The public option ain't what it used to be

[IndianaGreen]

DINOs and the DLCers are giving the working class a Public Option In Name Only, and they expect us to support their BOHICA!

The public option ain't what it used to be

There's almost nothing left to give away in a healthcare compromise

By Robert Reich
Salon
Thursday, Nov 19, 2009

First there was Medicare for all 300 million of us. But that was a nonstarter because private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it was too much like what they have up in Canada -- which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)

So the compromise was to give all Americans the option of buying into a "Medicare-like plan" that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn't hear of it, and Republicans and "centrists" thought it would end up too much like what they have up in Canada.

So the compromise was to give the public option only to Americans who wouldn't be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and ... you know the rest.

So the compromise that ended up in the House bill is to have a mere public option, open only to the 6 million Americans not otherwise covered. The Congressional Budget Office warns this shrunken public option will have no real bargaining leverage and would attract mainly people who need lots of medical care to begin with. So it will actually cost more than it saves.

But even the House's shrunken and costly little public option is too much for private insurers, Big Pharma, Republicans and "centrists" in the Senate. So Harry Reid has proposed an even tinier public option, which states can decide not to offer their citizens. According to the CBO, it would attract no more than 4 million Americans. It's a token public option, an ersatz public option, a fleeting gesture toward the idea of a public option, so small and desiccated as to be barely worth mentioning except for the fact that it still (gasp) contains the word "public."

http://www.pnhp.org/news/2009/november/the-public-option-aint-what-it-used-to-be

[Cant trust em]

1. What does BOHICA stand for? nt

[IndianaGreen]

2. BOHICA = Bend Over Here It Comes Again!

[Kurt_and_Hunter]

3. Another one of those communist nut-left Clinton appointees

(joke)

[RufusTFirefly]

4. The unrecs are winning. Amazing

This is Robert Reich for heaven's sake. What are people afraid of?

[IndianaGreen]

5. The DLCers support the current system, they profit from the stocks they have

in the health industry. Evan Bayh's wife even sits on the board of a major health insurer, WellPoint.

They all want us to support their Public Option In Name Only because it will profit them, at our expense.

[RufusTFirefly]

6. I understand that, but

.. is Evan Bayh's wife personally un-reccing your thread?

Who's doing it? What are their motivations? What are they telling us?
Are people truly that delusional and self-loathing?

I'm just aghast.

[IndianaGreen]

8. It is the corporate wing of the Democratic Party!

They have been at war with the democratic wing of the Democratic Party for years now.

[RufusTFirefly]

9. Sorry to sound obtuse, but I'm talking about specific, rank-and-file DUers

It just seems bizarre that people would undercut their own health and well-being.

I thought only Republicans did that.

[IndianaGreen]

11. Many DUers believed the lies about WMD in Iraq

If you don't believe me, check the DU archives.

[David Zephyr]

23. True. I know. I was in those "debates" here.

And then there were the ones who would say, "but what if Bush is right?"

The only thing I would add to the old adage: question authority, is the word always.

[PassingFair]

58. Look for the "Lieberman has the most liberal voting record" posts while they're at it.....

The DLC makes me ashamed to call myself a Democrat.

And THAT'S the plain truth.

[dflprincess]

64. Call them what they really are,

the Republican wing of the Democratic party. I wish they'd go back to the Republicans and fix that party rather than moving into the Democratic party and destroying it.

[debbierlus]

12. Truth. They want to think that they are being represented by their political 'leaders'

The preservation of their delusions trumps truth.

[slipslidingaway]

19. +1 .... History of the Public Option ...

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6456383&mesg_id=6456383

"....Starting in January, we began to take Jacob Hacker to see the presidential candidates. We started with John Edwards and his advisers -- who quickly understood the value of Hacker's public plan, and when he announced his health proposal on "Meet The Press," he was very clear that his public plan could become the dominant part of his new health care program, if enough people choose it.


