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Did Nancy Pelosi just declare health care dead?

"I don't see the votes for [passing the Senate bill] at this time," she said. If the pressure eases now, it's hard to see the votes emerging at some later time. And if the House backs off now, it's impossible to imagine the Senate stepping in to pick up the slack.

To appreciate what's happened over the past few days, imagine if all Democrats had read from the same hymnal and responded to Scott Brown's election with a low-key "it's a shame Martha Coakley ran such a bad campaign, but health-care reform is on the 1 yard line and we're not turning back now." Brown's victory would have been as big story, but not a cataclysm for the Democrats' legislative agenda. Instead, Democrats have decided to act as if they're in the minority for the next year and will actually become the minority in 2010.

Update Reading Pelosi's comments in full, that line is being ripped out of context a bit. It reads more like she's arguing the Senate bill will need to be changed in order to pass, which is a pretty normal stance right now. "We have to get a bill passed," she said. "we know that. That's a predicate that we all subscribe to."

By Ezra Klein  |  January 21, 2010; 12:02 PM ET
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If this is the way that health reform dies then the democrats just gave up on us, and I give up on them.

Posted by: lazza11 | January 21, 2010 12:06 PM | Report abuse

Sorry, but I saw this coming from miles away.

Posted by: scarlota | January 21, 2010 12:17 PM | Report abuse

Funny, but I see a lot less whining from lefty perfectionist trolls now that reform is dead. Be careful what you ask for, people.

Posted by: Jasper99 | January 21, 2010 12:20 PM | Report abuse

The fact that the democrats are lying down like this (with the Speaker leading them to the floor, apparently) is simply disgusting. I urged my representative (Allyson Schwartz, PA-13) to support bringing the Senate bill to a vote, and to vote for it, but that possibility is being tossed out, it seems. Most disheartening.

Posted by: bdballard | January 21, 2010 12:21 PM | Report abuse

You have to keep in mind that with zero support from Republicans, you would need large majorities of Democrats taking brave, determined stands in both houses.
There just is little prospect of that happening. All of the paths forward have serious downsides, you can't get overwhelming consensus on any of the options available.

I would identify villian #1 is the unions' stranglehold on the House Dems. The tax on healthcare benefits in the Senate bill is too much for the House to swallow.

The reason that Republicans can hold together is that they are rallying around a very simple concept - kill the bill.

Building is tough, destroying is easy. I know that is a trite concept, but you need to keep it in mind before declaring the Democrats failures in their battle with Repbulicans.

Don't get me wrong, I am depressed. I haven't felt this bad since Yitzhak Rabin got assasinated in Israel. It seemed like peace was finally possible, then it collapsed in one day. I would say the loss of the Massachusetts Senate seat within two weeks of major health care overhaul is a similar tragedy.

Posted by: HuckFinn | January 21, 2010 12:21 PM | Report abuse

I'm deeply disappointed that some progressives are hoping to pass a bill called "health care reform" that merely enriches special interests than act in a ethical and transparent manner pass a bill reforming health care.
Back room deals and legislative trickery are not the methods used by anyone who seriously upholds the ideals of democracy.
It was one thing when Reid used bargains and threats to push the Senate bill before a Christmas break to prevent Senators from hearing from angry voters back home. But what many progressive blogs, including this one, are proposing will set back the party and progressivism decades. The voters, sans maybe 25% of the party, will not tolerate such shenanigans.

Posted by: cprferry | January 21, 2010 12:31 PM | Report abuse

Regarding Pelosi's updated comment: "We have to get a bill passed we know that. That's a predicate that we all subscribe to."

Pelosi or Harry Reed can not muster the Democratic Party. Obama is the leader. If Obama is going to sit on the sidelines, making comments about targeted changes without expansion of coverage, you can't expect stiff backbones in the House where people stand for re-election in 9 months.

Posted by: HuckFinn | January 21, 2010 12:32 PM | Report abuse

The problem with going ahead and passing the (awful....) Senate bill anyway, is that all the great changes it will make (the insurance exchanges, the subsidies, the expansion of medicaid...I don't know about the pre-existing conditions..) will not start until 2014 or even later. In the meantime the Republicans will use the imminent threat of the "socialist, grandma killing, big spending, deficit making, gonna make all these scary changes to the health care you already have, taxing..." Health Care Bill to take back the congress in 2010 and the Presidency in 2012, and repeal Health Care without anybody ever getting any good out of it. And we will have lost the power to do anything positive or progressive for the next generation without even getting health care reform as a consolation prize.

The dogs don't like the dog food, no matter how good for them it may be. This is a democracy guys, you can't force it down their throats, they have the power to refuse. Smell the coffee.

If we get the economy back on track and show some improvement in folk's everyday lives, and show that government CAN work in ways that people can see and feel, then we may establish some credibility to use government for other things. We haven't realigned yet, we are still living in Ronald Reagan's political world, and we are about to lose our oppurtunity to do so by thinking that passing things and doing things are the same thing.

Posted by: rvanwye54 | January 21, 2010 12:35 PM | Report abuse

"You need to keep it in mind before declaring the Democrats failures in their battle with Repbulicans."

I'm sorry but I see this as the democrats needing only to win a simple battle against themselves - they have already passed a bill through the senate, all they need to do is show some discipline and some balls and pass a bill with their what - 80 seat majority??? (not sure about the numbers - but still)

Any changes to the bill would go through 50 vote reconciliation in the senate, where they still have the largest majority in decades.

Republicans don't even enter in to the equation.

Posted by: lazza11 | January 21, 2010 12:36 PM | Report abuse

what is happening to our country?

is there anyone credible in the senate who can step forward and at least, lead or help, or be a voice of courage or reason at this moment?
ron wyden?
claire mccaskill?
is there anyone left??

webb, frank, murtha,wiener, howard dean, john edwards, the clintons, dodd...i cant even remember all of their one point or another, they received trust...and they all dug us deeper into the mess we are in.
abandoning ethics,honesty,rules,sane governing...and abandoning us, while leading the good life for themselves.

is there anyone left?
maybe they should just all pack up and go home with their bags filled with the money they all managed to make while in office, if they wont help us anymore.

Posted by: jkaren | January 21, 2010 12:36 PM | Report abuse

"If we get the economy back on track and show some improvement in folk's everyday lives, and show that government CAN work in ways that people can see and feel, then we may establish some credibility to use government for other things."

There is no way in which failing to pass THIS health care bill will improve dems ability to do these things - in fact if they go back to the drawing board on HCR then they will waste even more time and have a colossal 1 year failure on their record. At the same time passing this bill does not mean they cannot do anything else you suggest.

I dunno if a new republican majority/president would have the votes/commitment to rewrite HCR once it is passed - they would (under current law) need 60 in the senate! Not impossible, but unlikley!

Posted by: lazza11 | January 21, 2010 12:41 PM | Report abuse

Prediction: if HCR goes down, it will be the catalyst for progressives to organize a 3rd party. This abdication of basic governing fundamentals can no longer be rewarded with our continued support, and I for one will not be held hostage any longer by the possibility that a split vote on the left will increase the chances of GOP victories.

Posted by: BigTunaTim | January 21, 2010 12:51 PM | Report abuse

Seriously, the Democrats can have a healthcare reform bill, however imperfect, on the President's desk tomorrow with one party-line vote in the House. They don't need a single Republican, they just need a simple majority.

If they can't manage to do this, then the blood in the death of healthcare reform will be on their hands, not on Scott Brown's hands, not on the hands of the Massachusetts electorate, but theirs. And they will deserve whatever electoral scorn is heaped upon them in November.

Posted by: cockybovine | January 21, 2010 12:58 PM | Report abuse

I'm sorry but progressives will NEVER be a viable third party. They'll be bigger than the Tea Party conservatives on the other side but they're still only a fraction of the full Democratic party. This was as close as they've ever gotten to that and the pendulum will now swing back the other way. All they'll succeed in doing is weakening the Democratic party. If that works for them fine.

The talk of this Democratic Party fracture reminds me of the past summer when everyone forsaw the Demise of the Republicans at the hands of conservatives. Again it'll be which party holds themselves together better. Dems did in for the 2008 election and Republicans are doing it for now.

Posted by: visionbrkr | January 21, 2010 12:58 PM | Report abuse

I guess I just don't understand. Do House Democrats honestly believe that the Senate bill is going to be vastly improved if they aren't willing to go after the Senate's 8% income exemption on the individual mandate? With the 8% income exemption, it's virtually impossible to strengthen the community rating and/or increase the minimum actuarial value as more young, non-users of health insurance will face higher premiums, be exempt from the individual mandate, and choose to go bare. This will blunt a good deal of the benefits to older adults, who rely on the community rating's generational subsidy from young, healthy people to afford health insurance, and make health insurance considerably less affordable to these older adults.

And of course, the excise tax compromise was not exactly comforting. It made sense on a political level, but was absolutely nuts on a policy level. Do unions really need until 2018 to renegotiate their contracts? In a world of scarce resources, why do dental and eye care get a $2,000 exemption but not services such as maternity care, durable medical equipment, mental health, substance abuse treatment, etc.?

A better way to deal with the unfair age, occupational, etc. effects of the excise tax is to have a tighter community rating such as that of the House bill (2:1 age rating, no smoker rating, no "prevention and wellness" discounts), and apply the rating rules and minimum benefit packages to all markets -- large group and self-insured included, as the House bill does. Then you must have a stronger individual mandate to avoid exempting too many young, healthy people, facing higher premiums from a tighter community rating and being required to purchase more coverage, from the individual mandate, and the House's individual mandate seems just fine. This is a trade that should have happened -- the Senate gets its excise tax, and the House gets its version of the community rating (including being applied to all markets) and individual mandate.

Posted by: BradGabel2002 | January 21, 2010 12:59 PM | Report abuse

visionbrkr, you don't understand the dynamic, and you never have. I'm not even sure what your babbling is trying to get across. The wide consensus is for HCR. What was passed was essentially a heavily compromised one, influenced by moderate/conservative Senate power brokers.

Posted by: constans | January 21, 2010 1:01 PM | Report abuse

Who has read the H C Bill? Where is Obama's "open door policy"?
Here is just a tidbit of what the Progressives are trying to achieve...
To begin with, much of what has been said about the law and its implications is in fact true, despite what the Democrats and the media are saying. The law does provide for rationing of health care, particularly where senior citizens and other classes of citizens are involved, free health care for illegal immigrants, free abortion services, and probably forced participation in abortions by members of the medical profession.

The Bill will also eventually force private insurance companies out of business, and put everyone into a government run system. All decisions about personal health care will ultimately be made by federal bureaucrats, and most of them will not be health care professionals. Hospital admissions, payments to physicians, and allocations of necessary medical devices will be strictly controlled by the government.

However, as scary as all of that is, it just scratches the surface. In fact, I have concluded that this legislation really has no intention of providing affordable health care choices. Instead it is a convenient cover for the most massive transfer of power to the Executive Branch of government that has ever occurred, or even been contemplated. If this law or a similar one is adopted, major portions of the Constitution of the United States will effectively have been destroyed.
Are you willing to give up our Bill of Rights and our Constitutional rights so quickly?
Please read the Bill... it says Health Care, but it should be labeled "Executive Power Shift" Embracing Marxist/Communist

Posted by: sircraigsalot | January 21, 2010 1:01 PM | Report abuse

Doesn't anyone understand that Americans are dying and being forced into bankruptcy every day that passes without a health care bill?

It is obvious that the Republicans couldn't care less. The Democrats have no moral alternative but to proceed as quickly as possible. Hopefully, that is the driving force that will motivate the Democrats to do something.

Posted by: stsimons | January 21, 2010 1:05 PM | Report abuse

I think comments by 'HuckFinn' are right and appropriate. Unless Obama speaks in clear terms, we will not get anything.

All this 'public parsing' of utterances from Dem leaders to read 'tea leaves' there, it seems fools errand; no point.

Without any serious homework on Dems side, all this public dithering is very damaging.

Even if the entire HCR is to be dumped and start over new (foolish to believe GOP will come aside knowing that their victory of obstructionism is so near); Dems will be better off if they do it quickly and in clinical manner.

In absence of 'frozen deer in a head light' situation; every passing day is bringing the collapse of Dem Politics near.

Posted by: umesh409 | January 21, 2010 1:11 PM | Report abuse

@visionbrkr: "All they'll succeed in doing is weakening the Democratic party. If that works for them fine."

How can it get any weaker than it is right now, with its 59 vote minority?

@sircraigsalot: that's quite an impressive list of Republican talking points you've cobbled together. Literally, straight-from-the-book talking points. Good job on independent thought, and bonus points for including "Communist".

Posted by: BigTunaTim | January 21, 2010 1:13 PM | Report abuse


sure the consensus is for reform but in what version? The House, the Senate, something more? something less. Talk to 10 people you'll get 10 different answers and if you talk to 10 business owners most all of them don't want it. The ones that ask me about it all think it'll increase their costs, taxes etc. That's their words, not mine.

And please share with me the dynamic that I don't get. Am i wrong to think that progressives think they're a more powerful part of the Democratic party than they are? Same goes for the Tea Party on the other side.

Posted by: visionbrkr | January 21, 2010 1:14 PM | Report abuse

These people do. not. want. to. win.

Posted by: adamiani | January 21, 2010 1:18 PM | Report abuse


i guess you have a point there when it comes to healthcare but other issues it may not (ie financial regulation, climate change etc). If healthcare was the only democratic agenda then I'd get. But its not and shouldn't be.

Posted by: visionbrkr | January 21, 2010 1:25 PM | Report abuse

As a lifelong democrat, I am just disgusted over this. The Congressional party is simply proving itself unable to govern. The GOP is unwilling to propose any real solution to the problems of the 21st Century and the Democrats are apparently unable. Maybe it is time for Obama to really go postpartisan-go to the House and say
"Are you Democrats or not? Do you believe in what the party stands for or are you just shills for different interest groups seeking govt. benefits. Pass the Senate bill and we will use reconciliation to fix the problems we all agree need to be fixed. If you cant do that, then you must not be Democrats-not Harry Truman or John Kennedy or Ted Kennedy democrats, thats for sure. And if you think you are Democrats, and will not do this, then I must not be a Democrat. I will announce at SOTU that I am no longer a Democrat and will govern as an independent. I will continue to propose real solutions to our problems and will pledge to campaign for anyone, Dem or GOP, who works with me, and against those who do not. If need be, I will encourage independent candidacies. Maybe OFA can raise some good money for them. And, oh, I am a lot more popular and respected than you are. So, are you going to pass the Senate bill and use reconciliation, or not?"

Posted by: gregspolitics | January 21, 2010 1:35 PM | Report abuse

For all my obsessive reading of blogs, I pretty much never actually get off my butt and call my congressman. Today I did. I can't remember the last time I felt so disgusted with Democrats.

If the dems let health care reform die now, when it's within their caucus's power to pass it, they will have richly earned the inevitable beatdown they will get next November.

Posted by: rayrick1 | January 21, 2010 1:35 PM | Report abuse

sircraigsalot... of dumb.

Handy hint: making straight-faced comparisons between HCR and Communism marks you out as the sort of person who has trouble with shoelaces.

Posted by: pseudonymousinnc | January 21, 2010 1:45 PM | Report abuse

@BigTunaTim Thanks for the compliments! Well I guess I'm just brainwashed in thinking the oath to preserve our Constitution is just a formality when taking office...The 10th Amendment states : The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are preserved to the States respectively, or to the people. Under the provisions of this piece of Congressional handiwork neither the people nor the states are going to have any rights or powers at all in many areas that once were theirs to control.Get the idea? This is not about health care; it is about seizing power and limiting rights. Article 6 of the Constitution requires the members of both houses of Congress to "be bound by oath or affirmation to support the Constitution." If I was a member of Congress I would not be able to vote for this legislation or anything like it, without feeling I was violating that sacred oath or affirmation.
For those who might doubt the nature of this threat, I suggest they consult the source, the US Constitution, and Bill of Rights. There you can see exactly what we are about to have taken from us.
And while you're at it... READ THE BILL!

Posted by: sircraigsalot | January 21, 2010 1:46 PM | Report abuse

visionbrkr, the point is that your statements are a non-sequitur.

Posted by: constans | January 21, 2010 1:56 PM | Report abuse

Huckfinn wrote: "I would identify villian #1 is the unions' stranglehold on the House Dems."

You have got to be kidding me? Unions were locked out, while cowardly senate dems gave the whole damn store to pharma, ins. co's and every corporate interest -- while making sure to look as stupid as possible on the banking issues.

Oh, they are still talking!!! Great, keep talking cowards. See you in a few years!

Unions knock on doors, and they know something you guys don't -- how people making under 6-figures think. Unions have a stake in the dems not being corporate shills, and thus successful. Clinton lost in '94 because of the betrayal that was NAFTA, as much as losing the health care bill. (Of course, the corporate press re-wrote the history on that -- because everyone agrees our insane version of 'free trade' is unanimously loved! Except, it isn't. See link at bottom, 56% want it re-done, only 16% don't.)

This whole health reform project took a huge turn for the worse when pharma deal was revealed. It got much worse when public option got dropped. (Look at Lie-berman's poll numbers for god's sake!) And, the final straw was when obama FINALLY revealed that he had to have the excise tax he campaigned against, because some harvard guys thought it'd be nice. (Granted, it was not the excise tax exactly in the campaign, but if you are not clueless you will realise that the difference between the schemes politically is ZERO.)

And, you say unions are to blame for not forcing people to eat garbage? You have no idea how disappointed and burned people feel who actually work to elect dems. Sit in your ivory tower and criticize, and maybe we'll stay in our warm houses in 2010.

Blame the politicians, that's who ran this show. Max Baucus, anyone? Good job getting Enzi and Snowe! Damn fools.

Posted by: rat-raceparent | January 21, 2010 2:08 PM | Report abuse


my original post which you replied to was mainly a response (although not mentioned as one) to BigTunaTim's response that he expects that if reform doesn't happen that it will start a third party progressive organization. I was pointing out that while that may happen I don't expect it has the numbers to make any real impact. A third party of progressives (IMO) will never garner majorities in Congress.

The best option for reform is to convince the house to sign the senate bill as is and then move on to jobs. Part of the problem of this reform effort is the all the side deals (unions, pharma, insurers, hospitals etc.) Everyone got a side deal EXCEPT the 85% of the American public that have healthcare now who mainly like it but just don't like the cost. Now no one will get anything except a year wasted it seems.

Posted by: visionbrkr | January 21, 2010 2:13 PM | Report abuse

sircraigsalot: Virtually everything you wrote (the post at 1:01) is dead wrong.

When you asked 'who read the bill', one clear answer is 'not you'.

If you were right, I would hate to see health reform passed -- but you are so totally wrong that I feel you may need help. Honestly.

Posted by: rat-raceparent | January 21, 2010 2:20 PM | Report abuse

I doubt that Sircraig's constitutional analysis is correct. (If it is, then not to worry --- the law will be struck down.)

But the gov't payng for health care for the middle class is certainly a move toward socialism.

Posted by: MarkatWash | January 21, 2010 2:21 PM | Report abuse

We should be so lucky! I would (still) be shocked - though pleased - if the Dems were to give up on their omnibus reform bill and pare it back to something more modest that could garner bipartisan support.

It's not just Brown's victory; it's the polls. Brown has just crystalized for Democratic politicians the fact that their support for the unpopular bill could be a big liability in a year that was already shaping up to be a tough one for the party.

Posted by: tbass1 | January 21, 2010 2:24 PM | Report abuse

Rat-race, Most working people were incensed to learn that union workers who make 30% more than comparable non-union workers (according to the AFLCIO), would be exempt from paying taxes for the HCR that they had so vociferously advocated.

Posted by: MarkatWash | January 21, 2010 2:27 PM | Report abuse

"Talk to 10 people you'll get 10 different answers and if you talk to 10 business owners most all of them don't want it. The ones that ask me about it all think it'll increase their costs, taxes etc. That's their words, not mine." - visonbrkr

IMHO, that's been the problem since before the election: Democrats never achieved any sort of basic consensus about what health care reform should do for the American public. They had no actual plan but decided that since "everyone" agreed on what needed to be done, they didn't need one.

The result is the chaos we see today. The fact that Ezra & Company keep talking about the currently proposed legislation as Health Care Reform, rather than what it is --a medical poverty program -- is an indication of how impoverished the Democratic vision was to begin with.

The newspeak in this discussion would be laughable if it weren't for the consequences. Reform, mandate, affordability, and universality have all been redefined by advocates of the bill to less than any of us could have imagined just a year ago.

And while they have single-mindly pursued extending the broken model that got us where we are, most Democrats have ignored what businesses, large and small, have had to say about the situation: nothing in the current legislations will stop premiums, co-pays and deductibles from rising.

Posted by: Athena_news | January 21, 2010 2:41 PM | Report abuse


seriously? Unions locked out? They were there when it mattered most (at the end). They've spent more time in the White House (as per the released logs) this year than at any other time. They've practically been staying in the Lincoln bedroom.

Please explain to me why a union employee DESERVES to have a better deal on healthcare than the same non-union working person (other than the fact that they were part of the group that bought the 2008 Presidential election).

Posted by: visionbrkr | January 21, 2010 2:45 PM | Report abuse

Democrats enjoy a large 256-178 majority in the House. With the Senate bill, they have before them a legislative proposal that essentially encompasses everything we have been fighting for for the last half century. I wonder how many days they will be able to continue in this bizarre coma they are in without passing the bill. It's like having won the lottery and refusing to redeem the prize until the ticket expires. If the Democrats do not pass the Senate bill in the House, we will have to throw them out of Congress in the fall.

Posted by: opinionpieces | January 21, 2010 2:45 PM | Report abuse


Labor fought to repeal it for everyone, right? Does that make them evil? Did they not warn the dems that it was a huge mistake? Yes, they did.

So, the dems, who locked labor out of the process until the 11th hour threw in special favors instead of addressing the issue. That's not labor's fault, either.

It is the fault of the dems trying to saddle the middle class with the costs, instead of the corporate fat cats in the health industry. (I'll bet our health system has produced more millionaires in this country than wall st, by a mile. And, we can't touch any of them, or so we're told...)

You can say 'well, people don't like it...' But, it wasn't labor's decision to make. They fought the good fight and lost (they don't ever want a cap, a short-term exclusion wasn't their goal, right?)

Put the blame on the fools who offered such a thing, instead of the people fighting the good fight -- only to lose to corporate interests yet again. That provision was designed to avoid progressive funding of the bill. Period. And, labor would never fight for that.

Posted by: rat-raceparent | January 21, 2010 2:47 PM | Report abuse


Yes, locked out. Baucus created the senate bill. I have it on good authority that the bill was crafted with corporate interests, then presented to labor as take-it or leave-it. They probably took it, thinking the reconcilliation could make it better.

What did labor fight for? Do you even know? I'll help you:
-Public Option - dead
-Employer contribution -- basically stripped to death
-no excise tax - dead, possibly with short term relief

Oh yeah, they wrote the whole thing! I can tell. (You have an impression in your mind, which doesn't match reality. I get that, because that's what you heard on the tv.)

Labor gets invited to events and meetings sometimes, but you are absolutely kidding yourself to think they are running the show.

In my opinion they are closer to the anti-abortion folks getting used by the right, than they are to Goldman folks running every branch of our nation's finances.

Second, I didn't say they DESERVE a better deal. I said, that was likely the most they felt they could get (it is still a disaster for them after 2017.)

But, I would say this to those complaining middle-class folks: "Fight for yourselves, too! Stop whining because your neighbor's life wasn't destroyed, and fight for yourself."

Posted by: rat-raceparent | January 21, 2010 2:56 PM | Report abuse

*my original post which you replied to was mainly a response (although not mentioned as one) to BigTunaTim's response that he expects that if reform doesn't happen that it will start a third party progressive organization.*

Aha. Thanks for clarifying. That statement makes more sense, now. The more liberal Dems need to go the "club for growth" route-- simply pick and threaten more conservative Dems with primary challenges to keep them in line. Third parties don't work, and staying home just makes things worse.

*The best option for reform is to convince the house to sign the senate bill as is and then move on to jobs.*

Basically yes. This seems to be the consensus here.

*But the gov't payng for health care for the middle class is certainly a move toward socialism.*

Calling it "socialism" is like waving around a talisman and trying to claim that the idea is cursed. Providing modern infrastructure and amenities to the public is just what living in a first world nation should be doing. It's not an ideological stance, it's simply a given.

Posted by: constans | January 21, 2010 2:56 PM | Report abuse

(I'll bet our health system has produced more millionaires in this country than wall st, by a mile. And, we can't touch any of them, or so we're told...)

Posted by: rat-raceparent | January 21, 2010 2:47 PM | Report abuse

Really? as my friend pseudo would say we need to get you fitted for a dunce cap.

Have you seen the profits at Goldman Sachs today?

Bonuses were TRIMMED to 16.2 Billion at one firm. Not profits, BONUSES. Some how I think if insurers paid bonuses anywhere close to that we'd hear about it. Ezra wouldn't and shouldn't let it go by the wayside.

Now here's insurers profits:

Posted by: visionbrkr | January 21, 2010 3:00 PM | Report abuse

sircraigsalot: Great moronic teabag parody. It hits all the high spots.

Posted by: henderstock | January 21, 2010 3:10 PM | Report abuse

But, I would say this to those complaining middle-class folks: "Fight for yourselves, too! Stop whining because your neighbor's life wasn't destroyed, and fight for yourself."

Posted by: rat-raceparent | January 21, 2010 2:56 PM | Report abuse

Oh, ok. So you go by the "I've got my union card so I get mine" mentality then. Ok. Its just that kind of mentality that helped Senator Brown win in MA. No one should have been exempt from a "haircut" to make healthcare work in America. Not insurers, not doctors, not hospitals, not unions, not Pharma, not lawyers, NOBODY. Because that's what Obama promised. He promised an end to the special interests and all that happened is the special interests changed or increased depending on your perspective.

Sure WellPoint's point man wrote the bill. Who else knows how health insurance works other than a health insurer. Having someone other than an insurer write the legislation is like asking a lawyer to prescribe medicine. Its idiotic. That doesn't mean that its necessarily pro-insurance to start with or will be so at the end. I'm sorry but if I had a choice of when to be in negotiations it would at the end and not at the beginning.

Posted by: visionbrkr | January 21, 2010 3:14 PM | Report abuse


I didn't say insurers. I said health care system. I didn't say 'how much per millionaire', I said the number of millionaires.

Every specialist has to make $300,000 out of school? Really, to pay $200,000 in loans? Putting them out of debt, plus a $100,000 salary in thier first year? (Maybe we could subsidize training costs to bring that to a reasonable level, even though it is a terribly regressive subsidy -- it'd could still be a good deal.)

Every drug has to be under patent for years, then extended, then slightly modified -- so people can get rich lying to dr's about their proper uses (see off-label marketing). I think one specific drug by pfizer was improperly marketed to the tune of $22 billion itself! (I think Spitzer got them for a small fine on that one, so the system had to get spitzer and shame him. They did...)

A 15 minute test costs thousands of dollars? No room to save there! Totally reasonable.

Look at the guys making $30,000 for working 2500 hrs!!! That's the only place to find money in our societ, says the senate, whose taking orders from labor. (The idea is to absurd for me to actually not laugh at.)

Our health care system is 17% of GDP. Yes, it is bigger than goldman, or a few billion. Hell, Bill Frists' family probably defrauded medicare for more than Goldman's profits that you mentioned (it was settled for pennies on the dolllar by bush, as the good dr settled in to run the senate for... bush). That number is peanuts compared to the size of our health system.

I'd note a lot of the health cost excesses flow to wall st, too. Allowing us to argue whether its profits from a or b, but...

Our costs are simply out of line, and the senate acted cowardly.

Posted by: rat-raceparent | January 21, 2010 3:26 PM | Report abuse


sorry I misunderstood your post. You're right they're all out of line but that doesn't excuse (IMO) unions or anyone else for that matter for having a healthplan that is out of touch with reality. A couple months back Ezra posted on the comparisons to this reform effort to what Nixon and Kennedy did. What they asked for was an old style indemnity plan for all that was between $300 and $450 deductibles. In today's dollars that's an HSA. The problem is your unions want everyone to have a $5 copay for everything that has everyone over-visiting doctors, over taking medicine etc. People need to feel cost. I believe I've had this argument/discussion with you before and regardless of the tax implications you can't convince me that for what I know and see every day as the differential in a $10 to a $20 copay you wouldn't be better off having that in wages. If it works for non-union it would work for unions. The fact that unions are too blind to see that is their fault and the rest of us pay for it. I pay for it in my property taxes (my state is among the highest in the country) and we all pay for it when cadillac plans over-utilize care which is an absolute fact.

