Corporate welfare bill to private health insurers passed in US

I think the National Undertakers Association backed the GOP plan a few months ago. So I dunno.  I think China will achieve universal health care before the U.S. does. Too many Americans are more willing to fatten morticians' bottom lines than share anything with their fellow Americans. I think the country is definitely running a fever.

The right wingers heads are starting to explode...Talk of revolution and insurrection!!!

hehehehehehe....

The truth about the Health Care Bill

http://fdlaction.firedoglake.com/2010/03/19/fact-sheet-the-truth-about-t...

"Real health care reform is the thing we've fought for from the start. It is desperately needed. But this bill falls short on many levels. And it hurts many people more than it helps.."

I'll bet Wall Street bankers can afford health care, and especially now that theyve been provided so many guarantees in life by US taxpayers. I'll bet not one fat-cat banker will have to declare bankruptcy and lose everything if or when they're ever sick. Not a single one.

David Frum wrote an interesting essay:

http://www.frumforum.com/waterloo

The exploding teabagger heads are worth celebration in itself.

This is the most anyone there has been able to achieve since the creation of Medicare and Medicaid - all other attempts at universalizing health insurance at the federal level have gone down in flames. It's sad that this was probably the most they could have done as the insurance and other medical lobbies are so powerful. Glass half-full. It's only the end of the beginning of the struggle for better health care.

There's no question that what people get under the health care reform is a raw deal in comparison to wht we have in Canada. And that it does not strip the medical insurance industry of its business and power.

[Duh.]

The insurance lobby fought this tooth and nail. How do you square that with the thread title: that this was a bill FOR private health insurers?

David Frum has been trying to position himself as the voice of reason on the American right. 

Talk about cherry picking.

Anyway.  One could have an easy time slice and dicing this health care reform bill as not measuring up.  But, I think if those who were active in supporting health care reform in the States look at it as a foot in the door, and build on it, it could yet measure up to the victory Obama claims it to be.

How do you build on this?  There's no public option.  If they ever tried to bring one in after this, they'd be back to square one, whereas Obama could have used his incredible influence to include it if he'd really wanted to.

This plan is just forcing people to line up at private insurers' doors and hand over their cheques, with no competition from a public option to keep them honest.

BBC provides a sampling of US media response

http://www.bbc.co.uk/blogs/seealso/2010/03/us_view_obamas_healthcare_bil...

How do you build on this?  There's no public option.

Well, unlike the first attempt by Clinton, this one forced all the opponents out into the open, exposed tactics and personalities that can be targeted strategically in the coming years.   And, when people start to enjoy the few things this does bring them, then it's easier to get them clamouring for more.   

I'd love to be on a pro health care lobby group with a good budget in the States right now.  I'd make Karl Rove look like Albert Schwietzer.

Again: how do you sqare this with these simple facts that should have been observable to even the most superficial observation of what has been going on in the US for months now?

1.] The private insurers spent TONS of money lobbying and TONS more on advertising against the basics of the Obama plan.

2.] Republicans in Congress coordinated with that playing upon peoples' fears. They also stoked the Tea Parties and exploited the opening they created.

It is obvious the private insurers wanted nothing to do with Obamas plans- they put EVERYTHING behind it going down in flames.

Please square that with "The Republicans couldn't have come up with a better plan to reward their corporate buddies than this one."

And think about how you answer that in its own right, before moving on to the next questions in reply to your comments.

"Obama could have used his incredible influence to" get the public option "if he'd really wanted to."

Excuse me. Obama just staked everything on getting what he got. Once he took that step, hed have no clout to get anything done if he lost. No small gamble in its own right when there was nothing like a guarantee he would win. Plus the credibility on a number of other things he torched to get this [and not just the ones that matter to people around here].

He staked all of that, and barely won.

Yet we have people saying "if he had really wanted it he could have got a public option."

How about sqaurieng that one too?

Not to pick on you personally Michelle. You express what is easily the majority opinion around here.

He barely won because the majority of Americans who voted for him for health care wanted a real option and a public option, not this.

I don't feel picked on, that's okay.  I sure wouldn't say this on Daily Kos! :D

It's a lesson for us all.   Whatever you think of that bill, it represents the biggest challenge to established power in the States that we've seen in the longest time.    And, look at how the stops were pulled out by the establishment to fight it.  I think, through the Teabaggers and their media flying monkey squad, they were nakedly trying to incite violence, even.

That's why we've got to be fighting now, and continually, against such enterprises already lined up and waiting to defeat anything we try to do.

You know, many here are quick to point out the short memories of the general public and of right wingers, but I often find it short here too, being the only crank who remembers Navigator and their tendrils in the media.    They, and PR firms, formal and informal, who operate more competently than Navigator, truly behind the scenes and under the radar are already working on ways to privatize our system.    

This is a battle of no quarter, make no mistake.

"He barely won because the majority of Americans who voted for him for health care wanted a real option and a public option, not this."

How is this suppossed to work?

You can't take what people say in opinion polls to get what you want in politics.

A majority of Americans say they want a public health care option?

Two thirds of Canadians say they don't want ANY kind of tax increases. In the same poll, over 70% of them want no spending cuts.

The comparable thing in the US is that a great many of those people who said they wanted a public policy option, ALSO were not liking the aspects of the Obama plan that made the private insurance industry do ANYTHING. And having a public policy option would require FAR more beating down of the private insurers than Obama was proposing.

Sure they want a public policy option. But if having one means substantially cutting in to the gold plated plans that about one third of Americans have, then forgot it. They were just assuming they could have their cake and eat it too.

