Getting higher on the page

by: Mike Lux

Wed Nov 11, 2009 at 11:45


I was at a retreat over the weekend with musicians and managers of musicians re how to best involve musicians in making social change, and the organizer of the event asked me to do a brief overview of what public policy advocacy actually means, so I drew some lines on four different pieces of posterboard to show people. Given that these simplistic, dumb-looking charts seemed to put advocacy into perspective for folks, and given the intensity of emotion we all feel about what is going on in the health care fight, I thought it would be worth reproducing them for a blog post.

Before I show them to you, I wanted to say a couple of things re this health care fight, and all other policy fights for that matter.

Details and charts in the extended entry.

Mike Lux :: Getting higher on the page

The cool thing about elections is that you can pick a side, and then you have one goal you are focused around that is simple and clear-cut: if your candidate wins, you are happy, and if they lose you are not (unless you are one of those folks who are into "moral victories" where you lose but feel good about the effort anyway. I am not one of those people). Legislative fights, especially on the big complicated messy issues like health care, are not like that at all. Progressive minded people who all share the same values, or at least many of them, can come to starkly different judgments on whether a bill is good or bad, worth passing or not, a victory or defeat. And beyond the policy compromises, the process itself is an utterly confusing mess, leading people to vastly different judgments about whether certain tactics were the right ones or not.

All of this complication leads to a lot of anger and a lot of angst. That's natural and it's okay- these issue debates are worth getting passionate about. For example, while I am more sympathetic to Pelosi when she had to make a choice re health care dying vs. having to accept the Stupak amendment in this round (knowing that she could very likely kill it in conference committee), I am very glad that grassroots people are so mad about this, because we have to kill this terrible amendment and the grassroots anger helps us do that. The legislative process is such a mess, and the tactical decisions you have to make are complicated, that getting angry at each other is natural and healthy.

What I hope can happen, though, is that we can stay long-term allies in the process. I am upset at Kucinich and Massa right now for voting no on the bill Saturday night, but I still admire them as strong progressives and am glad they are out there fighting for progressive policies. I strongly disagree with those of you who don't think this bill is good enough to move forward on, and know many of you think I'm wrong for continuing to support it, but I hope as progressives most of us can agree to disagree and not question each other's motives. People in movements throughout history have always had strong disagreements with each other over specific tactics, or what compromises to make when, but also kept working together for the common goal. All of us have to figure out whether given bills do more good than harm, are a step forward or not, and on the complicated bills, those are tough calls. For me, getting everyone covered, ending insurance abuses on pre-existing conditions/recissions/lifetime caps, and getting a public option off the ground that can be strengthened over time is worth the considerable imperfections in this bill. And understanding that if we lose on this bill, it will make the Democrats fearful of ever trying to take on health care or any big issue again for a long, long time, makes it even more important to get this done. If we get a decent bill, we can build on it over time, and we give some confidence to the Democrats that something big can get done.

Which brings me to these simple drawings I did. The basic idea is that there are two lines, one representing the best policy, the other representing what is possible to get done. In my first chart, the two lines are separate from each other, never intersecting at all, which is unfortunately what happens most of the time:

The next chart is what happens the next most often, which is that they intersect near the bottom of the page: maybe you get a little bit of good policy done, but you are disappointed by the result. When the lines intersect this low on the page, you have to really think through whether it's worth it to go forward, whether it might do more harm than good even.

My 3rd chart is where the two lines intersect solidly in the middle- you fall well short of ideal, but you still get some very good things done.

And my final chart, which happens very rarely, is when the two lines intersect towards the top. I am not aware of a single piece of legislation in the history of the country where the best policy imaginable, at the very top of the line, was passed, but every so often- Social Security, the Civil Rights and Voting Rights bills, Medicare, a few other times- you get close to the top of the page.

The goal of issue advocacy campaigns, of movements, is to get the intersection as close to the top as you possibly can.

