Pass the Bill II

I heartily agree with Joan Walsh here:

There is a genuine and justified concern among progressives that this bill enshrines an alarming corporatist Democrat view of “reform”: Make nominally liberal social-service expansions safe for the private sector. That is absolutely what is going on.

But that’s as far as the Democrats and the progressive movement have taken us to date. We have a lot more work to do. In my opinion, left and center Democrats need to compromise now, make good on their campaign promise to pass the bill and insure millions more people. And then progressives need to challenge the corporatist pillars of the party in rhetoric, legislation, and in elections, in 2010 and 2012, and beyond.

I said before the 2008 elections that one election would not turn America into progressive paradise. I said it would take many elections and many years of pushing elected officials back to the idea that they represent people and not corporations. The 2006 and 2008 elections were not the culmination of a great progressive effort, but just the beginning. I think we’re going to have to have a substantial turnover in Congress, and not just among Republicans, before we get legislation that doesn’t stink out loud.

However, in the meantime, we have a genuine crisis on our hands. People are dying who shouldn’t have to die. People are being financially ruined by medical bills. The bill as it is, like it or not, will make a huge difference in the lives of millions of people.

It’s as if you see people drowning in the ocean, but in order to save them you’ve got to rent a boat from some unsavory character who will use the money for an unjust cause. As I said in an earlier post, if we had a reasonable expectation that killing the current bill would inspire Congress to go back to the drawing board and come up with a better one, then I’d say kill it. But there’s no way that would happen. The reality is that it’s this bill or the status quo for at least a decade.

I also think that killing the bill plays into the Right’s hands. Killing this bill will do nothing to help the cause of progressivism going forward. Killing this bill is, ultimately, what the corporate interests want. Yes, the corporate interests like the compromised bill better than a progressive bill, but they’d like no bill at all even more.

Someone has said that on the Left, wonks tend to be for the bill and activists against it. Without naming names, it seems to me that many of those activists against it are people who have no personal experience with life without health insurance. Maybe I’m wrong about that. However, for me, living with the status quo for another ten or fifteen years is unbearable, considering the millions of Americans who have no insurance unless this bill is passed.

By all means, let’s complain loudly about the parts of the bill we don’t like, such as the giveaway to Big Pharma. Keep pushing for improvements, before and after the bill is passed. Let President Obama know we are disappointed he didn’t push harder for the public option. But don’t kill the bill.

37 thoughts on “Pass the Bill II

  1. Pass the bill out of the Senate, go to conference, strip out BOTH the mandates and the abortion language, and pass it or go directly to reconciliation.

    • strip out BOTH the mandates and the abortion language

      The mandates are necessary. Reform is not going to work without the mandates. Sorry, and I wish it were otherwise, but that’s the truth.

  2. I’ve heard plenty of stupid statements during the health care debate – this makes the top ten.
    At one point, Sen. Roger Wicker (R-MS) tried to argue that so-called “Gang of Six” members wanted to support a compromise, but “it dawned on them that my friends on the outer side of the aisle wanted to Europeanize the health care system of the United States of America.”
    Let’s see – MOST expensive in the WORLD. Ranked 37th for quality of care. Why would we want change the status quo in the U.S. for health care like some cheese eating surrender monkeys in socialist Europe? Freedom Fries 4evah! When I see an R next to a southern state I’ve learned to swallow what’s in my mouth before reading any further.

  3. Bordering eloquent, maha – Oversight of oversighters by congressional committees has got to be an ongoing task for them, a responsibility which some members of Congress (at least Dems) have committed themselves to by allowing the health insurance consortia to deep-six the public option, the ‘trigger’, the medicare expansion, their exemption from anti-trust laws to remain…

    Unfortunately, Congress’s record on oversight is dismal – the economic meltdown screams where-were-the-regulators-and-where-were-congressional committees who were supposed to be monitoring the regulators. Nowhere.

  4. Pelosi had enough horses to pass a good heath care reform bill; Reid — with a scant 60 member majority (including Lieberman) — does not. Any one of those 60 has the power to torpedo the entire health care reform effort with a single vote.

