"he's only nearly dead." --miricle max

At this point, pushing for it has a marginal chance of success, and a perhaps slightly higher risk of killing the legislation. It's not going to happen this time around.

We all know Social Security and Medicare started small and were fixed and improved over time. It's not inconceivable that in a few years (2013, after the election?), after people see that the sky hasn't fallen in after implementing initial reform, it could be taken up again.

The wheel turns so very slowly, but it turns.

Of course, a less trusting soul, say, Glenzilla over at Salon, might not find it disappointing, of course, but not at all unexpected in exactly the same way...

He'd say, shrilly, it's all been a bait-and-switch. Naaaahhh...

The public option has served only two purposes. A bone thrown to progressives early on the process who would have much preferred a single-payer plan and, longer term, as a barginning chip to give up in order mollify 'moderate' Democrats.

It's not dead, because Bernie Sanders is going to propose it as an amendment, and senators will have to vote up or down.

Who are the 9 Democratic Senators who would kill the reconciliation package over the popular Public Option provision? Anyone? Guess what? The White House never wanted it. They played us. End of story.

At last we finally get to the truth.

All HCR features, both good and bad, are the expression of policy preferences of the Democratic party.

The public option, just like single payer, is dead because of Democrats.

The mandate that forces people to buy a POS policy from the same folks who've been screwing them for years? That's alive and well because of Democrats.

That whole b.s. "debate" during the Democratic party presidential campaign about health care, mandates, and universal converage has been exposed as the kabuki fraud it always was.

We are getting the *exact* opposite of what Obama said he'd deliver during those debates. No to a P.O. but yes to mandates. exact opposite.

Hopefully, this blog and others can quit blaming Republicans for things which, we now know, are entirely under the control of the Democratic party.

When legislation forces me to give thousands of dollars of my money either to the John Wayne Gacy Corp. and the Ted Bundy Corp., I'm not going to work for its passage very enthusiastically.

Getting to choose which of my orifices are violated is not much of a choice.

Better to hold this very popular provision for this election year unburdened by the (necessary) baggage of the main bill. It will only grow in popularity as it becomes better understood, and will be a fantastic issue for defining the difference between Democrats in favor of the people and Republicans protecting insurance companies and their greedy CEOs. It can win back the momentum.

Pass the damn bill, go back to work immediately to restore your relationship with the strongest Democrats who have become disillusioned, and change the momentum completely for November. The President needs to lead the way, sending the message the moment he signs the bill that the public option will never go away and insurance companies better learn to deal with that reality.

no mention of the medicare for all public option bill put forth by Alan Grayson?

What a shock.

Calling the removal of the only part of the health care reform package that actually mattered "disappointing" is more than a little underwhelming. Without a PO the bill will not do any of the good it is supposed to. It cannot control rescission. It cannot control costs. It cannot get people better access to health care without an alternative to the for profit insurance companies that are causing all of these problems.

The purveyors of the Status Quo have more dollar-votes than all the people in America who wanted a public option to make health care affordable.

When the Status Quo wins, we all lose.

Why is the policy a POS? What option does that "forced" person have now that is so great? She said person be allowed to free ride and then if stricken get medical care at public expense? Tough luck, buy the freakin policy.

The Public Option was always the number two priority to making this bill work. Yes it is important and needs to be put back in the mix when we can but the number one priority was and is a mandated minimum Medical Loss Ratio for insurers. That provision was in the original House Tri-Committee and Senate HELP Bills, was gutted in the Senate Finance Committee Chairman's Mark, reinserted in a temporary and useless way in both Reid and Pelosi's version, and then at the last second reestablished by the Senates Team of 20.

With a mandated minimum MLR Health Care Reform works. Without it it probably doesn't. I put up a blog post that got picked up by the people at Open Congress.
http://www.opencongress.org/articles/view/1357-The-Most-Important-Health-Care-Reform-Provision-You-ve-Never-Heard-Of
It turns out I missed the weakness that ended up getting fixed by the Team of 20 a little later but the overall point stands, a mandated minimum MLR guts the existing predatory 'deny care, make money' business model of the insurers. Right now their dream is a pool of young healthy adults mandated to buy insurance but unlikely to make claims. With a mandated minimum MLR that pool would cause insurers to starve to death, they would simply have to refund all the premiums, they need enough people making enough claims to meet their requirement for 80% payout for the individual market or 85% for the group market or they have to rebate the difference. The whole thing is a brilliant feedback mechanism making all the foo-rah over the PO kind of a sideshow.

