Howard Dean

Howard Dean goes to the Op-Ed:


If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.

...In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.

...I know health reform when I see it, and there isn't much left in the Senate bill. I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.


In my notes, once Blanche Lincoln took credit for killing the public option; once Ben Nelson took credit for retaining exemption from the anti-trust laws for Insurance companies from the bill; once Joe Lieberman took credit for killing the medicare buy-in... whatever fig-leaf of reform that existed in HCR, has been reduced to a bill that provides corporate subsidies to insurance companies via a politically toxic mandate to buy insurance.

As for Gibbs, he's been on the wrong side of Howard Dean since 2003, so there's nothing new on that end. Gibbs and Pfeiffer, in using stronger criticism toward Dean than this WH uses toward even Republicans, are tipping their hand that Rahm Emanuel is in enraged in full-fledged freakout mode inside the WH right now.

We are watching a wholesale panic by Democrats in DC. They are peeing their pants about the 2010 midterms and got it stuck in their minds that HCR passage asap, with its dire 30-35% approval rating in its current form, is some panacea that will lay the golden egg that turns everything around. The problem is that this bill is a turd by standards of those on the left, center and the right spectrum, and really only satisfies the insurance companies. I don't think getting a bounce works that way.

Here's how Dean explains it: “In Washington, you get into this crunch where bad- good money gets thrown after bad- good money gets thrown after bad- and good policy gets thrown after bad policy. And at this point, I think, the bill is not worth passing in its present form,” Dean said.

The thrust of the bill, in its current form, is basically along with lines of what John McCain campaigned in in 2008, with its credits/subsidies to be used by people who to buy insurance-- maybe a bit more generous but the same idea. But I don't even recall McCain backing the notion of it being a mandate, and Obama had the sense to campaign against a mandate in the '08 primary (a mandate requirement will get you 21% in the polls--and that's before its been attacked.)

Howard Dean points out some good things in the bill:

The legislation does have some good points, such as expanding Medicaid and permanently increasing the federal government's contribution to it. It invests critical dollars in public health, wellness and prevention programs; extends the life of the Medicare trust fund; and allows young Americans to stay on their parents' health-care plans until they turn 27. Small businesses struggling with rising health-care costs will receive a tax credit, and primary-care physicians will see increases in their Medicare and Medicaid reimbursement rates. What I don't understand, is why the Senate Democrats would endure so much political damage as has been self-inflicted over the past 8 months, only to come up with so little reform. They could have passed those good things back in June easily; they could probably have co-signed McCain to introduce his bill and attach those things on it with a bipartisan stamp of approval.

I'll betcha there will be no more partisan attempts at getting 60 next year. If McCain (or some other Republican like him) and Lieberman are not on board, anything in mind of passing is not going anywhere in the Senate.

Tags: Howard Dean (all tags)

Comments

78 Comments

Not even insurance reform as McJoan/WaPo covers

http://www.dailykos.com/story/2009/12/16 815324-Insurance-Reform-

"If insurers are prohibited from openly rejecting people with preexisting conditions, they could try to cherry-pick through more subtle means. For example, offering free health club memberships tends to attract people who can use the equipment, says Paul Precht, director of policy at the Medicare Rights Center.

Being uncooperative on insurance claims can chase away the chronically ill. For people who have few medical bills, it is less of a factor, said Karen Pollitz, research professor at the Georgetown University Health Policy Institute.

And to avoid patients with costly, complicated medical conditions, health plans could include in their networks relatively few doctors who specialize in treating those conditions, said Mark V. Pauly, professor of health-care management at the University of Pennsylvania's Wharton School.

By itself, a ban on discrimination would not eliminate the economic pressure to discriminate.

"It would probably increase the incentive for cherry-picking," Pauly said. "I'm strongly motivated to try to avoid you if I'm not allowed to charge you extra."

This argue does not include issue over cost being so prohibitive as to make the insurance junk insurance. So, creating the appearance of coverage without actually, you know, affecting the behavior so that people will go to their doctors so that more lives are not lose due to lack of insurance. Inadequate coverage does not save lives. Someone looking at a 100k bill that they can not afford is not going to becoming more likely to go to the doctor for a smaller size bill that they still can not afford.

