Political Thoughts Before Bed

Slightly rambly as I’m running on a deficit of sleep.

* First, of course, it does seem that the Democratic ability to snatch defeat from the jaws of victory seems wholly undiminished. Depending on one’s personal politics, you could argue whether the newly-minted Senator-Elect Brown deserved to win the election, but given the campaign she ran, it appears Ms. Coakley squarely deserved to lose it, and did. Regardless of Brown’s virtues (or lack thereof) that would have been enough in itself. That’s some nice work there, Coakley. As for the Massachusetts Democrats, this is what you get for apparently assuming you’d win in a walk. Losing Edward Kennedy’s seat — and imperiling the last major legislative initiative he championed — is a fine job all around.

* That said, contrary to apparently popular opinion, health care isn’t quite dead yet. Now the real interesting thing is to see what the Democrats do next — whether they curl up in a legislative ball, moaning softly, and let their health care initiative die, or whether they double down, locate their gonads and find a way to get it done (there are several ways this can be accomplished).

From a purely strategic point of view, I’m not sure why they don’t just ram the thing through the House as is, fiddle with it a bit during reconciliation and get to Obama to sign it. To put it bluntly, the Democrats will look better by flipping the GOP the bird and then using the ten months until the 2010 election to get voters back on their side than showing to the voters that despite a large majority in both houses, they collapse like a flan in the cupboard at the first setback. We’ll see what happens now, and I suspect what happens in the next week or so will make a significant impact on what happens in November.

* If health care legislation ultimately collapses and the Obama Administration and its overall slate of initiatives take a severe hit, then, congratulations, progressives, you’ve just manufactured your “Nader 2000″ moment for this particular decade.

Yes, yes, I know, the GOP and conservatives have been completely losing their goddamn minds over Obama from the moment he was elected, but they were always going to do that, because the GOP today is comprised of hopped-up ignorant nihilists, and that’s all they know. You, on the other hand, are supposed to have brains, which are actually able to model consequences to your actions. And you should have been smarter about the political realities surrounding the Obama administration’s attempt to shepherd health care through Congress and into law.

Progressives were never going to get everything they wanted out of health care from Obama, and while I have no problem with them getting their hits in — indeed, glad they had their say — at the end of the day they should have more actively had Obama’s back in getting something through anyway because — once again — getting into law the idea that every American should have access to good and useful health care was the thing that had to happen now. Once that was through everything else would be up for negotiation in time. But that first step was the thing. The fact so many progressives spent so much time publicly and enthusiastically crapping all over the health care legislation made it easier for the people trying to bring it down to do so. Again: Well done, you.

And now the Obama health care legislation is on the verge of extinction, and if it goes, then it’s gone. And I’m sure that some of you progressives and liberals will be just fine with that, because you didn’t get everything you wanted out of it. Well, you enjoy that, then, over the next several political cycles at least. And hope you don’t actually need your health care coverage. But remember that you’re getting older. You know what that’s going to do to you.

No, it’s not all your fault. But if the health care legislation goes the way of the dodo, you’ll not be exactly blameless, either.

* Now I’m going to bed. Be polite to each other in the comments whilst I sleep. If I come back and have to do a bunch of malleting, I am going to be very cross.

215 thoughts on “Political Thoughts Before Bed

  1. I’m not sure why they don’t just ram the thing through the House as is, fiddle with it a bit during reconciliation and get to Obama to sign it,

    Because, they can’t. They can go into reconciliation now, but that would require republicans having authority in the negotiations process, that’s why they have to ram it through whole and complete through the house, since though won’t have a second chance in the senate.

    Reconciliation is currently an option without having to enter into debate in the house, but they don’t want any republicans being a part of it, because, yes, the republicans will say no to just about everything, and it would die in committee that way.

  2. Totaly screwed that up.

    Sorry.

    I don’t know why I was mixing up reconciliation and committee. I think it’s cuz I misread the way you mentioend reconciliation in combination with the house.

    Blech.

    I think going the reconciliation route is a bad idea.

    But If that’s what they do, that’s what they do, and they will get smoked in the midterms..

    Sorry about that tank.

    In knew the two methods you were referencing, but for some reason I thought you were demonstrating some moderation in political practice.

  3. Douglas:

    My understanding was they they can get the house to pass it as is and then if desired to additional fiddling afterward with reconciliation. The Republicans being a part of it in the house doesn’t ultimately matter because there’s no filibuster there — they can simply take the vote.

    Either way, however, the point is that the Democrats could pass it, if they have the will.

    ETA: Your confusion noted.

    Also, I don’t think how passes (or not) matters, frankly. What will matter is whether it passes or doesn’t.

  4. Thank you for everything here about the Nader moment. Couldn’t agree more. I really don’t understand what people expect. They need to get the bill through, and the people with issues need to wait until it’s through to optimize.

  5. First, the obligatory farewell to AG Coakley’s career ambitions. (Background here.)

    Second, at this point the Dems can have this current health care bill or their majorities beyond 2010. They cannot have both; if they try to force this thing through they will pay a price. And both sides know it. Discretion may be the better part of valor, particularly given how the Democrats hacked the CBO budget scoring process to make it appear the bill is much less expensive than it actually is.

  6. They nominated a horrible, horrible candidate, and they got what they deserved. I can’t emphasize this enough: Martha Coakley was a transparent hack of a candidate and is a vile, contemptible human being. Deval Patrick and the rest of the MA democratic party should do the honorable thing and slash their ankles in a warm bath for having let things get to this juncture.

    One person who might be justifiably a little happy tonight: Gerald Amirault.

  7. You know… for all of the worry about the Rs filibustering the health care bill in the Senate you’d think filibuster was enshrined in the Constitution or something.

    In fact, it’s merely a Senate rule. Senate rules can be adopted by a simply majority. They can also be repealed by a simple majority. If they wanted to, the Senate Dems could simply change the rules to disallow filibustering, pass the damn bill and then reinstate it. They could have done that at any point, actually.

  8. That race was the Democrats to lose. And boy did they. I bet Ted is rolling in his grave right now, as the saying goes.

    Why do you have to be so wise? This is what I’ve been saying to my significant other, otherwise known as my husband. But you didn’t get angry and walk out of the room like I did. I should print this out and hand it to him, then walk out of the room. It sure is messy when you mix political parties in a marriage.

    This will be the last chance for anyone to fix healthcare in a long time. Do you think that Obama really has it in him to give the Republicans the finger? Does Pelosi have the balls to do it? I just don’t know. I truly hope something is passed.

  9. John @ 4: My understanding was they they can get the house to pass it as is and then if desired to additional fiddling afterward with reconciliation.

    The whole point of the ping-pong option is that the House would be accepting the Senate bill wholesale. There would be no future reconciliation, because there would be no modifications — and no modifications means no second round of voting in the Senate.

    There would, however, be opportunities in future bills to pass modifications to the newly-enacted law.

  10. Definitely a poor sign for the Dems, the only party in the world that can play Russian roulette with flamethrowers. Ever since November 7, 2008, every single faction of the party has been shouting to the O-man “Why haven’t you done anything for US yet?” And, of course, when they don’t get the expected response in a reasonable amount of time (Response being “Yessir! Right away, sir!” and reasonable amount of time being about 3 seconds.), they then threaten to take their shiny votes and stay home.

    Of course, the GOP hasn’t exactly helped matters any. They’ve heard the chant of “Yes, We Can!” and responded with “Like hell you can!” The Senate Republicans in particular have taken obstructionism to a whole new level, even to the point where I now refer to it as occluded-colon-ism: all kinds of crap gets backed up.

    Nothing is getting done. Whether because the Republicans are assembling roadblocks the size of the USS Ronald Reagan or the Democrats are too busy playing me-first-you-last, it doesn’t really matter. Why? All John Q. Voter sees is the me-first games of the Dems, because that is what actually makes the noise, and reacts accordingly: throw the bums out and give us a new set of bums to get pissed off at in about 4 years!

    Give me a week or so to analyze the post-mortem and I’ll have the new line for the general. Previous lines: Senate -4, House -25.

  11. You seem to fail to realize that both parties are completely brainless, not just the one that just so happens to take the positions you don’t like.

    Basically, politicians in general are a bunch of brainless egotistical scumbags.

    It is a sad fact that the modern campaign process insures that only the brainless egotistical scumbags become politicians.

  12. I’m hearing a lot of sturm und drang about “losing Kennedy’s seat.” Bullcrap. It’s exactly that sense of entitlement that lost the Dems the race — because they failed to understand that Kennedy didn’t win the seat because he was a Democrat, he won it because he was TED FREAKIN’ KENNEDY.

    And now they’re reaping the whirlwind. Now we’ll see if the Democrats have any steel at all — starting with telling the 41 Republican Senators, “OK, you want to filibuster, you’re damn well going to do it RIGHT. Here’s a phone book. Start reading.” — or if they run around in circles for the next ten months, pointing fingers and wondering how they could possibly have lost a “safe seat.” Free tip: You lost it because you weren’t willing to fight for it, and the GOP was. If you can’t learn that single lesson, then come Election Day, there’s going to be carnage aplenty.

    The GOP is girding up for a long summer of fighting in the trenches for every single inch of space they can take. If the Dems aren’t sharpening their blades starting today, they don’t understand 21st-century politics.

  13. It’s worth remembering, amidst the rant that A) There were a lot of progressives who did, indeed have Obama’s back, both on the health care bill and here, and made calls for Martha Coakley (like me. I made 22 calls to Mass. and I have a friend who made many more) and who accepted that half-a-loaf-health-care was a damn sight better than none.

    Also that we’re dealing with a shallow, skewed media–very little mention of the fact that 44,000 Americans die, every single year, because they can’t afford reasonably decent health insurance.

    Hopefully the House will just pass the Senate bill, and then get back to work on the economy. I see a great deal of today’s problems–whether with Americans not understanding the basics of Keynsian economics (deficits are, in fact, okay!) or with a failure to understand that, yes, Medicare is a government program (39% in a recent poll want the government to “keep its hands off my medicare.”) is due to 37 years’ worth of successful, multi-million-dollar, long-term (and very smart) advertising/propaganda on the part of conservative Republican millionaires. There are going to be battles lost along the way. But the war dang well isn’t over.

  14. The fact that the current GOP leadership would rather sodomize puppies (CUTE puppies, mind you) than pass any version of the health-care bill is enough reason to pass it.

  15. You know, the filibuster can be discarded in the Senate by a simple majority vote. Why the hell not? Do they thing that the GOP is going to keep it around next time they have a majority?

  16. Did anybody watch her concession speech? My god. She seemed thrilled to be in the public eye. The dream may live on, but we’ll never hear from her again.

    I very much understand the resentment regarding the sense of entitlement that led to some folks ‘lose Ted Kennedy’s’ seat line. But, at the end of the day she is the democrat responsible for running a campaign that couldn’t elect a democrat in Massachusettes. How could she possibly be so chipper at the death knell to her political career?

    I’d make a Bill Buckner reference, but I think it would go right by her. Plus, at least Buckner had some justifiable talent prior to the asterik that ended his career.

  17. @15 Greg “Also that we’re dealing with a shallow, skewed media–very little mention of the fact that 44,000 Americans die, every single year, because they can’t afford reasonably decent health insurance.”

    You just need to have Pat Robertson mention their pact with the devil. :-(

  18. Two sad points now arise from the results of this election , but these two probable eventualities that will bring massive negative results .

    Number one is now there is very strong chance we will only see a stalemate between the two parties and the president’s plans and goals being derailed at every turn now in the future .

    Number two is occuring now and will just continue to increase more and more since we will maybe now not see any health care program at all , except for the ineffectual current one we have now . Where when people cant afford health coverage they just use emergency medical care that only racks up a bill that they will probably never pay. Resulting in the premiums going up as well as the cost of any future health care for the people who do posses coverage . Then to top it all off people who were poor to begin with now have the fortune of bad credit to help make their lives easier in such an easy economic time .

    People might stop and realize that we all affect each other not just nationally but globally as well .

  19. “Also, I don’t think how passes (or not) matters, frankly. What will matter is whether it passes or doesn’t.”

    You’re kidding, right? In the worst case the Senate Dems delay the seating of Brown so they can pass HCR first, which might cause rioting in the streets. Even if they pass it without blatant anti-democratic shenanigans they’ll get creamed in November… HCR has only 33% support, and that hasn’t moved in months. Meanwhile, the number against HCR has risen to 46%.

    An already unpopular bill, a suddenly clear mandate against it, and partisans pushing the “pass anything now, fix it later” line. Not a good formula for political success.

  20. As soon as you referred to it as “Ted Kennedy’s seat”, I had to stop reading. The seat belongs to the people of the Commonwealth of Massachusetts’, not Ted Kennedy.

  21. Coakley ran the worst campaign I’ve ever seen. She was a lousy choice, and I have no idea why she ran for the Senate at all if she wasn’t going to take it seriously.

    Of course, knowing Senator Centerfold, the first time his darling lil’ girl gets booed singing the National Anthem at a Sox game, he’ll try cussing out the Fenway Faithful. And then they’ll find his limp corpse swinging gently in the breeze on Yawkey Way….

  22. If the Democrats had actually put someone considered a human being on that ballot they probably could have carried it. I’m not saying that the Republican candidate was any better, but in the face of proof of Coakley’s inhumanity towards her fellow beings, the Republican candidate’s probable future inhumanity towards his fellow beings kind of pales. They should have both been sent to the fishes, but I’ll take potential sociopath over proven sociopath any day of the week. It must be so much fun living in a country where your choices are that cheerful.

    I have to agree with Andrew @14, that the reason Kennedy had the seat was because he was a Kennedy, and not for any other reason.

    Regarding the health care bill. I wouldn’t want anyone to pass legislation with a higher marginal price per vote than Waxman-Markley’s 3.5 billion. That money simply isn’t there to be paid out, at least until the current wars are ended and military spending can be reduced. And it certainly has to come from somewhere, just printing it won’t do much good for the economy.

  23. Sadly, I’ve come to expect this sort of cockup in American politics by now. It’s like some kind of horrible karma where everything you try to do to fix stuff ends up making it worse.

  24. RickWhoIsNotThatRick

    Senate rules can be adopted by a simply majority. They can also be repealed by a simple majority.

    Actually, I believe that it takes two thirds of the Senate to change or adopt a rule.

    And for all those who think this is a win for the Republicans, think again. Recall NY 23 where the same people who backed Brown, turned their back on the Republican candidate and supported their own candidate who narrowly lost, but forced the Republican candidate to withdraw from the race.