    This is not how a democracy is supposed to work, of course, but it is our current situation. For now, we serfs have no choice but to settle for whatever crumbs the Blue Dogs and Lieberman choose to toss our way. But, hopefully, come the next elections, we’ll remember who was bought and who was not, and that not a single Republican senator lifted a finger to help Americans in a time of great crisis.

  5. I’m 67 years old, and fairly observant, but no real genius. I have seen these people going without health care, dying and going bankrupt for at least ten years. I worked in in industry where the choice was between health insurance and feeding your family the several meals per week that the cost of that insurance would take away from them; and that didn’t just start, it’s been going on for well over a decade.

    So why is this just now suddenly such an emergency? Why were not all you “liberals” screaming about this ten years ago like I was? We ignore this for tens of years, and then it is suddenly such a disaster that we have to act in haste and pass anything, anything at all no matter how bad, to solve this because “people are dying.”

    I’m not saying it shouldn’t pass, but I want to know where you were ten years ago? We needed you then, and you were sipping your lattes at Starbucks. Now there’s a bandwagon, but when it was dirty and unpopular we were alone.

    • Why were not all you “liberals” screaming about this ten years ago like I was?

      Ah-HEM. We were screaming about it ten years ago. Oh, wait, you didn’t hear us? That’s because for many years real liberals were effectively barred from mass media. Insead, we’ve had faux liberals standing in for us but not speaking for us. Eric Alterman wrote a book about that awhile back. See also David Brock’s The Republican Noise Machine.

      Or maybe you just weren’t paying attention. Progressive presidents and congresspersons have been calling for health care reform since Teddy Roosevelt’s Bull Moose run in 1912. Did you know that?

      More recently, Michael Dukakis made health care reform a centerpiece of his presidential campaign in 1988, although you had to pay close attention to the campaign to know what Dukakis was running on, since media rarely reported on issues and instead just reported on the “horse race.” But I knew he was running on health care reform, because I was paying attention. Did you vote for Dukakis, or did you reject him because he looked funny driving a tank?

      Bill Clinton promised health care reform when he ran in 1992, and Hillary Clinton attempted to put a program together that was quickly shot down after the health-industrial complex advertised against it. What she came up with had problems, but if it had been put into place 15 years ago a lot of lives would have been saved. Did you support “Hillarycare”? Or did you assume she was just a screaming harpy who was up to no good?

      I’ve been screaming about health care reform since the late 1980s, because I could see up close that the old system was breaking down. I’ve gone through some times without health insurance myself, so I know what that’s like. I can’t tell you how many times over the past 20 years I’ve been to some social gathering with other liberals and discussed whether health care reform would ever be possible. We didn’t think it was possible, because every time someone attempted to bring up health care reform it was shot down, and the general public didn’t seem to see the purpose of reform.

      I was saying several years ago that reform wouldn’t be possible until matters got so bad that a critical mass of middle-class, working people began to be affected. And here we are. And then, of course, we had to elect a Democratic president and Congress to have the issue addressed at all, because a Republican president and a Republican Congress won’t even acknowledge there’s a problem. We have the best health care system in the world, dontcha know? So when we got our Democratic president and Congress one of the first things we liberals demanded was health care reform. We’d been waiting for a long time to be in a position to demand this.

      So, Mr. Bill H, don’t come to me and ask why liberals weren’t screaming for health care ten years ago. Believe me, we were.

  6. I want to know where you were ten years ago?

    Tell you what, Bill, I’ll go all the way back to where I was twenty-nine years ago: I was supporting Ted Kennedy’s presidential campaign, futile though it was, because he was the only voice crying in the wilderness for universal health care.

    What Kennedy (and I) learned in the interim was that incremental steps do improve the lives of working people in this country. I personally have benefitted (twice) from the COBRA act creating portable health insurance, and (once) from the Family and Medical Leave Act– just two of Kennedy’s many health-care increments. And when I heard Righties bitching about “Hillarycare” or now about “Obamacare,” or about the Great Satan who was Ted Kennedy in their eyes, I reminded (and continually remind) them of all the good even the seemingly smallest change can do.

