The Biggest Battle In the Upcoming Health Care War

by: David Sirota

Wed Mar 04, 2009 at 17:46


A government sponsored, public health care plan is a must-have for any universal health care program to work. And Congressional Quarterly tells us today that that's exactly what Republicans aim to stop:

Republicans have already begun to warn that they would oppose a health care overhaul that includes a government-run insurance plan that would compete with private insurance, fearing it could lead to a single-payer system as people drop their private insurance or employers stop offering it. As a result, Democrats may be forced to drop the idea if they want significant Republican support for an overhaul.

"I have a concern that the Congress could water down health care reform so that they're just throwing money at the private insurance companies," Campaign for America's Future Roger Hickey said. "If that happens, then we won't achieve universal coverage and we certainly won't get health care costs under control."

Polls have long shown broad public support for some form of government-sponsored health care. The idea, then, that "Democrats may be forced to drop the idea" in a Congress with almost 60 Senate votes is preposterous - and unacceptable. But clearly, this will be the major battle at the center of the health care war.  

David Sirota :: The Biggest Battle In the Upcoming Health Care War

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So in other words they're afraid that business can't compete. (4.00 / 6)
I thought the free market was all about competition and the consumer choosing the best product. Guess it only is when it doesn't conflict with conservative ideology.

Yes (4.00 / 5)
and if you read Paul Krugman's "Conscience of a Liberal", that is exactly his rationale for this type of program.

Nobody is forced into the public system - but - the public system gets to compete with the private systems.  Krugman is convinced, as am I, that this is a battle that the government system can win and you get to Universal Health Care that way.

Republicans are being very explicit and unusually open about their ideology here:  they think that government must never be allowed to compete with private industry even if that results in a worse deal for consumers.

To win, Democrats need to engage this ideology head-on.  Our position needs to be that allowing government into the marketplace is justified if it leads to a better deal for consumers.  What are the private insurance companies afraid of?

By stepping out so boldly, Republicans have opened a door for us here.

It would be a bloody shame if this issue got shoveled down Harry Reid's 60-votes-needed-to-win meat-grinder and compromised down to worthless nothing.  THIS is the issue, above all others, that Republicans should be forced to filibuster over.

sTiVo's rule: Just because YOU "wouldn't put it past 'em" doesn't prove that THEY did it.


[ Parent ]
This may well be THE issue of the '10 midterms (4.00 / 5)
But Obama might not be able to pass the plan we need until after it, when we'll have an excellent chance to get over that 60 seat threshold in the senate. Until then, he might have to settle for smaller but still good measures that get us part of the way there, and both soften the political ground and whet the public's apetite for true universal health insurance, like expanding Medicare down to 55 and to all children, and raising the payroll cap to help fund it.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
We desperately need for some form of public plan... (4.00 / 3)
...even if it's extremely limited, 'cos it would be much easier to expand an existing plan then create a new "public option" benefit in the future...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
It's sort of like football (4.00 / 2)
You get to the end zone several yards at a time, every now and then pick up a dozen or two, and forgo Hail Mary passes until the very end--and we're clearly a ways away from that. I.e. determined, persistent and occasionally bold incrementalism, chipping away at the modern and quite broken private health insurance system, rather than trying to do it all at once. I don't think that the latter can be done, nor should be attempted, given the economic situation that we're in and all the other things that Obama needs to do. This is more like a full if not two term project, not something that can be done in a year or two.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
At the same time... (0.00 / 0)
...there is no guarantee that we will pick up more Senate seats in 2010...  We have to assume this is our best shot right now...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
Obama and Dems would really have to crater (0.00 / 0)
for us to not pick up 2-3 seats in '10. OH, PA, NH, NC, LA, FL, SD and even TX are all pickup opportunities, with few to none for Repubs.

Although I'd agree that if we can do it all now, we should. I just don't think that we can. Not the whole deal at least. But I hope that I'm wrong and you're right, as the lack of UHC is literally killing us.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton


[ Parent ]
loosing a seat in IL (0.00 / 0)
I think there is a real, though not overwhelming, chance we will loose a seat in IL.  Just sayin'.