The rest is history. Following Edwards' lead, Barack Obama and Hillary Clinton picked up on the public option compromise. So what we have is Jacob Hacker's policy idea, but largely Hickey and Health Care for America Now's political strategy. It was a real high-wire act -- to convince the single-payer advocates, who were the only engaged health care constituency on the left, that they could live with the public option as a kind of stealth single-payer, thus transferring their energy and enthusiasm to this alternative. It had a very positive political effect: It got all the candidates except Kucinich onto basically the same health reform structure, unlike in 1992, when every Democrat had his or her own gimmick. And the public option/insurance exchange structure was ambitious.

But the downside is that the political process turns out to be as resistant to stealth single-payer as it is to plain-old single-payer. If there is a public plan, it certainly won't be the kind of deal that could "become the dominant player." So now this energetic, well-funded group of progressives is fired up to defend something fairly complex and not necessarily essential to health reform. (Or, put another way, there are plenty of bad versions of a public plan.) The symbolic intensity is hard for others to understand. But the intensity is understandable if you recognize that this is what they gave up single-payer for, so they want to win at least that much..."

[slipslidingaway]

7. knr - bait and switch per Kip Sullivan nt

[debbierlus]

10. Kick

[RufusTFirefly]

13. Only two recs. Clearly not an important issue. Let's move on.

:sarcasm:

I love my country. I think our Constitution is one of the most amazing documents in history. I love the beauty of our land, the diversity of our people, and the fact that we were founded on an ideal.

Yet I am now beginning to look for a new place to live, a civilized country where I don't have to claw and scratch for something that should be a privilege of citizenship.

It's depressing.

P.S. Only my subject heading is sarcastic. The rest of my post comes from the heart.

[IndianaGreen]

14. PO premiums will be higher than the private sector

On the public option

• The public plan option is a sham. According to the Congressional Budget Office, the premiums will actually be higher than premiums in the private sector, and fewer than 2 percent of Americans (6 million people) will enroll.

• Payment rates would not be tied to Medicare. Instead, the government has to negotiate payment rates with providers.

• So the public plan option will be an expensive, tax-funded subsidy to private health insurance, because the public plan option will take the sickest patients off their hands. It won’t expand coverage or decrease costs. In the Senate bill, only about 1 percent of Americans (3-4 million) will enroll in the public option, and states can choose not to offer it.

On the employer-mandate

• Starting in 2013, employers with payrolls over $500,000 are required to provide coverage and pay a share of the premiums (72.5 % for individual, 65% for family coverage) or pay an 8 percent payroll tax. The Senate bill places the burden on individuals, not employers, to obtain coverage. Employers would only pay a $750 penalty per worker for employees who sought subsidized coverage.

• Employers are not required to meet benefit standards until 2018, but even then are only required to help fund the “lowest cost plan” that meets the “essential benefits package,” and so may offer very skimpy coverage. The “basic plan” on the insurance exchange, for example, is only required to cover 70 percent of benefit costs. As there are no cost controls, coverage will deteriorate further, leading to a rise in underinsurance nationwide.

• Millions of working Americans will continue to lack coverage. In Hawaii, which has had an employer mandate since the 1970’s, many employers circumvent the requirement by hiring part-time employees or using consultants. Also, small businesses are not required to provide coverage (but receive a paltry tax credit for two years if they do).

http://www.pnhp.org/news/2009/november/talking-points-on-hr-3962-with-some-comparisons-to-the-senate-reid-bill-in-bold

[LWolf]

15. And I don't support this bill in it's current incarnation. nt

[Aramchek]

16. Bitterness on Parade

[bvar22]

17. K&R.....UP to +5

Many are Party Partisans who just can't believe that the Democratic Party "leadership" would force the Working Class to eat another shit sandwich.

I learned that lesson during the 90s.
The Democratic Party ain't what it used to be.

"A Uniquely American Solution"....indeed.
BOHICA

[Yuugal]

18. K&R nt

[jenmito]

20. Yeah. Let's just wait 'til we get 60 Kuciniches in the Senate.

Sorry-we live in reality where liberal Dems. get elected in liberal states and conservadems. get elected in conservative states.

[slipslidingaway]

21. Policy is set from the top, exclude not for profit advocates from the discussions...

and include the for profit companies.

We might have had a better bill if the not for profit advocates were included.

[jenmito]

25. Obama doesn't get to make Congress pass a certain bill. They're a separate and equal branch of govt

and will pass what they want, regardless of what HE wants.

