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Is There a Deal to be Made on Health Care? An Interview With Sen. Lindsey Graham.

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Earlier this week, Sen. Lindsey Graham was the sole Republican on the Senate Judiciary Committee to vote in favor of Sonia Sotomayor. A few days later, he co-signed an op-ed in The Washington Post with seven Senate Democrats and four other Senate Republicans that began, "We refuse to let partisanship kill health reform." If there's a deal to be made on health care, he'll probably be at the center of it. Earlier this week, I spoke with Graham about the pitfalls of bipartisanship, the Wyden-Bennett bill, and what an eventual deal on health-care reform might look like. A shortened version of the interview appeared in the Outlook session. This longer transcript was lightly edited for clarity.

Is there a deal to be made here?

The bargain that will eventually be made is that Republicans will give in to the idea that every American should have coverage, and it should be mandated. There's resistance to that because it runs counter to some of the doctrine. Democrats need to understand that there won't be a public option any time soon, if ever. The public option in many ways has become what "amnesty" was for immigration reform, or "privatization" was for Social Security. Every big issue gets boiled down to one phrase.

Walk me through your thinking on that. The public option would be competing on a level playing field with private insurers, it's limited in who can purchase it. Why can't this be the compromise?

My belief is that no private-sector entity can survive over a long period of time competing against the government. The public option will be written by politicians. It will be generous. Nobody in my business worries about the bottom line. Eventually, the public option will dominate the marketplace because the political forces in the public sector are different than the economic forces in the private sector. Eventually, the private sector will give way.

You know, we already have Medicaid and Medicare. The private sector covers the middle. If a public option becomes part of that mix, you'll have the whole deal covered by the government. That's why I'm against it. And what I'd like to do long-term is enhance the options available to the retirement community and reform Medicare.

We need to come to grip with the fact that our entitlements programs are unsustainable. We talk about one trillion dollars for health-care reform, but what about the 36 trillion unfunded liability on Medicare? Do you know that 78 percent, I think it is, of Part B premiums are subsidized by the government? Every American on Medicare pays $96 a month. That's 25 percent of the cost of the service. Why should the government subsidize my health-care premium when I retire? I'll have money available. I think we should look at that.

If you could start from scratch, would you scrap Medicare?

No! Medicare was a safety net for those seniors who couldn't afford coverage. I buy into the idea of everyone having health coverage. You can have the public-private partnership in retirement. You can have a government-run system for those who are needy. But above that it's best for the private sector to cover people. There's still a government role. Look at the Wyden-Bennett bill. The government helps people buy their health care in the private sector. To me, that's proper. I don't mind helping people be covered in retirement. We're not going to get rid of Medicare and there's no reason to get rid of it. We just need to be sure it's a well-run program and we can afford it.

The negotiations in the Senate are becoming more poisonous. One of the difficulties, though, has been that people are having trouble distinguishing between those who want to strike a deal on health-care reform and those who really want to kill the bill. How do you tell the difference between a senator looking for Obama's "waterloo" and people who want their ideas more developed in the legislation?

I think that over time you'll tell them apart. You gotta flush them out. There's two ways to fix a hard problem in Washington. You make people afraid of opposing you or you get them rewarded for helping you. There's no fear for opposing Obama's public option, and the reward is for opposing it. Right now, Republicans feel no political exposure from opposing the president's health-care initiative.

One of the things that's caused bipartisanship to fall into some disrepute is that bipartisan compromise doesn't generally mean that the final bill incorporates the unique insights of both sides, but that it trims the ambitions of the legislation. It makes a bill smaller rather than better. Is there anywhere that you can see that not happening on health care?

That's exactly right. I think health care is so personal. Climate change is more of a theoretical problem. The immigration problem is complex but people who aren't in a border state don't live with the consequences of it day in and day out like they do with health care. But every year we fail to reform the health-care system is another year where neither the government nor the private sector can pay the bill. The growth rate of medical costs is unsustainable in the private and public sector and that's why there will be a bipartisan solution eventually. The Republican and Democratic parties won't be able to say "no" forever without the public rebelling.

Where could a compromise make the bill more rather than less ambitious?

The number one thing you gotta remember is you can't look at health care as if nothing else has happened in the last seven months. We've had a downturn in the economy. We've spent a lot of money. The stimulus has been successfully attacked for being more government than jobs. Deficit politics are taking center stage in a way I've never seen. If you come out with a plan that has government involvement Republicans don't like and adds money to the deficit you're going nowhere.

I think there's a consensus around three things right now. That health care is unsustainable as it is and everybody deserves to have some coverage. That we're spending enough and can spend it wiser. And that we're afraid of losing choice and we don't want the government to come in and ration care. Those things have stuck on health care. And you can't underestimate the power of deficit politics. Any bill that's revenue neutral is going to get some attention. Any bill that covers everybody is going to be easier to support than one that relies on darwinism.

If the deficit politics are so powerful, where do you specifically see an opportunity for cost savings? Where can the curve be bent?

The basic problem with health care is this: Have you ever asked a doctor how much it costs to get a treatment? I haven't either. You ever gone to a hospital and asked how much they charge for surgery? When I go to buy a car I go to four or five dealers. Somehow we gotta get people believing that once you pay the deductible it still matters how much money you spend. Third-party payment is unique to health care. It makes the consumer two or three steps removed from their purchase. Cost containment to me is trying to tie the consumer to the service.

The car example is interesting. When I go to get a car I can walk out of the dealership of I don't like the prices. But if I have a pulmonary embolism and am on a gurney, it's hard to comparison shop, or to have anyone do it for me. And so we generally give that power to the doctor.

Can I be my own critic here? Lindsey Graham is wrong when he suggested a health care purchase is the same as buying a car. I realize that. We have an entitlement mentality to health care that we don't have with a car. There is no belief in America that everyone deserves cable television. When someone says they don't have cable TV, I don't worry much. If they don't have health-care coverage, I do worry. We have to understand that a hybrid system has to be built around health care. Most Americans understand we're going to cover the poor and the elderly and the downtrodden. Every American family should have some form of coverage so they don't become bankrupt if it becomes sick. But we also got to be okay with the idea that health-care choices and spending still is real money. That's the problem I think. Real money is still being used here.

One reason that people don't know how much is spent is that their employer pays for their health care. One of the reasons that Wyden-Bennett saves money is that it begins to unwind the employer-based system and let people see the full cost of care. But the White House started this process by saying that if you like what you have, it won't change, which is to say that the employer-based system won't change. And Republicans have made a lot of hay of CBO projections saying that people's health-care coverage could change because they would choose something outside what their employer offers.

I think Wyden-Bennett is a start in the right direction. Employers who offer health care are in a constant battle with insurers and their employees about the cost. You sign your employees up and the insurance company is going to make money and it becomes your becomes your biggest growing obligation as a company and you can't control the cost. Thus you have some employers who just begin to dump employees. What Wyden-Bennett does that's important is that it changes the tax code and takes that money that employers pay and gives it to me. It becomes my choice, and my bottom line comes much more clearly into focus. If I gave you and your family x amount of dollars to purchase health care, you'd be able to go shop around and make a choice and if the incentives were such that you could actually benefit from those choices, you'd make those choices.