    I’m not saying [the current bill] shouldn’t pass

    So what was the point of your comment? Just feeling irrepressibly holier-than-thou? I’m sorry… can’t help you with that.

  7. Bill H, when was the last time the Democrats held both Houses and the Executive Branch? There are many reasons for the urgency to pass health care reforms immediately, if not sooner. primary among them being: 1) If we lose the House, the Senate, or the presidency in the next election, health care reforms are dead, 2) the sheer numbers of people without health care (for a variety of reasons), has increased dramatically as a result of the current financial meltdown and unchecked corporate greed, 3) health care reform is a vital component in stablizing our downward spiraling economy.

    Ten years ago, Bill, many of us agitated for health care reform. Trouble was, with Republicans doing the dealing, the cards were stacked against us. I do not think this is the time to be snarling at each other over what we should have done — but couldn’t — when there is a real possiblity that now, at long last, we finally can.

  8. I will go out on a limb and express my views about the health care bill mostly because the nurses’s union came out and said just about what I have been thinking. I worked 30+ years as a nurse so I have an insider’s perception. Not that that makes me right but it is my humble opinion. Also, I am 70 years old and have Medicare only at this point. I have never used it simply because I am in excellent health and have no need. Many times as a nurse, I chose to forgo insurance benefits from my employer simply for the same reason. I was healthy and wanted the extra money instead. I am adamantly opposed to the mandate. I don’t care how much people cry that it is necessary. If it is necessary, that is one of the problems. Also, because I am “old”, I remember a time when the insurance companies did not control health care and when employers did not offer it as a benefit. Yes, I think those were the “good ol’ days” and I know we cannot go back. However, the system is so out of control that I have lost faith that it can be fixed and I believe sometimes it is better to just demolish something and let the phoenix rise out of the ashes. Maybe some will think that is fantasy but look at history. It has happened over and over again in a lot of areas.

    Having said all that, I do not blame the insurance companies entirely for the problem. Everyone is responsible. People thought it was great when employers started offering insurance as a benefit. Some people also do not pay attention to what things cost if they have insurance. I have heard the comment: “I don’t care how much it costs, I have insurance. Doctors thought it was great to have patients who have insurance because they could make more money. Doctors order tests and have no clue as to the cost. They also have no clue as to the cost of the drugs they prescribe. So, the insurance companies took more and more control until today we are where we are.

    It’s true, if I had a chronic ailment or some catastrophic illness, I might feel differently. But I don’t at this point and I have always been somewhat of a radical so take that for what it’s worth. I feel better for having vented. I know I can’t have things my way and besides nobody asked me, did they?

    I realize that I am extremely fortunate to enjoy good health and not need those b…….. I also realize that it may not always be that way. I have longevity in my family so I could live a long time yet and I know the body does wear out. However, I am prepared mentally and psychologically to deal with whatever happens.

  9. Many times as a nurse, I chose to forgo insurance benefits from my employer simply for the same reason.

    That’s exactly why there has to be a mandate. Uninsured people who get sick and injured are one of the biggest reasons everybody else’s health care costs so much. Maybe you got away with it, but it’s irresponsible and selfish, not to mention stupid, to choose not to pay for health insurance when it was available to you.

  10. Barbara, the mandates are necessary when there is a public option. The mandates as currently constructed are not a mandate at all, really, as it can be easily gamed. If the insurance costs up to 8% of your monthly income and you don’t buy it, you pay a 2% tax penalty. 2% is less than 8%, so no mandate exists.

    The insurance companies want a mandate to buy their products, of course. If we give them that now, we have nothing to negotiate with for the public option.

    Finally, you aren’t going to strip off that abortion language if there is a mandate. Period. Take them both off or neither. Personally I wouldn’t consider supporting depriving women of equal rights to health care.

    • No, mahakal, the mandates are necessary whether there’s a public option or not; the public option merely made them less odious. The mandates are otherwise unconnected to the public option. You are willfully and stubbornly refusing to see the reason for the mandates.

      I am growing very tired of trying to explain things to people who refuse to listen, but here is a Paul Krugman on the subject, back in 2007 when candidate Obama was against mandates (note the parts in boldface):

      Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they’re currently healthy, and in return everyone has insurance coverage if and when they need it.

