Here’s some more details on the final bill—Sen. Ron Wyden’s exchanges were expanded, and smart cost control measures introduced by freshman Democrats also made it into the final bill. Conservatives/Republicans should like both of these thing — pity they, instead, spent all of their time acting like children (forcing the clerk to read entire amendments), refusing to join in improving the bill at all, and simply lying about the contents of it. For shame — and for stupid, too, because now, after all of that, it’s going to pass anyway.
It looked like our base was going to be about as stupid as yours there for a while (thank you Howard Dean and Glenn Greenwald!)–but the logic of incremental reform finally kicked in. Ultimately, Dems/liberals really do want to help people — it’s what we do, it’s who we are (he says proudly, if smugly) — we weren’t going to miss a chance to get 30 million plus people health insurance for the rest of their lives. Apparently the Democratic caucus was overjoyed — and that was the reason why.
35 responses so far
1 Chekote // Dec 19, 2009 at 1:26 pm
we weren’t going to miss a chance to get 30 million plus people health insurance for the rest of their lives.
Of course 30 million will be insured. They will be forced to purchase it.
2 ProfNickD // Dec 19, 2009 at 3:14 pm
“Lying about the contents of the bill?”
The fact that socialists support it indicates that every criticism of it (“death panels” inclusive) were/are correct.
3 franco 2 // Dec 19, 2009 at 3:25 pm
Who cares what this Democrat hack says?
4 teabag // Dec 19, 2009 at 3:45 pm
The party of no strikes again. That 30 out of 33 voted against FUNDING THE TROOPS is and was a total disgrace.
5 rbottoms // Dec 19, 2009 at 4:21 pm
That’s terrible.
Next ‘they’ will force people to buy car insurance and to send their children to school.
What a world.
6 debs // Dec 19, 2009 at 4:26 pm
Chekote: You’re right. Why would working class people without health insurance actually want to buy it (with the assistance of subsidies)? Why would people with pre-existing conditions like cancer or diabetes even *want* health insurance? Who needs it?! After all, you don’t care whether you and your family have health insurance or not, do you? It’s of no consequence to you at all, right–take it or leave it! Oh, and the mandate you object to is standard in every other advanced capitalist country in the world–every single one. But, hey, what do they know–they only provide their citizens with universal coverage, equal or superior health care outcomes, and all of it at a half to 2/3rds of the per capita gdp that we spend. USA USA!
ProfNickD: Hmm…prof, I doubt you’ll get tenure employing such tenuous logic. Let’s see, using that argument, I could say that everything that the Left ever said about Ronald Reagan must be true because the KKK endorsed him in his presidential campaigns. Back to school for you, prof.
Franco 2: Always glad to read the wisdom of somebody else who seeks inspiration from a historical figure. Of course, in your case, you chose a vicious, vilified fascist dictator. You must be quite an interesting person–and certainly not a hack!
7 teabag // Dec 19, 2009 at 4:37 pm
Debs,
Logic and facts do not work with these teabaggers.
8 ProfNickD // Dec 19, 2009 at 6:11 pm
rbottoms: Please state the clause in the Constitution where the federal government is permitted to require individuals to purchase health insurance, car insurance, or anyting else. You can’t? Well, then, why should it bother you when the federal government detains foreign enemy combatants captured overseas?
teabag: Get your hands out of your boxers and grow up. If you really want to use the term “teabaggers” to describe a protest movement, you should use such pejoratives about the “gay-rights” movement — you’d literally find teabaggers there.
debs: Your retort is nonsensical. The KKK doesn’t exist. Socialism does. I’m far more concerned about who and what socialists are for or against than the Klan used to — socialism has killed 100 million people and impoverished billions more. Having that legacy to its credit should establish that whetever socialists are for, reasonable and freedom-loving people should be against.
9 rbottoms // Dec 19, 2009 at 6:46 pm
Go drive without it. Heh.
Because it certain people work harder to kill our soldiers in retaliation and defeats our stated mission of winning hearts and minds.
Silly, ideological thinking that helps us keep winning. More please.
10 Chekote // Dec 19, 2009 at 7:41 pm
Go drive without it. Heh.
Lots do. And lots of people will realize that it is cheaper to pay the fine than to purchase health insurance.
