I'm with Dr. Dean.

Kill it!

For now, just do a Utah-style safety-net plan, funded by raising the age for initial Social Security benefits from 62 to three years before full eligibility based on birth year, lnking Medicare eligibility to the latter as well, abolishing the earnings cap on FICA, and imposing an excise tax on items like pre-paid phone cards and international money transfers (like the type that are used for "remittances" to Mexico).

Then, if the Republicans try to block that, they're toast next November.

I'm beginning to get the feel that we might be passing through a memorable point in Obama's presidency and perhaps the crisis. The global warming meeting in Copenhagen is not going well. The health care bill in Washington is not going well. There is nothing really important happening with respect to the economy just now, but that isn't exactly looking great, either.

It is entirely possible that nothing worthy is going to happen. Obama talked the talk with respect to change on many fronts, but his efforts might well fall short.

I'm still not sure the Republicans are electable, even if Obama has some bad weeks. I don't know that anyone on either side of the aisle is going to pull America together and do better.

But some sort of turning point might be pending.

I still support passage of the Senate Bill, preferable without the individual mandate.

My decision was most influentenced by Nate Silver's analysis that surprisingly wasn't a political calcuation but a policy one -

http://www.fivethirtyeight.com/2009/...-crazy-to.html

Why Progressives Are Batshit Crazy to Oppose the Senate Bill

with this graph -


and explanation -

Senate Bill. These estimates are straightforward -- they're taken directly from the CBO's report on premiums for people at different income levels. A family of four earning an income of $54,000 would pay $4,000 in premiums, and could expect to incur another $5,000 in out-of-pocket costs. The $4,000 premium represents a substantial discount, because the government is covering 72 percent of the premium -- meaning that the gross cost of the premium is $14,286, some $10,286 of which the government pays.

One caution: this reflects the situation before the public option was removed from the bill. But, provided that the subsidy schedule isn't changed as well, that shouldn't change these numbers much.

Status Quo. In 2009, the average premium for a family in the individual market was $6,328, according to the insurance lobbying group AHIP. However, this figure paints an optimistic picture for two reasons. Firstly, the average family size in the AHIP dataset is 3.03 people; for a family of four, that number would scale upward to $7,925, by my calculations. Secondly, the CBO's estimates are based on 2016 figures, not 2009, so to make an apples-to-apples comparison, we have to account for inflation. According to Kaiser, the average cost of health coverage has increased by about 8.7 percent annually over the past decade, and by 8.8 percent for family coverage. Let's scale that down slightly, assuming 7.5 annual inflation in premiums from 2009 through 2016 inclusive. That would bring the cost of the family's premium up by a nominal 66 percent, to $13,149. And remember: these are based on estimates of premiums provided by the insurance lobby. I have no particular reason to think that they're biased, but if they are, it's probably on the low side.

and i like this stepping-back conclusion -

Because this is primarily a political analysis blog, I think people tend to assume that I'm lost in the political forest and not seeing the policy trees. In fact, the opposite is true. For any "progressive" who is concerned about the inequality of wealth, income and opportunity in America, this bill would be an absolutely monumental achievement. The more compelling critique, rather, is that the bill would fail to significantly "bend the cost curve". I don't dismiss that criticism at all, and certainly the insertion of a public option would have helped at the margins. But fundamentally, that is a critique that would traditionally be associated with the conservative side of the debate, as it ultimately goes to mounting deficits in the wake of expanded government entitlements.

Also, Klein and Yglesias helped with my anger -

http://voices.washingtonpost.com/ezr..._insurers.html

A bailout for insurers?
There's an argument on the left that the health-care bill represents a "bailout" to the insurance companies. Matt Yglesias puts this in the proper context:

I’ve seen Marcy Wheeler characterize the plan as an “industry bailout.” And, indeed, if I were a small government conservative one political tactic I would employ would be to start characterizing all initiatives involving government spending as a “bailout.” You could say that [the stimulus]’s provisions funding K-12 education are a “bailout for teacher’s unions.” You could call [cap and trade] a “bailout for windmill makers.” And you can call the health care bill an “insurance company bailout.” But the mechanism by which insurers can get extra money under reform is that ... more people get health insurance at a price they can afford.

