Where's the Outrage?

I’m extremely pleased to have Barbara O’Brien, who has written on many progressive blogs (Crooks and Liars, Mahablog and AlterNet), offer to post on mine. I’m thrilled. Enjoy -

Many politicians and pundits warned us that the health care reform (HCR) legislation that just became law will destroy America. Government bureaucrats will take over health care decisions, we were told. The old and infirm would be hauled away by death panels. Everything about the way we receive our medical care will change, and change drastically, they said.

Medicare recipients have been frightened by stories that their benefits will be cut. Middle-age people are worried they will lose their jobs when the law’s dreaded regulations, or taxes, or maybe regulations with taxes, would destroy their employers’ businesses.

The truth is, very little will change for most people. If you were insured by employee benefits before HCR, you will be insured by exactly the same policy in exactly the same way after HCR. You will have access to the same doctors on the same terms. “Government bureaucrats” will no more be involved in your health care than they were before.

And the same is true of Medicare, which of course is a government program, although many of the people who opposed the HCR bill don’t seem to know that.

Here are the “cataclysmic” changes to health care that are now in effect, or which will go into effect within the next six months for people who are already in group insurance plans:

• The law says you can’t lose your insurance coverage because you get sick. Before, in many states, if you were stricken with a severe illness such as mesothelioma cancer that would be expensive to treat, your insurer could use just about any excuse to cancel your coverage. That is over.
• HCR has ended lifetime limits on coverage. As long as you are receiving medical care, your insurer pays the bills.
• Your children can be covered on your existing policy until they are 26 years old.
• In six months, insurers cannot refuse to insure people under the age of 19 because of “pre-existing conditions.” This provision will go into effect for everyone in 2014.

And if you are on Medicare, you will be asked to struggle with the following:

• You get a free annual checkup.
• The co-pays and deductibles on many preventive care services are eliminated.
• If you are in the Medicare D “doughnut hole,”  you will get a $250 rebate check in a few weeks. The hole itself will be closed gradually and will be gone by 2020.

But what about all those terrible regulations and taxes that are about to drive businesses out of business? Um, there really isn’t much to report. Oh, wait, here’s one — a 10 percent tax on indoor tanning services that use ultraviolet lamps will go into effect July 1. That’s about it.

However, beginning this year a tax credit will be available for some small businesses to help provide insurance coverage for employees.

Soon the politicians and pundits will start trying to frighten you about the provisions that will go into effect after this year. I assure you they are about as scary as the provisions that go into effect this year, but I will discuss them in a follow-up post.

— Barbara O’Brien

Tags: Healthcare by ecthompson md
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President Barack Obama went to Iowa for a pep rally, selling the Healthcare Plan and reminding the base that there is more work to do. He gave a great speech that combines information on what the healthcare bill will deliver right now and the inspiration to keep fighting for progress.

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Tags: Healthcare, Obama administration by ecthompson md
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I am not the first (and hopefully not the last) to express my own outrage over the recent violence toward many some members of Congress. The violence has been directed at their offices for the most part. I am deeply saddened by the fact that we cannot have a reasoned and thoughtful discussion in this country without its deteriorating into name-calling, finger-pointing and then violence. We have some significantly serious problems facing us today. The solutions to these problems will require us to change something — our habits, our consumption, our work environment, etc. We have been sitting on our ever-expanding rear ends and simply watching problems with our electrical grid, our crumbling infrastructure, our deteriorating educational system, our need for election reform while they get worse and worse. So, we can ignore the middle class, which should be the largest segment and the backbone of our society, as it continues to shrink. Millions of Americans slide into the lower-class category as wages stagnate and benefits are cut. We can ignore all the warning signs or we can confront our problems. We can sit down and have thoughtful, vigorous and reasonable discussions. We can come up with solutions and then try and implement them, understanding that we will not agree on everything. Yet, our disagreement should never deteriorate into violence. We will lose some discussions. We will win some discussions. That is the way our democracy works. That’s the way our democracy should work.

Watch the video:

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From Political Animal:

• Done deal? “President Obama and his Russian counterpart, President Dmitri A. Medvedev, have broken through a logjam in their arms control negotiations and expect to sign a new treaty in Prague next month that would slash American and Russian nuclear arsenals, officials from both nations said Wednesday.”
• U.S. housing market still struggling.
• Not helpful: “With strains still high between Israel and the United States over the issue of Jewish settlements, construction of a contentious Jewish housing project in a predominantly Arab neighborhood of East Jerusalem could start at any time, Israeli officials and experts said Wednesday.”
• Improved prospects for financial industry reform?
• As promised, President Obama signed that executive order today on abortion funding.
• Today’s must-read: “For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.”
• Funny, I didn’t realize Republicans would be able to parse “full repeal.”
• What’s in the new health care law? The White House puts together a compelling list.
• Brian Beutler puts together a wild list of the 10 most ridiculous GOP-proposed health care amendments.
• Virginia Attorney General Ken Cuccinelli (R) should probably offer taxpayers a hint as to how much of their money he’ll waste challenging health care reform. (Ed. I talked about the constitutionality of healthcare reform a couple weeks ago.)
• The Wall Street Journal makes very odd editorial decisions.
• Winners in the fight over student loan reform.
• And Justice Ruth Bader Ginsburg wants everyone to know, “I am pleased to report that, contrary to Sen. Bunning’s prediction, I am alive and in good health.”

Tags: Healthcare, Legal, Obama administration, Party Politics, Rachel Maddow Show by ecthompson md
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This video takes Will I am’s great video and splices in House minority leader John Boehner’s Hell No, You Can’t.

