What Next on HCR? [Updated]

(This began as a comment to Charles' diary on Clyburn's stupendous tactical blunder.  I post it here as its own diary because I think this site needs more discussion that goes beyond criticism and looks forward to framing strategies for the next phase, strategies that can bring us together to do a much better job as a left flank.)

The problem that progressives face, particularly on domestic issues, is an entrenched opposition that would be happy with nothing and has shown the ability to spin obstruction successfully as a victory.  But beyond belaboring the obvious, this leaves the democratic caucus with three options:

1. Vote down a bad bill and try to win the spin in order to regroup for a better version.

2. Take the "something is better than nothing" attitude.

3. Try to get a bill through that cracks open the door for further reform.

With regard to health care, I have advocated 3 for the last week or so.  I respect principled opposition based on critical analysis of the bill's flaws (option 1).  But there is a preponderance of opinion by those close to the process, both policy wonks and legislators, that even the senate bill can function as groundwork for further amendment and reform.  The public and legislative attention span is finite.  Going back to the proverbial drawing board seems a bad dice roll.  The idea that this bill is simply "better than nothing" (option 2) seems a form of cynicism or defeatism that will do nothing more than ultimately embolden the opposition and demoralize those who want real reform (I think that includes all of us here at MyDD).  Clyburn seems to be falling into this option.  Otherwise, why raise the white flag before convening conference?  

In a certain sense, the die has been cast.  It seems almost a done deal that we will get a bad bill resembling the senate version.  Regardless of which of these 3 options seems the best path, number 3 is where we are at.  What we must do now is look down the road:

1. We need to identify those legislators who actually put up a constructive fight for the PO, for repealing anti-trust, and for drug re-importation and make sure they know we have their backs.  

2. We need to identify those who urged passage based on the argument that there will be further opportunity to improve this bill and that there is more to be gained from passing than killing in the long run, and hold their feet to the fire.  I will be looking for Harkin to make good on his stated intention to push the PO in separate legislation next year.  We must remind him and others of this commitment and it should be coupled with a public campaign that makes this a critical issue for the midterms.

3. We need to do a much better job of confronting the anti-reform spin.  This is where we needed much more effective leadership from Obama.  We needed him to use his talents and charisma to cast reform in terms of identifiable "values" just as Reagan did with his tax cuts and Friedmanesque anti-governmentalism.  We can't rely on him for this.  He has disappointed on this account.  So we need to find a better way.  Maybe then he will get on board.  Presidents often lead when pulled and pushed.  It was true of FDR on the New Deal and with LBJ on civil rights.

4. We cannot successfully primary all those conservadems and those who have caved like Clyburn.  But we do need to identify one or two symbolic races where we can replace a centrist or a progressive with insufficient backbone with someone willing to fight, and make sure that it captures national attention.  This is what the teabaggers are doing effectively.  We don't need the same kind of rabid purity police that we see in the GOP, but we need to display some muscle or Obama will be having lunch with Lieberman, Nelson, and Specter all too often for the next three years.  The consequences of that will be bad if he wins reelection in that manner and even worse if he doesn't.  

Update [2009-12-29 19:42:58 by Strummerson]: I have been uninvolved in the debate here as my day has been devoted to vacation childcare and some precious work time. But there haven't been many openings for the discussion I wanted this diary to spark. Most of us actually share the same goals with regard to HCR. Yet instead of thinking ahead about how to push forward, the debate has once again fallen into personal sniping. I thought that the removal of a few bad actors from the conversation yesterday would have helped. I guess I was naive.

But again, the bill will most likely pass and resemble the Senate version, which most of us find flawed and deficient to varying degrees. We've got several options. Jed Lewison has a piece up at Dkos that outlines them as follows:

Broadly speaking, once it passes, there are three different positions one can take on health care reform:

1. Say that health care reform once and for all solves the national health care crisis ("Mission Accomplished"

2. Say that while health care reform is a major step on the path towards solving the national health care crisis, it doesn't finish the job and more must be done, particularly on cost containment/affordability ("Mend it")

3. Say that repealing health care reform is essential to addressing the national health care crisis ("End it")

For Republicans, the choice is between options #2 and #3 -- "Mend it" vs. "End it."

For most Democrats, the choice is between options #1 and #2 -- "Mission Accomplished" vs. "Mend it."

http://www.dailykos.com/storyonly/2009/12/29/820155/-Mission-Accomplished-vs.-Mend-it-vs.-End-it

There are those among us who show no interest into efforts to mend it without rationale for why future efforts might succeed where current efforts fall short. I would rather frame the question as an inquiry into how further efforts might improve upon the present situation. This is how "progressives" pursue "progress." Analyzing how this bill falls short from a policy and a political perspectives should be preliminaries for trying to conceive further possibility, not for dismissing current and future efforts and not for sniping between fellow travelers. I am interested in /any/ suggestions that do not include declaring victory or defeat and walking away. Can't we do that with a bit of civility?

Tags: Health care, left flank (all tags)

Comments

155 Comments

Looking ahead

How do we get more specific with regard to the 4 strategies I suggest in general here and what other ideas can we generate for the next phase?

by Strummerson 2009-12-28 07:03AM | 0 recs
Re: Looking ahead

Like your update: which I'll now paraphrase as commend it, mend it or end it.

As for your plea:

Can we please have some civility?

No, f*ck you. A*rsehole. I don't come to MYDD for civility.

/snark

by brit 2009-12-29 04:33PM | 0 recs
Re: Looking ahead

Kick over the wall
Cause governments will fall
How can you refuse it
Let fury have the hour
Anger can be power
You know that you can use it

Just wish we could channel our anger more productively.  Personally, I think violence against insurance execs here and their lobbyists could be justified as national self-defense.
 

by Strummerson 2009-12-29 04:38PM | 0 recs
Re: Looking ahead

by brit 2009-12-29 04:43PM | 0 recs
Re: Looking ahead

I'd mack the hell out of that little amphibian if I thought it might turn into single payer.  Not much chance though...

by Strummerson 2009-12-30 01:55AM | 0 recs
Hey Strummerson, this is OT, but

could you drop me a line at sricki23@yahoo.com, please? I have something to show you.

by sricki 2009-12-29 07:14PM | 0 recs
Re: What Next on HCR?

I've probably fallen with #1 more than #3 over the past month, increasingly; and still don't believe going into the conference w/o the leverage of accepting #1 is helpful to the overall goal here.

The HCR bill really sucks at its basis (mandate to buy private insurance, punishable by IRS, without cost controls in an industry that is exempted from anti-trust laws). I don't really care what posters think about Jane, Marcy, or John personally (I happen to think the world of their fighting ideals), the fact is that they are correct in their assessment of the bill.

But yea, its likely to get passed pretty close to what it was out of the Senate. I doubted that it would get done by the end of the year, and now its likely to go into Feb. I think there's a good shot still of some in the House drawing a line and it getting better, but we'll see.

I think you are right on in your assessment of what's next.

The transition is going to have to be some primary action against Democratic incumbents... I know that AN is pretty active in that regards, so hopefully we will hear some news soon.

by Jerome Armstrong 2009-12-28 09:10AM | 0 recs
Re: What Next on HCR?

Not fair calling option #2 "option #2".

by QTG 2009-12-28 11:00AM | 0 recs
Suckitude

Jerome the problem is that too many progressives have fallen into Republican talking points.

"punishable by IRS". This was in origin a talking point explicitly solicited by the office of Rep. Dave Camp from the JCT. He asked what was under current law the maximum penalty for violating that section of the CURRENT tax code for failure to comply with the Individual Responsibility requirement. The response of the Joint Committee on Taxation is here: (1.1 MB PDF) http://republicans.waysandmeans.house.go v/UploadedFiles/JCTletter110509.pdf
Does the actual substance of that letter really justify the title of the Press Release from Camp's office? PELOSI: Buy a $15,000 Policy or Go to Jail : JCT Confirms Failure to Comply with Democrats' Mandate Can Lead to 5 Years in Jail Not even remotely, it is the standard Republican method of using an outlier that in this case would apply to tax evasion of the type that put Al Capone in Federal prison and state that it is the norm. In the letter the JCT explains that of 393,000 cases where violations of this provision of the tax code resulted in a penalty only 666 of those were the result of misdemeanor or felony prosecution and only 498 people were incarcerated. And you can bet that none of those were the result of refusing to pay $95 to $795 in fines. Willfully hide millions of dollars of drug profits? You might go to the slammer but otherwise the odds are around 500 to 1 you will come away with a small civil penalty. Yet you visit FDL or some others and erstwhile progressives are repeating this "Nancy Pelosi wants to put you in jail" crap and assuming that the actual penalties are set forth in the bill. Well they are not, it is just another in a long line of Republican distortions.

"without cost controls". Well no, there are cost controls and in my mind very effective ones. It is true that these controls were over the summer watered down to the point of uselessness at which point people like Howard Dean turned against the bill. But at the last minute the Team of Ten put them back in and Dean flipped over to support it. At which point the FDL people themselves flipped and cried "Traitor".

So I don't believe they were "correct in their assessment of the bill", instead they locked in on what they thought would come out of the bill in between the SFC Chairman's Mark and the actual bill introduced by Reid, including the "without cost controls" mantra and never bothered to examine the actual end product. Sec 2718 as included on page 7 of the Manager's Amendment changes EVERYTHING. It replicates in stronger form Sec 116 of the original HR3200 (which was watered down and nearly eliminated over the late summer/fall) and by itself turns what was an acceptable bill transformed into a pretty crappy bill into a really good bill. If you read it and work out how it functions in relation to the premium caps and rating rules of the  bill as passed. I see no evidence that any of the FDL folks have bothered to do any of that, instead choosing to label anyone who has departed from the party line a traitorous sellout.

But oddly enough bill language specfics matter:

``(b) ENSURING THAT CONSUMERS RECEIVE VALUE FOR THEIR PREMIUM PAYMENTS.--
``(1) REQUIREMENT TO PROVIDE VALUE FOR PREMIUM PAYMENTS.--
``(A) REQUIREMENT.--Beginning not later than January 1, 2011, a health insurance issuer offering group or individual health insurance coverage (including a grandfathered health plan) shall, with respect to each plan year, provide an annual rebate to each enrollee under such coverage, on a pro rata basis, if the ratio of the amount of premium revenue expended by the issuer on costs described in paragraphs (1) and (2) of subsection (a) to the total amount of premium revenue (excluding Federal and State taxes and licensing or regulatory fees and after accounting for payments or receipts for risk adjustment, risk corridors, and reinsurance under sections 1341, 1342, and 1343 of the Patient Protection and Affordable Care Act) for the plan year (except as provided in subparagraph (B)(ii)), is less than--
``(i) with respect to a health insurance issuer offering coverage in the large group market, 85 percent, or such higher percentage as a State may by regulation determine; or
``(ii) with respect to a health insurance issuer offering coverage in the small group market or in the individual market, 80 percent, or such higher percentage as a State may by regulation determine, except that the Secretary may adjust such percentage with respect to a State if the Secretary determines that the application of such 80 percent may destabilize the individual market in such State.
How this translates to effective premium and so profit controls is a little complicated, but the short version is that even without the prohibitions on such things as rescissions for daring to actually make claims or denials of whole categories of care, this provision on its own makes those predatory tactics counter-productive. As it does arbitrary increases in premiums. But this reality has simply been smothered by the over the top rhetoric. Analysis has been trumped by talking points.

Which have sucked in people I truly admire on just about every other topic.

by Bruce Webb 2009-12-28 11:05AM | 0 recs
Re: Suckitude

Ah, no, these are my own points. But lets make it simple.

1. mandate to buy private insurance--punishable by IRS (you basically agree, saying, 'don't worry the percentages of those thrown in jail are very low'), LOL.

2. without cost controls--exempted from anti-trust laws (you seem to have skipped that point-- and no, this was not re-inserted).

by Jerome Armstrong 2009-12-28 12:16PM | 0 recs
Jerome that is lame

Nobody is going to jail over this. You have a provision of tax law that covers a huge range of possible types of tax fraud including serious criminal conduct. Cheating on $750 doesn't meet the threshold.

http://republicans.waysandmeans.house.go v/UploadedFiles/JCTletter110509.pdf

The document is imaged in a way that doesn't allow a cut and paste but no one reading page 4 could possible come away believing that incarceration would be the result of violating this provision.

What the hell does the anti-trust exemption have to do with anything? That companies can collude doesn't mean they can simply violate the law. You know the one that would have you punishable by the IRS? The provisions of 2718 can not be effectively dodge without similarly faking certain tax returns and SEC filings which would expose insurance companies to some serious charges, to which the anti-trust exemption won't serve as a Get Out of Jail Free card.

by Bruce Webb 2009-12-28 12:55PM | 0 recs
Re: Jerome that is lame

I was just going off of what you wrote (your implication that they 'could' be jailed-- not mine):

In the letter the JCT explains that of 393,000 cases where violations of this provision of the tax code resulted in a penalty only 666 of those were the result of misdemeanor or felony prosecution and only 498 people were incarcerated. And you can bet that none of those were the result of refusing to pay $95 to $795 in fines.
And besides, I think when it gets to a couple of years, you might be right to imply the possibility?

