Editore"s Note
Tilting at Windmills

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August 24, 2009

KENT CONRAD AND 'SIGNIFICANTLY LESS'.... There's one thing conservative Democratic senators seem to agree on when it comes to health care reform. Despite the big Democratic majorities on the Hill and the Democratic president, they see the need for a bill that's much weaker, less comprehensive, and less effective than what the Democratic mainstream has in mind.

The Gang of Six members made this much clear late last week, and Sen. Kent Conrad (D) of North Dakota, one of the six negotiators and a long-time opponent of a public option, reiterated the point yesterday. Reform is "going to have to be significantly less than what we've heard talked about," Conrad said.

In terms of "what we've heard talked about," the center-right Democrat was almost certainly referring to Democratic proposals that have already passed the House Education and Labor Committee, the House Ways and Means Committee, the House Energy and Commerce Committee, and the Senate Health, Education, Labor and Pensions Committee. These efforts, apparently, don't meet Conrad's standards. Americans and their failing health care system, Conrad insists, need less.

It's likely that means legislation that costs "significantly" less and does "significantly" less.

Jonathan Cohn explains that the reform bill that's already passed four of the five relevant committees were already scaled back to satisfy the demands of less-progressive lawmakers.

In order to keep the price tag at or below $1 trillion over ten years, Democrats had to write bills that would roll out reforms slowly, over several years, so that a new system was not fully in place until 2013 or later. That's a long time to wait for change, particularly if you're one of the unlucky souls who ends up without insurance -- or with inadequate insurance -- when illness strikes.

The saving grace of those four bills was that the consumer protections and financial assistance in them remained reasonably strong. If reform ends up looking like those four bills, then financial assistance would be available to people earning up to four times the poverty rate -- or around $88,000 a year in family income. (Subsidies would be available on a sliding scale, so that a family making $70,000 would get very little, a family making $60,000 would get more, and so on.) Such a measure would also limit out-of-pocket expenses to $10,000 a year per family, while providing other crucial protections. And, of course, it would include a real public insurance option.

If Conrad and his supporters get their way, the new health care system won't be nearly as generous -- or protective. They've made clear they want a package that costs less than $1 trillion. A lot less.

As a practical matter, that means "significantly less" help for the uninsured, and based on the research of the Center on Budget and Policy, many middle-class families that wouldn't receive any subsidies for coverage at all.

Atrios noted this morning that when all is said and done, Americans will actually have to like the health care bill if/when it comes law. Conrad, whose role is inexplicably critical to the process, insists reform has to offer fewer protections, less coverage, and fewer benefits, especially to the middle class. It wouldn't only be a lost once-in-a-generation opportunity, it would be a solution that almost no one likes.

Cohn concluded, "You can imagine why Republicans might think this is a dandy idea. But why on earth would Democrats agree?" Sen. Conrad, that's not a rhetorical question.

Steve Benen 10:20 AM Permalink | Trackbacks | Comments (24)

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Yes, I'm amazed that NOWHERE can you find any "debate/discussion" on the TIMELINE for the legislation now waiting in the wings for Bachus and his crew to finish...if this is so urgent and so many people are desperate for some relief how in HELL do Dems sign off on a phase in that will take until 2013 to actually help those most in need?????? And, why isn't that being discussed? Because we are all manipulated by the corporate press and the politicians who have their own interests to protect FIRST!!! OOPS, nowhere but HERE I might have mentioned...let's see how far that goes...

Posted by: Dancer on August 24, 2009 at 10:25 AM | PERMALINK

A question on the Gang of Six(TM):

Has anyone heard what Bingaman thnks on all this? I've heard Enzi, Grassley, Baucus, and Conrad prattle endlessly. I've even heard Snowe comment on the fact that they aren't even considering the public option.

I may have missed it, but I have yet to see or hear a quote from Bingaman.

Posted by: howie on August 24, 2009 at 10:45 AM | PERMALINK

Perhaps those right leaning Congressmen/women will experience "significantly less" time in office?

Posted by: John D'oh on August 24, 2009 at 10:46 AM | PERMALINK

Kent Conrad is a hypocrite. He voted for the Bush tax cuts and the prescription drug bill without batting an eye. If a Republican president had proposed a public option, Conrad would be bending over and backwards to get it through.

Posted by: Micheline on August 24, 2009 at 10:46 AM | PERMALINK

Look, Sen. Conrad gets elected in North Dakota. North Dakota, though it often elects Democrats to statewide and local office, is basically a conservative state. Co-ops, incidentally, are very big in North Dakota, always have been. So Conrad is their chief advocate of health co-ops as an alternative to a public health insurance option as well as a critic of health reform's cost.

This stuff is what it is. Elected representatives respond to the views of the people that elected them. If they are left on their own to work out all the details of complex legislation on a subject like health care reform, they are going to roam far off the legislation.

President Obama and his team have spent too much time worrying about what Clinton did wrong in 1993 and not enough studying what President Reagan did right in 1985-86 during the debate over overhauling the tax code. The Reagan administration let plenty of Congressmen and Senators put their "stamp" on tax reform, but always had its own ideas on the table -- and had hard bottom lines for what the President would and would not accept. At the end, the issue was whether Congressmen and Senators were for or against reform, not how they felt about bits and pieces of it.

