Thread: Health Care Reform 2009; The Latest News and Opinions...

Felt this Health Care Reform topic needed to be bumped as it is likely to become the BIGGEST part of the daily news for several weeks. I looked at resurrecting one of several existing threads with this news... but they were titled and focused on other more narrow issues/aspects... plus the discussions therein had sometimes veered wildly from the main points (NNTIAWWT). Also felt that until today there have really been a half dozen or more different "plans", IMO the announcement today marks a narrowing of the debate and beginning of the main battle phase as it were.




And away we go...

Reid: Public Option No 'Silver Bullet' But Strong Consensus For Opt-Out

Christina Bellantoni | October 26, 2009, 3:24PM

Senate Majority Leader Harry Reid announced what we've been reporting today - the merged health care bill will include a public option allowing states to opt-out.

"Under this concept states will be able to determine whether the public option works best for them," Reid told reporters. He said it was the "fairest" way to go.

Reid (D-NV) said after "countless hours" of talking to his caucus, there is a "strong consensus" for this plan. He said he will not submit a plan with a triggered public option to the Congressional Budget Office.

"As we've gone through this process, I've concluded, with the support of the White House and Senators. Dodd and Baucus, that the best way to move forward is to include a public option with an opt out provision for states," Reid said.

Reid said he was "disappointed" the public option had "frightened" Sen. Olympia Snowe (R-ME) but that he hoped she would "come back."

"I spoke to Olympia on Friday...and at this stage she does not like the public option of any kind. And so, we'll have to move forward on this, and there will come a time I hope, where she sees the wisdom of supporting a health care bill," he said.

"We hope Olympia will come back, she's worked hard, she's a very good legislator," Reid added.

He also blasted Republicans, saying he can count the moderates in the GOP on "two fingers."

Reid said it had been "a great opportunity" to work with the White House and said he feels optimistic about overall health care reform because of "momentum" and the caucus consensus. But he wouldn't tell reporters if he had done a count that got him to the needed 60 votes to break a filibuster.

Reid said he is a "strong supporter" of the public option but that is is "not a silver bullet." He said it was a key way to ensure competition among insurers and "to level the playing field."

Today Reid implied that under the current bill, states will have until 2014 to opt out of the government plan.

He also said "there will be a co-op in this bill."

In the next several hours, Reid will send the CBO a draft bill with alternative provisions on certain issues, to get a range of cost estimates on the plan he'll bring to the floor.

Late update: The White House issued a response that President Obama is "pleased" public option included. Reid said he hasn't asked Obama to make calls yet.

Also, we clipped the video of Reid's presser.

Do you think this newly announced Senate Plan can get 60+ votes to avoid being killed by filibuster? Any hunches on how unexpected new amendments might reshape it even before it makes it to a full vote there in Senate? Not sure how this meshes with any current House versions... but will be curious to hear Pelosi comment. Any guesses if and when something lands on Obamas desk for his signature?

A few other interesting details on all this from around the webs;

Originally Posted by NYTimes.com

...Pressed on whether he could advance the bill with the public option included, Mr. Reid said he believed Senate Democrats would remain united to do so. “I believe we clearly will have the support of my caucus to move to this bill and start legislating,” he said.

But other Democrats were not so sure. Even as liberal groups quickly began heaping praise on Mr. Reid for his decision to support a government-run plan, some Democrats on Capitol Hill privately expressed worries that he did not have firm commitments from all 60 Senate Democrats.

Mr. Reid’s decision, made after nearly two weeks of deliberation, reflects a calculated gamble that the 60 Senate Democrats will stay united and vote in favor of a motion to bring the bill up for debate before the entire Senate.

If 60 senators refuse to support the bill including the government plan with a state opt-out, Mr. Reid would then have to regroup, make changes and try again. Some Democrats believe that liberal members of the party would not relent in their push to include the public option unless faced with such a clear defeat.

...

Originally Posted by Huffington Post

...

"It's a zero-sum situation," said Durbin, who is in charge of counting votes in the Senate. "If we thought that just putting the trigger in meant that we'd end with 61 votes," he explained, then that's what leadership would have done.

