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Has Howard Dean lost his mind?

Question for Howard Dean: Have you lost your mind?

"Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill," the former chairman of the Democratic National Committee told Vermont Public Radio.

“At this point, the bill does more harm than good,” he told George Stephanopoulos on ABC’s Good Morning America. “This is an insurance company’s dream, this bill. ”

This is self-defeating lunacy. The Senate bill would extend coverage to more than 30 million Americans who would otherwise be uninsured. It would protect people against being denied coverage because of preexisting conditions, from having their coverage summarily dropped if they get sick, from being charged more on the basis of their gender or their health status. For the first time, childless adults living at or near the poverty level would be assured coverage under Medicaid. Children could remain on their parents’ insurance policies until age 27.

This is “not worth passing in its present form,” according to the good doctor, because the new insurance exchanges on which those without employer-sponsored insurance will be able to shop for policies does not include a publicly-run plan.

“Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform,” Dean writes in The Post. “Washington has decided, once again, that the American people cannot be trusted to choose for themselves. Your money goes to insurers whether or not you want it to.”

But when Dean was running for president in 2004 -- and he launched his campaign in significant part on a platform of health-care reform -- the public option was nowhere to be found in his proposal. He wanted to give tax credits to help the uninsured afford coverage and let the uninsured and small businesses join together in insurance pools. Sound familiar? Like, for example, the plan he’s now trashing?

“With my plan, we'll organize a system identical to the one federal workers and members of Congress have,” he said back then. I happen to know a lot about that system because, since my husband is a federal employee, my family is on the federal plan. And, guess what: it gives us a choice among...private insurers.

Setting that aside, the argument by Dean and his fellow public-planners is that only with a government-run insurance plan alongside private insurers will there be a mechanism to ensure competition and keep down costs. But premium increases are driven in significant part by the rising price of underlying goods and services. Consolidation among hospitals has reduced insurers’ ability to bargain for better prices. Pharmaceutical makers are far more profitable than insurers -- and the wholesale price of brand-name prescription drugs has risen by 9 percent in the past year. There’s plenty to criticize about the insurance industry, but the singling out of this industry alone for demonization by Dean and others is unwarranted.

More important, the worst insurance industry practices would be barred under the Senate bill. Insurers would no longer have as much incentive to spend huge amounts of money on administrative costs -- identifying and excluding beneficiaries apt to cost them too much -- because the measure provides for “risk adjustment,” compensating insurers who end up with more expansive than average enrollees.

The Senate bill, Dean complains in The Post, “allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage.” But older people cost more money to insure than younger Americans -- and more than three times as much. Is it fair to require younger people to shoulder all the extra cost?

With his usual penchant for understatement, Dean describes the Senate bill as “a bailout in a situation that dwarfs even what happened at AIG.” Perhaps he could explain why those diabolical insurers are lobbying so hard to defeat the bill. Or, maybe, they’re just pretending to be against the measure in order to lure lawmakers into passing it.

This is ridiculous. The bill isn’t perfect, although my worries about it are more about whether it does enough to drive down costs and whether it will turn out to be affordable than about whether it gives too much to insurers. The alternative is not, as Dean would have it, starting from scratch and getting it through the Senate with 51 votes; Senate rules, for better or worse, will not let lawmakers get much done that way. The alternative is squandering this opportunity -- leaving millions of Americans uninsured and without the prospect of getting coverage far into the political future.

By Ruth Marcus  | December 16, 2009; 3:45 PM ET
Categories:  Marcus  | Tags:  Ruth Marcus  
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Comments

Where have you been?
He had lost it quite a long time ago...

Posted by: wizclique | December 16, 2009 4:01 PM | Report abuse

Bravo - not sure what Dean is doing. Morally repugnant - he's not the one that needs the reforms that the Senate Bill puts forth.

Posted by: trichw | December 16, 2009 4:03 PM | Report abuse

Howard Dean never had it. It's just that his lunatic followers can't tell he's crazy because they're the same kind of crazy.

Posted by: charlesbakerharris | December 16, 2009 4:04 PM | Report abuse

Thank you, Ms. Marcus - great article...

Posted by: LABC | December 16, 2009 4:04 PM | Report abuse

Actually, Howard Dean lost his mind early in 2004. Remember this?

"Not only are we going to New Hampshire, Tom Harkin, we're going to South Carolina and Oklahoma and Arizona and North Dakota and New Mexico, and we're going to California and Texas and New York ... And we're going to South Dakota and Oregon and Washington and Michigan, and then we're going to Washington, D.C., to take back the White House! YEEAAAARGGGGHHH!!!"

Posted by: seraphina | December 16, 2009 4:05 PM | Report abuse

"But older people cost more money to insure than younger Americans -- and more than three times as much. Is it fair to require younger people to shoulder all the extra cost?"

Excellent point. But women cost more to ensure than men. So you must also oppose Barbara Boxer and those like her who wish to force insurance companies to charge women and men the same rates, right? After all, "being a woman is not a pre-existing condition."

Posted by: seraphina | December 16, 2009 4:06 PM | Report abuse

We all know a single payer system is the best route to cover everyone as a right of citizenship, those who want more and can afford it are free to find it..

But the insurance companies will fight that, and the republicans joined them because they think they will have a better shot at getting back into power if they can block this president from doing anything about our most serious problems.

This legislative effort makes the Democratic majority look incompetent.
Get a democratic bill, start it in the Senate, and tell the Republicans and Lieberman to go ahead and filibuster in front of the nation if they dare.

It will give the nation a chance to contrast corporate America's plans for the future with those who want a modern health system that gives the right to health care to all, rich and poor.

I am so ashamed of the nation's failure to reflect the informed will of the people

Posted by: shadowmagician | December 16, 2009 4:08 PM | Report abuse

Both sides of the argument routinely abuse language and generalize, causing average folks like me to wonder what and whom to believe, if anything or anyone. Case in point: "The Senate bill would extend coverage to more than 30 million Americans who would otherwise be uninsured.."

This is NOT TRUE. The Senate bill would REQUIRE uninsured individuals to either a) purchase insurance (subsidized based on income) or b) pay a fine. This is patently not the same as "extending coverage to more than 30 million Americans..." Why not just use accurate language, something to the effect that "The Senate bill would require 30 million currently uninsured Americans to purchase private health insurance, with subsidies for lower income persons, or individuals could elect to pay fines and remain uninsured."

Why not just be accurate? It doesn't seem that hard to do.

Posted by: Curmudgeon10 | December 16, 2009 4:11 PM | Report abuse

Ms. Marcus writes:

"But premium increases are driven in significant part by the rising price of underlying goods and services."

This presumes that the insurers are operating on a regulated cost-plus basis, where pricing is somehow connected to costs. In point of fact, an insurer will charge the maximum amount they can in order to maximize their profits. If an insurer is charging $4x a year for a given product and they think they can charge $5x and keep the same business, they would be negligent to their shareholders if they failed to do so. Would a movie theater charge $9.50 if it thought it could get $10 without losing any business? This is how the free market is supposed to operate (which may be an argument why the free market and quality health care may be antithetical).

Posted by: chiefwj | December 16, 2009 4:17 PM | Report abuse

Pass the bill. It's obvious to every non-Republican (ie intelligent American) that requiring people to pay for insurance is only the first step. There's no way the insurance industry will do anything but continue their hyper-inflated prices. It'll be just after the 2010 elections when we'll add the public option. Within five years, every medical insurer will leave (with honest competition their incompetence will take them down) and we'll have single-payer. A stupid way to get to the correct result, but hey, there's a lot of stupid Republicans out there (obviously - see G. W. Bush, Sarah Palin, et al)

Posted by: bflorhodes | December 16, 2009 4:18 PM | Report abuse

The Right-wingers had been against a public option, because they state it's against the Constitution to mandate the a person to have health insurance in order to create a larger pool.
Now I wonder what they will say to this now that it would mandate the purchase from a private sector that is motivated by profit (of course). I think they will be all for it.
Health Ins. will enjoy the winfall, because now they can jack up the premiums, and if more monies need to be spent on per dollar, just increase the profit margin of services offered by their in-network clinics.

Posted by: TrulyIndy | December 16, 2009 4:18 PM | Report abuse

so Ms. Marcus, you and your husband are on the federal dole...good for you...

Mr. Dean is right on..Obama is just putting money into the insurance companies pockets...and probably some in his too..he needs to make his money while he can..he will have no base left in 2012 except the black vote..

this bill is just like joe biden's bankruptcy reform bill of a few years ago..just aided credit card companies..wonder how many us are paying 32% interest now...what a great reward..

obama has changed me from a leftie to a tea bagger...thats not the change i expected.

Posted by: rmcgolden | December 16, 2009 4:21 PM | Report abuse

So, apparently some Democratic Congressmen are upset at Obama because they haven't been able to put together a healthcare reform bill that's to their liking. Aren't they misdirecting their fire? Shouldn't they be looking in the mirror?

Simply put, they don't have the votes in the Senate to do any more than what's currently in the legislation and they're not going to get additional votes by putting additional items in the bill. Do the math.

The mistake made by Obama and Reid was not knowing months ago what they could get through the Senate with the 60 votes to be found in the Democratic caucus. Yes, it appears Joe Lieberman has been impossible to read, but Ben Nelson hasn't been. Without Nelson, you have no bill. Find out what Nelson will accept and leave it at that.

That's not very idealistic, I know, but it's time for realism, something Howard Dean needs to recognize.

Posted by: baltova1 | December 16, 2009 4:22 PM | Report abuse

Dean is not arguing for no Health Care bill. He's arguing, cogently, for a stripped down bill that eliminates the worst of insurance company abuses and establishes aggressive state exchanges for individuals and small businesses, without the provisions compelling individuals to purchase insurance from the private insurers and without federal subsidies to do so.

Such a stripped down bill would not achieve the needed goals of (near) universal coverage and premium cost containment, but then neither would the current Senate bill forced upon us by the likes of the industry's bought and paid for Senator from Connecticut. Such a bill would, however, improve life for a great many Americans who can afford to purchase coverage and add greater long-term certainty to the lives of many more who presently receive coverage through their employers.

Posted by: washpost29 | December 16, 2009 4:27 PM | Report abuse

Thank you, Curmudgeon10, for calling Ms. Marcus on her deceptions. I get the impression that Robert Gibbs is whispering talking points in one of her ears and David Axelrod in the other. She should be embarassed; this post is beneath her.

Calling Howard Dean crazy is a facile, glib characterization. He's a bright man w/ real, hands-on, health care experience, who has nothing to lose and is willing to speak truth to power.

And despite Dr. Dean's unfortunate and infamous howl, he has excellent political instincts. Requiring citizens to pay private health insurers thousands of dollars per year for coverage, under threat of govt prosecution, is a horrible thing. It would inspire lawbreaking to rival Prohibition, and legal challenges would most likely find it unconstitutional.

Posted by: MattNYC1 | December 16, 2009 4:27 PM | Report abuse

I agree. The Senate bill is far better than what we have now. It seems to have some flaws. I would prefer single payer, public option, and / or expansion of Medicare. We can't get those so let's get what is possible. It may turn out that they are not needed. Any problems with the new law can be dealt with by Congress in the future.

I like Howard Dean, but he is not facing the realities of the legislative process.

Posted by: esch | December 16, 2009 4:33 PM | Report abuse

Let's not go ad-hominem, Ruth. What Dean and many other Americans with whom I've spoken are concerned with is the HCR bill, while accomplishing the increased coverage , is falling down on the cost savings to current policy holders. As one who worked for an insurance -network- (not a provider or a claimant but a middle man skimming profits on the way to a billion dollar industry) I can say with complete assuredness there is far too much waste in the current system and NONE of it is addressed without a public option - or at least a medicare buy-in. This is a huge problem. One Obama and the Senate Democrats are betting an average American will care little - to their peril.

Posted by: mas92102 | December 16, 2009 4:35 PM | Report abuse

Dr Dean God bless you. Unlike the blood suckers you really care for Americans suffering or perhaps dying for lack of health care. Obama, Congress and their media lackeys like Marcus can kiss your as...s.

Posted by: bluelagoon21 | December 16, 2009 4:36 PM | Report abuse

No. No. No! Dean is dead right. The Senate bill adds millions more people onto a system broken because of out-of-control costs at taxpayer expense. This is not reform; it is bankruptcy and political suicide. The system is broken because of costs. The ONLY way to systemically attack the cost problem is introducing competition and the ONLY appropriate place to introduce it is in the insurance system. The insurance industry won't compete unless a public option forces them to.

Ruth, you're the one who's nuts.

Posted by: pmcgann | December 16, 2009 4:36 PM | Report abuse

Dean appears to be the only Democrat who hasn't lost his mind. Obamacare is pure excrement on many levels. The only reason the Democrats are rushing to pass it is to assuage Obama's vanity.

Posted by: mike85 | December 16, 2009 4:40 PM | Report abuse

washpost29. you can't reform insurance company "abuses" like pre-existing condition exclusions, without mandating that everyone buy a policy (otherwise any sane person would wait until they got sick). you can't do that without making subsidies available to those who can't afford care. you can't do that without paying for it somehow. that's pretty much the whole bill. the rest is details.

Curmudgeon10: making insurance coverage possible for the uninsured amounts to extending coverage to them. we all pay for it, but some of us don't have it because we can't get it. now we can. so the language is pretty accurate. the mandate is for another reason (see above)and actually helps pay for the subsidies.

Posted by: JoeT1 | December 16, 2009 4:40 PM | Report abuse

I agree with Dean, this bill is a disaster. Complete giveaway to the insurance companies.

