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The heroes of health-care reform


Right on the heels of Joe Lieberman trying to kill the bill because it had a Medicare buy-in proposal, Howard Dean is exhorting Democrats to kill the bill because it doesn't have a Medicare buy-in proposal. Sigh.

So let this serve as an encomium to Ron Wyden, Tom Harkin, Chuck Schumer, Sherrod Brown, Chris Dodd and Jay Rockefeller, among many others. All of these senators could have been the 60th vote. All of them had issues they believe in and worked for. Chris Dodd built and passed a bill. Sherrod Brown whipped up liberal support for the public option. Chuck Schumer spent countless hours devising compromises and searching for new paths forward. Ron Wyden spent years crafting the Healthy Americans Act, getting a CBO score, pulling together co-sponsors, speaking to activists and industry groups and other legislators. Jay Rockefeller has spent decades on this issue and wasn't even invited into the Gang of Six process.

But you know what? They're all still there. Because in the end, this isn't about them, and though their states and their pet issues might benefit if they tried to make it about them, the process, and thus the result, would be endangered. I've said before that the remarkable thing isn't that Joe Lieberman acts the way he does but that so few join him. The legislative process is given a bad name by the showboats and grandstanders, but the only reason it functions at all is because the vast majority of the participants keep their role in perspective.

If this bill passes, it will not be because Lieberman was pacified. It will be because senators such as Rockefeller, Wyden, Schumer, Harkin, Brown and Dodd swallowed their pride and their passion and allowed him to be pacified. They are the heroes here, and beneath it all, their quiet determination made them the key players.

Photo credit: By Jose Luis Magana/Associated Press

By Ezra Klein  |  December 15, 2009; 5:22 PM ET
Categories:  Health Reform  
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Ezra, you think Dean wants to kill it because of pride or pique or anger? That's just not the case. He believes it doesn't contain real reform. Lots of people believe that. I know you don't, but it's an honest policy disagreement, not a process disagreement. (There is totally a winning argument that the WH screwed the politics from the beginning, but that is a different post.)

Even the watered-down level playing field public option would have been a trusted safety valve for people without coverage who did not trust any insurance company. Some people without insurance would have opted for private plans. That's fine, we wouldn't have to worry about them. ALL people who already have insurance but can't really afford it would be getting subsidy relief through the exchanges (I believe), even if they were stuck in a plan they didn't like. Wyden was working hard to get them even better choices, but they were OK.

But at bottom, it was going to be the mere existence of a public plan that mattered. Over time, it would grow and develop a more balanced risk pool, which would have allowed it to control premiums and gain real traction in negotiations with providers and pharma. It would have been a living, breathing, natural bridge to Medicare. It would have been a game-changer. THAT's why it was killed.

A public option, or something that achieves the same competition, choice, and cost control goals, is absolutely necessary for the physical and fiscal health of the nation. Now, without it, the prognosis remains unchanged. Premiums WILL rise unchecked; more people WILL lose their coverage, and be penalized for it; and our country WILL go broke.

Posted by: andrewlong | December 15, 2009 5:40 PM | Report abuse

The term heroes has been devalued for quite some time. Calling a bunch of wealthy senators with excellent health coverage heroes for what is essentially health insurance reform and should have perhaps been legislated long ago is presumptuous. I suggest that pragmatic is a better word.

Posted by: goadri | December 15, 2009 5:41 PM | Report abuse

edit: I suggest they are pragmatists.

Posted by: goadri | December 15, 2009 5:48 PM | Report abuse

They're not heroes until they corner Joe the Ho in one of the Senate's more dimly-lit corridors.

Posted by: pseudonymousinnc | December 15, 2009 5:57 PM | Report abuse

"Howard Dean is exhorting Democrats to kill the bill because it doesn't have a Medicare buy-in proposal"

I guess that means Howard Dean doesn't care if people die, all over such a picayune things as the Medicare buy-in proposal.

