Cancer was once diagnosed via prosopochiral ratio. Try it!
Wow, I almost made a fool of myself there.
My wife says the same thing about kids arms. Nice to hear some confirmation.
My college prof for human development said that was, in fact, a very effective way of determining school readiness, particularly in times and places where children's ages were difficult to accurately determine. At the time he had been working with Romanian orphans.
Should be: readiness to learn to read
How long do their arms have to be before it means they're ready to move out?
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...aaand Howard Dean says it's time to take the Senate bill behind the barn, put it out of its misery, and start over using reconciliation.
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I agree with him. A mandate without a public option, forcing people to buy expensive, shitty insurance from one of the least ethical industries in the United States is horrible policy and even worse politics. It's a recipe for electing Republican majorities and enriching the insurance companies so they can fight any future reforms even more effectively.
Maybe the bill could just go live on a farm, where it would have room to run around and play and be happy?
A mandate without a public option, forcing people to buy expensive, shitty insurance from one of the least ethical industries in the United States is horrible policy and even worse politics. It's a recipe for electing Republican majorities and enriching the insurance companies so they can fight any future reforms even more effectively.
It sure seems that way to me. I suppose it's mildly gratifying to have my longstanding opinion of Joe Lieberman so very very thoroughly vindicated, but somehow that doesn't make up for it.
Can we skip the part about forcing everyone to buy terrible insurance from monopolies, and just pass all the experimental cost-cutting and data-gathering measures that Atul Gawande wrote asbout this week?
Of course then they would have to take it through all the committees again, right?
(If they went to reconciliation.)
A mandate without a public option, forcing people to buy expensive, shitty insurance from one of the least ethical industries in the United States is horrible policy and even worse politics.
Except the public option as it's been discussed for the last ever, the Schumer "level playing field" public option without Wyden's free choice amendment, was crap. Basically, this whole process has been designed by Nelson and Lieberman to demoralize liberals and convince everyone to burn down the Senate and make Nancy Pelosi prime minister.
Maybe the bill could just go live on a farm
They didn't mention that option in the Schoolhouse Rock explanation, but I'd accept that.
demoralize liberals and convince everyone to burn down the Senate and make Nancy Pelosi prime minister.
This seems like more of an either/or, no? (Go option 2!)
Remember when it was going to take Obama getting shot for us to BURN SHIT DOWN? Boy, has that bar gotten lowered.
No more masturbating to Oral Roberts.
21 makes me sad that I don't believe in hell.
Well then, you can keep masturbating, togolosh.
24: There is a notorious mural on the side of a storefront church near my house that shows Jebus doing some laying on of hands, except that the person he's healing is kneeling directly in front of him. It's on Franklin Ave., but it seems that no one has seen fit to take a picture of it and post it on the web. Oh well.
http://www.flickr.com/photos/nadarinempls/1338684739/
bing translation tells me "Have you eaten" should be "do you like to eat"
But as long as we are into inappropriate religious graphics, here is a rather poorly chosen logo: http://logodesignerblog.com/wp-content/uploads/2009/04/image-209.jpg
30: Thank you! I am apparently inept at googling. But pretty good at oogling.
36: Google didn't work for me either, but Flickr's search did.
Yeah, I don't go on Flickr very often, so it doesn't always occur to me to check there.
It's a big mural too, 2/3 lifesize or so. And on a street where the odd exchange of currency for pleasure has been known to occur. Silly Xtians.
I'm streaming Vermont PR now. Dean's interview is supposed to air at 5:30.
I am streaming Vermont MS right now, straight down my gullet.
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Hey, did you guys hear that some Canadian writer had some trouble at the border?
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I think essear may know something about it.
16: Right. Basically, this bill is designed to move us toward being Switzerland or the Netherlands, there were people who wanted to make us Canada or England, and they latched on to the public option as a way to retain hope. You can also view it as a brilliant maneuver to draw fire away from the rest of the bill.
Can't believe the Dorgan drug reimportation amendment failed. Pharma is power-ful.
44. I can't depend on continental drift. Will Congress say that insurance companies cannot profit off of basic insurance (as in CH)? Will government set the rates?
What is going through now might move us toward any number of points in the future. It could even move us toward NHS. What we can say for sure is what it will do now. That may be enough. But it ain't Switzerland.
You people are just trying to get me banned from a second blog in one day.
Dave Johnson was just wonderful guesting at OL. All the Open Left people have taken my heart. There it is, somewhere on the sidebar.
Chris Bowers reaches new heights of snark and bitterness.
Everything over there is smart and emotionally moving today. That is why Emerson moved.
Klein? The best comment at Klein's was about him getting a "tingle in his third leg" at the awesomeness of Baucus and Dodd.
46: I was surprised to find myself hearing DaveJ's message when I was reading him a little while ago. I've heard a number of people declaring that we should ditch this whole thing, and I've resisted, but you know, a public mandate to purchase health insurance from a private company with no alternatives provided is deeply troublesome.
It's not clear to me any more what we're getting in return for this gift to the insurance companies. Consideration for those with preexisting conditions? Is that it?
Consideration for those with preexisting conditions? Is that it?
They snuck in a "reasonable" loophole, so we really aren't getting that. Or recission.
We are getting the subsidies for 50,000 people without healthcare. This is why it is so hard.
It is partly paid for with a half a trillion cut from Medicare. I am not sure how we will know if that causes less care for some 80 year old so she gets 5 less years of life. I guess we can watch the numbers.
None of it much matters to me, since I think the Republicans win in 2010 and 2012. Most of Obamacare will never get implemented.
the 50k number is wrong, that is what Ezra says will die if the bill doesn't pass.
I think Obama wants the bill to die to make change happen: only then will we be mad enough to get out in the streets and truly demand a chimp for us each.
I was not informed there would be chimps involved.
They hid that from you. You probably don't even realize how badly you need a chimp.
This country had a chimp for 8 years, it didn't work out well.
Chimps are pretty awful. Try a bonobo instead!
Mm, blah. Fucking Senate supermajority. Fucking Pharma. Etc. I honestly don't know what to do.
My best case scenario might be that the bill dies and while Republicans, even in my fantasies, escape the blame, at least Lieberman doesn't, and he gets tarred with killing what was already a dead bill, retiring ignominiously to his giant fortress made out of money.
54: some even demanded a chimp for us each during his reign.
57: In my best case scenario, Lieberman's giant retirement fortress is made out of poop.
Howard Dean may have the right idea. I really hadn't taken seriously the idea of ditching the whole thing -- the thing as it currently exists -- until just today.
Unfortunately Lieberman has entered your fantasy and turned the poop back into money.
For what it's worth, I can't put it all on Lieberman. The 55+ Medicare buy-in wasn't exactly a cure-all, and he's not single-handedly responsible for killing the public option. This went awry a while ago.
If there were a way of ditching the mandate without everything else collapsing, I'd favor that. I think the mandate is really be best leverage available against the insurance industry. Plus, its both immoral, politically stupid, to require people to buy shitty private insurance without offering the opportunity of purchasing a better, public plan.
I don't see how you get a whole lot by doing reconciliation at this point. A weak public option is probably the best you can hope for that way, and in return you're guaranteed a lot of uncertainty and delay and another stretch of time like last August when reform opponents can make a lot of noise and scare people.
It is partly paid for with a half a trillion cut from Medicare. I am not sure how we will know if that causes less care for some 80 year old so she gets 5 less years of life. I guess we can watch the numbers.
This is a lie, McManus - they're cuts to Medicare Advantage, which is an actual giveaway to insurance companies (as 86 cents on the dollar flows to insurance companies. But hey, tomato, tomahto, right? Go teabag yourself.
42:
Hey, did you guys hear that some Canadian writer had some trouble at the border?
http://www.boingboing.net/2009/12/11/dr-peter-watts-canad.html
66: Man, the fallout from essear's evildoing just keeps coming.
I think what we're learning from this Watts thing is that there's no longer anyone who reads all the threads here.
In addition to essear's perfidy, of course. We learned that too.
65:First link is bullshit, but does give a useful number, 186 billion for MA. 300 billion is in "efficiencies"
Try reading the comments to the 2nd link at Klein's for a better understanding of Medical Advantage. 86% overhead and profit is absurd.
You are misinterpreting that 14% number. It does not mean that 14% of the additional payments goes to seniors, basically all of it does. What the 14% means is that under the assumptions in that study seniors would only be willing to spend 14 cents of their own money for those additional benefits that MA pays a dollar for. What this illustrates is that third party payment shields people from the true cost of something which in turn increases the cost of that good. The 86% is not going to profit or other costs, it is going to overpayment for those additional benefits. To correct this we ought to be moving towards less, not more, shielding people from the true cost of providing care. More cost sharing, higher deductibles, no first dollar benefits.
And this is even unclear. But Ezra was hopeless in the OP.
According to our work, the increase in benefits from [Medicare Advantage] plans since 2003 is valued by beneficiaries at 14 cents per federal dollar spent on them. Then I said the other 86 cents in part pays for the cost of those benefits. Some people have claimed this is a contradiction. It is not.
The 14 cents is consumer surplus.... There are two interpretations that may help:
- Beneficiaries would be no worse off receiving the 14 cents in cash instead of the extra MA benefits.
- Beneficiaries would be willing to spend only 14 cents for the extra MA benefits they receive. (In both cases "extra" here means beyond those provided in 2003.)
Meanwhile it really does cost the government $1. That other 86 cents is not a benefit, in the consumer surplus sense.
I'd modify to this: I think what we're learning from this Watts thing is that there's no longer anyone a lower percentage of regulars who reads all the threads here than in the past. I certainly read something very close to every thread, and my social life reflects that fact.
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Just found out that there's now a Google Chrome Beta for MacOS. (Apparently out for a week now.) It's not clear to me that there's anything to make it preferable to Firefox, but it's kind of nifty nonetheless.
I leave it as an exercise to bob to explain how this comment indicates that I think people who can't afford health insurance should suffer and die with no relief.
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72: Fair enough. I certainly don't read all the threads, so I'm in no position to judge.
73: I've been playing with it for the week it's been out, a nd I still can't quite figure out the appeal. Then again, I'm a notorious tech moron, so my opinion probably isn't worth a damn.
All the threads? Oh god, I have a kid who can't reach his arm over his head yet. Whatever essear's done will have to wait 'til I can read the fucking archives.
Beneficiaries would be willing to spend only 14 cents for the extra MA benefits they receive.
C'mon, snarkout, what does this even mean? "If you had to fill the Med D "donut hole" with your own money, and weren't sure about your drug costs, how much would you spend?"
This is like asking a healthy 20 year old how much he would be willing to spend on insurance. Answer:not much. And then using that answer to determine how much insurance that 20-yr-old needs. Answer not much.
76: I, on the other hand, have a girlfriend who moved far away, and have been feeling meh about going out lately (Cf. last night: great Sharon Jones show in town, plus numerous other shows in town, and I just punted).
C'mon, snarkout, what does this even mean?
It means that the Medicare Advantage plans are being overpaid -- something like a 15% premium over the cost of simply expanding Medicare -- and then, because they're hugely profitable customers, getting a lot of goodies they don't particularly need -- free gym memberships! free Band-Aids! -- to entice them to join up.
"We do the full workout, treadmill, the works," Powers boasted. "And it's all free. We were paying $600 a year for our gym membership before."
The plans are hugely more expensive than traditional Medicare, "about $1,450 per beneficiary per year since 2005, compared to $147 under traditional Medicare". (Note that I'm not saying -- that nobody is saying -- that's $1300 profit.)
But the important point is that the vast majority of MA money does go to providers. It may drive up the price of Celebrex. I think this is more a problem of the "donut hole" and other weaknesses in Medicare on covering out-of-pocket expenses and co-pays in rural areas than any scam.
The Medicare Advantage plans, if properly regulated, fill a important niche for people with moderate incomes, particularly in rural areas. Also, these plans will by the beginning of 2011 become almost exclusively network type plans, as private-fee-for-service plans are discontinued. By 2011,there will be only a handful of PFFS plans remaining (all in rural areas), which is a boon for taxpayers and patients alike. The remaining network style plans (HMO, HMO w/POS, PPO) arguably provide better care than other options, since they are more likely to require coordination and "medical home" types of services. A large study in Health Affairs last year indicated that, based on their treatments of critically ill patients, these types of Advantage plans often outperform traditional indemnity coverage -- probably because of the coordination of care aspect. These plans should compete on a level-playing field, though, without subsidies. In 2010, the avg. subsidy will be reduced by about 4.5%, and, unless Congress intervenes, these subsidies will likely disappear within three years).
I keep telling y'all, Ezra can be no more trusted than anybody else who works for Fred Hiatt.
79:I suspect this will get soon in deep wonky waters about the relative costs of urban versus rural health care due to concentration and network effects, Montana is not Manhattan, and will have different cost structures.
But let's stop.
great Sharon Jones show in town
Every time I hear a Sharon Jones song, I think "wow, this is great! I should listen to more of this." But somehow I haven't even picked up any of her albums yet. I should do that.
83: She is great, and so is the live show. Go if she puts on a show near you.
As you say, we're going down the rabbit hole here, Bob, but:
The Medicare Advantage plans, if properly regulated, fill a important niche for people with moderate incomes, particularly in rural areas.... In 2010, the avg. subsidy will be reduced by about 4.5%, and, unless Congress intervenes, these subsidies will likely disappear within three years.
What this leads to is the idea that Congress shouldn't be trusted to regulate the insurance industry but that, if properly regulated, Medicare Advantage is a fine idea. And further, stopping Congress from cutting some fat from Medicare Advantage to do things like allow more people onto Medicaid will show that Congress can be trusted to cut fat from Medicare Advantage.
My take on this is that this plan is something of a shitburger, and you and Emerson were much more right than I was about the amount of good that would be excised and bad that would be ladled back in. But killing this bill is going to demonstrate that there will never be serious expansion of the social safety net -- even if you don't think that's what this bill is -- to anyone but old people. I can see Wyden's Free Choice Act or Medicare buy-in building on the framework of this bill; I can't see "kill it and start over" or "ram it through under reconcilliation without the exchanges or regulation" working, and what it'll demonstrate is that sweeping progressive bills can't pass even in a shitty, watered-down form. The Senate will officially be good for nothing other than tax cuts, prescription drug plans for senior citizens, and bloviating about starting wars. Maybe it already is.
I love you with the fire of a thousand suns, snarkout.
and you and Emerson were much more right
Who's Emerson?
I realize this was a long time ago, but further to 33:
Of course he does; those birds are hot!
73: I don't know about on a Mac, but on Windows, the advantage of Chrome over Firefox, is that when you open a new tab, it opens right next to the tab you were working on, rather than opening all the way at the far end of you many open tabs. Plus, Chrome doesn't have the stupid broken "Awesome Bar" that Firefox has.
People are underestimating how much is in this bill. The exchanges and regulations create a framework to turn insurers into essentially regulated public utilities. But it doesn't happen until 2013/2014, a lot can happen between now and then. It doesn't take a lot of changes to shoot this thing full of holes.
It doesn't take a lot of changes to shoot this thing full of holes.
In a good way or a bad way? Serious question.
I've gotten used to the awesome bar and now I like it. I resisted at first, but it battered me into submission.
The awesome bar is the address bar? I can't say I really notice it, or use it, much; it's pretty unobtrusive. Though I'm always a little worried I'll be doing something at work and someone will be staring at my laptop screen when I type something that makes "porn" or "unfogged" pop up in some autocomplete option.
96: Lots of people applying to the University of North Florida in your neck of the woods?
94: in a bad way. The bill provides multiple levers to both mandate the quality of coverage insurers offer and control their profit margins. But it's not hard to disable those levers with a couple of legal changes plus insurer-friendly regulators in charge.
This is a disappointing bill in a lot of ways, but it's still a quite tangible advance. And I don't quite understand the howls of astonishment and outrage -- it's pretty much exactly the framework described in Hilary and Obama's debates in the campaign. They agreed on 90 percent of it then.
92: Get the firefox add-on "tabs open relative"
you can make new tabs open wherever you want.
Though i like chrome, the real advantage is that you can use different thread priority, so if one thing is slow you can still do other things .
As far as i can tell, everyone should be happy. Lieberman gets to stick it to the grassroots, which is what he is into. The dirty hippes, like Bowers/ermson/taibatti, get to complain about Obama selling them out, really is manchurian Goldman, how they aren't being listened to, and generally get off on thier persecution complex. obama gets to look moderate. meanwhile, the shitty 'public option' gets dumped, which is good since any compromise version after about september was going to be no better than 'private' health insurance, and worse some, like kaiser. even if it wasn't a dumping ground for bad risk patients, it would be fodder for 'horror' stories about someone getting denied care (nevermind it would be expensive unproven junk) and thus made government services look bad. and medicare for 50 somethings can be added just as easily next year as this.
98: The bill provides multiple levers to both mandate the quality of coverage insurers offer and control their profit margins. But it's not hard to disable those levers with a couple of legal changes plus insurer-friendly regulators in charge.
Exactly. The R's will get in, destroy the regulations while keeping the mandates. Free money for insurers! All the tightly-designed, wonk-friendly, ultra-complicated mechanisms in the world don't work when the insurers can just buy off some senators. That's why you don't create ultra-complicated mechanisms, until you have a rough working mechanism. Not if you're doing engineering.
This is a disappointing bill in a lot of ways, but it's still a quite tangible advance.
Well, it's an advance to somewhere. I don't think I want to go in that direction.
And I don't quite understand the howls of astonishment and outrage -- it's pretty much exactly the framework described in Hilary and Obama's debates in the campaign. They agreed on 90 percent of it then.
I didn't pay any attention, because I didn't think they could pass such thing in functional order (just so) and I didn't think anyone would be stupid enough to try to implement such a mechanism in the first place. Using the Congress of the United States, mind.
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AND THEN HE SCOLDED THEM. It is their fault that they don't get ahead. It is their fault because they tolerate drug dealers and unwed mothers in their midst instead of shunning and ostracizing. He slammed rap music for the violence and misogyny of the lyrics. "A new culture is growing on our community like a cancer." Was he referring to gangs? Hip hop culture? He didn't specify.
"We should not treat as leaders those whose only accomplishment is success in entertainment or sports." He exhorted the congregants to treat teachers, clergy and the elders as leaders because they "bring infinitely more value to our lives than someone with a good jump shot."Great. Our Attorney General is the black Ed Meese.
Lessee. A Republican at DoD. The black Ed Meese at DoJ. Reappointed a Republican to run the Federal Reserve. A Republican at Treasury. Stimulus full of tax cuts. Larry Summers running the econ team. Committed even more troops to both of our current wars. Pushing for even more state surveillance powers. About to give the insurance companies a free cartelization & monopoly & back rub. I guess the only thing left to do is to sack Hillary and replace her with Leiberman.
This just keeps getting better! (What? This is pure black comedy gold!) Last time this happened... hrmm. Well, either the Dixiecrat racists of Al Smith became (after four years) the (racist) New Deal Democrats of FDR. OR the anti-racist Northern Republicans of Nixon became (after eight years) the pro-racist Southern Republicans of... Nixon.
Which means Obama is either Herbert Hoover or Hubert Humphrey. Or maybe just Humphrey Hoover. Humphrey Milhous Hoover. Yeah!
Sorry. The whole black Ed Meese thing kind of got to me.
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max
[''Whom the gods wish to destroy, they first drive mad.'']
I actually kind of hate it when tabs don't open at the far end of the list. I tend to open a lot and look at them later instead of right after I open each and I find it easier to find them. If I need tabs next to each other, I drag them that way.
That said, IE 8 does some tab grouping stuff too. I might find it useful if I ever did much in IE 8 except update windows.
Also, can't you just change the settings for the location bar in the privacy options if you don't want the auto-complete/dropdown searching history/bookmarks/anything? Or is the mac version not able to do that?
Does anybody know of a good article on Lieberman's rise and NR's campaign to boot Weicker? The last time I groaned about Lieberman, he said, "Where did we get this guy?" And all that I could say was that he'd gone to Yale law school, I thought that maybe he'd been AG in Connecticut and that William F. Buckley and National Review wanted to get rid of a liberal Republican.
Has somebody like Charlie Pierce written anything?
A former partner of mine was Joe's housemate )or next door neighbor) back in the mists of time. He worked for Humphrey, and Lieberman for Ribicoff, I think. They've stayed friends over the years, and my colleague and I had to avoid conversation during the 2006 election. We would now as well, if I hadn't left town.
I tend to open a lot and look at them later instead of right after I open each and I find it easier to find them.
This. Though I sometimes find them days later and wonder things such as, "Why did I open a ten-year-old NYT Magazine article about potatoes? Oh, right, that food thread."
Why did I open a ten-year-old NYT Magazine article about potatoes?
SHHHHHHHHHHH
101
and medicare for 50 somethings can be added just as easily next year as this.
A problem with what you're saying seems so obvious to me that I'm surprised you would leave it unaddressed, and I'm worried it is addressed in some other comment that I stupidly missed, but since I can't see it I just have to ask: what makes you think this is true, especially in an election year that will follow a very tepid result from the current bill; even if true, what makes you think politicians could do so, given that it apparently hasn't been that easy this year; and even if they could and would, don't your same objections to "the shitty 'public option'" apply equally well to medicare for 50-somethings, in which case why should it even be welcomed?