This bill is smoke screen. You have now providea  reason why- do they seriously think this will save them next year. Reid is toast. It is only a matter of who else he will take with him.

by bruh3 2009-12-16 01:17PM | 0 recs
Re: Howard Dean

Incidentally more on why this still not enough for the corporate Dems. This time- this article addresses Medical Loss Ratio:

"It's not clear whether the proposal will survive as the Senate Democrats work to finish up their bill by as early as next week or, if it does, whether certain qualifications are made to limit it to certain kinds of health insurance policies."

http://in.news.yahoo.com/137/20091214/37 1/tbs-analysis-u-s-senate-deal-would-kno ck.html

by bruh3 2009-12-16 01:21PM | 0 recs
Re: Howard Dean

This bill is as described a turd and should be voted down. Either way, the party is gonna take a big hit next November. They had a chance to do this right, do this in a thoughtful manner...instead they shit all over it....

by BuckeyeBlogger 2009-12-16 01:23PM | 0 recs
A friend of mine sent me a note

"Obama went on Oprah and said that he would increase his self assessment from B+ to A- if HCR passes.  That is all the bill will accomplish..."

by Ravi Verma 2009-12-16 01:24PM | 0 recs
Agreed


The problem is that this bill is a turd by standards of those on the left, center and the right spectrum, and really only satisfies the insurance companies.

We're screwed.  Is it up to Obama and Rahm to pull a rabbit out of the hat before Christmas?  Pretty unlikely.  I'm not sure where to lay the blame for this and am tempted to suggest that it was sensible of Obama to give the Democratic legislature a long leash to accomplish what they can.  But it has clearly failed.  And I don't see how any arm-twisting on the executive's part would have made much significant difference although I know others disagree.

But I would have to agree that 'declaring victory' over the bill as it now stands is not credible.

by Shaun Appleby 2009-12-16 01:24PM | 0 recs
Re: Agreed

Clearly, they didn't recognize the playing field they were on with Lincoln, Nelson & Lieberman to get to 60. I'm pretty sure that if Obama had a do-over, he would have passed what he could in June (probably the good things that Dean points out), and have moved on.

by Jerome Armstrong 2009-12-16 01:33PM | 0 recs
Re: Agreed

Yeah, well that's a 'do-over' we're never going to have.  And progressives would have been equally underwhelmed if he had done so, I'm guessing.  Seems to me we may have gambled and lost.  Looked pretty promising when we were eight votes short of Medicare + 5 in the House but it has been downhill ever since.

Probably more relevant to work out where we go from here than to apportion blame.  Plenty of time for that later.  We better come up with something credible.  Obama's 'victory at all costs' strategy is not flying with me at the moment, not now.  Let's hope he does a course correction on that promptly.

by Shaun Appleby 2009-12-16 02:00PM | 0 recs
I spoke to an Obama precinct captain today

A friend who was out there knocking on doors for Obama in the cold while pregnant. She doesn't read blogs, but she follows politics closely enough to have figured out what happened with health care reform. And she is mad.

The escalation in Afghanistan didn't help either.

When Obama loses people like my friend as well as you and icebergslim and this self-described "former Obamabot" and this early Obama volunteer in Iowa, no one should be deluded about the "benefits" of passing the bill in its current form.

by desmoinesdem 2009-12-16 02:49PM | 0 recs
We'll See...

But I am starting to have my doubts over this legislative initiative as things now stand.  I have a lot of patience with the underlying ethos of the Obama administration but it has its limits.  I don't blame Obama for this outcome, necessarily, but spinning it as a victory would be my first parting of the ways with this administration.

It ain't over yet but I can't quite see the next move, frankly, that would pull the irons from the fire.  This could be a 'teaching moment' on the limitations of legislative change in the current toxic political context but I would prefer to see it framed as such given this apparent outcome.

by Shaun Appleby 2009-12-16 03:10PM | 0 recs
Re: here's apro active idea

This must be one of the stupidest things ever written in English.  Tom Harkin didn't do so well in 1992, and hasn't tried the Preznit thing again since then (other than endorsing Dean).  How would a bit of PUMA poutrage get him into the race, much less give him a chance?

by TexasDarling 2009-12-16 07:05PM | 0 recs
I will give you a reason

for this fiasco.