Posted by: ostap666 | December 15, 2009 5:58 PM | Report abuse

There's nothing heroic about mandating the purchase of a consumer product (Private Health Insurance) that has been shown, time and again, to be a rip-off to consumers. The failure of Congress to offer a public alternative, with the much-ballyhooed 60-vote super-majority, is just that: a failure.

There's nothing particularly heroic about denying that, and nothing wrong with urging members of congress to take an alternative path (reconciliation, etc.) to get a better outcome. Dean's recommendation is the truly 'pragmatic' one, since it has the best chance of actually bearing results, rather than further excuses for mediocrity.

Posted by: andrewbaron78 | December 15, 2009 6:02 PM | Report abuse

A large percentage of Democrats has always opposed the mandate. The subsidies and public option mollified them, but only if those things were as substantially good as the mandate is substantially bad. That is no longer the case; it's not even close. The current objection is out of principle, not pique, and it is consistent with positions that have been explicit for at least a year. The senators you cite may have different priorities, but that doesn't make the fact that they prefer this diminished bill to nothing heroic. It just means they aren't very eager for change -- and we already knew that. Centrist Democrats compromise! News at 11.

Posted by: Ulium | December 15, 2009 6:10 PM | Report abuse

I have a question.

Can't we:
1) Pass the senate health care bill after making Holy Joe happy,

2) Pass the exact same bill through the house, (so no need for a second senate vote) and then ...

3) The second it's signed push a public option bill through via reconciliation?

I would deeply enjoy the look on Holy Joe's face when the penny dropped.

Posted by: GeorgeKay | December 15, 2009 6:20 PM | Report abuse

Well, I don't think it's heroic of you to write a pretentious "Sigh" in response to Dean's criticism.

When you posted your own criticism the other day about how the latest version of the bill won't even prohibit insurers from setting limits on coverage for grave, costly illnesses, a commenter asked you where the tipping point was when you would stop supporting the bill. Howard Dean has evidently passed his own tipping point. Perhaps he's a "hero" for holding out for so long -- after all, following his insistence on the public option, he "swallowed his pride" and supported the bill anyway once that got compromised out.

How bad must the bill get before an end to this talk about heroes and pride?

If you read Dean's statement, you will also note that he's not for torpedoing the whole reform effort. He wants to use reconciliation.

Posted by: Former_Prospector | December 15, 2009 6:23 PM | Report abuse

I think senators who come out great after this year long ordeal are:

- Jay Rockefeller
- Ron Wyden and you forgot
- Max Baucus. (I hated him, but he delivered the high water mark of this bill - Sen. Snowe's vote).

Principle fault lies with Sen. Reid - with such a long shot on PO; he should have been straight and had never attempted to be 'half smart'. Looking back you would realize, real damage is the 'let down of Progressive folks' in this journey.

Sen. Lierberman was right to point when Medicare buy-in was proposed; it was a start of the 'single payer system'. I do not remember Ezra you reported like that or not. But face it, it was more to the Left than the original PO. There was no business for Sen. Reid to introduce PO in the first place and then you take Liberals to further on a ride by opening gates for a 'single player' system. Why would Progressives not get provoked and feel let down?

This really gives the impression that Senate Democratic Leadership 'used' Progressives. I think this is one of the worst politics here. Shame on American Democracy.

Look, I do not support PO or many of the Liberal / Progressive policy measures. I am content with Sen. Baucus's committee bill. But treatment of Progressives leaves a bad taste and indeed that was avoidable politicking.

If every time to pass any legislation Democrats are going to extract 'this much emotional price' out of their Base; the Base will not remain.

Truly speaking Sen. Reid, Sen. Schumer and Senate Dem Leadership at least owe apologies to the Liberal Base.

Posted by: umesh409 | December 15, 2009 6:24 PM | Report abuse

It's also unfair of you to equate Dean's opposition to Lieberman's opposition in your 1st paragraph.

Posted by: Former_Prospector | December 15, 2009 6:25 PM | Report abuse

Ezra, perhaps since you don't pay directly for your insurance, you don't see the perverse incentives that this bill can create.