To put this a bit more sharply, if I could construct a system in which insurers spent 90 percent of every premium dollar on medical care[And yes, Indy, I realize that we're not likely to get the 90% - I still agree with this view], never discriminated against another sick applicant, began exerting real pressure for providers to bring down costs, vastly simplified their billing systems, made it easier to compare plans and access consumer ratings, and generally worked more like companies in a competitive market rather than companies in a non-functional market, I would take that deal. And if you told me that the price of that deal was that insurers would move from being the 86th most profitable industry to being the 53rd most profitable industry, I would still take that deal.

And that may be the exact deal we're getting. The profit motive is not, in and of itself, a bad thing. The Apple computer I'm typing on, the Netflix movie I wish I were watching, the pork buns I wish i were eating -- it all comes from profit. But Apple isn't allowed to have slaves build its computers, Netflix can't destroy the incentive to make films by pirating all of its DVDs, and Momofuku can't let rats infest its kitchen because exterminators are expensive.

Health insurance suffers from market failure in part because it suffers from regulation failure. We're adding the regulations now and we'll see, in 10 years, whether people hate insurers somewhat less, or whether they've embraced the nonprofit model, or whether they're clamoring for public insurance. Either way, putting insurers into a structured market where they'll have to compete against one another and users will rate them should make things a lot better. Public insurance might be the best way forward, but an insurance market that works for consumers is progress nevertheless.

And then there is looking at the possibility of the Senate Bill becoming a foundation to build upon. That's where my preference for removing the individual mandate comes in. From a policy-only prespective, the mandate makes infinite sense; from a political perspective, it is a big problem - the teabaggers and Glibertairans will use it like a stick to beat on the Dems. However, its removal is not just election politics for me, it's removal offers the potential for an even bigger political solution - something that I do not want to talk about until the HCR Bill has been signed by the President.

I'm hanging in for a chance to do more relatively soon - something that will be impossible if we don't get enactment of HCR now.

[Also, just to note, this is helping me see a method to "Obama's madness." He really is thinking long-term and my faith is returning that he's at least a step or two ahead of the crowd.]

Playwrite:

Thanks, again, for doing the homework here.

So Klein, Yglesias, and Silver are all still on board? They are three of my favorite geeky X/Millennial cuspers -- does that give them some objectivity on this issue that we oldsters lack?

I have to keep reminding myself that we're still a long way from the final product on this.

Originally Posted by Child of Socrates

Playwrite:

Thanks, again, for doing the homework here.

So Klein, Yglesias, and Silver are all still on board? They are three of my favorite geeky X/Millennial cuspers -- does that give them some objectivity on this issue that we oldsters lack?

I have to keep reminding myself that we're still a long way from the final product on this.

You're welcome, and thanks for pushing me a little to really think this through.

Another plank in my support -

http://www.childrenshospital.org/new...blevel577.html

Insurance Coverage Status Affects Mortality Rate in Pediatric Trauma Patients

...A study led by Heather Rosen, MD, MPH, research fellow in the Department of Plastic Surgery at Children's Hospital Boston and Harvard Medical School, found that uninsured children were over three times more likely to die from their trauma-related injuries than children who were commercially insured, after adjustment for other factors such as age, gender, race, injury severity and injury type in an analysis of data from the National Trauma Data Bank. ..

Ah, I can hear the exclamations of “another damn bleeding-heart liberal!” through the gnashed teeth of our forum's glibetarians, teabaggers, and social Darwinists.
- I love that sound in the morning. It sounds like progress. Someday, this war's gonna end (with apologies to LTC William Kilgore)

I sympathize and fully understand the conflicted feelings of my progressive brothers and sisters. In the end, it comes down to one thing for me - is the bill better than what we have today?

Based on what I know that is in it, the answer is YES.

I sure wish they had done some of this using reconciliation and ended up with a complete Medicare expansion. But that train has left the station I am sorry to have to admit.

Originally Posted by haymarket martyr

I sympathize and fully understand the conflicted feelings of my progressive brothers and sisters. In the end, it comes down to one thing for me - is the bill better than what we have today?

Based on what I know that is in it, the answer is YES.