[ Parent ]
Possible, but highly unlikely (0.00 / 0)
You really think Obama's going to let his old seat go to waste? Nuh uh. But we'll pick up net seats no matter what, and probably be at 62-65 in '11, which should ensure some really good legislation. And judges. If only Kennedy would retire, which I suspect that he'd like to do, as he's looking at pushing 80 before a Repub might be president again.

I'm also guessing that Obama might have SCOTUS in mind after he's president, to replace Nino or maybe Breyer. But that's way off now.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton


[ Parent ]
Exactly (4.00 / 3)
They're afraid that government would offer a superior product.

[ Parent ]
The free market only (4.00 / 1)
applies when the major corporations are not threatened.  It is only when we fight for the little guy the free market actually does exist at all.

Unbiased reviews of internet traffic providers.  http://www.webtrafficfast.blog...

[ Parent ]
Obama isn't right with this issue either (0.00 / 0)
I understand that advocates for single payer aren't allowed at the table in his discussions either.

Thanks (4.00 / 1)
For the update. It made my day!

[ Parent ]
Massive freakout (4.00 / 5)
Republicans and "centrist Democrats" are going ape-shit right now over the budget, even "moderate-conservative" Obama supporters like Andrew Sullivan, and this is a big part of why. They're scared and there's almost nothing they can do to stop it.

Conduct your own interview of Sarah Palin!

I actually think that part of this budget freakout (4.00 / 3)
is these people--and the media--reverting to knee-jerk default "wasteful spending" mode in which anything that isn't about funding a war or bailing out Wall St. is seen as wasteful. Grape disease research! Mormon crickets! Pigshit projects! Gangster tattoos! ONOEZ we are going broke in a handbasket! Never mind that it's only 1-2% of the whole budget and that 40% of these earmarks are GOP, they've railed against earmarks for years, it's implanted in the public consciousness as an EVIL BAD THING, and they're just doing what they always do when fake controversies arise. It's all completely predictable and not something to get too worked up over let alone cave in to. Let 'em waste their political capital on meaningless battles as we save ours for the real ones coming up.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
Baucus/Grassley (4.00 / 2)
This is actually frustrating: Baucus is going to co-write his version of the health care reform (which should feature prominently in the debate) with non-other than CHUCK GRASSLEY, who voted against SCHIP.

Baucus' plan has a public option component... n/t (4.00 / 3)


REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
Heh, Repubs and AHIP are afraid of some competition (4.00 / 5)
What happened to that "free market" of yours, fellas, and fair competition? As your new-found hero liked to say, if you can't stand the heat, get out of our doctor's office kitchen!

And yes, I realize that the government has an unfair advantage in that it can borrow heavily to fund affordable Medicare for all plans to the general public. But one, that money can and almost certainly will be paid back eventually through premiums, cost shares and payroll taxes--including lifting the payroll cap (and yes, I realize that this would be "wealth redistribution", like I care--if you want to be rich, you need to ante up in a civil society).

And two, does anyone really believe that if private insurers were able to offer similar plans at similar prices to the public and present a viable long-term business plan and be willing to be rigidly regulated and overseen, the government wouldn't be willing to lend similar amounts of money to them? And does anyone really believe that they can and would do this?

Ultimately, it's about what's best for the common good, not the "free market".

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton


If you are rich (0.00 / 0)
enough to be affected by the President's tax increases, congratulations.

Unbiased reviews of internet traffic providers.  http://www.webtrafficfast.blog...

[ Parent ]
Me? (0.00 / 0)
Not even close. I was speaking generally.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
There is no competing logic ... (4.00 / 1)
...as long as the facts can be made glaringly clear. With every other civilized system being much better and Much cheaper, only lying about them worked in the past.

Now Information has alternative sources. We just need to ram the facts down their throats.


we already know he doesn't need "significant Republican support" (4.00 / 1)
They made the mistake of letting that be clear in their opposition to the stimulus.  Three votes in the Senate is more than Obama needs.


New Jersey politics at Blue Jersey.

And is all he'll get... (0.00 / 0)
...regardless of the plan that comes out of congress...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
Agreed (4.00 / 7)
Any Democrat who opposes a government run health care plan (doesn't have to be Single Payer... I'm fine with a gov plan that competes with private insurance) has to be primary challenged.  And we need to let them know that will happen.  We go after these people like the wrath of God and take out as many as we can.      