Your is just another parallel universe view that politicians don't have more support because they don't push radical alternatives for which a lot of you create a mythical backing for.

 KenS.  I've followed the healthcare debate quite and have to agree with most of your assessment.  Obama has influence yes but he's not a miracle worker.  Republican antics aside it became quite clear that when the public option came initially on the table that there were a significant amount of more conservative Dems that weren't going to fly that way no matter what sort of behind the scenes arm twisting occured and boyo there was a lot of it.   Most of this debate happened within their own caucus with the Republicans on the outside shouting, no, no, no! death panels!, omg killing grandma, ABORTION funding and socialism/marxism/facism booga booga.   Sad to watch from the outside but to me it was a major example of the differences between our system and the US's.  Here the PM would just say you are going to vote this way, deal with it and it's done.  

 Of course I would have loved to see some sort of single payer implemented and bar that some sort of public option.  It sucks that political climate and discourse stinks to high heaven right now.  With all things considered I'm actually surprised they managed to get as much as they did.  I'm uneasy about the whole fining people thing though I get the reasoning behind it.  I think it's a wait and see how that all plays out.  I keep reading that it's not necessarily a killer because the fine is way less then insurance and there is already those stating that it won't even work the way it's supposed to anyways.   There's also some sort of insurance exchange to help deal with affordability though I admit I don't really no how that is supposed to work.

Bright spots include the one thing that pisses me off no end and that I personally find morally unconsionable.  It will be against the law to deny anyone coverage who has a pre-existing condition and kick people off plans when they actually get really sick.   The removal of insurance caps is also a big one. 

These two things are huge and imo there is no way that insurance companies think these are good things.  People are already talking lawsuits over these provisions.   It's a major blow to how they do 'business' and keep their numbers(profits) flowing.   What I see as significant in passing these things is that the government now has a foot in the door of enacting some oversight in insurance business practices.  That in itself is a step forward and I can see that potentially being built upon.

And here are the big reasons why the insures saw this as violently oppossed to their interests Michelle.

The government is ending a lot of the practices that allow the insurers to cherry pick who and what they cover. That is how they make their money. Very simple.

In return they are being handed new business they must take that they don't want- where there is no profit.

I suppose in Alice in Wonderland that could be called 'corporate welfare'.

KenS, in answer to your earlier question about why the Republicans were so dead set against it if it was such a conservative plan - David Frum answered it well, dog forgive me for using him to support my point.

The reason the Repugs went batshit is because, frankly, they went batshit.  They got their base all riled up in mob psychology and escalating rhetoric about Obama=Hitler and birther conspiracy theories and stupid shit like that, and then when it went spiralling out of control, they couldn't back down from it because, as Frum says, when you demonize your opponent as Hitler and death panels, you can't back down.

But Frum also made the point that, from a reasonable Republican point of view, it's a pretty good deal for them, and similar to what Republicans have been putting forward anyhow - private insurance for everyone.  It's exactly what a Republican would have put forward had they been pressured into putting forward their own plan.

And it's a total dream that the private insurance companies who have made a killing (literally!) on selling shit plans and refusing claims now have a completely captive audience - all the people who were denied or couldn't afford plans before are now being FORCED to buy private shit plans, and if they don't, they face a fine.

But you can bet that while insurance companies won't refuse to insure them (because they can't now), that they'll do their damndest to deny as many claims as possible, from routine to major surgery.

And don't get me started on the "gold-plated plan" rhetoric.  You know who that's aimed at, KenS?  Union members.  Workers are the ones whose "gold-plated plans" (or, "Cadillac plans") are being so attacked and vilified in the American media.  And Obama went with that, and decided to TAX those plans on the employer end, which will eventually erode those plans because the employer won't want to pay those taxes.  So, good job.  Destroying workers' health care plans in order to help pay for shit plans from private providers to the poorest, instead of including a public option that rivals unionized plans and letting people have a real choice about their health care.

It's a fucking scandal, is what it is.  A Republican dream.  And once the teabaggers get over their hissy fits, they'll see what a dream it is.

  They weren't just trying in the past. They still are.  Go to any harder right site right now and the comments and calls for violence have increased since yesterday. There were at least two assassination calls that went out over twitter yesterday.   The rhetoric is quite astounding and there are a great many people who believe that the passage of this bill means the end of America.  The republic is dead. America is now communist/nazist.   It's worse then 9/11.   People are in mourning.   People are calling for God to come save them.  Weeping, wailing and gnashing of teeth.   The hyperbole would be rather humorous is it wasn't so widespread or in the fringe but no it's echoed through the media and through actual elected reps.    Beck should be a treat or horror to watch today.

 I agree.

It's been suggested, time and again, that Obama is letting down his troops, is a sellout.  Paul Krugman has just as insistently pointed out just what forces of madness and racism that he was up against. He had to water it down to get it past some of his own bloody party.

Krugman sums it neatly today:

"Instead, the emotional core of opposition to reform was blatant fear-mongering, unconstrained either by the facts or by any sense of decency.

It wasn't just the death panel smear. It was racial hate-mongering, like a piece in Investor's Business Daily declaring that health reform is "affirmative action on steroids, deciding everything from who becomes a doctor to who gets treatment on the basis of skin color." It was wild claims about abortion funding. It was the insistence that there is something tyrannical about giving young working Americans the assurance that health care will be available when they need it, an assurance that older Americans have enjoyed ever since Lyndon Johnson - whom Mr. Gingrich considers a failed president - pushed Medicare through over the howls of conservatives.