    And if you think these people who backed Brown and Hoffman (in NY 23) are just Republicans, recall that on 11% of the people of Massachusetts are registered Republicans.

    And if you think that these people who supported Hoffman and Brown are all fundies, recall that Brown is “pro-abortion”.

    And if you think that these people are satisfied and will now go away, I’m thinking they are just getting started.

    Just to clear up few other points: The only way to get this Bill through the Senate and to the President’s desk without risking another cloture vote is for the House to accept the bill as is: no changes. At that point it will not go back to the Senate at all, it will go straight to the President’s desk: no opportunities for changes.

    Reconcilliation is a special process for financial matters only. It requires only a simple majority in the Senate, but all policy parts of the bill would have to be stripped out: all of the regulations on the Insurance industry (as well as most of what the bill is supposed to do) would have to go.

    There really is no precedent for such major legislation like this to be passed on stricly partisan basis. Both Social Security and Medicare passed with bi-partisan support. The biggest mistake the Democrats made on this (besides not sidelining it in favor of working on providing jobs) is they locked Republicans out of the bill crafting process.

    But this is only part of why there was a revolt in Massachusetts. I’m very sure that people are extremely anxious about the level of debt this Congress has racked up.

    And about the fact that the Democrats don’t seem to care….

  25. I would have voted for him just because he’s really good looking. But then I’m very shallow.

  26. “From a purely strategic point of view, I’m not sure why they don’t just ram the thing through the House as is, fiddle with it a bit during reconciliation and get to Obama to sign it. To put it bluntly, the Democrats will look better by flipping the GOP the bird and then using the ten months until the 2010 election to get voters back on their side than showing to the voters that despite a large majority in both houses, they collapse like a flan in the cupboard at the first setback.”

    They don’t because they know they’ll get utterly slaughtered in the 2010 elections if they do that. Contrary to what many progressives believe, what passes for health care reform is just not massively popular in America. As it stands, Democrats should hang onto the House in the fall. If they are so foolish as to flip the GOP and the Tea Party movement the bird, they will lose it.

    Of course, all either party has to do to become dominant in the near-term is run against the banks on a platform of financial and economic reform, but both are too in Wall Street’s pocket to do so.

  27. @27 Your thought meshes perfectly with the headline for this article:

    http://www.dagbladet.no/2010/01/19/nyheter/obama/utenriks/10004775/

    For those of you who don’t read Norwegian the headline translates as “This nude model can ruin everything for Obama”, it even includes some of the photos from Brown’s 1982 Cosmo spread.

    Comparing the shallowness of that article with what I usually read on American politics is as disturbing as the level of concern most politicians have for spending money they don’t have.

  28. My thought, and perhaps it shows a certain cynicism about the American people, was that the American people LIKE congressional gridlock. Whenever a party is in control it’s only a matter of time before the voters dilute the control. Granted, I thought it would happen at the two-year mark (oh yeah, baby, I think a lot of democratic reps & senators are going to be on the unemployment line), and the Mass senate vote may be an outlier, but, uh, well… it might just be the first domino.

    And I agree with you 100% about healthcare reform. I believe Kerry hoped the Democrats wouldn’t form a circular firing squad on this, but, well, they’re Democrats, for God sakes! As Dave Berry so correctly pointed out, if your car gets a flat tire, a Republican won’t stop and help you; a Democrat will stop and help you but he’ll set your car on fire trying to replace the tire.

  29. Mark, you’ve got it exactly right. Once you get away from the so-called “progressive” hard left, Americans understand that government is not a force for good (and not usually a force for evil), but a great big unintended consequence generator. A Congress in gridlock will do much less damage than one where both houses are run with iron fists by hard-liners of either party.

    The American public has come to understand a basic fact: for all of Obama and Pelosi and Reid’s words, health care reform has nothing to do with getting the economy back on track. It was always a stretch to tie the two together, and the voters have snapped it.

    The Democrats tried not to let a good crisis go to waste, instead of simply fixing the problem. They’r paying the price now, and will even more in November. 2010 will turn out very much like 1994.

    Oh, and as for Republicans not helping if you get a flat tire: Barry seems to forget that Republicans donate to charity at a far higher rate than Democrats. That woman the Left loves to hate, Sarah Palin, donated 40 times as much to charity in 2007 as did Joe Biden…

  30. I completely agree with everything you’ve said, except the assertion that progressives have brains.

    I don’t believe this has ever been true.

    Republicans are assholes, Democrats are idiots. Douchebaggery and incompetence, the two pillars of our legislative process. God bless America.

  31. Is there anyone who doesn’t think the Democrats aren’t going to get slaughtered in the 2010 elections anyway? We might as well get some measure of health care reform out before they inevitably lose seats.

    Health care reform hasn’t worked brilliantly in MA. There’s a shortage of primary care physicians. Health care costs have not gone down. However, a majority of state residents are happy with the system we now have. On the whole, it’s working well enough that MA residents want to keep it.

    Note that Scott Brown didn’t campaign directly against health care reform. That’s now an untenable position for a MA politician. He wanted to “slow down” the process so that they could “do it right.” (I’d argue given the history of health care reform in the US, that’s tantamount to saying, “We’ll get back to it in another 10 years.” I suspect if he’d actually said that, his position wouldn’t have played as well.)

    Personally, I think everyone has given this election undue significance. (I live in MA and was sick of hearing about this election weeks ago.) What the Democrats need to do now is behave as if they control the Senate because, oh yeah, they do.

    Even after they seat Scott Brown, the Democrats will have *18* more senators than the Republicans. One would think that’s a majority one could work with. The Republicans haven’t had so many in the Senate for decades and they managed to accomplish things. (Of course, it helps that the Democrats appear pathologically incapable of uniting and so filibustering never really seemed a threat.)

    I’m with Andrew@14. If the Republicans threaten to filibuster, call them on it. Then in 2010, I want to see the political ads with the C-SPAN footage of Republican senators reading phonebooks. And if substantive debate spontaneously breaks out instead, so much the better.
    (Yes, I know. The Republicans will merely complain that it’s the Democrats being silly and wasting them when it’s the Republicans filibustering. I hope the Democrats would merely point out that the Republicans can stop their filibuster at any time and choose to work with the Democrats to govern instead.)

  32. RSM @29, Damn! I thought he was hot with his clothes on! I want him as my Emperor now! Even aged up a bit he’s still got the looks to buy my trust and vote.

  33. The Democrats/Obama losing is their own fault. If they hadn’t had an Epic Fail on the whole economy/Wall Street/Bernanke mess and had made more than cosmetic changes to Gitmo and other failed foreign policies they might have had a chance even with a bad candidate.

    At this point the only reason I still support Obama is because the right is literally crazy. If any reasonable candidate pops up on the Republican side the independents will be gone. Of course, that isn’t likely given the magnitude of crazy on the right.

  34. Some random thoughts…

    1. Totally agree with JS that the Democrats just seem to be absolutely incapable of seeing the forest for the trees. Say what you will about the Republicans, they are extraordinarly capable of exercising party discipline (sometimes for morality ‘s stake) for good gain.

    2. Not certain that this is a referendum on National Health Care though I have no doubt at all in will be painted as such. Health Care does not resonate in a state that already has universal health care. Fiscal responsibility certainly does and on the tail of the huge stimulus bill and the current economic situation, that was a more powerful driver than anything.

    3. Horrible horrible candidate for the Dems. I did not pay much attention to what she was saying prior (I am a NY resident and focused on NY State politics god help me), but when I looked up the recent news on her, absolutely appalled that this was who they chose to represent them.

    4. Suprisingly, I think that this is a bad news story for Republicans in the long haul. The Reps are going to be extremely happy about last night’s events but the sad fact for them is that Mass did not turn Red last night, and the basic demographic reality is that this country is turning more minority and combined with younger votes, the Rep message just holds no resonance with them. The message of the Mass election (a good candidate with a moderate to moderate right agenda can run a good campaign that appeals to independents in a mostly blue state) is going to be lost on the GOP at large. The Tea Partiers and the Far Right Conservatives are going to be embolden and believe that this was a repudidation of the Obama ‘mandate’ and for them to go gunning for him at every turn. Party Discipline will likely grow tighter (if possible).

    The sad truth for them is that when the Dems have the supra-majority, they could snipe and be obstructionist without any real blowback and ride anger at congress and the public unease without any of the hard messy work of actual responsible governence actually sticking to them. Now that the Dems have lost their supra-majority, the GOP is now back in the game and vulnerable to the effects of simply saying no to every initative that the congress and the president attempt to pass. If I was the President now, I would smile and come on camera and say, “The people have spoken and they are disatisfied with the lack of progress and business as usual. I will look to get my house in order but GOP, they were speaking about you too. My agenda has not changed. I am still bringing health care, will be addressing the deficit in 2010 even if it means that I have to roll back one of the two wars we are fighting, looking at responsible financial regulation to safeguard the system and will be introducing cap and trade legislation. You may disagree with it, but now you have to sit at the table and actually talk to me because the American people have spoken..and they are watching”. The GOP now have to come up with solutions when they say no and I don’t think they are ready.

    Bottom line: Losing last night’s election I think would have resulted in one more year of their current ‘winning strategy’ and would have netted them more impressive gains in November. Now, they are in a much more vulnerable position because they have to do something and I think that is going to translate to less gains to breaking even in the next cycle.

  35. This situation and discussion is all infinitely sad, mixed with a healthy dose of outrage. All the procedure and rulemongering is tiresome and obscures the point. The point is, in what universe is it bad to offer your friends, neighbors and relatives a guarantee of basic heathcare service? How can the wealthiest nation on Earth (or one of the wealthiest, it doesn’t matter) not spend some GNP on basic health for all citizens, especially the least strong among us. It’s truly sad that we’ve lost the will as a nation to do something generous and noble.

  36. 1: No self-respecting Senator is giving up the option to filibuster. The hold has been so abused that this is another issue.

    2: This very poor version of healthcare reform (I’m not sure anything lacking a public option is worth it) is a tribute to the hollowing out of the parties as vessels of ideological meaning and being reduced to merely collections of special interests. Not enough nice white suburban people are finding themselves without health insurance to get this deal done yet. Avoiding the stench of failure is still sufficient reason for the House Democrats to hold their nose and pass the Senate bill as is.

    3: Next two questions: 1. Does Obama get his backbone out of hock? 2. Who does the GOP run in 2012? My bet is on Pawlenty and McConnell; particularly if the assumption that Palin is too congenitally lazy to do the work holds.

    4: GOP wishful thinking aside, the Democrats are still likely to hold both houses of Congress this year. This only changes when conservatives face up to demographic reality. There’s a fine future for a conservative party in this country; it just can’t be lily white.

  37. Actually, I believe that it takes two thirds of the Senate to change or adopt a rule.

    Nope, they can kill the filibuster by majority vote. It’s just no Senator ever will, since they all gain power by being more likely to be able to block legislation.

    he biggest mistake the Democrats made on this (besides not sidelining it in favor of working on providing jobs) is they locked Republicans out of the bill crafting process.

    Frank, the Democrats in the Senate spent months involving Republicans in the processes. Remember Baucus’s committee? The one that wrote it and had several Republicans on it? The Republicans decided ages ago that voting against *anything* the Democrats put up with was their strategy, and their best chance at regaining power. And they’re right too!

    Also, what exactly do you expect the Democrats to do about jobs? There’s no magic “jobs” bill that can be passed at a whim. And you’re already complaining about debt, so stimulus/WPA-style legislation is out too.

    I’m very sure that people are extremely anxious about the level of debt this Congress has racked up.

    And about the fact that the Democrats don’t seem to care….

    Replace “Democrats” with “Politicians” and you’ve got an answer there. The health care bill does play a few games with CBO scoring, but it is deficit-neutral over a 10-year period. Compare to the Republicans last major health care bill (the prescription drug bill) which was decidedly not deficit-neutral

  38. Pats @ 21

    Your comment makes me think of something CS Lewis wrote. I think it was in the Screwtape Letters. He argued that a person was irredeemable when he could no longer distinguish between the many definitions of the words “my” and “mine”. The goal, from the demonic narrator’s perspective, was to make every use of those words become as childlike and selfish as possible. So when a person said “my cup of coffee”, “my car”, “my house”, “my family”, “my friend”, “my neighbors”, “my country” or even “my god”, he always meant the same thing: “it’s my property and I can destroy it if I want”.

    I think you’re making a similar mistake. English is a remarkably flexible language, and it’s possible to say that the senate seat belongs to Ted Kennedy, Scott Brown, the Commonwealth of Massachusetts, the Republicans, and even the Democrats without ever contradicting yourself. If you (innocently, I’m sure) stopped reading because you didn’t understand how John applied a possessive adjective, I encourage you to go back and read it again. There’s a lot of good stuff here, and you’ll get more by reading it than you will by making a cheap (and somewhat obtuse) point.

  39. Couldn’t have put it better myself. We need some new parties in this country. I’ll vote for any candidate that promises to do campaign finance reform.

  40. #38, jeffn – We do spend “some GNP” on basic health care… it’s called Medicaid. If fact, 50% of all health care is currently paid for by Medicare or Medicaid.

  41. The point is, in what universe is it bad to offer your friends, neighbors and relatives a guarantee of basic heathcare service? How can the wealthiest nation on Earth (or one of the wealthiest, it doesn’t matter) not spend some GNP on basic health for all citizens, especially the least strong among us. It’s truly sad that we’ve lost the will as a nation to do something generous and noble.

    What exasperates me is that it’s clear from other countries that there are various ways to do this that (1) cost less per capita and (2) result in measurably better outcomes. Even if one doesn’t see an ethical motivation, there are practical reasons for universal health coverage.

    But for some reason, in this country, many people don’t want bureaucrats involved in health care decision unless they’re corporate bureaucrats. Feeding the coffers of insurance CEOs evidently has a purifying effect on the process, or something.

  42. My understanding was they they can get the house to pass it as is and then if desired to additional fiddling afterward with reconciliation.

    there are two things called “reconciliation” by the Congress. The more common is the reconciliation between two versions of the same bill, where the Senate and House get together to splice their respective bills together, and then everyone votes again on the final product. Congress is actually in the middle of that process right now on the insurance reform bills (I won’t call them “health care reform”, because they aren’t.) That’s not going to fly anymore, because the Republicans in the Senate are determined to keep the reconciled bill from passing. And can.

