They have begun this debate by claiming that their objections lie at the margins of health reform, not at its core.

Right, they object to the insurance companies not having a license to steal. Not that most Dems are much better. Can you say kleptocracy?

Alternatively we could have a system that works and is affordable. AFAIK no country does that using for-profits for basic coverage.

Their second objection pretty much ensures that they will oppose any real reform.

Well I certainly hope that Ezra doesn't believe that the Public Option is "at the margins." Indeed, reprising James Carville, the mantra for progressives should become:

"It's the Public Option, stupid."

We've already been down the Republican path of keeping the government out of the medical insurance marketplace. It's called Medicare Part D. And in a more insidious fashion, Medicare Advantage programs, which, hopefully, may be going the way of Judd Gregg in 2010.

BTW, a nomination for the George W. Bush "Fool me once, fool me twice" award, the line in the Republican Senators' letter which reads:

Doing so [e.g., insisting on a public option] would "make it difficult to gain broad bipartisan support."

Oh, right.

To be fair, the right counts as "universal coverate" a person's ability to drag themselves to an emergency waiting room, get treated despite not having insurance, and going bankrupt trying to pay the bill.

Well I certainly hope that Ezra doesn't believe that the Public Option is "at the margins."

Seconded!

First, they warn against using the budget reconciliation process to pass heath care. Doing so would "make it difficult to gain broad bipartisan support" and "do a disservice to this important issue."

Well, OK, let's play bargain. If you (GOPers) allow a public option and define universal access as affordable health insurance for all (guaranteed issue, community rating) with subsidies for those who can't afford one of the authorized plans and agree to commit publicly to vote to approve such a bill,

then, we'll (Dems) give up treating health reform as budget reconciliation (which doesn't require 60 Senate votes).

No bargain? Then reconciliation it is. Take it or leave it.

They're only card is to threaten to withhold bipartisan support? Really? How many people actually believe than more than possibly one or two Republican senators will vote for a heath care reform bill, any health care reform bill, that comes before Congress?

JimPortlandOR said. They're happy to support any reform that isn't actually a reform, and keep everything that's 'uniquely American' (i.e. uniquely shit) about the system as it stands.

As such, they can roll up their letter into a straw and suck on it.

First, they warn against using the budget reconciliation process to pass heath care. Doing so would "make it difficult to gain broad bipartisan support"

This is an awfully empty threat, unless the votes of Republicans are needed to use the budget reconciliation process. I don't know enough about the workings of congress to know if that's the case. Does anybody know if, using the budget reconciliation process, the Democrats are likely to have enough votes to pass national healthcare without any GOP votes? This seems to me a key question.

Their second objection pretty much ensures that they will oppose any real reform...

Well, I'd say universal private coverage (for those not eligible for Medicare/Medicaid) with generous subsidies (capping premiums at under, say, 10% of income) combined with guaranteed issue and community rating would constitute genuine form. Going from 45 million uninsured to zero is a pretty massive change. Mind you, I doubt such a plan would be optimal reform. And it would certainly be expensive -- and almost certainly unsustainable in the long term. But I'd take that deal if that's the best we can get. As Leonard Garment (I think it was he) once said, if something's unsustainable in the long run, it won't be. Meaning, if we go to a very pricey "giveaway-to-private health-insurance model" in order to get to 100% UHC, and we can't afford it in a few years, we'll have to switch to single payer at that time. No rich country public has ever ceded the right to UHC once they've gained it.

Gov. Jindal 8/31/08:

“I am conservative. No doubt about it. But when you go back to what it means to be a conservative, I also think, as conservatives, we should believe in universal health care coverage.”

Jasper: if we go to a very pricey "giveaway-to-private health-insurance model" in order to get to 100% UHC, and we can't afford it in a few years, we'll have to switch to single payer at that time

I dunno. The "giveaway-to-private banks model" might bankrupt us before we can implement a "giveaway-to-private health-insurance model". Kleptocrats please form a line to the right.

No rich country public has ever ceded the right to UHC once they've gained it.

And how many powerful vested interests have ever ceded the right to steal money by virtue of government action?

And how many powerful vested interests have ever ceded the right to steal money by virtue of government action?