And let's be clear: the campaign of fear hasn't been carried out by a radical fringe, unconnected to the Republican establishment. On the contrary, that establishment has been involved and approving all the way. Politicians like Sarah Palin - who was, let us remember, the G.O.P.'s vice-presidential candidate - eagerly spread the death panel lie, and supposedly reasonable, moderate politicians like Senator Chuck Grassley refused to say that it was untrue. On the eve of the big vote, Republican members of Congress warned that "freedom dies a little bit today" and accused Democrats of "totalitarian tactics," which I believe means the process known as "voting."

Without question, the campaign of fear was effective: health reform went from being highly popular to wide disapproval, although the numbers have been improving lately. But the question was, would it actually be enough to block reform?"

The enemy [1] of my enemy [2] must be my friend. The "logic" of despair.

[1] Mandatory private health insurance.

[2] Frenzied racist right-wing fanatics.

I'll just hustle this little note over from the other thread before Ken's fatwa on the thread of the "believers" is carried out. (Or is that non-believers? Don't know where orthodoxy lies any more)  :D

"My cousin's son in Florida will now be able to get the healthcare insurance that was denied him because of insurance companies not wanting to take him on for less that $1200 per month.  And another 30,000,000 people (Canada's population) will be covered.

Strange how the empathy for those folks is swamped by invective about "corporations".  Not the corporations in which one's life savings are invested, though.  Other corporations.   What meaningless, so-20th-Century "analysis".

quote:

"He knew that his bill was more a beginning than an end. The Social Security Act, Roosevelt said, "represents a cornerstone in a structure which is being built but is by no means complete." And Bush nearly destroyed this, proposing the individual social security fund recipient be turned into an investor. Perhaps it will take more than a year to claw their way back from the madness of King George."  (That's George Bush, the reviled president preceding the current reviled president, but about whom we read diddly squat any more...opinion posing as analysis being so fickle).

How much will his premium be, out of curiosity?

And what will be covered?

I'd like to see some focus on how to stop increasing health care privatization here, people.

Not going to happen anytime soon.  Hissy fitting is going to get worse and 'health care death of America bill' is already playing into the next thing on the agenda. Even as this bill was being passed they were segwaying and leveraging the horror of it all  into immigration reform.

An Attack on Health Care in the Guise of Reform

http://www.wsws.org/articles/2010/mar2010/pers-m22.shtml

"In the end, what decided the bill's passage was pressure brought to bear by the White House, acting on behalf of the most powerful sections of the financial elite.."

I fully agree. As I have said before, the U.S. will get precisely the health care it wants and deserves. Its starting point is at the bottom of the "western" countries, and it will remain there after this cynical so-called "reform". Canada, notwithstanding all the pressures our economy and culture and political system undergo from the south, has quite courageously established and maintained a single-payer system which Obama didn't even dare suggest, for close to a half century now. In Québec, we have universal mandatory drug insurance - with a public option. Home care is covered in Manitoba and coming to your home soon.

Yet, as Boom Boom points out, privatization is a growing danger. We need to meet it head on. Going by the past half century, what happens in the U.S. in this regard will have little or no effect on our struggle here. So, while I lament the fate of the people of the U.S. in being unable to access public affordable health care, in the final analysis, it's as much my battle as the battle for health care in Kazakhstan. Both are important, but my sympathies will always tend more toward the weak and powerless than to those who need only to get over their own prejudices and misconceptions.

I'm glad to see that you follow what is actually said in the media.

Given that, I'll be interested to see how you square that this was 'corporate welfare' when the insurers fought so hard against the plan. I'll get back to that in another post.

I can see how trade unionists think that was directed at them, and certainly they get caught in it. But this is a product of the realities of the Gordian knot of US health care.

It is simply impossible to build a public option while leaving all the private plans untouched.

In Canada we had a public plan first, and the private plans arose as a supplement to that. And here the union plans are the backbone of that supplemental system. Not so in the US. Even for those who do have health care in the US there are 2 major categories- people with coverage that doesn't dump them and get generally good care. And those who get shitty coverage that routinely weasels out of any catastrophic care. People how are in the first world system because of union contracts are the smaller part of it.

Imagine what it would be like tobuild a public plan if we didn't already have one. The one we have was built before the insurance industry dug their claws into the system. And- crucially for a leader getting public support- our system was built when even unionized workers had shitty health care. They had nothing to lose. That is not true any more.

It would have been very easy for Obama to pander by building a public policy option while leaving the private system alone. And the industry would have absolutely loved it- let the government have all those people they don't want to ensure. Questions aside about the principles of that kind of pandering- that option wasn't fiscally possible.

A real public option, can only be built by really bearing down on the private insurance industry. I don't know enough to know if that was seriously considered- but I doubt it. [And if it had been- you'd see the unions lining up to oppose it. No doubt they didn't like this taxing of their plans, but did they voceiferously oppose it?]

At any rate- Obama chose the route of regulating the existing industry- force them to insure everyone and to end denial of care. Which is why they fought so hard. The tax on people with higher end health care was just the fiscal reality and a redistribution to pay for expanding the system.

I don't watch the debates anywhere close enough to see what the academics and health economists are saying. But all these political and legal battles are just one of the 2 circus rings. Think about our debate of how we are going to pay for health care in the years ahead. The US pays twice as much per capita and have just added new costs. They claim this will be expense/revenue neutral, but even with the tax on higher end plans it can't be true. Alone: forcing the insurance companies to stop denying care is going to bring in a lot of new costs.

There will not be a public option in the US without 'de-constructing' the private industry. And even the more moderate version of forcing companies to provide first world coverage to everyone cannot be done without taking some money out of the private care system... where the big expenditures are because cost controls are minimal compared to what we have in a single payer system. The tax on good health care plans was unavoidable. You can bet that if Obama could have got this done without that he would have, because it was obvious that it would be ammunition for the lobbyists and the hysterical ads.

