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Tilting at Windmills

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June 26, 2009

QUOTE OF THE DAY.... I don't usually think of Sen. Jay Rockefeller (D-W.Va.) as a champion of progressive public policies, but on health care, it sounds like he's exactly where he needs to be. (via TPM)

"We can't count on insurance companies. They are just maximizing their profits. They are sticking it to consumers. I am all for letting insurance companies compete. But I want them to compete in a system that offers real health-care insurance. I call it a public plan," Rockefeller said.

Earlier this month, Rockefeller introduced the Consumers Health Care Act that would give all consumers the option to participate in a government-run plan competing with private plans. [...]

On Thursday, Rockefeller admitted he expects little bipartisan support.

"There is a very small chance any Republicans will vote for this health-care plan. They were against Medicare and Medicaid [created in the 1960s]. They voted against children's health insurance.

"We have a moral choice. This is a classic case of the good guys versus the bad guys. I know it is not political for me to say that," Rockefeller added.

"But do you want to be non-partisan and get nothing? Or do you want to be partisan and end up with a good health- care plan? That is the choice."

Good for Jay Rockefeller -- a moderate from a "red" state where Obama lost last year by 13 points.

Steve Benen 9:15 AM Permalink | Trackbacks | Comments (34)

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Saw these comments yesterday and was astounded. I hope he's sending up a flare for the rest of the chickenshit moderates. Republicans DON'T WANT A COMPROMISE. They want sabotage disguised as compromise.

Posted by: Run Up The Score on June 26, 2009 at 9:25 AM | PERMALINK

Also check out what Rahm said -- By defining bipartisanship as consultation and including ideas from both parties he's saying they don't need Republican votes to pass a bipartisan health care reform bill. Very encouraging!

“That is a test the president laid out, and he has said it repeatedly: This will be bipartisan. There will be ideas from both parties and individuals from both parties in the final product,” Emanuel said. “Whether Republicans decide to vote for things that they’ve promoted will be up to them.”

Posted by: Amy on June 26, 2009 at 9:26 AM | PERMALINK

There was a time when states would not allow a for-profit medical insurance plan to operate, as such an enterprise was considered inherently immoral and contrary to the public interest. I have been trying to research when the public policy changed to allow these corporations which now curse us, and while I think it was in the '20s I would love it if anyone knew exactly when that change was.

It seems like reversing that mistake should be the first thing needed to fix things.

Posted by: Xenos on June 26, 2009 at 9:28 AM | PERMALINK

Interesting comments from Jay. He's probably seen the effects of poor health care options on constituents as much as anyone.

Posted by: Matt on June 26, 2009 at 9:36 AM | PERMALINK

Presently insurance companies have no real competition, they are mostly local monopolies or near monopolies.

A public option is the only 'competition' they'll ever see.

Posted by: alan on June 26, 2009 at 9:39 AM | PERMALINK

Dwellers in red states can be distracted with rubbish from the King of Poop (Rush) for only so long. They have to work, pay for insurance, deal with the companies when they get sick, etc. We can only hope that real life will continue to trump BS misdirection for most voters.

Posted by: Neil B ♪ on June 26, 2009 at 9:43 AM | PERMALINK

Rocky was, along with Ted Kennedy, one of the biggest supporters of Hillarycare back in the '90's. He's a complex politician, but on this issue, he's consistent.

Posted by: Danp on June 26, 2009 at 9:44 AM | PERMALINK

I think this health care debate is focusing public attention on just who is actually representing the interests of the people and who is representing the interests of an industry that is responsible for a morally reprehensible for profit health care system fueled by greed.

We now are able to see whose coffers are being filled by the powers that be who will resort to any measure in a desperate attempt to secure their cash cow, despite the fact that large majorities of Americans realize the current system is broke and has to be fixed.

If we are a nation that can accomplish anything anymore, it must be this.

