Dear Republican senators Charles E. Grassley, Orrin Hatch, Richard Shelby and your 52 other colleagues in the Senate and House of Representatives who steadfastly and on principal oppose a public option, despite being on Medicare:
Must be nice.
Not only do you have access to what has to be considered the Rolls Royce of Cadillac health plans, you are also eligible for and take advantage of America's original public option, Medicare. In fact, according to New York Representative Anthony Weiner, a total of 150 of you lawmakers in Washington "currently receive government-funded, government-administered single-payer health care", also known as Medicare.
But you know what? I don't have a beef with the other 95 of your colleagues. It's you 55 I'm interested in.
The big piece of news being bandied about today is that our favorite "Democrat" - Joe Lieberman - vows he'll block any healthcare reform bill that includes the public option, as he positions himself, according to the Politico report, to be a "fiscal hawk" on the issue. Even though the CBO has time and time again scored any reform bill that includes a public option lower than bills without it. In fact, the bigger and more inclusive the public option, the lower the cost of reform.
And Harry Reid appears nonplussed about Lieberman's threat.
(Frankly, I would like to see the Senate Democratic leadership pull out the stick for a change. You know, strip Joe of his committee chair and deny him of his appropriations requests, and watch how his lobbyist friends abandon ship. No better way to hurt a Senator like Lieberman than to go after his goody bag.)
And as Lieberman disses the public option, its popularity among voters continues to climb.
No wonder a majority of Americans in a recent WSJ/NBC poll think the US is on the wrong track. And while conservatives are off braying, seeing in the results a rejection of liberal politics, if you look closer at the numbers, it's pretty obvious the reverse is true:
-- Obama's approval rating remains at 51% in the poll, exactly where's it's been for the last few months.
-- 43% approve of the president's handling of health care. For Republicans, it's 23%.
- 42% have a favorable opinion of the Democratic Party. For the Republican Party, it's 25%. (Update: The GOP's rating is even worse now than it was during Bush's two terms.)
- On the generic ballot test, respondents favored a Democratic candidate over a GOP candidate, 46% to 38%. A month ago, the margin was only three points in Dems' favor.
- 63% believe the economic problems the White House is dealing with were inherited from the Bush era. That's down from 72% in June, but it's still quite high.
Combine those results with, say, Sarah Palin's popularity, and it's obvious the numbers show that the Republican brand is toxic. That's the real story here. No one scores worse on healthcare than Congressional Republicans. The economy is still seen as a Republican creation. And the likely drop-off in numbers about the direction of the country and the handling of healthcare is likely coming from disillusioned liberals and independents, who see Congress playing politics-as-usual footsies with corporate America.
And politicians know it, too. Those Senators facing tough re-election campaigns are often the public option's biggest boosters. First, it was Alren Specter, who favors a robust and accessible public option. And, more recently, there's Harry Reid, who looks like he's going to include it in the Senate healthcare bill over fears for his approval numbers back home.
The key, now, is to hammer this home, again and again to our elected representatives. Yes, it's work. Yes, it's slow and painful. But, yes, we can move this thing, bit by bit...
Best Ezra Klein analysis I've seen in a long time. And it's framed around this quote from Rep. Anthony Weiner:
What are we trying to protect when we're trying to protect against the destabilization of a system we all agree isn't working and that we think people are trying to leave?
And Klein lists the various contradictory precepts driving healthcare reform, explaining the limping pox-scarred legislation Congress came up with to link all the contradictions. Klein:
You can go on in this vein, of course. It's a bit of a problem. Underlying it is the political insight that people want the system changed but are afraid of rapid changes to their personal situation, and so reformers are trying to build out their reforms such that people can transition to new and better options gradually. The problem with that, of course, is that the reforms won't necessarily have the size or scale to show their power, and many people will be legally prevented from changing over even if they would like to. It's a bit like rolling out a new television, but refusing to sell it to people who own televisions larger than 25 inches. You've lost a big pool of early adopters, which means you might also lose the people who would otherwise follow them.