If they made the public option better than the "gold-plated Cadillac plans" you can bet that people would be leaving their plans in droves to pay into the public option.

That was an option, too, you know.  To make the public option so good that everyone would want it.

Um, Ken, what are you talking about? There was all kinds of private insurance (I'm old enough to remember "hospitalization insurance") before medicare was implemented federally. The Canada Health Act put an end to private plans covering basic services.

Maybe I misunderstood you?

That system was just nothing in comparison to the indusrty that exists today in the US. And the private plans we have today arose as a supplement to our public system. Thats the important point, not whether or not there was private insurance before. Of course there was. I'm also old enough to remember the medical plan my family had then because my parents had union contracts- and it did not fundementally change the working class reality that going to the doctor and buying drugs cost you money you didnt have.

You bet they would. But its just a complete fantasy.

Dismantling the private system would be a pre-condition of building that public option.

And all Obama had to do was snap his fingers to do it.

 It was an option and a good one at that.  It was in there at one point.  Unfortunately it didn't have the votes it needed to stay in there.

"If they made the public option better than the "gold-plated Cadillac plans"....

You don't even need to have close knowledge to know this for the fantasy it is.

We all know that they pay far more for health care in the US. And you are going to leave that system intact, and build next to it an even better publicly funded system...

Can I go to this planet right now?

"Never had the votes" is a severe understatement. It didn't have enough support to stay in the ring even.

There has never been a possibility to leave the existing system as is, and build an equal or better public system.

There were some people who thought that proposing such a wonderful public system would be the first step to pushing the private system out. Needless to say, they didn't have a road map for that.

And you have to admit that given the reaction there was to just having the profit opportunities of the industry trimmed, its difficult to see how proposing its demise was supposed to work.

And even more to the point: if you can find any of the politicians or policy wonks proposing that ideal public system, despite their obvious dissapointment you won't see them calling Obama a sellout or saying that this plan is just 'corporate welfare'.

I think the next step in the battle begins one second after Obama signs it into law.   Just because insurance companies are now forbidden from dropping sick clients, and can't deny coverage for pre-existing conditions doesn't actually mean that they will stop doing so.

Catalogue every case, and publicize it to the max.    For starters.

Sorry Ken - explain that please? "Medicare" in the U.S. is a single-payer public option, is it not? Was the private system for over-65s and retirees "dismantled" when LBJ introduced it?

No, I didn't think so.

In 1997, Québec made prescription drug insurance mandatory for all Quebeckers, no exceptions. If your employer has a private plan, you must join it. If not, you must join the public plan.

Do you remember the massive lobbying campaign by the insurance companies and Big Pharma and the vicious battles needed to pass this legislation?

Neither do I.

Sure. It's a planet where a public system is not-for-profit - like ours. How much of the "they pay far more for health care" is after-expense profit, Ken? That entire saving can make a publicly funded system "even better".

I'm sure you are right on that Tommy. Drop people anyway, fight it through the courts, get the law changed in the next Congress.

Oh, it's like anything else.  The companies have had a fall back contingency for probably six months at least, like whenever there is campaign finance reform, the parties are exploiting the loopholes before the ink is even dry on the legislation.

You have yet to answer the fundamental question: how could Obama's plan be a huge gift horse for the insurance industry, and they were fighting the plan tooth and nail? Like I said already:'

It would be corporate welfare if people were being forced to buy their shitty plans. But the new law means they can't do anymore what makes those plans shitty for consumers and profitable for them.

They will not be able to cherry pick who they cover and deny care.

Like Tommy said, they'll fight a rear guard action against the new law. But they are doing it because it is the opposite of the 'corporate welfare' you wave it off as... simply because you are sure it must be true.

 Well it did manage to stick around for awhile.  The if I recall correctly congress did get through a vote that included a form of a public option and Pelosi did what she could to stick to the public option guns for a time.  Took a whole lot of political grief for it too.  The senate was the big stumbling block. Too many Bluedogs that tipped the small majority they held away from it.  For a time it looked like any reform whatsoever was going to be scuttled over the public option fight between the two houses.   I remember it being declared pretty much dead a number of times due to the stalemate over it.  Ted Kennedy dying and the political fallout from his successors election didn't help numberwise  or politically either.    Then the Repubs  introduced the abortion funding strawman diversion which sucked in the Pro-life dems from the congress and put even that vote at risk.

I don't know enough about American politics to say whether Obama could have done better; from what I've read, while most leftist American critics agree that this bill was a massive capitulation to the Republicancs and to the drug companies, they don't seem to suggest that anything more radical would have made it through the house. I could be wrong on this point.

At any rate, a public option, it ain't. But it does accomplish one significant thing, indeed, the only thing of note accomplished by the election of Barack Obama in 2008: it galvanizes the will and belief of the American wide left. Not as platitudes, but as a measure of utopian thinking that the elite have been grinding out of the working classes since the late-nineteenth century. The people are happy and they believe that change is possible. That's a good thing.

 If net talk and some news reports can be taken at face value the next battle or one of the next ones will be in the courts.  There are several State attorney generals who have gotten together and said they will be filing Constitutional challenges in reference to states rights.

States rights arguments before the courts haven't been too successfull since Dred Scott.   But then, there's no telling what those nut bars in the Supreme Court are capable of these days.

Do you have anything other than personal attacks to offer, KenS? 

I'll tell you what.  When I read your posts, I will read as far as comments like "You're living in a made up world" and then I'll stop right there and won't read further.  I just come here for fun now - who needs your abuse?

