Universal Healthcare Is Nothing To Fear— A Guest Post By Julie Oliver

After her first run against corrupt Republican Roger Williams-- in a gerrymandered central Texas district where she did far better than anyone expected-- Julie Oliver was unsure if she would run again. But at that time-- back in February-- she wrote a post about universal healthcare. “Those who use ‘socialism’ as a pejorative term to fear-monger,” she wrote, “want you to think that America can’t afford to provide universal healthcare. But the fact is, we can’t afford not to.”

On her campaign website, Julie is clear: she is “running a bold campaign for Medicare for All, a Green New Deal, a pathway to citizenship, and an economy that works for everyone, not just corporations and the wealthy few… She spent her career in the healthcare industry, crunching numbers and doing the books for a large hospital system. She has 20 years of experience in healthcare finance and taxation, and she was appointed by the Austin City Council to serve on the board of Central Health, whose mission is delivering healthcare to low income Texans. In this role, Julie has been an outspoken champion for accountability and transparency, and for getting high-quality healthcare to Texas communities who have traditionally been underserved.”

In this piece, I’m going to make the case for 4 arguments:

1- Universal healthcare is fiscally responsible.

2- Not only is universal healthcare the moral thing to do, our current system is un-American and anti-entrepreneurial.

3- The status quo props up a hugely wasteful, inefficient system— a.k.a., socialism for corporations and the rich.

4- America has never been afraid of taking on the big, bold, ambitious and aspirational goals. Providing a basic necessity like healthcare to our fellow Americans is nothing to fear. Failing to do so is un-American.

Universal healthcare is fiscally responsible, and American taxpayers already provide socialism for corporations and for the rich. Our blended economy would derive enormous benefit by moving to single-payer healthcare.

In his State of the Union address, Donald Trump declared that “America will never be a socialist country.”

Dr. Martin Luther King would often point out that America is already a socialist country-- our government provides socialism for the rich, powerful, and corporations. And the rest of us pay for it.

Universal healthcare is fiscally responsible. Our current path is not.

During my 2018 campaign for US House of Representatives, Republican candidates in Texas used the word “socialist” in the hope of frightening voters into supporting them and to fear-monger around candidates like me, who chose to listen to the people of Texas instead of corporations and lobbyists. (Despite those claims, our first-time campaign, relying 100% on individual grassroots donations, swung our heavily gerrymandered “red” district 12 points.)

Exploiting fear for political ends is nothing new. It is most pronounced in this country in the way politicians scapegoat immigrants and any imagined “other,” to produce paranoia and anxiety to justify any political end-- even an unpopular, failed, racist campaign promise like Trump’s border wall.

But in addition to anti-immigrant scapegoating, Republicans have been trying to use the word “socialist” as a dirty word since FDR’s New Deal, LBJ’s Great Society, and of course, President Obama’s Affordable Care Act.

And that appears likely to continue.

Socialism for the rich, capitalism for the poor

Never mind that Donald Trump enjoys taxpayer-funded trips to his own for-profit golf club, or that Trump’s inherited real estate empire grew as a result of $885 million in taxpayer funded subsidies. Never mind that Congress, comprised overwhelmingly of millionaires, either enjoys a gold-level ACA product, 72% of which is subsidized by taxpayers, or Medicare-- our country’s wildly successful socialized healthcare program.

We see socialism for the rich in a tax bill, literally written by lobbyists for the banking industry, that added $2 trillion to the national debt, and which handed 80% of the benefits to the top 1% wealthiest people in this country.

None of that has stopped politicians from trying to fear-monger by using the word “socialism.”

And nowhere is the term “socialism” used more pejoratively than in the status quo’s defense of America’s massively failed for-profit healthcare system, a system of legalized corruption that enriches lobbyists and corporations at the expense of every American, of the sick, of the poor, of medically fragile children, and of those with disabilities.

In the discussion surrounding the fact that the wealthiest, most powerful country in the history of the planet does not provide healthcare for those who need it most, “socialism” is the term most often deployed by politicians to terrorize voters.

The fact is that the majority of Americans favor single-payer healthcare-- that support is broad and bipartisan.

Yet while our insurance premiums-- and with them, the amount of people unable to see a doctor or afford their prescriptions-- continue to increase, and while medical GoFundMe’s become the norm, those in power have stymied any efforts at healthcare reform.

How did our Congressional priorities get so out of whack?

Those politicians’ campaigns are massively funded by the for-profit insurance, healthcare, and pharmaceutical lobbies. The Supreme Court ruled in Citizens United that corporations were people and money was speech. That unleashed a dangerous amount of spending by PACs, corporations, and special interests-- meaning that those who are politically connected are protected from accountability and that the American people suffer as a result. Pharmaceutical and insurance corporations are able to buy influence and outcomes through lobbying, PAC contributions and sympathetic political appointees.

We’re left footing the bill.

You already pay for everybody’s healthcare.

One of the complaints we often hear deployed amongst those politicians who oppose universal healthcare is: “You, the taxpayer, shouldn’t have to pay for someone else’s healthcare.”

I’m an expert in how healthcare finance works. I worked in corporate healthcare finance for 15 years for one of the largest healthcare corporations in the world. (I also have a law degree, and I’m an accountant with a tax background). So I can say, definitively and with authority:

You already pay for everyone’s healthcare. You just do it in the most expensive, inefficient and wasteful way, with the worst outcomes.

All of us already currently pay for everyone’s healthcare in America under both federal law and, in Texas, state law.

Federal law requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay. Many people think that hospitals eat this cost; some do, but many don’t. Texas state law requires counties to provide healthcare assistance to eligible, indigent residents; this requirement creates a huge burden on rural hospitals, and that leads to hospital closures in communities where hospitals are one of the primary economic drivers.

Tex. Health and Safety Code § 61. The Indigent Health Care and Treatment Act. Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. “Sec. 61.022. COUNTY OBLIGATION. (a) A county shall provide health care assistance as prescribed by this subchapter to each of its eligible county residents.”

The argument against socialized medicine is clearly being made in bad faith, because it’s too late-- we already pay for universal emergency care regardless of whether someone has insurance or can pay for it.

So what’s the difference between what we have-- wasteful, expensive, inefficient, propped up by the status quo, and subsidized by the taxpayer-- and what we should have?

The critical difference is that under our current system, preventive care isn’t covered.

Preventive care is life-saving, and providing it for everyone is fiscally responsible-- it is a fraction of the cost of emergency care. Until we provide preventive care for every single person in this country, everyone’s taxes and insurance premiums will continue to go up.

Let’s take two very treatable chronic illnesses as examples-- Type 2 diabetes and hypertension. Diabetes and hypertension are very common and also very treatable. But if left untreated, these conditions cause devastating complications and become some of the most expensive conditions to treat.

If a patient comes in through an emergency room because they’re in cardiac arrest that could have been prevented by medication management and regular office visits with a physician, the cost of that patient’s care is exponentially more expensive because of the trip to the ER. Assuming a hospital charge of $160,000 for cardiac surgery and a hospital stay, a patient could have scheduled visits with his doctor over 1,000 times (assuming an office visit charge of $150).