I sure wish they had done some of this using reconciliation and ended up with a complete Medicare expansion. But that train has left the station I am sorry to have to admit.

With the passage of this mutated bill, what they will have done, my brother, is secured those elements that would have otherwise been deemed "Byrd droppings" because they do not meet the test for being germaine to deficit reductions.

On a somewhat separate note -
The Prez now seems to be 'capitulating' to the call for a deficit-reducing commission -
http://www.cnn.com/2009/POLITICS/12/...bt.commission/

Obama weighs creating commission to propose tax hikes, spending cuts
.
.
The Obama administration's deliberations are taking on some urgency behind closed doors because the president is facing heavy pressure from Senators Kent Conrad, a North Dakota Democrat, and Judd Gregg, a New Hampshire Republican, to appoint a commission.
Conrad and Gregg, along with a group of moderates led by Senator Evan Bayh, an Indiana Democrat, have been threatening to block a large increase in the nation's debt ceiling unless the president agrees to a commission.

Come into my parlor said the spider to the flies.

The game is still afoot - and fortunately, many believe it’s being played only in two dimensions.
http://www.youtube.com/watch?v=RbTUTNenvCY

Those who support health care reform really need to get the camel's nose under the tent.

Pax,

Dave Krein '42

Kill the bill!

It's nothing more than a gift from the government to the insurance industry, much like how Medicare Part D (Bush) was a gift to Pharma.

I'm almost done with college, when I graduate I'm leaving the USA for the EU and becoming a citizen. Paying for health care in the 21st century is ridiculous. No wonder we have an obese and uneducated society against this, but are pro-war (teabaggers/Republicans/neocons) that enjoy feudalism more than democracy.

While the Netroots haven't yet seen the 3D chessborad, they are starting to see the possible silver linings -

http://www.dailykos.com/user/kos/diary

Strip the mandate, and put GOP on the spot
.
.
So here's the deal -- a progressive should step up with an amendment to strip out the mandate. He should get a non-Wall Street Republican to join him, be it Tom Coburn or Jim DeMint, one or more of those guys. And then force a roll call vote on the issue.

Republicans are then forced to make a genuinely difficult position. If they vote "yes" on removing the mandate, they help make the health care bill less electorally toxic, helping Democratic electoral chances in 2012, while also pissing off their insurance industry pals. If they vote "no", then they are exposed as being just as culpable on the issue as the Democrats driving their party off a cliff. In addition, the teabaggers will be incensed, and as we know by now, they're not shy about primary challenges

or alternatively -

Pass the bill with the mandate, and then come back in January and propose a single-sentence bill to strike everything referring to the mandate out.

And make Joe and the Republicans filibuster a one sentence bill that every American can understand. You have to buy insurance because of Joe and the GOP.

Then introduce another one-sentence bill to remove the HI industries anti-trust exemption. And make Joe and the party of the free market (ha!) filibuster that.

Make the GOP and Joe own the bad parts of the bill.

the game is still afoot (on several levels) and that challenge may sooth hard feelings more than anything else.

Originally Posted by The Rani

Obese and uneducated people come in all ....... flavors.

Okay, that's a vision I didn't need planted in my brain this afternoon!!!

Nate Silver has some pinted questions for those Progressives now wanting to kill the Senate Bill. Its worth your consideration. but I suggest starting with #20 -

http://www.fivethirtyeight.com/2009/...l-killers.html

20 Questions for Bill Killers

1. Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?

2. Would a bill that contained $50 billion in additional subsidies for people making less than 250% of poverty be acceptable?

3. Where is the evidence that the plan, as constructed, would substantially increase insurance industry profit margins, particularly when it is funded in part via a tax on insurers?

4. Why are some of the same people who are criticizing the bill's lack of cost control also criticizing the inclusion of the excise tax, which is one of the few cost control mechanisms to have survived the process?

5. Why are some of the same people who are criticizing the bill's lack of cost control also criticizing the inclusion of the individual mandate, which is key to controlling premiums in the individual market?

6. Would concerns about the political downside to the individual mandate in fact substantially be altered if a public plan were included among the choices? Might not the Republican talking point become: "forcing you to buy government-run insurance?"