I'm scared of using Chrome because my gmail account is my Heebie-geebie, and I'm worried that identity would pop up unexpectedly around real-life people.
Like when a tangible friend sends my yahoo account a picasa photos link, it'll say "Heebie-geebie is viewing these photos" and I'll freak out.
Anyone have insight?
I'm mostly with 85. On the shittiness of the bill as it stands: this is one of those maddening policy issues where I know I'm over my head. A mandate sounds awful to me too, for all the reasons people have said in this thread. OTOH, I think (and the possibility that I'm confused about this is large) that pretty much the system in the current bill -- mandated private insurance, heavy regulation on the insurers, works okay in Switzerland and Holland, and while it's not ideal, is much better than what we've got now.
I don't quite understand how it works decently well, and I really am not on top of fine grained differences between the current bill (without public option and Medicare expansion) and the Swiss/Netherlands system that make what we're proposing way lousier than what they have. But I know that I'm confused enough to be unsure that we want to walk away from this bill now.
Anyone have insight?
You can have more than one gmail account. I have moby.hick and my real name. You just have to be very careful about how you are logged in, I think. (Not that I've installed Chrome.)
heavy regulation on the insurers
Except (and better informed people can correct me) that the regulation of the insurers, which was never that heavy to begin with, has been shot through with additional loopholes already and the horse trading isn't over yet. I'm not hearing the insurance companies screaming, and if they aren't screaming, then Congress has failed.
This looks to me like the bank bailout all over again. If you didn't read Bob's link to Dave Johnson in 46, please do. What started out as a mediocre but solid first step has been turned into something that could end up being the biggest albatross Democrats could possibly hang around their necks.
It isn't possible to pass a good, workable bill with 60 votes. It just isn't.
if I hadn't left town.
Some people might think this is an extreme reaction to having a colleague who is a friend of Lieberman, but it seems moderate and reasonable to me.
You can have more than one gmail account.
I do have more than one gmail account. But I like having a yahoo and gmail account so that I can be simultaneously logged in as both. I'm just worried that Chrome would fish out Heebie-Geebie and overapply it in ways that could potentially out me.
From 46:
the public does not yet understand that the government is about to order people to buy health insurance, with their own money.
I thought that relatively few people would be affected by this? At least, few enough that this wasn't political suicide, as 46 is claiming.
This looks to me like the bank bailout all over again.
Me too, but I take a different lesson from the bank bailout. If the choice is between the crappy bank bailout that occurred and no bank bailout at all, then I have to endorse the bailout. (To be clear: I don't think that was the actual choice with the bailout.)
Do I want the Senate to pass health reform in its current crappy form, or ditch health reform entirely?
Johnson linked in 46 is indeed persuasive, but it's at least conceivable that the public will respond to the crappy aspects of the bill by demanding they be made better. In any event, the alternative here, today isn't some better bill; it's nothing at all. This proposal is significantly better than nothing.
It isn't possible to pass a good, workable bill with 60 votes. It just isn't.
Then it's not possible to pass a good bill, because you can't regulate via reconciliation. (The Byrd rule forbids use of reconciliation for bills that don't "produce a change in outlays or revenues" or produce "a change in outlays or revenues which is merely incidental to the non-budgetary components of the provision".) Certainly the other lessons being taught here (Obama's people fucked up hugely by not hanging the bank bailout on Bush or at least blowing up Citi to prove their bona fides and thus wasted their political capital on preventing global economic meltdown as opposed to something tangible; Reid is less competent than even Frist; Holy Joe Lieberman is an even more vile and self-aggrandizing prick than I thought) are not happy ones; the last sentence of 85 is probably right.
Here's what the denatured bill consists of. I don't think Reid's loophole for annual expenses survives conference committee, but I've been wrong so far.
At least, few enough that this wasn't political suicide, as 46 is claiming.
Singling out a group that ought to be among your base for special charges is politically problemmatic, to say the least. Erstwhile commenter Cala, who viewed herself as a target of the mandate, was pretty eloquent on the subject during the campaign.
113: I did read it, but there doesn't seem to be much to it -- worrying that the mandate is going to be unpopular if demagogued is reasonable, but still, that kind of system works okay other places.
Except (and better informed people can correct me) that the regulation of the insurers, which was never that heavy to begin with, has been shot through with additional loopholes already and the horse trading isn't over yet. I'm not hearing the insurance companies screaming, and if they aren't screaming, then Congress has failed.
Maybe. I'm not sure one way or the other about this. But (I believe) we've still got guaranteed issue (I think that's the phrase -- companies have to sell you insurance regardless of pre-existing conditions) and no recission. That's pretty huge.
Singling out a group that ought to be among your base for special charges
Why is the group that will be mandated to buy insurance necessarily in one party or the other? Or do you just mean the subset that is in the base?
This proposal is significantly better than nothing.
Not if it leads to landslide Republican victories, it isn't.
Then it's not possible to pass a good bill
If the Democrats aren't willing to bite the bullet and nuke the filibuster, then it probably isn't possible to pass a good bill. In which case, I honestly believe we'd be better to scrap comprehensive reform and just work on ramming through insurance regulations.
Younger adults run Democratic, and also are likelier to be both uninsured and not eligible for all that much in the way of subsidies.
wasted their political capital on preventing global economic meltdown
Wasted?
Not if it leads to landslide Republican victories, it isn't.
Where do you stand on the Civil Rights Act?
Younger adults run Democratic, and also are likelier to be both uninsured and not eligible for all that much in the way of subsidies.
Oh, true.
Anyway, I do think that a mandate to buy insurance is ethical. Insurance doesn't work if healthy people don't buy it.
Not if it leads to landslide Republican victories, it isn't.
I really don't trust anyone's predictions about how this will be spun in hindsight.
124 - On something intangible. You can't point to Earth-597 where McCain won and unemployment is 21% as an explanation for why 10% unemployment and a stagnant economy shows the success of your plan.
119: Singling out a group that ought to be among your base for special charges is politically problemmatic
Especially when the charges are particularly applicable to the younger portion of your base, who may well end up pissed off at your party for the rest of their voting lives.
The rescission loophole is big enough to drive a truck through, LB. If you committed "fraud" when signing up, they can drop you. What's fraud? Whatever the insurance company lawyers say it is, and that's what they use to justify most of it now. So you're left with the option of, while trying to secure care for your expensive medical condition, hiring lawyers and suing your insurance megacorporation and their army of lawyers. And hopefully you win before you die.
Yeah. I don't think people are calculating on how popular guaranteed issue (someone confirm that that's the phrase I'm thinking of?) will be. If we get that through, every Democrat can campaign on "You never have to be afraid of losing your insurance ever again." That's a big fear, and even the lousy bill we've got now solves it.
130: But they can't refuse to insure you for having a pre-existing condition. As I understand it, someone with cancer, now, currently, will be able to buy insurance at community rates from any company they want to.
Especially when the charges are particularly applicable to the younger portion of your base, who may well end up pissed off at your party for the rest of their voting lives.
I don't think this will happen. People in their 20s don't have years of how-things-ought-to-be built up. This is their new norm. And even more, people in their teens will just enter the new norm without feeling any loss.
119, 129: This doesn't seem to have happened in Massachusetts, which admittedly may be an outlier due to a lack of a functioning Republican party to demagogue it.
128: I would describe this view of politics as "Rovian." I am not dismissing your view by describing it thus - Rove certainly had his successes.
Yes, good politics and good policy are often in conflict, but that doesn't relieve us of the obligation to seek good policy.
132: If I'm wrong about the guaranteed issue point, then I'm very wrong. But it's been my understanding all along that that was the core of the plan, and why the mandate was necessary (that is, the mandate pays for guaranteed issue).
136: That is my understanding, though things keep shifting. There is certainly no way you can do a system where coverage is guaranteed without a mandate. Unless you want to subsidize gambling.
I really don't trust anyone's predictions about how this will be spun in hindsight.
This may not be quite what you mean, but I just want to vent here at one thing: the ongoing belief by congressional Dems that, if they concede on Point A-D, Republicans won't run against them on Points E-Z. The Republicans will run against you no matter what you pass, so pass something that you can run on.
I realize that this isn't an original point, and also that many of the guilty are, in fact, in agreement with Republicans on the merits of A-D, but the sense that they think they can avoid nasty rhetoric by giving in just a bit more is palpable, and maddening.
135 - What's Rovian about it? It needed to get done, so Obama did it; it just would have been better to realize it would be politically unpopular and hang it more on the Republican party. I think sending Citi into government receivership could have been managed (and would have cost me, personally, money, as I have a few shares in my IRA) and would have been both good politics and good policy pour encourager les autres.
138: Jesus Christ, yes. There is nothing we can do to avoid the nasty rhetoric. At which point giving up anything of value at all to avoid it is insane.
Re: "Why will adding features in the future be easier than getting them included in comprehensive reform now?"
The sad fact is that most of the individual elements of reform (including the more progressive ones) poll much better than reform as a whole. Expanding medicare could actually be an electoral winner for many of the blue dog Dems in an election year.
Guaranteed issue + a mandate is a good thing if and only if either 1) insurance rates are regulated like utilities and Congress is serious about keeping them low, or 2) the industry's anti-trust exemption is removed. Because otherwise, they'll be happy to take their legally mandated customers and jack their rates year on year. Is there anything in there that would cheer me on this front? (that's not a rhetorical question; is there?)
(The Byrd rule forbids use of reconciliation for bills that don't "produce a change in outlays or revenues"
Umm, why didn't we just write the bill so that it did? You know, huge subsidies for struggling people, no premiums for the unemployed and all that. It would cost money and act like a stimulus. I'm sure that I'm missing something, but what does this violate other than Obama's promise to be deficit neutral?
Is there anything in there that would cheer me on this front? (that's not a rhetorical question; is there?)
Are there any policies that would compensate the giant handout to insurance companies, to you?
Is there anything in there that would cheer me on this front? (that's not a rhetorical question; is there?)
There, can't we count on politics? Mandate + exorbitant rates will be excruciatingly unpopular with a broad spectrum of the population. Won't that actually produce a political impetus to regulate rates?
144: I think I put two of them in the first sentence of the comment.
Won't that actually produce a political impetus to regulate rates?
Hasn't worked with the financial industry.
144: I think I put two of them in the first sentence of the comment.
I thought you were saying that those would also keep this from being quite as giant a handout to insurance companies.
147: I'm not required by law to personally write large checks to the financial industry. I hate them, but no one's making me write them checks (directly, rather than indirectly through tax dollars). That's a very different level of political pressure.
Umm, why didn't we just write the bill so that it did? You know, huge subsidies for struggling people, no premiums for the unemployed and all that. It would cost money and act like a stimulus. I'm sure that I'm missing something, but what does this violate other than Obama's promise to be deficit neutral?
Because people want things like "no recission" and "community ratings" and "guaranteed issue", which are (according to people who study this stuff) incidental under the parliamentary definitions in use and would be stripped out of the bill. You can't pass new regulatory law through reconciliation*.
* Unless you use the nuclear option, but anyone who thinks that Harry Reid is going to do that is fooling themselves.
As far as i can tell, everyone should be happy.
To be serious and non-political for a moment, I should be clear that HCR is something my family needs. Once we went on food stamps, the kids were automatically enrolled for some sort of thing (I actually think it's not S-CHIP), and I think that AB & I have some sort of catastrophic coverage, but the bottom line is that I'm self-employed (and so have no affordable access to insurance) and AB works part-time, getting (not-cheap) insurance for 8 months of the year. When Kai was 6 weeks old, he was uninsured (and when we looked into S-CHIP, it turned out that the enrollment process is so long that we would basically be back on insurance by the time S-CHIP kicked in). COBRA for 4 months would have represented 20% of our income last year.
Near as I can tell, all of this bullshit will help us precisely not at all*. It's un-fucking-believable that they can fuck this up so badly.
* If I'm reading things correctly, we will, in fact, be forced to pay $1000/month for COBRA whenever we're not covered, and - maybe - we'll get some sort of subsidies that will probably involve a shit-ton of paperwork and long waits while we front the money for the United Fucking States Fucking Treasury.
There is nothing we can do to avoid the nasty rhetoric.
I am occasionally amused to remember that one of the pro-Obama talking points was that he wouldn't drive the right wing crazy the way Hillary would've.
151: "Not help us at all" means, in that comment, that you don't believe the subsidies will really exist, or will make insurance affordable enough for you. You might be right. But the current version of the bill as I understand it does include substantial subsidies: Here's Nate Silver saying that it brings insurance for a family of four earning 54K down to 9k/year. That really is something.
154: Sorry, that was health care costs down to 9K. Insurance would go down to 4K, and possibly out of pocket expenses would add the other 5K.
JRoth, if I can make a non-snarky suggestion, fire off an email to Ezra Klein and lay out the basics of your situation; ask him to write a post about what you would see if this passes as it's currently constructed. My understanding is that Medicaid expansion might be helpful for you and the exchanges + subsidies almost certainly would, but I'm not an expert and I certainly don't actually know anything about the mechanisms of the subsidies. (One hopes they're not expecting people at 150% of the poverty line or whatever to have the cash for their premium just sitting around.)
154: And yet, 9K is a hell of a lot of money.
157: It is a hell of a lot of money. But it's a hell of a lot less than people are paying now. (And again, to compare apples to apples, that's 4K for the cost of insurance. 9K is insurance plus out of pocket costs.)
157: It is a hell of a lot of money. But it's a hell of a lot less than people are paying now.
Not (until luck runs out) if they're just uninsured.
Wow at 9k being a lot less than people are paying at the moment. That's pretty amazing.
And Obama can say that you're getting a lot, but also saying that it "covers everyone," as if there's a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don't get it from their employer. I guess you can call that progressive, but that doesn't make it so. In fact, mandating that all people pay money to a private interest isn't even conservative, free market or otherwise. It's some kind of weird corporatism that's very hard to square with the common good philosophy that Democrats supposedly espouse.
Nobody's "getting covered" here. After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won't make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn't or didn't want to write. Indeed, it actually looks like the worst caricature of liberals: taking people's money against their will, saying it's for their own good. --- and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks.
snarkout--young people in MA are actually decently served by reform if they don't have huge student loan debt. A single person could make 30K or so andpay about $100/month for generous coverage. If you've got roommates,you're fine even with some debt.
If you're under 26, you can also buy crappy, but cheap young adult plans. As you get older your premium goes up--even with community rating.
The problem is somebody who's an older couple with kids making around $67,000. They're not eligible for the subsidies, and they're deemed to be able to afford around $352 per month, but there's nothing, even with a high deductible for less than $800/month.
people in their teens will just enter the new norm without feeling any loss.
Every year, teens start doing their own income taxes, and a good chunk of them get pissed and start listening to Republicans more than they used to*. Sending away your hard-earned money for intangible benefits is a good formula for looking for someone to blame. The promise that you won't be victimized by rescission in 28 years doesn't cut it.
* First time I ever did taxes, I was already quite liberal, but it was during the '96 Freemen standoff in M (?), and my joke was that all of a sudden I understood what they were talking about.
158, 159: As a matter of public policy, spending less money on health care is better than spending more. As a matter of politics - it's a problem.
151: Anyone eligible for food stamps would almost certainly be eligible for very substantial subsidies on the individual mandate. Yeah, presumably there will be lots of paperwork. But your family will be insured at substantially below market cost. So (ignoring that you'll probably be UMC by the time these features kick in), there's quite alot there for you. I haven't gone too far into the details, which will depend regulations that don't yet exist, but it would be extremely surprising if you were required to front costs. That's not how programs for low income taxpayers work.
The biggest part of the legislation is $90 billion in subsidies every year to pay for insurance for the lower income brackets, to be paid for by the upper income brackets. If that were the entire bill, it would be an enormous achievement for social justice. The rest provides modest benefits in lots of ways, including cost control and some limited regulation over the insurance industry, and doesn't make anyone worse off. Anything the next Congress comes up with will require more Republican votes than this one does. Dropping the project now would be insane.
$800 a month, on health insurance? Jesus...!
JRoth--my sister works for a school district in a job that pays not much. She did work part of their summer program, but not all of it. She still got the health coverage. I wonder if there's some way, you and AB can work around this. DidI mention that I think it's totally stupid. Yes, I did.
One hopes they're not expecting people at 150% of the poverty line or whatever to have the cash for their premium just sitting around.
One does hope that, doesn't one?
I'm glad that instead of lots more coverage and less bureaucratic overhead for individual taxpayers and health care providers, we're getting I have no idea what anymore and more bureaucratic overhead. YAY!
After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already.
Isn't it ethically obligatory to have an insurance mandate? Because of precisely this: otherwise people who can't afford it won't scream that they can't afford it - they just will go without.
In terms of backlash at the polls in 2010, I'd bet on 'no bill' being a lot worse than 'mediocre bill.' It depends a lot on how fast things phase in too: people aren't really going to know what this is costing them until they start paying it. They will, however, know that Obama and the 'Democrat-controlled' Congress have failed on a signature issue -- Obama's Waterloo -- the day the effort is abandoned.
The costs of giving up ripple far beyond this issue as well.
Isn't it ethically obligatory to have an insurance mandate?
If you give people a low-cost public option, yes. Or if you aggressively cap rates. The first definitely isn't happening and, best I can tell, neither is the second.
161: "Covers everyone" means guaranteed issue and community rating. That's what the mandate pays for, and I'm not sure why Digby is ignoring it.
If you give people a low-cost public option, yes. Or if you aggressively cap rates.
It is absurd not to have these in place, definitely. But I think they're more likely to happen once the mandate is in place.
171: Or if you subsidize to the point that it really is affordable to the consumer. Capping rates is vital as well, but subsidies can cushion consumers against exorbitant rates.
ttaM, There was a case study about a family like who this on Frontline who actually settled on an $1,100 per month plan that was kind of middle-of-the road, medium deductible and co-pays. That was more than their mortgage and more than twice their food budget. They were both self-employed. In the end, she quit her job as a realtor (i.e. estate agent) and got a job with benefits.
The premium subsidies in the bill would really be pretty generous. At 133 percent of poverty, you won't pay more than 2 percent of income for insurance premiums, and even up to $88,000 per year you won't pay more than 9.8 percent. But neither the subsidies nor the mandate go into effect until 2013 or 2014 (I think the implementation delay is crazy, but never mind).
Is there anything in there that would cheer me on this front? (that's not a rhetorical question; is there?)
Dianne Feinstein is fighting hard for explicit rate review (with the power to disallow rate increases), but it's unclear whether she'll win. In the bill there's a requirement that insurers in the group market must spend at least 80 percent of revenues on medical care (75 percent in the individual market), Rockefeller is fighting to strengthen this by increasing the minimum level.
Globally, I should say that I'm not claiming the bill (as it appears it will be) doesn't suck. But the really hostile rhetoric I'm seeing about it doesn't seem to acknowledge the parts of it that are important and don't suck.
re: 175
And you aren't killing people? Why is this?
[The UK is pretty crap, but I don't grumble at all about my total tax burden. And it's less than the figures quoted here for health insurance alone...]
Mine's about $1400, going up 'only' 11% this year. It's pretty annoying coverage -- lots out of pocket and all -- but at least we wouldn't be wiped out by cancer or something.
more likely to happen once the mandate is in place
Why? The financial bailout is a pretty clear lesson in the value of getting your pound of flesh at the outset. This is the biggest majority we're likely to have. Putting the screws on the insurance industry will only get more difficult once we swell their lobbying budgets further.
Ditto, rfs in 180.
We had some problems here in MA--which were "sorted out" by determining that more of the uninsured couldn't "afford" insurance which meant that they wouldn't face a tax penalty. That was possible because of local activism. I think that it would be harder to get Federal regulations changed quickly. And now, they don't actually get insurance, they just get to fill out paperwork to show why they shouldn't be penalized for not having it.
154, etc.: That is not such a good deal for me and my family. Right now, my wife's ~$3600 salary from her PT job basically goes to 8 months' worth of health insurance. I've laid out the picture for the other 4 months. Our out-of-pocket is nominal (because we're all healthy, knock wood), but it sounds like, from Nate's post, we'll get enough subsidy that - maybe? - the 4 months of COBRA will be cheap or even free. Although, as I say, I'm pretty sure the mechanism will be that we pay $4000 out of pocket and then, sometime in the spring, the gov't sends us a check for that amount.
The upside is that we probably get year-round insurance for little additional cost (until I start earning more money, anyway). The downside is that we're still beholden to this shitty company that regularly dicks us over, and we can expect to continue to spend hours of our lives on the phone arguing over charges and such.
I guess that's an ok deal. We'll see whether the subsidies hold up.
178 -- We're not communists, like you people. And, aircraft carriers are expensive, not to mention hopeless wars. (I know you guys have been playing along with the hopeless wars, but I'm not sure it's comparable on a per capita basis).
The upside is that we probably get year-round insurance for little additional cost (until I start earning more money, anyway).
Well, it's not nothing. Not as much as it could be, but not nothing.
180: Because more people will care, sooner than when they are sick. People won't want the fact that they have health insurance rolled back, they'll want their premiums lowered. If bloated insurance profits are seen as the culprit, something will be done about that.
This is the biggest majority we're likely to have.
It's the biggest majority of democrats, but not the most mobilized, irate population of voters.