We've the framework for reform. The next battle: getting access to reform.
So we got a public option in the Senate bill. The bill and its version of the public option is far from perfect - that it's opt-out at the state level is the least of its problems. For one, it'd be available - along with the community standard provisions - to only a handful of consumers. And that's critical, for in order for the public option to be successful it needs to be national, and it needs to be big. Still, if this is the most conservative, weakest version of the public option that could make it to the final Congressional bill - the worst-case scenario, if you will - that's not a bad thing.
Still, that it got in the bill is a huge victory for the progressive activists who fought for it. Huge. Despite being outspent by industry lobbyists, despite not garnering the frenzied media coverage that the Teabaggers did (memo to self: blog while armed), despite the attempts at marginalization by both Congressional and White House Democrats and the open hostility of some single-payer advocates, a lot of good people stirred up a big fuss, and a public option will be in the final bill.
We were wanted for door-knocking and phone-calling and t-shirt-buying and our votes, but we weren't wanted when it came time to craft policy. Well, despite the public option's relative insignificance (compared to say, real health care reform in the form of a single-payer system), we've forced a place a the table. And we're not going away. We'll be there for climate change legislation, immigration reform, bank regulation, Net Neutrality, consumer protection legislation, gay rights, tax reform, and on and on and on.
Ezra Klein today reported that Harry Reid was very close to including a national public option into the healthcare reform bill that would be voted on in the Senate. Until...
...Max Baucus held a meeting.
Here, stories begin to diverge. Depending on who you talk to, Baucus either held a routine, informational meeting telling the Senate moderates and members of the Senate Finance Committee what's going on, as he's been doing fairly regularly, or he held a meeting in which he tried to rally Senate moderates to change Reid's mind. Or maybe there's no difference between the two. The first to really speak out after the meeting was Sen. Ben Nelson, and, as one staffer pointed out, Nelson didn't need Baucus to remind him that he was opposed to a national public option. Soon enough, Olympia Snowe was also making firm statements against the public option, and threatening a filibuster.
Sort of astounding for a Senator who claims to support the public option. In fact, right now, we have to assume that Max Baucus is actively working against the public option.
This week, George Ochenski wrote a pretty d*mning op-ed in the Missoula Independent, accusing state Democrats of lining up to praise Baucus' efforts on healthcare and his bill because of money. Campaign money. Oodles and oodles of cash. And you know what? He's got a point.
But money isn't everything. Votes matter, too. And I guarantee they can't have both Baucus' money and widespread support among voters, especially those of the Democratic base. Because this bill, without a robust, widely-available public option, is going to affect a majority of Montanans' not one single bit, except to raise their premiums. Many, if not most, voters will wake up the day the bill goes into effect, and still find rejected claims due to preexisting conditions in their mailbox along with a stiff little premium hike to cover those the insurers will be forced to cover. (You know how they'll frame it, too. Those "shiftless""irresponsible" ones, the "parasites" who don't take care of their health.) And a lucky few union families will find a nice fat tax hike in their pay stub, too.
The bill without a robust public option is a kind of welfare program for the poor. Which is fine. But it's been framed as healthcare "reform." And when people hear "reform," and want "reform," and you give them something else that's definitely not "reform," you know what their reaction will be.
It will destroy the Democratic party.
So. Montana Democrats. You either stick with Baucus and drive off a political cliff, or you ditch him and find another way to raise money. H*ll, if you come out strong and hard against Baucus and for the public option, raising money probably won't be an issue.
