The center-left's disparagement of the a-little-further-left is the greatest enemy of progressive policy achievements. The Republicans don't have to divide to conquer -- the center-left does it for them.

But steve, this group is misbehaving so badly. They are using ad hominems, making guesses about motivation, and disparaging anyone who disagrees.

I suppose two wrongs don't make a right, but Jeebus, they are so obnoxious! And yet they wonder why they can't be more effective in getting what they want...

It's to do with a sense of entitlement, I think. We *owe* Obama loyalty, because he's the one who liberated us from Bush/Cheney. It isn't enough that, in a choice between him and the insane McCain, he can pretty much count on our vote. No, having voted for him, any criticism now of (what are now) his own policies of illegal wiretapping, illegal detention, torture, coddling of Wall Street, coddling of Lieberman, etc. are DISLOYAL! Not to be engaged with on merit, but to be dismissed out of hand!

Assholes. Well, they'll still get my vote in general elections, but not in primaries!

here is the problems I see -
the bill mandates coverage, for you not for the insurance companies who will retain the right to take your premiums and then decide at a later date you did not disclose some minor thing having nothing to do with your current situation and refuse to pay out.

Worse is that the gov will subsidize whatever the companies want to charge so rates will skyrocket.

The result will be the Republicans saying the increased cost are because the government got involved. The press will kindly ignore that it was what they didn't do that causes the problems. And the common wisdom will be that federal intervention in health care is bad so it will be impossible to make things better later.

Contemporary journalists in America, like Michael Steele, don't do public policy.

Charles

Ideological opponents of the Senate bill have never supported any of the legislation proposed in this process.

No one could flip from supporting the House legislation to opposing the Senate legislation for ideological reasons. There are substantive reasons and political reasons why some are opposing it.

But there's no doubt Howard Dean will be blamed for whatever the "center-left" folks want to blame anyone for once this process is over. Just because he dared speak out.

Sheryl Gay Stolberg of The Times is against us? Oh, Jeebus, we're doomed. No one will respect us now.

OK Brownstein is outta line...he is. But the FIRST night that Howard and Jane Hamscher came on TV they were PISSED and letting everyone know it. The 'substantial' problems with the bill didn't break until yesterday. They all need to STFU and TALK...civilly...

Brownstein is the type of manipulative arse that I love to avoid like the plague. He can go spank himself in the corner.

Len Franciscus,
Which group are you referring to when you say "this group"? Because your comment could easily refer to both "groups" on the left.

You have TPM comparing Obama to Lincoln and Matt Y shrieking about how we all support giving little kids cancer.

Yet we're the 'unserious' ones.

You guys wanted to know why we brought up the Iraq War? Here it is. this is the same BS you people pulled on us then and we are NOT fucking amused.

Steve Benen wrote: "I think the remaining health care reform policy has merit and should be passed (and then improved upon)."

The Senate proposal does not create a foundation that can be "improved upon" so as to eventually move towards universal, nonprofit, single-payer health insurance under open, accountable, efficient public administration.

It does the opposite. It entrenches the for-profit insurance corporations and compels every man, woman and child in America to guarantee their profits, in perpetuity, under penalty of law, and effectively ensures that single-payer, or a public option, or Medicare buy-in are "off the table" -- permanently.

The Senate proposal takes the ONE so-called "industry" in America that produces and contributes NOTHING OF VALUE, that in fact sucks value out of the economy while giving nothing in return, that in fact profits ONLY by denying its customers the services that they have paid for, and virtually elevates it to the status of another branch of government.

There is a reason that insurance corporation stocks are skyrocketing as the Senate moves closer to enacting this legislation.

The Senate proposal is not a foundation for ongoing progressive health care reform -- it is the "health care reform" to end all health care reform.

And the sneering, dismissive attitude of the corporate-owned "sensible liberals" is not surprising at all. It is the exact same attitude they took towards progressives who opposed Bush's invasion of Iraq.

And reall,y pretending that ideology is irrelevaant is BS. Ideology is the only reason you cling to your mandates. Ideology is the only reason the Public Option isn't in the bill. so fuck off with your criticisms of other people's ideology.

You all knew some of us were only interested in government run healthcare or a system that would get us to that point. You had to know we would try to blow up any process that closed off that possibility. You made common cause with us. So shut the fuck up about how icky our ideology makes you feel.

Change is slooooow. Has been and always will be. Keep it mind, proceed civilly and keep advancing. They have some right to be pissed and in general I think we all are. It's just that it is as a matter of policy better then nothing. The idea of universal coverage is enshrined in legislation. Tell me that 3 years ago I'd have jumped up and down in joy. If reconciliation would succeed, why won't it succeed in the next congress?
and no, the insurance company can not just drop you,not anymore, rescission is dead.

