How Worthwhile Is Obama's Healthcare Bill?

I guess he doesn't have the will-- let alone the power-- to line all the Insurance Industry CEOs up against a wall (plus their lobbyists, including Ben Nelson and Joe Lieberman) and give them blindfolds and last cigarettes, so the weak tea in the form of oversight is the best we can expect from Obama's breathtakingly sad healthcare "reform" bill. Not only is it a pathetic bill that will have no support on the right or the left, he says he'll use reconciliation to pass it. Unless, he's got some tricks up his sleeve to make the godawful Senate bill-- which is essentially what his stinker of a bill is-- more family-friendly, using reconciliation will probably guarantee a massive landslide in November... and not the kind we'd like to see. The White House is trying to spin it as a "bridge" between the relatively progressive House bill and the worst of all worlds Senate bill. It's good he removed the bribes Ben Nelson and Mary Landrieu traded their votes for-- so it's only 99% crap instead of 100%. OK, ok, I'm exaggerating... a little.

The Obama plan maintains key elements of the Senate proposal but also incorporates stronger anti-fraud provisions and allows the federal government to review insurance rate hikes. On a call with reporters Pfeiffer insisted that the administration has not determined “on which path to move forward with,” but the bill’s substance suggests that Obama is hoping to bypass a prolonged-Senate debate and use the reconciliation process to fix the Senate bill and convince reluctant House progressives to pass the Senate legislation. “The American people deserve up or down vote on health reform,”Pfeiffer said. “We can get an up or down vote if opposition decides to take extraordinary steps of filibustering health reforms.”

But it’s unclear if progressive House members will embrace the new compromise. While the bill addresses House members’ affordability concerns, increases the excise tax thresholds and completely closes the donut hole in Medicare Part D, the legislation does not include a public option, retains the Senate bill’s state-based exchanges and keeps the start date for most reforms at 2014. (Obama’s plan also retains the Senate’s abortion compromise and most other core provisions).

Yesterday I was on the phone with a supporter of genuine healthcare reform, Iowa Senate candidate Roxanne Conley (who's running against anti-reform fanatic and saboteur Chuck Grassley) and I mentioned that her opposition to escalating the Afghanistan War was contrary to the president's-- President Obama, not "President" Bush. I got back to her a few hours ago about Obama's healthcare proposal to see how she was reacting. Here's what she told me-- word for word:

I have held town hall meetings in half of Iowa's 99 counties over the past two months and Iowans from all walks of life are telling me they want a public option. The public option can help contain runaway costs, increase competition in the marketplace, while providing greater access and accountability to the system. I'm disappointed the President has not included it in his plan-- and hope he will continue to work with Congress to make it part of health care reform. I welcome his ambition to close the "donut hole" Chuck Grassley created for Medicare prescription drug beneficiaries and strongly support that effort.

Another grassroots Democratic candidate running far from the confines of the Beltway, Mitchell Howie, is up against Blue Dog obstructionist-turned-Republican-obstructionist Parker Griffith in northern Alabama. He's running a very grassroots populist campaign and, like Roxanne, he doesn't think Obama's proposal serves the interests of his neighbors and prospective constituents.

I will always represent the folks of the 5th district first. And occasionally that means not supporting the president's agenda in every respect. When Washington's proposals diverge from the interests of the people I represent then I will work for the people always, not Washington. 

Regarding health care: It is important the president put forward proposals that allow for a full debate of issues on the merits that may bring down health care costs that are a burden to our economy.

The single payer/public option debate is one that should be held in the halls of Congress (on C Span as previously promised) not decided on in back rooms.

It's easy to detect the palpable sense of discomfort from Democrats who are profoundly disappointed in Obama's attempt-- unsuccessful attempt-- to placate obstructionist Republicans, who, by their very nature are implacable-- at the expense of ordinary American families. It's especially strong among incumbents. I don't know anyone who fought harder to pass the public option than Maryland progressive Donna Edwards and I know she will continue to fight. Last night she said that Obama's bill is a step in the right direction. “We are closer than ever to passing historic comprehensive and affordable health care reform. The President’s proposal is a step forward that includes several strong reforms from the House and Senate bills including a proposal I championed that would require rate reviews of insurance premiums to hold down costs. Without affordability, families do not have access to quality care.  However, we have further to go towards ensuring that Americans have truly meaningful health care reform that will hold down costs for middle class families, invest in long-term care, guarantee transparency, preserve women’s full reproductive health care access, sustain state Medicaid programs, and help the unemployed afford quality care. I look forward to the President’s Health Care Summit so we can finish the job of implementing meaningful health reform for American families.” 

