Baucus, Lincoln, Bill Nelson, Carper and Conrad just voted "no" on Rockefeller's amendment.

[jenmito]

It failed 8-15. The Repubs. were united, as always. :eyes:

[Captain Hilts]

1. Let's hold their feet to the fire then. nt

[Pab Sungenis]

4. Screw that. Let's get rid of them.

That's what primaries are for.

[Captain Hilts]

Agree. But..but the White House doesn't want competitive primaries!!! nt

[27inCali]

40. let's hold all of them in the fire

not just their feet.

[ProSense]

2. And Carper.

Fuckers!

[Bolo Boffin]

5. Yes, that weaselly MFer did as well. n/t

[jenmito]

7. Thanks.

Yup, hopefully, it'll pass in the final bill without them.

[ProSense]

13. Five reasons for the Dems to

use reconciliation to pass the strongest public option they can. They can lose up to 10 and pass it with Biden. Offer one or two holdouts a really sweet deal, like Baucus' chairmanship.

[jenmito]

14. Exactly.

I REALLY hope they do it.

[Jersey Devil]

3. Add Carper (nt)

nt

[jenmito]

8. Thanks. I just did. n/t

[MarjorieG]

6. Would they vote for lkess competition Schumer one? Chance they'd vote against reform, totally?

[Mass]

9. They need to get 4 out of 5. Difficult.

[jenmito]

10. We'll soon see.

[Jack Rabbit]

11. Can you say primary challenge?

[jenmito]

12. "Primary challenge." Yup.

[rhett o rick]

27. Primary Challenge is big talk but the chances of that are lower than zero.

The Democratic Party and the WH DO NOT want incumbent Democrats challenged and will stop all such attempts. Where are you going to find challengers willing to buck the Party and President? Where are you going to get the money. No big money will back a primary challenger.

Read John Nichols article in "The Nation", Sept 28.

[jenmito]

31. I agree...

but I can SAY it. That was the question. :D

[rhett o rick]

41. Yes but some people say it like it is a threat and it isn't. We need to come up with a real threat.

Like supporting an organization outside the party, like moveon or PDA. Someone that isn't held back by the Party's desire to save incumbents at all cost.

[Freddie Stubbs]

36. Lincoln is the only one of the five who is up for reelection next year

She does have a potential primary challenger, State Senate President Bob Johnson. But Johnson would be challenging Lincoln from the right:

http://campaigndiaries.com/2009/08/24/a-potential-primary-challenge-for-blanche-lincoln/

[kestrel91316]

15. Is the Rockefeller amendmant good? Bad? What did real Dems support?

[DrToast]

18. Rockefeller's was the strongest public option

[kestrel91316]

23. How is it we have 60 Dems in the Senate and we still can't do jack shit??

[jenmito]

24. "Blue Dogs." n/t

[Mass]

16. Nelson voting for the Schumer amendment,\nt

[Jersey Devil]

17. +1 Nelson says he will vote for Schumer Amendment

just now

[thatsrightimirish]

19. What is the difference between Schumer and Rockefellers?

[Jersey Devil]

20. dunno, but there are 2 Schumer amendments

as I understand it if Schumer 1 fails there will then be a vote on Schumer 2. Let's see if we continue to pick up votes as we move along.

[napi21]

21. I don'/t know about all of them, but Conrad had a valid

objection. There's not a lot of $$ in ND and the hospitals are struggling to make ends meet. The Rockefeller ammendment had the reimbursement for the PO linked to Medicare reimbursements and they really ARE only 80% of a provider's costs. That was the biggest objection I heard from him.

I happen to think the conspicuous answer to this is to increase taxes of some kind to cover the cost of raising the reimbursements! But then, God forbid anyone mention raising taxes!

BTW, my best friend is the Director of Finance for a very large hosp. system and does all the negotiations with the ins. co's for their system. That's her biggest objection to any gov't system too. Medicare reimburses at an avg. of 80% of costs and Mediaid is worse at only 65%. I want the PO too, but that's a valid objection.

[rhett o rick]

26. Please explain 80% of costs. What does that mean? That they only pay 80% of the asking price? nt

[napi21]

33. No. Every provider has certain fixed costs they have to

cover, the same as any business. Those costs are applied to each procedure on a usage basis. In other words, if an operating room is used for an appendectomy and it takes 1 Doc, 4 nurses & and anesthetist, all the costs of those individual things is applied to the avg. # of appendectomies performed in a year. Let's say that procedure's calculated cost is $1,000. (BTW I have no idea about the individual procedure costs.) Medicare reimburses that hosp. for $800.00 & Medicaid at $650. The hosp. has to find some other source to cover those losses. Right now, they are being added to the premiums of all those who have ins. and of course to the poor guy who has no ins. but has to pay the bill out of his own pocket.

That was an over simplification but I think it explainers roughly how it works.

[warpigs]

37. So how would the Public Option change this?

You say that the uninsured is billed at a higher rate, but how much is this is ever collected by the hospital? The costs just get shifted to Private and Medicare/caid. With a PO the hospital would get some money from everyone who comes in. Also, the poor guy doesn't go bankrupt because he has insurance. That's the societal argument for the PO (actually single payer universal) - so that everyone is covered, no one goes bankrupt if they get sick, emergency rooms aren't overwhelmed with uninsured and hospitals/doctors get something for everything they do and don't need to chase around people to pay bills.

[napi21]

43. The uninsured payments go directly to the hosp & the other providersd you are billed. for.

Think of it this way. You own a roofing co. Your cost to reroof a std. 1,400 SQ FT home with a std gable roof is $1,500 & you charge $2,200. A friend's home is hit by a bad storm & his roof is destroyed and he has no ins. He calls you and asks if you can reroof his house for $1,000 because that's all the $$ he has. You feel bad so you say OK, but you still have to pay your crew and for the materials so you have to make up $700, so you add $100 to the next 7 jobs.