It can be summed up this way: Essentially, they solve the plight of the uninsured by forcing the to buy insurance. Don't buy it, and you'll get fined. And since they now won't allow coverage to be dropped (a good thing), and other restrictions, premiums are likely to rise 20-25%. So the people who presently cannot afford insurance are now being forced to buy the unaffordable insurance, except at a cost 20-25% higher. Beautiful. this will work perfectly.

The people who couldn't pay before obviously still can't, so they won't, and will be fined. Lots of middle-class Americans out there just had a $2500 tax passed on them...

Posted by: maurban | December 16, 2009 4:42 PM | Report abuse

Passage of the Senate bill means 30 million more madated clients for insurers-without any cost control. Sure, pre-existing conditions can no longer be a bar to coverage. But, the supporters don't ever tell us that the bill allows carriers to triple the premium for these insureds. Ruth, the answer to your question about why the carriers are fighting even the Senate bill is that, notwithstanding the new revenue source, the bill sets a precedent for future government interference. In other words, the camel's nose in in tent and the insurance companies understand that eventually it won't tolerate the smell.

Posted by: BBear1 | December 16, 2009 4:43 PM | Report abuse

I don't buy Ms Markus's argument. If you start discriminating on age, next will be sex, followed by genetic makeup (if your dad had hypertension then your insurance goes up, etc). The idea of insurance is to spread the risk all around and this would include age as well. If you would want to discriminate based on age, then let those people have a choice of enrolling into Medicare which caters for the elderly. The insurance industry would actually like it since it would eliminate high risk groups. The only logical approach would be to allow ANYONE to enroll into Medicare at a reasonable rate. I would presume this would encourage a majority of Americans to enroll into the health plan and there would be no need for mandates. It is so abhorrent to mandate people to buy into private insurance especially poor folk or lower middle class when the price of college education is all but not affordable to most middle class families. I strongly support Dr. Deans sentiments and don't care for yours.

Posted by: ns3k | December 16, 2009 4:45 PM | Report abuse

The Individual mandate delivers 31 million new customers to the existing Insurance Companies. There are no price controls. There is no competition. This HCR bill orders 31 million people to buy a product at any price or face fine and prosecution.
It'd a joke or a nightmare. Dr. Dean is right. Kill it now and start over.

Posted by: dboz1970 | December 16, 2009 4:45 PM | Report abuse

I am totally with Dean on this one, this bill does nothing but push mandates on people to buy overpriced health insurance that they can still lose if they dare to get sick.

It is fascinating how the media defends Lieberman's little petty revenge act as 'reasonable' but Howard Dean gets painted as some kind of lunatic. Ill take Howard's passion over Joe's Insurance company sponsored talking points any day of the week!

KILL THIS BILL!

Posted by: MarcMyWords | December 16, 2009 4:46 PM | Report abuse

pmcgann: there's plenty of competition in the insurance industry - one more player (the feds) won't change a thing, and the public option was only going to be available to an insignificant segment of the market anyway. Other reforms no one has discussed (bundled payments for episodes of care instead of our absurd fee for service system that allows a doctor to tell you what you need and makes you pay for everything a la carte) need to take place. Right now it's the very fact that everyone will have insurance that will slow the growth in costs. That's reason enough to take what we can get. We can't get a single payor now, and we can't leap from here to there, so maybe we need a middle step of universal coverage to bridge us to universal coverage by a single payor somewhere down the line if we don't figure out our other problems otherwise.

Posted by: JoeT1 | December 16, 2009 4:48 PM | Report abuse

Ms. Marcus's premise is that Democrats should be happy to settle for a suboptimal solution rather than fighting for something more optimal. In Washington, perhaps this is hailed as practicality. Outside the beltway (in the real world), this is generally accepted as cowardice.

If Democrats believe this solution is suboptimal, they are right to reject it in favor of something better. At its heart, this is precisely what Dean is recommending.

Moreover, the substance of Ms. Marcus's article is woefully inadequate. "But premium increases are driven in significant part by the rising price of underlying goods and services. Consolidation among hospitals has reduced insurers’ ability to bargain for better prices."

Right, so.....advancing a single payer system here is.....disadvantageous?

Ms. Marcus, perhaps some refresher classes in economics, corporate finance, and insurance would help. Your perspective here is - by Washington standards - regrettably pedestrian.

Posted by: dsk36 | December 16, 2009 4:50 PM | Report abuse

Dr. Dean is absolutely right. The Senate bill will simply enlarge the current system, providing little cost reduction and less consumer protection. No competition, no real pre-existing condition protection (they get to pay a triple premium), a mandate for 30 million Americans to buy into a Wall-Street loving insurance cartel (subsidized with taxpayer funds) while leaving 20 million still uninsured.

We progressives supported this process as much as anyone, but this is rancid sausage and should be tossed.

Posted by: gingles | December 16, 2009 4:50 PM | Report abuse

If you want to control costs:

1. Require insurance companies to spend 95% of their income on h/c payments. They actually used to do that till about 1993. The big ones are now below 80%. The extra 15% they have goes to executive compensation and the like;

2. Doctors and especially hospitals give insurance companies a 60% discount (literally). If we're all insured, that should be their standard charge;

3. Finally, there is elective care. Those who want it, can always have separate insurance. By the way, I am not including 'abortion' under that (the arguments against abortion coverage amount to saying that living is elective, so there is no need to cover anything).

Posted by: AMviennaVA | December 16, 2009 4:54 PM | Report abuse

I'm with Dean on this one. Health care in this country is on life support mainly because of rising costs. Without a public option there will not be enough countervailing pressure to reverse this trend. This is particularly true for the many areas of the country where there is only one health care provider. If the health care reform bill cannot lower health care costs it is only a band-aid.

Sadly, the votes are not there to get this done. Lieberman's dishonorable flip-flopping has screwed us all. Obama should take a principled stand and yank this bill.

Posted by: bidalah | December 16, 2009 4:55 PM | Report abuse

2009
Democrats the party of Wall Street.

Democrats the party that makes Americans buy from private health insurance companies or are penalized by government.

Democrats are out of their minds if they believe Americans will vote for them in 2010.

Posted by: bsallamack | December 16, 2009 4:55 PM | Report abuse

I guess it is easier to play into the Howard Dean is crazy meme. Then to do an honest column on how the Senate sold us out.

Posted by: AnitaPaul | December 16, 2009 4:55 PM | Report abuse

Dr Dean God bless you. Unlike the blood suckers you really care for Americans suffering or perhaps dying for lack of health care. Obama, Congress and their media lackeys like Marcus can kiss your as...s.

Posted by: bluelagoon21 | December 16, 2009 4:56 PM | Report abuse

Marcus's analysis is delusional in almost all respects, but her insistence that the big health insurance companies are fighting this bill is downright bizarre. The health insurance companies have opposed only those aspects of the bill that would have provided more competition - the public option and the medicare buy-in. AHIP, the health insurance lobby, has been running ads SUPPORTING the rest of the bill - the mandates, the subsidies, comprehensive coverage.

There have been many TV ads opposing this bill, from the Chamber of Commerce, the RNC and various other rightwing organizations. The health insurance companies have been conspicuously missing from this campaign. Does Marcus recall seeing a SINGLE "Harry and Louise" ad? The insurance companies savaged the Clinton healthcare reform efforts in the '90s with a $20 million, year-long advertising campaign featuring "Harry and Louise." By contrast, AHIP is now running ads advocating the proposals in the current reform bills that mandate coverage and force millions to buy high-priced private insurance policies.

If Marcus really finds it necessary to ridicule Howard Dean's principled opposition to the debased Senate bill she could at least keep her facts straight. But, as we've all come to learn, that's too much to ask for one of Freddie Hiatt's purveyors of conventional wisdom.

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

Thank you Dr. Dean.

Posted by: ba3344 | December 16, 2009 5:00 PM | Report abuse

Those who are obsessed with reducing health care costs, such as most of the pundits writing for this newspaper, need to and start paying their health care costs out of their pocket, then they will use health care facilities only when they really need to and seek cheap care.

Howard Dean is right, the Senate bill is all but a complete sell-out to private health insurance companies. Obama flip-flopped on an individual mandate and importing less expensive medicine from Canada.

Posted by: Aprogressiveindependent | December 16, 2009 5:01 PM | Report abuse

I thought that Obama lost his mind when he didn't pick Dean, as health secretary instead of Sibelius, or together with Sibelius, as Dean's assistant. I continue to think so. Obama doesn't have the solid plan of his actions, has a lot of vanity though. People, who took control over him because of it, or use weak features of him to manipulate him, or whichever, are not people with the rightfully set minds of what is the best way to increase and to maintain the welfare of this country and to solidify its statehood. I always believed and believe now that Dean is the differently thinking person in comparison with those people. I am sure that Dean was able and is able to implement the right health reform. I also think that the current one, which is pending, is wrong.

Posted by: aepelbaum | December 16, 2009 5:02 PM | Report abuse

Democrats in Congress with penalties for Americans who do buy health insurance from private companies.

Democrats of Congress to spouses
I could not get you milk for your cereal so I bought Milk of Magnesia.

Posted by: bsallamack | December 16, 2009 5:04 PM | Report abuse

8 years of Republicans who did nothing and claimed government could not do anything good.

Less than one year in government and the Democrats prove the Republicans right.

Posted by: bsallamack | December 16, 2009 5:07 PM | Report abuse

Would someone explain to me, please, why the Dems don't call the Republicans' bluff and make them actually filibuster the bill rather than take a poll and see how many will say that they would not vote to end a filibuster? I'd like to see the Republicans stand at the podium and read War and Peace into the record all the way through Christmas. Why does everyone keep repeating the mantra that it takes 60 votes to pass this? I must be missing something.

Posted by: cuteasashark | December 16, 2009 5:07 PM | Report abuse

charlesbakerharris, your co-thinkers brought the level of life in the country to the lowest since great depression. What gave you
any ground to fight Dean, who didn't do anything similar to welfare of his subjects, while in power, just vice versa? Craziness, by definition, is to do exactly the same things over, and to expect the completely different results. Obama is imitating Bush globally and in local features of behavior and is expecting different results. This is craziness, and nothing else.

Posted by: aepelbaum | December 16, 2009 5:07 PM | Report abuse

I think Ms. Marcus is off-base in her criticism of Dr. Dean. The Senate's proposed system will not eliminate the frustration doctors face when trying to get procedures approved by low level administrative aides. Primary care physicians I know would prefer a single payer system. With a single payer system, so much overhead could be eliminated. It seems Ms. Marcus is like many who have got their's, so why can't the unwashed millions get on board and stop complaining. Health care is a privilege much like a drivers' license to Ms. Marcus' way of thinking. I wonder when the Washington Post will be hiring Glenn Beck or Rush Limburgh to write their screeds.

Posted by: rgraham505 | December 16, 2009 5:08 PM | Report abuse

"The bill isn’t perfect, although my worries about it are more about whether it does enough to drive down costs and whether it will turn out to be affordable"

No problem with an expensive plan that Americans will not be able to afford.

Great bill that leaves us back to the problem of private insurance plans that were too expensive and that Americans could not afford.

Great that now Americans will be penalized by the government if they do buy private health insurance.

Thank god for the Democrats in Congress giving Americans everything they do not want.

Posted by: bsallamack | December 16, 2009 5:12 PM | Report abuse

In principle Dean is right.

If we actually rolled out his 2004 $88 billion plan it might not be a bad stop-gap measure until we can get real reform.

The "public planning" dig too is a pretty stupid, inside the Beltway line.

It's especially ironic given that the majority of the people who will actually be subject to the plan; and who, unlike most DC pundits, actually have experienced the individual insurance market first-hand -- favor a more robust reform.

Yet, you know better?

Come on.

Posted by: JPRS | December 16, 2009 5:12 PM | Report abuse

I agree that even in its present form the Senate bill is better than nothing but it is nevertheless thin gruel. Not passing a health care reform bill would be a disaster similar to the one that happened the last time an attempt was made. What was the result of failure last time? Health care costs have continued to rise (albeit a bit slower than predicted), health insurance is becoming unaffordable for those not provided with it by employers and the cost of health insurance to employers has become a major headache. I part company with the statement that older people should pay more for insurance than younger people. The whole point of insurance is to share the cost of those in need with those who don't need it. The larger the pool, the cheaper the insurance. That is one of the strongest arguments for a single payer system. Younger people will one day be older and there is no reason why they should pay more for insurance simply because they lived longer. In a single payer system the payments could be adjusted to income, so younger people who earn less than older ones would indeed pay less, but not because they are healthier. Unfortunately in this country that is just a dream and we will have to do with what we can get. What I can predict with confidence is that the present bill will not be the final word because the fundamental problem of rising costs has not been addressed. A chronic crisis will become acute in a few years.

Posted by: serban1 | December 16, 2009 5:15 PM | Report abuse

I agree that even in its present form the Senate bill is better than nothing but it is nevertheless thin gruel. Not passing a health care reform bill would be a disaster similar to the one that happened the last time an attempt was made. What was the result of failure last time? Health care costs have continued to rise (albeit a bit slower than predicted), health insurance is becoming unaffordable for those not provided with it by employers and the cost of health insurance to employers has become a major headache. I part company with the statement that older people should pay more for insurance than younger people. The whole point of insurance is to share the cost of those in need with those who don't need it. The larger the pool, the cheaper the insurance. That is one of the strongest arguments for a single payer system. Younger people will one day be older and there is no reason why they should pay more for insurance simply because they lived longer. In a single payer system the payments could be adjusted to income, so younger people who earn less than older ones would indeed pay less, but not because they are healthier. Unfortunately in this country that is just a dream and we will have to do with what we can get. What I can predict with confidence is that the present bill will not be the final word because the fundamental problem of rising costs has not been addressed. A chronic crisis will become acute in a few years.

