http://patriotboy.blogspot.com/2009/12/health-care-reform-by-corporations-for.html

the general leads us to understanding, as usual..

"Even if the reform bill is signed into law, it's the end of the policy work. But as the op-ed reminds us, it's not the end of the sales job, either."

I'm gonna assume you mean to write " ... it's NOT the end of the policy work..."

No proofreaders?

As the saying goes, "half a loaf is better than none." An example of this is the Teddy the K vs Dickie the Nix, way back when.

Do we really think we will be better off with the 'status quo'?

Is it a smart move for them to deliberately misinterpret Dean's concerns and try to lump him, and by extension, the portion of the base that trusts his judgement, in with the teabaggers? It seems kind of counterproductive and bitchy to me.

With all of the talk about this bill, I have seen nothing that actually leads to reduction of premium growth, let alone placing actual restrictions or prohibitions on it.

He says that, "Annual and lifetime caps on benefits will be history," but I have heard much objection that annual caps have not been prohibited.

And both House and Senate versions place taxes/levies on manufacturers of medical devices and/or on medical providers and insurance companies themselves to pay for their plans, which cannot fail to drive costs for those things upward. Since insurance companies pay those costs, how can not the plan itself raise insurance premiums, as the CBO has, in fact, said will be the case? That makes Mr. Biden sound rather full of it when he says that the plan will reduce the premiums for people who already have insurance.

The plan does allow 30 million people to buy (as opposed to "provide insurance for...")insurance who were not able to buy it before, but part of the cost is that people who have insurance will pay a bit higher price for it.

Howard Dean came across very well on MTP this morning. He articulated the problems with the current Bill while giving credit for the improvements that came in late (even as good features were on the way out.) He expressed hope that we can improve on what we're going to get, but worried about years of struggle against insurance companies over keeping them honest and worth dealing with. It was fun seeing Kos on there too. Both took apt cracks at the Republicans over their deliberate obstructionism when Gregory offered the inevitable Broderist challenge over bipartisanship.

Again, disappointment with this Bill is not "perfectionism" - the latter means, wanting it all and settling for somewhat less. But if you think key elements make something dangerous, that isn't perfectionism. A Bill isn't a homogeneous, non-interlocking "loaf" that is proportionately as good as the percentage of what you wanted. Nor is it "ideological" - to be concerned about cost-control and regulatory issues is the essence of true pragmatism. As for such details, indeed: can all these newly "insured" folks afford the deductibles etc, the actual costs? And I worry about the electoral issues. Plenty of people will be grateful, plenty others pissed off in various ways. I'm just glad only 1/3 of the House is up in 2010.

"He says that, "Annual and lifetime caps on benefits will be history," but I have heard much objection that annual caps have not been prohibited."

Wouldn't it be better to read rather than rely on what you hear? There are no annual caps. Reid inserted some language about no "unreasonable" annual caps for some budgetary purpose I can't pretend to understand but it is out of the manager's amendments - at the urging, I understand, of the WH.

"it's not the end of the sales job,"

Obama promised transparent, even televised negotiations. He promised imported prescription drugs and Medicare negotiated prices. He promised an affordable public option for individuals. He promised there would not be an individual mandate. But Obama not only failed to deliver any of this, he actively opposed all of it in secret backroom negotiations.

So yeah, I think you have some selling to do.

neil b, you mean a third of the senate (six year terms...)
not the house -- which, if we ever got our shit together we could clean out in one fell swoop of a given every-other-year...

Neil B,

I guess my question would be how is this bill worse than what currently exists? I don't think, by the way, that that is the standard the bill should be judged on but those who say kill the bill, a la Dean, are implicitly saying that it is better to have nothing change for the next 10 years than for this bill to be enacted. I for one would like to know why this is so, no-one I've seen has explained this.

i dont think i heard howard dean say he advocated 10 years of no change in heath care...but it must be true, i read it on the internet...