Well, it looks to me like Obama will likely succeed in significantly curbing payments to private Medicare insurers. Indeed, this (Medicare/Medicaid) is one area in general where the government has successfully chiseled away at the profits of private companies. Also, we're not spending nearly as much of our GDP on, say, space exploration as we once did -- and that represents billions of lost potential profits to aerospace. But at any rate, I'm not saying giving vast sums to Big Insurance is the optimal way to get to UHC. I just think that-- as long as it's combined with subsidies to shield individuals from financial pain -- such a compromise is superior to continuing the status quo, and continuing to have tens of millions without meaningful access to healthcare. I fully expect many liberals will disagree with me, and I agree that such a move is a gamble. But so is not taking advantage of this political moment to finally get UHC enacted.

The advantage the rightwingers have is that "universal health care" means nothing to them. They could care less about that as a goal. And for that reason, they're released from having to come up with solutions which have even a slight chance of working. The truth is they're free to propose whatever hokus-pocus they want.

I mean, for years, one of their solutions has been Health Savings Accounts (HSA's). If there were ever a quack remedy, HSAs are it.

The only way we're going to get UHC -- even what Obama or Hillary were proposing during the campaign -- is to shove it down their throats. There's just going to be no cooperation.

JimPortland: that isn't the deal. The deal is eliminating the tax subsidy to employers for covering their workers (McCain's campaign position) in exchange for the public plan (the Democrats core reform). Unless the Wyden-Bennett initiative gains currency soon.

Jasper: Evan Bayh can't get more than three of his Senate Blue Dogs to vote with the opposition at any given time, so I don't think standing up to the president on this issue is going to fly during budget reconciliation; if we have an unsustainable system, we could choose cost reform or we could inadvertently ruin the economy with - sigh - crushing debt.

Leo: there are some Republicans that are favorable to universal health care. They may not consider health care a right, and they may be very skeptical about public provision/single-payer, but insisting that there isn't common ground is a good way to ensure that there isn't even a semblance of an effort to negotiate with them. Real conservatives care about labor market flexibility, regressive incentives, the impact on businesses, and presumably the health of their family, friends, and constituents. Intellectual honesty on both sides gets us, roughly, to "our society would benefit from a health care system in which everyone received preventive care." Why not build from there?

Ezra,
Is someone in the progressive world thinking about how to call the GOP on their claim that the private sector cannot compete with government in health care? That is in stark contrast to their second favorite ideological point (after tax cuts, natch). I've seen remarks about encouraging competition, but that doesn't strike me as gaining the most from this opportunity.

Finally, the time has arrived to fix Americas Healthcare crisis, and Americas healthcare knightmare. Hundreds of thousands of you are killed needlessly every year by your healthcare delivery system in a rush to profit. And because of a rush to profit Hundreds of thousands more of you are needlessly dying from treatable illness that people in other developed and civilized countries don't DIE! from. Rich, middle class, and poor alike. Insured, and uninsured. Men, women, children, and babies.

Additionally, thousands more of you are driven into financial ruin, and bankruptcy just because you, or one of your loved ones got sick or injured. And all of this is happening at a time when America spends twice as much of it's GDP (Gross Domestic Productivity) on health care than any other country in the developed world. Individual Americans spend about ten times as much on health care as any other people in the developed world. This is a CRIME AGAINST HUMANITY. AND IT MUST END!

But before we can truly fix this healthcare crisis and disgrace, everyone needs to clearly understand what the problem is. And everyone needs to clearly understand the real enormity of the problem. The problem is that HEALTHCARE AND MEDICAL DELIVERY IN AMERICA IS SEVERELY CORRUPTED AND COMPROMISED BY GREED! AND THE PRIVATE FOR PROFIT MOTIVE. And it is corrupted, and compromised IN EVERY ASPECT, AND EVERY PLACE OF HEALTHCARE AND MEDICAL DELIVERY. Unfortunately for all Americans, compromised healthcare ALWAYS results in needless suffering, injury, disability, and or death. Which is exactly what is happening now in America in shocking numbers.

Health care is NOT! a private for profit business. Healthcare is an essential public service. Like police, and fire. And healthcare is also a human right! PRIVATE FOR PROFIT HEALTHCARE IS AN OXYMORON, AND AN IMMORAL AND UNETHICAL PERVERSION OF HEALTHCARE AND HUMAN RIGHTS.

So how do we fix this healthcare disgrace? I believe the fix for Americas healthcare disaster is essentially the same thing that every other developed country in the World has essentially done. "NOT FOR PROFIT, TAX PAYER SUPPORTED, SINGLE PAYER, AUTOMATIC, FREE UNIVERSAL HEALTHCARE FOR ALL. Essentially HR676 (enhanced, and expanded medicare for all). Just like every other CIVILIZED! country in the developed World has. There is no other way to truly fix and reform our current disastrous healthcare delivery system.