 Well it will be interesting to watch.  Just watching the news and it's not just a few filing suit when the bill is signed tomorrow.  They're saying in will be 38 states.

Old math insurance companies used to determine which polices to drop:

drop policy if cost of covering illness > premiums paid.

New math insurance companies will use to determine which policies to drop:

drop policy if cost of covering illness > (premiums paid + weak assed fine)

--------------------

Can anyone confirm that the restrictions against, more or less, unlimited premium hikes are still in the bill? I heard from a somewhat reliable source that this part was stripped out of the bill as part of the concessions to the Repugs for zero votes, but I have not seen any confirmation and I'm not going to go looking for it in a bill that is taller than myself.

I'm not exactly sure your point. But Medicare is most definitely not a single payer system. The fact it would be an 'option' alone would make it not a single payer system. Single payer means that you have one player- in practice but mot necessarily the government[s]- who has control over all the main levers of the whole system.

Take out the profits of the health care industry and the US system would be 10% less than twice as expensive per capita.

The main issue is the single payer [or not] thing. [See above.] The fact Canada has am [in pronciple] single payer means that governments can exert control on costs that even the big players in the US like the big HMOs can only influence. That means doctors salaries are held down, that hospitals cannot trip over each other to offer expensive services, drug prices brought down. The US private industry would like to do all that too, but as big as they are they don't have the clout.

This is why public policy was not a real option. You can only have it in the US by taking out the existing private industry. The talk of building a parralel pubic system was predicated on simply glossing over that fact. No surprise that ducking wasn't viable.

Exactly, No Yards.  It'll just cost them a little more to screw people over now.  Which is why they opposed the bill.  But that doesn't make it a good one, and that doesn't mean it's not a gift to them in the long run.  They'll find a way to make it work for them.

I'm willing to be corrected, however, if there are reasonable caps to the premiums, or if premiums are pro-rated to income for the poorest people in the US, and everything covered by OHIP here is covered by those plans.

I'm sorry for that Michelle. The words are taken out. Could you try reading again?

In my defence- that sarcasm comes out after I've asked the fundamental question nicely and you just ignore it. "You have yet to answer the fundamental question: how could Obama's plan be a huge gift horse for the insurance industry, and they were fighting the plan tooth and nail?"

I answered it.  You just don't like my answer.

Michael Moore looks at it from both sides:

However:

Good quote from Michael Moore.

And I would suggest that unlike you, he gave a nuanced answer to the question.

You completely dismissed it as nothing more than corporate welfare. It cannot be passed off as perhaps an exxageration to say that its a gift to the private insurers.

Yes, the private insurance companies were not totally slapped down. That isn't news. But more to the point: if you had quoted Michael Moore I wouldn't have taken exception. I took exception to what you said. [And you still didn't answer how the bill is a big gift for the private insurers. Nor of how to account for how that could be true when they fought it so hard. Moore didn't make such a claim.]

You managed to avoid answering both my points, Ken.

Medicare is "single-payer" for the scheme that it operates - not for all senior health care - as opposed to being a publicly administered kind of "broker" that still contracts with private insurers. Read this:

Now, delete the word "single payer" from my post and please consider my two points:

1. Medicare was introduced as a public option in 1965 without dismantling the private system. Why would that be a precondition now?

2. Québec introduced a public pharmacare option (plus mandatory universal coverage) in 1997. No battle with insurance companies or Big Pharma. Nada. And no one got dismantled.

I understand your point about exerting control over costs in a non-single-payer system. But that doesn't exclude a public option.

Why didn't Obama do this (if he was scared to even mention "single payer", which he apparently was):

1. Public option, open on a voluntary basis to everyone.

2. Subsidies to those too poor to pay for the public option.

3. No mandatory coverage for anyone.

4. No new regulations or obligations on private insurers.

Kind of the opposite of what he did, isn't it (except #2)? It's free-market driven, it doesn't do anything to the private insurers or Big Pharma... I would have called that "reform", even if it was still pathetic next to any other western industrialized economy.

I think that Obama could've pushed a lot harder, I think the Senate leadership should've pushed a lot harder, and I think more could have gotten into this bill.

But, while it's not perfect, it seems like there are definitely good things.  32 million people will get coverage who didn't have it before.  Companies will not be able to deny coverage for pre existing conditions (this will take time to kick in) and investments are being made in community health clinics.

Moveon members voted overwhelmingly to support the bill.  Kucinich voted for it even, saying that it's better than nothing.  An overwhelming majority of Americans supported the passage of this bill, saying that it is better than nothing.

Are progressives here really saying that this bill is worse than nothing?  That it would've been better not to deal with health care at all?

I just have to add my two cents here.

Ken S is simply wrong in saying that the private health insurers fought this bill tooth and nail.  They supported most of it, and as the firedoglake link above indicates, wrote a great deal of it, in conjunction with Max Baucus's Senate Finance Committee.  The Chamber of Commerce fought it tooth and nail, but they're not insurers.

Nor is the bill a "challenge to established power."  It entrenches the for-profit health insurance system by giving the private insurers 25 to 30 million new customers without giving them, or anyone else, the choice of a public alternative.  And it pays for it over the long run by imposing a 40% excise tax on quality health plans.   So, instead of getting the wealthy to pay for the subsidies, those with good health plans, typically middle class and unionized, will see their coverage get worse.

In short, this law is a betrayal of the progressive principles which have guided the health care debate.  It is essentially what Bush I proposed in the early 1990s.  It is only because the right has succeeded in moving the debate, and the general political environment, so far to the right, that some "progressives" see what they would have rejected out of hand a decade or two ago, and what some did only a few months ago, as a victory.  It isn't.