On health care, my view is that we are somewhere in the middle of the page, and that the middle is worth doing. Your mileage may vary.


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One demographic fact (4.00 / 1)
This is the oldest America ever, and it gets older every day.

The old don't have a stake in the future, except through their progeny; on the whole the old cannot care more about the future than their progeny.

For example, the old cannot be rallied to prevent a 1 degree increase in global temperatures over 50 years, when they'll be dead in 20.

The old don't want disruptive change; they want to see as little of their stored wealth invested in the future (education, infrastructure, technology).

Medicare, Social Security, and a military/police state (that they control) are sacrosanct;

jobs for the young; well, let's just say they'll get to that... eventually.

The Constitution is a relic of the Agrarian age, it operates on timescales that no longer are relevant. When you staff the offices of the Constitutional government with geriatrics, you compound the problem of slowness.

If the voting age was limited to 40, Progressives would control both parties of a two-party system.


Limited view point (4.00 / 10)
Your stereotypical portrait of people over the age of 40 is wrong headed and will prevent you from building the coalitions required to achieve political progress.

I know people over 40 who are in fact as greedy and short sighted as you portray them, then again I know people under 40 who also fit that description.

But, I also know a great many parents and grand parents who care far more about the future that their kids and grand kids will have to survive in, then they care for their own well being.

Liberals, Progressive, Radicals come in all ages, races and income brackets, and to achieve any kind of social progress will require all of us coming together to fight for needed reforms. No one age bracket has a monopolly on wisdom, and no one age bracket will solve the massive problems we face.

I suggest the next grassroots effort that you are involved in, you go out of your way to connect with some person over 40 who are striving for the same cause you are, and talk to them about why they think things need to be changed. Your prospective will be different, but I think you will find there are things that you can learn from them, and things they can learn from you.

(Note: The above reply assumes that you are under 40, which I have no way knowing if that is true. Paul, if you are over 40 and you have this exceedingly cynical view of your own peers, you need to work more with young people. Perhaps you can regain some youthful idealism.)

 


[ Parent ]
I'm 66, (4.00 / 6)
and I say that you don't know what you're talking about. We left-wing geezers may be in a minority among our peers nationwide -- the consistent votes against school bonds would tend to indicate that we are -- but we do exist. I'm sure that if I'd posted something about kids these days, you'd be all over my ass, so please remember this gentle objection the next time you're tempted to speak in broad generalities.

Let me put it this way: I've been where you are, but you've never been where I am. You might want to give some thought to what you'll think of yourself when you do get here. (Trust me, barring an act of God you will get here, and sooner, much sooner, than you think.


[ Parent ]
this would be news to the group that i have dinner with (4.00 / 1)
every so often.

age range [other than me] = 75-85 years. they're about as forward-looking and liberal [and politically active] a group as you'll find anywhere.


[ Parent ]
Top of the page (4.00 / 2)
every so often- Social Security, the Civil Rights and Voting Rights bills, Medicare, a few other times- you get close to the top of the page.

I don't think any of these are good examples of top of the page.  Social Security originally left off farm workers and basically anyone who wasn't white and middle class.  Over time it got much better.

Civil Rights is a pretty good example, though it should be thought of as one of the final steps for Emancipation, a struggle lasting hundreds of year.  It was near perfect at the time, I suppose, but it also highlights how imperfect previous attempts to free blacks had been.

Medicare, of course, is a highly compromised version of single payer.  From that point of view, it isn't even close to perfect.

In other words, your central point is even more true than your post suggests.


One medium-sized quibble (4.00 / 3)
I agree with you about the imperfections of the original Social Security and the reasons for them, but take issue with your description of the beneficiaries as "middle class."  That's kind of an anachronistic projecting back.  While most of those people later became "middle class" in the current American usage, thanks in large part to Social Security and the rest of the New Deal, at the time, while they may have been in the broad middle of the income distribution, their standard of living and social status were pretty damn low.  Whether best described as "working class" or "lower middle class," today we would call them "poor," and even back then many thought of themselves/were thought of as such.  There's no better evidence than the extraordinarily bad physical shape many World War II recruits were in, with widespread evidence of malnutrition.