Universal healthcare is fiscally responsible.

Because Texas did not expand Medicaid, we have the highest population of uninsured people in the country. But, insurance or no-- and it seems silly to even have to say this-- every single person is going to need healthcare at some point in their lives. Healthcare is a basic human necessity. And when those without insurance need healthcare, they go to an ER.

What happens when uninsured folks visit emergency departments at hospitals? The federal government does provide some reimbursement to hospitals who have a significant Medicaid or uninsured population through disproportionate share (DSH) and 1115 waiver payments-- but these payments only cover a fraction of the associated costs.

If a hospital is in a high-density, urban area with lots of insured patients, it bundles the costs of “uncompensated care” (a term used to describe anyone who can’t or doesn’t pay their medical bills), and pushes them to insurance companies the next time they negotiate insurance reimbursements.

The insurance companies, in turn, push those costs (plus their profit and administrative fees of up to 20%) to employers, who then share the costs with their employees. That leaves insured people and the companies who employ them footing the bill for billions of dollars of healthcare annually.

So even if you’re lucky enough to have insurance through your employer in this country, your premiums will continue to rise as a function of the way we pay-- or don’t pay-- for healthcare in America.

Former Governor Rick Perry opted Texas out of Medicaid expansion. That left Texas taxpayers footing the bill for billions of dollars in uncompensated care. You can thank him (and Governor Abbott) for high insurance premiums and high property taxes.

Texas’ rural hospital crisis

Texas leads the nation in hospital closures, with 15 since 2013-- almost double any other state-- and they have all been rural. If there isn’t enough county tax revenue, hospitals close. Many county hospitals in rural Texas no longer deliver babies-- so if a mom goes into pre-term labor, and the next hospital is an hour or more away, the outcomes can be and often are unfavorable. Time is of the essence in treating strokes, heart attacks, brain injuries, and rattlesnake bites; if a county hospital closes, the danger is very real, and that community suffers.

Remember those “uncompensated care” costs that hospitals in urban areas pass along to insured patients and their employers? Hospitals in rural communities aren’t able to do that; they can’t push those costs onto insurance companies. Many operate at a deficit and must collect property tax revenue to cover the shortfall (urban communities also collect property tax revenue to pay for indigent healthcare). That means that it is the counties-- and those paying local property taxes-- paying for the uninsured who seek emergent care.

The way forward

So how do we lower healthcare costs for everyone? We allow every American to seek preventive care, and to avoid unnecessary and preventable hospital visits. We move to guaranteed universal healthcare-- that reduces the administrative fees that all of us subsidize in the massively wasteful corporate healthcare business in America.

Insurance companies are the middle men we pay for administering insurance claims. Medicare’s administrative costs are 2%, and there is no profit margin with Medicare. On the other hand, insurance companies’ administrative fees and profit are roughly 20% of the costs of care they administer; part of this 20% includes the 2017 compensation for health insurance CEOs of $342.6M; those costs are part of our healthcare costs.

Insurance companies also notoriously deny claims, and hospitals pay millions of dollars annually fighting these denials; again, we, the American taxpayer, end up paying for these costs.

The case is not that America can’t afford to provide healthcare to everyone. It is that it would be disastrous for this country to continue not to provide it.

The reality is that our county’s mixed-market economy would derive huge benefit from healthcare reform, and specifically by introducing singe-payer healthcare. We are already the beneficiary of socialized programs. When you travel by highway or air, a federal agency ensures that your travel is safe. Veterans can seek healthcare and housing services through the Veterans Affairs department. And the FDA ensures we are safe from virulent strains of E. coli, botulism, or salmonella because we have national food safety guidelines and testing. And, of course, public schools are probably the largest social program in our country.

The economic benefits to single-payer healthcare are transformative and impossible to ignore. Imagine the increase in productivity across the American workforce: when people are well, they can live and work to their full potential. Imagine the freedom that would come with separating insurance from employment-- when providing insurance is no longer a barrier to starting a business, or it’s no longer keeping you from chasing your version of the American dream.

Today’s politicians use the term “socialism” in the way that Orwell described political language in Politics and the English Language: “to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.”

But all of us should have a say in how the country’s vast wealth should be used, and nowhere can that do more good than in providing healthcare for every single man, woman and child, rich or poor, young or old, pre-existing conditions or not. That is only going to be possible when we get corporations and big-money donors out of our democracy, and when lawmakers are truly accountable to the people.

I don’t think that’s too much to ask.

Corrupt Political Hacks Like Steve Israel And Chuck Schumer Promote Other Corrupt Hacks Like Themselves... Take Patrick Murphy In Florida

Today I got another shameless fundraising email from a Senate Democrat doing Wall Street's bidding-- Barbara Boxer, disgracing herself as she hobbles out the door by referring to reactionary "ex"-Republican, Patrick Murphy, as a "bold progressive" and asking people who trust her to contribute to his right-wing campaign. Maybe "bold-faced liar" would have been more precise. Until Murphy realized he would have to run against Grayson in a primary-- a Democratic primary-- he regularly voted with the GOP on almost every crucial roll call. He had the 4th worst voting record among Democrats, having carried water for the banksters for his whole time in Congress, while voting for oil drilling off Florida's pristine beaches, to undermine and wreck the Affordable Care Act, for the Keystone XL Pipeline 6 times-- as well as for a bizarre and unconstitutional GOP law to remove President Obama from the decision-making process-- and even to authorize the Benghazi witch hunt against Hillary Clinton. Boehner had come to depend on Patrick Murphy so he could say his agenda was "bipartisan," meaning supported by Republicans + Patrick Murphy and a few mangy Blue Dogs.

Then someone let Murphy know that a primary is different from a general election and that he had to at least appear a little like a Democrat. So now he's just the 12th worst Democrat in the House. What a bargain! Bold progressive, my ass!

This morning Progressive Democrats of Florida sent out a letter to its members pointing out that Patrick Murphy "stands somewhere different each and every day. First, he was for improving mass transportation by supporting a high speed rail project crucial to moving Florida forward. Then, after his 'Daddy Warbucks' lost a big construction contract related to the project, Murphy was all of a sudden against it. He was a Republican mega-donor, before being elected to Congress as a Democrat and espousing his 'progressive' credentials. According to the East Orlando Post, a top staffer for John Boehner called him a Republican at heart."

That same Boehner staffer referred to Murphy as one of the GOP House leadership's "best assets on the other side of the aisle." And his support for All Aboard Florida's high speed rail project and then his opposition was all based on his family business, the corrupt Coast Construction Group which does business with Trumpf and bankrolls Murphy's political campaigns ($250,000 to his SuperPAC, American Sunrise in 2012, $76,750 to his campaign directly that year and another $50,300 to his campaign directly last year.) Coast Construction Group-- and Muphy's parents-- have been buying endorsements for Murphy's campaigns from transactional politicians like Alcee Hastings, Frederica Wilson, Ami Bera, Sean Patrick Maloney and a gaggle of disreputable and corrupt DCCC candidates who were all defeated in 2014 after their parents were caught illegally trading maxed-out contributions.