A weak public option or medicare is vastly different from none at all because a weak option can be improved when real data comes in, while a non-existent option never even gets started.

Responding to your previous post, what keeps the insurance companies from raising the premiums more than 7.5%/yr?

(for that matter, what keeps drug companies and hospitals from raising their prices? insurance companies surely would find it easier to pass along the increases than deny the coverage.)

and how would the government penalize insurance companies when the audience is fully captive? wouldn't it be like penalizing tobacco companies? the fines simply result in higher prices for cigarettes?

Weird incentives happens when there is a mandate for a captive audience and the financial analysis is static.

It's responsible for Dean to say, okay, if this is where we're at. let's expand medicare now, cover some people, pass a smaller bill at lower cost, instead of cementing in a system where insurance companies can extract the consumer benefit to use against us.

Posted by: dieselmcfadden | December 15, 2009 6:30 PM | Report abuse

Now that the public option has been ditched and it will be all private health insurers, Americans can look forward to the savings from outsourcing overseas claim processing.

Americans can prepare for the conversations with overseas claim processors. The Hindu word for heart is dil. The Oxford Hindi-English Dictionary sells for under $30 on Amazon.

This dictionary will also be useful in conversations regarding your account in your American bank or the computer you bought from an American company.

Posted by: bsallamack | December 15, 2009 6:30 PM | Report abuse

Heroes? The correct word is Cowards! A mandate that forces people to spend money they don't have on crappy insurance, taxes on people with good health plans, nothing for people who already have health insurance except more taxes, no limits on premiums, no limits on profits, no new competition, etc. This is a bill created by cowards.

Posted by: AuthorEditor | December 15, 2009 6:33 PM | Report abuse

"If this bill passes, it will not be because Lieberman was pacified. It will be because senators such as Rockefeller, Wyden, Schumer, Harkin, Brown and Dodd swallowed their pride and their passion and allowed him to be pacified. They are the heroes here, and beneath it all, their quiet determination made them the key players."

See this is why I think a really robust process to reform Dems' caucus rules is worth pursuing. There is something shockingly ugly about the fact that the enormously complicated and difficult work contributed by these Senators can be destroyed in an offhand manner by a single egomaniac halfwit who shamelessly abuses his considerable power.

The current rules structure makes "heroes" like these -- people who are genuinely interested in the policy, who take time to craft compromise, who attempt to find a workable middle ground between policy necessity and political expedience -- irrelevant benchwarmers when it comes to the actual passage of the bill. I find it hard to believe that the majority of Democratic Senators support such a result.

Posted by: NS12345 | December 15, 2009 6:38 PM | Report abuse

If anyone actually wants a true health care reform bill with a very strong public option there is only one way to get it.
What is needed is a nation wide three day no work protest. This will have an effect on our government for the loss of revenue will be huge. They will also be notified via this action that if nothing is done then a longer No Healthcare No Work Care strike will be planned. All the talking, emailing, blogging in the world will result in a big fat 0.
Organize a Nationwide work stoppage for three days starting December 28th through December 30th! Spread the word and demand your public option healthcare now with action!

Posted by: raypc800 | December 15, 2009 6:42 PM | Report abuse

"If this bill passes, it will not be because Lieberman was pacified."

This statement is completely ridiculous. OF COURSE it will be because Lieberman was pacified. He's made it his objective to prevent a bill from being passed if he is not pacified.

Posted by: TheBagman | December 15, 2009 6:45 PM | Report abuse

Of course it is about Joe.

It is only about Joe.

Everything is about Joe.

And when cap and trade comes around, that will also be about Joe. Mark my words, he isn't finished.

Posted by: pj_camp | December 15, 2009 6:53 PM | Report abuse

Your "Sigh" in this article is the commentary of a cub reporter on people who have been playing this game a very long time. Dean is trying to make this bill a better bill. Dean is trying to show that Obama and the Dem leadership cannot take the "Left" for granted.