And, frankly, Baucus isn't the only one who appears to be against us. Also from Klein's piece:
On Thursday night, Reid went over to the White House for a talk with the president. The conversation centered on Reid's desire to put Schumer's national opt-out plan into the base bill. White House officials were not necessarily pleased, and they made that known. Everyone agrees that they didn't embrace Reid's new strategy. Everyone agrees that the White House wants Snowe on the bill, feels the trigger offers a safer endgame, and isn't convinced by Reid's math. But whether officials expressed a clear preference for the trigger, or were just worried about the potential for 60 votes, is less clear. One staffer briefed on the conversation says "the White House basically told us, 'We hope you guys know what you're doing.'"
Frankly, I hope the White House knows what it's doing. Because from here, it looks like they're pushing for the clusterf*ck.
The warning bell for timid Democrats from Public Policy Polling's Tom Jensen:
Our polling continues to find that the problem for Democrats right now isn't so much that people are switching sides to the Republicans, but that D voters have become sort of complacent/disengaged. There is no greater threat to the party next year than for its voters to feel like getting in power in 2006 and 2008 hasn't accomplished anything, and that their votes didn't really make a difference in policy making. That's when they stay home. So the impact on turnout next year that not doing something meaningful on health care could have is to my mind the greater risk for Democrats right now.
Let's see. The public option. It saves money for reform, even helps reduce the deficit over time. It promises reliable, affordable insurance that will help keep costs down. It's wildly popular. (With sixty-one percent in a CNN poll.)
And if you don't pass it, your base will turn on you.
Okay. We all know the public option is wildly popular.
Fifty-seven percent of those polled favor it, only 40 percent oppose. Support for the public option shoots up to seventy-six percent if states run the public option, and it's available only to those who have no option for private insurance. In that case, even 56 percent of Republicans favor it. Additionally, 51 percent prefer the public option, even if Republicans don't support. A meager 37 percent prefers a bipartisan bill without the public option. Independents prefer a public option to bipartisanship on a 52/32 percent clip.
But what's surprising is when you compare those numbers to approval of healthcare reform overall, in which only 45 percent support it, while 48 percent oppose it. That's right, the public option is +11 over the reform package as a whole! More intriguing, 56 percent of those polled favor an insurance mandate. And if subsidies are provided for "lower-income" consumers, support jumps to 71 percent! (In fact, that jump so violates DC Conventional Wisdom on healthcare reform, that Kevin Drum called out for some help in showing the numbers were the result of how the poll questions were asked.)
Add that data to the low confidence Americans have in the Republican party - only 19 percent said they had "confidence" in the GOP to make "right decisions" for the country - and Obama's approval rating (57 percent), what I take away from this data isn't that Americans are uneasy about healthcare reform from conservative, Teabagger-like concerns, but because the legislation isn't progressive enough.
That, of course, runs counter to how moderate Democrats have reacted to polling data and Teabagger protests. What it's beginning to look like is that the traditional media - and jumpy Dems by proxy - was punked this summer: it wildly inflated Teabagger protests and charted them against declining support for healthcare reform, thinking the two related. Instead, it's looking like Democratic and independent voter defection that's driving support down.
In short, any moderate backing off the public option for fear of a public backlash is making an egregious mistake.
The New York Times: "In the debate over health care reform, no issue has produced more fury and sound bites than the question of whether to include a government-run insurance plan. It is not indispensable, and its role would be limited. Even so, we strongly support inclusion of a public option - the bigger and stronger the better. That is the best way to give consumers more choices, inject more competition into insurance markets, hold down the cost of insurance policies, and save money for the federal budget."
Open Congress put up S.1796 - the Senate Finance Committee's health care legislation - on its site.
Max Baucus thinks a "watered down" version of the public option could get 60 votes in the Senate:
"This issue is alive and we are looking at it to see what makes the most sense," the senator declared on a conference call with reporters. "The major overall goal here though is to get health care reform that passes the Senate, gets 60 votes, and I just don't know if there is 60 votes for the most pure kinds of the public option. There may be 60 votes for the less pure kinds."
The less pure kinds, Baucus explained, were co-ops, a public plan triggered by economic conditions and an insurance structure that allowed states to opt in or out of a public option. He seemed to find the last option the most intriguing.