I find the arguments against a public option absurd:

Private companies can't face a little competition? Please. Are 'private market' and the 'free hand' principles not applicable in this scenario?

Government can't run an efficient system? Hogwash. The VA in study after study has proven to provide better health care at a lower cost than any other major HMO or health care company.

Posted by: citizen_pain on June 26, 2009 at 9:45 AM | PERMALINK

When elected officials put their own well being (i.e. getting re-elected) second to doing the greatest good for the citizens, then we will see progress made.

On healthcare, on education, on national defense- I could go on. . .

Posted by: DAY on June 26, 2009 at 9:48 AM | PERMALINK

this is the first statement i have heard in a long long long long long long LONG time that connotes a modicum of "justice" in the consciousness of this legislative body of this nation. Most in the Senate long ago forgot the country they serve.

a wink and a thumbs up to ol' Jay for just doing his job...

Posted by: neill on June 26, 2009 at 9:49 AM | PERMALINK

Well, well, Jay. There's the guy we occasionally used to see. Welcome back.

Posted by: shortstop on June 26, 2009 at 9:50 AM | PERMALINK

Yes, it is the very rarity of such comments in current political discourse that makes them so refreshing.

I find it interesting that Rockefeller used the word 'justice'. He could just as usefully as used 'good for everyone'.

Posted by: PowerOfX on June 26, 2009 at 9:55 AM | PERMALINK

Don't forget: Healthcare is what Rockefeller knows, he never knew shit about Intelligence, health was always his strong point. And that's precisely why he was installed on the Intel committee during the Bush years, to provide ineffectual opposition. R's bitched for days when D's floated other names before settling on him.

Posted by: bubba on June 26, 2009 at 10:01 AM | PERMALINK

@ Xenos

I don't know much about the start of for-profits but I know Nixon and Kaiser Permanente had an impact with the Health Maintenance Organization Act of 1973. The first for-profit HMO's grew out of the 70's.

Alternet has a good piece about some of the history of the for-profit insurance industry including this gem

At the forefront of these service (non)providers was U.S. Healthcare, which grew out of the first for-profit HMOs in the 1970s. By the early 1990s, it was the largest publicly traded HMO, with annual revenues of more than $1 billion. The company -- a notorious proponent of gag clauses in physician contracts that prevented doctors from giving patients a thorough description of their treatment options -- took on the mission of revolutionizing the insurance industry. In a 1992 interview with Business Week , U.S. Healthcare founder and chairman Leonard Abramson expressed scorn for traditional carriers, calling them "dinosaurs" and saying they operated in "a dying world."

Four years later, U.S. Healthcare agreed to be acquired by one of those dinosaurs, Aetna Inc., for $9 billion. It was clear from the start that Aetna was going to be adopting the style of U.S. Healthcare and not vice versa. "Strong forms of managed care, gated managed care, is really coming into its own," said Aetna chief executive Ronald Compton, who also announced that Abramson would join the board of the parent company.

Aetna's marriage with U.S. Healthcare was part of a larger consolidation of the industry and a shrinkage of the non-profit portion. Aetna itself went on to acquire healthcare operations from New York Life and Prudential Insurance, while rivals such as United Healthcare (later UnitedHealth Group) also bought various competitors to rise rapidly in the field. For-profit hospital chains such as Columbia-HCA gobbled up insurers. Even the Blues were abandoning all pretenses that their main mission was to serve the community. Some set up their own HMO subsidiaries, and by the late 1990s a bunch were preparing to take the next step: abandoning their non-profit status and becoming for-profit enterprises. A few such as Anthem Inc., formerly Blue Cross and Blue Shield of Indiana, went yet further, becoming publicly traded companies.


Posted by: about time on June 26, 2009 at 10:02 AM | PERMALINK

I'm not surprised that Rockefeller came out strongly in favor of a public option - for all of his faults, he's been a strong supporter of healthcare reform for years - but I'm a little surprised to see him call out GOPers like he did. Hopefully, his message will be a call-out to the wishy-washy dems to get on board.