Now this doesn't mean the PO is unimportant, if there was a PO and it had a MLR much higher than that of the privates and so presumedly a resulting lower premium it would keep the privates from boo-hoo-hooing that nobody could operate at those margins, or alternately allow the government to tell them to pound sand and let that particular market segment go Single Payer, so those of us with Social Democratic leanings should absolutely continue to push it. But as of right now a mandated MLR is part of the Senate Bill and so adds to 'the fierce urgency of now'.

Pass the damn bill, everything else will sort itself out over time.

Should said person...damn typo's!

Urban Legend,

the only thing the POTUS is going to do after this HCR bill is finished is to declare success and move on.

To get elected he'll
a) call HCR a success,
b) pick some b.s. fight over regulating Wall Street
and
c) claim that the Republicans are siding with the bankers over the people.

You and many, many others are seriously deluding yourselves if you think that the Dem leadership actually wanted a public option or are going to spend any political capital on it if this HCR bill passes.

Bruce,
Great point that never gets told. I explained that to someone and they couldn't believe it. Believe it, it's in there.

As much as I am for the public option, I never actually expected it to be part of this reform package. My hope was/is that this present version of reform will move the ball way down the field toward that end. Lets get what's on the table through. In a year or two, even rabid FOX viewers will have no choice but to notice the lack of gulags, death panels and martial law. From there, it should be much easier to sell.

"the number one priority was and is a mandated minimum Medical Loss Ratio for insurers"

No. The MLR is a gimmick that insurers will circumvent instantly. they've had a year to come up with the accounting tricks and game out the options, by the time the bill is implemented the MLR will be just as effective as the auditing of enron and worldcom.

I can't make this more clear- NONE of the reguilations have any chance of working unless you have an alternative for people to go to. Without that thereat there is nothing we can hold over their heads. This bill gives the insurance companies all of the power. They own health care in america once this bill is signed, and they will never let go.

"My hope was/is that this present version of reform will move the ball way down the field toward that end."

It doesn't. It entrenches the insurance companies and makes a public option basically impossible unless and until the whole system falls apart. Notice how much power the insurance companies held this time around. Next time they will have at a minimum 50-70 billion extra dollars a year to lobby with and buy votes. And that's assuming the supporters pie in the sky hopes that costs don't explode come true. In all likelyhood when we try for actual health care refrom the AHIP won't be dropping 10 million on ad buys. It'll be dropping 10 or 100x that much and will thus dominate the entire conversation (to say nothing of buying congressmen outright).

Without a PO the bill will not do any of the good it is supposed to. It cannot control rescission. It cannot control costs. It cannot get people better access to health care without an alternative to the for profit insurance companies that are causing all of these problems.

Tlaloc - We went over this last night when I explained to you what the insurance exchanges will be, which clearly showed that you're mistaken when you say this stuff won't be controlled. And I don't know if this will be in the final bill, but the site you read said that the Senate bill mandated that non-profits be included in the exchange.

Once the exchanges are going, people will be able to choose good insurance that prohibits insurers from doing the bad things you're complaining about. So why are you lying about this now and pretending you don't understand this stuff?

We could have and should have had a very fine Claret of a HCR bill. However, it has been reduced to a fortified chemically type of Thunder Bird 2010 bill which, only, will anesthetize our collective brains and delude us into thinking that "we won". It is akin to the shooting down of capping credit card rates for the Credit Card Bill and then, declaring, victory because we have "forced" the industry to allow us a few more days to be notified about how we are going to get screwed over. Ah yes, Great Victories Galore. Please tell me, once again, how our "Leader" is really leading us. Oh, yes he is a MaHvelous Three Dimensional Chess Player, is he not?

Pelosi, and Steve, have both spoke before hearing this from Dick Durbin--

If House Democrats include a public plan in the reconciliation bill they craft to "fix" the Senate's legislation, Durbin will work hard to make sure the provision (as part of the reconciliation package) has the votes for passage. If it's not in that reconciliation package, he won't lift a finger. In fact, he will work against efforts to add it as an amendment.

"Sen. Durbin and the rest of the Senate Leadership will be aggressively whipping FOR the public option if it is included in the reconciliation bill the House sends over," [Durbin aide Joe] Shoemaker wrote in an email that he authorized PCCC founder Adam Green to make public. "Conversely, the Leaders will whip against any attempt to alter or amend the bill if the public option is not in it (or as your email says -- whip against adding the public option as an amendment in the Senate.)

"The reason is simple. There can be no amendments - good or bad - to the reconciliation bill once the House passes it and sends it to the Senate. The House will not do step one (passing the Senate healthcare bill in the first place) if they do not have assurances that the fixes they want (i.e., the fixes in their reconciliation bill) will be passed unchanged by the Senate."