I'm white working/lower middle class in origin, and one of my first political lessons, learned at my grandparents' knee, is that "the Republicans are for the rich, the Democrats are for the poor," and there was no question where we fit.


[ Parent ]
I'll accept that (0.00 / 0)
Even when I wrote that it occurred to me that was the one part I wasn't 100% sure of.  

[ Parent ]
Benefits of the current bill (4.00 / 2)
My experience in talking to a fairly wide variety of people about the current bill is that the only major benefit that is universally understood is that the bill will end discrimination against those with pre-existing conditions and subsidize (and require) some people to buy insurance. Some people are aware that the bill also closes the "doughnut hole" in prescription drug coverage.

Can anyone here quickly name two otjher major benefits?  

There has been a ton of advertising on HC reform but most of it seems very simplistic and image driven and very short on information.

I would have voted for the bill but I find myself going closer to the Kucinich/Massa position every day -- increasingly concerned that the bill locks in the current private health insurance model and will make it harder for the system to evolve toward the Canadian or French model.  I'm also more pessimistic by the day about the cost impact of the current bill.  I'm close to the tipping point.


Here's some other things I do like (4.00 / 4)
1. There's a start to a public option to compete with insurers that will be national in scope, and will expand over time.

2. The no recission and no lifetime caps regulations are incredibly important.

3. Community rating is incredibly important, means older and sicker people, and women, won't face the same kinds of discrimination.

4. Creating the insurance exchange will provide lower prices and more choices for many people.

5. It does provide immediate help for the un-insured, even before the public option is in place.

6. It extends coverage for young people wanting to stay under their parents' coverage up to 27 years old.

7. Strengthens Medicare in several modest but important ways- no co-pays for prevention services, more help for low-income seniors, stops Medicare Advantage from screwing seniors.

8. Provides more disclosure of insurance rate increases.

9. Allows people to keep their COBRA until the exchange is in place.

10. Creates a new long term care insurance program.

11. Makes it easier for early retirees (55-64 years old) to get health care coverage.

12. Doubles the number of patients Community Health Services can treat.

13. More money for education/training of primary care providers.  


[ Parent ]
Thanks for the detailed response (4.00 / 2)
I'd love to see that list in some of the ads rather than the soft stuff involving smiling seniors and distinguished looking doctors.

[ Parent ]
On #1 (0.00 / 0)
Didn't we "start" a "public option" 40 years ago?  Or do you know something about Medicare's future that the D party isn't telling the rabble?

[ Parent ]
Private Insurance Does Not Have to Be Bad (0.00 / 0)
While I want S-CHIP, Medicare, and all the rest rolled into a single government health program, I realize (and would accept) that a strong public plan with private insurance also works. Not as well as what I want but it would work. Government health care would be for the elderly, kids, self-employed, people between jobs, and the unemployed. A strong public plan would constrain what private insurers could charge. But this public/private approach only works IF it preserves what we have with Medicare and S-CHIP and other programs as it extends health care to people private insurers do not care about. That's a big if.

To Mike's point, I'm unsure where on the page the House and Senate bills fall. The House bill appears to fall in the middle in that Medicare +5 could be added later and other parts of the public plan could be fixed later, subsidies could be increased, taxes on the wealthiest to pay for it all could be increased. The Senate bill appears to be near the bottom of the page. Especially if we get crappy state by state triggered co-ops. If that is not a sell out... Reid would deserve to be voted out of office for that stunt.

All that said, I do not trust private insurance companies based on personal experience and the experiences of friends and families. But I would settle for a government program that is built to restrain the worst excesses of private health insurance companies and pharmaceutical companies. Not a program that relies on the kindness of appointed bureaucrats in the Executive branch to define benefits and subsidies.