How do Democrats and progressives start to reclaim the Democratic Party from the buckets of slime like Steve Israel, Chuck Schumer and Patrick Murphy? By never contributing to any of the party committees-- the DCCC, the DSCC or the DNC-- or their front groups, like the alluringly-named EndCitizensUnited, and by contributing directly to progressive candidates with progressive records-- like these four-- not corrupt conservative candidates useful idiots like Barbara Boxer are told to fundraise for. By the way, I called her office to find out if she knew anything about Murphy's ethics or voting record and i was told to send my opinion to bulletinfeedback@boxer.senate.gov/

How about we end the night on a more positive note? Did you read Bernie's OpEd in the NY Times this morning? "Wall Street," he reminds us, "is still out of control." And that would not be the case without the active connivance of Wall Street politicians-- whether we're talking about Paul Ryan ($5,519,391), Mitch McConnell ($11,435,701), Marco Rubio ($5,076,359) and Ted Cruz ($4,134,237) on one side of the aisle or about Chuck Schumer ($23,538,638), Patrick Murphy ($2,388,998) and Hillary Clinton ($36,846,987) on the side of the aisle that is supposed to be protecting us from predatory banksters, not enabling them the way the Republicans do.

Seven years ago, the Federal Reserve and the Treasury Department bailed out the largest financial institutions in this country because they were considered too big to fail. But almost every one is bigger today than it was before the bailout. If any were to fail again, taxpayers could be on the hook for another bailout, perhaps a larger one this time.

To rein in Wall Street, we should begin by reforming the Federal Reserve, which oversees financial institutions and which uses monetary policy to maintain price stability and full employment. Unfortunately, an institution that was created to serve all Americans has been hijacked by the very bankers it regulates.

The recent decision by the Fed to raise interest rates is the latest example of the rigged economic system. Big bankers and their supporters in Congress have been telling us for years that runaway inflation is just around the corner. They have been dead wrong each time. Raising interest rates now is a disaster for small business owners who need loans to hire more workers and Americans who need more jobs and higher wages. As a rule, the Fed should not raise interest rates until unemployment is lower than 4 percent. Raising rates must be done only as a last resort-- not to fight phantom inflation.

What went wrong at the Fed? The chief executives of some of the largest banks in America are allowed to serve on its boards. During the Wall Street crisis of 2007, Jamie Dimon, the chief executive and chairman of JPMorgan Chase, served on the New York Fed’s board of directors while his bank received more than $390 billion in financial assistance from the Fed. Next year, four of the 12 presidents at the regional Federal Reserve Banks will be former executives from one firm: Goldman Sachs.

These are clear conflicts of interest, the kind that would not be allowed at other agencies. We would not tolerate the head of Exxon Mobil running the Environmental Protection Agency. We don’t allow the Federal Communications Commission to be dominated by Verizon executives. And we should not allow big bank executives to serve on the boards of the main agency in charge of regulating financial institutions.

If I were elected president, the foxes would no longer guard the henhouse. To ensure the safety and soundness of our banking system, we need to fundamentally restructure the Fed’s governance system to eliminate conflicts of interest. Board members should be nominated by the president and chosen by the Senate. Banking industry executives must no longer be allowed to serve on the Fed’s boards and to handpick its members and staff. Board positions should instead include representatives from all walks of life-- including labor, consumers, homeowners, urban residents, farmers and small businesses.

...Financial reforms must not stop with the central bank. We must reinstate Glass-Steagall and break up the too-big-to-fail financial institutions that threaten our economy. But we need to start with fundamental change. The sad reality is that the Federal Reserve doesn’t regulate Wall Street; Wall Street regulates the Fed. It’s time to make banking work for the productive economy and for all Americans, not just a handful of wealthy speculators. And it begins by making the Federal Reserve a more democratic institution, one that is responsive to the needs of ordinary Americans rather than the billionaires on Wall Street.

That's just one crucial issue that differentiates Bernie from the establishment candidates like Rubio, Cruz and Hillary. Today he pointed out another important one for progressives to remember: "I want to talk with you about one of the very real differences between Secretary Clinton and me that surfaced during last weekend's debate, and that is our approach to health care in this country," he wrote to supporters. "I was, and all progressives should be, deeply disappointed in some of her attacks on a Medicare-for-all, single-payer health care system. The health insurance lobbyists and big pharmaceutical companies try to make "national health care" sound scary. It is not. In fact, a large single-payer system already exists in the United States. It's called Medicare and the people enrolled give it high marks. More importantly, it has succeeded in providing near-universal coverage to Americans over age 65 in a very cost-effective manner...

"[A] Medicare-for-all, single-payer health care system will expand employment by lifting a major financial weight off of the businesses burdened by employee health expenses. And for the millions of Americans who are currently in jobs they don't like but must stay put because of health care access, they would be free to explore more productive opportunities as they desire. So, what is stopping us from guaranteeing free, quality health care as a basic fundamental right for all Americans? I believe the answer ties into campaign finance reform. The truth is, the insurance companies and the drug companies are bribing the United States Congress."

You can contribute to Bernie's campaign here if you believe in his vision for a more equitable America.

Health Care Reform-- Prairie Populist Style: Montana

In the midst of the right-wing jihad to do away with the social safety net and turn America into an-only-the-strong-survive kind of Jungle, you may have heard the presumptive GOP presidential nominee whining to Sean Hannity this week about how the individual mandate in the health care reform bill was not just his idea, but a conservative idea. It's certainly the least popular piece of the fatally compromised legislation-- especially among conservatives and teabaggers-- and needs to be replaced with a sane, single-payer approach.

Mitt Romney described the individual health mandate as a “conservative idea” yesterday afternoon on Sean Hannity’s radio show, just as the federal government asked the Supreme Court to review the constitutionality of the provision in President Obama’s Affordable Care Act.

“The idea for a health care plan [in Massachusetts] was not mine alone,” Romney explained. “The Heritage Foundation-- a great conservative think tank-- helped on that. I’m told Newt Gingrich, one of the very first people who came up with the idea of an individual mandate, did that years and years ago.”

It is a conservative idea, a crappy conservative idea that Obama and pathetic and weak conservative Democrats used to compromise away working families' futures. Many progressive state governments have already started moving beyond this foot-dragging, fifth rate approach to health care. And yesterday the Billings Gazette announced that Montana may be the next in line. Governor Brian Schweitzer has gotten the ball rolling with a universal health care proposal for the state.

Like Republicans who object to the federal health care law, the Democratic governor also argues it doesn't do enough to control costs and says his state should have more flexibility than the law allows. But Schweitzer has completely different plans for the Medicare and Medicaid money the federal government gives the state to administer those programs.

The popular second-term Democrat would like to create a state-run system that borrows from the program used in Saskatchewan. He said the Canadian province controls cost by negotiating drug prices and limiting nonemergency procedures such as MRIs.

Schweitzer said the province's demographics and economy are similar to Montana in several ways - yet its residents live longer while spending far less on health care.

...Schweitzer told a federal official Wednesday that he will be asking for a waiver allowing the state to abandon the federal programs in favor of one the state will design itself. Schweitzer said details would be coming in the next few months when the request is complete.