    The other thing called “reconciliation” is a budgetary process that was exempted from the Senate’s filibuster rules. The House initiates a bill that is entirely (or nearly) a matter of government spending. The Senate leadership declares that this is a budget reconciliation process, and that it is exempt. It can pass on a simple majority. Bush used this process repeatedly to get his military funding for Iraq.

    Expanding Medicare to everyone over the age of 50 and under the age of 25 would be purely a budgetary matter. For instance.

  43. It never ceases to amaze me how we liberals never seem to get what we want yet we’re to blame for EVERYTHING!

  44. Two things:

    1. I can see a Liberal state being more disappointed with the current Congress and administration with the same old bosses and policies than a Conservative state. Where’s the Change?

    2. Again and again and again, I see voters selecting the candidate they would most like to sit and have a drink with. This seems to be a much better indicator of who will win than issues are.

  45. mensch @ 46:

    It never ceases to amaze me how we liberals never seem to get what we want yet we’re to blame for EVERYTHING!

    It’s because liberals are so loud. If they just shut up and quietly backed the group of people who are doing things somewhat less wrong than the other group of people, then everything would be just hunky-dory.

    And then, the magic ponies would appear.

    Actually, it’s not quite that bad. Liberals don’t have to be totally quiet. They just have to ask for everything very politely and quietly, so as not to joggle the elbows of the people-who-are-doing-things-somewhat-less-wrong. After all, the people-who-are-doing-things-somewhat-less-wrong are clearly very very attentive to that sort of input.

  46. The Healthcare Reform bills were so clearly written and so well thought out, I can’t understand why they didn’t receive popular acclaim.

    Our elected officials are so much smarter than I am, than all of us are, I really wish we’d just give up on this voting thing and let them do what they want.

    Why can’t we understand that they have our best interests at heart?

  47. stretch @ 40:

    Frank, the Democrats in the Senate spent months involving Republicans in the processes. Remember Baucus’s committee? The one that wrote it and had several Republicans on it? The Republicans decided ages ago that voting against *anything* the Democrats put up with was their strategy, and their best chance at regaining power.

    Which makes me wonder about the sanity — or at least the sincerity — of the Dems involved. Some of the Repubs actively “helping” to write the bill publicly said they’d oppose any finished product. In what universe does it make sense to care about their input?

  48. I agree with mensch@46. I’m left-wing, and me and mine had nothing to do with Obama’s commitment to rewarding the people responsible for our financial chaos, nor with his refusal to hold Bush people accountable for their wrong-doing, nor with his chief of staff’s fondness for pushing on liberals to compromise and for supporting the most reactionary elements of his party, nor with his coziness with religious zealots who actually did make it a capital offense to be what I am in one country and keep talking about wanting that here, nor with his continued escalation of a war the American public has wanted ramped down a long time, nor with his embrace of lawlessness and untrammeled power in the pursuit of that unwanted immoral war, nor any of the other things that have been wearing a lot of us out.

    I voted for him in 2008. I feel like I made a mistake in the primary, except that by the time of Washington’s primary the only alternative seemed clearly worse. I voted for him in the national election, too, and I don’t think that was a mistake. But goddamn it, you can’t really expect a lot of us to feel very enthusiastic about any of this right now, and blaming people for getting discouraged over just how much of Bush policy continues in full force or even intensified is pretty low. Blame the Democrats doing bad stuff and the moral defectives who fill the ranks of Republican officialdom and who make it possible for them to stay there, for starters. Let them do some compromising and giving up for a change.

    I’m 44 years old. For at least 30 of those, the vast majority of the country has had no real increase in income at all, while our infrastructure continues to collapse, and when a guy who talks about doing the right stuff finally gets into office he does…more of the same. I’m tired.

  49. Some liberals are loud – but some conservatives are loud.

    What’s worse is when they are loud and Righteous. When they Know they’re Right, nothing else matters. And there is no shortage of Righteous Liberals (and obviously Righteous Conservatives).

    Righteous people commit most of the evil in the world today.

    That said, the big problem with Congress today isn’t with the Righteous, it’s with those who are bought and paid for by special interests.

  50. Don’t have time to read through the comments, so maybe this point was already brought up, but progressives and liberals don’t just want any health care/insurance reform. We want GOOD reform.

    The current Senate bill sucks. No public option (which was itself a day-zero compromise), the Stupak Coathanger amendment, low subsidies, no real change to the employer/employee system… what exactly does this bill accomplish? It helps a few million people by turning health insurance into car insurance (Want to drive/live? Buy insurance! You’re welcome, Blue Cross Blue Shield! Oh, donations? Why sure! Send ‘em to my PAC.).

    It’s not that we “didn’t get what we wanted.” It’s that without some real changes, the Democrats are simply giving a massive gift to the insurance industry. Current legislation is essentially the health care version of the bank bailouts of 2008.

    All that said, I still want the bill to pass, if only because it’s easier to fix a broken bill than it is to get anything new through Democratic incompetence and Republican obstructionism.

  51. Bearpaw@50: Why should the Republicans have bothered at all? It was obvious from the very beginning that the Democrats wouldn’t settle for less than a full government takeover of medicine, and the destruction of a sixth of the American economy. When “bipartisanship” means “you must buy into our partisanship”, as it does when Democrats use it, there’s nothing to be gained by helping.

    The only reason the current health care “reform” bills look as they do is that compromises were needed to hold the Democrats together. They never cared what the Republicans thought, in the rush to not let the crisis go to waste.

    One other thought, for those bashing the health care insurance industry: Medicare denies claims four times as often as does private insurance. Given that fact, you’re damned right that I’d rather have a corporation that at least has to please its customers in that decision path than a government bureaucrat that has to please nobody at all.

  52. I’m Canadian and have NO idea what anyone is talking about here. But I come away with a slight better understanding of the US goverment (not sure if this would be considered the right term) then I had before so Thanks everyone your comments and to John for posting this :)

  53. Matt Moore: I’m fighting health troubles today – I turned out to be the one in several thousand with a particular very severe reaction to calcium channel blockers, and getting it out of my system is lumpy – but there’s a shift in there from individual to household numbers and some other missing links. I will try to have some other info the next time a suitable thread comes up, and wanted to let you know that I see and read even though I’m disagreeing.

  54. The real tragedy here is that the HCR bill has good sections in it. No descrimination against pre-existing conditions, no lifetime limits, etc…

    I think there was stuff in there that, if the democrats could get over single-payer, and the republicans could get over their blood-lust for obama, they would agree are nessecary. At this point I’d be in favor of a bare bones HCR bill, but I don’t think that’s going to happen.

    The same thing is going to happen that happened in the early 90s. Dems are going to put their tails between their legs, and shelve HCR for until after their senate races… which they will lose (rightly or wrongly) and we won’t get back to this for another 15 years.

    How did bush get all the stuff done that he wanted without a super majority?

  55. My 2 cents:

    The election yesterday was quite definitely a referendum on health care reform as it exists in the current bill.

    The current system sucks.

    Health care in this country is NOT an entitlement… I don’t see the guarantee of heath care anywhere in the Constitution. If you want to make it an entitlement, start a movement to create a Constitutional Amendment guaranteeing the right of U.S. Citizens to a minimum level of heath care–THEN it would definitely be an entitlement. I could get behind that.

    How do we fix things?

    1) Term Limits for EVERY elected office in the country. Bring back the concept of the elected official as a citizen volunteer, NOT professional politicians.

    2) Any bill submitted to congress cannot be larger in size than the original Constitution. Citizens should be able to read the entire bill in a very short time. If you want to add rider, earmark, etc. write it up in a new bill.

    3) Enforced transparency–CSPAN has access to every meeting that doesn’t involve national security.

  56. Ceri B.,

    Right my point is that liberals do not run the country or get what they want yet we take all the abuse from conservatives and “centrist” (i.e. corrupt) Republicrats.

    I’m not playing this game anymore. Conservatives get to get all jacked up on blind rage when they STILL dictate what happens.

  57. Penny,

    Here’s the bottom line: the corporations in the US are a political party/movement/group but it is NEVER acknowledged because they own the media. They take a percentage of the profits they make off us and use it to shut us out of power. Then they take that justifiable rage at it all and use the media to divert that anger at homosexuals, liberals, minorities and whoever is not actually causing this. This phenomenon is called the Tea Party.

    Our country is sick. And it’s only going to get worse than this. I’m just not accepting blame for it when I have never gotten to see what I support happen.

  58. John,
    You’re spot-on about the progressive/liberal camp having sacrificed the good in favor of the perfect here. I’m pretty far to the left, more so than even some of these self-styled progressives would claim, but I know the reality of the health care system, and the legislative process. The notion that a single player system can just aport itself into being is little more than magical thinking.

    Dealing with real problems in the system (denial on pre-existing conditions, recission) while working to extend some measure of coverage to as many people as possible is a huge and positive step.

    Brown won based on populist anger. 10%+ unemployment, two wars dragging out and on (and all the families left behind), and some real failures when it comes to dealing with foreclosures have left many people legitimately angry. Combine that with Coakley running a slipshod campaign consisting largely of “Hey, I’m the Democrat! Vote for me!”, and you’re going to get what you got.

    One thing that actually got my goat on this was watching Keith Olbermann, who varies between entertaining and in need of sectioning on a nightly basis, go into full on attack mode on Brown. Calling him sexist, racist, homophobic and I believe a bad juggler too. More crazy, this we do not need.

  59. I’m surprised that someone who writes such compelling, humane fiction believes that ” the GOP today is comprised of hopped-up ignorant nihilists”.

    Scott Brown ran a clean, positive campaign focused on the issues:

    – Opposition to a radical reworking of the health care system that would bankrupt the country and degrade health care, that’s so popular that it has to be forced through at 2AM using bribes and parliamentary tricks with no chance to review the content.

    – An emphasis on protecting America from terrorists, and opposition to giving KSM the rights due to American citizens.

    – Reining in the explosion in Federal spending exemplified by the pork-filled “stimulus” package.

    – Opposition to the nationalization of failing companies like GM and Chrysler.

    – Recognition that the path to economic recovery must avoid imposing punitive burdens on employers and entrepreneurs.

    Brown is a social moderate, supporting Roe v. Wade and civil unions, and ran a true grass roots campaign. The voting public rewarded him with 75% of the Independent vote and 23% of Democrats. Large numbers of Obama voters supported Brown, after Obama came to Boston and told us she was “vital” to his agenda.

    Coakley, on the other hand, ran a nasty, nihilistic campaign, supported entirely by the Democratic political machine, with help from the SEIU and ACORN. She constantly claimed that Brown wanted to “deny medical care to all rape victims”, a claim that was repeatedly debunked in the local media. She repeatedly demonstrated a level of cluelessness about both Massachusetts (“Curt Schilling is a Yankee fan”) and the world (“The Taliban is not in Afghanistan. They’re gone”).

    The voters here repudiated her as well as Obama’s agenda. If the GOP is lucky, the Democrats will convince themselves that we’re all “hopped-up ignorant nihilists”, keep smearing the American people as “teabaggers” and lose both the House and the Senate this fall.

  60. Again my point: Coakley runs a universally panned campaign, the Tea Party attacks the race while the Dems are sleeping on the job but it’s the left’s fault for being so selfish.

    Ummm no, sorry.

  61. I’m of two minds about this:

    My biggest hopes for Obama were a public health option , cleaning up the mess over state secrets and torture, and getting the energy mess straightened out. Yes, I wanted him to figure out Afghanistan, Iraq, and the financial crisis, but I was willing to bet that the answer for those was going to be the same for McCain as for Obama on those.

    So far:
    –I can’t tell whether the health care bill will fix the crisis, but the public option has gone bye bye. I lost my job earlier the year, and we decided to push up our marriage so that I could be covered, because, *surprise* they’re fucking with my COBRA coverage (as in charging more than they should and not covering costs).
    –State secrets mess: Obama’s continuing Bush’s policies.
    –Solar: Their current big idea is to plop down huge solar plants next to national parks and in the middle of wilderness areas, and then to run the power lines to them. Granted, these are ideas of solar developers, but the Obama White House is poised to push these through without proper environmental review.

    As an environmentalist, I can tell you that we’re doing the developer’s job for them, locating suitable solar sites on degraded land near existing power lines, so that the don’t destroy more pristine lands, and then trying to get the developers to move their proposed plants. It’s amazing that we can do this with a couple of volunteers and a couple of paid staffers, whereas the solar developers have millions to throw at consultants and couldn’t care less about doing a good job.

    For the ignorant, proper environmental review is: figure out what harm the project is going to cause, and mitigate that harm as part of the project. It’s about as political as the Hippocratic Oath of “First, do no harm,” but somehow it always gets politicized.

    Anyway, on my top three issues, Obama’s batting 0.0%.

    Yes, I understand that the Republicans are even worse, but I don’t get that enthusiastic about the lesser of two evils.

    Now, I’m hoping that the Democrats will remember their vertebrates with gonads, as our host noted. We’ll see.

  62. This is why we like you as an author, your metaphor “collapse like a flan in the cupboard ” is like something Tom Robbins–king of literary metaphors would come up with. I salute you, sir!

    This of course assumes you did not mis-appropriate it from someone else…say a brit comedian known for performing in drag.

  63. The GOP moaning over Obama is a given, sort of like Dem whining over Bush in the past.
    As for the healthcare, well I dont want it to pass.

    At least not how it stands now with the inside dealings that have been going on, most recently with the Unions. So much for change and transparency eh?

    I think the Dems losing the Kennedy said is rather interesting. Like it was said, the dems snatch defeat from what should have been sure fire victory. However, I think the Obama, either through his actions or inaction against what he said is what has driven this failure.

    For many, today marks the point where they can say “3 more years”.

  64. Regardless of the details of the individual candidates, their party affiliation and campaigns they ran the MA Senate election should be seen as an implicit referendum on the quality of representation they have been getting overall lately. All elected officials should take note.

    I personally agree that health care legislation is needed having been without health care in the past, and having a loved one that would be with me now if he had better health care.

    But I currently have health care that would be deemed a “Cadillac” plan by some in Congress (the end result being that I simply rarely pay a copay). And I don’t belong to a union, so the end result would be that my employer would likely scale back my health care (and my childs) in order to not pay that ruinous tax.

    So I don’t see the current ideas (or methods to get the legislation “pushed through” for that matter) as good ones.

    Further, having a health care plan doesn’t really help you if you are unemployed so perhaps the priorities should be shifted somewhat.

