Scary little detail in that pre-scripted colloquy: Wyden refers to "local insurance exchanges" and STATE choices.

... workers who don't get affordable coverage from their employers ... could shop at their local exchange.

Lotsa luck, there.

Anybody else have the feeling that this "insurance reform" legislation has turned into Frankenstein's monster? Passing an individual mandate without cost control and middle class premium subsidies is like repairing 1/3 of a broken levee. Pointless.

"Bill, except that the exchange is where you'd be guaranteed high-quality plans and where you'd get the subsidies. (Now, a "local exchange" whether single-state or multi-state is clearly less worthwhile than one big national exchange, that's true.)"

Where is the money coming from for these "high-quality" plans? I have the federal employees plan, Blue Cross, better family plan. The government chips in $9,166.56 per year, I pay $4,279.08 per year for a total annual amount of $13,445.64. "High-quality" is relative, but I wouldn't ascribe that term to this plan with its limits on payments and deductibles and practically nothing for dental. If my wife or I get something serious the plan could be a benefit, but if one of us gets something more than serious then we could be in trouble. For $13,445.64 a year a high-quality plan should cover a hell of a lot more than this plan covers. Something along the lines of what the French and Italians get for around half of that.

Kari - do you know if the health bill will pay for "weight control"? I currently weight 633lbs and am hoping I can get into a government program for weight loss. Also need gutters cleaned.

"For $13,445.64 a year a high-quality plan should cover a hell of a lot more than this plan covers. Something along the lines of what the French and Italians get for around half of that."

Correction: The above figure approximates what a couple would pay in Europe for their national plans, but still they get much better coverage - no risk, for example, of going bankrupt for medical reasons.

How can you possibly take American politics seriously? ...on the final night of the mark-up, Sen. Kent Conrad waved his blackberry in the air and told Wyden his amendment had never really been scored at all. It's a bit hard to say what happened there...

Only in the third world is that simply a "who knows what happened". This is some of the most important leg. of the century, and no one understands exactly how the PROCESS is or isn't working. "Something we don't understand happened. Move on". Find me even one somewhat similar example from an industrialized nation since the break-up of the Soviet union. Yeah, even worse things happened, but they are documented, understood and not forgotten. This is just pure love of ignorance. "Ignorant? Third world? We can bomb your ass to oblivion!".

And we wonder why America politics sucks and "real" people don't get involved.

OK. "Political junkies"- seems to be BO's favored term for wonks that get right into the details without questioning the context/efficacy- can get back to their very important health care debate.

If the Baucus monstrosity as is good as we mere plebs can expect. Then it would be better for the Progressives to not voite and help defeat it. This is the worst possible plan, it does not guaranteee price or cost control yet forces us all to buy the policies. This is suicide for the Democrat party. Then perhaps that is a good thing as maybe one of the Ugly Sisters would be dead and a new real progressive party can arise.

Baucus pretty much put a turd in the punchbowl with the Finance Commttee bill, but as long as he is allowed to be chair of that committee, the bill had to go through him.

But there is also a health insurance reform bill--a good one--that has been passed by the Health Education Labor & Pension Committee. The Senate now has a chance to merge those two bills by taking the crap out of the Baucus Bill, putting in the good terms of the HELP Bill, and letting THAT be what the full Senate votes on. Unlike in the Finance Committee, Baucus will not have so much power over the process. Public Option advocates Schumer, Harkin and Rockefeller will play a big role.

The House should hurry up and pass its own robust public option bill and thereby increase the pressure on the Senate to follow suit.

Of course, there's always the chance they could leave the Baucus crap in and take out the HELP provisions. It's hard to see how any amount of lobbyist money would be worth ending their own political careers and crippling the Democratic Party for the foreseeable future, but it could happen and so we'll have to keep watching and raising Hell. Eternal vigilance and all that.

Admiral: We can only hope more of the HELP provisions are taken on board. But looking at how miserably Obama and the Dem majorities have stood up to Corporate domination..I am not hopeful.