All Universal health care systems work best when everyone participates. But I know that the healthcare lobby, and some politicians will try and undermine "Not For Profit, Tax payer supported, Single payer, Automatic, Free Universal Healthcare for all" by falsely claiming that it will limit your choice, and require you to participate.

So, I propose that everyone be included in the national plan unless they choose to opt out. If you opt out and need medical care the national plan will insure your provider that they will be reimbursed under the rules for members in the national plan. But those who opted out, and their insurer will be responsible for the FULL! cost to the national plan for providing your care if you or your private insurer fails to reimburse the provider or the national plan in a timely manor to at least the standards of the national plan.

Including reporting you to credit agencies, withholding of taxes, leans, and garnishment of wages for unpaid medical bills. Just like you have now under private for profit healthcare, and private for profit health insurance.

Further, people who opted out will be required to provide proof of financial responsibility for future illness or be required to participate in the national plan. And everyone with children will be required to participate in the national plan. Or provide proof of insurance coverage on each child to the standards of the national plan. It will be against the law to report anyone in the national plan to a credit agency for unpaid medical bills.

Frankly, only a dope would want to opt out of the national plan and opt to keep our current disastrous private for profit medical, and insurance plans. But they will be free to choose. The most important thing is that the vast majority of Americans that want the protection, benefits, and higher quality of a universal national plan have that choice.

You see, one of the most important aspects of a universal healthcare system is easy access, and patient protection. This is accomplished by having a single payer without a conflict of interest in patient care. And by having a payer who has the power to enforce minimum standards of excellence in healthcare delivery for everyone in the plan. This is much of what Medicare does now for senors. "Aeger Primo" (The patient first). Unfortunately in our healthcare system the patient comes last. We are just a peace of meat to them. Cash cows to be slaughtered for profit.

So this is IT! my fellow Americans, My fellow human beings, My fellow World Citizens. And my fellow Cyber Warriors. :-) The time has come. D day. H hour. HEALTHCARE REFORM THIS YEAR! Let no one stand in our way. Contact your representative and tell them you want "Not For Profit, Tax Payer Supported, Single Payer, Automatic, Free Universal healthcare for all. And tell them you want that choice now. Tell them you want President Obama's budget passed as is, without delay. President Obama's budget is brilliant. And exactly what is needed now.

President Obama, and his allies will need all the support you can give them. The healthcare lobby will try to take out his people if they can, like they did with Tom Daschle and Nancy Killefer. And they will try to neutralize President Obama's popularity, and political power. Or they will try to take him down someway. Don't stand for it. If they attack him. Go after them ten times harder and remove them from office. We had an election. And you the people chose President Obama's leadership, and change agenda. Let no one in government disrespect the will of the American people and remain in office.

To President Obama, his Cabinet, the Congress of the United States, and the Supreme Court. I have noticed for some time a disturbing tendency for key members of your bodies to come down with illness, or medical problems at critical legislative times. This may just be coincidence. But I can tell you that there are a million subtle ways to medically injure someone just by doing nothing when something needs to be done. Or by doing things to someone when nothing needs to be done except to give them reassurance. I know for a fact that there are those that would have no qualms about hurting any of you to preserve our current disgraceful medical status quo.

So, I recommend as a matter of national security that you enlist the help of a friendly power to regularly review, and oversee the medical care you receive from your local regular healthcare providers. Briton, France and many other countries have excellent medical providers. As well as Canada. Briton, and Canada may be less of a language barrier for Americans.

Let's get this healthcare reform done now my fellow Americans. This year. Take no prisoners.

God Bless All Of You

Jack Smith — Working Class :-)

http://jacksmithworkingclass.blogspot.com/
(http://jacksmithworkingclass.blogspot.com/)

First, they warn against using the budget reconciliation process to pass heath care. Doing so would "make it difficult to gain broad bipartisan support" and "do a disservice to this important issue."

In other words, please step into this nice dark alley and pay no attention to the club I'm holding behind my back.

By attempting to use non-reconciliation processes Obama (or really Reid) would be setting himself up to be filibustered and handed a major political defeat which would also just happen to block the substantive issue.

Chris,
Budget reconciliation is a parliamentary tactic whereby the bill under consideration cannot be filibustered. If they don't play Obama's bipartisan game, he gives the country Democrats-only health care reform.

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