Obama pursued bipartisanship not as a means but as a policy. Don't forget that for the entire summer we were waiting for his "friends" Chuck Grassley to deliver. He was too enamored by the myth of his new coalition and that at his bidding Republicans will leave everything and come and hold hands with him. For the longest time ever, we have been hearing that reconciliation is the last course. Well we are at the final moments, the end game, even now reconciliation is off the table. And now his sales pitch for this bill makes him sound like a snake-oil salesman.

by tarheel74 2009-12-16 03:45PM | 0 recs
hmmm

should we start a diary on Pakistan to cheer up ?

by Ravi Verma 2009-12-16 03:23PM | 0 recs
LOL

Sure.  The NRO went down in flames today.

by Shaun Appleby 2009-12-16 03:58PM | 0 recs
Re: LOL

Yea, that wasn't good news at all.

by Jerome Armstrong 2009-12-16 04:11PM | 0 recs
Re: LOL

Well, it's not stabilising news.  On the other hand it is seems a direct consequence of the lawyers revolt which may have some good omens in prospect for sane governance.  Not sure how it effects Sharif but it does suggest some 'new blood' in the civilian political leadership unless the generals pull the pin again.

I think the Obama administration's recent cozying up to Gillani was well timed, in the short term at least.

by Shaun Appleby 2009-12-16 04:46PM | 0 recs
Re: LOL

But Gilani is a puppet without any base of his own...

I have a much more pessimistic view of this.  Every time democracy has been inaugrated in Pakistan, they follow a pattern ~ about 18 months of the new leader in charge, followed by another year of palace intrigues, and eventually the hammer comes down in some form.

This is the palace intrigue stage!!

by Ravi Verma 2009-12-16 04:52PM | 0 recs
I Share Your Concern

Hence my 'generals pull the pin' comment.  And yet I wonder.  This is a matter of governence and the NRO was clearly flawed.  I'm willing to wait and see.

Is Sharif threatened by the NRO repeal?  Or is this part of his master plan?  Sharif and PML-N were pretty activist in the reinstatement of the deposed judges.  On the other hand he was blocked from holding office by the Supreme Court upholding his 2008 ban back in February.  I've got to admit I have trouble following Pakistani politics sometimes.

by Shaun Appleby 2009-12-16 05:04PM | 0 recs
See...

I feel better already =)

by Ravi Verma 2009-12-16 04:50PM | 0 recs
Re: Agreed

One of those rare cases where we swap opinions on Obama's judgement. On the policy I agree with you, Obama went the wrong way here. But on the politics what he is doing makes sense.

First you have to recognize a few economic realities, without a mandate neither universality nor most of the new insurance company regulations are possible. Obama knew this in the primaries but chose to use mandates to score points rather than help educate the public about the actual choices before them (see Paul Krugman for more background). Once he had to govern he flipped on mandates with no protest. His public option was always a rump public option, it was obvious that he intended to sacrifice it. He gave congress a long leash to provide the political cover of having tried to include it. I think he was wrong to sacrifice the public option.

But on the politics Obama wins in the end. This bill is not incremental change, it is a major change to a huge sector of our economy, the health care system. The effects of legislation this sweeping are hard to predict, it will have unintended consequences, but it opens the door to a progressive health care system for all Americans. We can expect regular improvements as Congress and administrations adapt regulations to people's needs. There are enough short term benefits for the bill to show positive results before next years elections.

Yes, for the moment the polls will reflect unease as Congress remains confused and people ponder  what this will mean for them. But once it has passed, Obama signs it, and Obama and the Democrats begin explaining it, those numbers will pick up. As Democrats realize how historic this victory is their enthusiasm will return.

by souvarine 2009-12-17 02:44AM | 0 recs
Re: Howard Dean

You better believe that if we pass this sham of a bill, Dean's words (along with lots of others) are going to be used in Republican attack ads against the Democrats in 2010 and 2012

by jeopardy 2009-12-16 01:25PM | 0 recs
Re: Howard Dean

the bottom line here

lets see what this Bill doesn't do.
__

It doesn't provided meaningful competition for the insurance monopolies.