The more I read the more questions I have. Since my favored single payer option is no longer on the table I am trying to find something to like in the Senate bills. Seems to me that there need to be some very powerful consequences to enforce the individual mandate or this whole "reform" will be a disaster.

Back in the days before public fire departments, homeowners had the option of joining a fraternal organization which provided private fire protection services. Enrolled members placed plaques on the front of their homes to indicate membership, and if a fire occurred, the appropriate fraternal fire department would respond. However, if a homeowner failed to join a fraternal organization and had a fire, his house would be allowed to burn to the ground even as the local fraternal fire departments stood ready at the scene to protect any nearby member-owned structures from damage. The fraternal fire department knew - correctly I suspect - that if they showed pity and saved the house of a nonmember, that the incentive for everyone to join a private network would be greatly impaired.

To make the Senate style bill work, I think we are going to need the equivalent enforcement system of the old private fire-protection days. If "Bob" fails to enroll himself or his family in the mandatory coverage system, the government, the public and the medical establishment - including otherwise progressive caring folks - need to stand by and let "Bob" and/or his family members die from lack of medical services. Otherwise, if Bob knows he can still get free ER care for urgent medical conditions, or if Bob knows he can wait to purchase medical insurance until after he is diagnosed with a serious condition, the whole system will fail. Everyone will become a "Bob".

Posted by: aenewman | Oct 13, 2009 8:18:02 PM

Kari - do you know if the health bill will pay for "weight control"? I currently weight 633lbs and am hoping I can get into a government program for weight loss. Also need gutters cleaned.

Tell it to Rush, fucking dittohead!

Then it would be better for the Progressives to not vote and help defeat it.

This "I'm taking my marbles and going home" attitude is truly frightening. No reasonable progressive who understands the health care system can argue that the status quo is better than this bill. You just can't do it.

You didn't get what you wanted, fine. But right now, the debate this country is having is whether we are going to take a huge step forward, or put off for any major reforms for another 15 years.

You can hate the insurance companies as much as you want. But it is immoral to argue against a major expansion of Medicaid, a major expansion of health coverage for kids, and a major subsidy for the uninsured at this point in time. This plan, with all of its flaws, will insure millions of people.

This is the decision we face. There is still time to push for some changes, but a version of this bill must pass.

Miles. I would much rather we take the good parts you talk about and pass seperate Bills for childrens health care, expansion of Medicade. But to just give the Insurance Corporations what they want..US ALL with the whole force of law behind them is unthinkable for a civilized person. Within 10 years they will have us all up to our ears in debt and the Federal government fully supporting them. I would rather tinker around the edges than go with horriffic mandates. How long now before "our" Representatives vote for debtor prisons ( privatly ran by the Corps. of course) to deal with those that wont pay the other Corps for insurance?

O.S., do you know how bad the current system is? Are you aware of the horrors that the uninsured face every day in this country? If so, how can you advocate keeping them uninsured for the foreseeable future?

Mandates are the only way to eliminate the free rider problem. And since this bill covers low-income families and childless adults under Medicaid, and provides subsidies to middle class families, I'm having a hard time understanding your objection. Will some families making $60,000 - $70,000 a year have to pay more for coverage than they currently do, since they're currently choosing to be uninsured? Yes, because each one of those families costs each of us when they end up in the emergency room. The mandate puts the costs back on the family, where they belong. Think of it as an additional income tax to pay for health care -- something single payer would require as well.

MIles you think families earning $60,000 are well off,rich? You must be crazy. The dollar aint woth that much anymore. A new car costs 30,000. THese mandates will again lead to regular middle class folks taking the vast burden while the "poor" and wealthy get a free ride. Its either siongle payer or tinkering. Mandates play into the hands of the ultra-rich.

No surprises here for people who have been paying attention.

"You didn't get what you wanted, fine. But right now, the debate this country is having is whether we are going to take a huge step forward, or put off for any major reforms for another 15 years."

