Krugman: Pass The Bill Already

Filed in National by on January 22, 2010

Congressional Democrats, please listen to this man:

A message to House Democrats: This is your moment of truth. You can do the right thing and pass the Senate health care bill. Or you can look for an easy way out, make excuses and fail the test of history.

A message to House Democrats: This is your moment of truth. You can do the right thing and pass the Senate health care bill. Or you can look for an easy way out, make excuses and fail the test of history.

Tuesday’s Republican victory in the Massachusetts special election means that Democrats can’t send a modified health care bill back to the Senate. That’s a shame because the bill that would have emerged from House-Senate negotiations would have been better than the bill the Senate has already passed. But the Senate bill is much, much better than nothing. And all that has to happen to make it law is for the House to pass the same bill, and send it to President Obama’s desk.

Right now, Nancy Pelosi, the speaker of the House, says that she doesn’t have the votes to pass the Senate bill. But there is no good alternative.

Some are urging Democrats to scale back their proposals in the hope of gaining Republican support. But anyone who thinks that would work must have spent the past year living on another planet.

I have no idea why Democrats want to draw defeat out of the jaws of victory because of a defeat in Massachusetts. They need to quit freaking out (especially in public) and just get back to work.

I kept telling people during Bush’s term (especially during the 2004 campaign): don’t judge by his words, judge by his actions. Well, I have the same judgment on Democrats. Just because they talk about things I agree with, like fixing the problems with our health care system, doesn’t mean they are on our side. It’s time for action now. The Democratic Party should be more than a debating club – all talk and no action. They have the power to do something right now. Pass the bill. Prepare fixes for the current bill and introduce them. Make ConservaDems and Republicans say no.

Just do it. If it isn’t done the American people will still face the following:
1. If you get sick you could lose your coverage
2. If you don’t have coverage you could go bankrupt
3. After you’re bankrupt you won’t be able to get coverage
That’s just unacceptable to me.

There is no win for progressives if this bill doesn’t pass. Health insurance corporations will still make profits. People will still be thrown off of insurance plans for being sick. Joe Lieberman will still be a Senator.

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Comments (76)

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  1. Smaller and weaker, and still not likely to pass the Senate:

    And then there’s the possibility of a smaller, “scaled-back” reform plan that would bring health coverage to maybe 12 million to 15 million people, instead of the 30 million in the bills already approved by the House and Senate. What would the pared-back approach look like? The NYT report offered the most details:

    Lawmakers, Congressional aides and health policy experts said the package might plausibly include these elements:

    * Insurers could not deny coverage to children under the age of 19 on account of pre-existing medical conditions.

    * Insurers would have to offer policyholders an opportunity to continue coverage for children through age 25 or 26.

    * The federal government would offer financial incentives to states to expand Medicaid to cover childless adults and parents.

    * The federal government would offer grants to states to establish regulated markets known as insurance exchanges, where consumers and small businesses could buy coverage.

    * The federal government would offer tax credits to small businesses to help them defray the cost of providing health benefits to workers.

    * If a health plan provided care through a network of doctors and hospitals, it could not charge patients more for going outside the network in an emergency. Co-payments for emergency care would have to be the same, regardless of whether a hospital was in the insurer’s network of preferred providers.

    There are at least three obvious reasons why this is a bad idea. First, the scaled-back plan is considerably worse than the Senate bill, and would help far fewer Americans. This may seem like a radical concept, but if House Dems have a choice between two approaches, and one is superior to the other, they should probably support the better one.

  2. anon says:

    It depends how Obama interprets the wake-up call this week.

    If he sides with Democrats, we will get the Pelosi plan – a watered-down Senate bill, coupled with a bunch of goodies passed in reconciliation, up to and maybe including a public option.

    If he sides with Repubs and conservadems, we wlll get a package of jury award caps and insurance deregulation.

    Time to choose, Mr. President.

  3. anonone says:

    A bill with mandates to pick the pockets of Americans for private insurance company profits without any cost controls or a public option is not HCR. Krugman and UI are wrong: this bill is worse than nothing, which is why Americans don’t support it, even though they do want HCR with a public option.

    Kill the bill, and start with Medicare buy-in for all people over 55. You can do that with reconciliation.

    Krugman also wrote “But I have to say, I’m pretty close to giving up on Mr. Obama, who seems determined to confirm every doubt I and others ever had about whether he was ready to fight for what his supporters believed in.”

    Many of us already have given up on him.

    HCR 2010 = WMD 2002 Obomba lies while HCR dies.

  4. pandora says:

    Luckily I have calmed down since yesterday – Sorry for going all A1 on everyone. 🙂

    That said, UI makes an excellent point.