I think that the recent rash of 40% or more premium increases should pretty well cover the cost of fines and fighting the odd court case.

KenS - per your comments about squaring the Insurance Industry's attack against the bill with it being a sell out to the Industry .... I've found a link to a leaked insurance industry strategy document outlining the plan for making people think the bill was bad for the Industry that you might want to take a look at  .... http://www.youtube.com/watch?v=NH6fu1AF0R4&feature=related

And by the way- those exceptions to care Michael Moore has talked about are not unique to people that the bill that will be bringing for the first time into first world health care.

A great many Americans with those really good health care plans have had those kind of exceptions forced on them in recent years. My father has one of those top of the line union negotiated health care plans, which no one ever thought would be threatened. And now it has one of those caps, which he may well hit.

Obama supporters are just happy that their guy managed to do something since being elected.

I've already spent way more time on this than I can afford. [Leaving aside its rationality even ifg I had the time.]

And I look at the questions i get and its just getting worse. So I'll cut my losses and leave now.

I think you're right to some extent.  Rather than setting things up as the government public option, they should've pitched it as, optional buy in to Medicare.

Now that this bill has passed though, with many changes to regulations, medicare buy in could be introduced much more easily as a simple bill.  Progressives in congress are definitely planning this, although who knows how it will go.

Quebec isn't the empire, doesn't have the red fear, doesn't have teabaggers.

I think he didn't do this for pragmatic, political reasons.  I agree with you that I think he could have gotten more for the people if he had done things differently.

But, I think the USA is a strange place.  The Republicans whipped up fear of and opposition to this plan in part by saying it would cut medicare benefits.  That's what some people were really upset about.  Never mind that that the Republican plan made huge cuts to medicare way beyond anything in the Obama plan.  The media there is pretty fully owned i'd say.

So I agree, I strongly suspect that a lot more could have been achieved if Obama had pushed harder.

I still think this is a win.  And if progressives in Congress are interested, they can take this further.

ETA: While I am saying, with qualifications, that this is a win, Obama did promise a public option while campaigning.  Since they're touting this as health care reform, Obama's campaign promise should be treated as broken.  That should be clear.  Until there is a public option, Obama has not delivered on health care.

I'll cut Obama a little slack simply because I think it's pretty hard to understand the USian mind set regarding healthcare ... as hard as it is for most of us to get our heads around, a very large percentage of USians do not consider heathcare as a right ... to them it's a commodity that if you can't afford then you don't deserve it, and you should take whatever "charity" is offered you and be thankful that you got even that.

Also, from a purely Canadian "mercenary" point of view, it's good to see that the bill does absoluetly nothing to errode Canada's economic advantage that comes with having a single payer healthcare system.

josh, do you think that Obama could have passed a public option through the house?

It did pass the House.  Could have he gotten it through the senate?  I think if he fought and campaigned for it, it's possible.  But his style of governing seems to be to take the path of least resistance.

I believe the house did pass a public option at one point that was later removed after "negoiations" with the senate ... didn't they? I know at least at one point Pelosi announced very firmly that the house would NOT pass a bill without a public option.

It was the Senate where the problems really came from.

Not in negotiations.  The House just caved and gave up.  About 80 progressives signed a letter last year to Pelosi saying they would not vote for a bill without a public option.  They all ended up voting for the senate bill yesterday.  Without a public option.

Yes it did. I talked about that up thread. The senate was a sticking point and most of the furor over the public option occurred there. It came really close to killing any reform altogether because at the end of the fighting no one was budging. Then when the Repubs brought up the abortion funding diversion it set everything into a furor. Even though what they were saying was BS it did enough to put the house bill and support from the majority of the house to support the senate bill regardless of the PO issue in question. Brilliant but absolutely disgusting maneuver on their part.

"Negoiations" was my attemt at trying to be polite

Yes - just as Harper's "$100 a month" cynical substitute for child care was worse than nothing. It effectively shut down the movement for child care for the last 4 years, because no party was willing to stand up and say: "Not one child-care penny to parents - direct subsidy to the providers!".

I think what people here are saying is that it would have been better to deal with health care effectively, and not through some cynical entrenchment of the power of the private insurers.

And yes, it would have been better if Harper hadn't "dealt with" child care at all. At least it would still be on someone's agenda.

The House passed a bill with a public option.  The House was able to do a bit more than the Senate because the Senate requires 60% majority to agree to vote.  Even without that restriction it was hard for the House to pass the bill.  They needed to add anti choice restrictions to the plan in order to bring Conservadems on board.

Then it went to the Senate and yeah that's where the roadblocks started.  A few Dem senators tried to kill the whole thing by refusing to bring it to a vote.  The Senate leadership, rather than strong arming those holdouts, caved, and all kinds of crap was put into the bill, public option removed, medicare buy in which looked like a go was removed.  Then the bill was passed.

At this point, the House and Senate could've gone to committe to bring the bills closer in line.  But, the Dems lost that 60th seat in Massachusetts, which meant that further changes to the bill would not be passable in the Senate (because the 41 Republicans would never agree to have an up or down vote).

So, that left them with one clear option.  Reconciliation, which removes the 60% supermajority in the Senate, and allows an up or down vote.  BUT, reconciliation only applies to budget related bills.  So, the House passed the Senate bill, and then the house passes the budget related fixes to the Senate bill, then it goes back to the Senate, and the Senate uses reconciliation to vote on the budget related fixes to the previously approved Senate bill.

The whole process is one big clusterfuck designed to block change for the people.

Violate my own rules with one mostly information point.