7. Roughly how many people would in fact meet ALL of the following criteria: (i) in the individual insurance market, and not eligible for Medicaid or Medicare; (ii) consider the insurance to be a bad deal, even after substantial government subsidies; (iii) are not knowingly gaming the system by waiting to buy insurance until they become sick; (iv) are not exempt from the individual mandate penalty because of low income status or other exemptions carved out by the bill?

8. How many years is it likely to be before Democrats again have (i) at least as many non-Blue Dog seats in the Congress as they do now, and (ii) a President in the White House who would not veto an ambitious health care bill?

9. If the idea is to wait for a complete meltdown of the health care system, how likely is it that our country will respond to such a crisis in a rational fashion? How have we tended to respond to such crises in the past?

10. Where is the evidence that the public option is particularly important to base voters and/or swing voters (rather than activists), as compared with other aspects of health care reform?

11. Would base voters be less likely to turn out in 2010 if no health care plan is passed at all, rather than a reasonable plan without a public option?

12. What is the approximate likelihood that a plan passed through reconciliation would be better, on balance, from a policy perspective, than a bill passed through regular order but without a public option?

13. What is the likely extent of political fallout that might result from an attempt to use the reconciliation process?

14. How certain is it that a plan passed through reconciliation would in fact receive 51 votes (when some Democrats would might have objections to the use of the process)?

15. Are there any compromises or concessions not having to do with the provision of publicly-run health programs that could still be achieved through progressive pressure?

16. What are the chances that improvements can be made around the margins of the plan -- possibly including a public option -- between 2011 and the bill's implementation in 2014?

17. What are the potential upsides and downsides to using the 2010 midterms as a referendum on the public option, with the goal of achieving a 'mandate' for a public option that could be inserted via reconciliation?

18. Was the public option ever an attainable near-term political goal?

19. How many of the arguments that you might be making against the bill would you still be making if a public option were included (but in fact have little to do with the public option)?

20. How many of the arguments that you might be making against the bill are being made out of anger, frustration, or a desire to ring Joe Lieberman by his scruffy, no-good, backstabbing neck?

Ezra and Markos are going at it over what's best - Senate with or without mandate. Pretty insightful stuff -
http://voices.washingtonpost.com/ezr...2/draft_1.html

The importance of the individual mandate

It really comes down to better policy vs. better politics. I usually side with better policy, but I lean towards the latter here and not for the 2010 election attributes. I like the mandate as a bargaining chip that will make Lieberman and his insurance cronies squeal for it like the pigs they are. But that is based on HCR going through, without the mandate, and Ezra probable has the inside track on the viability of that.

As I write this, I’m tilting back to leaving it in but having an amendment proposed to take it out come up during these final moments before passage. Then, after enactment, have a single line bill to strip it out brought up over and over again for Lieberman and Repugs to threaten filibuster over and over again - drive the teabaggers, glibertarians and social Darwinists completely mad (as in anger, since they are already crazy) Our stopping the attempt to strip out the mandate will become a sufficient bargaining chip to bend if not break these dudes - - and, with youtube, we only need to do it once or twice to capture and transmit the full vileness of Slimy Joe, the Wall Street Repugs and their insurance. cronies.

Originally Posted by The Rani

Dean urges defeat of emerging health care bill

Third party candidate for prez in 2012? Stranger things have happened.

While Obama has made some neat speeches, if he fails in Washington with health care and in Copenhagen with global warming, Dean might not need to form a third party.

Without any public option, the plan effectively Massachusetts-izes the nation. Yes, there are additional things in there, and they're important, but the national plan looks more like Mass. than anything else.

I think that the experience of the nation will largely mirror that of the state, which is an expensive mixed bag.

That being said, I suppose access can be priority #1, but let's not kid anyone and say the problem is fixed- a couple years down the road, after premiums continue to increase unabated, someone is going to have to circle back and work on cost containment that doesn't involve policyholder cost-sharing ponzi schemes.

Am I missing something in cost containment here? Do I not see something in the bill that will actually bring premiums and costs of services down? It seems to me that if you bring costs down, the rest of the problems (access, etc) start to sort themselves out as people either buy the then-cheaper insurance or are more able to pay for services on their own.