[slipslidingaway]

30. Again, policy is set from the top...the WH summit excluded not for profit...

advocates (there was a last minute invite to Conyers and Dr. Fein after a planned protest) yet included the for profit representatives and then Baucus followed the lead.

Waxman had supported a not for profit national plan, then he stated he was following the lead of P. Obama and building on an employer based model.

Policy is set from the top, unless you think the person at the top has no power to influence policy.

:shrug:

At the WH Summit - President Obama calls on Karen Ignagni of AHIP to speak on HC reform

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=385x328837

Imagine if P. Obama had called upon Dr. Maria Angell to speak at the WH summit (or even let her in the door) instead of Karen Ignagni, members of Congress might be pleading for a public option.


Dr. Marcia Angell not invited to attend and therefore not called upon to speak, Conyers asked that two single-payer advocates be invited to attend....Dr. Quentin Young and Dr. Marcia Angell - his request was denied.

[Sebastian Doyle]

39. Then he should refuse to sign a shit bill

Send it back and tell them to get it right. Because the minute he signs a shit bill, it IS his fault.

[jenmito]

42. Any HCR bill would be better than NO HCR bill since a bill could always be added to.

You can't add something to nothing.

[Sebastian Doyle]

49. That's what Bill Clinton told us about NAFTA

And look where that got us.

[jenmito]

57. HCR is not NAFTA. n/t

[Sebastian Doyle]

63. NO, but it's being done in much the same way

Pass any old shitty bill now because "we can always fix it later".

But if we can't pass real reform with supposed majorities in both houses and a president with an electoral landslide, then exactly when can we?

[jenmito]

66. When we "throw the bums out" and

elect enough liberals and moderates (not conservadems like Lincoln and Landrieu) who will start amending it.

[Garam_Masala]

69. Can President Obama VETO a bill which is too watered down?

Yes or No?

Or is this part of that 3-D chess again?

[IndianaGreen]

22. The only reality is that most Democrats are corporate whores

and we are at fault for voting for them.

[jenmito]

26. Again-we'll never have 60 Kuciniches in the Senate. We have the majority because we

have a "big tent." Unfortunately, that includes Dems. who will NOT vote for a public option.

[IndianaGreen]

28. Having a Democratic Senate has not helped the working class one iota

and the working class will respond in kind.

[jenmito]

33. That's bull:

http://www.whitehouse.gov/briefing-room/signed-legislation

http://www.whitehouse.gov/briefing-room/signed-legislation?page=1

[PassingFair]

60. We don't NEED 60 Kuciniches...just ZERO Mary Landrieus

minus TWO Nelsons.....

[dflprincess]

65. Democrats who vote like Republicans are worthless

and if we continue to elect them we are no better than the teabaggers who vote against their own interests.

[IndianaGreen]

74. Evan Bayh won't get my vote next year

Bayh's wife sits on the board of a major health insurer, WellPoint. Evan Bayh came out against single payer a long time ago.

[RufusTFirefly]

27. Oh puhleeze. What makes Medicare for All a liberal issue?

Are you telling me that poor, conservative people aren't getting screwed by our rapacious health care industry?

If everyone had the facts instead of corporate-sponsored propaganda and if Congress represented us instead of their corporate masters, Medicare for All would not only pass easily, it would prove to be the most popular piece of legislation in generations.

So, don't keep spouting tautological refutations and claim they represent reality.

[nichomachus]

34. Medicare for all is actually a very conservative idea

Actually, Medicare for All is a rather conservative solution. Conservatism isn't necessarily pro-corporate. In fact, quite the opposite. The corporate structure today is really a covert form of government. We don't call it that, but it is, and it has an overweening influence on our lives -- and costs us lots of money. And, we don't get to vote for it.

So, our current system has the worst outcomes, the highest cost per outcome, the least amount of coverage, the highest overall cost, and a humongous governance system (whether you call it "government" or not).

Medicare for all would increase the presence of the public government but drastically reduce the presence of the covert government. So, overall governance would be smaller, costs would be lower, coverage would be greater, and the cost per outcome would be dramatically lower. That sounds pretty conservative to me.