The industry lobby did not get what it wanted. It wanted complete defeat of the bill because of the parts about being forced to cover people and not deny care.

Their Plan B is to fight a rear guard action and get it all undone. The concessions they got in the bill via the blue dog Democrats is not in itself even Plan B.... it just contributes to it.

They still plan to put the boots to this 'gift horse'.

What Unionist said in post 70. 

I just watched an analysis of ObamaCare on CNN and while they confirmed that if you do not purchase a health care plan you will be financially penalized, they did also confirm the following:

- the worse abuses of the health care inusurers will be eliminated

- for those at the lower income scale who have difficulty getting insurance, a government-provided Group Purchasing Plan will find the cheapest and best plans for those at low income levels

- no one will be refused coverage

- insurers can not refuse coverage for pre-existing conditions.

You're just wrong Ken S.  While there were aspects of the bill the industry did not like, overall they're quite happy with it.  And their stock prices in the past several months, and today, reflect that.

"The whole process is one big clusterfuck designed to block change for the people."

Yes it is. Which is why you should never have an elected senate based on anti-democratic representation. Get rid of it while you can.

Also: the thing is, Obama could've tried.  I mean really TRIED on the public option.

The guy is practically god-like when it comes to his oratory skills.  He could have done presidential messages, come up with extremely persuasive arguments in favour of the public option and really communicated them to the American people.  I mean, during his campaign, he was pretty short on substance, but damn, he was long long long on personality and persuasiveness and charisma.  Combine that with a killer argument in favour of a public option, along with a few stories of people who have been fucked over by private insurers, and I'll bet he'd have had a fighting chance. 

At least, he would have had a fighting chance at getting the right-wing Democratic senators in line, if he'd really spurred his base and the swing voters who voted Democrat in the last election because of his promise of universal health care.

It would have been worth fighting for.  It would have even have been worth a one-term presidency.

We'll have to wait to see if health care has been removed from everyone's agenda.

So I'm seeing a few takes on this bill here:

1 - This bill is not effective health care reform but as an incrementalist approach it's a victory

2 - While this bill would improve some aspects of health care it is actually worse than the alternative of nothing at all because it means that now real health care reform is less likely/further away

3 - This bill actually worsens the health care situation in the USA

I think it's clear which babblers are holding position 1).  I'm having a harder time sorting out whether some people feel 2) or 3).

What do you think would've happened if the bill in the House yesterday didn't pass?

Progressives yesterday voted for this bill.  How come?

Here's Alan Grayson, one of the most vocal proponents of universal health care in the House, today on DailyKos building support for the Medicare You Can Buy Into bill:

http://www.dailykos.com/storyonly/2010/3/21/848909/-A-Near-Death-Experie...

He's not giving up yet.

Unionist - thank you for your analogy in line 70!  I completely agree. 

Obama's campaign promises have been shown to have little connection to his policies when in office.  In addition, to calling for a public option, which he tried to deny he ever made, he also opposed the individual mandate, which Clinton supported, and the excise tax, which McCain, albeit in a different form, supported.  He supported both of those when in office.

I agree that it would have ben worth fighting for, and he didn't.  Disagree completely that it would have been worth a one term presidency.

Then Obama should have taken those parts out, in exchange for a public option which embodies those principles (and others). Even if you're right about the insurers being against the bill (which I hear Josh saying was not as cut and dried as you're suggesting), that would have ended their opposition - according to your analysis - right?

Wrong question. That bill should never have been proposed.

Similar reasons that progressives in our House of Commons couldn't bring themselves to boldly oppose Harper's $100 child-care substitute: Lack of confidence in their principles, in their ability to explain things to people, and in the prospect of winning something worthwhile - so, they retreat to political expediency.

Do you think passing this bill has been politically expedient?

How come progressives in Canada know what's better for the USA than progressives there?

ps: in addition to the points I mentioned in my post #74, CNN also reported that significant tax breaks are going to small businesses and lower-income-earners to allow them to afford compulsory health care insurance.

ETA: I have been living on a disability allowance since 2002, and I have no choice but to spend over $2,000 per year on a Blue Cross Group Plan for prescription, dental, eyeglasses, and hearing aid extendicare package. I live in Quebec, btw.

Believe me, most progressives in the U.S. don't know what's good for them.  That's why they continue make themselves marginalized and ignored.

See link below.

Oh, I'm just listening to what U.S. progressives say about each other:

The health-care Hindenburg has landed

I don't think we know better than US progressives what's best for them.  But I also don't think that US progressives are in lockstep on this one.  And the arguments of the progressives who are critical make more sense to me.

Here's another take:

Black Agenda Report

MoveOn surveyed their membership and 83% supported passing this bill.  Kucinich voted in favour.  Michael Moore, not even a politician (ie who need to worry about fundraising through the party machine), gave his (reluctant) support to the bill.

As far as the argument that this brings the USA further away from single payer, because now health care is off the agenda, I think we'll have to wait and see.  I see more people (online, so take it with a grain of salt) arguing that this is an empowering victory for progressives that will lead to more.

I don't really know what will happen, but I can certainly see that American progressives are responding far more positively to this news than Canadian socialists.

Amazing empathy demonstrated throughout this thread for the several tens of millions now covered or will be covered by this measure.  They actually like the prospect.  Confirms the social principle that when you have it made in the shade, the grasp on political reality falters.

Because "Canadian socialists" know what real universal health care is like.

And all should live so long as to realize nirvana...and in the meantime, quit complaining.

Absolutely.  So from our perspective it's ridiculous.  They call this health care reform?  It's a joke.  Their system is based on private insurance companies, which is why they pay more per capita for health care than anyone else.  The way they have their system set up is dumb by design, because the corporations run the country.  And the way the teabaggers get controlled like puppets and spout all kinds of ridiculous bs would be hilarious if what they were saying weren't so hateful.

