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Is health care the stimulus redux?

stimuluscrew.JPG

Remember that picture? I pulled it from The Washington Post's archives. It was taken in February, though it feels further back than that. But back then, this picture was all over. It wasn't worth just a 1,000 words, but $100 billion of desperately needed stimulus funding.

Back in June, I predicted that health-care reform would follow the path of the stimulus: a huge accomplishment that nevertheless feels like a defeat to its supporters. "As the legislation winds its way through the Senate, there will be unpleasant compromises, and unconscionable omissions, and the constant knowledge that though this is progress, it is not sufficient, and the people who stand in the way of a better bill are frequently incoherent or disingenuous."

And here we are. The bill is winding its way through Congress. The awful compromises have begun, the unconscionable omissions glare angrily, and some of the participants are both incoherent and disingenuous.

It's hard to step out from the health-care discussion and examine it dispassionately. But tempers have cooled on the stimulus. It was too small, most agree, but it has helped. We are better off for its presence. People are better off for its presence.

We are also more likely to get more of it. The likelihood of a third stimulus increases by the week. The White House has released job plans and members of Congress have begun talking up everything from 'Cash for Caulkers' to state and local aid.

In part, that's because the recession has been worse than we thought. But it's also because some of the basic argumentation is done. The principle is settled. Government does stimulus. It's part of the job. And does anyone doubt that the total stimulus level will be higher than if the original bill had fallen?

I still believe health care will look more similar than different when the day is done. A good bill will pass, if not a sufficient one. A sum of money will be appropriated, and a basic infrastructure constructed that will be, in the long-run, understood as a tremendous, even unlikely, political victory. The next steps will be easier, because $80 billion is easier to find than $900 billion, and because the argument over whether America has a universal health-care system and whether government provides some of the funding and scaffolding will be over. The money will be there. The scaffolding, too. The universal structure, built around the mandate and the exchanges and the subsidies, will be firmly in place.

At this point, an odd dynamic has developed, in which most all of the right, and some on the left, believe they'd be better served by the defeat of this bill. It is unlikely that they are both correct. But the right has had substantially more experience than the left opposing government initiatives before they can take root and grow into popular entitlements.

Look at the development of Medicare and Social Security, of Medicaid and S-CHIP, the Swedish and Canadian health-care systems, public education. Social Security was designed to exclude African Americans. Medicare didn't cover prescription drugs. Medicaid was mainly for pregnant women and their young children. Canada's system was limited to a single province. There was no University of California at Los Angeles.

It's difficult to conclude that these things slip backward rather than marching forward. The $900 billion for people who need help, the regulations on insurers and the exchanges that will force them to compete, the structure that will make health care nearly universal and the trends that suggest more people -- and more politically powerful people -- will be entering the new system as employer-based health care erodes -- it all makes this look even more like the sort of program that will take root and be made better, as opposed to the sort of common opportunity people should feel comfortable rejecting. It doesn't feel like that now. But then, it rarely does.

Photo credit: By Richard A. Lipski/The Washington Post

By Ezra Klein  |  December 16, 2009; 5:33 PM ET
Categories:  Health Reform  
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Comments

The bill is a giveaway to insurance companies. Where are the controls on premiums that we have to pay? Ultimately, insurers get 30 million more customers, but provide little in return.
What are the penalties for stealth cherry picking?
What are the penalties for the standard practice insurers use (Discuss, Delay, Deny)?
Where are the guarantees keeping people from going into medical bankruptcy even if they have insurance?
Why should I be forced to pay for absolutely crappy service? I don't know anyone who has actually had to deal with a major illness that has anything but derision for how the insurance companies treated them.
If these things are there, someone better lay them out so that we can see some of the benefits from this bill. Right now it looks like building economics. Insurers get the elevator, we get the shaft.

Posted by: srw3 | December 16, 2009 5:46 PM | Report abuse

Ezra, Thanks for being a rational and well informed voice in this debate. It is hard to watch Dean, who I admire very much, try to derail this bill. We can add a public option or medicare expansion through reconcilation in the future.