Also, I thought CW is that bloated insurance profits aren't the problem underlying rising health care costs, even though they're despicable in their own right.
180: I think this is overly pessimistic. The problem with the bailout is that it's over. They got the money, and now we can't do much about it. This is going to be an ongoing relationship, and we'll be able to adjust the terms going forward.
Personally, ttaM, I'm getting very good coverage cheap right now. We'd hoped that these reforms would slow cost growth, but they're not.
The next step is to try to reform payments away from fee for service. We'd have to get a waiver from the Feds to do this with Medicare. But already the hospitals are screaming bloody murder that it will hurt the economy, because hospital bills subsidize research at academic hospitals and without that research there would be no Biotech industry.
Somebody should be shot.
185 makes me sound far more rooty-toot-toot than I actually feel. I just don't want us to bail on the current pathetic bill.
the most mobilized, irate population of voters
Those would be the people shrieking about creeping socialism.
Christ, I didn't think I could get more discouraged about HCR, but the rate is actually accelerating.
188: I want the insurance reforms passed, because people in other parts of the country don't have those protections. My biggest beef is that insurance is still so tied to employment. That's the biggest weakness of the MA law. You still have to change insurers when you change jobs, and I was hoping that national reform would do away with that.
I'm also not sure how the exchanges are going to keep costs down if everyone isn't in them.
167: AB works spring semester; they let her buy for the summer, but not for the fall. She may - may - actually teach next fall, which would largely solve our problems. But they've already put off this course twice, so we count no chickens.
re: 183
Not in terms of cost expenditure, no. In terms of lives lost, the UK has lost proportionally more in Afghanistan, actually.*
* much less in Iraq, though.
Chicken counting is a college-level course? Is it under the math or biology department?
otherwise people who can't afford it won't scream that they can't afford it - they just will go without.
I always wanted health insurance in my 20s, but could never afford it; that's why I went without. And I'm pretty sure that I was earning enough, as a single/no dependents, that I would've gotten no subsidies. The MA plan would be fine - $100/mo. would have hurt but been manageable - but I don't think the national plan will be that good.
If bloated insurance profits are seen as the culprit, something will be done about that.
I'm biting my tongue here, trying not to say anything condescending.
But, seriously?
194: Interdisciplinary; that's why they've had trouble getting it started. The departments are fighting over pecking order.
195 actually supports the quote in question.
re: 197
The Gender Studies people are particularly up in arms over the crude dichotomous taxonomy the department intends to employ.
196: Look, bite your tongue away. Yes, we're mad. Is the general population irate and mobilized? No.
JRoth, the problem is that once you hit around $33K gross income, you lose access to the subsidies. Suddenly, you have to pay what a self-employed person making $100K pays. So, fairly quickly you're up to $400-500/month, and you may not really be able to afford to see a doctor. So you get a thousand or a bit more a month extra and you have 3-4000 more in expenses for less comprehensive coverage with higher copays. It's better than it was, but it's not really a good system for the long haul.
Look, bite your tongue away.
Make sure that's covered under your existing plan first.
Also, is Obamacare going to cover my kids' arm-lengthening surgeries so I can get them out of daycare and into public school? I haven't read every page of the bill, but my gut says no.
203: You're just going to have to move their ears higher, like the rest of us.
I highly recommend this documentary by Frontline to everyone, really, but especially to residents of nations with universal healthcare.
Also did anybody see the Reason op-ed by a libertarian about why a lot of people would probably prefer French healthcare to U.S. stuff and why he uses it?
191 - I think it's a good exercise in general for understanding what good things are in the proposal and what aren't! I'd be interested to read his response, on top of any value you get from it directly.
and doesn't make anyone worse off.
New Excise taxes on very good plans, for example. Families in the 75-100k range will get hit with taxes on their coverage. Everybody is seriously wondering why the AFL-CIO is not screaming bloody murder.
Firedoglake ...this morning
To translate, they both conclude the tax will effectively force employers to scale back the health insurance benefits they offer in order to avoid the excise tax. This can be done by reducing what benefits the plan covers and/or increasing cost sharing (i.e. higher co-pays, higher deductibles, higher out-of-pocket limits, and possibly lower annual limits). If you have a good employer provided health insurance plan, it will be dramatically scaled back. Contrary to Obama's direct promise, you will not be able to keep the coverage you currently have, and that is by design.
198: My point was that the proposed mandate would fuck over 20something JRoth, because I couldn't afford it, and the subsidies for 25-y.o.s earning, I dunno, $20k, will be jack shit.
206: Why don't you email that to Ezra:
Hey, E, I was wondering if you could apply the proposals to a real life example; maybe a family that's anticipating a shift upwards in income?
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Cookie tables at Pittsburgh weddings FTW!
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211: Why is there a picture of peanut butter blossoms? Is this some rare delicacy elsewhere in the US? That's so strange.
I am not nearing the point of not voting in 2010, of course (not that it matters, I'll probably live in DC or Md.), but: I think I do now regret supporting Obama over HRC in the primary. No guarantee she'd have been better, of course, but it's become plausible enough that I wish I had voted for her. Maybe that idiot Mark Penn would even have realized that "angry, angry unemployed people" were going to be a key demographic in the 2010 election & were not so happy with Wall Street. (probably not, but maybe Clinton wouldn't have listened to him).
Based on everything I've read, I do think it's much better that this bill pass than that it doesn't--for the subsidies & Medicaid-up-to-133%-of-poverty line expansion, if nothing else; I had no idea, until I heard a story about it on NPR, just how awful Medicaid is now in many states. And realizing that I'd lacked that basic knowledge makes me inclined to side with the policy wonks over netroots activists who are feeling mad as hell at the White House & not going to take it anymore. But I'm mad as hell at the White House, & getting very frustrated with wonks who are:
1. hailing it as the greatest progressive achievement of our lifetimes rather than arguing that it's a mess and a sellout in many ways, but still worth passing.
2. claiming that the Obama administration in no way sold us out, did all it could (or close to it) with the cards it was dealt, etc. When I read Russ Feingold saying "this seems to be the bill the administration wanted anyway," & remember hearing all summer about how the Finance bill was where the real action was because the WH supported it, & when I look at the Dorgan amendment roll call, & read transparently false statements from Gibbs, this seems like obvious bullshit.
I'm mad as hell, and am going to continue to take it!
Concerning 207, there is some sbtle political science floating around, Yglesias and Bruce Bartlett for two, about not focusing on redistribution, but focusing on benefits to the poor. (The House bill pays for the subsidies with a tax on the top 1%, the Senate bill taxes the upper middle class.)
It usually isn't discussed how the improved social safety net will be paid for, but a VAT is likely.
My interpretation is a leveling, a compression, not at the very top, but a compression of the poor and the UMC or professional class, say up to 250k. As far as I am concerned, the people in the 100-250k range aligning their interests with the very rich is a huge problem, and if we can change their alignment to the lower classes great political progress can be made.
Maybe this justifies that excise tax. But I don't think there will be time to realign before Rethugs regain power.
209: The quote you quoted was responding to "After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already." So, great. 20something JRoth had reasons for not doing it already.
My point is: The order ought to be:
1. Cost-controlling measures
2. Individual mandate.
But the order is not going to be that way, and I think an individual mandate is an ethical obligation, and I think it's somewhat likely that cost-controlling measures will follow the individual mandate.
If 20something Heebie had been self-employed and couldn't afford coverage, she would have been nervous about not having health insurance but she would not have considered this a political issue.
If she were forced to buy coverage she couldn't afford and was hearing about bloated insurance profits on the news, she would consider it a political issue. And she would not want to go back to not having insurance.
So all of a sudden I'd be irate and mobilized for affordable insurance.
it's a mess and a sellout in many ways, but still worth passing.
I'm not sure of myself at all, but this is where I tentatively am right now.
Whoops. Here's the Reason piece.
The result of that political pressure might be to just let people out of the mandate w/ less of a penalty, of course. Also, public opinion seems to have very little to do with what's happening now, and I see no reason this is going to get less true with smaller Democratic majorities/GOP majorities/Republican presidents.
As far as I am concerned, the people in the 100-250k range aligning their interests with the very rich is a huge problem, and if we can change their alignment to the lower classes great political progress can be made.
I agree with this completely.
And I buy the argument in 216 as plausible.
222: I think the bailout did that for a lot of people.
Good to see you Katherine.
Also, if you want your vote to count, you could move to Northern VA instead of DC. I mean, of course, there are so many other considerations, like what's actually a nice place to live.
Why do you think HRC would have been better, certainly not worse, but why better? I think that the economic team would have been about the same, and foreign policy wouldn't have been much different. And there would be the wailing about HillaryCare. Her policies have been pretty incremental after her first failed attempt.
Eh, Nechaev was right.
The revolutionist is a person doomed. He is merciless toward the state and toward the whole formal social structure of educated society; and he can expect no mercy from them. Between him and them there exists, declared or concealed, a relentless and irreconcilable war to the death. He must accustom himself to torture.
218: yeah, that comment came off as more sure it's worth passing than I really am. For one thing, I don't actually know what's in the Senate bill (due to a combo of my lack of expertise & the fact that no one knows), and it could still change for the worse.
Part of me hopes that maybe if it fails Obama will fire Rahm & this administration may start to resemble the one I thought/hoped I was voting for. But I think that's much too much of an "if only the czar knew!" fantasy to take seriously.
"Why do you think HRC would have been better, certainly not worse, but why better"
It's not based on much--a bet you didn't take looks better than a bet you took & seem to have lost, basically. In the areas where I thought Obama was better, he's done precisely the sorts of thing I feared HRC would. In domestic/economic policy, I think she might have done better, but I don't really know at all.
Mark Penn is a professional union-buster, Katherine.
The Gravel administration would not have led us down this dark path.
226: What if you are supportive of the "formal social structure of educated society" to a point (being, you know, educated and all), but you just want to slap it around and maybe give it a metaphorical wedgie? Is there less of a chance for being tortured?
I really wouldn't have cared if John Edwards installed a goddam seraglio in pavilions in the Rose Garden. (Well, I would have thought he was an ass, but wouldn't have cared politically.)
In retrospect, I don't see any real ideological daylight between Clinton and Obama, and don't see what would be any different, especially on HCR. John Edwards was the only one who seemed to understand who the enemy was in the health care debate.
http://www.nytimes.com/2007/12/17/opinion/17krugman.html
232: Nope, it's torture all the way down.
the greatest progressive achievement of our lifetimes rather than arguing that it's a mess and a sellout in many ways, but still worth passing
Are these incompatible? Our social safety net is so crappy that even a mess and sellout could be the greatest progressive achievement of our lifetimes.
Is the general population irate and mobilized? No.
A lot of the defeatist talk on the left assumes not merely that a shitty (or nonexistent) healthcare deal will demobilize the left, but that it should demobilize the left. "If the Democrats screw this up, then fuck 'em."
I hope this attitude isn't too common. Liberals were right to vote for Obama when he proposed his lame healthcare plan, and they'll be right to support Democrats after that plan is passed.
Substitute "shitty Afghanistan plan" for "lame healthcare plan" and it's still true.
But John Edwards could never have gotten elected after that stupid affair with the flaky woman came out. Only Republicans are allowed to be involved with astrologers.
237: This is limitedly true. It's not a reason not to, e.g., primary sucky Democrats from the left for fear of letting in Republicans. But it is a reason to support Democrats where the alternative is worse.
Gotta walk the dogs. I want spring, and winter isn't even here yet.
FDL is rocking. Jane Hamsher anf Howard Dean say "Not this bill" WH says "Go Joe! Damn Dean!"
Apparently Ben Nelson is still holding out for near Stupak language or he filibusters. Will there be a conference? Would Stupak be a dealbreaker for progressive Congresspersons? Damfino anymore.
The sensible center reeks of shame and desperation.
I want spring, and winter isn't even here yet.
Damn it, Obama can't do anything right.
The sensible center reeks of shame and desperation.
Sorry. The saleslady said it made me smell manly and she was hot.
Apo is probably right--I'm not seriously interested in making the case for a fictional Clinton administration. I just figured I'd give PGD & some other regulars the satisfaction.
SP---We could be charitable by reading bob's comment metaphorically.
238 is true, but beside the point. There was only room for one not-Hillary and Obama took up that room. What Edwards was saying during the campaign, however, is still true. If you try to accommodate the insurance and pharma industries, you will gut any serious reform of our health care. Obama has gone out of his way to do exactly that, and we're left with a bill that even Howard Dean (who, like Edwards, is miles away from being a radical) says isn't worth passing.
Why do the Rethiugs ourplay us so easily?
If the meme next year is:"Progressives killed healthcare because they wanted the Feds to pay for abortions"
...which is a lie, but will be the word if the bill is defeated on Stupak...
the far right will be energized and the center-left horribly demoralized
If Healthcare + Stupak passes
...the far right will still be energized and the left suicidal.
Why do we always lose?
243: It's appreciated -- I was one of the lukewarm Clinton defenders (I supported and voted for Obama, but didn't think there was that much distance between them, and thought the opposition to her was more intense than was justified), and felt bad about the back and forth hostility there. So it's good thinking that the tension back then probably was stronger than it needed to have been.
OpenLeft was saying that it seems like Lieberman is just trying to extract his pound of flesh and piss off liberals. Counterintuitively, the best way to get the bill to pass may be for the netroots to oppose it. A Medicare buy-in was only truly a terrible idea when Anthony (?) Weiner supported it. (I would have dropped the first name, but I didn't want anyone to think that I was referring to our late blog friend. (Late of the blog, that is.))
Counterintuitively, the best way to get the bill to pass may be for the netroots to oppose it.
I've seen that, and while it's appealing on some level, is anyone really going to fall for "Don't throw me in that briar patch, Br'er Fox!"?
Also, the growing opposition from the netroots isn't a ploy. It's legitimate. Which returns to Bob's question: why do we always lose?
It is surprising to me that 237 is often read to conflict with 239. (Not saying you read it that way.) Yes, people should mobilize to change the Democratic Party, but undermining the party is inevitably counterproductive.
As Yglesias says, if you're a liberal who thinks we're better off not supporting Democrats, grow up.
AFL-CIO and SEIU might be withdrawing their support from the Senate bill.
Hey, if you always lost, I'd be waiting for the surviving bus in London so I could pointlessly show up at the gutted hulk of the office after Vice-President Palin arclit the whole eastern half of the city because she read there were Muslims there.
251: Well, there really are hard tactical considerations. I think there are probably circumstances where we'd be better off damaging a bad Democrat in a primary, and then losing the seat to a Republican, than letting the bad Democrat go unpunished. But how often and which ones? When does changing the party turn to undermining it? I don't think those questions are answerable globally, but they're going to lead to a lot of conflict on an issue by issue basis.
The AARP's endorsement of it worried me a bit. I would have thought that they would have liked the Medicare buy-in, since they have members in their 50's. Maybe it would have destroyed their prescription drug business.
253: True fact. Thanks for saying something cheerful. (Even if Orlando is a hellish dystopia, unredeemable by any number of fraudulent ducks.)
The TPM piece apo linked to mentioned a manager's amendment. Can someone tell me what a manager's amendment is?
(As a donor, I just got a Christmas card from the Obamas (paid for by the DNC). It was really tempting to scrawl an angry note listing reasons I wouldn't be giving again on it and send it back. But I didn't. Maybe I still should.)
Supporting the Democratic party means what, exactly? It's entirely possible that it's worth voting for them b/c they're the best option on the ballot, but that you're, e.g. much better off donating to the ACLU, organizing for unions rather than the DNC, etc.
259: Well, the tactics of it all are very individual issue/race dependent. But on top of voting, it's also worthwhile to work for/give money to a lousy Democrat as against a terrifyingly awful Republican, where those are the choices. I feel like a sucker having given money to Obama and worked for him. OTOH, I'm very glad he beat McCain, and to the extent my efforts were a necessary part of that, I think what I did was useful.
Emerson: "The Democratic Party is not our friend and we shouldn't ever think that it is. Working through the Democrats is not like falling in love or finding Jesus. It's strictly business."
I don't have the will to get into HCR in great detail, settling instead for trusting the voices I always trust. But next year, man. I look forward to agonizing over the details of the climate change bill with all y'all.
And more: Fight for the best compromise, not just any old compromise
In discussion of healthcare negotiating strategies at Yglesias's site, the whole "don't let the best be the enemy of the good" / "politics is the art of the possible" / "politics is the art of compromise" meme came up one more goddamn time. Democrats and liberals have learned those lessons far too well, but they seem to have forgotten two other lessons: don't make your final offer at the beginning of negotiations, and don't let the other guy know how desperate you are to make a deal.
Politics is the art of compromise and the art of the possible all right, but it's also the art of fighting for the best compromise and the best possible. Democrats never fight and Republicans also do, and for that reason Republicans can dominate with tiny majorities and Democrats can lose with 60 Senators.
Manager's amendment (Reid is the manager) is how all these deals get put in. None of these compromises have actually been voted on yet- a bunch of other amendments have, but when they say "we have a deal!" it means that the final amendment that Reid will offer will tie all these things up and presumably will pass since everyone agreed to it.
Thanks, SP. So theoretically, he could put whatever he wanted in the final bill before it goes to conference?
Does Reid as majority leader have to be the manager. Of course, he would be on onmajor legislation, but is it a given on smaller bills?
Nancy Pelosi as prime minister with the Senate playing a role like the House of Lords sounds better every day.
261: Emerson makes a lot of sense. Good essay on Self-Reliance a while ago, too.
I've given up. It takes too much energy to wade through the lies and distortions and deceit in US politics. I'm powerless, I know I'm powerless, and the only way things will improve for me is if I remember to always carry the lube because I know I'm gonna get it.
I want to see a Canada option in the HCR bill: anyone who owns real property should be allowed to opt out of the US and become a part of Canada. Not just for health care, but for all purposes: secede and join Canada.
261 -- Oh sure. It's a coalition, and one that includes a bunch of people who are pretty much unlikable. But nearly always better than the alternative. I'd trade my idiot Republican congressman for pretty much any Dem you can name. I was represented by a Republican congresswoman most of the 90s through 2002. Connie Morella was probably as good as that coalition gets, but her mere presence in the body changes House committee assignments and the like.
I'm pretty mad at Obama too, but not seeing anything he's done that I think Clinton would've done better. She'd be just as much a captive to Wall Street, and just as cautious about the incipient mutiny lurking just below the surface in the armed forces.
For the stimulus, they did a bunch of discussing of deals and such that was all over the news, leaving the impression that the bill was changing officially (i.e. in a way that shows up in the legislative history), but all of that was really behind the scenes. When it came time to put in the compromise bill, they proposed it as an amendment as a substitute for the then-existing bill, took votes on it as a whole with no votes on further amendments or votes on individual provisions or anything like that, and went to conference.
It's all about Ben Nelson now, unless someone on the left like Sanders breaks, or Snowe or Collins gets on board (seems unlikely to me).
The managers amendment will have hundreds of pages and will make some pretty significant changes in the bill.
Does Reid as majority leader have to be the manager. Of course, he would be on onmajor legislation, but is it a given on smaller bills?
Reid is the manager because this bill merges the work of two different committees. Normally the committee chairman is the floor manager, but they can choose to give it over to someone else.
Then it's not possible to pass a good bill, because you can't regulate via reconciliation.
I'm out of my league here so have no idea who has the stronger argument, but Jon Walker disagrees.
I saw little to choose from policy wise between Obama and Hilary. I liked that Obama had not voted for the Iraq war, I thought electing him sent a better message that way. But on a speculative basis, what I liked about Hillary was that she might have been more skeptical of and a little more independent of DC experts, having been so saturated in that environment for so long. Obama is too swayed by the Clinton-era wonk community, and I think it's partially because his rise was so meteoric and he's new on the scene. He's got to feel a lot of need for guidance. He really surrounds himself with elder statesmen. I wondered if Hillary was better equipped to make a break.
This bill is such a glass half full/glass half empty situation. I go back and forth between imagining the best possible version of the Exchanges and insurance regulation and liking it, and imagining the worst possible version and hating it. I'm very concerned about what happens over the next 3-4 years before hte major part goes into effect. Has there EVER been a major piece of legislation where the major parts don't take effect for so long? I guess it gives us a framework to fight in and fight for.
I vote for the nuclear option myself, not that anyone in authority cares what I think.
Al Franken pointed out that insurance regulation and money for high risk pools would go in right away. It's not nothing at all, but it's not much.
Yeah, fuck the filibuster!
273: the problem is that you couldn't get the individual mandate with reconciliation, it wouldn't get 60 votes, and the argument is that guaranteed issue (preexisting conditions) requires the mandate. There are ways around that using general taxes, that move you more in a single payer type direction, but they might be unpopular.
Anyway, reconciliation is like everything else, if you really wanted to do it you could and the problems wouldn't hold you back.
Emptywheel at FDL
Healthcare on The Road to Neo-Feudalism.
Marcy Wheeler
I remember, so far way back when, like 2004? being so excited to see emptywheel independently coming up with the Neo-Feudalism analysis while I was reading Newberry and Welsh
It's about the bigger picture, like cash flow to finance and TBTF insurance. It guarantees the horrible choice of debt serfdom or revolution.
