Screwed

Sorry, that's the word that comes to mind when I read The Note (A Complicated Enemy: Obama Seeks to Vilify Health Insurers, Give Them $336 Billion Check) and its wrap on the HCR bill.

The framing of the bill has become so terrible in the mind of the press, that its no wonder that the poll numbers show an ever-declining support of the measure.

The negatives in this article:

Obama and Sebelius demand that the insurance companies justify their premium hikes.

Republicans counter that HRC would:

...would give the insurance companies millions of new customers required by law to buy health insurance... 336 billion over the next ten years. That money, ultimately, would have to go to... drum roll... insurance companies.

There are some very good things in HCR, such as the requirement of insurers to cover everyone, regardless of age, gender or pre-existing condition.

But Obama, as a candidate in 2008, compared with what his HCR looks like in 2010, just strikes such a raw reversal that I don't see any possible way that this is ever going to be a net positive after passage.

He was against the mandate, hammered Clinton on it, and now backs it fully.

He was for the public option, said he'd fight for it, and has now abandoned it.

He belittled McCain for proposing subsidies that go directly to insurance companies, but now that's the heart of the plan.

And yet that’s exactly what Democrats' proposal would do and why so many would prefer public insurance option to compete with the private market. Supporting the Senate bill will be tough for many liberal Democrats in the House.

The adminsitration realizes that the optics look terrible, so they come out with PR that attempts to put them on the popular side if the debate, with Sebelius calling out the Insurance companies through an HHS statement.

"If insurance companies are going to raise rates, the least they can do is tell us why.”

That's the hammer? And really, its not even a 'do this or else' type of letter, but rather, a letter requesting the info to "give Americans the opportunity to learn more and ask questions about rate increases that affect them." Better PR!

How can the administration PR's be helping Obama's credibility with toothless statements like this from Sebelius that beg to be mocked by the Republicans, and pointed out as hypocrisy by the media?

Okay, to wrap this up. There are good things in HCR (mostly looked over), but the big picture is a largely useless (and debatable as inaccurate) frame of benefits (30 Million people covered by subsidy), against the optic of a corporate giveway. This, alongside no Republican support at all, or among many activists the left (because there is not a public option), but that's not the worst of it.

The worst is that many who are pragmatic progressives in their backing of HCR really don't believe that this HCR is going to solve the big problems. Instead, that it lays the groundwork for the ultimate bigger failure that will come, and we can fix it better at that point.

Now, I find myself in this latter camp usually (given the electoral considerations of failure at this point), and its certainly not a good way for the framing of the bill to wind up. Obviously, the better frame of it is a smaller step toward the ultimate goal. But given the investment of time (nearly a year center-stage now), it can hardly be portrayed as anything other than monumental, by both the media and the administration, if it does wind up passing.

Moving from screwed to success is going to take a massive overhaul of the perception of the bill once it moves from Congress to the desk of the President.

Tags: hcr (all tags)

Comments

25 Comments

Four walls and a roof

Wall 1 - Insurance companies need to cover everyone.

Wall 2 - To make sure that rates don't go up too much, you mandate that everyone has insurance.

Wall 3 - In order the ensure that people can afford insurance, you provide subsidies.

Wall 4 - You control costs somehow.  The options are: a public option, clearly the most sane and effective way; the exchanges, not pittance, but not the public option; or, medical loss ratio standards, seems like a good idea but heavy-handed and especially prone to fraud or watering down.

Pop the roof on it and it's done.  Negotiate any of the walls away and what's the point of having a house in the first place?

 

by the mollusk 2010-03-09 12:08PM | 0 recs
RE: Four walls and a roof

The healthcare reform  bill proposed by Alan Grayson works - if we pass that bill we're good to go on the key issue almost all activists were after.

 

The rest of the reform package is basically sound.  My view is that Obama is getting the job done but a deeply. deeply flawed legislative process is occluding the work. And we are clearly seeing - that at least the house has some transparency and process benefits. Maybe one day the senate will not be controlled by lobbyists.

by Trey Rentz 2010-03-12 08:29AM | 0 recs
meanwhile, in Iowa

Governor Chet Culver (D) ordered the insurance commissioner to put a stay on the largest insurance company's enormous rate hikes, which were to go in effect on April 1. An independent audit will determine whether the premium increases are justified.

by desmoinesdem 2010-03-09 12:50PM | 0 recs
Now it is not a good way for the framing to end up

But it is bullshit of the highest order.