11 Chekote // Dec 19, 2009 at 7:46 pm
debs
As someone who has seen socialize medicine at work in two different countries, I can assure you it is no dream as many liberals have convinced themselves it is. The reason they spend less is because they ration. That is why they have higher mortality rates as far as cancer and other diseases. So let’s copy them and start rationing here. I will bet you won’t like it when you see someone you love wait months, months for treatment or he or she is deemed too old to spend the money. And please don’t bring up that silly OECD report saying that we have higher mortality rates. I say silly because that report fails to take into account the fact that we have higher murder rates, accident rates, HIV infection rates.
12 anniemargret // Dec 19, 2009 at 7:55 pm
Ask the families of the 45,000 Americans who died if they fear ’socialized medicine’ for the rest of their families.
http://www.harvardscience.harvard.edu/medicine-health/articles/new-study-finds-45000-deaths-annually-linked-lack-health-coverage.
13 Zilu // Dec 19, 2009 at 8:10 pm
Chekote:
“I say silly because that report fails to take into account the fact that we have higher murder rates, accident rates, HIV infection rates.”
Actually, this AEI study conclusions you appear to be referring to have been rebuked by OECD. The AEI authors seemed to have either misperformed their multiple regression analysis, or lied. Adjusting for the factors you listed, the US moves from 19th to 17th out of 29 OECD countries, not 19th to 1st as you and the AEI suggest.
Here’s the link the OECD study, scroll down to the first footnote, where the AEI study result is corrected.
http://books.google.com/books?id=-WrRoL_YSd8C&pg=PT139&lpg=PT139&dq=OECD+Economic+Surveys:+United+States+2008+Ohsfeldt+and+Schneider&source=bl&ots=ugBBxUpyRh&sig=31d64-BRof9M8fWdhVHF7DF5PoU&hl=en&ei=VrSNSoziL5CEMorT-K8K&sa=X&oi=book_result&ct=result&resnum=3#v=onepage&q=&f=false
14 rbottoms // Dec 19, 2009 at 8:31 pm
Ah, strong supporters of following the rule of law, but only for the darker hued of the population? Please drive without it, but should you hurt or kill someone in an accident you get to lose everything you own in judgment and maybe find your a** behind bars.
Damn socialist gummint telling me I have insure my car!
15 sinz54 // Dec 19, 2009 at 8:31 pm
rbottoms:
AFAIK, the Federal government does not force you to do either of these things.
16 sinz54 // Dec 19, 2009 at 8:44 pm
Chekote:
I agree that the fines are set much too low to serve as an adequate deterrent.
But that’s easy to fix in the future, if need be. Politicians are always adjusting the penalties for violating this or that law.
Besides, the surveys I’ve seen suggest that the most common reason that Americans don’t purchase insurance is that they can’t afford it. Make health insurance affordable, and lots more folks will sign up. And this bill does provide subsidies and other mechanisms to make health insurance more affordable.
17 sinz54 // Dec 19, 2009 at 8:49 pm
Chekote:
But so do we.
If you have a pre-existing condition and can’t get health insurance in your state, or if you just can’t afford to purchase it, then YOU are going to do your own self-rationing: Eschewing regular checkups and routine physicals, not going for the routine screening tests the authorities recommend for your age and health condition, etc. And if you already have a pre-existing condition, you will be playing Russian Roulette with your life.
America rations health care by affluence: The poorer you are, the less health care you get.
The question is: Can we bring more such people into the health care system and pay for the care they need, without unduly restricting the care that those Americans with generous health care plans already enjoy?
18 anniemargret // Dec 19, 2009 at 9:10 pm
“America rations health care by affluence: The poorer you are, the less health care you get.”
God’s awful truth.
“The question is: Can we bring more such people into the health care system and pay for the care they need, without unduly restricting the care that those Americans with generous health care plans already enjoy?”
And why can’t this country do just this? Because we have politicians more interested in winning the next election than doing what’s right for this country and its citizens. People dying and suffering from lack of healthcare in the ‘greatest country in the world?’ – There is no other word for this….shameful.
19 debs // Dec 19, 2009 at 9:34 pm
Wow. Rationing–that really is a dumb argument. You mean they have global budgets for their health care costs so they don’t go broke? Yes, they do do that–they also pay their doctors and hospitals much less than we pay ours and also have much cheaper rates charged for medical tests and services. That’s the difference, not standards of care. In France, an internist–even though the State pays for his medical education–makes about 25-30% of what s/he would in the United States. And we’re going to have do all of these things, too, unless the almost 17% of gdp we spend on health care now becomes 20 or 22% of gdp–everybody actually agrees on this.