State Rep. Franke Wilmer is running for the congressional seat being abandoned by Tea Party Caucus member Denny Rehberg and part of her populist campaign is based on her strong support for universal health care. She's consulted with Gov. Schweitzer on this and is very enthusiastic about Montana finding a better solution than Congress did. This is what she told me last night:

Americans pay 100 percent more for health care-- twice as much-- than any other industrialized country. We still rank 37th in quality and outcomes. An estimated 14,000 Americans lose health insurance coverage every day. In the big economic picture, overspending on health care is siphoning off capital that could be put to more productive use. Wages and income flat-lined in the 1990s mostly because employers who offer health insurance benefits faced skyrocketing costs. Studies show that our overly complex and fragmented payer system weakens the demand side of the market and inflates administrative costs. Walmart's vision center tells insured customers that "we accept over 1,800 plans." It doesn't make market sense; it doesn't make capitalist sense. Absolutely states should be allowed to set up their own universal health care systems.

Her two Republican opponents-- the job exporter and the KKK organizer (they have a primary)-- both oppose Medicare, Medicaid and, in a general sense, health care for the non-wealthy. If you'd like to help her get elected, you can do it here

Will The Medicare Payment Advisory Commission Save Us From Our Corrupt Elected Officials?

Two days ago I got a jarring letter from my primary care physician.

Dear ("Howard," written in by nurse),

It has been a privilege and a pleasure to know you, and to be your primary doctor. I think we have an excellent relationship, and this gives me a rewarding feeling. At this time there is an important matter that I would like to discuss with my patients.

My office associates and I have been discussing a difficult problem. Medicare payments to us fall very short of what they should be. Our rent and other expenses just go up and up. Cutbacks by Blue Cross and other insurers are affecting us seriously as well.

We try to deliver very personal care, and give our patients time to discuss their concerns, both in the office and on the phone. Unfortunately, as rent and other expenses rise, many doctors have been forced to squeeze more patients into the schedule. We do not want to accept new Medicare patients, and are dropping out of insurance plans with their severe restrictions. You may have friends whose physicians now require an annual fee of $1500 or more of every patient in their practice.

An article recently in the L.A. Times described a primary care physician who was forced to close her practice for these very reasons.

After much consideration, I have decided to ask for support from my patients. A contribution of $1,000 per person per year would help us continue our current style of practice. I hope this plan will enable us to continue to offer the same high quality service, including same-day emergency appointments, telephone consultations and individualized care that I feel is crucial, while continuing to accept insurance plans. With your payment, please sign and return the enclosed consent form, which is required by your insurance company.

Thank you very much for your trust and friendship over such a long time. Whatever you decide on this matter, I hope we can continue our fine relationship for many good years ahead.

When I retired I was "lucky" that I was in a plan that allowed me to keep COBRA forever. Most people get a few months-- like 3 or 6 or 9 I think-- and then have to go find their own insurance on the (very predatory) market. With a pre-existing condition, it's next to impossible. My COBRA payments come to $9,444 annually. I see my doctor once a year for a check up and some tests. I don't use pharmaceuticals and don't have nearly as much faith in western medicine as my doctor does. My COBRA plan makes good money from me. I'm following the debate over the "public option"-- supposedly a first step towards single-payer, universal health care-- with great interest, both social and personal.

Yesterday the White House released a letter the president sent to Ted Kennedy and Max Baucus, the chairs of the two committees dealing with health care reform-- Kennedy trying to come up with a workable plan, and Baucus shilling for his insurance industry patrons in trying to kill it. The letter was heartening-- at least in terms of knowing which side Obama is on (perhaps). An excerpt:

The plans you are discussing embody my core belief that Americans should have better choices for health insurance, building on the principle that if they like the coverage they have now, they can keep it, while seeing their costs lowered as our reforms take hold. But for those who don't have such options, I agree that we should create a health insurance exchange-- a market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs. I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.

Even though he works for the Washington Post, Ezra Klein is a health care expert who knows what he's talking about. In yesterday's Post he reported on a meeting Obama had with Senate Democrats from Kennedy's and Baucus' committees and how he plans to control the costs associated with his reform plans.

The Medicare Payment Advisory Commission is an independent congressional agency of technical experts which was formed in 1997 to advise the Congress on matters relating to Medicare. Its recommendations are blocked by the lobbyists who donate to congressional campaign committees and its reports are shelved. Obama wants to bring the commission into the executive branch and give it real power-- sort of like a Federal Reserve for Medicare.

[His] plan would package MedPAC's yearly recommendation and fast track them through Congress for a simple, up-or-down vote. No filibuster. No changes to the package of recommendations. Health reform, under this scenario, would become a yearly legislative project.

And that's how some in the White House would prefer it. The health system changes too quickly for Congress to address through massive, infrequent, efforts at total reform. New technologies and new care structures create new problems. A health care reform package signed in 2009 might miss some real deficiencies, or real opportunities, that present themselves in 2012. A health reform process that recognizes that fact is a health reform process that is continual, rather than episodic.

But the reason health reform is so infrequent is that it's structurally difficult. Small tweaks are too technically complex for Congress to easily conduct and so are dominated by lobbyists. Large reforms attract broad interest but are impeded by polarization and the threat of the filibuster. The MedPAC changes under discussion are, in other words, nothing less than a new process for health care cost reforms. They empower experts who won't be intimidated by the intricacy of the issues and sidestep the filibuster's ability to halt change in its tracks.

MedPAC, of course, is restricted to Medicare. But there's little doubt that where Medicare leads, the health care industry follows. Private insurers frequently set their prices in relation to Medicare's payment rates. Hospitals are sufficiently dependent on Medicare that a reform instituted by the entitlement program becomes a de facto change for the whole institution, and thus all patients. A process that empowers Medicare to aggressively and fluidly reform itself would end up dramatically changing the face of American health care in general.

Thus far, we've heard a lot of talk about cost control. But this is the first time, at least to my mind, that we've seen anything that actually looks able to deliver on controlling costs. To flip the old line, this is where health care reform becomes entitlements reform.

Senate Democrats plan to officially unveil their plan next week. Meanwhile it comes as no surprise to anyone who follows the money and the money-tainted politics of the Blue Dog caucus that these right-wing Democrats are abandoning President Obama (and their own constituents) and siding with the Republicans and the medical-industrial complex in opposing health care reform. Their goal is to so disable any public option that no one will want to use it, a significant victory for their patrons at the insurance companies and HMOs. Not all Blue Dogs are Republicans in disguise. One, Maine's Mike Michaud, immediately broke with the caucus' approach and endorsed the need for the real health care reform that Obama and progressives are trying to pass. Another, Patrick Murphy (D-PA) also distanced himself from the extremist and corrupt Blue Dogs, putting out a press release reiterating that he "stands with President Obama in supporting the inclusion of a public option in health care reform legislation."


UPDATE: Will We Be Paying For Medical Care The Way We Pay For Utilities?