A. Co-ops and a trigger are not a public option, even "watered down."
B. Why does anyone care what Max Baucus thinks anymore? Frankly, he shouldn't be involved in the creation of the final bill the Senate votes on. His role now is to vote for cloture on whatever bill the leadership crafts.
Be sure to check out "This American Life" and its two-part series on healthcare reform: "Someone Else's Money," on the health insurance industry; and "More is Less," on the reasons behind the rising cost of health care in the US.
Here's the SNL sketch where the "Rock Obama" makes Max Baucus bark like a dog, and then throws him out the window:
I have to admit, I enjoyed watching the Rock rip off Mitch McConnell's arm...heh heh.
...a new Washington Post-ABC News poll shows that support for a government-run health plan to compete with private insurers has rebounded from its summertime lows and now wins clear majority support from the public....
On the issue that has been a flash point in the national debate, 57 percent of all Americans now favor a public insurance option, while 40 percent are opposed. Support has risen since mid-August, when a bare majority, 52 percent, said they favored it. (In a June Post-ABC poll, support had been at 62 percent.)
Additionally, 56 percent favor an insurance mandate. A full 71 percent favored the mandate -- including a majority of Republicans -- if government subsidies were available for "lower-income families."
Unbelievable that any conversation in Congress wouldn't include a public option.
One of the more interesting numbers from the poll shows that Democratic support for Obama dropped 15 points since mid-September. Essentially, it appears that if numbers are dropping about healthcare reform as it stands in Congress, the wavering is coming from the left, not independents or conservatives.
In short, if Democrats really want to lose a lot of House seats in 2010, they should ditch the public option.
All hell broke loose on the 'Tubes when an insurance industry trade group - AHIP - announced plans to release a study showing Congress' healthcare reform would result in rate hikes: an extra $4,000 per family in 2019!
Klein:
In the hallowed tradition of the tobacco and energy industries, the health insurance industry has commissioned a report (pdf) projecting doom and despair for those who seek to reform its business practices. The report was farmed out to the consultancy PricewaterhouseCoopers, which has something of a history with this sort of thing: In the early-'90s, the tobacco industry commissioned PWC to estimate the economic devastation that would result from a tax on tobacco. The report was later analyzed by the Arthur Andersen Economic Consulting group, which concluded that "the cumulative effect of PW's methods ... is to produce patently unreliable results." It's perhaps no surprise that the patently unreliable results were all in the tobacco industry's favor. He who pays the piper names the tune, and all that.
Color me completely unsurprised. Even if this is all a sham intended to derail reform, who doesn't believe the insurance companies won't raise rates? Of course they'll raise rates!
Frankly, I wouldn't expect any less of them. They will raise premiums sky high even if reforms don't pass. They always have before. Indeed, the only thing that kept them in check at all over the past 20 years was a roaring stock market, which allowed them to make huge profits while only gouging their customers at about 15% inflation. Lately, they've had no choice but to jack that up and gouge the sick customers even more. They are, after all, profit driven corporations.
Digby suspects this has something to do with an amendment capping industry tax exemptions for executive salaries at $500K instead of $1M. (Er...we allow companies to deduct executive salaries???) Digby jokes, "Nobody puts CEOs in the corner," and says this:
There has never been a better argument for the public plan than the one the insurance company just handed the Democrats in congress. They have produced a shoddy, self-serving report as a blatant threat to raise premiums higher than they already plan to raise them. If there has ever been a more obvious case of bad faith than this, I haven't seen it. The only thing that will keep these corporate criminals in line is either price controls or stiff competition and if they can't keep their companies solvent without giving their executives outrageous pay packages, charging ridiculous prices while denying care to sick people, then maybe their financial model just doesn't work.