Raul Grijalva, Chair of the Congressional Progressive Caucus, has worked very hard with Donna to keep the public option on the table. Today he patted the president respectfully on the head for what was included in the bill and didn't mince words about what's missing from it.

I appreciate the president working to move the health care agenda forward. Given the gridlock produced by constant Republican obstructionism, the White House’s continued effort to reach a meaningful solution is welcome. The president’s plan includes several essential elements-- including efforts to hold down premium increases and eliminating the special Nebraska deal in the original Senate bill-- that I think are vital.
 
I and many other progressives would enthusiastically support the bill if a public option, which would provide insurance industry competition and greatly reduce the deficit, were a higher priority. I am also concerned that affordability credits are not sufficient for many working Americans who often have to choose between health care and other equally basic expenses each month. Insurance industry regulations in the bill could be stronger, and I will look carefully at the outcome of final negotiations on this point.
 
I look forward to finalizing a reform package that will give all Americans adequate, reliable health care access. Although the president’s bill does not include certain elements that I consider fundamental to successful reform, I applaud his commitment to the issue and fully expect to work with other lawmakers to produce a strong final product that we can be proud of.

Another progressive who has fought for healthcare reform, Washington state Sen. Craig Pridemore (Blue America's newest endorsee) has a similar read on what's happening here to Donna's and Raul's. Last night he told me that "It’s difficult to just walk away from what little progress this bill does make. Covering 31 million more Americans and pre-existing conditions are great things and should be done immediately. But the rest of this proposal, as with both the House and Senate versions, leaves far more to be desired than it does to satisfy. If this really is the best we can accomplish right now, health care reform will continue to be a high priority issue in the next Congress." That what Donna has been warning me for months.

Yesterday CREDO was first out of the box with a petition urging Congress to oppose Obama's attempt at a weak, shameful, "bipartisan" bill and to demand a public option be put back on the table.

The president's plan is just an opening bid for discussion with Republicans, so you might think that it would include a public option that is supported by most Americans and is extremely popular with Democrats. But there is no public option in the president's proposal.

Instead, it is largely based upon the negotiations that were happening before Jan. 19th's election in Massachusetts. It's still a plan that is written with 60 votes in mind to succeed. It still includes elements written by Joe Lieberman and Ben Nelson. It includes proposals from Republicans. It has all kinds of trade-offs aimed at senators who will never vote for this bill.

President Obama has given the Republicans and conservative Democrats ample opportunity to get on board with health care reform. It's time to pass health care without them.

Inside the Beltway, there is confusion and a lack of clarity on how progressives will feel about Obama's offering. In America, there isn't any lack of clarity. Francine Busby is hardly a leftist. She's a solid Democratic Party grassroots activist who was a major Obama campaigner in 2008. She's running against ex-lobbyist Brian Bilbray for Congress in North San Diego County this year. Her comments were quite clear:

I firmly support a public option because it is necessary to provide a viable alternative to private insurance companies who have proven that they have no interest in the health and well-being of Americans or our health care system. Without the public option, we are exacerbating the problem by giving these for-profit companies tens of millions more customers on the taxpayers' dime. We must unite in support of the people of this country to bring meaningful reform that will lower the cost of health care, increase competition and give everyone the peace of mind that they have access to quality health care.

And Francine isn't the only southern California Democratic challenger less than overjoyed with Obama's approach. Marcy Winograd, the Blue America-endorsed progressive running against Blue Dog Jane Harman has been a leading voice in Los Angeles for the single payer approach favored by most Democrats. This morning she told us flatly that she "cannot support mandated purchasing of private health insurance. Why would we force Americans to buy from a health insurance industry that consistently denies care and gouges the public with usurious rate increases? If the President and Congress want to outlaw pre-conditions or limit rate increases, then they should do that-- separate and apart from mandated purchasing. Ultimately, the answer is single-payer."

John Thrasher is running against one of the most extremist members of Congress, terribly angry-at-the-world closet queen Trent Franks (R-AZ) and, needless to say, Franks doesn't want anyone getting healthcare (other than himself and his own family). Thrasher is a big supporter of real healthcare reform. His point of view is about as far from the Beltway bullshit as you'll get.

With Arizona's economy in serious trouble and a Legislature that cannot pass a budget, it is most likely time to take a look at how we spend taxpayers' money. Should we reconsider whether to spend taxpayers' money overseas, or would spending taxpayers' money on America's infrastructure be more productive? Encouraging the demand side of labor will create jobs, negotiating for costs of health care and returning our fare share is required to rebuild the middle class.