"But there were some [senators] that felt that that just didn't go far enough moving toward a public option," said Durbin, who is himself a backer.

"We have 60 people in the caucus," Reid said. "We'll all hang together and see where we come out."

Sen. Roland Burris (D-Ill.) had insisted he would oppose any bill without a public option and rejected the trigger as a compromise. Sen. Bernie Sanders, a Vermont independent and self-described democratic socialist who caucuses with Democrats, had come close to making such a threat but said he was "playing it day to day." Sen. Russ Feingold (D-Wisc.) said over the weekend that the lack of a public option was a "good reason" to vote against it.

Durbin said that he is confident the progressive wing in the Senate is satisfied with the opt-out compromise.

...

And good additional commentary here; http://www.huffingtonpost.com/2009/1..._n_334284.html

Originally Posted by Huffington Post

...

By including the public option in the bill before it goes to the floor, Reid is offering conservative Democrats a fig leaf of sorts. They can cast a vote in favor of ending a GOP filibuster -- when 60 votes are required -- but then vote against the public option later when the matter is debated on the floor, and only 50 votes are needed for victory. The move is also a gift to liberals, as the specific provision won't need to reach the traditional 60-vote threshold that is so often the death of genuine reform legislation.

...

Sen. Lamar Alexander, a Republican leader from Tennessee, said on the Senate floor Monday, in advance of Reid's announcement, that the opt-out provision isn't to be taken seriously. Medicaid, he noted, has an opt-out provision, but not one state has opted out. Public health insurance, in other words, is too popular for states to opt out.

...

Don't most states already have some sort of "public option"?

Originally Posted by I Dunno

Don't most states already have some sort of "public option"?

http://www.coverageforall.org/our_services.htm#apps

Seems to be little interest left in this subject... but I'll update anyway; In related news, Lieberman is a douche;

Reid, Durbin Open To Majority Vote To Beat Health Care Filibuster

First Posted: 10-28-09 09:02 AM | Updated: 10-28-09 09:45 AM

As Senate Majority Leader Harry Reid works to cobble together the 60 votes he needs to overcome an expected Republican attempt to block a floor vote on health care, there is still one powerful parliamentary weapon he could draw from his back pocket.

The process known as budget reconciliation only requires a simple majority -- and can not be filibustered -- meaning Reid (D-Nev.) would need only 50 Democrats plus a tie-breaking vote from Vice President Joe Biden to declare victory.

Is he still considering going that way?

"Sure, it's always an option," Reid said after leaving his press conference Monday, when he announced that he'd be pushing forward with a public health insurance option with an opt-out provision that would give states the right not to participate.

Reconciliation gained new relevance on Tuesday, when Sen. Joe Lieberman (I-Conn.) said that unless the public option is stripped out, he's prepared to join a GOP filibuster of the health care reform package. Without Lieberman, Democrats would only have 59 votes to end a filibuster -- one short.

Majority Whip Dick Durbin (D-Ill.), who is in charge of corralling and counting votes, also said that reconciliation is still being considered. "The failsafe on this is reconciliation," Durbin said. "I hope we don't reach it because you can only do a limited amount of things on reconciliation."

Durbin was referring to the Senate parliamentarian's ability to strip out parts of any bill going through the reconciliation process that don't have a direct impact on the budget. (More on reconciliation here.)

But reconciliation is also a club that Reid can swing at conservative Democrats and Lieberman.

If only 50 votes are needed, Lieberman becomes irrelevant, the most damning sentence that can be handed down to a Senator.

For evidence, just witness this week's fuming from Sen. Olympia Snowe (R-Maine), who was moved from the center of the debate to the periphery by Reid's decision to move ahead without her. (What would Reid have to change in the bill to win her back? "The whole thing," she snapped.)

Lieberman said he hopes that it won't come to reconciliation, but told reporters that the threat wouldn't change his vote.

"I hope not," he said, when asked if he thought Reid might go the simple-majority route. "But that possibility, which I think would be a mistake, is not enough to lead me to vote for something I think would be bad for the country and bad for the 180 or 200 million Americans who currently have health insurance."