Sparta 286 Athens 254 a crooked timber comment on Newberry's classic election piece. I have the full original on my harddrive somewhere, but this will give a taste
The hietararchical society tries to tax by forced savings the tradesmen, and keep the "rabble" in line with force. The hierarchy is not a mere marriage of convenience - each knows that it needs the other. The reactionary side of the ledger is not cleavable between "economic and social conservatives" - because the wealthy knows it needs a military, and the miltiary knows it needs someone to batter the rising professional classes into line."
Emphasis mine.
For those who want to end the filibuster, what are your thoughts about the next time the Senate is controlled by Republicans under a Republican chief executive? I ask this in all seriousness, by the way, without even a hint of snark.
And this:
the incipient mutiny lurking just below the surface in the armed forces
is something that seems to get almost no play. I wonder why that is? Because it's just too scary to think about? Or because it's not as big a deal as I tend to think it is?
Also: I'm struck, again and again, by how much of the outrage over this bill seems to be rooted in people's deep-seated frustration over the bailouts and the stimulus package. We really do seem to be in what's either the start of a populist moment or a blip of populism. And people, including, for example, Apo, are absolutely infuriated*. It's all a bit scary to me, to be honest, as I tend to think less about how much I hate the bankers than I do about how much I hate congressional Republicans. Maybe that's because I'm a Jew? I really don't know.
* As in, burn-down-the-Democratic-coalition infuriated.
For those who want to end the filibuster, what are your thoughts about the next time the Senate is controlled by Republicans under a Republican chief executive?
Fuck it. Do it anyway. The ghastly things Republicans want to do, they mostly can manage without the Senate's help. The filibuster systematically favors them. (And regardless of who it favors, it paralyzes the legislature antidemocratically.)
I wonder why that is? Because it's just too scary to think about? Or because it's not as big a deal as I tend to think it is?
I get very confused by this as well. I'm really troubled by the amount of political influence the military leadership has these days -- the American tradition of an apolitical military seems very important to me. And it does seem to be driven, in a weird way, by fear on the civilian government's point of view of a confrontation with the military going badly. And I can't believe that's a realistic fear -- if it is, things are much worse than I can imagine, but I just don't believe it.
I don't know what's going on in this area, but I'm baffled and worried.
280:
1) I am not enthusiastic about ending the filibuster or going to reconciliation.
2) I think you know how pessimistic, paranoid, and terrified I am. At least in the blogosphere. IRL, I sit under trees with my dogs and watch Taken 7 times in a week.
"Sky blotted out with black swans" as Kunstler said.
I smell revolution. Politics went permanently weird around 1997 and ain't going back without catastrophe.
what are your thoughts about the next time the Senate is controlled by Republicans under a Republican chief executive?
That's the way the game's played. But in general, progressives want to move legislation and conservatives want to stop it so the filibuster is almost always to their advantage. It would be trading some potential losses for way, way more potential gains. I'm willing to roll those dice. I would only keep the filibuster for judicial appointments, because they are for life.
burn-down-the-Democratic-coalition infuriated
The coalition isn't working. I'm not angry about the stimulus package; it wasn't put together very well, but the problem there was doing less than we should have, as opposed to strengthening the root of the problem. The bank bailouts, though? I still think there should be people pulled into the streets and ripped to shreds by howling mobs.
The ghastly things Republicans want to do, they mostly can manage without the Senate's help.
Examples? And so I'm clear, your argument, at least in part, is that the Democrats are so worthless/fractured that they don't use the tool effectively when they can. But the Republicans are so depraved that they're happy to use it when then can. So take the tool away. Is that right? Again, I'm not snarking; I'm just trying to grapple with these arguments, and I'm curious what other people are thinking.
I smell revolution.
For once, Bob is more optimistic than me.
When the Republicans come to power, they will have no compunctions about blowing up the filibuster, if and when it suits them. The only reason they didn't do it during the Bush administration was because Democrats were generally willing to capitulate to their wishes.
I would only keep the filibuster for judicial appointments, because they are for life.
I may be just hitting a cynical period about my profession, but I've been really wondering lately how much the judicial system matters, from a policy point of view, and thinking that the answer isn't much. Oh, judges who aren't straightforwardly corrupt are a good thing, but even the worst ones mostly aren't. And once you're talking about influence on policy, that's pretty marginal.
I wouldn't give anything up to hold onto the filibuster for judges, either.
ari is the historian
None of this, good or bad, is the Big Deal yet. Just preparation and postponement
1855-75 was a big deal. 1915-25, 1935-45. 1968.
I think it's coming, bigger than any of those.
EOTWAWKI, and I feel fine.
286: They don't want effective regulation, so they don't enforce the regulations we've got. That's all executive branch, and the legislature can't do much about it. They want to do aggressive things with our military -- the Senate's shown no capacity for stopping them with or without the filibuster.
And what Apo said: But in general, progressives want to move legislation and conservatives want to stop it so the filibuster is almost always to their advantage.
283: I think that talk of a tradition of an apolitical military doesn't really hold up to much scrutiny. Lincoln sent soldiers home during the Civil War so they'd vote Republican. And they wore uniforms and carried their weapons to the polls in some cases, which certainly would have encouraged others to reconsider voting Democratic. Generals during Korea and Vietnam made all kinds of noises. And there are other examples. That said, things feel somehow different now. And from where I sit, the difference may be the mainstreaming of fundamentalist Christianity in the military -- and the culture more broadly. But now we're back to wondering if I'm paranoid because I'm a Jew.
284: I think the system was set up (and has been reinforced through the years) in such a way that very little changes, except in tiny increments, without catastrophe. And because the aftermath of catastrophes is so uncertain, and I'm a pretty cautious person when talking about re-engineering a society (not to mention personally invested in the system in all sorts of ways), I tend to worry about seating catastrophe at the dinner table.
285: I know that you're not outraged about the stimulus package. But some people are. I should have been clearer about implicating you in that. Also, the Democratic coalition has basically never worked, except for a brief period of time. This is equally true for every other political coalition in the country's history. Which is to say, see my reply to bob above. The structural constraints are pretty absolute, in most cases.
290: I hadn't seen this when I wrote 292.2. Look, I'm not trying to piss you off. I've appreciated that you've let up on calling me an abettor of murderers and whatnot, so the last thing I want is to stand in as your proxy for all that's wrong with the Obama administration, okay?
But now we're back to wondering if I'm paranoid because I'm a Jew.
Well, this part sounds paranoid.
I think that talk of a tradition of an apolitical military doesn't really hold up to much scrutiny.
A tradition to paying lip service to the ideal of an apolitical military? There's something there, isn't there?
295: Sure, there's a tradition of lip service. And double sure, that's not nothing. But I didn't think that's what you were saying above.
293:I was not attacking you. My naming you was hoping for support, in that catastrophes, discontinuous events or eras, are not avoidable but only exploitable by being prepared. Are we ready, or getting prepared for, the next financial collapse? Coming soon.
I personally believe that some kinds of attempts to avoid catastrophes or fratriidal conflicts guarantees total collapses. Sparta. Ante-bellum Whigs. Edwardian era diplomacy. The last thirty years, especially the last ten, has taught me that liberal meliorism is just one of those futile delusions. Socialism or barbarism.
And the Obama administration has very much become a symptom and an effect to me anymore, not a cause. I am rapidly losing interest in quotidian politics and stocking up on canned goods, bottled water, and ammo.
Metaphorically.
297: Well, what's weird to me is that "The military leadership won't like it" seems to be an acceptable, openly stated reason to reject, or at least to worry about the feasibility of, a policy. It's my understanding that the tradition of lip service to an apolitical military would have made this the kind of consideration that wouldn't have been out in the open in the past (barring moments of serious crisis --I'm sure that sort of thing was a worry at times during the Civil War).
298: Ah, fair enough. See heebie? I really am paranoid.
"The military leadership won't like it" seems to be an acceptable, openly stated reason to reject, or at least to worry about the feasibility of, a policy.
Right, that was my point above. And I'm not sure what to say, other than it freaks me out. I do wonder, though, how different the current calculus is from "We can't do that, because the anti-Communists, both within and outside the military, will paint us as soft on the Reds."
300: I really am an assimilationist, so we're even.
I am rapidly losing interest in quotidian politics
That's my problem. Once upon a time I believed in the existence of participatory democracy. I thought "If I only took the time, then I too could participate in our democracy in some meaningful fashion."
Nope. I think I mentioned that I spent somewhere around 250 hours as a volunteer for Kerry, and another couple of hundred hours with the local Democratic party and local candidates, and it was like pissing into the ocean. No one noticed, no one cared, and it just made me feel chilled and exposed. I folloowed the stories of people here who volunteered for Obama, and I surely didn't hear a lot of people saying they felt as if they'd made a whole lot of difference.
Now I listen and it's like hearing people talk about spectator sports: "If the manager would only send in the relief pitcher and have the catcher give him the sign for on on-side kick, the bill could be saved in reconciliation"
Right. Whatever. I don't follow sports, either. Yeah, Obama is better than McCain. It's like a purchasing decision: yes, this television set is better than that television set, but my participation in politics is like my participation in the market: I get my6 choice between two products that someone else decides to market. Whoopee.
and I surely didn't hear a lot of people saying they felt as if they'd made a whole lot of difference.
I did. Not so much individually, but I felt like a unit in an effective organization that was probably a respectable part of the reason he won the election. Working for Obama is about the only time I've ever felt better about something after volunteering for it.
I'm pissed off now, but the man built an organization that knew how to use volunteers, at least in PA.
"The military leadership won't like it"
This absolutely makes me see red. You are the commander in chief. If the military leadership doesn't like it, too goddamned bad. We pay them to follow orders, just like the rest of the military. If they don't like that, they can tender their resignation.
299, 301, 305: We all seem to be on the same page here -- baffled and annoyed.
By my students taking exams, not by you guys.
304: I stopped answering the phone because so many people called me, nearly all of them Obama's people.
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First three Swallows & Amazons books purchased from Powells for Sally. I have also found out that I will be unable to shop online after the end of the month -- my credit card just expired, and was replaced with a new one with no expiration date, giving me nothing to fill out on the little online form-y thingies. This should have good effects on my cashflow, although should also decrease my reading volume.
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Maybe they'd like to say hi to me.
and was replaced with a new one with no expiration date, giving me nothing to fill out on the little online form-y thingies.
Weird!
310: Did you ever check out that "The Works" book? It's really good.
Al Franken pointed out that insurance regulation and money for high risk pools would go in right away. It's not nothing at all, but it's not much.
It's nothing, if I heard him right. I heard him say $5 Billion.
Here in NM the high risk pool costs $49 million to cover about 7,000 people (including me). At that rate the $5 Billion would cover ... carry the 17 ... integrate over the rate of essears per fidy ... less than a million people. Probably way less than a million, given that NM costs are considerably lower than the national average.
I don't know a single person over 50 who doesn't have a pre-existing condition of some sort. 1 million must be only a tiny slice of the people who need the high risk pool. Now maybe I'm thinking wrong, that the community rating and the underwriting ban will move all of us out of the high risk pools and into the general pool, but I really don't believe that.
I did
I stand corrected. I vaguely remembered you as saying that you didn't think you had changed anybody's mind, or added any votes, but I'm sure I'm wrong. I saw all the talk about what a great organization it was, but all I actually saw was the usual theater designed to look like a lot of perposeful activity but without any actual accomplishments that could be identified or measured.
And the grading. I can't stomach any more grading.
313: Before I saw that comment, I was in another tab searching for it on Amazon, because Powells only has it used. I'd forgotten it until about five minutes ago, and had it come to mind because I was getting Mannahatta for Buck.
Teh aweszomxorz! I hope the kids enjoy it. (And it will probably be interesting for you and Buck too.)
Hedrick Smith's The Power Game (written in the 80s) has a chapter on military contracting that gets into ways the military manipulated politics during the Cold War - placing some bases/plants for the purposes of gaining constituencies rather than for strategy, even having their own internal scorecards on how members of congress vote - but it's not something you hear much about now and with the end of the Cold War and the base closures, maybe it's not as much of a problem.
Also, Lincoln using soldiers to help win an election is not apolitical, but still falls on the civilian control side of things.
305 -- It's not like giving in to them on the abu ghraib pictures won him anything. Losing the WH counsel is a steep price, but ongoing credibility much worse. People can blame Rahm, but it's the czar's job.
One shouldn't underestimate the difficulties, though. 305 is the answer I'd like, but one has to recognize that the military/intelligence establishment is lawless, and plenty willing to operate in as bad faith as anyone in American public life. With a strong chunk of the country ready to buy any allegation of treason etc, and an officer corps that did not vote for Obama, I see the appeal of making the wrong decision: kowtow to the military on this, and maybe the climate is a little better for health and climate.
(I completely reject JRoth's idea that these compromises are about whether Republicans will say mean or untrue things. They are about whether the mean and untrue things will stick, which depends more on just their being said.)
$5 billion for high risk pools is a joke. Doesn't even begin to dent the problem.
314: It's five billion over either three or four years. You're talking a few hundred thousand people per year. (The money would be supplemented by some premium payments from the individuals involved).
Hooray! The last student turned in her exam! WHEEE! I'm outta here!
....to do more grading back in my office.
What with the random number function of Excel, how hard can it be to grade these days? You don't even need a dart board.
320.last: Why do the untrue things that Rs say about undocumented workers and health care stick, then? I guarantee that, if you ask anybody who's opposed to HCR, they'll mention "it's gonna cover illegals," if only in passing.
I just got an email from the fine folks at barackObama.com. They say "Your senators are fighting hard for health reform. Please call today, thank them for their work, and let them know we need them to keep fighting." That seems like such a pointless, even ironic gesture.
"The military leadership won't like it."
Is Catch 22 out of print or something?
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That was weird -- just got a call from a judge's clerk reminding me that I was scheduled for a conference tomorrow. I don't think I've ever gotten a reminder call from chambers before. Nice, but strange.
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Emerson: "The Democratic Party is not our friend and we shouldn't ever think that it is. Working through the Democrats is not like falling in love or finding Jesus. It's strictly business."
Emerson is right about this, but sometimes he forgets it. This, after all, is essentially the point Yglesias is making in the post I linked in 251, but Emerson argues against Yglesias there.
That's not the point Yglesias is making. He's just saying vote Democratic or be accused by some guy with a blog of being childish.
I will be unable to shop online after the end of the month
If you care, it's possible to get an awful lot of stuff online using paypal.
Though, perhaps that's more true in the used book/cd market than for new books. But many (though not all) of the people who list used items on the Amazon marketplace also sell via ebay.
I also see that alibris accepts paypal, so that gives you as much access to the used book market as you'd want.
It is hard to beat Amazon for new books, though.
He's just saying vote Democratic or be accused by some guy with a blog of being childish.
Ah, he was issuing a threat in an effort at coercion. Now I understand why he caught so much flack from people.
Basically, as I understand him, Bowers is saying this is a horrible bill, as policy and politics, and should be defeated...but...
Obama and Rahm will be using everything they have to defeat the most progressive liberal members of Congress next year, and a progressive will not be able to fight Obama's Blue Dog candidate after having voted against Obama's Health Insurance Bill, no matter how horrible it is.
Obama and Rahm are already supporting Blue Dog opposition to progressive members. Noe Blue Dogs will be hurt most, whatever happens, but progressives might be able to withstand Obama's attack on decency and fairness progressivism if they vote for the enslavement of the people to Big Insurance Liebercare.
Anybody remember Rahm's tactics in 2006 and 2008? Obama is such a Blue Dog he might as well be a Republican. He means to destroy the progressive wing of the Democratic Party, and this bill is designed, and the tactics played out, as part of that strategy.
If you want examples in the House, I can find them. But you probably know the conservative Democrats Obama has already supported in the Senate. Casey & Specter. Lieberman, etc.
How do I feel about a President who is using war and depression to move the Democratic Party to the right? Don't ask, I don't want to go to jail.
And I think Stupak will be in the final bill, and progressives will have to vote for it.
By forcing progressives to vot for this piece of shit bill, probably includining Stupak, Obama is hoping the progressive base will stay home ijn those districts, and Obama's hand-picked Blue Dog primary opponent will win that district.
If not maybe a Republican pickup, which would be ok with Obama.
The forecasters are now saying Democrats will lose 35-40 House Seats in 2010.
I think we should have talked more about cookies.
If you think Bowers suggested that the President is going to support a primary challenge to a sitting Progressive Dem member of Congress, I think I'm going to have to see a quote.
What he does say, bob, is that the worst possible outcome is the bill's defeat by Republicans and Progressives.
What he does say, bob, is that the worst possible outcome is the bill's defeat by Republicans and Progressives.
I am so sick and tired of hearing "we gotta support this because, as gawd-awful as it is, it's marginally better than the truly horrendous alternative." That should be our motto: America, Not Quite As Terrible As It Could Have Been, By Just A Tiny Bit.
It may be true, but it's not heartening.
338: Whether or not Bowers suggests it, Glenn Greenwald seems to be gesturing in that direction, at least with respect to the administration's alleged behavior over voting on the supplemental spending bill for the war. See the quotation about halfway down the page:
The White House is playing hardball with Democrats who intend to vote against the supplemental war spending bill, threatening freshmen who oppose it that they won't get help with reelection and will be cut off from the White House, Rep. Lynn Woolsey (D-Calif.) said Friday. "We're not going to help you. You'll never hear from us again," Woolsey said the White House is telling freshmen.
Greenwald links to a Huffington Post story that notes that the White House denies this, but who knows.
I'm not yet ready to go the distance with those announcing that Obama et al. are declaring war on progressives; I'm too aware that I'm swayed by the rising chorus of voices sounding that theme. It is worth keeping an eye on, though.
I'd like to hear more about the good things in this bill (PGD? Mr Carp?). Basically, I'm leaning toward endorsing a "kill the bill" position, but am willing to be talked out of it.
A mandate without a public option seems very very wrong to me. Wrong on principle, but also wrong-headed in terms of longer-term (and/or perhaps shorter-term) electoral consequences. To make people purchase something from a private, profit-maximizing entity without providing a publicly-funded/-assisted alternative sounds like forcing them into a kind of indentured servitude to the insurance industry. And also looks like a gift that keeps on giving...both to Aetna and to the GOP.
Is there no way of forcing the public option back in? or maybe sneaking it in or something?
338:Obama supported Lieberman against Lamont.
He is supporting Specter against uhh, whomever.
It is actually a little late, but I would like to check the various contested primaries to see.
Obama did kill Dean's 50 state strategy and organization, so Republicans wouldn't face opposition.
Obama did also pull the very cream of the possible Senate candidates into his cabinet. Sibelius
"This is not an abstract worry. Consider, for example, the emerging shape of Regina Thomas's challenge against White House backed Blue Dog, John Barrow: "
What he does say, bob, is that the worst possible outcome is the bill's defeat by Republicans and Progressives.
The worst political outcome, not the worst policy outcome.
Is there no way of forcing the public option back in? or maybe sneaking it in or something?
It seems not, but I don't know. To be completely honest, it's not clear to me what the health insurance exchanges and community ratings, which are apparently to control costs through competition, are supposed to be. It's said that these are suitable (enough) in the absence of a public option, whether a strong or a weak one. I really haven't wonked out enough on all of this. I could use a primer.
Obama supported Lieberman against Lamont.
Not after the primary.
Community rating, if I've got it straight, means that the insurance company isn't allowed to consider your health history or status in deciding what to charge you for insurance. All forty-five-year-olds pay the same. So a company that wants to attract healthy people with low prices can't do it without offering the same prices to sick people.
345: Obama's post primary support for Lamont was totally perfunctory "yeah, yeah... I'll support the democrat" support. Given the opportunity to actually go to Connecticut to campaign for Lamont, he, along with the rest of the friggin' democratic establishment, refrained.
345:Obama never campaigned for Lamont, or showed up in the state.
Now since Lieberman was working for Republican and independent votes, direct support from Obama might have been counterproductive. But by not working for Lamont, Obama made his preference known to whatever Democratic support Lieberman has left.
Asa far as I am concerned Obama and Lieberman are conjoined twins.
Huh. Having just set myself to understanding what community rating and health insurance exchanges are meant to be and to do, and in the general search for a primer, I find this from NPR, dated November 18th, outlining the Senate Finance Committee's bill (or is it the Finance Committee's bill mixed with the HELP Committee's bill? not sure).
Check out the "likelihood to be included in final bill" ratings for the various features. Public option? Turns out not so much.
In any case, insurance exchanges need clearer definition. I already get annual statements from my health insurance provider telling me that it's met various minimum requirements for coverage, that it has the seal of approval. That's good and fine; this is not about my learning which plans are shitty plans, though that information should, of course, be out there. The problem is that the non-shitty plans are too expensive.
As far as I see, then, the only thing about the current bill that keeps things affordable is subsidies (for some). In the absence of a way to negotiate rates, there's not much else to control costs except some hope for goodwill on the part of insurance companies.
Yeah... when I look at this bill from a "what's in it for me?" perspective, the answer appears to be "jack shit."
the only thing about the current bill that keeps things affordable is subsidies
Those are also the easiest part of the plan to get jettisoned or reduced later on.
346: Some types of community rating actually involve charging everyone the same without regard to age.
In MA, age is definitely considered as is your zip code, since medical care is more expensive in eastern MA than it is in the western part of the state.
Obama and Lieberman are conjoined twins
I think this is more a case of the Black using the Jew as muscle.