[boppers]

67. Republican would *love* some portions of Medicare for all...

Medicare refuses to cover abortions, putting everybody on it would mean that the 70% of women who currently have abortion coverage would lose it.

[jenmito]

37. Ask poor conservatives why they vote against their own interests.

They do-and you SHOULD know it. It's reality.

[RufusTFirefly]

45. Aw jeez. There you go again.

Conservatives are voting against their own interests for a number of reasons. Here are two

1. They are receiving utter bullshit information in the corporate-controlled media.
   
   
2. The only party that seems to be tapping into widespread discontent is the Republican Party. But they are doing it in the filthiest possible way -- by blaming all the problems on "the Other" instead of on the corporations who are the primary cause. The Democratic Party used to be the party of working people. The Republicans have filled the vacuum with vile, racist, xenophobic, fundamentalist demagoguery.
   

If you're angry and think the little guy is getting screwed, it makes a kind of twisted sense to vote Republican.

We Democrats should be there for the Little Guy, but that would involve biting the corporate hand that feeds us. So we leave the door wide open for the whackos instead.

[jenmito]

56. "There you go again"? When did I "go" before??

You're agreeing with me that poor Conservatives vote against their own interests. No matter the reasons, they DO. Thanks for agreeing with me.

[RufusTFirefly]

59. You really are a poster child for logical fallacies

Have a nice day.

[slipslidingaway]

24. Interesting graph at link below - U.S. Health Spending Breaks From the Pack

http://economix.blogs.nytimes.com/2009/07/08/us-health-spending-breaks-from-the-pack/

[ProSense]

29. "First there was Medicare for all 300 million of us." What? Who campaigned on that?

That was never first. Never!

[slipslidingaway]

31. For years polls showed that Americans wanted a national HC policy...

but that was quickly silenced by people wanting to protect the for profit companies.

[ProSense]

Who campaigned on that?

That was the question.

[slipslidingaway]

36. Where does the original article say anyone campaigned on that? You introduced...

that issue best I can see, the only person who did not folow the original Hacker idea was Kucinich.

[ProSense]

40. "The public option ain't what it used to be"

If this isn't about the public option Obama promised, then what's the point? What's the point of comparing some extraneous plan to the current plans as if to imply that they're all somehow related?

[slipslidingaway]

46. Please read what you wrote in your original reply - Medicare for all

"First there was Medicare for all 300 million of us." What? Who campaigned on that?
That was never first. Never!"

The OP never said that Obama campaigned on that!

[ProSense]

47. So the OP is irrelevant in terms of where the current plan originated.

Completely irrelevant.




edited extra word.

[slipslidingaway]

52. We all know the idea of a public/private plan began with Jacob Hacker and

the major candidates then modified the idea, that is why Edwards said Clinton stole his plan. Obama was smart to let Edwards test the mandated coverage portion of the plan, once he saw there was a backlash from the people he let the others push that portion - clever.

Jacob Hacker plan - "Health Care for America"

http://www.youtube.com/watch?v=e-J9ZgCRiD8

[ProSense]

55. What does that have to do with the logic of

comparing the current plans to something irrelevant? The current plans are based on Obama's proposal.

[slipslidingaway]

61. The public option did not begin with Obama, many people agreed with...

the original Hacker idea and the original projections of coverage and cost, for some to look back and compare what we have now is not unusual.

Not everything revolves around P. Obama, many have been working on HC reform for decades.

[inna]

70. i think your response in this thread and your constant, nearly pathological, cheerleading

is "irrelevant".


to each their own, i guess.

[DU GrovelBot]

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[ProSense]

35. Here is what Obama campaigned on:

NYT May 2007:

Mr. Obama would create a public plan for individuals who cannot obtain group coverage through their employers or the existing government programs, like Medicaid or the State Children’s Health Insurance Program. Children would be required to have health insurance. Subsidies would be available for those who need help with the cost of coverage.

WaPo:

Every American has the right to affordable, comprehensive and portable health coverage. My plan will ensure that all Americans have health care coverage through their employers, private health plans, the federal government, or the states. My plan builds on and improves our current insurance system, which most Americans continue to rely upon, and creates a new public health plan for those currently without coverage...