"What the hell does the anti-trust exemption have to do with anything?" Well, it's just to point out that even a meager whiff at regulatory reform was axed. You be sure to alert me when the DoJ starts redlighting the anti-competitive mergers in the insurance industry and I'll be sure to listen up.

by Jerome Armstrong 2009-12-28 01:38PM | 0 recs
Re: Jerome that is lame

A lot of people who would be just fine with the combination of individual mandates and a public option like to trot out this anti-tax "obey or go to jail" slogan when it would be equally applicable even if we had a PO.  Bruce is right, it's the kind of rhetoric you'd expect to hear from Grover Norquist.  If we ever have a single-payer system, guess what - you will be forced to fund the program or go to jail, even if you don't want to participate!  Just because we're not fond of the final bill doesn't mean we should be adopting slogans that would be GOP talking points in any other scenario.

As for cost controls, can you find me anyone reputable who says the excise tax will not control costs in a significant way?  Saying there are no cost controls doesn't make it so.

by Steve M 2009-12-28 02:17PM | 0 recs
Re: Jerome that is lame

Can you find anyone reputable that says that costs will be contained as a result of the proposed HCR (as opposed to saying that the proposed HCR contains x number of cost control elements) ?

by Ravi Verma 2009-12-28 03:35PM | 0 recs
I don't know how reputable

Ezra Klein is in a given person's view, but he sounds like he knows what he's talking about:

On a superficial level, the policy is simple enough: Health-care premiums above $21,000 for families, and $8,000 for individuals, are hit with a 40 percent surtax. So if your family's insurance plan costs $23,000 a year, then $2,000 of it will be taxed at 40 percent. The tax will be levied on the insurer, who will in turn pass it onto your employer, who will in turn pass it onto you. But that's only if it doesn't work.

If it does work, your insurer will design more affordable plans that don't run afoul of the tax because your employer will refuse to purchase plans that do run afoul of the tax. That's the point of the policy: to give employers an incentive to become more value-conscious purchasers of health-care insurance. "Employers are not shopping very well," says MIT economist Jonathan Gruber. "They're signing up with Blue Cross or whichever insurer they know, because what do they care? They just pass it onto wages." But employers don't like wasting their money and workers don't like big jumps in health-care costs.

According to the Joint Committee on Taxation, the tax will raise a shade over $200 billion over the first 10 years, and more after that. The bulk of the money -- $142 billion, according to the JCT -- will come because people won't pay the tax. Employers are expected to choose cheaper plans, and redirect some of that money into paychecks. That means more of a worker's compensation will be in wages, and wages, unlike health-care benefits, count as taxable income. That's how the tax raises money even if it's not being paid.

by chrisblask 2009-12-28 03:45PM | 0 recs
Re: I don't know how reputable

I understand that there are several cost control elements in the proposed HCR (such as the surtax)/

But my question is whether anyone reputable (such as Ezra Klein) is claiming that costs will actually be controlled as a result of all these cost control measures.

For instance, the answer I am looking for could be...the relevant metric (health spending as a fraction of GDP, or per capita health spending) will be brought down from current levels by X amount.

As far as I can tell, the answer to that is No.  Instead, we are offered 9 different cost control elements (as you did).  

Quite telling, actully!!

by Ravi Verma 2009-12-28 03:49PM | 0 recs
Well I am specifically not reputable

(at least, I'm definitively unqualified to predict the numbers), but I'd venture to say it's anyone's guess.  The Democrats will predict cost savings with a line of experts testifying as to their veracity, the Republicans will do the same in the opposite direction.  At best IMHO, as Mr. Klein says, it all depends whether things work one way or another.  Apart from any reforms to this incredibly complex system (as if that wasn't enough), there are untold developments in medicine ahead of us with unpredictable costs.  

As with the whole bailout/don't-bailout, stimulus/no-stimulus debate, the one thing for certain is that we'll never know what would have happened if we had taken the path not chosen.  There is no way to predict how an alternate choice would have worked out in such massive systems, and anyone claiming otherwise is delusional.

Not, of course, that this will stop folks from claiming to be able to do so.

by chrisblask 2009-12-28 04:38PM | 0 recs
Unfortunately,

it is not anyone's guess... at least, if you consider the CBO to be bigger than "anyone"

And, it would have been interesting if the Democrats had been predicting cost savings while the Republicans were predicting the opposite.  They are not!  Almost everyone agrees that HCR will result in increased spending (even with the PO in there).

Democrats are claiming 9 cost control elements, without ever talking about the costs themselves.

At best, if things work out, it will result in a slowdown in the rate of growth of per capita spending; but only after an initial jump in the rate of growth of the per capita spending.

by Ravi Verma 2009-12-28 05:08PM | 0 recs
Re: Unfortunately,

Claiming that slowing down the rate of growth is not the same as saving money is the kind of verbal gymnastics I am unqualified for.

I guess you're right, if health care costs are going to go up no matter what we do, we definitely shouldn't try to pass any laws aimed at making them go up by less.

by Steve M 2009-12-28 05:34PM | 0 recs
Au contraire

I am going to open a bottle of fine wine to celebrate the potential slowdown in the growth of health care costs in the next date.

Never mind that the actual costs will continue to go up, and that HCR will not make any difference to that.

by Ravi Verma 2009-12-28 08:00PM | 0 recs
Re: Au contraire

Except there is no hard evidence to prove that.

by FUJA 2009-12-28 08:44PM | 0 recs
Steve M has a point,

which is part of what I was saying about advancing medicine.  If I'm not mistaken every country is dealing with increasing costs regardless of the system they have.  Do you think there is a way out there (short of single-payer, which for better or worse simply isn't going to happen) to actually lower costs?

Also, I would expect the per-capita to go up if we're going to cover more people.  Charge me premiums or pay it with taxes, it's more money to cover more people in total so more per capita.

by chrisblask 2009-12-28 06:18PM | 0 recs
Re: Steve M has a point,

The fundamental difference between the US system and many others is that we are going to be funnelling that money into the hands of the private sector.  Sure, Germany has a private system, but it is stringently regulated.  You are trying to mitigate the effects of this bill on the average citizen by some weak play to, well, health care costs increase everywhere.

by orestes 2009-12-28 06:41PM | 0 recs
Re: Steve M has a point,

The effect of this bill on the average citizen, based upon my review of the evidence, is that they will pay less for health care than they would have without the bill.

by Steve M 2009-12-28 07:25PM | 0 recs
Re: Steve M has a point,

Provide your evidence so that we can review it with you.

by bruh3 2009-12-28 08:54PM | 0 recs
Re: Steve M has a point,

I doubt I have seen anything that a student of the issue like yourself hasn't also seen.

by Steve M 2009-12-28 08:56PM | 0 recs
Re: Steve M has a point,

You are always asking me to prove my arguments including on the CBO, which I happily provided. Turn around is fair play. Where's is your evidence?

It would be helpful at this point to see where people are drawing their conclusions from rather than just being given bare assertions. That way I can judge whether I buy the evidence rather than just the assertions.

by bruh3 2009-12-28 09:08PM | 0 recs
Re: Steve M has a point,

I agree with Bruh, please provide some support for your contention.  And please be sure to clarify what will be paid for health insurance v. health care.

by orestes 2009-12-28 11:04PM | 0 recs
Re: Steve M has a point,

You're right and I would LOVE some hard core Regulation... But ultimately all the people saying that this money going into the private sector are GUESSING it will raise premiums.  There is no hard evidence, only extreme disdain for the insurance companies (something I feel myself... A 1000 dead Insurance Execs at the bottom of the sea is a good start) that we will be screwed.   Which could easily happen.  But just as easily, the bill could lower premiums.     This all boils down to guessing whether the cup is half full or empty.   Even a PO doesn't guarentee lowering wages, since most people wouldn't be able to choose the PO.

I do agree though that I would love to see things like Anti-trust exemption removal and more price controls in the bill to actually guarentee lower wages.    

by FUJA 2009-12-28 08:42PM | 0 recs
Re: Steve M has a point,

Actually, they are not guessing. They are basing it on the fact that you are a) dealing with a monopoly so it is not much of guess b) we know from the last decade it rose 100 percent without cost controls c) we know from independent non-CBO research that it will increase by similar numbers by 2020 d) We know that the exchanges (even if you buy the CBO's position) will have no effect on cost and on and on. What's left to say this is just pure guess? I do like the straw man in the middle where you try to make this about emotional outrage when you provide no evidence of your own on the subject.

Here's some data:

"Two-thirds of big companies that cut health-care benefits don't plan to restore them to pre-recession levels, they recently told consulting firm Watson Wyatt. When the firm asked companies that have trimmed retirement benefits when they expect to restore them, fewer than half said they would do so within a year, and 8% said they didn't expect to ever.

Changes like these are reshaping employment in America, injecting uncertainty and delivering the jolting news that pay can go down as well as up. The changes are eroding two pillars of the late-20th-century employment relationship: employer-subsidized retirement benefits and employer-paid health care.

Even as Congress wrestles with how to extend health insurance to more Americans, and considers putting pressure on employers to offer coverage, some companies feel they have no choice but to pull back -- dropping health plans or weighing such a move.

[snip]

The percentage of employers offering health-care benefits is 60% this year, down from 63% in 2008 and 69% in 2000, according to the Kaiser Family Foundation.

In a survey by Hewitt last winter, 19% of large employers said they planned to move away from directly sponsoring health-care benefits over the next five years.

In the meantime, workers' share of health costs is headed up. For next year, 63% of employers that offer health coverage plan to increase employees' share of the expense, according to a survey of 1,500 employers by another consulting firm, Mercer."

http://emptywheel.firedoglake.com/2009/1 2/17/the-cadillac-turned-chevy-salary-in crease-myth/

And more on the excise tax:

http://emptywheel.firedoglake.com/2009/1 2/17/the-cadillac-turned-chevy-salary-in crease-myth/

And more on cost containment:

"According to "Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes," employer-sponsored family plans will rise from an average cost of $12,298 in 2008 to $23,842 in 2020 (the same coverage would have cost close to $9,200 in 2003) if health-care costs continue to rise at the current rate.

The study found that:

The rapid rise in health insurance premiums has severely strained U.S. families and employers in recent years. This analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise from $12,298 (the 2008 average) to $23,842 by 2020--a 94 percent increase.

However, if health system reforms were able to slow premium growth by 1 percentage point in all states, by 2020 employers and families together would save $2,571 per premium for family coverage, compared with projected trends. If growth could be slowed by 1.5 percentage points--a target recently agreed to by a major industry coalition--yearly savings would equal $3,759. The analysis presents state-by-state data on premium costs for 2003 and 2008, as well as projections, using various assumptions, for costs in 2015 and 2020."

http://www.huffingtonpost.com/2009/08/23 without-reform-health-ins_n_266589.html

Historical data:

"From 1999 to 2007, average insurance premiums have risen 120%, while US wages (on average) have risen only 29%.  Moreover, in that same time, the profits of health insurers have risen 428%!"

428 percent. That's the hidden regressive tax that is threatening to not only continue, but get worse. Yet conservatives speak of tax and spend. Don't make me laugh. If they were worried about American families, this would be considered unacceptable. I describe myself as a moderate. Why? Because although I believe in progressive, my believes are not particularly idealogically driven. They are driven by what I see as need. These changes are needed. Any incremental step that does not seek to make the minimum change necessary is theatre for centrists. Not for anyone who truly believes in necessary moderation.

If you want another sign that we are already off the tracks:

"Investors warm to healthcare overhaul"

http://online.wsj.com/article/SB12510665 6304052223.html

And more on public versus private:

Here's the reality of cost containment, and why financing of health care is one of the larger components:

"During the decade that ended in 2006, to cite just one set of relevant statistics, the level of health spending per head (for similar benefits) grew 4.6 percent annually under Medicare, while spending under private health insurance rose by 7.3 percent. For many years, in fact, Medicare has performed better at controlling costs than private insurance companies.

One reason is simple and obvious: Eliminating profits for shareholders and management cuts out a major cost factor.

Another is less obvious: Private insurers consistently spend more on overhead and administration than Medicare. To anyone who shares the broad prejudice against government, the difference will be startling, although these numbers are very well known to health experts. The average overhead cost of Medicare is roughly 2 or 3 percent, far below the administrative costs of private insurers, which range between 27 and 40 percent."

http://www.creators.com/liberal/joe-cona son/why-so-scared-of-a-public-plan.html

By the way, if the regulations work, they will raise premiums because that was the way that the private sector attempted to control cost in the past.

I can provide a lot more data rather than assertions.

by bruh3 2009-12-28 09:03PM | 0 recs
An opinion piece by Joe Conason

isn't data.

I have no idea where he got that 27-40% figure but it seems bogus to me. Numbers from CMS showed that the overall private insurance sector was showing Medical Loss Ratios at around 88% where that 12% includes insurance company admin costs. But that number is skewed because it includes non-profits. The MLRs are much lower for FOR-PROFIT insurers with average MLR of the top six ranging from 76% to 84%. There may be particular plans with MLRs as low as 60% but the idea that the range is from 60%-73% company and industry wide could use some linkage, something Joe didn't seem to be able to do. Now if you include administration costs in handling and appealing claims on the providers' side I could see Conason's number but as the matter stands that is not 'data'.