If the health care bill passes with the state's right to opt. out of the public option I wonder how many states will decide to opt. out?

Originally Posted by Adolf Allerbush

If the health care bill passes with the state's right to opt. out of the public option I wonder how many states will decide to opt. out?

Probably "0". I'll bet the federal gov't will include a clause in the legislation that states, sure opt out and you'll then lose "x" number of $ for some related program.

Originally Posted by OSECS

Probably "0". I'll bet the federal gov't will include a clause in the legislation that states, sure opt out and you'll then lose "x" number of $ for some related program.

I agree it will likely be zero, but I'd say it would be because the Republicans are at least smart enough to realize that their asses would get voted straight out of office if they didn't let their residents participate in it. I think it's really in the legislation to give moderate Dems or Republicans cover to vote for either cloture or the bill itself.

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Originally Posted by OSECS

Probably "0". I'll bet the federal gov't will include a clause in the legislation that states, sure opt out and you'll then lose "x" number of $ for some related program.

You can opt out but you'll still have to pay in.........

An update on the House side of the process;

Democrats Optimistic, Progressives Coming To Terms, On Health Care Bill

Brian Beutler | October 29, 2009, 12:22PM

Before House Democrats unveiled their health care bill, the caucus huddled in the basement of the Capitol to get fired up. As the meeting broke, Majority Whip James Clyburn (D-SC) darted down the hall and a reporter asked him how many votes he had.

"All we need," Clyburn shouted back, cheekily.

Inside the caucus room, members broke into applause.

Unsurprisingly, optimism was the theme of the morning among House Democrats, though some progressives aren't completely pleased with the outcome.

Rep Lynne Woolsey (D-CA)--co-chair of the Congressional Progressive Caucus--said, emphatically, that when she and other liberal leaders meet with the President tonight, she wants to hear him say "that he supports a strong public option and he will take that over to the Senate." As for whether she can support the bill in the House with a somewhat weakened public option, Woolsey told me she needs to learn more.

"We're looking at what they've put in the bill to make up for it not being Medicare-plus-five, to see if it covers...our same goals," she said.

"The fact of the matter is, if I would have said to you two months ago we would have a bill with the public option, most of you would have said, 'nah, that's not gonna happen,'" said Rep. Anthony Weiner (D-NY) "now it's a virtual consensus that it's going to."

In order to accommodate progressives, who have been demanding that the bill's public option be maximally robust, House health care leaders strengthened other aspects of it, including a Medicaid expansion, and a mandate that insurance companies spend at least 85 percent of their premium dollars on paying for care--a regulation that will take effect immediately if it survives in conference with the Senate.

Though official CBO numbers aren't in yet, Rep. Jerrold Nadler (D-NY) told me that the bill "continues to reduce the deficit" 11-20 years out.

The unveiling ceremony itself was as much a news event as a pep rally for Democrats, who, though confident, may still need to convince fence sitting members to support the bill. The only unscripted moment came when a man in small crowd of protesters, shouted at Speaker Nancy Pelosi, repeatedly, through a megaphone "You will burn in hell for this."

"Thank you, insurance companies of America," Pelosi said, breaking her stride momentarily.

When the ceremony ended, I asked Rep. Henry Waxman (D-CA)--chairman of the House Energy and Commerce Committee--what all the cheering in the caucus room was about. Was it 218?

"I don't remember," he said smiling, "but it was not that."

Do you think you'll get there?

"Yes."

According to a House leadership aide, the bill could be on the floor late next week.

It's definitely a huge step forward to get it past the house committee, but they've still got both the house and senate, and with the looks of things, it's far, far, farrrrrrrrrrrrrr from over.

Some more uplifting news. (Politico)




1,990 pages at $2.2 million a word
By: Jonathan Allen
October 29, 2009 04:22 PM EST

It runs more pages than War and Peace, has nearly five times as many words as the Torah, and its tables of contents alone run far longer than this story.

The House health care bill unveiled Thursday clocks in at 1,990 pages and about 400,000 words. With an estimated 10-year cost of $894 billion, that comes out to about $2.24 million per word. .

And for some members, that may not be enough.