Good ol' Krugman makes the case for doing the deal on health care. I think that he's got it exactly right on all counts.
Those are also the easiest part of the plan to get jettisoned or reduced later on.
The same way they've found it so easy to cut the subsidies in Social Security and Medicare?
Anyone who thinks Obama and Lieberman are on the same side is delusional. Obama endorsed Lamont in that general election, and Lieberman endorsed McCain in that election.
Obama has made a calculation - correct or not - that Lieberman has a lot of leverage and must be treated deferentially. Note that among the Democrats' enemies, Lieberman is among the select few that can be won over to some plan. Even Lieberman is likely to be a gettable vote before, say, Snowe or Collins. And maybe even Nelson. Lieberman is a fucking sociopath, but without even thinking hard, I can name 35 worse senators.
352.1: From random googling around, that's what I'd understood it to be. Everyone in the same pool is charged the same. But it's unclear what a pool is: everybody in a given group plan, regardless of age, so that costs are evenly distributed? Or everyone in a given age range within a given plan (which is how my current plan works).
This is why we needed a public option, to gather a large pool together which might negotiate rates, with its leverage being its size. I must surely be stating the obvious.
350: Well, yes. But there are categories of us. There are those who are barely making it and who cannot afford health insurance no way no how, period, without subsidies. There are those -- and I fall here -- who don't make a hell of a lot, are self-employed and don't enjoy the benefits of employer-provided subsidies, and are now paying 15-20% of our gross income for health insurance. I can barely afford it, and if it continues to go up, it will be a real problem. Then there are those who enjoy employer-provided and subsidized health insurance. I haven't been in that category for a long time, so I don't know how you all are doing.
I think Bowers is mainly referring to the WH supporting conservative Dems in primaries where the conservative Dem is the incumbent, or there is no incumbent--not trying to take out sitting members of Congress. (He has said there are rumors that Rahm is supporting a challenger to Donna Edwards, which is completely infuriating if true and not implausible, but I would be shocked if the WH did so *openly*. OTOH, even if the rumors are true I bet that they're not pulling out the stops to clear the field for her the way they've tried to for say, Specter (who, it is blatantly obvious, is only any use because of Sestak).
The same way they've found it so easy to cut the subsidies in Social Security and Medicare?
Both of which cover all Americans of a given age equally (and SS actually gives a bigger check to higher earners). This is precisely what insurance subsidies don't do.
This occurred to me, regarding reconciliation:
We all agree that there are 55-57 solid votes for basically whatever gets shit out of the process. There are doubts about whether there are really 50 votes (plus Biden) for reconciliation, but most people agree that it's in the ballpark (it's not obviously impossible to use reconciliation).
So can anyone explain to me why Senators 45-57 weren't taken aside, early, to be told, "We need reconciliation as a credible threat; we hope not to use it, and we certainly wouldn't force you to vote for it. But unless you want to eat a shit sandwich, we need to be able to threaten reconciliation with Nelson, et al. Can you hem and haw but not reject reconciliation outright when we float it?"
That seems to me to be a very effective approach because, among other things, it's a large enough crowd, and you have a big enough margin, that no one (or even gang of three) has any leverage over it. Unless they all reject it (which would be an odd way to act wrt a bill they intend to vote for no matter what in non-reconciliation form), it keeps reconciliation as a credible threat and undermines the beloved leverage of Nelson et al.
I might add that this meeting can be accompanied by all sorts of low-level bribery - stuff that Senator 48 can't get access to on the basis of the irl process because her vote isn't in doubt, but that rewards a little unity and well-timed vagueness.
Is there some obvious reason this wouldn't have worked?
I would indeed like a run-down at this point, per MC's 342, of what's good about this bill.
PGD? You said in comment 93 that the exchanges and regulations create a framework for future changes. I'm not seeing what the exchanges do. Help? It looks like they just establish minimum standards for coverage.
After all, minimum coverage standards and protection against being turned down for a preexisting condition, i.e. guaranteed issue, is absolutely worthless if you can be charged 15 kajillion dollars/month for the plan.
BTW, Katherine, as someone who got into a shouting match or two with you last year, I do appreciate your 213. I hope your little one is doing well.
As for whether it's reasonable to think that HRC would have been better, I'll say this: there were 2 points of (plausible) significant difference between the two. One was the whole civil liberties/GWOT thing, and the other was postpartisanship. I think it's hard to argue that HRC could have been worse than Obama on the former (as many have argued, Obama has done virtually everything Bush did that hasn't been explicitly outlawed), which leaves postpartisanship. I don't think it can be denied that Obama wasted a lot of time and energy on his postpartisan fantasies and has gotten exactly nothing in return. However HRC would have governed, that's a mirage that she wouldn't have pursued (Obama really seems a true believer on this postpartisan BS, whereas HRC would presumably have made a good-faith, but nominal, effort, then gotten on with running things).
It's certainly possible that HRC would have been worse than this, but I think it's hard to actually make the argument based on anything concrete.
What makes you think there are ~45-47 Senators who'd vote for reconciliation, JRoth. My understanding is that the number is nowhere near that high. And that even if it was, many people are concerned that passing landmark legislation like this through the back door makes it much more, rather than less, likely that it will be watered down in the future.
Continuing my 361.last: if you can be charged 15 kajillion dollars/month for the plan, which are you required to buy/pay for. Mandate, you know. Many people will take the $750/year penalty instead.
I'm trying not to laugh.
JRoth's approach in 360 sounds good; I believe people are mad at Reid, or perhaps Obama himself, for failing to twist arms in such a way.
JRoth, there were other important points of difference. Some examples: Mark Penn, Lanny Davis, the Clinton campaign's odd inability to figure out the rules of the nominating process (likely related to Mark Penn), the way in which the Clinton campaign chose to attack another Democrat in a really horrible fashion (this is debatable, I'll grant you), and Obama's (perhaps lukewarm) stand against the Iraq War. Honestly, I don't want to re-litigate any of this. But I do think it's worth getting the history right. It's too soon for hand-wringing revisionism, I think.
However HRC would have governed, that's a mirage that she wouldn't have pursued
I understand that Hillary Clinton is not Bill Clinton, but if his presidency offers any evidence, I think it's to the contrary.
362: thanks, she's great. Walks, talks (well, says words, anyway), dances, ocasionally tries to sing, & is turning one this week.
more, rather than less, likely that it will be watered down in the future
As opposed to being watered down prior to passage. Awesome.
366: Clinton did his triangulating when he was faced with a Republican majority. The most important thing he did in 8 years (his first budget) passed without a single R vote. I don't see any reason to think that HRC would have dicked around with self-defeating BS like talking about 70 votes for stimulus or encouraging Baucus' stupid Gang of Six process.
367: Wow. Whereas Kai is still pre-verbal at 17 months. But isn't the dancing great?
368: Sorry, Mr. Crankypants, it's the best I've got.
363: Huh. I've never read anything that made me think that it was impossible to get the votes (or to get close); mostly I've read about how inadequate such a bill would be, and that it would be hard (not impossible) to pass.
I think it's really comical that you believe that HCR passed this way is somehow under greater threat from Rs than HCR passed under reconciliation. Either the Rs can destroy it after 2012 (Obama would veto any such efforts in 2010-1), or they can't; they won't scruple for a second about how it became law.
Next you'll be telling me that Rs would never impeach a President unless he'd done something really awful.
365: I'll see your Mark Penn and raise you a Rahm Emmanuel.
I'm absolutely unwilling to reënter debates about who attacked whom more awfully. But it's utterly irrelevant to the question at hand, which is whether HRC would have been a more or less effective President that BHO. I used to be willing to entertain the idea that smooth-talking, consensus-building Obama might be able to achieve things that Clinton couldn't; I think that that notion should be laid to rest.
372: I'm not trying to figure out who would be a better president (talk about beside the point); I'm correcting your contention about there having been only two key differences between the candidates during the campaign. And Obama didn't tap Emanuel as CoS until a couple of days after he was elected, right?
372: Also, if he passes hcr, he will have accomplished something that no president has in approximately a century. Will it be a great bill? No. Will it nevertheless be the most important piece of Democratic legislation since the Great Society? Probably -- though who the hell really knows? Also, he's been president for less than a year and came into office facing a country as deeply fucked as at any time since 1860.
I like to picture Ned Lamont and Gray Davis getting lunch one day and toasting the world we "We TOLD you, motherfuckers."
376: I do recall a moment in undergrad when I claimed Gray Davis would be president one day.
374: I was talking exclusively about policy issues, ari. I don't give a fuck about who gives you warm fuzzies as a candidate.
Memory lane on the Emanuel appointment. (Election night thread in which I am embarrassingly snippy to JRoth, but appropriately paranoid about Emanuel, but not quite paranoid enough.
warm fuzzies
Ah, the good old days! I think the phrase you're looking for is "whirly-eyed" or maybe "starstruck Obamabot".
Either the Rs can destroy it after 2012 (Obama would veto any such efforts in 2010-1), or they can't
So nothing about the way it's passed or what's in it matters? Why even pay attention or get so exaltedly righteously indignant about things then? Either it will pass or it won't. Either the Rs will destroy it or they won't.
I won't say Clinton would be any better. DLC, all fucking DLC all the time is what we got at the effective margins.
Well, I thought Obama was scarier than Clinton because he actually could get Republican support. But the Republicans are batshit crazy or radical evil and I won't even blame O for post-partisanship, because it look irrelevant.
I also always made a point that any marginal Senate gains were going to be Blue Dog. This fucking country has a very serious Blue Dog center problem, different, but comparable to the bullshit I watched in the 60s. There just isn't a 60% liberal majority to be found. My feeling is that FDR and Truman and LBJ had their own kinds of conservative Democrat hell, and their accomplishments were bloodsoaked miracles.
I guess I shouldn't hate Obama, just another centrist tragic figure. But I would have enjoyed just a little thrill of quixotic leadership, a small sense of being listened to and cared about, even if I lost every fight.
I did get that a little with Bill Clinton, some sorrow. Yglesias is begging for some feckless quixotism.
Obama feels like a smug centrist, a self-righteous compromiser, a happy and proud Blue Dog. Like Rahm and Summers, I am not seeing any compassion or guilt. Can we please give Lieberman just a little pain?
This country is just so fucking fucked.
Bob, let's stipulate that you're totally right about everything, that you are the putter-of-true-facts-into-brains. Still, the schtick gets old.
I'm sorry you pooped yourself.
Stumbling & Mumbling, a British econblog, talking about Britain
It estimated that, in 1923, the richest 10% owned 89.1% of all wealth. By 1952, this fell to 70.2%, then to 60.6% in 1976*. This paper (pdf) reports that the proportion fell to 48% in 1993. And the ONS estimates that it is now 41%, if chattels and pension rights are excluded; the data is beneath figure 2.2.
Shit like this and European healthcare just makes me crazy. Americans aren't fucking martians, why can't we get it done.
I have always fed beans to boars.
Americans aren't fucking martians
We would be, if we knew where they were hiding.
386: Sorry, bob, but the correct response is actually "That's not what your mother said."
I'm so divided about this bill. On the one hand, I get the point -- the mandate is like a tax, the exchanges and regulation will force insurers to deliver value for that tax, the subsidies will reduce the net price of health care for the middle class, the fact that insurance costs will move directly on to government budgets will change the political dynamic significantly.
On the other, there are really legitimate concerns that can't be dimissed by an appeal to be realistic. Like so much else in the establishment Democratic party, this approach is a product of 90s market ideology. The Heritage Foundation was the first to push a "market competition" exchange model for public health care (as a way to "reform" Medicare, based on the FEHBP, back in the 1998-2003 period). Then Mitt Romney was the first to put it into action, in Massachusetts. The model is a play for the liberal center back when that center was defined by 1990s market worship. So much in the Democratic intellectual establishment is shaped and conditioned by that period. Liberalism really got caught flat footed by the crisis moment this year.
I keep coming back to the delay in implementation. After all this endless fuss, people will really see very little for years. (Unless the managers package takes some pretty significant steps). I just don't know how that plays out.
It's like, this legislation is so defined by the box the planners of it believed themselves to be in. But there's no objective take on the political box. So many subtle choices were made and then not revisited, even staying within the Exchange framework one could have been significantly bolder in insurance regulation.
And Bob isn't boring. He's ever-evolving, always transfixed by the approaching catastrophe, but his perspective on it shifts gradually and subtly over time. Now he's learning empathy for Obama as the helpless tragic centrist.
I've been trying to figure out why the entire HCR debate has made me so completely angry, and it's really the same thing that made me so angry about the bank bailouts. I don't really expect much from the federal government but, to me, the most important role the government plays is protecting me from corporations. The massive transfer of wealth from the middle class to the very institutions that just wrecked the economy, with no tangible repercussions for them whatsoever, was absolutely infuriating. And mandating that now every American will be legally obligated to effectively tithe to the insurance industry, possibly the only legal industry in America that could compete with finance for unethical behavior and rapaciousness, well it's a tipping point for me.
These are terrible, predatory industries. I have almost nothing but bad experiences with insurance companies. It's almost always been a nightmare and I'm relatively young and healthy. I have warmer feelings toward the tobacco industry than insurance and they wanted me to buy addictive carcinogens. The insurance companies are precisely what's *wrong* with health care in this country. Saying we're going to reform health care by strengthening the insurance industry is like saying we're going to end the war in Afghanistan by expanding the war in Afghanistan. Which, amazingly enough, is indeed the plan. At least they are thematically consistent.
Or what PGD says, but with extra venom and bombast.
For what it's worth, I agree with almost all of 392, Apo. It's just that I don't see how any better alternative could have passed the Senate. And also, I trust the people that I trust. And they say that the current bill is MUCH better than the status quo.
That said, I entirely sympathize with your outrage. And I'm not trying to drive a parade through your rainstorm.
It's just that the "fuck the Democrats and the ponies they didn't ride in on" attitude freaks me out. Have you seen the alternative? They're evil. You've got to be a Trotskyite or a nihilist -- ferrets, anyone?* -- to think that handing power over to Republicans is preferable to building a more progressive Democratic majority. Because I don't buy the argument that the revolution will hurry up if we just let President Sarah Palin close every library that doesn't front-rack her book.
* Have I mentioned how much I miss Emerson?
The Heritage Foundation was the first to push a "market competition" exchange model for public health care
This. This exactly. We finally get a Democratic president, a Democratic House, and a Democratic Senate, and they ask me to accept a right wing think tank's model of changing the health care system. And when some on the left say "this is wrong, this is an actively harmful way to do this," the main response we get from the rest of the coalition is "grow up."
It's distressingly reminiscent of the lead-up to the Bush wars.
I don't think handing over power to the Republicans is preferable to building a more progressive Democratic majority. I'll continue to vote for them because my first priority in voting is keeping Jesus' stormtroopers furthest from the levers of power. But terrible policy from Democrats is still terrible policy and should opposed.
If I believed that it was bad legislation, then I'd agree that people of conscience should oppose it. But as I said above, the people I trust are saying it's much better than the status quo. And given that, killing the bill seems like the greatest gift the Senate could give to the Republican Party. Happy Holidays!
We trust different people. That's okay. I'll note that a lot of the people around the blogs that I read saying we should pass the bill also thought we should invade Iraq. I don't think that's a coincidence.
110 Like when a tangible friend sends my yahoo account a picasa photos link, it'll say
"Heebie-geebie is viewing these photos" and I'll freak out. Anyone have insight?
Take a look at Youtube settings too, it will nominate your gmail contacts as youtube friends.
Using Opera, Chrome, Firefox, Camino logged into samesitesdifferentaccounts, but not for sock puppetry.
A little anecdote: I was talking to a pleasant, competent, thoughtful, somewhat influential Democrat in what you would think be a quite liberal setting. We were looking at a document that argued for tightening regulations in a particular area and said something like "because of the direct relationship between action X and financial sector profitability, regulators will always be under pressure to loosen constraints on X". He didn't like that -- we didn't want it to seem like we thought profits were bad. It was important to be business-friendly, etc.
This kind of thing is absolutely endemic among establishment Democrats. The ideological presuppositions of Reaganism are very deeply engrained. The Democrats are the kinder, gentler face of capitalism --- we take the surplus it generates and redistribute it some (but not too much!). Government spending goodies are fine, but the notion that it can be socially beneficial to truly restrain and control corporate power is still somewhat alien and scary.
Saying the Republicans are worse is true enough but misses the point. The threat is not delivering for the middle class in a tangible and understandable way. The establishment Democratic ideology may prevent the party from doing that.
To the extent independent voters come to share the attitude Apo expresses in 392, that will move the political center. After a decade of no median income growth and no private sector job growth you can already feel the changes. But I wonder about who will capture the momentum.
In the end the health bill doesn't need to be killed, because the framework it sets up is so open to improvement -- just as industry shills could easily push it into being an insurance industry subsidy, progressives could make it into a true framework for finally controlling the insurance industry. At this point, "killing the bill" would be counterproductive; pass it and live to fight another day. But based it won't be an easy fight.
42, 66 Hey, did you guys hear that some Canadian writer had some trouble at the border?
On topic:
Anthony Galea was writing Rx for Tiger.
120 Maybe. I'm not sure one way or the other about this. But (I believe) we've still got guaranteed issue (I think that's the phrase -- companies have to sell you insurance regardless of pre-existing conditions) and no recission. That's pretty huge.
Why is that ? I would have expected some federal re-insurance program to cap losses. It worked so well to give people mortgaes they can't afford, it should also work to give them health insurance they can't afford, too.
It's just that the "fuck the Democrats and the ponies they didn't ride in on" attitude freaks me out. Have you seen the alternative? They're evil. You've got to be a Trotskyite or a nihilist -- ferrets, anyone?* -- to think that handing power over to Republicans is preferable to building a more progressive Democratic majority. Because I don't buy the argument that the revolution will hurry up if we just let President Sarah Palin close every library that doesn't front-rack her book.
To start with, Trots don't believe that at all, so yeah. But more importantly, is there anything that the Democrats can do that would lose them your vote? Because if there isn't, you have very little power over them. One way you make Democrats act more progressive is to convince them that's where the votes are; if the progressive votes are there anyway then why bother?
(Aside from supporting left-wing primary challengers, and doing all the boring organisational work that a left-wing movement needs. But that's boring.)
I'm basically a bad person, so part of me sort of wishes that bad things happen, just to see what happens next. In the run-up to the 2004 Presidential election, part of me wanted Bush to win just to see if it would be as bad as I feared. Would he really bomb Iran? That sort of thing.
So when I'm imagining the possibility that the Democrats are about to pass a bill that forces people to write checks to insurance companies, and as a side-effect causes insurance companies to stop covering abortion, and part of me thinks "awesome". What will happen next? Record losses in 2010? President Palin in 2012?
because if there isn't, you have very little power over them. One way you make Democrats act more progressive is to convince them that's where the votes are; if the progressive votes are there anyway then why bother?
Exactly. See also, New Labour (tragic history, thereof).
if you don't have some red-lines, you're basically asking to get fucked.
But more importantly, is there anything that the Democrats can do that would lose them your vote? Because if there isn't, you have very little power over them.
I'd imagine that the answer here is "be more right-wing than the Republicans".
405: To be fair, the difference is that now the Republicans are considerably worse than the Tories.
re: 407
There are also has to be some force pushing back towards the left, otherwise we just get the same old relentless race to the right that has characterized political parties in both countries.
Careful, ttaM. Matthew Yglesias will tell you to grow up.
re: 410
Nothing more tedious than 'realists'.
...but there's the one nuke problem. One nuclear bomb is the most useless thing in the world; let it off and you've made it absolutely certain that every other world power is going to DESTROY you, and you have no further deterrent.
One thing that always strikes me about US politics is that the President may as well be the Emperor to the rest of the world, but in terms of internal politics it's all about the other two branches of government. In so far as anything touches on foreign affairs, the president can usually do what he damn well likes. But internally, anything that isn't settled in the courts is decided by legislation, and it's on internal politics that presidents are made and unmade.
To what extent do you think the administration would recover from losing the health care bill?
It also strikes me that the eventual meaning of this legislation is going to be defined by the courts - like it always is in common law jurisdictions - and perhaps by whatever executive agencies have a say in it. For example, the provision that is meant to stop insurers walking away from their customers - that could be nothing, or it could be very valuable indeed, hinging entirely on what precedent is set in the test case. There's a reason why so much of US history is remembered by the titles of court cases.
Of course, that would also have been true had they hypothetically kept the ponies in the bill.
I haven't really thought about the constitutionality of a mandate, but I can imagine the Roberts court having some serious issues with it. Thomas would like to roll back the New Deal, seems to me, and maybe this is his chance. I don't think there are five votes for that, but an unpopular and punitive mandate might get struck down. This puts single payer in the drivers seat. Single payer or nothing.
All kinds of things are boring when repeated. Most professional politicians think there are more votes to be had in from the center by dissing the left than would be gained by embracing the left. This'll be different from jurisdiction to jurisdiction, and in both presidential and congressional politics local orientation is crucial.* Clinton did triangulate a bit in the first half of his first term -- indeed his whole 'new covenant' bit at the convention and in the campaign was supposed to show a centrist path. Same for candidate Obama's embrace of escalation in Afghanistan and rejection of single payer.
Are they wrong? A childish Left killed Al Gore, and got nothing whatsoever to show for it. Hey, maybe it'd be different next time.