And yes, we ration too–except we call it only providing health insurance for those with the ability to pay for it. That’s why 1/6th of Americans lack it, the only advanced nation in the world who bears such a shameful statistic. Actually, with the exception of the UK–which spends only 40% of what we spend–cancer stats are comparable to ours in Western Europe and Canada. Actually, in France, for example, death from respiratory illnesses is about half our rate. All in all, in a few categories, we are slightly better than the Western Europeans, in a few they are better than us, and in most, it’s wash. In short, you don’t know what you’re talking about.
20 rbottoms // Dec 19, 2009 at 9:43 pm
The Transportation Department withholds funds from any state that doesn’t have laws to ensure drivers have insurnace. Net effect, the Feds force compliance. Which bothers me not a bit.
21 sinz54 // Dec 20, 2009 at 12:12 pm
anniemargaret:
I think we just did:
The CBO, in scoring the Senate plan, found that it would raise the percentage of insured among those younger than 65, from 83% as it is now, to 94% with the Senate plan. That is indeed over 20 million more people. And without threatening the private markets in either health care or health insurance.
So while this isn’t the bill that I, as a conservative, would have written,
it’s about as good a bill as I would expect to see coming from a bunch of liberals.
If you liberals would give up your single-payer pipe dream ONCE AND FOR ALL–I mean FOREVER–you might just realize just what a great achievement Obama/Pelosi/Reid have accomplished. It’s only because you can’t give up your Quest For The Holy Grail that you’re unappreciative of what they have accomplished here.
22 sinz54 // Dec 20, 2009 at 12:15 pm
debs:
I’m not familiar with the French model,
but similar conditions obtain in the Japanese health care system.
In Japan, since doctors’ salaries are so limited, there’s not much incentive for an internist to go on to get board-certification in some specialty. He’s not going to get paid any more than if he doesn’t bother and remains an internist.
And thus if you have, say, a GI problem, you are likely to be stuck seeing an internist rather than a board-certified gastroenterologist. Internists will tell you that they’ve done a lot of studying and have a lot of experience in that specialty–but they still won’t have board certification.
Is that also the situation in France?
23 debs // Dec 20, 2009 at 12:41 pm
Sinz:
French specialists earn substantially more than their internists–a bit less than three times more, according to the OECD, around $145,000 per year. This still leaves them about $100,000 per year behind American specialists, but certainly gives French doctors an incentive to continue their education. In all cases, the state pays for their minimal insurance needs, too (in the non-litigious French context, that is very low–something that should appeal to American conservatives). The French manage access to specialists much as American HMO’s too (in order to limit costs)–via a gatekeeper system managed by a patient’s internists. So: specialists are not difficult to see, but you access them via your primary physician.
24 Zilu // Dec 20, 2009 at 1:42 pm
Debs:
Don’t forget to leave out that whereas an American doctor is likely to have hundreds of thousands of dollars in med school debt, French medical school is pretty much free, if you are good enough to get in.
That lack of a cost should matter.
25 debs // Dec 20, 2009 at 2:34 pm
Zilu:
Yeah, I mentioned that earlier. It’s just a different way of doing things. The fact that French med students are debt free incentivizes them to go into internal medicine, rather than specialities–or at least doesn’t argue against going into primary care medicine. American medical school debt is one of the major reasons there is a primary physician deficit in the U.S. I’ve talked to several med students who have told me that they won’t even consider primary care medicine because of the high medical school debt they have to pay off. That’s a perverse incentive structure–those costs shouldn’t decide what kind of medicine these talented young people wish to pursue.
26 Who Wins In Healthcare Reform? // Dec 20, 2009 at 3:59 pm
[...] one hand, there are the Republicans who have said no since the summer, refusing to do anything but obstruct. On the other, are the Democrats who have chosen to go the road alone and ended up with a bill that [...]
27 sinz54 // Dec 20, 2009 at 5:34 pm
debs:
The American health care system is an accident,
a tax-break hack created during World War II as compensation for the mandatory wage freezes that were in effect then. Health care was to be treated from then on as a tax-free fringe benefit.
After World War II ended, the IRS tried to relinquish the tax breaks–but they had proved so popular that Congress summarily overruled the IRS. And that was that! From then on, we would have a health care system that bound workers to corporations like serfs.
