Yesterday's health care summit laid out the basic philosophical difference between the Democrats and the Republicans. Steve Benen has written his conclusions this morning, and I agree.
The Republicans do not recognize any major problems in the American health care system, and even if they did they do not believe that government could fix them. The top priority of the Republican Party is that it not regulate business or anyone and that taxes be kept very low. Every government action has to meet those two criteria before anything else. Government action is generally wrong and should not occur.
The Democrats believe that America has a broadly dysfunctional health care system that leaves out too many people and that offers suboptimal outcomes for many others. Too many Americans get sicker than they should and many die unnecessarily. In addition the system itself costs too much and the cost is increasing too rapidly. Looking at other wealthy industrial nations around the world these are problems which can be controlled, but it requires government action.
Yesterday' health care summit laid out those two positions along with the proposals the Democrats have developed over the recent year. The Democrats then asked the Republicans to join them in developing an appropriate set of activities to deal with America's health care problems. The Republicans replied "Not just no but Hell no!" and demanded that the Democrats abandon the effort to fix the system.
Since the Democrats are the majority party, they are now left to pass health care reform on their own. They have to. They were elected on the promise that they would.
That's where we are this morning, the day after the health care summit. The next step has to be for the Democrats to by-pass the filibuster in the Senate.
Showing posts with label Health Care Reform. Show all posts
Showing posts with label Health Care Reform. Show all posts
Friday, February 26, 2010
Tuesday, December 22, 2009
Health care, the Republican Party and the non-functional Senate
We are seeing groundbreaking Legislation finally drag through the Senate. Because of the nature of the Senate, it's far from an ideal bill, but considering how dysfunctional the Senate is, this is the best we'll get.
Lindsay Graham complained to NPR about how Nebraska was getting the federal government to cover the state portion of Medicaid while South Carolina was not. Somehow that seems unfair to Sen. Graham, but he could have worked his own deal by agreeing to vote for the bill and replace Sen. Nelson. Really, all Graham and the Republicans want to do is complain. The irrational aspects of the Senate bill are the responsibility of the Republicans.
That's because the Republicans have created the dysfunctional Senate using its small state bias (which magnifies the numbers of Republicans elected), its arcane rules, and the tradition of the filibuster.
The Republicans lost control of the Senate because they can't govern. Now they are making the Senate itself unworkable because they believe that short-sighted voters and the conservative media will blame the Democrats for the results of the Republican scorched earth policies and refusal to deal with the deep problems America currently faced. The Republican effort to Filibuster the defense appropriations bill in hopes they can delay passage of health care is unacceptable and irresponsible.
Consider what the Republicans have done to the Senate. They are demanding a 60 vote super majority in order to pass any significant legislation, and they are refusing to even present legislative actions to work with. The Republican Senators have abdicated their duty to the American nation in favor of somehow damaging the Democrats. The result it that the Senate now can only function by unanimous vote of all 60 Democrats. That's the reason for all the political deals to pass health care. With the requirement of a unanimous vote each Democratic Senator can block all Senate legislation unless he or she is effectively bought off.
The Republicans could stop this overnight. They just need a few Republican Senators to vote for the health care bill and replace the Democratic Senators who are holding up the Democratic Party. But the Republicans refuse to do anything for the American nation because they want to political advantage.
If the Democrats do not hang this action around the necks of the Republicans running for election in 2010 then they deserve to be voted out of office. Only the American people do not deserve the return of the Republican Party to Senate power.
In the meantime we get maybe half the health care bill that we could have if the Republicans had the interests of the American public in mind instead of the hope for return to power.
Lindsay Graham complained to NPR about how Nebraska was getting the federal government to cover the state portion of Medicaid while South Carolina was not. Somehow that seems unfair to Sen. Graham, but he could have worked his own deal by agreeing to vote for the bill and replace Sen. Nelson. Really, all Graham and the Republicans want to do is complain. The irrational aspects of the Senate bill are the responsibility of the Republicans.
That's because the Republicans have created the dysfunctional Senate using its small state bias (which magnifies the numbers of Republicans elected), its arcane rules, and the tradition of the filibuster.
The Republicans lost control of the Senate because they can't govern. Now they are making the Senate itself unworkable because they believe that short-sighted voters and the conservative media will blame the Democrats for the results of the Republican scorched earth policies and refusal to deal with the deep problems America currently faced. The Republican effort to Filibuster the defense appropriations bill in hopes they can delay passage of health care is unacceptable and irresponsible.