Tags: Healthcare, Music, Party Politics by ecthompson md
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Questions

From Speaker Pelosi:

Under the legislative package the House passed on Sunday (the Senate-passed health bill as amended by the reconciliation bill) many key provisions take effect this year – here are some of them:

IF YOU ARE A SMALL BUSINESSES OWNER:

SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available. Effective beginning for calendar year 2010. (Beginning in 2014, small business tax credits will cover 50 percent of premiums.)

IF YOU ARE A SENIOR:

BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand-name drugs in the donut hole; also completely closes the donut hole by 2020.)

FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

HELP FOR EARLY RETIREES—Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment.

IF YOU HAVE PRIVATE HEALTH INSURANCE:

NO DISCRIMINATION AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to adults as well.)

NO RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.

NO LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.

NO RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)

FREE PREVENTIVE CARE UNDER NEW PLANS—Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. Effective 6 months after enactment.

NEW, INDEPENDENT APPEALS PROCESS FOR NEW PLANS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions. Effective 6 months after enactment.

MORE FOR YOUR PREMIUM DOLLAR—Requires plans to put more of your premiums into your care, and less into profits, CEO pay, etc. This medical loss ratio requires plans in the individual and small group market to spend 80 percent of premiums on medical services, and plans in the large group market to spend 85 percent. Insurers that don’t meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

NO DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

IF YOU DON’T HAVE HEALTH INSURANCE:

IMMEDIATE HELP FOR THE UNINSURED WITH PRE-EXISTING CONDITIONS(INTERIM HIGH-RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition – through a temporary high-risk pool – until the Exchanges up and running in 2014. Effective 90 days after enactment. (Beginning in 2014, health plans are banned from discriminating against all people with pre-existing conditions, so high-risk pools would phase out).

EXTENDING COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.

GENERAL REFORMS:

COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly doubling the number of patients served over the next 5 years. Effective beginning in fiscal year 2010.

MORE PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

HEALTH INSURANCE CONSUMER ASSISTANCE—Provides aid to states to establish offices of health insurance consumer assistance to help consumers file complaints and appeals. Effective beginning in FY 2010.

A NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

And in 2014, once the exchanges have formed, more insurance reforms go into effect, including:

NO DISCRIMINATION AGAINST ADULTS WITH PRE-EXISTING CONDITIONS

BAN ON HIGHER PREMIUMS FOR WOMEN

PREMIUMS BASED ON AGE CAN ONLY VARY BY A MAXIMUM OF 3-TO-1 RATIO

CAP ON OUT-OF-POCKET EXPENSES for private health plans

Tags: Healthcare by ecthompson md
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By a vote of 219-212, the House of Representatives has passed health-care reform. This brings almost universal coverage to the United States. President Obama praised Nancy Pelosi and Steny Hoyer, along with many others, for getting this bill through.

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Representative John Boehner could not help himself. He was the one who earlier called for decorum. Of course, he was the one who breached it. In a last-ditch effort, he tried to stir up the passion of doubt and those wavering Democrats. I think you’re being more than disingenuous when he suggested there were backroom deals in a bill that has been available on the Internet for months. He couldn’t resist bringing up publicly funded abortions. Who is surprised?

So, after the Senate passes this legislation, which is not a done deal, what can the American people expect? Unfortunately, the answer is not clear. No matter how great legislation is, it is the implementation of that legislation that will determine the impact on Americans. It is up to the Department of Health and Human services. Overall, I think that this is going to be an excellent piece of legislation for all Americans.

Tags: Healthcare, House of Representatives, Obama administration by ecthompson md
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Good Morning!!

• Healthcare Reform updates here and here. We are really, really close.
• House Minority Leader John Boehner (Republican — Ohio) told bankers last week to fight financial reform and stand up to “little punk staffers.” Yesterday, Representative Barney Frank handed out buttons to many Capitol Hill staffers which read, “Little Punk Staffer.”
• The racism and homophobia that is rampant in the Tea Party Movement was on display once more on Saturday. This cannot be what America is about. I do appreciate the Tea Partiers for showing America who they really are.
• Representative Tim Ryan took to the floor of the house to denounce the ugly slurs. Good for him. Watch below:

• Glenn Greenwald points out the hypocrisy of Glenn Reynolds, who called for Israel to bomb Iran and cause as much trouble for Russia, China and the United States as possible. Wouldn’t this be treason? If you incite another country to take actions which causes America to take military action, isn’t that treason? I’m just asking.
• Police in Aruba are following up a possible lead which may lead to solving the mystery of Natalee Holloway ‘s death.
• Do you have old video games? I mean from the early 1990s? They could be worth a lot of money.
• While I find it impossible to keep up with March Madness, there are somewhere around 1000 games played over two weeks. Who’s got time to watch all of them? Well, somebody does. Whether you love basketball a lot or can barely stand it, everybody has to cheer for Northern Iowa. The Northern Iowa Panthers have knocked off the number one seed Kansas Jayhawks. The Jayhawks looked incredibly good all season. Almost everybody had been going to the final four. Outstanding performance by Northern Iowa!!

Tags: Healthcare, Party Politics, Race, Sports by ecthompson md
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Unfortunately, as with many things, the poorest aren’t getting what they need. It is the poorest that can benefit the most from this vaccine.

From USA Today:

Mississippi and Arkansas, two of the nation’s poorest states, also have the highest death rates from cervical cancer — a result of poor access to basic screenings and health care for a large number of women, says Peter Bach of New York’s Memorial Sloan-Kettering Cancer Center.

HUMAN PAPILLOMAVIRUS, OR HPV, CAUSES …

• 100% of cervical cancers
• 90% of anal cancers
• 40% of vulvar and vaginal cancers
• 12% of throat cancers
• 3% of oral cancers

Source: The New England Journal of Medicine

Yet in Mississippi, where the vaccine could perhaps save the greatest number of lives, only 16% of teen girls in 2008 received the shot, called Gardasil, according to Bach’s paper in Saturday’s The Lancet. About 22% of Arkansas girls ages 13 to 17 got the vaccine, which costs $390 for three shots.