* It won't make any difference in national politics if I sit out 2010. My Republican congressman is going to be re-elected, and neither senator is up. The state house seat is open, though, so I'll vote.
407: I'd imagine that the answer here is "be more right-wing than the Republicans".
Well, that's the point. Everytime I do the math, as far as I can tell Obama is, in main substance, now off to the right of the Elder Bush.
I grant that Bush had some nasty police state habits (see Ruby Ridge, Waco, the drug wars), and he got into a big war, and so on. As far as I can tell (I keep checking!), Obama has embraced all those positions, excepting that he's FOR more free money for banks, and he's AGAINST any tax increases. Meaning that he could have run in the Republican primary from the right of Bush's then effective positions.
I also grant that, were the elder Bush to have been elected in 2008, he would be further off to the right of Obama now. That's the point: the R party has moved ideologically to the right - but not the libertarian right, the fascist right - and the D party has essentially followed right along, embracing the 1992 positions of the Elder Bush as the 'moderate alternative'. In turn the R party calls the D party a bunch of liberal weenies, much like they called the Elder Bush a liberal weenie. (And the Elder Bush called them 'extra-chromosome conservatives'.) The really really weird part is that not only has the R drift avoided libertarianism (excepting in rhetoric), they still haven't hooked up with Patrick Buchanan either. Possibly some of the teabaggers want to go there.
If the R party is the answer, the question must be, 'What if Mussolini decided to start working for Maoists?'
None of this would be a big deal, as any success by the D's would involve a drift to the left (some left), excepting that the leadership of the D party apparently hates its base even more than the R leadership hates the R base. Summary: we just elected a bunch of convinced Reaganites - and they're the moderates!
I am totally trying to acoid rhetorical excess here - I am downtuning the fire to absolute demonstratable baseline of Obama's actual efforts to date. Holy shit, this is just weird.
I can derive four things here (besides, holy shit, this is just freaky): 1) This is not going to end well, 2) Ain't gonna vote for Mussolini, 3) Have to get rid of these fuckers before they really screw things up, 4) Have to be careful about letting Mussolini in.
max
['Must zig when Bomb zags.']
Ruby Ridge, Waco
That was Clinton.
Obama was elected on a platform much further left than the one he appears to actually be enacting. If supporters of the party aren't supposed to hold him to that, because that would be 'unrealistic' then what is the point?
414: Bush I was an underrated president: he was fiscally responsible when it would have been politically easier to do otherwise and finished all the wars he started. We could do and have done worse.
Bush I was the best (officially) Republican president since Eisenhower, certainly. But that's kinda like being the tallest midget in the circus.
I sort of hope that Gray Davis and Ned Lamont wouldn't be best buds. I really hated Gray Davis because of his prison policies and the fact that he hadn't let anybody out on parole. He also seemed --even for a politician -- to be extra cozy with peoplewho gave him money, saying I won't do anything for you unless youcough up money.
Summary: we just elected a bunch of convinced Reaganites
McManus tried to warn us.
417: not really -- if you check his actual words Obama ran pretty much on what he's doing now.
I think there's value in having the party aware that a loss of enthusiasm on the left costs them in voter turnout. I do think that affects decisions. But the key thing is the center of gravity among independents -- if people who don't think of themselves as committed Democrats/liberals start feeling viscerally pissed off (more Apo-like) and lose enthusiasm for candidates who don't reflect their beliefs, then the party will eventually move to find them. This may already be happening on financial reform.
But that's kinda like being the tallest midget in the circus.
Or the most progressive legislation since the Great Society.
And also -- Obama ran pretty much on what he's doing now -- but let's not forget that he's doing now is governing as the most liberal President since Carter. He ran on the liberal edge of the establishment Democratic center. (But it was the establishment center -- he supposedly wanted Evan Bayh as VP!). But given the economic situation that's not a high enough standard for many.
Richard Shelby will vote no on Bernanke nomination.
My guess is Bernanke still wins though.
Or the most progressive legislation since the Great Society.
Bullshit. As written, this bill is not at all progressive. It's aggressively corporatist.
With the Senate shifting sharply away from a "pure public option," an insurance industry insider who has been deeply involved in the health care fight emails to declare victory.
"We WIN," the insider writes. "Administered by private insurance companies. No government funding. No government insurance competitor."
let's not forget that he's doing now is governing as the most liberal President since Carter
No. At this point, that's still Bill Clinton, which is one sad statement.
So nothing about the way it's passed or what's in it matters? Why even pay attention or get so exaltedly righteously indignant about things then? Either it will pass or it won't. Either the Rs will destroy it or they won't.
How it's passed doesn't matter*; what's in it does. For instance, if it's a bill that results in people seeing positive change in their lives starting immediately, then the Rs can't kill it regardless of (plausible) electoral outcomes. OTOH, if it's a bill that makes people who vote feel like they've been screwed, then it's in danger. But I can't see any meaningful change in outcome from actual method of passage. Medicare Part D was passed in the House through the longest open roll call in House history and outright (legislative) bribery on the House floor, but no one has ever hinted that the benefit is in danger because of that (by contrast, the worst bits of that bill are at risk in the current legislation, which is a good thing).
As for the last part of your comment, it applies equally to everything that happens in DC. We talk about it here because it makes us feel like we're in a functioning democracy. But that's irrelevant to what I've been talking about.
* freely granting that reconciliation will have a big impact on the content of the bill, and could, in fact, screw up the outcome. But there's nothing in theory or practice that makes reconciliation-passed legislation more vulnerable to repeal
No. At this point, that's still Bill Clinton, which is one sad statement.
I disagree. Clinton chose deficit reduction over a big stimulus package when he came in, and later in his term deregulated financial markets. The Clinton health plan was pretty similar to this one -- more liberal than the Senate version, but around where the House version of the current health care plan is.
There are also has to be some force pushing back towards the left, otherwise we just get the same old relentless race to the right that has characterized political parties in both countries.
This is clearly correct. The question is: When should that force be applied against Democrats? The correct answer (in almost every case) is: "In the primaries."
Joe Lieberman is a vile human being, and there are a lot of reasons that it's important to emphasize his vileness. But we ought not lose sight of the fact that, by the sociopathic standards of the Senate, he's a pretty middlin' fellow. There are 40 worse Senators.
New Labour's history would have been somewhat less tragic had a small number of American liberals not tried to apply pressure on Al Gore in 2000. Apo (correctly, I think) distrusts health-care reform supporters on the grounds that among their number are a lot of the folks who supported the Iraq War. But apo overlooks the fact that health-care opponents are dominated by people who were on board for that tragedy, and other tragedies besides.
There are 40 worse Senators.
I don't think I agree. At least Olympia Snowe doesn't act out of spite, and lets you know what she is and is not willing to accept ahead of time. I would have been much happier with a situation where they cut off Lieberman and agreed to work with Snowe. At the very least, they could have gotten "triggers" out of that negotiation. Triggers kind of suck, but its better than nothing at all, which is what working with Lieberman got.
Fair enough, though I find it difficult to place those sorts of decisions (stimulus versus deficit reduction) neatly on a liberal/conservative axis.
New Labour's history would have been somewhat less tragic had a small number of American liberals not tried to apply pressure on Al Gore in 2000.
Unlike a lot of people I'd already jumped ship on New Labour before the 2001 election.
The system as currently set up does largely seem to be, "do what you like, as either way, improvement isn't coming".
430.last: The right-wing opponents of health care reform are right like a stopped clock is right twice a day. They just oppose everything a Democratic administration proposes. The tendency I see with the Drum/Yglesias/Klein crowd (and I like those guys overall, but...) is different. It's not a result of partisanship, but an instinctive trust of inside-the-Beltway common wisdom.
Of course, it's hard to compare Obama to others because this is/should be a liberal moment -- Clinton would have governed differently now, and Obama would have likely governed differently then.
432: For example, the avatar of conservatism, Ronald Reagan, went all in with stimulus in the form of a massive military buildup, and gave not a care for the deficit. Cheney was claiming that deficits don't matter right up to the point that somebody else owned it.
I'm thinking about not voting in the general of my special election, since I don't care for Martha Coaakley. The challenger from her left, who was thoroughly establishment and probably as much of a machine candidate, lost. She's guaranteed to win.
I've also thought about going in to vote but submitting a blank ballot.
If you're going to submit a blank ballot, you may as well write in the person you wish was the candidate.
I don't think I agree. At least Olympia Snowe and lets you know what she is and is not willing to accept ahead of time.
"Spite" is a pretty good one-word description of the entire Republican ethos nowadays, and Snowe is reliably on board for the worst of it. To pick an example, let's look at the Republican filibuster of the recent spending bill. Opposition to that bill - to the point of filibuster! - was pretty damn spiteful, and Snowe filibustered. Lieberman voted for cloture in a situation where his vote was decisive.
If Reid could do a deal with Snowe on health care, he'd have done it. Snowe's vote isn't gettable. Lieberman's is.
We judge Lieberman and Snowe by two different standards - and we should! As someone who caucuses with the Democrats, Lieberman is in a position to damage Democrats in a way that Snowe is not. And Lieberman is vulnerable from the left in a way that Snowe might not be - so that's another good reason to amplify the loathing. Heck, the existence of Lieberman takes a lot of heat off of Snowe, which is another good reason to hate Lieberman.
I'm just asking for a little perspective.
Whoops - I suppose I don't need to point out that 439 was me.
And GWB went whole hog on stimulus with his tax cuts and doubled the deficit.
re: 434
re: the Yglesias, etc crowd.
Plus, actually not being remotely 'of the left' [even in a very moderate sense] in the first place.
Clinton chose deficit reduction over a big stimulus package when he came in
The economy was already in recovery and adding jobs by the time Clinton was elected; arguably, had the election occurred 6 months earlier or later, Bush wins. So stimulus would have been incorrect. Furthermore, deficit reduction at that point in time was actually the correct thing to do. Right now, Obama's talking about deficit reduction when it's absolutely the wrong thing to do, because it's the "conservative" path.
|| Stanley and his grandma are the best!!|>
Snowe's vote isn't gettable. Lieberman's is.
Is it?
re: 445
Are there supposed to be public links to that photo pool? [Or can people only follow the link if they are registered in it anyway?]
442: Yglesias is an interesting writer because he combines a number of stances. He's very much a creature of the establishment (Dalton, Harvard), but also very aware of that ("no one should donate $$ to Harvard"); because he got the Iraq War wrong and became an adult in the age of Bush, he lacks some of the permanent crouch of the previous generation of Dems, but he has also lived his entire life in the shadow of Reagan; he's careerist, but not afraid to call politicians and established pundits out in a pretty aggressive way; he's not of the Left, but he has more respect for and engagement with genuinely (if only historically) Left thinking than just about any non-Left, American pundit I can think of.
I'm not trying to get all Tale of Two Matts here, but I think one of the reasons that he's an engaging thinker is that he's not a down-the-line guy along any axis (although I think he's far too prone to the groupthink of his DC blogger cohort, as has been discussed here before). You can say that he's establishment and non-Left, but he immediately took the news that Bernanke was Time's POTY and used that to attack both Bernanke and Beltway consensus.
Or can people only follow the link if they are registered in it anyway?
It is a private pool so you should only be able to see the photos if you are a member.
Is this bill actually a bigger contribution to the welfare state than Medicare Part D?
447: I just changed a setting on it -- tell me if you can see it now. It's so super smile-inducing.
Re: Yglesias et al:
I'd feel less annoyed with them if their positions felt more authentic. I realize this a hopelessly vague complaint, but Matt's rhetoric in particular carries the smell of language used as a tool rather than a means of expression. If his centrism were instinctual I'd be less bothered.
448 is exactly right.
Also, 453 to Becks, as anyone who RTFA or watched the Rachel Maddow show would know.
The liberal I voted for in the primary or the guy I wanted to run in the first place?
Also, as an aside, drug reimportation really annoys me. I'd much rather have Medicare negotiate drug prices or even have some sort of standardized price across the board.
Also, as an aside, drug reimportation really annoys me.
I actually rather like drug reimportation, because it allows me to order my astma meds from a shady website online, rather than have to schlep to a doctor to get a prescription. And the cost is about the same.
Although, as policy, it is, admittedly, crap.
The tendency I see with the Drum/Yglesias/Klein crowd (and I like those guys overall, but...) is different. It's not a result of partisanship, but an instinctive trust of inside-the-Beltway common wisdom.
The thing is (and I feel like a sucker saying this, but) in this case, they're making arguments I can follow, that this bill is, while nowhere near as good as it could be, much better than nothing. I'm not saying they're irrebuttable arguments, but I haven't seen them (mostly) rebutted.
I agree with the general evaluation of those guys generally as inside the Beltway (well, not Drum, but might as well be) moderates who aren't leftists in any sense of the word, but where I understand their arguments better than the alternative, I respect them enough to be persuadable.
The guy you wanted to run in the first place. If you're just making a symbolic protest vote, may as well protest for your best-case scenario.
||
If the instructions are "Simplify the following expressions completely" then your final answer should not be sq rt (9).
|>
much better than nothing
Some individual pieces are, but taking the package as a whole, I really disagree. It sounds to me like women are better off under the Karzai/al-Maliki governments than the Taliban/Saddam (questionable assertions but work with me here), therefore invading is better than not invading.
The things that are worth saving in the bill can be passed individually without turning the money hose on the insurance industry. If they scream about it, then all the better. But where this bill takes us is a richer, more powerful insurance industry (which has already proven itself to be both deeply immoral and wildly dysfunctional) with a fully captive customer base. That's not an improvement, even if there are some silver linings to the giant black cloud.
Huh. What are you thinking of as 'the money hose'? The main 'money hose' I see are the subsidies, and those are important, even if they do ultimately go to the insurance companies. The only other source of new money to the insurance companies are the unsubsidized uninsured who will have to buy insurance, and that doesn't seem like a huge problem to me.
What are you thinking of as 'the money hose'?
350 million customers that are legally obligated to buy their product, under penalty of prosecution.
(minus the Medicare population and maybe the Medicaid population, but I expect the next push will be to gut Medicaid)
But the subsidies are a real problem. The existence of the insurance industry is driving a huge amount of excess health care costs. 15-20% overhead versus 3% overhead for Medicare. Turning people over to an industry that has never proven itself to be anything but predatory and amoral, on the vague promise that we'll get to improve it later because to get it passed we stripped damn near all of the cost controls and thumbscrew regulations?
Not progress.
under penalty of prosecution.
No, unless I'm very confused. Under penalty of a civil fine. People who can't afford health insurance with all the subsidies and so forth still aren't going to pay for it, and they'll have a fine on their tax bill. If they can't pay their taxes, that'll be another problem, but we're not talking about criminal prosecution.
And the vast majority of those 350 million people are covered by the same health insurance companies now. If this thing works perfectly, more people will be covered, which means the health insurance companies will have a large market to sell to, but we knew that going into this mess.
we stripped damn near all of the cost controls and thumbscrew regulations?
But we haven't -- there's still (IIUnderstandC) a set 'medical loss ratio', the exchanges have that prudential purchaser thing... there are regulations in the bill that's getting passed.
No, unless I'm very confused.
Right. Sorry, typing quickly.
a set 'medical loss ratio'
Set at what? This is still being driven by the need to protect industry profits, rather than efficiency of care delivery. It's like community rating, which people keep pointing to as a win. So the insurance companies have to charge similar rates for a community. Do I have any reason to believe that will be seen as a floor, rather than a ceiling?
as a floor, rather than a ceiling
More poor word choice. That everybody will get charged similar high rates rather than low ones.
When the insurance insiders are crowing that they have won, I believe them. Under this bill, they have.
Set at what?
If this is still accurate, 85%.
That everybody will get charged similar high rates rather than low ones.
Well, there's the prudential purchaser thing on the exchanges -- if regulators don't like the price, the companies won't be able to sell through the exchanges. It may not work in practice, but I believe that's the idea.
And if this is still accurate, only until 2014, when the mandate kicks in.
And I hate having this argument, because I don't know enough to know that this will work well. You might be right, that it will be a disaster. But the arguments that I see for it being a disaster don't seem to engage with what's in the bill (as currently formulated, and of course that's in flux).
I don't think anybody really understands it. It's a giant system and predicting outcomes is like predicting where a specific pachinko ball will land.
The arguments for the bill seem to rely on Democrats standing up to large corporations. Thus far, they have not inspired confidence.
rely on Democrats standing up to large corporations
...that contribute heavily to their re-election campaigns. If we don't get the pound of flesh up front, it won't ever be gotten.
Now we're in Megan's baliwick. That's not something wrong with this bill, that's a problem with regulating anything -- you can't tell the difference between a good system of regulation and a bad one unless you're an insanely knowledgeable insider. And if you don't trust the insanely knowledgeable insiders, you're screwed.
But that leads to libertarian nihilism -- I don't like trusting the feds to regulate insurance companies properly, and I don't expect them not to be captured to some extent. But if you want insurance companies to be regulated, there's no one to do it but the (admittedly untrustworthy) administration, and no way to do it simply enough for non-obsessed laypeople to do any kind of full check on them. If we want regulation, we have to trust the kind of people in a position to be regulators.
477: The arguments for the bill seem to rely on Democrats standing up to large corporations. Thus far, they have not inspired confidence.
Does it help any if you think of it as Democratic legislators passing the buck to bureaucrats who don't have to run for office?
If we want regulation, we have to trust the kind of people in a position to be regulators.
Or we decide that just as we don't want regulated private armed forces for national defense, and we don't want private regulated fire departments, maybe we should admit that the privately owned market driven model of health care is something we just don't want.
that leads to libertarian nihilism
Agitating for a public option rather than expansion of the private insurance industry really isn't libertarian nihilism.
we should admit that the privately owned market driven model of health care is something we just don't want.
Does anyone here disagree with that at all? But we can't pass single payer, and we really can't blame that on a tactical failure of the Democratic party.
480: It helps when Democrats are in power.
But we can't pass single payer
Well, nobody tried. If we'd started with that as the opening position, rather than starting with a half-assed option and preemptively taking reconciliation and the nuclear option off the table, maybe we'd have hit a compromise that I could grudgingly live with. But instead, we started with something I could grudgingly accept, and then compromised it down to a shit sandwich.
482: But it wasn't going to be public option or expansion of the private health insurance industry, it was always going to be public option and expansion of the private health insurance industry. I get that public option is better than no public option. I'm just not convinced that this bill as it stands now, without the public option, is not an improvement on the status quo.
475:For LB
20 Reasons Why the Health Care Bill Needs to Die Ian Welsh at Open Left
Other News:Sanders and Burris are "No" votes, possibly but not probably on cloture
Ben Nelson is officially a No vote on cloture, based on abortion language and "other things"
Snowe is a probable "Yes" vote on cloture, but who knows
Steny Hoyer is demanding a conference
Welsh addresses the politics more than policy. As I said, recission and coverage denial remain in the bill, forbidden except when it is "reasonable" to deny coverage. Up to regulators, and maybe courts?
Somewhere this morning I read that yes, that will not be able to deny converage for pre-existing conditions, but will be able to charge 50% more in premiums for those cases. If you insist, I will find it...FDL I think.
Scarecrow at FDL finally is claiming the Rahm & Obama do want the Democrats to lose Congress in 2010.
485: How would starting with an opening gambit of single payer have helped? My guess is that fewer than (looking at list of Democratic senators) ~18 senators would have supported such a position. And it certainly wouldn't have come close to passing the house. Opening with a joke doesn't work, Apo, unless you get a laugh.
Spike: Oh, I don't mind all drug reimportation. I used to order allegra and zyrtec from Canada when I lived in a high pollen area and neither were OTC.
And I think that antidepressants that aren't FDA approved can be really helpful as long as a good psychopharmacologist is monitoring them.
But, making it totally legal to make regular old FDA-approved drugs available at a lower cost is stupid.
Again, a question that nobody has answered is: How could truly* progressive legislation have passed through this senate? Seriously, leave aside whether Obama's dreamy, or Lieberman's personally vile, or the bailout angries up your blood, or whatever all else, and just ask yourself the above question, remembering that votes 57-60 were always going to have to come from some group of Bayh, Landrieu, Lieberman, Nelson, Collins, Snowe, Lincoln, etc.
* For whatever your value of "truly" is.
485: How would starting with an opening gambit of single payer have helped? My guess is that fewer than (looking at list of Democratic senators) ~18 senators would have supported such a position.
I have to wonder if the difference between USian and European social policy is that European plutocrats were taught fear.
479 - That's funny, because I deleted a timid comment saying that since I've liked what I've seen out of agencies in the past year, I'd be encouraged by the thought that regulations would be promulgated by agencies and not Congress. But then I thought that was slim hope and vague besides.
I know all the cool kids have been asking this for a while, but really, when did it become the case that you need 60 votes?
I have an idea for improving the nations finances and its governance. It involves increasing revenue from the estate tax, but not how you might expect.
Is your proposal endorsed by the National Coalition of Undertakers, Eggplant?
How would starting with an opening gambit of single payer have helped?
That's how moving the window of acceptability works. You start with an opening gambit of allowing anybody to buy into Medicare. Which isn't exactly single payer, I know. But the process of lopping off bits started before any bill even existed. I'd love to play poker against Obama.