    They need to quit freaking out (especially in public) and just get back to work.

    Especially in public. Dems/Liberals/Progressives need to learn how to keep a family fight within the family and put on a public face.

    Most of my frustration has been born out of our public appearances. I never thought the bill was perfect, but I also never believed it was all crap either. And my frustration grew when I saw people on my side tearing HCR to pieces without ever acknowledging the good that existed in the bill.

    Instead all I was hearing was the bill sucks, Obama sucks, this or that Dem sucks. Which may, or may not be true, but even if it is true what exactly did that tactic accomplish?

    One of the reasons I want the bill to pass is momentum. And, to me, that’s what was really lost yesterday. I believe it’s easier to build off accomplishments – even if they aren’t perfect – than to build off failure. And whether you like the bill or not, Dems walking away now will be viewed as a failure. Any argument pointing out the details of why it was good, or why it was bad, will now be lost to the meme of Dems failed to pass health care. The Republicans, however, will claim victory.

    So much of politics is perception. And for those of us who don’t live and breath this stuff, the perception we’re creating doesn’t bode well for 2010 and beyond.

  5. A. price says:

    speak for yourself A1. with the SCOTUS decision it is going to be a LONG time before any major industry allows itself to be anywhere NEAR regulated. this bill is the best we are going to be able to do until we can find away to strip corporations of there better-than-constitutional rights.

  6. Truth Teller says:

    Time to go for Single Payer with 51 votes anything else is a failure

    Add on the Regulation of the insurance companies later

  7. anon says:

    Pandora – some of us reached that point of frustration much earlier when we realized the public option wasn’t going to be in the Senate bill.

    Even then I kept clinging to false hopes that there was an eleven-dimensional chess strategy to sneak the public option through reconciliation. Howard Dean even said as much last fall.

    My disillusionment came when I realized Obama really and truly was not willing to work for the public option. In the blog world, it amazed me when I read Democratic bloggers here and elsewhere who kept pushing for the Senate bill even after the public option had been stripped. It stung to be dismissed as a purist.

    Progressives want single payer, so for progressives the public option IS the compromise. To ask them to vote for HCR without the public option is a slap in the face. House progressives are right to stand their ground. Maybe they will get more respect on the next issue, like tax cuts for the rich.

    I don’t buy the hype that “if we don’t pass it now, we won’t get another chance for 15 years.” That is a talking point and a scare strategy. There are lots of things that can be done to improve health care with or without the Senate bill. Actually I think we are a lot better off approaching health care without the individual mandate.

  8. anon says:

    Right now, Nancy Pelosi, the speaker of the House, says that she doesn’t have the votes to pass the Senate bill. But there is no good alternative.

    There are lots of good alternatives, even better ones. Medicare +55 would be a good start. Get a Medicare +55 bill on the table and let the AARP start running ads promoting the hell out of it. It has a built in constituency that votes reliably. Get Democratic candidates ON MESSAGE in supporting the bill, and dare Republicans to vote against the interests of Americans between 55-65.

  9. anonone says:

    Exactly, anon. And most major medical expenses happen after age 55, so many of our important concerns (as U.I. listed) are addressed for at least that population.

    Also, young people would support it too because it helps their parents.

  10. anon says:

    If Obama presents his State of the Union address without health care reform passed, what will he talk about and what “accomplishments” will he site?

  11. anon says:

    Re Medicare +55: I would love to see the teabaggers spend the summer before the elections screaming against Medicare. Pictures of their “No Medicare” signs would poison media coverage of every teabag rally.

  12. pandora says:

    I was all for single-payer and the public option as well.

    I’m also for the Medicare +55 plan, but I’m not sure how that happens when everyone is busy writing HCRs obituary. The path I chose for my goals probably no longer exists, and I’m coming to terms with that. What I’m not seeing is another path, complete with votes.

    Actually, what I am starting to see is a complete watering down of HCR, the Dems passing it, and then trying to pretend they accomplished something.

    This was always my greatest fear – that killing the bill would result in less, not more. Hopefully, my concerns are unfounded… but I don’t think so.

  13. liberalgeek says:

    Don’t worry, Pandora. The underwear gnomes will make it all better.

  14. anon says:

    What I’m not seeing is another path, complete with votes.

    Pandora, this thing of demanding to see the votes first is a bad thought pattern. The only thing we can do with all the votes up front is maybe name a post office.

    Any legislation worth having will have to be worked heavily by the White House and Congressional leaders to get the votes. That is a given.

