I've called Schrader's office locally and in Washington D.C. a couple of times in the past week. Schrader is fence sitting and not making any commitment at this time, according to his staff. This kind of thing might push him into the Blue Dog obstructor camp. I definitely get the feeling he's backing away from campaign promises.

The Republican base is definitely the low information voter. One of their great lines, "keep government out of Medicare." Obama had some fun with this today at the AARP town hall:

http://www.talkingpointsmemo.com/livewire/2009/07/obama-pokes-fun-at-dont-touch-my-medicare-people.php?ref=fpa

If "social" medicine is so bad, why do these republicans and "blue dog" democrats use their health care? Why don't they pay out of pocket and buy their own "privatized" policy and save us some money? The looks of most of them, they would get kicked to the curb for being obese,old, previous conditions, etc. I guess we need a 80% majority to get anything passed, since the democrats can't count.

Ask your local Wingnut this: if government run healthcare is so bad, why do they subject our veterans to it. I mean, the GOP had 8 years to privatize the VA hospital system and they didn't. Either it works pretty good or they really don't care about the vets.

Yes the RNC is stupid. But so is "Schrader is fence sitting and not making any commitment at this time, according to his staff. This kind of thing might push him into the Blue Dog obstructor camp.".

Are Earl Blumenauer and Peter DeFazio "blue dogs" because they have questioned the wording and the reimbursement mechanism of the House plan?

Or might they be wise in saying details matter?

mp97303 -

The veteran health care system is similiar to Medicare/Medicade. For the most part both programs serve the retired or disabled. Eligibility for both programs earned by service or loss. There's a price paid.

The health care program Obama and Dem Congress are talking about implementing is much larger in scope and from what I understand, eligibility for a large amount of recipients won't require the same kind of reciprocity of service that a soldier, sailor, airman or marine might render.

The GOP gave this county Medicare Plan D in 2003. That has been of enormous help to many and the most significant Progressive health care leap in the last quarter century. Personally I think Plan D stinks. Its paid for by the same Ponzi scheme that will eventually collapse when foreign governments eventually stop buying our debt.

The GOP needs to wake up and smell their future electability. We've had "socialized" medicine in this country for the better part of 50 years. Between Medicare and the VA system, there are LOTS of people getting coverage- even Bill Kristol admitted as much today.

I'm tired of the GOP standing on their alleged moral high ground. Besides being completely controlled by the insurance lobby and BigPharma, they have justified their stance as a moral issue in their own minds. This is how they think: having good healthcare in America is linked to employment. If you're employed in a good job, and you get good healthcare, that's your "reward" for being a good worker and making more money for THEM. However, if you're not employed, or underemployed and don't get healthcare, well that's you're own fault. You don't deserve it, in their minds. You're doing nothing to contribute to their pockets, so therefore you don't deserve the benefit of decent healthcare.

It's time that access to a quality healthcare system that doesn't bankrupt it's users became a right in this country. Single payer, public plan, universal to all.

@ LT

When a staff is asked, "Does Rep. Schrader support the president in his goals for health care?" "Does Rep. Schrader support the Dem. party in passing a bill for universal health care?" Does Rep. Schrader support any form of a public option?" And the staffer says, "the congressman hasn't decided yet. That's not about details of a bill. I call that fence sitting.

If you think the GOP is holding back health care reform you're missing the boat. Dem's control all three houses.

Both parties are controlled. If you want real change then support term limits and independent party candidates. Its crazy that we have members of Congress with longer tenures than Castro.

I'm surprised Obama didn't hold up single payer as an option. He couldn have used it to make his current proposal more palatable. He's played his hand all wrong so far. I hope he fails on this, I can't afford it and neither can our kids.

The recrimination and splintering that we see on forums like this between Democrats is a foreshadowing of what's to come in a 2010 election if there is no significant health reform bill with universal coverage passed this year. There are already calls to boycott Democratic campaign fund raising. But Dem. office holders seem intimidated by the fear mongering of the right, and quiet and indecisive at a time when their voices should be most heard. If Kurt Schrader can't make a statement supporting unequivocally what he allegedly campaigned for, then we're all in trouble.