Consider what the Republicans have done to the Senate. They are demanding a 60 vote super majority in order to pass any significant legislation, and they are refusing to even present legislative actions to work with. The Republican Senators have abdicated their duty to the American nation in favor of somehow damaging the Democrats. The result it that the Senate now can only function by unanimous vote of all 60 Democrats. That's the reason for all the political deals to pass health care. With the requirement of a unanimous vote each Democratic Senator can block all Senate legislation unless he or she is effectively bought off.
The Republicans could stop this overnight. They just need a few Republican Senators to vote for the health care bill and replace the Democratic Senators who are holding up the Democratic Party. But the Republicans refuse to do anything for the American nation because they want to political advantage.
If the Democrats do not hang this action around the necks of the Republicans running for election in 2010 then they deserve to be voted out of office. Only the American people do not deserve the return of the Republican Party to Senate power.
In the meantime we get maybe half the health care bill that we could have if the Republicans had the interests of the American public in mind instead of the hope for return to power.
Friday, December 18, 2009
Health care reform: Maybe it'll look better in hindsight
I am very dissatisfied with the compromise piece of garbage the Senate has created and tried to call health care reform. I am also highly dissatisfied with the behavior of the White House and President Obama during the last six months. Howard Dean's recent announcement that the bill has gotten so bad that we should just kill it and come back for another try frankly resonates strongly with me.
Only, I recall the effort in 1993, and now 2009 is the next try. Sixteen years delay. That's a lot of insurance company unearned profits and quite a few Americans dead, sicker than they should be for much longer than they should be and many, many unnecessary bankruptcies.
I've got a list of some of the flaws in the Senate HCR bill as it was last night which I won't even bother to post. But the big one that I hear is the problem of the mandates demanding that people pay up to 17% of their annual income to private insurers for health insurance that will still stick them with annual and lifetime caps and shift a lot of the expense from the insurance to the sick people. But of the 47 million estimated uninsured, this bill still insured 31 million more.
It's a step. A big one. And while is has a lot of flaws, it moves the correct direction in a large jump and in a reasonable (if slow) period of time. This needs to be done regardless of how bad the bill is. Get this done now, and then fix what doesn't work, because this is still fixing a whole lot of what does not work today. Except for the piece of crap that was Part D of Medicare (the unfinanced drug bill with the doughnut hole to save money) there has been no major positive improvement in the health care system since the Medicare bill in 1965.
So for anyone who thinks that Howard Dean's call to kill the bill and start over, take a look at the history of Lincoln's Emancipation Proclamation as presented by TPM Reader PT.
This health care reform bill is massively significant for the nation. It can be moved towards right now, or it can be killed now, to someday in the far future be again resurrected - at massive cost to the nation. The really big flaws in the current bill and feeding the massive egos of Senators Nelson and Lieberman notwithstanding, it is still time to pass the damned bill they allow us. It will be fixed afterwards. It will have to be. But that will be much easier than this initial restructuring of the system.
Only, I recall the effort in 1993, and now 2009 is the next try. Sixteen years delay. That's a lot of insurance company unearned profits and quite a few Americans dead, sicker than they should be for much longer than they should be and many, many unnecessary bankruptcies.
I've got a list of some of the flaws in the Senate HCR bill as it was last night which I won't even bother to post. But the big one that I hear is the problem of the mandates demanding that people pay up to 17% of their annual income to private insurers for health insurance that will still stick them with annual and lifetime caps and shift a lot of the expense from the insurance to the sick people. But of the 47 million estimated uninsured, this bill still insured 31 million more.
It's a step. A big one. And while is has a lot of flaws, it moves the correct direction in a large jump and in a reasonable (if slow) period of time. This needs to be done regardless of how bad the bill is. Get this done now, and then fix what doesn't work, because this is still fixing a whole lot of what does not work today. Except for the piece of crap that was Part D of Medicare (the unfinanced drug bill with the doughnut hole to save money) there has been no major positive improvement in the health care system since the Medicare bill in 1965.
So for anyone who thinks that Howard Dean's call to kill the bill and start over, take a look at the history of Lincoln's Emancipation Proclamation as presented by TPM Reader PT.
This health care reform bill is massively significant for the nation. It can be moved towards right now, or it can be killed now, to someday in the far future be again resurrected - at massive cost to the nation. The really big flaws in the current bill and feeding the massive egos of Senators Nelson and Lieberman notwithstanding, it is still time to pass the damned bill they allow us. It will be fixed afterwards. It will have to be. But that will be much easier than this initial restructuring of the system.
Tuesday, December 15, 2009
Notes on the current stage of the Health Care Reform bill.
The political effort towards passing health care reform is approaching the climax. This is going to be a time we all look back at and ask "What happened?" Well, here are a few notes to try to catch a bit of the zeitgeist. A lot of stuff has actually been settled and everyone agrees on it. The questions remain about only a rather small number of things that are not settled. For several weeks the largest of those things was the fate of the public option, but it appears that Joe Lieberman's ego (and maybe his retirement plan) have settled that one for us.