    I think you, LG, UI have succumbed to the myth that Dems need to run to the center to win. This myth has always destroyed Democrats, but we keep coming back to it like a moth to a flame – we just can’t help ourselves. Left-center kitchen table stuff like public health care actually polls pretty well everywhere except in the Senate.

    If we ram through a public option, or Medicare +55 in reconciliation, what’s the worst that can happen? – “Oh noes, they might call us Socialists!”

    From now on, any HCR worth having will have to be introduced by progressives. So I suggest you start seeing progressives as the keepers of the Democratic flame and the source of HCR ideas, not as some kind of problem child.

  15. anon says:

    the myth that Dems need to run to the center to win. This myth has always destroyed Democrats

    … because Repubs keep dragging the center to the right, and we keep shuffling our feet and try to reorient ourselves in their new center. It is time to put a damn stake in the ground.

  16. anon,

    What I think has nothing to do with running to the center. I think it’d be a lot easier sale to the public to have reform + public option + Medicare buy-in. I certainly have no objection to using reconciliation to get better reforms.

    My concern is getting an accomplishment. Democrats giving up on their biggest domestic priority after a year of work is a complete disaster for the party and for America. Democrats have to prove to voters that they can govern this country. It will be a hard sale to the public to say “we have really good ideas we can’t get implemented even with a supermajority – vote Democrat.” Heck, if Democrats can’t get stuff done why not vote for the party of no at least they’re telling you they not interested in accomplishing anything.

  17. liberalgeek says:

    Fine. Let’s just stop referring to Blue Dogs as part of our caucus. We do not have a majority in the Senate, we have a plurality.

  18. Geezer says:

    “what I am starting to see is a complete watering down of HCR, the Dems passing it, and then trying to pretend they accomplished something.”

    So now you know what a lot of us felt like before we ever heard of Scott Brown.

  19. pandora says:

    If we ram through a public option, or Medicare +55 in reconciliation…

    I am really not trying to be difficult, but how do you see this happening? I saw a slight chance of this happening after the HRC bill passed (my momentum theory) but I’m not seeing the will or desire now.

    And I realize you don’t buy my momentum theory, but I will point out that you’re simply arguing my theory in reverse.

  20. anon says:

    True, UI… better to be the “Party of No” than the “Party of Won’t”

    There are lots of paths forward on HCR bubbling up from Pelosi and progressives. Time to learn what they are instead of complaining they don’t exist, and then get behind them.

    Obama and Reid led us into a swamp. Our last leader left with a shot at leading us out is Pelosi. I think we need spend our energies telling Obama, Reid, and the Senate to get behind the latest plans coming out of the House.

  21. a.price says:

    they will not have the votes in the senate anon. remember you need an 80 seat majority in the senate to do ANYTHING. I personally would LOVE to see the republicans filibuster…. call the bill “the patriotic healthy children and seniors bill for Americans” But there are traitor demo-rats… including our own Tom Carper who wont even get behind it…. especially now that private corporations can act as political action committees. The democrats only hope is to employ Rovian tactics and play the PR game. the terrorists (repukes) have won in the sense it is now impossible to have an adult political culture and only deal with facts.

  22. anon says:

    The tax issues will be in the budget bill, and there is no filibuster on the budget. The tax cuts WILL be decided in reconciliation with 51 votes. That would make Dems even more pathetic if they lose this one.

  23. anon says:

    Oops, I thought I was posting on the tax thread. Never mind.

  24. pandora says:

    This is worth a moment of your time, and when you finish reading could someone please explain why this path is so much worse, or completely unacceptable, compared to the path of killing the bill and starting over. It seems to me both sides of this argument are shooting for the same end goal.

    “Both houses of Congress have adopted legislation that would provide health coverage to tens of millions of Americans, begin to control health care costs that seriously threaten our economy, and improve the quality of health care for every American,” reads a letter, obtained by TPMDC. “These bills are imperfect. Yet they represent a huge step forward in creating a more humane, effective, and sustainable health care system for every American. We have come further than we have ever come before. Only two steps remain. The House must adopt the Senate bill, and the President must sign it.”

    “Some differences between the bills, such as the scope of the tax on high-cost plans and the allocation of premium subsidies, should be repaired through the reconciliation process,” the experts say. “Key elements of this repair enjoy broad support in both houses. Other limitations of the Senate bill can be addressed through other means.”

    They also warn of political recriminations if the year-long push for reform falls short.

    “Alternatively, Congress can abandon this effort at this critical moment, leaving millions more Americans to become uninsured in the coming years as health care becomes ever less affordable,” the experts say.

    Why is this a bad idea?

  25. anon says:

    The letter is wrong… only one bill includes cost control.