      And it’s not just a matter of principle. As a practical matter, letting people opt out if they don’t feel like buying insurance would make insurance substantially more expensive for everyone else.

      Here’s why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance — then sign up for it if they developed health problems later. Insurance companies couldn’t turn them away, because Mr. Obama’s plan, like those of his rivals, requires that insurers offer the same policy to everyone.

      As a result, people who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn’t sign up for insurance until or unless they needed medical care.

      This is the case now. One of the reasons insurance costs go up, up, up is that as more and more people lose insurance, hospitals and doctors have to pad the bills that do get paid in order to stay solvent. And then insurance premiums are more expensive, and more people can’t pay, etc. It’s a downward spiral, in other words. The only way to get that under control is to get as many people insured as possible, and I think mandates are necessary to do that, because too many people are pigheaded and stubborn and selfish and will refuse to see the problems they are causing by not being insured.

      The mandates are a cost-control feature, in other words, and they control cost whether there is a public option or not. The public option had a somewhat different function regarding cost control and also was favored by people who didn’t want all that mandated money going to corporations. But removing the public option does not remove the purpose of the mandates. The fact that extremely poor people can opt to pay a fine instead of insurance probably is not the best way to go about it, but that also is unrelated to the ultimate purpose of the mandates.

      Nobody expects there to be 100 percent coverage after all the provisions go into effect, but the bigger percentage of the population is insured, the lower costs for everyone. That’s why mandates are necessary.

      Mandates also are unrelated to abortion language. If you are making an argument that the two are linked politically — well, maybe, but I don’t see it. But as for making health care reform functional, they are unrelated.

  11. Admit it all Dems and Pres, DO NOT CARE.

    There’s so many things leadership does to arm twist BOTH Repubs and Dems to get on board. Do you ever want highway money going to you state again? Do you want any defense money going to your state over the next 4 years? I’m sorry, but the Democratic leadership does NOT have to give Repubs any earmarks, especially since Repubs think earmarks evil.

    If the Democrats wanted a public option we’d have a public option. Dem leadership from Obama on down have tremendous power over discretionary spending, over the allocation of resources, over how rules are interpreted, and monies are spent. It’s all about the money. Squeeze their money sack and those pigs will squeal any tune you desire.

    But no one squeezed, because no one cared. You stop that Katrina money from flowing to Mississippi and you’d even find a Southern Republican having a change of heart tantamount to a full blown coronary.

  12. maha – Do you know the particulars of the mandate? I have heard that there is a fine for those who don’t subscribe, however, if they don’t because they can’t afford the premiums, how can they ‘afford’ the fine. And what happens if they don’t pay the fine? Jail? How long? Is their a provision in the mandate which states that if a person’s income isn’t enough to buy insurance, the government will subsidize the purchase?

  13. Could be that Bill H. doesn’t know any liberals, has never known any liberals and therefore doesn’t realize that we’ve been complaining for years? In reading some of our comments here, Bill will at learn something about us – we’re a self-righteousness bunch.

  14. It’s a distinct possibility that the Democrats could pick up additional seats in the Senate in 2010. Voinovich and Gregg are quitting and those seats are winnable. The difficulty is activating and enlarging the “base”.

    Robin Williams parodied Congress in his recent “Weapons of Self-Destruction” saying that politics should be more NASCAR – they should have to wear their sponsors names plastered all over their clothes. I think this is an excellent idea for ads against the shameless plutocratic corportists that gave more to the rich and increased suffering for the rest.

    It’s going to take several election cycles, but we can still alter this nation in a way that benefits the electorate, not the corporate masters.

  15. Barbara, the mandates and the abortion language are very much linked politically. Refusing to see that does not make it otherwise. The fetus people don’t want to be forced to buy coverage for women, and while it is a moral imperative to provide universal coverage, your karma is going to get run over by their dogma on this.

    Separate but equal coverage for women is not a solution either.

    • Barbara, the mandates and the abortion language are very much linked politically.

      I don’t see the link. Right-wingers want the abortion language, and progressive wonks want the mandate. I don’t see what links them politically.