From TPM Reader JM It looks like killing the public option in any form is more important to Joe Lieberman than is getting the HCR bill at all.
My question: Does the U.S. Senate create narcissists or just attract, hold and maintain them?
Why is it that the Republicans under Bush could pass what the wanted through Congress and the Democrats can't? TPM Reader JM also suggests a reason for this. The Republicans wanted only one thing - tax cuts and more tax cuts. As long as they all agreed on what they wanted, they could ram it through Congress. It's quite clear that the Democrats do not suffer from such a lack of thought and imagination.
Evan McMorris-Santoro reports that House Majority Leader Steny Hoyer says the House will accept a health care reform bill without the government-run insurance. I guess the House Democrats agree with me that what is left if the HCR bill is worth saving. What's left includes ending screening for preexisting conditions and subsidies to allow more Americans to buy coverage.
Brian Beutler reports that Obama is encouraging Senate Democrats to "get this done." Obama was speaking to a gathering of roughly 12 Democratic Senators and, according to Sen. Bob Casey (D-PA) was giving them the big picture as well as motivational advice. This was rather obviously intended to counter the tendency of individuals in the thick of the battle inside the Senate to fixate on one or two aspects of the bill, like the public option, and forget what the overall goal is.
Josh Marshall writes that the chorus of frustrated Democrats who complain that the Senate HCR bill has been so watered down as to be worse than useless is not matched by the attitudes of the hard core policy wonks who understand and closely follow health care reform. The hard core wonks are disappointed, but they still generally want to keep what is left rather than just throw the whole thing out and start over. Personally I agree that there remains a lot of improvement in the system that should not be abandoned in a fit of pique just because so many very important things (like effective cost containment) have been blocked. I think that if the "It's not enough! Throw everything out and start over!" crowd get their way, the will to get even this far will not be there for a decade or more and that cost is way to high. Throwing out what is left would also be politically disastrous for the Democratic Party, and the Republicans who would replace Democrats are NOT going to even address this set of problems in any realistic manner. Nor would they do anything else except steal from the government and cut taxes on the rich. No. I don't think much of the incompetents, hacks, thieves and religious bigots who make up the current Republican Party.
Steve Benen addresses the question - How is it that the Republicans under Bush could get legislation through Congress without a 60 vote minimum and for some reason the wimp Democrats can't?
AARP has announced that it supports the health care reform bill. They point out that it will
Kevin Drum thinks that what's left of the Senate Healthcare Bill is worth saving. He points out among other things that we still get community rating You have to be an in-depth insurance policy wonk to realize it, but that is really big and in my opinion is worth passing all by itself! But right now we can get it along with laws preventing insurance companies from refusing to provide insurance because of preexisting conditions and also ending the insurance company practice of cancelling the policies of those who get sick (Recissions.)
Here's the final paragraph of Kevin's article:
Addendum 11:35 pm
Well, well. Apparently there is a reason for Joe Lieberman to pull the plug on the Medicare buy-in even though he supported it himself three months ago. The Washington Post reports that before the Medicare buy-in was killed the influential hospital and physician lobbyists were furiously contacting Democratic Senators to get the plan killed. The details of the lobbying effort provided in the story are quite interesting and tell us why we are getting the Rube Goldberg legislation that is currently being discussed.
From TPM Reader JM It looks like killing the public option in any form is more important to Joe Lieberman than is getting the HCR bill at all.
My question: Does the U.S. Senate create narcissists or just attract, hold and maintain them?
Why is it that the Republicans under Bush could pass what the wanted through Congress and the Democrats can't? TPM Reader JM also suggests a reason for this. The Republicans wanted only one thing - tax cuts and more tax cuts. As long as they all agreed on what they wanted, they could ram it through Congress. It's quite clear that the Democrats do not suffer from such a lack of thought and imagination.
Evan McMorris-Santoro reports that House Majority Leader Steny Hoyer says the House will accept a health care reform bill without the government-run insurance. I guess the House Democrats agree with me that what is left if the HCR bill is worth saving. What's left includes ending screening for preexisting conditions and subsidies to allow more Americans to buy coverage.
Brian Beutler reports that Obama is encouraging Senate Democrats to "get this done." Obama was speaking to a gathering of roughly 12 Democratic Senators and, according to Sen. Bob Casey (D-PA) was giving them the big picture as well as motivational advice. This was rather obviously intended to counter the tendency of individuals in the thick of the battle inside the Senate to fixate on one or two aspects of the bill, like the public option, and forget what the overall goal is.