  65. tom:

    “This of course assumes you did not mis-appropriate it from someone else…say a brit comedian known for performing in drag.”

    Hey. It’s not like he had a flag in it.

  66. mgfarrelly @ 64

    “More crazy, this we do not need.”

    Amen to that! So much bluster. And so loud too. My ears are tired. I’m ready to throw rocks (or maybe cream pies with a seltzer chaser) at every pundit with an enemies list.

    As a Christian progressive (there are dozens of us, I tell you. DOZENS!!) this entire debate has been exhausting. It’s ugly and disheartening to see people who share my values (whether they’re progressive, Christian, or just plain human) abandon charity and compassion and exchange them for petty revenge and entitlement.

  67. Ryan @ 54:

    Don’t have time to read through the comments, so maybe this point was already brought up, but progressives and liberals don’t just want any health care/insurance reform. We want GOOD reform.

    That. Very much that.

    All that said, I still want the bill to pass, if only because it’s easier to fix a broken bill than it is to get anything new through Democratic incompetence and Republican obstructionism.

    I’m not convinced of that. I think it’s at least as likely that even what little gets through will get water down afterward, when political attention — such as it is — is focused elsewhere.

    If it weren’t for the mandate, I might support it anyways. And I don’t even object to the mandate per se, it’s just stupid to have it without an insurance option that doesn’t involve corporate profiteers.

    ben @ 59:

    I think there was stuff in there that, if the democrats could get over single-payer …

    Dems “got over” single payer before the discussion even began. It was never even “on the table”, despite the endless hyperventilating of people about “a full government takeover of medicine”. Obviously there was no point in even discussing a funding system that works well in other countries. This is America, dammit!

  68. Someone needs to form an “Evil” party so that everyone can have some perspective when they’re arguing with someone on the other end. You might think twice about comparing progressive Health Insurance reform to Nazi Germany if there was a third party who gave speeches from the floor periodically about how we need to pass legislation rewarding the stealing of candy from children.

    It could be a public service, like the Wizard in the Terry Pratchett books who’s job at the university is to be the Evil Wizard.

  69. Bearpaw @74

    technically yes, though really, we’re not over it. Hell, I’m a democrat, and I’m not really over single payer yet.

  70. “conservatives have been completely losing their goddamn minds over Obama from the moment he was elected, but they were always going to do that”

    And you’re not losing your goddamn mind because a Republican has been elected? You are what you hate.

  71. I get the impression that a lot of people in American people think they are entitled to government care. I never in my life thought the feds would be there to take care of me. But then I’m a cynic. What we need to do is to convince doctors that they need to be the new working poor. They should spend years in school and work like slaves as residents, just because they have a calling, and are willing to take a vow of poverty. No wait, let the rich take care of everyone, because, they didn’t really work hard enough for that billion buck bonus. Then cut their heads off. Or legalize pot, tax it, and that pays for everyone’s medical care.

  72. Derek:

    “And you’re not losing your goddamn mind because a Republican has been elected?”

    Nope. As I’ve noted before, I’m registered independent and I’ve voted for Republicans when I thought it made sense to do so. Had I been in Massachusetts in a voting capacity, I don’t suspect I would have voted for Brown, but I also don’t imagine that voting for Coakley would have been a thrill for me, either.

  73. Jay @55, thanks for giving us an illustrative example of the kind of thinking – or at least, the kind of rhetoric that pretends to be a principled position – of why there is strong Republican opposition to any healthcare plan. When you all dismantle Medicare, get back to us.

  74. I’m somewhat encouraged by this election. Some take it as a referendum on health care reform, but I think the proper lesson is that the people won’t vote for truly terrible candidates – who Coakley, with her apparent willingness to ride roughshod over justice, certainly was in my view. That said, I’m not sad to see the current set of proposed health care reforms being thrown into a little bit of chaos. I tend to think that insurance and tort reform might more effectively help more people than the creation of a new institution that will be lobbied to hell and back by special interest groups looking for their cut of the public treasury.

  75. John ya got a great blog. I’ll point out though that the reason the democrats can’t just ram it through is that health care reform simply ain’t popular right now.

    Right now the vast majority would rather see nothing done at all.

    There is so political capital to spend. There is nothing to gain.

    At this point there are no good choices for the democrats to make. The only good news is the fact that the republicans can reliably be counted on to screw up whatever golden ticket they’ve been handed.

  76. Someone needs to form an “Evil” party so that everyone can have some perspective when they’re arguing with someone on the other end.

    Isn’t that the purpose of those damned Libertarians who just want to let people starve and pay no taxes while taking drugs and paying for gay prostitutes with gold coins?

  77. @The Grey Area

    What we need to do is to convince doctors that they need to be the new working poor.

    What a steaming pile of tosh!

    Doctor’s around the world who work in systems with universal coverage aren’t exactly living in poverty.

    As somebody else said. This is something that every single other comparable nation manages to do and manages to while spending less money.

  78. Ben @ 80 said, “Do you know what a straw man argument is?”

    Of course I do. I’m not stupid. That’s when He argues with the Tin Man or maybe the Lion. Either way, it’s all straw and ready to go up in flames. Burn baby burn.

    I don’t pay for my health care, but I get taxed on it. Thank you Government! Woot!

  79. mythago@82: I’d be happy to dismantle Medicare. It’s an entitlement program that we can no longer afford and that will cause us major problems in the future. The solution to that, however, is not to create an even bigger government entitlement to replace it, which is exactly what the Left wants. The solution is to get government out of the business to begin with and let the private sector do its job unfettered.

  80. No, no, the Libertarians are the “Annoying Whiny” party. I’m pretty sure the current “Evil Party” is the aggregate of persons opposing Objectivist goals.

    (With apologies to those Libertarians who actually do things like show up at city council meetings to ask why the latest municipal contract is being awarded to a company run by the mayor’s brother-in-law, vs. those who sit around on the Internet whining that laws preventing them from screwing 13-year-olds are fascist.)

  81. Maynard@88

    Can you please explain how well the unfettered private sector performed from 2001-2009 under the free market proponents?

  82. Daveon@86: The US has the finest health care system in the world, and Americans are happy with it, no matter what the Left would have us believe. There’s a reason that Rochester International Airport in Minnesota is bigger and has more capacity than many commercial airports in much bigger locations: to handle the people who come from all over the world to the Mayo Clinic for the finest care anywhere. The same goes for places like the Texas medical Center and other centers of medical excellence recognized worldwide.

    The reason that other industrialized nations spend less is because they get less. We have rejected that, as a society.

  83. mensch@90: The economy did just fine from 2001 to 2009 – except for the market distortions imposed by Congress refusing to stop two government companies from lying to investors, because doing so would have made people actually be creditworthy before getting a mortgage. The Democrats caused the Great Dempression of 2009, and they’ve been running form it ever since when they were not trying to not let a crisis go to waste.

  84. @92

    Your “opinion” is garbage. Time to act like a man and take responsibility for the implosion of your ideology. Good luck. Done talking to you.

  85. The one inarguable point of this entire mess was identified by Daveon; socialist and moderately socialist (not communist) countries manage to get better medical results for less money.

    The samething happens here, but between towns/cities. A good example is the very expensive Texas town of McAllen, which operates on more of a “capitalist” system and gets worse results than the Mayo Clinic, one of the top medical facilities in the world. On top of getting poor results the McAllen healthcare is more expensive than the Mayo Clinic, which has what some would label “socialist” practices. Enjoy the article.

    http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

    This should be a problem for both parties, but the Republicans never offer any real solutions, just platitudes…”free markets!”, “less regulation!”, etc. This works really well, just ask the banks and Goldman Sachs…they love it.

  86. Oh, and I used to pay for my health care all on my own. I do almost everything on my own. I’m not a child that needs or wants to be taken care of. Our modern culture needs to remember that the best things in life are in fact paid for. And that the rich do live better. Damn the rich, they get better cars and watches and food and houses, and in those houses they get better mouses! It’s so unfair! It’s so unjust! But that’s what you get when it’s for money you lust.

  87. Ben, thanks for the link. I was just kidding around. I know that the straw man is only as strong as those who would poke at him. Ouch!

  88. mensch@95: And people complain about political discourse becoming polarized…

    Whether you like it or not, the American public is getting wise to the smoke and mirrors that dazzled it in 2008. A story in the Wall Street Journal yesterday showed that the 2008 election did not represent the fundamental shift in Americans’ political beliefs that many on the left were claiming, but instead the specific Republicans that were in power at the time. That, as much as anything, is why we’ll see a massive change in Congress this fall, and then maybe the Democrats – who are just now learning they need to govern, not campaign – will truly work in a bipartisan fashion.

  89. Jay Maynard @ 91

    Be careful you don’t confuse your own circle of friends and associates with the whole of US society. Politically we’re split pretty close the the middle, which is why a single seat in the Senate is so important right now. With the exception of a very few “hooray for puppies!” issues, there isn’t a lot of society-wide agreement on anything.

    I’m also not sure that the Mayo Clinic is the best example of health care across the US. Their patients are at the happiest end of the curve. Most people have to make do with much less than that. I suspect their actual level of care isn’t much different than in we see in other developed countries. There may be some areas where we do better, but there are others where we do substantially worse.

  90. @Jay: Interesting the Mayo Clinic is run along lines that somebody from France or Scandanavia or Germany would recognise over, say, somebody from Texas. There was some very interesting reporting on that recently.

    The US has some of the best healthcare money can buy, but it’s not THE best, at least not against measurable objectives in all categories and has a set of failure modes that are unique in the western industrial world.

    It’s nothing to do with getting “less” – that’s complete, as we say in the old country, bollocks. I’m happy to know, as are most of the Brit ex-pats I know, that if push comes to shove I can head back to the NHS for treatment.

    @Gray: Glad you’re not all that ill then. I can buy the medication I need from CostCo for $6 a quarter. OTOH my wife’s quarter meds cost in excess of $600 a quarter, of which we still need to find about $180. Now, we can afford that, but I don’t particularly find the “if you’re poor it’s tough cheddar” argument to be neither morally or logically all that compelling.

    Of course, for both of us, that’s just the drugs – factor in 4 check ups a year and a bunch of labs.

    Here’s another one. My optician thought I might have Glaucoma, so off I trot to see a specialist. All clear, I have an unusual optic nerve. However, that little trip was $778… now I was insured and I could have afforded that myself anyway. But is it better for somebody with poor insurance or none to go blind with Glaucoma because they can’t afford what I can?

  91. strech @41

    Nope, they can kill the filibuster by majority vote. It’s just no Senator ever will, since they all gain power by being more likely to be able to block legislation.

    From the Senate Rules web site

    In certain respects, moreover, the system of Senate procedure places greater obstacles in the way
    of bringing the Senate to a vote on a proposal to amend the Standing Rules than for other matters.
    As with most other matters, the Senate can adopt amendments to its Standing Rules by a simple
    majority of those voting. On most matters, however, the vote required to invoke cloture is threefifths
    of the full Senate membership (60 votes, if no vacancies exist), while for amendments to the
    Standing rules it is two-thirds of Senators voting (67, if there are no vacancies and all Senators
    vote). This more demanding requirement contributes specifically to the entrenchment of the
    Standing Rules against change.9

    Frank, the Democrats in the Senate spent months involving Republicans in the processes.

    Uh huh. An precisely which Republican ideas are in the bill? Is it tort reform? Allowing insurance companies to compete nation-wide? Which? You know you have to do more then let the kids sit at the adults table if you want bi-partisanship. You have to actually swap ideas: give here, get there. Wasn’t done. Republicans weren’t even invited to the conference sessions. Oh that’s right, they by-passed that step…

    Also, what exactly do you expect the Democrats to do about jobs? There’s no magic “jobs” bill that can be passed at a whim

    I’ll repeat what I’ve pointed out before. Both President’s Kennedy and Reagan had more effective “stimulus packages than the one that was passed recently. Kennedy announced and funded the Moon shot and Reagan expanded the military. Both required large numbers of high paid engineering and manufacturing jobs which had secondary ripple effects throughout the economy. Not to mention both programs had technological secondary effects of which we are still today reaping the benefits.

    Replace “Democrats” with “Politicians” and you’ve got an answer there.

    Good point. But Democrats too the wrong message from their wins in 2006 and 2008. It’s not that Americans no longer wanted less government and less Federal spending, it was that Republicans stopped delivering that. So it is no surprise when the Democrats turned out to be worse than Republicans that they are getting (and will get) spanked by voters. Instead Democrats decided to believe that they were voted in to advance big government liberal agendas. They did not realize, or refused to realize, that they didn’t get voted in so much as Republicans got voted out.

    And now its the Democrats turn.

    mensch @47

    It never ceases to amaze me how we liberals never seem to get what we want yet we’re to blame for EVERYTHING!

    Well here the thing about that: America is a Center Right country. I don’t know how many times I (or events) have to point that out. The more you try to move the Democrats to the Left, the more they will pay at the polls.

    America does not buy the Progressive agenda anymore than it buys the agenda of the Christian Right.

    Not today. Not in the foreseeable future.

    It’s just a fact.

    Paul in BarneyFrankistan @65

    Brown is a social moderate, supporting Roe v. Wade and civil unions, and ran a true grass roots campaign. The voting public rewarded him with 75% of the Independent vote and 23% of Democrats. Large numbers of Obama voters supported Brown, after Obama came to Boston and told us she was “vital” to his agenda.

    It’s also not widely pointed out that he is not opposed to Health Care reform: He voted for the “universal” health care system in Massachusetts.

    He he opposed to this atrocity posing as healh care reform.

    Most people want health care reform. I want health care reform. But it has to also reduce costs and be more effective than what we have now.

    And we ain’t there yet.

  92. Jay, again, when you pretend that there is a unified Left, that it is a separate entity from “Americans”, and that anyone who disagrees with you is not merely wrong but is attempting to bring down catastrophe, you’re simply bolstering the argument that the Democrats ought to do whatever they want and tell the Republicans to STFU. If politics is merely an exercise in ingroup favorability bias and Go Team power-struggles, then why on earth should they listen to you? You’re really saying either that never the twain shall meet, or that the only reason we have not all adopted your entire correct propositions is that anyone who doesn’t is bad for America.

    The Gray Area @97, I hope you’re still indulging yourself with strawmen, because it’s pretty funny to listen to people posting on The Internet fercrissakes and living in a developed nation bragging about ‘I do everything on my own’.