[slipslidingaway]

38. Another diversion, where does the article say Obama campaigned on...

Medicare for all???

[ProSense]

41. Repeat:

If this isn't about the public option Obama promised, then what's the point? What's the point of comparing some extraneous plan to the current plans as if to imply that they're all somehow related?

[slipslidingaway]

48. Repeat - read your original post and my reply

your original post...

"First there was Medicare for all 300 million of us." What? Who campaigned on that?
That was never first. Never!"

The article never claimed Obama campaigned on that - another diversionary tactic...that is all.

[ProSense]

51. Then you can read my response at comment 47

Or do you want to keep having the same discussion in two places?

[Bluenorthwest]

44. He speicifically campaigned on a 'no mandates for adults'

platform, and utterly mocked Clinton for demanding mandates and fines. That is why in you first quote is says 'would require children' because that was his position, parents mandated to cover their kids, but no mandates for adults.
So what he campaigned on has little to do with the moment, does it, really? Considering the mandates and all. Which he so vehemently opposed, so specifically in mailers, debates, TV and radio ads.

[ProSense]

50. He was right to criticize the others

Both Hillary and Edwards wanted to garnish wages as part of their mandate.

If you cannot, you will automatically be enrolled in either a public plan that you qualify for (like Medicaid or S-CHIP) or the cheapest plan offered by his Health Insurance Market. Bills will then get sent out, and if they're not paid, will be collected just like the government collects on student loan debts, or taxes, or anything else, using tools up to and including collection agencies and wage garnishment.

Obama was simply more adept at making the case for affordability before mandates.

[ClarkUSA]

43. Yeah, fuck those millions of folks who'll get HHS' public option while you Failers stay bitter. nt

[AVID]

53. fuckin a! BITTER ASSHOLES with very limited intellegence and logic

Just stupid, stupid people listening to bullshit and regurgitating it here like scripture.

[ClarkUSA]

62. Amen and pass the sour grapes.

I couldn't have said it better.

[elleng]

54. Ain't what it used to be, and it never was.

It was in our imaginations, folks.

[Better Believe It]

68. A trip to the hospital emergency room might be a better deal for the uninsured.

[slipslidingaway]

71. Video of Jacob Hacker and EPI introducing Health Care for America...

http://www.youtube.com/watch?v=e-J9ZgCRiD8

[slipslidingaway]

72. Bait and switch: How the “public option” was sold

http://pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%e2%80%9cpublic-option%e2%80%9d-was-sold/

by Kip Sullivan

"The people who brought us the “public option” began their campaign promising one thing but now promote something entirely different. To make matters worse, they have not told the public they have backpedalled. The campaign for the “public option” resembles the classic bait-and-switch scam: tell your customers you’ve got one thing for sale when in fact you’re selling something very different.

When the “public option” campaign began, its leaders promoted a huge “Medicare-like” program that would enroll about 130 million people. Such a program would dwarf even Medicare, which, with its 45 million enrollees, is the nation’s largest health insurer, public or private. But today “public option” advocates sing the praises of tiny “public options” contained in congressional legislation sponsored by leading Democrats that bear no resemblance to the original model.

The bait

“Public option” refers to a proposal, as Timothy Noah put it, “dreamed up” by Jacob Hacker when Hacker was still a graduate student working on a degree in political science. In two papers, one published in 2001 and the second in 2007, Hacker, now a professor of political science at Berkeley, proposed that Congress create an enormous “Medicare-like” program that would sell health insurance to the non-elderly in competition with the 1,000 to 1,500 health insurance companies that sell insurance today.

Hacker claimed the program, which he called “Medicare Plus” in 2001 and “Health Care for America Plan” in 2007, would enjoy the advantages that make Medicare so efficient – large size, low provider payment rates and low overhead. (Medicare is the nation’s largest health insurance program, public or private. It pays doctors and hospitals about 20 percent less than the insurance industry does, and its administrative costs account for only 2 percent of its expenditures compared with 20 percent for the insurance industry.)

Hacker predicted that his proposed public program would so closely resemble Medicare that it would be able to set its premiums far below those of other insurance companies and enroll at least half the non-elderly population..."

[Blue_Tires]

73. k+r