The wallets will close and the base will stay home, or vote for third parties in 2010, and 2012, and we can all look forward to Mitch McConnell as Senate Majority Leader and John Boehner as Speaker of the House, and Blue Cross and United Health Care will own a third of everyone's income who has any kind of coverage (except those, of course who are lucky enough to have a public option, like elected officials, seniors over 65, military, etc.).

Recommended Read- Ezra Klein Op-Ed on Health Care Reform in Washington Post. http://www.washingtonpost.com/wp-dyn/content/article/2009/07/28/AR2009072802114.html?hpid=opinionsbox1

He gives a good explanation of the role of "the Exchange" in current proposals. He winds up with some strong kudos to Ron Wyden's consumer choice bill as the politically smart and economically sound policy choice of the moment. He frames the current reform moves as a bridge from the disaster we are in to conceivably where we would want to be in a future health care system.

"We've had "socialized" medicine in this country for the better part of 50 years."

And it needs to stop TODAY!

We need to get all these freeloading veterans, active duty military, retirees, the disabled, and members of Congress, judges, and all elected officials off the government gravy train and into a true "pay or die" for-profit private insurer system. We need to get back to the true American system of 2 or 3 large insurance companies in direct competition to deny medical coverage to maximize profits.

And for the 45 million uninsured ... well they should of done something about that before they choose to became poor or disabled.

"Call me crazy, but the huge public support for health care reform and for President Obama"

Yeah I'll call you crazy.

Tell me, are the millions of publc employees who elect Democrats demanding health care reform? Or are they supporting a reform for eveyone but them?

How is it that you blues never suggest something like this?

"But the postal service is the perfect laboratory for the federal government to enact all the big changes it wants for the rest of the country. It can reshape health care benefit packages to give employees an incentive to keep costs down. It can burn less imported gasoline by eliminating vehicles and days of delivery. It can cut its use of electricity by closing facilities. These are things the government wants to encourage all of us to do. The least it can do is to let the postal service show us the way"

http://www.oregonlive.com/opinion/index.ssf/2009/07/postal_service_in_crisis.html

Why only the postal service? Goverment could show us all the way by adapting reforms to millions of public employees.

Unfortunately the Blue left is hypocrite central.

The EPA wastes milions because workers don't turn off the lights at the end of the day.

Here in Oregon the left attacks and obstructs virtual charter schools which save energy and money.

TriMet spends 1900 per employee for lavish health benefits.

Millions of public employees are getting health care benefits without deductables or copays or participating in the comeptetive consumption of health care services.

Please, quit dancing and spit it out. What does the "huge public support for health care reform" really consist of? Who is it and what is the "reform" they "support"?

Obama et al claim people can keep their own current coverage if they choose? How's that? Everyone who get's it through work has no say in where it comes from. Businesses will need to join the goverment health care to maintian current costs and they'll get less coverage. The employees will get what they are given.

The national cost will skyrocket, millions more will have to enter the goverment program than forecast, the unfunded portion will soar and rationing will be certain.

Gee why would anyone not support such a dream come true.

Your health care dollar in action:

I have a 30 plus year career as a mental health clinician. A few years ago in my capacity as a geriatric specialist a pharmaceutical asked me if I wanted a free dinner and some good seats to a Blazer game. I said, "sure, why not?" So I ended up at this grade A dinner buffet attended by a variety of physicians and geriatric health providers. The topic of the presentation was a new Alzheimer's medication, presented by a top level speaker from some medical research university ( paid top dollar no doubt), basically doing a sell job on this expensive medication with all the industry paid research and the predictable findings of what a wonder drug it is.

Well we suffered through all that, and all the promo talk, then we got our two tickets to the Blazer game that night, good seats (which I would never be able to afford in real life). That was the real draw of course.

This scene gets repeated throughout the U.S. daily. The next time you pay for your medication, or your insurer, think about the fact that you are also paying for a whole lot of sports tickets and expensive buffets and promotional productions like this one, in addition to the multi-million dollar blitz to muscle Congress into more gravy train, in addition to the millions of dollars of campaign money to our Congress. It's the corporate health care industry in action, our pseudo-free enterprise system at work.

