Editore"s Note
Tilting at Windmills

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August 20, 2009

IT'S NOT ABOUT THE UNINSURED?.... Just for a moment, let's put aside the important discussions of specific provisions -- public option, co-ops, mandates -- of the health care reform debate. Instead, let's consider why reform is worthwhile in the first place.

Why do reformers want reform? Painting with the broadest possible brush, there are two main reasons: (1) there are tens of millions of uninsured Americans who have no coverage, a moral outrage in the wealthiest nation in the world; and (2) there are tens of millions who have been, could be, or will be screwed over by insurance companies, and they need some protections.

Whether you like the various proposals or not, this is why health care reform is on the table. It's what reform is all about. This is what it's always been about.

If only the leading Blue Dog on health care agreed.

Rep. Mike Ross (D-Ark.) said on Wednesday that providing healthcare to uninsured Americans is "not what this healthcare reform debate is about."

In making his comments, Ross, who is the centrist Blue Dogs' health reform point man, questioned one of the primary healthcare goals of the White House and Democratic leaders.

"That is a side benefit to healthcare reform and an important one," Ross told the Arkansas Educational Television Network. Instead, the fifth-term congressman said the bill should focus on "cost containment."

We're the only industrialized democracy on the planet that doesn't guarantee health care coverage for all of its citizens. Tens of millions of Americans have no coverage, and half of all bankruptcies in the United States stem from health care expenses that destroy families financially.

Addressing this is a "side benefit"?

For what it's worth, Ross identified specific provisions that would prevent him from voting for reform -- forcing Americans who want a private insurer to take the public option, taxpayer subsidies for abortions, coverage for illegal immigrants, rationing, and deficit increases.

Depending on whether Ross is prepared to use Republican-friendly definitions of some of these phrases, it sounds like he should be able to support the Democratic proposal.

Steve Benen 1:05 PM Permalink | Trackbacks | Comments (33)

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Comments

Ever think the tent has gotten too big? Expel this bozo.

Posted by: doubtful on August 20, 2009 at 1:12 PM | PERMALINK

This is what happens when a president chooses not to lead, when he proves himself so impotent as to concede his agenda to members of Congress. This is also, what happens when a party doesn't stand for anything.

Posted by: Ralph Kramden on August 20, 2009 at 1:13 PM | PERMALINK

we already know mike ross is a sleasebag Big Pharma hack who could care less about his constituents in Arkansas.

he has a shit-filled soul...

i guess i'm too pure to think that obama should deal with scumbags like him the way he is.

(oh, and ross is a democrat, so i guess i'm just as pure as the driven snow...)

Posted by: neill on August 20, 2009 at 1:17 PM | PERMALINK

Steve, what it's about is that without serious reform, we're looking at an economy-wide wipeout toot sweet. The GOP and some Blue Dogs may still be in denial, but Obama and most of Congress aren't.

Posted by: lotus on August 20, 2009 at 1:20 PM | PERMALINK

Well, it isn't just about the uninsured, as Michael Moore has pointed out; there are also all the people who think that they are covered who will not collect when a sufficiently large bill comes due.

My father had health insurance that would not pay for any of the care related to my brother's heart condition that eventually led to his death, because it was a "pre-existing condition" at the time my father first got the policy. After the family lost all of its savings, we managed to get money from Medicaid. My father felt shamed by this, and was severely depressed for the rest of his life (he didn't survive long after that).

Posted by: Joe Buck on August 20, 2009 at 1:22 PM | PERMALINK

I am going to side with Ross on this one though I doubt we are going to end up at the same place. We decided as a country long ago that we would treat sick people whether they were insured or could pay or not. The result is a lousy system littered with bankruptcies, bad preventive care, unnecessary deaths, overburdened emergency rooms, high property taxes to cover the uninsured at county hospitals and cost shifting to those who pay for their health care. It is way past time to design a system that does what we have already decided to do but in a more effective, efficient and therefore less expensive way. That is why I support tax funded single payer with the added benefit of taking the health insurance burden off companies and freeing employees to pursue entrepreneurial dreams without health care worries. That is why I support reform efforts and why this reform is looking pretty weak.