It doesn't do anything to keep down the price of premiums

It doesn't keep the Insurance monopolies from putting on caps that limit coverage for very sick people

It doesn't keep the Insurance monopolies from claiming fraud or using other tactics to keep from covering your illnesses

It doesn't keep the Insurance companies from rejecting people for preexisting conditions (they will just price them out with sky-high premiums)

It doesn't ensure that the poor will be able to afford coverage (the Insurance monopolies can just raise premiums to pocket the extra money from the subsidies)

It doesn't even lay a decent foundation for future change (like a weak PO might have, or like expanding Medicare might have)

__

However, the bill DOES give more power to insurance monopolies (including a legal decree that people must buy insurance)and more money to the insurance monopolies so they can buy off more senators.

by jeopardy 2009-12-16 01:36PM | 0 recs
Re: Howard Dean

SEIU, AFL-CIO backing off of LieberCare?

http://workinprogress.firedoglake.com/20 09/12/16/seiu-afl-cio-backing-off-of-lie bercare/

The LieberCare health care bill is an absolutely catastrophe for labor unions, and it looks like the unions are finally waking up to that fact.

Both the AFL-CIO labor federation and SEIU, one of the country's largest unions are holding emergency meetings today to decide what to do about the Senate bill.

While the unions won't make a final decision on the bill without the actual language to evaluate, these meetings are critical to deciding if they'll pour their considerable resources into supporting, blocking, or sitting out the bill.

Sam Stein reports:

Though there's no official word yet, early indications based on talks with various officials are that the groups will either formally oppose the legislation or, less dramatically, just not fight very hard to ensure its passage.

by jeopardy 2009-12-16 01:47PM | 0 recs
Re: Howard Dean

And when I was working for the Voter Protection Program for Obama's campaign in another (swing) state during early voting and election day last year, the SEIU guys were all over the place helping out.

Obama's Administration hasn't seemed to be too helpful for the unions yet (cardcheck, etc)

by jeopardy 2009-12-16 01:49PM | 0 recs
Re: Howard Dean

Just to be clear, the consensus around here seems to be that expanding health insurance to 30 million people while reducing overall costs according to the CBO score doesn't accomplish anything.  I find that stunning.  

I have a ton of respect for Howard Dean.  He's a smart guy and an important progressive voice.  But I don't understand, at all, how this same bill was worth supporting a few days ago, when Medicare buy-in would have reached a MAX of 2 million people, but it's not worth supporting today.  A bill with a strong public option, tied directly to medicare rates, would have been better.  A bill with a weak public option, or the medicare buy-in, still would have been preferable to what is now on the table.  But I don't understand how anyone that cares about health care can seriously argue that doing nothing is better than passing the bill before the Senate.  

by HSTruman 2009-12-16 01:50PM | 0 recs
Re: Howard Dean

"Just to be clear, the consensus around here seems to be that expanding health insurance to 30 million people while reducing overall costs according to the CBO score doesn't accomplish anything.  I find that stunning."
__

If we believed that the bill does those things, I assure you that most of us would be supporting this.

But it doesn't. (btw, the CBO hasn't scored this thing yet. you are referencing the version with the public option, which would be great)

by jeopardy 2009-12-16 01:53PM | 0 recs
Re: Howard Dean

I'm really not making this stuff up . . .

The CBO numbers on the Senate Finance Bill, which didn't have a public option, estimated the Bill would expand health insurance to approximately 30 million people.  So I really don't see how that number is up for debate.

Similarly, there's no uncertainty regarding whether the current bill reduces costs.  Again, the Senate Finance Bill was scored as reducing the deficit by a small amount over the first decade and by a larger amount over the second decade, despite the fact that the CBO assumes that all of the new delivery reform and preventative care mechanisms in the bill will fail.  

Taking the public option out will make the bill worse, as even the weak option Reid proposed would have saved some money over the next decade. But it doesn't make a huge difference, largely because it was always limited to the exchanges and unlikely to enroll more than 4 or 5 million people nation wide.