Doc B., there's theory and there's reality.

In theory, the SEC was regulating Wall st so that a Madoff size ponzi-scheme would never happen.
In theory, the NY Fed was regulating Lehman so that couldn't cook the books.

The nitty gritty fine print in the HCR bill will never get implemented in the manner that you expect and there's no rational reason to expect it so. Moreover, whenever the Republicans take back over Congress, for sure this stuff will not be regulated like you expect.

There is no tomorrow. The problem isn't that, theoretically, you can't achieve legislation incrementally. The problem is that liberals haven't kept any carrots or sticks in reserve for future negotiations.

Once the Senate Bill signed into law, it is game over for meaningful HCR. The insurance industry will have no incentive to come back to the table to negotiate. And you can't pass anything as long as the insurance industry opposes it.

My suspicion is that most of those who are advocating that we pass this bill and then simply hope for some improvements and some ponies down the road have little or no experience with high-level negotiations in their professional life

I WANT SINGLE PAYER UNIVERSAL HEALTH CARE IN THE UNITED STATES OF AMERICA IN MY LIFETIME!!!

And I'm 53. I swear, the Cubs will win the World Series before I see true universal health care access in this country.

The nitty gritty fine print in the HCR bill will never get implemented in the manner that you expect and there's no rational reason to expect it so.

And you know this because...oh yeah, you "know" it because it's the only way your argument makes any sense, now that you understand how the rules will be enforced. The reality is that the government DOES regulate this stuff, and while the Bush Admin allowed Madoff to slip by, he was an exception, not the rule.

Beyond that, I'm not sure if you're aware of this, but it's the EXECUTIVE branch that will be implementing these policies, not the legislative branch. You read that last night too, so I'm not sure why you remain so confused about this.

Once this bill is passed, it's up to the people Obama hired to take care of it. You know, the same people who handle Medicare and would have handled the Public Option, had we gotten one. So if you think this bill doesn't work, you must surely think the Public Option would have failed too.

Sorry to tell you this, but if this bill passes, you're likely to get the insurance you really wanted.

And you can't pass anything as long as the insurance industry opposes it.

um, they're pretty strongly opposed to even the Senate bill--you're saying that won't pass either?

otoh, I do agree that making any substantial changes, or even smaller modifications, will be next to impossible until this temporary fix runs its course.

"I WANT SINGLE PAYER UNIVERSAL HEALTH CARE IN THE UNITED STATES OF AMERICA IN MY LIFETIME!!!

And I'm 53. I swear, the Cubs will win the World Series before I see true universal health care access in this country."

--Single payer and universal access are two different things. The first is probably less likely in your lifetime than the second.

The problem is that liberals haven't kept any carrots or sticks in reserve for future negotiations.

You've got this backwards. While it would have been nice to get all this for policy reasons, politically, we just tapped a brand new vein of election year rhetoric. Every year, Republicans will vow to overturn this law, and every year, Democrats can vow to improve it. Republicans will insist it's bloated and expensive, and Democrats will rise to its defense and tell everyone how they'll improve it.

And unlike abortion, which Republicans love to rail against but don't really want to ban; Democrats will be HEROES every time they improve this bill. By holding back some of the goodies now, Dem politicians can have Christmas every two years; while Obama's got more healthcare stories to talk about in 2012. He'll champion reform, and insist that the job still isn't done. The speeches write themselves.

Beyond that, I really think you people need to consider how the insurance exchanges are going to neuter the insurers. We're not just putting a few more rules on the insurers; we're completely changing the way people buy insurance. Hell, once they're stuck to spending most of their revenues on medical costs, they're not going to have much left over to buy votes. It's a whole new day.

I want this done -- this month. Once and for all. Then the dems can make changes as the years go by.

If House Democrats include a public plan in the reconciliation bill they craft to "fix" the Senate's legislation, Durbin will work hard to make sure the provision (as part of the reconciliation package) has the votes for passage. If it's not in that reconciliation package, he won't lift a finger. In fact, he will work against efforts to add it as an amendment.

"Sen. Durbin and the rest of the Senate Leadership will be aggressively whipping FOR the public option if it is included in the reconciliation bill the House sends over," [Durbin aide Joe] Shoemaker wrote in an email that he authorized PCCC founder Adam Green to make public. "Conversely, the Leaders will whip against any attempt to alter or amend the bill if the public option is not in it (or as your email says -- whip against adding the public option as an amendment in the Senate.)