You're right that nobody should ever have to file bankruptcy because of health care bills, but all the providers have to cover their costs! If they don't, you would be shifting the [roblem from the public to the providers. THEY will declare bankruptcy or just close up shop. Not a good solution, huh?

[warpigs]

46. You didn't answer the question.

How would the PO change the total amount going to the hospital?

Currently the hospital can charge full rack rates to the uninsured, but most of this is not collected. So if they add a PO and more people are insured then the hospital doesn't need to cost shift to the private insurance.

You are making it sound as if the reimbursement rates will need to stay the same for the private insurance. But if the hospital collects from uninsured than they won't need to cost shift as much to private insurance. I doubt hospitals are going to go bankrupt.

The way the current system works it has huge inefficiencies and cost-shifting. Why would we want to continue this?

[napi21]

48. I did answer you, but maybe I wasn't explicit. If the PO reimburses

at the sale rate as Medicare (which is what the Rockefeller ammendment stated) the providers would lose money on every procedure. How do you suggest the providers make up for that loss?

Oerhapse I didn't state it in this post, but I have posted many times that some kind of taxes have to be increased to fund increases to Medicare/Medaid reimbursements.

The current system is unsustainable!

I have no problem with people making money & a lot of it. But at some point, when their overly greedy wealth infringes on the life & health of every American, someone has to draw the line! THAT;s where the problems really are! I can't believe the stockholders of these co's aren't bitching! Even under the current dishonest system, THEY should be getting a better return on their investment...not paying some idiot $mllions every year!

[rhett o rick]

42. I think it is a good explanation. But it seems to me that those costs you mentioned get inflated.

I know my doctors charge a high fee for services that I think is too high to begin with. If the insurance only pays 80%, i think the doctor is ok. Just my feeling.

[napi21]

45. I can't speak to the individual dr's but the hosp system I

referred to is a non-profit & is audited every year by a major CPA firm. Certainly it's debatable how much a brain or heart surgeon should make, but the actual costs are not inflated.

[LooseWilly]

49. Actually, I've heard that hospitals, knowing in advance about the 80%/65%... adjust their rates.

That is to say... knowing that they'll get an average of 80% coverage from Medicare, 65% from Medicaid, and also knowing that private insurance companies often reject or reduce billing submitted to them from hospitals... knowing all of that hospitals then set about adjusting their billing rates even higher, so that they are able to "cover costs" when they are receiving 80/65/0/(whatever the hell the private ins company decides they're willing to offer) %, respectively, of the amounts that they are billing.

It sounds like your roofers example... but slightly more complicated. The actual costs of the roofing job is $1500... but factoring in the average of all of the above numbers (assuming PIC payouts average the 80% that Medicare pays, when rejection of service billing is factored in... you get 225/3 % ... which comes to a nice even 75%). Now, if a hospital has to come up with $1500, knowing averages will be 75% of billing price, simple algebra comes up with 1500 = .75x... and x=2000. Then, add the 8% that is estimated for the uninsured... x=2160. So, when all is said and done... just for a little breathing space, the hospital bills $2200 for the $1500 job. With single payer, even assuming the continued 80%... the hospital can bill $1875, and be assured that it will be paid. That's a savings of $325 (or 21.666%) per procedure-widget. And it doesn't even take into account all the billings that the insurance companies manage to sneak out from under paying... leaving collection agencies, foreclosures, and bankruptcies to enter even further into the picture.

Of course, the original "fixed price" of $1500 undoubtedly includes someone who spends their entire day juggling paperwork... but with a single form, that cost is reduced. A central source for all patient information further decreases the administrative costs.

It's all a matter of economies of scale. The difference between Wal-Mart and my corner liquor store.

Presuming, of course, that I understood that doctor I was talking to once upon a time correctly.

[SIMPLYB1980]

22. So two more pubic option amendments to go?

:shrug:

If so I hope one of them passes or we will have to try to get it in when we combine the House and Senate bill.

[rhett o rick]

25. For those of you that are Blue Dog apologists, this is a victory for you.

Bastards.

[jenmito]

28. Conrad just repeated AGAIN that other countries like France, Germany, etc.do NOT have government-run

health care. :wtf:

[Mass]

32. This would be very surprising to French people. Securite Sociale is not govt run?

[jenmito]

34. I don't understand why Schumer didn't just correct him. Maybe he will when he speaks again. n/t

[ProSense]

35. The five shitheads should be denied Medicare.

It's beyond lunacy for Democrats to be making arguments against Medicare.

[jenmito]

38. Jeez! Baucus just repeated his BS line that even though Schumer's amendment is better

than Rockefeller's, he'll STILL vote against it because "It doesn't have 60 votes in the Senate." :eyes:

[mvd]

44. Way to fight for what is right, Baucus

Really, what kind of logic is that? Plenty of bad bills have even had 65+ votes and passed. Are Landrieu and Lieberman actually going to filibuster or just vote against the PO? I don't even know that.

Hi, jenmito. :hi:

[jenmito]

47. Yeah. Doesn't he realize that

HE'S one of the Senators who won't vote for it? I think and hope they WILL get it through-even if it has to be with 51 votes!

Hey, mvd! :hi:

[rhett o rick]

29. I get sick of the pollyanna's that keep yammering on about having 60 votes.

Read my lips, WE DO NOT HAVE 60 VOTES.

[Mass]

30. And. Why does that prevent Baucus to do the right thing.

His bill is not the bill that will be voted upon, anyway.

[rhett o rick]

39. My point is that we do not have 60 votes to pass need legislation. Even tho

some here are ecstatic that we have 60 so-called votes. We don't have 60 Senators standing with the people.