Posted by: Mollie2 | December 16, 2009 5:51 PM | Report abuse

It's as simple as this:

If this doesn't pass, we have less leverage against the insurance companies than we did before this started. The issue will be toxic, and we will have no way to address insurance company abuses for the next 15 years.

If this does pass, and the insurance companies don't lower premiums in spite of having lots of new low-cost customers, we'll have an even stronger political case for additional regulation and/or a renewed public option.

Plus, we'll cover a bunch of people who weren't covered before, and allow people with pre-existing conditions to do things other than cling desperately to the same job for decades whether or not they like it or are productive in it.

I want to see Joe burn at the stake as much as the next guy, and it is also galling that there is more in here for insurers than anyone else. But the price we pay if it fails is way higher than the problems we face if it succeeds.

Posted by: dal20402 | December 16, 2009 6:01 PM | Report abuse

Ezra ,
I have learned so much from reading your blogs and I agree with almost everything you say HOWEVER this time Howard Dean is right in my opinion.
We have to hold the line somewhere ! This is a huge giveaway to big Insurance and big Pharma and once again the consumer has no protections as srw above says. A very bad is worse than no bill, split it up or as Dean says , take it to reconciliation . Progressives have caved enough ..,

Posted by: sligowoman | December 16, 2009 6:05 PM | Report abuse

The day after this bill passes the fight to include a public option on the exchanges starts.

The fight to increase physician capacity (or otherwise make Medicaid more of a real ACCESS program) starts.

The fight to tighten up the insurance consumer protections. The fight to increase subsidies. The fight to go from universality to affordability. They all start the day after this bill passes.

And all of those fights happen without needing to argue about whether universality is important. Whether uninsurance kills people. Whether caring about the 55 year old widow with that weird lump who's putting off getting it checked out because who knows if she can afford it -- whether that's "Socialist." All of those fights happen without needing to think about 2010, and 1994. All of them happen without worrying about "Barack Obama's Waterloo." This bill opens up a vast new canvas for progressives to paint on, and it's baffling to me that so many want to throw it away.

I am very, very angry at Joseph Lieberman. But that's not worth going back to the drawing board in the middle of the total meltdown of our system.

Posted by: NS12345 | December 16, 2009 6:14 PM | Report abuse

From your pen to God's ear, or at least to the ears of the conference committee.

I hope these are best wishes for the New Year.

Posted by: AMrE | December 16, 2009 6:14 PM | Report abuse

I share the anger of many people who wanted a public option and had accepted that as a compromise to a single-payer system. I share the fear that more customers and larger profits will make insurers more powerful.

However, I do recognize that this is a big step in the right direction through a wall that has been in the way for a century or more.

Additionally, Ezra is correct that the bill will change the system in significant ways that shifts political power from employer groups to the individual market and instills the right incentives that will lead to a less costly, more affordable, and more fair system. I'll be happy to see this legislation signed into law.

Posted by: bcbulger | December 16, 2009 6:16 PM | Report abuse

Oh and this whole "take it to reconciliation" thing is about the level of Senate procedural fanfic. You may not need a filibuster but you'd need 51 votes willing to circumvent established procedure. We don't have them -- NOBODY, not dKos, not Hamsher, nobody has produced anything close to a headcount showing that. I doubt even Brown will go on record supporting it.

Posted by: NS12345 | December 16, 2009 6:16 PM | Report abuse

Time to keep working, just like NS12345 says. Reform was always going to take more than one bill. Passage would be a huge win and would set up easier, smaller battles for later improvements.

Posted by: etdean1 | December 16, 2009 6:24 PM | Report abuse

Unfortunately, this is probably the best that can be done at this time in the system of government that we have. The founders would probably think the Senate has worked exactly as they wished in this instance. What we need to do is to get passed everything that requires 60 votes-get the insurance reforms, the beginnings of cost control, the affordability subsidies built on the end of the medicare advantage subsidies. The nature of the health insurance business is being changed from one where insurance companies have a market incentive to not cover people who are or may become sick into one where the health insurance business is one where everyone must be covered regardless of pre-existing condition and cannot be cancelled because they actually get sick. This is a big change in a big portion of our economy. I am fine with insurance companies making profits. The primary cost problem is not with insurance its with the mostly profit-making doctors and hospitals being paid by that insuranc and yet no one on the left is demanding that the legislation be defeated because it permits doctors and hospitals to still make lots of money. All that the mandate really does is use the existence of the law as a reason why people feel an obligation to purchase health insurance and make them pay a little something if they still dont. And that mandate helps make insurance more affordable for all who are buying it. Reform of this sort is just VERY VERY difficult in our system of government. But once this is done, the other items we want to add can be done through the budget process and only need 50 votes in the Senate. Dems can campaign in 2010 that they have established a system that gives people real health security that the GOP cares not a whit about and that it is the Dems who must be trusted to make any improvements to that system, if anyone is going to do so. The 2010 campaign can be turned into a referendum on what more needs to be done and that should be incentive for those who want more to get out and vote and provide a mandate for doing just that. Nothing would make the GOP happier than for this to fail because at this point that would appear to be a failure of the Dems, not the GOP, and the Dems would pay a big price for that failure and none of the change that anyone wants would happen for a long long time.

Posted by: gregspolitics | December 16, 2009 6:38 PM | Report abuse

if you believe this is a good bill, you're right as far as the insurance and drug companies are concerned.

it is a giveaway to the Corporations.

i hope the villagers are happier now. Joe was there to make sure the middle class gets screwed, as usual.

this is such bad theatre, if they only deviated from the script once in a while.

Just wait till the Republicans get back. oh what fun awaits the American people.

Posted by: BernardEckholdt | December 16, 2009 6:39 PM | Report abuse

Ezra, thanks for being the voice of reason on this. I know the liberals (of which I count myself as one) are apoplectic about the compromises that have been made on this. It's fine to rail against the conservative democrats and people like Lieberman, but this is how sausage is made, and at the end of the day would the liberals prefer to have those Senate seats in Democratic or Republican hands?

At the end of the day this is a good (though far from perfect) bill. It gives 45 million people who are not currently covered an opportunity to be a part of the system, it bans some of the more egregious practices of health insurance companies, and it makes some serious attempts at cost containment.

Do people seriously believe that if we junked this bill and started from scratch our chances would be better in 2010 (an election year) or 2011 (when the Democrats could have an even smaller majority)?

Posted by: sambam | December 16, 2009 7:17 PM | Report abuse

To quote you:
"But from the perspective of consumers, the insurance regulations will be very important in keeping average premiums low and product quality high. That means you need a strong individual mandate, a tight cap on what insurers can spend on things that aren't medical payments, sharp limits on their ability to discriminate on the basis of age, really good risk adjustment (so there's no incentive to cherrypick), and aggressive oversight of annual limits, rescissions, and similar practices (none should be allowed). ... but we don't know what they are yet."

Until we DO know, you should probably pull back on the cheerleading a bit. Coz the devil is DEFINITELY in these details. If they ARE in the bill, your argument will carry a lot more weight.

Posted by: Melinochis | December 16, 2009 7:19 PM | Report abuse

According to T.R. Reid's "The Healing of America," health care economists agree the first step to cost containment is getting everybody health coverage. The current Senate bill does not cover everybody. It also does not put everybody in this country into the same system, which would be ideal for cost containment. But it does get 30 million more Americans health coverage. Yes, they will get coverage in an inefficient system, but this bill is a crucial step toward covering everybody, and thus a step toward real health care reform.
Look at all the other countries with universal health care. When their systems run into problems with costs, they reform the system. They do not seek to drop a group of citizens from the system. It will be the same in America.
Once we get everybody health coverage, we will reform our health care system when we find the costs are unsustainable. We will not react to these costs by dropping health coverage for 30 million Americans.
I am as disgusted as anyone that special-interest money has derailed some of the extremely useful and needed reform in this bill. I am as disgusted as anybody that for-profit health insurance companies continue to be a part of our health care system. Remember, though, no other nation in the world with universal coverage has found it possible for for-profit insurers to play more than a minor role because for-profit insurers are a miserable tool for cost containment.
The closer we get to universal health coverage, the closer we get to the end of for-profit insurance in America. Because this bill covers 30 million more people, it is a step — granted an awkward and nearly noxious step — toward real health care reform and should be passed.

Posted by: jeff01 | December 16, 2009 7:20 PM | Report abuse

If this bill passes, everything that goes wrong in healthcare for the next five years will be attributed to it. It will be hated and repealed before its benefits even kick in. And the cause of progressive reform, true progressive reform, will be set back for a generation.

On the other hand, let this farce of a bill fail, and all the problems that are certain to continue worsening will be blamed on the failure to enact reform. As the insurance companies continue their abuses and rate hikes, the demand for REAL REFORM will be overwhelming and we will get a bill worth passing - perhaps in about 5 years.

Either way, many people will needlessly die in the next five years, with or without this bill passing.

Not an attractive choice, but for me, I'll take Door Number 2.

Posted by: liberalart76 | December 16, 2009 7:28 PM | Report abuse

While recent developments are really disappointing, those who are calling for the death of the reform bill should remember that Ted Kennedy's greatest legislative regret was not seizing upon the Nixon plan. What we are getting here is a national version of the Massachusetts plan and I don't think that is such a bad thing.

Another thing worth mentioning is that current the bill with a weak public option barely squeaked through the House. What makes people like Howard Dean think that a bill that only passes the Senate with the reconciliation process will be approved by the House? With the Senate in a full civil war mode, those few House blue dogs who voted for the original bill will have run for the hills by then. The result? No reform until 2030.

Posted by: joshuavision | December 16, 2009 8:28 PM | Report abuse

Ezra, why no discussion of the fact that Coburn's procedural move today basically blocked a troop funding bill? I recall this being a big deal when the Democrats briefly slowed down a funding bill -- your bosses at WaPo blew a gasket and accused them of lacking patriotism, etc...

If the President was looking for an opportunity to blast the opposition for its single-minded obstructionism, this seems like as good a time as any.

Posted by: NS12345 | December 16, 2009 8:44 PM | Report abuse

After the elitist crazies who dominate Huffpo, Daily Kos, and the rest of the blogosphere, it is a breath of fresh air to read the voice of reason and sanity from Ezra.

Posted by: cmpnwtr | December 16, 2009 8:44 PM | Report abuse

"Nearly universal," I suppose the twenty or so million persons who are projected to be uninsured in ten years hardly count. Mr. Ezra was outraged at Mr. Lieberman, yet does not seem anywhere near equally outraged at the prospect of tens of thousands needlessly dying in the future because they are not included in "nearly universal" health care coverage.

The bills in Congress, especially the Senate, are a near complete sell-out to health insurance companies, the drug industry and other associated special interest groups at the expense of the middle class, as well as persons receiving Medicare benefits.

A health care bill passed will create the illusion of "reform," especially as the propagandists at the white house and among Democrats in Congress go all out to fool the unthinking sheep. There will probably be no further attempted "reforms" for at least a decade or two.

Posted by: Aprogressiveindependent | December 16, 2009 8:51 PM | Report abuse

The reason that so many progressives are upset is in large part due to HOW we got here, not just what is in the bill.

Although I'm very unhappy with this bill, and am very sympathetic to Howard Dean's opinion, I feel that it will be easier to pursue true reforms in the future if we pass what we can in this bill.

However, we could have had a lot more if there had been leadership from the Obama White House.

I'm now convinced that Obama is indeed a master political tactician, and that he got the HCR bill that he wanted. Unfortunately, it is now clear that we Democratic voters have been "punked," and that we didn't elect the guy that we thought that we elected.

So let's get what we can out of this bill. But let's also remember that, going forward, this president doesn't deserve one iota of any "benefit of the doubt" or "let's trust his judgment" on any other policy issues. If he wants to escalate more wars, or continue some other Bush policies, let him do it with Republican votes in Congress.

Posted by: r_wheeler2 | December 16, 2009 9:31 PM | Report abuse

count me with Howard Dean and Markos on this one , its time for Progressives to JUST SAY NO and maybe they will finally get some respect for a change. Instead of courting Lieberman lets see them courting Bernie Sanders to get HIM on board. Pressure can be applied to the Blue Dogs to get a better bill

Posted by: sligowoman | December 16, 2009 10:33 PM | Report abuse

It seems that most of the comments on this blog strongly support a public option for healthcare. I wonder the ages of the posters. How many are actually on Medicare? How many have had major surgeries? Worked to retirement? It seems the voice of idealistic youth abounds on this board. Give some credit to the points made by those that have had experiences. Pay attention to the polls that show less than 50% want major healthcare reform. Place your energy in cutting the waste and fraud from the system (and the federal government), cut the pork out of the budget, and stop bending to the will those that demand, but do not deserve, entitlements. Try to open your eyes and have a little objectivity and a little respect for the opinions of others. Yes, I am an independent; and you may think that makes me a bad person. But, I am not a bad person; I am like the majority of Americans. I don't like the extremes of either end of the political spectrum.

Posted by: my4653 | December 16, 2009 11:01 PM | Report abuse

This bill now contains a giant compromise:

Liberals - you get coverage.

In exchange, it will shift enormous amounts of wealth to the investor class.

That's the deal, and you can judge for yourself if it is a good deal or if we stand a better chance in some other way or whatever. But, the middle class will continue to get milked for the little they have left, but we won't have people dying because our politics are disgustingly corrupt.

Oh... We'll still have a disgustingly corrupt political system, but we'll have bought off one of the worst byproducts from the class that controls the system.

It's terrible politics, too. And, it will expose the left as toothless -- if left to pass. We'll get rolled on everything to come. So, we'll be buying off climate change, 'financial reform', and we'll probably have an EFCA bill that strengthens management's hand. Those are the consequences to me.

Yes, Ezra. In the past, failed efforts led to lesser attempts. But, they were killed from the right. This one will not be. The ball is in our court now. The bill now looks like this:http://www.americanhealthsolution.org/assets/Uploads/healthcarereformproposal.pdf

Posted by: rat-raceparent | December 16, 2009 11:01 PM | Report abuse

Ezra,
The point you leave out is that all of the mentioned benefits programs are funded by the continuing roll over and increase of government debt. The government does not provide benefits within its means.

It is no different from the homeowners who buy much bigger, more luxurious, more expensive houses than they can afford. It cannot go on forever. At some point, the merry-go-round and music stops. At some point, Americans and the American economy will no longer be able to afford its debt load. What then?

The fact that CBO finds a bill deficit neutral is irrelevant when it is analyzing an entitlement program, such as health care, because we all know, from history that the program will be expanded and costs will increase.

As much as there are valid reasons to modify our health care and health insurance systems, it is being done with upfront government funds in the hope of later cost savings that may or may not materialize. Knowing government, savings are always spent. Just look at the unused TARP funds and the government efforts to spend them.

The US government acts like a diner in a restaurant that keeps inviting more hungry people to eat at his table on his check. Unfortunately, the diner cannot afford to feed all his 'new friends' so he uses his credit card, but when the credit card statement comes, he finds the amount is still unaffordable.

Posted by: MiltonRecht | December 16, 2009 11:16 PM | Report abuse

my4653, where do you get off saying that people do not "deserve" health coverage?

The young can get away with thinking that they never need health insurance. Everyone a little older with a couple pre-existing conditions under their belt realize that they are effectively uninsureable on the individual market and have to hope that they never end up becoming unemployed or self-employed.

Posted by: tyromania | December 16, 2009 11:55 PM | Report abuse

Ezra,

Your latest argument in favor of Obamacare really takes the cake. Pass it now, you urge, and it will eventually morph into a full-fledged single payer system like the one they have in Canada.

Won't that be wonderful. When we need medical care, we'll be able to enjoy the same life threatening waiting lines and rationing as our lucky northern neighbors.

Posted by: hartlex | December 17, 2009 12:42 AM | Report abuse

It's NOT a good bill. There is nothing in it to icrease competition and rduce costs. And so most of theose subsidies will simply bacome transformed into insurance corporation profits. It's a huge bailout for them, and that's why their stock exchange prices are rising now!