499: It only works if your opening gambit isn't laughed out of the room as so unrealistic, by the standards of your own caucus, that your legislation becomes a running joke for years to come.
when did it become the case that you need 60 votes?
more serious answer: in 1975, the cloture limit was changed from 2/3 of the Senate to 3/5.
The original cloture rule was passed in 1917.
Yggles also takes the position that there's nothing that can be done to change political beliefs and attitudes - but that must be wrong. They do change over time. Talking and exhorting and such can work (see, e.g., neoconservatism)
Starting from the assumption that single payer was unobtanium, and that there's nothing that could be done except to try and fit something to what some minority of the population already found acceptable, is no way to get the change we hoped for.
If they wanted to filibuster, we should have made them get on the floor and keep talking. Screw this filibuster-lite
498: No: the Pork Producers Council.
By the way, just to pour fuel on apo's file, I'll bring up Liz Fowler's name again. Former chief lobbyist for Wellpoint, now the main Finance staffer writing this bill.
She'll be a very wealthy woman in a few years.
499.last: IIRC he used to play with Ira Glass, and it was claimed he was quite good.
499-500: An optional Medicare buy-in for 55-64 year olds would definitely not have been laughed out of the room as an opening gambit. It's a massively popular program. That would have been a much better place to start than a rump "public option" in exchanges.
A Medicare buy-in for everyone would have been a lot tougher, I think that's a bridge too far, but 55-64 year olds would have been both politically imaginable and a big threat working to bring people to the table.
This is an administration that works hard trying to get the centrist liberal consensus through, but it's just just not an administration that exhausts its options trying to move the centrist liberal consensus further to the left. It simply isn't. I mean, it's totally clear the White House didn't get nearly enough from pharma. Did you know Obama initially wanted Evan Bayh as VP?
I found this set of answers to Silver more convincing than Welsh's.
The reason 60 votes are needed now is that the GOP caucus is using the powers available to it to accomplish its policy goals. I can't tell you how many times I was told the Democrats just couldn't filibuster, oh, Roberts, Alito, Gonzales, Mukasey, the Military Commissions Act, etc. etc. etc. etc. I just looked up the roll call on Gonzales for old time's sake. He got 60 votes for confirmation (including, of course, Ben Nelson, who won't even vote yes on cloture Dawn Johnsen.)
The Senate Democrats' party discipline is amazingly awful. Part of it, I guess, is that the GOP base & donors' desires align much more than Democratic base & donors' desires. But why it's a good idea for me to just accept as "reality" that the administration considers it essential to write a bill that meets the demands of PhRma, the insurance companies, etc. etc., whereas it can safely blow off Democratic voters, the SEIU, etc., I cannot fathom.
If the bill is such a moral & political imperative & no bill would be such a disaster, would the outcome if Bernie Sanders balked really be no bill, or would the administration actually try reconciliation? I found this extremely convincing. But it is possible that the White House wouldn't try it, or that it wouldn't succeed now because they ineptly kept publicly renouncing it & let the Gang of Six screw around for so long.
499, 504: Yeah, I agree about this. But I got pissed off about that way back in the campaign. I'm still pissed, but for me it's not part of the current conversation about this health care bill, which has always been starting from Obama's half-ass campaign plan.
Goddamn John Edwards anyway. Maybe if he hadn't known he was doomed because of the affair, he would have campaigned better and would have had a shot.
A Medicare buy-in for everyone would have been a lot tougher
It would have been tougher, and likely impossible (though you can't know for sure without trying; it was crazy to think a black guy named Hussein Osama could be elected president), but *that* is what would have gotten defined as the crazy socialist option. Instead, corporate welfare got defined as the crazy socialist option.
I found this extremely convincing.
I didn't. This bit, particularly.
Technically, provisions not related to the budget can be removed by the Byrd rule, and that includes the important new insurance regulations (ban on pre-existing conditions, community rating, lifetime limits, etc.), but there is a very important caveat: these provisions will only be removed if they fail to get 60 votes to wave the Byrd rule for those provisions.
I dare all 40 Republicans plus one conservative Democrat to vote for a stand-alone provisions that would let insurance companies continue to exclude people for having pre-existing conditions. If they are foolish enough to vote against extremely popular insurance regulation as stand-alone provisions they will face the mother of all attacked ads in 2010.
To make a vote like that politically damaging, we'd need media cooperation that I just can't imagine getting. I feel defeatist saying that, but the quoted text sounds like a fantasy to me. Maybe the reconciliation process would be worth it without the provisions vulnerable to the Byrd rule, but I can't imagine that it wouldn't be stripped as bare as 40 Republicans plus Lieberman could get it.
It was the "just attach it to a must pass appropriations bill" part that I found convincing.
This is an administration that works hard trying to get the centrist liberal consensus through, but it's just just not an administration that exhausts its options trying to move the centrist liberal consensus further to the left.
This is very true.
trying to get the centrist liberal consensus through
This is true if you take out the word "liberal".
The Senate Democrats' party discipline is amazingly awful. Part of it, I guess, is that the GOP base & donors' desires align much more than Democratic base & donors' desires.
This is because Republican donors are basing their donations from a cut-throat business perspective, and Democratic donors think (as was noted upthread) that the party is their friend.
Democratic donors think that the party is their friend
Maybe Obama is changing something after all.
516: No. It's because donors are largely rich people, and the Republicans are explicitly out to service the moneyed class. Democrats have an alignment problem because they're on some (painfully risible) level they're trying to serve the interests of the poor, but they need money from rich people to do it with.
519: That's what I meant, except better phrasy. Except I was trying to borrow the friend/sympathy/nice language from upthread to describe Democrats.
they're on some (painfully risible) level they're trying to serve the interests of the poor, but they need money from rich people to do it with.
I bounce back and forth like a ping-pong ball in these discussions, but it's unfair to say it's at a totally "risible" level. If you're unemployed, it's not a laughing matter when the Democrats are fighting to extend your COBRA health benefits. There is a real difference.
But why it's a good idea for me to just accept as "reality" that the administration considers it essential to write a bill that meets the demands of PhRma, the insurance companies, etc. etc., whereas it can safely blow off Democratic voters, the SEIU, etc., I cannot fathom.
As others have noted, Big Pharma can switch to the Republicans and labor can't. You'll note that when the insurance companies get frustrated on policy issues, they don't talk about forming a third party, or sitting out the election.
Goddamn John Edwards anyway.
Goddamn the american electorate for being such a bunch of ignorant hypocritical moralistic prigs. I know, I know, Emerson is right in saying that insulting the electorate really doesn't help.
But there is a point where exhorting and talking and modelling and teaching and whatever can shift the social currents. We got a lot of talk about change and aspirations during the campaign, and then what? Suddenly Ezra K is a pariah for pointing out that Lieberman is trying to kill 40k americans a year. Oh, my fur and whiskers! In a land where much of the population disbelieves evolution and global warming and does believe in theocracy, surely there's some way to influence ideas and beliefs. And just as surely that's what Obama was elected to do. He had four years. Now he has less than three, and he's been losing his audience.
The FDL response to Silver is very effective, IMprejudicedO.
Actually, I'm not especially prejudiced on the topic - I probably lean towards passing the piece of shit, although I think there were and are better options.
I'm getting tired of the dichotomy that this is a case of either "pass this piece of shit" or "kill the bill." What's obvious to me is that the current bill is deeply unsatisfactory and time needs to be taken to fix it. When fixed, either its something that doesn't suck that can get 60 votes, or, better yet something that can get 50+Joe Biden in reconciliation. But I'm not buying the urgency that the senate should pass a shitty bill, just so it will be ready in time for the State of the Union speech. This is the future of American health care - time should be taken to get it right.
When fixed, either its something that doesn't suck that can get 60 votes,
Who's going to vote for the non-sucky bit? Lieberman, Snowe, or Collins? I don't see how this happens.
better yet something that can get 50+Joe Biden in reconciliation.
With all the regulations stripped out of it.
I don't think the 'just pass the piece of shit now' caucus is imposing artificial problems. There seem to be real problems.
Ideally, we nuclear-option the filibuster (actually, while I want the filibuster gone, if I remember the nuclear option I procedurally hate it. But it's not bad enough that I'm going to be fussy about it), and pass a full bill with 50 + Biden. But we can't seem to get those assholes in the Senate to go for that.
With all the regulations stripped out of it.
The regulations are popular. They could probably be passed separately with 60 votes.
Or allowed to come to the floor and passed, anyhow.
Maybe? This is the kind of thing I really don't know enough to guess? But who's the vote you're counting on for them -- Lieberman, Collins, Snowe, or someone else?
The objection of those people were to a government-run insurance plan. I haven't heard any of them say they would oppose the pre-existing conditions regulations, for example.
I think the regulations are comparatively unimportant compared to real structural reforms of how insurance works in the United States. Fix the structural issues first, and the regulations become easier and less necessary. Adding regulations to the shitty existing institutional structure is just lipstick on a pig.
But there again, the question is whether they'd filibuster the regulations as stand-alone bills, not whether they'd vote for them.
531: The structural stuff is what we're talking about pushing through with reconciliation. But (if I understand what people have said correctly), the regulations can't be enacted through reconciliation because they aren't budgetary considerations.
532: At this point, I don't think there's any difference between what any of the hard votes would vote against and what they'd filibuster. If they oppose it, they'd filibuster it.
531: What are you thinking of in terms of structural reforms?
Leiberman and Nelson should have real reason to fear the possibility of something setting a president for passing 51 votes. It would suddenly make them irrelevant. If there was a real possibility of that happening, I could see them going along to make 60.
Or, if they don't, fuck 'em. Pass a better bill with 51.
533: Got it -- structural reforms was referring to the public option.
You'll note that when the insurance companies get frustrated on policy issues, they don't talk about forming a third party, or sitting out the election.
Er yes they do; they point out to the Republicans that it's cash for policy. That's how this shit works, if the insurance companies don't feel there's pro quo for their quids, the quids dry up.
(Well, they don't say that because holy fuck bribery statutes, but that's the basic point. Here in NZ the BRT apparently had an unofficial no Brash, no cash policy when English was Leader of the Opposition. The same thing happens everywhere.)
||
Forest Service the Bush administration rules for forest management and starting over.
The USFWS has agreed to take another look at 110 species to see if they should be listed.
That's just today. If you want to know what Obama wants to do, you could look at the third of government that he has full control over.
|>
531.2 I think the most important thing is getting rid of the employer based health care system. I would, of course, prefer single payer, but realistically, a public option that provides strong competition with the private market would go a long way toward keeping private insurance companies honest. Medicare buy-in for all would be good, but that would only get 45 votes. Still, it represents a much better starting point for negotiation, especially if you are only shooting for 50 instead of 60.
I do recognize that ship has basically sailed on this go-round, but my fear is that what gets enacted now will make such a thing even more difficult in the future. If we aren't tearing down the health insurance industrial complex, we are building it up.
538: Could be good news. But the biggest lesson I've learned so far with this administration is to never give them credit for something they haven't done yet.
True. Worse, it is a "collaborative process", which means that they're going to weigh different interests and bullshit like that. But they didn't have to open the logging rules at all (so far as I know). I can't see why they'd get into it at all unless they want to change the direction from how Bush left it.
"collaborative process"
It has to be, right? At least that's my understanding with both USFS and NPS: that because they're "public" agencies managing "public" lands, they have to open almost every significant decision-making process to all interested parties. And then, after they hear from all comers, they proceed to do pretty much what they wanted to do from the get-go. For better or worse, I should add. Also, friends at USFS tell me that this is the end of the "Healthy Forests" initiative, which was both a huge end-run around ESA and a giant giveaway to the timber industry. So this will be better. Probably not great, but marginally better.
And then, after they hear from all comers, they proceed to do pretty much what they wanted to do from the get-go.
We read and carefully consider all comments, and are grateful for your input.
Right, that's what I meant to say, of course.
I said:
You'll note that when the insurance companies get frustrated on policy issues, they don't talk about forming a third party, or sitting out the election.
And Keir responds:
Er yes they do
And I respond, no, they don't.
They'll deal with whomever can and will move the needle in their direction - no matter what the location of the needle is. If public sentiment is against them and the politics are moving away from them, they try to move things back in their direction. They don't stomp off and pout. That's one reason they win so much.
OpenSecrets has a nice little table illustrating this.
The liberals are have all kinds of different interests and objectives, but the ones who propose to actually accomplish things don't argue for withdrawing from two-party politics. (At least I don't think so. If someone has seen, say, Moulitsas try to make that sort of argument, I'd be interested to see it.) The fact that Kos argues against the Senate compromise is pretty persuasive (though ultimately not dispositive) to me.
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320.last: Why do the untrue things that Rs say about undocumented workers and health care stick, then? I guarantee that, if you ask anybody who's opposed to HCR, they'll mention "it's gonna cover illegals," if only in passing.
Because everybody knows lots of you would like to cover illegals if you could figure out some way around the fact that most people are opposed.
everybody knows lots of you would like to cover illegals
I suspect the vast majority of liberals don't give that much thought one way or the other.
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Yeah. I don't think people are calculating on how popular guaranteed issue (someone confirm that that's the phrase I'm thinking of?) will be. If we get that through, every Democrat can campaign on "You never have to be afraid of losing your insurance ever again." That's a big fear, and even the lousy bill we've got now solves it.
Actually the fear is that you will lose your job and the subsidized coverage you get from your employer will go away. Which means a big additional expense at the same time as your income drops. And as far as I can tell the bill does nothing to solve this.
Other than provide subsidized insurance to low-income people. Like, if you're unemployed.
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130: But they can't refuse to insure you for having a pre-existing condition. As I understand it, someone with cancer, now, currently, will be able to buy insurance at community rates from any company they want to.
And the rates will be such that only people with cancer would want to buy.
If the cost controls in the bill don't work. We'll have to see how that turns out.
551
Other than provide subsidized insurance to low-income people. Like, if you're unemployed.
While removing my option to go uninsured and take my chances. Presumedly because many people would prefer to do this. So you are making those people worse off.
553
If the cost controls in the bill don't work. We'll have to see how that turns out.
What cost controls?
Yup. If the subsidies are good enough, I don't much care about infringing on someone's right to go uninsured. If they're not sufficient, that will be a problem.
555: Until the exchanges kick in, the limitation on the medical loss percentage. After the exchanges kick in, the prudential buyer provision, allowing regulators to remove plans from the exchanges if they're too expensive.
And I am saying that when the insurance companies don't get what they want they threaten to withdraw cash; how on earth do you think they get people to do what they want?
The exchange of money for policy only works if when you don't get the policy you don't give the cash.
Sure they don't withdraw from two-party politics, but there's a whole range of options between `fringe sect' and `loyal and committed Democrat who'd vote for a monkey if it had a (D) next to its name'.
This is petty and unimportant from a policy point of view. But I grow ever fonder of Al Franken.
The liberals are have all kinds of different interests and objectives, but the ones who propose to actually accomplish things don't argue for withdrawing from two-party politics.
To me, it's a question of where to invest what energy I have for political activity. For the last 5 years or so, the "netsroots" wing of the Democratic party has been very focused on the nuts and bolts of producing the kind of electoral super majority that could enact a real progressive agenda. Aided by real popular anger over Iraq, Katrina, and the financial collapse, it was able to do that. Yet, even with a Democratic president and the best partisan math in Congress that we're likely to see in a generation, policy is still being influenced by corporate interests over the popular constituencies the Democratic party supposedly serves.
My reaction to this is to stop investing my energy on following the nuts and bolts of national electoral politics and work directly in mobilizing and organizing the popular constituencies who have no real effective representation by the party that nominally serves them.
the best partisan math in Congress that we're likely to see in a generation,
I dunno. Or at least, it's probably a partisan
high point, but I think there's a real chance of ideological improvement -- converting ten Blue Dogs to five Republicans and five real Democrats (progressives if we can get them, but liberals at least) would be a profit, and I don't know that it's out of reach. The thing about the high water mark we're at now (in the House at least), is that we've got room to purge some of the real horrors without losing control.
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Until the exchanges kick in, the limitation on the medical loss percentage. After the exchanges kick in, the prudential buyer provision, allowing regulators to remove plans from the exchanges if they're too expensive.
This assumes that insurers are the reason for high medical costs which isn't true, at least in any direct sense.
he supposedly wanted Evan Bayh as VP
Bayh as buried in VP irrelevance (unless he Cheney'd up the place) and Biden in the Senate seems like a good trade.
Well, it's a control on the possibility that insurers will use their newly captive market as an excuse to raise prices through the roof. You're right that there's no leverage on providers to hold costs down.
Here's Ezra explaining why he thinks the mandate won't itself cause prices to go up.
564 565
The mandate may not drive prices up but community rating, coverage of pre-existing conditions and mandated features (like mental health care coverage) will drive prices up.
Community rating and coverage of pre-existing conditions exist now in employer-provided health care, and yet that's (I believe) generally less, rather than more, expensive than the same plans on the individual market.
who won't even vote yes on cloture Dawn Johnsen
Bradbury ran OLC without being confirmed. It's a bad precedent to follow, but maybe Obama should do the same with Johnsen.
But (if I understand what people have said correctly), the regulations can't be enacted through reconciliation because they aren't budgetary considerations.
My understanding of this is that in reconciliation they can strip out the provisions that aren't budgetary considerations, but that they aren't stripped automatically. I think the FDL post is saying that they could then put the regulations up for individual votes: do we waive the reconciliation rules for this provision? It still takes 3/5 (I think) to waive the rules and let the regulation through, so the FDL post argument is that individually these regulations are very popular so they'll get the 3/5 because there's no more cover for the anti-HCR voters to hide behind like there is when they can vote down a package and point to other provisions as their reason.
I'm not convinced this would happen, as I wouldn't underestimate the spinelessness of members of Congress to avoid allowing any vote that could be unambiguously scored against them among the majority of their constituents. That is, I think FDL is right that they'd probably vote for the provisions individually; that's why those votes will never be held.
567
Community rating and coverage of pre-existing conditions exist now in employer-provided health care, and yet that's (I believe) generally less, rather than more, expensive than the same plans on the individual market.
I don't know the exact legalities but employers have considerable freedom in who they choose to employ and hence provide medical care for.
Shearer, I know you think that mental healthcare is all voodoo, but there have been studies which show that the increase isnegligible.
I know this conversation is over, but checking a few of what could now be called establishment blogs, I see the anti-progressive rhetoric is out in full force.
Also, I've been wondering why Al Gore didn't try to get some of those votes on the left if he needed them and there were some votes there to get, and also wondering what happened to pointing out that he did actually get a popular vote majority and that the 2000 election loss wasn't solely the fault of the left. There was like some recount or something. Anyway, I didn't vote in 2000, but in Berkeley, it's not like my vote was going to sway things in any direction on the national scale. And I plan to vote in 2010 and 2012, almost certainly for Democrats. So I'm just venting powerlessly, as usual.
Sure they don't withdraw from two-party politics, but there's a whole range of options between `fringe sect' and `loyal and committed Democrat who'd vote for a monkey if it had a (D) next to its name'.
The traditional expression is "yellow dog Democrat." That's me. I'm not asking for a life form as advanced as a chimpanzee, but if we could get 'em, I'd vote for 'em in a heartbeat.
A Democratic chimpanzee would be a hell of a lot better than Lieberman, and Lieberman isn't even in the bottom third of Senators. If we replaced the 45 worst Senators with 45 Democratic orangutans, the political situation in this country would be considerably improved.
564: Well, it's a control on the possibility that insurers will use their newly captive market as an excuse to raise prices through the roof.
What I don't look forward to is the possibility that while premiums may not rise once the exchanges kick in, whatever level they've reached by that time will become the new standard. And that's frankly too high. I'd have liked to see controls not just on price increases in future, but some means to lowering costs as they stand right now (or will stand 4 years from now). It's not clear to me that there's anything in the bill to accomplish that, though I can be corrected if I'm wrong.
I suspect that what will wind up happening is that some not-insignificant number of people will begin to hide some of their income from the feds in order to continue to qualify for subsidies (i.e. in order to stay below 400% of poverty level); and some other not insignificant number will opt to pay the fine for remaining uninsured.
That's not necessarily a doom-saying scenario, but the first outcome, anyway, sets the stage for eventual calls for reform of the reform, not unlike the calls for welfare reform which claimed to crack down on welfare moms who were abusing the system in order to receive government handouts. The subsidies, in other words, are going to be extremely vulnerable.
That's not necessarily a doom-saying scenario
Cue, at the end of a dead thread
For the wonkish, from Barry Rittholz
Seen M3 Lately ...forecast of another crash, well, actually the same crash. We are 1930, or even 1925. Nowhere near bottom
And then, because I am that I am, a long comment from Digby's pasted in full:
"This will be a pitched battle for some time to come." -- DigbyUh. No it won't. Is Medicare Part D a "pitched battle?" No, it isn't. It's a shitty program that props up PhRMA's profits first and foremost, but hey. Old folks get a lot of free or low cost drugs because of it, and not too many of them have to eat cat food anymore because of the drug coverage the shitty program provides. It was supposed to be "fixed" and supposedly the HCR bill will take care of that pesky Doughnut Hole.
As for the HCR, well.
There's not going to be all that much gnashing of teeth and rending of garments if they roll it out right. In fact, the way they've got it set up, it will be a real boon to some of the worst off right now, and as its various pieces are enabled, more and more will come to see it as a "pretty good" thing. Just like they see Medicare Part D.