A friend of mine, who writes at FDL under the name Scarecrow, sent me a fascinating perspective on this. He said he didn't mind if I shared it:

That letter you quoted from the Doctors asking for $1000 payment/patient tells me we're in a very different paradigm from the one assumed by the public/medial debate. The public debate is in terms of "competition," and "Markets," and public vs private competition, etc, but in fact the paradigm that Obama described (and your letter confirms) is really starting to look like utility regulation, or a cross between partial markets and partial cost-of-service regulation of utilities. The health reform features being discussed have exact counterparts in the quasi market, quasi regulated electricity world I work in. 

The basic commodity in electricity is energy. We pay for energy on a cents/kwh basis.  But there is also a feature called "capacity payments," in which consumers are also required to pay a capacity charge to generators on top of the price they pay for the basic commodity of electrical energy.  This capacity charge is designed to cover capital and other fixed costs of the supplier that are not otherwise covered by the surpressed prices for energy. If they did not receive this extra payment, they would eventually go out of business and you would eventually get shortages, because if you can't cover your capital costs, you won't build enough capacity to meet demand and replace your units as they age and retire.  

Your doctor is asking for the equivalent of a "capacity charge." Basically, he/she's saying that I need this extra payment to cover my fixed costs-- insurance, rent, etc-- to the extent that my payments I get from insurance companies or Medicare don't cover those costs. 

What this tells me is that Obama is moving, perhaps without realizing it, along the path that eventually winds up with single payer-- unless he misunderstands it and screws up the entire system. I think his people are smart enough to figure this out; this appears to be the stealth strategy; the insurance companies also get it;  but I'm not optimistic about Congress. Moreover, I don't know how the politicians are going to explain this to the public. It's a very radical transformation that's occurring, and most people don't know it.

More on the analogy. The utility regulation elements are:

1.  Guaranteed electricity service for all-- if the public health plan is open to all, that's the same concept.

2.  Cost oversight-- state utility regulators (or municipal utilty boards) do this for electricity; they set rates and guarantee service; the MedPAC could do this for the public health plan

3.  Quality oversight = state utility regulators set quality of service including reliability -- same as MedPAC

4.  Mandatory funding-- that is, you must pay for the required service, with subsidies to low income -- that's standards utility rate-setting; in health care, it's a combination of taxes, credits, exemptions, co-pays and premiums. It won't take long to realize this can be simplified into e.g., payroll deductions plus taxes for self-employed simplify/replace the rest, because it's not cost-effective. 

One other thing: in some states with organized markets, consumers can shop among competing private suppliers and sign contracts with them. Just like private health plans.  But they can also just have their utility buy from a public pool open to everyone, where all suppliers contribute based on least-cost, and pass the pool price through on the utility bill. The rules make the pool open to everyone, non-discrimination, and people can use it as much as they want. That's something like the public plan for health.

Who Is Rick Scott And Why Does He Want To Kill Health Care Reform For American Working Families?

Rick Scott is one pissed off, angry, right-wing sociopath-- and he's all over my TV. I don't watch much but every time I turn on CNN on come the transparent distortions from Rick Scott's swiftboat operation, CPR, the acronym for a Republican Party front group calling itself Conservatives for Patients Rights. But if recent history is any clue to what they are actually for it's clearly one thing: cheating Americans out of health care reform-- and they're spending millions of dollars in the attempt.

The ads purport to show a series of horror stories about people living in countries with universal health care. I've lived and worked in both Canada and England and used the health care system in both. As a former corporate president I have pretty sterling health insurance here in the U.S. I found the U.K. system much better. Scott's TV ads paint the U.K. system so that it sounds nearly as bad as the system everyone in America actually does hate. Oddly, in each vignette his ads highlight, there's a portayal that sounds as though it's a story we've all heard a dozen times from friends, family and co-workers about the private insurance everyone detests. And know one knows more about this inadequate system than Rick Scott himself, who has been one of the pre-eminent creators of a health care company widely acknowledged to be the McDonald's of medical care.

And that brings us back to why Scott is so pissed off, so angry and a dangerous sociopath. He build his hellish empire, Columbia Health Care, and was caught cheating, lying, stealing, fined $1.7 billion and forced to resign. Watch this short film that explains exactly who Rick Scott is and think about it next time you see one of those swiftboat ads he's running:



Yesterday Rasmussen released a poll that shows 62% of Americans still believe that our ongoing economic problems were caused by the Bush Regime. Public trust in the Obama Administration to do the right thing is still running very high. And there's no one inside the administration who I trust more on health care than OMB Director Peter Orszag, who has been tasked with making sure Obama's reforms are within the boundaries of fiscal discipline. Yesterday he talked about how the administration's cost containment falls into two categories:

Medicare and Medicaid savings that are key to achieving scoreable savings over the medium term but that by themselves would be unlikely to generate substantial long-term efficiency improvements in the health system, and "game-changers" that are unlikely to generate significant scoreable savings in the medium term but that are crucial to moving toward a health system that addresses the issues discussed in Atul Gawande’s compelling New Yorker article. (These game changers include, among other steps, items such as patient-centered quality research and re-orienting financial incentives through bundling and payment for quality rather than quantity of services delivered. After attending innumerable meetings of the Institute of Medicine and other gatherings of health policy types, I believe we are aggressively pursuing virtually all the game changers that have been put on the table by analysts. If anyone has ideas for what we’re not doing that could be done, please let me know! I also believe that since health care constantly evolves, it is impossible to specify today all the steps that will be necessary to reduce cost growth in a sustainable manner over the long term. Instead, cost containment must be a dynamic process, in which different processes are employed in an ongoing effort to make the system more efficient.)

What should not be overlooked in all these discussions of cost containment measures, however, are the backstop fiscal constraints we are demanding of a plan in the short to medium term: We are insisting that health reform be deficit neutral even over the next five to 10 years, through scoreable offsets such as savings within Medicare and Medicaid and (as necessary) additional revenue.

This belt-and-suspenders approach means we are not just banking on the long-term impact from the game changers to protect the budget. We also are demanding quantifiable cuts, efficiencies, and revenue-raisers so that the budget is not adversely impacted in the medium-term. That is to say, if the long-term savings from the game-changers materialize as expected, we wind up with a more efficient health care system and a better fiscal position. If they don’t, then at worst, we have a deficit-neutral plan that will not worsen our fiscal situation.

This isn’t the "voodoo economics" of supply-side tax cuts – not only because of the weak empirical basis for the claims behind such tax cuts, but also because proponents of supply-side economics were not willing to offset the cost of tax cuts through hard, verifiable offsets in the medium-term. Our approach, by contrast, not only attempts to address the key forces behind inefficiencies and rising costs in our health care system, but is also backstopped by hard-headed budget accounting and clear-eyed fiscal discipline.

I can't help but wonder, though, what all the reasonableness is going to mean up against corporate shill like Chuck Grassley (R-IA), Mitch McConnell (R-KY), Jon Kyl (R-AZ), John Cornyn (R-TX), Richard Burr (R-NC), Max Baucus (D-MT), Ben Nelson (D-NE), Arlen Specter (R-D-PA), and the two kooks each from Oklahoma, Idaho, Wyoming, Alabama, Mississippi, Louisiana, Georgia, Utah and Arkansas who are not thinking about anything that benefits their constituents, only about how to serve the special interests who have bankrolled their careers in politics. Rachel Maddow explained Rick Scott's role in the health care battle a couple weeks ago.