Look there are some on the Left particularly the FirePups who delude themselves that 'Public Option' means 'Single Payer' and that the Kucinich Bill/Weiner Amendment was actually a viable alternative. It wasn't, it is a piece of aspiration for a National Health Insurance system far to the Left of even the British system. As written it would eliminate for profit pharmacies and optical shops and provide free unlimited free long term care to everyone while banning the possibility of buying an upgrade for grandma via supplementary insurance. It is not Medicare for All, Medicare delivers much of its care through private sector for-profit providers, HR676 almost bans for-profit care across the board.

In short HR676 is exactly the kind of Socialized Medicine Democrats have been insisting we were not interested in going to, and totally violates Obama's pledge that "if you like what you have, you can keep it". Because Kucinich said "Nope"

It is essentially a piece of street theater very much as the Republican Boehner Amendment was.

No the Public Option in the original Tri-Committee Bill and the Senate HELP Bill would have functioned much like Medicare and had a similar advantage in lower Medical Loss Ratios, it is quite likely that they could have sent 95 cents of every premium dollar back out the door to providers. Like Medicare mostly private providers. But even at their worst private insurers are sending 70 cents of that premium out the door, which under the bill will have to be raised to 80 or 85 cents, to imply that $365 billion simply sticks to their hands is dishonest special pleading, unless you admit that the same would be almost as true for the Public Option.

The "corporate giveaway" is WHAT IS HAPPENING NOW. Claiming that a new system where premium dollars BY LAW have to cover an 'Acceptable Benefits Package' with no enrollment or renewal bars, no recissions, much stronger rules on community rating, plus a built in ceiling on combined profit, expenses and compensation via mandated minimum Medical Loss Ratios as a 'corporate giveaway' is just throwing read meat to the FirePups who frankly have a lot more passion than reading ability, I have yet to find one willing to discuss the actual bill language of H.R.676, what they think of as 'Medicare for All'

Easiest way to see that HR676 was never really meant to be taken seriously? Look at the financing Sec 211 http://www.pnhp.org/nhibill/nhi_bill_final.pdf

(c) FUNDING.— 

(1) INGENERAL.—There are appropriated to the USNHI Trust Fund amounts sufficient to carry out this Act from the following sources: 

(A) Existing sources of Federal government revenues for health care.

(B) Increasing personal income taxes on the top 5 percent income earners. 

(C) Instituting a modest and progressive excise tax on payroll and self-employment income. 

(D) Instituting a small tax on stock and bond transactions. 

How the hell can CBO score 'small' or 'modest and progressive' or 'increasing'? They can't. And by 'existing sources' does this mean taking over the entire medical care budget of the Indian Health Service, the Public Health Service, the Veterans Administration, and the National Institutes of Health? Stripping the Department of Education of any and all programs for Physician training? Well mostly yes. For example Sec 401 carves out a ten year exemption for VA and five years for IHS and then strongly suggests that the former to taken into the larger system while mandating it for the latter. Similarly the bills claims exclusive rights over capital improvements to medical facilities Who was the fucking genius that thought he could sell a program than mandates unlimited free (no copayments or deductables or any other charge for covered services Sec 102(c)) for all residents of the United States, while explicitly barring checks based on residency or income status, (i.e. free care for illegals) including all vision, dental and long-term care while phasing out specialized services through the VA? Well it is the same fucking moron who is now smugly making non-negotiable demands to take down the bill from the Left, and getting lavish praise for it from the FirePups. One Dennis Kucinich. Yeah were screwed, because we let too many people buy into the happy talk of the 'Single Payer Now' crowd. "Look a 30 page bill that saves the world!". Well not if you read it.
by Bruce Webb 2010-03-09 01:03PM | 3 recs
I am so done with HCR

I am annoyed with Administration apologists but I want the bill to get passed so we can stop hearing about it. I can't imagine how low-info voters feel about hearing this incessant droning on and on about crap that never gets explained to them.

