Reconciliation (0.00 / 0)

there's a chance we won't be able to pass the public option through reconciliation if the Senate parliamentarian decides it should be stripped from the bill.

just FYI

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by: DTOzone @ Wed Aug 12, 2009 at 10:35:37 AM CDT

Who are the parliamentarians? (4.00 / 1)

And who makes them God? Can't Dems say this is a budget matter and leave it at that?

John McCain won't insure children

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by: magster @ Wed Aug 12, 2009 at 10:52:47 AM CDT

[ Parent ]

The person who decides is not the parliamentraian it is Biden. (4.00 / 3)

And if Biden says no then we all go home and make candies for selling at fairs. If Biden is opposed to this, we are toast for reform.

I have not heard anything however that Biden is anything but on board.

Change
"We must break up the banks and never again let them get so big that they distort our politics and take down the economy.

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by: HousesofProgress @ Wed Aug 12, 2009 at 11:08:04 AM CDT

[ Parent ]

"I did not know that" (4.00 / 1)

Well then, why the hell are we dicking around in the SFC kissing a WY Senator's ass?

John McCain won't insure children

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by: magster @ Wed Aug 12, 2009 at 11:28:45 AM CDT

[ Parent ]

Biden will act on advice (0.00 / 0)

from a parliamentarian on the floor. If you ever watch CSPAN, you were occasionally see the Speaker pro tempore sitting in the Speaker's chair in either the House or the VP's chair in the Senate, they will occasionally have someone whispering in their ear or handed them a piece of paper.

That person is the parliamentarian. The idea is to have someone there so that the person acting as presiding officer doesn't abuse the rules.

So it really doesn't matter what Biden thinks. Biden won't preside over the vote anyway, a Democratic Senator will.  

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by: DTOzone @ Wed Aug 12, 2009 at 15:09:22 PM CDT

[ Parent ]

The person making the descison will be Biden if necessary (0.00 / 0)

And Biden will be there if it looks like we need his vote. That makes the 50% +1 so much more important.

Thank you fpr the clarification. But I repeat, the advise may be given, but the decision will be made by the person in the chair, Biden if necessary. IANAL and this is merely what I understand. I will accept correction gladly, as always.

Change
"We must break up the banks and never again let them get so big that they distort our politics and take down the economy.

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by: HousesofProgress @ Wed Aug 12, 2009 at 16:27:33 PM CDT

[ Parent ]

It's rare (0.00 / 0)

a Senator goes against the advice of a parliamentarian and I would consider it unlikely many Senators would be willing to go against parliamentarian advice, meaning ignoring his/her advice could lead to a vote count of under 50 votes anyway. It could also lead to the legislation being challenged in courts. The danger here is that many Senators/Congressmen know parliamentary procedure very well and many will be able to tell if Biden (or whoever is presiding) is ignoring the parliamentarian.

There are times when the presiding officer has ignored the advice of the parliamentarian...I remember there was a case when Mike Ross did it as Speaker pro tempore back in like 2007 and Lynn Westmoreland called him out on it on the House floor, but I can't think of a situation where it's been on a major part of a major piece of legislation like this.

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by: DTOzone @ Wed Aug 12, 2009 at 16:53:47 PM CDT

[ Parent ]

CAFTA 2005 (0.00 / 0)

now that I think of it, the GOP ignored the parliamentarian during the CAFTA vote in 2005. They kept the vote open for 105 minutes longer than they were supposed to in order to twist arms to change votes. The parliamentarian had suggested they announce the results that it had been defeated, then filed a motion to reconsider, allowing them to vote again.

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by: DTOzone @ Wed Aug 12, 2009 at 17:01:36 PM CDT

[ Parent ]

It's the parliamentarian's job (0.00 / 0)

To advise on parliamentary procedure.  We're talking about a non-partisan legal expert here with a very narrow specialty.  Ignoring the parliamentarian on procedure is like a president overruling the advice of the Office of Legal Counsel that a particular law or policy is unconstitutional.  It's like a layman overruling a doctor's medical opinion.  It can and has been done and sometimes it's right to do so, but it's not something to be done lightly.