  93. @Jay @92 – “the economy was doing just fine…”

    I recommend “Too Big Too Fail” for your bedtime reading.

    The economy was most certainly not doing just fine. When the CEO of BoA (to pick one*) has to admit that he doesn’t understand the way they’ve been making money, it’s time to stock up on bottled water.

    * – he was far from being alone.

  94. @92 Jay Maynard
    What’s your profession? I hope it isn’t in the finance/accounting world. Your comment suggests you don’t understand how the current economic mess actually happened. Did Freddie and Fannie cause some of the mess…sure. Where they the main reason or even in the top 5 main reasons? No. CRA loans were not the problem, as they were only 15-20% of all bad loans.

    A listing of who was actually at fault from an independent who has to be right to make a living.

    http://www.ritholtz.com/blog/2009/06/who-is-to-blame-1-25/

    And, here is where he challenges anyone to put their own money on the table and argue the point against him. No one took him up on the challenge.

    http://www.ritholtz.com/blog/2009/06/100000-cra-challenge/

    This appears to be a little off topic, but it’s important to understand that most political arguments, and almost all recent ones from the right, are just platitudes. There are only glimmers of facts in these arguments and then only the glimmers that back their ideology.

  95. @Jay @92:

    except for the market distortions imposed by Congress refusing to stop two government companies from lying to investors, because doing so would have made people actually be creditworthy before getting a mortgage

    Actually this is far from the real problem that emerged and actually the “traditional” sub-prime mortgages have actually performed in line with the overall mortgage market. Probably because there was an upper cap on what they could lend.

    The real damage was done with allowing Credit Default Swaps as a method of insuring funds against loss when indulging in much higher risk mortgages.

    The real catastrophes in the US housing market haven’t happened in poor neighbourhoods where people were trying to get their own home but assumed middle class areas where people could buy “McMansions” and remortgage with no proof of income to finance their life style.

    Having read Too Big To Fail I am seriously coming around to the idea that all banks should be mutual societies and that having banks as LLCs with shareholders is a failure mode that we can’t afford to support as tax payers.

  96. Heh. Sorry Chad we seem to have cross-posted roughly the same thing. I’ll be quiet now. I’m feeling extra snarky this morning. I’ll blame watching Human Target last night.

  97. #
    # Jay Maynardon 20 Jan 2010 at 11:45 am

    Daveon@86: The US has the finest health care system in the world, and Americans are happy with it, no matter what the Left would have us believe. There’s a reason that Rochester International Airport in Minnesota is bigger and has more capacity than many commercial airports in much bigger locations: to handle the people who come from all over the world to the Mayo Clinic for the finest care anywhere. The same goes for places like the Texas medical Center and other centers of medical excellence recognized worldwide.

    The reason that other industrialized nations spend less is because they get less. We have rejected that, as a society.

    I’m an American and I’m not happy with it. Currently my family pays $1500 a month to a crappy HMO that charges us high copayments every time we turn around and has annual and lifetime caps on many things. And thats the BEST deal I could get.

    At this point I’d much rather be Canadian or French. I don’t think that they’d agree with your assessment of their situations.

  98. @Daveon

    No need to apologize. I actually jumped in. I can’t stand poor arguments on important issues and had to say something. There is a legitamite argument to be made against the current healtcare bill (and economic policies for that matter), but it needs to be backed by real info or the discussion is useless. A real discussion would benefit everyone and get us a real solution. Just yelling commie, unpatriotic, socialist, etc. only hurts is in the long run. Unfortunately, this is how most of the right (at this time) and some of the left operate (guilty too, but not as blatant at this time in history).

  99. Ben I agree with Planet Money’s summation. A nice look at almost all the problems, even a little psychology was covered. Unfortunatly, most people don’t realize that’s it’s almost all about pyschology.

    Mythago, my point was that if you have a mindset that indulges itself in the ME ME ME meme, then of course you’ll feel like someone owes you something. Guess what? You aren’t owed jack. The Universe doesn’t care about you. Your Governement doesn’t care about you. And if you’ve been telling yourself otherwise you have some growing up to do.

  100. gray area

    “my point was that if you have a mindset that indulges itself in the ME ME ME meme, then of course you’ll feel like someone owes you something. ”

    Not sure if this was intentional, but it really seems like this could describe someone on either side of the debate.

  101. Chad@108: I’m an unemployed computer consultant. The company I worked for saw its business disappear into thin air the first week of November 2008, and hung on until it finally collapsed in May 2009, owing me $40K in back salary and unpaid expenses. I haven’t worked in my field since. The economy has a direct effect on my life. If the Democrats had had a plan to fix it that didn’t mean a massive increase in the size and cost of government, I’d have been all in favor of it. They didn’t. Instead, we’ve got crushing debts to go on top of the other woes.

    rochrist@112: Since I’m unemployed, I have no insurance coverage. I’m wondering where I’ll get the $1500 I’ll need next month for my next 3-month batch of medications. Would government medicine help me? Superficially, yes, but not in reality. The real fix is an economic recovery that will let me earn my own way, including the medical care I need. I have no more right to demand that others pay for my medical care than I do to demand that they pay for my food or shelter.

  102. So I’m going to take it from all the detailed comments here that his is a “hot button” issue for you Americans eh!!

    So who wants to migrate to Canada yet?

    (this was ment to lighten the mood, insert witty laugh here)

    @mensch thanks for the breakdown :)

  103. #116 @Jay Maynard

    I didn’t say one word supporting Democratic economic policies, which, by the way, are same policies Bush was implementing as he left. Not one word I typed supported current policies and I even hinted in one part that I didn’t like them.

    Don’t change the topic of the argument. I’m still waiting for your response to the initial subjects (what caused the economic crisis and the best medical care).

  104. @Jay Instead, we’ve got crushing debts to go on top of the other woes.

    That was going to happen whoever won the election. Based on the “hole” in the markets that they knew about in Q1 2008 it was inevitable. Sorry.

    If you can think of an alternative to what’s been done that doesn’t involve the end of Western Civilisation I’d LOVE to hear it.

    And by the end of civilisation, I refer to a call between Jamie Dimon (CEO of JP Morgan) and Hank Paulson which happened in September 2008 on the weekend where they tried to do TARP telling him that JP would open on Monday morning, but that Merrill Lynch and Morgan Stanley wouldn’t, and that on Tuesday JP Morgan and Goldmans would be filing for bankrupcy.

    At that point ATMs and Credit Cards stop working.

  105. #97: “Oh, and I used to pay for my health care all on my own. I do almost everything on my own.”

    I gather you’re fortunate enough to afford good health insurance on your own; good for you.

    I gather you don’t have various ruinous preexisting conditions hanging over your head; that makes you lucky.

    That increasingly few of us are in those positions is precisely the problem.

    The only way to get decent insurance at a decent price is to get the group rate, that is what this should have been all about; creating viable groups. The administration’s biggest failure might have been in not considering how to make this work for small business, at least as far as I can see, as that’s where the rubber meets the road.

  106. Chad@120: I didn’t say you were supporting the current economic policies, either, just that I was opposing them. As for your post on what caused the crisis, we’re going to have to agree to disagree, because to me, without the CRA and Fannie Mae/Freddie Mac running rampant and letting bankers dump loans they knew were more likely to go bad, we wouldn’t have had the toxic assets in the first place.

    As for the best medical care, I’ll take a system tha makes the best care in the world available over one that results in universal, but mediocre, care run by unaccountable government bureaucrats any day. Again, I suspect we’re going to have to agree to disagree.

  107. Superficially, yes, but not in reality.

    Sorry, this is really a hot button topic for me today. Yes, in reality. If you need the meds and if you’re spending $1500 a quarter you need them.

    If the alternative is sickness and/or death then in reality a government system will help.

    It’d help me as a small business owner trying to hire staff in a city where the largest employer offers European style 100% “free” insurance. Try competing with that as a startup!

    The real fix is an economic recovery that will let me earn my own way, including the medical care I need. I have no more right to demand that others pay for my medical care than I do to demand that they pay for my food or shelter.

    Except we do effectively pay for food and shelter because nothing you do living in the Western World is really based on your ability to pay. It’s based on a complex interplay of factors where we do actually try to make sure that people have a roof over their head and aren’t starving on the street. Part of it is common sense – it’s messy and upsets the children, part of it is that we’ve evolved as a empathic social animal that cares for it’s immediate neighbours because that’s a GOOD evolutionary response for survival.

  108. @Jay: without the CRA and Fannie Mae/Freddie Mac running rampant and letting bankers dump loans they knew were more likely to go bad, we wouldn’t have had the toxic assets in the first place.

    There isn’t enough space to try and explain that you’re way off the mark with this without John beating me around the head with a metaphorical brick.

    The CRA and Fannie and Freddie are a fraction of the toxic assets problem. Bankers weren’t dumping loans and they didn’t think they were likely to go bad. They really didn’t.

    Worse still, there was no regulation to stop them insuring the increasingly high risk equities they were investing in against loss. Credit Default Swaps were the cancer that almost toppled the banking system, not loans to poor people to buy their first home.

  109. I’ll take a system tha makes the best care in the world available over one that results in universal, but mediocre, care run by unaccountable government bureaucrats any day.

    So, ignoring that it isn’t actually the best care.

    You’ll take faceless and unaccountable insurance company bureaucrats who have to make a profit over government ones?

    Really?

  110. Daveon@124: That’s why i said it would help superficially. There’s no question that not having to pay that money out of my pocket would help.

    The reason that it would not help in reality is that it would destroy the economy in such a way that I’d be in healthy poverty for the rest of my life. This is not an improvement.

  111. mensch said, “Sorry Scalzi for the tone but propaganda disgusts me.”

    Mensch, is it all propaganda, or just that which you don’t agree with? Sometimes, when you’re really embedded deeply in a culture, it’s had to tell the propaganda from the regular slurry of the consensus reality. We more often than not propagandize to help ourselves cope with the Outsider or the Mythic Other. We need to be one big happy soviet family, after all. By the way, some of the propaganda out of 60’s Soviet Russia is very graphically interesting. A lot of bold design and use of black and red.

  112. The Gray Area @114, I too have read The Art of Deception and am familiar with the rhetorical technique by which one attempts to salvage a loser argument by claiming one was merely attempting to draw attention to a Greater Truth. Sorry.

    Guess what? If you live in the US (and for that matter, in most developed nations), you live in what is, at least in theory, a nation with a government that provides certain collective services like national defense and collects taxes to pay for them. In the United Squabbling States of Libertaria, it would absolutely make sense to sneer that anyone who wants the government to provide a service has ‘gimmes’ and a sense of entitlement; in the United States of America, not so much.

    And, p.s., not everybody who supports the government paying for something benefits from it directly. I would guess that most bleeding-heart urban-dwelling liberals who support government aid to the poor are not, themselves, recipients of free school lunches, for example.

  113. While I do LOVE the phrase hopped up, ignorant nihilists, honestly I find the manner in which the GOP conducts its politics to be a greater threat than their individual lack of intellect. The formula of their political demeanor (attack character + attack patriotism + deny, deny, deny = victory) rapes the public discourse of any semblence of rational conversation and undermines the framer’s ideals for the conduct of a republican government. Add in polarized MSmedia and the truth, fact finding and debate are fatally wounded. It is a sad, and I believe unintended, consequence that our constitution is leashed to a two-party animal which for the most part produces gridlock unless there is a majority in Congress. Nonetheless, Mr. Scalzi is also right that the democrats, for the most part lacking common sense and cajones, shoots itself in the foot. I didn’t pay attention to this fight in Mass., and staunchly refuse to inebriate myself on its 24 hour coverage by cable news. But what do I know anyway, I’m just an ignorant [i]pleb[/i].

  114. Daveon@126: You’ll take faceless and unaccountable insurance company bureaucrats who have to make a profit over government ones?
    Yes, for two reasons: 1) The insurance company bureaucrats are accountable to their shareholders, while government bureaucrats are accountable to exactly nobody; and 2) the record shows that insurance companies deny coverage for procedures less than one-fourth as often as government bureaucrats do. I often wonder why those who howl at the evil insurance companies for denying coverage aren’t howling louder at the government doing more of the same thing…

  115. @Jay

    As for the best medical care, I’ll take a system tha makes the best care in the world available over one that results in universal, but mediocre, care run by unaccountable government bureaucrats any day.

    I don’t see why one precludes the other. Ensuring that every American citizen has affordable access to basic health care in no way stops the super rich from getting the finest health care money can buy. Similarly, stopping insurance companies from discriminating based on pre-existing conditions will not make the Mayo Clinic go out of business.

    We need universal health coverage for the same reasons we need universal fire and police coverage. We all understand that if my house burns because I couldn’t afford “fire insurance” and that spreads to my entire block (or apartment complex) that has a negative effect on everybody.

    Along the same lines, if somebody comes to work with untreated TB because they don’t have health insurance, that’s bad for everybody.

  116. @Jay

    The reason that it would not help in reality is that it would destroy the economy in such a way that I’d be in healthy poverty for the rest of my life.

    Except it wouldn’t. It doesn’t have that effect in Britain, France, Germany, Japan or any other comparable industrial nation who all have similar outcomes from their healthcare systems for significantly less money. You can kid yourself that these systems produce worse results but the reality is they don’t. In the US you’ll get better treatment if you can actually pay for it, but if your insurance doesn’t cover it or you’ve spent what they allow you to spend you’re just as screwed as if you were asking for a treatment that isn’t covered on, say, the NHS.

    The shear amount of paperwork involved in a simple visit to the Doctor in the US shocks me every time I go.

    You know how many forms I sign and papers I fill in to go to the Doctor where I lived in London? Zero. Zip. Zilch. Nada. No forms, no paperwork. No admins running it.

    The bill we got for some surgery my wife had a year ago ran to 3 pages – every single swab, ml of drugs, stitch etc… was itemised.

    That’s where your money is going.

    Even if you don’t want something as “socialist” as the British, the French run a private single payer system extremely well and one that delivers better results on almost every metric except a few forms of cancer – and even then it’s marginal.

  117. The Gray Area @114, I too have read The Art of Deception and am familiar with the rhetorical technique by which one attempts to salvage a loser argument by claiming one was merely attempting to draw attention to a Greater Truth. Sorry.

    Guess what? If you live in the US (and for that matter, in most developed nations), you live in what is, at least in theory, a nation with a government that provides certain collective services like national defense and collects taxes to pay for them. In the United Squabbling States of Libertaria, it would absolutely make sense to sneer that anyone who wants the government to provide a service has ‘gimmes’ and a sense of entitlement; in the United States of America, not so much.