A “robust” public option can’t be found in the bill. Neither can the word “doctor” – save for a few references to degrees. No “cost curve” is bent. No “blue pill” is dispensed.

“Death” and “taxes” are both in there, but “death panel” is not.

The text defines dozens of words and phrases, including “family” (“an individual and . . . the individual’s dependents”), “health insurance coverage,” “exchange-eligible individual” and “Indian.”

And for those who cry “read the bill,” beware. There are plenty of paragraphs like this one:

“(a) Outpatient Hospitals – (1) In General – Section 1833(t)(3)(C)(iv) of the Social Security Act (42 U.S.C. 1395(t)(3)(C)(iv)) is amended – (A) in the first sentence – (i) by inserting “(which is subject to the productivity adjustment described in subclause (II) of such section)” after “1886(b)(3)(B)(iii); and (ii) by inserting “(but not below 0)” after “reduced”; and (B) in the second sentence, by inserting “and which is subject, beginning with 2010 to the productivity adjustment described in section 1886(b)(3)(B)(iii)(II)”.

The section deals with “incorporating productivity improvements into market basket updates that do not already incorporate such improvements,” if that helps.

Optimistic lawmakers say it could take a week just to get through the bill’s text.

“I’ll have to call an emergency meeting of my staff and drop the customary procedure of me reading and my staff not reading,” joked House Judiciary Committee Chairman John Conyers (D-Mich.), who famously told filmmaker Michael Moore that lawmakers “don’t read most of the bills.”

“It’s one thing to read it,” said Rep. Lee Terry (R-Neb.), a lawyer who voted against the first version of the bill on its way through the Energy and Commerce Committee. “It’s another thing to understand it when it’s written in legalese.”

When given the bill’s dimensions, Rep. Anthony Weiner (D-N.Y.) noted that some members are faster readers than others.

“That’s one afternoon for Barney Frank,” he said.

Republicans aide said a print-out of the bill weighs more than 19 pounds and stands nearly nine inches tall.

North Carolina Republican Rep. Patrick McHenry, 34 years old and a few inches taller than 5 feet, said the bill could act as a ”booster seat.”

Democrats say the essence of the bill isn’t much different from the three sister bills they moved through committees this summer, which came in around 1,000 pages.

If you read those, they say, you pretty much know what’s in this one.

“It’s almost a complete certainty that we have already discussed and debated almost every element that’s in this bill,” said Rep. Steve Rothman (D-N.J.)

McHenry took issue with the notion that the 2,000-page bill hasn’t changed much from the earlier, 1,000-page versions. To prove the point, he pulled out a Democratic-written summary of the changes.

All eight pages of them.

Asked why the House will vote on the roughly 400,000-word bill in a week when it takes a congregation a year to read the 80,000-word Torah at a synagogue, Rothman, who is Jewish, exhibited the wisdom of a Talmudic scholar.

“It only takes a year because you read one section a week,” he said.

But Republican Rep. Joe Barton, who is Texan, said the bill is “about four reams of paper” that add up to the American public “getting reamed.”

© 2009 Capitol News Company, LLC

ABC News Poll: More Americans Prefer Public Option to Bipartisan Bill:

Fifty one percent said they preferred the public option; 37 percent said they preferred a bill with some support from Republicans in Congress. Six percent said neither and seven percent expressed no opinion.

Americans divide about evenly on the reform plan and Obama’s handling of health care alike –neither better nor worse for him since summer. But 57 percent support one of the plan’s most contentious elements, a government-sponsored insurance option, and that soars to 76 percent if it’s limited to those who can’t get affordable private insurance.

without a public option the public will be screwed by the Insurance companies. There is not enough cost controlling measures in the bill to keep insurance companies from charging exorbitant amounts for coverage that we are mandated to purchase. Without price controls there has to be a public option.

Originally Posted by doughboyshredder

without a public option the public will be screwed by the Insurance companies. There is not enough cost controlling measures in the bill to keep insurance companies from charging exorbitant amounts for coverage that we are mandated to purchase. Without price controls there has to be a public option.

Wage and price controls were tried in the 70's by Nixon -- non-starter. But if you're still hell bent on it how is this going to help?