[ Parent ]
Medicare Part D (0.00 / 0)
Some people are aware that the bill also closes the "doughnut hole" in prescription drug coverage.

Will this bill also revise the drug benefit so that it's available through traditional government Medicare instead of through private plans or Medicare Advantage?

Having insurance companies act as the middleman is a huge flaw in Part D.


[ Parent ]
Although Helpful In Some Ways (4.00 / 6)
I'm more aware of the shortcomings of this simplistic model.

Mark raises questions about the appropriateness of the examples you chose.

I'd raise questions regarding how legislation either impedes or enables further progress.

With the current health care bill, this largely revolves around the degree to which it strengthens the existing status quo by funneling so much public money to the private insurers, making them all the more powerful for fighting against any future improvements.  This could be offset by a strong public option, and by allowing state-level single-payer programs--both of which presently are off the table.

Per Mark, above, Social Security was improvable over time because of broader progressive gains, and the advancement of the civil rights movement.  Medicare proved to be much less improvable in fact (though not in theory), as the parallel with it would have given us universal single payer by now--and in terms of that progression, at least, it represents a step backwards.



"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3


Power (0.00 / 0)
With the current health care bill, this largely revolves around the degree to which it strengthens the existing status quo by funneling so much public money to the private insurers, making them all the more powerful for fighting against any future improvements.

I don't think I agree with this.  For one, a large chunk of the bill is paid for by lowering payments for Medicare Advantage, which is already a huge insurance corporation giveaway.  This combined with even a weakened public option mitigates a large chunk of the concern.

More importantly, though, the exchanges themselves put the Federal Government directly in the role of regulating insurance.  I believe that framework will be easier to improve over time than anything we are likely to see for a long time.


[ Parent ]
I MIGHT Be Inclined To Agree (4.00 / 4)
If there were ANY other indications of seriousness with respect to regulatory seriousness in the Obama Administration or the Congressional Democrats.

Oh how I long for the Republican socialism of Dwight D. Eisenhower!

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3


[ Parent ]
I've almost given up on that (4.00 / 3)
My argument has nothing to do with this administration.  My expectations for health care in the next several years aren't much different than yours.  I guess I'm still hoping a second term will be better, but I'm not depending upon that.

But right now there isn't even a framework for federally regulating insurance.  Once that is in place, an entirely different sort of questions and government policies get debated.  Right now the "free market" is the response for everything.  That ends after this bill passes.  The exchange is regulated.  Minimum requirements are part of the bill, and so on.  That is a game changer.

Sure, the insurance corporations will win a lot of these battles, but they will lose some too.  The main point, though, is these are battles that aren't even being fought right now.  Today they win by default.


[ Parent ]
So, Regulation In Principle, Regardless of How Well Executed (4.00 / 2)
Okay.  But we know the GOP argument will be "regulation doesn't work."  And we also know it will leave a lot to be desired, so folks may well buy into that.  But even so, you're right.  It would be a different argument.

Don't get me wrong, I'm still basically in agreement with your position.  It's just that doubt level has been rising monotonically of late for me, leading me to take another long hard look at things.  

"You know what they say -- those of us who fail history... doomed to repeat it in summer school." -- Buffy The Vampire Slayer, Season 6, Episode 3


[ Parent ]
Kucinich and Massa are right... (0.00 / 0)
and you are wrong, and doubly so for slandering them as you did the other night.

Shame on you.


Thanks (4.00 / 5)
for your reasoned, nuanced reply.
Look, I know that people disagree on this, and that's fine with me. But I didn't slander them, I just said I thought they were wrong.
Shame on me? C'mon. We disagree, but there's no shame in either side.

[ Parent ]
Jane Hamsher- (0.00 / 0)
Today

According to Jim Clyburn's own count, the Stupak amendment only bought them 6-10 votes.

...

So they threw the biggest piece of red meat culture-war social conservatism issue at the ConservaDems they possibly could - and abortion means a heck of a lot more to the conservative base than something as new as a "public option."   It's been deeply ingrained for decades.  And they still only picked up 10 votes maximum. This is after PhRMA has spread so much money around the Democratic caucus that they've lured just about everybody over to the "pro" side they possibly could.

(Y)ou're talking about a group of people who have been screwed over, disrespected, spat upon, forced to vote against everything they believe in over and over and over again "for the good of the team," who have had to kneel down and get stomped on so their Blue Dog caucus breatheren can collect all the campaign cash and the district pork and the "wins" that will get them re-elected. On the war supplemental.  On Waxman-Markey.  And now on choice.

I imagine that list of progressives who will vote "no" on any bill that doesn't have a public option is somewhat larger and stronger after the Stupak debacle, because progressives who hail from strong Democratic districts once again look weak, ineffectual and unprincipled to their constituents after they voted for a bill that included an amendment that is certainly the worst attack on choice since before Roe v. Wade became law.  They're ready to take a stand.

The White House calculates that the "give" is on the House side, or they would have been putting pressure on the Senate "centrists" all along. They're not.  Rahm Emanuel's over-confidence that he can continually roll progressives in the House created the situation where Pelosi couldn't pass a bill without one in the first place.  He's gone to that well too many times. I don't think he gets another trip.

And until the White House and the Senate face that reality, we're looking at no health care legislation passing in this Congress.  Until Joe Lieberman and Ben Nelson start facing consequences for handing the party a huge legislative defeat for their recalcitrance, we're looking at a repeat of the Clinton failure of 1994.  And that, as many will recall, handed the House Democrats a 54 seat swing to the GOP.  But it won't be just a House phenomenon this time.

So I'm hardly the only one who thinks this is a huge sell out that you are cheerleading for.

Stop spreading pixie dust.  We aren't going to clap for Tinkerbell this time.


[ Parent ]
Well, this assumes (0.00 / 0)
that progressives in congress are actually going to take a stand this time. What reason do you have for thinking that they are?

[ Parent ]
Reminder (0.00 / 0)
Kucinich was anti-choice before he conveniently changed his position just before running for president the first time.

[ Parent ]
What's your point? (0.00 / 0)
He voted against Stupak.  Then he voted against the bill.  Just as he had said he would.
Also, that "just before running for president the first time" meme is a myth that Markos inflated, which has been oblivious to Kucinich's true evolution on this issue, which began years before 2003.

[ Parent ]
He did not (4.00 / 4)
Mike didn't slander anybody. I don't agree with him either, but I'm sure as hell glad he's around. With a few more like him in Congress -- say 10 in the Senate, and 40 or 50 in the House -- we might not be having this argument at all.

[ Parent ]
Once again (4.00 / 1)
great post Mike.  

John McCain: Beacuse lobbyists should have more power

I want to hear more (0.00 / 0)
I want to hear about this retreat, Mike! Who was involved? I've always walked a dual path in music and politics, occasionally making the two intersect (I used to work with Music for America) so it's always interesting to hear about other people making things happen in these worlds.

angle of "What's Possible" line (4.00 / 4)
I think a big part of the problem is that big money keeps the "What's Possible" line aligned too straight down.  We just had two good election cycles, filled with promises about the war and health care and clean energy--and then it turns out that none of what we might consider the best policy can even be considered to start with.  Worse, as the process drags along with our suddenly "amnesiac" elected officials, the "What's Possible" line keeps dropping straight down, almost parallel with your "Good Public Policy" line, until finally it weakly intersects far below where it seemed probable on election day, when we had just elected large majorities in both Houses of Congress.
When attacked, the amnesiacs say they have tough districts and now have to vote moderate, despite the fact that their constituents want to end the war, have a public option or even single payer, and want to fight global warming (all of which are true in most of their districts, especially among Dems).  What the amnesiacs really mean is that they have to appear "moderate" to corporate money.

honest disagreements vs ... the other (4.00 / 2)
I hope as progressives most of us can agree to disagree and not question each other's motives.

us as in you personally, and the people around here, yes, i think so, i'd hope so.

but when that gets difficult is when you suspect that you are being suckered. when people loudly claim to agree with you and then inevitably find some reason in the end why they just can't follow through, well, one becomes suspicious.

not everything worth doing is profitable. not everything profitable is worth doing.


I just can't get over (4.00 / 1)
how there's anyone who still thinks it's possible to "regulate" entrenched rackets.

Anyone who can look at the evidence of just the last ten years on Wall Street, let alone the rest of the corporatist onslaught, and still think regulation can ever restrain things like the insurance and drug rackets is simply impervious to evidence.

These rackets can only be destroyed completely. Nothing short of that will work.

Even if real regulations were enacted on paper, and regulators started out with full funding and the aggressive will to do their jobs (but this will clearly never happen under Obama, nor under any Republican, and almost certainly not under this version of the Democrats), they still face a  permanent war of attrition from a racket who will never for a moment let up on its efforts to gut, weaken, evade, or have the regulator restrained. It is rich and will always deploy however much money is necessary to achieve this.

Just look at one of the other posts right here on this page today (I forget the title) - the Dems are trying to roll back one of their own Bush-era regulatory achivements. Under these economic and political circumstances!

The best analogue for what's been happening in American business and government in recent years, and which phenomenon is accelerating, is the medieval Dance of Death - simply a deranged, debauched will to go hedonistically insane, since no one believes anything other than crime can or should be accomplished, and time is running out anyway so grab what you can. The health racket bailout bill is the latest example of that.

So to think that under these circumstances the paltry regulation in this vile bill will ever be enforced, will ever prevent skyrocketing costs, will ever provide real coverage for anyone who lacks it now, you'd have to believe these regulators will be a veritable combination of hero and saint.

None of them will be either.

http://attempter.wordpress.com


That's why I'm so sick of the anti-government philosphy of this country (4.00 / 2)
The philosophy that says that government can never do anything right, so that whenever it does do something it has to rely on some private, for-profit company as a middleman.

That's why we have this Rube Goldberg contraption of a health care bill that still entrusts private, for-profit companies to do the right thing and take care of the people's health.  Oh no but it'll be okay since the government will be watching them!

Instead of always relying on greedy and unreliable private companies to do the people's work, and "regulate" them and hope they'll behave, why don't we just have government directly do the job?


[ Parent ]
The problem with your graphs... (0.00 / 0)
...is that we never know what is "possible" until we have the fight, right?  What is "possible" is what we can negotiate--and that is the job of progressive activists, changing what is possible.  One of the most dis-spiriting factors in this whole process was the immediate rush by Dems to cut deals with PhARMA and AHIP, and limit the possible.  Say what you want against Dennis Kucinich and Eric Massa, they should be applauded for sticking to their progressive priniciples and using their time in Congress to fight for genuine healthcare reform, not massive

That said, I cannot really agree with your comparison of this bill to Social Security, Medicare, and the major civil rights legislation.  That comparison has floated around quite a bit lately, and to me it only seems to be setting up progressives for failure, as the American people will then expect us to live up to these gaudy promises we're making.  I think this bill is a much more mixed bag.  Rose Ann DeMoro, executive director of the national nurses' union, put it this way:

To be sure there are commendable provisions in the House bill that bear note. Among the most important are:

Expansion of Medicaid to millions of low income adults.

Reduction of the "doughnut hole" in the Medicare drug coverage law making drug costs more affordable for many seniors.

Increased federal funding for community health programs, such as home visits for nurses and social workers to low income families.

Additional regulation of the insurance industry, mostly targeted to people who are presently without coverage rather than those with existing health plans. Those include limits on insurers ability to drop sick enrollees or refuse to sell policies to people with prior health problems, extending the age that dependent children can be on their parents' plan, and repeal of the anti-trust exemption for insurers.

