Thursday, October 22, 2009

Thursday Health Care: 60 Votes Edition

Marshall: Bold 
Specter: "We have 60 votes without Sen. Snowe."
Yglesias: The Klein Guide to Public Option Compromises 
Give it a read. The essence of compromising is, I think, to have a clear sense of which compromises count as a pretty good deal. And to me this is pretty clear. If you can’t get the public option of your dreams, the “opt-out” idea is still pretty good. It’ll lead to the creation of a big, viable public option and if it works well the pressure will grow on the opt-out states to opt back in. The other compromises involve giving much more away.
Unfortunately, Olympia Snowe also seems clearly opposed to the opt-out idea.
Think Progress: Rep. Weiner Identifies 55 Republicans On Medicare Who ‘Steadfastly Oppose’ The Public Option
Rep. Anthony Weiner’s (D-NY) office today released an internal study showing that 151 members of Congress “currently receive government-funded; government-administered single-payer health care — Medicare.” Of those 151 members, 55 are Republicans who also happen to be “steadfastly opposed [to] other Americans getting the public option, like the one they have chosen.” Included on Weiner’s list are anti-public option crusaders Senate Minority Leader Mitch McConnell (R-KY), Sen. Chuck Grassley (R-IA), Sen. Jon Kyl (R-AZ), Sen. John McCain (R-AZ), Sen. Orin Hatch (R-UT), Sen. Richard Shelby (R-AL), Sen. James Inhofe (R-OK), Sen. Mike Enzi (R-WY), Rep. Virginia Foxx (R-NC), and Rep. Peter King (R-NY).
This morning on C-Span, Weiner explained the idea behind the project:
WEINER: It’s more another way of looking at this debate, this discussion about the public option, to put it in focus. We went, just out of curiosity, looked at how many members of Congress get the public option. And I know a lot of people have said, “Well under the new bill, how many of you members of Congress would choose the public option?”
Well there already is one; it’s called Medicare. And we found 55 Republicans and 151 members of Congress are on Medicare right now. So they’re already getting the same type of public option that we’d like people who are without insurance to be able to get. And I guess the purpose of this list was to kind of point out some of the hypocrisy of this debate.
“You have members of Congress thumping their chest how they’re against government health care,” Weiner noted, adding, “and yet when it’s time for them to accept Medicare, they’re like, ‘Sign me up!’” Watch it:

Back in July, Weiner offered an amendment that would eliminate Medicare, saying at the time that it was “put-up or shut-up time for the phonies who deride the so-called ‘public option.’” Of course, no one voted for the measure.
“Even in a town known for hypocrisy,” Weiner said in a statement today releasing his study, “this list of 55 Members of Congress deserve some sort of prize. They apparently think the public option is ok for them, but not anyone else.”
The AP reports this morning on the Senate Democrats "who are more concerned about their next election or feel they have little to lose by opposing their party's hierarchy," and who may stand in the way of health care reform.
Many of the usual suspects were mentioned, but one stood out.
Sen. Mary Landrieu of Louisiana, where Obama lost by a similar margin, said she might be willing to let some states try "fallback or trigger" mechanisms that would create a public option if residents don't have enough insurance choices.
But she told reporters, "I'm not for a government-run, national, taxpayer-subsidized plan, and never will be."
That is, except for Medicare, which is a taxpayer-subsidized national plan that Landrieu supports.
And Medicaid, which is also a taxpayer-subsidized national plan that Landrieu supports.
And the V.A. system, which is also a taxpayer-subsidized national plan that Landrieu supports.
And S-CHIP, which is also a taxpayer-subsidized national plan that Landrieu supports.
And the Federal Employees Health Benefits Plan, which is also a taxpayer-subsidized national plan that Landrieu supports -- and takes personal advantage of.
Yes, except for all the "government-run, national, taxpayer-subsidized plans" Landrieu already favors, she's not for them and she never will be.
Good to know.
Defining Medicare Part E  Oct. 22: Author Jonathan Cohn discusses whether passing a public option will succeed in expanding health care to everyone and control costs.