Posted by: Th on August 20, 2009 at 1:22 PM | PERMALINK

Is it possible that rhetorical overreach will bite the Repubs in the posterior? After a few weeks of legislative horse-trading that leaves the main bill elements intact, the Blue Dogs could truthfully announce to their constituents that they voted for a bill that didnt have any Death Panels in it!

Isnt this the context of Steve's final sentence in the post?

Posted by: troglodyte on August 20, 2009 at 1:25 PM | PERMALINK

Great Britain spends 9% of their economy on Health Care.

The United States spends 16% of our economy on Heath Care and at present rates may soon be spending 25%.

And we get WORSE health outcomes then the British.

Ross is right. This is about cost containment. Of course, getting everybody on some form of health insurance that actually pays for their health care would give us cost containment because they would all be cheaper to treat and keep healthy if their were under regular health care rather than emergency room care.

Posted by: Lance on August 20, 2009 at 1:26 PM | PERMALINK

Am I the only one here who disagrees with this?
While I wouldn't go anywhere near as far as saying that covering the uninsured and preventing medical bankruptcies even among the insured (and all the other insurance-co abuses) are "side effects," I also don't think they're the only, or even primary, reason to pursue reform. And that's certainly not the way to sell it to Jane and Joe Sixpak, especially in a recession (and double-especially when that recession's recovery looks to be another "jobless" recovery, and especially-squared given a mass media that on this issue is just FoxNews without the slogan and the blondes).
Am I the only one who thinks the primary goal should be adjusting the system so that we don't spend, what is it, from 50% more to twice what any other "advanced" [sic -- or should that be "sick"?] nation does on healthcare, only to wind up, what is it, 26th in healthcare outcomes performance among such nations?
And that, while covering the uninsured and underinsured, and reigning in the insurance-firm abuses are huge components of attaining that goal, they're neither the only nor the primary goals themselves?

Posted by: smartalek on August 20, 2009 at 1:29 PM | PERMALINK

Ah, good -- I'm clearly not the only one who disagrees.
As usual, beaten to it by posters who said it better and more concisely than I did.
Joe Buck, I'm horrified. That's so far beyond vile. So very sorry to hear that.

Posted by: smartalek on August 20, 2009 at 1:36 PM | PERMALINK

I just want to point out that it is idiotic to claim that the primary goal of health care reform is cost containment and then declare rationing as a non-starter. It is typically American to decide that we want things to be cheaper but we also want them to be unlimited, but it is also painfully dumb. Realize that isn't me arguing that Ross is right about cost controls, but that his list of deal-breakers suggests he is deluding himself about his priorities (and the priorities of his constituents).

Posted by: socratic_me on August 20, 2009 at 1:37 PM | PERMALINK

BHO is the most dangerous man since FDR, and has to be stopped.

There are numerous groups- some armed, some organized, some both- with various explanations of WHY he is dangerous, just as there are many ideas about HOW he should be stopped.

Meanwhile, the democratic party is conducting a circular firing squad. . .

Posted by: DAY on August 20, 2009 at 1:39 PM | PERMALINK

"BHO is the most dangerous man since FDR, and has to be stopped." - Day

Amazing the people who will promote armed insurrection when they can't win at the ballot box.

Effing Coward is what you are Mr. Day.

Posted by: Lance on August 20, 2009 at 1:42 PM | PERMALINK
BHO is the most dangerous man since FDR, and has to be stopped.

Obama is about as dangerous to the ownership class as a slingshot is to a tank.

Posted by: Steve LaBonne on August 20, 2009 at 1:43 PM | PERMALINK

Hey, the system works. It does what it's supposed to do - it sends CEOs to the Bahamas. Why fix what ain't broken???

Posted by: Roddy McCorley on August 20, 2009 at 1:48 PM | PERMALINK

Can someone please explain to these people that we already ration health care under our current system? And that there isn't a single healthcare system in the world that doesn't?

Posted by: Allan Snyder on August 20, 2009 at 1:53 PM | PERMALINK

"What this healthcare reform debate is about" is how to ensure that America continues to have the most profitable "health care" system in the world.

We have to get it right. The multimillion-dollar salaries of insurance corporation and pharmaceutical company and HMO executives, not to mention millions of dollars in bribes (a.k.a. "campaign contributions") to elected officials, depend on it.