Well lets see, they got rid of a public option to keep costs down, they got rid of expanding medicare to keep costs down, they got rid of stripping the insurance cartel of their anti-trust exemption, and then they got rid of any strong regulatory panels to keep costs down ..... what is left is making the insurance companies rather happy.

Dean says that the language in the bill allows companies to charge 300% more for people who would have been excluded for previous conditions but now they have to take them..... some benefit.

I find all this very discouraging.

Something to consider from one who really knows how things work -

"Before, it was healthcare every 15 years," Rockefeller said. "From now on it's going to be every single year."

More from one of the strongest supporters of the PO in the Senate here -

http://thehill.com/blogs/blog-briefi...-irresponsible

Some more wise words from Ezra (damn, if this kid is an example of the Millie/Xer cusp, the wingnuts really are doomed!) -

And be sure to go to the link; the picture he refers to is worth a 1000 words -

http://voices.washingtonpost.com/ezr...imulus_re.html

Remember that picture? I pulled it from the Washington Post's archives. It was taken in February, though it feels further back than that. But back then, this picture was all over. It wasn't worth just a 1,000 words, but $100 billion of desperately needed stimulus funding.

Back in June, I predicted that health-care reform would follow the path of the stimulus: A huge accomplishment that nevertheless feels like a defeat to its supporters. "As the legislation winds its way through the Senate, there will be unpleasant compromises, and unconscionable omissions, and the constant knowledge that though this is progress, it is not sufficient, and the people who stand in the way of a better bill are frequently incoherent or disingenuous."

And here we are. The bill is winding its way through Congress. The awful compromises have begun, the unconscionable omissions glare angrily, and some of the participants are both incoherent and disingenuous.

It's hard to step out from the health care discussion and examine it dispassionately. But tempers have cooled on the stimulus. It was too small, most agree, but it has helped. We are better off for its presence. People are better off for its presence.

We are also more likely to get more of it. The likelihood of a third stimulus increases by the week. The White House has released job plans and members of Congress have begun talking up everything 'Cash for Caulkers' to state and local aid.

In part, that's because the recession has been worse than we thought. But it's also because some of the basic argumentation is done. The principle is settled. Government does stimulus. It's part of the job. And does anyone doubt that the total stimulus level will be higher than if the original bill had fallen?

I still believe health care will look more similar than different when the day is done. A good bill will pass, if not a sufficient one. A sum of money will be appropriated, and a basic infrastructure constructed, that will be, in the long-run, understood as a tremendous, even unlikely, political victory. The next steps will be easier, because $80 billion is easier to find than $900 billion, and because the argument over whether America has a universal health-care system and whether government provides some of the funding and scaffolding will be over. The money will be there. The scaffolding, too. The universal structure, built around the mandate and the exchanges and the subsidies, will be firmly in place.

At this point, an odd dynamic has developed, in which most all of the right, and some on the left, believe they'd be better served by the defeat of this bill. It is unlikely that they are both correct. But the right has had substantially more experience than the left opposing government initiatives before they can take root and grow into popular entitlements.

Look at the development of Medicare and Social Security, of Medicaid and S-CHIP, the Swedish and Canadian health-care systems, public education. Social Security was designed to exclude African-Americans. Medicare didn't cover prescription drugs. Medicaid was mainly for pregnant women and their young children. Canada's system was limited to a single province. There was no University of California at Los Angeles.

It's difficult to conclude that these things slip backwards rather than marching forwards. The $900 billion for people who need help, the regulations on insurers and the exchanges that will force them to compete, the structure that will make health care nearly universal and the trends that suggest more people -- and more politically powerful people -- will be entering the new system as employer-based health care erodes -- it all makes this look even more like the sort of program that will take root and be made better, as opposed to the sort of common opportunity people should feel comfortable rejecting. It doesn't feel like that now. But then, it rarely does.

That line I bolded is the key, for me. It is why I part company with Markos on his thought captured here in a nutshell -

http://www.dailykos.com/user/kos/diary

In short, there appears to be a divide between those who think the insurance industry will play nice, even with little incentive to do so, and people like me who don't. They believe that government will enforce the new regulations, people like me have seen entire industries employ armies of lawyers and lobbyists with the sole intent of undermining and avoiding such regulations. I'm a half-empty guy, others are half-full.