The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):

Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.

So, you can’t try to seek alternatives to lawsuits if you’ve actually done something to implement alternatives to lawsuits. Brilliant! The trial lawyers must be very happy today!

While there is debate over the details, it is clear that medical malpractive lawsuits have some impact on driving health care costs higher. There are likely a number of procedures that are done simply as a defense against future possible litigation. Recall this from the Washington Post:

“Lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits, congressional budget analysts said today — a substantial sum that could help cover the cost of President Obama’s overhaul of the nation’s health system. New research shows that legal reforms would not only lower malpractice insurance premiums for medical providers, but would also spur providers to save money by ordering fewer tests and procedures aimed primarily at defending their decisions in court, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, wrote in a letter to Sen. Orrin Hatch (R-Utah).”

Stay tuned. There are certainly many more terrible, horrible, no-good, very bad provisions in this massive bill.

No no no, it's 1,900 pages to make sure they cover all the things that can screw the tax payers. It has nothing to do with political payback to trial lawyers or other scum...er special interest groups. It's no coincidence that trial lawyers contribute overwhelmingly to the DNC. (yes I know malpractice suits only account for at most 2-3% of costs). So the DNC takes their money and uses it to fund campaigns (while protecting lawyers rights to receive exorbitant fees from others misfortune) (SEE: John Edwards). The DNC and the trial lawyers both win cause they get to feed from the public trough. one the money trough and the other the gullible trough.

The democrats would never write a bill that would intentionally mislead the public, I mean they are for the little guy after all ?? Right ?? Right ??






Cue the crickets.........

Talking Points are Awesome



To read an historical analysis on why legislation has become so lengthy: Is Ronald Reagan Responsible For 1,990 Page Health Bill?

And it's not just Democrats: Republicans Amend Baucus Bill To Lower Affordability Standards, Stop Funding For ACORN.

In a nutshell, the bill is so long to try and prevent insurance companies from gaming the rules (a futile effort because this is the health insurance companies core competency) and because partisanship means that the minority party will do what it can to block legislation—adding amendments, filibustering, and increasing the Fear Uncertainty & Doubt in the legislative process. Therefore, the majority tries to stuff the bill with everything it can so the provisions it wants, make it through.

This could be a big get for health care reform proponents...

AP Sources: House Democratic health care bill to be endorsed by the AARP

ERICA WERNER and RICARDO ALONSO-ZALDIVAR
AP News

Nov 04, 2009 18:20 EST

In a coup for House Democrats, AARP will endorse sweeping health care overhaul legislation headed for a history-making floor vote, officials told The Associated Press on Wednesday.

An endorsement from the seniors' lobby was critical when then-President George W. Bush pushed the Medicare prescription drug benefit through a closely divided Congress in 2003. House Democratic leaders are hoping it will work the same political magic for them as they strive to deliver on President Barack Obama's signature issue.

An announcement from the 40-million member group is expected Thursday, said officials with knowledge of the group's decision. They spoke on condition of anonymity because the endorsement is not official yet.

Backing the 10-year, $1.2 trillion House bill is a tricky move for AARP. Many retirees are concerned about cuts in Medicare payments to medical providers, which will be used to finance an expansion of health insurance coverage to millions of working families who now lack it. Also, AARP says its membership is about evenly divided among Democrats, Republicans and independents, meaning its endorsement in today's highly politicized atmosphere could anger many members.

Floor votes on the House bill could come as early as this weekend. Asked Wednesday if Democratic leaders had the 218 needed for passage, House Majority Leader Steny Hoyer, D-Md., responded: "We're counting. We're counting."

House leaders moved on Wednesday to shore up support for the measure among the Democratic rank-and-file, even as they sharpened their fight with the health insurance industry.

Last minute changes to the legislation, released late Tuesday night, started a 72-hour legislative clock and cleared the way for votes as early as Saturday.

In a move aimed directly at health insurance companies, the revised House bill would launch a federal-state crackdown on what it terms "unjustified premium increases." Insurers have sought above all to block creation of a government insurance plan, which happens to be the top legislative goal for liberals.

