Thursday, October 15, 2009

Health Care

QOTD, Thers:
The things that are news to Senators. Oy.

As a class, Senators are fucking morons. I mean, good for Susie, but Christ, a sitting Senator having to be told that our stupid healthcare system is bad for entrepreneurs... gah.
Aravosis: Is there anything the administration can't live with? 
As the NYT reports this morning, two senior administration officials say the White House likes Olympia Snowe's "trigger" plan that will basically kill the public option, and ensure that we don't have real competition in health care in this country. Big surprise there. The White House isn't willing to fight for a better bill, isn't willing to fight for the President's own promises. Isn't willing to use the President's power - which he most certainly has - to cajole all 60 members of the Democratic caucus into voting the right way. So, President Obama caves, as he so often does when faced with the prospect of having to fight for his beliefs.

If President Obama isn't willing to fight for what he reportedly considers the most important piece of legislation of his entire presidency, then what will he fight for? It's never going to change, folks. This is what the next three years are going to be like - always settling for less, when he could have had more, in order to avoid a fight. Democrats need to start demanding that this White House give Democrats just as much say in legislation as it always seems to give Republicans.

And keep something in mind. The last few weeks we finally had momentum on our side. The "opt-out" proposal took everyone by surprise, and even critics of the public option said they were intrigued. But, rather than use that momentum to get the kind of bill the President promised us during the campaign - to get something better - President Obama settled for a Republican proposal that was being discussed weeks ago, long before we had the momentum on our side. The White House never intended to try to get a better bill, regardless of whether we provided them with the political landscape to do just that. The last month of hard work by health care advocates was meaningless.
At some point, perhaps someone can inform President Obama that he won the election.

Sudbay: “I think the administration has put [Olympia Snowe] in the driver’s seat; it’s very disconcerting.” 
It is very disconcerting. Very.

Last night, John wrote a post explaining how President Obama could and should use his power to pass a strong health insurance reform bill out of the Senate. That require presidential leadership. Yet, for some reason, the White House brain trust has chosen to give its power to Olympia Snowe:
One day after the Senate Finance Committee approved a measure without a “public option,” the question on Capitol Hill was how President Obama could reconcile the deep divisions within his party on the issue. All eyes were on Senator Olympia J. Snowe, the Maine Republican whose call for a “trigger” that would establish a government plan as a fallback is one of the leading compromise ideas.

Two senior administration officials, speaking on condition of anonymity, said the White House looked favorably on the Snowe plan. But liberal Democrats were maneuvering against it Wednesday, arguing that Ms. Snowe, the lone Republican to vote in favor of the Finance Committee’s bill, was gaining undue influence over the talks.
Who are these "senior administration officials"? And, why are they so eager to cede power to one GOP Senator? Is that what last year's election was about?

Rep. Grijalva, who co-chairs the House Progressive Caucus, said on-the-record what most of us are thinking:
“It’s one vote, she won’t make the commitment on the final product, and she says she’s got to have the trigger,” said Representative Raúl M. Grijalva, Democrat of Arizona, who is leading an effort in the House to round up votes for a government plan akin to Medicare. “I think the administration has put her in the driver’s seat; it’s very disconcerting.”
Very disconcerting.

What's next? Changing OFA from Obama for America to Olympia for America?

Ezra Klein: Olympia Snowe Vs. Ben Nelson 
A lot of people are concerned that Sen. Olympia Snowe is going to have an outsized role on health-care reform. It's a fair concern. Indeed, it's a virtual certainty. But it's worth comparing Snowe's outsized role to the alternative: Ben Nelson, the 60th least-liberal Democrat, being in the driver's seat on health-care reform.
Snowe represents Maine, which gave 58 percent of its vote to Barack Obama. Nelson represents Nebraska, which gave 57 percent of its vote to John McCain. Polls out of Maine show heavy support for health-care reform in general, and the public option in particular. Polls out of Nebraska show heavy opposition to health-care reform in general, and the public option in particular.
In other words, you'd much rather have the crucial moderate hailing from Maine than from Nebraska.
Now, representational concerns are often less important than partisan concerns: Tom Harkin wants a liberal health-care bill while Chuck Grassley wants a conservative health-care bill, even though both of them represent Iowa. In that case, party and ideology is clearly stronger than constituency. But Snowe has already proven her willingness to break with her party on health-care reform, so it's fairly clear that her personal politics, and those of her state, are more determinative than her party's desires.

If that's indeed the case, then Snowe's state is much more liberal than Nelson's state, and Snowe, by most accounts, is more liberal than Nelson, at least on health care. The compromise she's likely to detail will probably be substantially to the left of the compromise Nelson is likely to detail. In addition to that, she's already got her fingerprints on the Senate Finance Committee's bill, and won't feel like she has to move that document to the right to demonstrate the fruits of her involvement. Nelson hasn't been involved in any of the bills, and would probably attempt to broker a whole new compromise if he were the decisive vote.

Among Senate Democrats, few have been as conservative on health care reform as Sen. Mary Landrieu of Louisiana. Yesterday, she elaborated a bit on her perspective in an interesting appearance on MSNBC.