Look, I'm not trying to argue this bill is awesome; it's not.  But if we're talking about killing this thing outright, I think it's important to at least be clear about what it does and doesn't do.    

by HSTruman 2009-12-16 02:00PM | 0 recs
Re: Howard Dean

The same CBO that recently wrote the following regarding the Medical Loss Ratio shift from 85 percent in the House to 90 percent in the Franken Amendment:

"In CBO's view, this further expansion of the federal government's role in the health insurance market would make such insurance an essentially governmental program, so that all payments related to health insurance policies should be recorded as cash flows in the federal budget."

by bruh3 2009-12-16 02:07PM | 0 recs
Re: Howard Dean

The report you're quoting from sure doesn't make me think their score was intended to give the Senate bill a boost.  Care to elabortae on your reasoning?  

by HSTruman 2009-12-16 02:09PM | 0 recs
Re: Howard Dean

When someone makes such an absurd argument as the CBO makes there, it makes it clear that one should stop wasting time with what the CBO thinks.  When I read that comment, I was pretty much done caring, and returned to looking at non-partisan, non government based studies to determine what is best such as reports about what will happen without real cost containment mechanisms that have been coming out all year outside of what the CBO says on the matter.

by bruh3 2009-12-16 02:11PM | 0 recs
Re: Howard Dean

Care to share these authoritative studies?  Because everything I've read agrees that the bills being considered will (a) expand coverage and (b) at least start to address the issue of cost.  

by HSTruman 2009-12-16 02:17PM | 0 recs
Re: Howard Dean

The expanded coverage is illusionary if the underlying policies suck.

by bruh3 2009-12-16 02:19PM | 0 recs
Re: Howard Dean

To clarify- A CBO scoring saying that more people will be covered is meaningless for example if you do not have adequate protections regarding life time caps (Reid took that out), cost containment (no longer there, and will not happen because insurance is a oligopoly), medical loss ratios (on its death bed as the article that I link to illustrate), still allows co pays, still only require coverage up to a certain percentage above which the patient becomes responsible, etc. What we are doing here is moving the approaches that the insurance company will use to act in bad faith, but have not removed their ability to act in bad faith toward customers. That's why this is not even insurance regulation reform at this point. Its a sham.

by bruh3 2009-12-16 02:25PM | 0 recs
Re: Howard Dean

can i see some links please to the CBO having scored this?

the SFC bill has extremely small subsidies, btw. It was completely unacceptable and was written by the insurance industry

by jeopardy 2009-12-16 02:07PM | 0 recs
Re: Howard Dean

I didn't say the CBO has scored the current bill. I simply noted what the scoring on the SFC bill looked like.  And even those inadequate subsidies (and I completely agree they're too small) were estimated to expand coverage to approximately 30 million people.  

by HSTruman 2009-12-16 02:11PM | 0 recs
Re: Howard Dean

Do you know what junk insurance is or how it does not help regarding coverage to have people paying for expensive insurance that does not actually provide them proper coverage? At this point,  you seem to be a few steps back from where most people are on the specifics here. Coverage is only as useful as it actually covers people's health care cost. If it does not do that, it is an expensive illusion.  In other words, getting 30 million peo "covered" even if the CBO is right is not going to help when the coverage still leaves people dying because they will not go to the doctor because the cost of going to the doctor is still too high for them to go even with coverage. I provided a pre-"reform" example in my recent diary:

"Cost of health care can prevent some from seeking cancer treatment    "

"I've been doing this for 37 years," he said. "Deductibles used to be $250 to $500. Now deductibles for many people are $2,000, $2,500 or $3,000. That's a lot of money to pay out of pocket. When it was $250, it was easy to make five payments of $50 each. Now it's five payments of $500 each."

http://www.thecompassnews.org/index.php? option=com_content&view=article& id=220:cost-of-health-care-can-prevent-s ome-from-seeking-cancer-treatment&ca tid=37:Local&Itemid=67

The diary was written quickly without me explaining how a lack of real COLA (one that addresses increased cost in a realistic fashion in the budget) means that premiums will be increasing in practical terms regardless of subsidies. I also did not go deeper into how a lack of real regulation will mean people still will not be going to the doctor for treatment under the new "reform.' This bill moves the problems around rather than addresses their underlying causes.

by bruh3 2009-12-16 02:18PM | 0 recs
Re: Howard Dean

The coverage that would be available on the exchanges isn't "the best," but it's also not "junk." Honestly, what is your basis for that assertion?  You seem to be basing your conclusion off of flaws in insurance generally.    