 

We have other battles that we need to prepare for. Energy and financial reform are at the top. Cap-and-dividend probably couldn't get through a fucking committee vote at this point.

by bay of arizona 2010-03-09 01:26PM | 0 recs
Poll numbers

The framing of the bill has become so terrible in the mind of the press, that its no wonder that the poll numbers show an ever-declining support of the measure.

I thought support/oppossition numbers were pretty steady.

http://www.pollster.com/polls/us/healthplan.php

by vecky 2010-03-09 01:44PM | 0 recs
RE: Poll numbers

You wind up looking at internet polls compared with live persons is that graph, and all kinds of different questioning. Take one, I'll do Democracy Corps:

May 2009, there was momentum,  45 -  36 - 19 (favor - oppose - undecided)

June 2009, time to pass it, 43 - 38 - 19 (time to pass the bill)

Obama set a July deadline, and let it get blown off. The right course then was to pivot to get a smaller bill passed, but instead, it got bogged down.

Nov 2009, 43 - 49 - 9 (the undecideds going negavite)

Jan 2010, 42 - 51 - 7 ( a majority goes negative)

The interesting thing through this is that, though a declining level of support for the measure overall has occurred, the actual level of support for the bill has remained the same about, just dropping 3 percent. Those oppossed has risen 15 percent, and the amount of undecided has dropped to 7 percent.

Democracy Corps actually had an email out today (just got it) that cites some polling (not theirs) that shows lately, polling getting better. However, its probably the case, given the numbers, that support is going up with the hope/optimism tha a public option replaces the Senate bill (something I really doubt and the above posts assumes not). Here's part of what they said:

In the wake of the Massachusetts special election, public surveys showed support for health care reform declining to record lows. Yet, in recent weeks, support for reform has started to recover in nearly every public survey and now stands almost even – 46 percent in support compared to 47 percent opposed according to Pollster.com’s current average of public surveys. This is a far greater level of support than the supposed 55 to 37 percent opposition touted by McConnell.

While the uptick in support is certainly encouraging to supporters of reform, almost all of these surveys still show at least pluralities in opposition to the current reform measure being debated. However, when Ipsos probed further, they showed a surprising result. Of the 47 percent who oppose reform, 37 percent do so because reform does not go far enough (meanwhile, of the 41 percent who say they support the current proposals, 12 percent say they do so because they think the current proposals will stop reform from happening). Combining these results shows a majority – 53 percent – that supports reform or something that goes further. Yet, just 35 percent want to kill reform because it goes too far.

The sale will be to those among the 1/3rd that oppose it because it doesn't go far enough that it does, which it doesn't w/o a public option, but thats the key audience.

by Jerome Armstrong 2010-03-09 02:32PM | 0 recs
RE: Poll numbers

I don't agree on a smaller bill strategy. That's not reform, merely tinkering around the edges. The Bill is already pretty small, dealing almost solely with insurance and payment reforms.

That said the bill has been pretty steady for the past four months. Despite all the increasing talk of how bad it is. So there has not been a "ever-declining support of the measure".

by vecky 2010-03-09 03:22PM | 0 recs
RE: Poll numbers

This is not declining support for the bill?

May 2009, 45 -  36 - 19

June 2009, 43 - 38 - 19

Nov 2009, 43 - 49 - 9

Jan 2010, 42 - 51 - 7

I'm sure you can make a point, if you insist I was talking about the last couple of weeks or months, but the reference is to the last 10 months that have been all about HCR.

by Jerome Armstrong 2010-03-09 07:32PM | 0 recs
RE: Poll numbers

Well I was only referring to the action since October, which is what saw the finalization of the House and Senate Bills. There being no bill from May to September. Certainly considering the spate of all bad news since Oct - the watered down PO, Stupak-Pitts, the loss of the PO, the special deals in the Senate, the MA Senate election, grumblings from the House, I would have expected a much greater loss of support for bills since then. But that really hasn't happened, surprisingly.

by vecky 2010-03-09 08:18PM | 0 recs
RE: Poll numbers

Well "Vecky", you haven't been following the poll numbers if you really believe there's been no erosion in support....but then again, you often seem to make up your own numbers. Since team Obama first unveiled their thoughts last summer, public opposition to HCR has steadily increased---due in large part to Barack's ineptitude and inability to communicate.