The Democratic Party has refused to use all the tools to obtain cloture on the Senate bill. Instead the politicans have made Obama a buffoon. Use the tools to get this moving!!! Stop waiting for a Senator who promised to stall the bill to decide not to stall. He is not interested in providing health care to Americans. He wants to force his questionalble morals about abortion on Americans instead. I am a woman and I do mot want some farmer from Nebraska telling me what to to do with my body!!!
It is my choice not his!!!
USE the TOOLS!Reconcilation This Democratic inertia is killing the bill. At least Franken, Dean and Sanders want to do SOMETHING rather than wait for cow manure to be thrown in the face of the Obama administration.

Bad News: This bill will destroy the Congress in 2010 whether they pass it or not because it's a piece of crap that only an insurance industry exec could love.

Good News: The news media will soon be able to attack ALL of progressives as "irrational loons" because seeing this bill in action will unite EVERYBODY in America in opposition. That includes the current divisions in progressive blogssphere.

As numerous commentators have pointed out the current split between those wanting to scrap the bill and go back to the drawing board and those continuing to hold out hope and want a bill mirrors the split among some progressives supporting the Iraq war in 2002.

But, it didn't take long for everybody to unite in opposition to the war and it's not going to take long for progressives to unite in opposition to the health care bill once it's passed.

I doubt there will be very many Americans who DON'T hate this piece of shit when they see it in action.

I do like to look for the silver lining in every cloud, and it seems this recent debate we're having among the left is completely sidelining attention toward the Republicans. As the two parents (read: two Dem factions) discuss reality in the kitchen, the immature little kids (read: Cons) are in the corner stamping their feet and waving "what about me!"

What I take "ideological" to mean is "hidden agenda" or for reasons having nothing to do with the merits of health care reform itself, or its overall objectives to expand coverage and lower costs long-term.

Republicans act ideologically, for example, when they oppose reform simply because they think it is anti-free market or because it involves the government in a private, profit-making area. Liberals act ideologically when they support health reform simply to expand the role of government.

But very few liberals have such an ideological government-for-governments sake attitude. Most genuinly believe that achieving the progressive aim of reasonably priced health care available to most Americans requires minimizing or challenging the market power of the private, for-profit insurance companies. And for those who ask "does it work" that is an empiracle issue, not and ideological one.

soullite, respectfully, you are wrong on one point. the Public Option is out not because of any meaningful ideological justification. It is out because the insurance industry could buy 4 democratic votes. Ideology has nothing to do with it. You can argue that medicare for all was off the table for ideological, as well as simply pragmatic reasons, but there has never been a SERIOUS argument made by any of the dem opponents that the public option is against their idelological foundations. This is about game theory and the distorted representational strengths of individual senators.

eric

Gibbs and Axelrod made a giant mistake with their comments personally attacking Howard Dean. Brownstein is trying to cover their asses.

The fact is Gibbs and Axelrod's comments reveal that the White House didn't realize just how angry they were making their base. Only now is it sinking in that the "President's historic achievement" might cost them dearly in the 2010 elections.

What's so awesome about this, frankly, is that the Dirty Fucking Hippies are using the establishments knee-jerk, reflexive hatred to turn things around. If we like something, it's "extreme". We hate it, they rally round. It's pure stimulus/response.

So, the hippies despise HCR - suddenly Ronald Brownstein is connected with the average folks who suffer without insurance. Suddenly, Chris Matthews is a champion of the reasonable middle, which is defined as, anything we despise as oppose.

Mark my words, a Broder column is on the way, this time not about Reid's need to compromise reasonably with Nelson but about how reasonable HCR is, and how us crazies are too extremist to sieze the moment.

When you get Broder to rally around HCR to be against us, then the bill is finally ready to go through.

Eric, thats your opinion. You believe Obama wanted a better bill. I believe Obama wanted the bill he got. THAT is something you refuse to acknowledge. We both think entirely different things just happened.

You talk about game theory? At this level, niether of us have an absolute ability to distinquish between who is making what covering move. We are both only able to do so to the best of our ability. You see this as Lieberman going Rogue. I see this as Lieberman acting as Obama's handmaiden.

I'm hardly alone in that opinion.

Steve, you're one of my most trusted bloggers, and I agree with most of what you say. And I agree that all sides need to calm down. But I think you miss the point of what Brownstein and others are saying (well okay, Brownstein is annoying. Read Krugman instead).

I don't think Krugman, Yglesias, Klein, and others are "mocking" progressives, nor are they denying that "any fair reading of concerns raised by most progressive opponents shows a great deal of specific, substantive, policy-centered concerns."

This is a straw man, Steve. They aren't any happier than Kos, etc. about this bill. The point that all of them are trying to make is that this compromised bill still saves lives and helps Americans to get life-saving health insurance. That's all.

Really, the target of Obama's anger is obvious here. He is not angry with Lieberman. He is not angry with the blue Dogs. He is not angry at Republicans. He is angry at us.

You can tell a lot about someone by who their friends and enemies are. I see who is lined up behind Obama. I'm not blind. I see a line of corrupt hacks, lobbyists, and corporatists. Against him I see voters from all walks of life and people who are passionate about the future of this country. That's all I need to know to make my determinations as to what Obama wanted.