Again, there are good elements of reform apart from the public option. Universal coverage, say, a community standard that prohibits insurance companies from discriminating against the sick. But none of this works, IMHO, without a widely available public option as a safety outlet for American consumers against rising policy costs and increased unreliability of coverage...
Saw it on the b'birds, who saw it on Kos, who read it on a Chris Bowers' post, who heard "word" that Jon Tester supports Chuck Schumer's version of the public option.
Which pushes the Senate whip count in favor of the public option to 51.
You voted for him. You walked the streets, knocking on strangers' doors for him. You manned the phone lines for him. Not only because there was a Senator representing the state who was bloated with corruption, but because Jon Tester was one of us, someone who didn't live and breathe politics, a farmer who was as far removed from DC as you could be. Someone who promised to be a progressive populist, looking out for our concerns.
So. Where did he go? We haven't heard a peep from Jon on healthcare. Well, except for the news that jhwygirl related, as reported in Roll Call, that he - and Schweitzer - are concerned about the share of the Medicare expansion that states are expected to bear, and will lobby Baucus to have that provision struck from his bill. (And while Republican Senators have adopted that concern as their new means to oppose any and all reform efforts, it's actually a legitimate concern, especially for small states like Montana.)
But what we want to hear about is Jon's stance on the public option. Where does Jon Tester stand on the public option? Based on the usual fare we get from Tester's office, who can say?
A spokesman for Sen. Jon Tester said the public option makes sense to Tester, but Montana's junior senator "wants to make sure whatever the Senate does is right for Montana."
"Jon isn't ruling out supporting a public option, as long as it's done right so that it works for Montana families and small businesses," said Tester spokesman Patrick Devlin. "He knows that our health care system is badly broken and the status quo is the worst option on the table for working families."
We are left knowing less than before.
As Yellowstone Kelly pointed out today, Democrats have really scr*wed themselves with their lukewarm (at best) approach to reform and public policy. Hiding from healthcare reform is only going to hurt Jon Tester in 2012. On the other hand, with Democrats and independents overwhelmingly supporting a public option, seizing the issue and advocating for it can only benefit Montana's junior Senator.
Oh, and supporting the public option is the right thing to do.
And I'm glad to see that Health Care for America Now is asking Jon to sign a letter addressed to Senate Majority Leader Harry Reid that he ensure a public option is contained in the healthcare reform bill that passes the Senate.
Senator Sherrod Brown of Ohio signed it. This is why:
As we finalize health reform legislation, we shouldn't forget that a majority of Americans, doctors, and Members of Congress support a public option. Four out of five congressional committees passed health reform legislation that includes a strong public option. We owe it to hardworking families, small businesses, and taxpayers to pass a public option that lowers costs and ensures much-need competition in the insurance industry.
Riffing off Rafiki for a moment...and leaving aside whether Max was pragmatic, or an obstructionist...he said this about the public option, a variant of a statement that a lot of others repeat:
Aside from the fact that public plan isn't the crux of health care reform (worth fighting for? yes! the ONLY thing going on in health care reform? certainly not...
Why? What is the "crux" of healthcare reform, anyway?
Can someone please demonstrate how, without a robust public option and a wide-open health insurance exchange, the basket of proposed reforms actually does more good than harm?
Update: Thanks to Rafiki for posting a response in the comments. Check it out:
Universal coverage and controlling costs in the delivery of healthcare stand at the center of healthcare reform. Universal coverage is important (and the Baucus bill gets near-universal coverage estimates from CBO even without a public plan), but so too is preserving access - controlling the growth of healthcare costs so that the market doesn't price out everyone but the super rich.
Also, remember that most of the versions of public plan being discussed now are what are called "level playing field" public plans. These plans would function just like private insurance companies: meeting solvency requirements, building a provider network, and, importantly, negotiating reimbursement rates. Unlike Medicare, these public plans can't just go out and set the rates they want to pay. Like private insurers, they have to negotiate. Given that CBO estimates that only about 5% of the population would consider enrolling in public plan, it's entirely possible that a private insurer like Humana or Aetna might provide you lower rates for the same insurance product in the health exchange than the public plan because they have a larger network of customers (and more leverage).