On a separate but related note, in my book decent insurance beats the heck out of no insurance.  

by HSTruman 2009-12-16 02:23PM | 0 recs
Re: Howard Dean

What makes this decent insurance?

by bruh3 2009-12-16 02:29PM | 0 recs
Re: Howard Dean

From what I've read, we're not talking about catastrophic insurance with huge deductibles; instead, the SFC assumed insurance that was in the middle of what people currently receive (usually through their employer).  But if I'm wrong about that, please correct me.  

Given your assertion that the insurance being offered is "junk," I'm certainlyu curious to know what the empirical basis for your assertion is.

by HSTruman 2009-12-16 02:34PM | 0 recs
Re: Howard Dean

The bill established 4 levels of insurance - bronze (basic catastrophic + some other stuff), silver, gold and platinum.

The PO was tied to the silver option, i.e: it would still have a deductible of over $2500. "A lot of money" as some say.

Ofcourse the bill also completely banned payments for preventative care and screening. But the Bill is just awful. Clearly the the status quo is way better. And hey if the status quo is better, it can't be that bad can it? What's the need for reform then...

by vecky 2009-12-16 02:34PM | 0 recs
Re: Howard Dean

then can you please post links to the CBO scoring the similar but different bill? I would still like to see it

by jeopardy 2009-12-16 02:20PM | 0 recs
Re: Howard Dean

Sure.  According to this, the SFC, whose subsidies were worse than what the Senate bill now contains, was estimated to reduce the number of uninsured by 29 million by 2019.  

http://www.cbo.gov/ftpdocs/106xx/doc1064 2/10-7-Baucus_letter.pdf

by HSTruman 2009-12-16 02:31PM | 0 recs
Re: Howard Dean

see below.

the SFC had a fairly robust employer mandate.

I don't think you can draw conclusions about the current mess from the SFC scoring

by jeopardy 2009-12-16 02:38PM | 0 recs
Re: Howard Dean

The SFC employer mandate was stripped out (or heavily dilluted) by Snowe & friends during negotiations.

by vecky 2009-12-16 02:56PM | 0 recs
Re: Howard Dean

but the scored part had the employer mandate, right?

by jeopardy 2009-12-16 03:12PM | 0 recs
Re: Howard Dean

Oh, and the SFC bill contained an employer mandate.

http://www.cbpp.org/cms/index.cfm?fa=vie w&id=2921

"The health reform bill that the Senate Finance Committee approved this week...

The provision would require employers who do not offer health coverage to pay substantial amounts -- apparently up to $4,000 per worker or more -- for low- and moderate-income individuals"

...

Two changes approved during the Finance Committee's deliberations make these problems worse. First, looking for a way to offset the costs of another change it wanted to make in another part of the bill, the Committee voted to deny employers the right to deduct the payments they would be required to make under this provision as business costs.

Although employers can deduct the costs of health insurance premiums, they would be prohibited from deducting these payments.

Second, the Congressional Budget Office's preliminary cost estimate of the Finance Committee bill says that employers would be charged the sum of the national average premium subsidy provided to those who get such subsidies and the national average subsidy for cost-sharing assistance.
____

I would really caution using the CBO's numbers for the SFC bill to figure out the scoring of the current steaming pile of horse dung

by jeopardy 2009-12-16 02:34PM | 0 recs
Re: Howard Dean

You make some fair points.  I will certainly be curious to see what the scoring on the Senate bill ultimately looks like.  I tend to think the score will still be good, but if I'm wrong I'll be happy to admit it.    

by HSTruman 2009-12-16 02:45PM | 0 recs
Re: Howard Dean

yes, the scoring will be interesting.

however, I would also like to know what predictions they make about insurance company behavior for the scoring.

DO they predict rates rising the same as inflation?

Do they predict based on historical factors?

Do they predict how the rates are going due to the incentives the bill would give?

Do they predict good faith dealing by the insurance companies?

by jeopardy 2009-12-16 03:21PM | 0 recs
Re: Howard Dean

You aren't listening.  

The bill doesn't give coverage to anyone.  It imposes civil monetary fines on people who don't write out big premium checks to the insurance companies for crappy coverage.  

How can the Democrats survive in 2010 when the people who write these checks get wise to the scam? What are they going to say "We gave you coverage?"