"By the way, if the regulations work, they will raise premiums because that was the way that the private sector attempted to control cost in the past."

Wow first that is an assertion. Based on a logical fallacy. Which confuses apples and oranges. Ignores the nature of the regulations proposed. And misrepresents history.

There are two main cost sectors in health care: providers and insurers. And when it comes to over cost control in the sector they work at cross purposes. So I don't think you can really say that "the private sector" ever attempted anything, nor that the providers raised premiums. Nor does it make sense to say that insurers raised premiums to "control cost", not at least for the health care sector as a whole, instead those premium increases would have been directed at lowering MLR by denying claims which might or might not have meant cost savings for the sector at large but would certainly have helped the bottom line of the insurer.

Second there is a fundamental difference between regulation and self-regulation in that regulation may be directed directly against the material interest of the entity regulated. Under the bill the government seeks to control costs in the insurance sub-sector of the overall health care sector in two or more ways. One it imposes limits based on individual or family income which serves to cap real dollar premiums at a rate corresponding to the overall increase in Real Wage. Two it imposes premium limits via the 85/80 MLR mandate which serves to cap premiums increases at a rate corresponding to the overall increase in provider spending.

The resulting combination squeezes insurers at both ends. The sweet spot for them is to charge premiums high enough to push everyone to the maximum premium allowed per the subsidy table while keeping payments to providers right at the minimum needed to keep their MLR ratio at the minimum allowed. In this scenario they can only boost premiums with Real Wage increases while increases in provider spending reduce its MLR. And their attempts to keep that increase of MLR at bay are crucially limited by rules on the Acceptable Benefits Package, inability to deny coverage or charge more for pre-existing conditions, or to rescind policies based on 'fraud' definitions the company has made up. In light of that declaring that outside regulation will only have the same methods and results as self-regulations, i.e. increasing premiums seems logically and factually more than suspect.

As to the WSJ piece I couldn't get it to load, but the idea that you can tell anything from a short-term jump in health care stock prices assumes a variation of EMH, that the typical individual or even fund manager actually understands the policy and hence profit implications of a provision inserted at the last minute. I know that AHIP sent around an e-mail telling members essentially 'Not so fast' because those millions of new customers  came with some MLR baggage.

But I am always ready to examine data. Should you come up with some.

by Bruce Webb 2009-12-29 06:54AM | 0 recs
Re: An opinion piece by Joe Conason

Quick and dirty:

a) The cited stats  are those that anyone here can look up. The idea that it matters who mentioned this is typical personality driven politics.

b) Profit versus non profit is not a factor.  the only relevant distinction for cost is between the public and private sector. I have the numerical differences between those two as well.  

c)  I have no idea what you are talking about regarding regulation versus self regulation.

The relevant issue for regulatory strength is:

i) if the statutory language sufficient to be enforceable or does it leave room enough to allow for tricking the effect of a given statute on private actor behavior at the agency level of regulation where the rules are written (assuming federal enforcement which we apparently can not assume here since even that's a loophole in this bill)

ii) enforcement of provisions in the courts (which is packed with conservatives such as Alito, who was advocating in one court ruling before being put on the S.Ct. that someone working in a mine is not a "mine worker" for the purposes of a statute). In effect, it is self regulation. Weak statutory language is an issue that runs throughout the bill.

c) What has other examples taught us about the effect of similar regulations, and what have proven to be effective regulations both domestically and abroad.  This is why MA is inapplicable for various reasons including enforcement mechanisms. Those are the comparators I expect to see from you in order to answer my concerns.

iv) Are enforcement mechanism generally workable, or does ultimately it leave the burden on individual consumers. Why this matters? because of how insurance companies work

d) The link was not to stock prices. It should have been for the cost increases over the last decade health care, which the government UNDERESTIMATED, rather than overestimated. Another reason not to trust that they are getting it right now and why I am a strong advocate of using market forces rather than assumptions.

e) The MLR is a sham requirement that is not set in stone.

f) this line:

"In this scenario they can only boost premiums with Real Wage increases while increases in provider spending reduce its MLR. "

Is nonsensical.

by bruh3 2009-12-29 03:58PM | 0 recs
I've been looking up those numbers

a) And never found them as stated by Conason. If you have them link them.

b) You cited the difference between public and private as being the result of profit and executive compensation then turn around and say profit/non-profit doesn't matter.

c) you claimed that because private cost control (self regulation) only took the form of premium increases the same would be true of public regulation

I) is a question you don't attempt to answer along with a doubtful assertion

ii) assumes that all attempts to enforce this through the courts will end up in front of the Supremes rather than say an administrative judge.

New c) where you ask and don't answer a question while referencing Mass which wasn't part of my argument

After you skipped iii) we have iv) which assumes that the bill has no effect on the pattern of litigation

d) I mentioned that your link didn't work but it suggested the refrence wa to the much touted stock pop. I guess my bad

e) you call the MLR requirement a sham and not set in stone. Well technically none of the bill is set in stone which doesn't keep you from passing judgement on it and you advance no argumentas to MLR at all.

f) after showing that in your alphabet their are two 'c' and that in your version of Roman numbers there is no 'iii' that you can't figure out the relation between MLR and income based premium caps. Well I can't say I am surprised.

by Bruce Webb 2009-12-29 04:36PM | 0 recs
The fundamental problem

in my opinion,

is that our costs are simply not sustainable.  And HCR does not do anything to address that.

Other countries have rising costs as well, but their costs are much more sustainable, by comparison.  From a competitiveness viewpoint, this is a very bad thing.

Other than that, I am all for HCR!

by Ravi Verma 2009-12-28 08:18PM | 0 recs
I don't disagree that our costs

are high relative to other countries, our cost delta is enormous.  This HCR bill (whatever it looks like in the end) does not make that go away.  Nothing short of a complete overhaul of the system down to either single payer or a dramatically regulated private system - neither of which are on the table now or have been - would do so.

If I could wave a wand and wipe out the health insurance companies and institute single payer I would - phase it in over 5-10 years and most of those thrown out of work processing paper could hopefully be absorbed into other jobs.  But I can't and I don't think anyone else can, either.

by chrisblask 2009-12-28 09:41PM | 0 recs
Yes, I know what you are saying...

and I am all for celebrating something meaningless, because we all agree that we cannot do anything meaningful !!

by Ravi Verma 2009-12-29 05:43AM | 0 recs
Re: Steve M has a point,

Yes, complete Private Sector with hard core regulation... nearly as easy to pass as Single Payer.

by FUJA 2009-12-28 08:43PM | 0 recs
Re: I don't know how reputable

THe problem of course is whether it will work or not, it sounds TERRIBLE politically.   More than the PO or the mandate, Dems will get hammered on this.

by FUJA 2009-12-28 08:38PM | 0 recs
depends on how it's spun

the mandate in general is terrible politically, regardless of whether you're forced to buy insurance from the insurance companies or the government...people don't care for either.

If it works, it can be spun as "Democrats get insurance for millions of uninsured."

Plus, keep in mind, the vast majority of people are already insured anyway, so it's pretty much moot for them.

by ND22 2009-12-28 08:39PM | 0 recs
Re: depends on how it's spun

No, it doesn't depend on how its spin, that's your political ineptness showing. It depends on what the truth is, so quit telling us spin.

But well, you are right, about that "millions being insured" being all spin.

by Jerome Armstrong 2009-12-29 04:59AM | 0 recs
one man's truth is another man's spin

and one's spin may actually be the truth.

I stopped caring what you think a long time ago Jerome.

by ND22 2009-12-29 05:15AM | 0 recs
Re: one man's truth is another man's spin

Good, glad you get that you don't have a clue as to whats spin and whats truth.

by Jerome Armstrong 2009-12-29 08:00AM | 0 recs
Re: one man's truth is another man's spin

how can one characterize the projection that millions (more) will be insured as "untrue" or "spin" when the accuracy of the projection can only be judged as to whether it is reasonable or not. Since 2 or more millions would satisfy the projection's literal meaning, then it's almost certainly going to be a slam dunk.

Confidently and regularly predicting failure before any data becomes available seems to me to be a pretty good description of 'spin'.

by QTG 2009-12-29 08:18AM | 0 recs
Because you do?

by ND22 2009-12-29 09:11AM | 0 recs
Re: one man's truth is another man's spin

Says the man who somehow never understood that Obama was going to change his ME focus to Afghanistan.

Reality>Jerome.

by lojasmo 2009-12-30 02:47PM | 0 recs
Re: Jerome that is lame

No Steve. I'm trotting it out not as a matter of wanting to avoid political suicide. To say I'm mimicking Gover when I'm just pointing out what he's going to attack on is rather clueless.

I can't believe the extent to which some progressive are going to in order to speak on behalf of insurance corporation profits, yourself included.

by Jerome Armstrong 2009-12-29 04:56AM | 0 recs
Re: Jerome that is lame

You know who else pointed out that mandates would be politically suicidal?  This guy.

Course, that goes for mandates with a PO, too, so we need to give up on that loser of an idea as well.

Or you could look at it my way, where the vast majority of people already have health insurance and are hardly going to be driven to vote Republican because they're being forced to buy insurance, and then we go from there.

by Steve M 2009-12-29 06:12AM | 0 recs
Re: Jerome that is lame

Look, don't try to play foolish games by having it both ways.

You are advocating for a privatized mandate without a public option at all.  That's the bill, don't fantasyland about some other time.

by Jerome Armstrong 2009-12-29 07:58AM | 0 recs
Re: Jerome that is lame

I don't agree that a mandate is political suicide.  But it certainly can't be suicide when it's in a bill we don't like and just fine and dandy when it's in a bill we like.

by Steve M 2009-12-29 08:34AM | 0 recs
This was my point

It's a little ridiculous to think anyone would feel much better about a mandate because they can buy insurance from the government instead of Aetna. Anyone who doesn't like the mandate won't like it because they don't like to be told what to do or be forced to spend money on something...and isn't going to want to buy insurance from either.

by ND22 2009-12-29 09:10AM | 0 recs
Re: This was my point

They don't have to buy insurance...they'll pay into the pool instead.  Stupid, but it's an option.

by lojasmo 2009-12-30 02:49PM | 0 recs
The notion

that even the fines in these bills won't be amended if it appears that it will apply to anything more than a small minority is simply nonsese.

Nothing is going to be amended more quickly than the fines for failure to buy insurance.

As is the "go to jail notion" which sounds like it comes straight from Hannity.

by fladem 2009-12-29 05:53AM | 0 recs
Re: Jerome that is lame

Bruce, come on, answer the question. I'm wondering when the first person might go to jail for not having health insurance and need an educated response?  

Basically, I realize the fine amount in one year isn't going to send someone to jail, but take it out 5-10 years, and its real money, right?

I'm hoping you can give me a good-faith estimate.

by Jerome Armstrong 2009-12-29 05:02AM | 0 recs
Re: Jerome that is lame

Yes, bad things tend to happen to people who don't pay their taxes for 5-10 years.  Are you postulating someone who will refuse to pay their taxes as a protest, becoming a national hero thereby, or someone who is unable over the course of a decade to restructure their affairs to afford another 2% in taxes or whatever the amount is?

It's just funny, because I can't remember progressives like yourself ever going down this line of thought when we discuss tax increases in other areas.  "No no, we can't possibly raise taxes, someone might not be able to afford it and then they'll go to jail!"

by Steve M 2009-12-29 06:09AM | 0 recs
Re: Jerome that is lame

So now you are claiming that Obama is raising taxes on the middle class through HCR?

by Jerome Armstrong 2009-12-29 07:56AM | 0 recs
Call it what you like, that is

exactly what this bill will do.  Any other bill, as well, unless it purely taxed the rich (who, like any corporation, would build the cost into things the middle class buy).

It won't cost less to insure more, the money will come from somewhere.  Mandates may not be taxes in the legal sense, but it would be the height of naiveté to insist that's not what they effectively are.  I'm not a fan of mandates whether it is the President of the SoS proposing them, but that's the net-net of universal healthcare by any definition: "it ain't free, everyone gets to pay for it".

The only way to avoid raising taxes while providing more coverage would be the destruction of health insurance companies and their replacement with a single-payer system (which, desirable as it may be, is not going to happen).  This would still raise costs for the uninsured, though, because again now everyone would pay something even if most would pay less.

by chrisblask 2009-12-29 08:43AM | 0 recs
Jerome you need to read the JCT letter

If you fail to file taxes or make some misrepresentations the IRS will levy  financial penalties. If you obstinately refuse to pay they might ultimately slap a tax lien on your real or personal property and if necessary collect from your bank account or garnish your wages. The odds they are going to spend hundreds of dollars in attorney and clerical time per hour plus court costs trying to prove you meet the standard for either a misdemeanor or felony charge because you owe $3500 plus interest and penalties and then pay $100'a day to have you sit in a jail sell at Club Fed seems kind of remote to me. The expression 'killing a fly with a sledgehammer' comes to mind.

by Bruce Webb 2009-12-29 04:51PM | 0 recs
Why losing the PO was not fatal for HCR

Cost Controls and the Public Option: Why Losing the Public Option would be Terrible-But Not Fatal. I put up this post back on August 22nd and I think it holds up well. It starts:

The part of the blogosphere that caters to the Progressive Left is hardening its position around the Public Option, it has become a non-negotiable point, the line in the sand, the "are you with us? or against us?" line. And I don't have any problems with that position as a matter of strategy and tactics, the Public Option is much better policy than any proposal that would leave it out, and I don't think it has the political risks that the appeasers believe it does. So 'Fight, Fight, Fight for Old PO!' can be our fight song.