Republicans and moderate Democrats like Ross understand this, and are correct not to be distracted by side issues like the problems of uninsured and underinsured people.

Posted by: SecularAnimist on August 20, 2009 at 2:12 PM | PERMALINK

Sam Stein has a good one over at HufPo (though it looks like an o'er-hasty posting, so click through to Gallup and Kos for better data-display). Anyhow, it compares the most uninsured (by state, Gallup polling Jan 2 - June 30) with the most misinformed (by region, Research 2000 polling Aug 10 - 13). You can guess the pattern, I bet.

Posted by: lotus on August 20, 2009 at 2:15 PM | PERMALINK

Frankly I don't care one bit what Ross will vote for. In my opinion he has damaged the negotiations so badly that he has lost all his chips in this game -- he should sit on the sidelines and shut up.

All I care about is this: will he filibuster? If he says yes, he should be pulled off every meaningful committee, put on the "pick up dog shit in the park committee" (I don't know the name of that one, someone might want to help me out here) and made even more irrelevant.

Or does Rahm not know how to play hardball politics?

Posted by: Joesbrain on August 20, 2009 at 2:20 PM | PERMALINK
All I care about is this: will he filibuster?

Umm, he's a Representative.

Posted by: Steve LaBonne on August 20, 2009 at 2:22 PM | PERMALINK

I have a question:

My health benefits are touted by my employer as part of my salary. They claim "we are not paying you x; we are paying you Z". So will they now have to pay me out if I want to change to a private plan on the health exchange?

Posted by: coral on August 20, 2009 at 2:27 PM | PERMALINK

I also have to side with Ross here -- if health insurance reform becomes all about insuring the uninsured without talking about the other benefits of doing it (like not having to be afraid of losing your house if your kid gets in an accident), we're going to lose.

Healthcare reform will benefit ALL of us, not just the uninsured. There's been a major problem getting that across to people and I don't think it's a bad thing to have people point out that people who already have insurance are going to benefit, too.

Posted by: Mnemosyne on August 20, 2009 at 2:36 PM | PERMALINK
I also have to side with Ross here -- if health insurance reform becomes all about insuring the uninsured without talking about the other benefits of doing it (like not having to be afraid of losing your house if your kid gets in an accident), we're going to lose.

Which is why mandates without a serious public option would be a really, really stupid political move. Perhaps someone should explain this to Ross.

Posted by: Steve LaBonne on August 20, 2009 at 2:40 PM | PERMALINK

I'm with various of the other posters here. One of the things that's clear from this month of public activity is that many vocal Americans are, well, selfish. If they think they're doing health care reform to help out 45 million other people (who they can paint with any broad brush they like), they're not going to go for it. This specific issue needs to be reframed:

There are 45 million people who do not pay for healthcare but who show up in emergency rooms when they are sick. Who's paying for them? You are, with your property taxes, and with your insurance premiums. Wouldn't it be better if these uninsured paid for the care that they're going to need?

Steve, I agree with you on the moral dimensions here. But right now, this is about selling the plan. I think Democrats should massage Ross's words into something that does what we want but at the same time comes does a good job at messaging.

Posted by: YW on August 20, 2009 at 2:48 PM | PERMALINK

I'll state the obvious (which has probably already been stated since I don't have time to read everyone's comments): coverage and cost containment are inextricably intertwined. You can't have one without the other. We already have universal health coverage. It's the ER Healthcare Option and it's the crappiest, most expensive, most morally repugnant kind of coverage you can have, short of having no coverage at all and dying in the gutter.

The debate is what kind of real universal coverage are we willing to provide, and whether there are enough people who understand that the better we care for the un(der)insured, the less it will costs us. I'm truly wondering if there are enough Murkans who have the requisite wattage to reach this critical mass.

Posted by: bdop4 on August 20, 2009 at 3:30 PM | PERMALINK
The debate is what kind of real universal coverage are we willing to provide, and whether there are enough people who understand that the better we care for the un(der)insured, the less it will costs us. I'm truly wondering if there are enough Murkans who have the requisite wattage to reach this critical mass.

If we had real leaders they would LEAD, and after seeing the benefits to themselves, the people will follow. See under: Social Security; Medicare.