 

by BJJ Fighter 2010-03-09 11:55PM | 0 recs
RE: Poll numbers

The Poll numbers are cited right above you, and I even posted a link. The support column has generally operated in a narrow range of the low 40's for several months. As they say you are entitled to your own opinion, but not your own facts.

by vecky 2010-03-10 12:15AM | 0 recs
RE: Poll numbers

I don't think you understand how the pollster.com chart generates. I'll give you another example to make the point again, and am done with this, CNN:

June 2009, 51 - 45 - 4  Clear support

July 2009, 50 - 45- 5 Support remails

Aug 2009, 48 - 51 -2 Scales tipping

Sept 2009, 51 - 46 - 3 Scales tipping

Oct 2009, 49 - 49 -2 Tied up

Nov 2009, 46 - 49 - 5 Scales tipping

Dec 2009, 36 - 61 - 4 Support plummets

Jan 2009, 40 - 57 - 2 Clear opposition

Jan 2010, 38 - 58 - 3 Clear opposition

Maybe your point is that its not ever-declining, but instead that it was a dramatic decline, so fine.

But none of this was even the point of the post. The point is that if this is an example of the media framing of HCR, we are screwed.

And as noted in the comment I made after the post, YouGov polling shows that its changed, and maybe so, we'll see.

 

by Jerome Armstrong 2010-03-10 12:53AM | 0 recs
RE: Poll numbers

I don't see a dramatic decline either. My "point" was that there was a decline initially I guess, though initial support is what i would call soft. But then support sort of stabilized. Now for sure there have been individual variances between polls and dates but the average data is broadly in the same range - which is why I linked to Pollster.com, and not some specific polling agency.

Here for example is Gallup:
http://sas-origin.onstreammedia.com/origin/gallupinc/GallupSpaces/Production/Cms/POLL/kcrowlqj3ukbaliyxdi_aq.gif

There most recent poll showed support at 45 -48 - 7. Things just havn't moved very far.

by vecky 2010-03-10 01:10AM | 0 recs
RE: Poll numbers

This is a good point as to why I think looking at the aggregate of these type of issue polls is pretty worthless.

The Gallup "healthcare" questioning is bizarre, don't you think? All framed around how you would "advise" a congressman ("advising your member") to vote for or against, instead of the actual position of the voter. But it does show little change.

I'll stick to the position of there having being a dramatic decline, and point out the MA Senate result as the obvious anecdotal evidence. And offer the "Cornhusker Kickback" as the penultimate moment of the decline.

by Jerome Armstrong 2010-03-10 01:23AM | 0 recs
RE: Poll numbers

I agree with the anecdotal evidence. My surprise was that it wasn't evident in the polling. I don't know why. If you don't like Gallup you can always check Rasmussen, which I provided below. But it was to avoid questions over individual polls and outliners that I provided the pollster.com link in the first place.

by vecky 2010-03-10 01:36AM | 0 recs
RE: Poll numbers

I'll also post the following commentary from Rasmussen:

Last week, support for the health care plan inched up to 44% following the president’s televised health care summit. However, that mild bounce has faded, and support is back to where it was for months. With the exception of last week’s results, overall support for the president’s health care plan has stayed in a very narrow range from 38% to 42% since Thanksgiving.

 

See... support is back to where it's been for months. Narrow range since Thanksgiving. That's been my point.

by vecky 2010-03-10 01:30AM | 0 recs
RE: Poll numbers

Jerome already did an excellent job of burying you.....no need for me to pile on. His re-cap of the poll numbers is pretty thorough.

 

by BJJ Fighter 2010-03-12 12:41AM | 0 recs
RE: Poll numbers

Still can't face facts? If you can't read a graph, even Rasmussen stated that support for health care has been steady for several months now. I even provided a helpful link above.

Think before you post buddy! :D

by vecky 2010-03-12 01:45AM | 0 recs
Only half screwed

There is no question the WH let the narrative get away from them this summer. That was a misstep. But I'm looking at the same poling, and I see an improving trend as well.