Posted by: serban1 | December 16, 2009 5:15 PM | Report abuse

I think Howard Dean has a right to express his opinion without having his sanity questioned. It's a pretty low tactic on your part, Ms. Marcus, to make this kind of reference in the headline. Also, the adjective "ridiculous" does not tell us much. I think he's right to the extent that the bill is so watered down and doesn't address the profiteering that takes place among private insurance companies.

Also, with regard to what he said as a candidate five years ago and now, I think Dr. Dean is dealing with the present moment, when Democrats are in control of both houses of Congress. That wasn't the case in 2004.

Posted by: ndpol | December 16, 2009 5:15 PM | Report abuse

The one reason that the bill is a giveaway for insurance companies and the one point you completely failed to address in your pity, ad-hominem attack on the doctor is the bill MANDATES that the uninsured buy coverage from the current system or pay a fine. Without any form of public option competition, there's absolutely nothing to require the insurance industry to lower costs.

The whole point of the whole debate in the first place was to extend coverage to the uninsured, eliminate abhorrent insurance industry practices AND reform costs that were wildly out of control. The finished product accomplishes the first goal through a mandate and offers nothing to achieve the second or third. I personally think the bill should pass if the mandate is stripped out, but it's hardly evidence of "losing one's mind" to support killing crappy legislation.

Perhaps if this paper would do more than mindless recycle conservative talking points you might see Dr. Dean's point of view.

Posted by: jbanks979 | December 16, 2009 5:16 PM | Report abuse

Republicans
Prescription plan for elderly Americans from private companies.

Democrats
Health insurance from private companies with penalties if insurance is not purchased.

Who says the Democrats can not top the Republicans?

Posted by: bsallamack | December 16, 2009 5:17 PM | Report abuse

there's absolutely nothing to require the insurance industry to lower costs.

Posted by: jbanks979
...................................
Do not worry the private insurance already have plans to lower costs.

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

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

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

Posted by: bsallamack | December 16, 2009 5:20 PM | Report abuse

I don't think Marcus understands basic economics. The idea of a public option is to use the government's bargaining power to obtain lower costs from providers. The lack of such an option is part of the reason why providers' costs have increased so much.

Marcus seems a bit hysterical on this issue. You can have a reasonable discussion without calling someone a lunatic (can't you?)

Posted by: bbrockhouse | December 16, 2009 5:22 PM | Report abuse

I think Dean is right. Lieberman held the bill hostage to his paymasters, the big insurance companies. The bill is now just a way to shovel money to the same people who have made such a mess of healthcare coverage. Bah.

Posted by: frodot | December 16, 2009 5:23 PM | Report abuse

Hyperbole aside, Mr. Dean and Ms. Marcus are both right--the bill would improve the lot of millions of Americans, but without anything in the way of substantive reform (expanding access to a dysfunctional system doesn't count). Whether that makes it worthy or unworthy of a vote is a moot point. Regardless of whether it passes, the rising cost of care makes its provisions no more sustainable than the status quo. With or without the bill, only the imminent collapse of the current system under the weight of its cost will foster the political will to make substantive reforms. Given that the bill would expand access to health care under the current unsustainable system of delivery, perhaps passage of the bill would hasten the approach of that point. Then again, maybe that's a reason to vote yea for folks on either side of this argument.

Posted by: ranger399 | December 16, 2009 5:23 PM | Report abuse

@ shadowmagician, re your post of December 16, 2009 4:08 PM:

Hear, hear!

Posted by: apn3206 | December 16, 2009 5:26 PM | Report abuse

I totally agree that the Deans (both Howard and his brother Jim, who keeps bombarding me with panicky email broadsides) is out of their minds on this.

The bill that now SEEMS to be ready to clear the Senate--if Ben Nelson can be accommodated on his abortion obsession and if Lieberman doesn't double-cross again, both big IFs--is certainly far from perfect. To my mind, a single-payer system would be ideal, but given the political culture of the United States it is unattainable in this generation. I would strongly prefer including the public option as cost-control leverage, but the votes for that just aren't there, given the filibuster. (The filibuster is an abuse that needs to be scrapped, but that's a different question.)

Still, as Marcus writes, the benefits of the present truncated Senate bill far outweigh the horrible damage that would be done if our present broken system is allowed to stand.

The thing to do is pass the present bill, hopefully with improvements such as Senator Mark Warner and Senator Ron Wyden have proposed.

If that means giving the Roman Catholic bishops their anti-choice pound of flesh, then do it. That's something that can be fixed later on.

The perfect cannot be the enemy of the good. The two Deans want to act like Samson in the temple--and they are playing right into the hands of the Republicans and the right, who want only one thing: for Obama to fail. (See Ponoru's column in today's WaPo.)

Posted by: jasm917 | December 16, 2009 5:27 PM | Report abuse

Although I have a lot of respect for Dr.Dean, his passion and his straight talk, it was clear 8 years ago that he didn't have the temperament to be a serious legislator, let alone be President. Too often he lets his emotions get ahead of his head, and this is a perfect example.

Although this bill is far from perfect we do need to recognize that we live in a divided country, and move forward with reform that would cover 45 million Americans who can't get coverage today, outlaw some of the more egregious practices of insurance companies, and put some serious cost containment efforts in place.

You're right Ruth, has Dr.Dean lost his mind?

Posted by: sambam | December 16, 2009 5:28 PM | Report abuse

In 2008 Obama said his plan would include a public option and no mandates (except for parents with small children).

In 2009 Obama sang the praises of a health insurance plan that included mandates, but no public option.

If there's no public option, then there shouldn't be any mandates (and yes, I understand that this means many rules and regs get jettisoned -- so be it, they're unlikely to be enforced by this administration anyways).

Posted by: JPRS | December 16, 2009 5:28 PM | Report abuse

As Dr. Dean said, “This is an insurance company’s dream, this bill.”

And if you find the factors of protecting people against being denied coverage because of preexisting conditions, from having their coverage summarily dropped if they get sick, from being charged more on the basis of their gender or their health status, and childless adults living at or near the poverty level would be assured coverage under Medicaid, or children could remain on their parents’ insurance policies until age 27, then pass a separate bill that will force insurance companies to accept these requirements, not to simply force people to be insurance and hand over a windfall of 40 million uninsured to the insurance companies without some requirement to keep costs down.

What's the sense!


Posted by: helloisanyoneoutthere | December 16, 2009 5:34 PM | Report abuse

bsallamack,

Interesting points, that I would amend slightly:

"Republicans
Prescription plan for elderly Americans from private companies."

More along the lines of:

"Republicans
Prescription plan for elderly Americans from private companies [purchased with tax dollars at the highest possible price]."

The Dems formulation follows from there.

Interesting too that Baucus actually had even nastier penalties in his original conference bill.

That's what happens when industry lobbyists are allowed to bypass the electoral process and serve in the stead of elected officials.

It's a practice that the Washington Post op-ed writers by and large recommend -- except when trial attorneys or labor activists are involved.

Posted by: JPRS | December 16, 2009 5:35 PM | Report abuse

Dean may be an idiot but hes right on this one. In explaning what you would do instead of what Dean writes also tells me that what is in this bill isn't right. Deans says why its not right and you say what you would do differant but what you are saying is not in the current bill. Bottom line is why should the rest of the country bring hardship on themselfs to help a small group of just 30 million. 95% of the country is supposed to cater to 5%. Thats like a small group of people don't want crosses on government property or don't want IN GOD WE TRUST on our money or prayer in school because they don't believe in god. I am tried of the government letting a small group regulate the way they make jugdments for the rest of us. Im am also tried of the president being more concerned with just passing a bill instead of passing the best bill for the whole country and not just for the 5%.

Posted by: rainman2 | December 16, 2009 5:36 PM | Report abuse

The former office manager of Sen. Edward M. Kennedy (D-Mass.) has been charged with stealing more than $75,000 from the U.S. Senate, authorities said.

Ngozi T. Pole, 39, was indicted Tuesday on charges of wire fraud and theft of government property. The Waldorf resident could face up to 20 years in prison, according to the Justice Department.

Authorities said that Pole was Kennedy's office manager and was responsible for transmitting salary and bonus information to the Senate Disbursing Office to ensure employees were properly paid. From 2003 through 2007, the indictment alleges, Pole submitted fraudulent paperwork that boosted his pay and bonuses by more than $75,000. He hid his scam by giving Kennedy staffers documents that falsely showed he was receiving the proper pay and bonuses, prosecutors said.

Posted by: stephenwhelton | December 16, 2009 5:37 PM | Report abuse

JoeT1,

You say "you can't" to a great many things. But the only "you" that "can't" in your formulations are the insurance companies - not without either taking a hit on their comfy profit margins or jacking up already exorbitant rates in a politically suicidal way.

By their die-hard opposition to any effective means of long-term cost containment, the insurance industry essentially reneged on the implicit bargain that has under-girded health care reform efforts all along: That the industry would accept greater regulation on their policies - a.k.a., lesser average profit per policy - in return for a much larger, indeed, near universal, federally guaranteed and policed base of policy holders.

Dean is proposing, in essence, that the industry reap the fruits of its intransigence with a stripped down bill that regulates and reforms but does not deliver the windfall of a massive, compulsory, expanded client base, with a blank-check unregulated rate structure underwritten with taxpayer dollars.

Posted by: washpost29 | December 16, 2009 5:38 PM | Report abuse

No, you stupid byotch, you never had a mind, despite your expensive Harvard education.

Health care reform is dead. Anything that passes at this point is a a gift to corporate prostitutes like yourself. Was it good for you? And is that so hard to understand?

Posted by: bigbrother1 | December 16, 2009 5:40 PM | Report abuse

The question is not "has Howard Dean lost his mind?". The question is "what planet Ruth Marcus is living on?".

On Ruth's planet, insurance companies do not need competition because she simplistically reasons that insurance is bad and premiums are high because of "underlying prices of good and services". Guess what, Ruth, those underlying prices are high because the providers of goods and services have to fight for payment from private insurance companies and the insurers collude and monopolize. She also naively believes that the worst practices of insurers would be barred and eliminated because of "risk adjustment". Not on this planet. The worst practices will continue because it will be prohibitive for the victims of the insurance companies to fight because they are already in a compromised position because of illness and at a disadvantage monetarily in fighting for their rights against insurers. The insurance companies will have figured loopholes and avoidance techniques long before the ink is dry on any regulation. Additionally any regulation is useless against corporations as wealthy as the insurers are now and will be after this giveaway. Any fines or punitive regulations will be a drop-in-the-bucket for these giant wealthy entities.

Of course Ruth cannot understand why Howard Dean would consider this worthless. She cannot understand life outside her planet of privilege and lobbyist-spouse turned WH appointee, planet K Street, planet money. For those of us who don't live there, Howard Dean makes perfect sense and it is Ruth Marcus who has lost her mind and her heart.

Posted by: ophelia3 | December 16, 2009 5:44 PM | Report abuse

As a side note here, I'm a little curious, according to this columnist --

Dean is a lunatic for saying that a reform bill should include measures that enjoy popular support and help to protect consumer and taxpayer interests.

Undoubtedly, Joe Lieberman, then, whose second highest fundraiser in 2006 was the health insurance lobby, is an ocean of sanity and principle for opposing a measure that a majority of his constituents and Americans want (and which his sugar-daddies, incidentally vehemently oppose).

The president is also acting wisely by reneging on not one, but TWO campaign promises.

Only inside the Beltway is this logical.

Posted by: JPRS | December 16, 2009 5:44 PM | Report abuse

In 1945 President Truman wanted a single payer plan for national health insurance where Americans could choose to participate.

This was called socialism and defeated.

Now we have a plan by Democrats where Americans are penalized if they do not buy insurance from private companies.

Democrats are as brain washed as the Republicans if they believe this is what is wanted by the majority of Americans.

Posted by: bsallamack | December 16, 2009 5:47 PM | Report abuse

If Howard has lost his mind so have you. One of his main contentions is this bill doesn't do enough to contain costs. You stated that was your concern also. For most Americans with insurance and businesses that provide it, this is the biggest problem. And, we all agree that pharmaceuticals are the most out of control health care cost - and this bill does not include a reimportation provision, which would address that.

Posted by: steve-o5 | December 16, 2009 5:51 PM | Report abuse

"Without Nelson, you have no bill. Find out what Nelson will accept and leave it at that."

In other words, democrats aren't finished gutting their own bill yet. How much worse can it get? Btw, Nelson wants to bar insurance companies from covering reproductive services for women. So we may end up with a HCR bill that basically outlaws abortion.

Posted by: rodneythecat | December 16, 2009 5:56 PM | Report abuse

Has Marcus lost HER mind? What in Dr. Dean's column does she not understand? It's written in English. He makes a case for real reform. Marcus prefers the legislative fraud being acted out at the White House and in Congress?

Posted by: mftill | December 16, 2009 5:57 PM | Report abuse

We already know single payer works best from Medicare and the collective experience of a dozen other industrialized countries (who use a socialized system). It only has an overhead of 3% vs. the private sectors 20%. So, if we already know this, Dr. Dean is correct. Why put in place a system doomed to fail because it will never contain costs? Private health care is already a proven failure. This bill is an insurance company "Trojan Horse," that will only make real reform much more difficult in the future.