    “Some differences between the bills, such as the scope of the tax on high-cost plans and the allocation of premium subsidies, should be repaired through the reconciliation process,” the experts say.

    Holy crap – is this junk what they think progressives are holding out for?

    “… Other limitations of the Senate bill can be addressed through other means.”

    Out with it!

    Sorry, not enough to make it worthwhile for progressives to go back on their pledge and their principles.

    “The House must adopt the Senate bill, and the President must sign it.”

    STFU, boys, and get a Medicare +55 bill out on the table by next week. Heck there is probably one all ready to go. Give Anthony Weiner a call if you can’t find one.

  26. pandora says:

    So… there is no compromise here? The letter is simply wrong? I really find that disheartening.

    I’m also really trying not to get upset with the it’s my way, or the highway approach. But I’ll suck it up for now since you obviously see a way to scrap this bill and get Medicare +55. I’m still not sure how that comes to be, and you really haven’t offered an explanation on how this happens… and if it doesn’t come to be, what then?

    Those are my concerns, which basically mirror your’s. Altho… I really wish I shared your hope and optimism and certainty.

  27. anon says:

    I spotted two places where the letter was wrong. Others might find more.

    1. It characterizes both bills as having cost control. But only the House bill has cost control. The Senate bill does not. This is a major reason why the failure of the Senate bill is not such a tragedy.

    2. It says the House “must” pass the Senate bill. This imperative is simply incorrect because it ignores all the other options for achieving health care reforms.

    The people who have lost on the Senate bill and are petulantly refusing to pursue other alternatives are now the ones who are refusing compromise.

    you really haven’t offered an explanation on how this happens

    There are two main approaches out there. Pelosi and House progressives are working on the “dual track” approach where the Senate bill is gutted even more and passed in the House, contingent on immediate passage of certain improvements in reconciliation. This is not bad depending on the details. But I suspect it still leaves us saddled with the individual mandate and no public option.

    The other is the Howard Dean approach, of the Medicare buy-in. Not sure who in Congress is behind this, but I know it is out there. Probably Weiner and others.

    I am certain there are other better more creative options I don’t know about or that haven’t been thought of yet. That is not a reason to stop looking for them though.

    The good news is the Medicare +55 option remains available whether we pass the Senate HCR bill or not. It’s not an either-or.

  28. Jed Lewison at Daily Kos:

    As Paul Krugman argued in his column earlier today, there are three choices on health care reform: (1) pass the Senate bill, and improve it later; (2) try to come up with some new health reform plan; or (3) do nothing.

    The third choice would be such a pathetic abdication of the possibilities of the moment that I do not seriously entertain it as an option.

    In my view, the second choice option is the “I want my unicorn” approach. Face it, we have a dysfunctional Congress — particularly in the Senate. The odds of them coming up with a new health care bill are roughly zero, maybe less. It’s just not going to happen. In other words, there isn’t much distinction between options two and three. And even if there were, as Krugman points out, what’s the point of a one-legged stool?

    So for me, the first option — passing the Senate bill and then trying to fix it later — is really the only option. Otherwise we’re not going to get a single damn thing.

    Does being limited to that one option make me angry? Yes. The Senate bill has glaring weaknesses. It relies on the excise tax to cut costs, it doesn’t have the public option, it doubles down on our current system. But if we do nothing, we’re still going to have our current system. We’re still not going to have a public option. And while we won’t have an excise tax, the cost of health care is skyrocketing so fast that it might as well be an excise tax.

    I guess it’s time to push Jed Lewison out of the progressive ranks, too?

  29. Perry says:

    A1, anon:
    Although I like the idea of Medicare +55, what makes you so sure that it could qualify for passage by reconciliation, 51 votes?

    Here is the first Byrd rule requirement for a provision of a bill to be acceptable for the reconciliation process, to wit: do not produce a change in outlays or revenues

    Medicare +55 would be an increase in outlays to pay for it, therefore we can cancel that otherwise good idea.

    We are than left with UI’s favorite, that is, the House passing the Senate Bill which then would go directly to Obama, thus filibuster proof. But Pelosi needs to get on her horse and get the votes to pass it. In a Dem controlled House, you mean to tell me she can’t do that? The House Progressives will have to swallow a bit of their pride, otherwise HCR really is dead, a resounding defeat for Obama and the Dems! No way can I stomach such a defeat.

    The other alternative is the pared down bill, set up to pass the Byrd rule criteria and therefore go through reconciliation. UI is correct, this is weaker than the Senate Bill. Who in their right mind wants that?

    I think UI’s opinion is the better one on this thread. Let’s go for it, then get onto to job creation, reigning in the banks, and the other critical economy related legislation.