When people who they really are, don't lie to yourself. Believe them. That's who they really are, not the person they pretend to be when everything is fine and dandy/

Thank you for yet another good post. I share the apprehensions in Secular Animist's post - in particular, I am bothered by propping up a largely parasitic industry when a government program would be so much more efficient and equitable. Nonetheless, I haven't given up on this process. This seems to me that if we blow this one we will have just seen our last best hope for substantial reform for a generation. Obama's unwillingness to dictate any details to Congress comes from Clinton's failure: what will the next generation of politicians learn from the failures of Clinton and Obama? Medicare and Social Security were initially dreadful, but they could be painted to look like a success and democrats were able to ride that to continued political control and significant improvement of both systems. Without anything, we will have nothing to build on, even if we retain power. With something, we can modify it to build something more sensible.

Whatever the Senate passes goes to conference, where some compromises may be unmade by leveraging the House version, although I'm not very hopeful for this round, but more hopeful for future years.

Although I don't agree with the "scrap it now" thinking, I'm not unhappy to see people lashing out in anger over the bad compromises already in place - without that, we'd get even less. That being said, I'd prefer that the anger was more focussed. Yes, Obama could have pushed more and shouldn't have given away so much at the start, Baucus' delay was unforgivable and crucial in letting teabaggers get out of control, and Reid's leadership has been disappointing. Nonetheless, the primary enemies here are the Republicans, followed in quick order by biased and incompetent media, and Lieberman and Nelson, and the "solution" of disengaging from politics and withdrawing support from Obama and all democrats is insanely self-defeating. The only solution that can work will be to dig in and elect better democrats, and generate grass root support that is stronger than corporate influence.

and no, the insurance company can not just drop you, not anymore, rescission is dead. - JM at 1:41

Except that it isn't. A few points:

1. As I understand it, there is to be 3 broad brackets for pricing policy premiums. Different for different age groups, geography locales, and so on. Let's say that in today's mobile society, especially among young adults, a young person purchases a policy on an exchange and then moves across country forgetting to update his/her policy. Months go by, he/she gets injured and needs to use the insurance and viola, grounds for rescission.

2. Are there any punishments in this bill severe enough to actually deter the practice? If not, insurers would gladly take a wrist slapping for a practice all their CEOs recently said, sober faced before congress, they had no intention of stopping.

3. Medical bankruptcies are still likely to happen as there are still annual caps.

as I've pointed out several times this week, any fair reading of concerns raised by most progressive opponents shows a great deal of specific, substantive, policy-centered concerns.

To argue otherwise is to ignore the readily-available text.

I've been reading Markos and friends. I'm not ignoring their text at all.

Let's take as our particular text their answers to Nate Silver's 20 questions.

Each question is Nate's; MM is Markos Moulitsas, and JW is Jon Walker of FDL.

1. Over the medium term, how many other opportunities will exist to provide in excess of $100 billion per year in public subsidies to poor and sick people?
MM: The assumption here is that this bill is the only option on the table. The House still has a say in the matter. And really, the point of reform isn't to shovel taxpayer dollars to the insurance companies, it's to expand care and lower costs. I'm not willing to surrender on costs.
JW: Killing the current deal does not preclude passing the good parts of health reform through reconciliation. When they are forced to face passage of some of these reforms with reconciliation, or the threat of reconciliation, it is not impossible to envision Lieberman, Nelson, and Lincoln backing down on their threat of joining a filibuster.

But the Senate bill is the only bill on the table. The House is in a position where it dare not change things in any way that might give an excuse to Lieberman and Nelson/Snowe (depending on which becomes vote #60). So Markos is wrong here. And while the point is to expand care and lower costs, the first thing has to be to expand care. Why should we libruls want to bend the cost curve before everyone is covered? (And if Kos is talking about costs for individuals, Nate's little graph answers that objection.) And as far as Jon's logic goes, it's true that the opacity of the Senate makes it hard to tell for sure what's going on. But if Obama and Reid had 50 votes for reconciliation, don't you think they'd try it? I think Yglesias is right: you probably don't have 50 Dems who want to be one of 50 votes for a bill that every Republican and a bunch of centrist Dems are opposed to.

I think the burden's on Walker to produce evidence of 50 votes for reconciliation if he's going to raise this argument.

And then there's question #2:

2. Would a bill that contained $50 billion in additional subsidies for people making less than 250% of poverty be acceptable?
MM: This betrays a simplistic view of liberals, as if our answer is to merely shovel money at a problem. What we're looking for is good policy, which in this case, would also be good politics. So no, throwing money at the insurance companies doesn't change a thing. The insurance industry would simply absorb the new subsidies just like universities have raised tuition to shovel up any increases in financial aid.
JW: That money will help a few people in the short term, but, in the long run, our system built on private insurance companies is unsustainable, and will ruin our entire economy. I have zero confidence that the subsidies promised today will remain the same in the future. They might be increased by future Democrats or reduced in 2016 by a Republican Congress. Without cost controls, that money will quickly be eaten up by the ever-growing cost of health care. This reform is about trying to fix the system, not patch it with more money.