Really, Ezra, would you pls stop putting lipstick on Lieberman's pig? That's a shame.

Posted by: Gray62 | December 17, 2009 7:23 AM | Report abuse

Good job, Ezra. The Kos-faction et al. seems to be detached from reality here. They will never have another chance at reform -- what other democratic president will EVER try health care reform again? And if Medicare goes bust during a republican admin... bye-bye. Kos etc. have no stomach for pragmatic, literally progressive politics.

Posted by: b4kny2sak | December 17, 2009 8:33 AM | Report abuse

Ezra, hang on, that's not fair. You're trying to make a reasonable point looking at a timeline that extends beyond the next 24 hours!? How dare you! don't you know that with the election of Barack Obama, all progressive plans that had been on the shelf for decades can now be immediately implemented. I mean, Howard Dean's healthcare plan that was the basis for his historic presidential campaign back in 2004 - you know the one that the progressive blog community absolutely loved - I mean that plan can be implemented immediately can't it?

What's that you say? Dean's plan didn't expand Medicare? it didn't have a public option? it was way weaker than the current senate bill (with all its flaws)? My bad.

But yes by all means, let's block this bill by having progressives vote against cloture - because when we say that dems should not join republican filibusters we only mean those dems with whom we disagree. progressives can filibuster as long as they want.

My god, the left wing blogs (save for you Ezra, Benen, Cohn, Marshall et all) have gone absolutely mad. It is just as much of a disgrace to the country as the right wing tea bagger nutsos.

Posted by: homeruk | December 17, 2009 9:03 AM | Report abuse

"...as our lucky northern neighbors."

Stop lying, hartlex. You're either an ignorant liar or a deceitful liar, so choose which one you are and stop being it.

Posted by: pseudonymousinnc | December 17, 2009 9:26 AM | Report abuse

Tyromania....There are programs in effect to cover the truly disadvantaged. It is the notion that "just because I am a citizen that I deserve having the government take care of me" that drives me bonkers! We have made it too easy for people to get on the government teat (and stay there indefinately) in this country....and the size of government has gotten ridiculus! Yes, healthcare reform needs to take place...but in a more orderly specific manner. Put the fradulent doctors in jail, fire the incompetent boobs that screw up the system, and streamline the admin. process! Everyone knows that hundreds of millions are wasted each year...but will do nothing substantial about it.

Posted by: my4653 | December 17, 2009 10:02 AM | Report abuse

"Everyone knows that hundreds of millions are wasted each year..." Like every dime of profit that goes to the private health insurance industry. Are you ready for single payer, my4653?

Posted by: henderstock | December 17, 2009 10:35 AM | Report abuse

Henderstock....Never! There are other ways to mitigate the problems. I don't want a USPS-type organization running my healthcare. Streamline Medicare & Medicaid! If these brilliant legislators would actually do something to improve the system we have instead of spending their time blustering, the system would improve.

Posted by: my4653 | December 17, 2009 11:11 AM | Report abuse

With idiot writers like Klein, the end justifies the means; Do anything, say anything, just pass a bill - ANY bill.

This goofball needs to stay in Washington... because in the real world REAL citizens have to deal with limited resources to handle increasing challenges.

Klein wouldn't know a solution from a sleaze ball. How many people is Klein killing today?

Posted by: wilsan | December 17, 2009 3:33 PM | Report abuse

Obama promised that with the first stimulus, that unemployment would not go over eight per cent. That promise did not come true. When will Americans figure out the Obama over promises and under performs? Bring us together? Over promise and under perform. Government secret meetings on CNN .. never happened. Over promised. Close Gitmo by January. Over promised. Out of Irag. Over promised. Push back the waters ... Oh no one thought that promise was real!

Posted by: edgar_sousa | December 17, 2009 4:03 PM | Report abuse

I read up until the point where you said that the stimulus was too small, but it's working. There was no need to read any further. If you're living in that sort of a fantasy world, you probably believe that this HC Leviathan will actually reduce the deficit. Like I said, I didn't read any further, so I might have missed you actually stating something that ridiculous.