Your faith in comity overlooks many of the dynamics of power.

Posted by: michaelterra | December 15, 2009 6:54 PM | Report abuse

Yes it is an imperfect bill and not what I wanted. But it is my understanding that the penalties for not buying insurance are pretty mild. True, any penalty is a pain, but it is not all that draconian, and so maybe the ins cos will not get all the people they are expecting. And maybe they will offer cheaper, catastrophic plans that are what many younger, healthier people want. And considering that many people will have subsidized insurance that is better than what they had before, maybe this part isn't so bad.

Cost control has two aspects, and insurance profits are much the least of it. Provider profits are a much bigger factor, and this bill does have many programs to begin to cut costs and to find out how best to cut costs. That is one of the big virtues of the bill, as Ezra has written many times.

I agree from the perspective of 67 years with Ezra that if this fails we won't get something better. We won't get anything for another 6-10 years, whrn a new group of people wants to try something.

With this bill it ccan be improved on over time, such as resurrecting the Medicare buy-in at 50 or 55 when Lieberman is gone in 2013, along with Lincoln and a couple of other obstacles and Schumer or Durbin is Majority Leader.

Posted by: Mimikatz | December 15, 2009 7:03 PM | Report abuse

If we force the insurance companies to cover more people and we force people to buy insurance without controlling costs, isn't that basically an unfunded mandate? How does it improve the health care system in the long term? Wasn't the public option a large part of cost control? Doesn't this amount to speeding up the collapse of the health care system, with the hope that this forces us to confront this problem more quickly? In Dean's defense, this sounds like a terrible idea, but, in Ezra's defense, maybe this is the best we can do.

Posted by: TheWacoKid | December 15, 2009 7:24 PM | Report abuse

They're losers. Too weak to press for reconcilation, the only way to reign Lieberman and Nelson in. Instead, their strategy was like believing in fairy tales. Losers.

Posted by: Gray62 | December 15, 2009 7:39 PM | Report abuse

Ezra -- This looks like the beginning of a "Profiles in Courage" list. I would add Baucus; he began working on this more than a year ago, and he did a lot of heavy lifting in SFC.

Posted by: BillKramer1 | December 15, 2009 8:07 PM | Report abuse

Baucus!? If Baucus hadn't wasted *months* watering down the bill in the hope of appealing to Republicans who will never vote for it, it would have passed ages ago, when the political environment was much more favorable. We would have had a better bill, and we'd now have moved on to other issues.

Ezra, if you have the opportunity to be the 60th senator and dictate the contents of the bill, then does failing to take that opportunity to make a bill that provides better coverage mean that you're responsible for all the excess deaths caused by the worse bill that results because you abdicated the power to Lieberman instead?

Posted by: KCinDC1 | December 15, 2009 8:34 PM | Report abuse

Heroes don't cave in and compromise. There is nothing left in this bill but a big shaft to the consumers.

Posted by: Single_Payer | December 15, 2009 8:35 PM | Report abuse

It's nice to see ezra get a tingle down his third leg over his "heroes".

He win the EJ Dionne I am a kool aid drinking idiot for Tuesday.

Congrats Ezra.

Posted by: manbearpig4 | December 15, 2009 8:58 PM | Report abuse

"Heroes don't cave in and compromise."

oh yes, they most certainly do.
it is the pompous ones who stand on ceremony. above compromise. above acceptance and apology.
heroic people pave their road with sacrifice, acceptance that life isnt always fair, one doesnt always get what one wants, and in order to live, one must make compromises, and more times than not, one must accept less than one hoped for, and do the best with it. things dont always work out to the best of matter how hard we try.
and the realization of that is a learned wisdom, and in itself, a heroic thing.

there is no stark black and white in this lifetime. we live in a million shades of gray.

if you think that the simple, noble heroes of this world dont walk that walk, then you are sadly mistaken.

Posted by: jkaren | December 15, 2009 9:02 PM | Report abuse

Tweaks in insurance regulation are "heroic"? Because that's what we're left with - that, and a clone of the same Massachusetts healthcare plan that's underfunded, oversubscribed and failing.