In the wealthier state of Rhode Island, where cervical cancer mortality is half as high as in Mississippi and Arkansas, 55% of girls received Gardasil, the paper says. Though there’s nothing wrong with wealthier girls getting the vaccine, Bach says, the low vaccination rates in poor states are “a failure.”

The Food and Drug Administration approved Gardasil in 2006 and another vaccine, Cervarix, in 2009. Both block infection with the cancer-causing human papillomavirus, or HPV.

Merck spokeswoman Pamela Eisele says the company has several programs to help poor women afford the shots.

Low-income girls also can get free vaccines from the federal Vaccines for Children program, says Lance Rodewald of the Centers for Disease Control and Prevention. Partly because of that program, 46% of girls in households with incomes below the poverty level received at least one HPV shot in 2008, compared with 36% of those above poverty level. The federal poverty level is $22,050 for a family of four, according to the Department of Health and Human Services.

But women’s health activist Barbara Brenner of Breast Cancer Action says Bach’s study highlights broad inequalities in American health care. “There are places in this country where women have nothing,” Brenner says. “But we don’t notice them until a story like this comes out.”

Tags: Healthcare by ecthompson md
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We need to call, e-mail or fax these guys:

From TPM:

As the Democrats’ push for health care reform enters the home stretch this weekend, we’ve got our eyes on a small number of key undecided Democrats. The fate of health care reform largely rests in their hands. House Speaker Nancy Pelosi needs 216 votes to pass the Senate’s health care bill in the House — and she doesn’t have them yet.

Here’s our rundown on the key votes that are still in play. We’ll be updating the list as these Democrats declare their intentions.

As of 6:19 PM ET March 19:

Undecided Dems Who Voted ‘No’ On The House Health Care Bill

John Tanner (D-TN), Brian Baird (D-WA), Jim Matheson (D-UT), Glenn Nye (D-VA), Harry Teague (D-NM), Rick Boucher (D-VA)

Undecided Dems Who Voted ‘Yes’ On The House Health Care Bill

Many of the undecideds who previously voted “yes” are comprised of pro-life Democrats who are leery of the Senate bill’s abortion language and are led by Rep. Bart Supak (D-MI).

-Easy to get Stupakers: Kathy Dahlkemper (D-PA), Henry Cuellar (D-TX)

-Hard to get Stupakers: Marion Berry (D-AR), Jerry Costello (D-IL), Joe Donnelly (D-IN), Steve Driehaus (D-OH), Marcy Kaptur (D-OH), Dan Lipinski (D-IL), Bart Stupak (D-MI)

(While Costello, Donnelly, Driehaus, Lipinski and Stupak have all declared their opposition to the Senate bill’s abortion provisions, their votes still may be in play)

Several key House Democrats have already flipped. Reps. Scott Murphy (D-NY), Suzanne Kosmas (D-FL),Allen Boyd (D-FL), John Boccieri (D-OH), Bart Gordon (D-TN), Dennis Kucinich (D-OH) and Betsy Markey (D-CO) have all switched from “no” to “yes.”

And Reps. Michael Arcuri (D-NY) and Stephen Lynch (D-MA) are switching from “yes” to “no.”

Rep. Jason Altmire (D-PA), who voted “no” on the House bill but was undecided on the Senate bill, has alsoconfirmed he’s still a “no.”

And Rep. Brad Ellsworth (D-IN), a Stupaker who voted “yes” on the House bill but was undecided on the Senate bill, has confirmed he’s still a “yes.”

Follow all the latest developments at our Countdown to Reform Wire.

Update Feed

6:19 PM ET March 19: Rep. Scott Murphy (D-NY) switches from “no” to “yes.”

5:28 PM ET March 19: Rep. Brad Ellsworth (D-IN), a Stupaker who voted “yes” on the House bill but was undecided on the Senate bill, confirms he’s still a “yes.”

5:25 PM ET March 19: Rep. Suzanne Kosmas (D-FL) switches from “no” to “yes.”

4:40 PM ET March 19: Rep. Jason Altmire (D-PA), who voted “no” on the House bill but was undecided on the Senate bill, confirms he’s still a “no.”

4:08 PM ET March 19: Rep. Allen Boyd (D-FL) switches from “no” to “yes.”

11 A.M. ET March 19: Rep. John Boccieri (D-OH) switches from “no” to “yes.”

Tags: Healthcare, Obama administration by ecthompson md
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I’m not an economist, I don’t play one on TV and I didn’t stay at a Holiday Inn Express last night. I do know that these guys are smart. They are economists and non-partisan.

From Ezra:

My colleague Neil Irwin has a very good piece on the difficulty the Congressional Budget Office has predicting the cost of something complex like the health-care reform bill. But because his piece is coming in the context of a coordinated conservative effort to discredit the CBO’s analysis of the health-care reform bill, it’s worth making a couple of points.

First, be very careful with any criticism of CBO that seems to be merited by a particular score rather than a particular methodological difficulty. To put that slightly differently, does anyone think that conservatives would be squawking if CBO had disappointed Democrats by saying the bill would save less money than either the House or Senate incarnations? If not, then keep in mind that this is a political, not technical, dispute. To establish my own credentials on this, here’s thepost I wrote defending the CBO when liberals were arguing that it was underestimating health-care reform’s savings.

Second, don’t confuse uncertainty with bias. It’s true that the CBO’s estimates of the health-care reform bill are uncertain. But that cuts both ways. A lot of very respected health-care economists and experts think the CBO is being way too conservative in how much the bill’s payment reforms will save. Historically, CBO has frequently underestimated the savings from health-care reform legislation. To use one example, they heavily overestimated the cost of the Medicare Prescription Drug Benefit. More examples here.