Well, i said implicitly because clearly he didn't say it, but that must be the logic behind the kill the bill sentiment - and I've heard plenty of people say this is worse than half a loaf and worse than nothing but I haven't really heard any reason why they think that to be the case. As to the 10 year timetable it's just my guess but if this thing doesn't pass, there is no way anyone is going to try again for a long long time.

options:

http://firedoglake.com/2009/12/20/the-insidious-myth-of-the-progressive-“bill-killers”/

Perhaps Biden, Emanuel, and Obama could try, I dunno, not insulting their base for a change? Might be worth a try.

Cranky

I simply don't understand how entrenching the criminal private insurance companies is a progressive victory. Single-payer or medicare for all is further away not closer because of this bill.

Homeruk, I would be amazed if there weren't plenty of viable alternatives to the current Bill, like various smaller Bills that enact desirable features and so forth. For example, a Bill just to take away the anti-trust exemption for insurance companies. And there are procedural tricks, little understood by me, to do (or have done) about attaching to appropriations, reconciliation, etc. Not passing this Bill would not be the same as "doing nothing" as long as progressives kept doing things. Even so, I am less revolted due to some improvements as Dr. Dean noted.

Yeah, sorry about the mixup. Maybe we can sweep out some crappy Senators next year?

"Even if the reform bill is signed into law, it's the end of the policy work."

That sure as Hell better NOT be the case, or else the sales job WILL fail.

If the White House has any sense, a big if given their performance the last few weeks, sometime about 6 weeks after the new bill is signed they will introduce some smaller health reform measures aimed at curing the defects in the current bill. Those smaller measures will be fought out one by one during the year.

They will also get behind setting permanent limits on the estate tax. They need to take command of some issues that David Broder and the rest of the Village feel strongly about, and they feel most strongly about transferring much of their wealth to their children.

Single-payer or medicare for all is further away

Underlying this concern, however, is the Great Myth that seems to animate the "kill-the-bill" strain of progressivism: that there was ever anything close to enough votes to pass the gold standard of progressive health care reform.

"Further away" doesn't mean much when we were never very close to start with. Yes we have the WH and majorities of Democrats in both chambers -- but Democrats are far from homogenous, and even if we had the leadership, strength and will to break the ridiculous cloture rules, it is not clear we ever had 50 votes for single payer or Medicare E.

I can measure my birthday presents each year against my wishes for a pony, the possibility of receiving a magic lamp with a genie in it, or a bazillion dollars in gold. it wont really get me anywhere and assures frustration and disappointment. it is no more logical to compare the final Senate bill against single payer or Medicare E -- they were never in the realm of reality or possibility. It would require us to win with good progressive candidates for several more cycles of Senate elections (in some cases primarying incumbent Dems) to get to where that pushing single payer "further away" is a relevant concern. And when only 20% of Americans self identify as "Liberal" those kinds of sustained electoral wins aren't going to come easy, either -- especially since I keep seeing all the activist liberals on here claim they'll just take their vote and go home next election, which only ensures the Senate wont get any better.

The sales job is failing for me. Hey we women have two breasts maybe the Dems could use those as more bargaining chips. They already used our uterus but still plenty of opportunities to wave them in front of conservative men and women for punching.

Come to think of it, there are fallopian tubes, two of those, a vaginal canal too. Oooh see plenty of organs for Dems to use.

I'll have to send the senate Dems a list organs they can use to screw women over for future bills.

Either little ponies will trot out of the senate bill for 35 million more folks and magically the blood-bloated medical insurance companies will have been able to harness a bunch more warm bodies into their miasma of a money-making machine that will continue to suck out more and more of the wealth of this country for profits for the few.

Or, the failure of the Clown Car bill to reform health care in this country, will move us further and more quickly toward collapse. And if you wipe that mist of hopey-changey from your eyes you'll see "collapse" written all over this stinking bill.