Extending the same health benefit tax benefits available to married couples to domestic partners.

A progressive tax to help pay the bill through a surcharge on wealthy earners and required contributions from large employers, in sharp contrast with the Senate proposal to tax health benefits on misnamed "Cadillac" plans, comprehensive coverage available to many union members, for example.

But the acclaim now flowing from some quarters would have been better deserved had these provisions been enacted on their own - not accompanied by the many shortcomings of the legislation. To cite a few:

Healthcare will remain unaffordable for many Americans. The bill does not do nearly enough to control skyrocketing insurance, pharmaceutical, and hospital costs. Indeed, by various estimates, with no effective limits on the insurance industry's price gouging, out-of-pocket costs for premiums, deductibles and other fees by some estimates with eat up from 15 to 19 percent of family incomes by several accounts.

No meaningful reform of the rampant insurance denials of medical treatment the insurers don't want to pay for.

Little assistance for individuals and families who presently have employer-sponsored health plans and face frequent erosion of their coverage and health security. No help for the healthcare cost-shifting from employers to employees.

Minimal expansion of consumer choice. The much debated public plan option will be available only to about 2 percent of people under age 65, mostly those now not covered who buy insurance on their own (it may or may not be expanded in 2015). Further, no additional plan options for those in the many markets dominated by one or two private plans, and no additional choice of doctor or hospital within existing plans.

The new limits on abortion extended to poor women.

Ultimately, the combination of the mandate to buy insurance, federal subsidies to low income families to purchase private plans, failure to adequately control insurance prices or crack down on the abuse of insurance denials make the House bill - and its Senate counterpart - look a lot like a massive bailout for the private insurance industry.

Don't be misled by the howling from insurance industry which has been spending some $1.4 million a day to steer the direction of legislation. They would have preferred the status quo, but will be more than happy to count the increased revenues coming their way.

As Rep. Dennis Kucinich said on the House floor, "we cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem."



National Nurses United (AFL-CIO) is America's RN union, representing 150,000+ nurses from all 50 states.

I do see... (0.00 / 0)
...that you actually contrasted this legislation with social security, medicare, and the civil rights legislation, rather than did a straight-up comparison....nonetheless, my point remains, that many progressives are selling this legislation like an un-alloyed victory, which really does us no good, especially once/if it gets watered down further.

National Nurses United (AFL-CIO) is America's RN union, representing 150,000+ nurses from all 50 states.

[ Parent ]
you need a third line (0.00 / 0)
something that measures cost, not necessarily in dollars, but in how much bad legislation was created as a trade-off to get 'what's possible'.

social security and medicare/medicaid weren't 'perfect' but at least the compromises to get 'what's possible' did not entail [for the most part] funneling large amounts of tax dollars to private corporations, nor were any of these programs designed to 'incentivize' people to choose to give their money [or the taxpayers' money] to private corporations.

and social security did not, for instance, set up a small pool of publicly-funded retirees with the intention of competing for the business of privately-funded retirees.

if taxpayer $$ only went to subsidize people who want to buy into the public option [not private insurance], and only to people who go into traditional [public] medicaid rather than the managed care [private] plans, you might have been able to call this good [but needs improvement] public policy.


Main problem with the graph (0.00 / 0)
is the lack of a goal, or a bottom-line for what is to be considered "good policy". What's to stop folks from trying to push the intersection to the lower end of the page? Nothing. That's why it's been happening from the start of this "debate" - how low will you go? A question that has yet to be answered.

Second problem is a lack of units and labels of the axes. How do you (or any of us) know the slope of those lines? Without any indication of what factors you are actually plotting on these graphs, how can anyone formulate a strategy to move the intersection upwards.

A pretty picture intended to justify a compromised bill and a poor strategy (I know YOU didn't design the strategy), but little substance.



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


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