"TriMet spends 1900 per employee for lavish health benefits."

Do you mean to tell me that if I drive a bus 40 hours per week that my employer will pay for checkups, low pharma co-pays, x-rays, and maybe now and then a referal to a specialist should I encounter a serious health issue?

Please define "lavish"?

"Call me crazy, but the huge public support for health care reform and for President Obama"

Im with Richard, I'll call you crazy.

Do you really think the public knows the details of 'health care reform'? I highly doubt most law makers have even read it. Obama recently admitted he hadn't read.
Once the public actually has to use the new health care system, I imagine there will be alot of surprises - and finger pointing by the lawmakers that never read what they were voting for.

As for 0Bama's popularity - he certainly doesn't have the rock star status the media billed him as. And after his recent racial meddling with Sgt. Crowley, the public is beginning to see the real Obama.

Please define lavish?

Gee I don't know. The highest costing coverage in the country? No co pay, no deductable, 100% dental, 100% optical and cosmetic for entire family and covergae for life after retirement.

Lavish would be the excessive benefits far above the so called reasonable national coverage we're all supposed to pay.

Is this debate so screwed up that you can't even recognize the extreme coverage at TriMet?

Why no comments on the greater public employee coverage? Is that topic verboten for you Blue activists who care so much?

"we got our two tickets to the Blazer game that night, good seats (which I would never be able to afford in real life). That was the real draw of course." Bill R

And there you have it. Bill has no problem feeding at the trough that he so despises.

Bill R,

A very telling little anecdote that also pretty much encapsulates the way that health care policy gets made.

At the 2004 Dem convention in Boston, one of our state letgislators, being double booked, gave me some tickets to a harbor cruise. What an eye opener. It was mounds of fresh lobster and other delicacies, an open bar with top shelf spirits and so forth. It was sponsored by the DCCC and funded by healthcare industry lobbyists, and I had a nice chat with the money guy who represents a Swiss pharmaceutical manufacturer.

Even my old pal Peter Courtney was there, growling and glowering as is his custom. A good time was had by most....

These stories might provoke a yawn or two among BO regulars, but they are at the core of why little gets done in industry and governance based on best outcomes.

Let's see critics; Under a Democrat/Obama plan you will be able to keep the hideously expensive private healthcare plan you already have. Providing of course you do have one. And of course shoulder the ongoing risk of being dropped from the plan any time you actually become sick on the whim of the insurance company bean-counter who sits between you and your doctor making the real decisions about your medical care.

Oh, and should you become sick and through the kindness of their corporate hearts they don't cancel your insurance, don't forget to pay the astronomical fees for the 'uncovered expenses' until you enter bankruptcy. Latest figures estimate that more than 60% of bankruptcies are related to unpayable medical expenses by people who had private health insurance. Good luck with that. At that rate every family in the US with private health insurance will, at some point be overwhelmed with unpayble debt. It's not a question of if, it's a question of when.

So clearly what we need is portable, affordable insurance that covers everybody and does not contain loopholes that will bankrupt consumers.

I don't see the republicans offering anything that doesn't make the situation worse.

Healthcare reform needs to be a two pronged solution. Insurance is one part of the equation. The other part is the healthcare delivery system.

What we need is a delivery system built on the VA model. They have the higher satisfaction rating, better outcomes and the lower cost per patient than the private insurer model.

They get the most bang for the buck and that's what we need in healthcare. Reform both healthcare insurance and the healthcare delivery system and you will have an efficient, cost effective system.

And you can keep your private insurance if you want to.

"There may be some unforseen problems, too. But are you really suggesting we should do nothing...or move slower on reform because there might be some surprises?" - Carla

Why not apply "health care reform" in phases and work out the 'unforseen problems' that way?

Peoples lives will be on the line with your reform. Shouldn't we take the time to make sure it's done right - or is all about trying to build up Obamas very thin resume?