But what about the political impediments to that?

You got Republicans arguing give everybody a tax credit. We're schizophrenic. How many of our bills say we'll give a tax credit and you go buy the health care you want it? But then we attack Democrats for doing away with employer health care. It makes no sense. Now, they want to give it to the government. We want to give people choices. Wyden-Bennett is a middle ground. We say we'll do away with the employer's tax benefits and give that money to the individual but you have to agree that every individual has to be covered and there is a basic plan that has to be covered. That's where it breaks down on our side.

Speaking of Wyden-Bennett, which you've co-sponsored, you co-signed an op-ed with Sen. Ron Wyden, Sen. Bob Bennett, and nine other co-sponsors of the Healthy Americans Act that said the bill was proof that partisanship need not kill health-care reform. If that bill came to the floor tomorrow. Would you vote for it?

Yes. There are a couple of things I'd like to see changed, if possible. But yes.

One of the things that's been complicated about that process is that many of the other co-sponsors don't offer that same answer.

There are some people on the Wyden-Bennett bill who are probably there for political cover, because they need to be for something. But that's a good thing, not a bad thing. You've rejected the idea of saying "no" as a safe harbor for you politically. The encouraging thing about this op-ed piece is not so much that everyone would vote for the bill as is. It's that 15 people see the benefit of trying versus just saying "no." And some of them are in states that are very blue or very red.

You know, this is not smart politics for Ron Wyden. He comes from [Oregon,] a very blue state. He's getting the crap kicked out of him. I wanted to jump on this bill like I wanted a hole in my head. But he is so persistent. He was willing to say to Bennett and me and others that he'll get off the public option. I wanted to help him. A guy like him is necessary. A guy like [Utah's Robert] Bennett is necessary. There's a comfort zone in politics where you just say no to the other side and it'll be okay. But the country is changing. Those who step out of that zone will be rewarded. We're a ways off yet, on immigration and health care and Social Security. But the day is coming when the people like Ron Wyden will be seen as the solution and not the problem.

Photo credit: Melina Mara -- The Washington Post Photo .

By Ezra Klein  |  August 8, 2009; 5:33 PM ET
Categories:  Health Reform , Interviews  
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Comments

That guy sounds interesting and thoughtful. I wonder if he knows Senator Lindsey Graham.

Posted by: chrismealy | August 8, 2009 6:19 PM | Report abuse

I want to choose a public insurance option. Why does Lindsey Graham want to restrict my choices?

Posted by: bluegrass1 | August 8, 2009 6:32 PM | Report abuse

Let's see. This was a private interview where he got to express his opinion. There wasn't anybody there to yell him down, threaten to kill him or call him a Nazi. One of the first things Senator Graham and his party should do is to call of the mobs.

Posted by: tinyjab40 | August 8, 2009 7:11 PM | Report abuse

It's a damn shame that Wyden-Bennett isn't in play.

Posted by: SteveCA1 | August 8, 2009 7:19 PM | Report abuse

Graham like nearly all Republicans and many Democrats is hypocritical in ostensibly being concerned about a health care bill adding to the deficit. They did have any similar concerns about budget deficits when Bush was president, wasting hundreds of billions on the occupation of Iraq, reducing taxes in ways that primarily helped the rich get richer.

The Wyden-Bennett bill is another conservative idea, to take away employer provided benefits. The fact some very conservative Republicans support this bill should cause all progressives and moderates to be wary.

Posted by: Aprogressiveindependent | August 8, 2009 7:39 PM | Report abuse

Reform that makes every American a mandatory customer of privatized health insurance is reform in the opposite direction unless someone regulates the bejeezus out of. Who would have thought that it would be a Republican promoting this?

Posted by: SarahBB | August 8, 2009 8:09 PM | Report abuse

Why is taking away employer provided benefits a conservative idea? I don't want to be stuck with whatever health plan my employer picks and I'm not conservative.

Posted by: SteveCA1 | August 8, 2009 8:10 PM | Report abuse

As a Canadian I have to say we are quite satisfied with our health care system (65%). Its not perfect but I have choice and good care. I had prostate treatment within 4 weeks of diagnosis and immediate hospitalization for two heart attacks, I have a great Cardiologist and great care through Nurse Pactionioners for Diabetis. Do I want US type care? No way! Thanks. Get with the program!

Posted by: wallerdick | August 8, 2009 8:12 PM | Report abuse

"Why is taking away employer provided benefits a conservative idea?"

It's not. Single-payer invented it.

Posted by: bluegrass1 | August 8, 2009 8:17 PM | Report abuse

So, if I understand this correctly, congress gives an employer a tax credit which the employer gives to the employee (minus his cut, excuse me, "expenses", of course) and then the employee gets to shop around for some kind of affordable health insurance that will take him and his pre-existing conditions AND also now has to negotiate the costs with his doctor. How does this in anyway make the average citizen's life better? This seems to only add to individual citizen's burdens and let companies off the hook.

Do Republicans actually think Americans are dumb enough to fall for this?

Posted by: caed | August 8, 2009 8:24 PM | Report abuse

Sen. Graham once filed an amicus brief documenting as legislative history a conversation on the floor of the Senate that never took place to the Supreme Court. That's about as big a lie or series of lies that you can tell in government. So take everything the guy says with a grain of salt the size of the Death Star.

http://www.slate.com/id/2138750/

Posted by: jamusco | August 8, 2009 8:25 PM | Report abuse

This interview with Graham proves that Republicans dont' give a rat's ass about universal health care.

Posted by: NealB1 | August 8, 2009 9:00 PM | Report abuse

the typical republican senator (and i certainly consider lindsay as typical of that bunch) who expresses a belated approval of medicare is a damned liar. just as they will be another forty years from now when they express approval for the public option, the same kind of program for the rest of society, if it passes. had lindsay and his ilk been around in 65, you'd have to look up medicare in a history book.

Posted by: jimfilyaw | August 8, 2009 9:02 PM | Report abuse

I like the real-politics aspect of what Graham is saying. He is talking like a tactician in the legislature instead of a crazy person shouting slogans. Whatever the motivation, I am encouraged by this and his vote for Sotomayor. If this is good politics for him, I wish more Republican Senators would see it the same way -- but judging by the same Sotomayor vote, they obviously don't.

Posted by: fairfaxvoter | August 8, 2009 9:04 PM | Report abuse

This is a good interview.

The failure of American Political System is so stark - every thinking person in this debate, include Sen. Graham, sees the value of Wyden-Bennett bill; but collectively we cannot even bring this bill to Senate!

You know if President Obama is as 'honest' as he claims, he owes to Americans that he 'politically rebut or co-opt' Wyden-Bennett bill / approach. But alas, we know that it is never going to happen. If that much honesty and integrity were there in Washington; this Republic would not have been in the 'dog house' where we are. Curiosity - did any journalist ask President (or to his Press Sec. Gibbs in the daily White House Press Briefings too) about what does he think of Wyden-Bennett bill?

Till then, we will hang out to Sen. Graham's words - '... the day is coming when the people like Ron Wyden will be seen as the solution and not the problem.'

What a hopeless political system in the era of 'audacity of hope'.

Posted by: umesh409 | August 8, 2009 9:08 PM | Report abuse

Like rest of the right wingers, Senator Graham is a scam artist and totally untrustworthy. He belongs to a party that is thuggish with no ethics or morality. It is also unpatriotic; it doesn't give a damn about its people or rule of law. It survives by spreading hate and fear. Its aim is to achieve power by any means necessary including threat of violence.

Posted by: kevin1231 | August 8, 2009 9:12 PM | Report abuse

I am really shocked that Sen Graham thinks that seniors ALL pay $96 for Part B. In fact, Part B of Medicare is means tested and increases with income to over $250 a month! Please tell him that!

As for private plans competing with public? He says he doesn't know of any instances where that has worked. Hello!! Come to California. In our Medicaid program in over a dozen counties, we have private plans competing directly against public plans. Neither has driven the other out of the market. Doesn't ANYONE know about this? It's an excellent example of how to construct the playing field so public and private can compete equally. Ezra, please pass this on to Sen. Graham. I'm sure he will want to know the facts.
:-)

Posted by: LindaB1 | August 8, 2009 9:20 PM | Report abuse

senator graham's state does not make insurers cover people with type 2 diabetes-for me, that's means i have to pay $1600 per month for state high risk. i don't earn that. also, i don't think that many people are getting health care thru employers. we need to re-evaluate and see whether that's true. employers can change the plan at any time and and employees have no say or choice. need another option- and i don't need a waiver cause i'm poor, i need health insurance i can pay for.

Posted by: ruqru | August 8, 2009 9:37 PM | Report abuse

THIS IS IT!

Two thirds of the American people want a single payer health care system. If they cant have a single payer system 76% of all Americans want a strong government-run public option on day one (85% of democrats, 71% of independents, and 60% republicans). Basically everyone.

The healthcare reform bills released by the first two committees of the House Of Representatives are excellent bills as I understand them. They are bills with a strong, robust, government-run public option, and an intelligent, reasonable initial funding plan to cover almost all of the American people. They are carefully written, and thoughtfully constructed, informed, prudent and wise. These bills will save trillions of dollars, and millions of your lives. They are also now supported by the AMA.

These are the type of bills that all Americans can feel good about. And these are the type of bills that have the potential to dramatically improve the quality of healthcare for all Americans. Rich, middle class and poor a like. Democrats, Republicans, Independents, and all other party affiliations. These bills have the potential to dramatically improve the quality of life of every American.

The house healthcare bills released by the first two committees should be viewed as the minimum GOLD STANDARD by which all other proposed healthcare legislation should be judged. All supporters of true high quality healthcare reform should now place all your support behind these healthcare reform bills released by the first two committees of the United States House Of Representatives, as the minimum Gold standard for healthcare reform in America.

You should all now support the first two committees bills with all your might, and all of your unrelenting tenacity. These first two House committees healthcare bills are VERY, VERY GOOD! bills for all of the American people. Fight tooth, and nail for every bit of these bills if you have too. Be aggressive, creative, and relentless for these bills.

From this time forward, go BIGGER and DEEPER with the American people every day until passage of healthcare reform with a robust, government-run public option.

FIGHT!! like your life and the lives of your loved ones depends on it. BECAUSE IT DOES!

SPREAD THE WORD

Senator Bernie Sanders on healthcare (http://www.youtube.com/watch?v=RSM8t_cLZgk&feature=player_embedded)

God Bless You

Jack Smith — Working Class

Posted by: JackSmith1 | August 8, 2009 9:51 PM | Report abuse

Very good interview. Graham can be one of the sane ones, even though sometimes it's hard to remember that. I would like to go pop over into an alternate universe where Wyden-Bennett is the bill working its way through the process and see how much support it would really have. Presumably you'd have at least two Republicans for it (Bennett and Graham) and that might be enough, though a lot of other forces would surely come into play as well.

Posted by: Chris_O | August 8, 2009 9:52 PM | Report abuse

Clearly, Graham has a great deal of compassion and sympathy for the "private-sector" entity that is the insurance industry and little for the people whose lives they control.

Graham claims the "private sector" cannot survive competing with the government. Tell that to FedEx and UPS who have been competing with the government for years. The insurance industry cannot compete if they provide bad service and continue to seek profits from delaying and denying payments and charging usurious rates and maintaining exclusive control our medical care and operate in a manner that is harmful to the nation's health both economically and physically.

Graham claims that the public option will be written by politicians. This is your job. To write legislation the people want. 70% want a public option. Presumably, Graham would prefer policy written by the industry, maybe BCBS, one of his top five donors.

Graham claims a public option would be "generous". If that is the case Graham should consider a less generous government entitlement for himself.

Graham claims there is Medicare and Medicaid and the "middle" get private insurance. That is simplistic and unrealistic. 14,000 people in the "middle" are losing health care every day. When a system is already in place with structures and mechanisms to handle health care for all - Medicare - it is just congressional folly and greed to oppose its expansion in favor of an obsolete and uneccessary industry.

Posted by: ophelia3 | August 8, 2009 10:04 PM | Report abuse

umesh409,

Obama has said that he thinks Wyden-Bennett is too radical. But it seems obvious that Obama is against Wyden-Bennet because the unions are against it.

Posted by: SteveCA1 | August 8, 2009 10:21 PM | Report abuse

Tax dollars to keep people healthy should not be used to support private, profit-making corporations. That is precisely why the prescription drug benefit costs more than it should. It is no accident that the VA can negotiate for bulk pricing and why this health insurance reform effort should lean on generics first and brand names only when generics are not available.

Posted by: patr2 | August 8, 2009 11:01 PM | Report abuse

It's nice to hear Lindsey Graham talking without repeating the GOP talking points of the day. I disagree with nearly everything he said. Except I do agree with delinking employment and health care. But unlike Senator Lindsey Graham who has a health care entitlement as a senator and a member of the military, I think all American citizens should have a health care entitlement. Funny how those people who require other people to pay for their entitlement want to shame the ones who are paying for wanting the same thing.

Posted by: cmpnwtr | August 9, 2009 12:43 AM | Report abuse

I want single payer. I think thats the only way to save money and get everyone covered. Anything else is just a bailout for insurance companies who make their money by denieng people healthcare. People, wise up, the less insurance companies help you, the more money they make. Rush Limbaugh is against single payer. Rush has so much money that he could not be bankrupted by any illness. Can most other people say that? If not why listen to him?

Posted by: waawaazaire | August 9, 2009 2:01 AM | Report abuse

Someone who votes to spend hundreds of billions of dollars on weapons and soldiers every year, yet is willing to let millions of Americans go without health insurance to save a few billion dollars here or there, is either a lunatic or evil.

Also, I wish Ezra had asked a bit more about how Graham thinks the public plan will eventually drive private plans to extinction. Does he have any reputable economists to back that up? It's weird seeing this socialist fatalism suddenly appearing on the free-market right. What happened to the power of markets? Why do they believe they are so fragile?

Posted by: Ulium | August 9, 2009 2:18 AM | Report abuse

Graham said Senator Wyden told Republicans and others he will "get off the public option" if they support his plan.

If true, Ron Wyden, a supposed liberal, has sold his soul. If true, Wyden is deliberately going completely contrary to the wishes of his constituents in Oregon, the nation's citizens and the party he represents.

If true, Wyden will be directly responsible for the future failure of the party and the continued suffering of millions by allowing the insurance their continued monopoly and stranglehold on heathcare - just so he can selfishly get "his" bill passed.

As a long-time supporter and voter for Wyden, no words can describe the disgust I feel for him right now.

Posted by: nandssmith | August 9, 2009 3:23 AM | Report abuse

nandssmith,

There is no public option! At least not as you envision it. It's only going to be allowed on the exchange, it's not going to use medicare rates, and only 10 million people are expected to ever sign up for it. And that's IF it even survives the remaining health care debate.

More likely the public option will get scrapped, too. And we'll get stuck with the remaining elements of the health care bill, all of which are pretty much inferior to Wyden-Bennett.

Posted by: SteveCA1 | August 9, 2009 7:12 AM | Report abuse

I've missed in Wyden-Bennet how they are going to assure me my employer gives me the necessary amount of money to actually buy health insurance. With my current employer I once opted out of their health care plan because my wife's company provided better family health care. For opting out of their coverage they gave me $60 a month extra in my paycheck. Yup, health care costs the employer so much for me but when they didn't have to pay it the amount that went to me to not have them pay anything was $60. Fat lot of good that would have done me if I was choosing to opt out of their coverage to go buy a better plan (my employers CDHP plan is better than nothing but a far cry from medicare).

So is this going to make sure employers give sufficient money to shop around. Or are we just going to be a further gift to the insurance industry because we have to buy their insurance without a pooled number of people to negotiate fair pricing. Without that economy of scale the insurance industry will eat us alive. Where is their competition to do otherwise?

Posted by: zattarra | August 9, 2009 8:54 AM | Report abuse

I can see why Lindsay Graham is liked. I'm not saying I agree with him, but unlike many conservative politicians -- or even many conservatives you meet in day-to-day life -- he doesn't mindlessly repeat talking points that insult your intelligence and leave you feeling dumber for having heard them. I have to wonder whether he catches flak for going "off message" when it comes to these things. I'm not saying I "admire him" or "give him credit." After all-- "you're *supposed* to use intelligent arguments you low-expectation-having m-f'er!"

It's kind of funny that Graham feels he is in a position to make demands like "there will be no public option." His party has a 40 seat minority. He doesn't get to make those decisions. The first thing I want to hear out of every Republican politician's mouth when they discuss health care is, "I want to thank the Democrats for not going with a single payer system." Because, really, the entire health care reform plan itself is a concession to Republicans and conservatism.

Posted by: tyromania | August 9, 2009 10:11 AM | Report abuse

I was dismayed in years past with Graham's war stance went he went on the "Iraq tour" with other pro-conflict Senators (and his remarks on news shows--overly inflammatory). He has always struck me as an articulate, bright Senator however, just one I did not like or agree with.

With his recent Sotomayor comments, and in particular, his pragmatic and sensible interview above, I am willing to reevaluate. I am sure there is plenty under the hood that would still infuriate me, but heck, the man sounds like he is reaching out.

I particularly like the retraction on PE and cars--he got off a talking point. No small thing these days. Not sure what to make of his "govt rationing" line, Ezra let him get away with it, but still, if pressed, based on narrative above, he would likely concede private markets ration like stink as well.

Anyway, enlightening and good job.
brad

Posted by: BradF1 | August 9, 2009 10:13 AM | Report abuse

I was dismayed in years past with Graham's war stance went he went on the "Iraq tour" with other pro-conflict Senators (and his remarks on news shows--overly inflammatory). He has always struck me as an articulate, bright Senator however, just one I did not like or agree with.

With his recent Sotomayor comments, and in particular, his pragmatic and sensible interview above, I am willing to reevaluate. I am sure there is plenty under the hood that would still infuriate me, but heck, the man sounds like he is reaching out.

I particularly like the retraction on PE and cars--he got off a talking point. No small thing these days. Not sure what to make of his "govt rationing" line, Ezra let him get away with it, but still, if pressed, based on narrative above, he would likely concede private markets ration like stink as well.

Anyway, enlightening and good job.
brad

Posted by: BradF1 | August 9, 2009 10:16 AM | Report abuse

I was dismayed in years past with Graham's war stance went he went on the "Iraq tour" with other pro-conflict Senators (and his remarks on news shows--overly inflammatory). He has always struck me as an articulate, bright Senator however, just one I did not like or agree with.

With his recent Sotomayor comments, and in particular, his pragmatic and sensible interview above, I am willing to reevaluate. I am sure there is plenty under the hood that would still infuriate me, but heck, the man sounds like he is reaching out. I particularly like the retraction on PE and cars--he got off a talking point. No small thing these days. Not sure what to make of his "govt rationing" line, Ezra let him get away with it, but still, if pressed, based on narrative above, he would likely concede private markets ration like stink as well.

Anyway, enlightening and good job.
brad

Posted by: BradF1 | August 9, 2009 10:21 AM | Report abuse

graham says"But above that it's best for the private sector to cover people"

the interviewer never asked him to explain how he came to this conclusion

bad interview

like joe liberman and some others he has a tendancy to organize small groups of senators who wave the flag of biparisanship as a political negotiating tool

linsay graham made his fame in the clinton-monica fiasco, he is as partisan as you can get

i don't have a problem with partisan politics and neither does graham

his party continues to become a regional party - as though they were replacing the old southern democrat bloc

they drove spector out, is lugar next?

Posted by: jamesoneill | August 9, 2009 10:58 AM | Report abuse

the best part that no one is touching on is the fact that we need to bend the cost curve.

Nothing that any of us purchases reacts the way healthcare does.

Has anyone every thought to ask what a doctor charges now for procedures? He charges Aetna differently than Blue Cross and differently than what he's TOLD he can charge for medicare.

That's the point. I suggest some of you go and buy a house and then after you've signed the reem of paper make sure you ask the attorney at the closing, oh yeah how much was that house i just bought?

oh and the devil that is the insurance indsutry has been working on this transparency issue for years. My God they're horrible.

Do people even realize that you can walk across the street to a different MRI center and pay radically different costs? "But what do I care, its just my copay" is the normal response.

no, its much more than that. Just wait until you get your annual renewal and then come complaining to insurers about it.

Its funny that people hate insurers so much. They're nothing more than a payment/funding mechanism. Nothing more, nothing less. Ya they'll throw in utilization review, step therapy, disease management to spruce it up a bit but in the end they're a basic payment/funding mechanism that is an absolute necessity because I would bet that of the people on here there's maybe .00001% of them that could afford to save up for a lifetime and pay what their ACTUAL medical costs are going to be.

If you can tell me for sure you're going to be completely healthy for your lifetime and then be hit by a bus to kill you instantly then you're right, you don't need insurance. If you're not sure of that, don't think so. Insurers are the most necessary evil there is out there.

Posted by: visionbrkr | August 9, 2009 11:13 AM | Report abuse

*Do people even realize that you can walk across the street to a different MRI center and pay radically different costs? "But what do I care, its just my copay" is the normal response.*

It's not my job to squeeze out the best deal from the health care provider. That's the job of the *insurance company*.

Some people enjoy the push and pull that comes with haggling over a car and the sense of accomplishment they receive from knowing that they got a "good deal." However, I pay health insurance companies so that I don't have to worry about any of that.

Posted by: tyromania | August 9, 2009 1:01 PM | Report abuse

If this is the deal, it is a very, very bad one.

Graham is a wolf in sheep's clothing. Mandates with no public option? The worst of all possible worlds. It is merely cover for forcing people to give their money to private interests who are in it only for the profit, which is a guaranteed profit and full employment act for insurers. Improve health care? Contain costs? Prevent bankruptcies from huge deductibles and co-pays? Not much. Graham states that "Every American family should have some form of coverage so they don't become bankrupt if it becomes sick." Doesn't he understand that the vast majority of those who become bankrupt due to health care expenses, HAD "some form of coverage?" That's the problem. Is he ignorant, or deliberately obtuse?

R's don't have to "give in to the idea that every American should have coverage," without the public option it is exactly what their buddies in the insurance industry want.

"Democrats need to understand that there won't be a public option any time soon, if ever." Sorry, Senator, you need to understand that you can not prevent this.

When every poll shows 60 to 70 percent support a public option, how can Graham say, "There's no fear for opposing Obama's public option, and the reward is for opposing it."

Of course Graham supported McCain Palin, so we know he has keen political instincts with his fingers on the pulse of American opinion and is always on the right side of the issue.

Just because he understands that many in his party are pretty much of the deep end does not make him a friend to any progressive, nor his prescriptions and easier to swallow.

I just hope you don't buy the crap he is serving up, Ezra.

Posted by: mjshep | August 9, 2009 1:26 PM | Report abuse

How callous Republicans are -- when it doesn't concern their own flesh and blood.

Finding out what the market's like for MRI's is probably the last thing you'd be able to do if a doctor told you you might need one.

You don't go to witch doctors for medical advice; You don't go to Republicans for health care policy. It's just not something they're licensed to do.

Let's get this thing passed and shove it down their throats. America will be a better country for it.

Posted by: leoklein | August 9, 2009 2:04 PM | Report abuse

"My belief is that no private-sector entity can survive over a long period of time competing against the government."

Always the same with those Rethuglicans. Belief trumps facts, science, and evidence. And hypocrisy rules. Because at the same time, they are for outsourcing services to the private sector which is so much more competitive, they claim. Are they really that logically handicapped, or do they only play the fool in order to hide the fact that all they care for big business, not the people???

Posted by: Gray62 | August 9, 2009 2:12 PM | Report abuse

waawaazaire we can't afford a single payer. I use 2008 numbers as an example.

For a minimal copay/non profit everyone in single payer system. Subtract the governments 008 share out so we don't pay twice (which was about 46 percent of $ 2.4T in total health spending = $1.104T) your left with $ 1.296T of non government expense against $ 1.125T personal income tax revenue which eats up everything and leaves a 171 billion dollar deficit. To keep paying for the rest of government plus pay for what you intend in new spending (i.e. pick up the the rest of the healthcare tab) you have to double your income tax rate.

The compounded growth of healthcare inflation marches at 2.5 percent a year (regardless of anything) doesn't sound like a lot but it can break you. And Medicare for all would do nothing to stop it.

Out-Of-Pocket Spending was $278.8 billion in 2008.

Posted by: DougHuffman | August 9, 2009 2:19 PM | Report abuse

*Do people even realize that you can walk across the street to a different MRI center and pay radically different costs? "But what do I care, its just my copay" is the normal response.*

It's not my job to squeeze out the best deal from the health care provider. That's the job of the *insurance company*.

Some people enjoy the push and pull that comes with haggling over a car and the sense of accomplishment they receive from knowing that they got a "good deal." However, I pay health insurance companies so that I don't have to worry about any of that.

Posted by: tyromania | August 9, 2009 1:01 PM | Report abuse

the problem is YOU DO PAY FOR IT. just like you pay for the uninsured, you pay for this as well.

When you go to a provider that's out of network but the provider waives costs in full that's because they're billing your insurance 10x that amount. Ya who cares about insurers is the next retort. Well, i do because then they increase our rates in the form of higher premiums.

The fact that people don't see this is just sad.

Posted by: visionbrkr | August 9, 2009 2:42 PM | Report abuse

Choice quotes from economist Timothy Taylor as to if lowering administrative expense lowers total health care costs. (It doesn't).

" Britain's spending on health care, as a share of gross national product, is the lowest of any highly developed country. The methods for controlling cost include letting physical plant run down; having long waiting lists for elective surgery (like hip replacement); and simply denying some care. For example, men over the age of 55 cannot usually receive kidney dialysis. "

" Canada has been relatively unsuccessful in controlling the rise in health care spending. Canadian spending on medical care is well below U.S. levels -- 9 percent of gross domestic product vs. 12.4 percent in 1990 -- but health care spending in Canada is higher than in Japan, or any country in Europe. Canadian health care costs have risen at about the same rate as U.S. costs for the last two decades; in other words, Canada spends less today only because it started from a lower base, and continues to have a younger population. "

Further talking about profits.

In 2007 profits for 10 of the country’s largest insurance companies were $ 12,900,000,000 (billions) out of $ 2,200,000,000,000 (trillions) dollars spent - if I did the math right that's barely over half a percentage point (0.5863636363636363).

Posted by: DougHuffman | August 9, 2009 2:56 PM | Report abuse

visionbrkr, as I said, it is the job of the insurance company to haggle on my behalf. That's why I pay the insurance company: not only to dilute my risk but also to provide me with negotiating leverage that I could not manage on my own. It's the job of the insurance company to know how much the different MRI providers charge and the job of the insurance company to negotiate an acceptable rate.

Posted by: tyromania | August 9, 2009 2:56 PM | Report abuse

Every time I hear someone talk about the need for skin in the game to control health care costs, I think back to Adam Smith, who explains very carefully that one necessity of a viable market is equal knowledge.

Health care will not and cannot respond to normal market forces because most people do not have any idea of what is valuable and what is not. Systems with very high deductibles and co-pays have demonstrated over and over that people make poor decisions about what is worthwhile. They forego low cost prevention like vaccinations and blood pressure management, defer care early in diseases when intervention would be easy and cheap, and avoid useful screening tests like mammograms and colonoscopy. Instead they tend to seek out high tech management like MRI and surgery, and wait until they are deathly ill to seek help. This produces poor results and high costs.

BTW, the quote about health costs as a percentage of GDP is old. Japan now spends the lowest portion of GDP among highly developed countries, and Canada continues to trail the US in costs and growth of health care costs in Canada remains slower.

