Monday, October 26, 2009

Breaking: Impossible looking increasingly possible

The Senate healthcare reform bill will create a national public option with an opt-out provision to allow states to choose not to participate.

Remember four weeks ago when the public option was declared dead?

A few thoughts:

1. The progressive grassroots organizations that took all that heat for running tough ads against wayward Democrats deserve some credit. They refused to cave.

2. Harry Reid deserves some credit. Though grassroots pressure made success on the public option absolutely critical to the Senate leader's reelection next year, Reid had to do the heavy lifting to get Baucus and other moderates on board with a public option. He is forging ahead with the preferable opt-out compromise even though the trigger policy seems to have had more votes. That shows backbone.

3. The White House deserves slightly less credit. Though I wish we'd used single-payer as a starting point and think we'd be much further along if we had, you have to give the White House some applause for preaching patience and for allowing space for the Senate to negotiate.

4. We have a bit of a ways to go and a lot more work to do. Call Mary Landrieu and urge her to support the opt-out compromise. Reach her in New Orleans at (504) 589-2427. Reach her in D.C. at (202)224-5824.

We are so close to passing a pretty damn good healthcare reform bill.


Dambala said...

I'm not being a smartass...but if we get the public option, do you still think we need Charity?

E.J. said...

Will it cost money to opt in? If not, why would states opt out?

jeffrey said...

No credit to White House for anything. It appears as though they've been dragged this far kicking and screaming all the way.
The fact that we've gotten this much movement is, I think, an excellent indicator of what could have been had they set the proper tone at the beginning.

I still don't understand how "opt-out" is going to work. Will a state opt-out via public referendum? By executive order of the Governor? By act of the legislature? Would it be a different process in each state? You can see how very different each of these mechanisms might be.

Worst of all, though, the villainous insurance industry survives here pretty much intact. But what do you expect when you are governed by plutocrats and their friends.

E said...

Dambala, there are a wealth of opinions about how any kind of healthcare reform legislation will affect the reimbursements paid down to local public hospitals, not just in Louisiana but all over the country. In fact, the loss of DSH money is one of the main reasons LSU is being forced to start from scratch in terms of its operating plans for a proposed new medical center. I take no position on what kind of operating model is most appropriate when we build a new hospital, only that we should build a new hospital in Charity's facade and not as part of a Taj Mahospital on top of Lower Mid-City.

E said...

E.J. states would only opt-out in instances where totally ridiculous governors want to score political points by taking silly stands against President Obama. The secret genius of the compromise is that it will be incredibly difficult for GOPers to convince voters that they should deny themselves access to an option program available to everyone else.

E said...

jeffrey, I think you're being somewhat hyperbolic. I've read reports that the White House preferred trigger to opt-out. Other than that, I'm not sure what you're talking about. The White House made healthcare reform their number one domestic priority. They kept public option afloat while it looked dead. They made some tough compromises with the drug industry that I don't agree with but were likely necessary to get us to where we are. One real turning point for public option was Obama's incredible speech on healthcare reform in September.

jeffrey said...

Trigger, Opt-Out, hell the notion of a "public option" insurance plan itself are all excuses to perpetuate the unacceptable business of profiteering off of the sick and the dead. The problem here is the health insurance industry itself.

Obama's strategy from the beginning seems to have been to protect these death profiteers from harm just as he has protected the finance industry at the expense of the majority of the population.

E said...

Right. I wish I could have single payer, too. I didn't expect to get single-payer right now from this or any President. I'm comfortable with incremental progress as consolation, especially since it seems we're avoiding even less progress that would have occurred even more incrementally.

Anonymous said...

Great, way to think this one all the way through. We are spending 1 Trillion dollars to cover another 14 million people, which will increase everyone's insurance rates across the board. Remind me never to ask E for investment or business advice.

Granted, I have to give the Democrats credit for pooch screwing this as much as it could have been and still getting it past the pathetic Republicans. Also, I wouldn't jump for joy just yet, there are still multiple bills and alot of negotiation to get through before this thing is law and several years before its actually put into effect. However, I think the media will help them out with keeping the final version hidden long enough to get it passed or use the "nuclear option".

Doesn't this bother anyone? We are paying a grip of money for a service we can't use in years. States can opt out, but that's silly because we will will still be taxed, fined or rates increased to cover the damage this bill has done. The bill won't provide coverage for all of the 30 - 50 million that are uninsured (whichever stat you believe), only a about a third. You're telling me there isn't a better and cheaper way to do this? Really?!

My biggest problem with this initiative is that we are not getting the best solution, we are getting the best solution for the Democrats buddies that they can pass. Why don't the doctors, lawyers and pharma industries focused on to cut cost and improve quality? Because they give bunches of money to the Dems.

I have no problems with sticking it to the insurance industry, but what evil entity are you going to blame when there is still mass medicare fraud, elevated prices because no tort reform hasn't been enacted, the price of drugs is ridiculous (compare the profits of the insurance industry and the drug companies fellas - then look at who gives money to what politicians).

I'm tired of this being Democrat and Republican or the moral obligation nonsense (yeah, I said it) that E likes to preach. Clearly none of you have had access to government ran health care. I have for 8 years in the military and since with the VA, there's a reason I choose to use my private insurance over the VA - IT'S BETTER SERVICE & QUALITY.