Oh, and I understand those heroic changes in insurance regulations will be enforced by the traditionally industry-friendly state governments, and not the feds.

Really, Ezra, try not to be so gullible. It's embarrassing.

Posted by: uberblonde1 | December 15, 2009 9:17 PM | Report abuse

If the current bill fails there will be no health insurance reform in the foreseeable future. This will be a catastrophe here in Michigan, where I live, and elsewhere in the industrial midwest. I simply can't understand the carefree attitude of Dr. Dean and his many admirers posting in this thread. For God's sake, people, think of the consequences of your acts.

Posted by: sjj1231 | December 15, 2009 9:53 PM | Report abuse

And if the bill passes, the health insurance junkie gets $800bn of smack to cure its habit.

Posted by: pseudonymousinnc | December 15, 2009 10:10 PM | Report abuse

I think that Ezra has found that the worship of "savvy" is a rewarding line of work as a Washington-based political reporter.

Posted by: michaelterra | December 16, 2009 12:18 AM | Report abuse

Why even bother to blog for a major news outlet instead of a hyper partisan site like Daily Kos when you absolutely refuse to believe people can oppose this bill in good faith and for legitimate reasons? Ezra Klein seems to be completely unaware that a majority of Americans oppose this absolutely terrible bill. Opposition is either attributed to ego problems or is equated with murder. This blog epitomizes the left-wing echochamber mentality. Now you only need to start making anti-semitic jokes about Lieberman and you will be set.

Posted by: Bob65 | December 16, 2009 12:20 AM | Report abuse

So now individuals who are raising taxes, forcing us to buy insurance against our will, slashing Medicare and spending trillions of dollars we don't have are heroes? The notion that those Senators are heroes may well be the stupidest thing I have read on this entire issue, even more stupid than the ridiculous claim that subsidizing health care for millions will somehow save money. Because spending more money is the same as saving it, evidently.

Posted by: Bob65 | December 16, 2009 12:22 AM | Report abuse

"I guess that means Howard Dean doesn't care if people die, all over such a picayune things as the Medicare buy-in proposal."

When are you idiots going to learn that opposition to this terrible bill is not tantamount to murder? Those making such claims are essentially stating that ANY opposition, AT ALL, to this bill means one doesn't care that people are dying. In other words DISSENT=MURDER. Yeah, that attitude is really healthy in a democratic free society.

Posted by: Bob65 | December 16, 2009 12:24 AM | Report abuse

"But it is my understanding that the penalties for not buying insurance are pretty mild."

We live in a free society. The notion that I should have to buy health insurance against my will is absolutely insane. Any penalty at all is too much. Furthermore, the House bill can throw you in jail if you don't buy insurance. It seems that when it comes to choice, the Democratic Party only thinks about abortion. But when I choose not to have insurance, well, we can't have that can we?

Posted by: Bob65 | December 16, 2009 12:28 AM | Report abuse

hey ezra, who slipped you the naive pills? heroes? do you remember (maybe not) lucy pulling the ball away from charlie brown just as he's about to kick it. happens all the time. that's what these heroes do, time after time after time. they are also practiced in the arts of swallowing pride, so practiced they have no pride left.

Posted by: tintorelli | December 16, 2009 12:29 AM | Report abuse

A mandate is the only way a ban on preexisting condition discrimination can work. If you want people with cancer (or virtually any other chronic condition) to be able to buy into the system, you're going to have to accept a mandate.

Stripping out the mandates as Kos, Dean, and the others have advocated is just irresponsible for this reason. You can't kill one without the other.

Posted by: NS12345 | December 16, 2009 12:41 AM | Report abuse

So Ezra,
Is this:

Just left wing paranoia? Or a plausible outcome of this lousy bill? What do you think?

Posted by: michaelterra | December 16, 2009 1:49 AM | Report abuse

Cowards ... who I am sure got their own payoffs for their states in the managers amendment and once that was done, dried their crocodile tears, booted the public option, and will gladly and enthusiastically vote for this insurance industry dream bill.