And despite the bill's probably retrenching elements that hinder further attempts at real reform -- single payer, medicare for all -- the very collapse that the bankrupt clown car senate bill stimulates will then require radical action. or all hell will break loose.

that is the point. even with a Dim majority, and President Hope in charge, we now see the limits of their vision for this country. It's like finding out they are pod people...they are all corporate dealers. they live and work in a system that sees it as legitimate and moral to wreak peoples' lives by the millions according to the dictates of corporate profits.

45,000 dead a year. continued misogynous dehumanizing women's bodies, and more... the villagers of washington have decided that it benefits them to allow the corporations to keep up the killin' and the denial of decent health care to all -- maybe even increase the killing and misery, we'll see -- but when it becomes an even more obvious crime against humanity to more of our fellow citizens, and they join the progressive ranks, we'll be back.

and we'll be back for more than just health care.

it is getting pretty standard for team obama to foment disingenuous arguments for passing the bill and the horsecrap about 'looking into Americans eyes'. The most important parts of progressive health care reform could have been passed through reconciliation. But team obama CHOSE to hold the whole thing hostage to the likes of LIEberman, snowe, baucus, landrieu, bayh, and lincoln, and to make sure that the real winners are the insurance companies.

I guess my question would be how is this bill worse than what currently exists?

What currently exists: Insurance plans are so insanely expensive that nobody can afford them, and claims are routinely denied and policies rescinded when you actually need them.

This Bill: Democrats force the middle class to buy the insanely expensive plans, which the insurance companies will still rescind for "fraud" right when you need them.

Would reconciliation be as "realistically" possible as supporters claim, or would there be too much political fallout. If little of the latter, then where is the excuse for not having done so?

I guess my question would be how is this bill worse than what currently exists?

let me count the ways...

1) Forces Americans to buy crappy insurance - lower income Americans will never use the insurance because of the high deductibles - so team obama has covered no one new that needs coverage.
2) limits a woman's ability to pay for her Constitutional and inalienable right to reproductive choice.
3) has unenforceable limits on premium increases
4) has unenforceable measures to limit rescission, and escape clauses - Americans with pre-existing conditions (including old age) will pay at least double on premiums.

team obama sell job = snow job.

Would reconciliation be as "realistically" possible as supporters claim, or would there be too much political fallout.

"political fallout" - surely you jest. This bill hands 2010 and probably 2012 to republicans:

1) republicans have had no problem cementing lies as CW about the bill

2) the sop to corporations that this bill is has demoralized the progressive grass roots - far fewer will lift a finger for the democrats and obama in 2010 and 2012

3) the "center", i.e., the uninterested will go ballistic when they starting paying for crap insurance they didn't want.

at least 2010 and probably 2012 will be a democratic massacre because of team obama letting a few skank conservadems and snowe run the show.

what team obama has done is nothing to lessen the "political fallout" of the bill, while delivering a crappy bill - a double loser.

***"overcoming fierce attacks from Republicans, the insurance industry, corporate lobbyists, "***

Wha???? The Republicans, insurance industry and corporate lobbyists got JUST WHAT THEY WANTED from this rotten bill.

Those "attacks" were all kabuki. They did their work behind closed doors in the White House, and in the halls of Congress to construct legislation benefitting them and screwing the American public.

The insurance companies are high-fiving each other amid shouts of "we win," opening champagne bottles, and contemplating what they're going to do with the gobs of money made off the obscene run-up of their stock prices [as a result of the likelihood that this crap will pass].

Doesn't this tell you SOMETHING about who benefits from this travesty?

I have to agree with Greenwald over at Salon. Proponents have been working overtime trying to identify the social benefits in this legislative "initiative" and emphasize them over and above the corporate benefits but it must be exhausting. There may very well be individuals who will be helped immensely by this program (and you can bet that they will be identified and trotted in front of the cameras as often as it takes to blunt the opposition) but those will be the rare exceptions to the larger rule.

It's just a practical reality that after full implementation most people who need this option will find that while they are forced to pay premiums every month and while those premiums may be subsidized at some level, there will still be the bad behavior of the insurance companies to deal with when they file a claim. Nothing changes except they actually have "insurance". Which works fine until they need it. At which time they will spend 100 hours dickering with the claims department like the rest of us.