The problem here is, you're only going to fix the system a bit at a time - and if history's any guide, if this attempt fails, the next try (in 15 years) will try to fix even less than this one does. This legislation has some smallish fixes which can be the basis for bigger ones over time.

But a big part of the fix is throwing money at the problem of the uninsured. $900 billion of subsidies going from richer to poorer, to finance their health insurance coverage. Less money means weaker subsidies, which would suck. More money would mean better subsidies, which would make insurance more affordable.

It's really hard to take these guys' objections seriously. I didn't even bother going on to see how they responded to #3, after seeing their answers to #1 and #2. It's like talking with Eric Cantor.

Everything Soullite said:
We are all battered voters now.

I suppose it's possible to find some liberal, somewhere, who recommended killing the Senate plan for purely ideological/political reasons, but as I've pointed out several times this week, any fair reading of concerns raised by most progressive opponents shows a great deal of specific, substantive, policy-centered concerns.

I don't think it is necessary to attack the bill on purely political grounds, as substantive, policy-centered reasons abound.

Having said that, what is the problem with opposing the bill for "political" purposes?

For one thing, the bill's defenders largely concede that the current iteration of legislation is sorely lacking, but that it should be "fixed" at some undefined point(s) in the future. Well, isn't that an entirely political reason for passing the bill? That it would create a political climate for future legislation?

For another thing, if the bill's defenders require that the bill be fixed in the future, isn't it entirely legitimate to point out that passing a bill with an individual mandate and no significant cost controls is going to be a political disaster that will make it much more difficult to "fix" the bill in the future?

The entire argument behind creating a limited (but not eviscerated) PO was that it would be POPULAR. Once it was shown to work and did not cause the Earth to explode, the popularity of the PO would create the political environment to expand it.

But believing that an unpopular program is going to be expanded in the future, for no reason, is simply magical thinking.

It's petty when one side claims the other are Iraq supporters and the other compares them to Nader. The ideology charge is also limp. Godwyns law always applies when emotions are in the mix, but this is nothing like the primaries.

I value Krugman's opinion very, very highly, and frankly, totally agree. I don't see this as an easy, cut and dried, black/white issue. Krugman said he struggled, I struggled, I am struggling. Frankly, I don't know what the magic bullet is, and can't possibly have a problem with anyone who wants this passed.

I see both as essential, frankly. JMM's post on Lincoln - could Lincoln have gone as far in the Emancipation Proclamation if he didn't have his own DFH's to appease, always pushing for more and whining when he only went to free half a slave?

Who has the superior moral high ground? They are all essential parts of the machine that will make it possible for anything to be achieved, the idealists demanding the perfect and driving teh demand and wonks who implement it.

HCR isn't possible without Kos and Krugman, and they're both right.

Steve Benen wrote: "I think the remaining health care reform policy has merit and should be passed (and then improved upon)."

I agree with Steve. If we don't pass this bill it was all just a waste of time. The last 6 months squandered for nothing. When will we try again, another 15 years?

I am sorry but this bill will help my family. This bill will help my kid. What kind of mother would I be if I didn't support it because it could be better? I am supporting it because it will make my life better. PERIOD.

Thanks again Steve for a respectful take on the left-opposition, even as they give you some flack and I did a bit too. But his decent tone just shows the distinction, of how full of crap many of the neoliberal/establishment actors on "our" side really are. They have always hated the really liberal side, any threat to the comfortable status quo and corporate-friendly framing.

Important: progressive oppo to the Bill is not much about ideology or even "fetishizing" the public option. It is the essence of rational, even pragmatic concern: that mandating purchase from private providers (the same ones liberals pick on in general) may not be coupled with adequate oversight and cost control. Really, progressives are the ones being consistent here by being suspicious of being herded into forced relationships with profit-seeking entities that haven't ever gotten enough oversight in history.

And it's time for Obama and crew to quit groveling for that 60th vote. It may be worth it sometimes, but is this suspicious and massive offering one of those times? Voters don't respect weakness and desperation, over and above their own affiliations and opinions.

Neither do you deal with the crux of Brownstein's argument--most of the benefits 200 billion dollars worth go to poor whites and minorities. They support it, while rich whites are free to remain 99 and 3/4 percent ideologically pure. Get one more concession and pass it--we don't why a repeat of the Hillary 1994 debacle.

thank you steve. Sanity is returning on this debate.

I am sorry but this bill will help my family. This bill will help my kid. What kind of mother would I be if I didn't support it because it could be better? I am supporting it because it will make my life better. PERIOD.

I hear you. But what most of the bills detractors seem to think is that it will only be a short term victory because the bill in its current form is set-up to fail. And when it does, Republicans will be waiting in the wings.

And off point, but I for one don't think Obama wanted this bill or even that his "weak" leadership led to this. I'm still a big fan of his. I look no further than the Senate and a small handful of Republican moles in the majority party for my frustration. I just think that as we edge closer to a possible finish, we damn well better make certain we don't all just jump on board a ship the Republicans/Lieberman/Nelson just shot a bunch of holes in.