Posted by: magnifco1000 | December 16, 2009 6:02 PM | Report abuse

Has He lost His mind? ... No more than the rest of us Ms. Marcus.
... But I must say, the Man knows what racketeering looks like, when He smells it. Me too.

Posted by: deepthroat21 | December 16, 2009 6:06 PM | Report abuse

Yeah, it's the damn insurance companies. They're making three percent profits. That's unacceptable; they should be required to run at a loss - like the government.

Doctors, hospitals, medical device makers, drug companies, chiropractors, podiatrists, rehab specialists, of course, have nothing to do with the cost of health insurance; they're working for free - aren't they?

Posted by: neilwied | December 16, 2009 6:10 PM | Report abuse

Marcus is shocked that Dean has betrayed the mighty Obama. Every month since this bizarre health care bill began, it has morphed into something different. This is morphing you can count on to confuse the electorate, Members of Congress and the healthcare lobby.

Every month some provision is dropped or changed or added. All of a sudden, it begins to resemble an expensive nightmare nobody can afford and nobody really desires either.

True universal healthcare costs less than 12 percent GDP. This bill moves us in the wrong direction with zero cost controls. It is literally a license to steal from the American people.

Posted by: alance | December 16, 2009 6:10 PM | Report abuse

Dr Dean God bless you. Unlike the blood suckers you really care for Americans suffering or perhaps dying for lack of health care. Obama, Congress and their media lackeys like Marcus can kiss your as...s.

Posted by: bluelagoon21 | December 16, 2009 6:11 PM | Report abuse

No, you, Ms. Marcus, are a lunatic. Which planet are you on?
"The Senate bill would extend coverage to more than 30 million Americans who would otherwise be uninsured."
You make it seem like the bill is basing this on some amazing arithmetic and commendable charity on the part of doctors and hospitals. How moronic!
Let us be clear that 30 million Americans will get insured because we will be FORCING them to buy insurance or pay fine. As simple as that.
Get that?
We are being sold that the reason behind these mandates is to evenly distribute the risk. Mandates are the cost we have to pay to the insurance companies for dropping discriminatory practices such as pre-existing conditions. YET, the insurance companies will be allowed to charge up to THREE TIMES MORE to insure such individuals. If this is not highway robbery what is?
You say,
"The Senate bill, Dean complains in The Post, “allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage.” But older people cost more money to insure than younger Americans -- and more than three times as much. Is it fair to require younger people to shoulder all the extra cost?"
Your stupidity is mind boggling to me. Do you even read what you write?? I mean, isn't that the same as saying: "A sick person costs more money to insure than a non-sick person so why shouldn't the insurance companies have price/premium discrimination on the basis of that?"
Dear God, where does Post get these writers!
Howard Dean is dead-on. This is a scam folks.

Posted by: tuscany1 | December 16, 2009 6:14 PM | Report abuse

Yeah, it's the damn insurance companies. They're making three percent profits. That's unacceptable; they should be required to run at a loss - like the government.
Posted by: neilwied
..............................
So I guess you are in favor in a single payer plan of national health insurance without private insurers.

The private insurers then could do what they want as they currently do.

The majority of Americans want a single payer plan of national health insurance without private insurers.

They do not want to be penalized to buy insurance from private insurers.

Posted by: bsallamack | December 16, 2009 6:19 PM | Report abuse

It didn't make it. That's all. The Bill. They killed it. All according to plan.
... Each one of them will now lay back and reflect on how hard they tried. ... But to no avail. ... The "Conservatives" won.
... Shame about the economy though. It's twin. ... Bummer!

Posted by: deepthroat21 | December 16, 2009 6:24 PM | Report abuse

The saddest thing is that while I'm not sure if I'm with Marcus or Dean on this question, the Republican Party was not with the American people at any step of the way on this. We're debating between something that can get 60 and something that can get 51 votes precisely because the GOP hates main street America.

The sad thing is they've convinced some of their "useful idiot" voters to come out and wave tea bags in support of the insurance companies and Big Pharma. These people are certifiably mentally ill. You could get them to drink cyanide if you just told them "the commie liberals don't want you to drink this".

Posted by: B2O2 | December 16, 2009 6:35 PM | Report abuse

Dean is crazy.

But even a crazy man can see what an awful bill this is. He's right, this doesn't "extend" coverage, it simply forces us all to buy insurance.

Rates will go up, taxes will go up, and we'll get poorer coverage.

Ruth is really very partisan on this issue.

Posted by: Ombudsman1 | December 16, 2009 6:36 PM | Report abuse

The Democrats in this Congress and the President will make as many Americans happy with this bill to force American to buy health insurance, as the policies that have made the Democrats the party of Wall Street, and the plans for dealing with massive unemployment.

The previous President always claimed that everything was hard.

Now the current President with a majority in Congress appears unable to do anything except make matters worse.

Before we had expensive private health insurance that Americans could not afford, and now it is proposed to have expensive private health insurance that Americans will pay a penalty if they do not buy it.

The nation is in serious problem when the President and his party can only come up with plans that are with sense.

The idea is not to sign a bill but to create a plan that actually makes things better.

The banks are still as unsafe as they were in 2008 and not lending.

There is massive unemployment and only a mad man would believe that plans of jobs of caulking and installing installation would deal with this problem.

The Republicans may have no new ideas, but so far the ideas of the Democrats are worthless and in many cases border on the insane.

Posted by: bsallamack | December 16, 2009 6:42 PM | Report abuse

What a great bill! We can move from a system of expensive private health insurance that many Americans can't afford, to a new system of expensive private health insurance that will prosecute and fine Americans for not being able to afford it.

Posted by: dboz1970 | December 16, 2009 6:55 PM | Report abuse

nothing I have seen by any party has come close to doing what is best for the country. The only thing I have seen so far is the president pushing to get something anything pasted just to get it through regardless of content. I have seen democrats write in self serving amendments without thinking about how it will affect the rest of us. I have seen republicans name call and stall just to win for their side. I have not seen anything that a true offical and patriot thinking of country would have done. There are a select few who come close but a very select few and thats not enough to complete the job of whats best for the country and not just for the president. I am very disappointed in these officals. I just hope the history that Obama wants to make with passing a health care reform is for the good of us all and not just for history sake.

Posted by: rainman2 | December 16, 2009 6:56 PM | Report abuse

I am not sure that you are giving Dean credit for all of his comments on the plan. He said that the plan was just too expensive and would be a disaster in practice. He said that this is not health care reform and he is right, it is just an expansion of health care insurance with taxpayers footing the bill for subsidies, and effectively footing the bill for 27% margins for health care insurance stockholders.

The author wants health care to be a right, I get that, but if you are going to assert that it is a right there must be reform so that it can become a practical right.

As a Canadian who moved to the U.S. in 1986 I have seen this movie before. This is the part where good intentions ignore reality and we pretend that all can have coverage, all can keep their doctor and health care won't be truly rationed. In the case of this bill it is even worse because there is no tort reform, no real incentives to save and costs are exacerbated by the level of profit earned by the insurers. In short there is no shared sacrifice and no realism in the bill's design.

We will be back to fix an even more broken system in a few years, having expended incredible amounts of money and undoubtedly without ever seeing Congress enforce the reimbursement adjustments that are supposed to make the numbers work.

Posted by: gpmacct | December 16, 2009 6:57 PM | Report abuse

I'm with Howard Dean. The Democratic base - the people who have worked long and hard to get a Democratic President and a large Democratic majority in Congress wanted a single payer system. Congress said no, too radical. So we settled for a public option and worked hard to get it. It was very popular with the public but the insurance lobby said no, so we settled for extending Medicare to 55 year-olds and above. Lieberman was on record not long ago as supporting it so we again got our hopes up. but Lieberman killed it and as far as I'm concerned that killed the bill.

Isn't if funny that it's okay with the Washington crowd if Lieberman throws a fit and tries to kill the health care reform bill, but when Howard Dean wants to kill it everyone in Washington FREAKS!

Lieberman killed the bill, not Howard Dean, not the liberals, not the Democratic base.

Posted by: Trakker | December 16, 2009 7:15 PM | Report abuse

"That's not very idealistic, I know, but it's time for realism, something Howard Dean needs to recognize."

Speaking of realism, this bill's approach of mandated business for the insurance companies is sheer political poison. You thought 2006 was impressive, wait until 2010. Congress is going to think it got run over by a truck.

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

Sorry Ruth. Dean is right. The current Senate bill is worse than nothing. It deserves to die.

Posted by: st50taw | December 16, 2009 7:29 PM | Report abuse

Perhaps the only good that will come out of this bill where Americans will be penalized if they do not purchase private health insurance, is that Americans will recognize that this nation can not survive when government only considers the special interests.

The major banks have not been forced out of investment banking and back to lending because of the Wall Street interests to keep the major banks as their customers for Wall Street paper.

There are no jobs for Americans except non-exportable jobs such as caulking and installing insulation, because of the special interest of American companies that want to outsource overseas American jobs and use visas for foreign workers here in the United States.

This government even goes along with the special interest and pretends that Americans are insufficient in education and that this is the reason why an individual in India who can barely speak English is speaking to an American about their account in an American bank, instead of an American.

It is perfectly acceptable for this government to have banks that do not lend and massive unemployment instead of opposing the special interests. And now it will be perfectly acceptable for this government to penalize Americans for not buying from private insurers, instead of opposing the special interests.

For both Democrats and Republican in government this is no longer the nation of Americans. This is the nation of the special interests.

Posted by: bsallamack | December 16, 2009 7:29 PM | Report abuse

Is Dean a loony? Yup!

Is he right on this? My gut says yes, but my head says that, although I'd prefer the camel's shoulders inside the tent, his nose is good enough.

For all that can be said about this entire insane and painfully inefficient process, at least we are addressing the issue.

Funniest thing I heard this week? When Canada passed their universal publicly-funded health care reform, the bill was - wait - 8 PAGES LONG!!!!!!!!!

Does anyone else think that a bill longer than that includes too many bonuses for campaign contributors?

Posted by: fr3dmars | December 16, 2009 7:31 PM | Report abuse

Dean's point is that the bill is going to force all people to buy coverage with little or no control over how much the insurance companies charge and little or no competition among them. Yes, we'll add 30 million people to the system but at an exorbitant cost. The insurance industry, the pharmaceutical companies and the health care providers like their friends in the banking industry will be feasting off what's left of the American middle class.

Posted by: seldoc1 | December 16, 2009 7:38 PM | Report abuse

Dean's point is that the bill is going to force all people to buy coverage with little or no control over how much the insurance companies charge and little or no competition among them. Yes, we'll add 30 million people to the system but at an exorbitant cost. The insurance industry, the pharmaceutical companies and the health care providers like their friends in the banking industry will be feasting off what's left of the American middle class.

Posted by: seldoc1
.........................
Recognition that this is the land of the special interests.

Your vote for Republican or Democrat is as meaningful as a write in for Mickey Mouse.

The only difference is that Mickey is in bed with Minnie and not the special interests.

Posted by: bsallamack | December 16, 2009 7:57 PM | Report abuse

There are 2 main focuses of the healthcare bill and that gets lost in all the back and forth.

1. Provide healthcare to every American
2. Make healthcare more affordable so it doesn't break our economy

The time for incremental change is 17 years too late. We need a drastic overhaul of the system or the financial tidal wave of increased healthcare costs is going to destroy us.

The fact is we currently pay almost double per capita for our healthcare of any other nation, we insure only 80% and our outcomes are 35th in the world. This is the definition of a completely broken system.

Is taking the profit away from the insurance companies the only thing driving up our costs? NO. But it's a damn large chunk, maybe the largest chunk. We need to remove private profit from the health insurance industry so we can find the next biggest problem and address that.

The public option is not even that, it is simply providing a means for Americans who don't want their health care dollars going to private industry a way to pay for healthcare from an institution that serves their interests rather than the shareholders.
The public option IS the compromise.

So F this healthcare bill. Lets get 51 vote healthcare.

Posted by: pdxgeek | December 16, 2009 8:01 PM | Report abuse

Has anybody said this yet?

YEEEHAAAA!

Posted by: johng1 | December 16, 2009 8:16 PM | Report abuse

Some people just don't seem to get the fact that mandating that people by mandating people to buy coverage they are in fact lowering premiums by decreasing the ratio of claims to total revenue.

Yes, this means that healthy people must essentially subsidize insurance for less healthy people for being forced to join, but guess what? They already do, when those too poor to afford insurance must go to the emergency room. The difference with paying for insurance instead of emergency room visits is that with the former there is an emphasis on preventative care, which is a lot less costly.

I am a young person who is healthy and, if given the choice, would rather pay out of pocket if and when I need to see a doctor than pay United $2,000 bucks a year for an insurance plan, when if uninsured all my hospital bills will probably only add up to about $1,000 or less. But I also know that by buying it I'll be driving its cost down for everybody else, as has happened in Massachusetts, and that I won't have to pay taxes for somebody with a serious case of diabetes because they don't have the health coverage to get it treated.

On top of that, having insurance will also come in handy if I get sick myself, so overall it's not such a bad idea to tell me I have to buy it, even if I'd rather not do it in general. That being said, I should not have to pay the same amount for my plan as an older person with more risk, so Dean is completely off in saying that the bill should require that I pay the same rates as a 65-year-old, who on average has more money than me to begin with. Allowing people to pay rates commensurate with their risk levels will make them want to reduce their risk factors, and thus drive down health costs even further.

This bill is gonna drive costs down overall, no matter what Howard Dean says. He's clearly never taken an economics class, and just doesn't get it. With him it's always the same formula of us vs. them, main street vs. wall street, blah blah blah. This country spends over 16% of GDP on health care, and I want to see this bill get passed, even without a public option, if it will free up some of this money, enable companies to hire workers at a lower cost, decrease obesity, improve overall health, and make this country's labor force more competitive in the global market.