Josh Marshall writes that the chorus of frustrated Democrats who complain that the Senate HCR bill has been so watered down as to be worse than useless is not matched by the attitudes of the hard core policy wonks who understand and closely follow health care reform. The hard core wonks are disappointed, but they still generally want to keep what is left rather than just throw the whole thing out and start over. Personally I agree that there remains a lot of improvement in the system that should not be abandoned in a fit of pique just because so many very important things (like effective cost containment) have been blocked. I think that if the "It's not enough! Throw everything out and start over!" crowd get their way, the will to get even this far will not be there for a decade or more and that cost is way to high. Throwing out what is left would also be politically disastrous for the Democratic Party, and the Republicans who would replace Democrats are NOT going to even address this set of problems in any realistic manner. Nor would they do anything else except steal from the government and cut taxes on the rich. No. I don't think much of the incompetents, hacks, thieves and religious bigots who make up the current Republican Party.
Steve Benen addresses the question - How is it that the Republicans under Bush could get legislation through Congress without a 60 vote minimum and for some reason the wimp Democrats can't?
AARP has announced that it supports the health care reform bill. They point out that it will
- Give the uninsured and small businesses access to quality affordable plans
- Close the Medicare Part D coverage gap or “doughnut hole” by 2019
- Eliminate cost barriers to preventive care
- Reform Medicare's payment and delivery system to promote care coordination
- Reduce hospital infections and preventable readmissions
- Strengthen home and community-based care and assist individuals in saving to meet future long-term care needs
Kevin Drum thinks that what's left of the Senate Healthcare Bill is worth saving. He points out among other things that we still get community rating You have to be an in-depth insurance policy wonk to realize it, but that is really big and in my opinion is worth passing all by itself! But right now we can get it along with laws preventing insurance companies from refusing to provide insurance because of preexisting conditions and also ending the insurance company practice of cancelling the policies of those who get sick (Recissions.)
Here's the final paragraph of Kevin's article:
"Ten years ago this bill would have seemed a godsend. The fact that it doesn't now is a reflection of higher aspirations from the left, and that's great. It demonstrates a resurgence of liberalism that's long overdue. But this is still a huge achievement that will benefits tens of millions of people in very concrete ways and will do it without expanding our long-term deficit. Either with or without a public option, this is more than Bill Clinton ever did, more than Teddy Kennedy did, more than LBJ did, more than Truman did, and more than FDR did. There won't be many other times in our lives any of us will be able to say that. So pass the bill. The longer we wait, the worse it will get. Pass it now."I'm sure it comes as no surprise that I very much agree with Kevin on this.
Addendum 11:35 pm
Well, well. Apparently there is a reason for Joe Lieberman to pull the plug on the Medicare buy-in even though he supported it himself three months ago. The Washington Post reports that before the Medicare buy-in was killed the influential hospital and physician lobbyists were furiously contacting Democratic Senators to get the plan killed. The details of the lobbying effort provided in the story are quite interesting and tell us why we are getting the Rube Goldberg legislation that is currently being discussed.
Wednesday, December 02, 2009
The amazing Republican health care lie machine
About the health care reform plan in the Senate Steve Benen points out "Senate Republicans now have a detailed obstructionism plan, but not a detailed health care reform plan." Of course, all the Senators have a Cadillac health care plan from a selection of carefully vetted and government approved plans, provided to them free of charge and paid for by the very taxpayers they would deny similar benefits to. They also have as well as a fully staffed health clinic sitting in the basement of the capital.
And as long as I'm talking about Republican health care plan obstructionism, the Republicans have been mouthing off to the clueless media about the Medicare cuts that are supposed to help fund the HCR. What they will never say is that those Medicare payments are subsidies to private insurers so that they will offer slightly tweaked competing versions of Medicare, but those subsidies mostly go directly to the profit line of the insurance companies. AARP backs the Democrats in taking those unearned benefits away from the health insurers. Medicare recipients are better off in basic Medicare in the first place. "'...the legislation does not reduce any guaranteed Medicare benefits,' A. Barry Rand, the AARP's CEO, said in a letter to senators."
And as long as I'm talking about Republican health care plan obstructionism, the Republicans have been mouthing off to the clueless media about the Medicare cuts that are supposed to help fund the HCR. What they will never say is that those Medicare payments are subsidies to private insurers so that they will offer slightly tweaked competing versions of Medicare, but those subsidies mostly go directly to the profit line of the insurance companies. AARP backs the Democrats in taking those unearned benefits away from the health insurers. Medicare recipients are better off in basic Medicare in the first place. "'...the legislation does not reduce any guaranteed Medicare benefits,' A. Barry Rand, the AARP's CEO, said in a letter to senators."
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