So, is a non-profit competitor in the insurance market one of many important parts of heath care reform? Yes. Should public plan be THE measure of success or failure in health care reform? Certainly not.
Here's an interesting wrinkle to healthcare reform that illuminates the difficulty of hammering out legislation with so many voices pulling lawmakers in different directions. It played out in the wee hours of the Senate Finance Committee's last markups to the healthcare bill submitted by Baucus last Friday morning. I'll let Ezra Klein set the stage:
But the drama came late in the evening. About one in the morning, Wyden's Free Choice Act came before the committee. But it never came up for a vote.
Instead, Max Baucus effectively ruled it out of order. The reason? It didn't have a full CBO score. This came as a surprise to Wyden and his team, who'd gotten the amendment scored by the CBO, and had been in endless negotiations with Baucus, the White House, employers, and labor over the past week. If the score was in fact partial, as Baucus and Conrad claimed, you'd think someone might have mentioned it. No one did.
But suddenly, in the wee hours of Friday morning, the chairs of the Finance and Budget Committees were explaining that the amendment lacked a valid score. ANde an amendment without a valid score is "out of order." Wyden was left with little choice but to withdraw the amendment. It was not deliberative democracy at its finest. But it served its purpose: it killed the amendment.
Klein does a great job of explaining Wyden's amendment and its importance to reform, but here I'll just say it would have given all Americans full access to the health insurance exchange, the place that allows consumers to buy a policy that falls under the restrictions of newly enacted community standards - no discrimination against preexisting conditions, etc - as well as the public option, when that's passed. If you work for a big company and you don't like your insurance, under Wyden's amendment you could ditch it and get something better.
With the amendment scratched, however, you're stuck with what you have. Reform will not touch you in any significant way.
For those of us who have been watching the legislative "process" unfold, that's not really much of a wrinkle, right? We've seen how Senators, time after time, cut down legislation that would open up the market to real competition, real choice, and access to effective and affordable insurance for fear of injuring the private insurance industry. Old hat, eh?
But the surprise in this particular amendment's demise is who opposed it:
The proposal was doomed by the joint opposition of businesses and labor. Businesses didn't like it because they lose control over their employees' health benefits. Labor groups didn't like it because they lose control over their members' health benefits. That's not an entirely selfish concern: It is easier to bargain on behalf of your workers or members if they have no other options, and thus are guaranteed customers for the insurer. But it is a short-sighted concern. It means the protection and preservation of a system where employers offer us one or two health-care choices, which may or may not be of high quality, and which will almost certainly dissolve if we leave or lose that job. It also means a system in which insurers compete less, and costs are further hidden from consumers, and businesses continue to bargain on their own.
One of the biggest mysteries to me swirling around healthcare reform is, where were the major corporations? Of all the stakeholders in healthcare reform, it's America's business community that stands to gain the most from good, comprehensive healthcare reform. (Okay, maybe the uninsured and the ill stand to gain more from an individual's point of view...) Under, say, a single-payer healthcare system, the burden for providing employee health benefits would - poof! - vanish. Sure, there'd be taxes to pay for the system that business would necessarily share, but it'd be no doubt considerably less than what they're dishing out now.
Of course, the present character of reform has removed them from the debate. Their beef isn't with the uninsured. It's with costs. They're there to shoot down anything that might steal from their bottom line - an employer mandate, say - but sitting quietly otherwise. And why not? For most of them, as with most of us, this bill will change the present healthcare status quo not one bit. Killing Wyden's amendments ensures that.
As for the unions, well they're looking out for their members. Period. A robust public option open to all reduces their bargaining power for their members.