But this does not mean that everyone who argues that life would be worth living even without a Public Option is some treasonous Quisling intent on selling us all out to the insurance companies, as the risk of introducting French into the discussion I suggest the situation is more nuanced than that.

Ultimately I don't think we will ever get overall cost-controls in Health Care in place without the PO because only it allows you to attack both of the cost centers, that which comes from the providers and that which comes from the insurers. Now these two sectors of health care are both natural allies and mortal enemies. They are allies in that insurers would be glad to sell coverage to everyone, and providers would be happy to charge for giving care to everyone, meaning each has a lot to gain from mandated insurance coverage. But at that point their interests diverge, under current business models doctors and hospitals gain most when they can supply ever more and ever more expensive treatment, while the financial incentives of insurance companies work in exactly the opposite direction.

Not to dislocate my shoulder patting myself on the back, but things shook out just as I feared, supporters of the PO did draw that line and issued that challenge. And threw nuance and analysis out the window.
by Bruce Webb 2009-12-28 11:16AM | 0 recs
Re: Why losing the PO was not fatal for HCR

Am not sure what you are patting yourself about other than being adept at mental gymnastics... you basically, there ("I don't think we will ever get overall cost-controls in Health Care in place without the PO") are admitting to what you are trying to argue the other side of, up above.

by Jerome Armstrong 2009-12-29 05:05AM | 0 recs
The argument above

Relates to cost controls for individuals. Most of the objections  to this bill have been about the mandate delivering you into the hands of private insurance which will then jack up premiums while providing POS coverage, I.e. citizens being bent over for the insurance companies. I argued above that the bill insulated the actual individual 'forced' to buy insurance while leaving the burden of increasing provider costs on the shoulder of the government and the insurers.

No contradiction, just another layer of analysis.

by Bruce Webb 2009-12-29 04:59PM | 0 recs
legislation doesn't ever get fixed later

Obama and the Obamadog democrats are not going to spend one more dimes worth of political capital to fix this legislation later.  If this passes insurance companies and the campaigns they support are the only entities that are going to benefit.

I can not believe the gutlessness and ability to be conned that I see in some people here.  If Bush had tried to pass this crap you all would have been screaming bloody murder.
Where is Zombie Nixon when you need him?  His reform was better than this.

by TeresaInPa 2009-12-28 01:20PM | 0 recs
A History Lesson

Why do you think the GOP wants to stop this bill NOW? Because they know we'll have a European system eventually.

ALL of our big social programs have been improved and updated over the years.

Medicare
Social Security

In fact, in 1935, FDR was branded a sell out on social security because it covered a tiny fraction of the population.

The whole concept that this must be a one shot deal for perfection is not only implausible, but ignorant of American history.

by NoFortunateSon 2009-12-28 07:55PM | 0 recs
Re: A History Lesson

You really believe the republicans want to stop this?  Sure, they will make a stand, but they are whoring for those industry dollars as much as the Democrats.  If the repulbicans were really against this on principle, they would be screaming from the rafters.  I think you're being naive.

by orestes 2009-12-28 11:08PM | 0 recs
They aren't screaming from the rafters?

How much louder do you think they can scream? They seem pretty unhinged.

But I agree they are schizophrenic in their criticism because the bill is in part favorable to private interests.

by NoFortunateSon 2009-12-29 11:01AM | 0 recs
They're simply being competitive.

"I want President Obama to fail" (quote from some former GOP leader. Think he's been replaced by a younger guy...).

Obama and the Dems could offer tax cuts to corporations and the Right would still lose their minds.

by chrisblask 2009-12-29 11:27AM | 0 recs
Re: legislation doesn't ever get fixed later

Check your history, you are factually incorrect.  Social Security was improved several times after its initial passage.

by FUJA 2009-12-28 08:32PM | 0 recs
Re: legislation doesn't ever get fixed later

Yes, AFTER Social securities passage. That's not applicable here. Neither price controls which may have addressed the monopoly or competition were added to this bill. You are still on the bench rather than in the game.

by bruh3 2009-12-28 09:11PM | 0 recs
There are price controls in the bill

You may be in the game but I see zero signs you actually read the rule book.

The 85/80 MLR rule in conjunction with the income based premium limits combine to create very strong cost controls on the insurance side which is after all the cost sector most people see. Moreover that rule injects competition even in the absence of the PO. How and why? Well you would have to read up on the bill that actually exists and not the fantasy bill that seems to exist in many self-proclaimed progressives' head.

Can you explain why the 85/80 MLR mandate WON'T work as designed? Or are you just going to repeat stale talking points original put forth by the Single Payer Now! contingent? (A contingent who mostly didn't seem to have read their own rule book, HR 676 in its original form (before Weiner turned it into a real bill) was a 30 page joke that had nothing to do with "Medicare for All" if by "Medicare" you meant the program we have today.)

Anyone is free to argue why the specific cost controls in the bill will not work, but to claim they are just not there is just ignorant. Try reading Section 2718 of the Senate Manager's Amendment which closely tracks Sec 116 of the original Tri-Committee Bill which was John Dingell's proposal to establish cost controls. And HR3200 in this respect paralleled the Kennedy-Dodds HELP Bill. Yet to listen to you dunderheads Kennedy and Dingell spent decades planning on a way to simply turn you over to the insurance companies without a thought for price controls or competition.

What people should be asking is why when handed the task of building the Tri-Committee and HELP Bills that Dingell and Kennedy simply decided to drop the Single-Payer approach of the 2007 Kennedy-Dingell Medicare For All bill and take the approach they did. Hint, it wasn't out of some new-found desire to fuck over the working class.

You are playing the game from the Press Box and not mixing it up on the actual policy ground. This is not a POS bill. Not if you read the relevant sections starting with 2718.

by Bruce Webb 2009-12-29 05:09AM | 0 recs
Re: There are price controls in the bill

You are once again bullshitting, and frankly I tire of it. I would have to go through point by point to demonstrate how you are bullshitting, but after reading your post below first, thankfully, I am going to forgo that effort.

by bruh3 2009-12-29 06:18AM | 0 recs
Re: There are price controls in the bill

You ask for data. Bruce Webb comes up with two posts full of analysis and data (compared to you citing some op-eds) and then you say he's 'bullshitting'.

Come on, bruh. If you're going to debate, debate.

by brit 2009-12-29 07:12AM | 0 recs
Re: There are price controls in the bill

blah, blah, blah. Your turn to respond with your talking point.

by bruh3 2009-12-29 08:25AM | 0 recs
Re: There are price controls in the bill

you've painted yourself into a corner again, haven't you?  yet another argument to have no choice but to walk away from, crying bad faith.  The 'if I had a nickel for every time...' saying seems appropriate here.

by fogiv 2009-12-29 08:01AM | 0 recs
Re: There are price controls in the bill

Yes forgiv. You are right along with the rest of your gang.

Because I dont' want to  do anything more than chide you and others for the manipulations that takes a 5 minute google search to disprove, it is because I am 'afraid" rather than because I see chiding as the most appropriate responses. I mean- the MLR thing- we aren't suppose to realize that there are loopholes in that a mile wide.  It is not at all because you're all as predictable as rain. It is not because I read  comments by others who attempt to engage you on actual substance, and once they pin you down, only to see you say it doesn't matter, or attack them or try to distract.

It is all about just me. Not any of you. That's why with everyone else who disagrees with your little gang of thugs, it is the same response as I receive.

by bruh3 2009-12-29 08:32AM | 0 recs
Re: There are price controls in the bill

Thugs?!?  

You really want to hit that note?  Really?  

After the last several days I thought we'd all had more than enough name-calling, and of this name in particular.  

by January 20 2009-12-29 10:32AM | 0 recs
Re: There are price controls in the bill

And the fact that you each herd in with each other commenting but essentially adding nothing, and giving each other 4s for sayin nothing- certainly proves you are not engaged in thugish pack animal behavior. Just once- if one of you could act alone. You might actually be believeable about being individual in your thinking.

by bruh3 2009-12-29 02:36PM | 0 recs
Re: There are price controls in the bill

It's your judgement that everyone else other than you 'adds nothing'. The fact we mojo each other occasionally is not thuggish behaviour, any more than clapping in a theatre.

If you get some boos it's because you switch from aggression to victimhood at the drop of the hat.

Back to the debate...

by brit 2009-12-29 02:59PM | 0 recs
Re: There are price controls in the bill

4s?

My poor version of MyDD allows a range of only 0 - 2.  There certainly are comments that deserve the higher recognition, but those would be exceptional occasions.

As for who is saying nothing, I'll only agree that replying to your bizarre accusations is not at all productive and is a distraction from Strummerson's thoughtful diary.  If your rebuttal to my fairly empty comment manages to steer clear of personal insults I'll just leave it unanswered, ensuring that you get the last word on the matter.  Maybe then the diary can return to the serious discussion for which it was intended.

by January 20 2009-12-29 03:48PM | 0 recs
Re: There are price controls in the bill

Yes forgiv. You are right along with the rest of your gang.

The bit in bold is the only part of your comment that approaches an accurate fact.  The rest is your typical 'ready, fire, aim' stuff.  I'll leave it be, as I know all too well where that particular path leads.

by fogiv 2009-12-29 01:53PM | 0 recs
Thugs

Wow that sounds familiar. Maybe because it was a favorit epithet of a commenter who with his sockpuppet MMM manage to get a few hundred comments hidden over the last week. I thought the three comments of yours that got hidden in the course of the flame war was just collateral damage.

Hmm.

by Bruce Webb 2009-12-29 05:12PM | 0 recs
Re: There are price controls in the bill

Thank you for mentioning the specific cost control elements.  I was not aware of the 85/80 MLR limit until you mentioned it previously  (btw, is it 85 or is it 80 ?).  And I agree that the MLR is an important cost control element.

However, I am puzzled by one question: with all these cost control elements, why is it that costs are not being projected as going down.  And it is not just "Anyone" that is projecting this, it is the CBO.

In the end, I am not interested in the number of cost control elements, but in the costs...

by Ravi Verma 2009-12-29 07:47AM | 0 recs
Re: There are price controls in the bill

Do me a favor: Google the Senate MLR and put in the term loop holes. See what comes up.

by bruh3 2009-12-29 08:33AM | 0 recs
Re: There are price controls in the bill

First result is Corrente (really?!? lol), and the second is FireDogLake.  Took about twelve seconds to find Corrente complaining about the idiocy of FDL, and dumping on Goddess Hamsher.

http://www.correntewire.com/messaging_ma dness_firedoglake_edition

Do us all a favor and explain how this google search is your Rosetta Stone.

by fogiv 2009-12-29 02:09PM | 0 recs
Re: There are price controls in the bill

First, it was that I didn't have any sources that I could use. Now, when I point out that I choose not to do so since a quick google search could yield refutation, you whine about that. Perfectly illustrating why I said from the outset that argument with you is futile since this is where we would have ended up in the first place with you simply denying counter arguments, attacking the sources or making a bare assertion. The list of tricks up your slaves is predictable. That's why I don't feel the need to even comment with facts. You end up doing what you commarade in arms Bruce did- demonize even the victims of this bill from the middle class as "club goers." And on and on your merry go round of distraction goes.

by bruh3 2009-12-29 02:43PM | 0 recs
Re: There are price controls in the bill

Fine bruh.  Everyone who disagrees with you is a slave incapable of independent thought and a member of a gang of thugs.  You've made your opinion of the majority of posters here quite clear.  Anything else?

by Strummerson 2009-12-29 02:49PM | 0 recs
Re: There are price controls in the bill

And now another chimes in from the pack proving how it is not a pack.

by bruh3 2009-12-29 03:19PM | 0 recs
Re: There are price controls in the bill

Your opinion of me is well established.  

Do you have anything to add that might actually address this diary?  Or do you want to keep squabbling with the same people over the same points on which you will likely never agree.  I am not proprietary regarding my diaries.  I respect your right to weigh in as you see fit.  But have you nothing to say on what we can try looking forward?

by Strummerson 2009-12-29 03:25PM | 0 recs
Oh good God bruh

we don't all get together in some secret meeting place and lay out battle plans on how to gang up on you in the next thread.