Posted by: Stetson Kennedy on June 26, 2009 at 10:11 AM | PERMALINK

Yay, Jay!

Posted by: Jon on June 26, 2009 at 10:22 AM | PERMALINK

Wow - that is much more recent than I had thought. Much of this mess then is part of the great neoliberal clusterf*ck of the late 20th century.

Thanks, about time!

Posted by: Xenos on June 26, 2009 at 10:31 AM | PERMALINK

Thank you, about time--It was my recollection that the for-profits came about under a Repub administration; however, if it were Nixon, it would have been a Dem Congress which passed the law, right?

What were they thinking?

Now, it would be good to know when the for-profits did come about. And when they became real players. If I recall correctly, HMO's were supposed to be modeled on things like the Mayo Clinin and Kaiser Permanente: groups where doctors were paid a fixed rate and thus essentially healthy patients and very ill patients paid the same. So, was it about fee-for-service being viewed as causing costs to rise back then?

Posted by: jawbone on June 26, 2009 at 11:14 AM | PERMALINK

Again, I wonder whether Barry is playing jiu-jitsu? The insurance lobbies, PHarma, and AMA have had their say in the media, and it's taken root...somewhat. But the pushback has been far more effective in a grass-roots sorta way. Rockefeller, Wendell Potter. Skillful deployment of public opinion polls. Etc.

The combined effect is to make the for-profit health care faction look clumsy and venal. I can't help but wonder whether this is a bug or a feature...

Posted by: Jamey on June 26, 2009 at 11:24 AM | PERMALINK

Concerning Kaiser Permanente, I consulted there in 2000 on their Information Engineering Systems and had a chance to read internal documents describing how the organization was started, under different name, before WWII as a cooperative or precursor HMO to provide prepaid health care to workers who could not otherwise afford healthcare. They filled a need for an affordable cost to those fortunate enough to be working on projects that were part of the future Kaiser Permanente network. This was before predatory insurance companies took control of the health care industry.

Posted by: Captain Dan on June 26, 2009 at 12:00 PM | PERMALINK

Hooray! Happy Days can be here again!

Posted by: stan on June 26, 2009 at 1:02 PM | PERMALINK

Good for Jay Rockefeller -- a moderate from a "red" state where Obama lost last year by 13 points

I get the shakes when I contemplate what's going to happen in WV once Byrd kicks the bucket.

Posted by: Mauimom on June 26, 2009 at 1:18 PM | PERMALINK

Steve: "Good for Jay Rockefeller -- a moderate from a 'red' state where Obama lost last year by 13 points."

Given Barack Obama's truly dismal 27% performance against Hillary Clinton in the Democratic primary earlier that year, I was actually quite pleasantly suprised that he got even that close in West Virginia last November.

Posted by: Donald from Hawaii on June 26, 2009 at 3:51 PM | PERMALINK

I realized some time ago that this is one of the pitfalls of the free market in areas such as healthcare. The free market "works," but the problem is that the health care industry's chief customers are not the people who need health care, but the investors who want to give money to the most profitable insurance companies and health care services. As things are, it is systemic that companies are more interested in collecting premiums while NOT providing services as much as is possible so they can turn that money over to investors.

I don't know if having a public option with a mandate to serve people rather than placate investors will solve the problem, but it seems like a step in the right direction.

Posted by: cooner on June 26, 2009 at 4:55 PM | PERMALINK

What a surprise coming from Rockefeller (FISA immunity champ) but perhaps he's getting it that instead of worrying about the votes he might "lose" by such a stance...he sees the huge number of votes he's likely to "gain" by speaking out boldly for truth and for the American people. Then perhaps it is so OBVIOUS why such a plan is absolutely necessary for the good of the entire nation that he feels compelled to do the 'right' thing over the lobbyists dictated thing.