Brownstein writes that Dean and the "digital left" are able to "casually dismiss" the bill because "they operate in an environment where so few people need to worry about access to insurance." He adds that for these critics, the debate is "largely an abstraction" and merely a crusade to "crush Republicans and ideologically cleanse the Democrats."

No, this is completely, 100% right. And I say that as someone who agrees with both the policy objections that the critics of the bill are raising, and the idea that the public option was the most important thing in the bill. That doesn't make the behavior excusable. If you're going to flip-flop on your opinion of core parts of the bill (like the mandate) because some other portion of the bill changed, if you're going to believe you can completely ignore 1,990 pages of a bill while you make the case for the other 10, if you're going to outright make the argument that beating Joe Lieberman and setting a precedent is more important than whether tens of millions of people get insurance, then you lose the right to hide behind the "but the center left is meeeeean" thing. At that point you are actually validating the center left's constant "the real left isn't serious" refrain and you are disgracing all of us who fought torture, fought the war, fought Bush's economics while the center left tried to defend it.

In short: it doesn't even matter if the ideological objections are right or substantive or whatever. When the "kill the bill" talk started we left the realm of talking about ideological objections or policy positions and entered a different argument: Is our single policy position on the public option-- because that's all this is about, all the other problematic or improvement-needing elements were in there the day before the blogosphere's flip-flop on whether the bill was must-pass or evil-- more important than whether 29 million people get health insurance? "But there are policy problems elsewhere in the bill" isn't important to that argument. There are ways to improve the policy elements of the bill [other than reviving the public option, which we lost on] without killing the bill itself. Those paths aren't being explored, the goal is to win back the public option fight and beat the people who killed it rather than get any improvements made. Those "substantive" arguments about the problems in the bill are not being made as part of any honest attempt to fix the problems or improve the substance, they're being used as a club to smear a bill we've decided we oppose for unrelated reasons.

If your politics matter more to you than ensuring the most people get the best health care possible then you are a tea party activist, to someone dying in six years for lack of insurance it won't matter why you chose to deny it to them or how pretty and well-founded your arguments they shouldn't receive it were.

I want to amend my previous comment. The completed thought is this: that to come to the conclusion, as Brownstein does, that much opposition to the HCR bill is ideological does not necessarily exclude the acknowledgment that "concerns raised by most progressive opponents shows a great deal of specific, substantive, policy-centered concerns."

Brownstein is simply making a not unlogical connection: that if, despite all this policy knowledge, some still prefer to choose to withhold health insurance that might otherwise be available. As we have been arguing all along, to not have insurance kills people. This is an unalterable fact.

And all seem to agree that if the bill dies, HCR is dead for years, if not decades.

Perhaps it is unnecessary or unkind to state in public the existence of ideologues on both sides of the political spectrum, but Steve, please. I think you need to take of the rose colored glasses. Just read the vitriol on your comments page.

"...should be passed (and then improved upon)."

Not that I don't think the bill should be passed, I think it should be, but why are you so sure that the vested interests which prevented features from being included in the reform to begin with will allow them to be passed as incremental change in the future? If you think that corporate influence over our legislature is going to diminish with time, you might need to examine your grip on reality.

No mcc, you fail to see that it is very important just how much regulation and cost controls go with any kind of mandate to buy from private companies, and without an alternative at least available. It is not hard for something to become worse than nothing because of a missing "fine point", like taking a gyro out of a jet. Look at it this way, in terms of the "shot full of holes" above: right now, Obama is groveling before a Senator who is a former insurance executive. That guy, the worst choice to be the deciding factor, gets to have it the way he wants it. You ought to be suspicious of the Bill.

But I agree, it's a difficult position the Dems were put in. But how many voters will realize that fine point?

"I think the remaining health care reform policy has merit and should be passed (and then improved upon)"

How will that happen ?

If you pass the Senate bill, if the Dems don’t lose their majorities in both Houses, they will be lucky to have bare majorities, and will be UNABLE to improve a damn thing.

Shades of Monty Python’s Black Knight.

I think you need to take of the rose colored glasses. Just read the vitriol on your comments page.-LIz at 2:37

One side is saying:

Pass the bill now, it helps people, it saves lives, it can be improved upon later, not passing it will surely lead to Democratic electoral defeat.

The other side is saying:

The bills best cost-control mechanism has just been stripped out without anything substantive to replace it, it is political poison in its current form, passing it will surely lead to Democratic electoral defeat, and it won't save any lives for several years (by which time a newly elected Republican majority will get their hands on it).

I'd call that good vitriol.

Thank you.

neil b's comment gives a couple good examples of the problem here. Substance-based arguments, dishonestly made.

No mcc, you fail to see that it is very important just how much regulation and cost controls go with any kind of mandate

This is not an honest argument. The public option was not a cost control mechanism at the point it was removed, and would not be a cost control mechanism if we put it back in. The public option served several purposes. To the extent it was a cost control mechanism, this was a result of its medicare-linked rates. Those were taken out a very long time ago. The version of the public option in the House and HELP bills-- in other words, the only versions of the bill which could effect final passage at this point-- used "negotiated rates". The CBO projects the negotiated rates version of the public option will cost more than a private plan. You can't be a cost control mechanism if you cost more than the thing you're trying to cost-control.