This to me is the issue; (4.00 / 3)
lives are on the line.  We simply can not give people the choice of be rich or die.  If Democrats usurp the President on this and we lose healthcare, the last vote I ever cast for anything political may be for the President's reelection in 2012.  Simply put I have had it with Blanche Lincoln and her whoring for corporate money byopposing EFCA, fuck these moderates for worrying about spending on healthcare.  I got news for them; the horse is out of the barn, get over it.  You want to cut spending?  Get the fuck out of the Middle East( I disagree with President Obama on Afghanistan).  You want to increase revenues?  Create jobs.  Know what would help create jobs, "Bonehead" Ben Nelson?  If companies were relieved of the healthcare cost burden. I spent a good part of the day on the phone to these moderates' offices saying you screw me out of healthcare it is your political ass.  Just remember I told them, any good University has a good liberal professor or two we can primary them with.  And with it get an army of liberal college kids.  Hold them accountable.  

Unbiased reviews of internet traffic providers.  http://www.webtrafficfast.blog...

[ Parent ]
You have to wonder why some of them are even Dems (0.00 / 0)
Probably because everyone in their family was and in their states it was unthinkable to switch parties. But for all practical purposes, many of these Dems are 50's Republicans.

"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton

[ Parent ]
so basically they're afraid that government insurance (4.00 / 4)
will be superior to market insurance.

Well... (4.00 / 1)
I think THEY are afraid that the Insurance industry will stop writing them campaign checks.    

The Industry is afraid it will be superior.


[ Parent ]
This "public option" was always going to be... (4.00 / 3)
...the sacrificial lamb.  It was the bone they threw at liberals to accept the idea of insurance mandates, but it was always going to be the first thing thrown away...  You could tell that by the way that Hillary refused to talk about the public option in public (and the Baucus plan is very similar to the Hillary plan).

Obama's position on this is unknown...  I think if we press hard enough, though, we can get it in there.  They have said that they'd include this in the budget to only need 50 votes...

The battle is only beginning... so, let's stiffen up the sinews and release the dogs of war!

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


if they ask for mandates in exchange for the public option what do you do? (0.00 / 0)


[ Parent ]
I hate private insurance mandates... (0.00 / 0)
I think that the rest of the country does, too... and I'm not sure if the right wing SCOTUS of ours would even say it's constitutional... but, if there is a decent public option (and it has to be decent... not like medicaid... actually well funded...) then, yeah, I could get behind that easily.

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
You mean that forcing me to buy auto insurance (0.00 / 0)
is unconstitutional?  

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


[ Parent ]
Very different... (0.00 / 0)
One, those are state laws governed by state constitutions.

Two, driving is a privilege, not a right.  You can also choose not to drive if you want to opt out of a mandate.  You can't choose not to live to opt out of health insurance mandates.

It may be (and I say may, 'cos I don't know how a right wing court would rule on this) unconstitutional, since it's government forced property transfer from one individual to another without the due process of law.  It's not like medicare, where you pay a tax for a service.  This is much different and much more ominous.

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
Is health care a right? (0.00 / 0)
I mean, just because you and I think so, doesn't make it so, in an official sense.



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


[ Parent ]
There is civilisation... (0.00 / 1)
...and there is Republicanism.

A civilised society does not let its poor and helpless die unnecessarily. A Republican society objects to any plan that could rule that out.

It's really fucking simple - if you want private health insurance, you can pay for it. But if you don't think government should be able to offer a better deal, you should be taken down to the marshes and shot. Why negotiate with dickheads?

Forgotten Countries - a foreign policy-focused blog


Well... (0.00 / 0)
Unfortunately, shooting them isn't an option.    

[ Parent ]
Well, for one thing (0.00 / 0)
this is not a dictatorship and we don't take people to the marshes and shoot them.


[ Parent ]
Evo and Devo of public education and public health (4.00 / 2)
Along with all the other doomsday scenarios describing a gradual collapse of momentum to establish a national health service, it's also possible that Democrats will produce a minimal system of national healthcare that gradually gets worse.

Republicans won't just lie down and die if some form of national healthcare becomes a reality...

What they will inevitably do instead is cut away at the core of the program by highlighting anything that can be sold to the public as a "problem," or by selecting a few specific sub-programs to pillory as extravagances that only benefit a few patients, and so on.