The apologists maintain the meme that "if only we pass this major initiative then we can start the long process of improving it over time" and get everyone under the private, for-profit "insurance" blanket with companies that have already demonstrated that they can't control costs, won't apply community rating principles and will continue to siphon 27 cents out of every premium dollar sent their way regardless of the source. The current reform legislation only reinforces their business practices and nothing will have changed in 10 years. Optimists are digging deep to remind us of the federal government's inability to address the problem in the past but revoking that same rationale looking forward to assure us that things will be much improved if we just pass something/anything.

Those saying "Kill the bill" from the left are just acknowledging the practical reality on the ground... that rebranding and blowing smoke can't disguise the fact that this corporate subsidy is terrible public policy. When they close the window on this whole thing the only winners will be those who continue to accept campaign contributions from pharma and insurance interests.

Gee ... if a few Liebercrats, with White House connivance, hadn't stripped out everything in the bill that "Democrats, liberals, and proponents of health care reform" wanted the most, do you suppose so many of them would be feeling "disappointed, frustrated, and dejected by the success of health care reform?"

Frankly, I wanted a public option or a medicare expansion, etc., because I'm sure they are the right policy, and I'm not at all sure about an individual mandate without them, or about these dodgy exchanges. So while I am grudgingly in favor of passing the Senate bill, it is a victory that feels like a defeat, not least because the White House opposed what I supported, and because, goddamnit, the people both inside and outside the Senate that agree with me are a majority. What has happened here is just plain wrong. I don't know what a few op-eds are going to do to change that.

"Do we really think we will be better off with the 'status quo'?"

Let me put this as clearly as I can:
the status quo, as nightmarish as it is, is almost infinitely better than what we'll have after this bill is passed.
I mean that emphatically and with no exaggeration. It's hard to conceive of a worse bill to write. In fact it's hard to conceive of a bill more likely to doom any kind of real reform while simultaneously reversing the gains made by democrats.

Yes if this is the option we absolutely want the status quo. That said I don't think that is the choice before us and we still might salvage a bill that will do a little good.

This bill is half a loaf in that it assures that we will continue to pay more than twice as much per capita for health care as any other country in the world, but there will be some public subsidies to help lower-income people buy it.

Proponents are simultaneously arguing that if the Senate bill doesn't pass now, there will no further health reform legislation for a decade,but if it does pass it will be improved and refined with further legislation.

Every "protection" in the bill -- against recission, rate increases, treatment denials, whatever -- rests on the same foundation of "regulation" as it always has. When has this worked? But magic pony! -- it will work now.

Steve Benen wrote: "Democratic policymakers are poised to achieve the generation's most important progressive policy accomplishment -- a triumph decades in the making, overcoming fierce attacks from Republicans, the insurance industry, corporate lobbyists, and right-wing activists -- only to have the left feel disappointed, frustrated, and dejected by the success of health care reform."

What a load of preposterous hype.

This bill isn't a "triumph". It is a failure.

And the Obama administration and the Senate Democrats didn't "overcome fierce attacks" from the insurance corporations and corporate lobbyists -- they sat down and negotiated the bill with them.

That's why any new or expanded nonprofit publicly-administered health insurance program is "off the table". That's why all Americans will now be required to guarantee the profits of the insurance corporations, in perpetuity, under penalty of law.

That's why insurance corporation stock prices have skyrocketed to a 52 year high.

I for one feel "disappointed, frustrated, and dejected" by this FAILURE of health care reform.

It is not a "triumph" and it is not "progressive". About the best that can be said is that it may represent a somewhat "kinder and gentler" corporatist governance -- IF the meager regulations it contains actually succeed in curtailing the most egregious, murderous abuses of the insurance corporations. And that may be the best we can hope for from Obama-era corporatist "liberal" Democrats.

But the kind of overblown hype that Steve is offering these days is silly.