You numbskulls are so caught up with putting it to the Republicans you have ZERO idea what you are signing up for. At what point did single payer become so friggin popular? They can't sustain it in Canada, Massachusetts system is in complete shambles and everything I have read about the German system its a bust. NPR had a great article on the Germany system last year.

I'm not against a public option, I just wish they would clean up the waste, fraud and abuse first in Medicare to prove they will be responsible and they take this shit seriously. Otherwise, you're just giving the government far more control and more of our money than they think they deserve for the quality of service they have shown at this point.

jeffrey said...

If I may paraphrase Keynes, Incrementally we are all dead.

E, this whole system is so fucked, so rigged in favor of the leeches who own what's left of the wealth our economy once produced that it's going to take far more actual change than what CHANGE (TM) has sold us to this point to rectify the fundamental societal injustices to which we are subject.

I don't think we're getting what we need from the Democrats in general and Obama especially.

Yes I know Obama campaigned as a status-quo moderate, so I'm not "disappointed" or unduly "surprised" as Obama supporters invariably charge as though that were an argument of any substance.

But for me, the question is why are we supposed to accept this? What do we have to lose in expressing displeasure with these phonies who fail to represent us? Are they not going to take us seriously? Because that doesn't seem any different from what happens now. Don't the young hippies these days like to talk about "being the change they seek" or some such thing? Why are they, instead, so eager to apologize for the non-change that they are getting?

Dambala said...

- E, this whole system is so fucked, so rigged in favor of the leeches who own what's left of the wealth our economy once produced that it's going to take far more actual change than what CHANGE (TM) has sold us to this point to rectify the fundamental societal injustices to which we are subject.

There's always that. But let's not talk about the rusted out hull of the ship, lets just paint over it.

That's exactly how I see this whole charade, J.

On a smaller level than health care, look at the Credit Card legislation which was just passed...the result was that the companies are now moving back to service charges in order to meet their bottom line. Nothing has changed because we're just legislating the symptoms of the problems instead of addressing the actual disease.

Without a public option, any plan you create is essentially a government bailout for insurance companies...AIG 2.0....with the public option it becomes something marginally better but I can assure you it will only be a matter of time before that public plan is sabotaged and dragged through the streets of small town USA as another failed big government experiment.

Sorry to be so dismal, but I may be even more pessimistic than Jeffrey on this matter.

E - Tajmahospital is that your copyright?

jeffrey said...

Tajmahospital made me laugh too.

E said...

Dude what is your strategy then?

I too was and remain frustrated by the corporatism of the Democratic Party. That is why I was so excited to be part of the grassroots movement that elected Barack Obama. I wasn't so excited because I think Barack Obama is a singular answer to all of the nation's problems but because I believe that the coalition that mobilized for him, volunteered for him, and voted for him is indicative of a resurgent grassroots left-leaning movement capable of pressuring all of our politicians to move forward more aggressively.

I think this resurgent political alliance between young people, people of color, and organized labor is something to be happy about. I think the leveraging of this coalition to force Democratic leadership to dig in hard on the public option is a small but important victory.

Tell me what else there is. Tell me what other path you see to the change you want. I don't see people 'accepting' the situation as it is. I see people fighting really hard, organizing within this powerful new coalition, to make the situation better. I'm proud to be a part of it.

If you've got a better way to organize, a better way to mobilize, and a better way to win, I sure as hell want to know about it so I can get involved.

Perhaps you're just upset with the fact that I consider the way that the grassroots mobilized to win the public option after it was declared dead to be an important victory instead of indicative of how much further we have to go. If that's the case, I will use a sports metaphor.

Imagine the Left is a football team you care about that has been really bad for a really long time. Finally we go 0-16 and fire the coaching staff and GM.

Then we bring in a new GM and a new coach and they get to work turning over the roster. The next season we finish 4-12.

I'm excited because I see that we're setting up important infrastructure to continue to improve the team moving forward. You're pissed because we're still 4-12 and want to fire the coach and GM again.

Maybe that doesn't work exactly. The bottom line is that I think you can both be excited by the progress being made by an emergent left-leaning coalition and frustrated by how difficult it is to make change. What I don't accept is those that just think we should all throw our hands up, mutter 'fuck the system,' and do nothing at all to help.

E said...

Yes! Tajmahospital is my copyright, I've been using it for months and I cherish it like I would my first-born son! LOL.

GentillyGirl said...

Single-payer is the best way to go, but with the Moderates trying to maintain the status quo it looks like an opt-out Public Option is what we will get. Still that can be improved upon in the Future. (I'm sticking with my socialist VA health care)

Taj Mahospital? Priceless.

GentillyGirl said...

E, remember I was the first to call the project the "Glittering Jewel". LOL

Papa Bear said...

Eli, we aren't 4-12.

We are more like 3-1. We are quickly forgetting that President Obama has only been in charge for 9 months.

I don't get why everybody thought that every problem was going to get fixed by July.

Dambala said...

- I'm excited because I see that we're setting up important infrastructure to continue to improve the team moving forward. You're pissed because we're still 4-12 and want to fire the coach and GM again.

no. I'm pissed because the refs are bought and paid for.

Just ignore me...i'm being bitter.