UPDATE: Insurance Industry Has Figured Out A Key To Win The Battle-- If Obama Acquiesces

Hard to imagine Obama and the Democrats would let the Insurance Industry roll over them on the #1 issue in America-- but, as much as it pains me to say so, the Democrats really are as useless and craven as the Republicans. Mike Lux, author of The Progressive Revolution: How the Best in America Came to Be understands better than most what a catastrophe this would be for the progressive cause. He explains over at HuffPo what the GOP front groups are up to and how the Insurance Industry plans to win the existential battle over health care reform. The fate of the entire health care debate rests on a debate raging in the incredibly corrupt Senate over a so-called "trigger mechanism" for having a public option in health care insurance.

The insurance lobby has had multiple tactics for stopping the public option idea, which they despise because they know if regular folks have choice to go to a public option, insurance companies won't have the same ability to treat their customers like garbage when they get sick. The first tactic was just to try to kill the public option outright, and the good news is that they appear to have failed at that. This so-called trigger proposal is the second tactic: the idea is to write a "trigger" that will allow for a public option only under certain conditions, but write the legislation so that those conditions would never get met in the real world. It's a classic DC tactic, right up there with calling for a commission to study something. Olympia Snowe is carrying the insurance industry water on their trigger proposal, proposing triggers that would only get tripped in some fairyland none of us have ever visited.

The great thing for the insurance companies in a tactic like this is that it gives "centrist" Senators (centrist in Washington, DC usually means those who have taken massive amounts of campaign contributions from the affected industry) an excuse to help the insurance industry while looking like they are open to the public option that their constituents have been demanding.

Barack Obama and Democrats in Congress have gotten some good things done so far, and are building real momentum in getting us moving in the right direction on health care. But if conservative Democrats force the adoption of the trigger, it will destroy Democratic unity and doom health care reform, because progressives will start attacking Democrats rather than insurance companies. We really are at a critical moment.

The only committee seriously considering the trigger turkey is the Senate Finance Committee, whose members average several hundred thousand a piece in insurance industry contributions. If you care about getting true health care reform, now is the time to make your voice heard: call the Senate Finance Committee members and tell them "NO to a trigger."

The Fix Is In: Ben Nelson (D-NE) To Administer The Death Blow To Health Care Reform

Ben Nelson in a graphic frame normally reserved for Repugs

The Senate's most Republican Democrat (see chart below), Nebraska reactionary Ben Nelson, has long been in the pocket of the Medical-Industrial Complex and Big Insurance. He was a former insurance company executive. They have underwritten his career with millions of dollars in legalized bribes-- $1,196,799 from Insurance special interests and another $1,000,366 from the HMOs and other "health care" industries. And they're promising him lots more if he will do their dirty work for them again this year. And he will.


Nelson is worried that voters in Nebraska will start understanding that he doesn't work for them-- not ever-- but that his real employers are the wealthy and powerful vested interests he is always serving. His main function in the Senate seems to have always been to water down all reforms and make them meaningless. Today he went to the Lincoln Journal Star to spin his role in the killing of health care reform so that the dull minded among his constituents miss the point. "Sen. Ben Nelson," reads the friendly and deceptive first line, "says he’s open to a government role in securing universal health care coverage."

A couple nights ago progressive health care reform advocate, Maryland Congresswoman Donna Edwards explained how the Insurance company shills in Congress would embrace the public option and then make sure it non-robust, worthless and uncompetitive with the plans of their "generous" patrons.

Nelson says, he does not want to “destabilize or adversely affect” the private health insurance coverage now in place for most Americans.

“I have not closed my mind to any option,” says Nelson, a key figure in the approaching showdown over health care reform.

While he’s opposed to opening the door to choice between a government and a private plan, Nelson says he wants to “see how a public plan is crafted.

“It’s a deal-breaker for me if there’s a government-run plan to replace existing insurance plans,” he says.

“I see a role for government, but not the primary responsibility,” Nelson says. “I see a backup plan,” but not at the expense of “erosion of a market-based system.”

...What’s not on the table is a single-payer universal health care system managed by the federal government. 

Nelson says he’d adamantly oppose it, but the Obama administration and congressional leaders aren’t even crafting such a plan.

“Single-payer can’t pass,” Nelson says.

What’s open is how to construct coverage for 45 million uncovered Americans who would be brought under the umbrella of universal coverage.

The private insurance industry is prepared to eliminate barriers to coverage for Americans with pre-existing health conditions if there is universal coverage, Nelson said.

So what is it that the insurance companies and shills in the Senate like virtually the entire Republican caucus plus the worst of the Conservadems want to kill? In short, anything that looks like it will compete with the awful private insurance plans that almost all Americans hate with a passion.

Progressives demand a plan that is fully risk-bearing, like Medicare. It must fully bear the risk of medical claims for its enrollees. The idea is to keep administrative costs low-- like Medicare and unlike the private insurers-- and guarantee a high standard of care. As for payments, again Medicare is a good model to start with, but the new entity should be free to use its buying power to establish fair provider rates. It should have the authority to structure provider rates that build on Medicare’s payment system and to develop and implement payment system reforms that promote quality care, prevention, and chronic care management. At the very minimum it has to be available to anyone (which also means everyone) who lacks employer-provided insurance. And it must allow patients to have access to their choice of doctors and other providers that meet defined participation standards, as Medicare does.

Imagine having representatives in our own government who are there to fight for us, not for their campaign contributors in big business? It'll never happen until we get rid of the horribly corrupt way we finance our "democracy." Until then there will always be stooges like Ben Nelson and Max Baucus-- not to mention the entire GOP-- who fight for the lobbyists and for the industries that underwrite their careers rather than for their own constituents. Not a single Republican voted for Social Security when Roosevelt proposed it-- not one. They called it socialist and said it would bankrupt America. Sound familiar? As I mentioned yesterday, when Rep. John Sullivan, Oklahoma's rabid anti-health care fanatic, decided he needed-- reason not yet clear-- to fly across the country and check himself into the Betty Ford Clinic to treat his long-documented dependency on alcohol, the taxpayers were forced to pick up the entire tab, probably $30,000. Nice for him, but isn't it a bit hypocritical for him to vote against that kind of health insurance for the rest of us?

A Little Chat With A Congresswoman About Afghanistan Leads To The Real Problems Confronting Health Care Reform

Last night I went to a gathering of people interested in hearing from a member of Congress who had just returned from Afghanistan. After a frank talk-- that confirmed my feelings that our presence there is as completely hopeless as it was when Cheney was running the show-- she opened the floor to questions. One woman-- with whom I had co-hosted a fundraiser for state Senator Barack Obama many years ago when he was first running in a seemingly hopeless Democratic primary for the U.S. Senate-- prefaced her question like this: "Since you're the smartest member of Congress..."