Americans are not stupid, despite the assumptions of certain arrogant bastards in the White House.

by TJ1 2009-12-16 01:56PM | 0 recs
Re: Howard Dean

So passing hugely significant subsidies, which would make coverage affordable for a broad segment of the uninsured population, doesn't expand coverage?  You're also completely ignoring the fact that millions of people would qualify for SCHIP and Medicaid if the Bill passes.

As to the politics of it, I think we're probably screwed either way at this point.  

by HSTruman 2009-12-16 02:08PM | 0 recs
Re: Howard Dean

"So passing hugely significant subsidies, which would make coverage affordable for a broad segment of the uninsured population, doesn't expand coverage?"

what makes you think that the insurance company won't raise rates?

bottom line is that they are going to squeeze every dime from people they can, and they won't insure those they don't want to insure, and this bill doesn't do anything to fix that.

by jeopardy 2009-12-16 02:13PM | 0 recs
Re: Howard Dean

If you don't understand why Dean and many others don't support this bill at this point, I don't know what to tell you.  There has been plenty of back and forth all over the blogosphere.  And I think Dr. Dean's points are pretty clear.  I would simply take the plain meaning of the words he uttered:  this is not healthcare reform.  Does that help you to understand?

by orestes 2009-12-16 01:58PM | 0 recs
Re: Howard Dean

I'm not trying to change anyone's mind, and I'm certainly not insulting Howard Dean, who I genuinely respect.  I just wish this debate involved a few more facts.  

Without question, there are tons of things this bill doesn't do or that it doesn't do enough of.  But it also does a lot more to expand coverage than anyone seems to want to admit.  Now, is the money that allows that going to go to insurance companies?  Yep.  Does that suck?  Yep - it absolutely does.  But at the end of the day, those subsidies are going to allow a LOT of familes that currently have no health care to afford it.  If people ultimately decide that's not enough to justify supporting the bill, fair enough.  But denying that the bill does that is intellectually dishonest.  

by HSTruman 2009-12-16 02:06PM | 0 recs
Re: Howard Dean

if the insurance companies can just charge 3x as much, there absolutely zero guarantee that this thing will expand insurance at all, or that the poor or those with preexisting conditions will be able to buy insurance

by jeopardy 2009-12-16 02:08PM | 0 recs
Re: Howard Dean

That's theoretically possible, but I have yet to see a single health care policy wonk that thinks that's likely to happen.  Which is why no one has offered any empirical support for that proposition.

For the sake of argument, assume that the Bill really does expand coverage to 30 million people, but otherwise still sucks for all the reasons that have been articulated.  Would it be worth supporting then?      

by HSTruman 2009-12-16 02:15PM | 0 recs
Re: Howard Dean

Readging Ezra Klein does not constitute doing due diligence on the nature of what is being proposed.

by bruh3 2009-12-16 02:30PM | 0 recs
Re: Howard Dean

Are you trying to be insulting?  Because that's how your posts often come accross.  

You and I disagree regarding whether this bill is worth supporting; fair enough.  But your judgment is not self-evident.  And it really doesn't advance the conversation to glibly suggest that I I haven't done my "due dilligence" because I disagree with you.    

by HSTruman 2009-12-16 02:39PM | 0 recs
Re: Howard Dean

I will take a step back. Provide links for the basis of your analysis.  

by bruh3 2009-12-16 03:09PM | 0 recs
Re: Howard Dean

nobody thinks that the insurance company will raise rates if they think they can make more money?

you've got to be kidding me.

by jeopardy 2009-12-16 02:30PM | 0 recs
Re: Howard Dean

All of the economic modeling I've seen suggests that won't happen.    

by HSTruman 2009-12-16 02:41PM | 0 recs
in more than 90 percent of the markets

One or two insurance companies have a virtual monopoly.

In Iowa a single company controls 70 percent of the market.

Now there is no public option whatsoever, not even a crappy one that could be improved in the future.