"The reason is simple. There can be no amendments - good or bad - to the reconciliation bill once the House passes it and sends it to the Senate. The House will not do step one (passing the Senate healthcare bill in the first place) if they do not have assurances that the fixes they want (i.e., the fixes in their reconciliation bill) will be passed unchanged by the Senate."

--it ain't necessarily over.

"Tlaloc - We went over this last night when I explained to you what the insurance exchanges will be, which clearly showed that you're mistaken when you say this stuff won't be controlled."

uh no- it pretty clearly showed you;re dreaming when you think the exchange is going to be this indusr=try goliath that has great power. On the contrary it's shaping up to be a tiny niche market that the feds are going to BEG insurance companies to be a part of.

You have no evidence at all that being kicked out of the exchange will matter to insurance companies but you assume it will be such a huge threat that it'll mean more than all the various lawsuits they've been it with over the years.

I find that incredibly naive. Every fact in our discussion supported my side yet at the end you went off and ignored it all to contiue saying what you'd said all along.

Again- this is why I gave up on rational debate.

Doc B.,

Your optimism is based on what exactly?

When the Republicans take control of the executive branch and congress, none of this stuff will be regulated properly. How do I know this? because when republicans are in charge of either Congress or the White House, nothing ever gets regulated properly. Madoff was not an anomaly. There's Enron, strip mining, arsenic levels in the water, SuperFund cleanups, you name it. There is no end to Republican perfidy.

The assumption that the Obama administration will do a better job is nice but meaningless. Despite contra evidence galore (no public option, yes on mandates, changed FISA vote, no Gitmo closing, backtracking on KSM trial, arguing *for* indefinite detention without a criminal conviction), let's assume Obama does what you think he'll do.

Then what? People are supposed to pray every four years that a Democrat wins the White House?

This is not a plan for success.

"And you know this because...oh yeah, you "know" it because it's the only way your argument makes any sense, now that you understand how the rules will be enforced. The reality is that the government DOES regulate this stuff, and while the Bush Admin allowed Madoff to slip by, he was an exception, not the rule."

Wow. Enron. Worldcom. Housing bubble. Credit default swaps. Yeah Madoff was such the exception.

You're twisting reality to meet your preconceived conclusion.

"And unlike abortion, which Republicans love to rail against but don't really want to ban; Democrats will be HEROES every time they improve this bill."

Case in point. The dems will never improve this bill. Insurance companies will own the discussion from here on completely. You geniuses just handed them all the money and clout they could ever dream of.

my favorite part of the bill is the Section which allows annual caps on coverage. whoohoo! no more parasitical cancer patients draining the insurance companies of their profits!Change We, the stockholders, Can Believe In.

On the contrary it's shaping up to be a tiny niche market that the feds are going to BEG insurance companies to be a part of.

Uh, no. That's entirely in your mind. You found one part of the Senate bill which said that on-going plans will be allowed too, and you're not even sure if that's even in the final bill. So you decided that this somehow means that most insurance will still be unregulated, while the exchanges are ignored.

But could you please explain to me why ANYONE would purchase insurance outside an exchange, when the exchanges will be highly regulated and do all the things you want it to do? Because I can't imagine why that would happen. And again, I'm not even sure if that's going to be in the final bill, as it's not in the House bill.

So you're basically hanging your entire opposition to this bill on the off-chance that people will reject good insurance that the government will help pay for, and opt for crappy insurance that the government won't help pay for. That's nonsense.

And hey, who cares, right? You'll be one of the smart ones to get the regulated plans through the exchanges and get the insurance you want. So what's the problem?

Steve, I love your columns, but I'm seriously disappointed in this one. I know the "promise" that progressives report Obama made in last week's meeting that the public option would get its own reconciliation vote, once HCR is actually passed, so as not to create further chaos in the HCR + sidecar bill cluster (http://rawstory.com/2010/03/obama-promises-progressives-revisit-public-option-bill-passes/) is weak hearsay, & I know it's been traditional progressive blogging to say the public option's dead because it's not going to be in the main sidecar, but I honestly expect better of you - at least a mention that maybe Rasputin's not dead - yet. Oh well, I'm certainly not perfect, either. :o)

Observer - Say you're right. Say Obama will let us down on regulating reform, and then a Republican president comes in and destroys everything. Could you please explain how the Public Option would have saved us from that?

And look, you just cited a small handful of examples of corruption which all got exposed. I just read in the quarterly newsletter the Texas CPA board issued about yet ANOTHER Enron accountant who lost his CPA license and paid a huge fine for what he did. And no, there AREN'T endless streams of fraud going on. I'm sorry, but I believe in the government's ability to get things done. Is it perfect? No, but it works.