Or, like Dean, we can continue to complain when things aren't exactly what we want, and continue to lag behind everybody else.

Posted by: fordman_81 | December 16, 2009 8:16 PM | Report abuse

It's interesting that 'personal attacks or other inappropriate comments ...will be removed from this site' bit Mrs. Marcus is allowed to question Howard Dean's credibility and misrepresent his views.
Many have noted this and were able to see through Mrs. Marcus' mean-spirited and elitist rhetoric without the ad hominen retorts.
I wonder if this users observations will survive WAPO'S scrutiny; but have you ever notice that you never see Dr. Ruth (the crazy 'ol post-menopausal sex therapist) and Ruth Marcus in the same room?

Posted by: seansets | December 16, 2009 8:25 PM | Report abuse

Hey fordman_81,

Your statement...
"Some people just don't seem to get the fact that mandating that people by mandating people to buy coverage they are in fact lowering premiums by decreasing the ratio of claims to total revenue."

You are a top notch moron if you think that ANYTHING (aside from plants) might not already be aware of this kindergarten math you point out. What's more, most creatures on this planet have already gone beyond this and grasped that based on the senate bill the insurance companies will be gaining a lot more from the mandates than what they will be forced to spend by extending coverage to people with pre-existing conditions especially since the bill allows them to charge upto THREE TIMES more for "older" people anyway.
So why don't you stop craping on this forum with your childish assumptions and get lost.

Posted by: tuscany1 | December 16, 2009 8:26 PM | Report abuse

Dean is right, absolutely right, 100% right! The current bill is a tax increase on the middle and working class generated solely to transfer wealth (measured in billions of dollars) to the corporate elite. Without competition, there is no incentive to hold down costs. Without a publicly run insurance option, there is no competition. Most insurance markets are controlled by one or two large health insurers. Flooding the market with money, will only ensure that medical costs continue to rise, with insurance premiums following right behind. If $100 billion doesn’t cover the cost of premiums, then we will be throwing $200 billion at this next year. Soon, we will be spending 20% to 30% of our GDP on health care and insurance costs. And all the while corporate profits will be piling up at the tax payer’s expense. No, Governor Dean has not lost his mind. The Senate bill is steaming pile legislative manure; it should be killed, and the blame laid to rest at the feet of Holy Joe Lieberman and his Republican pals.

Posted by: codexjust1 | December 16, 2009 8:36 PM | Report abuse

Some people just don't seem to get the fact that mandating that people by mandating people to buy coverage they are in fact lowering premiums by decreasing the ratio of claims to total revenue.
Posted by: fordman_81
....................................
This is only true when you have a single payer system.
It is not true when you have private insurers that have to create a profit.
Look at car insurance. There is no set rate for car insurance in country. The only way there would be a set rate for car insurance is if there was a single payer.

Posted by: bsallamack | December 16, 2009 8:43 PM | Report abuse

Ruth Marcus, you are the one who lost your mind. Dr. Dean is 100% right. After all, Ruth, aren't you the little one who proclaimed yourself as a "responsible adult" for throwing all kinds of tantrum against Dr. Paul Krugman back in 2007? You are throwing the same tantrum against Dr. Dean like a little one who proclaims herself as a great "responsible adult" would do.

http://www.washingtonpost.com/wp-dyn/content/article/2007/11/20/AR2007112001651.html?hpid=opinionsbox1

Posted by: politicalmajority | December 16, 2009 8:43 PM | Report abuse

There's nothing wrong with you Ruth that a little bout with unemployment and lack of affordable health care insurance due to a bogus or otherwise re-existing condition wouldn't cure.

Has Howard Dean lost his mind? At least he would have one to lose. Way to demonize anyone who advocates for the little guy though. This is Insurance Care, a bailout for an industry that doesn't need bailing out but isn't ashamed to pile on. It's not Health Care Reform.

I make chocolate sauce. Where can I lobby for a Public Act that mandates that every person in this country has to buy a jar?

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

Ruth, some of us are simply sick of watching our tax dollars transferred into the pockets of politically well-connected corporations. This year it's Blackwater/Xe, next year it's Cigna and Aetna. No one is arguing against some of the good things these bills will do. But the soaring cost of insurance coverage will continue as long as a few insurance behemoths control regional markets...and our Congress.

Posted by: Ladyrantsalot | December 16, 2009 8:45 PM | Report abuse

There was once a time when Unions were abundant in most job fields. When the unions were in existence, the employee not only had a living salary, but great benefits including health Insurance... Those that were unable to land a union job organized and fought against the unions. (Suddenly the unions were the bad guys.)Good luck finding a union employee protected job today... Today Americans looking for a job are faced with positions that are not only insufficient in pay, but most do not include health care Insurance... This was the beginning of the end of Majority union positions. Their main purpose was to look out for the rights of the employees in their union. Now employees are left on their own to fight for what ever they can...usually being left unsatisfied with their job and benefits. Well America .....YOUR jealousy and greed...worrying about what others were getting that you were not, lead to the downfall of unionized positions and any chance of comfortable living and future. That was the only the beginning.....Keep up the "me first" attitude and the "I want for free" attitude and we will all have to suffer the consequences. Just so we are all clear about this....THERE IS NO SUCH THING AS FREE HEALTH CARE....It is a benefit...."NOT a right." BTW...The biggest expense is pharmaceutical/drugs...and the cost of diagnostic testing... Many diagnostic tests ordered today.. are due in part to the many law suits that awarded unrealistic amounts of money. Once again...Americans were greedy...Physicians and hospitals order additional testing today to protect themselves...many unnecessary tests which increase the cost of health care. (Can you blame them?)
**********
Finally B202 WROTE: "The sad thing is they've convinced some of their "useful idiot" voters to come out and wave tea bags in support of the insurance companies and Big Pharma. These people are certifiably mentally ill. You could get them to drink cyanide if you just told them "the commie liberals don't want you to drink this"

?/?/?/?/?/?/?/

Just because some Americans have different beliefs than others....They do not deserve to be insulted by name calling and insults. Adult debate/conversation is a way to help both sides learn the opposite point of view. The above comment....is the reason that nothing ever gets accomplished in this country today. It is non-productive and childish....In the end....
We all pay for it. Americans (all Americans) end up paying the consequences for such ignorance. I am neither Democrat or Republican however, The protests by what you called,"Tea Baggers," Were very very impressive. Now just imagine if Americans would just unite with mature, intelligent motives and ideas.....What we could accomplish.....Imagine....(*John Lennon)

Posted by: Intuition1010 | December 16, 2009 8:49 PM | Report abuse

By the way, just what is the incentive for a private, for-profit insurer to investigate insurance fraud? Investigators cost money (lots of money) and investigations take time (lots of time). If the government is subsidizing and mandating premiums, wouldn’t it be simpler and more profitable simply to raise insurance premiums to cover the inevitable cost of fraud?

Someone else has opined that this is similar to college tuition. Because the government guarantees student loans, tuition has risen nearly 500% since 1982, while the median family income has only risen a little over 100%. In that same time, the cost of medical care has risen over 250%. Adopting the Senate bill could lead to a doubling in the rise of medical care and insurance costs simply because there is no incentive to keep costs down. In fact, the incentive is to keep raising prices and so increase profits.

So, people with brains oppose the Senate bill, liberals oppose the Senate bill and Republicans oppose any bill at all. Who is left to support it? Who is going to come out and vote for President Obama and the Democrats if they pass this piece of drek?

Posted by: codexjust1 | December 16, 2009 8:55 PM | Report abuse

This bill is not perfect, but once again the party of no and the liars who lie for them in the media have convinced a large number of people that it is better to continue to get ripped off year after year, for hundreds of thousands to slide into bankruptcy and tens of thousands to die on the alter of republicon politicking. The republicon party is a disgrace and one of the most harmful organizations to ever foul the earth with it's existance. It is no stretch to say that by protecting big insurance, big tobacco, big oi, and bug wars the republicon party has killed more Americans than UBL in his wildest wet dream.

Posted by: John1263 | December 16, 2009 8:56 PM | Report abuse

Well said, Ms. Marcus.

I think Howard Dean will come around.
His "kill the bill" comment is predicated on the false alternative of pushing the whole reform through reconciliation. That simply won't work. Dean will come to terms with reality in time.

If the political will is really there to push a public option through reconciliation, why not do it at a later date, after the main bill is locked in as law?

Posted by: HuckFinn | December 16, 2009 9:00 PM | Report abuse

This bill is not perfect, but once again the party of no and the liars who lie for them in the media have convinced a large number of people that it is better to continue to get ripped off year after year, for hundreds of thousands to slide into bankruptcy and tens of thousands to die on the alter of republicon politicking. The republicon party is a disgrace and one of the most harmful organizations to ever foul the earth with it's existance. It is no stretch to say that by protecting big insurance, big tobacco, big oi, and bug wars the republicon party has killed more Americans than UBL in his wildest wet dream.
............................
What a strange comment from an obvious Democrats that fails to recognize that the Democrats, instead of a bill based upon a single payer, are offering a bill that will benefit the private insurers.

Time for Democrats to recognize that all the Democrats in government are for the special interests just like the Republicans in government.

How else explain someone coming up with the insane idea that massive unemployment will be solved by jobs in caulking and insulation, instead of stopping the special interests that since 2002 have outsourced overseas over 2 million American jobs and have allowed visas to replace millions of American here?

Welcome to the nation of the special interests.

Posted by: bsallamack | December 16, 2009 9:07 PM | Report abuse

We need a third party in this country.

The party of the special interests.

This way Republicans and Democrats in government can come out of the closet.

Our government has been ineffective so far in the work for the special interests.

Think of the prosperity of this nation if Democrats and Republicans could openly work for legislation for the special interests.

Think of the campaign coffers that would be quickly filled if Democrats and Republican simply came out and stated that they were the party of the special interests.

Perhaps the President is already considering coming out of the closet in 2012 as the first candidate for the presidency of the party of the special interests.

Hip Hip Ho-ray for party of the special interests.

Posted by: bsallamack | December 16, 2009 9:17 PM | Report abuse

If the health care bill isn't passed, especially because of scum like Joe Lieberman, I'll never vote for a Dem again. What weak failures

Posted by: dudh | December 16, 2009 9:19 PM | Report abuse

If the health care bill isn't passed, especially because of scum like Joe Lieberman, I'll never vote for a Dem again. What weak failures

Posted by: dudh
..........................
Vote instead for the new party of the special interests.

No more inhibitions and full transparency where former Democrats and former Republicans join together for the new prosperity of America.

These are individuals in Congress who have worked so hard to give you a bill geared to the special interests of the private health insurers.

Support them when they have the courage to come out of the closet.

Posted by: bsallamack | December 16, 2009 9:26 PM | Report abuse

"compensating insurers who end up with more expansive than average enrollees."

So the insurance companies get more money for the obese patients?

Posted by: ezeitler1 | December 16, 2009 9:26 PM | Report abuse

Dr. Dean is right. This bill is just corporate welfare for the insurance companies.

Posted by: Jihm | December 16, 2009 9:27 PM | Report abuse

Gov. Dean is right from the standpoint that the present Senate bill has been made toothless by failing to have a public option, or, barring that, a buy-in for Medicare. But no, there's not one reason for insurance companies to compete, not one to standardize benefits and lower premiums, not one to reduce the cost Americans pay for drugs. The core of reform was to reduce the influence insurance companies have in the distribution of health care, and that goal has been missed entirely in the Senate.

But Americans seem to ignore that our needs as citizens have been trumped by business - a top-heavy business bloated even now by an excess of profits and its own self-importance. We have been thwarted in our effort to get a system that offers a fair return for what we pay. Instead we get accursed lies from Republican senators who spread fear and misinformation and day after day bring out the very worst character and selfishness in our population. Then we'll turn around and not make an appointment tomorrow for the pain in our arm or leg or back because we can't afford the out-of-pocket co-payment. We'll skimp on our medication because it'll last longer. We'll go without healthcare when we're unemployed because we simply cannot afford any premium. And we'll say it's okay: the best system in the world.

I'm disgusted. I'm disgusted with the insurance companies and their shills in Congress. I'm disgusted with the near-sighted ignorance of media hacks who pour vitriol into every political discussion. And most of all, I'm disgusted with us, we citizens - of, by, and for whom this republic is supposed to exist - for not being wise enough and angry enough (at the right damn bas***ds who act so pious while helping their kin in industry to fleece us) to tell them who is in charge. Get disgusted too, I say, and throw the bas***ds out!

Posted by: Jazzman7 | December 16, 2009 9:31 PM | Report abuse

Ruth,

Dean is a realist. He hasn't changed since he ran in 2000.

Face it the GOP would rather protect the healthcare insurers, pharmaceutical companies, doctors, pharmaceutical companies, pharmacy benefit manufacturers, -- THEIR PROFITS, monopoly status, and tax cuts/breaks

instead of helping their working and unemployed constituents -- the people who really matter.

Obama is a smart guy, he's going to stick it right back in their face -- if it doesn't pass; he'll just put the blame where it belongs with the GOP, their lobbyists, and of course their tea-bagging supporters.

If it does pass, he will veto it or send it back to Congress and say it doesn't have the protections for the taxpayers and citizens; and still score points...

Obama can't really lose at their game.

See, the GOP and conservatives are gambling that it will get voted down or he will sign it with all the goodies for the healthcare industry.