  30. anonone says:

    Jed Lewis: “it doubles down on our current system. But if we do nothing, we’re still going to have our current system.”

    What a dopey thing to write. Our current system sucks, so let’s “double down” on it and call it “reform.”

    Kill this bill. Americans don’t want it.

  31. pandora says:

    The other alternative is the pared down bill, set up to pass the Byrd rule criteria and therefore go through reconciliation. UI is correct, this is weaker than the Senate Bill. Who in their right mind wants that?

    Looks like Republicans may like that, and vote for it, and take credit for it, and run on it.

    Via Ezra Klein:

    Health care reform advocates are concerned that passing a scaled-back version of reform legislation — an option being considered by President Obama and Democratic Party leaders — could end up playing into the hands of Republican electoral politics. […]

    Senate Minority Leader Mitch McConnell “will have his whole caucus vote for it and make it a political win for the Republicans,” one well-connected Democratic health care strategist said. “They’ll say, ‘This was the Republican plan from the beginning. We’re glad the Democrats joined us.’ And take all the credit for passing reform.”

    Kill me now.

  32. Perry says:

    In addition to the passing of the Senate Bill by reconciliation, the House could craft another bill that covers only a public option, which is very popular among the electorate. Then, when it comes up for a vote in the Senate, let the Repubs do their filibuster, which won’t go over very well with the public for a number of reasons, thus putting the Repubs on the defensive. If the filibuster prevails, we have one more important campaign issue for the mid-term election.

    Let us not desist from this fight, Dems!

  33. Passing the Senate bill now does not preclude trying to introduce the public option or Medicare expansion through reconciliation. It’s putting a W in the win column.

  34. anon says:

    Perry – I don’t concede that the Byrd rule prevents Medicare +55 from being done in reconciliation. The Medicare +55 plan is a buy-in, so can be designed as deficit neutral. The buy-in amount can be reduced later.

    Medicare is a sound program with cost control and no major inherent flaws, so I would be very happy to accept a “fix it later” approach to a Medicare +55 bill that starts out as deficit-neutral.

  35. We’re all dumb and you’re smart. We’ve heard this already A1.

  36. Perry says:

    “Looks like Republicans may like that, and vote for it, and take credit for it, and run on it. “

    We have the power to thwart this, by not voting the bill out of committee. We obviously cannot let a weaker bill come to the floor for a vote, let alone pass the House first.

  37. Jerrold Nadler:

    WASHINGTON, D.C. – Today, Congressman Jerrold Nadler (D-NY) issued the following statement on the current status of health care reform in the U.S. Congress:
    “As Speaker Pelosi has said, the House of Representatives does not have the votes to pass the Senate health care bill alone. It is clear that the great majority of the House Democratic Caucus – right, left and center – is unwilling to pass the Senate bill as it stands. But we must not let this fact, or the election results in Massachusetts, cause us to abandon comprehensive health care reform.

    “We must instead negotiate an agreement with the Senate to pass a few key changes to the Senate bill through the reconciliation process so that both Houses can pass a comprehensive bill. We can then take various popular insurance reforms that cannot be passed through the reconciliation process – dealing with such subjects as pre-existing conditions, rescissions and annual and lifetime benefits – put them in a separate bill, and see if the Republicans dare to filibuster them. The alternatives – giving up on comprehensive reform or attempting to only pass small pieces separately – are either unacceptable or impractical.

    “Though the process of crafting and passing health care legislation has been frustrating and disappointing for many of us, we still have a rare opportunity to enact true reform, and we must not give up.”

    I say hurry up, the sooner the better.

    I wish this guy would shut up:

    Sen. Chris Dodd (D-CT) told reporters today that Democrats should take a “breather” on health care reform, the Associated Press reports.

    Democrats should “maybe take a breather for a month, six weeks” and focus on other issues, Dodd said today.

    Dear Democrats, quit sounding like losers and cowards in public. Think twice about saying dumb things when microphones are shoved in your face.

  38. pandora says:

    Doesn’t yesterday’s Supreme Court decision come into play regarding HCR, as well? I don’t know about anyone else, but this sure looks like a death knell to the idea we can scrap a bill and start over.

    And as far as Medicare+55… why would you believe a Congress willing to walk away from a year’s worth of work (and their already cast votes) would suddenly be willing to go for broke over this idea? I keep hearing how much Obama and the Congress suck, and now I’m hearing they would pass/implement a Medicare +55 solution. I’m confused.

  39. Exactly pandora. We still have the same Congress minus one Ted Kennedy.

    I don’t want to start over. We’ve been working on this bill for a year. Just stick together and vote the bill out to the president. It’s simple. Just do it.

