Alright my Brothers And Sisters, the word has come down, and I doubt if many, if any of us are surprised. Once again the public option has been sacrificed, in the hopes of getting enough votes to pass Some kind of health care reform bill. And I can hear the sounds of outrage and betrayal from the ones out there who have more hope than sense. And I'm sure that there will be renewed calls to kill the bill etc. Well you know what? It's time to look to a new source for inspiration about how Progressives should proceed.
One of the few Republican ideas brought up at Thursday's Health Care Reform summit that seemed to be really popular with both parties was suggested by Senator Tom Coburn. The idea basically is to have people go and visit doctors, and try to get them to break Medicare rules. I presume that if they created such a program for Medicare they would try to see to it that it was applied to Medicaid as well. It has been compared to the practice that many fast food restaurants and retail clothing stores have been employing for a while now, commonly known as "Mystery Shopping". This is a horrible idea for several reasons, and the comparison to the Mystery Shopper, is frankly weak and ultimately inaccurate. More importantly I have a suggestion that contains none of the yuck factor of Under Cover Patients, and could potentially play a significant role in changing the way that doctors and patients relate to one another.
Allow me to make a confession. I was being naive thinking that I had any hope in hell of managing to come up with a coherent analysis of today's Health Care Reform summit in time to have it up any time today. In fact I'm not sure if it will be ready before next week. But never let it be said that I don't come through with at least a little something for my loyal readers.
Today's article comes from a comment that one of my readers at Daily Kos made in the comment section of my look at Obama's suggestions for Health Care Reform. He opined that he felt it was inappropriate for Doctors to ever have an investor interest in providing extra services. I said something to him in my reply, that the more I thought about it today seems more and more true.
I said, "What's more I'd like to see us return to a very old fashioned notion that there are simply some jobs you take expecting to not get rich. Medicine used to be one of those."
The conservative videographer who donned a pimp suit to embarrass the anti-poverty group ACORN was arrested in New Orleans, LA for allegedly conspiring to bug the office of Democratic Sen. Mary Landrieu.
It's not clear why Landrieu was targeted, but many suspect that she was singled out because she played a pivotal role in advancing health care reform.
Filmmaker James O'Keefe and three other men have been charged with been charged with entering federal property under false pretenses for the purpose of committing a felony, according to Justin Elliott of TPM Muckraker. At RH Reality Check, Rachel Larris notes that, if convicted, the four could face up to 10 years in prison.
Like chum in the conservative shark tank
Landrieu, a conservative Democrat, negotiated an extra $100 million in Medicaid funds for Louisiana in exchange for allowing the health care bill to come to the senate floor. Accepting health care for the poor in the interest of health reform was like chum in the conservative shark tank.
Rush Limbaugh called her the most expensive prostitute of all time. "She may be easy, but she's not cheap," crowed Glenn Beck. It got so bad that Democrats call on Sen. David Vitter (R-LA) was called upon to denounce the chorus of conservatives attacking his fellow Louisiana senator as a prostitute. (Correction: Vitter did not call Landrieu a prostitute.)
"This is Watergate meets YouTube," said Mother Jones Washington Bureau Chief
Health care reform in limbo
The arrests could not have come at a better time for the Democrats. Health care reform is in limbo as congressional leaders plan their next move after losing their filibuster-proof majority. The bugging scandal is deflecting attention from tense internal negotiations.
Brian Beutler of TPMDC reports that the House Democrats are converging on a strategy to get reform done: The House will pass the Senate bill and the Senate will fix it through budget reconciliation.
The Republican counter-strategy
While the Democrats agonize over what to do next, that senate Republicans are honing strategies to thwart any Democratic attempt to pass health care reform through budget reconciliation, as Dave Weigel reports in the Washington Independent. The reconciliation process allows both sides to vote on unlimited number of amendments. GOP leadership is hinting that if Dems take the reconciliation route, they will be forced to vote on every politically embarrassing amendment the opposition can dream up.
The stakes are high. In the American Prospect, Paul Starr reminds progressives that there's till a lot worth fighting for, even without a public option. For all its faults, the Senate bill would still cover 30 million uninsured Americans, expand Medicaid, end discrimination based on preexisting conditions, and set up exchanges designed to keep rising insurance premiums in check.