They won't be able to scream victory if he vetos the bill or sends it back to Congress telling them to take out all the goodies.

Let's see what really happens.

Posted by: FranknErnest | December 16, 2009 9:35 PM | Report abuse

How is what Howard Dean saying crazy?

As is, the reform is now in such a shape that it mandates insurance without ANY form of a tangible cost control. That too me makes absolutely no sense.

And for that matter, how come you're now asking if Howard Dean has "lost his mind" but you don't ask the same question of Joe Lieberman who went against his own stated position 3 MONTHS ago?

Posted by: Liebercreep | December 16, 2009 9:44 PM | Report abuse

Ms. Marcus, You are wrong precisely where you are right: "The bill isn’t perfect, although my worries about it are more about whether it does enough to drive down costs and whether it will turn out to be affordable than about whether it gives too much to insurers. "
This bill lets the antitrust-law exemption for the healthcare insurance industry intact, and introduces no competition. It might give an estimated 30 million of people coverage for a short while, but it leaves the government hold the bags while the cost continue sky-rocketing. Not a sustainable situation. Furthermore, as cost continue to rise, others now covered will lose coverage. Thus, it might help some now but only temporary, so the partial solution is only temporary but at great and increasing cost.
While we are at it, this healthcare reform bill also does not allow import for foreign drugs, even those the FDA can verify. How can cost be contained if both the health insurance and phamaceutical industries retain their monopoly and unfair practices? So this healthcare reform is not a real reform but rather just a temporary and costly bandaid, not worth fighting for.
Single-payer system now! Medicare system works and that's why the Taiwanese government choose a system modeled after it for all their citizen in 1995, and why our senior citizens are so protective of it. Listen to Bernice Sanders, and expand Medicare for all American. Or at least, put in a public option.

Posted by: pspox | December 16, 2009 9:49 PM | Report abuse

Ms. Marcus, You are wrong precisely where you are right: "The bill isn’t perfect, although my worries about it are more about whether it does enough to drive down costs and whether it will turn out to be affordable than about whether it gives too much to insurers. "
This bill lets the antitrust-law exemption for the healthcare insurance industry intact, and introduces no competition. It might give an estimated 30 million of people coverage for a short while, but it leaves the government hold the bags while the cost continue sky-rocketing. Not a sustainable situation. Furthermore, as cost continue to rise, others now covered will lose coverage. Thus, it might help some now but only temporary, so the partial solution is only temporary but at great and increasing cost.
While we are at it, this healthcare reform bill also does not allow import for foreign drugs, even those the FDA can verify. How can cost be contained if both the health insurance and phamaceutical industries retain their monopoly and unfair practices? So this healthcare reform is not a real reform but rather just a temporary and costly bandaid, not worth fighting for.
Single-payer system now! Medicare system works and that's why the Taiwanese government choose a system modeled after it for all their citizen in 1995, and why our senior citizens are so protective of it. Listen to Bernice Sanders, and expand Medicare for all American. Or at least, put in a public option.

Posted by: pspox | December 16, 2009 9:49 PM | Report abuse

I love my health coverage. My premium is high but I get great care. With the Senate plan, 30 million more people come into the system. Great. My taxes are going to go up to subsidize them, and my premiums are going to go up because there are not enough doctors to take care of all those extra people. Supply and demand. So I think the health care bill sucks.

Posted by: retabroad | December 16, 2009 9:50 PM | Report abuse

No

Posted by: thelaw1 | December 16, 2009 9:52 PM | Report abuse

Actually, I'm beginning to think this whole thing is a replay of the egos involved in the 2004 Democratic primaries -- especially Howard and Joe -- fighting over the same constituencies they each lost that year. Or is this a New England thing -- with each posing as the high-minded purist when in fact they're scrapping like boys out of control on the playground. And everyone else has to pay the price when they want to take their "ball" and go home. It's time for the grown-ups to step in and pass the bill already.

Posted by: Marit | December 16, 2009 9:55 PM | Report abuse

Crazy? For telling the truth?

Posted by: notabeliever | December 16, 2009 9:56 PM | Report abuse

Marcus is right on this. If the bill fails we are most likely another decade away from moving toward universal health protection. Whether the public option would raise or lower costs is not clear and is not central to the moral issues. Should everyone have the access to decent health care and is everyone who can afford to obligated to bear some responsibilty for their own care and for the care of less fortunate individuals. The political system requires that the health insurance system maintain the structure of private insurance. This means that individuals buying in the non-employer market will compare their premium with an expectation of benefits received. If these insurance benefit is severely out of line with the cost, voluntary compliance will likely be impossible. The employer contribution hides the cost of wage reduction from the employee facilitating the pooling of risk. If we want to have improved health security for the far more than 30 million persons who over a several year period are one accident or illiness away from serious health insecurity then we have to swallow hard and accept a first step.

Posted by: SCONLY1 | December 16, 2009 9:59 PM | Report abuse

Marcus is right on this. If the bill fails we are most likely another decade away from moving toward universal health protection. Whether the public option would raise or lower costs is not clear and is not central to the moral issues. Should everyone have the access to decent health care and is everyone who can afford to obligated to bear some responsibilty for their own care and for the care of less fortunate individuals. The political system requires that the health insurance system maintain the structure of private insurance. This means that individuals buying in the non-employer market will compare their premium with an expectation of benefits received. If these insurance benefit is severely out of line with the cost, voluntary compliance will likely be impossible. The employer contribution hides the cost of wage reduction from the employee facilitating the pooling of risk. If we want to have improved health security for the far more than 30 million persons who over a several year period are one accident or illiness away from serious health insecurity then we have to swallow hard and accept a first step.

Posted by: SCONLY1 | December 16, 2009 10:04 PM | Report abuse

Ms Marcus also forgets what else Dr. Dean proposed-expanding Medicare/caid to cover those who make just too much now for Medicaid and lowering the age for those who are just too young for Medicare.

One of the reasons why he LIKED the previous bill that was stripped when Senator Lieberman betrayed every person he represents in Connecticut by reversing his 9 year old position to gain cheap political points.

Posted by: emayrogers | December 16, 2009 10:04 PM | Report abuse

The main problem with health care is insurance inflation. This bill puts in mandates that will accelerate premium inflationary pressure, and eschews the public option that would have provided to the insurance oligopoly.

As it stands now, we are going to spend $1 trillion of taxpayer money to make health insurance even more expensive for us all.

Posted by: AxelDC | December 16, 2009 10:08 PM | Report abuse

I support Howard Dean's views on the current senate health care reform bill. I appreciate that he is giving voice to what I think a goodly number of progressives want from health care reform.

Posted by: mickster1 | December 16, 2009 10:18 PM | Report abuse

Passing this bill will lead the way to the eventusl demise of the insurance companies and the end of the gravy train for the fat cats that run them.

We can and should "eliminate the middleman"

Its not personal, its business.

I'm sure they'll understand :-)

But our first responsiblity is health insurance for "Tiny Tim" so he can get that bone marrow transplant and keep his leg.

If we let the Republicans kill this bill our chances of passing an alternative one are slim to none.

Dr. Dean isn't helping things, he's pulling a "Nader"

Posted by: RealityAlwaysBeatsPerception | December 16, 2009 10:25 PM | Report abuse

The fundamental problem with Dean and those who think like him is that they learned absolutely nothing from Reagan. Reagan would be more than happy to sign the bill exactly as it exists right now. Then next year, he'd be back for another shot at some of the things he didn't get. And the next year, he'd be back for the rest. It's not necessary to get everything in the first go-round! Getting uninsured people on the rolls, eliminating pre-existing conditions and life-time caps, etc. is enough for 2009. Go back in 2010 and go after the public option, etal. And, while we're at it, when do the Democrats start peeling the Republican onion and getting their real agendas out in the open?

Posted by: philasportsphan | December 16, 2009 10:26 PM | Report abuse

Dean's right on this, Marcus is wrong. this bill, in it's current form is, like Reagan's deregulation, just another blow to consumers and a boon for the industry.

The lobbying was not so much a effort to kill the bill as it was a calculated, tried and true method of turning it into a boon for the industry.

It has worked many times before, and as shown by this bill, has worked again.

Every senator who votes for it should find themselves unemployed.

Either fix it, so the Insurance industry does not enslave us, or kill it - and Marcus? Stop shilling for the insurance industry - they ain't hurting - but we are.

Posted by: maxtor0 | December 16, 2009 10:33 PM | Report abuse

Ms Marcus piece is so filled with falsehoods and irrelevancies that it suggests she is nothing but a sop for the health insurance cartel and the President who is now playing the "any bill will do" game. He wants to have a signing ceremony at which he will pretend that the reform legislation is good when its not. Folks, do you remember President Bush on the ship claiming mission accomplished when it wasn't.

The important issue Dr. Dean address is the inclusion of the individual mandate without the ability of individuals to make real choices. Real choices were taken away with the removal of the "public option" and the Medicare buy in. The final health care bill should have a public option and/or the Medicare buy-in plus the individual mandate or it should have none of these. At least the "none of these position" will preserve some of the good features now in the Senate bill.

Too bad that Ms Marcus is has joined the Joe, Max and Ben ranks and is carrying water for the health insurance cartel.

Posted by: pbarnett52 | December 16, 2009 10:34 PM | Report abuse

"Question for Howard Dean: Have you lost your mind?"

No Ruth, but you and many other Democrats have.

A bill with no real reform.
No real cost control-certain to lead to much higher expenditures for marginal gains in covering more Americans.

Corrupt (primarily) Democrats paying each other off with taxpayer money in exchange for votes. (Hello Mary Landrieu!)

A total lack of cohesive leadership from Obama to Reid to Pelosi-unless corruption is your definition of leadership.

Change we can't believe in. Neither can Howard Dean. At least he is honest in what he's saying. You are not.

Large majorities of Americans are against this as well.

Ruth-take your pitiful reasoning skills and purely partisan columns and go away.

Posted by: Towson_Tiger | December 16, 2009 10:35 PM | Report abuse

Hey RealityAlwaysBeatsPerception,
Not in your case.
"Passing this bill will lead the way to the eventusl demise of the insurance companies and the end of the gravy train for the fat cats that run them."
Erm, how exactly? You wrote a lot of additional garbage in your comment but not one word to support this.
"If we let the Republicans kill this bill our chances of passing an alternative one are slim to none."
One, Dr. Dean is the exact opposite of a Republican, you will agree. Dr. Dean is the person under whose stewardship we got these majorities. Do you think it's easy for him to bust the house he built? Dr. Dean is asking the bill to be killed. And for a reason. Only thing this bill is doing is forcing people to buy into the old system with the hope that the insurance companies will then keep the premiums for everyone low. Because they gave their word? Do you seriously believe that?
I mean, this kills me. First we had Bush trying to give away dough to the financial sector by trying to privatize social security, now we have another moron trying to give away dough to the insurance sector by forcing these mandates.

Posted by: tuscany1 | December 16, 2009 10:39 PM | Report abuse

As a diehard liberal Democrat, I believe that this bill is a rancid piece of garbage. Yes, it brings uninsured people in the system -- by force. And it creates an even larger captive audience for our voracious for-profit health care industry, without any meaningful form of cost controls, so premiums are going to skyrocket while our doctor's offices will be jammed with people who should be in bed with a bowl of chicken soup. I've already lived the Massachusetts version of universal health care -- my health care premiums went up by OVER FORTY PERCENT this year -- and now it seems we're doomed to see this mistake replicated on a national level.

Face it, folks, we were sold down the river before this bill ever made it out of committee, starting with President Obama's back-room deal with the pharmaceutical companies. The Senate's craven surrender on the public option (the ONLY chance to place any kind of containment on costs) is only the final act of this clown show. This monster is going to keep on growing until it collapses under its own weight...

Posted by: jerkhoff | December 16, 2009 10:50 PM | Report abuse

Marcus pitches the usual talking points for a bill that is ALL ABOUT funding the insurance industry AT THE EXPENSE of working people and the young. 30,000,000 people, many out of work, will now be dragooned into paying health premiums, OR ELSE, and getting nothing back but the right to have needed care delayed or denied until it's not available at all, along with the rest of us who are "covered." People with pre-existing conditions will not be denied coverage -- if they don't mind paying twice or three times as much! And the no-importation of drugs is a big fat payout to Big Pharma.

This bill is an obscenity, but it's even more repulsive that comfortable Washington pundits like Marcus do the insurance industry's propaganda work for them. Shame!

Posted by: reflecter | December 16, 2009 10:55 PM | Report abuse

Sorry but Ms. Marcus is wrong. The passage of this bill WILL be a giant giveaway to the insurance companies while offering little to people who have insurance and those who don't. Dr. Dean has nailed it right on the head.

But more importantly what passage of this bill would do is kill the Obama presidency. For the rest of his time in office, he and the Senate Democrats would be left kissing the asses of Ben Nelson, Mary Landrieu, Olympia Snow, and "Traitor Joe" Lieberman to get anything passed, meaning that nothing of any importance or substance would make it through Congress. Even his modestly progressive agenda would be watered down to the point of irrelevance, and the changes America needs to keep us from becoming a second or third rate power will never happen; we will sink further and further into the mire of once great nations that allowed themselves to be rendered impotent by the rich and powerful using the ignorant and stupid.

We've seen this happen before. When Republicans and ConservaDems succeeded in backing down Bill Clinton's plan to lift the immoral and discriminatory policy on gays in the military---resulting in the horror that is "Don't ask, don't tell" and the purges that followed---he was forever compromised and his presidency never recovered. Had he stood his ground, he might have lost the first battle but might have ultimately won the war by showing he was a man of principle. Instead, his 'compromise' showed the Republicans that he could be rolled and they kicked him around the whole rest of the time he was in office, starting by taking both houses of Congress in the next election and ending in his impeachment over sexual misconduct that half his accusers were involved in.