Krugman: The facts have a liberal health-care bias 
A quick thought: now that Congress is getting close to actually passing health-care reform, the question is not so much whether to do anything, and more how to pay for whatever it is we do. As a result, sound-bites and slogans are mattering less, and CBO estimates are mattering more.
And this is pushing reform in a progressive direction.
Serious students of health care have known for a long time that the magic of the marketplace doesn’t work in health care; the United States has the most privatized health-care system in the advanced world, and also the least efficient. The pale reflection of this reality in the current discussion is that reform with a strong public option is cheaper than reform without — which means that as we get closer to really doing something, rhetoric about socialism fades out, and that $100 billion or so in projected savings starts to look awfully attractive.
It has also been clear from international evidence that universality is cheaper than leaving a few people expensively without care. That’s reflected now in the projected savings from a strong employer mandate.
The point is that reality is pushing for a more progressive reform than the Baucus bill. Truly, the facts have a liberal bias.
Long-time regulars may know I have quite a few "conversation enders." These are comments that lead you to know, the moment you hear them, that the writer/speaker is either clueless or intellectually dishonest, and there's really no reason to engage the person in a serious dialog.
We all have them. When I hear, "Tax cuts are fiscally responsible because they pay for themselves," it's a conversation ender. When I hear, "Evolution is just a theory," it's a conversation ender. When someone says, "Global warming can't be real because it's cold outside," it's a conversation ender. More recently, references to "death panels," Democrats' similarities to Nazis, or questions about the president's birthplace are automatic conversation enders.
But one of the all-time classic conversation enders is the belief that seniors can't get hip-replacement surgeries in Canada. Here's Rep. Todd Akin (R) of Missouri on the House floor yesterday:
"I just hit 62, and I was just reading that in Canada [if] I got a bad hip I wouldn't be able to get that hip replacement that [Rep. Dan Lungren] got, because I'm too old! I'm an old geezer now and it's not worth a government bureaucrat to pay me to get my hip fixed."
This is comically wrong, and it's been debunked over and over again. For one thing, the comparison itself is nonsensical, since Democrats aren't proposing a Canadian-style system.
But more important is the fact that seniors in Canada get hip-replacement surgeries all the time: "'At least 63 percent of hip replacements performed in Canada last year...were on patients age 65 or older.' In 2006-2007, an additional 1,577 hip replacement surgeries were performed in Canada on patients over 85."
As it turns out, just a few months ago, Rep. Roy Blunt, Akin's fellow Missouri Republican, made the identical claim. When it was proven false, Blunt walked it back and vowed not to repeat the bogus claim again.
If only Todd Akin paid closer attention.
Update: Paul Krugman takes this a couple of steps further, adding some socialized-medicinal details that I'd overlooked.
Well, I guess it's safe to say private health insurers have no intention of rebuilding burnt bridges. Suzy Khimm noted the other day, "Activists on the left have long insisted that insurance companies aren't to be trusted. But up until now, it's been hard to make the charge stick, since the insurance lobby -- a.k.a., America's Health Insurance Plans -- has been cooperating with the White House and its allies."
That cooperation is officially over.
It started last week with a deceptive report on health care premiums. Soon after, insurers launched a new round of attack ads. Now, Sam Stein reports on the industry's message to Republicans.
A top lobbyist for the major private insurance industry trade group, America's Health Insurance Plans (AHIP), urged Congressional Republicans to not even consider helping Democrats pass health care reform lest they aid an "enemy who is down."
Steve Champlin, a lobbyist for the Duberstein Group who represents AHIP, declared that the road to a bipartisan health care reform bill was, essentially, dead. And he urged GOP members to keep it that way.
"There is absolutely no interest, no reason Republicans should ever vote for this thing. They have gone from a party that got killed 11 months ago to a party that is rising today. And they are rising up on the turmoil of health care," said Champlin. "So when they vote for a health care reform bill, whatever it is, they are giving comfort to the enemy who is down."
Chaplain made the remarks at an annual AHIP conference. He added that he expected reform with some kind of public option to pass, though he emphasized the importance of Republicans standing firm in opposition.
Now, it's worth noting that this isn't especially surprising. Private health insurers don't support health care reform? They consider Democratic policymakers "the enemy"? Well, sure.
Reading this, though, I'm reminded of the Republican Meme of the Week. If the White House criticizes AHIP, and tries to leverage the industry's antics to rally support for reform, the administration, we're told, must be creating an "enemies list." If Obama criticizes insurers, he resembles, we're told, be a modern-day Nixon.
In other words, AHIP can try to derail reform, pressure Republicans to vote in lock-step against improving the broken system, and characterize the majority as "the enemy," but if the White House pushes back, it's the president and his team who are being outrageous.
Our discourse can be awfully frustrating sometimes.

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