A memo for reform
Finally, our sources tell us that Steve Benen of the Washington Monthly is making quite a stir on Capitol Hill with his memo advising the House Democratic caucus on the need to forge ahead with health care reform. In 1994, conservative commentator William Kristol wrote a health care memo to Republicans that became the backbone of their anti-reform strategy, even up to the present day. Benen hopes his memo will be a useful counterweight for Democrats. Benen warns the Democrats that it's far riskier to fail than to pass reform that doesn't please everyone.
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We at Open Left are taking the New Year's weekend off. Golden Oldies will run in their place. Regularly Scheduled programming will resume on January 4th--Chris Bowers
A Paul Rosenberg Golden Oldie From Sat Jan 17, 2009. Original here.
Did you know that Obama has a mandate to slash Medicare and Medicaid? Probably not, I'd wager. But it seems that Obama believes he has such a mandate, according to an item at the Washington Posts' website ( h/t Digby ), that reads, in part:
Obama To Hold Fiscal Responsibility Summit
President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements, he said during an interview with Washington Post reporters and editors this afternoon.
"We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect....
Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said.
This is not just something he didn't run on. It is, in fact, the exact opposite of what he ran on-or at least appeared to, as can be seen from economist Dean Baker's op-ed in The Guardian, a few days earlier, in which he wrote:
Although Social Security is paid for long into the future, Medicare does face problems due to the explosion of private sector health care costs. The way to address Medicare's shortfall is to fix the private health care system, as President Obama has pledged to do.
The truth of Baker's statement is readily apparent from the following chart, which I presented in my diary from last April, "Medicare Myths--Don't Blame The Boomers". Our medical costs are far higher than other countries with a significantly larger share of older citizens:
Not only is Obama's "fiscal responsibility" kick at odds with his actual mandate and his own health care proposals, it reflects a deeply ideological worldview that--far from being bipartisan or "post-partisan"--is strongly opposed by solid majorities across the political spectrum. It is the very essence of Versailles insiderism.
During a press conference yesterday, President Obama voiced support for government-administered health insurance for all who need it (aka the "public option"), as a key component of healthcare reform. Though Obama stopped short of threatening to veto a bill that didn't contain such an option, he said that a public option is needed to enforce market discipline. If the system is going to reform, the health insurance companies can't just keep selling the same bad coverage with bigger public subsidies for their monopolies. Essentially, Obama isn't about to force taxpayers to buy overpriced insurance from private companies.
"The public plan, I think, is an important tool to discipline insurance companies," Obama said during yesterday's White House news conference. "I think there is going to be some healthy debate about the shape that this takes." He outlined three options: Get insurance through your employer, buy insurance on your own, or buy insurance from a marketplace where public and private insurance providers compete for business.
This week, the White House teamed up with healthcare industry giants for a two-day PR blitz on health reform. A coalition of industry leaders sent a letter to president Obama over the weekend, pledging to help contain healthcare costs. The signatories include PhRMA (drug makers), Advamed (device manufacturers), the AMA (doctors), the AHA (hospitals), AHIP (health insurance), and SEIU's Health Care project. The corporate signatories are the very same interest groups that have fought U.S. healthcare reform for generations. AHIP, America's Health Insurance Plans, helped torpedo the Clinton plan in the 1990s with the infamous "Harry and Louise" TV spots.
My earlier diary, "Obama's 'Mandate' To Slash Medicare, Medicaid & Social Security", focused attention on the fact that Obama's potential intention to slash Medicare, Medicaid and Social Security is wildly at odds with what his great mass of supporters wanted, and consciously voted for. Now I want to pivot, and focus attention on the small handful of folks who stand to gain exactly what they wanted from him, even though it went diametrically against the overwhelming majority of his supporters. It is, in large measure, the presence of such people in high levels of influence that substantially heightens my concern that Obama might actually take this sort of ill-advised action.
The classic definition of "chutzpah" is the kid who kills both of his parents and then begs for mercy because he is an orphan. The Wall Street crew are out to top this. After wrecking the economy with their convoluted finances, and tapping the Treasury for trillions in bailout bucks, they now want to cut Social Security and Medicare because we don't have the money.
That paragraph pretty much says it all, in terms of laying out the basic foundations of this fight. In fact, given how tenacious, how vicious, and how deeply entrenched these bastards are, we're going to be fighting them for a good long time, so you may want to print it out and tape it to you refrigerator. Or tattoo it onto your eyelids. Because they will do everything imaginable to make you forget that simple truth.