Donna Edwards (D-MD) demurred. "I don't know what Barney Frank or Jerrold Nadler would think about that." And there are a number of other exceptionally bright and thoughtful members of Congress as well, probably more than a dozen. But no one who knows her would deny Donna Edwards fits right in with that crew. Many of them were on a short list that caused Rahm Emanuel's short fuse to blow 2 weeks ago-- the 4 dozen Democrats who refused to vote for the supplemental budget that would continue unmerited war funding in Afghanistan. Although Nadler fumed and decided to give Obama the benefit of the doubt at the last minute, most of the other best and brightest Dems in the House courageously voted "no"-- from Alan Grayson (D-FL), Dennis Kucinich (D-OH), Carol Shea-Porter (D-NH), Tammy Baldwin (D-WI), Jan Schakowsky (D-IL), Jared Polis (D-CO), Keith Ellison (D-MN), and Maxine Waters (D-CA) to Barney Frank (D-MA), Jim McDermott (D-WA), Steve Cohen (D-TN) and, of course, Donna Edwards.

But it wasn't her insights about the pathetic non-policy in Afghanistan that I walked away thinking about. It was something she said about the bitter battle over health care reform. One of the House's most outspoken and well-reasoned advocates of universal health care-- sidetracked by the puppets of the Medical Industrial Complex to a chance for a "public option"-- Donna is worried that Big Insurance will embrace the "public option." Embrace and then smother to death in a bear hug. They don't want the competition, so they have given their well-paid allies-- Republicans, Blue Dogs, members of the Evan Bayh anti-Obama Bloc of Senate Conservadems-- their orders: let it pass and then make it dysfunctional. They will gamble everything that their three highest paid shills-- Arlen Specter (R/D-PA- $4,026,933), Max Baucus (D-MT- $2,833,731) and Mitch McConnell (R-KY- $2,758,468)-- will be able to sabotage the public option sufficiently enough to ensure that it is not robust and not competitive.

Although Ted Kennedy is the Chair of the committee that deals with health issues, the Medical Industrial Complex hasn't been forthcoming with the "donations" to him the way they are with the career criminals who always support them, what I call the "over two million dollar men-- like John Cornyn (R-TX), Lamar Alexander (R-TN), Richard Burr (R-NC), and Orrin Hatch (R-UT), These 4 have also been tasked with guaranteeing that a public option will be non-functional. Unfortunately, no one can reasonably expect anything more from Republicans. They are the party that seems to live to torture-- including American working families.

We do, on the other hand, expect more from Democrats. Sometimes I wonder why. Truth be told, though, for every corporate whore like Max Baucus, Evan Bayh, Ben Nelson and Tom Carper, the Democrats have stalwart defenders of working families-- Bernie Sanders, Jeff Merkley, Dick Durbin, Sherrod Brown and, of course, the Lion of the Senate, Ted Kennedy. And today, despite the mealy-mouthed manipulations of turds like Baucus and Nelson, the Lion was roaring again.

Senator Edward Kennedy, chairman of one of two Senate panels drafting health-care overhaul plans, said he will include a government-run program to compete with private insurers in a measure to be considered in mid-June, asserting his role in the emerging debate despite his battle with brain cancer.

..."An important foundation of our legislation is the following principle: If you like the coverage you have now, you keep it," Kennedy wrote in an op-ed article in the Boston Globe. "But if you don’t have health insurance or don’t like the insurance you have, our bill will give you new, more affordable options."

This is the insurance companies worst nightmare, and the hope for millions of American families. And stopping this is why the Medical-Industrial Complex has spent hundreds of millions of dollars in legalized bribes to corrupt members of Congress-- basically the entire Republican Senate caucus plus Max Baucus, Ben Nelson, Evan Bayh, Blanche Lincoln and a few other untrustworthy bribe-hungry Democrats. And what about the White House?

Playing on the corporate side you'll always have Rahm Emanuel, the darkest force inside the Administration who went from being the Democrats' Tom DeLay in Congress to being their Karl Rove in the White House. But his isn't the only voice-- only the loudest, most insistent and most malevolent. On the other side of the issue, also vying for the president's ear is OMB Director Peter Orszag. Orszag is committed to real health care reform, exactly what the Baucuses and Nelsons are joining the GOP to prevent. And he's doubly dangerous to their cause because he makes his case in terms of fiscal discipline:

When I give public talks on health care reform, the question I receive most often is "given the government’s fiscal situation, how can it make sense for the government to take on new spending commitments as part of health reform?"  The answer is two-fold.  First, health care reform has two components: cost containment provisions and expanded coverage.  In the near term, the impact of expanded coverage will temporarily dominate, and health care reform will therefore temporarily increase government spending.   Over time, however, the impact of the cost containment provisions will accumulate, and the net impact will be a reduction-– and perhaps a dramatic one-– in government spending.  Second, while we are waiting for the cost containment provisions to take hold, we are insisting that health care reform be deficit neutral.  In other words, the Administration is committed to a health care reform that is at least deficit neutral over 10-years -- and deficit-reducing, potentially to quite a significant degree, over the longer term.

It's important to bolster the worthwhile voices inside the Administration despite the cloying relentlessness of the self-serving legendary Emanuel hype-machine.

MoveOn.org is running radio ads in Maine, North Dakota, Oregon, Delaware, Washington and Florida aimed at senators on Baucus' committee who are still on the fence about the public option. All of the ads but one target Democrats.

MoveOn.org has also organized “thousands” of members, including doctors, nurses and small-business owners, to visit senators’ district offices to call on them to support the so-called public plan option.

“President Obama and 70 percent of voters support healthcare reform that includes a public health insurance option to contain costs, increase competition and guarantee coverage,” the narrator in the ad states.

“The insurance industry says with new rules they can do it alone, but they’ll find a way to put profits first. We need a health insurance choice not run by the insurance companies to keep costs down and ensure access to quality, affordable care.”

The question over whether to make the public plan option available in all parts of the country has emerged as one of the thorniest of the healthcare debate. Republicans say a nationwide public plan option would be a “non-starter” and would represent a march toward a single-payer, socialized healthcare insurance system. They argue that government competition would drive private healthcare companies out of business.

It's important to remember that the real battle for real health care reform has nothing to do with the GOP. It will take place entirely inside the Democratic Party. Frank Luntz explained the strategy to his GOP clients a few weeks ago: "You're not going to get what you want, but you can kill what they're trying to do." They can-- but only if they can peel off enough corporate Democrats to water down Obama's plans. The Republican smear machine is full operating now and their front groups are operating as though they were in the middle of an election campaign. They're wallowing in the mud and sowing discord and confusion. MoveOn has succinctly distilled the thrust of the Obama plan down to 5 key point:

1. Choice, choice, choice. If the public health insurance option passes, Americans will be able to choose between their current insurance and a high-quality, government-run plan similar to Medicare. If you like your current care, you can keep it. If you don't-- or don't have any-- you can get the public insurance plan.

2. It will be high-quality coverage with a choice of doctors. Government-run plans have a track record of innovating to improve quality, because they're not just focused on short-term profits. And if you choose the public plan, you'll still get to choose your doctor and hospital.