His words are heroic...now if other dems would just get on board even to the point of using a nuclear option to end senate filibuster obstructionism, the country could get what it demands and desperately needs.

Without a gov. run ins plan there is no reform. Anything else is a stall for time or a distraction until the private ins companies can figure a way to continue their profiteering.

Kerry's "Trigger"; Conrad's "co-op"...all plans to doom healthcare reform. There is no credible reason to deny us what Rockefeller calls for...none. It will be American Healthcare ins...the gov. plan...now get it done.

Posted by: bjobotts on June 26, 2009 at 5:41 PM | PERMALINK

"...There was a time when states would not allow a for-profit medical insurance plan to operate, as such an enterprise was considered inherently immoral and contrary to the public interest..."-Xenos

Blue cross may still be, I don't know, but most private HC ins. companies were listed as "not for profits". They just paid their CEOs and execs. huge salaries and bonuses. Does that make a difference to you. Hell even one of the so called "co-ops" that folded a few yrs back paid an annual salary to it's CEO of $750,000/yr (some congress man's wife) which drove the co-op to bankruptcy leaving its clients without health care. Hope that doesn't confuse the issue.

Posted by: bjobotts on June 26, 2009 at 5:50 PM | PERMALINK

Does anyone know of a website link to Rockefeller's plan? Any kind of summary to any of the available bills on healthcare reform should be noted, so people can look at the options and to compare them.

Posted by: MarkH on June 26, 2009 at 6:06 PM | PERMALINK

The difference between the insurance companies and government is that the insurance companies are specifically aimed at making profits, while the government has no mandate other than taking care of the cost for Patients.

Whatever the priority goal of the organization is will always be achieved first. Everything else will be sacrificed to achieve that primary goal. That's why having the primary goal of making profits hurts patients.

Profits can be increased by sacrificing patients, as so many recently reported cased show that insurance companies are doing. That's why the insurance companies target and practice policy rescissions on cases in which a very expensive claim has been filed. There is no profit in those cases.

Government has no such motivation, and often - well, sometimes - has the media on its ass forcing transparency when it fails. So government health insurance is the only insurance that can be trusted to work to help patients to the greatest extent possible.

That's the normal working of the free market in a profit-oriented society work under Milton friedman's rules. That's why America has a second-rate health care system. It's profit oriented.

Posted by: Rick B on June 26, 2009 at 11:48 PM | PERMALINK

Very impressive comments from Rockefeller. Let's hear it from the rest of the Democratic caucus. Spit the meal out and tell it like it is.

Posted by: Nancy Irving on June 27, 2009 at 7:44 AM | PERMALINK

The insurance companies had competition until the government tried to get involved in them in the first place. Before the government required businesses with more than 25 employees to offer HMO coverage to employees (HMO Act of 1973), there was competition in the insurance market. However, when the government stepped in, they didn't foresee that by making the nonprofit model for health insurance, which don't offer better cover necessarily, they eliminated a lot of private coverage from smaller, private insurance companies. The goverment needs to de-regulate health care if they want to see the benefit of true market economics on the health care industry.

Posted by: Ross on June 28, 2009 at 10:08 PM | PERMALINK

Also, the government has to make at least even on the healthcare industry as well, if they offer a public plan. If not, we are going to end up lending more money from abroad, and eventually, the United States will default under the weight of enormous social programs and will be owned by other countries. That's what a government insurance plan would do. Its ludicrous. The government, when funds run short, will short an 80 year old a kidney transplant, when they could give it to a 40 year old. Its common sense. There will be rationing in health care if the government is in charge of it, because eventually there will be a limit to how much can be spent. There will be a line item on the budget that can't be surpassed. With private healthcare, the expense can grow to infinity, providing there are payers. And so far in American History, we've never run short of spenders.

Posted by: Ross on June 28, 2009 at 10:15 PM | PERMALINK

Hmm. Is it true? :-)

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