Republicans didn't destroy public education in California by declaring war on it. Republicans were always totally in favor of quality education for everybody!

But in these hard times do we really need music education? In these hard times do we really need a library in every school? Why can't the kids just use public libraries?

And so on, and so on, until education in California turned into a joke with 50 kids in a high school classroom, and who are you to say that 50 is too many?

They will inevitably try to do exactly the same thing to any kind of national healthcare, large or small, and...

With the unlimited support of corporate media conglomerates, and the collapse of newspapers, and marginalization of the progressive blogosphere, which is already marginal enough...

The Republicans will probably win again.

This is a nation of tax-cutters right down to the bone, because every day in every way the media conglomerates are selling a picture of taxes as essentially wasteful, and almost entirely useless,  and without the disaster-Presidency of the obviously inept George W. Bush, and a war that turned into an obvious fiasco, it's hard to believe that Democrats could have won their majorities on both sides of Congress, and a whole big chunk of those majorities is Blue Dog tax-cutters anyway.

As long as the media are mainly controlled by right-wing corporations, (and what other kind of corporation is there?) we can look forward to perpetually renewed and eventually successful attacks on every government program that benefits the average citizen.

De-consolidating the media may not be the sexiest theme in Washington, but without it, every other element of the progressive agenda will eventually be suppressed, including public health and public education.



they're gonna spin Medicare for 55 and up as the public option -- (4.00 / 1)
that's it.

and it's not a battle -- Baucus and Kennedy and the Administration wrote this legislation and ruled out all the best, most needed and wanted, and cheapest options ages ago -- like Medicare for All.


"Since last fall, many of the leading figures in the nation's long-running health care debate have been meeting secretly in a Senate hearing room..." (0.00 / 0)
http://www.nytimes.com/2009/02...  -- Health Care Industry in Talks to Shape Policy

Since last fall, many of the leading figures in the nation's long-running health care debate have been meeting secretly in a Senate hearing room. Now, with the blessing of the Senate's leading proponent of universal health insurance, Edward M. Kennedy, they appear to be inching toward a consensus that could reshape the debate.

Many of the parties, from big insurance companies to lobbyists for consumers, doctors, hospitals and pharmaceutical companies, are embracing the idea that comprehensive health care legislation should include a requirement that every American carry insurance.

While not all industry groups are in complete agreement, there is enough of a consensus, according to people who have attended the meetings, that they have begun to tackle the next steps: how to enforce the requirement for everyone to have health insurance; how to make insurance affordable to the uninsured; and whether to require employers to help buy coverage for their employees.

The talks, which are taking place behind closed doors, are unusual. Lobbyists for a wide range of interest groups - some of which were involved in defeating national health legislation in 1993-4 - are meeting with the staff of Mr. Kennedy, Democrat of Massachusetts, in a search for common ground.
...
Kennedy aides summarized discussions of the stakeholders, known as the "workhorse group," in a recent memorandum obtained by The New York Times.

"While there was some diversity of views," it said, "the sense of the room is that an individual obligation to purchase insurance should be part of reform if that obligation is coupled with effective mechanisms to make coverage meaningful and affordable."

The ideas discussed include a proposal to penalize people who fail to comply with the "individual obligation" to have insurance.

"There seems to be a sense of the room that some form of tax penalty is an effective means to enforce such an obligation, though only on those for whom affordable coverage is available," said the memorandum, prepared by David C. Bowen, a neurobiologist who is director of the health staff at the Senate Committee on Health, Education, Labor and Pensions.
...
The 20 people who regularly attend the meetings on Capitol Hill include lobbyists for AARP, Aetna, the A.F.L.-C.I.O., the American Cancer Society, the American Medical Association, America's Health Insurance Plans, the Business Roundtable, Easter Seals, the National Federation of Independent Business, the Pharmaceutical Research and Manufacturers of America, and the United States Chamber of Commerce.
 ...



[ Parent ]
I'd be happy if we get medicare for 55 (0.00 / 0)
it'd be a good step

of course I'd prefer medicare for 0, but even 55 is a good first step


[ Parent ]
but if they want a mandate in exchange (0.00 / 0)
the 55 number should go lower?

[ Parent ]
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