    And, p.s., not everybody who supports the government paying for something benefits from it directly. I would guess that most bleeding-heart urban-dwelling liberals who support government aid to the poor are not, themselves, recipients of free school lunches, for example.

    Jay – again, you’re arguing with platitudes, not facts. “The best health care system in the world” and “unaccountable government bureaucrats” are not actually information; they are buzzphrases. If your only goal is to declare your moral belief that Government Bad, Free Market Good, they are effective. Not so effective for anything else, like convincing others you are right or that your views are based in fact and logic.

  118. @Jay:

    1) The insurance company bureaucrats are accountable to their shareholders, while government bureaucrats are accountable to exactly nobody;

    Well, yes… except the only thing they are accountable to shareholders to do is increase shareholder value. How that is compatable with treating the sick is something of a mystery to me, because all the data I see, from information on excision and the like suggests that the two are incompatable.

    As for the second… generally speaking I get to vote for the government. Of course not at the moment as a resident Alien I have taxation without representation. But if you don’t like what your government does YOU get to pick them.

    and 2) the record shows that insurance companies deny coverage for procedures less than one-fourth as often as government bureaucrats do.

    What record? Where?

  119. If someone is claiming to hold an opinion that no one in their right mind could come to the conclusion to by objective analysis, that “opinion” is propaganda.

  120. I hope universal healthcare passes, not for myself, but the 1/3 to 1/4 of Americans working without it. No industrialized country should have that high a number of people with no healthcare, there should be no excuse for that.

  121. Erik @132

    We need universal health coverage for the same reasons we need universal fire and police coverage. We all understand that if my house burns because I couldn’t afford “fire insurance” and that spreads to my entire block (or apartment complex) that has a negative effect on everybody.

    You are aware that we here in the United States do not have universal fire and police coverage, right?

    In my town, if it wasn’t for the volunteer fire and rescue, we wouldn’t have fire and rescue.

    And there are many small towns in the US that do not have a police department and are minimally served by State Police or Sheriffs.

    Now, give people the opportunity to get minimal insurance coverage (by allowing insurance companies to operate outside of State mandates) and you might get a system that covers more people (especially the young) at an affordable cost.

  122. Daveon@135: Just because you get to vote for the government does not mean you get to have a say in what government bureaucrats do or how they do it. They are a law unto themselves, and neither Congress nor the executive branch has any meaningful control over them. To see that, you need look no farther than the CIA’s war on George W. Bush.

    mensch@136: Thank you for coming out and saying you think I’m not in my right mind. This is, unfortunately, what the Left tends to do when presented with arguments they can’t counter: they claim that no rational person can think that way – because to them, anyone who thinks that way is not rational. That’s the kind of argumentation that polarizes debate.

  123. @ 123 Jay Maynard

    Actually, I don’t think we can agree to disagree, as you are giving me opinion and belief, and I’m providing facts:

    – 15% of all bad loans are CRA loans that means 85% of bad loans are to “solid” clients who the banks/lenders could have declined (gov’t did not force them to do this part)

    – Real expert testimony on who is responsible.

    – Overall medical stats for Canada and the U.K. all show the U.S. behind in medical quality and that U.S. care is more costly. Sure the U.S. may have a few facilities that are trully top tier in quality, but neither you or I will see them whether we have insurance or not. Your statement “I’ll take a system tha makes the best care in the world available over one that results in universal, but mediocre” is just plain false based on almost every conceivable national health measurement.

    We can agree to disagree when you provide me more than propoganda to back your argument.

  124. @Frank 139

    Actually I wasn’t aware of that. If we don’t have universal fire and police coverage, we should. For the same reason we should have universal health coverage. Because not having it is bad for everybody.

    So what do these towns without fire coverage and no volunteer force do when there is a fire? Let it burn? I’m glad I live in a city.

  125. I’m very interested in a source for the claim that “government bureaucrats” deny valid claims four times as often as for-profit health insurance companies do. (Although it’s a bit unclear what Jay means by “government bureaucrats” here – Medicare? Medicaid? State insurance plans? all of the above?)

    Jay is entirely correct in one assertion, of course: for-profit health insurers are accountable to their shareholders. Not to their customers, and not to their insureds, despite internal and industry standards which pretend that claims have a duty to assist insureds rather than treat them as adversaries and suckers.

  126. I want to comment on this, but every time I write something and reread it, I think “John would kill me if I posted that,” and I delete it.

    So I’ll limit myself to two observations and a question.

    Observation One: Jay Maynard, you’re making slightly more sense than a Fox News pundit. Please note that I do not mean this as a compliment.

    Observation Two: No real health care reform will be passed with Republican cooperation because any real health care reform would seriously hurt the profit margin of the health insurance companies (indeed, any serious reform should be aimed at doing just that), and the Republicans will never go along with anything that hurts their fat-cat corporate clients.

    Question: Hey, what happened to the “nuclear option” the GOP thugs threatened to use last time the Democrats tried to kill something with a filibuster? Why aren’t the Dems making similar threats? Are the goppies just better at bluffing? Or is it that the Democrats still care, at least a little bit, about our public institutions, while the goppies care about absolutely nothing but their own power?

  127. Just because you get to vote for the government does not mean you get to have a say in what government bureaucrats do or how they do it. They are a law unto themselves, and neither Congress nor the executive branch has any meaningful control over them. To see that, you need look no farther than the CIA’s war on George W. Bush.

    Sorry but you’re pulling a bait and switch here with this.

    You do get to vote for the government and the government gets to control the civil service. In this context the “CIA’s war on GWB” is meaningless – I’m also not entirely sure what you’re referring to here either.

    Contrast to a public business which has no other aim than to increase shareholder value. That’s all – if the shareholder value goes up by denying your claim, they will be beholden to the shareholders to do it. End of story. Good luck suing them because time is on their side and you don’t have any money anyway because you’re spending it all on healthcare.

    Now, if we were talking about a first step of making all the insurance providers mutual societies i.e. not-for-profits where any “profit” is kicked back into the spending then I’d be prepared to consider it. I just don’t see how primary healthcare can turn a profit without screwing a lot of people over.

    Likewise, I’m seriously coming to the position that having banks that are Too Big to Fail is an insane failure mode and that we should go back to all banks being mutually owned by depositors too. The failure modes there are less likely to cripple the entire global economy – OTOH – they won’t provide the kind of bonuses and returns that apparently are hallmarks of a robust market economy.

  128. mythago@143: My memory was incorrect. It’s only twice as often, according to the American Medical Association.

    Chad@141: You fail t convince me, and discussing it with you is clearly unlikely to change anyone’s mind.

    In fact, I’m coming to that conclusion about commenting here at all. There are so many diehard leftists in here that reject the possibility that, just maybe, bigger and more government is not the solution to all problems and are willing to only listen to each other that I’m wasting bandwidth posting an opposing viewpoint.

  129. Mensch @ 136, how are you defining “right mind?” You seem to be saying that if someone has a different opinion than you do, that the other opinion is crazy. You sure about that? And objectivity has little to do with it, it’s all about subjectivity.

    Mythago, you cought me, dude. How could I have so easily beem lead down that path? Yes, I’m wrong, but the straw man made me do it! Wrong book, wrong conclusion. The Art of Deception? Try the Psychopath’s Bible. At least you made me laugh. Now calm down and stop being so serious.

  130. Xopher, I would not assume that fat-cat insurance companies are not also giving to Democrats. It’s more about making sure Obama doesn’t actually accomplish something that might be popular and give the Democrats a public boost. Allowing a health-care bill for which Obama gets credit to pass would only be palatable if it were clear that the bill would, as Jay insist, bring the entire US economy to a crashing halt, preferably in such a short time-frame that the voters would connect the two. There’s really no other reason that there would be such a solid bloc of GOP opposition to this.

    Frank @ 139 – “State police and sheriffs” are provided by state and county governments, respectively. They’re not private or volunteer police forces. I would also assume that in the smaller, rural areas you describe that rely on volunteer firefighters, people do not have to buy “fire insurance” such that if your house burns down, the dispatcher will have to run your insurance number and confirm you have coverage before she calls in the firefighters. Also, that you’re not seriously proposing large urban areas should switch to a volunteer system.

  131. Erik @142

    So what do these towns without fire coverage and no volunteer force do when there is a fire? Let it burn?

    Well, I don’t know about everywhere, but most towns without Fire or Rescue contract with towns that do. They usually agree on a fee-per-service but it is the homeowner who pays the fee. They also pay in response-time.

    Even here where we have Fire and Rescue, if you are not a member of the fire or rescue squad, you will be billed for the service.

    Hey somebody has to pay…

    You know, there’s lots of folks who like to have their house out in the woods on big pieces of property so they can “enjoy nature” and “have their privacy”.

    But that usually means, at least around here, that response time to a fire, rescue or police call is outside the optimal time period to effect a good outcome.

  132. Jay, in responses to your There are so many diehard leftists in here that reject the possibility that, just maybe, bigger and more government is not the solution – the point you’re missing is there are literally dozens of single payer universal systems which all deliver and cost less to run than the current US system. That suggests that there are better ways to do it.

    By any measurable metric the current US system isn’t really any better than the comparable other systems and by a number of metrics it’s actually worse.

    Spending vast sums on ER treatment of preventable conditions is just the tip of an extremely messy iceberg.

    Taking my example again. I could afford $700 for the Glaucoma consult. If I couldn’t AND if I’d had Glaucoma, the failure mode is me going blind. Do you think that’s an acceptable outcome purely because somebody is poor?

  133. Jay – oooo, look out for the scary diehard leftists.

    Or try engaging with the facts. On no metric is the US healtcare system the finest in the world. Dollar for dollar, it’s more expensive, and less efficient, than many others. These include both single-payer systems (Canada), compulsory mandate systems (Singapore/Switzerland), single provider systems (UK), and mixed public/private systems (New Zealand).

    If you engaged with the facts, rather than simply repeat rhetoric all of us have heard 28 times before, you might change the mind of some of the scary diehard leftists.

  134. Gray @147

    I’m saying that this discussion bores me. Calling Obama or anyone else a “Communist” or a “Socialist” or whatever “ist” the rightwing pretends to understand is simply a slur and a pejorative, not objective analysis.

    I’m saying (again) that I’m not going to allow the rightwing to run the country and blame me for the problems. You broke it, you own it. Not me son. Not me.

  135. Erik @ 142 said, “So what do these towns without fire coverage and no volunteer force do when there is a fire? Let it burn? I’m glad I live in a city.”

    Ah, I guess you don’t live in Detroit, which I beleave is still on fire. We do like our fires in this town. Please move here and enjoy the flames.

    From 30 Rock: “After last night’s freak snowfall it’s 98 and humid. In other global warming news a tornado hit downtown Detroit putting out several fires.”

  136. But Mensch, if it looks like a socialist, and it talks like a socialist, then chances are it’s either a socialist poser, or the real deal. So, maybe being a socialist isn’t such a bad thing. I’m sort of a socialist in a Bitchun Society sorta way.

  137. Jay @146: It is true that if you want to be able to shout down anyone who disagrees with you merely by using buzzphrases like “government bureaucrats” and “unfettered markets”, rather than actual, supportable facts and reasoned argument, you may not find this an ideal place to comment.

    Your link does not go to the AMA; it goes to a blog post for a Libertarian think tank. Happily, that particular op-ed does link to its sources; but it doesn’t say quite what you claim it says. For example, it admits that in 2008, Medicare denied 6.85% of claims, while Aetna, the leader of the pack, denied 6.8%. Granted I am not all that good at math, but I’m pretty sure that 6.85% is not twice as large as 6.8%.

    Oh, but in 2009 Aetna got better! They only denied 1.81% of claims, while big evil Medicare dropped to a mere 4%. Of course, if you go and look at the actual source for some of these numbers, the AMA 2009 report, you might also find out that Anthem Blue Cross Blue Shield had a denial rate of 4.34% and Coventry was at 3.99% percent. Again, a math maven I’m not, but I’m pretty sure that means that Anthem BCBS was worse than Medicare and Coventry was trivally better.

    The blog post tries to blur this by talking about averages, but the bottom line is that you are flat-out wrong when you insist that private insurers deny claims less often than Medicare. Some have lower denial rates, some have higher denial rates, and which is which has absolutely jack-all to do with whether the claims processor is sitting in a mediocre government office building instead of a corporate cubicle.

    We’re not even getting into reasons for denial here, which is a whole nuther and actually important issue, because I’m assuming that Jay is going to declare that the close-minded liberals are afraid of his unbeatable arguments, declare victory, and wander off at some point; it’s easier than actually making a solid argument and backing it up, sadly. But the figures are in the AMA report if any policy wonks want to go at it.

  138. The idea that this country is best served by one party, who happens to have maybe 60% on its side, “flipping the bird” to the other 40% and ramming through the biggest government social program ever conceived, is part of the problem, not part of the solution.

    If we will ever get Health Care Reform (and it should be called “pay for my doctor bill” reform– it modifies the money, not the care) that will be a meaningful improvement to the lives of citizens, it will have to come from a process that lets both sides have input and be happy with the results.

    The Founders weren’t big on “ramming” — the system they set up was meant to produce concensus.

  139. It’s really amazing how much I agree with John on this (and I rarely agree with anybody on ANYTHING). And thanks for the back of the hand to Nader and knee-jerk “progressives”. Even though the loving mallet of correction is unlikely to change anyone’s mind in this case, it sure is good for my morale to see it applied.

  140. As a liberal I get blamed for everything or I get an “equal” amount of blame just like my parents would punish me AND my brother after he kicked me in the nads instigating a fight.

    Stop blaming liberals people. Even when the Democrats are in control they do not do anything we want them to. Time to grow up, centrists and rightwingers.

  141. Bill, I don’t believe anybody has suggested that a majority is a blessing from Zombie Patrick Henry (or any of the other Undead Framers) to do as thou wilt. I do believe that people have noticed if you are trying to compromise, and the other side’s version of compromise ranges from “Do exactly what I want” to “Nuh uh, not happening” that there’s not a lot of point in trying to compromise.

    Some of the disconnect here is because the discussion is, for many, not really about facts or results, despite the pretense that it is.

    If it were proven beyond question that we could have free, universal healthcare at equal or less cost to what we spend now, only if we publicly tortured to death three hundred newborn babies on the steps of the White House every full moon, how many people would really support it? Just about nobody, in all likelihood; the benefit is not worth the morally repugnant cost.