Posted by: Steve LaBonne on August 20, 2009 at 3:33 PM | PERMALINK

He's right though. It's not pretty but there it is. The Public doesn't really care about the uninsured unless they happen to be one. Even if they do know someone who is uninsured half the time their response is only "Glad it's not me!"

Pushing "but X million uninsured!" is never going to be a winning option. The focus should be on cost control, improved outcomes, choice and a safety net for those with insurance. Yes that those rest will be covered is important, but you will not be winning the argument on it.

Posted by: MNPundit on August 20, 2009 at 4:31 PM | PERMALINK

Healthcare reform will benefit ALL of us, not just the uninsured. There's been a major problem getting that across to people and I don't think it's a bad thing to have people point out that people who already have insurance are going to benefit, too.

This has been my major beef with the way Obama and the Dems have conducted the messaging. It is way too easy for people who have insurance to convince themselves that those 47 million are somehow "the other," and that this can never happen to them.

All pro-reform elements should have consistently included as major parts of the messaging:

--You CAN lose your insurance via job loss, your employer deciding to stop offering it or your insurance company dropping you when you get sick
--You MAY NOT be able to get more if you have a preexisting condition
--Even with insurance, you ARE in danger of going bankrupt, losing your house or otherwise giving up your assets to medical bills

Posted by: shortstop on August 20, 2009 at 5:09 PM | PERMALINK

"...For what it's worth, Ross identified specific provisions that would prevent him from voting for reform -- forcing Americans who want a private insurer to take the public option, taxpayer subsidies for abortions, coverage for illegal immigrants, rationing, and deficit increases..."

Since none of these things are true or even being considered, why is Ross even referring to them?

Like Ross saying "I refuse to support any HC ins reform that mandates all women under 20 be sterilized and all men over 50 be forced to cease working"...yeah, no shit stupid. Blue dogs did not get Obama elected nor do they stand for the dem agenda and they are only fiscally conservative for the rest of us, as they brag about being the leaders in bringing home pork barrel spending and voted for every war funding bill ever passed.

Only now (thanks to the ins. donations to their PACs) are they 'concerned' about the cost of a much needed HC reform. The hypocrisy reeks.

Posted by: bjobotts on August 20, 2009 at 5:50 PM | PERMALINK
Whether you like the various proposals or not, this is why health care reform is on the table. It's what reform is all about. This is what it's always been about.

I'm surprised you wrote that, because it is almost certainly completely wrong -- as others above have already pointed out.

If pushed, I think the president would admit that the most important reason (to him) for reform is fiscal -- health care costs are going to bankrupt not only millions of individuals, but the country as a whole. We can continue allowing people to suffer, die, and face financial ruin and still maintain a "workable" country. (Disgusting and grotesque, but workable.) But the costs of health care threaten to bring the country to its knees. Or so I've heard Obama argue.

DAY wrote: BHO is the most dangerous man since FDR, and has to be stopped.

I guess the proof of that statement is in the obvious fact that FDR destroyed this country and we've just been slowly rotting since the thirties. The apparent prosperity that followed FDR was proof positive that the country was dead.

Now, Obama has showed up to bury the carcass.

Thanks, DAY, that's probably the dumbest thing I've read all day. Shouldn't you be hanging out on survivalist and militia websites?

Posted by: oh really on August 20, 2009 at 7:44 PM | PERMALINK

DAY was describing the Republican point of view, not his own, Einsteins. Sheesh.

Posted by: on August 20, 2009 at 8:03 PM | PERMALINK

OK, if I give you a $20 bill and you bitch that it wasn't a fifty, that's not rationing.

Posted by: Aatos on August 21, 2009 at 2:19 AM | PERMALINK

I'm struggling with the concept of a public option as a "tool" to control costs. I can not see politicians making the difficult "immoral" decisions on which treatments to allow/disallow within a public plan.

Recently my son, age 24, was denied his own health policy because of a "pre-existing" condition. He was 40 pounds over weight. My son understands he can improve his ability to obtain health insurance (and more importantly better long-term health) with proper diet and exercise). With 40% of all healthcare costs related to treating conditions resulting from poor behavior choices (excessive diets and tobacco use), how will a government managed insurance plan create disincentives for poor health related choices?

Posted by: m on August 21, 2009 at 1:20 PM | PERMALINK
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