Conrad changed it back. The Politico reported that Conrad made this decision "because of the uncertainty of long-range forecasts." Others thought he did it to hide the size of the deficit. In any case, 10 years, as the alert reader will notice, is less than 20 years. If 10 years was too long a time period for certainty, then it is difficult to see how 20 years could possibly be acceptable.

The second came in 2003, when Conrad voted for the Medicare Modernization Act, better known as Medicare Part D. The Congressional Budget Office estimated that the bill would increase the federal deficit by $421 billion and reduce federal revenue by another $174 billion. The total cost to the deficit, then, neared $600 billion. Conrad not only accepted the CBO's 10-year time frame, but he voted for the bill. His press release enthusiastically touted the fact that the bill would "bring more than $70 million to North Dakota hospitals over the next ten years."

Conrad's record in the Senate, then, would lead you to believe a couple of things. For one, he distrusts long-range projections. Even 10 years is too uncertain. He also believes some priorities overwhelm deficit concerns, health-care coverage being one of them. But when faced with a health-care reform that will be deficit neutral within the 10-year time frame, he is demanding that it instead be measured against an even more uncertain 20-year time frame, and by an agency that he claims underestimates savings. The CBO's scores are terrible, in other words, and come in such small portions!

Chris Cillizza argues that the political number of the day is five.

That's the number of networks -- ABC, CBS, NBC, CNN and Univision -- that President Barack Obama will appear on this Sunday as he seeks to re-build momentum for his health care plan.

Putting the president so far forward on Sunday -- particularly so soon after his primetime address to a joint session of Congress last week -- is evidence that the White House recognizes that the deal is far from closed with the American people when it comes to health care.

In moments of crisis during the 2008 campaign, Obama's campaign always put their candidate front and center -- knowing that he was the most convincing and compelling advocate for his own policies that they had in the stable.

I tend to think this is a good strategy. There will be plenty of pundits talking about the president being "over-exposed," but having the president in front of the public, making the case for his own agenda, seems wise. Why hit five networks? Because news consumers are fragmented, and reaching a large audience requires making the rounds.

And after the Sunday shows, President Obama will be in New York to appear on David Letterman's show on Monday night.

Of course, you might notice that there's one network missing from the president's line-up. A senior administration official told CNN that Obama will be appearing on every network except Fox News.

Time's James Poniewozik argues that this is a "mistake."

The perception may be that Fox is a nest of Obama-haters whose audience is monolithically opposed to him, but I think he would only benefit from being perceived to have the stones to do Fox and do it regularly.

The White House would be wise to ignore Poniewozik's advice. Fox News isn't even a news network -- it's a propaganda outlet that just finished promoting a right-wing march on Washington. The network exists as an appendage of the Republican Party. For the president to reward the network with "regular" interviews makes about as much sense as chatting with Limbaugh or the Weekly Standard, and expecting quality journalism with professional standards.

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