Things You Don't Talk About in Polite Company: Religion, Politics, the Occasional Intersection of Both

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by: Anthony de Jesus @ Wed Aug 12, 2009 at 12:41:00 PM CDT

[ Parent ]

Hmmm (4.00 / 1)

Seems unlikely to me that Senate Democrats are actually willing to go the reconciliation route.

I think the only plausible route to victory is that the Senate bill sucks hard, they (partially) fix it in conference, then the wanker caucus in the Senate is strong-armed into not joining the Republican filibuster.

Still, that's a pretty serious up-hill battle. The Baucus bill, at this point, actually seems worse than the status quo.

Conduct your own interview of Sarah Palin!

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by: fwiffo @ Wed Aug 12, 2009 at 11:40:45 AM CDT

[ Parent ]

Yes... (0.00 / 0)

The Baucus bill, at this point, actually seems worse than the status quo.

And that's why it's critical that the final Senate bill that passes looks more like the HELP bill and less like the Baucus-Conrad-Grassley POS. Hopefully if the House passes a stronger bill, we'll then have more of an upper hand in conference as the negotiators try to merge the final House bill and the final Senate bill into THE final bill.

Want to save marriage equality in Maine? Ask me how! ;-)

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by: Andrew Davey @ Wed Aug 12, 2009 at 13:29:52 PM CDT

[ Parent ]

I would add the need for one more Senate vote (0.00 / 0)

based on Sen. Kennedy's health.

John McCain won't insure children

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by: magster @ Wed Aug 12, 2009 at 10:53:35 AM CDT

If Kennedy is still breathing (4.00 / 4)

he will find a way to make it in for the vote. If he has to be wheeled into the Senate chamber, hooked up to a respirator, he will make it in for the vote. This will be the vote of his life. There's no way he's missing this, no matter how sick he is.

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by: Starving Student NYC @ Wed Aug 12, 2009 at 11:12:23 AM CDT

[ Parent ]

Fortunately, my Senator... (0.00 / 0)

Who just happens to be Mr. Majority Leader, finally replied to one of my emails earlier this month and said he wants a public option. However, Harry Reid has still been pretty vague on exactly what kind of public option he wants and how hard he is willing to fight for it.

Unfortunately, NONE of the Nevada Senators or Reps will be holding town halls to discuss this. I guess I'll just have to keep writing and calling to figure out where exactly my Congresscritters stand. (Well, I already know Johnny "Cheater" Ensign is a no-go. I just have to get Dina Titus to commit to a good HR 3200 & see if Harry's willing to provide more specifics.)

Want to save marriage equality in Maine? Ask me how! ;-)

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by: Andrew Davey @ Wed Aug 12, 2009 at 11:33:15 AM CDT

Are all the GOP senators not runnin for reelection on record opposed? (0.00 / 0)

If not, I wouldn't automatically write them off either.  

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by: tremayne @ Wed Aug 12, 2009 at 11:44:04 AM CDT

Kohl (4.00 / 1)

He's being typically and frustratingly noncommittal on this, but he's not a "conservadem": His ADA score averages 95 over the past four years.

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by: WI Dem @ Wed Aug 12, 2009 at 11:57:52 AM CDT

Reminds me... (4.00 / 1)

Of when I lived in California and had to deal with Dianne Feinstein. She sometimes leaves the fold (and especially angered me when she did so on matters like EFCA, FISA, Iraq AUMF, and the Bush tax cuts), but usually she's a fairly reliable Dem vote and quite solid on civil rights matters. However, she always frustrated me when she'd be noncommittal at first on what was supposed to be an easy sell to oppose an anti-choice bill or sponsor pro-LGBT civil rights legislation. She'd always come around in the end, but it was SO irritating to beg and beg until she'd finally do so.

I'm glad she finally came around on health care, and I hope your Senator Kohl does the same.

Want to save marriage equality in Maine? Ask me how! ;-)

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by: Andrew Davey @ Wed Aug 12, 2009 at 13:34:11 PM CDT

[ Parent ]

feinstein... (0.00 / 0)

arrggghhhh.  this is why i vote green.

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by: M.B.S.S. @ Wed Aug 12, 2009 at 13:45:03 PM CDT

[ Parent ]

you guys are gonna have to fight even harder. (0.00 / 0)

i've been sending emails that explicitly say that all we need is tort reform and tax cuts to solve this issue.  this is amurika.