It's frustrating to watch all this, isn't it? To get something good and comprehensive, like a single-payer system say, or a public option open to all, would require compromises from deep-pocketed groups to allow legislation to pass that would work against their interests. In short, they'd have to support something that's good for the country and its citizens, but bad for them in the short term, which takes courage.
I'm not saying it isn't possible. But under the conditions that this debate started - with a complex array of hodge-podge proposals and counter-proposals born out of the lukewarm pot of compromise with disparate and competing ideologies - there never was something to get excited, or courageous, about.
And thus died the Wyden amendment in the early morning hours in a Capitol Hill committee room late last week.
A couple pieces of good news today on the healthcare front. First, this news: Senate majority leader Harry Reid said legislation coming out of Congress will have a public option. Additionally, Sen. Harkin said that no Republican will participate in the group that will merge the two Senate health care bills before sending one to the floor. Which makes sense, if you think about it for a half-second: Republicans have shown no interest in reform, and Senate Democrats ultimately decide whether a bill is filibustered.
The public option is alive and well, folks. It's slowly seeping into the consciousness of Congressional Democrats that any healthcare bill passed has to include it. Why? This chart. The public option is popular. Kevin Drum:
If they don't pass a healthcare bill at all, they'll be viewed as terminally lame. If they pass a bill, but it doesn't contain popular features that people want - like the public option - they'll be viewed as terminally lame. At a wonk level, a bill without a public option can be perfectly good. But wonks aren't a large voting bloc, and among people who do vote, the public option is very popular. So, um, why not pass it?
(Of course I disagree that reform without the public option "can be perfectly good." Well...it could if the regulations over private insurers had teeth...but...well...the same people who would define the regulations are the same people who say they can't pass a public option.)
Okay. Fine. A "public option" is on the table. But, what will it look like? Will it be open and available to all? Ezra Klein has summed up the various public option "compromises" of late (and interviews Maria Cantwell and Tom Carper about their proposals), but the one that's catching the eye of the DC insiders is Carper's compromise, which would essentially allow states to create their own public plans - although an amendment dropped into the Baucus bill by Ron Wyden may have already done that. Of the Carper/Wyden-type state-based compromise, Klein has this to say:
Each state would, in other words, be allowed to create a public option. And states could band together to give their public options more bargaining power and efficiencies of scale. This would do a couple of things. First, it would give residents access to a public competitor. Second, it would provide an acid test of whether a public competitor substantially changes an insurance market. Does it force private insurers to bring their prices down? Does it create more competition and transparency? Are consumers more satisfied? And if all that happens, will other states really resist adopting the public option?
The problem with it is that it is, at best, regional. It doesn't have the buying power of a national public option. But that's a question of votes. If Schumer's proposal doesn't have 60 votes, which is what he's currently saying, this might well be a better option than Snowe's trigger.
Wyden's amendment apparently would not place any restrictions on states as to how they would choose to implement their public plan. Is Wyden's amendment essentially the Senate version of Kucinich's HR 3200, which would allow states to set up single-payer healthcare systems? Is Carper's compromise essentially a reworking of the co-op scheme, but with states running the show?
In any case, things are looking up. It's no longer a question of "if" a public option is included, the question is now "what"? That said, we still need to do a lot of work to ensure that the public option is robust and available to as many people as possible...
You're looking at the narrative that will be written about this Democratic Congress, with Max Baucus as its figurehead, if the public option, and healthcare reform along with it, fails.
It may not be fair, it may show a lack of understanding of "how Washington works," it may even be pessimistic, but that's how it is. And I'm flabbergasted that this is surprising anyone, especially those that have the means to move the debate and change the narrative. And, oh yeah, pass meaningful healthcare reform.
Here's a Fax I sent Max's Office today. I just can't take the abuse anymore.