You are either ignoring the CBO score because you're angry, or you don't care enough about the facts of the debate to learn about the CBO score. Neither of these possibilities is intellectually honest. If you actually meant what you are saying you'd have been saying it a month ago when the cost-control aspect of the public option was finally struck from the bill, not only after Joe Lieberman pissed you off.

As for regulation, that can go back in the bill in conference. Unless we kill it.

right now, Obama is groveling before a Senator who is a former insurance executive. That guy, the worst choice to be the deciding factor, gets to have it the way he wants it. You ought to be suspicious of the Bill.

In other words, it doesn't matter what's in the bill, what matters is who supports it. That's the tea party argument. That's the basis of their movement. And you've embraced it.

Recission- I am guessing no way House let's the senate wording stand and the final bill goes with something we should demand...
House Section 103 takes direct aim at rescission, stating unequivocally that:

A health insurance issuer may rescind group health insurance coverage only upon clear and convincing evidence of fraud described in subsection (b)(2), under procedures that provide for independent, external third-party review.

I'm not sure I agree with you Steve, but I want to. Can someone say more clearly why we should let go of what isn't in there and support what little remains?

1. I like what Howard Fineman said..there has been NO real intent to push or sell the Public Option from day one. Only token comments from Obama saying he'd 'prefer' it, but actually stating early on he'd be willing to toss it out!

Talk about undermining from the get go!

2. And there has been NO attempt to educate clearly what it is, that it's not a "Government Takeover".

3. And there's been NO education or details or emphasis on just how jerked around we are by the Insurance Industry and Big Pharma.

4. The administration IMO is in bed with the Insurance Company and this IS the status quo...
the same "Status Quo" Obama promised to undermine..he hasn't, he lied.

5. Oh. And, yes.. the observation Lawrence O'Donnell has been making is spot on: that what Obama has done (nothing, passive, hands off) is the polar opposite of what Clinton did (hold up his veto pen from day one if there was no Universal Coverage). Talk about reacting and
dong the other extreme...

AND NEITHER OF THESE APPROACHES HAVE WORKED...both have failed miserably!

Is there anyone in there that realizes a middle ground approach is what's been needed all along?

Or is the larger true issue folks in the cabinent like Rahm Emanuel and others truly don't give a damn?

Insanity: Even if it were accurate that "Obama" did a poor job at selling the bill, does that have anything to do with whether or not the bill should pass? This seems like exactly what Brownstein was describing in the OP quote-- judging the bill as if it were a crusade to beat Republicans or move Democrats to the left rather than an attempt to improve health care.

I could try to offer an argument in favor of "what little remains" in the bill, but it's hard to know what to say if I don't even know what it is your goals are here. If all you want is Obama to display a certain kind of leadership, then nothing one could say about the bill could provide that at all.

AND NEITHER OF THESE APPROACHES HAVE WORKED...both have failed miserably!

Looks like Obama's approach worked fine; the bill is passing.

Shorter mcc: "You can't complain about the lack of cost controls. It never had any cost controls!"

Strangely, I don't find this argument compelling.

Ron Brownstein: "And Joe Klein has dismissed critics [of the current Senate health care bill] for being in the grip of 'ideological fetishes.'"

How appropriate that the likes of Mr. Brownstein would cite Joke Line, who fraudulently denied being the author of Primary Colors when it was first published back in the mid'90s.

Both Brownstein and Klein exemplify the D.C. establishment's core problem, which is that it has in residence far too few robust warriors for the common people, and far too many solicitous coutiers of the rich and powerful.

I think democrats are laboring under this illusion that somehow they are getting backstabbed, that it's Dolchstoss. It really isn't. From the beginning it's perfectly clearly that only a minority of the Senate, what, 40-50 Senators, seriously and badly wanted an Obama health bill. The other ones were just going along, and really could not care either way if there was a health bill or not.

So from the very beginning, the Zone of Possible Agreement (ZOPA, it's actually a term) is between having a bill at all, and simply not having a bill. It wasn't between having a Conservative Bill A and a Liberal Bill B. The very existence of health care reform is a compromise; and the conservatives in the caucus feel like they have compromised significantly by even allowing a bill.

So from the very beginning, given that the leverage is so limited ("Yeah, you don't like this version? Well, that's great, because I don't mind not having a bill at all.") it is clear that left will get a very significant portion of what they want. Lieberman merely articulated that reality.

I could try to offer an argument in favor of "what little remains" in the bill, but it's hard to know what to say if I don't even know what it is your goals are here.

As someone who spends an ungodly sum of money per year on health insurance for my family, I want my premiums to go down. I also want to be completely secure -- from rescission, denial of treatment, and payment caps -- in the event of a catastrophic illness or injury.

That's what I want. I am not an ideologue. I believe that my goals can be achieved through a single-payer system, through robust competition, including a public option, through aggressive industry regulation, or through a combination of the above. In exchange, I am willing to accept an individual mandate (in lieu of taxes, if necessary).