Posted by: PatS2 | August 9, 2009 4:01 PM | Report abuse

It's blatantly dishonest and cynical for Graham to talk about deficit politics when he and his GOP colleagues pushed for a 2 trillion dollar war of occupation to be funded off budget.

Posted by: cmpnwtr | August 9, 2009 8:29 PM | Report abuse

Graham says the public option will kill the insurance companies?


The only possible way for that to happen is if the companies don't compete. That would otherwise entail reversing their current policy that focuses strictly on maximizing profits.

They make tens of billions in profit every year. They are fighting tooth and nail to keep it that way. Competition, so the argument goes, would cut into those profits.

In other words the public option would allow Americans to choose affordable insurance, better quality and guaranteed coverage than is currently offered. If the big insurance companies want to stay in business their customers need a reason to stay. Satisfied customers are loyal customers.

The insurance companies don't fear the public option they fear shrinking profits. But their profits will shrink anyhow, sooner or later. With insurance already unaffordable for most, premiums cannot go much higher. Once they've purged all the unhealthy people off their rolls what else is left?

With the public option insurance companies would have a better chance of survival. Loyal customers keep businesses in business.

Without a public option for those with a life-threatening dis_eases and no insurance, bankruptcy is all but guaranteed.


Posted by: serena1313 | August 9, 2009 8:51 PM | Report abuse

visionbrkr, as I said, it is the job of the insurance company to haggle on my behalf. That's why I pay the insurance company: not only to dilute my risk but also to provide me with negotiating leverage that I could not manage on my own. It's the job of the insurance company to know how much the different MRI providers charge and the job of the insurance company to negotiate an acceptable rate.

Posted by: tyromania | August 9, 2009 2:56 PM | Report abuse


-----------------------------------------

you're not getting my point. My point is that when you go "OUT OF NETWORK" the insurer loses the flexibility of negotiation. So i guess we could force the entire country to HMO's but that wouldn't be popular either.

Let me give you a real life example to make my point. A friend of mine had hip replacement surgery last October. She found a network doctor to ensure her costs were as low as possible (great idea!). Then the network provider said that well instead of performing the procedure at a network hospital they would do it at another facility he liked better, but don't worry, they've agreed to waive their fees entirely so it won't even cost her what she would have paid if she was in network (it would have been a $500 copay for hospitalization) WOW SIGN ME UP RIGHT!!

If the facility billed the in network rate the insurer would have paid $1500 per day or $6000 (she was in for 4 days).

Instead they billed the rate of $197,000 for the four days and the insurance since by law they have to pay out of network reimbursement of over $100,000.

So basically she saved $500 but it cost her insurance an extra $94,000.

Multiply that out by the amount of surgeries done and you can see why costs are skyrocketing.

Oh and her insurance went up 20% this year. And she wonders why.

transparency is the ONLY thing that brings these things to light.

Posted by: visionbrkr | August 9, 2009 9:27 PM | Report abuse

PatS2,

you are right in your points and one of the things that i've been thinking about that was brought up in the very beginning of the healthcare debates on capitol hill are now never mentioned.

"The Safeway Model". People need to see how they are spending less as a company. They PAY people for wellness. its sad that they have to do that but they do and it works wonders for them. They pay people to take a baseline screening level of tests (cholesterol, body mass index etc) and then if they reach certain incentives they get paid cash. I'd also expect if they maintain that, they'd also get paid. Not a lot mind you (i remember figures around $1000 to $1500) but its worth it to do that and not have to pay for heart disease, diabetes etc.

It makes sense, which is probably why Congress isn't even talking about it.

Posted by: visionbrkr | August 9, 2009 9:34 PM | Report abuse

visionbrkr, you won't see any argument from me when it comes to transparency, but it seems that the criminals here are the doctor and the hospital for basically setting up a scam to get more money out of the insurer. Plus, this scenario *isn't even possible* in a single-payer system. If anything, this is a failure of the "network system," to say nothing of the fact that the insurance company should have been the one to haggle with the out-of-network hospital over how much they were willing to pay.

Also? $6000 vs $197,000? This sounds like a cooked up example invented for the precise purpose of getting me outraged.

Posted by: tyromania | August 9, 2009 9:37 PM | Report abuse

tyromania,

I wish there was some way I could paste an attachment on here so i could provide proof. And it wasn't $6000 vs $197000, it was $6000 vs $100,000 which is still very bad.

and i'm not expressly worried about getting you, one single person outraged and more asking people in general that may read to become informed about what these things cost.


Also you can't haggle with an out of network hospital. they won't hear any of it. they're backed by the law that requires them to be paid at UCR levels which was put in place to protect the consumer but now its being used by some hospitals to make them rich.

Yes a single payer system wouldn't have these issues but they'd have others. I truly believe if we forced these hospitals to lower reimbursements for all comers as they would in single payer we'd find many of them going bankrupt and we'd end up with less hospitals and less providers and i don't think that's right either.

Posted by: visionbrkr | August 10, 2009 7:22 AM | Report abuse

PatS2 I was talking about as to whether the US could expect to reap huge savings by lowering administrative expense I think the answer is still no. This is what's going on today .. I think this true of other areas as well go ahead prove me wrong. Such non cost control would not be sustainable here.

" The health-care sector will continue to consume all available resources and crowd out other priority areas. Spending on health care is set to rise by 6 per cent in fiscal year 2008–09, forcing the Ontario government to reduce non-health-care spending by 4.1 per cent. (See Chart 1.) Moreover, health-care spending will continue to grow at about 5 per cent per year in the two fiscal years following 2008–09. This year, health-care spending will consume nearly 42 cents of every dollar in revenue, up from 36.3 cents in fiscal year 2001–02. "

Found that on the The Conference Board of Canada website (the report is no longer online there.)

Profits why bother? PCT's are Primary Care Trusts in the UK.

" Thus a top-flight hospital like Suffolk East PCT was ordered to impose a minimum waiting time of at least 122 days before patients could be treated or the hospital would lose a portion of its funding. As the Daily Telegraph explained:

In a real competitive market, increased demand can allow prices to rise, thus increasing profits, which allow the market to grow. Efficient producers can then reduce their unit costs and their prices, and so give a better deal to the consumer. The prevailing logic is that the more customers who are served—or products that are sold—in a given period of time, the better the business does. But PCTs have budgets that are predetermined by Whitehall spending limits, and there is no way for them to conjure extra revenue out of the air or to grow their market. As a result, the hospitals that are most successful in providing prompt treatment are running through the finite resources of their PCTs at an unacceptably rapid rate. "

See The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World. by Michael D. Tanner PDF page 24.

Posted by: DougHuffman | August 10, 2009 8:09 AM | Report abuse

" Over the long term, the program is underfunded. According to the Medicare trustees, it would take an immediate 134 percent increase in the Medicare tax rate, or an immediate 53 percent cut in spending, to bring Medicare’s hospital insurance program into long-term fiscal balance. "

See, Can Democrats assure seniors that reforms don’t threaten them? By Tom Curry. And, A SUMMARY OF THE 2009 ANNUAL REPORTS Social Security and Medicare Boards of Trustees

Posted by: DougHuffman | August 10, 2009 8:28 AM | Report abuse

"Healthy Americans Act" Wyden-Bennett, that Bennett is co-sponsor of.