As a matter of fact, I think I speak for most of the "gang" when I say...couldn't care less about you.

by ND22 2009-12-29 04:03PM | 0 recs
Re: Oh good God bruh

Let it go.  The personality disputes are irrelevant.  Bruh wants to use this space to continue to make his case for the bill's deficiencies.  It's beside the point of the diary, but his right.  He clearly has a greater grasp of policy detail than I do.  That's fine.  Even most of the bill's advocates admit that it falls far short of where we need to go.  But regardless of what any of us want, the die is cast for this stage.  We need to look toward the next.  

by Strummerson 2009-12-29 04:07PM | 0 recs
Re: Oh good God bruh

Sorry to put this dark thought into your head ND, but what if you just haven't yet been invited into the inner circle yet?

That'll keep you up nights!

I couldn't resist but I promise this will be my last post distracting from the diary itself.

by January 20 2009-12-29 04:07PM | 0 recs
Re: There are price controls in the bill

More strawman abuse from 'teh Bruh'.  You're Olympic caliber, Dude.  Really, you should have an agent.  

What you've posted above is in no way a response to my comment.  Is this diatribe intended for Bruce Webb?  Either way, it's unclear what people are supposed to find when they try your little search engine excercise, and it's unclear how same is a response to Bruce's substantive and detailed comments, much less my very different question.

Do me a favor, Google 'cream cheese' and the phrase 'well oiled midgets'.

See how that works?

by fogiv 2009-12-29 03:25PM | 0 recs
Re: There are price controls in the bill

There's been enough sparring around here of late.  I have been in the center of much of it.  Let it go if it's only going to provoke more reciprocal nastiness.

by Strummerson 2009-12-29 03:26PM | 0 recs
Fair enough.

FTR, yours is a good diary and asks the right sorts of questions, foremost being where do we go from here?

For better or worse, it seems to me that something calling itself HCR is going to pass soon, and we'll all be stuck in that smelly van together.  We can either work together to keep it on the road toward a better place, or (as some are despeate to do) pull the e-brake so we can continue to bitch about the color of the curtians.

Obviously, this bill will need to be fixed, amended, augmented and/or adjusted (and I haven't seen a convincing argument that it can't be).  I agree that a strong left flank will be necessary to see those kinds of efforts through.

by fogiv 2009-12-29 04:00PM | 0 recs
Ravi the 85% is for group

Insurance and Is a pretty hard floor. The 80% is for individual and perhaps small group and has a loophole under conditions where the 80% would create market failure (i.e. no private insurers willing to participate)

by Bruce Webb 2009-12-29 05:20PM | 0 recs
Thank you

Any comments on why this cost control element does not result in any cost controls ?

OTFOI (on the face of it), an MLR of 85% is substantially greater than current MLR levels of around 70%, so it should have resulted in a 15% savings right off the bat (corresponding to about 5% overall, if private insurance is 1/3 of the market).

Why does it not ?

by Ravi Verma 2009-12-29 05:46PM | 0 recs
Don't be so dismissive

Yes, AFTER Social securities passage. That's not applicable here. Neither price controls which may have addressed the monopoly or competition were added to this bill. You are still on the bench rather than in the game.
I never finished our conversation from the earlier thread, but I did learn more about where you are coming from.

I do, however, wish you would elaborate without dismissing peoples' constructive criticisms of your arguments. An argument isn't worth holding if it can't be defended.

Yes, there needs to be greater competition in the bill. Period. And in my opinion, it's not currently there.

But that doesn't mean it can't be added later.

I disagree. Social Security and Medicare are excellent examples of programs expanded after their inception. The difference is that the program was expanded in terms of eligibility versus internal competition.

In fact, it could be argued that health care will be easier to improve later, because the most favorable element (consumer price protection) isn't sufficiently in place. I think it is a much heavier lift to expand an existing program to a new part of the population than to tweak the internal structure by. Repeal Glass-Steagall, Repeal the ban on reimportation of drugs from Canada, create a non-profit or public competition service can all be done by the Legislature.

by NoFortunateSon 2009-12-29 11:08AM | 0 recs
Re: legislation doesn't ever get fixed later

You do understand there are two bills, right?  Each one is different.

Framing it as "the bill" is a false frame.  Of course if you're talking about the Senate version...but you would say that then, right?

by lojasmo 2009-12-30 02:52PM | 0 recs
Re: legislation doesn't ever get fixed later

legislation doesn't ever get fixed later

This, of course, is why black people still don't get social security and have to pay a poll tax to vote.

by ND22 2009-12-28 08:36PM | 0 recs
Re: legislation doesn't ever get fixed later

I don't know about the Nixon reference, but I do agree that this point the political strategy can be summed up as "We want to punt this."

There's a quote that I pulled yesterday from Bloomberg that sums up his frustration with talking to Representatives as he tries to make heads or tails of the bill that needs to be repeated:

"You know, if you really want to object to something in this bill, number one, I have asked congressperson after congressperson after congressperson. Not one can explain to me what's in the bill, even in the House version. Certainly not in the other version," Bloomberg said during an appearance on "Meet the Press.""And so for them to vote on a bill that they don't understand whatsoever, really, you got to question how-- what kind of government we have. Number two, when they talk about bending the curve as -- the governor said, bending the curve is a flimflam euphemism for increasing costs, but we're going to say we'll do it at slightly lower rate than we would have otherwise."

"They are not talking about reducing costs," he added. "They're talking about changing the first derivate, slowing the growth down. And when you look at where the cost savings are going to be, well, they're going to cut something out of Medicare and Medicaid. Now anybody that runs for office will tell you, you don't do that. I mean, the bottom line is it's so politically explosive, it really would be a first time in the history of the world that they ever cut anything [from those programs]."

http://www.huffingtonpost.com/2009/12/27 /bloomberg-on-health-care_n_404271.html

Interestingly, when people discuss slowing the growth, they don't understand this can mean nothing if the growth in cost is still out pacing wages, which is a strong possibility especially in urban areas where the median income can rise above 45k a year, but has not increased significantly despite reaching the threshold for no subsidies.

by bruh3 2009-12-28 09:30PM | 0 recs
Only for urban singles

Which I think is much the problem here.

"especially in urban areas where the median income can rise above 45k a year, but has not increased significantly despite reaching the threshold for no subsidies."

Families are eligible for subsidies up to $88,000. And while $45,000 may not be a picnic for a single in Manhatten, a worker in NY State earning minimum wage for 40 hours a week, 52 weeks a year earns $15,080 and I would think would laugh that some single guy up town was stuggling by with triple that.

I mean I am sorry the mandate might cut into the clubbing and concert budget for comfortable Gen-Xers or self-proclaimed rad-libs, but I am thinking that guy with three kids selling you gyros out of that street cart is not exactly feeling your pain here.

Plus I like that "especially in urban areas", because God knows rural regions in this country are simply dripping in gold with high wages and low unemployment - the lucky duckies. As if.

by Bruce Webb 2009-12-29 05:27AM | 0 recs
Re: Only for urban singles

Reality check:

"Here's a version of one family's total household costs under the plan: a middle class family with two cars and some child care costs. Note, in this scenario, I'm assuming the middle class family will pay 7.9% of its income for health insurance premium, significantly less than the 9.8% the plan assumes that family could pay to get the subsidies available. This, then, shows what a family would be required to pay (or incur a penalty) under the 8% opt-out rule.

301% of Poverty Level: $66,370

Federal Taxes (estimate from this page, includes FICA): $8,628 (13% of income)

State Taxes (using MI rates on $30,000 of income): $1,305 (2% of income)

Food (using "low-cost USDA plan" for family of four): $7,712 (12% of income)

Home (assume a straight 30% of income): $19,275 (30% of income)

Child care (average cost for just one pre-school child in MI): $6,216

Health insurance premium: $5,243 (7.9% of income, max amount before opt-out w/o penalty allowed)

Transportation (assume 2 cars, 12,000 miles each, @IRS deductible cost of $.55/mile): $13,200*

Heat, electricity, water: $1,500

Phone, cable, internet: $1,200

Total: $64,276 (97% of income)

Remainder (for health care out-of-pocket, debt, clothing, etc.): $2,091

In other words, assuming this family had no debt (except for that related to the two cars), no clothing costs, and no other necessary costs-all completely unrealistic assumptions-it would be able to incur just $6,970 of medical care out-of-pocket costs before spending all that $2,091 and going into debt (the opt-out is based on an insurance plan that provides 70% of costs, so this assumes the family will pay 30% of health care costs). Yet that family would be expected to spend up to $5,882 more out of pocket before the "subsidies" started picking up its out-of-pocket expenses. (If the family paid the full 9.8% of its income on premiums-at which point it would become eligible for subsidies under the plan-it would have just $825 left to spend on all other expenses, including health care out-of-pocket expenses.)

This family couldn't even go through a normal childbirth without going into debt."

http://emptywheel.firedoglake.com/2009/1 2/27/affordable-health-care/

If you are going to engage in generational attacks, by the way, that tells me you are not a serious person here. Just one of many people seeking to  "win" the argument who does not care about underlying impact. That's abundantly clear anyway, but your additional behavior about specific groups of people only underscores how childish you are. Many of you are simply non serious posting assertion after assertion after assertion. Never proving anything.

The above are not my numbers. I have done something similar but had not previously went as indepth just to check my instincts.

Here's another reality check, the above does not include the cost of student loans (the average is 20k and rising for undergrad and 50k or more for graduate school). It also does not include savings (where are they going to have the ability under these budgets with rising costs like health insurance to save money for the future?). Etc.

These are practical consideration that you gloss over because frankly you are trying to one up rather than respond substantively.

by bruh3 2009-12-29 06:14AM | 0 recs
Familiies of four earning 150%

Of FPL may not exactly be sympathetic here. Oddly working class families survive without two cars at $1100 a month, paid child care and $1800 in rent and utilities per month.

What kind of parents would choose to park their kid in child care for $6216 a year but leave the family with no insurance even if it just cost $5243 a year for the whole family?and maybe they could cut back on that $675 a month for food? There is no reason why food consumption should automatically scale up by income at a fixed 12.% Buy a bag of potatoes and a five pound hamburger value pack for Gods sake.

And does the typical working/middle class family really spend $35 a day to keep their cars on the road? I had a job that reimbursed my driving at IRS rates, I smiled every time I picked up my expense check, maybe because I was driving a five year old Hyundai and not a new Volvo.

This comment reeks of middle class privilege

by Bruce Webb 2009-12-29 06:03PM | 0 recs
Hmm

in my town in New Jersey, a family of four with an income of $66k would be considered quite poor, and I don't live in a posh part of Jersey either.

by ND22 2009-12-29 07:23PM | 0 recs
Re: Familiies of four earning 150%

I do not know how to bold this so I will cap my thesis:

YOU ARE ENGAGED IN CLASS WAR FARE AGAINST THE MIDDLE CLASS:

First, you say anyone who making above 45 k in NYC who worried about the cost of their health insurance (15 percent rise for Blue Cross next year alone)  while addressing housing, student loan, transportation, savings, stagnant wages and other downward pressures on the middle class are just seeking extra money to go "clubbing."

Now, anyone who disagrees with your distortions of the economic circumstances by actually looking at the average budget of the American middle class "reeks of middle class privilege."

What's the median  income for the U.S.? Do you know that? I do.
It is $50,303. If you don't believe me- google it. And please don't come back with the wikipedia numbers. Put in as I did 2009.  The median wage in this country for those below the 95th percentile has remained stagnant for decades. As per the discussion of that issue here:

http://www.epi.org/publications/entry/bp 195/

This has been true since the 70s (including during the centrism of the Clinton era that Obama is now repeating in which neoliberalism shifted risk, and now, directly is assaulting the middle class in this country. Do you care? Apparently not. These people to you are "privileged."

You are engaged in class warfare against the middle class.

Plain and simple when you make the comments like you are making a long this thread. Now, that warfare has moved from risk shifting such as deregulation to directly transferring income from the middle class to the wealthy and the corporations through mandates, a lack of cost containment and excise tax

No one looking at the issue believes the tax will increase real wages. Ironically enough, your argument is Reagan's trickle down economics mixed with open hostility to the middle class.

What they believe is that the corporations will hold the savings while passing on the cost discussed in two pieces:

http://www.nytimes.com/2009/12/29/opinio n/29herbert.html

http://emptywheel.firedoglake.com/2009/1 2/17/the-cadillac-turned-chevy-salary-in crease-myth/

To believe otherwise is to ignore how your arguments rely on the Reaganomic ideas of trickle down economics.

At this point, to be frank, I don't take any of your posts seriously or those of your cohorts who run up and down the thread patting each other on the back for being ignorant of your bullshitting.

Ironically, one of them with this post finally dimly gets a glimpse for a second of how much of a bullshit artist you are here by going "wait a minute that wage is not privileged." Shocker to realize that 50k a year is not wealthy in a high cost area like NYC or LA. Next you will be arguing I am sure they should all just move from the city if they can't afford it. Afterall, underneath your arguments is "Let them eat cake" and meanwhile people pet you on the back for saying it.

I must commend you. You are getting the ignorant to support policies against their own interest under the rubric of using the progressive desire to "help" others. This is a new spin on "What's the Matter With Kansas" in that people are acting against interest by having it sold as something else.

In that sense Rove was right- it is a matter of being faith based. Say progressive enough or reform enough to people who consider themselves progressives and branding wins out over substance. People feel in their hearts it is true. The problem is that it is not.