The Rs will not try to kill it once it's launched. What they'll try to do is capture the Industry campaign money by promising more and better profit margins to the cartels. They might succeed that way, too. But they won't kill it, no matter all their huffery and puffery at the moment.
The deficit hawks want to limit/cripple Social Security and Medicare, and essentially transform them into welfare programs -- that is, assuming they can't privatize them. They are already calling them welfare programs, so we already know where they're headed. What they'll do is essentially blend Medicare and Medicaid, and reduce their funding, and blend SS with SSI. In other words, they'll refuse to honor the Treasury IOU's to fully fund SS, but rather than get rid of it altogether, they'll cap benefits at whatever SSI is. Wah-lah! No new taxes, deficit at least neutral.
And we'll see minimal medical coverage become a sort of cap as well. Unless you've got the Big Bucks, tough luck sucker! You'll have access to minimal care, to be sure, but you'll have to pay for much of it out of your own pocket.
It's all part of the neo-liberal race to the bottom. Just like maintaining high unemployment indefinitely.
By the time the Boomers die off, pretty much everybody will be poor. And they'll like it.
Ché Pasa | Homepage | 12.17.09 - 6:17 pm | #
Lurkers support the current health insurance reform bill in email, according to David Plouffe.
http://www.thenation.com/doc/20091221/melber
via Digby, to whom I just sent twenty five bucks, because I heart her.
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Shearer, I know you think that mental healthcare is all voodoo, but there have been studies which show that the increase isnegligible.
According to this (pdf file) negligible means 5-10%. And that was just one example. Other examples are in vitro fertilization, acupuncture and chiropracters.
549
I suspect the vast majority of liberals don't give that much thought one way or the other.
Here is Yglesias:
... Similarly, contrary to Rep Wilson, the bills under consideration really won't give health insurance to undocumented immigrants. But like Alexandra Gutierrez this seems regrettable to me--undocumented immigrants are people, too!
And who, James, is the Council for Affordable Health Insurance?
The Council for Affordable Health Insurance (CAHI) is an association of insurance companies, actuarial firms, legislative consultants, physicians and insurance agents.
There's a weird strain of gullible conservatism that tells us that we should 1.) Not blame tobacco companies for things like the Tobacco Institute because nobody would believe that nonsense. Also that we should 2.) Not blame tobacco companies for things like the Tobacco Institute, because the Tobacco Institute is entitled to their point of view, which is based on rigorous study and sound views about peoples' rights.
George Orwell and Leo Strauss had the same insight about people - but Orwell thought that doublethink was a flaw of human nature.
I'm curious what Shearer would prescribe as an immigration policy. Ours is currently ridiculous: we've got maybe 12,000,000+ "illegal" people hanging around, lots of 'em doing more or less fine, working, not doing bad stuff, etc. The problem is clearly the policy, no? Shearer?
Genuinely curious here.
580
So if you don't like their numbers what do you think mental health parity costs?
Mr. Nelson has said he wants to change the bill to let states decide if they want to expand Medicaid, though he has not suggested how very low-income people would otherwise gain insurance coverage. Democratic leaders said they were working on a compromise.
That may be the compromise that makes me say, screw this bill. And I'm a lot less worried about angry netroots types tanking the bill than Rahm Emanuel giving away the store yet again--and the angry netroots types who already want to tank the bill because Obama's conceded too much seem like a major asset on that front.
581
I'm curious what Shearer would prescribe as an immigration policy. Ours is currently ridiculous: we've got maybe 12,000,000+ "illegal" people hanging around, lots of 'em doing more or less fine, working, not doing bad stuff, etc. The problem is clearly the policy, no? Shearer?
I would make it much more difficult for illegals to exist in the United States by among other things changing the law to make it illegal to employ them (as opposed to the current fake law against employing illegals which actually forces employers to hire illegals even if they don't want to). This would greatly reduce the number of illegals.
Incidentally the current fake law against hiring illegals is one reason many suspect any prohibitions against providing health insurance to illegals will be fake as well.
So if you don't like their numbers what do you think mental health parity costs?
Nuh uh. Not gonna play. If you want to pretend that intrinsically non-credible sources are credible, you're not prepared to engage in a good-faith discussion.
But I've got a question for you, because the whole Straussian thing is really interesting to me: By your own ethical lights, would it be appropriate conduct for insurance companies to use company funds to promote data that didn't match company interests? How could you - I mean you personally - justify such a prima facie violation of corporate fiduciary duty?
Your whole ethical framework demands dishonesty in situations like this, does it not?
584: Oh, duh, I'm pretty sure I've asked you that question before and gotten, more or less, the same answer.
Do you think people already here should be allowed to stay under any sort of arrangement? Also, what if they had a kid here during their, uh, illegality, which kid is now a USian?
Because everybody knows lots of you would like to cover illegals think the price of requiring verification of immigration status is far too high compared to the cost some unqualified people getting access to care.
That's for the 15% of liberals I know who actually think about it. The rest of them are apo's 549.
(OK, there are a handful of extremely unrepresentative activist types who truly believe everyone should get coverage. But I'm not delusional enough to think they represent any measurable slice of the electorate.)
586
Do you think people already here should be allowed to stay under any sort of arrangement? Also, what if they had a kid here during their, uh, illegality, which kid is now a USian?
Parents take kid when they are deported. When kid is 18 he can return if he wishes. If parents are unwilling or unable to take kid and no US citizen is willing to assume responsibility, kid becomes ward of state and parents lose all parental rights. Incidentally I would try to get rid of birthright citizenship (when parents are illegals) going forward but not retroactively.
Would not allow existing illegals to stay in any great numbers.
"Incidentally I would try to get rid of birthright citizenship (when parents are illegals) going forward but not retroactively."
Wow, I knew anti-immigration people wanted to partially repeal the 14th amendment, but the idea that there are some who want to denationalize current natural-born US citizens is a new one.
585
Nuh uh. Not gonna play. If you want to pretend that intrinsically non-credible sources are credible, you're not prepared to engage in a good-faith discussion.
Credibility is a continuous property not a binary property. That was the first source I found and the numbers seemed reasonable to me. If you have a more credible source which disagrees you can give it. It is often difficult to find truly disinterested sources for information like this because the people who care tend to have stakes.
But I've got a question for you, because the whole Straussian thing is really interesting to me: By your own ethical lights, would it be appropriate conduct for insurance companies to use company funds to promote data that didn't match company interests? How could you - I mean you personally - justify such a prima facie violation of corporate fiduciary duty?
Your whole ethical framework demands dishonesty in situations like this, does it not?
I have heard the name Strauss but that is about the extent of my knowledge of him or his ethical lights so I don't know what you are talking about. My ethical lights do not demand that people lie about the cost of mental health coverage and I don't exactly see why you think it is even to the advantage of the groups you listed to lie about it.
589
Wow, I knew anti-immigration people wanted to partially repeal the 14th amendment, but the idea that there are some who want to denationalize current natural-born US citizens is a new one.
The liberal bubble in action.
FWIW, I vote for open borders. Or no borders.
Watching Greece, Spain, Iceland, Ireland, Estonia. The EU's halfassed post-nationalism is running into trouble.
The liberal bubble in action. s/b "faith in human decency"
My ethical lights do not demand that people lie about the cost of mental health coverage and I don't exactly see why you think it is even to the advantage of the groups you listed to lie about it.
I don't really know anything about Strauss either, but I've gotten interested, as his view explains a lot about how obvious bullshit becomes part of the conversation among smart people.
And you don't see why insurance companies would spread false information about the costs of public policies related to insurance? Seriously?
How can you justify insurance companies paying money to spread information that is harmful, or even neutral, to their business interests? Surely you understand and support the concept of fiduciary duty to shareholders? No?
Shearer, I'm with you on chiropractic and acupunture, and I don't really think that in vitro fertilization should be mandated.
But there are also studies which show that there's less absenteeism and better worker productivity when depression is treated. Ronald Kessler is the main guy who works on this.
Credibility is a continuous property not a binary property.
I am indebted to dsquared for the definitive rebuttal of this idea. Here's one relevant bit from the linked text:
Fibbers' forecasts are worthless. Case after miserable case after bloody case we went through, I tell you, all of which had this moral. Not only that people who want a project will tend to make innacurate projections about the possible outcomes of that project, but about the futility of attempts to "shade" downward a fundamentally dishonest set of predictions. If you have doubts about the integrity of a forecaster, you can't use their forecasts at all. Not even as a "starting point".
The Senate is not worthless: Baucus and Tester are betting Montana elk and bison jerky against Specter's and Casey's Philadelphia soft pretzels that UM will be victorious.
OK, there are a handful of extremely unrepresentative activist types who truly believe everyone should get coverage.
That this is a considered an extreme view is what's wrong with this country. Personally, I think its extreme that people should be left to get sick and die because they are from a different tribe.
And I'm not even an "activist type".
596: Heh. I had exactly the same thought.
595
But there are also studies which show that there's less absenteeism and better worker productivity when depression is treated. Ronald Kessler is the main guy who works on this.
Nothing is stopping companies from including this in their plans if it is advantageous.
596 599
dsquared is referring to proven liars not interested parties (and I don't really agree even there although certainly the credibility of proven liars is low). His analysis would appear to apply more to the backers of the current reform effort who are making all sorts of ridiculous claims for it and seem driven by the same blind faith as advocates of the Iraq war.
598
That this is a considered an extreme view is what's wrong with this country. Personally, I think its extreme that people should be left to get sick and die because they are from a different tribe.
Which is why people don't believe liberal claims that illegals won't be covered. And do you want to cover sick people all over the world or just those who have managed to sneak into the US?
595: Probably the most advantageous plan from the point of view of a single company is to have all the people with depression go work for somebody else because you don't cover depression.
The liberal bubble in action.
Whereas the conservative bubble seems to consist of inventing goals for liberals. More salutary, surely.
BTW, does 591 imply that the average voter is aware that conservativesradical reactionaries want to do these things?
594
How can you justify insurance companies paying money to spread information that is harmful, or even neutral, to their business interests? Surely you understand and support the concept of fiduciary duty to shareholders? No?
This is crazy. CAHI appears to have a bunch of funders and can't possibly only spread information that is favorable to all of them. Each funder presumedly feels it is getting a positive return on average. CAHI claims to be "credible" which suggests it recognizes that a good reputation has value even when honesty has short term costs.
I don't actually have any previous knowledge of CAHI and I could be convinced they are unreliable but the mere fact that they receive industry funding isn't going to do it.
604
Whereas the conservative bubble seems to consist of inventing goals for liberals. More salutary, surely.
I am not inventing the idea that many liberals would like to cover illegals.
the same blind faith as advocates of the Iraq war.
All this time and you still don't understand what was wrong with Iraq War proponents, James?
I'll give you a hint: Richard Perle and Dick Cheney weren't hoodwinked by their "blind faith" in anything.
603
Probably the most advantageous plan from the point of view of a single company is to have all the people with depression go work for somebody else because you don't cover depression.
Depressed people are unlikely to do this. The claim is depression is curable and it is better to cure it than have a bunch of employees with untreated depression. I am a bit dubious as depression tends to go away even untreated. In any case depression is probably the best case as far as the efficacy of mental health treatment and I don't think think depression is the only thing covered by mental health parity mandates.
See how rewarding discussing things with James is?
608
All this time and you still don't understand what was wrong with Iraq War proponents, James?
I'll give you a hint: Richard Perle and Dick Cheney weren't hoodwinked by their "blind faith" in anything.
So you think Perle, Cheney et al were conscious traitors deliberately betraying the nation for some private interest? Seems doubtful to me.
607: You've invented the idea that it's a meaningful part of the liberal agenda. It's a big country, James. There are tens of millions of liberals. "Lots of" them want to do all sorts of things. In the real world of what will happen in Washington, DC, nationalized medical marijuana is more likely to become law than free health care* for "illegals."
* Because, of course, in the current system, when an illegal immigrant shows up in the emergency room bleeding, they have to pay cash, upfront.
Actually, James, I do think that Dick Cheney is a traitor by any reasonable definition of the term. He actively worked to subvert the Constitution of the United States. Perle didn't have enough power to rise to that level of culpability, but he certainly supports the Cheney project.
The claim is depression is curable and it is better to cure it than have a bunch of employees with untreated depression.
Depression is often curable, often not curable, often only partially curable. Think something like type II diabetes treatment for a group of people living across the street from Dunkin Donuts. Adverse selection would be a big problem for any health insurer or employer who got too far ahead of the crowd on covering depression as it is correlated with other health problems.
Depression isn't the only thing covered by mental health parity mandates, just the one most likely to have an impact when you are discussing employer-provided coverage. Treatment for people with schizophrenia is far more expensive, but nearly all of it is paid for by the government one way or another. Even the most effective antipsychotic treatment doesn't put more than a handful of people back into the competitive workforce.
611: So you think Perle, Cheney et al were conscious traitors deliberately betraying the nation for some private interest?
Yeah, that seems to be the likeliest explanation.
The thing that's annoying me about the bullshit that Yglesias is spewing these days is that it completely ignores everything we've learned about Washington politics works over the last 8 years, especially how a White House gets things done. The Bush administration wasn't good for much, but they were very good at controlling the rhetorical agenda. They knew how to roll out the Iraq War so that it became inevitable. The Obama administration has completely flubbed this.
615
Yeah, that seems to be the likeliest explanation.
Not to me. And how far down did the treason spread? Was Hilary Clinton involved? Was Yglesias supporting the war, although he knew it was a bad idea, in order to advance his career?
612
You've invented the idea that it's a meaningful part of the liberal agenda. It's a big country, James. There are tens of millions of liberals. "Lots of" them want to do all sorts of things. In the real world of what will happen in Washington, DC, nationalized medical marijuana is more likely to become law than free health care* for "illegals."
This is just saying liberals realize the idea is a political loser that they don't have the power to pass openly.
And do you want to cover sick people all over the world or just those who have managed to sneak into the US?
I just want to cover everyone whose last name begins with S. After we get this first step in place, which is certainly an improvement on the current system, we can tweak the regulations to make the system better. You're with me on this, aren't you?
609: No it's not the only thing covered. Schizophrenia and bipolar disorder generally are too. Let me ask you: if someone's kid showed up in the emergency room manic beyond belief, ready to stay up to the point of dying from exhaustion, and psychotic, would you want them to be on the hook for paying the cost of the psychiatrist and hospital admission?
The Bush administration wasn't good for much, but they were very good at controlling the rhetorical agenda. They knew how to roll out the Iraq War so that it became inevitable.
Dick Cheney, traitor Ultimate eXtreme Troll.
max
['Ha ha! Everybody knows Saddam doesn't have nukes! Just ask Archimedes Plutonium!']
620
No it's not the only thing covered. Schizophrenia and bipolar disorder generally are too. Let me ask you: if someone's kid showed up in the emergency room manic beyond belief, ready to stay up to the point of dying from exhaustion, and psychotic, would you want them to be on the hook for paying the cost of the psychiatrist and hospital admission?
Actually I think it should be easier for family members to involuntarily commit severely disturbed people. Which includes not sticking them with an enormous bill.
The thing I really object to mandated coverage for is where you lie on a couch for an hour and talk about yourself.
Anyway whether or not particular mandates are a good idea they will generally raise costs which was my original point. And since I think people are generally over treated I am not enthusiastic about further insulating people from costs as this will lead to even more over treatment.
619: I was just asking, because Whole Foods health coverage won't pay for anything psychiatric."No payment shall be made to any psychiatrist" was the wording that I remember.
Almost nobody lies on a couch anymore, and that level of coverage isn't provided by almost any insurance. It hardly exists outside of New York, Boston and L.A.
Things like Cognitive Behavioral Therapy, exposure therapy and phobias do. A lot of what we're talking about is medication management. I happen to think that psychotherapy is pretty useful, but it's mostly more active than that.
The thing I really object to mandated coverage for is where you lie on a couch for an hour and talk about yourself.
What a relief. For a minute there I thought you knew what you were talking about.
I oppose covering depression for the simple reason that the blog was funnier when it was depressed.
625: And now it's just worthless and dumb.
Oh hell, it's way more complicated than that.
To what, parsimon, does your "it" refer?
I, too, would like parsimon to make her "it" explicit.
How did I miss that James B. Shearer, Philosopher, has a blog?
"It" referred to the blog's vicissitudes. But I'm happy to let it refer to discussion of HCR, or to Shearer's orientation to illegal immigration, public education, mental health care, et al. Or to life, the universe, and everything.
Tangentially: I've been reading about master and slave morality, to be honest.
the blog was funnier when it was depressed
It used to be disgusted, but now it tries to be amused.
How does reading about master and slave morality help you to be honest?
The blog said "I'm so happy I could die".
Okay, fine. The Honduran family in my basement aren't technically guests.
634: Put on this leather collar and she'll tell you true.
The blog don't want you to be no slave,
The blog don't want you to work all day,
The blog don't want you to be sad and blue,
The blog just wanna make love to you.
I haven't thought about Elvis Costello for a while.
640: Yes, but you have to put on "Ask" first.
How does reading about master and slave morality help you to be honest?
It goes toward what's interesting (to me, obviously) and what's not.
I'm reading one Stephen Mulhall (good guy), something called Philosophical Myths of the Fall. Mulhall is a Cavellian, for what that's worth: it means he's interested in the difference between what we say and what we mean. The book is about the persistence of the Christian theme of fallenness (and redemption) in philosophers in whom you would not expect to see this, to wit, Nietzsche, Heidegger, Wittgenstein. The idea is that you see a conception of the human condition as essentially (always already!) fallen -- from its original authentic state, or at least as always already self-undermining -- in these thinkers; the conclusion will be that we're wholly entrenched in this framework, such that overthrowing it is one hell of an impossible project, and indeed, the project is rather to diagnose and accept the perversity of this condition.
Clear?
To clarify how master and slave morality relates to this, and what it has to do with atheism and scientism and therefore to this blog and its habitues, I'd have to get into Nietzsche, and that seems like a silly thing to do at this time.
All I meant is that this place is pretty seriously glued to its secularism (as am I), and I'm reading about the extent to which we're infused with seemingly non-secular ideas nonethless, and it's reminding me that we lose a lot of richness when we become technocrats.
642:Good stuff
Look, I try and try to bring some irrational around here.
Better to rant in darkness than reason in...candle something. Won't fool me twice.
Our mayor thinks it better to wear a dress onstage than rant in the darkness.
This thread is probably dead and maybe everybody will miss this comment, what with being made early on a Saturday morning, but this Glenn Greenwald post and the Ed Kilgore post it links to are excellent summations of the basic dividing line between the commentariat here. Highly recommended.
645: Seems to me I've been saying the same thing since early November, 2004. The spurious popular front that persisted for about 8 years was never a stable political constellation. If healthcare & Afghanistan hadn't been the triggers for its dissolution, something else would have taken their place.
And to Shearer: What you're suggesting is that it is more correct to use withholding healthcare to punish people who break the law. Why can't you just admit that? Sounds like cruel and unusual punishment to me, but if that's your position, then at least have the courage of your convictions and fight for it.
645: thanks much, great link.
What Greenwald leaves out is the question of who will tame who -- will government get the corporations to heel, or will the corporations coopt government? Some of the most progressive countries in Europe are heavily corporatist, but the government and unions get corporations to accept more of a social mission. The problem isn't completely working with corporations, it's that corporate culture in the U.S. has become so relentlessly profit-driven.
647
And to Shearer: What you're suggesting is that it is more correct to use withholding healthcare to punish people who break the law. Why can't you just admit that? Sounds like cruel and unusual punishment to me, but if that's your position, then at least have the courage of your convictions and fight for it.
I think my position is clear enough, people in this country illegally have no entitlement to any government services or subsidies including health care.
As for punishment I think the government is obligated to provide prisoners basic care only.
648.2: Interesting angle. The anti-corporatist in me screams: No, it's not that. It's the large-scale privatization of public services, period.
You may be right, though, that some European models manage to privatize (to this extent?) without it becoming predatory, but, well, IF we're stuck with this, and we do seem to be rather impotent here, how do we manage to finesse it in the case of the US? It does not appear that regulation is working very well.
These are not quite rhetorical questions, but I'm frustrated enough by them that I can't frame them more productively than that.
Thanks for the link, Apo.
I should say that the Kilgore article, which I hadn't looked at yet, speaks to some of my overly-simplistic ways of framing this in 650.
What Greenwald leaves out is the question of who will tame who -- will government get the corporations to heel, or will the corporations coopt government? Some of the most progressive countries in Europe are heavily corporatist, but the government and unions get corporations to accept more of a social mission.
I don't think it's a matter of corporations in European countries accepting a social mission. Dutch Shell or Airbus don't behave any differently than our own multinationals with respect to exerting pressure on governments to legislate their own interests. I also don't think it's a matter of the managerial class in the government bureaucracy having an independent, anti-corporate agenda. The bureaucracy will generally reflect the agenda of the interests that are in power.
I do think there's a difference in that generally progressive countries have trade unions, civil society groups, and other forms of bottom-up political organization that are stronger than anything we have. There's also a more unified class consciousness as it plays out in politics (i.e., no tea-baggers). In general, that's enough in a parliamentary democracy to ensure that the legislative process can't simply be uniformly captured by the interests of capital at the expense of general welfare.