Richard writes:

"No co pay, no deductable, 100% dental, 100% optical and cosmetic for entire family and covergae for life after retirement. "

You just described the healthcare benefits of: 1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland

or as it is better known - the top 20 countries that provide and deliver better healthcare that the United States. And here's two more facts to chew on:

1. the United States pays more per capita than all of these countries
2. Not one of these countries uses the US "pay or die" private insurance for care model.

But I understand your point of view Richard. After all why should those lazy ass bastards at Tri Met get healthcare benefits when the GOP mantra is "race to the bottom."

Kari,

The KATU article has several quotes from TriMet officials regarding the $1900/mo benefit costs paid by TriMet. Also an auditor's report.

Granted, TriMet spokeswoman Mary Fetsch indicated a little more than 20% of employees had this level of coverage. The article does state that benefit costs are a burden.

Promising developments in the House today on health care bill. Blue Dems compromise with the leadership. http://tpmdc.talkingpointsmemo.com/2009/07/house-retains-public-option-in-compromise.php?ref=fpa

Mike Pence- GOP House Leader " We hate public insurance, but we love Medicare."

These guys are laughable.

http://www.dailykos.com/storyonly/2009/7/29/759321/-GOP:-We-hate-public-insurance,-but-love-Medicare

"Gee I don't know. The highest costing coverage in the country? No co pay, no deductable, 100% dental, 100% optical and cosmetic for entire family and covergae for life after retirement."--Richard

Might I ask why this is bad? It seems we can either work to get that type of health coverage for everybody, or we can be Richard and apparently be pretty damned miserable and try and bring everybody down to his level.

wingnut,

Medicare/cade operates much like an insurance policy, paying other healthcare providers for providing services to you.

The Veterans Health Administration owns its hospitals and employs doctors, nurses and other personel to provide services. In 2006 they spent $1300 less per patient than the national average ($5000 vs. $6300) with better overall care and higher patient satisfaction despite serving a higher proportion of disabled patients. Here's a report with references.

The big problem with Part D prescription coverage is it forces Medicare to pay MSRP rather than negotiate bulk purchase prices with drug manufacturers unlike nearly every other country in the world.

The US is by far the most costly per capita healthcare system in the world and yet we're ranked in the 30's on many measurements of care provided. The only way our current healthcare system could be cheaper than other industrialized nations would be if we treated it like a commodity and you could only get care if you could afford it. Do you really want to live in a country like that?

So why don't we look at what works around the world and come up with a system that incorporates the best practices? I don't really care if private insurance companies can't compete. They are not the most efficient way of providing the coverage so why should we protect their business?

Dave

Good points Dave/riverrat - there are parts of the VA system that deserve greater consideration. I dont think its a complete panacea but there's certainly merit in regional consolidation models.

I would rather see the govt. fix our current system than to see a complete overhaul. Plan D has some obvious low hanging fruit. Leveraged buys and mail distribution of perscriptions (in 90 day supplies rather than 30) is probably something Obama has the political capital to execute now.

I think maintaining competition in health care is of grave importance. The research paper you cite recognizes this:

An important component of the VHA’s quality improvement initiative is the effort to recognize outstanding quality performances. Maximum awards of one program are up to $25,000 per facility and $5,000 per person. The VHA encourages competition between VISNs for these awards as well as general competition for the best metrics.

Reduced competition is one of my fundamental oppositions to the health care reform in its present form. In most sectors of government there isn't motivation for continued improvement and cost reductions. Its true in any monopoly. No one is seriously talking single payer at this stage of course. The fear however is that's the road we'll eventually land on once the hooks are in.

Why do people always bring up union pay and benefits and scream that they are "too lavish" or "too generous"? Why not work to give everyone terrific pay/benefits? Instead of knee-capping unions, why not create more unions so that more workers can benefit from collective bargaining?

Our society is pathetic on health care. Preventative care is a joke, if you don't have money you die, your doctors won't discuss all the options/medicines/treatments available but only the ones that their "group" or your "insurance" covers. This isn't "health" care by any means. A public option can't be worse than what we've got and in many ways will level the playing field. And I say this as a union member who gets really great coverage right now---and yes, I'm in favor of taxing my benefits if it will help cover others. C'mon, it's time that the US joined the 21st century (or even 20th) on health care!