The Best We Can Do ~ Digby on Health Care Reform

by digbyJim VanDehei was on Mitchell this morning talking about his new article which evidently reports that Obama is going to twist arms today to make sure health care reform passes before Christmas. Mitchell asked him if (as Chuck Todd absurdly posited) Lieberman actually pulled back from the brink and decided not to blow up the Democratic party or if he is sitting pretty because he actually got exactly what he wanted:

VanDeHei I don’t think there’s any question that he got what he wanted. He’s been able to kill, or help kill, the public option and now he’s single handedly killed this Medicare expansion for people over the age of 55.

And so now what the president is doing is calling in Democrats in the Senate and saying “listen this is the last chance we have to get health care reform and if I fail, like Clinton failed, we’re talking about generations before another Democratic president with this big of a majority can actually tackle health care reform”. His case is going to be that if we don’t do this in the next two weeks it’s never going to be done.

The big question is, will that message pacify liberals? Liberal Democrats on the hill are saying “listen we wanted a single payer system or at least we wanted the public option or at least we wanted the medicare buy-in. Now we’re getting squat on that end so what are we actually getting?”

Obama will say, you’re actually getting a lot. You’re getting coverage for everybody. You’re getting insurance reform. And he’s going to have to convince them that that is sufficient.

That doesn’t make sense and if Obama is able to persuade liberals with that incoherent line of reasoning then he really is good and they really are stupid.

If this is the only chance for reform in generations, wouldn’t it have made more sense to fight for a truly comprehensive bill that actually solved the problem? If you’ve only got one bite of the apple every couple of decades, it seems remarkably foolish not to really go for broke. To end up with a bill like this as your once in a generation liberal accomplishment is about as inspiring as a Bobby Jindal speech.

And Obama can say that you’re getting a lot, but also saying that it “covers everyone,” as if there’s a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don’t get it from their employer. I guess you can call that progressive, but that doesn’t make it so. In fact, mandating that all people pay money to a private interest isn’t even conservative, free market or otherwise. It’s some kind of weird corporatism that’s very hard to square with the common good philosophy that Democrats supposedly espouse.

Nobody’s “getting covered” here. After all, people are already “free” to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won’t make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn’t or didn’t want to write. Indeed, it actually looks like the worst caricature of liberals: taking people’s money against their will, saying it’s for their own good. — and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don’t miss the money as much when they never see it.

And as for the idea that insurance reforms are a huge progressive victory that can only be accomplished once in a generation, well that’s a pretty sad comment on our country — and progressivism.

What this huge electoral mandate and congressional majority have gotten us, then, is basically a deal with the insurance industry to accept 30 million coerced customers in exchange for ending their practice of failing to cover their customers when they get sick — unless they go beyond a “reasonable cap,” of course. (And profits go up!) If that’s the best we can expect of progressivism for the next generation then I’m afraid we are in deep trouble.

*I realize that the subsidies and the medicaid expansion are meaningful. But they are also going to be subject to ongoing funding battles in an age of deficit hysteria. I don’t hold out much hope for any improvement on that count. Indeed, I fully expect they will be assailed as welfare and eliminated as soon as Republicans gain power. They have learned from their mistakes — don’t let any liberal “entitlement programs ” become entrenched. That’s why a big comprehensive program would have been better. It’s much harder to disassemble.

Update: I think it’s really cool being lectured to by Obama about not getting everything you want. I would imagine that Joe Liberman laughed and laughed and laughed at that one.

What Exactly Do The Insurance Companies Get From Health Care Reform? ~ Olbermann and Potter

AHIP, Billy Tauzin, Broadcatching, Health Care Reform, Kent Conrad, Rahm Emmanuel, Wendell Potter

Harry Reid ~ Health Care Reform Bill ~ Presser

United Health

Conservative Democrats Signal They Won’t Block Public Option

Aetna, Alan Grayson, Barack Obama, Betsy McCaughey, Bill Nelson, Broadcatching, Charles Grassley, Cigna, Congress, Dylan Ratigan, FOX News, GOP, Health Care Reform, Howard Dean, Kent Conrad, Max Baucus, Rahm Emmanuel, Republicans, Rick Scott, Senate, Shepherd Smith, United Health

R A W S T O R Y
By John Byrne
Friday, October 23rd, 2009 — 8:07 am

Conservative Democrats signal they wont block public optionSupport for including some version of a public option in the Senate’s version of a healthcare overhaul appears to be solider than initially believed.