Bennett's bill has an abortion provision.
There is an exception for companies such as DMBA, but the rest of the insurance companies are out of luck.

http://thomas.loc.gov/cgi-bin/bdquery/z?d111:s.00391:

Bennett's bill, S.391 Healthy Americans Act

(3) COVERAGE FOR FAMILY PLANNING-

(A) IN GENERAL- Except as provided in subparagraph (B), a health insurance issuer shall make available supplemental coverage for abortion services that may be purchased in conjunction with enrollment in a HAPI plan or an actuarially equivalent healthy American plan.

(B) RELIGIOUS AND MORAL EXCEPTION- Nothing in this paragraph shall be construed to require a health insurance issuer affiliated with a religious institution to provide the coverage described in subparagraph (A).

Posted by: Utah1 | August 10, 2009 9:49 AM | Report abuse

also the problem with the end of life issues can be addressed with Mr Obama's own words early in the campaign for reform. When a questioner at his "town hall" in the white house that was staged with invited guests, one of them asked how he would handle his loved ones case and he basically dodged the question.

What it will eventually come down to is people will need to save to pay for end of life care that most insurers pay for now but eventually government will have to ration through no fault of their own but for cost sake.

Posted by: visionbrkr | August 10, 2009 10:01 AM | Report abuse

DougHuffman --

Canada is projecting spending 10% of GDP on health care next year. We are projecting spending 17% -- heading rapidly toward 20% and 25%. As you say, Canada has a 5% rate of health care inflation. The US has a health care inflation rate of over 7%. It is true that Medicare has an inflation rate of 5.5%, similar to Canada, but private insurance has an inflation rate of 8% in costs and about 10% in premiums.

Canadians have some concerns about their program, but have made it clear overwhelmingly that they oppose adoption of a US style program.

The quote about the waiting times in England is taken out of context. There are no waiting times in England for acute care or emergencies. There are waiting times for elective procedures, but there are waiting times for elective procedures in the US too. Try to get an opthamology appointment for non-acute care.

In general, everything wrong with foreign health systems is also wrong in the US, in spades. Our system consumes more dollars, has more problems with access, is less effective, and -- believe it or not -- consumes more government dollars than any other in the world. No informed person does not believe it needs serious repair.

The complaints about foreign health care systems resemble complaints that your Mercedes uses too much gas. True, but not likely to be seen as grounds for scrapping either the health care system or the car.

Posted by: PatS2 | August 10, 2009 10:05 AM | Report abuse

PatS2,

one of the problems the US also has is a lack of doctors which is barely being addressed. When you flood 50 million americans (legal or otherwise) out of ER's and into doctors offices the costs will go down but the access won't be there. THey aren't doing enough to address this issue.

Posted by: visionbrkr | August 10, 2009 10:15 AM | Report abuse

PatS2 As I understand it, Medicare pays less than supply and demand this passes extra cost to the private market in the form of higher inflation (amounts to a hidden tax). Were it to pay market rates inflation would be reduced and there'd be closer to equilibrium in stats.

Wyden/Bennett not only pays for itself at going rates but creates surpluses (negative inflation) (amazingly) throughout the system. Both CBO and Lewin concur. Rube Goldberg is sometimes just what you need. Only a regulated market could accomplish this task which is (without new taxes) bring supply and demand in balance.

Posted by: DougHuffman | August 10, 2009 10:37 AM | Report abuse

Not one word out his mouth about the mob tactics being used at the Townhalls. The GOP is not to be trusted. They are defending and determined to prop up and shelter the insurance industry which is fundamentally at the root of the health care crisis. Keep private insurance in place and costs will continue to explode. Why should we give away our money so these leeches in insurance so they can siphon off a growing portion only for bonuses, excessive executive pay and profits to Wall St? Do away with the employer tax exemption and then we might be able to believe what republicans are saying about a competitive market. Right now they are just blowing smoke.

Posted by: motodude | August 10, 2009 11:26 AM | Report abuse

Graham: "My belief is that no private-sector entity can survive over a long period of time competing against the government."

I guess that's why the Postal Service is driving UPS and Fedex out of business. Oh wait, the government can't do anything right or efficiently. Which is it, Senator Graham?

Graham: "Why should the government subsidize my health-care premium when I retire? I'll have money available."

Nice for him. So is he saying that the government should only subsidize the premium of those that don't have the money? Reasonable people could have a civil discussion about that, but it's my understanding that the Republicans consider that class warfare, as anathema as raising taxes on the top 1 percent of wage-earners.

Posted by: fkooyman | August 10, 2009 1:19 PM | Report abuse

Mandates with no public option. Great lets create a bill that costs the taxpayers more just so we can say private industry does it better. Gee! I'm tired of wasting taxpayer money.

Posted by: Judy_L | August 10, 2009 1:47 PM | Report abuse

Since the Republican position has ALWAYS been that everyone should be covered and that there should be no public option, this amounts to saying that the deal to be had is to accept the Republican position without compromise.

I still find it odd, after all these years of shouting that private enterprise always does everything better and cheaper, and using that to justify privatizing one government function after another, that they have now started claiming that private enterprise is so weak and fragile that it cannot stand up to the cost cutting power of government.

I think they are well aware that, in this case, there is no real function for private insurance. It is the purest form of middle man. It adds no value to health care per se, but it adds substantial cost.

Posted by: pj_camp | August 10, 2009 2:02 PM | Report abuse

"Only a regulated market could accomplish this task which is (without new taxes) bring supply and demand in balance."

You're not worried about your own personal bottom line here, DougHuffman, are you? Just wondering...

Posted by: pseudonymousinnc | August 10, 2009 2:53 PM | Report abuse

I'm sorry, but no one seriously interested in economics could use the words "supply and demand" in a post about health care and mean it.

Supply and demand simply have no connection with health care. In fact, the greater the supply (doctors, hospitals, and other providers) the greater the utilization, independent of population and of need for health care. That is a well established fact, with about a gazillion studies proving it.

That said, we are going to need more primary care providers in the future, not surprising since we don't have enough primary care providers now and we are talking about giving 50 million to 100 million uninsured and underinsured people access to health care who haven't had it.

It would be good idea to start working on that now. But that is not an argument against health care reform. To suggest it is is to make the same argument as suggesting that starving people should not be fed because we are short on trucks to get food to them.

As far as the notion that Medicare pays too little, a few facts are useful here. First, according to the AHA, 42% of hospitals actually make a profit on Medicare. Further, the median hospital makes a profit on 77% of its Medicare patients. The remaining balance -- accounting for a 7% overall deficit if you believe the AHA or a 3% deficit if you believe the insurance industry -- needs to be examined. Three important facts need to be looked at: first, what exactly are hospitals counting as costs and are those costs rational? We don't necessarily want to pay for advertising and 7 figure executive salaries when we have our prostates fixed. Second, do these figures include an accounting of the fact that hospital billing offices spend roughly two to four times as much dealing with private insurance as Medicare? Cost accounting for Medicare should obviously include the items where Medicare saves hospitals money as well as costing them, and data I have seen does not appear to do that. Third, having examined both one and two, we may need to do some ammendment to Medicare payments.