    Similarly, the Jays of the world are not really interested in whether government-run health insurance costs more, is more efficient, or saves the lives of sick little children; because it is government-run health care, it is inherently wrong and morally unacceptable.

  142. Mensch, I’m not sure I get it. Do liberals normally look to government to help out? It sounds like liberalism, when reduced to its most basic core values, is about helpig others. Like Jesus. But it’s one thing to be poor and downtrodden and to get a helping hand, it’s another to expect it. Don’t expect people to be good, and that includes the people who compose our government. What you can do is Be good to others without any expectation that you will be rewarded. Be a Mensch already, right?

  143. @ #146 Jay Maynard

    I didn’t expect to convince you. The lack of facts in an argument always suggests a belief and beliefs are very very hard to change as they aren’t based on concrete evidence.

    What I was demonstrating is that our current discourse in this country is all based on beliefs…not facts.

    I was eager to have a discussion on the facts, as I do actually believe a legit argument can be made against the healthcare bill. However, I have yet to hear any argument from the right other than “Hmmmm, government…bad!”

    There is no legit argument to back up your CRA/Fannie/Freddie theory, as the cause of this financial crisis.

  144. No it is about helping ourselves as we are a representational democracy in which the people have a say. Supposedly.

    Remember “We, the people”?

    The rightwing had 8 years to demonstrate to me and other skeptics how superior the “free market” is in running society. It was objectively a disaster.

    I do not want socialism I want 20th Century style American capitalism – capitalism with regulation, with oversight and with sanity. It worked pretty well certainly better than the unshackled Frankenstein that brought our financial and economic systems to the brink of collapse.

  145. @ 166 mensch

    Agreed. I would point that MSNBC and Olberman aren’t a ton better than Fox, and Obama isn’t quite as fact focused as I would have hoped.

  146. With all due respect I hate that response. I refuse to believe that I’m just the other side of the coin from the Tea Party Pod People. Yes, Olbermann is a d!ck and Maddow is a partisan but FOX lies and sells an alternate reality. Plus MSNBC came AFTER FOX and is a reaction to it (and more importantly it’s ratings success). There is no equivalent to Glenn Beck, Rush, Coulter, etc.

    What they sell is that you can believe whatever nonsense that pops into your head is the truth. And anyone who thinks they know better than you and your b.s. “common sense” is an elitist. That includes scientists, experts and people with more and better educations.

    This is a radical notion. That the accomplishments of those who have come before you and the expertise of people who specialize are worthless next to your phony gut instinct. It is dangerous, radical, and most certainly NOT tradtional.

  147. I’d just like to point out that the UK NHS spends less per capita providing universal health care to the English [1] than the US government spends per capita on the public health care it already provides. (Medicare, Medicaid, vet benefits, etc.)

    From one POV, this means socialized medicine in the USA wouldn’t necessarily bankrupt it, since it could provide it for less money than it is already spending now.

    From another POV, this means that socialized medicine in the USA is obviously impossible, since the USA government is so impressively corrupt and inefficient.

    [1] The UK NHS is run by region, so the Scottish, northern Irish, and IIRC the Welsh all have distinct systems from the English.

  148. It is now politically incorrect to call bullshit bullshit. And we have no future whatsoever in the face of that.

  149. “I want 20th Century style American capitalism – capitalism with regulation,…”

    So, you want a fantasy? You want an America, but one that didn’t have the Great Depression? You want an America without recessions? You get more and more regulation and you get socialism, at least by my historical accounting.

    Also, helping ourselves is fine, as long as it isn’t hurting anyone else. As for representational democracy, it’s an ongoing experiment, one that has consistently let us down. But that’s people for you. And there doesn’t seem to be a better way of doing things, yet. Still, do unto others as you would have them do unto you, seems like a good way to live life. It’s golden.

  150. Gray go ahead and ignore what just happened to this country at the hands of Republicans and free market conservatives but stop lecturing me and blaming me for your problems. I’m done and don’t care what else you have to say. You run the country and always have – time to act like a man and admit it.

  151. On the subject of “better” health care, something I’ve been following for years, I come up with the following conclusions:

    1. In terms of “everyday care,” you get a wide range of quality in the US. Some plans are simple, low co-pays for checkups and what might be called “standard” care (as in, established procedures.) Some are ruinously expensive, and are almost arbitrarily so. The worst part is that the availability of these plans seems to be very dependent upon your choice of employer, with small business workers getting the shaft.

    2. In terms of outlier care*— the rare, the critical, and the new— US tends to be the best. Take premature babies; a relation of my husband’s had twins at an astonishing 22 weeks and they told her “There are no statistics of survival for twins at this age because there are no surviving twins from this development.” And now there are— they’re three. If your baby is premature, there is a far greater chance of survival in the US than in other countries.

    3. Most people I know are happy with their healthcare, and that includes people from the US, Canada, and Britain.

    4. I’ve heard horror stories from all three countries.

    Which means what? Well, mostly that the above phrase, that Congress is a “giant unintended consequence generator”, seems to be the issue. People against universal health care are likely to be dubious at the ability of the federal government to administer it (just listen to my mother gripe about TriCare, the military program.) It’s not that people don’t want something better; it’s that fear of something worse is far greater.

    *When I say “outlier cases” it should be known that my family is chock full of them, including a niece whose asthma (plus side effects, plus drugs to control it, plus their side effects) got so bad that her bones were breaking when she coughed and her immune system shut down (fine now) and the above-mentioned relation with the premature twins. The hilarious point is that everybody takes different lessons about health care and you can find nearly every point on the spectrum in the family.

  152. Mensch, no one, least of all me, is blamng you for my problems. For one thing, I’m pretty much problem free–today. As for ignoring what has happened in the past: ah, I have been a player the entire time, working with the tools that modern capitalism has afforded me. I work with whatever system is in place across an entire planet of time zones. If I wanted to blame anyone (or anything) for our collective problems, I’d blame the unfixable human propensity to be greedy. But along with greed, most of us have a little human kindness mixed in, so it’s not a lost cause. After all, Pandora unleashed all the evils upon the world, but she also released Hope.

  153. @159, that sounds great, but you can’t make that happen when the two side fundamentally disagree on whether the problem exists, what it is, and what would fix it. Oh, they might be able to find some trivial bits in the middle that they can agree on, but that’s just picking out tablecloths on the Titanic. A pro-lifer and I can agree that maybe tax money shouldn’t fund abortions for illegal immigrants, but we aren’t really accomplishing anything important by doing that.

    When I get in an online debate on health care reform I always try to start off with my statement of what I think the problems are and then suggest some solutions. Alas, plenty of people either say that some of my claims are actually untrue or that they are true, but not problems that need solving. It’s not possible for us to come to an agreement because we can’t even define the terms for the debate (that, and the fact that they are all weenie-heads).

    So, screw bi-partisanship. Let’s get the best bill we can and ram that bad boy through.

  154. @173, B Durbin

    Sweden actually has pretty remarkably survival rates for premature babies, certainly comparable to the US. The US gets more premature births than most developed nations (for reasons that are not well understood), which (a) makes us better at handling them (more facilities and practice) and (b) artificially drags down our child mortality rate relative to other countries.

    I’m not sure I agree that most people are happy with their health care in the US. I *do* agree that most people who *have* health care in the US are, generally, pretty happy with it, but that’s not the same thing.

  155. Mensch, without Hope why do you bother? I know that one man’s stupidy is just another man’s best effort to understand a complex world. We do have to allow for many opinions in our pluralist society. And I think most of us want to eat our cake and have it too. It’s magical thinking in action.

  156. Jay @146: You’re misrepresenting the facts somewhat, there…but in fairness, the article itself is selectively skewing. It points out that Medicare denied claims IN 2008 ONLY at a rate UP TO double of the AVERAGE. In other words, Aetna denied only .05% less than Medicare that year.

    Further, glancing through the actual data of the PDF, you see a different picture. 10.5% of Medicare’s denials AREN’T ACTUAL DENIALS. They are codes for “Procedure is not Payable, this is for informational purposes only.” Another 15.3% were listed as “Claim not covered by this contractor, you must submit claim to correct payer/contractor.” The single biggest code listed, at 27.8%, is “Claim lacks information for adjudication”. And the single biggest claim for the 3.4% denier, Coventry? “Expenses incurred prior to coverage.” In other words, a claim denied due to pre-existing condition or treatment prior to coverage. Given that the context for the AMA’s data is provided by a Libertarian Think tank, I don’t find their interpretation that surprising. Their intention is to make the government option look far worse than it actually is.

    There has to be some sort of happy compromise between vast government control and the free market. Adam Smith’s “Invisible Hand” assumes generally that financial groups work in their own selfish best-interest, which in turn will be in everyone’s best interest. But even Smith recognized that this wasn’t a universal rule. And the problem also was that the rule assumes that the market is making the decisions in it’s own best interest. We’ve seen plenty of CEOs in the last 10 years who were more concerned with stock price than fiscal health and reward bonuses than continued employment. Companies like Enron and Worldcom were not run into the ground by executives who didn’t care about the companies health, merely their own pockets. This hardly means that unlimited government oversight is the solution to all our problems. Far from it, IMHO. But the suggestion that all government oversight is onerous strikes me as magical thinking.

  157. No Gray the stupid in America are not making an effort to understand. They are listening to their media who are telling them they should be proud to be stupid and that anyone who thinks their not-thought out nonsense is stupid is an elitist and is worthy of contempt.

  158. This is exactly why I like being middle of the road independent. When the far left and the far right start pissing on each other, the stream just arcs right over those of us in the center, and we continue on our merry ways.

    And for what it’s worth, I do think that health care reform needs to happen, I just don’t think we need to spend like crazy on a plan that we know won’t work, but is “just the framework” for the final product. Dems could go a long way with just a little fiscal responsibility, and Reps could do themselves a huge favor by not turning everything into a God, Guns and Gays issue. I’ve heard one of my own state’s Senators turning healthcare 09/10 into a gun rights and marriage issue. Trying to wrap my head around that one just hurts.

  159. Alan @ 178: “The US gets more premature births than most developed nations (for reasons that are not well understood)”

    The best arguments I’ve heard are demographic; we in the US have several entrenched high-poverty sub-cultures with the attendant health factors that lead to premature babies.

    As for child mortality, the unfortunate thing is that there are no valid statistics on that point because developed countries measure that according to their own standards, some counting as “live births” the presence of a heartbeat, even if it fails immediately, some according to developmental age, and what have you. The US is pretty thorough, but I don’t know if there’s even any breakdowns into categories. So on the one hand, you get “The US has a horrible infant mortality rate!” and on the other “But we count more!” and the real answer is, there’s not enough data for a valid comparison.

    NB: I was uninsured for a few years following college. Aren’t most people?

  160. This is exactly why I like being middle of the road independent.

    EVERYBODY likes to portray themselves as the Golden Mean between two undesirable extremes. (Heck, Ross Douhat makes a career out of it.) It’s also great because you don’t actually have to take a position, present an argument or, really, think very hard; merely declare yourself the reasonable middle between the other silly, shouty positions and head back to the sofa for a rousing evening of L4D2.

    It’s also a position that tends to work only when you’re privileged enough that you’ve got no skin in the game. Public health care? Dude, I’m a single young person with no chronic health issues on a fine BigCo health play, what do I care?

  161. This seems to have turned into a private discussion between a select few, and I should probably stay out of it…but I won’t.

    I’m a licensed healthcare provider and am on all of the insurance panels in my state (and our state Medicaid, which requires three different panels). Getting me on all of those panels took over a year (Medicaid was the worst, taking not quite 18 months.) I am also fortunate enough to have a reasonable (not “cadillac”, but reasonable) insurance plan provided by my employer.

    I firmly believe that we need healthcare reform in this country. It is too complicated, too arbitrary, and too difficult to obtain insurance independently, and often to use what is provided by an employer.

    However, I agree with #53 and #54 on a couple of points:
    First, we don’t need just any old reform, we need good reform. We need something that is well thought out and logically developed, not cobbled together for political expediency. Which brings me to: I believe that the government is not acting in the best interest of the country and that special interests are exerting undue influence on a process that has stunning implications for all Americans. How else to we explain the fact that the unions got a pass on helping to pay for healthcare reform for the next several years?

    Some of the ideas put forward in this legislation are truly disturbing to me: for instance, I put money into a flex spending account every year, going without other things to make sure that I’ve saved enough to defray at least some of my medical costs. But the current legislation would count my personal savings towards whether or not my plan was considered to be a “premium” plan. I’m not happy with the idea that my choice do without a flat screen TV (nope, don’t have one) or HBO or a new blouse somehow bumps the value of my insurance plan. What is the value of my trying to be personally fiscally responsable in that case?

    I’m also fearful of just passing “something” with the idea that it will be tidied up later. How often do politicians really stick with something long enough to make it tidy and reasonable?

    I agree that this is probably a horribly wasted opportunity, but I think that there is enough blame for that to spread around, and that Democrats probably own more of it than Republicans. They have been in charge for a year and could have made it happen, but instead they worried about who would pay for what in Nebraska.

  162. Daveon@124: That’s why i said it would help superficially. There’s no question that not having to pay that money out of my pocket would help.

    The reason that it would not help in reality is that it would destroy the economy in such a way that I’d be in healthy poverty for the rest of my life. This is not an improvement.

    And yet every other civilized country in the world manages to do it and spend less on health care overall than we do.

    Go figure.

  163. christy @186, while I doubt anyone would argue that unions put a lot of effort into influencing legislation, one reason they may get a pass on contributing to health care is that they set up their own health plans through collective-bargaining agreements. So they give up X benefits to get health-care plans, and now the government is telling them they have to give up more; naturally they’re not going to be thrilled with that.

  164. I am lucky enough to work for my state as a librarian and still have my job. I have state health insurance, and although I pay about 1/5 my pre-tax pay to be insured, it’s better than the alternative. It’s WAY better for my husband, who due to extensive surgery in his youth, would either be uninsurable or pay more than he makes currently for his premiums; I can cover him under my insurance plan.

    What we need is a plan that will allow people like my husband access to health insurance that won’t take so much of their paycheck that they can’t survive on the remainder, then poop out when you have to tap it. Presently COBRA seems to do just that, and for the segment of the population that can least afford it.