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by: M.B.S.S. @ Wed Aug 12, 2009 at 12:34:05 PM CDT

Sen. Byrd almost certainly a yes for 60, no for 50 (0.00 / 0)

Sen. Byrd is a special case.

He's said little about the merits of the bill, but is unlikely to vote no. (He supported medicare, SCHIP, etc.) When it comes to a vote, I will be very surprised if he votes no.

Short of that, if there is something he objects to in the bill, it's possible he'd vote no but I'd be shocked if said no to personal requests from Sens. Kennedy, Rockefeller and President Obama to allow cloture.

The one thing Sen. Byrd will get upset about, though, is if the Senate tries to violate the spirit of the Byrd Rule and pass health care reform through budget reconciliation. That will pretty well guarantee that he's a "no" vote.

In other words, I think the best and worst cases are that Sen. Byrd is neither one of the first 50 "yes" votes required nor one of the 41 "no" votes that stop (or greatly complicate/compromise) the bill.

They call me Clem, Clem Guttata. Come visit wild, wonderful West Virginia Blue

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by: WVaBlue @ Wed Aug 12, 2009 at 13:14:20 PM CDT

What about Lugar? (0.00 / 0)

Dick Lugar, R-IN, is close with Obama and not mentioned here.  Why not?

His home state of Indiana is home to WellPoint, the largest health insurer in the country, which wants healthcare reform to pass if only to have a chance to add to it membership from the uninsured.  Indiana is also home to Eli Lilly, one of the biggest drug makers, which would likely be on board with whatever PhRMA negotiates, so they might end up in favor as well.

But at any rate, when I look at the 40 Republicans in the Senate, I put Lugar first in line as a potential yes vote, even before the Maine girls.

He doesn't have to run again until 2012, and when he ran in 2006, he was unopposed.  He practically defines "safe seat."  He might even retire at the end of this term.

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by: gas28man @ Wed Aug 12, 2009 at 13:48:53 PM CDT

In a perfect world (0.00 / 0)

where legislation was easier to pass, like in the 60's or 30's, Republicans like Lugar, Snowe, Collins, Voinovich and Murkowski would be on our side.

But we don't live in that world anymore, which is why this is so fucking hard.  

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by: DTOzone @ Wed Aug 12, 2009 at 15:11:35 PM CDT

[ Parent ]

Klobuchar (0.00 / 0)

I sent her e-mail asking for her positions. Verbatim response below. Other than negotiating with pharma for lower prices, she's pretty careful with her language.

Dear Constituent:

Thank you for contacting me about health care. Knowing your views is important to me as I work to ensure that Americans have affordable, high quality health care choices. I am committed to protecting what works and fixing what's broken in our health care system. It is getting harder and harder for Americans to pay for health care and that is why I am focused on making it more affordable.

Good health care is a very personal matter for me and my family. When my daughter was born she was very sick. But due to an insurance company rule, I was forced to leave the hospital just 24 hours after she was born. Along with other mothers, I went to the state legislature and got one of the first laws passed in the country guaranteeing new moms and their babies a 48-hour hospital stay. That experience was a crucial part of my decision to enter public service and fight for common sense health care solutions.

Americans rightfully expect to choose their own doctors and their own health plans. While protecting these basic principles we must reform the way our system delivers quality care, and in so doing reduce costs, provide safeguards so that people don't lose their coverage if they lose or change jobs, and promote wellness and prevention. According to the Congressional Budget Office, each year nearly $700 billion is spent on health care services in the United States without improving health outcomes. We must make the system cost-effective, proactive and stable.

I believe the following priorities should guide our health care discussions: First, we must reform our system to reward high-quality, efficient care. As it happens, doctors and hospitals in many regions of the country, including Minnesota, practice exactly this kind of medicine. However, Medicare does not currently reward them for it. The problem is that, despite periodic efforts at reform, Medicare pays for quantity not quality. States that have historically delivered low quality, inefficient care are still rewarded for wasteful practice, while efficient states such as Minnesota are punished. For example, according to a study by the Dartmouth Institute for Health Policy and Clinical Practice, if spending for chronically ill patients everywhere in the country mirrored the efficient level of spending in the Mayo Clinic's home region of Rochester, MN, Medicare could save $50 billion in taxpayer money over five years. To reign in costs, we need to have all states aiming for high-quality, cost-effective results like those we have achieved in Minnesota. That's why I've introduced bi-partisan legislation that would create a "value index" as part of the formula used to determine Medicare's reimbursement system. My bill would give physicians an incentive to maximize the quality of their care to patients and help to reduce costs.