  40. Perry says:

    anon: We need to know the cost for making Medicare +55 revenue neutral, as it would be paid for by the premiums charged. Could be that the premiums would be too high to be affordable/competitive, compared to private insurance which draws from a larger pool containing younger, healthier people.

    Why not put this bill through as an additional bill to the Senate Bill approach and a bill for the public option.

    I am beginning to see that we have options to launch a robust offensive on the HCR issue.

  41. anonone says:

    U.I., then perhaps you can explain why “doubling down on the current system” is an improvement on our current system.

    Mandates without cost controls and a public option are a recipe for disaster.

  42. a.price says:

    a1, perhaps YOU can explain why no change in the current system at all is a good thing. I bet you have health insurance dontcha?

  43. pandora says:

    A1’s points would make sense to me if he was saying, “Kill the bill, it’s worse than the status quo, and Obama and the Dems suck and are liars.”

    All of which he has said, and has a certain consistency about it. But then he goes on to say… Kill the bill, and start with Medicare buy-in for all people over 55. You can do that with reconciliation.

    And this is where he loses me, because I’m not seeing how he suddenly is counting on those he claims are liars and who suck. There’s a disconnect here.

  44. anon says:

    Pandora, those are the same people you told us could “fix it later.”

    And if House progressives vote for the Senate bill, they automatically become liars.

  45. anonone says:

    Because not all changes are good, a.price. Mandates without cost controls and a public option are a recipe for disaster. Extorting money from people simply to fatten insurance company profits is wrong.

  46. Perry says:

    A1, Medicare +55 is not sufficient reform by itself, assuming that the premium costs would be competitive. With it alone, I can see the insurance companies ditching their 55+ customers, causing the premiums for Medicare +55 to be even higher. Then, of course, the privates would profit.

    I don’t think you have presented enough information to demonstrate that Medicare +55 alone is viable, or even desirable.

    At the very least we should get what we can get, which is the the House voting the Senate Bill, then to Obama.

  47. Perry says:

    anon: “And if House progressives vote for the Senate bill, they automatically become liars.”

    No, anon, they become realists, which you and A1 ought to consider as well!

  48. anonone says:

    U.I., Obama sold HCR out to the LIEberman and a few bluedogs. If he worked hard, I think he could get 50 votes plus Biden in the Senate to pass a medicare for 55+. He would need to get 50 out of 59 in his caucus to vote for it. I also think Pelosi and the House would easily pass it.

  49. pandora says:

    But, anon, I don’t hate the Senate bill. There are things about it I think are really bad, but there’s also a lot of good. And when you look around the world what you find is that while people are constantly demanding changes in the health care, no one is calling to get rid of it.

    I have no reason to believe we would be any different. If the bill passes there will be parts that people will demand be changed, but I doubt they’ll be calling for it’s total repeal – just like in Massachusetts.

  50. John Manifold says:

    The guys who’ve spent the last three decades fighting for HCR say, “Sign it.”

    http://www.tnr.com/blog/the-treatment/47-health-policy-experts-including-me-say-sign-the-senate-bill

  51. anonone says:

    Medicare for 55+ is the best first step to single payer. It is better than the current system, much better than the Senate bill, and would help a lot of people. I believe the public would support it overwhelmingly, too.

    Mandates without cost controls and a public option are a recipe for disaster. That is the reality of the Senate bill.

    I love the way people always complain that progressives don’t have a spine and then become angry when they actually decide not to be bullied.

  52. Medicare for 55+ is not comprehensive reform. I think expanding Medicare is a great idea (Medicare for all or single payer) but if Medicare 55+ is your idea for reform you’re leaving a lot of people out, namely everyone under 55 that can benefit from the subsidies, the health care exchange, the lifetime caps, the end to recission. All those things are in the bill.

    Medicare 55+ is not a cost control bill either, which you say is the problem with the Senate bill.

  53. pandora says:

    Oh please, no one is bullying you.

  54. anonone says:

    I am talking about the progressives in the House, pandora, not me!

  55. anonone says:

    U.I. Medicare does limit payments to Doctors, so there is cost control right there.

    I said it was a good start, and better than the Senate Bill. By the way, NOW came out against the Senate bill, too.

    http://rawstory.com/2010/01/kill-bill-entirely/

    “O’Neill said as a result of Nelson’s amendment, “insurance companies will in a few years stop offering abortion care even in private policies because it’s too much of an administrative hassle,” forcing women to “pay for abortions out of their own pockets.”

    “That’s the conclusion of the George Washington University School of Public Health,” she added.”

  56. pandora says:

    I’m yelling at everybody, not just progressives, in the House to Pass The Damn Bill!