Again, the logical argument here is to repair, not to give up.

Posted by: PatS2 | August 10, 2009 5:45 PM | Report abuse

You realize that Lindsey Graham lied to the Supreme Court during the Hamdan v. Rumsfeld case don't you? Sure some of this stuff seems to be in complete sentences and maybe even thoughtful, but you are talking to someone that lied to the Supreme Court. The sort of person who doesn't think twice about lying to the highest court in the land has absolutely no qualms about feeding you a bunch of B.S.

Posted by: flounder2 | August 10, 2009 5:49 PM | Report abuse

I noticed that some people use the term "universal health care" as if that meant something obvious. Does it mean health care for each in accordance with his needs? Then that is impossible, because needs are so various and means are necessarily limited. If one refers to the French system, anyone can usually get treatment--if available. But budgetary limits means that what is appropriate is often unavailable. Like where is a taxi when you need it? Even if taxis are free, they cannot always be available.

Posted by: RobbyS | August 11, 2009 12:13 AM | Report abuse

On topic: I conclude that Mr. Graham is a man without principles. The principled liberal and the principled conservative. I think, can agree on that.All he wants to do is make a deal, like a lawyer trying to settle out of court. He doesn't care about who wins or who loses; he just wants a share of the action.

Posted by: RobbyS | August 11, 2009 12:18 AM | Report abuse

I would also like to "choose" the public option. I choose NOT to have my already usurious tax burden increased to finance the perpetual taxpayer bailouts that Fannie Med/Freddie Doc will require.

Somehow, I don't think that's the kind of choice you folks will allow.

Posted by: marincanuck | August 11, 2009 1:07 AM | Report abuse

I am going to ignore most comments as Mr. Graham's character which I can hardly attest to but I will say he comes off very well in the article perhaps it is indeed a stringer. But certainly his words are clear and concise and discuss the policy in such a way that summarizes the severity of the situation and how dangerous the impediments to it are namely Joe Senator trying to please the Rush Limbaugh base. Or Al Senator trying to appease the Hollywood crowd.
Still Medicare and Medicaid are going to bankrupt the nation at no one has the "intestinal fortitude" to quote Mr. Hulk Hogan to get in the way of the speeding train. Mr. Graham pretends to be the person and perhaps he is. But in the meantime the real question is what the heck to do right now if you have no health insurance and are waiting for a magical Washington bean. At http://www.ECHealthInsurance.com we have tackled these goals albeit only for Florida and made health care available to every single Floridian if they will just get off of their ottomans and put down their remote controls and walk their behinds into our office or even pick up the phone and call us as we have found the utopian health care plan which was really there all along and they call it the County Health Plan. Its usually free and its amazing and if you don't qualify then you were probably trying to get something for free that you should be paying for anyways. Either that or you should be on Medicaid. Perhaps one day we will shed our wide reaching flashlight onto your state and identify all the free health plans in it but should you feel inspired perhaps you can tell your neighbors to investigate the current plans which I can assure them is actually better then most of the schlock that we sell.

Posted by: jeremyeast | August 11, 2009 3:46 AM | Report abuse

Some info about the bill discussed (copied from another site... just trying to inform those interested):

The Wyden-Bennett plan includes a number of positive features.

According to the estimates of one independent analysis, it would succeed in providing health insurance to nearly 99 percent of Americans and thereby almost attain the goal of universal coverage.
It would rely on group health insurance made available through new state-based purchasing pools, rather than the unregulated individual market, to pool risk so coverage is more accessible to people in poorer health as well as to those who are healthy.
Premiums for the health insurance offered through the state-based purchasing pools would be “community-rated” — that is, sicker individuals would not be charged higher premiums than healthy people, as is the case in the individual health insurance market in many states today.
It would set standards for the health insurance plans offered through the new pools, requiring plans to be actuarially equivalent initially to the current Blue Cross Blue Shield Standard Option available to federal employees.
It would limit premiums and cost-sharing on the basis of income in an effort to ensure affordability for low- and moderate-income individuals. It also would prohibit any cost-sharing for preventive, chronic disease management and chronic pain management services.
It would automatically enroll families in health insurance plans and enable families to retain the health insurance plan in which they are enrolled when a breadwinner switches jobs or becomes unemployed.
It would make the financing of federal subsidies for health insurance, particularly those provided through the tax code, more progressive than under the current system.
It seeks to tackle the problem of rising health care costs by incorporating a number of financial incentives designed to encourage individuals to enroll in more cost-effective health insurance plans and to slow the rate of growth in health spending over time. It also includes a number of financing mechanisms. As noted, the Congressional Budget Office and the Joint Commission on Taxation together estimate that the plan would be roughly budget-neutral by 2014, assuming the plan was enacted in 2008.

Posted by: Averagecitizen | August 11, 2009 7:44 AM | Report abuse

As far as too much supply leading to over utilization of technology thats the point of cost effective guidelines and having participation through copay based on income (price sensitivity /shared responsibility). Better to have food stamps than scarcity based on the sophistical idea of price rationing. What would happen if you made cars a generic right Yugos to Maseratis all one big public good free as the air courtesy of Uncle Sam's Club and high taxes? Would quality say go to the middle or plummet to bottom? Veterinary Care Faster Than Health Care for Humans? Why does supply and demand work for animals but not people?

http://www.thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=M1ARTM0013232

Posted by: DougHuffman | August 11, 2009 11:09 AM | Report abuse

HAA would reset the tax exclusion so that benefits greater than what members of congress are now eligible for were taxed - everyone else gets a credit and a 4x federal poverty subsidy to pay premiums (there are no deductible) based on income including totally free care (maintenance of effort payments). Maximum out of pocket is currently & 4,000 a year. Cadillac plans insulate people from the market and help drive inflation. The plan (I guess) could be modified to let people keep what they have with a upgrade option to the standard plan were they to desire it later. What HAA does is transfers the benefit level of congress to every single American, where Medicare for all is a lie this the real deal.

" If Congress taxes health care, the revenue has a chance of rising with health spending. A health tax will also create an incentive for workers and businesses to slow the growth of health spending — thus reducing the amount of taxes needed to pay the nation’s health bill. "

Posted by: DougHuffman | August 11, 2009 11:52 AM | Report abuse

pseudonymousinn the bottom line with HAA is everyones premiums would go down but I guess that would be a tough sell hey wait a minute.

Posted by: DougHuffman | August 11, 2009 12:00 PM | Report abuse

I beleive this new legislation is a big win for consumers who is ready to buy a new car with fuel efficient models

Jhenry
Blogger
www.cashforclunkersfacts.info
http://www.cashforclunkersfacts.info

Posted by: jhenry1208 | August 12, 2009 6:43 AM | Report abuse

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