The Decisions That Must Be Made

by: Mike Lux

Mon Dec 14, 2009 at 11:45

The health care debate has officially arrived at its most critical juncture. Joe Lieberman’s “I will never compromise in any way whatsoever that could hurt Aetna” tantrum, which proves definitively once and for all that he needs to be stripped of his committee chairmanship and targeted for defeat by Democrats in 2012, has brought progressive groups, activists, and members of congress to the brink of a decision we fervently hoped we could avoid making. Absent some miracle of policy creativity or leg breaking persuasion, progressives are going to have to make a choice: do we give in on the public option but then use our leverage to demand the most progressive possible legislation on everything else in this bill, or do we say no to the whole bill, forcing Democrats to start over or give up entirely on passing the health bill? (Reconciliation in my mind is a form of starting over given how complicated it is procedurally, and given that the bill would probably have to broken up into at least two different pieces of legislation to pass it.)

First though, other than thoroughly denouncing Lieberman for the arrogant, insurance flack that he is, I think progressives should hold our powder and wait to see the next maneuver by Reid and the other Democrats. There is still a chance that a creative new approach on the policy side, combined with extreme pressure on Lieberman from the political side, might resolve this situation in some manner progressives could possibly live with. I think we should save our flamethrowers and grenades for a day or two to see what happens next, because I know Reid and others inside are continuing to work this thing internally. And with the news this weekend catching everyone by surprise (Lieberman had actually signed off on the compromise before he decided to oppose it), I honestly don’t think we have enough information to make a decision yet anyway. Given that we literally don’t know what bill Reid is intending to introduce yet, it’s hard to know whether to oppose it or support it.

So I’m holding my powder for the moment. Reid came through on putting the public option in the original merged bill, and he came through in delivering 60 votes for the motion to proceed with debate, so I’m willing to give him the benefit of the doubt for a while longer. But I go back to what I have written before, and what those of us at Openleft have demanded in our petition to Reid: one way or another, you have to deliver. Get it done, whatever it takes, Senator: breaking Lieberman’s legs (metaphorically, at least), reconciliation, the nuclear option, they all work for me. Whatever it takes. In terms of that ultimate decision I discussed at the beginning, while I’m not ready to make that decision, I know what my inclination is: stand up to Lieberman. One man’s tantrum should not determine the fate of the entire Democratic party’s policy decisions. While I have been more understanding than many progressives of why Reid doesn’t want to go the reconciliation route, for example, I think we should be ready to do it if that is what it comes down to. It would be problematic on many different levels, but whatever we have to do to get a good bill should be done. Whatever it takes.

Medicare + White Out = HealthCareReform?

by: larry91403

Fri Dec 04, 2009 at 20:03

There are roughly 300 people living in the United State today.  
There are roughly 45 million people on Medicare today.
There are roughly 200 million people with many types of other insurance today
There are roughly 45 million uninsured people.

I'd like to be clear from the very beginning that I believe that health care is a moral covenant and therefore should be a right not a privilege.  It should not be something required by law but provided by law.  There is only one way to ensure that all people in America have access to the care they need - a government system.

I know that there are many people who disagree with me for many reasons.  But if government was truly incompetent as they suggest then all the services they depend on would have ceased to exist long ago.  Last I checked my water still comes out of the tap, the trash gets picked up, the police keep pulling me over, and the military protect me pretty darn well!

So let's focus what government does well - Collect revenue, hire people, and deliver services.  I'd simply like to expand single payer health care to forty million more people.  Expand you say?  Yes...Medicare is single payer and I'd like to open it up to some additional patients.  

I recognize that it would be impossible for our toothless congresspersons to do what is easiest and simply take some whiteout and remove the "over 65" from the Medicare law.  Then we'd all have healthcare in about five minutes.  So I propose a compromise that provides coverage for all and pays off their sugar daddies at the same time!

Let's agree on some basic concepts:  1.  Everyone has the right to see a doctor or get emergency medical care.  2.  Everyone will need a specialists at some point.  3.  Some will want elective procedures.

1: GP/ER

I'm guessing that they'd rather not be in the primary care business anyway since that is the front lines.  They actually have to provide actual services and give them the opportunity to vie for your business!  

Medicare should be opened up to all citizens for general medical visits, prescriptions and ER visits free of charge.  This might seem like a costly change but preventative care is the silver bullet.  The leading reason why most people wind up with delimitating sickness is because they avoid initial doctors visits in the first place.  General Practitioner visits are low costs and are important to triage more severe illnesses.  This would also help prevent the spread of disease as people who are more likely to see a Doctor are more likely to get shots and get treated when they are sick.  Providing prescriptions and emergency room services will be a life line to millions.  It will also cut the cycle of medical bankruptcy and the problems that hospitals are having making ends meet.

2: Specialists

Insurance coverage could be purchased from a Health Insurance Exchange choosing from an addition to Medicare benefits or any one of several private alternatives to add a "Specialists Benefit".  This would be necessary to see any doctor who is not a primary care physician.  It would be important to make sure that all doctors (at least in a geographic region) to accept all insurance carriers by law.  Because this would be required, there would be sliding scale affordability credits issued for lower income levels.  I'm willing to be that this would be a very popular service since it would include things like Chiropractors, Physical Therapists, Mental Health, and Alternative Medicine.

3: Elective

Nearly 9 million people in the US had cosmetic surgery in 2003.  Private insurance companies should be able to provide additional coverage for elective procedures like liposuction or cosmetic surgery with a cap on spending and deductibles.  Who amongst us hasn't dreamt of a little nip and tuck but it wasn't covered under your insurance plan?  There could be different levels of coverage like there is in auto plans and a requirement that the patient be in the plan for a certain amount of time before using the benefit.

We have a moral crisis in this country.  Millions of Americans, insured or not, need reform to guarantee that when they need access to the best medical care possible they not only receive it, they won't mortgage their families future to do so.  We can no longer ask people to pull themselves up by their bootstraps.  We can no longer expect for-profit private insurance companies to adequately cover all Americans.  We also must acknowledge that our system of government is way too entrenched to  allow either liberal or conservative solutions to win out.  Therefore we must come together and take from both.

Aetna's actions today prove that there is no way to continue without reform.  Healthcare should no longer be "for profit".  I'm interested to hear your thoughts.