    And, anon, why would you say… And if House progressives vote for the Senate bill, they automatically become liars.

    I’m not getting that.

  57. anon says:

    Medicare for 55+ is not comprehensive reform.

    Nobody ever said it was. But it is a better foundation for “fix it later” than the Senate bill. And Medicare has no recission or lifetime caps.

    Medicare does have cost controls, since payments are set by Congress (I think). And subsidies can be added later once the principle of 55+ is established.

    Better to have half a good loaf, than a whole rotten loaf.

  58. Perry says:

    A1, I note that you are great for persisting in promoting your idea, but you are poor in responding to objections, like that the premium costs might be prohibitive/uncompetitive, that the privates could exploit it to their profit, that it is not comprehensive reform. Therefore, you case is not convincing, yet!

    What is wrong with going with the Senate Bill, and introducing the Medicare +55, to get the OMB take on it, and to determine if it will pass muster for reconciliation?

  59. pandora says:

    Perry is a wise, observant man.

  60. anon says:

    And if House progressives vote for the Senate bill, they automatically become liars.

    A number of House Progressives pledged way back in August not to vote for any bill that did not contain a public option. Now they have a bill before them with no public option, and you expect them to break their pledge and vote for it.

    Also, way back in August:
    Weiner: Senate healthcare deal could cost 100 House votes

    What part of “We’re not voting for a bill without a public option” did Obama not understand?

  61. anonone says:

    perry, as far as the medicare premium costs go, they would be cheaper than private insurance because they won’t have 15-20% profit built-in and the government has pretty powerful negotiating and buying positions with suppliers. The privates don’t want a public option because they know that they can’t compete with it and maintain their high profit margins. So what? If they drop their over 55s, let those customers come to Medicare – it make a bigger insurance pool, reduces administrative marginal costs, and gives the government more clout in keeping down costs.

    We agree it isn’t comprehensive reform, but it is a much better start to single-payer universal HCR than the current Senate bill. What’s wrong with your plan is that the Senate bill is HCR in name only – mandates without cost controls and a public option is not HCR and are a recipe for disaster.

    A majority of the American people, who desperately want real HCR that includes a public option, don’t want the Senate bill.

  62. Perry says:

    Anon, now you are presenting an historic argument which is no longer applicable in the current context. You are behaving like an absolutist, like there is only one way to make progress, just like the game the hard line Republican absolutists play consistently. Sorry, I don’t buy it as being convincing. It’s no sin to change one’s mind when more knowledge has been acquired!

  63. anonone says:

    anon asked: “What part of “We’re not voting for a bill without a public option” did Obama not understand?”

    Obomba probably assumed that they were lying just like he was.

  64. Perry says:

    Let us examine the Senate Bill:

    * Subsidizes premium payments for a family of four @ 4x poverty
    * Create health insurance exchanges
    * Limit total out-of-pocket expenses
    * No more pre-existing conditions denials by the privates
    * No more higher premiums based on gender or existing med conditions
    * Expand Medicaid coverage to families @ 1.33x poverty
    * Paid for by tax on privates’ cadillac plans
    * Also hike Medicare premiums for incomes > $250K
    * Creates nonprofit private plans overseen by the Feds
    * Insurance mandate or penalty: $750 or 2% of income
    * Hardship exemption from penalty for the poor
    * Abortion coverage up to the states

    A1, you say there are no cost controls in the Senate Bill. You can see that there are. Moreover, the CBO concluded that this bill would reduce the deficit over a ten year period.

    I agree, this Bill could be much better, but your comments have mischaracterized it.

  65. anonone says:

    perry, there are plenty of “controls.” There are very few cost controls. In fact, I don’t see any in your list.

    There are, however, a lot of “controls” to ensure that the government can extort money from every one to put in the pockets of private insurance executives. You even cited them.

  66. Perry says:

    A1, I just now read your 2:50 pm comment.

    I don’t think anyone on here doubts the merits of Medicare +55.

    Let us do both, then adjust the Senate Bill later if a later cost analysis indicates unintended consequences. If we are successful with getting M +55 passed, then it will compete with the Senate Bill wrt premium costs and benefits.

    There are many reasons already discussed why we have to break this ice jam with what we can get; we know that we can get the Senate Bill which has its merits! Moreover, we must be aggressive on this issue, considering November, and, we must move on to the other important legislative initiatives we must tackle to continue to rescue our economy. If serious unintended consequences arise, both parties should be motivated to make the necessary adjustments.

  67. Perry says:

    A1, regarding the federal budget, the CBO analysis result is indicative of cost controls. With regard to the insured, the exchanges will exert premium cost control.