Nothing is finalized at this time so there is a lot to be said for pushing for the best possible deal now and settle for something less later on. Whatever comes out of Congress will be what we will be stuck with for a long time.

MIles you think families earning $60,000 are well off,rich?

Who said that? What I said is that those $60,000 middle class families who currently choose to be uninsured will, under this bill, have to start paying for their own health insurance, instead of asking me to pay for it through my insurance rates, as I do now. If they have two or more kids they'll even receive some subsidies at that income level. What exactly is so wrong with that?

As a single payer advocate, I also can't understand your opposition to mandates. Single payer ONLY succeeds with mandates requiring everyone to join. You seem to be fine requiring people to join a government-run system, but opposed to requiring people to join a government controlled, privately run system. That kind of intellectual rigidity rivals right-wingers who refuse to support anything government, even when it works.

MIles. "government controlled, privately run system" You gotta be jokeing? What is likely to be put in place will have only the fig leaf of "regulation" like we have now but is never used to the benefit of the consumer. Only the Corporations. I want born yesterday. Also there will likely be no price controls put in place so you might end up paying 50% of your entire budget on health insurance. Is that really were you want to go? I lived in the UK for my first 25 years under a single payer system my National Insurance payment was maybe 5-10% of my income. MY payment here..it is already 20%. With a mandate the sky is the limit for the Ciorporations. Do you REALLY trust them to help you out?

Hopefully we can now see true Bi-partizanship in defeating the threat of mandated Corporate bail-out. The Left and the right joining to crush the corporatists.

Cool I'm glad that this is happening...

Let's cut the BS Kari: Baucus gave Wyden his fake-choice provisions and Wyden voted for a mandate with no public option and no real choice. Exactly what those who really know what is going on have said would happen. Exactly what Wyden has always stood for, and exactly what shows his empty rhetoric about how he "supports" the public option for the lie that it is. You don't support the public option by proving it doesn't matter enough to insist it be in any measure you vote for.

And Kari, don't make an further ignorant ass of yourself with the empty excuse this was about getting it out of committee. Those of us watching the hearing and vote yesterday saw Wyden and Baucus smuggly congratulating each other for screwing the majority of the American public who wants the public option after the vote. Today Reid obnoxiously and angrily already fired the next shot against the public option without a peep from Wyden.

Fortunately, Ed Schultz today publicly humiliated Stabenow on his national radio show for giving that lame argument and she deserved it for playing Judas against herself just to be a team player in the Senate. She is kind-of for the public option --- as in she voted for a mandate without a public option in committee and, just like Wyden, has refused to say she won't vote for a mandate without a public option on the floor.

Wyden won't get the dressing down he deserves on lame Oregon media like 620KPOJ, but it is inevitable he will in the coming months simply because he has become such a stereotype of a disgusting, lying, back-stabbing, ignorant politician.

OregonScot is correct no bill is better then a bad bill. And the Baucus Bill is a bad bill. It is not a step forward but rather a major step backwards. It is unfortunate that the progressives on his committee voted for it. It would have been better for the Baucus bill not to have been passed out of committee and the point be made that there are not the votes to pass a bill without either a robust public option or real regulation of the health insurance industry.

Right now the onus is on the Democrats to get a bill passed; the public sees we have a strong majority in the House, a super-majority in the Senate and a Democratic President. This apparent Democratic domination of Congress has given the Republicans a free ride, they can attack from the sidelines without fear of being held responsible for the result or lack of a result.

The Democrats need to do one of two things, pass a strong health insurance reform bill or if it cannot get the 60 votes for cloture it needs to eject from the Senate Democratic Caucus those individuals who would not vote for cloture. It is better to not have a 60 seat majority in the Senate then it is to have the illusion of one.

Posted by: Yajaj | Oct 14, 2009 8:02:13 PM

Let's cut the BS Kari:

I can hear Kari screaming, Lenny Bruce like, "Don't take my words away from me!"