So from that sense, without being smug about it, you're right.  There's no reason to expect any critical Canadian to get caught up in all the celebration of this super amazing wonderful victory that compares so inadequately with our own health care system.  Definitely some of the people crowing about how historic this just don't know any better.  They don't know much about health care in other countries.

But we know far less about the political reality on the ground.  Here's a video from anti HCR rally:

http://www.youtube.com/watch?v=gFOnG9a1Pzw

The sense I get, solely from online activity, is that health care activists in the states are behind this bill, and while they're aware it isn't real reform it is most definitely a step in the right direction.

32 million people is the USA will have health care who didn't.  That's 1/10 of their population.

Statement today from Physicians for a National Health Program, representing 17,000 physicians:

Health bill leaves 23 million uninsured

I have a small request:

Would everyone please, please start using the bloody [ quote] function? Many of these posts are incomprehensible, composition-wise. (That is, in addition to and above the usual incomprehensible Obama worship.)

i agree with George  - Unionist and Michelle are arguing as if it's all a game of Politicos proving their purity of principles.  It's about 32 million real people who will be covered.

Where is the Obama  worship in this thread?

Federal Insurance Rate Regulation Dropped From Bill To Meet Reconciliation Rules By Susie Madrak Sunday Mar 21, 2010 4:00pm

Clearly, passing this health-care bill is just the beginning, because it doesn't really contain strong regulatory powers [103]. It was pulled under reconciliation rules, and Obama reportedly will try to introduce it later:

WASHINGTON -- A Democratic plan for new federal power over health insurance rates was dropped Thursday from the final health care bill, squeezed out by the way the Democrats are pushing the bill through Congress.

Rolled out with fanfare just weeks ago, the Democratic plan was a response to double-digit rate increases proposed by health insurance companies in California and elsewhere.

It was first proposed by Sen. Dianne Feinstein, D-Calif., then picked up by President Barack Obama.

It would have given the federal government the power to reject proposed rate increases. It also would have allowed the secretary of health and human services to order insurance companies to give back part of premiums if the government decided that the companies spent too much of their incomes on salaries or advertising.

http://crooksandliars.com/susie-madrak/federal-insurance-rate-regulation-dro [104]

ObamaCare may not sound progressive to some, but the United States is not Canada, and they have an extreme independent streak, and that streak extends down to being proud of whatever private health care they can afford. Of course that overlooks the 30-million-plus without basic health care other than welfare-provided, but that leaves more than 300 million under private health care plans, so ObamaCare has an enormous hurdle to overcome just getting out of the gate. I think we should be encouraging Obama, because he's made a start towards universality, which is probably more than presidents all the way up to Bush ever did.

Yes, we don't care about those 32 million people, right?

As someone who has spent most of her life (up until the last five years or so) in extremely low-paying jobs without benefits, I'm pretty sure I'd have been one of those millions of people without health care had I lived in the US, because I know I certainly couldn't have afforded to buy my own plan.

So in order to think about this clearly, I've been trying to put myself into the place of one of those people who are uninsured, knowing it could have been me had I not had the lucky break I did in geography when I was born.

I'm trying to imagine myself suddenly being faced with being forced to spend ten percent of my income on a shitty insurance plan from a private company that will jerk me around every time I try to claim anything.  (I can't even imagine shelling out 10 percent of my income NOW, and my budget was a lot tighter then than it is now.) 

I know an American with a "Cadillac" plan - and even those ones involved a bunch of red tape and wrangling to get them to pay out.  I can only imagine what the poverty plans will be like.

I'm thinking about people who are going to be majorly ripped off by this.  And there's no choice now - you either pay ten percent of your income to a private insurance company for crappy coverage, or you get fined.  Plus you have to pay all the deductibles anyhow, and whatever else the crappy plan doesn't cover.

I think I might be rather upset were I one of those 32 million people right now, who thought they might get a public option but instead are being forced to buy a rip-off plan.

I understand your sentiments, but according to the CNN analysis I heard earlier today,  those 32 million are able to choose which plan they want, and also have access to a new government-sponsored Group Purchase Plan to help them get adequate coverage, in addition to tax breaks that make it more affordable. No one has said this is perfect, it's just a tiny baby-step towards something better.

In 2013, I believe, there will be a publicly provided plan that people can pay into - so they're really not being forced to buy "private shitty plans".

As for the fine, it doesn't apply to the unemployed or people who can't afford insurance - it only applies to those who don't want to pay, not those who can't pay.

The fact is that people are still left to fend for themselves in social reproduction. It is still about the individual making market choices for their health, and the ability for insurers to profit from individuals paying into the system. This is about as forced as paying for shelter and being castigated by the state for being homeless. The state will treat them with punitive measures for failing to make good market-choices. The poor are left to pay for services for profit, unless they qualify. In that case they get subsidies it will be like renting a slum house on a Section 8 voucher. The landlord (or insurance company, if you're still following me) still makes a profit off the state's subsidy, regardless of whether they provide a quality service to the tenant who deserves nothing more than a slum house.

That's a lot of faith in the US system. You know that war/security surveillance companies manage the social assistance programs in the US? You know that the equivalent of a "terrorist" in the welfare system is a "convict" or a "welfare queen". We will find out who is forced to pay and who is covered by the subsidy in due time. I can guarantee you that there will be a crackdown on the so-called "welfare terrorists" when the monitoring system for healthcare is up and running, and there ain't going to be a check in the mail to the insurance company for them!

Over here.