  68. anonone says:

    Perry, To me, having the government force citizens to pay billions and billions of dollars directly into the profits of private insurance companies with no other option is wrong. That is a deal breaker for me. Those billions and billions of dollars could be spent by the people who actually earned them for things like education, actual healthcare, homes, rent, food, etc. or it could be used for the public good.

    Furthermore, what many fail to realize, is that even after you have been forced to pay for your health insurance, you will still have to pay high co-pays to actually get healthcare. Many people are not going to be able to afford both health insurance premiums and health care co-pays. Add on to that the high cost of drugs (which Obomba lied about reducing), and you can see why this is a bad bill.

    I would have supported this bill “as is” if there was a viable and accessible public option to offer an alternative to being forced to purchase a product from fat private companies at fixed profit margins.

    There are many many people in this country who are counting their pennies at the end of every week. This bill will hurt, not help them. They can’t afford to lose 8% (a full month’s worth of income) to give to the insurance companies. All because the repubs, Obomba, and a few Dem senators put the wealth of insurance executives over the need for real healthcare reform that the country desperately needs and Obomba promised.

    This is a good bill if you want people to be forced to pay for insurance company profits before rent, food, education, and healthcare. If you want people to be able to actually get healthcare that they can afford, it is a terrible bill.

  69. anonone says:

    Perry, in regards to the CBO estimates, lets be real. You and I both know how impossible it is to predict GDP 2 or 5 years out let alone 10 years out.

  70. Perry says:

    A1, I concur with many of your sentiments, but I have to tell you that you are ignoring items 2 and 3 on the list I posted, namely “health exchanges”, which will force competition among the privates, and limiting “total out of pocket expenses”. When you do this, ignoring valid debating points, it makes your case less convincing.

    And of course I agree on the drawbacks to the CBO analysis, but we “go to war with the army we have”. (Sorry!) 🙂

    Moreover, you must take into account today’s political context, the political realities of the MA election result and the Supreme Court Ruling. Both of these changes the political context in which we must construct an HCR strategy to give some health care/insurance benefits to many people.

    You can lament all you want about Obama’s failures, and Lieberman’s adverse influences, but those laments do not enable progress at this point in time.

    You also did not comment on the idea of going for both the Senate Bill and Medicare +55.

    A1, let us move forward on this, as best we can, unified in purpose!

  71. anonone says:

    Hi Perry,

    I am not ignoring those points. As I mentioned, the items I discussed are deal-breakers, regardless of those points. Even with somewhat improved competition (and remember that the states have a say in this), there is still $billions flowing to private corporation profits. And in regards to spending limits, “out of pocket” limitations is meaningless when you have nothing in your pocket after paying for the insurance company profits first. Do you really think that working-poor are suddenly going to have a month’s worth of income that they can afford to spend on insurance and co-pays on top of rent, transportation, food, energy, etc.? Otherwise, they are forced to pay a fine – money that they could spend on actual healthcare.

    So this bill is a deal breaker for me, even if adding the 55+ medicare. People are trying to rush this bill through with fear and scare tactics like they did the war in Iraq. The majority of people in this country don’t want this bill, even though they want HCR. They get it. They can recognize a sell-out when they see one.

    Finally, the argument that people continue to put forward that “you didn’t address each point so you’re less convincing” is a non-starter. I think that I am pretty clear as to why this bill is horrible and should be killed. A bill with mandates for insurance company profits that doesn’t have real cost controls and a public option is not HCR and does not further real healthcare reform in this country.

  72. Perry says:

    OK A1, I understand your position. Thanks for taking the time to express it. You have not changed my mind, so that’s how it is for now. If I were to attempt to continue our discussion, I would just be repeating myself.

  73. anonone says:

    Thanks for the civil and thoughtful discussion, Perry!

  74. I agree, Democrats, please pass the bill so we can dispense with you for a decade.

  75. just kiddin' says:

    A deal is being made. Pelosi and Reid have agreed to permit the Senate bill to go to the house in 2parts. Pelosi will permit no amendments or modifications. Reid and Pelosi have ageed in principle to the changes in the Senate Bill, to satisfy the Liberal house members, but ONLY after the Senate bill is signed by Obama.

    Reid to provide Pelosi with a pledge of 52 senate votes to give a him a simple majority to pass any changes they want. In the House with a simple majority if the House passes the Senate bill by 60-39 there is no need for a conference on the bill and it can go straight to Obama for signature.

    Do we trust this deal? Do we trust they will fix all the problems? Progressives are flooding the House today with calls to put in the public option before it goes to Obama. I doubt that will happen.