Seriously, being able to say things like that with a straight face is the difference between being a policy wonk and a cynical ne'er do well, in our political system!

Meanwhile, we absolutely have to have...what is it, 30?...Trident submarines on full operational status. Do you realize how much that costs? I would like to hear the most rabid hawk describe a scenario where we need, or could even use, 30 Trident submarines.

The UK, deep in recession, has gone for deep defense cuts. They're going to table one new sub.

"And the Baucus Bill is a bad bill. It is not a step forward but rather a major step backwards. It is unfortunate that the progressives on his committee voted for it."

What progressives? There are very few in Congress that can honestly claim to be progressives and none on the Senate Finance Committee.

While we are at it, let's remember this debate is about restructuring health care INSURANCE - NOT HEALTH CARE. Someone - it may have been Wyden - said the aim was to provide everyone with an insurance plan equivalent to the Blue Cross version of the Federal Employees Health Benefit Plan (FEHBP). That's the plan I have. If I get sick it will prove to be a great benefit - as long as I don't get too sick then I could be out of luck. This plan compares miserably with what the Brits, French, Italians and others, including apparently the South Koreans, have.

Let's imagine that Congress comes up with a plan providing health INSURANCE for all. Great. But what about the provisions in the policies? Nobody is talking about them.

OregonScot is correct no bill is better then a bad bill.

Tell that to the 50 million uninsured. And be sure to kick them in the teeth while you're doing it.

Miles

I am one of the 50 million uninsured. The Baucus Bill does nothing for me. Currently my problem is preexisting conditions. Under Baucus it will be unaffordability because while the insurance company will have to sell me a policy my expectation is that the premium will be in the $2000-3000 dollar range before the annual 10-20% increases. And when I get really sick they will still be able to dump me using the fraudulent application provision and the “list every condition you had where you did not seek medical treatment and should have” question. At least it didn’t contain a mandate, though that would have given me federal health care along with three hots and a cot for a year for only $25,000.

What we need is single-payer as it is the only way to stop the cost shifting that makes medical cost reduction so difficult. But the wimps in Congress dumped that with all the other savings to the individual before it could get a hearing. So all that is left is a robust public option, a poor second choice, but a workable one as it will use competition and favorable cost shifting to drive premiums’ down and discourage Wall Street investment in insurance companies. Which means true reform might be possible.

Bill

I should have said “progressives” on the committee meaning Wyden and Rockefeller.

"I should have said “progressives” on the committee meaning Wyden and Rockefeller. "

By my definition of the word, Wyden and Rockefeller aren't progressives either.

From today's Huffington Post: Punishing the Health Insurance Cartel for Extortion and Fraud

I am one of the 50 million uninsured. The Baucus Bill does nothing for me.

That's not true, David. Under Baucus, you will have guaranteed issue and community rating. This means 1) that insurers CANNOT deny you for your preexisting condition and 2) that they will have to charge one community rate to everyone, meaning you'll be paying the same as someone without a preexisting condition. And they won't be able to drop you later, assuming you disclosed everything when you applied.

In terms of premiums, it will depend on what kind of coverage you want, but you will be able to buy from the insurance exchange, which will provide more competition than exists now. Depending on your income, you may qualify for subsidies.

I think it's legitimate to say that other plans would have been better for you. But it's wrong to say that you won't benefit from this one.

It's an understatement to say I'm very disappointed in the Finance Committee Bill, and in Wyden...but beyond that, I'm disappointed that the leaders of the Democratic Party are so out of touch with the real world that they don't realize the consequences of trying to foist this "reform" on the people...the voters. The probable consequences I see are loss of a Dem's majority in the Senate and possibly the House, and a GOP presidential win in 2012, because the "progressive" voters who helped swing the 2008 election will be very pissed off. Many will stay away from the polls, many others will work to build one or more alternate political parties, unless the "reform" eventually passed is of incontrovertible benefit to the majority of americans.

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