Third, some argue that the problem with CBO’s estimates is that they can’t control for Congress. The actual evidence shows that Congress ismuch better at sticking to tough cost controls than people give them credit for. But beyond that, if Congress can’t do hard things, then everyone is screwed. Conservatives, who strongly believe in entitlement reform, are perhaps in the worst shape as that’s the hardest thing to do. Moreover, the health-care bill has the Medicare Commission, which explicitly makes it easier to do hard things because it takes some of the power away from Congress and gives it to independent experts. If you think Congress is the problem here, then this bill is the best answer anyone has yet come up with. (more…)

Tags: Economy, Healthcare by ecthompson md
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The more things change…

From Robert Reich, former Secretary of Labor under Clinton:

Health care reform is necessary, and House Democrats should vote for it because it’s best for the nation.

They should also remember the political lessons of history. To paraphrase Mark Twain, history doesn’t repeat itself but it does rhyme. As the White House and the House Democratic leadership try to line up 216 votes to pass health care reform — and as Republicans, aided by the National Association of Manufacturers and abetted by fierce partisans like Newt Gingrich, try to kill it – I can’t help thinking back to 1994 when the lineup was much the same.

I was serving in the Clinton administration at the time. In the first months of 1993 it looked as if Clinton’s health care proposal would sail through Congress. But the process dragged on and by 1994 it bogged down. We knew health care was imperiled but none of us knew that failure to pass health care would doom much of the rest of Clinton’s agenda and wrest control of Congress out of the hands of the Democrats. In retrospect, it’s clear Republicans did know.

On February 5, 1994, the National Association of Manufacturers passed a resolution declaring its opposition to the Clinton plan. Not long after that, Michigan Democrat John Dingell, who was managing the health care bill for the House, approached the senior House Republican on the bill to seek a compromise. According to Dingell, the response was: “There’s no way you’re going to get a single vote on this [Republican] side of the aisle. You will not only not get a vote here, but we’ve been instructed that if we participate in that undertaking at all, those of us who do will lose our seniority and will not be ranking minority members within the Republican Party.”

In early March, 1994, Senate Republicans invited Newt Gingrich, then House minority leader, to caucus with them about health care. Gingrich warned against compromise, a view echoed by Senator Phil Gramm. A few months later, at a Republican meeting in Boston, Bob Dole, then Senate minority leader, promised to “filibuster and kill” any health care bill with an employer mandate.

By then Gingrich had united House Republicans against passage of health reform and told the New York Times he wanted “to use the issue as a springboard to win Republican control of the House.” Gingrich predicted Republicans would pick up thirty-four House seats in the November elections and half a dozen disaffected Democrats would switch parties to give Republicans control. [Read more →]

Tags: Healthcare, Party Politics by ecthompson md
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15 or 16 months ago, many people began to ask me if Obama was a shoe-in to win the presidency. I pointed out that Democrats find ways to fumble the ball just before the goal line. I had an uneasy feeling for two weeks before the election. Even on election night, as every major state was going towards Obama, I still had that queasy feeling. Now, reports are coming in that health-care reform is in the bag. The Democrats have found a way to pass everything they need to pass in order to get a bill to President Obama within the next week. Everything is a green light. Not so fast. I’m getting that queasy feeling again.

From TPM:

Whoops! The votes aren’t there in the House

While this would kill reform in swift fashion, it’s also the least likely scenario. House Democrats aren’t going to bring a bill to the floor they don’t have the votes to pass. But where they could run into trouble is if rank-and-file Democrats start to buy into Republican claims that the procedure leadership chooses for getting the bill done isn’t fair or smacks of a backroom deal. Yesterday, Rep. Jason Altmire (D-PA) suggested as much.

Whoops! The votes aren’t there in the Senate

They only need 50 plus Vice President Joe Biden to break a tie, but as we’ve seen in this yearlong fight it is not always that easy. Several Senate Democrats have expressed reservations over the next vote. They’re probably close to it, but sometimes those whip counts aren’t as robust as they initially seem. This will be a critical question in the coming days.

Sens. Blanche Lincoln (D-AR) and Evan Bayh (D-IN) have already pushed back from the table, and others could follow. Lincoln already said she doesn’t like the procedural moves in the House. Bayh is retiring and could throw a wrench in the plans and insist the Senate have a bipartisan bill. He also has complaints about the student loan provision that might be included in the final product. (See below) Then again, Sen. Olympia Snowe (R-ME) could always come back into the fold.

I asked Rep. Barney Frank (D-MA) about this earlier, and he scolded me and the rest of the press for looking for problems when things look so certain. But he did concede that there was “no question” the Senate has the votes to pass the reconciliation measure and that “there would be no way for this to happen” without Senate leadership giving reassurances to frazzled House Democrats who don’t always trust the upper chamber.

Parliamentary problems

The bigger risk is something we’ve been writing about a lot in recent weeks. It is not clear that the Senate parliamentarian will agree that the bill the House Democrats will reveal any minute actually fits within the narrowly tailored reconciliation rules.

The White House helped craft that measure with those reconciliation rules in mind, but anything is possible and Republicans say they are going to raise points of order against as many elements as they can. They aren’t likely to win those battles, but it puts the brakes on momentum. Sen. Kent Conrad (D-ND) told Brian earlier today he isn’t sure that everything in the bill will pass the reconciliation test.

Student loans, in a health care bill?

Rep. George Miller (D-CA) is chairman of the Education panel and is going full-speed ahead at including student loan reforms in the final reconciliation package. It’s a popular measure with some GOP support that sweetens the vote on health care – in the House. It originally passed 253-171, with six Republicans voting for it. Democrats tell me that so far they aren’t sure the votes are there in the Senate. Wary aides said they fear a repeat of the process that played out in the Senate last fall, with individual senators having the ability to gum up the works and every vote is critical. One aide told me that element “complicates the math” in the Senate.

Expect the unexpected

Blumenauer had it right, anything is possible with Congress. Unexpected retirements, illness or scandal have the potential to change the numbers need to pass a bill at any moment.

As the Democrats race the clock before Obama leaves on an (already delayed) international trip to Indonesia, Guam and Australia Sunday, there’s also the possibility the timing might not work out. The Daily Caller’s Jon Ward had a piece today with Democrats suggesting Obama shouldn’t be too celebratory about the vote in the House this weekend before he boards Air Force One. Rep. John Conyers (D-MI) warned that the American people can’t think the health care fight is over, since the bill would head over to the Senate before it’s passed in its final form.

Tags: Congress, Healthcare, Obama administration by ecthompson md
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I’m going to work. More later -

From Political Animal:

• Mexico: “President Barack Obama is ‘deeply saddened and outraged’ at news of the murders of a federal employee and two relatives of workers at the U.S. consulate in Ciudad Juarez, Mexico, an administration spokesman said.”
• Netanyahu is sorry U.S. officials are upset, but Israel isn’t changing course: “In the face of sharp American disapproval of an Israeli plan for an East Jerusalem building project, Prime Minister Benjamin Netanyahu firmly rejected Monday any curbs on new Jewish settlements in and around Jerusalem.” (ed. This is a big deal. This is a very big deal.)
• And predictably, GOP leaders are attacking the Obama administration for being unhappy with Israel. (ed. the knee jerk reaction of conservatives is nauseating but what is worse is that democrats are apologizing for standing strong and asking Israel how are more settlements helpful?)
• Step one is done: the House Budget Committee voted 21 to 16 this afternoon to send the final health care reform package to the House Rules Committee. Two Blue Dogs — Texas’s Chet Edwards and Florida’s Allen Boyd — voted with Republicans. Both voted against reform in November.
• Senate Banking Committee Chairman Chris Dodd (D-Conn.) kicks off his initiative to reform the way Wall Street does business. The White House is pleased. More surprisingly, Elizabeth Warren seems to like the plan, too.
• Good to see industrial production edge up.
• Eyeing an overhaul of No Child Left Behind.
• Student aid bill “hobbles forward.”
• Fantastic interview with Supreme Court Justice John Paul Stevens from Jeff Toobin. Of particular interest: Stevens will retire before the end of Obama’s first term.
• Fareed Zakaria on the success of Obama’s approach to Pakistan.
• After Rep. Dennis Kucinich’s (D-Ohio) votes against health care, against the hate crimes bill, against the Democratic budget, against the cap-and-trade bill, and against financial regulation, Nate Silver considers the liberal lawmaker’s value to the Democratic Party.
• Utah’s House Republican majority leader resigned in the wake of his under-age, hush-money, hot-tub scandal. Probably a good idea.
• Fact Checking the Sunday Shows.
• Harry Reid issued a statement today, noting that he still expects his wife to make a “full recovery.” (ed. I’m happy for Reid and his family. Both his wife and daughter were in a serious car crash on Thursday.)

Tags: Economy, Healthcare, Israel, Legal, Obama administration, Pakistan by ecthompson md
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I have a feeling that Glenn is probably correct on this. It was easy to point at the R’s and say they won’t play fair. This is what the Dems have done. We could pass healthcare reform if it weren’t for the big, bad Republicans. We have 54 or 55 votes. Well, now it is time to put up or get voted out of office.

From Glenn:

A couple of weeks ago, I wrote about what seemed to be a glaring (and quite typical) scam perpetrated by Congressional Democrats:  all year long, they insisted that the White House and a majority of Democratic Senators vigorously supported a public option, but the only thing oh-so-unfortunately preventing its enactment was the filibuster:  sadly, we have 50 but not 60 votes for it, they insisted.  Democratic pundits used that claim to push for “filibuster reform,” arguing that if only majority rule were required in the Senate, then the noble Democrats would be able to deliver all sorts of wonderful progressive reforms that they were truly eager to enact but which the evil filibuster now prevents.  In response, advocates of the public option kept arguing that the public option could be accomplished by reconciliation — where only 50 votes, not 60, would be required — but Obama loyalists scorned that reconciliation proposal, insisting (at least before the Senate passed a bill with 60 votes) that using reconciliation was Unserious, naive, procedurally impossible, and politically disastrous.

But all those claims were put to the test — all those bluffs were called — once the White House decided that it had to use reconciliation to pass a final health care reform bill.  That meant that any changes to the Senate bill (which had passed with 60 votes) — including the addition of the public option — would only require 50 votes, which Democrats assured progressives all year long that they had.  Great news for the public option, right?  Wrong.  As soon as it actually became possible to pass it, the 50 votes magically vanished.  Senate Democrats (and the White House) were willing to pretend they supported a public option only as long as it was impossible to pass it.  Once reconciliation gave them the opportunity they claimed all year long they needed — a “majority rule” system — they began concocting ways to ensure that it lacked 50 votes.

All of that was bad enough, but now the scam is getting even more extreme, more transparent.  Faced with the dilemma of how they could possibly justify their year-long claimed support for the public option only now to fail to enact it, more and more Democratic Senators were pressured into signing a letter supporting the enactment of the public option through reconciliation; that number is now above 40, and is rapidly approaching 50.  In other words, there is a serious possibility that the Senate might enact a public option if there is a vote on it, because it’s very difficult for these Senators to vote “No” after pretending all year long — on the record — that they supported it.  In fact, The Huffington Post‘s Ryan Grim yesterday wrote:  ”the votes appear to exist to include a public option. It’s only a matter of will.” (more…)

Tags: Healthcare, Obama administration, Party Politics by ecthompson md
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This is really neat. It clearly shows what people are worried about and what they are thinking.

