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Dan Savage, the brilliant and foul-mouthed sex columnist, has become one of the most important ethicists in America. Are we screwed?
By Benjamin J. Dueholm
The federal government is supposed to issue new rules about debt levels for students in for-profit colleges. In the meantime, the states are working on their own regulations.
By Daniel Luzer
Washingtons budget hawks want to decimate the federal workforce to shrink the deficit. It will have the opposite effect.
By John Gravois
There arent nearly enough counterterrorism experts to instruct all of Americas police. So we got these guys instead.
By Meg Stalcup and Joshua Craze
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September 18, 2009
MAKING THE BAUCUS BILL BETTER.... Paul Krugman notes today that Max Baucus' health care framework is, at present, "unworkable and unacceptable." But, he added, it's not as bad as some reform advocates feared, and it can be improved. "[T]his plan has to change," Krugman noted. "What matters now is the direction in which it changes."
Ezra Klein had several recommendations on how to make the Baucus proposal far more palatable, and Krugman has some specific suggestions in his column.
First, it bungles the so-called "employer mandate." Most reform plans include a provision requiring that large employers either provide their workers with health coverage or pay into a fund that would help workers who don't get insurance through their job buy coverage on their own. Mr. Baucus, however, gets too clever, trying to tie each employer's fees to the subsidies its own employees end up getting.
That's a terrible idea. As the Center on Budget and Policy Priorities points out, it would make companies reluctant to hire workers from lower-income families -- and it would also create a bureaucratic nightmare. This provision has to go and be replaced with a simple pay-or-play rule.
Second, the plan is too stingy when it comes to financial aid. Lower-middle-class families, in particular, would end up paying much more in premiums than they do under the Massachusetts plan, suggesting that for many people insurance would not, in fact, be affordable. Fixing this means spending more than Mr. Baucus proposes.
Third, the plan doesn't create real competition in the insurance market. The right way to create competition is to offer a public option, a government-run insurance plan individuals can buy into as an alternative to private insurance. The Baucus plan instead proposes a fake alternative, nonprofit insurance cooperatives -- and it places so many restrictions on these cooperatives that, according to the Congressional Budget Office, they "seem unlikely to establish a significant market presence in many areas of the country."
Sounds good to me. The question going forward, though, is how the negotiations will proceed. Is Baucus open to significant improvements? Just as important, is he prepared to use his mark as the starting point for moving to the left, or to the right?
Time's Karen Tumulty talked to Baucus last night, and reported that he's "sounding open to making some changes" and will "iron out" differences with Democrats. That necessarily means a better bill. Most notably, Baucus vowed to "address" Democratic concerns about the size of middle-class subsidies, which seems encouraging. On the public option, he added that the provision is effectively off the table for him, but Baucus described the "trigger" idea, promoted by Sen. Olympia Snowe (R) of Maine, as a "live possibility."
And speaking of Snowe, it's also worth noting that Democrats aren't the only ones demanding that Baucus improve the subsidy rates. Snowe told the NYT, "[T]here would have to be more subsidies" in the proposal.
—Steve Benen 10:35 AM
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this particular sausage-making has a real stench to it. the disingenuous are all lit up making the whole endeavor quite painful and depressing.
Posted by: neill on September 18, 2009 at 10:40 AM | PERMALINK
at the end of the day, this is the obama administration's error in action: fetishizing bipartisanship on this bill has weakened the effort, not strengthened it, and that was obvious to anyone whose vision was not clouded by kum-ba-ya fantasies.
still, we are at the point where the dems need to hang together lest they hang separately, and the awareness of that is likely to improve the bill to a decent level.
Posted by: howard on September 18, 2009 at 10:45 AM | PERMALINK
Weren't there 5 committees total working on healthcare plans? What happened to the other 4 that were ready prior to Baucus'? Why is it all Baucus all the time when his plan seems so putrid?