In a series of comments that have received little attention, conservative Democratic senators — even those who’ve publicly said they oppose a public option — say they are unlikely to join a Republican filibuster to block it. Under Senate rules, Democrats would need to convince 60 members to support the ability to vote on healthcare legislation with the public option (cloture), and then just 51 to pass it.

Sen. Mary Landrieu (D-LA) told a reporter earlier this week that she wouldn’t join Republicans in voting against cloture.

“I’m not right now inclined to support any filibuster,” Landrieu said.

“For the Republican Party to kind of step out of the game is very unfortunate,” she added, referring to the Senate Republicans’ intransigence on healthcare reform proposals. “I’m not going to be joining people that don’t want progress.”
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Indeed, Landrieu’s sentiment — that joining foes of healthcare reform would be an impediment to progress — may be the catnip that keeps Democrats on board.

Sen. Mark Pryor (R-AR), a moderate Democrat from the South, said Thursday he was open to some form of a government-run health insurance competitor.

“It depends on how it’s structured on whether I can support it,” Pryor remarked. “I just haven’t decided.”

But regardless of how he votes on the final package, he says he won’t join Republicans in filibustering the bill. Tellingly, he also signaled that he didn’t believe any other Democrats would either.

“I don’t think you’ll see me or any other Democrats do that,” Pryor told liberal blogger Mike Stark.

One conservative Democrat refused to tip his hand. Nebraska Sen. Ben Nelson (D-NE) occasionally joins Republicans on controversial issues.

“I believe in playing chess, but that’s about three moves ahead of me, and I’m not prepared to make those moves until I see some other moves in between,” Nelson told a reporter this week.

Jake Thompson, Nelson’s Communications Director, told Raw Story that he “would decline to comment” about how Nelson will react to a potential Republican filibuster.

Arlen Specter (D-PA) has said he’ll support a public option as well. Specter defected from the Republican Party to the Democrats earlier this year, against the backdrop of a tough primary challenge from his right. In an interview Thursday evening with MSNBC’s Ed Schultz (video below), he sounded confident that Democrats had the 60 votes to prevail.

“We have 60 votes without Sen. Snowe, so we can still invoke cloture and move to a vote on the public option,” Specter said. “With 50 votes plus the Vice President and my vote is going to be for the public option, robust public option, we can get it passed, even without Sen. Snowe. I hope we have her, but we may be able to do it without her.”

Sen. Olympia Snowe (R-ME) was the only Republican to join ranks with Democrats in approving a version of healthcare legislation that passed through the Senate Finance Committee. That version didn’t include a public option.

That said, Democrats need lose only one member to lose the battle for the public option. A 60-vote majority would also need to include independent Sen. Joe Lieberman (I-CT), who’s tangled with Democrats on various issues in the past.

Senate Majority Leader Harry Reid (D-NV) won’t say how many votes he has in his arsenal on a government run plan. In a statement Thursday evening, he said only that he was looking to pass a bill with as many votes as possible.

“We’ll continue to work together to seek broad consensus on the key issues before us and to craft the strongest possible bill that can garner 60 votes,” Reid said. “We will also continue to do our best to represent the views of all members of the Senate who have a genuine desire to see reform succeed. But our mission is clear: the American people want quality, affordable health insurance and failure is not an acceptable option. I am optimistic that we are close to laying a proposal before the full Senate that will do just that.”

In the House, some version of a public option is almost certain to pass. The version will likely be more liberal than that of the Senate’s, as Democrats hold a larger majority in the lower chamber.

President Obama’s position on the public option remains unclear. A Politico report Friday said that Obama prefers a “trigger option,” under which a public insurer would only be created if private insurers fail to meet key pricing standards. The White House, however, says Obama hasn’t taken a position either way.

The following video is from MSNBC’s The Ed Show, broadcast Oct. 22, 2009.

Why the White House Probably Doesn’t Want a Public Option

Why the White House Probably Doesn’t Want a Public Option
By: Scarecrow Tuesday October 20, 2009 9:26 pm
F I R E D O G L A K E D O T C O M

The question many health reform advocates have been asking about the public option debate is “what’s the problem”??? Why isn’t the President demanding it, pushing it, selling it? Well, maybe he doesn’t want it.
Why, given strong Congressional majorities in favor of a public option, continuing strong polling support across the country, and overwhelming support from Democratic voters, is Harry Reid treating the matter as though it were a close call?