3. We'll all save a bunch of money. The public health insurance option won't have to spend money on things like CEO bonuses, shareholder dividends, or excessive advertising, so it'll cost a lot less. Plus, the private plans will have to lower their rates and provide better value to compete, so people who keep their current insurance will save, too.

4. It will always be there for you and your family. A for-profit insurer can close, move out of the area, or just kick you off their insurance rolls. The public health insurance option will always be available to provide you with the health security you need.

5. And it's a key part of universal health care. No longer will sick people or folks in rural communities, or low-income Americans be forced to go without coverage. The public health insurance plan will be available and accessible to everyone. And for those struggling to make ends meet, the premiums will be subsidized by the government.

And in both Houses of Congress, the Democrats who were handsomely paid off to abandon their constituents' needs and work for the Insurance companies and HMOs are demanding a place at the table-- and veto power-- for their patrons. Blue Dogs are threatening to cross the aisle en masse and vote with the Republicans to kill the public option entirely unless they get assurances it will be a crippled and dysfunctional system. The Sunlight Foundation put together this chart of some of the Blue Dogs on the take who are throwing up the biggest problems for the people working seriously on mending the health care system.




UPDATE: The Deep Difference Between Kennedy And A Revolting Shill Like Baucus

Today's NY Times draws the clear distinction. Kennedy and all non-corrupt Democrats favor "a robust public health care plan, a government-sponsored entity that would compete with private insurers."

By contrast, Senator Max Baucus, the Montana Democrat who is chairman of the Finance Committee, has been working for months with the panel’s senior Republican, Charles E. Grassley of Iowa, in the hope of forging a bipartisan bill, which would probably play down the option of a public plan.

Mr. Grassley opposes creation of a new government insurance program and says “we cannot afford the public health plan we have already,” referring to Medicare.

The insurance companies have provided Baucus and other shills, notably Chuck Schumer, with a "fallback plan," that will feature a public option that is designed to not work.

Public opinion polls suggest that many consumers would like to have the choice of a public plan. But insurance companies and Republican lawmakers say a public plan could drive private insurers out of business and lead eventually to a single-payer system run by the government.

Supporters of a public plan have been putting pressure on Mr. Baucus. Mr. Kennedy and 28 other senators signed up last week as co-sponsors of a resolution supporting creation of a public insurance option.

“Health care reform must include insurance reform, and health insurance reform must include the option of a federally backed health insurance plan,” said Senator Sherrod Brown, Democrat of Ohio, the chief sponsor of the resolution.

How Is The Republican Party Trying To Spin Tedisco's Disastrous Defeat In NY-20?

Still the defining figure of the Republican Party

Reid Wilson, at yesterday's Hill, put forth the proposition that the GOP has learned a lesson and sees a silver lining in their latest electoral catastrophe (NY-20). No doubt everyone Inside-the-Beltway who saw the headline must have thought it was an announcement of Michael Steele's impending resignation as chair of the RNC. But, instead, Republican sources tried feeding Wilson a hilarious dose of Republican Party spin: "This race tended to be more of businessman versus politician," said one GOP strategist close to Tedisco's campaign when asked to offer a postmortem. "Fresh face [versus] guy who's been around for a while." Yes, they think it was that voters want more inexperienced businessmen instead of well-known and experienced politicians-- that and the fact that they forgot to put together an effective absentee voting outreach strategy.

Isn't that a convenient way of looking at the fact that voters hate obstructionists and hate Republicans? Do you think it ever crossed their minds mind that voters are concerned about the nature of the political experience, not just if someone has been in politics forever or not? Wilson didn't let that go by without a response.

Though Tedisco led by more than 20 points in an initial survey and was running in a district with a 70,000-person Republican registration advantage, Murphy strategists were able to label Tedisco as a career politician. Meanwhile, Tedisco's chosen line of attack -- that Murphy supported the economic stimulus package along with a provision that allowed executives at AIG to receive millions of dollars in bonuses-- fell flat.

The Repugs also claim that to even come close to a tie outside the old slave-holding states that seceded from the Union is a mindboggling accomplishment considering what they're offering voters. Right-wing activists in the district claim Tedisco wasn't extremist enough and should have tried to capitalize on the teabagger mentality; that would have probably have resulted in a 60% win for Murphy instead of the 50/50 split. Steele and the equally clueless head of the NRCC, Pete Sessions, claim they see this defeat as "real progress" (for Republicans). "The Republican Party must be competitive in districts like NY-20 if we are going to regain our Congressional majorities," Steele said in a statement released Friday. "While we were unsuccessful in this race, the combined efforts of our candidate, the national and state parties and NRCC show that the GOP is going to invest the resources necessary to regain our majority in the U.S. House of Representatives."

Carl Hulse in yesterday's NY Times looked at the Republicans' dilemma from another perspective, the problem they've begun encountering as the public comes to see them as the Party of No. They have no effective strategy, no message, no messenger (unless you want to count messengers that normal Americans say they absolutely hate, like Limbaugh, Coulter, Cheney, Newt Gingrich, Palin.) They're actually driven towards trying to figure out how to incorporate a ditzy and appropriately ignorant Miss California into their messaging initiative! And what do they brag about? Unifying to stop change and holding onto the Bush policies that the country overwhelmingly rejects:

Republicans point proudly to their ability to close ranks, noting that only three Senate Republicans backed the $787 billion economic stimulus measure (though they provided the crucial margin of victory) while not a single Republican voted for budgets approved by the House and Senate. They rightfully note that they have so far held the line against a measure that would ease union organizing in the workplace.

They say they are reconnecting with their core voters by emphasizing what they see as profligate Democratic spending. And they say they are laying the groundwork for a comeback by putting themselves solidly on the right side of multiple issues in preparation for the public souring on the Democratic agenda on spending, health care, energy, etc.

But not everyone in the country-- in fact, outside of Congress, almost no one in the country-- gets a piece of the $312,657,650 in bribes insurance companies have doled out since 1990 (63% to Republicans) and the $823,948,241 in bribes from the so-called "health" industry (57% for Republicans since 1990). Yes, something tells me that a revolt against universal health care, similar to what corrupt and hypocritical members of Congress get, is probably not something the GOP should be counting on to sweep them back into power. Some observers claim that the reason the Republicans are so frantic to stop the passage of effective universal health care-- and the reason they will stop at nothing to sabotage it-- is because if Obama succeeds in implementing it, it will relegate the Republican Party to the peanut gallery, at least nationally, for at least three decades.

Hulse points out that "while Republicans were effective in banding together against the stimulus and the budget, they have splintered elsewhere, most embarrassingly on a now-defunct Democratic House plan to levy a huge tax on executive bonuses. After Mr. Boehner, the Ohio Republican and House leader, heaped scorn on the plan, Republicans still split down the middle as dozens backed it out of fear of the political consequences of opposing a tax on executives cashing in on an economic crisis that they caused." He adds that the GOP defeat in NY-20 was "the ultimate reality check" and that "Republicans had the more experienced candidate and went at the contest hard, only to come up short. It is likely to haunt the party and potentially depress candidate recruitment and fundraising."