"I believe in the private sector," Landrieu said, in reference to giving Americans consumers a choice of a public option. "I don't believe in government running every program for everybody," she added, doing her best impression of a Republican.
Asked specifically about polling data showing the public option with strong national support, the conservative Democrat added, "I think that when people hear 'public option,' they hear 'free health care.' Everybody wants free health care. Everybody wants health care they don't have to pay for. The problem is that we as government and business have to pick up the tab, and as individuals. So I'm not at all surprised that the public option has been sold as free health care. But there is no free lunch."
This is pretty foolish. For one thing, Mary Landrieu, as a senator, takes advantage of a very generous health care plan that lawmakers give themselves. "Everybody wants health care they don't have to pay for"? I suppose that's true, but it's odd to hear the comments coming from someone whose coverage is subsidized by taxpayers.
For another, I haven't the foggiest idea why Landrieu thinks Americans perceive the public option as "free health care." What is that based on? I'll gladly concede that there may be some public confusion about the details surrounding the plan, but there's no evidence at all to suggest the public option enjoys broad support because consumers think they'll get something for nothing.
Of course, forgive me to re-emphasizing this all the time, but when push comes to shove, it doesn't really matter whether Landrieu is too far to the right on health care policy or shilling for insurance companies. If she wants to vote against the health care reform bill, she should. What matters is whether Landrieu would partner with Senate Republicans to deny reform a vote on the Senate floor. And on that point, we don't yet know what she might do.
Think Progress: Insurance company executive refers to high-cost patients as ‘dogs.’
In the state of New York, insurers are legally prohibited from discriminating against individuals who submit large claims. So when Guardian, a major insurance company, was faced with the high-cost claims of 37 year-old muscular dystrophy patient Ian Pearl, it decided to cancel its entire line of coverage in the state of New York rather than pay for Pearl’s claims. In an e-mail obtained by The Washington Times, it was revealed that one executive at the company refers to patients like Pearl as “dogs” that the company can simply “get rid of”:
Legally barred from discriminating against individuals who submit large claims, the New York-based insurer simply canceled lines of coverage altogether in entire states to avoid paying high-cost claims like Mr. Pearl’s. In an e-mail, one Guardian Life Insurance Co. executive called high-cost patients such as Mr. Pearl “dogs” that the company could “get rid of.”
A federal court quickly ruled that the company’s actions were legal, so on Dec. 1, barring an order by the federal Department of Health and Human Services, Mr. Pearl will lose his benefits.
The cost of Pearl’s annual treatment is approximately $1 million a year. The Pearl family is unable to receive the quality health care that Ian needs. “One-on-one skilled nursing is essential,” Mrs. Pearl said.
 Health insurance industry's power fade  Oct. 14: Senate Democrats are now calling for the repeal of a 1945 law allowing health insurers to have federal anti-trust exemption. Guest host Alison Stewart is joined by insurance industry whistleblower Wendell Potter.

When we last heard from Rep. Mike Ross (D-Ark.), the Blue Dog caucus' point-man on health care policy, he was moving sharply to the right. He announced last month that he would oppose any legislation with a public option -- despite already having voted in support of a public option in committee, and having defended the idea two weeks prior.
Today, The Hill reports that Ross has taken another unexpected turn.
Blue Dog Rep. Mike Ross, who made headlines by rejecting a compromise he'd negotiated on a public health insurance option, has suggested to Democratic leaders that the government-run Medicare program be opened to all Americans.
Ross (D-Ark.) has made the suggestion in meetings with House Democratic leaders and brought the idea to the closed-door House Democratic Caucus meeting Thursday.
"I -- speaking only on behalf of myself -- suggested one possible idea could be that instead of creating an entirely new government bureaucracy to administer a public option, Medicare could be offered as a choice to compete alongside private insurers for those Americans eligible to enter the national health insurance exchange, but at a reimbursement rate much greater than current Medicare rates," Ross said in a statement to The Hill.
If the quote hadn't come in a statement, I would have assumed that The Hill had made a mistake. Because, really, this doesn't make sense for Ross.
He's a conservative Dem. He's firmly opposed to letting a public plan compete against private insurers. Just five weeks ago, Ross said, "[I]f House leadership presents a final bill that contains a government-run public option, I will oppose it."
And yet, now Mike Ross open to letting Medicare compete against private plans? He's against existing Democratic proposals, because he perceives them as too liberal, but Ross is publicly suggesting letting everyone have access to a national socialized medicine program?
He added that he hadn't specifically endorsed this as a policy proposal, but then again, if Ross were dead-set against the idea, he wouldn't have suggested it to congressional leaders in the first place.
The only thing I can think of is this is Ross' way of killing health care reform -- tell Democratic leaders to give up on everything they've worked all year on, and start working on something they'll like even more (universal Medicare eligibility). Then, when that starts working its way through Congress, Ross and Blue Dogs would decide it's too liberal and rally against it, thus ensuring that the status quo is protected.
If that's not what's going on here, I'm at a loss. The same Blue Dog opposes a public option and then suggest opening up Medicare to all. Huh?

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