President Obama's health care plan did not mention single payer nor did it offer a public option that 82% of the American people have made very clear that must be included.

It is clear to the American people, but apparently not this Congress, that unless we stop the corporate control of our health care, that can control premium increases at a moments notice, and without getting approval from the owner of the premium, I do not see that I could support this Bill presented today. 

We must have an acceptable healthcare Bill, however, it has to be one that the owners of the policies have choices that will create competition and stop the rip-offs of continued cost increases, like the 39% raise by Anthem Healthcare in California, or refusing to keep a policy holder enrolled. It should be called the American Health Care System, covering everyone. Craft it to be similar to the Medicare (E), or Medicare for everyone plan, which does lower premiums and can operate in a similar 3% overhead cost, saving hundreds of millions in high profits for a few CEO's, and on our dime. Stop bonuses with money that should go to premium control and lower costs for the owners of health care. I will look for the public option and/or public policy to be included before I will consider such a bill acceptable.

Billy Kennedy is the Democrat running against one of the most doctrinaire of the GOP obstructionists, Virginia Foxx (R-NC) and his perspective takes into account the needs of ordinary working families in western North Carolina.

I am an independent person and will be an independent candidate and office holder as well. I am not beholden to, and will not put myself in the position of becoming beholden to, the corporate interests of the insurance and the pharmaceutical industries over the interests of working Americans. I, like the majority of Americans, am a strong supporter of a public option in any health care reform proposal, but would consider an optional Medicare buy-in in its place. I believe such a buy-in, if well constructed, would get us started on the path of providing competition and cost controls for a greater number of Americans. While there are some good beginning reforms outlined in the President’s proposed bill, there is little to nothing in the bill to control costs or drive them down, and there is no proposed Public option or Medicare buy-in. There is no anti-trust exemption repeal, and there is no national exchange. Furthermore, Americans will be mandated to purchase insurance policies they can’t afford from for-profit companies subsidized with tax-payer dollars to for-profit companies without some competitive agent (like a public option and/or a Medicare buy-in). In other words, we’re a long way from true reform. The good news, however, is it appears the President and the Senate Democrats appear ready to pass health care reform through reconciliation (and it’s about time). The unfortunate reality is that the President is not going to push for a public option or Medicare buy in, so that means those of us who believe so strongly that this is essential to any reform must find another means to deliver to Americans what they have strongly supported from the get go: strong non-profit competition to insurance companies. At the time I’m writing this, 20 Senators have signed onto a pledge to vote for a public option through Senate reconciliation. It seems to clear to me at this time, this is where we must apply pressure and demand accountability.

In line with Blue America's quest for Better Democrats, we were eager to hear from Andrew Gall, the courageous former Obama campaign staffer challenging Majority Leader and friend of all Blue Dogs, Steny Hoyer. Andrew has a far more family-friendly take on what the healthcare is all about that Hoyer, who has taken in immense amounts of money from Big Insurance ($546,477) and from the Medical Industrial Complex ($2,070,708). I got Andrew on the phone yesterday just after the details of Obama's proposal were posted online:

It is disappointing to see that there is no public option. While I do not have an ideological predilection towards seeing the inclusion of a public option, I do have an ideological predilection towards good policy. One of the two primary objectives of health care reform is to rein in costs, and the CBO scored the public option as one of the best tools put forth to do so.  Consequently, if lawmakers are serious about stemming the unsustainable rise in health care costs, they should support a robust public option. Unfortunately, President Obama doesn’t want to re-fight this battle. While I understand, pragmatic politics, the reality is that Republicans-- as Leader Boehner already demonstrated today-- are going to call anything the President puts forth a “government takeover of health care.” If you’re going to receive such political barbs, you might as well put forth the best policy possible. There are other disappointments as well, including a failure to adequately crackdown on uncompetitive pharmaceutical bidding and the lack of a national insurance exchange, but I disagree with those (including my father) that argue a bill without a public option isn’t worth passing at all. Obama’s proposal does in fact contain many positive measures: it would expand access to health care for a large swath of Americans by ending insurance discrimination, crack down on fraud, close the infamous donut hole, raise Medicare payroll taxes on the wealthiest Americans to provide larger subsidies to lower and middle income Americans, and, uniquely, give the government the ability to prevent exorbitant rate hikes. In sum, it is a middling bill, but health care is too important to make the perfect the enemy of the good.

Jennifer Brunner's campaign shot this video over the weekend, before Obama put out his flawed bill. It's a message from the heartland, very much in tune with what people who don't have lunches and dinners with lobbyists and CEOs are thinking. Give it a look: