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The truth about the public option

I am in trouble with the left -- again -- over the public option for health care. My offense? On MSNBC Monday, Andrea Mitchell asked, "how do they water down the public option to make it acceptable to some of the moderates but placate some of the more liberals?" My response, in part:

The president, I think, is going to have to tell the left wing of his party and the balking liberal senators that it is crazy to pull down the entirety of health care over this one issue which the president has already said is not the be all-end all of health reform.

This remark -- or, more precisely, blog commentary about the remark -- has generated too many e-mails to respond to each individually. But the more civil among them deserve a thoughtful response. One e-mailer writes:

It seems to me that the left has been compromising on health care since the beginning of this process earlier this year. Shouldn't the “Gang of Four” perhaps give way a little so this legislation moves forward? Given the sizeable majorities the Democrats have, not to mention a Democratic White House, it seems to me that the public option represents a reasonable middle-ground on health-care reform. (It's certainly a far cry from single payer).

This is a sensible question, but it ignores political realities. Like it or not, the so-called "Gang of Four" -- Sens. Mary Landrieu (D-La.), Blanche Lincoln (D- Ark.), Ben Nelson (D-Neb.) and Joe Lieberman (I-Conn.) -- hold the balance of power here. I think -- and I certainly hope -- that there are compromises on the public option that they could live with. But the fact is they have the cards. "Hello? 56 trumps 4!" was the subject line in one e-mail. Hello? Not in the Senate!

Yes, 56 other senators may support some form of public option, but they are also more committed to health reform than the four, who, if they go along at all, will do so grudgingly. "Isn’t it fair that both sides make compromises?" another correspondent asked. To paraphrase JFK: Nobody ever said the legislative process had to be fair. In that sense, my answer to Andrea was less a normative judgment about the public option than an objective look at the political landscape.

I’m perfectly willing, though, to make a judgment about the public option: it is nowhere near as important as advocates make it out to be. A public option that allowed the government to dictate Medicare (or close to Medicare) rates would end up driving other plans out of business; a public option operating on a truly level playing field would not have much impact. For a full explanation, see .here and here.

The notion that health reform without a public option is not worth doing -- "anything without it is not reform but just a bandaid [sic] with no chance of stopping the bleeding of our economy at the hands of the for profit insurance companies," one e-mailer wrote -- is simply incorrect. The Congressional Budget Office estimates that enrollment in the public plan outlined in the Senate bill would be just 3 to 4 million -- and that premiums would be higher than the average of other plans in the exchanges. President Obama was right when he described the public option as "just one sliver" of reform.

One of my correspondents noted that:


another 45,000 Americans…will die each year from lack of health care being available. Really Ruth, are you so happy that 45,000 Americans are going to die, while you, and the other Post employees, all have great health insurance? Nice.

Another posed the question:

What makes your children (or children of those close to you -- if you do not have them yourself) any more deserving of medical treatment than any other child in this country? Really. Seems pretty cold and indifferent to me. THAT is what I see in you when I watched your contribution to the debate. A cold, indifferent, and callous person that challenges the basic rights of others to services that they themselves seemingly take for granted.

Actually, my concern about letting the public option jeopardize health reform is precisely because I think that expanding access to health care is such a moral imperative. Every child deserves the access to the health care that my children have.

By Ruth Marcus  | November 24, 2009; 11:40 AM ET
Categories:  Marcus  | Tags:  Ruth Marcus  
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Comments

THIS FORMER 17 YEAR VETERAN INSURANCE EXECUTIVE IS HERE TO TELL YOU THAT YOU CANNOT REFORN THE INSURANCE INDUSTRY WITHOUT A STRONG PUBLIC OPTION, OR WITHOUT REMOVAL OF THE ANTI-TRUST EXEMPTION.

FACE THE MATHEMATICAL AND MARJKET-REALIST FACTS: THERE IS NO COMPETITION FOR THE INSURANCE INDUSTRY SO PRICES CAN'T DROP WITHOUT THE PUBLIC OPTION.

Marcus you're ignorant, brainwashed, and old.

Please retire and let someone who understands economics and reality have your spot on WAPO.

Posted by: onestring | November 24, 2009 12:35 PM | Report abuse

Ms. Marcus - Why would anyone want to use blogging data to learn about the Public Option when there are other sources where one can find intelligent, accurate information? I suggest www.usa.gov/ or factcheck.org
-- www.usa.gov is the official government web site and factcheck.org is a non-profit, non-political organization dedicated to truth in politics. I believe you know that, so why are you doing this?

Posted by: ThelmaMcCoy | November 24, 2009 1:13 PM | Report abuse

Ruth, while I hate to agree with those who post rude comments and ad hominem attacks, the fact is there are just a few large forces at play in our healthcare industry (HCI).

1 Regulation - the states have generally been patsies to the HCI - consequently the HCI makes a killing while ignoring the needs of the ill. The bills before congress would do much to fix that via Federal regulation.

2. Incentives - are mostly perverse: encouraging too much superfluous care for those who have good coverage, and too little essential care for those who don't. The current bills will help, but don't go far enough.

3. Competition - the anti-trust exemption has allowed the worst kinds of market abuses. Any rational person who understands economics has to be either for the public option - or for the removal of the anti-trust exemption. I frankly prefer the latter, and would like both, but we must have at least one - otherwise there will be no innovation aimed at reducing (and competing) on cost. All the innovation will be on providing more care - as it has been for decades.

Posted by: An_Open_Mind | November 24, 2009 1:43 PM | Report abuse

Ruth:

How's the Kool-aid?

Posted by: shpierce | November 24, 2009 1:58 PM | Report abuse

onestring shouted:
THIS FORMER 17 YEAR VETERAN INSURANCE EXECUTIVE IS HERE TO TELL YOU THAT YOU CANNOT REFORN THE INSURANCE INDUSTRY WITHOUT A STRONG PUBLIC OPTION, OR WITHOUT REMOVAL OF THE ANTI-TRUST EXEMPTION.
--------------------------------------------------

Maybe this will prove true. In that case, political and economic pressure to institute a public option will grow.

This initial round of reform is mostly about expanding coverage. The harder work of cost control will have to be tackled on a bipartisian basis in future legislation.

A triggered public option is an EXCELLENT approach that will work about as well as a Public Option that will be scheduled for 2014.

In the past I have been critical of Marcus for her tepid support of the public option, her early surrender on the issue was unwise. But I've come around to understanding that the health care reform bill is shaping-up to do a MOUNTAIN of good with little or no irreversible harm. Marcus has it right in this blog.

Posted by: HuckFinn | November 24, 2009 2:00 PM | Report abuse

I am so sorry for my opinion, Ms. Marcus. ... But your kow-towing to the "reasonable right" just simply won't do. ... The "halfway" house of the current bill, before Conress, simply "won't do".

... "It" is simply a "social" issue.
... Is "Health care" a "privelige" or a "right"?

Posted by: deepthroat21 | November 24, 2009 2:13 PM | Report abuse

I don't want to join the legion of armchair presidents telling the elected President of the United States what to do, so I will simply say I hope that President Obama gives a speech directed at liberals, "It's not about you!" Hit liberals for making health care as political as the GOP. Hit them for forgetting who this actually about: the tens of millions of Americans without insurance. Hit them for co-opting this debate to further an ideaological war against the right. Hit them for using the public option, a NOT major component of reform, as a ideaological weapon not a principled stand. Hit them for being as obnoxious, unreasonable and unbalanced as the right in this debate.

Posted by: NMP1 | November 24, 2009 2:13 PM | Report abuse

Why not make health care reform a reconciliation bill? Then only a simple majority would be required for passage. There would be no need to compromise with industry shills and opportunists who care more about their own job security than they do about their constituents.

Posted by: raschumacher | November 24, 2009 2:19 PM | Report abuse

"Like it or not, the so-called "Gang of Four" -- Sens. Mary Landrieu (D-La.), Blanche Lincoln (D- Ark.), Ben Nelson (D-Neb.) and Joe Lieberman (I-Conn.) -- hold the balance of power here."

That is a ridiculous statement. Landrieu has shown that she can be bought off; Lincoln likely has her price as well. As for Nelson and Lieberman, it is common knowledge that they have been bought and paid for by the (health) insurance industry. Four senators from small states should simply not be allowed to hijack the possibility of affordable health insurance for the hundreds of millions of Americans that they do nor represent. Ignore those four; shut them out; shun them. They are nothing but opportunistic egotists who are rotten to the core.

Posted by: Gatsby10 | November 24, 2009 2:25 PM | Report abuse

Ms Marcus. Just because something is not important to you doesn't mean it's not important to the rest of the universe. Get over yourself. The Public Option is vitally important to controlling healthcare costs and guaranteeing consumer choices in insurance plans. Private insurance is simply too costly to afford for people who can't get access to a plan through their employer.

Private insurance has a 30% overhead. Literally one third of what you are charged goes to fund profits and massive business infrastructure whose job it is to deny your claims.

And don't even get me started on turning people down for coverage due to pre-existing conditions. Where are these people going to get coverage at any price?

Medicare For All is the answer. It takes all patients and has an overhead of 3-5%.

But Ms Marcus you don't care about issues like that because you and all your Georgetown cocktail party friends have insurance and don't have those kind of problems like the rest of us do.

You are quite happy and content in your ivory tower.

Posted by: cfeher | November 24, 2009 2:25 PM | Report abuse

How do you control costs without a public option?

Competition provides the only effective form of cost control. Most insurance markets in the US are virtual monopolies for employers, and most employees have no choice in health care options other than that chosen by their employer.

Without a public option, insurers will react to the new mandates by jacking up premiums and face no consequences as consumers will be at their mercy.

Without a public option, the virtues of this health care reform bill are swamped by the fact that insurers will drive premiums out of the range most employers and employees can reasonably pay.

Is that such a small thing?

Posted by: AxelDC | November 24, 2009 2:31 PM | Report abuse

Ms. Marcus. I apologize. The "story" about the "Kentucky" census worker, that is appearing in the "media", simply won't "cut it". ... OK?
... EVERYTHING that is "wrong" about "America" is "contained" in that "story. ... OK?

Posted by: deepthroat21 | November 24, 2009 2:32 PM | Report abuse

4 Democratic conservative/fools trying to "WRECK Public Option, they should just join the Republican party and get the hell out of mine! I like my good friend United States Senator Sherrod Brown agree these 4 fools holding 56 U.S. Senators and country hostage, and they need to be "BOOTED THE HELL OUT OF THE DEMOCRATIC PARTY, and Joe Lieberman who I helped get re-elected is the biggest fool of them all, I am ashamed of him and regret helping him get re-elected, which next time he won't be and I hope the other three will be tossed out as well, how the hell did they ever get in the Democratic party in the first place, either you are with us or your against us!

..."As a registered Voter/Vet USAF, these 4 fools have to go, and the sooner the leaders of the Democratic party see this the better off we will be!

..."Pass the Public Option Democrats or pack your bags, these 4 fools need to start packing theirs...

Posted by: ztcb41 | November 24, 2009 2:35 PM | Report abuse

I "Apoligize" Ms. Marcus. "The" Kentucky "story", about the "census worker" is .... False.

... It is "Ugly", untrue. ...

... Please, please, .... investigate.

Posted by: deepthroat21 | November 24, 2009 2:36 PM | Report abuse

You could do this w/o a public option...HOWEVER, you would need a ton of regulation of the insurance industry that would include:
-price caps
-enforcement of not dropping or reducing coverage coverage
-ensuring each state is serviced by multiple firms (this means firms would have to abide the strictest state rules-Vermonts)
These would be the requirements at a minumum.
Not sure insurance companies would go for that either.

Posted by: jjj141 | November 24, 2009 2:36 PM | Report abuse

A STRONG PUBLIC OPTION is the only TRUE way to allow meaningful reform and also allow the INSURANCE INDUSTRY to shape up.

And this STRONG public option will only work if people have the CHOICE to join it.

As it is now, very few if any people will have the option to CHOOSE from a public option.
We will be REQUIRED to purchase lousy overpriced insurance through whatever lousy plan our employer can afford to offer. And as costs continue to soar, employers while meaning well need to pass along soaring costs to their employees through limiting their choice of plans, raising premiums, deductibles, decreasing the quality of plans and removing the ability to cover dependents.

Every citizen should be allowed to choose from whatever insurance CONGRESS has for the same price.

WHY IS THAT SUCH A PROBLEM to comprehend?

Why should I have to be confined to purchasing crapola insurance if there is a better product out there that suits me and my needs.

Posted by: kare1 | November 24, 2009 2:41 PM | Report abuse

Please, ... Ms. Marcus. Please. .... I implore You. ........ I KNOW these .... "People". ... Please.
... "They" are ..... "Fascists". .... Please. .... I. .... Beg You.

Posted by: deepthroat21 | November 24, 2009 2:41 PM | Report abuse

Not one of the comments that I've read indicates to me that any of you understand this bill. This bill doesn't address the core problem of rising premiums. This bill doesn't address the rising overall cost of health care. This bill is a sham, and I'm guessing that many of you are not aware of the "Doc Fix" provision. The house last week passed the HR 3961, which basically adds $215 Billion for medicare funding, where as the HR 3962 cut medicare costs by $420 Billion. It's a shell game, they take out medicare in one bill, just so it meets the presidents criteria of being "deficit neutral" to then only add it back in on another bill.

The CBO now scores the combined bills as adding to the deficit http://www.cbo.gov/ftpdocs/107xx/doc10732/HR3961_HonRyan.pdf Read it for yourselves.

Aren't you offended by these politicians for being deceitful? Where is your pride people?

Also, I've read the CBO scoring up and down, which I'm sure few of you have, If you look at the Bill, the expenditures for subsidies don't begin until 2015 yet taxes are collected right from the get go. http://www.cbo.gov/ftpdocs/107xx/doc10731/Reid_letter_11_18_09.pdf look for yourself people. Page 3,5,6. Learn to think for yourselves, don't trust what these bafoons tell you, read it, see if it makes sense. If you look at the bill, and you cost average from 2015 to 2025 with the HR 3961 THE DEFICIT EXPLODES!!

And this doesn't even take into consideration that this Reform will most likely have tons of wasteful spending. Medicare alone last year had over $50 BIllion worth of fraudulent spending.

You people don't understand where we are economically. We have a $12 Trillion deficit, and rising rapidly. Even according to the White House's rosy projections the deficit 10 years from now will be over $21 trillion.

Do you guys have any idea what the interest payments alone will be on $21 trillion 10 years from now? I'm sure most of you don't.

It will be between $1-$1.5 trillion a year. The White House estimates $700 Billion, but of course they have been wrong with all their projections, and they believe we will see benign inflation, which WON'T BE THE CASE.

We should be concentrating on the economy and a practical solution to Health Reform. There are many incremental steps we can take to reduce health insurance premiums, and we aren't doing anything to address this area. This is the worst piece of legislation that I have ever read.

It adds taxes, adds to the deficit, hurts small businesses (Chamber of commerce), doesn't bend the cost curve on premiums and lessens the overall quality of health care.

This bill is terrible. Just because we recognize that there is a problem doesn't equate to having the solution. This is not the solution.

Posted by: Magox | November 24, 2009 2:46 PM | Report abuse

"Mitchie Boy". .... How do ya' "get away with it"?
... Ya' all "suck excrement"!

Posted by: deepthroat21 | November 24, 2009 2:46 PM | Report abuse

It is the right and a few moderates who are threatening to go against the majority of Americans who want a public option. But, you are right Ruth, this isn't the be all, end all of health reform, specifically because those mentioned above have watered it down. And they are good a framing the debate, which is why you are willing to throw the public option under the bus. The Republicans can't be negotiated with because their is no middle ground for them. A strong public option would save money but they will spin this bill, one which they have made more costly, as a big spending bill. See how they do that. So you could try to reframe the debate instead of just taking their "reality". They will achieve short-term political gain for long-term harm to the country. And you are going right along with them.

Posted by: mnander2727 | November 24, 2009 2:47 PM | Report abuse

"Mine eyes have seen the eyes of a true Kentuckian". ... Abraham Lincoln.
... Please, Ms. Marcus?

Posted by: deepthroat21 | November 24, 2009 2:48 PM | Report abuse

If you, at the "WaPo", want to "truly" know "truth". ..... Please investigate the "Kentucky" story about the "census" worker

.... Abraham Lincoln, flawed though He was, .... knew what "simple truth" was.

Posted by: deepthroat21 | November 24, 2009 2:53 PM | Report abuse

........

Ruth Marcus:

You're 'just not that important."
You may not like it but that's
the truth.

........

Posted by: printthis | November 24, 2009 2:56 PM | Report abuse

In reading the Senate bill there is really no reform except the consumer will be paying higher health insurance rates. The stock rally of the major health insurers confirm this.

It will take some more time, but we will revisit the public option or single-payer in the not to distant future.

Posted by: Maddogg | November 24, 2009 2:56 PM | Report abuse

Please, .... if I die this day, .... Please .... investigate, WaPo.

.... I, ........ KNOW ..... These, ...... People?

Posted by: deepthroat21 | November 24, 2009 2:56 PM | Report abuse

A "sparrow" died. .... Why?
... Think about it.

.... A census taker was, .... murdered.

Please. ...Justice.

Posted by: deepthroat21 | November 24, 2009 2:59 PM | Report abuse

Perhaps, you are right, Ms. Marcus, the public option should not be allowed to jeopardize health care (insurance) reform. But if it is not all that important, why has the public option become the linchpin of Republican (and the so-called moderate Democratic) opposition to reform. There must be some reason why they are so opposed to it. Could you please enlighten us? If it is such a bad thing, wouldn't it be in their (opposition) interest to make sure a health insurance bill would include it?

Posted by: ZnanaB | November 24, 2009 3:00 PM | Report abuse

A STRONG PUBLIC OPTION is the only TRUE way to allow meaningful reform and also allow the INSURANCE INDUSTRY to shape up.

And this STRONG public option will only work if people have the CHOICE to join it.

As it is now, very few if any people will have the option to CHOOSE from a public option.
We will be REQUIRED to purchase lousy overpriced insurance through whatever lousy plan our employer can afford to offer. And as costs continue to soar, employers while meaning well need to pass along soaring costs to their employees through limiting their choice of plans, raising premiums, deductibles, decreasing the quality of plans and removing the ability to cover dependents.

Every citizen should be allowed to choose from whatever insurance CONGRESS has for the same price.

WHY IS THAT SUCH A PROBLEM to comprehend?

Why should I have to be confined to purchasing crapola insurance if there is a better product out there that suits me and my needs.

Posted by: kare1 | November 24, 2009 3:00 PM | Report abuse

You determined this is not important how? The old if we don't do it my way I will take my ball and go him is something adults are supposed to grow out of. If these holdouts mean we do not have the required number of votes I think we would be just as well off with republicans in those seats.

Posted by: jjmsan | November 24, 2009 3:02 PM | Report abuse

I, ...... I Know! ... these, .... people.
.... I BEG YOU!
.... To root out what is .... poisonous!

... Investigate the Kentucky "Census" taker .... death.

Posted by: deepthroat21 | November 24, 2009 3:02 PM | Report abuse

hmm a totally run government health care system. sounds totally like a public option. NOT. In 2013 join the government healthcare system or else pay fines? excuse me? sounds like socialism. ahem -- karl marx

Posted by: bbll23c | November 24, 2009 3:06 PM | Report abuse

If their is no public option then why are we doing this? Without the public option this is just a giveaway to the Insurance industry

Posted by: scon101 | November 24, 2009 3:14 PM | Report abuse

How in the world can health care reform work without a public option? We are going to trust the insurance industry to reform the insurance industry? Who in there frickin' mind would believe such a thing. Without a public option forget it. Don't even bother wasting our tax dollars. And democrats, screw you too. And republicans die in hell. Without the public option it win for the insurance industry, win for the congressmen who get there kickback checks for voting against the public option and lose lose for the American people.

Posted by: kubrickstan | November 24, 2009 3:16 PM | Report abuse

because the obama administration wants all power to belong in the government's hands. a step to what many believe is their main goal, socialism or total control by the government. If we want this country to succeed, we need to do what common sense tells us to do. And the founding fathers, along with thomas pain, had plenty of common sense. thats why, under the articles of confederation (their first draft for the set-up of this country before the constitution) gave the government a very WEAK amount of power. they clearly knew that a government with too much power would do the country no good. George Washington was a firm believer in this idea. We need to stop listening to these pursuading politicians because all they want is power. We need to do what is good for the people of this country, what our common sense tells us to do.

Posted by: bbll23c | November 24, 2009 3:20 PM | Report abuse

who cares WHAT any representative thinks if it is not in line with the voices of the AMERICAN PUBLIC? isnt this why they are all stumbling over each other? when are they going to get, "ITS NOT ABOUT THEM - THE FEW THAT REPRESENT THE MAJORITY?" it is about the millions of americans in the majority who for one DO NOT WANT GOVT. IN THEIR HEALTH BUSINESS TO BEGIN WITH, then there are all the other mis-deeds this Bill is piggybacking all to drop $$ in the hands of a selective few who are not deserving of it.

Posted by: ChooseBestCandidate | November 24, 2009 3:20 PM | Report abuse

I thought this article might mention actual reasons why the public option in not needed, instead all I see are the right-wing talking points. If all health reform consists of is government payouts to insure more people without any kind of cost control, then it's just going to be a burden on the middle class and drive people to the Republican party. I don't see how that's smart policy or smart politics. Maybe Ruth Marcus can afford to pay for the uninsured as well as ever growing insurance premiums, but most of us can't.

Posted by: posttoastie1 | November 24, 2009 3:20 PM | Report abuse

Monday, November 23, 2009
RASMUSSEN POLL:

38% favor the health care plan proposed by President Obama (lowest since June.)

56% now oppose the plan.

Posted by: ChooseBestCandidate | November 24, 2009 3:23 PM | Report abuse

did you know that insurance companies make a net profit of 2.2% less than those of the AVERAGE Fortune 500 company? the reason insurance companies must charge so much is to cover their asses for the amount they must pay for you to take your kid to the doctor because of their runny nose. The amount of money doctors much charge comes from their overly priced malpractice insurance bills. how do we solve this? Easy - ever heard of tort reform?

Posted by: bbll23c | November 24, 2009 3:24 PM | Report abuse

BIGGEST error of this bill:
not addressing the main reason premiums are high:::T-O-R-T???

= and why isnt the government concentrating on saving the millions they claim they are losing via fraud medicare, medicaid?

= HOW ABOUT fixing what's broken? Better oversight among healthcare providers?

= WHY is this administration ignoring the elephant in the room? WE THE PEOPLE DO NOT WANT YOU RUNNING OUR HEALTHCARE CHOICES... PERIOD...

= why are you ignoring your boss? the american people?

*the way this admin went about this is an insult - thinking that just because they got elected it gives them full reign to make decisions WITHOUT the input of the american people? well they are wrong. and until they get that right they will fail and obama will forever be known as the DO-NOTHING president.

Posted by: ChooseBestCandidate | November 24, 2009 3:29 PM | Report abuse

i think what some do not get is that the public option is anything but. it is a GOVERNMENT-run program and an open door to government having complete control of your life. TOTAL control.

just wait until

Posted by: ChooseBestCandidate | November 24, 2009 3:38 PM | Report abuse

I don't think I will ever understand why so many poor/middle class people feel a need to defend rich people; they are fighting for the "right" to not have adequate, affordable insurance coverage. Amazing!

Posted by: gsross | November 24, 2009 3:38 PM | Report abuse

thank you ChooseBestCanditate.

Here is a question for everyone wondering some of the reasons why health care is so expensive -- say you have a very small tumor on your thyroid. your doctor orders you a CT scan, which on average cost about $2,000. the results come back and the doctor says he is 99% sure the tumor is benign and that you probably won't need to have it removed. Thank god! But just to be sure, he orders you 3 other tests just to make sure that the tumor is benign, perhabs a biopsy, etc. The reason he orders these tests? He has to cover his ass to be 100% sure that that tumor is benign. If somehow that tumor is malignant, his ass is as good as sued. Well, who pays for those additional 3 tests. You got it, your insurance provider. An easy way to fix this? Reform the ways doctors can be sued. Hint hint, TORT REFORM. Doctors will not fight their case in court, they simply don't have enough time. So they just pay the insanely high malpractice insurance price so if they do get sued, they don't have to deal with it. They just pay the lawsuit and move on. thats why your premiums are so high. easy to fix, but not looked at in the bill. why? because it's too easy and would not give our government enough power over every aspect of our lives

Posted by: bbll23c | November 24, 2009 3:40 PM | Report abuse

no gsross. we all know that reform is needed. Who wants to pay more than we actually need. We are saying that the bill provides HORRIBLE ways of fixing it.

Posted by: bbll23c | November 24, 2009 3:42 PM | Report abuse

"another 45,000 Americans…will die each year from lack of health care being available. Really Ruth, are you so happy that 45,000 Americans are going to die, while you, and the other Post employees, all have great health insurance? Nice."

That canard about 45,000 deaths caused by a lack of health coverage is an even bigger lie than the Republican "Death Panels." The figure comes from a Harvard Medical School 'study' that was fatally flawed. The sample size in the Harvard study was only 350 deaths out of only 9000 total records examined, something that anyone who has ever taken Statistics 101 will tell you gives you an enormous margin of error when extrapolated over the entire US population.

A more reliable study conducted by Richard Kronick of UC, San Diego, (and a former Clinton administration health policy advisor) with a sample size of 640,000 found a small increase in the death rate of uninsured people compared with insured people. However, when the two groups were normalized for factors such as body mass index (obesity), smoking, and other health risk factors, "the risk of subsequent mortality is no different for uninsured respondents..."

It is hard to have a debate when people insist on using made-up 'facts.'

Posted by: hisroc | November 24, 2009 3:45 PM | Report abuse

"A public option that allowed the government to dictate Medicare (or close to Medicare) rates would end up driving other plans out of business"
-----------

You say this as though it is a bad thing. The free market has had over 200 years in this country to get healthcare insurance right. Their priorities are just not suitable for the challenge. Too many people get screwed. And prices go up. The public option starts to move this country toward a real solution that the rest of the industrialized world has enjoyed for decades. The weaker the option is, the longer it will take us all to get there. Is it worth losing everything for? Maybe, maybe not. You are suggesting we just cut and run when there is horse trading to be done. Not a particularly smart negotiating tactic, is it?

I'm one of those people who is self employed and have had my fill of pre-existing conditions denials, increasing premiums, limited coverage options and second mortgages to pay for what the insurance companies will not. My tolerance for these companies is pretty much all used up. From where I stand, the Public Option is pretty FREAKING important.

Posted by: tfspa | November 24, 2009 3:46 PM | Report abuse

Well, here I go again... The route (if any) to single payer is from the edges. Medicare already insures not only the elderly but also younger disabled, both groups that generally do not have employer coverage.

One can make a pretty good argument on similar grounds that children's health care should not be decided by their parents' employment. We can start by covering just children to age six, then extending the age annually until the eldest of the first cohort reaches 18 (or 21 or whatever).

What is especially appealing is that children are the cheapest group to insure and that there is a huge downstream payback for preventive care for children. If this flies, then it is a short step to include all pregnancy care as well (under the conservative mantra that this is effectively caring for an "unborn child")

The public will either be satisfied with the level of this care or not. If it is, then it will demand a broader single payer scheme at some later date. If not, the insurance companies will still be in the health care game because of superior service at acceptable cost.

Posted by: wgmadden | November 24, 2009 3:51 PM | Report abuse

Hey, I have public option health insurance. It is called Medicare. I love it. Don't tell me the public option is bad.

Posted by: tinyjab40 | November 24, 2009 3:52 PM | Report abuse

The truth is healthcare coverage could be expanded through thoughtful insurance regulation and reduced costs and without more healthcare dollars being sucked up by a new bureaucracy. The money for the new Bureaucracy has to come from somewhere. Isn't supporting a private insurance bureaucracy going to continue to be cheaper than a big government or the addition of the public and private sector. The concept of inefficiency and wast just seems not to factor in. The idea of government healthcare as a not for profit charity is a laugh.

Posted by: star_key2 | November 24, 2009 3:56 PM | Report abuse

The "Public Option" should really be called "Another Great Big Handout at Taxpayers' Expense plus Money from China".

It must be en vogue to run a war or give away benefits without having a plan to pay for it.

Posted by: joe_average | November 24, 2009 3:58 PM | Report abuse

Shorter Ruth Marcus:

"I got mine."

Posted by: kmblue | November 24, 2009 3:59 PM | Report abuse

Every child deserves the access to the health care that my children have
*******

so im guessing Ruth pays for the health care for at least one poor child, or perhaps a poor adult, right?

No? didnt think so.

guess you dont really think health care is a moral imperative. you just like to sound self-righteous and/or as innocent as the day you were born.

i find that pretty pathetic for a grown woman.

Posted by: dummypants | November 24, 2009 4:16 PM | Report abuse

I agree that we need to reform heath care and drive down the costs. Adding millions to the system and giving it away raises the costs not lowers it. Whether it be a public option or not. When it comes to goods and services people seem to take care of the things they pay for and not for the things that are "free". Public Housing is a perfect example of this. It was a great humane idea; however the poeple who lived there did not keep it up. Not all of course but enough to trash most public housing.

What Congress and the President should be doing is working to create more jobs and the additional tax revenue from those jobs. Cap and Trade, Health Care are not the priorities for the 18% percent unemployed or under employed. Fix that first and we will have the money to look at Health Care reform in a smart way.

Posted by: franco1958 | November 24, 2009 4:16 PM | Report abuse

The public option is interesting, but it's built on the same fundamentals as everything else, so it won't do what it's supporters hope for. There are far more serious issues we needs to talk about, and they are being pushed aside because of politics. For instance, we need to discuss why this version of reform will drive up health care costs to unaffordable levels. And please STOP thinking the public plan will drive costs down! The public plan doesn't have the necessary tools to do that. For a full explanation of why the costs will rise so dramatically just ask an expert that's not in politics.

Posted by: HealthNetwork | November 24, 2009 4:26 PM | Report abuse

So, Ms. Marcus, maybe you favor the much touted "Utah Plan" - nothing more than a lead generation exchange for private insurers with $6,000 per year premiums and $5,000 deductibles for a healthy, non-smoking, 36 year-old male?

Will no public option make these rates lower?
If not, how can you pretend these prices are "reasonable"?

Posted by: coloradodog | November 24, 2009 4:29 PM | Report abuse

I don't know why liberals have their panty hose in such a knot over the "gang of four" and the public option. It's pretty transparent to me what is being played out here.

The public option will disappear out of the Senate Bill. Bernie Sanders will magically (perhaps through a buy out or buy out, a la Mary Landrieu) suddenly, at a moment of high drama, decide he can indeed vote for a bill that lacks a public option. Ben, Joe, Mary, Blanche, everyone will be in front of the mikes claiming that the bill is now something they can support!! Much happiness will flow like champagne on the Hill.

Then in January, Harry and Nan form a conference committe of two, and SURPRISE!! The public option reappears in the legislation. Ben, Joe, Mary, Blanche -- even Evan, now all VERY UPSET!! Bernie BEAMING!! But guess what? Since the vote is now on the reconciled bill, you only need 51 votes. Ben, Joe, Mary, Blanche, Evan, even a few more with tough reelections can vote NO!!! Hold heads high, crowd mikes again for consitutuents consumption and use in reelection campaign ads; they voted NO to save the country.

Doesn't matter. Health care reform, with public option, becomes law of the land.

Liberals, calm down and take some deep breaths. What you want is on the way. Then we'll see how it works.

Posted by: Curmudgeon10 | November 24, 2009 4:53 PM | Report abuse

"Cap and Trade, Health Care are not the priorities for the 18% percent unemployed or under employed." Maybe not, but if we don't act on them soon, they will be. There are enough people in Washington to work on multiple issues at the same time. So save your false dichotomies.

As for tort reform. Go ahead, let's give it a try. Most indications are that it won't be any more of a panacea for health care costs than the watered down public option now on the table. But, I'm willing to support it as long as incidents where a doctor ruins the life of a patient through negligence have no cap for damages. Justice is justice. We don't want to surrender that basic idea in America.

Posted by: youba | November 24, 2009 4:56 PM | Report abuse

This is tough for me...

I align with no party, yet I tend to be socially progressive and believe access to care "should" be a right for all citizens and children. I really want to support a true reform of our healthcare system, but I think I have finally given up.

The dichotomy of ideals in our political system is simply too divergent, too complex, too opposed to ever have a reason-based solution.

The enterpriser's and fiscal conservatives will never, ever, ever support a federal program of any kind, be it insurance or subsidies, and don't believe anyone deserves ANY social subsidies, ever, no matter the circumstance.

On the other side, the liberals will never accept that someone should go without care, or that there are alternatives to government bureaucracy and take overs.
We are at a stale mate...and the result is a half-assed, dim-witted approach to insurance reform (not healthcare, since we aren't really addressing how care is provided). Thus, I say bag it...throw in the towel on the whole bloated rotting carcass. Maybe fast-track some small reform package on pre-existing conditions and recisions and forget about the rest.

In another 20 years, depending on the condition of the economy, we'll have to make a more painful decision; but frankly conditions are likely to be much worse and perhaps our willingness to compromise (one way or the other) will be increased.

I think single payer is probably the best solution overall, but I would be equally happy to see TRUE market based options on the insurance and care side. What I mean by that is give all insurers open access to all markets, eliminate the income tax exemption, and force transparency in costs from health service providers (how many of you knew how much you last check up cost before you were treated?). Those options would allow for consumer choice at all levels and would increase competition and efficiency.

Maybe in my lifetime I'll see one or the other...probably not, I am in my 30s and I doubt we'll fix this anytime soon.

Posted by: Mc2guy | November 24, 2009 5:03 PM | Report abuse

Ruth your arguments are so dumb you make Palin seem like an intellectual

Posted by: dhxx | November 24, 2009 5:04 PM | Report abuse

It's sad that so many of our fellow Americans aren't in favor of making our country a better place in which to live. I can understand why we have politicians opposed to reform: They're being paid off by lobbyists from the health care and pharmaceutical industries. I can understand why those same industries are opposed to reform: They're not going to make as much money as they currently are.

What I absolutely cannot understand is why my fellow citizens are opposed to reforming our broken health care system. They have no reasonable objection whatsoever, and I believe they'd all be singing a different tune if they or their loved ones were suddenly struck by a medical emergency that could possibly bankrupt them.

Unfortunately our government lacks the ability to care and to LISTEN. The arrogance and selfishness of our politicians on the health care issue has once and for all illustrated that fact in no uncertain terms. Are they willing to look at the health care solutions of Germany, New Zealand, Canada, and every other place on the planet that values the lives of their citizens? Not on your life. The outlook for this country is becoming darker by the day. But as long as taxes are raised little or none, lots of people will die happy. The rest of the civilized world does not even laugh at us anymore.....they pity us.

Posted by: shadowmagician | November 24, 2009 5:04 PM | Report abuse

Where and when did health care - insurance - become either a right or a moral imperative? Where is the personal responsibility to provide for your own darned care? How many of the so-called "poor uninsured" have cell phones? Cable TV? Own a car? And why all is this liberal hand-wringing about health care when we have millions of American children going hungry? Is there an overriding right to food ahead of health insurance? As one approaching eligibility age for both, I look upon both Social Security and Medicare as welfare, just like a public option will be (or will become). Call it what it is, welfare, pure and simple. And health care is nowhere mentioned in the Constitution, which, by the way, (would if could talk), would tell you that this sort of thing is a state issue anyway, since nowhere, like the aforementioned ills,- are these "rights" enumerated for the Feds. This is political power-grabbing pure and simple, so the left can control even more people on top of the terrified seniors and poor do now, who then vote to keep their dependency because they've never been taught to take care of themselves. The left is disgusting in this ruse ...

Posted by: LT369 | November 24, 2009 5:04 PM | Report abuse

tort reform and doing away with it are not the same thing. there needs to be a happy medium. isn't that whats America is all about? we must REFORM what has been made for us. not DELETE and ADD things that are completely unnecessary. especially with a group by all means is not qualified to do so.

and by the way, it is not a RIGHT for you to have health care. it is not defined in the constitution. If you decide to not work, or buy lavish things like LT369 said above, then you deserve not to have health care. get your priorities straight america. use your common sense. this is the land where you work hard for what you want and you keep what you earn. Not come here and expect everything to be free for the taking and provided to you by the government

Posted by: bbll23c | November 24, 2009 5:17 PM | Report abuse

Many of us Republicans want a safety net, as we have with food. What we don't want is socilized medicine. Majority rules except in rights and liberty. Nothing in the Constitution authorizes the Federal Government to run medical care. Your (liberal's) goal is for the government to run medical care ala' Canada or the UK.
This is still America, until you and the rest of the left put us under a red banner.

Posted by: TED3MSC | November 24, 2009 5:33 PM | Report abuse

"Jeopardize health reform"?! What health reform? Obamacare is NOT health reform! It's a criminal SCAM, a power grab that will destroy our health care, our economy, our freedoms and our country.

Imitating Hugo Chavez, Obama wants to nationalize everything, including our health care system! "Hey, Obama has just nationalized nothing more and nothing less than General Motors. Comrade Obama!" Chavez cheered on Venezuelan TV. He added that he and Cuba's Fidel Castro would now have to work harder just to keep up.
http://www.hacer.org/report/2009/06/us-obamas-red-chorus-investors-business.html

Fortunately, most Americans have not been dumbed down. Most Americans are not sheeple. Most Americans prefer to be FREE.

Posted by: AntonioSosa | November 24, 2009 8:28 PM | Report abuse

How could a criminal scam like Obamacare, much, much worst than Madoff's Ponzi scheme, be a "moral imperative"!

A real moral imperative is NOT to steal from our children and grandchildren to fund the immoral Obamacare scam, which is NOT going to improve anything. Obamacare will further destroy our country.

Posted by: AntonioSosa | November 24, 2009 8:34 PM | Report abuse

The "public option" is neither public nor an option. It's government-controlled health care. And you have to be a FOOL to believe that government-controlled health care is going to reduce costs or improve anything!

In addition to the added cost of corruption, you have to add the cost (billions or trillions?) of salaries for the armies of ACORN-type government workers to run Obamacare.

In countries suffering from socialized medicine, the cost of the bureaucracy becomes higher than the cost of actual medical services… and, as any bureaucracy, it keeps on growing.

For example, European parliament member Daniel Hannan, who represents South East England at the European parliament, says:

“How amazing to me that a free people, you know, citizens of a country founded on the principle of independence, independence for the citizen as well as independence for the state, should be contemplating, in peacetime, burdening themselves with a system like this, which puts the power of life and death in a state bureaucracy.”

Listen to Hannan: http://www.ronpaulforums.com/showthread.php?t=204359

Of course the dumbed down expect “the rich” to pay for it all. But as it happens in any commie country, “the rich” soon disappear. They either become poor or they are able to leave to a freer, more prosperous country.

Posted by: AntonioSosa | November 24, 2009 8:44 PM | Report abuse

Being forced to buy overpriced junk insurance is not the same as universal health care. And Obamacare is paid for largely by a 40% tax on employer benefits. The plan sucks, with or without the crippled public option.

We need a robust public option which has the power to set premiums and payment rates like a public utilities does. Nothing else will work.

Posted by: bmull | November 24, 2009 9:24 PM | Report abuse

Correct me if I am wrong.

The so called antitrust exemption of insurance companies is not a complete blanket exemption, but according to the legislative history of the law creating the exemption was to allow joint sharing of data among insurance companies so that appropriate rates could be based on large pools of actuarial data.

Thus the narrow antitrust exemption doesn't create a license for the health insurance companies to monopolize markets, collude, manipulate rates, practice consumer fraud by misrepresenting what their coverage is, etc., etc., etc.

With a simple demonstration in court that the antitrust exemption is irrelevant to and does not bar bringing an action for these matters there is no reason a state or federal court action couldn't immediately be brought to start wiping out monopoly, collusion, manipulation, and fraud upon insurance consumers...no 60 votes needed just one good legal team to start bring down the house of cards that allows corporations to strip mine profits out of human beings over their health!

Psst, Biden, tell Obama!

Posted by: gradya3 | November 25, 2009 1:16 AM | Report abuse

The so-called "public option" support in a few polls drops dramatically when the term is changed to "government option" which more accurately describes it, and which people understand when the pollsters ask the question.
All non-partisan polling indicates that the majority of the American public opposes the specific legislative plans of both Houses of Congress.
Although there is virtual unanimity in a desire for "health care reform," this is NOT the "reform" that most Americans want.

The best example of the inadequacy of a "government plan" or public option" is Medicare. Although it serves as a safety net, it fails to cover anything but the most basic care.
If you doubt this, randomly call 20 doctors tomorrow and ask if they are accepting new Medicare patients. See how long it takes you to find a physician willing to accept you as a new patient.
Then ask friends and relatives on Medicare if they purchase supplemental plans on the private market to provide the coverage and care that they reasonably expect, that is not included in Medicare. The majority of those who are able to afford it carry such coverage, often through AARP, which makes millions on royalties each year through the sale of such necessary coverage. Why do you think they're so eager to support Obamacare? When Medicare is cut dramatically under HCR, they'll make even more money.

The current proposals are bad legislation. Congress should start over, and work in good faith to give the American public the real reform it wants and deserves.

Posted by: parkbench | November 25, 2009 2:15 AM | Report abuse

I totally agree. I'm in favor of the public option (or single payer if we could get it) but if we get the other reforms without the public option, that will still be a big improvement.

We have to remember that the last time health care reform came up for serious discussion was 16 years ago, when Clinton was just starting. If we don't pass it now, it could easily be another 10-20 years before it even comes up again.

Have we already compromised a lot? Yes. Will we have to compromise some more? Yes probably. Will it all be worth it if the bill passes, and be a huge disappointment if the bill fails? Yes!

Posted by: mitchgart | November 25, 2009 7:39 AM | Report abuse

Ruthie when will you be signing on for Obamacare ? Tell us so we can be there for the photo op.......what - you arent going to go on the plan ? What ???Why ??? but Ruthie if its so good for all of America why not for you or Congress or Mr Obama etc ???? Why does it take 300 million in bribes to get one Senator to sign on ?? Wake up and start smelling the manure Ruthie before you make America roll in it..

Posted by: JUNGLEJIM123 | November 25, 2009 8:25 AM | Report abuse

Okay, Ruth, so what are some reasonable alternatives to a new Public Option that will increase private-sector competition, provide healthcare access for 46 million uninsured, offer reasonable price-affordability for all--and reduce the overall systemic costs of America's outrageously expensive status-quo healthcare system?

It seems like those few "options" that have surfaced either get shouted-down by many of the same opponents of a PO, or are discarded as being inconsequential as a one-for-one trade-off.

Perhaps the virulent opposition to the PO, is an indication as to just how powerful it would really be and, therefore, will require a gaggle of other alternative options to be added. Perhaps a combination of some of these "old" ideas and some new creativity are needed:
~ Eliminate the archaic anti-trust loophole and allow competition across State lines.
~ Expand the regional Co-Ops concept to allow "exchanges" for small businesses nationwide
~ Stimulate self-insurance for larger corporations
~ Reduce the Medicare age to 60
~ Make Medicare an "Option" to COBRA--for folks 55 and over
~ Establish more rigorous regulatory guidelines for Insurance Companies, Drug Companies and Medical Device Manufacturers related to executive compensation and bonuses
~ Restrict or eliminate the payment of corporate dividends
~ Restrict IRS tax exemptions for expenses related to lobbying activities and advertising (i.e. patient premiums or taxpayer subsidies should never have to pay for the cost of another Erectile Dysfunction ad!)

Ruth, encourage your readers, and Congress, to look at the demise of the Public Option as an opportunity to make reform even better--for patients!

Posted by: taus007 | November 25, 2009 8:38 AM | Report abuse

Rep. Alan Grayson (I know he's in the House, but still...)is proposing that the Senate modify its rules so that cloture can be achieved by fifty-five votes instead of sixty.

That would be a signal achievement. Grayson's reasoning is that about one hundred bills are sitting in the Senate queue that require 60 votes to pass, so legislation is dying on the vine. You reduce the threshold to fifty-five, then get that workload done--as well as HCR.

I hope his proposal catches fire in the Senate.

Posted by: ChrisNBama | November 25, 2009 9:06 AM | Report abuse

I'm disturbed that the conversation on single-payer has been shortchanged because so many people cite "political realities" as an excuse for taking the debate off the table. Whose political realities? Washington insiders? Lobbyists? Bill Moyers had an interesting interview in June with Jay Rosen and Brooke Gladstone where they discuss "savviness" in the reporting of the health care debate. In answer to Bill Moyers' question on the popularity of single payer among the general public, Jay Rosen responds: "...the inside players know that single-payer is never going to be the answer. And they're already factoring that into their political calculations about what's likely to result..."

The whole transcript is worth reading, if you want to know how "savvy" writers like Ruth Marcus are shaping the debate.
http://www.pbs.org/moyers/journal/06052009/transcript3.html

Posted by: CoolOnion | November 25, 2009 9:14 AM | Report abuse

By the way, Ruth Marcus is completely right.

The Senate does not have sixty votes to pass HCR in its current form. Lincoln, Nelson, Lieberman, and Landreiu are staunchly opposed to the public option as it stands. Lieberman, who is completely bought and paid for by Aetna, is even opposed to a triggered public option. This means, that there isn't sufficient political will in the democratic caucus to pass a public option of any kind at all!

Which means, that to even get a triggered public option is going to mean wooing Queen Olympia Snowe to compensate for the intransigence of Traitor Joe.

Finally, I agree with Ezra Klein and others, who have pointed out that you can not compromise with folks that actually face a political upside to HCR failing. This is more true of Landrieu, Nelson, and Lincoln. Their political fortunes improve if HCR fails, so the real compromise is with liberals: Is HCR important enough that passing it without the public option is necessary or not?

Posted by: ChrisNBama | November 25, 2009 9:17 AM | Report abuse

"I'm disturbed that the conversation on single-payer has been shortchanged because so many people cite "political realities" as an excuse for taking the debate off the table."

I'm disturbed that you make this point as democrats scurry around scraping up votes for a fairly conservative bill.

Can you see a Single Payer plan passing through the House and Senate? Really?

Posted by: ChrisNBama | November 25, 2009 9:20 AM | Report abuse

Subject: Joe Legal and Jose Illegal

You have two families: "Joe Legal" and "Jose Illegal". Both families
consist of two parents, two children, and live in California .


Joe Legal works in construction, has a Social Security Number and makes
$25.00 per hour with taxes deducted.


Jose Illegal also works in construction, has NO Social Security Number,
and gets paid $15.00 cash "under the table".


Ready? Now pay attention...


Joe Legal: $25.00 per hour x 40 hours = $1000.00 per week, or $52,000.00
per year. Now take 30% away for state and federal tax; Joe Legal now has
$31,231.00.


Jose Illegal: $15.00 per hour x 40 hours = $600.00 per week, or
$31,200.00 per year. Jose Illegal pays no taxes. Jose Illegal now has
$31,200.00.


Joe Legal pays medical and dental insurance with limited coverage for
his family at $600.00 per month, or $7,200.00 per year. Joe Legal now
has $24,031.00.


Jose Illegal has full medical and dental coverage through the state and
local clinics at a cost of $0.00 per year. Jose Illegal still has
$31,200.00.


Joe Legal makes too much money and is not eligible for food stamps or
welfare. Joe Legal pays $500.00 per month for food, or $6,000.00 per
year.. Joe Legal now has $18,031.00.


Jose Illegal has no documented income and is eligible for food stamps
and welfare. Jose Illegal still has $31,200.00.


Joe Legal pays rent of $1,200.00 per month, or $14,400.00 per year. Joe
Legal now has $9,631.00.


Jose Illegal receives a $500.00 per month federal rent subsidy. Jose
Illegal pays out that $500.00 per month, or $6,000.00 per year. Jose Illegal
still has $ 31,200.00.


Joe Legal pays $200.00 per month, or $2,400.00 for insurance. Joe Legal
now has $7,231.00.


Jose Illegal says, "We don't need no stinkin' insurance!" and still has
$31,200.00.


Joe Legal has to make his $7,231.00 stretch to pay utilities, gasoline, etc.


Jose Illegal has to make his $31,200.00 stretch to pay utilities,
gasoline, and what he sends out of the country every month.


Joe Legal now works overtime on Saturdays or gets a part time job after
work.


Jose Illegal has nights and weekends off to enjoy with his family.


Joe Legal's and Jose Illegal's children both attend the same school. Joe
Legal pays for his children's lunches while Jose Illegal's children get
a government sponsored lunch. Jose Illegal's children have an after
school ESL program. Joe Legal's children go home.


Joe Legal and Jose Illegal both enjoy the same police and fire services,
but Joe paid for them and Jose did not pay.

Do you get it, now? Where did the $10 an hour in pay go? In the pockets of the small businessowner who are now complaining about tax increases, health care reform and high unemployment taxes.

Posted by: ecbowles1956 | November 25, 2009 9:27 AM | Report abuse

One point that I haven't seen discussed about health care reform, is that the Republicans will eventually hold the Presidency and the Congress again, which they will eventually in our electorally-balanced country. Therefore, if reform is not radical enough, the Republicans, when they take control of the Federal Government, will reverse the reform, just as President Regan reversed many of President Carter's initiatives when he took office.

Only a radical reform will prevent such a reversal. For example, just requiring people to buy health insurance and subsidizing private insurance for those unable to pay would be easily reversible by the Republicans.

Consider the example of Social Security. By the time that the Republicans controlled government in the early years of the Eisenhower administration, Social Security was an important social safety net upon which many people depended for most of all of their retirement income. Although Republicans would have liked to reverse it, by that time that was impossible.

The Democrats need to make their health care reform program too important to too many people to be easily reversible.

Posted by: jwcross | November 25, 2009 9:45 AM | Report abuse

Amazing how many strong opinions there are about this issue. But I wonder how many of the posters actually know what the bill will/won't do? I keep pretty well informed, but I honestly can't say that I am confident I understand the ramifications of the current bill. It is a terribly complicated issue and I'm not sure anyone, including Congress, understands the implications. That said, reform is needed, and hopefully we are moving toward that end. It will be an imperfect process, but at least it is finally on the front burner. Something to be thankful for this holiday.

Posted by: mdonnelly1 | November 25, 2009 10:18 AM | Report abuse

thats exactly what us republicans are saying mdonnelly. The health care bill is far too complicated to run effectively. it seems odd that a group that has no experience whatsoever is trying to make a COMPLETELY new health care system. maybe they should just tinker with the old system to make it better. Why did they make it so complicated? so that hopefully nobody would read it or try to understand it so they could sneak it though congress. the obama administration is a bunch SOCIALISTS. they dont want anybody knowing about the bill because they want it to pass. they knew if anybody had a clue about it nobody would vote for it. they want power to the government! not to the people. that is why time is their worst enemy. the more that time passes on, more and more people actually read or find out about the bill.

Posted by: bbll23c | November 25, 2009 11:27 AM | Report abuse

I have been taxpayer my entire life. I have never received any benefit other than the honor of paying taxes. We are always presented the false choice of having to fight a war somewhere or health care. War always gets the money.

Posted by: fare777 | November 25, 2009 11:53 AM | Report abuse

Senate Majority Leader Harry Reid (D-NV) released a merged version of the Senate comprehensive reform on 11/19/09,
which Mike Oliphant, whom manages www.benefitsmanager.net for Utah based health insurance plans for employers could get
behind and support some of it (Patient Protection and Affordable Care Act, or H.R. 3590).
This should encourage the private sector health insurance carriers to form INSURANCE EXCHANGES which is what we have
done here in Utah. They carry the risk and burden, not the tax payer. See more about this at www.utahhealthplans.info
You would be surprised about the willingness of carriers to co-share risk amongst their immediate competitors. They simply
focus on profit from the 4 to 5 percent administration fees. A government run public option could not achieve this.

Posted by: mikeoliphant | November 25, 2009 12:44 PM | Report abuse

No matter how you slice, dice or disembowel it, the health bill that is now on the table in the senate is so full of exclusions and give-aways to the HCI (plus it does not come into effect until 2014) that it has become worse than no reform at all. Why is it that Americans feel that they know so much better than the rest of the civilized world about this issue. The way to do health care reform is to just provide medicare for all, full stop. All all this rhetoric about "we can't afford it" is such a load of crap. We couldn't afford a useless war in Iraq but we spent the money and what did we get for it - a boondoggle for a handful of defense contractors and oil companies and a whole lot of grief for many American families. We couldn't afford to bail out the financial services industry but we did it. the jury is still out if it truly saved the world's economy from a complete meltdown. Republicans keep forgetting that they put us where we are. If they hadn't been so irresponsible in the first place, every man woman and child would have decent health care already and we wouldn't be splitting hairs to make sure the corporate HCI elite still keeps fleecing the american public.

Posted by: guydesrochers | November 25, 2009 2:50 PM | Report abuse

There is a vast difference between health care reform and insurance reform. With no public option, there is no health care reform. Insurance reform is certainly necessary and the American people may have to be content with the watered-down version of the current legislative alternatives now under consideration. Howver, no one should claim it as health care reform because that is only possible with a strong public option. A robust public option is inevitable. It may not come in 2010 when this watered down piece of legislation is signed into law. It will, however, come eventually because the American people will demand it.

Posted by: Lavinsr4207 | November 25, 2009 7:36 PM | Report abuse

where are you getting this idea of a public option? under the current bill being discussed, there is NO OPTION! it is a wrongfully named piece of legislation to try to get people to hop on the falsified bandwagon. they know nobody would vote for it if they called it what it actually is, a totally-run-by-the-government-socialism option.

Posted by: bbll23c | November 25, 2009 11:16 PM | Report abuse

Ruth,
perhaps you have no idea of what the healthcare industry is doing right now.
My premium have gone from $964 to $1286 in 3 months, I called everyone I could and basically, Blue Cross Blue Shield said, read it and weep. We are a family of three, I'm out of work, as many are right now, I don't no how I can pay this exorbitant amount. I have a heart condition, am diabetic and with out health insurance I won't make it to 65 and Medicare.
Your narrow minded assessment of what real people are going through makes me sick. If I can't get relief then you along with the other people who have no clue will doom me to YOUR DEATH PANEL....THANK YOU.

Posted by: rosenfan1 | November 26, 2009 10:13 AM | Report abuse

jwcross said;

One point that I haven't seen discussed about health care reform, is that the Republicans will eventually hold the Presidency and the Congress again, which they will eventually in our electorally-balanced country. Therefore, if reform is not radical enough, the Republicans, when they take control of the Federal Government, will reverse the reform, just as President Regan reversed many of President Carter's initiatives when he took office.
/////////////////////////////////
I don't really disagree...
But what did Reagan do, to reverse of Carters policies?
He cancelled the Solar research Institute 1 billion $ annual grant? He took the solar water heaters off the White House roof?
He tried to start some western water and hydroelectric projects?
http://www.nytimes.com/1987/08/12/us/hodel-plan-may-revive-era-of-big-dams-in-west.html
But realise even "Democrats" are the peoples enemies.
Both parties are the enemies of the people, just one prefers guns, the other butter to 'buy' their way.

President Carter was a very conservative President, who himself killed National Health Care.
Carter (the farmer) who hated unions also opened up, or "Broke" the borders, advertised for immigrants and destroyed the labor market with masses of illegals.
Carter also killed the nuclear power industry, halted all expansion of hydroelectricity, and natural gas generators, and mandated we use coal in their place. Carter was heavily subsidised by the coal industry.
Carter began the policy, unchanged to this day, of keeping a permanent labor surplus to depress wages and thus stifle inflation.
6% unemployed was redefined as Natural Full Employment We used to have unemployment range between 1% to 4%....never since Carter.
Carter Appointed Volcker and Greenspan to head the Federal Reserve, to suppress UNIONISED manufacturing expansion in USA thus suppressing employment. Laws were passed giving tax breaks to encourage companies to outsource to Mexico and elsewhere. Foreign, NON UNION (guaranteed by new US laws) were encouraged to come and compete against unionised manufacturers in the USA.
Carter restarted the Cold War against the Soviets, began expansion of our military again (3% real growth every year was his mantra), and provoked the Iranian revolution by sending in Khomeni from France but it backfired on him.

^The Kennedy/Nixon plan killed by Carter
http://www.kaiserhealthnews.org/Stories/2009/September/03/nixon-proposal.aspx

What did Reagan cancell? He kept Volcker and Greenspan, he kept their labor policies, but he minimised the outsourcing, he kept the illegals and gave them amenesty, he kept borders wide open and pushed the Cold War just like Carter.

Posted by: WilliamBlake | November 26, 2009 10:40 AM | Report abuse

"I have been taxpayer my entire life. I have never received any benefit other than the honor of paying taxes. We are always presented the false choice of having to fight a war somewhere or health care. War always gets the money."

Posted by: fare777 | November 25, 2009 11:53 AM
///////////////////
I have also had the honor of 5 years military service.

We sure fight a lot of wars..

1974 State of the Union....

"In the past 5 years, we have steadily reduced the burden of national defense as a share of the budget, bringing it down from 44 percent in 1969 to 29 percent in the current year. We have cut our military manpower over the past 5 years by more than a third, from 3.5 million to 2.2 million"
"...we can and we will make the year 1974 a year of unprecedented progress toward our goal of building a structure of lasting peace in the world and a new prosperity without war in the United States of America."

This guy was deposed and exiled in ten months.

Posted by: WilliamBlake | November 26, 2009 11:13 AM | Report abuse


Ms. Marcus --

You are correct that keeping "the public option" is not worth sinking the whole endeavor. Indeed the concept has become so twisted and diluted, that if the CBO can't score it as saving money, why bother. What is more worrisome is Nelson's doing the bidding of the insurance industry to keep its anti-trust exemption intact. If we're to test whether competition can help control costs then there should be tooth and claw competition and not pretend oligopolistic "competition." I urge you to focus more on that matter, and to ask why something like Wyden-Bennett never made it the starting gate, and why Wyden-lite may not survive.

Posted by: DCLatCH | November 26, 2009 11:16 AM | Report abuse

"I have been taxpayer my entire life. I have never received any benefit other than the honor of paying taxes. We are always presented the false choice of having to fight a war somewhere or health care. War always gets the money."

Posted by: fare777 | November 25, 2009 11:53 AM
_________________________

POOR POOR guy,

I guess he never learned to read or write because he never went to SCHOOL.

I guess he never drove or rode in a car, took a bike or any other mode of transportation,
Never lived in a house, or had modern appliances.

I guess he never took an aspirin or a Tylenol.

I guess he never bought home insurance or FLOOD insurance.

I guess he never sent a piece of mail.

I guess he lives naked and never took a shower. He must have really bad teeth as well, because he never had fluoride in his water.

All in all how did this guy learn to type on a computer that was developed by a government agency and supplemented with his tax dollars. PROBABLY not at the LIBRARY

IDJIT.

Posted by: kare1 | November 26, 2009 11:45 AM | Report abuse

Too bad we don't have people wearing red bandanas closely and daily engaging the "Health Insurance" people ?

Lets have each Health Insueance CEO, most especially the formerly Non Profit now for profit Blue Cross have women like this singing to them each and every day oh Lord....lol
http://www.metacafe.com/watch/yt-QJrNPxZsXk8/american_coal_miner_war_during_matewan/

Posted by: WilliamBlake | November 26, 2009 2:18 PM | Report abuse

It is becoming tiresome to read posters like bbll23c throw out numbers like insurance companies only make a net profit or 2.2%. You've been fed a line of creative accounting by their accountants. They are very adept at hiding assets in dummy companies, cost shifting and using loopholes to hide their true profits. Try to understand, health-care, it should provide preventive care, rather than a revenue generating stream for greedy insurance company executives. We love to brag about how advanced we are yet because of selfishness and greed we blind ourselves to the truth. How many times do we hear americans who call themselves christians say I dont want my tax dollars to pay for illegal immigrants or those people need to find a job, while at the same time bemoaning the fact that the same companies they admire have shipped jobs overseas to save money. Ever talk to someone from your internet tech support or your bank and realize they are in india? If only those who support the GOP strategy of divide and conquer would only put their hate on hold they might get it. In NYC (maybe in other cities)there's a card game called three card monte, the shiller has an accomplice whom he allows to win, he pulls the gullible in by making think they too can win but the game is rigged. That is exactly what this current republican party does, they promise they and only they have the solutions, really? Bush had eight years, the republicans had 12 years, care to show us the reform.

Posted by: jestindam | November 26, 2009 9:10 PM | Report abuse

jestindam,

The response about insurance companies making a 2.2% net profit was a response to an earlier post about the insurance companies being the "big bad wolf" and "taking everyone's money." That is not entirely the case! Insurance companies, like all other businesses, seek to make money. I don't know of any business that don't have that goal in mind. But people have a false idea about what is causing health care to rise so dramatically. One of the main reasons, which I included in the post, is the unrealistically high cost of malpractice insurance doctors must pay. So no, I wasn't just throwing numbers out there. I was using them to prove a point, a point that most people don't understand because the democratic party wants to make private insurance companies look bad so that everyone will hop on the bandwagon of a government-run system. Which, by the way, would drive costs way up.

Posted by: bbll23c | November 26, 2009 9:58 PM | Report abuse

The bills in Congress do not address the fundamental issue of high costs and the fact that the consumers of healthcare are not the ones paying for it.

Patients do not bear the full cost of the health resources they use...people who paid nothing for health care consumed 30% more care than those with high deductibles (Kate Baicker, Harvard School of Public Health in testimony to Congress on March 2009).

Individuals' out of pocket healthcare costs decreased from nearly 50% of the total cost in 1960 to only 12% today. Medicaid/SCHIP pays 15% (vs. 2% in 1960), Medicare 19% (vs. 0% in 1960) and private insurance pays 42% (vs. 28% in 1960).

A consumer driven approach is the best way to get costs under control.

Posted by: rtr3200 | November 27, 2009 8:11 AM | Report abuse

The White House will tell you exactly
what you need to know.
Joseph Goebbels will be more then happy
to provide all the information currently
available to non-pary members.

as for statistics,
I read somewhere
that 100% of humans
will die.
we must do something about
this inhumanity!

Posted by: simonsays1 | November 27, 2009 10:34 AM | Report abuse

NOT.REMOTELY.PERSUASIVE.

We're about to pass legislation that will do virtually nothing to constrain costs and will commit the taxpayers and individuals to massive annual subsidies to price-gouging insurance companies. Better to have no bill than the piece of crap that moderate Dems have demanded for their insurance-company financiers.

Posted by: uh_huhh | November 27, 2009 11:24 AM | Report abuse

The urge to unleash a barrage of ad hominen attacks against you is strong but thankfully the earlier post by Thelma McCoy more gracefully conveys my feelings.
www.usa.gov, factcheck.org and others are more reliable sources to support a robust public option. Mrs. Marcus you are playing loosely with the facts here; the public option has been so watered down that it really is no option at all. Furthermore just as you so proudly proclaim that "Not in the Senate" does such inequities occur. It becomes clear how you and others like you could see the 'political realities' of a system that really doesn't care if millions go uninsured. I and millions like me(unemployed and uninsured) donated to the effort spearheaded by Keith Oberman to fund free health clinics in the cities/states of these four ConservaDems.
The thousands of people turning out to for free health care far outnumbered the Tea Party coalitions but not one mention of it in the WAPO.
I personally hope that this bill fails because it will not only fail to cover those who need health care but passing a bad bill won't help the Democratic party.
You know that....so why are you doing this?

Posted by: seansets | November 27, 2009 5:43 PM | Report abuse

There are actually more than just 4 senators among the "blue dog" democrats who oppose socialized medicine. A bill containing the public option and abortion funding will not pass. Furthermore, the bill has other problems, such as the provision that mandates FINES if you fail to carry health insurance.

Posted by: penniless_taxpayer | November 28, 2009 12:11 PM | Report abuse

Do you writers even read your own paper? Ms Marcus, you are either misinformed, or not truthful. It is widely, I mean w i d e l y reported that the actual situation is quite the opposite of your anti-public option piece of shillery. Your own paper, today, disagrees, Reuters, the NY Times. Really

You are in trouble with many because of disingenuous writing.

Posted by: critical44 | November 30, 2009 12:37 PM | Report abuse

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