Posted by: visionbrkr | January 21, 2010 3:33 PM | Report abuse

visionbrkr: "Oh, ok. So you go by the "I've got my union card so I get mine" mentality then."

That's not what I said. Maybe it's what you heard, but not what I said.

Maybe your advice would be "Sit home, take a beating, then try to drag your neighbors down with you." I think people should stand up for themselves. Sorry if that offends you.

Your formula has been very successful for the middle class in this country more concerned with spite than solidarity (will any benefits go to blacks? How about latino's? Oh noes, we better oppose it!) In the old days, the old formula resulted in all boats going up, though.

But, maybe today's different. Maybe having your neighbor take a beating will lead to you getting better health care. I doubt it. But, I hope so, because all evidence points to that attitude being overwhelming today.

Another question: You think the autoworkers in SC would have the same terms of employment if the UAW wasn't around?

Posted by: rat-raceparent | January 21, 2010 3:34 PM | Report abuse

visionbrkr: "sorry I misunderstood your post. You're right they're all out of line but that doesn't excuse (IMO) unions or anyone else for that matter for having a healthplan that is out of touch with reality..."

I won't repeat the whole thing, but wanted you to know what I was responding to.

Here's what I think:
- People don't go to docs for fun.
- Our utilization rates aren't out of line w/ other developed countries
- Our costs are, and our per unit of care costs are insane.
- Union plans are expensive largely because union workers tend to be very old.
- yes, their plans tend to be better (becuase they fight for themselves, unlike the doormats who have given up on the concept),
- but copays are a joke for lowering costs.

RE the senate bill, try these numbers.
- Plans have to pay for 60% of costs
- preventative services free!
- low out-of-pocket max!

Now, why do I think an average person, who doesn't go to dr very much -- but has an accident -- will feel like he's getting the worst deal ever? Remember, he's going to be contributing to covering all teh cancer and diabetes cases, and the overall coverage is 60%! What will his insurance cover when he's hurt? 30-40%? That's not coverage people even ponder when they say 'I have insurance'. It literally redefines our view of insurance so far down, it is scary.

He'll be paying an arm and a leg for coverage, then on occasional use, it won't cover much. The bill is designed to cover check ups and basket-cases. Great, I'm glad it's good on those counts. But to the vast majority entering the system, they will be occasional users.

That is a politically stupid design. And, all because senate dems want to blame the users, and ignore the per-unit cost of care.

I'm tired of the middle class being blamed for our political failures. We gave them an opportunity, again, to fix things. I'm very saddened by the senate's actions.

And, I absolutely reject blaming labor. They would have designed a far better system without having the industry write the bill. I can't believe you think the industry's 'point man' should write teh bill.

Posted by: rat-raceparent | January 21, 2010 3:46 PM | Report abuse

"The wide consensus is for HCR. What was passed was essentially a heavily compromised one, influenced by moderate/conservative Senate power brokers." -- constans

I agree that the majority of Americans want Health Care Reform and that Congress distorted that into an unpalatable plan. I disagree with your implicit notion though, that the was any consensus on spending vast sums of public money on reform.

Having worked in both the UK and France, I can tell you unequivocally that I prefer the French system (which contrary to what most people here think is *not* single-payer) and I suspect that most other Americans would too. The French (and German systems depend far less on public money that the the US does and yet they cover everyone for much less.

IMHO, part of our problem has been that more vocal liberals assume that ever "right thinking Democrat" wants single-payer. The fact is, what people want is *universality*. They want a coherent system that covers everyone in the same way with the same level of security. That could mean individual payer (as in the Netherlands and Switzerland) or all-payer (as in France or Germany).

There is absolutely no reason that such a system should cost the federal government a dime more than we are spending on the existing dysfunctional patchwork.

IMHO, Liberals need to give up on the idea of spending more public money on band-aids and propose a UNIVERSAL plan that builds on more successful models elsewhere.

Posted by: Athena_news | January 21, 2010 3:48 PM | Report abuse

"And, I absolutely reject blaming labor. They would have designed a far better system without having the industry write the bill. I can't believe you think the industry's 'point man' should write teh bill."

Next time your union contract is up instead of the union bosses and lawyers who know about it negotiate it how about letting someone who knows nothing about it negotiate it because that's what you're suggesting here.

you conveniently pick the lowest plan when speaking of the benefit. From my understanding people can pick from 60, 70, 80 or 90% actuarial value and can change per year.

Changes in copays etc also do have a major effect on the cost of coverage. I've seen cost vary by 10-15% when you simply talk about a copay change from $10 to $20. A single person would need to go to the doctor 10 times a month before it made sense to be on the lower copays. You're also going to argue that people don't use doctors offices and ER's unnecessarily? Isn't that one of the main premises of the liberal argument that people can ONLY use the ER due to EMTALA and if we gave them healthcare for free or subsidized then they'd go to the doctors offices instead of ER's? I'll gladly give you your valid points but you can't have both sides of the argument. Either people only go for necessary care or they dont.