But, I am the wrong audience for this crap. I actually check up on the things you say here. Most of which is just bullshitting like you did with the CBO question I raised.

I mean- nevermind that we have been destroying the middle class for decades now. Now, you call anyone with a problem with that destruction "privileged." I would call you Orwellian, but I think the better term for you is "Brave New World." Using people's desires to control them. Progressives want an egalitarian society. Well then, post crap manipulating those emotional cues, and hope no one notices or is too afraid to say anything about it.

by bruh3 2009-12-30 10:01AM | 0 recs
Re: Familiies of four earning 150%

The middle class is a very large and diverse group politically, and fully capable of committing class suicide, a phenomenon which has deep roots in history. I'm certain that the posted views of every participant who is here because of a genuine affinity for progressive politics is not exarcerbating the problem. Attacking a person (or their 'gang') and assigning such terrible motives to them is ridiculous, and comes across as being quite childishly petulant and reminiscent of schoolyard name calling.

The middle class largely abandoned the labor movement starting in earnest in the eighties by helping elect Reagan and Bush-daddy and simultaneously voting directly and indirectly to stick the knife of 'right-to-work' in many states. Of course many helped by not voting at all or by crossing picket lines.

Right wing radio hosts speak directly to and with 'middle-class' Americans who make up the large bulk of their idiot armies. Tea-baggers are largely from the middle class. Your valiantly defending millions upon millions of people who want the exact opposite of what you want for them.
Many would think you are a communist, bruh3, if they gave a shit to care one way or the other.

But what do I know? To you I'm a major part of the problem which stands between you and the success of your mission to save the middle class. The MyDD gang!

by QTG 2009-12-30 11:14AM | 0 recs
Re: Familiies of four earning 150%

I see. The middle class in your mind does not include Labor. I think labor would be shocked to hear that.

by bruh3 2009-12-30 12:02PM | 0 recs
Re: Familiies of four earning 150%

Read it again. Your comprehension score on the previous attempt is an F.

It's a crazy dream that the middle class as currently constituted is politically 'progressive' and as a group recognizes the benefits of trade unions, progressive taxation, single-payer healthcare, women's reproductive rights, religious freedom, sensible gun legislation, humane treatment of animals and immigrants, serious efforts to combat the effects of Global Climate Change, a humble foreign policy, a real commitment to Public Education, serious discourse on Race in America, reform and standardization to ensure transparent and reliable election technologies, decorporatization of the 'Prison Industry', decriminalization of drug addiction, ending the death penalty, recognizing and honoring GLBT persons and their relationships, and the whole litany of progressive causes.

The middle class is their own worst enemy. Wishing it weren't so won't help. Blaming your fellow bloggers for the problem is counterproductive. I wish you could see that, because if you stopped taking every disagreement personally, your contributions to the discussion would be better received. (We passed a resolution to that effect at the last gang meeting.)

by QTG 2009-12-30 12:32PM | 0 recs
Re: Guess Who?

Corporate America holds dominion over the Republican and Democratic parties through campaign contributions, armies of lobbyists that have swamped Washington, and control of political and economic think tanks and media. What was for almost two hundred years a government of the people has become a government of corporations, and the consent of the governed is now little more than a quaint rubric of our Declaration of Independence, honored as a perfunctory exercise in artifice, and practiced every two to four years in midterm and presidential elections in which only about half of our eligible voters go to the polls.

We stand on the brink of being judged by future historians as the generation that failed to heed Abraham Lincoln's call to assure that the "government of the people, by the people, for the people, shall not perish from the earth."

There is almost no countervailing influence in our society to mitigate, even at the margins, the awesome and all but total corporate ownership of our political system. Labor unions are nearing extinction, and those that survive are in the midst of internal leadership struggles to find relevance in our economy and our society. Most of our universities are rarely, if ever, bastions of independent thinking, social scholarship, and activism. Instead they are dependent and rely upon either the federal government or the favor of corporations and the wealthy for funding their very existences. Our churches are in decline and tend to expend their political energy on issues such as gay marriage and highly amorphous "family values" rather than on the relevant causes of our time...


 Hmmm.
Most alarmingly, our federal government has become so dysfunctional that it no longer serves well the needs of the people, nor do our elected officials assert the common good against the power of money and capital.

Can you name the person who wrote this?

by QTG 2009-12-30 12:49PM | 0 recs
Re: Guess Who?

I think I will just let all your posts speak for themselves. I really can not top what you do in damning your own cause.

by bruh3 2009-12-30 12:53PM | 0 recs
Re: Well, bruh

 I tried.  I am not at all surprised at your reaction.

by QTG 2009-12-30 01:01PM | 0 recs
Re: Well, bruh

This is example of the Brave New World language here. Your "trying" consist of a) saying the middle class  should eat cake and b) trying to attack me. If that's trying, I would be curious to see you not trying. But, hey, like the Brave New World that you represent, don't worry about it. Just duck you head in the sand, and think about what you desire.

by bruh3 2009-12-30 01:45PM | 0 recs
Re: Well, bruh

So many people have tried to explain the concept to you, in friendly good faith, but you either can't understand or won't understand - your manner of discourse is off-putting. You'd be well advised to be less defensive.

You have been told this very often for a long time. I expect no change, but in the spirit of the season, I thought I'd give it another shot.

by QTG 2009-12-30 01:52PM | 0 recs
Re: Well, bruh

Again with the Brave New World framing. You are not trying to have debate with me over the issues in the bill. You are trying to convince me that the middle class = bad because you think that influences whether someone will view the bill as good or bad. Good and bad are about desire. Take what people enjoy. Tell them  as with progressive idea, that something is not part of what they enjoy. Thus helping the middle class is not.  This is typical of that kind of world view.

by bruh3 2009-12-30 02:38PM | 0 recs
Re: Familiies of four earning 150%

No one looking at the issue believes the tax will increase real wages.

The Congressional Budget office, the Joint Committee on Taxation, Jonathan Gruber and many other health policy experts believe exactly that, based upon economic theory as well as empirical evidence.

You are entitled to believe whatever you want, but you're not entitled to claim that no one believes something just because you disagree with it.

by Steve M 2009-12-30 11:41AM | 0 recs
Re: Familiies of four earning 150%

Steve to blunt I really don't care what you say on this issue. Above, I gave you the opportunity to discuss the issue and now when I make an overstatement of wording in a blog post, this is what you chime in with? I saw your interaction with jeopardy when you did the same. Says a lot. Good luck

by bruh3 2009-12-30 12:02PM | 0 recs
Re: Familiies of four earning 150%

You mean where you asked me to spew every last link I have looked at regarding the health care bill, and I declined?  Yeah, sorry about that.  It doesn't seem like you're open to persuasion on this issue - you've reviewed all the evidence, and made your mind up based on that evidence - it seems more like you want anyone who disagrees to jump through a bunch of hoops to prove that they're arguing in good faith.

You seem to have a very, very real problem accepting that anyone who isn't a right-wing maniac, an industry shill, or an Obamabot apologist could ever come to a different conclusion than you on a wide variety of issues.  I honestly don't think my bona fides are subject to dispute.  But look, I have this habit of stepping in to correct statements that are really really false, like what you said above, whether the author is interested in hearing from me or not.

by Steve M 2009-12-30 12:09PM | 1 recs
Re: Familiies of four earning 150%

yes, steve, that's what I asked you to do. There is no hyperbole by you in this debate at this point. Frankly, you seem to have come unhinged on this issue- I see it with me, jeopoardy, Big Tent Democrat and others.

And no, despite your over the top rhetoric I do not think you an obamabot or a shill. I Just think you are vested now in a position.

My problem with you is that you losing credibility here except with those who already without credibility.

The example of jeopardy was given for a reason. He mentioned an entire state- 1/10 of the US - regarding the failures of regulatory reform, and you respond he's using a anecdote. That was the extent of your rebuttal.

Thus, were it just me, I could accept your argument about the situation. But, that's the point of the mentioning someone else with whom on this issue you engaged in similar tactical approach.

What you have a habit of doing is selectively discussing the issue, and when I make an error in writing a statement- only discussing that. I tend to write fast, and thus, yes, I am going to make mistakes about wording. That much is clear. The problem is that you glide over all else I wrote just to point out a single phrase. That to me is not credible.

Explain to me intellectually for example how your views or those of the people you cite are not trickle down economics? Explain how it has worked out as other trickle down economists have said it would? And if not, what does that say of the theory here? That would be a discussion worth having rather than this silliness of cutting out one line of my post and arguing over that.

The wider points,  however, you avoid.

by bruh3 2009-12-30 12:24PM | 0 recs
Re: Familiies of four earning 150%

I'm not sure why you want to back up jeopardy on that dispute.  He was basically going around citing a Huffington Post article about how California decided not to go after one big insurer because it would have cost too much, and from that single anecdote he drew the conclusion that the entire concept of regulation on the state level is an epic fail because the states can't afford it.  And he was jumping into every thread with 5 or 10 or 15 posts declaring as a settled fact that it is impossible for states to regulate effectively in this area, based again on this single Huffington Post article.  If telling him that he was way over the top makes me shrill, then I guess I'm shrill, but people can draw their own conclusions and I suspect not many would draw that one.

You ask what the difference is between the excise tax theory and trickle-down economics.  The difference, it seems to me, is that trickle-down economics means that we put extra money in the pockets of rich people and corporations and cross our fingers that they will use it to create jobs and pay people more money.  This isn't completely stupid, because the number of jobs you'll create with a tax cut is certainly nonzero, but it's a bad excuse for an economic policy because most of the money will get diverted to other things.  It's like handing out a bunch of capital to banks and hoping they use it to make loans.

The theory of the excise tax, on the other hand - which Gruber says is backed up by plenty of empirical evidence as well, although I haven't drilled down to that level - is not that employers will pay higher wages out of the goodness of their heart.  In fact, it's just the opposite; the theory assumes that compensation will remain pretty much flat, but because we remove the huge government-financed incentive to pay out that compensation in the form of health insurance rather than wages, your total compensation package will end up consisting of relatively more wages and relatively less health insurance.

I am not the sort of person who believes Econ 101 explains everything, but Econ 101 isn't automatically wrong, either.  What I believe, and what I think Econ 101 backs up, is that an individual's wages are set in one of two ways: (1) an actual negotiation, when the employee has real bargaining power (as when they're represented by a union) or (2) market forces and competitive pressure, when the employee doesn't have much power.  An employee is worth a given amount in the marketplace, based upon competitive forces and the amount of value he adds to the business, and by and large I think he's getting paid roughly that amount.  I think if employers could get away with unilaterally cutting everyone's pay by 10%, many of them would.  So when the excise tax suddenly means that health insurance costs the employer more, I don't think the response of the typical employer will be to cut the employee's compensation, because if the market would let them get away with that (again, speaking generally) it would have happened already.  That employee is still worth the same amount in the marketplace, but health insurance no longer has the same tax-favored status, so the compensation package will shift to a more normal allocation of wages and insurance.

To believe the alternative (and hey, I respect Atrios' economics degree, but he hasn't provided one iota of explanation), you have to believe that employee compensation right now contains a huge amount of fluff, money employers aren't obligated to pay due to market forces but are just voluntarily throwing at the employees anyway.  And then you can argue, if insurance gets more expensive, the employers' reaction will be to eliminate the fluff resulting in a compensation cut across the board.  But I haven't seen any evidence that there's a lot of fluff in compensation packages right now.

Based on my personal experience as both an employer and an employee, I know that employees don't typically think of compensation as one big number.  They think of their wages as the relevant number, and benefits are something else entirely that gets thrown into the mix.  But from the employer's perspective, the total cost per employee is a highly relevant figure.  My company grosses X, my overhead and expenses are Y, so I have a certain pot of money left over to compensate my employees and leave myself with a profit margin.  If I can get favorable tax treatment by spending a larger portion of that pot on insurance rather than wages, of course I'm more likely to do it.  But in any case, I'm paying the employees what I think I have to given the market conditions, I'm not simply handing out charity.  

You may disagree with any or all of this but I certainly hope you will deem it a good-faith explanation.

by Steve M 2009-12-30 01:29PM | 0 recs
Re: Familiies of four earning 150%

First,  unlike many, I don't question your good faith. Maybe sometime in the future I will, but right now, that's not my point. I don't even question the good faith of someone like CHarles, but I think he is caught up in being emotionally removed from the discussion in ways that are dangerous.

You do not typically  spin and I don't typically consider you a bullshit artist like say I believe Bruce Webb to be or a shill as say QTG or a fan boy etc.

I simply think we disagree here. I believe you are caught up on believing your position. I can be accused of the same, but I also believe that it matters to be skeptical of ideas that have failed in the past or are solely based on speculation that is unproveable.  We are betting against the American middle class, and this is a problem that goes beyond health care, and is in fact systemic, as I have written before.  Remember health care is only the latest because of a wide range of issues like student loans, housing, savings, etc. in which the middle class is facing downward pressures as a class.

Now, second to the specifics,

a) I used Jeopardy among others to illustrate how your tactical approach to the debate makes arguing with you on the specifics of the health care debate nearly early impossible.