Did you know that Obama has a mandate to slash Medicare and Medicaid? Probably not, I'd wager. But it seems that Obama believes he has such a mandate, according to an item at the Washington Posts' website ( h/t Digby ), that reads, in part:
Obama To Hold Fiscal Responsibility Summit
President-elect Barack Obama will convene a "fiscal responsibility summit" in February designed to bring together a variety of voices on solving the long term problems with the economy and with a special focus on entitlements, he said during an interview with Washington Post reporters and editors this afternoon.
"We need to send a signal that we are serious," said Obama of the summit.
Those invited to attend will include Senate Budget Chairman Kent Conrad (N.D.), ranking minority member Judd Gregg (N.H.), the conservative Democratic Blue Dog coalition and a host of outside groups with ideas on the matter, said the president-elect....
Obama said that he has made clear to his advisers that some of the difficult choices--particularly in regards to entitlement programs like Social Security and Medicare - should be made on his watch. "We've kicked this can down the road and now we are at the end of the road," he said.
This is not just something he didn't run on. It is, in fact, the exact opposite of what he ran on-or at least appeared to, as can be seen from economist Dean Baker's op-ed in The Guardian, a few days earlier, in which he wrote:
Although Social Security is paid for long into the future, Medicare does face problems due to the explosion of private sector health care costs. The way to address Medicare's shortfall is to fix the private health care system, as President Obama has pledged to do.
The truth of Baker's statement is readily apparent from the following chart, which I presented in my diary from last April, "Medicare Myths--Don't Blame The Boomers". Our medical costs are far higher than other countries with a significantly larger share of older citizens:
Not only is Obama's "fiscal responsibility" kick at odds with his actual mandate and his own health care proposals, it reflects a deeply ideological worldview that--far from being bipartisan or "post-partisan"--is strongly opposed by solid majorities across the political spectrum. It is the very essence of Versailles insiderism.
Crossposted from Show Me Progress
You say you can't keep track of all the health care plans for the poor popping up in Missouri lately? You say that a news article about the pros and cons of them causes your eyes to cross? You ought to be ashamed to find yourself in the lower ... what? 98 percent? ... of the citizenry. That makes you--and me, until tonva brought me up to speed--dummies.
But now that she's educated me, I'm here to do the same for you. Succinctly. Before your eyes glaze over.
When it was just Medicaid, we dummies could grasp the situation. Essentially, the state paid 40 percent of medical bills for uninsured people below a given income, and the feds paid 60 percent. Then a couple of years ago, Republicans knocked more than 100,000 poor Missourians off the Medicaid rolls. Ah, but they promised to come up with something better than Medicaid in a year or so.
Illinois is strapped for cash to fund it's Medicaid program and other budget needs. Democratic Governor Rod Blagojevich has yet to finalize a budget with state lawmakers, and the state is operating on month-to-month extensions.
Local hospitals are concerned with low Medicaid reimbursement rates and late payments for the essential medical care they provided to residents:
"As we see the state roll into a new fiscal year with a month-to-month budget approach, the true issues of the state - health care, education, transportation, pensions - are not going to get addressed," said Billings, president and chief executive officer of Blessing Corporate Services, the parent company of Blessing Hospital in Quincy [Quincey Herald-Whig, 7/13/2007].
With limited Medicaid funding, it's crucial that the state get the most value for it's health care dollars. Illinois can bolster funding for needed medical care for it's citizens by leaving purely elective treatments out of the state's coverage. For example, since 2003, Medicaid programs in Montana, Utah, Florida, Maine, Louisiana, Idaho, and Minnesota have joined a group of 16 states in de-funding elective circumcisions, each saving their share of an estimated $70 Million dollars spent annually by taxpayers on the optional surgery, with the typical state able to save about $1 Million each year.
Such low-hanging fruit, however, is not easy to come by, since Medicaid already, by and large, does not cover purely elective treatments.
Sullivan [state Sen. John Sullivan, D-Rushville] agreed that nobody is happy with a one-month stopgap spending plan. He believes Medicaid providers are hurt by the lack of a full budget plan. He said care for established Medicaid patients won't be affected, but if the state continued to do one-month budgets, revenue would not keep up as new people become eligible.
Increased efficiency in the use of Medicaid funds alone, however, are unlikely to make up the shortfall.
"The solution will not come without new revenue streams," Billings said. "You have to look at efficiencies in state operations, and some sort of taxing policy that involves all levels of citizenry in Illinois - the private citizen, the business citizen, the legislative citizen. Everybody's going to have to contribute in a parity way."