So, does the bill achieve my goals? No. Does it make it more likely that future legislation will achieve my goals? No. Therefore, FAIL. Return to sender.

YMMV.

"I am sorry but this bill will help my family. This bill will help my kid. "

Are you sure it will help? I mean are you absolutely 100% positive that it will help? because the enormous bad sides of this bill are going to be permanent. Once we entrench the insurance companies as a direct part of the US government with no real oversight and an enormous amount of money with which to lobby there is no way in hell we'll ever be rid of them.

So given that this change is not something you will ever get to go back and undo are you completely sure that the other parts of the bill will help you and your kids?

Even when you have a number of high profile and educated people who look at the matter and call it just this side of a suicide pact?

Maybe you're an expert on the matter and you are firmly convinced that this bill is a net positive. I'm a layman certainly, but from where i sit this bill is not only a huge net negative it is one we cannot possibly fix. There's no way I see the risk being worth taking.

Far better to scale back and get only good incremental steps. When we can pass a mandate plus a PO, do it. Or if we can pass the house bill, do it. Barring the latter and until the former we can take small steps forward to pave the way that will help you and your family without putting us all under a yoke for the insurance companies.

Hey soullite, You're surprised that Obama's angry at a bunch of last-minute traitors??? Please.

Yes, square1 is what I'm asking for: cost controls..for goodness sake, because I only work part-time, I have a private plan that keeps going up in premiums willy nilly-- even though I scarcely use it!!

I'm getting older and I understand they really discriminate against anyone over 40...

I was SO looking forward to the earlier option to buy in and then the option to buy in and then the Medicare early buy in...

Where is the competition and impetus for cost control?

That's what I need to know..if that's not there, how can we justify this?

Are we just afraid that NO change will happen EVER.. if we say no to this now?

"Hey soullite, You're surprised that Obama's angry at a bunch of last-minute traitors??? Please."

So that makes the pro-bill side the Quislings, then? I think I can live with that.

mcc, this thread is cold but I'm objecting to one point on principle: the confused idea that being suspicious of who is supporting something is about *the same idea* being disliked because soandso supports it. Uh no, silly, it's really the idea that that person will ask for shitty things and change what that something turns out to be.

Late response to square1, dunno if anyone is still reading this.

Shorter mcc: "You can't complain about the lack of cost controls. It never had any cost controls!"

That's what I'm saying, yes. And if that's not compelling as an argument in favor of the bill, it's because it wasn't particularly intended as one. I'm just saying, if you were fine with the lack of cost controls back when we had a public option, and you're attacking the lack of cost controls now that we've lost the public option, then you are a liar.

As someone who spends an ungodly sum of money per year on health insurance for my family, I want my premiums to go down. I also want to be completely secure -- from rescission, denial of treatment, and payment caps -- in the event of a catastrophic illness or injury.

The bill will cause your premiums to go down. This is what every analysis I've seen based on actual numbers or research has shown. Here for example are the CBO's projections of what will happen to your subsidies under the plan (see page 5). The argument that the bill will somehow do anything else depends on the idea that magically once the bill goes into effect your health care premiums will suddenly out of nowhere skyrocket without precedent, skyrocket so much it blows out the subsidies. This argument is based entirely, purely, on faith. There is no factual reason to believe it, no one has put forth any evidence this is likely except "insurance companies are evil". This argument is the same argument the tea partiers make, with the exact same basis: This bill will pass and something terrible I can't really define will happen to me. I'm afraid.

As it happens there is an existing test case we can use to test the "my premiums will skyrocket out of nowhere" theory. Massachusetts instituted a series of health care reforms earlier this decade similar in some ways to the current health care bill, for example the Massachusetts reform contained a mandate. Here is an analysis of the Massachusetts reform by an opponent of those reforms, the Cato Institute (since they oppose the reform, I assume they will not tend to underestimate the reform's downsides). Their finding is that whereas health care costs have risen by 33% nationwide since those reforms went into effect, they rose by 40% in Massachusetts. That's it. A 7% additional rise in costs beyond what would have happened anyway. If we take the incredibly pessimistic view that this is somehow ALL additional cost that the CBO projection (which the CBO does project some increase in costs), this increase in costs is still less than the amount the CBO (again, page 5 of the PDF I linked above) projects the amount you actually pay will decrease if you are eligible for subsidies-- in the case of someone who has access to the exchange, several times less. And of course this 7% increase in Massachusetts is not attributable solely to the mandate, since the Massachusetts reform did a number of other things other than the mandate that could increase costs, including adding risk to the pool by insuring previously uninsurable people and increasing demand for health care (i.e. the number of people accessing health care services). In other words even if we take the Massachusetts example to mean we can expect a 7% extra increase in the cost of health care, we could expect a significant portion of that increase from a mandate-less bill as well (or even a greater increase-- the mandate is technically a cost control mechanism, it just happens to be a cruel, regressive one).