For me, the half-full optimism is derived, in part, from 4T discussions here of a secular trend (as opposed to cyclical; I'm NOT referring to religion) in progressive thought and accomplishments. The passing of the Senate Bill provides considerable potential for such progressiveness. Yes, some half steps back for every step forward, and some risks, but the potential is there for so much more.

On the Tuesday, December 16th broadcast of COUNTDOWN on MSNBC, Keith Olbermann dedicated most of his hour long show to the compromised health care reform bill now before the Senate. In special ten minute commentary to end his show, Olbermann was at his absolute best pointing out that what was once a great idea had been compromised and compromised and compromised yet again and was now a travesty that would be forcing people to buy into a product that was not worth buying into.

If you can see this on the reruns that go throughout the night, you should watch it. Tomorrow, it will be available on the msnbc.com site and I will post a link for you. It was superb.

The people to blame for this tragedy are many. The forty Republicans in the Senate and their counterparts in the House - save a single one - who opposed this simply because it was the only way for them to politically survive are at the top of that list. The President and his employees in the White House who failed to provide strong leadership and a strong vision of what they wanted in this bill and were sucked into the mirage of phony bipartisanship time after time when they should have damn well knew better are also culpable. Then we have the Democratic whores in the Senate who have been bought and sold by the insurance cartel and only serve their rightful masters instead of serving the people. Max Baucus and Joe Lieberman head that list of infamy. And trailing behind those famous faces are the faceless zealots of the Tea Parties, the ideological neanderthals of the libertarian websites bowing to ideologies which exist only in their own 18th century minds as they fear the government which has been elected to serve us, and the just plain fear mongers who scream about death panels and killing grandma before her time.

The time has come for those on the Progressive side of politics to say "enough is enough". No more. Kill this thing now and begin the process of reconciliation. Allow the majority to have their will done and get a true reform bill which this nation badly needs.

Fight for true reform. Pass true reform. Run in 2010 and 2012 for doing so. Do the right thing.

Originally Posted by haymarket martyr

...
The time has come for those on the Progressive side of politics to say "enough is enough". No more. Kill this thing now and begin the process of reconciliation. Allow the majority to have their will done and get a true reform bill which this nation badly needs.

Fight for true reform. Pass true reform. Run in 2010 and 2012 for doing so. Do the right thing.

To understand the key (but not only) big problem with that approach, one only needs to read this fairly good description of reconciliation (note the date making the specific application out of date, but not the key descriptive points of the process) and apply that to full array of health care reform elements.

http://firstread.msnbc.msn.com/archi...9/2082655.aspx

Essentially, nearly EVERYTHING left in the Senate Bill including regulations on insurers (including ban on pre-condition exclusions), many of the delivery-side reforms, the health insurance exchanges, the individual mandate subsidies will become 'Byrd Droppings' - i.e., they will be removed from ANY consideration whatsoever. Even the subsidies could be vulnerable.

What could be considered is the expanded Medicare or public option since these are government programs. But do you think you'll get something more for these than what was already considered and dropped? Expanded Medicare was only for individuals from 55 to 68 and the Public Option was only for a small group of individuals seeking insurance that didn't have enough subsidies to afford a private plan. Are you willing to jettison everything else for that? Are you certain that you could even get the 50 Senators to pass - including those that have made it clear they don't want to go the reconciliation route? If you knew it would add nearly a year, in a mid-term election year, to the process would you be so willing to gamble for all this? If you have a sense of political momentum, how much do you think there will be if this gets killed after a year of intense efforts, particularly when the White House must, and will, pivot to unemployment?

If you really believe in the reconciliation process, why not lock in those things that can't be achieved through that process and hone in on those things that can be - THE VERY THINGS that where stripped out? Do you really think Rockefeller, Wyden, Harkin, Schumer, Sherrod Brown, or Dodd are going to be satisfied with what Lieberman allowed them to have? You don't think that they and the leadership are just itching to roll Lieberman on this? You don't think this fight, which is way winnable won't rally the shit out of the base that absolutely hate Slime Ball Joe? Come on, brother, think about it!