From 538:

Gallup did something pretty cool in connection with their latest health care survey, which was to provide the verbatim responses (.xls) of the rationales given by people who would tell their Congressman to vote for or against the current health care bills, respectively.

I ran the responses through Wordle, a word-cloud generating tool, omitting certain words that were parts of speech or were otherwise nongermane.

Here are the words that were used most frequently by the 45 percent of the country who would tell their Congressman to vote for the health care bill:

And here are the words used most commonly by the 48 percent of the country who would tell their Congressman to vote against it:

In some sense, this is a very old-fashioned debate about the proper role of government. The message that the pro-reform voters have taken away comes through loudly and clearly: ‘PEOPLE … NEED … INSURANCE’, whereas concerns among the anti’s boil down to ‘GOVERNMENT’ and ‘COST’.

Tags: Congress, Healthcare, Party Politics by ecthompson md
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I’d like to start with last Friday’s Bill Moyers Journal. Wendell Potter was his first guest. Mister Potter used to work for the insurance industry and has since had an epiphany. Although Mister Potter points out some flaws in the bill, he would vote for it. Moyers’ next guest was truly explosive. Doctor Marcia Angell is one of the representatives of physicians for a national healthcare program. She opens up on the current health-care bill in the Senate with both barrels. She is thoughtful, critical and informed. You can find the video — here. You can find the complete transcript — here. Below is a portion of what she had to say -

BILL MOYERS: But given that, why have the insurance companies, health insurance companies been fighting reform so hard?

MARCIA ANGELL: Oh, they haven’t fought it very hard, Bill. They really haven’t fought it very hard. What they’re fighting for is the individual mandate. And if they get that mandate, if everyone does have to buy their commercial products, then they’re going to be extremely happy with it.

BILL MOYERS: But this is all about politics now. It’s not about pure health care reform. So given that reality, what would you have the President do?

MARCIA ANGELL: Well, I think you really do have to separate the policy analysis from the political analysis and I’m looking at it as policy. And it fails as policy. Moreover, a lot of people say, “Let’s hold our nose and pass it, because it’s a step in the right direction.” And I say it’s a step in the wrong direction.

You’re right. Politics is different and there are a lot of people who say, “Look, it’s a terrible bill. Even a step in the wrong direction as policy goes. But we need to get Obama elected again and we need to continue with the Democratic majority in Congress. And so we need to give Obama and the Democrats a win. If we don’t, the Republicans will come in and take over Congress in the fall, and then the White House in 2012. But the problem with a political analysis is sometimes you’re right and sometimes you’re wrong. And Democrats and particularly liberals have a history of outsmarting themselves.

And I’m not so sure that if this bill goes down, it’s going to make it any harder for them politically. So I think it’s difficult times for the President and for the Democrats. But if you look at it as a matter of policy, the President’s absolutely right that the status quo is awful. If we do nothing, costs will continue to go up. People will continue to lose their coverage. Employers are dropping health benefits. Things will get very bad. The issue is will this bill make them better or worse? And I believe it will make it worse.

Currently, I would hold my nose and vote for this bill. I would work through the progressive movement to try to change the dynamics in Congress. Until the dynamics are changed, I don’t think we can get a better bill through Congress.

Representative Eric Cantor was on Meet the Press last Sunday. He had a few things to say about Medicaid. “The problem is with the president’s bill, it’s about expanding Medicaid. No one wants to, to go onto Medicaid. That’s why physicians in Florida and other states are leaving Medicaid in droves because of the imperfect reimbursement structure.” What I truly love about this statement is that Representative Cantor pretends that the reimbursement structure is because of something else or someone else. Republicans have been cutting physician reimbursement since the mid-1980s. Democrats jumped on the bandwagon sometime later. So it’s completely disingenuous for him to say the problem with the bill is that we are cutting physician reimbursement. He has the power to change that.

I’m really not going to spend much time talking about Eric Massa, because he is more of a side bar or distraction to real health care reform. He is the car crash on the side of the road that everybody stops to look at. You can read more about his craziness — here and here. From a healthcare standpoint, former Representative Massa stated that the Democratic leadership were pushing him out because he voted no against health-care reform. This seems to be completely false with no evidence to support it.

Representative Alan Grayson introduced a bill in the House supporting the public option. The bill basically allows the public to buy into Medicare at the existing cost of Medicare. This would give Americans the choice of buying into Medicare or simply buying private insurance. Personally, I think this is a good idea. It gives Americans options, but it is not the final solution.

Senator Bernie Sanders (Independent from Vermont) stated on Thursday that he was prepared to introduce an amendment introducing the public option into the Senate bill.

House Speaker Nancy Pelosi announced that there will not be a public option in the final bill. This is the politics of reform. This is the House and the Senate trying to get a complex piece of legislation passed. There’s been a lot of reporting that the House does not trust the Senate. The Senate has made promises in the past and yet somehow it’s not been able to pass the legislation promised.

Since Rachel Maddow spent a good deal of her show talking about it, I figured I should talk a little bit about Representative Bart Stupak. Mister Stupak is a Democratic representative from Michigan who has tried single handedly to hold up the health-care legislation because of its abortion language. Rachel does a great job trying to figure out who these 12 congressmen are who agree with it and stand with Bart Stupak. It appears that the 12 congressmen may be only three or four. House Majority Leader Steny Hoyer stated unequivocally that he was not negotiating with Bart Stupak. It appears that he has neither enough congressmen nor enough votes to hold up legislation.