Jeopardy for example, kept posting that article frankly because he or she was probably becoming frustrated with the lack of attempt by you to at the very least explain to him why the California outcome is not representative of the danger of relying on poorly constructed statutory language without any effective enforcement mechanism.

Rather than addressing that concern, your thesis seemed to be 'well I am going to just say that evidence is not evidence." I am going to say something pithy like "anecdote is not data," and think I have responded to the concern. Where in fact, you misused the concept of anecdote is not data. The California example represented 1000s of cases in a state that has a regulatory regime that is one of the more liberal. It is probably the best you are going to get.

In context, I can understand the frustration of debating someone who takes a state as big as California is on our regulatory schema  as it relates the state level regulation as just an anecdote.

Like he was talking some single one off without any greater meaning than that. And in which you provide no counter evidence to suggest your bare assertion is valid. You may think it shrill, but that only reinforces your disconnect from debating the specifics arguments. Much like your decision to casually gloss over the cost of this bill to the middle class does. There is a certain air of let them eat cake to all of this.

It was with lurking on that exchange that i decided with you to ask you truly back things up as opposed to requesting it as I had with the CBO exchange between you and I. Well, that and your exchange over at Talk Left where I also lurk, and noticed something similar since I happen to read Big Tent Democrat's post (not a Jeralyn fan, but like Big Tent even when I disagree with him , which is often).

You repeat the argument style above. That's why I am pushing for more. Ordinarily, I would give you the benefit of the doubt, you are losing that here with me on this particular issue. I am not saying you should care, but others are noticing it.

You are not providing arguments so much as "I am not going to worry about that pesky problem."

b) This will may be long (yeah I know my post already is, but I want to dig into some of the assumptions you are making and compare them to reality as I see it). By the way, before I start, I should point out I don't like the employer based system either. But the solution to that problem is not on the table, and the things being offered are not a solution. It is a conflation. That's  why I provided you this link:

http://fdlaction.firedoglake.com/2009/12 11/cms-excise-tax-on-insurance-will-mak e-your-insurance-coverage-worse-and-caus e-almost-no-reduction-in-nhe

You like the CBO. I question their accuracy. But above attempts to discuss this in more detailed. There is the other link I have. I will have to find it that also discusses the issue.

The discussion is about how the conflation of goals, one good, ending employer based health insurance, and the other bad, trickle down economics, will actually lead to a worse outcome-  a lack of ending employer based care , but instead passing the cost off to the already wage stagnant middle class, while any savings will go to the insurance companies and the employer.    I know people around here want to demonize FDL, but they do some very good analysis of the bill.

Your argument requires taking a big gamble that is very similar to trickle down economics, which has failed in the past , and that should be cause for concern over why one should buy the set of assumptions now.

c) Economic assumptions: By assumptions on labor economics is that the American work force is under assault by various forces that will hinder its ability to obtain any benefit from the cut in the benefits.

Whether that pressure is globalization, a higher unemployment rate set as the norm (read the business journals that are advocating this), existing debt (student loan or otherwise), these pressures are squeezing the employee. The employers know this. That means that it does not require a 'slack" in benefits already offered that does not need to be offered.

It means that we are in a race to the bottom to see what they can get away with. if they can get away with paying less, they will. If they can transform a formerly permanent position into a contractor position so that they do not have to pay benefits, they will.

Part of this is about the trajectory of where you think this country is headed. I think it is on the decline. Your argument relies on a growing economy.

I think what will  happen is what we already seeing happen. The cost will be passed on to the worker, and the savings will be kept by the companies. The insurance companies will raise up their rates because as monopoly/oligopoly markets, they have nothing to create a competition that involves pricing. The best one can come up with from the defenders of the bill is the MLR, which is another example of you have to look  under the hood of the car to realize how the used car sales man is jacking you up.

d) Part of this exposes the faultline between those of us who are behavioral economists in our view of the world, and those who are still believers in neoliberalism. I think you are  a believer in neoliberalism. I am not. That's another much longer conversation. This is what Glenn Greenwald was getting at the other day in his discussion of the issue:

http://www.salon.com/news/opinion/glenn_ greenwald/2009/12/18/corporatism/index.h tml

Ultimately, your arguments are just another form of trickle down economics to me. I understand that you say that it is not for the various reasons you state. But, in actual expected behaviors, it seems very similar to me.

What if people are not always rational like your model requires? What happens then? What if you want a public option or price control because you know there need to be something stronger in the mix to produce the results you want to produce?

In other words, to discuss another book that I currently like, what if your assumptions are wrong? Have you considered realistically what the means for the middle class? That book is called Bright Sided.

I believe realistically , in closing, that the only way we are going to stop the decline of the middle class is to address the systemic issues using a different set of assumptions. I tend to like this article discussing what are just a few pressures on the middle class are:

http://www.huffingtonpost.com/elizabeth- warren/america-without-a-middle_b_377829 .html

The problems are many and vast. I don't think it is a good idea to contribute to increasing those problems based on a set of assumptions that at the very least are questionable.

by bruh3 2009-12-30 02:29PM | 0 recs
Re: Familiies of four earning 150%

Here's articles getting into the deeper discussion of issue of assuming that health care consumers are rational:

http://seekingalpha.com/article/180178-c an-consumers-make-rational-healthcare-ch oices

The importance are the linked studies.

The point is that one can not easily make that assumption, and given the already big issue of market failure consider insurance companies are monopolies/oligopolies, then it becomes even more problematic.

by bruh3 2009-12-30 02:55PM | 0 recs
Re: Familiies of four earning 150%

Are you a Habsburg?  

To go on about how another can cut back here and there and question (by implication) the morality of how those less fortunate spend their income while accusing someone else of middle class privilege is a hoot.  Cake all around!

by orestes 2009-12-30 11:40AM | 0 recs
Re: Familiies of four earning 150%

I doubt Bruce really believes what he wrote. It is just an example of the say anything to win approach that's taken over their side of the debate. When you work your way down the road of the various arguments by forcing them to dig into what they are trying to distract you from, his response is what they have left-- attack the middle class or appeal to authority etc.

One of the reason why I am starting to see most of them as unserious is they will quote some source without regard to just thinking through the implications of a policy. The CBO says something, and it is gold. Apply the actual policy when looking at average cost- well that's just something where they should eat cake. Besides the CBO says they will be okay.

Why does that matter? No reason because when you look at the CBO's history on this sort of thing their actual history is not that good. They are better at crunching government numbers.

But, when you start to get into the real world examples of private cost, etc, it shows a completely different picture, and their response? Well,  let them eat cake.  I am sure they will be able to handle it. I am comfortable they will be able to handle it.

What proof do they offer? Their belief.

So long as the thesis is win the debate at all cost without any intellectual rigor required, there is really no point in debating.

My point at this point of posting here is to provide a counter weight to what are often bare assertions or statements based on appeals to authorities. ie, if the CBO says it well it must be accurate although we don't go into whether the CBO is good at determining private sector behavior such as the employer based health care system (which apparently if you google it is clear they are not).  

The point here ultimately is just to say trust them. Something that i advocate any lurkers not to do. Trust none of us. Do your own research to find out the answer.

by bruh3 2009-12-30 12:15PM | 0 recs
Re: Familiies of four earning 150%

By the way, for me this is a continuous process. Until recently I was more accepting of the numbers say out of the CBO as well until they made the mistake of being openly partisan with the MLR issue. That's when I began to do research. No one is immune from the issue of being too accepting of what the status quo tells us. Even the people I choose to quote should be tested as to their veracity. That's my point. Thus, when I read a post claiming that an excise tax on the middle class is okay because they can afford it, I am going to know to look that up to check it against what other costs people are seeking to cover right now.

by bruh3 2009-12-30 12:30PM | 0 recs
Re: What Next on HCR?

Where is Zombie Nixon when you need him?  His reform was better than this.

Wow. We're going back to the early 70s now, are we? Or perhaps last primary season, Teresa?

Vintage sour grapes.

by brit 2009-12-28 01:24PM | 0 recs
Re: What Next on HCR?

How many progressives who are supporting the bill really believe #2?  I don't think most of us feel its better than nothing, rather we feel its a solid foundation to build on and complete defeat is 1) a gamble and 2) forces us to have this same fight.  I read the Senate as more willing to see this defeated and give up rather than pass through reconciliation.    Instead, I support passing this and then immediately start working to further improve it... first and foremost by fighting to  pass the Harkin bill to reform the Filibuster.

by FUJA 2009-12-28 08:32PM | 0 recs
Re: What Next on HCR?

I read the Senate as more willing to see this defeated and give up rather than pass through reconciliation.

This would be because reconciliation would require a new bill go through all the committes, including the Finance Committee, and both Houses. What are the odds of a good bill doing that at this juncture?

by ND22 2009-12-28 08:38PM | 0 recs
Re: What Next on HCR?

What makes you think any bill from HArkin will pass in the future?  If it could pass, it would be added to this bill, no?  The only reason for excluding it is that it wouldn't pass.  Please explain what will change to make it pass in the future if it can't pass now.

by orestes 2009-12-28 11:11PM | 0 recs
Hmm no.

This isn't hard.

Let's say I have two proposals each with documented sixty-seven precent approval in both Houses of Congress. Does that mean combining them into one bill guarantees a veto proof passage? Of course not, anyone who ever saw a Venn Diagram understands that.

In the early sixties there were some big programs that in the end had strong majority support: Man on the Moon, Anti-Communist roll back (Vietnam, Etc), Medicare, AFDC, Food for Peace, Civil Rights Act of 1965. But only an idiot would have rolled up a space/defence bill with a civil rights bill. Just because Alabama had Marshall Space Flight Center in Huntsville and Fort Rucker didn't obviate the fact that they had George Wallace in the State House. Similarly Food for Peace was pretty popular among leftists not wanting millions of Asians to starve, it was real popular with Senators from farm states for whom it was a huge subsidy for domestic grain producers, while AFDC just went to a bunch of urban poor people (i.e. 'them').

To get back to the point, the Republican Party is in a no holds barred effort to kill Health Care which crucially depends on filibuster math of 40 + 1. There are four or five people in a position to supply that 1 including All About Joe who if it were not for the filibuster would be checking into his new offices in the sub-basement next to the boiler-room. The implied notion of "Well we got 60 votes, lets just throw in a filibuster" is just silly special pleading.

I really don't expect the Harkin Bill to pass, not at least until or unless Republicans get back closer to 50 votes and a chance to grab the majority, but it is not impossible. Just don't expect it as part of some omnibus legislation. Not enough overlappage in the Venn.

by Bruce Webb 2009-12-29 06:03AM | 0 recs
Re: Hmm no.

Your omnibus example is off the mark.  Harkin's public option proposal is a health care initiative.  Congress is debating a health care bill now.  This is not some apples and oranges melange.  I don't understand why you would bring this point up; it's completely irrelevant.  At least we understand each other.  I, too, don't think Harkin's pledged proposal for a public option will come to anything.  So, at least we can agree that the argument that the bill can be fixed down the line (see Harkin) is hogwash.

by orestes 2009-12-29 06:22AM | 0 recs
Re: Hmm no.

At this point this is a marketing campaign rather than a debate. They are throwing out talking points like "we will progress in the future" as a means of manipulating progressive psychology becaue they know what sort of language appeals to progressives who may be teetering on capitulation to get them to say "Okay, yes, this is the out I have been looking for. We will will progress in the future." The idea is to repeat enough so that people will believe it. Ironically enough, it is their use of previously Republican marketing tactics of staying on point by repeating a talking like this that tell me that they have no problem being aggressive when they want to be or changing strategy when it suits them, but choose not to use those tactics for progressive ends. I don't take Bruce all that seriously for that reason.

by bruh3 2009-12-29 06:47AM | 0 recs
Re: Hmm no.

You accuse some generalised 'them' of using 'talking points' as a means of 'manipulating progressive psychology'. The main form of mind manipulation you accuse 'them' of is saying 'We will progress in the future'.

What bit of progressive don't you understand?

Unlike revolutionaries, or reactionaries, progressives (since J S Mill who coined the phrase) have celebrated amelioration, evolution and victories (no matter how small) against the perfectionism (and attendant defeatism) of those who say all or nothing.

You say you can't take Bruce 'seriously' (as if your standard of seriousness was anything to rave about) but it ill behoves either your arguments or your good self to disparage someone's intent, just because you disagree.

by brit 2009-12-29 07:18AM | 0 recs
I want to be British when I grow up.

You Limey's have such a way with words.

by chrisblask 2009-12-29 07:23AM | 0 recs
Re: I want to be British when I grow up.

Please don't grow up, Chris. The world will be a poorer place. And you've a pretty turn of phrase yourself, young man.

by brit 2009-12-29 07:27AM | 0 recs
Re: I want to be British when I grow up.

What I also find amusing here is the whole "in group" reinenforcing  the marketing. This is also a marketing technique. If others like the product "progressives" (nevermind again what that means or whether it means anything substantively as orestes request you demonstrate). The important part is that we buy the product.

by bruh3 2009-12-29 07:40AM | 0 recs
Re: I want to be British when I grow up.

In group? Are you and Orestes forming your own 'in group'? What about FDL or Kos?