Under the bill, insurance companies would have to publicly disclose the justification for premium increases before they go into effect. The federal Health and Human Services department would monitor patterns of premium increases, and could take action if the price hikes are out of line. The bill would also provide $1 billion to state insurance commissioners, allowing them to ramp up their own enforcement.

Democrats also strengthened a provision that would strip the industry of its decades-old exemption from federal antitrust laws.

Supporters said the tougher approach is needed to keep insurance companies from artificially boosting premiums in advance of the major reforms taking effect in 2013.

Other late changes to the bill, such as enhanced status for the government's office of minority health, were intended as sweeteners for supportive lawmakers, including members of the Congressional Black Caucus.

With no Republican backing for the measure, Democrats will need overwhelming support from their own. A festering intra-party disagreement over how to prevent federal funds from being used to pay for abortion remained unresolved Wednesday morning.

The House bill is estimated to expand coverage to about 96 percent of eligible Americans. Beginning in 2013, it would provide government subsidies to extend coverage to tens of millions who now lack it, and ban insurance company practices such as denying coverage to people with pre-existing medical problems.

For the three years before the federal aid starts flowing, the bill would set up a temporary "high-risk pool" through which people who have been denied coverage because of poor health could obtain a government-subsidized policy.

The bill would set up health insurance "exchanges" through which self-employed people and small businesses could buy coverage, either from a private insurer or a new government plan that would compete. All the plans sold through the exchange would have to follow basic consumer protection rules, making it easier to shop and compare among them.

The majority of middle-class Americans covered under big employer plans would not see dramatic changes. But coverage for the poor through Medicaid would be significantly expanded.

Seniors in traditional Medicare would get improved preventive benefits. Also, the prescription coverage gap known as the "doughnut hole" would be gradually closed. However, seniors signed up for private insurance plans through Medicare could lose some benefits, as the bill scales back extra payments that the plans have been getting.

In addition to raising money by cutting payments to hospitals and other medical providers, the House bill boosts taxes on upper-income earners. Democrats also moved Tuesday to close a biofuel tax credit loophole, raising about $23 billion to help pay for the legislation.

____

Associated Press writers David Espo and Alan Fram contributed to this story.

Source: AP News

Sixty billion dollars in Medicare fraud is a lot of money, but how can we really put it into perspective? President Obama talks a lot about insurance companies and
their "record profits." Let's compare those numbers.

Fortune 500 tallies show that last year's profits for the ten largest private insurance companies in America were $8 billion--combined. Even the single most profitable insurance company didn't make five percent as much as what Medicare lost to fraud.

It may be surprising that you could multiply the profits of America's ten largest private insurance companies seven-fold and that Medicare would still have managed to lose more money than they make. But try this one on for size: The Washington Post reports that a high-school dropout in Miami submitted false Medicare claims from her laptop across four years, bilking Medicare out of $105 million. Four of the ten largest private insurance companies failed to make $105 million in combined profits. That's right: A lone criminal grossed more from Medicare fraud than four out of the ten largest private insurance companies collectively netted in profits.

http://www.weeklystandard.com/Conten...7/163wxrtd.asp

Evil profit driven insurance companies. Lets give our money to the government instead.

Originally Posted by Rubicon

Evil profit driven insurance companies. Lets give our money to the government instead.

The House is likely to take the vote on the Health Reform bill soon... last I heard it was going to be a squeaker!!! In case you are like me and don't mind having the soothing strains of Politicians droning on in the background while you are surfing your porn etc you can click here for a live stream of the House via the Socialist News Broadcast Network (oops, I meant MSNBC instead of SNBC); http://rawstory.com/2009/11/11th-hou...h-reform-vote/

Edit: Seems like the Republicans are consistent in calling it a "Job Killing" bill.

The time draws closer... though Republican douchebag stalling tactics have slowed it;

"WE HAVE THE VOTES"



I know some of you think Nancy Pelosi is the Devil incarnate... but if she was 20 years younger, or I 20 years older... I'd hit it. [/TMI]

Impassioned speech on House floor;

"G.O.P. = Grandstand. Oppose. Pretend."