Dear Sen. Baucus,
I just want to let you know how disappointed I was with your vote yesterday to refuse to entertain either of the public option amendments that came before your committee. I've been a supporter, donor, and advocate on your behalf for many, many years. But yesterday you had a chance to do something important for small businessmen like me, and you let me down. My BC/BS premium went up 20% this year, over $1,200, and I'm healthy. I have no realistic option here in Lewistown. So, next time you need a ride from the airport, call someone else. Signs put up around the county? Good luck with that. A contribution? Ask Blue Cross. I'm done. My next vote will go to a real Democrat. You had a chance to make history. Instead, you'll go down in history as someone who could have made a difference, and chose not to. That's if history remembers you at all. I should have known it would end up like this.
Finance is but one committee--an important committee, to be sure, but one all the same. The bill from the Senate Health, Education, Labor, and Pensions (HELP) Committee has a public plan. So do the bills that came out of three House committees over the summer. Senator Harry Reid has indicated he probably won't include a public plan when he merges the Finance and HELP proposals, but there will be a chance to add one duirng the floor vote debate and then again during conference committee deliberations, assuming the House passes one.
Remember, the public option doesn't need 60 votes in the Senate - as Baucus seems to be claiming - it needs 51. And, right now, it's likely a healthcare bill without the public option wouldn't pass the House. Even if reform passes the Senate without the public option, there's still reconciliation.
Despite how long it's seemed to take already, it's still early.
Rockefeller's ability to channel these feelings may seem odd, given his privileged pedigree. But it makes sense given what he's done with his career. Remember, West Virginia didn't choose him. He chose West Virginia, starting with his service as a VISTA volunteer. He knows his constituents very well. And he acts that way.
You see this in his advocacy for the public plan. The arguments you hear in the debate are mostly about costs, payment rates, and how best to make a market function. But for Rockefeller, it really boils down to a simple proposition: A public plan is good because you know it will always be there for you.
The government isn't going to point to an obscure provision on page 152 of your manual and deny you essential services. The government isn't going to comb through your medical records and decide that, having taken your premiums for several months, you're not eligible for coverage after all. The government isn't going to stop offering coverage next year because it can't make a profit big enough to satisfy Wall Street.
Most Senators have no idea what's it's like to be in our shoes.
Cohn and others (Matt Singer?) think health care reform is worth passing without the public option. I disagree.
Without the public option, there's still no protection from having insurers denying claims for typos or other arbitrary reasons. There's no protection from insurers subverting your doctor and deciding what treatment you receive.
Without the public option, there's no guarantee insurers won't raise their prices across the board. In fact, the legislation as written gives insurers an incentive to raise prices, especially under the most progressive legislation with the largest and broadest subsidies. After all, the more expensive insurance is, the more consumers qualify for subsidies, and the more taxpayer money insurers receive. And you can bet the insurers' number-crunchers are right now writing their algorithms calculating to the dime exactly how much they can raise their rates before consumers would rather to pay a fine than purchase their product.
Frankly, without the public option, this healthcare reform is nothing but a large bribe paid out to the private insurance industry to cover our ill citizens, but without any corresponding guarantee or controls to ensure that the industry will uphold its end of the bargain in good faith. And as someone who's been repeatedly burned by my healthcare insurers over the years, please forgive me if I'd like something a little stronger in return than insurers' promises....
Baucus, Conrad, Carper, Lincoln, and Nelson voted against Sen. Rockefeller's public option amdendment.
Baucus, Lincoln, and Conrad voted against Sen. Schumer's public option amendment.
Baucus' statements about the Rockefeller amendment are below the fold.
One of Baucus' reasons for rejecting the public option was his belief that there aren't enough votes in the Senate to pass a healthcare bill with the public option. But Sen. Harkin and others maintain there are 51 votes for the public option -- obviously Baucus means that one or more Democrats would join a Republican filibuster.
Now we have to single out those Senators and put massive pressure on them.
In the meantime, we need to support the Progressive House Caucus and ensure they stick to their promise to vote against any bill without the public option. And we can fund the ad attacking Baucus over the public option.