As a side note, this may save Dodd in Connecticut. He can run as the anti-Lieberman. Support in CT for HCR, particularly the public option, is running about 3 to 1. Sheer hatred of Lieberman is about the only thing that polls higher with Dems and Independents in CT - there is little doubt, he'll switch to the Repug side. Dodd could really play off of this and win PARTICULARLY if he leads the charge on a reconciliation that not only replaces what Lieberman tried to kill off but actually greatly improves. The poetic justice and irony is just too much for fate to pass this up!

A lot of moving parts on this chessboard - it be 3D Buck up, my brother!

I'm really disappointed with the bill.

That being said, I'm coming around to the playwrite position....

At this point, cleaning up the worst of the abuses and setting up a system that brings everybody in is an acceptable first step, for the following reasons:

1. Pushing everyone into the system increases the urgency of reform when they find out the various ways insurance companies might screw them. There is no more shrugging your shoulders and watching the death spiral. This by itself makes me more optimistic for future reforms, because more people will demand them when they are made to be part of the system.

2. I think the ultimate end is going to be government-run health care regardless, especially when we are faced with the hard realities of cost controls. Massachusetts is going to be facing some of the same issues imminently with its system. This pushes events in that direction more than it would if the bill were not passed. Effectively, it forces government to address cost issues in the future because the inertia will dictate so.

3. I think there is evidence that Massachusetts is not an abject failure, but rather a flawed program. Indeed, there is some studies that indicate premiums are much lower there than the rest of the country. (If anyone wants it, I'll have to hunt it down - but I recall I found one on Ezra Klein's blog that indicated this). While the federal program would likely share Massachusetts' flaws, I can't say no good has come from Massachusetts' attempt.

That being said, I am entirely confident that Sen. Rockefeller is correct - this is not the end.

Taken from that premise, that there will be more attempts in the future, I think it falls in favor of passing on balance. It's nowhere near where I wanted it, not at all, and I'm really pissed at Sen. Lieberman, and the Obama administration (for their lack of leadership and their abject stupidity in handling the left)... But in a lose-lose situation, it'll be better to go forward than not.

On the politics of it, I agree with Chris Bowers: http://www.openleft.com/diary/16527/...ng-to-this-one

Originally Posted by The Rani

Yeah, politicians know a lot more about health care than doctors.

What I'm referring to is that Rockefeller knows what is doable in the political process of the Senate.

Its okay though; I gotten use to explaining pretty basic stuff to Glibertarians.

It helps keep you guys around for the entertainment value.

Speaking of Dr. Dean, I caught him on Hardball this afternoon, and he was, if anything, more obnoxious than Chris Mathews, which is saying a lot. The good doctor is living proof, if any were needed, that passion is best confined to the area between the thighs.

Pax,

Dave Krein '42

HM:

I like Olbermann, and I love what he's done with the free clinics (I donated and urge anyone else here who gives a crap to do so as well).

But I wised up and watched "The Sing-Off" tonight instead of the special comment. Probably better for the old blood pressure.

I am glad that people like Playwrite, Klein, Silver, Yglesias, Senator Rockefeller, and our own Mr. Krein are keeping their cool about this whole thing.

MillieJim also had a great point:

1. Pushing everyone into the system increases the urgency of reform when they find out the various ways insurance companies might screw them. There is no more shrugging your shoulders and watching the death spiral. This by itself makes me more optimistic for future reforms, because more people will demand them when they are made to be part of the system.

Nothing like a splash of cold reality to wake people up.

Originally Posted by haymarket martyr

I sympathize and fully understand the conflicted feelings of my progressive brothers and sisters. In the end, it comes down to one thing for me - is the bill better than what we have today?

Based on what I know that is in it, the answer is YES.

I sure wish they had done some of this using reconciliation and ended up with a complete Medicare expansion. But that train has left the station I am sorry to have to admit.

I cannot support a bill with a mandate to buy insurance that has no public option and strong regulation of the health insurance industry. without those two things it is essentially FASCISM, using the power of the state to coerce me to by a product sold by a private enterprise.

Sometimes Right and Wrong cannot be boiled down to pure Utilitarian calculus.

KILL THE BILL!