Anyhow, an ignominious defeat, along with my two front teeth, is what I'm wishing for this Christmas. Nothing good can come from a bill where it started out as "comprehensive" reform, if in name only, but then, after throwing everything into the "universal" basket, the parts were horse-traded away with no consideration for the whole. This will be one all-too-significant an example of the whole being far disastrous than the sum of its parts.

Posted by: Dickens615 | December 17, 2009 4:42 PM | Report abuse

Alternative Plan:

Throw out this irresponsible plan!

Why not offer federal incentives (i.e. $1,000 tax credit) for individuals who contribute $2,500 (or 10% of their salary) into an individual health savings account (HSA)? In conjunction provide federal incentives for states to create non-profit, bare-bones, low-cost, high-deductable catastrophic insurance plans, funded equally by the insured/state governments/employers?

I am not sure why Liberals believe they need to pay ungodly sums to the federal government or insurance companies to get health care. Return health care choice to the individual!

Posted by: ELFopportunity | December 17, 2009 4:51 PM | Report abuse

Nice wishful thinking, Ezra. News Flash: when the conservatives, the true liberals, and (remember them?) most of the AMERICAN PEOPLE (check any poll you like)are opposed to a bill, you should trash it and start over. The bill will probably pass, rates for most of the middle class will go up, youth will be angry about paying fines, older people will watch Medicare being cut, and the Democrats will pay a huge price at the polls.

Posted by: jedwards3 | December 17, 2009 5:54 PM | Report abuse

About Ezra Klein: "...he was an associate editor at the American Prospect. Klein has appeared as a guest on CNN, MSNBC, NPR and C-SPAN and lots of online radio shows you've never heard of."

Ezra, where did you go to school? Did you ever take economics? Or even math?

You can't make something out of nothing. You can't cover more people with the same resources and the same system. The truth is the inefficiencies in the current system, done away with, would allow covering all the uninsured with the same resources or less.

Fact, not opinion. I'm seen it firsthand staffing and contracting for hospitals and physicians.

And the real irony...? The biggest source of the inefficiencies...? Greater even than "defensive medicine" due to lawyers! Ladies and gentleman, I give you ... GOVERNMENT REGULATION.

If you don't agree, before you scribble below blah blah blah....
1. Read Aristotle, don't compare the perfect that's not going to happen
2. Check out the cost of procedures overseas using the SAME TECHNOLOGY, SAME EQUIPMENT, SAME SUPPLIES as here in the USA

Posted by: mabarnes66 | December 17, 2009 6:25 PM | Report abuse

On a completely different subject:

Here is a question for the liberals out there. I can understand how Obama's dear aunt Zeituni can stay in the country illegally, after all her nephew is our president but why should we have to pay for her?

Hey Obama get her a plane ticket back to Kenya or pay for an apartment for her. Your aunt is not our responsibility.

Posted by: Ollie7 | December 17, 2009 8:10 PM | Report abuse

Ezra, Ezra,
When you can discount what everyone knows about, and hates about this bill, you're a true liberal. You, of course, know better than the rest of us what is best for us. Well, if the libs pass this, all the Republicans have to do is start their campaigns in January promising to reverse the awful bill the Democrats passed (plus put the unspent stimulus funds back in the federal budget) and they'll replace the tax and spenders. I'm glad you're willing to lay it all out there, and tell us what's going on, with Democrats building the scaffolding for socialized medicine, which we already knew. But WE DON'T WANT IT! There are a million ways to reform health care, and this bill is the worst of the worst.

Posted by: spk2moi | December 17, 2009 11:42 PM | Report abuse

I'm sorry, but listening to a 23 year old bloviate about these kind of issues is just to much for me to take. Do you people know Ezra is only 23? How many people are going to sit at the feet of a baby and receive wisdom on life's great challenges. The internet and it's many benefits are great, but when we get to the point where we are allowing 23 year old's to guide and influence social policy, we have big problems. I used to be 23, a long time ago, I remember. All I can say is I'm glad my ideas were not made social policy. God help us.

Posted by: doug31 | December 18, 2009 2:11 AM | Report abuse

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