You claim we are screwed, but I do not think such a conclusion is justified by the numbers. Unfortunately, a third (37%) as you claim does not oppose the bill because it does not go far enough.

Of the 47 percent who oppose reform, 37 percent do so because reform does not go far enough (meanwhile, of the 41 percent who say they support the current proposals, 12 percent say they do so because they think the current proposals will stop reform from happening).

I admit the wording in the quote from Ipsos is confusing. But if you look at the internals, 37% of the 47% opposing is just 17%.

So yes, there is a fraction that opposes the current legislation because it doesn't go far enough, but it's a mere sixth of the respondents, not a third as you claim. And I would be curious to see the party affiliation of those respondents.

I'm not sure health care could ever have been a net positive for the White House. But I still don't see the evidence that it is a net negative, even without a PO.

by NoFortunateSon 2010-03-09 04:57PM | 0 recs
RE: Only half screwed

I make no such claim. In fact, if you read to the end, you would know otherwise. The screwed reference is obviously about the media framing in that article.

Like vecky, you seem to be just looking for a disagreement with something you couldn't find.

I'm not sure health care could ever have been a net positive for the White House.

Seriously?

by Jerome Armstrong 2010-03-09 07:36PM | 0 recs
Well, when there's one error...

...it's not difficult to get thrown off the trail.

The sale will be to those among the 1/3rd that oppose it because it doesn't go far enough that it does, which it doesn't w/o a public option, but thats the key audience.

As I noted above, this is inaccurate. The real number is 17%, not 37%. I misunderstood, and thought that because one third supposedly desired more reform, that the narrative was screwed, to which I responded, well, I guess we're half screwed.

* * *

I'm not sure health care could ever have been a net positive for the White House.

Seriously?

When LBJ signed the Civil Rights Act in 1964, he supposedly remarked under his breath: "Well, we've lost the south for two decades."

It's still lost. I don't believe the issue of healthcare as a right versus a privaledge will be settled with this battle alone. I think we will have more improvements in the future, just like improvements were made to social security over time.

I do rescind my assertion that this won't be a net positive. I feel it will be a positive, but indirectly.

* * *

So again, sorry for any confusion. I was really just referring to the mistake with the numbers regarding those who do not support the bill because of more reform.

by NoFortunateSon 2010-03-09 10:07PM | 0 recs
the error

There's no doubt that there was support for HCR back in May-June-July of 2009. Its hard to compare it with something for I don't have any numbers.

And I don't disagree that support could return, but the whole framing of the topic will have to change dramatically from the example of the media (mainstream, The Note) that I gave in its coverage of HCR.

You just misunderstood the "among the 1/3rd that oppose it" part.

I was making a jump and in the reference of saying "a third" (instead of spelling out that the 37% of 47% is about 1/3rd) the total opposition, or 17% overall (as you point out).

The point though, that its among those 1/3rd oppossed, or 17% overall, that a change of perception could most easily occur.

 

by Jerome Armstrong 2010-03-10 01:10AM | 0 recs
Am I the only one who comes here just to relive the 2008 Democratic primary campaign

?

by masswaster 2010-03-09 09:27PM | 1 recs
Prediction: Obama's Waterloo

Will end up becoming the moment at which the American people realize the Republican party is useless to them, an anachronism, and an expensive liability - and historians will look back upon the passage of Healthcare Reform as the beginning of the end of the Republican party.

 

Those republicans like Olympia Snowe - who hail from independent minded constituencies - are only ahead of the curve in being able to work with the only party that will be left.

 

And eventually a new party will reform. As it stands now, the only framing that is really happening imho is the rationalization that the GOP has somehow not been handed its hat in its hand.

 

But look closely and you will see the reform measure has huge momentum, any polling numbers are reflecting a broad dissatisfaction with the legislative process - Obama just gave a speech today on Healthcare Reform and it was similiar to those that Howard Dean had given - large crowds, rowdy support.  The energy is definitely there even if the Senate is on the take.

And the GOP is on the way out.

 

 

by Trey Rentz 2010-03-15 02:31PM | 0 recs

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