28 debs // Dec 20, 2009 at 5:47 pm
Yes, the history here is correct. Then you had unions–which then had density of about one third of the non-agricultural workforce–able to leverage that density into strong health care packages with brand name employers like the auto companies and other major manufacturing companies. These companies set the benchmarks, not only for the unionized workforce, but for much of the rest of the non-organized worforce, too (in large part to keep unions out–thus companies like IBM, for example, assiduously matched union benefits in order to discourage union drives among its employees).
Effectively, then you had a dual welfare state system: One for well paid and well benefited union workers, and those companies who matched those benefits, and then a weaker one consisting mostly of just welfare, social security and unemployment benefits for the rest of the workforce. Off topic a bit, but, ultimately, this damaged the Democrats with the white, unionized workforce who grew resentful of paying two sets of “taxes”: their ordinary taxes, which they angrily viewed as supporting “deadbeats” (and there was a strong element of racial animus to this), and also paying their union dues to support the excellent wages and benefits they received via their union contracts. In the North, many of these folks became first the angry ex-Democrats who voted for Nixon and Wallace in 1968, and then the famous “Reagan Democrats” of 1980 (the non-union evangelical Christians of the South were a different constituency, of course).
29 rbottoms // Dec 20, 2009 at 5:55 pm
How’s that working out for them?
Heh.
30 balconesfault // Dec 20, 2009 at 10:55 pm
27 sinz From then on, we would have a health care system that bound workers to corporations like serfs.
But if I recall, one of your biggest objections to a public option, particularly a broad public option, was that companies would drop their healthcare (and probably as a result raise wages) because their employees would then go get coverage under the public plan.
So in essence … you support this serfdom?
31 athensboy // Dec 21, 2009 at 9:21 am
Did anyone catch the story of Tom Coburn praying that a senator wouldn’t be able to show up for the vote?Senator Byrd was rolled in in his wheel chair to make the vote. Was Coburn referring to Byrd? If so, the gop has sunk to a dismal low.We’ve spent almost a trillion dollars for the invasion of Iraq, but we can’t provide healthcare for our poor? Being a Christian means more than fighting abortion(which I’m against) and gay marriage. It means feeding the hungry and taking care of the poor.We’ve lost our way as a humane society.The healthcare bill is a good start to regain our footing.
32 sinz54 // Dec 21, 2009 at 12:28 pm
balconesfault:
Like both Hillary and Obama,
I too recognize that we’re stuck with it.
If we conservatives could start over, we would do away with this link between employment by a large corporation and health insurance. So would you liberals. The difference between us is what we would put in its place. (I opposed the public option because I didn’t want the replacement for corporate serfdom to lead to single-payer, NOT because I thought the current system is all that great.)
But it’s way too late to start over. 70% of Americans get their health insurance as group plans from their employer, tax-free. They’re used to it. And it’s too easy to scare them by proposing to do away with it–better the devil you know than the devil you don’t. Nixon found that out the hard way in the 1970s. The Clintons found that out the hard way with HillaryCare in 1993. McCain found that out in 2008.
33 sinz54 // Dec 21, 2009 at 12:31 pm
athensboy:
The poorest Americans are already entitled to Medicaid, which is means-tested.
The currently uninsured in America are those who are above the poverty level (i.e., working-class) but who don’t receive health insurance from their employers; the self-employed; those with pre-existing conditions who no insurer will take on.
34 SpartacusIsNotDead // Dec 21, 2009 at 1:59 pm
Sinz wrote: “The poorest Americans are already entitled to Medicaid, which is means-tested.”
I guess in the very narrowest sense, this statement is true. However, there are many poor and low to mid income Americans who can’t afford insurance and who aren’t poor enough to qualify for Medicaid. And, of course, there are many other Americans who can afford, and do have, insurance, but are still forced into bankruptcy and economic ruin because of the amount of their deductibles and co-pays or because of limits on their policies.
35 sinz54 // Dec 21, 2009 at 9:16 pm
SpartacusIsNotDead:
I believe I said as much.
Until the 2008 financial crisis hit, out-of-pocket medical costs accounted for over half of personal bankruptcies in the U.S. The most common scenario was when the family breadwinner fell seriously ill. Then not only did household medical expenses rise sharply, but household income dropped off by half or even to zero.
When it comes to health care, the middle class is often screwed more than the poorest and the richest of us.
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