  165. As a member of the great white north – Mari-times chapter – it saddens me every time I witness rugged individualism trumping basic common sense. Economic efficiency is the name of the game behind universal healthcare; an increase in productivity and profits for every enterprise except however, for-profit healthcare companies. Insisting on for profit healthcare is like insisting on staying inefficient.

    In other words, for every loafer in a universal system, there is ten times as much profiteering in a pay as you go system. I hate to be a downer, but despite lofty intentions of some (most?), I don’t think the USA will ever get an actual healthcare budget. The gut mindset seems to prefer exorbitant fees from corporations as opposed to rationalization of healthcare for all citizens via taxation.

  166. @ 168 mensch

    Oh, I agree there is no equivalent to Beck, Limbaugh, or Coulter in terms of extreme opinions. However, all of them, including Olberman, do one thing and do one thing very well…preach hate with every issue. It’s childish and amateur hour with all of them.

    With all due respect it wouldn’t take a lot for the left to join the right in crazy town. Yes, at this moment the right is doing a good job of claiming it for themselves, but the left could get their if they aren’t careful.

  167. @190 Craig M.

    As a fellow Canadian I agree with you. I see the debate going on in this very blog comment string and wonder WTF!!

    I just don’t understand, it’s a simple concept provide heath care for EVERYONE!! I wouldn’t be alive today if I lived in the US because of the care I needed when I was a child and continue to go through. I just can’t see why a person has to sell all their possession’s and claim bankruptcy just because they can’t afford treatment.

  168. Frank: Remember when Frist was threatening to kill the filibuster over the Democrats filibustering judicial nominees? And the “Gang of 14″ saved it? I think the amendment rule –

    As with most other matters, the Senate can adopt amendments to its Standing Rules by a simple majority of those voting.

    could be used to change it (perhaps to “simple majority”).

    Uh huh. An precisely which Republican ideas are in the bill?

    From what I can remember:

    Members of Congress will be required to buy their health insurance through the same exchanges that people in their own states will use, instead of having a separate Congressional health plan.

    There was also a compromise around taxation of employer plans (can’t remember the details off the top of my head), compromises on the public option, and an offer of Tort Reform at one point. Beyond that I can’t recall the details of the debate, but in that long slog there were several instances of Republicans demanding something, Democrats caving, and then Republicans not moving their opinion.

    (As for the insurers competing nationwide, that is an absolutely terrible idea, but that’s a side discussion if you want to bring it up).

    But even more than that has been the rest of their behavior – look at the Wyden-Bennett bill. Good bill, has republican co-sponsors. Except when those Republican co-sponsors were actually asked about the bill, they said they supported it as long as some changes were made – changes that entirely gutted the bill. The bipartisanship was a sham. Look at their demagoguery on the Medicare Advantage cuts – Med Advantage pays more than standard Medicare for the same treatment. An ideal thing to cut for anyone interested in reforming the system. They opposed them and shouted about the Democrats coming to get your Medicare.
    Even Snowe got what she wanted, and voted against it – because the endless billmaking happened “too fast”.

    Kennedy announced and funded the Moon shot and Reagan expanded the military.

    Both of which cost large amounts of money and massively increased the deficit. You really think if Obama tried this the Republicans would let it happen? Also, it’s a little early to call on the stimulus bill.

  169. mythago@188:Agreed that unions have what they have due to collective bargaining, and that the concept of “bargain” suggests that they gave up something to get something. But the entities that they were bargaining with were employers, not the American people. Even if the employer in question is the government, the govt is still an employer to the people in the unions, and thus provides employment compensation not social programs. The healthcare discussion deals with how we will pay for a new social program, and I’m not sure why the benefits that they were able to negotiate from their employer entitles them to a collective pass on their tax burden. I was able to negotiate a higher entry salary than most of my peers – I still have to pay my taxes on what I make.

  170. christy, as I understand it, the beef was that this tax was not simply on health-care benefits, but “Cadillac” or “gold-plated” health-care plans (however those are defined). It’s less about unions thinking they are too special for taxes and more a complaint that what was supposedly a tax on wealthy white-collar workers’ superfancy health plans was falling on blue-collar and service workers. Particularly as there was some campaign promise along the lines that such a thing would not happen.

    strech @193: please, please let’s not go into ‘tort reform’, aka ‘big insurance companies lobby to keep the lower classes from using courtrooms intended for their betters’. It’s likely to lead to malleting.

  171. mythago,
    Again, understood. However, in the present legislation, contributions to flex spending accounts are calculated into the total value of the heath insurance package, leading to situations like mine – the more I personally save, the more “cadillac” my plan becomes. I (and others like me) make personal financial decisions and save money out of my paycheck for my healthcare expenses, and become “gold-plated”. Unionized workers have far better plans that I do (I have unionized but “blue collar” relatives in a different part of the country with whom I recently comared benefit plans) but are exempted…sorry, that just doesn’t compute for me.

    And campaign promises….If I remember rightly, there was also a promise to reduce the tax burden of middle class Americans. But by imposing a “cadillac plan” fee, isn’t that truly imposing a fee on those who have good healthcare plans? Insurance companies will simpy pass those fees along as business expenses, and employers will pass them along to employees/insured, so that seems like a rather convoluted way of increasing taxes on the people who hold the plans.

  172. mythago,
    Forgot to mention: part of our discussion presupposes that the whole “cadillac tax” plan is a good idea of how to fund things…not something that I’m sold on.

  173. I feel your pain, Mr. Scalzi. We in Canada have universal health care, and have had for decades.

    Of course, it is not universal in the sense that you can get what you want done when you need it, but at least no one is left out of the lineup.

    Anybody can get in the lineup for the general treatments. Of course, there is provision for special people to jump the queue, but is that such a big deal? Some people ARE more important than others, after all.

    If this is such a disappointment to you, we welcome you to become a Canadian citizen. You will get your universal health access, plus, you can pay an extra 25-30% in taxes.

    We thank you in advance.

    The weather sucks sometimes, but there is always Cuba, where the weather is better. Everybody gets treated there, with something or other, as long as its treatment of some sort, at least it is provided.

    Sorry to hear about your troubles, hope things get better for you soon, like it is here.

    Bon Chance!

    zeno

  174. No, I haven’t read the whole thread, I just thought to post some thoughts here.

    I’m thinking we need to pass health care legislation — senate, house, or some combination — because implementing it would demonstrate to supporters just why socialism carried to an extreme fails.

    A few days back Rep. Kucinich noted to the effect that the Senate bill would hurt the uninsured, because many of the uninsured don’t have the money for insurance. Dennis is all for the public option — which would cover those too poor to afford private insurance; but as we’ve learned out here in California, it would place paying for medical care in the hands of government, and the government has a bad habit of not thinking through proposals and reform.

    What am I talking about? Simple, California’s MediCal program pays less than the going rate for medical care in the state of California. The fees California pays are paid on the premise that by limiting what one pays one can get them greedy physicians (etc.) to reduce what they charge. These fees set ignoring that one pays not just for the doctor’s treatment, but also for the doctor’s overhead. His staff, supplies, rent on his office, the electrical bill, the water bill, maintenance, repairs, the cleaners, and insurance.

    And then you’ve got the doctor’s need to save up for emergencies. Sickness, calamity, malpractice suits. Also his retirement, his kids’ education, transportation, further training and education, upgrades on his equipment, repairs and maintenance for his equipment. Being a doctor costs money if you hadn’t heard.

    Yes, the above is a tad disorganized, but you should get the gist of what I’m saying.

    So here’s my prediction. A Democratic health care bill gets passed within a years time you will see a resurgence of the Republicans that will see them nearly take the Congress entire in the 2012 elections, and Barack Obama loosing the 2012 Democratic nomination.

    Consequences old bean, consequences, and the consequences here bid well to destroy the Democratic Party.

  175. @ 198 Zeno

    Actually, if real or actual tax rates are calculated for the U.S., Canada, and the main European countries there isn’t much difference (U.S. is only barely less). You can’t just compare tax brackets, as no one actually pays that amount. Unfortunately, this what the media and everyone always compares.

    The real difference is how the taxes are spent. Canada and the Europeans spend the money on healthcare and other social programs, while the U.S. spends it on defense.

    Canada does not have 25-30% higher taxes it just looks that way when you compare rate to rate.

  176. @200 chad

    he average tax rate in Canada is much higher than in the United States. In Canada total tax and non-tax revenue for every level of government equals about 38.4% of GDP,[2] compared to the U.S. rate of 28.2%.[1] —— wiki

    Also the rate of tax on gasoline is higher plus GST and PST (fed and provincial value-added taxes) which goes into general revenue, unlike the states, where gas tax is directed to highway projects.

    There is GST and PST on almost everything except some foods.

    Don’t be deceived.

    You WILL pay.

  177. @199 Alan: “I’m thinking we need to pass health care legislation — senate, house, or some combination — because implementing it would demonstrate to supporters just why socialism carried to an extreme fails.”

    Hmmm. The US spends 15.3% of GDP on healthcare and 25% of the nation has no access to any form of primary healthcare whatsoever; whereas the UK and Australia spend 9.2% and 9.1% of GPD respectively and have open and free healthcare for all.

  178. chad @ 191: “However, all of them, including Olberman, do one thing and do one thing very well…preach hate with every issue. It’s childish and amateur hour with all of them.

    I’ve heard Olbermann lumped in like this, but I’ve never actually seen any example of it. Not being a regular watcher of any of these guys, can you give one or link to one? I don’t consider calling someone on a lie ‘preaching hate’. I DO consider calling the standing president a fascist to be (at least, in cases where he clearly is not).

  179. @ 201 Zeno

    I’m not fooled. Nor am I deluded by political rhetoric.

    Taxes as percentage of GDP
    U.S. – 28.2%
    Canada – 33.4%

    http://en.wikipedia.org/wiki/List_of_countries_by_tax_revenue_as_percentage_of_GDP

    I can pull numbers too. Unfortunately, the number you pulled and the numbers I did mean nothing unless you know exactly how they were calculated. Does the tax number include U.S. social security? It may not as this number is not taken into account when U.S. citizens actually pay taxes and half of this tax is paid by the employer, who definitly factors it in when they negotiate salaries.

    Or, as in your numbers non-tax revenue is factored in and distorts the actual percentages. Receipts from all nontax sources now exceed $40 billion for Federal, state and local governments combined (U.S.).

    Or, as with my numbers is the bump to GDP from the massive amount of debt the U.S. takes on factored into this calculation to get a real GDP?

    Does it include gas taxes, state taxes, local taxes, etc.?

    Or, are average tax rates paid by those earning an average wage a better judge?

    (Single)
    U.S. – 29.1%
    Canada – 31.6%
    U.K. – 33.5%

    http://en.wikipedia.org/wiki/Taxation_in_Canada

    Are corporate tax rates included in the calculation? They should be as the company will just pass the tax on to the consumer in the price of the goods and to the employee during wage negotiations.

    Looking at the graph in the following link if you add both lines together for the U.S. and Canada you get a total that is very close.

    http://en.wikipedia.org/wiki/File:Income_Taxes_By_Country.svg

    I’m not saying that Canadians don’t pay more. I’m just saying the difference isn’t as big as we are led to believe. The bigger difference is where our respective governments spend it.

    By the way, I am an accountant by training. I’m not just espousing an ideology or belief.

  180. @203 WizarDru

    I have only ever watched any of them a handful of times, so no I don’t have any ready examples. It’s been at least a year, but probably more since I even watched 5 minutes of them.

  181. Having paid tax in the UK and the US the hidden kicker in the US are the state taxes. I live in a state without them, but it’s quite conceivable that if you live in California there’ll be very very little in it.

    The US maintains an illusion of a low tax country but it isn’t really.

  182. Chad @ 205: I ask mostly because I’ve never seen anyone other than hardcore Republicans make the claim that Olbermann spouts hate. I’ve seen plenty of video of him attacking a specific political figure, but I don’t characterize criticism as hate.

    I have seen recent video of Glenn Beck referring to the Ganges river as “sounding like a disease” and calling our president a racist with a deep-seated hate of white people. Rush Limbaugh’s comments on Haiti have gotten plenty of press. Coulters announcement that she believes people who disagree with her should be murdered and that Jewish people could be ‘perfected’ into Christians…well all of them are designed to say shocking or outrageous things to get attention.

    Olbermann may fit into that category, but so far I haven’t seen anything to that effect. Googling controversy and each of their names had amusing results.

  183. Just a comment about the Ganges river reference. One of my colleagues actually plunged into the Ganges on a dare on the last day of a trip there. Wasn’t in the water longer than three minutes but was severaly sick for weeks afterward with some odd virus the doctors attributed to his Ganges Plunge O’ Fun.

    So, Ganges stirs thoughts of disease in my mind too. I’m just sayin :)

  184. @207 WizarDru

    My early comment is much more based on the attitude and tone of the talking heads than on any specific words. They are divisive and extremely unhelpful in the political discussion. This is why Olberman is included.

  185. @182 This is exactly why I like being middle of the road independent. When the far left and the far right start pissing on each other, the stream just arcs right over those of us in the center, and we continue on our merry ways.

    Actually, I think that’s a great way to get pissed on by everybody. Health care reform SNAFU being an excellent case in point.

  186. “The idea that this country is best served by one party, who happens to have maybe 60% on its side, “flipping the bird” to the other 40% and ramming through the biggest government social program ever conceived, is part of the problem, not part of the solution.”

    I beg to disagree. After eight years of Bush’s “my way or the highway” approach, it would be nothing less than poetic justice.

    It amazes me that Republicans feel entitled to any consideration at all. What part of “you ran the country into the ground and lost all your credibility” do they not understand?

    The sad thing is they’re regaining their lost ground with the same tired old Rovian tactics. If they win back their majority we will deserve what we get.

  187. Very well stated. Wish your comments were published on the opinion page of a major newspaper so more people could benefit from your perspective.

  188. Michael at 211: The Republicans have not ‘run’ the country, at least in regards to finances, since 2006. And prior to that year, the Democrats were equally complicit with the Republicans.

    If you want change, you’ll evaluate candidates on an individual basis, not on whether there is an R, D, L or any other label after their name.

  189. This is intriguing. You folks act like there’s a major difference between the parties. I mean, for generations government’s continued growing regardless of party; wars continue multiplying regardless of party; bankers get bailed out regardless of party; with each successive administration, regardless of party, another slice or two of the sovereignty of the nation is donated to global entities like the WTO; 80% of the presidents and their cabinets since Woodrow Wilson, regardless of party, have coincidentally been members of the Council on Foreign Relations; and you still think we have actual choices!

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