Obama still has time to get to this position. I'm hoping he's able to, because though I'm dubious about some health care reform ideas in play now I don't think doing nothing gets us anywhere. However, he and his team really need to change the way they've approached the task of getting this bill through Congress. They have to be the ones defining what "reform" means, and they're not doing it.

Posted by: Zathras on August 24, 2009 at 10:49 AM | PERMALINK

It may seem counter-intuitive, but the further reform moves in the direction of single-payer, the cheaper healthcare will be.

Kent Conrad may be a corrupt, disingenuous douchebag, but why are reform proponents making his case for him with their talk of subsidies, financial assistance and (OMG)one-trillion over ten years.

Taking the major facets of healthcare away from private insurers will be cheaper for everyone, even teabagging nutballs and rifle-toting tinydicks.

Posted by: henry lewis on August 24, 2009 at 10:56 AM | PERMALINK

Somebody help me here because I'm lost. Why is it that the SFC bill is considered "the" bill when there are already 4 bills that contain a public option? Isn't the SFC bill the outlier?

As someone said this weekend the Democratic bill - public option = RomneyCare.

Posted by: Unstable Isotope on August 24, 2009 at 11:06 AM | PERMALINK

We got boozers for leaders

Giving the Gang of Six all of August to control the Washington dialog for healthcare,
was equivalent in brilliance to...
disbanding the Iraqi Army after Sadam's fall.

Posted by: koreyel on August 24, 2009 at 11:07 AM | PERMALINK

Conrad, Bauchus, Lieberman and their "Kind" are part of our SENATE problem, not the solution.
IF the majority Dems in both houses & the Dem President FAIL to pass REAL Health Care Reform, You can forget selling the idea that the Republican obstructionists caused us to fail.
Time will tell whether the "Special Interest" $$$$$$ made them IGNORE our interests.
If they can't get on the Democratic unity train and support a REAL public option to stimulate competition within the Private sector, their chairmanships will disappear as well.
Opportunities for REAL change are rare.
I watched and EXPECTED the Bush administrations to disregard "Middle America". I never "DREAMED" I would EVER see a Democrat Senate operate in such a 2nd rate manner.
This Democratic Senate needs to CONFRONT those who Ignore our needs.
The idea that these "DEMS" have been allowed to conduct this Senate Finance Committee fiasco is outrageous.

Posted by: parityfanatic on August 24, 2009 at 11:09 AM | PERMALINK

Spending a hundred billion a year to provide health-care for all Americans (thus putting us in the same basic category with, you know, what every other developed nation in the world does for their people) is way way way too much.

After all, true health-care reform would help small businesses because owners wouldn't have to worry about out of control insurance costs or their workers having no coverage at ll. The many thousands of people each year that lose everything they have because they have the bad luck to fall gravely ill in the one "civilized" country in the world where health-care is not considered a right for all -- well -- tough luck there. If there was health-care reform, dammit, they'd still have some quality of life! We can't have that.

No. On the whole, a well-crafted health-care reform bill that clips the wings of insurance companies and forces them to be honest and in the process elevates the lives of hundreds of million of Americans (just by making those insurance companies treat them properly! without even signing on for that socialized crap the lefties want!) is just asking way too much.

After all, we have spent hundreds of billions of dollars already in Iraq alone -- for absolutely nothing. How well I recall these fiscal conservatives arguing over every penny.

I don't think there will be health-care reform in any meaningful way. I haven't thought so since our elected officials didn't properly ride the election momentum & get a vote in before recess.

(I especially enjoyed all the "what's the rush?" nonsense over legislation that has been discussed for more than hundred years now. Tell it to the folks who've lost everything while you elected officials dither & dance & mock everything America is supposed to stand for.)

Posted by: zhak on August 24, 2009 at 11:12 AM | PERMALINK

>"Elected representatives respond to the views of the people that elected them".

At certain points in history, legislators must find the courage to step up consider what is good for the nation as a whole instead of their own careers.

Nobody reads 'Profiles in Courage' anymore. So 1960's.

Posted by: Buford on August 24, 2009 at 11:15 AM | PERMALINK

Let's start a movement to take the Congress' healthcare away from them. Let them see what it feels like. If we can't do that, we need to "reform" it so that they have to pay the bulk of the cost and have a $10,000 deductible.

Of course, most of them are eligible for Medicare anyway, so we must additionally address term limits.

Posted by: Always Hopeful on August 24, 2009 at 12:01 PM | PERMALINK

Conrad's making policy the same way my old girlfriend used to buy shoes. If a pair was marked down enough, she'd buy them, even if they hurt her feet, looked like crap, and didn't last.

Posted by: Davis X. Machina on August 24, 2009 at 12:22 PM | PERMALINK

If you are interested in health care insurance you MUST hear Today's Fresh Air (npr) (after 3pm edt)
The text is available now.

TR Reid has written The Healing of America. Terry Gross interviews. He describes his experiences with health care in the many countries he's lived in and compares.