Random other things which may or may not make a difference to you: The Senate bill (the more conservative version of the bill) has a cap where if buying would cost more than 8% of your income to purchase that health insurance then you are exempt from the mandate penalty. In the House bill if you are employed by a business which spends at least $500k-750k on payroll the mandate essentially falls on your employer instead of you. Both bills have provisions where the mandate disappears as your income approaches the poverty line. Both bills have provisions which allow the dept. of HHS to grant hardship waivers to persons for whom no affordable plan exists. Both the 8% cap and the potential for the executive branch to grant hardship waivers would in practical terms prevent a scenario where the insurance companies openly gouge on prices once the bill goes into effect.

As for recission / caps / denial of treatment, the House bill would protect you from these things. The Senate bill would have some protections from these things, but would not be as reliable as the House bill. This is something it is possible to fix in conference when the bills are merged, and which the House if it is giving up the public option would have a lot of leverage to demand be fixed. No effort, as of yet, is being exerted by the progressive blogosphere to help fix any of this stuff. The only pressure being placed is to reinstate the public option.

Causing your premiums to go down while protecting you from recission, denial of treatment, and payment caps is the point of the bill. That's what it does. That's "what little is left".

Er, last post contained a typo:

"If we take the incredibly pessimistic view that this is somehow ALL additional cost that the CBO projection (which the CBO does project some increase in costs), "

should have been

"If we take the incredibly pessimistic view that this is somehow ALL additional cost that the CBO projection wouldn't have taken into account (which the CBO does project some increase in costs), "

Just wanted to make sure I didn't confuse anyone...

Hi Neil,

"the confused idea that being suspicious of who is supporting something is about *the same idea* being disliked because soandso supports it. Uh no, silly, it's really the idea that that person will ask for shitty things and change what that something turns out to be"

I'm sorry, I don't think I understand what you're saying here. I'm not being snarky, I'm just a little confused by your grammar. Do you think you could rephrase that?

Maybe the folks who support passing 'some/any bill' would understand the other side more if they broadened the context.

The context to which I refer is the Obama administration's support of torture coverup, wiretapping coverup, the Afghanistan war, Wall St., and many other Bush/Cheney policies.

Each time, the progressive 'Change' agenda under which Obama ran has been brushed aside in the name of "pragmatism".

Maybe I'd give ObamaRahma the benefit of the doubt if this were an isolated incident. But within this context it seems that this administration doesn't really believe in fighting for progressive ideas, and instead wants to co-opt the center-right into their corner.

The insidious part of all this is that when a Democratic administration supports such policies it legitimizes them far more than a Republican administration.

I agree that it's not productive to impugn people's motives (notwithstanding the fact that the people griping about this impugn the motives of other Democrats with whom they disagree all the time).

But I have read a lot of the progressive criticism of the bill, and I'm sorry, but a lot of is just substantivley incoherent. Yes, it makes an effort to root itself in policy concerns, but is either disingenuous or reflects an extreme degree of policy ignorance. For example, you have the DFA criticism that proponents' claim to extend health care coverage to 30 million people is based purely on the presence of a mandate to purchase health insurance -- but it makes no mention of the $900 billion in subsidies that will enable people to purchase insurance. This is not a serious effort at policy debate; it's demagoguery.

mcc,

"The bill will cause your premiums to go down."

Not any more.

"This is what every analysis I've seen based on actual numbers or research has shown. Here for example are the CBO's projections of what will happen to your subsidies under the plan (see page 5)"

That was when the bill still had a Public Option, which the CBO stated was the engine for keeping costs and premiums down.

It's gone now, as are any cost or premium containment.

That was when the bill still had a Public Option, which the CBO stated was the engine for keeping costs and premiums down.

No. Once again, this is so wrong that I can only call it dishonest. The CBO said the opposite of this, in multiple findings.

Here's what the specific CBO report you're responding to there says about the public option, at the bottom of page 15:

"CBO and JCT’s analysis of exchange premiums has also taken into account the availability of a public plan through those exchanges in some states. Premiums for the public plan as structured under the proposal would typically be somewhat higher than the average premiums of private plans offered in the exchanges.20 By itself, that development would tend to increase average premiums in the exchanges—but a public plan would probably tend to reduce slightly the premiums of the private plans against which it is competing... [because] a public plan is also apt to attract enrollees who are less healthy than average (again, because it would include a broad network of providers and would probably engage in limited management of benefits)... the higher costs of those less healthy enrollees in the public plan would probably be offset partially but not entirely; the rest of the added costs would have to be reflected in the public plan’s premiums. Correspondingly, the costs and premiums of competing private plans would, on average, be slightly lower than if no public plan was available. Those factors would reduce the premiums of private plans in the exchanges to a small degree, but the effect on the average premium in the exchanges would be offset by the higher premium of the public plan itself. On balance, therefore, the provisions regarding a public plan would not have a substantial effect on the average premiums paid in the exchanges."

The CBO has found this again and again. The CBO produced a new this morning, reflecting the new "compromise" without a public option; it again reasserts that the overall average effect of the public option on premium prices is nothing. The public option is not, and never has been since it moved to "negotiated rates", a cost control mechanism. That simply wasn't the point.