I saved one of the best statements of the week for last. Former Governor Mitt Romney decided that he would let us know that it is ridiculous that people die without healthcare. He said, “Look, it doesn’t make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way.” This is not the first time a Republican has said that anybody can go to emerge room and get excellent care. This is such a crock of garbage. If you have high blood pressure, the best way to avoid complications of that blood pressure is not to go to the emergency room but instead to go to your family doctor. This is how you keep costs down. Regular checkups. Management by the same doctor over a prolonged period of time. One of the great ways to drive costs up is to wait to have a complication then go to the emergency room.

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I would encourage everybody to take a look at HR 676. This bill was introduced by John Conyers months ago. He introduces that almost every legislative session. He’s done so for more than 10 years. This is the United States national healthcare act. This is the single-payer bill.

Tags: Healthcare by ecthompson md
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Do you remember Morris Day, the lead singer of one of the ultimate party groups, The Time? From the darkness, Morris Day would shout, “What Time Is It?” The music would start blaring and the party was on. It is time for health-care reform. It is time for us to have a universal program which covers everybody. We are currently spending 16% of our gross domestic product on health care. Personally, I think spending $2.3 trillion on health care is plenty of money. We should not have to spend any more to get everything that we want. We want access to quality primary care providers. We want these primary care providers to give us better outcomes — a better quality of life and a longer life. We want to be able to go to the drugstore to pick up our prescriptions without having to leave our first born as collateral. If we have an emergency – if we are in a car crash or fall off a roof; if we have a heart attack — we want to be able to be taken to a quality medical center where we can be treated with compassion, dignity and with the latest medical techniques. Why can’t we make this happen?

Last week, we had the rare opportunity to see Republicans and Democrats sit down and discuss a single issue. For over seven hours, we got to see our political leaders argue over healthcare. Yes, there was some political posturing on both sides but one thing should be clear to all Americans. The Democrats have a plan and a passion for health-care reform. Republicans had no plan, but they definitely have passion for stopping health-care reform. From Republican Minority Whip Eric Cantor to Senate Minority Leader Mitch McConnell, not one Republican put together a thoughtful argument that would control the escalating healthcare costs, cover the 45 million people who live in the United States without health insurance, nor a plan that can be taken from Maine to Florida to California.

Democrats, for all of our passion, where is our spine? Democrats are causing me to reach for my Pepto-Bismol especially, those who cannot stand up for healthcare reform.People who follow politics, as I do, have seen for over a year that it is going to be nearly impossible to get 60 votes in the Senate to stop debate on healthcare reform. Therefore, the Senate would need to go to reconciliation to pass health care reform. I talked about this on my radio show back in February of 2009. This summer, Senator Jay Rockefeller made an impassioned speech for the public option. He said it was morally right. It was only a couple weeks ago he said that he did not believe that we should use reconciliation to get health-care reform passed. What? Didn’t he say it was morally right? Senator Rockefeller was 100% correct when he said this was a moral issue. We need to get health-care reform passed.

Meet 11-year-old Marcelas Owens. Watch the video:

I would urge you not to fall for the same old clichés about our government. Government can do this right. We have to get this right. This is as important as landing on Normandy beaches on D-Day. If we want to have money for defense, homeland security, bridges and roads, education and green energy we have to control costs of health care now. Economists have estimated that health care will eat up 25% of our gross national product in 20 years if we don’t do something.

Finally, I’ve been listening to these talking heads on the Internet telling me that Democrats, liberals and progressives are not energized. Someone even suggested that we are depressed. Depressed? From what? I’m not sure who thought electing Barack Obama would be a panacea. I know that I’ve talked about the need for progressives to push harder with a Democratic Congress. We’ve seen Democrats in the past waiver and succumb to the whims of Republicans. We knew this would happen. Deep in our hearts, we knew this was going to be a huge undertaking. Just look at what we’re trying to accomplish – reversing 30 years of Republican rule and ideology (Clinton was the only bright spot). We are trying to reverse 30 years of giveaways to major corporations. We’re trying to put the American citizen ahead of big business. Even Democrats have bought into the ideology that the markets could fix everything. This is an idea that’s been pushed by the Republicans for decades. We have a lot of work to do. President Barack Obama has told us that this is not going to be easy. So, it is time for us to be fired up. Once we get health-care reform passed, we still have more work to do – create a green economy, create millions of green jobs, fix the Patriot Act and concentrate on lasting financial reform that will work for all Americans. We need to write and call our legislators. We need for them to support health-care reform. It is time to get busy.

Tags: Business, Healthcare, Party Politics by ecthompson md
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He is trying to stop all abortions with his bill; at least abortions that aren’t paid for in cash.

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From C&L:

The Rachel Maddow Show did some digging and it appears that Bart Stupak may not actually have all the votes he’s claiming he has to stop the health care bill from being passed in the House. As Rachel also notes, since Stupak’s requests for changes to the bill are either impossible to get passed under reconciliation or just based on lies about what’s even in the bill, it’s pretty obvious that he’s just doing his best to get himself on the television for some face time so he can demagogue the abortion issue and it has nothing to do with the health care debate.

Bart Stupak might come to regret that if Rachel doesn’t let up on the reporting she has done on the C-Street House and The Family. And as Susie noted, he’s now got himself a primary challenger.

You can Send The Democrats A Message They Can Understand and make a donation at Blue America to help Bart Stupak’s challenger Connie Saltonstall among others.

Tags: Healthcare, House of Representatives, Rachel Maddow Show by ecthompson md
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The great pianist and songwriter Billy Preston once sang, “nothing from nothing leaves nothing.” Although over 15 to 16 months I have seen the promise of health care reform start with single-payer and then morph into some sort of public option which, were it robust, should be able to contain health-care costs. This is kind of what the House passed. The Senate, on the other hand, is one confusing mess. Senator Max Baucus was given the keys to the city. I’m not sure what exactly he came up with. As chairman of the finance committee, he was in charge of coming up with a health care bill that was attractive to at least a couple of Republicans. Olympia Snowe and others were courted with sweeteners which seem to have eaten away at the core of health care reform. Senator Kent Conrad decided that he would introduce his own health-care legislation which was some sort of co-op. Although he sold this idea on the Sunday talk shows and pushed it hard for 6-8 weeks, thankfully (hopefully), it is died a quick death.