Posted by: anonymous on August 24, 2009 at 12:32 PM | PERMALINK

Tell me again why everyone was so concerned about the brain aneuryism Senator Conrad (R - ND) suffered last year??

Posted by: TCinLA on August 24, 2009 at 12:58 PM | PERMALINK

Zathras: your analysis is dead-on. Unfortunately. But definitely dead-on accurate.

Posted by: TCinLA on August 24, 2009 at 1:01 PM | PERMALINK

By the way - anyone wanting to read what is really going on in Congress about health care reform should definitely pick up the current issue of Rolling Stone and read Matt Taibbi's excellent article on the subject.

Big news: the "employer mandate" will not have any requirements for a minimum level of services provided. And if your employer offers a healthcare plan - no matter how craptacular - you will not be able to "opt out" and get insurance from the "public option" or any of the supposed other alternatives. If you opt out of your employer's crappy insurance, you will be one of those who can't get insurance and will get hounded by the IRS with a hefty tax penalty.

We'd best get ready for the fact that what the Dimocrats are about to try and bamboozle us with will be worse than what exists now.

Thank God I have the VA and by the time this crap becomes the law, my wife will have Medicare. But I do feel sorry for everyone else, particularly those who - like me - thought we really were getting "change we can believe in" and worked our asses off for these scum last year. I regret every penny I raised now.

Posted by: TCinLA on August 24, 2009 at 1:07 PM | PERMALINK

I'd like to have it all, too, but let's at least recognize that even the types of "cheaper" reforms being proposed by the gang of six would be a HUGE improvement over the situation we have now. A $10,000 per family out-of-pocket limit would prety much protect everyone from losing their homes and falling into debt for life, or simply not getting adequate care, in cases of major medical needs. This would eliminate the great bulk of the "horror stories" we hear about.

I'm still hoping for something more comprehensive and with a public option, but let's at least recognize that high-deductable coverage with an out-of-pocket limit would be way, way better than nothing. It would also be a means of establishing universal coverage, which could then be improved and expanded over time.

Posted by: Virginia on August 24, 2009 at 1:08 PM | PERMALINK

Bauchus & Conrad supported the $700 Billion "SWEETHEART" Bush Medicare Drug plan in 2003 & found no problem with supporting the Bush Taxcuts for the higher income Americans thru reconciliation.
I know the problem These DEMS think they are Republicans !
These are the "LEADERS" of Health Care REFORM?
If this fiasco turns out the way it is heading, I won't vote for ANYONE again !
Middle America gets the SHAFT no matter who wins !
The Prez better get some NEW advisors, they must be smoking something illegal !

Posted by: Parityfanatic on August 24, 2009 at 2:24 PM | PERMALINK

Ok. I know you DC types have this all figured out, but in 2008, Obama/Biden recieved about 69,500,000 votes. Obama campaigned across the country, and as we all know, won and did well from north to south, east to west, black, white, blah blah, blah... His campaign was pretty clear, and their goals were pretty clearly stated. People raised the points of the health care plan they proposed, and oh, did I mention, 69 million people voted for him.

IN THE AGGREGATE - "the gang of six" in their last elections, accumulated about 2.1 million votes, or 3 % of Obama/Biden total. As has been pointed out, they are from small states, and ALL had cakewalk re-elections. All, I might add, are white, and remarkably out of touch with the rest of the country, having become enthroned as senators for life. All but one come from states that are ethnically, culturally, and economically unrepresentative of the country as a whole. All from heavy ag or resource based states [4 with lots of oil/gas, for exa].

1. Why are we listening to any of these 6 at this point ? I know things ain't what they used to be, where a prez. could knock some heads, make some deals, as would the majority leader, etc. etc etc ... but there must be some way to get around them.

2. Can't the Obama people capitalize better on these numbers ? Talk Harry Reid into facing facts - and sweet talk him into a nice retirement if he is in trouble anyway, and get him to lead or get out of the way? Someone ? Anyone? Schumer? Waxman?

Posted by: bigwisc on August 24, 2009 at 2:24 PM | PERMALINK

Tell me again why everyone was so concerned about the brain aneuryism Senator Conrad (R - ND) suffered last year??

Although Conrad's behavior occasionally suggests a complete neurological workup is in order, it was neighboring Sen. Tim Johnson (D-SD) who was stricken....

Posted by: Davis X. Machina on August 24, 2009 at 2:29 PM | PERMALINK

North Dakotans hate the public option and 94% of people are insured. They also have co-ops and even a locally owned not-for-profit hospital (full disclosure: I go to the other place). So there's a reason Conrad is like this, but the pressure should be kept on!

Posted by: MNPundit on August 24, 2009 at 2:30 PM | PERMALINK

How has the finance committee elevated Republicans like Enzi, Grassley, Kyl, and Snowe, and shut Democrats like Schumer, Stabenow, Cantwell and Menendez out?

Posted by: OwnedByTwoCats on August 24, 2009 at 3:17 PM | PERMALINK

In a national healthcare debate, with all due respect to our 800,000 friends from North Dakota, who gives a rats a** if they don't like a public option.

Posted by: bigwisc on August 24, 2009 at 7:52 PM | PERMALINK
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