Posted by: visionbrkr | January 21, 2010 4:10 PM | Report abuse

should remove "only" on the last line. I really need an edit button.

Posted by: visionbrkr | January 21, 2010 4:15 PM | Report abuse


I'm white collar, but I like and respect unions. They've done a lot to create the affluent society which we've enjoyed. I hope that affluence lasts a while, that's all. I know the text books don't speak well of them, but I don't know who wrote them. Maybe the TX board who wants to teach about the wonders of McCarthyism?

I picked the lowest plan, because that is what I think the subsidies are based on (could be wrong, but don't think so.)

My larger point is that all the stake holders were given 'held-harmless' deals that made it impossible to save cost 'per-unit'.

There is no way you could ever convince me we should not negotiate under part d. It is just outright corruption. The R's did it, and I don't want to see the D's cement that into law further. That, apparently, was one of the first deals cut -- we find out later.

Maybe deductibles do change premiums a lot, but there's no financial sense to it. Maybe ins co's offer higher margin plans, when it's lower copays? But, I know people don't skip emergency room care over $10. And, I know that the vast majority of spending is on big ticket diseases. Copays are a joke, compared to the cost of these things -- so I can't find any way they save 15% of claims.

So, there's no logic (to me) in premiums dropping 15% over a $10 increase in copays, because plan payouts won't drop that much. Maybe ins co's just don't like that model, so they demand higher margins. You tell me?

I won't go to a dr unless I'm suffering badly, but my wife goes for everything. $20 won't change that. She's always convinced 'this time it's bad.' What can you do?

Further, I don't see that as unique to our country. If our utilization was way out-of-line, I'd agree with you. But, it simply isn't. It's an effort to shift blame from the guilty (who have money to fund such PR efforts such as research papers), IMO.

Do we go to the Dr twice as much as france or england, 60% more than canada? If not, then you are barking up the wrong tree, by trying to change people instead of the system.

I'd support healthy initiatives, getting a better food supply, and other things that could help. But, 60% (about our cost premium over similar countries) of our system is not from going to the dr with a runny nose. It simply isn't true.

How that is the fault of unions is beyond me... And, it's beyond me how one could think they wrote this bill with acorn. If they did, it'd be simple and sell-able: Medicare for all!

Posted by: rat-raceparent | January 21, 2010 4:31 PM | Report abuse

@pseudonymousinnc @rat-raceparent Wow! It's obvious you've been around the block! You've studied the HCR bill and our Constitution, and you, the all knowing, must certainly realize that there is no threat to our liberties and it's a wonderful bill full of bliss! No Pork Piggies in that bill pass it! pass it! Hurry and pass it!!!
Wait don't tell me you just want me to go away and act like a you can have your intellectual bias blogs uninterrupted. Sorry not happening!
Do you feel better by putting others down? It surely shows your superiority. Your wimpy put downs are really a cause for concern...It's a cute little tactic I see daily with lefty Dems.
At least you didn't call me LIAR!...Anyone who opposes you power hungry control freaks gets a personal attack ...Good form you bullies...Blog away... Pseudonymous bloggers...We know who u are.
The real truth is America wants to fix Health Care, but only on a moderate basis. You should be paying closer attention to the "We the People" part of this nation. Its the American public and what we want not your leftist dreams and wishes of a lobbyist, special interest, corporate controlled nation! We voted for change, but not this kind of change...
The 1st year for this administration has been a huge waste on HCR...or am I dumb, dead wrong, and need help. Honestly?
Fix the economy, create employment, protect our liberties, and listen to the people...We the people know because we are out here everyday in the trenches trying to survive and keep this country safe...
Oh! One last thing before I leave this blog spot...GO GLENN BECK!

Posted by: sircraigsalot | January 21, 2010 5:08 PM | Report abuse

*at I prefer the French system (which contrary to what most people here think is *not* single-payer) and I suspect that most other Americans would too*

Even the libertarian Matt Welch at Reason says that he prefers the French system and specifically goes there (his wife is French) for treatment.

Posted by: constans | January 21, 2010 5:10 PM | Report abuse

@henderstock Often, the most satisfying element of a good parody is seeing others mistake it for the genuine article...
You must be gifted...
This is my first day on this blog and some of you are so mean!
Have you seen that bumper sticker that says "Mean people suck"!
I think I'm going to get one...

Posted by: sircraigsalot | January 21, 2010 6:55 PM | Report abuse

Speaker Pelosi: CRE Loans will end the unemployment problem within 2 months....Glass mfg, electricians, truckers, STEEL, Aluminum, plumbers, office equipment, architects, construction workers, concrete industry--will all be working Los Angeles alone there are 140 entitled CRE jobs with 70 or more units.....Credibility will be restored and responsible Health Care Reform will be accepted with honesty and transparency. (The Banks are now unfettered to make Prudent Loans & there are thousands of pristine Projects out there Nancy.)

Posted by: MSFT-PELOSI | January 21, 2010 11:38 PM | Report abuse

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