FYI I got to know Chris, as well as Jerome, Steve M and various others here having been a member since 2004. We don't agree on everything, and Jerome and I barely agree on anything, but we've learned to disagree without constant ad hominems.

Politness is free, you know. And a bit of friendliness now and then might not hurt your case.

It's a marketing thing of course...

by brit 2009-12-29 07:53AM | 0 recs
Re: I want to be British when I grow up.

LOL. Okay. Am I suppose not buy that a statement like "we will fix the bill in the future" where you can not even explain how that's going to occur is now more substantive than just a talking point that acts a marketing for the present bill?

by bruh3 2009-12-29 08:16AM | 0 recs
Re: I want to be British when I grow up.

You're welcome to be sceptical all you like, but if you go around insulting other commenters, lumping all their various points of view as 'them', you'll just end up alienating even your ideological supporters. Strummerson, for example, is probably as pissed off with the current bill as you are. Chris was probably never a supporter of single payer. Meanwhile, coming from the UK, I can sing long and sweet about the value of socialised medicine.

Somehow you've managed to unite us all in your rhetoric. For which, many thanks. But if you're sincere in your advocacy (which I think you probably are) then I would suggest something more persuasive than cries of 'traitor' and 'corporatist shill' might work better for you.

On the other hand, if you're happy to unite progressives of various hues in antipathy to you... keep up the sterling work.  

by brit 2009-12-29 08:27AM | 0 recs
Flinging poo and peeing in people's

tea is also a form of marketing.

Say all you like about trying to convince others of a point (marketing), that's all there is to this using-words-to-convince-others debate thing (marketing) at any rate.

I'm not a big fan of the whole poo-flinging school of marketing, which is why I usually skip over comments with that tone.  Generally it has been my experience that these sorts of sabotage-the-other-person's-communicatio ns approaches do not produce the longer-term results which are the goal of any act to convince others of a point.

As an information security person, I do recognize the efficacy of the technique when the goal is not to achieve consensus but rather simply to disrupt the communications of an adversary.  It is particularly desirable when one is in an asymmetrical conflict where the only goal is to block one's adversaries from achieving their own goal.

All of that applied to debate about how to achieve goals which the aggregate group is in agreement on, however, demonstrates a worrying dynamic from the point of view of those who consistently choose tactics seemingly crafted to disrupt the discourse of others of the same group.  Occam's Razor suggests that any such actor cannot logically embody the desire to achieve the shared goal - in the case of the current discussion this would be to remedy flaws in the nation's medical delivery system - and must therefore desire to thwart these aims.  The only other possibility that remains is that the actor is acting against their own interest out of poor judgement, emotional drivers, or both.

by chrisblask 2009-12-29 08:30AM | 0 recs
Re: Hmm no.

Yes, I am accusing people of "OH MY GAWD" - marketing.

Repetition of a talking point in marketing works best if audience is predisposed to like it. What's works best on progressives  than promising them progress. Not the real thing managed you. Just the promise.   They certainly don't expect follow up such as those by orestes asking them to cut the bullshit, tell me how you are going to progress in concrete terms. The point is the emotions building up over "yes, we can."

The whole point of marketing through repetition is that others will repeat the talking point eventually who are not trying to manipulate, but who have emotionally bought into the sales job. That's what marketing does. It makes you think you want something.

I understand all of you just fine.

Then again, marketing works best if no one notices the guy behind the curtain, which orestes does.

by bruh3 2009-12-29 07:36AM | 0 recs
Re: Hmm no.

Oh, so it's all about

Yes, we can.

You reveal yourself too easily, Bruh. These various 'thems' you accuse of this come from a vast array of persuasions. Many of them weren't Obama supporters back in the day, but are political pragmatists when it comes to HRC, among other issues.

But you reveal your reverse Obamabot obsession.

Your current president doesn't rule the world, and clearly can't control both houses of congress (as the constitution planned) but still every aspect of policy has to be seen through the prism of your Kool Aid coloured spectacles.

If it's all about 'the guy behind the curtain' for you, then you're going to spend the next three years looking for every event and policy shift as a kind of retroactive vindication of your initial false premise. It will be a sad kind of existence, but at least a predictable one.

by brit 2009-12-29 08:00AM | 0 recs
Re: Hmm no.

Yes, I "reveal" myself by pointing out that you basically are marketing the present bill by saying "we will change it in the future" by providing an analogy of a now famous branding technique from a recent campaign.  How dare I use an analogy. It must mean more than being an analogy. Would you prefer I used the Bush ranch marketing of 2000? That seems a bit distanct for you to remember.

And we all know- discussing endless around a subject is actually not meant to distract , right?

Because-t hat's the point. Not the bill.. Not whether the statement "we will change things" substantively means anything rather than being a phrase one knows markets well with progressives since it fits perfectly into their language. The test here is what does it mean? It means nothing if one asks how will you do that, and you say we won't.  The separation between marketing and actuality is where you produce the outcome that you are trying to market or at least provide a road to doing it. Have you done that? No. Because you can't.

 As I said- marketing, and now the  comical attempts to distract from the fact that the statement of "look to the future" is a way to market to progressive psychology.

by bruh3 2009-12-29 08:22AM | 0 recs
Re: Hmm no.

It really helps if you try to work out what you're trying to say before you start hitting the keyboard. In that way your posts won't come across as a circular conversation with yourself.

But to the point. Progress is progress. If I were an American, would I be ecstatic about this bill? No. Could it be better? Hell, yes. Is it better than the status quo ante, much vaunted by republicans. From what I've read (from posters like Bruce Webb I've never encountered before) then I would say, yes too.

You are welcome to disagree on that. This is exactly the point of Strummerson's diary. Let's get beyond the accusations of bad faith to discuss his point.

From a personal perspective, I can well see how the republicans threw everything they had against this bill. It was exactly on this issue they defeated Bill Clinton, and began to fight back against the last democratic incumbent.  Even if this bill is no improvement (something I don't actually concede) it could still be better, politically and strategically, to pass something to prove that dems are not completely inept and incapable of governance.

Your line, and that of many other 'progressives' from FDL leftwards, creates the danger of confirming right wing talking point that the  current administration cannot unite its various factions in a governing coalition. Regardless of its merits, if this bill were to fail because of leftish agitation, then this would immediately be portrayed by republicans as an example of the dems unfitness to govern.

Strategically, this would be a disaster, and ensure a further shift rightwards for a generation.

by brit 2009-12-29 08:39AM | 0 recs
Re: Hmm no.

First you claim that my point is wrong. Now you claim you don't understand it. Which is it?

And, the interesting part is the band of thugs gives you 4s for the contradictory arguments.

I will say this in  a short sentence so you can understand: You are not fooling anyone with the marketing campaign. Marketing 101 is to use the emotional cues of the intended audience to sell them on the product. Discussing progress in which there is no way forward towards progress is a marketing campaign. You are not discussing substantive action or outcomes. You are not saying how it will be any easier to get the real reform through. What you are doing is distracting from the fact that this bill is a bad bill. Because you know it is a bad bill that is hard to sell, you are left with the distraction of marketing to us about the future.

Orestes, as I said, got your number pretty quick. This exchange between you and I does not change that. It just reinforces how much of a snow job you are doing.

by bruh3 2009-12-29 02:49PM | 0 recs
Re: Hmm no.

Welcome to the snow job!

I'll ignore the name calling and answer your question. I'm part of no marketing campaign. I'm a British writer with a lifelong (nearly half a century) interest in left and centre left thinking. I've seen partial reforms come and go, some lead somewhere, and some don't. I think this bill, as others point out, leads to the way to a more comprehensive healthcare system, just as the partial and 'treacherous' social security bill did in FDR's first term.

I may be wrong, I may be right: but I am part of no marketing campaign and never would be.

As for Orestes 'getting my number'. I think you're confusing me with Bruce Webb if you think Orestes has even made a comment in my direction.  But if he has refuted my points, then - like you - I'm bravely march on as a solitary voice of reason in this storm of opprobrium, trudging the lonely narrow path of truth.

Fun isn't it?  

by brit 2009-12-29 03:07PM | 0 recs
Re: Hmm no.

This bill will only lead to more comprehensive reform if people on the left make sure that it does.  And even then, I don't expect it to be a simple or quick process.  But given that there is some agreement regarding several points where the bill falls critically short, declaring victory and walking away is not an option.  That will only end up proving those who want this bill killed correct.  And that camp includes many progressives of good will who would happily be proven wrong if that is the cost of achieving more comprehensive reform.  We're approaching the end of a significant stage in this process.  We've got to keep pushing forward or whatever policy and political potential this bill might create will be lost.

by Strummerson 2009-12-29 03:21PM | 0 recs
Re: Hmm no.

From what I gather (from these distant shores) very few on the left are unaware of the inadequacies of the bill. Declaring a false 'mission accomplished' is one thing. Advancing ground and holding it is another.

Whatever is said on progressive blogs, it's clear to me the next stage of advance must come from targeting voters in two ways:

1. Better regulated healthcare is not creeping communism. Socialised medicine, like socialised education, is accepted by most capitalist countries.

2. Then target the various obstructionists in the senate and house. This ultimately relies on 1.

Nowhere is this complacency. On the other hand, it will take time, as the current bill beds down. From what I've seen of US reaction to this bill, it does represent a fairly big leap for the US population, and the bill reflects the rightward anti government suspicions of the electorate. A democratic progressive must recognise that, and seek to change that, as part of realistic programme. Accusing others on the left of complacency, betrayal or 'marketing' on fractures the coalitions that need to be built.

by brit 2009-12-29 03:28PM | 0 recs
Re: Hmm no.

Sure.  But I don't think the bill's biggest critics on the left are so far off base.  The alarm they raise regarding the corporatism and loopholes in the bill make continued efforts imperative.  Their concern that it could backfire and set the whole process back do not strike me as unsound.  Declaring victory can also occur as a result of fatigue.  This would be tragic.  

Obama has not led on this issue as most of us wanted.  Whether this is due to his policy or political dispositions or both, if FDR could be drawn into championing the New Deal and LBJ could be enlisted for civil rights (both driven by activism, advocacy, and crisis) we've got to at least try to find ways to try to pull him into the game as well.

by Strummerson 2009-12-29 03:37PM | 0 recs
Wow, that was beautiful lol

by ND22 2009-12-29 04:05PM | 0 recs
Apologies due from me

I asumed you were referring to Harkin's proposal to eliminate the filibuster and not his attempt to reintroduce the Public Option. Though in practice they are linked.

But hey when I am wrong I am wrong.

by Bruce Webb 2009-12-29 06:19PM | 0 recs
Obama throws house HCR under the bus

Remember he said he would be "fully" involved in the reconciliation.

by Joshuagen 2009-12-29 12:04AM | 0 recs
Re: Obama throws house HCR under the bus

Well, there's a lot more under that "remember" bus.

by Jerome Armstrong 2009-12-29 05:06AM | 0 recs
Re: What Next on HCR?

What's next?

Passage.

But first, more histrionics.

by QTG 2009-12-29 02:36AM | 0 recs
I'm not done with my histrionics yet!

Thank goodness Congress is in recess.

by NoFortunateSon 2009-12-29 11:11AM | 0 recs
Re: Violation of the rules.

I don't typically consider you a bullshit artist like say I believe Bruce Webb to be or a shill as say QTG or a fan boy etc.

Stop the attacks. It's not polite.

by QTG 2009-12-30 05:47PM | 0 recs
Re: Familiies of four earning 150%

I wonder why my more extensive response going into greater detail was deleted?

by bruh3 2009-12-30 07:31PM | 0 recs
Re: Familiies of four earning 150%

To let you  know Steve,  for some reason my comment was deleted in which I actually did provide a rather long break down explaining the issue and the various topics you raised in detail so that there is no further. I don not feel like re doing it. So I will discuss the behavioral assumptions about health care consumers as rational actors.

The problem in a nutshell is that you are arguing based on neoliberal assumptions of rational markets, and the problem is what happens if you are wrong?

What if consumers are not rational in their health care consumption? What is monopolist don't stop raising prices? What if cost is passed on to the irrational consumer? What then?

And there in a nutshell is the problem. We are passing on systemic reform from the system to the individuals shoulder. There are many reasons why consumers may not be rational here. Part of it is information theory, etc, which I won't get into.

Health care consumers are not always rational, and will tend to over and under use health care. Thus, you are faced with the same problem you have now, but worse because having passed the cost off to the consumer, they are even less likely to be able to afford health and even less likely to go. This is how you can make it worse based of having made the wrong assumption about future behavior.

. Now, you can argue that my assumptions are wrong- but you are taking a huge risk with the middle class, and between our two assumptions, policy should entertain the worse likelihood over assumptions rather than the one we would like to believe to make sure that it will achieve a positive result.

But no one is discussing any of that. Instead, there are all these underlying assumptions that are just accepted as fact when they actually aren't facts- they are right wingish assumptions that have been out there for some time that are now being used by progressives about rational health care consumers rationing their health care as if they know to take that life saving medication or not. Maybe they do. Maybe they don't.

by bruh3 2009-12-30 07:41PM | 0 recs

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