So what's going to stop the insurers from raising rates through the roof?

by desmoinesdem 2009-12-16 02:52PM | 0 recs
Re: Howard Dean

I would love again to see the basis of your arguments because it goes against basic economic thought on monopolies and captured markets like what is being described with the mandates.

by bruh3 2009-12-16 03:10PM | 0 recs
Re: Howard Dean

I feel sorry for the poor folk in MA. They have pretty much the senate bill with less reform for a few years now. Clearly MA health insurance is the worst in the country...

by vecky 2009-12-16 02:57PM | 0 recs
Re: Howard Dean

One can only predict how the insurance companies would act in the future based upon their past behavior.  If you look at current and past practices, it would be consistent for them to continue to deny care, increase premiums, co-pays and deductibles each year, and employ all the tricks in their bag to maximize their profits at the expense of their customers' health.  Past practices and basic logic (fewer services to insureds leads to higher profits) put the good money on

by orestes 2009-12-16 03:29PM | 0 recs
Re: Howard Dean

I have not noticed anyone challenging the estimate that some form of health insurance will be made available to 30 million Americans.  (I'm sure some are out there, but the debate hasn't focused on this point at all.)  The concern, as jeopardy keeps pointing out, is that compulsory health insurance does not equal actual (let alone good) health care.  The insurance industry has not acted in good faith; there is no reason to expect them to do going forward.  Furthermore, there is nothing stopping the insurance industry from trying to gain new customers by offering affordable products now.  Surely, there is a market out there.  

As Dr. Dean points out, if we take the good things from this bill and remove the mandate, I think most people would be okay with it passing.  That is taking the steady approach that the pro-bill people offer as a justificationfor backing the bill (we'll get to fix it, improve it, going forward), without giving away the farm (billions in hard earned income and public funds) to the insurance industry.  

by orestes 2009-12-16 02:21PM | 0 recs
Re: Howard Dean

exactly.

In order for this bill to help people, you have to assume that the Insurance Monopolies and their antitrust exemption will operate in good faith or in the people's interest - because there is nothing in there to keep them from screwing over people

by jeopardy 2009-12-16 02:40PM | 0 recs
Re: Howard Dean

The mandates are one of the reasons premium hikes are expected to go down.  The rest of the bill really doesn't work if you take those out, unfortunately.  

by HSTruman 2009-12-16 02:42PM | 0 recs
Re: Howard Dean

How will mandates cause premiums to go down under monopoly conditions? Again, I want to see what you are reading that tells you this is the case.

by bruh3 2009-12-16 03:29PM | 0 recs
Re: Howard Dean

Can you please explain this?

by orestes 2009-12-16 06:18PM | 0 recs
Re: Howard Dean

The mandates pull more healthy people into the insurance pool, which lowers premiums for everyone.  Although I personally don't think health care should be a for-profit industry at all, a lot of rate-setting is purely actuarial.  When you expand the number of healthy folks in the pool, the premium's drop.

by HSTruman 2009-12-17 04:47AM | 0 recs
Re: Howard Dean

Howard Dean points out some good things in the bill:

BAHAHAHAHAHA....

by vecky 2009-12-16 02:28PM | 0 recs
I'm Guessing...

You haven't been here long or have lost your Lonely Planet guide to Blogistan.

by Shaun Appleby 2009-12-16 02:50PM | 0 recs
Re: I'm Guessing...

One of the regular bloggers (I think it was SteveM) mentioned that the recognized ludwig from an earlier avatar...something about a distinctive style.  I am generally clueless about such matters, so I did not catch that!!

by Ravi Verma 2009-12-16 03:33PM | 0 recs
Re: its funny

There are a few people  here who see it as their purpose to protect Obama at all costs, but that's not everyone.

by bruh3 2009-12-16 03:12PM | 0 recs
Re: Howard Dean

I've come to the conclusion that you people don't deserve Health Care Reform. I hope you succeed in scuttling what you call this turd.

You all deserve to get exactly what you're asking for.

by QTG 2009-12-16 04:15PM | 0 recs
Re: Howard Dean

I thought you said "mark my words, we will get a very good bill" :))

p.s. do you have any credibility left?

by tarheel74 2009-12-16 04:56PM | 0 recs
Re: Howard Dean

Credibility at MyDD? Are you serious?.

I withdraw the question.

by QTG 2009-12-17 12:39AM | 0 recs
Re: Howard Dean

Thanks.  I didn't know you cared.

by orestes 2009-12-16 06:18PM | 0 recs
Re: its funny

I haven't checked in awhile myself, but the folks I've been noticing are the IHATEOBAMA types, who see a rift and happily salivate at the ITOLDYASO possibilities.

by mikeinsf 2009-12-16 07:55PM | 0 recs

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