To be sure, getting 60 votes for cloture is a challenge, but that is not the same as needing 60 votes for a public option, no matter how many times the media equates the two. Only 5 or 6 Senate Democrats are even opposed in concept. Yet not one of these holdouts has publically declared that he/she would join a filibuster to keep a public option from getting a simple majority-rule vote. Sen. Harkin correctly asks, why should these five be empowered to force over fifty to give in?

Everyone also knows that if Harry Reid puts a viable public option in the Senate bill, there aren’t 60 votes to remove it. So why is Harry Reid behaving as though Democrats had something to fear if they demand party loyalty on a cloture vote and then push through a measure that has more voter support than any health reform measure they’ve proposed outside banning insurers from denying coverage to the sick?

Night after night, we are reminded (thanks to Nancy Pelosi prodding CBO) that a strong public option will save tens of billions, give consumers a choice in an industry that is dangerously concentrated and lacking in competition, and put pressure on insurers to lower premiums in the face of their promises/threats to raise them. Everyone now realizes a strong public plan could provide a credible, government-guaranteed alternative even if the private insurers succeed in evading new government regulations banning their most outrageous practices — practices whose evil effects we see repeated on a daily basis. So what’s the problem?

The Beltway conventional wisdom, steeped in cynicism, is that the White House is being disingenuous when it repeatedly says the President supports a public option. WH officials claim Obama believes it is “the best way” to provide an affordable choice and reduce costs. But then why is he not working to get it adopted in the Senate, and explicitly directing his OFA troops to help that effort? Why has he ducked every opportunity to make even the logical argument that the burden is on detractors to show there’s a better measure? No one has seriously attempted such a case.

In House and Senate leadership efforts to merge their respective bills, it’s curious that no one has noticed that House Speaker Pelosi does not seem to need the White House to tell her how to merge three House bills while improving them. But apparently, Harry Reid is not capable — or cannot be trusted — to merge two Senate bills without having Rahm Emanuel, Peter Orszag and Kathleen Sebelius present every meeting.

There’s nothing wrong with the Senate consulting with the White House about what they’re willing to push and pay for. But the White House told reporters that all the key decisions would be made by Harry Reid. So why are these senior White House people, including the man who sees himself as the center of the universe, there if not to tell Harry Reid what he can and cannot decide?

It is hard to avoid the fear that this White House has now become a principal obstacle to getting meaningful health care reform. It claims it wants major cost reductions in Medicare, via a semi-autonomous cost-cutting commission. But the White House has already bargained away the savings it can achieve from most of the major providers: PhRMa ($80 billion), hospitals ($155 billion) so they can give it back to the doctors (for whom AMA is demanding $240+ billion more over ten years in relief from automatic Medicare reductions).

Why should we not also believe that the White House has a deal to shield insurers from competition by preventing the creation of a public option in exchange for the insurers agreeing to reforms on guaranteed issue and limited community ratings (with the flexibility Baucus provided) and to support this framework with tv ads? (Read Ignagni’s WaPo op-ed today; while defending the PwC study, she says they made a deal, but Baucus broke it; she didn’t say the deal’s off.)

The White House isn’t taking up most of the chairs in Harry’s Reid’s meetings just to watch him make decisions on his own. They’re there to make sure Harry Reid doesn’t undo the White House deals and wander off the reservation.

This President has filled the White House with people who have no inclination to pose any major challenge to the economic power of America’s dominant financial industries (GM being an exception). We’ve already seen this in their dealings with Wall Street investment banks and their too-big-to-fail is too-big-to-challenge approach to financial regulation. We’re seeing it now with efforts to shield the major health and insurance industries from any fundamental challenge.

Sure, there are changes being offered, new regulations being proposed, and more people will be insured than before. But there is no framework being laid for a new structure for how health care is delivered and paid for in America. That is the pattern of this White House, and there is little basis to expect otherwise.

Watch the decisions Harry “makes” in coming days. My bet is they’ll shore up the underlying deals — they’ll make mandated insurance modestly more affordable and fix the mandates a bit, while protecting the insurers from a viable, functioning public option. The industry will still control a system in which consumers will be forced to buy their unreliable products with government subsidies.

And seeing this coming, Nancy Pelosi will push a more reform-minded House to fight back as hard as they can. The House now carries the hopes for even limited reform. Sadly, her opposition is not just the Senate’s 60 vote barrier; it’s in the White House.