One of the driving forces behind Minnesota's well-earned reputation for high quality health care is a team approach of coordinated, accountable care, including prevention, and measures to remove perverse financial incentives from patient care decision-making. The beauty of integrated care systems is that a patient's overall care is managed by a primary care physician in coordination with specialists, nurses and other care providers, as needed. To better reward and encourage this collaboration, we need to have better coordination of care and less incentive to bill Medicare purely by volume. Increasing the "bundling'' of services in Medicare's payment system has the potential to deliver savings and start encouraging quality, integrated care. The lesson of the high-quality, efficient states like Minnesota is that someone has to be responsible for the care of the patient from start to finish. Bundling will help ensure that practice is rewarded.

Second, America has a serious problem with health care inflation, runaway costs and wasteful spending. Ever-rising drug prices are among the leading causes. The "non-interference" clause in Medicare Part D expressly prohibits Medicare from negotiating directly with drug companies to obtain lower drug prices for seniors and lower costs for taxpayers. To reduce prescription costs, health care reform legislation should allow the government to negotiate the drug prices for Medicare Part D. I also support the re-importation of drugs from Canada to help slow sky-rocketing increases in pharmaceutical pricing.

I also believe we can reduce drug prices if we intensify scrutiny of the anti-competitive practices of drug companies. Last year, after hearing concerns from Minnesotans that a life-saving medication for premature infants had suddenly and dramatically increased in price, I requested the Federal Trade Commission investigate this case. As a result, Ovation Pharmaceutical -- the company with sole rights to the drug -- was charged with price-gouging and anti-competitive practices in violation of federal antitrust law. Greater competition in health care will go a long way to reducing costs.

Another way to incentivize more affordable health care in general is to better regulate insurance and create meaningful competition for health care services. I have long advocated for an option like the Federal Employee Health Benefits Program to give everyone access to the same health care benefits as members of Congress, and that is one of the competitive options under consideration, along with many others. I am especially focused on making sure that any reforms make it easier for small businesses and the self-employed to afford health care.

Third, I want to ensure that health care reform takes into account the needs of rural Americans. People in rural areas are less likely to have access to employer-provided health insurance, which means more people rely on the individual insurance market or public programs like Medical Assistance and, in Minnesota, MinnesotaCare. Rural Minnesotans also tend to be older and may have to travel long distances to visit their health care providers. Similarly, we must ensure that all Americans have access to primary care physicians. We are facing a shortage, especially in rural areas, and research suggests that improving access to primary care can reduce reliance on specialty care and improve the efficiency and quality of the health care we receive.

Finally, it is imperative that health care reform does not ignore the importance of elder care. Seniors want to be able to live independently and stay in their own homes as long as possible. Family support is essential to making that option available. However, elder care responsibilities can result in high out-of-pocket health and long-term care expenses for families that care for aging parents and relatives. I have sponsored three pieces of legislation, the AGE (Americans Giving care to Elders) Act, the Long-Term Care Affordability and Security Act, and the Long-Term Care Insurance Consumer Right-to-Know Act to assist families who care for aging family members and to improve understanding of long-term care insurance policies. The legislation is designed as a starting point to relieve the financial and other burdens faced by family caregivers.

Time and time again, the President has used Minnesota as an example of cost-effective, high-quality care because Minnesota is ahead of so many states when it comes to health care. Before supporting any specific health care plan, I want to make sure that it works for Minnesota-that is makes health care more affordable for families, individuals and small businesses in our state. Unless we make a long-term effort to reduce costs, we will not make health care more accessible and responsive to Americans. One of the most important parts of my job is listening to what the people of Minnesota have to say to me. I am here in our nation's capital to do the public's business and to serve the people of our state. With that in mind, I hope you will contact me again in the future about issues of concern to you.

Sincerely,

Amy Klobuchar
United States Senator

"It sounds wrong...
     ...but its right."

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by: SpitBall @ Wed Aug 12, 2009 at 13:50:26 PM CDT