Unfortunately, this President has chosen to surrounded himself with the acolytes of The Great Compromiser like Rahm Wormtongue. And should he follow their advice (instead of showing real leadership), he will follow his predecessor into the annuals of history as one of the greatest politicians of his time who wasted his talent and his potential because he didn't have the courage to stand up for his convictions. That is what true leadership is about.

Posted by: mmonnett1 | December 16, 2009 11:09 PM | Report abuse

The fact is, there is no cost reduction. If we can't reign in costs, then all this bill does is ensure The insurance companies make more.

Posted by: mattdevir | December 16, 2009 11:25 PM | Report abuse

"But older people cost more money to insure than younger Americans -- and more than three times as much. Is it fair to require younger people to shoulder all the extra cost?"

Do you hear yourself???

What if you had no husband with a good plan, or lost your job at 53 and suffered unemployment because your company didn't want to insure you since younger workers are so much cheaper?

Yes, it is absolutely fair for everyone of all ages to pitch in and make sure everyone has appropriate, accessible health care. That is the moral thing to do.

I'd pitch in for you - are you saying you wouldn't pitch in for me?

Posted by: kathleen_oconnor | December 16, 2009 11:41 PM | Report abuse

Ms Marcus, you are clearly a fool, to my great surprise. We're all tired of being bilked; and the current bill is only a continuation of the same fleecing of the public for a small number to profit.

Posted by: eastriverrob | December 16, 2009 11:51 PM | Report abuse

"Dean complains in The Post, “allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage.” But older people cost more money to insure than younger Americans -- and more than three times as much. Is it fair to require younger people to shoulder all the extra cost?"

Hey Marcus, you hit the nail on the head; end the end, we, the citizens, shoulder the cost. And not just the young for the older, but also for 30 million other folks many of whom are dead-beats, dope-addicts, etc. . . . . . Ergo, we will see our insurance coverage go up, up, up. BUT THERE ARE REAL OPTIONS that could save plenty of money and cover everyone. But the Public Option is not one of them . . . it's just one more burden to our medical bills. We need single-payer and negotiated drug prices.

OUR NEWS IS CENSORED, it must be. . . . . How many Americans realize that the big savings will come when hospital and doctor paperwork having to deal with thousands of different policies from so many different providers are done away with? . . . How many Americans realize that 24 percent of hospital or doctor bills go to dealing with all that insurance paperwork?

Actually, a very small percentage of Americans do. And the reason is, you hardly hear about that simple fact from any of the news media: CNN, FOX, Public Radio News, etc. . . . Why is information about the advantages of single-payer health care being hidden in the closet?

Moreover, there are host of issues being hidden -- overpopulation in America is another issue that is taboo, never spoken of . . . and never refuted, denied, or even examined. . . . . Why?

AND YES HOWARD DEAN IS RIGHT, this health care bill is a boondogel.

Posted by: Here2day | December 16, 2009 11:59 PM | Report abuse

The author is an idiot. No one knows what is in the bill because Dirty Harry Reid is writing it behind closed doors.

Posted by: 2tired | December 17, 2009 12:37 AM | Report abuse

no. and you're just a pundit.

Posted by: daphne5 | December 17, 2009 12:50 AM | Report abuse

Dean is RIGHT. This senate bill is GARBAGE. It will raise premiums for everyone, it will not reduce costs of care, it will decimate Medicare, it will put huge unfunded Medicaid mandates on the states, and it will NOT insure 30 million people!

Posted by: anna_78750 | December 17, 2009 1:02 AM | Report abuse

>

What a great example of unclear thinking. Ms. Marcus, don't most young people become old people after a while? The purpose of insurance is to pool and share risk. Howard Dean is right about this.

Posted by: redant | December 17, 2009 1:12 AM | Report abuse

Dr. Dean is right. He speaks for the vast majority of those of us who worked so hard to see Obama elected and are now feeling betrayed and bitter.

Posted by: rjl11 | December 17, 2009 3:44 AM | Report abuse

Anyone that thinks it is only the insurer's driving up costs is blind to reality. We pay doctors, nurses, techs more than anyone else. We pay pharma more for the same drugs others pay 1/4 the amount for the most used drugs. An MRI is less than $100 in Japan, more than $1000 here. What works well is salaried providers, clinics, private firms like Target, and our Veteran's care are exmples of it's success. Expand the VA ability, use them as first choice for medicaid patients and when you can cover all medicaid, go with a public plan using these facilities. Not only will the for profit insurers have to match the government cost to compete, but private providers too. That's the way to get the government run option.

Posted by: jameschirico | December 17, 2009 4:50 AM | Report abuse

It may be a presumption to think he had one.

Posted by: gary4books | December 17, 2009 5:35 AM | Report abuse

Dean sees the Obama, bus wreck coming. He has decided to be a critic of the ObamaNation so that he will be cleansed of the taint of, yet, another failure.

Washing his hands of the whole thing.

Just like that Roman judge, way back when.

What was his name??

Posted by: battleground51 | December 17, 2009 6:49 AM | Report abuse

Marcus asks: "[O]lder people cost more money to insure than younger Americans ... Is it fair to require younger people to shoulder all the extra cost?" It's just as fair as to require childless people to share the costs of educating the children of others.

Spreading the costs of risk evenly is the purpose of insurance, which is defeated when we begin subdividing groups into smaller and smaller units that have to pay more than others. The end result of this is a trend to make every individual a profit center for insurance companies and defeat the primary purpose of insurance.

So of course it's fair.

Posted by: stephendclark | December 17, 2009 6:56 AM | Report abuse

Marcus has got her head wedged. Dean is correct. The bill is useless. We need a single payer system, that's the only way to make it fair. Get rid of for profit insurance whose only role is to increase revenues (premiums) and reduce costs (payouts for care). Insurance doesn't work for health care, only for fire, theft, etc, relatively rare events. Medical insurance companies provide no actual health care and suck up about 30% of all health care dollars. Dean is absolutely right. One more thing, young people should pay in. They eventually get old and require more care, don't they?

Posted by: jkarlinsky | December 17, 2009 8:02 AM | Report abuse

The fact that Democrats enjoy majorities in Congress and own The White House is due in large part to Howard Dean's strategy of contesting every election everywhere in the country. His objections now do not match his plan when he ran for the presidency in 2004? So what? Is he entitled to change? Did his years in Washington educate him on what needs to be done? I don't know, but he's right about this bill. It's bad, and it's getting worse as individual senators and representatives tack on their "druthers" for the benefit of their corporate sponsors and, of course, themselves.

Posted by: sailhardy | December 17, 2009 8:44 AM | Report abuse

Dean is right on this one. This bill is a mess.

Posted by: jckdoors | December 17, 2009 9:04 AM | Report abuse

Sorry I am a raving liberal, but Dean is not crazy and I do not care what health plan is passed as long as there is no mandatory decree with it. Its obvious it would be a goldmine for insurance companies, you don;t think you are being lied too about this, then you are crazy too!!!!!!!!

Posted by: honeybee1 | December 17, 2009 9:12 AM | Report abuse

Well... color me "out of my mind" too. Howard Dean is 100% correct that this bill is an insurance company's dream. It does have a few nice features, but it is an overall failure.

The Democrats show that they have no spine and Republicans show that they hate most Americans making less than $500,000 per year. In other news, the sun rose in the east this morning.

Posted by: CardFan | December 17, 2009 9:20 AM | Report abuse

Ms Marcus

Do you know how the "30 million people" get coverage under this bill? They will be REQUIRED to spend anywhere from 9% to 17% (or more in a few cases) of their total income to pay profit-making, poorly run, private companies for insurance. Its not like the govt. is going to wave a magic wand and buy health insurance for 30 million people.

Dean is absolutely correct, as is Wendell Potter, the ex-insurance executive. This bill is an unconscionable giveaway to insurance companies and drug companies. Take out the mandate, then pass the bill. After all, as all the bill's supporters contend, we can always "tweak it later" and add the mandate.

Posted by: smeesq | December 17, 2009 9:22 AM | Report abuse

Obama has really screwed this up big time. He takes an issue that is way down the list among Americans' concerns and devotes all his energy and capital to this one issue and loudly stakes his presidency on it (what genius told him to do that?). Meanwhile he has 60 senators on his side, a huge majority on the house, he starts out with a 78% approval rating from the American public and he is a bigger international rawk star than Bono, and what does he get? A crap bill that may not even pass and instead of bringing the Right and Left together, now the Left is viciously attacking its own. The problem is that he is so arrogant that he never learns from his mistakes. Wait until he tries to shove cap and crap down our throats.

Posted by: jbb34 | December 17, 2009 9:36 AM | Report abuse

Help me understand how the people with pre-existing conditions are going to afford this insurance, M'am? The same goes for the 30MM people who will now be covered. And then you will fine the people who cannot afford the costs for not signing up? Brilliantly INSANE! The fundamental issue with this bill is COST---for the taxpayer and for the the millions of newly insured. There's no cost containment coming from the insurer side. It's the same mess we have now... rising premiums with no end in sight. And if I see anymore teeth coming from Amy Klobushar's mouth on TV telling me how good this bills is, I'm going to vomit. When someone goes on and on to a question that begs a yes or no answer, you know you are buying swampland to build your condo on. I can't wait to see what agency gets to enforce the mandate! So everyone will sign up and no one will be able to pay the premiums then what happens? Another brilliantly stupid idea. I'm a huge supporter of health care reform. I agree with Dr. Dean. When Senators from pisant states (Baucus, Landreau just to name a few) who take thousands of dollars from insurers and related health care industries craft this nonsense, it's no surprise what we get. What should have happened and needs to change is the Senate and House committees who craft healthcare or any other major legislation in the future, cannot have taken any dollars from related industries--now or ever. Want to see major legislative bills that are fare and reasonable? Try that on for size.

Posted by: rectifyitnow | December 17, 2009 9:38 AM | Report abuse

Ruth honey, you need to stop using "off the rack" phrases and look at what the bill actually does. It does not "extend insurance to 30 million Ametricans," it forces approximately that number of Americans to buy insurance many have already determined they can't afford from a corrupt industry that the bill protects. There is no safety valve for this hapless 30 million; no public option or Medicare buy-in.
Dean is right--this is a travesty. And what he doesn't mention: it will kill the Democrats with voters. Win for Republicans, win for the insurance industry--everyone else loses.

Posted by: kstack | December 17, 2009 9:42 AM | Report abuse

This post was utterly unpersuasive. It was shrill, ad hominem, and manipulative. This bill isn't "extending" insurance to those 30 million; it is forcing those 30 million to send 20% of their incomes to greedy health insurance companies.

As others have pointed out, moreover, Marcus is absurdly inconsistent in demanding that men subsidize women's more expensive health care (which is fine with me) but finding it outrageous that the young should subsidize the old (which is exactly spreading risk is supposed to do). At least with regard to age, the young can look forward to someday being old and receiving support from the young. Men, however, won't at some point become women and thus beneficiaries of that cross-subsidy.

Posted by: uh_huhh | December 17, 2009 9:44 AM | Report abuse

Perhaps you have lost your mind, Ruth Marcus. For a progressive thinker like yourself to go to bat for health insurance companies is just plain ignorant.

1. Read, please, this for starters: http://robertreich.blogspot.com/2009/12/how-few-private-health-insurers-are-on.html

2. Know that the Medicare-for-people-over-55 compromise has been gutted from the bill.

3. Know that this health reform bill has no mandates, regulations, ceilings for the obscene 45% profits of the health insurance and pharmaceutical industries. (Not one CEO earns less than $6 million) What is to keep premiums from spiraling upward? The answer is nothing.

4. Know that this is not a conservative, liberal, Republican or Democratic issue---every American understands relief from the ever spiraling costs of premiums and drug costs, and they will support that relief. Industries, such as the auto industry, have been gouged by health insurance costs; small businesses have been ruined by them.

5. Know that you are missing the big picture if you think that adding to government subsidies AND adding millions of new subscribers with no cost controls on the insurance and drug industries is "healthcare reform."

Wake up.

Posted by: janeb2 | December 17, 2009 9:45 AM | Report abuse

Is Dean crazy - no more than the rest of people that supported, beleived in and voted for Obama. He has the right to be upset - people get that way when they get lied too. However Dean is a politican and all he wants is his fair share of the 2 trillion dollar (and growing) slush fund. Just pay him off and get it over it.

Posted by: ricepaddyrob | December 17, 2009 9:55 AM | Report abuse

We could buy private policies for 30 million for much less than the cost of this bill, and it wouldn't raise costs for everyone else. Make no mistake, everything in this bill is about laying the foundation for complete government control of the entire health care system. All you pundits are just blowing smoke to distract us.

Posted by: hdc77494 | December 17, 2009 10:17 AM | Report abuse

This bill is far from perfect, Ruth. The cost of health-care will rise, the federal deficit will increase, the costs of the overall health-care system will climb, and frankly most of Americans' health care would be better if the system stays as is. Indeed, let us improve the system, but not this way. Start over guys and do it right.

Posted by: KDG1 | December 17, 2009 10:35 AM | Report abuse

Ms. Marcus,

I respectively ask if you have read the bill Senator Reid and his hand picked staff are working on behind closed doors? If so, then perhaps your article is appropriate. If not, then you have no knowledge what is really contained in the bill and are only writing a fluff piece to support a power-hungry Democratic leadership and President.