Posted by: ckelly on September 18, 2009 at 10:48 AM | PERMALINK
It's nice that everyone is willing to kiss their sister and point out the "potential" in BaucusCare, but you know it's just a shitty piece of work when a farking Republican tells you you're cutting corners too much.
Posted by: dr. bloor on September 18, 2009 at 10:49 AM | PERMALINK
ckelly, I've been asking the same question for a long time and no one seems to have an answer.
Another thing that would make a trigger somewhat acceptable is the following. The program isn't supposed to go into effect for another four or five years (2013?), so that should be plenty of time for the insurance companies to get their acts together. If they haven't done it by the time the program goes into effect, the trigger is pulled right away. Anyone who believes that the insurance companies have any intention of getting their acts together believes in the tooth fairy.
Posted by: Texas Aggie on September 18, 2009 at 10:53 AM | PERMALINK
Who gives a flying crap about Baucus & Snowe anymore.
Just get it done
with 50 plus 1
Posted by: cwolf on September 18, 2009 at 10:59 AM | PERMALINK
My thought exactly ckelly. Why are we spending time talking about "Improving the Baucus Bill" when there are 4 (?) other bills on the table. Why buy into that logic at all? Why aren't we talking about limiting as much as possible the incorporation of the Baucus bill aspects into the actual final bill?
Posted by: kidcharles on September 18, 2009 at 11:05 AM | PERMALINK
I'm fine with a trigger. So long as it is applied retroactively :)
Posted by: Chopin on September 18, 2009 at 11:23 AM | PERMALINK
You want to make the Baucus bill better?
Throw it into the shredder, and support Medicare for all.
Boy, that was tough...
Posted by: Glen on September 18, 2009 at 11:43 AM | PERMALINK
As others have said: four out of five plans include the public option. Exactly why is it that Baucus get to decide whether or not it's included in the finance committee proposal or not ?
Posted by: stormskies on September 18, 2009 at 12:42 PM | PERMALINK
Baucus and conservatives are offering the possibiity of more subsidies and a "trigger" that will never be pulled, at least not without a fight that will be as difficult as the one right now to include a public option. It can't be emphasized enough that when you subsidize the present system of private insurance companies, you are subsidizing a system that we all agree is hopeslessly corrupt and unsustainable. I realize that you might provide some real benefits to real people who both need and deserve them, but you are not providing any mechanism to genuinely reform the system. In other words, you are prolonging and protecting the existence of the status quo. This, by definition, is not reform.
Posted by: Jason on September 18, 2009 at 12:44 PM | PERMALINK
I love how Baucus says he'll iron out differences with Democrats considering he's supposed to, um, be one.
His idea of ironing out the differences with the Republicans on the Senate Finance Committee was basically to cave in to their every demand. (And still get the finger.)
Posted by: jsullivan on September 18, 2009 at 1:25 PM | PERMALINK
And speaking of Snowe, it's also worth noting that Democrats aren't the only ones demanding that Baucus improve the subsidy rates. Snowe told the NYT, "[T]here would have to be more subsidies" in the proposal.
This sort of crap really pisses me off: folks being eager to find ways to assure that EVERYONE can send $$$$ to the insurance ghouls, but not an ounce of interest in holding down COSTS, and thus the volume of $$$$ sent.
Posted by: Mauimom on September 18, 2009 at 2:59 PM | PERMALINK
more from Krugman: Of course, those who insist that we must have a single-payer system — Medicare for all — won’t accept any plan that tries, instead, to cajole and coerce private health insurers into covering everyone. But while many reformers, myself included, would prefer a single-payer system if we were starting from scratch, international experience shows that it’s not the only way to go. Several European countries, including Switzerland and the Netherlands, have managed to achieve universal coverage with a mainly private insurance system.
His query: despite being a bad bill, will it nevertheless be just good enough to vote for?
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Posted by: Edwin on March 19, 2010 at 1:27 AM | PERMALINK
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