      The fetus people don’t want to be forced to buy coverage for women, and while it is a moral imperative to provide universal coverage, your karma is going to get run over by their dogma on this.

      That doesn’t have anything to do with the mandates. Now you’re talking about subsidies and the exchanges. That’s a different provision.

      In short, you’re confused.

  16. Okay, the dogma karma joke was reversed and I shouldn’t have tried to make a joke of this. But really, both go or neither, I think.

  17. Well as I said before here’s the deal, my parent’s health care costs are going to double since they make ~$60,000 and have a Cadillac plan through their union. So forgive me if I fail to support a bill that is going to cause a great deal of economic hardship to my parents.

    • MN — be sure you understand how the “cadillac plan” provision works. As the Senate plan has it, if a policy costs more than $8,500 for a person or $23,000 for a family, the insurer would have to pay a 40 percent tax on the cost above that threshold. Retiree policies require a slightly higher threshold. I don’t know how much the insurers would be allowed to pass the cost of the tax on to consumers. But I can’t see how your parents’ policy would double.

  18. If this bill saves 100 American lives, it should be passed. If it saves 10 American lives, it should be passed. And, if it only saves one American life, it should be passed. It is the right thing to do. It puts us one more step closer to getting the uninsured Americans insured, which will save many American lives.

  19. I’m not confused, Barbara. You “don’t see the link” because you want the mandates, but if you mandate that people to pay premiums for health coverage that includes medical procedures for women that the fetus people oppose on (however twisted) moral grounds, you aren’t going to pass the bill. Not possible. Drop both or neither, bring back the mandate with the public option when we have the strong moral ground.

    • mahakal, you’re talking about two different things. The abortion language is not linked to the mandates. It’s linked to insurance sold through the exchanges or with subsidies. Removing the mandate would have no impact on the abortion language.

      You “don’t see the link” because you want the mandates

      It’s not a matter of what I want. I have no personal desires attached to the mandates. It’s a matter of what’s necessary to make the reform work. I assume you don’t see this because you don’t want to spend the money and pay for insurance.

      I’m done arguing with you. Good bye.

  20. As the Health Care debate has evolved, we’ve dissected the issues into 2 major categories 1) the plight of Americans without insurance and 2) the abuses by the insurance companies. The ‘wonks’ place a high priority on the people who suffer and die for lack of health care. The ‘activists’ are enraged that the legislation does not punish the insurance comnpaines – it may increase the profits of the industry with the increased business – the activists are still out for blood.

    There’s a few insurance company CEOs who should be waterboarded – repeatedly and publicly. But that’s not going to happen, so I will focus on the more important aspect – helping Americans who need health care – delivered in a fiscally responsible way. If your anger has you by the – whatever – take a breath, let the anger go. and look again at that the bill HAS and DOES.

  21. I initially thought that liberals should push their legislators to kill this bastard of a bill. However, after reading Paul Krugman’s well-reasoned arguments, I have changed my mind. Now I think it should pass. Don’t get me wrong – I think this bill sucks the Big One. But, it can be built on and I am enough of a bleeding heart to want the 30 million people currently without health insurance to get it. But my opinion of the Democratic Party is diminished considerably as a result of this debacle, and I will not be blindly supporting the party anymore. Our two-party system is (pardon the expression) fucked up beyond all repair (FUBAR).

  22. Thanks for the positive attitude Maha. Sometimes it seams in such short supply. Stopping by Mahablog is a nice respite. I like when authors engage their readers. The comments are much more informative and entertaining. Thanks for taking the time!

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  24. Wow, what rightwous indignation. All I can tell you is that I was working like hell to get health insurance for agicultural workers, and maybe five people would show up to walk with us. Don’t give me your snotty tone. I was there and I didn’t see or hear from you.

    • I was there and I didn’t see or hear from you.

      I’m sorry you were so disappointed, but your little anecdote is a mere drop in the bucket compared to what many others have gone through over health care reform. You are several million light years out of line to say that getting universal health care for Americans hasn’t been a huge issue for many of us for many years.

      So don’t give me your snotty tone, dude, or you will never comment here again. Comprende?

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