Posted by: georgiarat | December 17, 2009 11:12 AM | Report abuse

I ahve two questions for all the liberals out there.

1. How does this bill reduce US health care costs? Ruth says she's afraid that it does not do enough, but I'm not aware of it doing anything. The CBO doesn't think it does anything on this front either. If this bill doesn't drive down costs, then it's not really health reform it's a new entitlement program. In short, it's welfare. Does anybody seriously disagree with that?

2. Why does this bill cost $900 billion? My understanding is that it doesn't even call for spending money on subsidized health insurance until 2013, meaning that it only covers 7 years of subsidies (there are ten years of increased spending and Medicare cuts). Most of those 30 million uninsured who will be covered are relatively healthy young people. Why will it cost some ($900 billion * 7 years) / 30 million people = $4,286 per person per year to cover them? That doesn't sound very efficient. Also, according to the government about 27% of the uninsured (~12.5 million) have incomes that are at least 300% of the federal poverty level - in other words, they can afford insurance. I would guess that those people will constitute a large percentage of the additional 30 million who will be insured by Obamacare.

So, to you liberals out there, do you honestly think this bill is worth the costs? If you really want to make insurance more affordable, why not allow trade across state lines and allow individuals to buy insurance with pre-tax dollars? That will cost a heck of a lot less than $900 billion.

http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm#The

Posted by: hroark314 | December 17, 2009 11:16 AM | Report abuse

The hardest part of reform is the public option. This is also the most important part of the bill to assure competition and affordability... Reconciliation for "Medicare for Everyone" option and stripping down the current bills to essential reforms and prevention strategies,... is the way to go. Otherwise, it will be another generation waiting on a bill and some politicians who dare to pass one.

Posted by: mcrcareer | December 17, 2009 11:31 AM | Report abuse

Weird how when right-wingers like Lieberman, Landreau, Nelson, etc. stomp their feet and say they won't approve the bill, Obama and his apologists like this writer are just fine. When Howard Dean, a real voice of the left expresses opposition, it's howls of outrage by the Obama administration.

This bill and Obama are of, by and for the big corporations.

Posted by: splamco | December 17, 2009 11:34 AM | Report abuse

Deans right. Kill the bill or remove the mandate.
They should pass an insurance reform bill not a health care bill.
Then after they reform health insurance companies, if the results are lower costs, then think about getting more people on insurance.
But really what should be done is Medicare for all with private supplemental insurance funded by a very progressive dedicated income tax. No more premiums!

Posted by: kreskytim | December 17, 2009 11:35 AM | Report abuse

The outrage from all sides-just shows how ignorant so many of us are!

40% of public cannot identify 3 branches of gvt- Civically illiterate says Lou Frey R-FL!

Justice O'Connor stated that Americans need CIVICS K-12!

WSJ/Murdoch: Dumb it Down Mr. President! President!

The USA does not even rank within the top 25 countries in the world for education!

The fact that most Americans do not own a passport- cannot read a map- FAIL in Geography is not a secret.

We suck at Science and Math!

DEC 6, 2009- Sen. Wicker from Mississippi was asked on C-Span Washington Journal why his state ranked #50 for Healthcare!

You know what his answer was?

They FAIL at education! Ranked #50 for EDUCATION too!

MURDOCH/WSJ: Dumb it Down Mr. President!

We got STUPID to entertain!

Posted by: sasha2008 | December 17, 2009 11:53 AM | Report abuse

Please help me to understand why there are 30 million uninsured people....this understanding may help us solve this issue. If it is because they cannot afford it, we need to look at why. There is a public option available for people who cannot afford insurnace...it is called Medicaid. In addition, when people state that people are dying in the streets because they have no insurnace...I know they are crackpots, as no one...and I mean no one, not evel illegals can be turned away from health services at a hospital...so what is the real reason people are uninsured....well...it is poor decisions on their part....use free TV, drop your cell phone, don't eat out, stop smoking...find ways to afford the insurance...when I was laid off, I found a policy to cover my family of 5 for $290 a month....I think this is affordable...so what is the real issue here?

Posted by: dlnagold | December 17, 2009 11:53 AM | Report abuse


So, now it comes out: THE DEMOCRATS HAVE NOT COMPROMISED ONE IOTA ON THIS BILL OVER THE PAST 6 MONTHS. Just like Obama, Dean, ever the progressive god, did not make a "public option" part of his president platform.

If Obama really believes his own illogical scare tactics that this is the "last chance" to get reform ever, and we cannot some avoid bankruptcy without expanding spending on health care entitlements, then the answer is simple.

START COMPROMISING BARRY!

Posted by: dummypants | December 17, 2009 11:57 AM | Report abuse

For once, I agree with Howard Dean; kill it. Something, in this case, is not better than nothing. I also agree with Curmudgeon10 that the hyperbole and misrepresentation of facts in order to fit particular arguments is absolutely not constructive. It is not that hard to speak in factual, unbiased terms, but so few are willing to do it.

Posted by: gardedgarton | December 17, 2009 12:05 PM | Report abuse

"The alternative is not, as Dean would have it, starting from scratch and getting it through the Senate with 51 votes; Senate rules, for better or worse, will not let lawmakers get much done that way"

Well, under budget reconciliation rules they could pass e.g. a universal option to buy-in to Medicare for over-55's or even everyone or some other form of public option. So I guess that's "not much" in Ruth Marcus' view. Were the Bush tax cuts (also passed under reconciliation rules since they only had a slim majority of support in the Senate) also "not much"?


Posted by: crust1 | December 17, 2009 12:16 PM | Report abuse

Ms. Marcus:
To answer your question: Howard Dean hasn't lost his mind but the same cannot be said for you and your facile spouting of Obama admin talking points.

Posted by: jwmurphy71 | December 17, 2009 12:17 PM | Report abuse

Just a quick reminder for everyone out there that not only are we going to New Hampshire, we're goin' to South Carolina and Oklahoma and Arizona and North Dakota and New Mexico, we're goin' to California and Texas and New York and we're goin' to South Dakota and Oregon and Washington and Michigan and then we're goin' to Washington D.C. to take back the White House! AAAAYYAAAAAHHHHHHH!!!!!!

Posted by: Candressuhmoose | December 17, 2009 12:18 PM | Report abuse

I guess calling other people names is what passes for journalism at the Washington Post these days.

Posted by: gmcduluth | December 17, 2009 12:43 PM | Report abuse

Lost it? He's been out of his mind since he was introduced on the natinoal scene! He was disposed of in 2004, but appointed DNC Chair and regained some credibility. That was an effective straight jacket from which he has now freed himself.

Posted by: NMP1 | December 17, 2009 1:40 PM | Report abuse

Bravo, Ruth Marcus. I am so sorry that some of these comments are so mean spirited. I wrote a similar blog this week and was appalled at the vicious response from the left. Question Dr. Dean? OMG. But he is wrong about this, both in the content of what he proposes and the strategy of the 51 vote reconciliation approach. Progressives, if you really wanted a public option, why weren't you in the streets in DC like the tea baggers? Why haven't you read ALL of both bills so you can argue effectively? Why are you complaining now? You didn't get a public option...now.... why not start fighting to get it next year by electing more progressive Senators?

Posted by: LindaB1 | December 17, 2009 1:55 PM | Report abuse

You can not lose what you never had.

Posted by: MaryThresher | December 17, 2009 2:08 PM | Report abuse

Apparently so, he is the only one who speak in real principles for a change.

Posted by: Wildthing1 | December 17, 2009 3:02 PM | Report abuse

Most people intuitively know -- that "if we can just get our Foot in the door, we have a chance of opening that door all the way! And, if we don't begin somewhere, and start "cooking the egg", then how much more expensive will healthcare costs become? And, if this reform is not a good thing, then why are they (GOP/ Conserva Dems) fighting so hard to stop it. Is it because they too know that if we just get our foot through the door, there will be no turning back? And, Yes, it is too bad that all Dems are not Jeffersons, Adams and Franklins who truly work for the people, but we have to work with what we have at the moment, take stock of this and work harder for true Jeffersons, and Washingtons and Franklins to be elected in the future. They will come... As for now, I have not given up on Pres. Obama, for I have not given up on what is good! He is fighting old, intrinsic and entrenched patterns of greed which will not die easily or go quietly into the night. He is however planting the seeds for their destruction. Take Heart!

POSITIVE EXERCISE: Sit quietly, focus in the third eye, link up with your Soul (the soul is light/love and always works for the good of all) and visualize health care reform As passed, implemented into law with a public option -- for energy always follows thought!

Posted by: wdsoulplane | December 17, 2009 3:03 PM | Report abuse

The Audacity of Hope???

We are losing 480,000 jobs a week,

but only 11,000 a month!

The Audacity of believing this lying
SOB!

The Truth gets a black eye from the press,
You Tell them Howard!!!

Posted by: simonsays1 | December 17, 2009 4:17 PM | Report abuse

why do we have so many butch liberal women?
That rachel Maddow is scary,
this 'gal' is not much better.

Posted by: simonsays1 | December 17, 2009 4:20 PM | Report abuse

About what I expected. Ruth, having coverage is useless if they can't get care. Have you noticed there is a shortage of both doctors and nurses in this country, and especially Maryland and DC? And if someone else (us) is paying for their coverage, what's the incentive for them to take care of themselves? Nothing.

AND, if the government is forcing insurers to refuse no one, the insurers will pass on thos additional costs...either in the form of increased premiums for those of us who have coverage, increased premiums for the companies we work for (who will need to lay people off to be able to afford those premiums), or both.

Conservative doctors, progressive doctors, and liibertarian doctors, all think this bill is crap, as I pointed out in a comment to another article. Who am I going to believe: them or you?

Posted by: bucinka8 | December 17, 2009 4:25 PM | Report abuse

The whole country has lost its mind, Ruth. Why would Howard be any different?

Posted by: KarimAbdulTares | December 17, 2009 4:28 PM | Report abuse

Pass the bill. It's obvious to every non-Republican (ie intelligent American) that requiring people to pay for insurance is only the first step. {snip}
----------
@bflorhodes: Because of this statement you made, I assume you also would agree that everyone should be required to buy a house, since homelessness is such a big problem (and it is).

And please don't throw the canard about everyone is required to carry auto insurance at us, because it's a false comparison. Not everyone is required to carry auto insurance, just those who own autos.

We will ALL be paying for everyone's requirement that you support. That means that before I can take care of my family's basic needs, I have to surrender part of my paycheck to give some total strangers something they might not even use or be able to use.

Those who think it works so well in Denmark and Sweden would do well to remember that Danes take home 48% of their paychecks, and Swedes 52%, for care that, let's face it, isn't all that good.

Posted by: bucinka8 | December 17, 2009 4:46 PM | Report abuse

No, Ruth.
Dr. Dean knows what he's talking about and he's right on target.
Take it to reconciliation in the Senate; proceed to conference mark-up, because the House has done a much better job, and pass what comes out of THAT process.
The stench of corruption is palpible even down here in Texas.
Now we have identified most of the organs of corruption and the 2010 mid-term election is going to be a blood-bath in BOTH parties.
That's a given.
Dr. Dean couldn't be more sane than he is right now.
That was a very cheap shot, Ruth.

Posted by: Judy-in-TX | December 17, 2009 5:16 PM | Report abuse

"Danes take home 48% of their paychecks, and Swedes 52%, for care that, let's face it, isn't all that good" bucinka8

I have been to Sweden, Norway, Denmark, England and Canada as well. They all live well without any anxiety about being bankrupted owing to illnesses. By the way, the standard of living of the Swedes, Norwegians and Danes are far superior to ours despite their high tax rates!

Having said that, let me also say that Ruth Marcus is dead wrong. The FEHB that she gets coverage thro her husband's federal employment does not charge higher premiums by differentials in age. Female federal employees with their dependents are not charged higher premiums. Would Marcus justify if insurance companies charge higher premiums for families headed by a female?

Under the proposed plan, insurance companies are free to charge higher premiums to the older persons and all those with pre-existing conditions. To mandate that all buy insurance from profit-making companies with no option such as a not for profit public option is asinine.

I did vote for Obama, but I am not sure whether I will do so again, because of his capitulation to the breaking of many of his promises, including his promises not to give in to health insurance and pharmaceutical lobbies. He has broken his promises, just to get the plaudits that he got a "health reform" measure through. I hope he fails, because the bill that is presented by the Senate will make our health care more expensive than ever. And, that will surely decimate the Democrats and Obama will end up as a one term President. As a retired physician, I agree with Dr. Dean's assessment of the emerging health care reform bill and strongly disagree with Ruth Marcus's ignorant opinions. I wonder how Marcus gets to be an op-ed writer with such shallow knowledge.

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

Remember Spaceship Ruthie from the old Real People TV Show? Some relation? Because the sum total of the writer's argument seems to be:
1. Eat your f'ing spinach hippies
2. Lick the boots of your betters, scum
3. The comfortable conservatives of the Washington Post still hate Howard Dean because he walks it like he talks it.

Marcus sure seems enamored of both gridlock and the social status conferred on her by being in the worthless Post. This folie a deux she has with Obama that the neutered plan the Senate is a-berthing will do a lick of good. It is the codification of a protection racket that will have the added joy of police protection. Way to make the teabaggers look prescient, CIA corporate Post.

Posted by: sparkplug1 | December 17, 2009 7:02 PM | Report abuse

Ophelia3 says of this columnist:

"She cannot understand life outside her planet of ... lobbyist-spouse turned WH appointee..."

Perhaps that explains it.

Posted by: janeb2 | December 18, 2009 12:22 PM | Report abuse

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