These politicians have no soul, once you start to think they do, you are setting yourself up for a big let down.

Posted by: cautious | December 16, 2009 3:48 AM | Report abuse

Heros might be a bit of an overstatement, but your point is well made and valid.

Health care reform should have been a lot better and there is plenty of blame to go around in the Senate. The Senators you named are not the problem; they struggled through under the circumstances. I prefer to focus my rancor on the Republicans and Lieberman.

Posted by: punchaxverulam | December 16, 2009 7:35 AM | Report abuse

The heroes of health care? Caving to every Republican and insurance industry demand is now called heroism? Oh swell.

What we now have is an insurance industry with 30 to 40 million brandy new customers, weather we want to be brandy new customers or not. And the people with pre-existing conditions (battered spouses included), are not left out anymore! No siree, Bob! You lucky ducks can get insurance at three times the cost it will be for the rest of us! Now, let's just work out the abortion details......

PRAISE THE LORD already for their good and honest works!

Oh yeah, and have a Merry Christmas middle class, and a POVERTY,OOPS I MEAN PROSPEROUS NEW YEAR!

Posted by: Terypat | December 16, 2009 8:33 AM | Report abuse

I really hate to say it, this being potentially the most important legislation of Obama's first term (and maybe his presidency), but I am with Dr. Howard Dean.

I want someone to tell me what reform is left in the bill. It appears the Senate is passing a bill that will force 30 million new customers into the hands of big insurance, which will still have no competition. They will charge what they will, and we taxpayers will simply subsidize and enlarged version of the disfunctional system we already have. Yes, there is a provision for pre-existing conditions, but my epileptic daughter can be charged (under the Senate bill) premiums three times higher than other policy-holders. Also, there is still no annual cap on out-of-pocket expenses for those with private insurance. Even the awful practice of recission is not really repealed in the bill. Even lost was the 85 or 90% provision on how much of your premium has to go to actual health care.

No public option, no Medicare buy-in, no competition, no real prevention of discrimination against pre-existing conditions, 20 million people still not covered, and now a fine from the government if DON'T buy their overpriced policies. And WHAT ELSE will be negotiated away before this bill becomes law.

This is not what we voted for. We don't need symbolic health legislation "to build upon"--we need health care reform and universal coverage. Very sad.

Posted by: gingles | December 16, 2009 9:19 AM | Report abuse

Oh, and Ezra, you should read your own paper, your hero (and mine, at least til now) Senator Wyden was one of several Senators who quietly helped shoot down the under a lobbying blast from physicians and hospitals who feared the low Medicare reimbursements. He conveniently let Lieberman take the blame on that.

Posted by: gingles | December 16, 2009 9:32 AM | Report abuse

Let' see....It's time to buy Liberman a one-way ticket to Isreali Knesett (MK). That's where he belongs because the political-man has no real conscience, methinks.

Posted by: hariknaidu | December 16, 2009 10:53 AM | Report abuse

Thanks for welcome relief from All Lieberman All the Time. These Senators richly deserve to be on the front row of any coming snapshot of success.

I am thinking that bloodied yet unbowed Harry Reid deserves to be there, too, for keeping the process going when it sputtered and threatened to conk out altogether.

Of course the process goes on and the story is still far from over.

Posted by: FirstMouse1 | December 16, 2009 11:20 AM | Report abuse

America deserves a cost-efficient bi-partisan bill. All a one-party bill will do is fall short of its main goals (i.e., public option), while being loaded with pork and other hidden issues (like more gun restrictions or something).

And, America doesn't even know what's really in this bill. There are 60 prima donnas sitting in a closed room and deciding how much debt to dump on 300 million citizens.

This bill should be closed down and new talks started after the 2010 elections. Both parties MUST work together on this thing or it will not benefit America.