The public option is been tossed around like a medicine ball. In junior high school, we were asked to throw a medicine ball in order to build up muscle strength and coordination. Every other throw, the ball was dropped, kicked and then picked up and thrown again. This is exactly what has happened with the public option. What was once a robust counterweight to private health insurance has turned into something that states can opt in or opt out of, depending upon the whims of their legislature. Oh, and it seems that opposing healthcare is a great way to get on TV and increase your image/status… as in the case of Bart Stupak.

I have stated both on my radio show and on this blog that health-care reform must include something that is cost-effective, portable and increases access to healthcare. Currently, we are looking at a health-care bill that seems to do none of this. Many progressives have decided that they cannot support this bill. They want something else done. I understand the sentiment. I find this whole process extremely frustrating. Democrats seem to be completely unable to stick to their principles and stand up for the middle class. It seems like the only difference between Republicans and Democrats is that Democrats know what is right but can’t do it. Republicans have no idea what is right and won’t do it. BTW, President Barack Obama is a leader-come-lately. Look, I love this man, but I’m telling the truth. Where was he in the middle of the heat of the summer when healthcare was taking the big hits? He needed to be out of front stating that we HAD to have a robust public option. Alas, he wasn’t there.

Here’s my problem. Washington seems to be controlled by big business. Lobbyists from K St. seem to surround the Capital like locusts. If we scrapped the health-care bill and start all over, how are we going to come up with a different outcome? We’re going to have the same politicians, the same White House and the same lobbyists. As a matter of fact, the lobbyists will be better armed to combat arguments they’ve already heard. They will probably be armed with more money. I’m afraid that starting over will leave us with a bill that’s even worse than what we’re looking at now — if that is possible.

We’re spending $2.4 trillion on health care every year (we spent that much in 2008). Isn’t that enough money? Why do we need to pay any more? Everyone agrees that insurance does not add any value to healthcare. Why is Washington coddling the insurance companies? The whole reason for their existence is not to improve health care, to help doctors deliver better care or to help increase access to doctors by patients. Instead, their whole deal is to simply make money. They make money by not paying claims.

$2.4 trillion is enough money to take care of all 300 million Americans. Combine Medicare and Medicaid and SCHiP and all of the state-run programs into one program. Medicare for All! The government will set up a system to negotiate prices with pharmaceutical companies and medical device/product manufacturers. Premiums are paid out of our taxes in a graduated fashion. The more you make, the more you pay. Let’s extend patent protection for pharmaceutical companies by 2-5 years. Since the government is negotiating drug prices, pharmaceutical companies can recoup some of their losses through this mechanism. Doctors will be awarded for opening early and staying open late and on the weekends. This way, Americans can go to their physicians without having to take off from work. This increases access. Anyway, Medicare for All, at least for now, is a pipe dream. Right now, I’m good to try to work with my congressional representatives to try to get the best bill possible.

Billy Preston was right. Nothing from Nothing leaves nothing. The Senate is trying to sell us nothing and tell us it is something. They need to do better.

Tags: Congress, Healthcare by ecthompson md
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I’m on call tonight and the beeper is seizing, so I will not have time to post anything else today.  I will say that I’ll definitely have more on healthcare. I’m not sure that I agree with the Political Animal when he gives a thumbs down to Dennis Kucinich. I think that healthcare needs to be about something. I have mentioned multiple times that I wanted a bill that will be cost effective, be portable and increase access to healthcare. I’m not sure that the current version really does any of that. I think that Keith is right:

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From Political Animal:

• The potency of Iraq’s insurgency seems to be waning: “Defying a sustained barrage of mortars and rockets in Baghdad and other cities, Iraqis went to the polls in strength on Sunday to choose a new Parliament meant to outlast the American military presence here.”
• On a related note: “Iraqi forces are on track to assume control of the country’s security and the United States is on course to draw down its troops to 50,000 by President Obama’s August deadline, U.S. officials said today.”
• Incredible bloodshed in Nigeria: “Officials and human rights groups in Nigeria said Monday that about 500 people had died in weekend ethnic violence near the central city of Jos, considerably more than what had initially been reported.”
• Vice President Biden travels to Jerusalem today, hoping to kick start Israeli and Palestinian talks. Negotiations have been on a hiatus for 14 months.
• U.S. troops begin their withdrawal from Haiti.
• A new TSA nominee: “President Obama has chosen a retired army intelligence officer, Maj. Gen. Robert A. Harding, to head the Transportation Security Agency, a job that officials call the most important unfilled position in the administration.”
• Rep. Dennis Kucinich (D-Ohio), still prepared to vote with right-wing Republicans to kill health care reform.
• Virginia Attorney General Ken Cuccinelli II (R) is urging the state’s public colleges and universities not to extend discrimination protections to LGBT employees.
• CNN’s Wolf Blitzer never should have aired that ridiculous “Dept of Jihad?” segment, but I was glad to see him apologize.
• Jon Chait 1, Mike Allen 0.
• Fact checking the Sunday shows.
• Can online schools simply purchase legitimacy?
• The unintentional humor of The Weekly Standard.
• If I thought the National Review‘s Mark Stein had any idea what he was talking about, I might not like health care reform either.
• Sullivan: “Halperinism really is part of what’s deeply wrong about Washington.”
• Anti-gay California Republican admits that he’s gay.
• Maybe someday racists will realize that their ugly emails can and should have consequences.

Tags: Healthcare, Iraq, Mess O'Potamia (Iraq/Iran/Israel/Palestine) by ecthompson md
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