Posted by: RealTexan1 | December 16, 2009 12:11 PM | Report abuse

The senior senator from New York is Ezra's hero? Is this the senator, the misogynist, who refused an order from a flight attendant, demanded special privileges, and the called the woman, a union member, a trained professional
a "Bit(h"??? That is Ezra Klein's hero??


Posted by: Cornell1984 | December 16, 2009 1:45 PM | Report abuse

The Villagification of Ezra continues . . .

Posted by: SqueakyRat | December 16, 2009 2:26 PM | Report abuse

This bill as it exists today, blows.

Capitulators for no reason are heroes. They surrender. They surrender for no apparent reason other than the fact that they are Democrats.

The only congessional 'heroes' coming out of this will be those who were bought by the anti-reformists and helped the 'reform' bill be anti-reform. Kind of like the Bush regime's legislative follies such as the Clean Air Act which of course provided for dirtier air.

O could have saved a year and just asked anti-reform lobbyists and the Republicans to write a 'reform' bill he could believe in which to him would be anything that passes no matter how sorry it is. When did O forget how to count and use reconcilation to get something good through? Oh, that's right, he didn't want to in the first place.

What O fails to realize is that his capitulations will bring him nothing but misery as he finishes his time as a one-term president thereby letting the Republicans back in power - wait, they never left anyway - so they can complete the Bush mission of destroying the country. The anti-reformists don't need to off-put a president by putting him on hold as the Wall Street Bankers did. The anti-reformists and that includes Obama want to ram this bill with no public option and no Medicare buy-in through asap, call it 'reform', and the same afternoon as the morning O signs the bill do a mass PR blitz to the media telling them what a failure the bill is, what a failure O is and what failures the Democrats are.

Same as it ever was: You can hand the Democrats something on a silver platter, like congressional majorities and the White House, and they still have no idea whatsoever what to do with them. But they did get better rates through the GEICO lizard and have beaucoup dollars in contributions from anti-reform interests so they can get re-elected again and continue to do a disservice to their country.

Posted by: Patriot3 | December 16, 2009 2:39 PM | Report abuse



Posted by: jdmanson | December 16, 2009 4:56 PM | Report abuse

I think Ezra is unfair to Lieberman - Medicare buy-in was a very questionable idea, and it seems reasonably clear other moderates would also have opposed it. As for being the 60th vote (or 41st), someone has to be it. Frankly, plenty of senators have tried to hold the process hostage (cf Roland Burris), but they can't make credible threats to vote against the bill.

As a mild public option opponent, I enjoyed the Commonwealth Fund report, but I still don't understand their argument that increasing provider concentration has to be met with massive payer concentration; why not just reduce provider concentration?

More important, let's root for the Cadillac tax, a strong Medicare commission, and aggressive payment reform!

Posted by: WP_reader427 | December 16, 2009 6:41 PM | Report abuse

"Individual Mandate."

That's a section of the Law that Requires every Single American Buy Private Health Insurance or Break the Law and Face Penalties and Fines.

Thank Joltin, Joe Lieberman, he Got What He Wanted, ENJOY !!

There's No...

"Government Take Over Of Health Care"

There's Government Facilitation, Helping Private Insurance Companies Take Over The Entire Health Care Industry.

You will Not be Buying Government Health Insurance, You'll be Buying Private Health Care Insurance as MANDATED BY FEDERAL LAW, Since You Low Life Sea Slugs, wanted Private Health Insurance...

You Got What You Wanted.

Private Insurance Companies have [[WON]]

Let You Tea Party People & Republicans, Can Go Out and Celebrate That Fact..

The Big Insurance Companies will Get BIGGER & RICHER...


Brings New Clarity to the Country Group, by the Name of...

"BIG & RICH"...Huh

Posted by: omaarsblade | December 16, 2009 7:40 PM | Report abuse

EK, what have you been sniffing lately ?

Posted by: arby5 | December 16, 2009 11:40 PM | Report abuse

Kill the bill in the house.

Posted by: Realitycheck6 | December 21, 2009 4:25 PM | Report abuse

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