And again, if we can't trust them to run things right, then we should only assume that the Public Option would suck, single-payer would have been a disaster, and the whole thing is pointless. I'm sorry, but at this point, you people are grasping for straws. That's the only way I can see how you think the Public Option was a magic bullet that would save us from all the corruption you say will doom reform.

"But could you please explain to me why ANYONE would purchase insurance outside an exchange, when the exchanges will be highly regulated and do all the things you want it to do? Because I can't imagine why that would happen. "

Let's turn it around- why would any insurance company agree to be part of such exchange? They aren't required to. Why would they voluntarily be part of a highly regulated market that's taking on people with pre-existing conditions that are sure to cost them money? You claim the big threat is that a company will be excluded from the exchange but that assumes they want to be there in the first place.

I particularly like how last night you admitted you don;t really have any idea how the exchanges work, and are not a policy guy but now you're absolutely sure they work this certain way that just happens to support your previous conclusion.

"So you're basically hanging your entire opposition to this bill on the off-chance that people will reject good insurance that the government will help pay for, and opt for crappy insurance that the government won't help pay for. That's nonsense."

Your hanging your entire support for this bill on the notion that the regulations will work because an institution you admit being almost completely ignorant of has just gotta work the way you wish it would. Yeah that seems entirely rational.

"Observer - Say you're right. Say Obama will let us down on regulating reform, and then a Republican president comes in and destroys everything. Could you please explain how the Public Option would have saved us from that?"

:O

Seriously... you don;t see where having a non-profit alternative to the insurance companies would maybe help? How can you not get that having an alternative to those bloodsuckers might be useful?

Okay lets walk through it real slow-
after the fifth of sixth insurance company has screwed you over by taking your premiums and not paying for your health care, and the government has show itself to be incapable or disinterested in doing anything about that, you join the public option. The PO, being not for profit, doesn't have the huge motive to screw you the way the insurance companies do. Suddenly you're paying a premium and getting something in return- they actually help pay your bills.

It's a night and day difference. Insurance companies make their money by not helping you, and they exist to make money. A public option would exist to make politicians popular, and they do that by helping people.

It's hard for me to place a whole lot of hope for a public option in what's going on in the Senate.

Things have reversed since last year, when the Senate was the more difficult house of Congress to get a health care bill through. In the House, we just needed a majority; we could afford to lose, at one point, as many as 40 Democrats. But in the Senate, we needed all 60 members of the caucus (including that snake Lieberman) to vote for the bill.

But now, as I said, things have reversed. The main bill has already passed the Senate with 60 votes, and the 'sidecar' only needs 50 Senators' support. The public option may well be able to get the support of 60 Senators.

But Pelosi no longer has her original 220 votes for a bill with a public option in it, and whatever losses she's incurred, she needs to make up from Blue Dogs, who don't like the public option.

She isn't going to pick up those votes if a public option is going into the sidecar. No way, nohow. Sorry, guys.

Let's just PTDB.

Let's turn it around- why would any insurance company agree to be part of such exchange? They aren't required to.

Again, that was one passage of the Senate bill, and you're not even sure exactly what it meant or if it's even going to be in the bill you're opposing.

And no, I'm not an expert on this. And neither are you. But at least I had a vague idea of what the exchanges were, while you had no clue about them. That's why I recommend reading more about them before opposing the bill. You wanted to know what the enforcement mechanism was for these regulations and now you know. Try learning more about them before insisting that they won't work.

And even if people could get insurance outside an exchange, they wouldn't. And just so it's clear, it's not that an insurer is either in the exchange or it's not. It's that they have plans in the exchange that we can choose from, so they could have some plans outside the exchange that sucked and good ones in the exchange; assuming it even works like that.

And honestly, are you now pinning your argument on the assumption that NO insurers will enter the exchanges? That's ridiculous. So once we get these, you can pick a good insurer that does what you want them to do. Or...you can imagine horrible scenarios in which the government is incompent and/or corrupt; which would also have applied to the Public Option and any single-payer plan.

And so you're wanting us to stop the only chance you've got of getting reasonable insurance, because a non-expert named "Doctor Biobrain" can't explain it better for you. Yeah, THAT'S rational.

Seriously... you don;t see where having a non-profit alternative to the insurance companies would maybe help? How can you not get that having an alternative to those bloodsuckers might be useful?

Ahh, but we're supposed to be assuming that Obama is incompetent and then a Republican president will destroy these reform measures. And if that's the case, the public option will be destroyed too. They'll either make it so crappy and inefficient that nobody would want it, or they'll just end it all together.

Sorry, but you can't have it both ways. Either the system works, or it doesn't. And if you get to theorize about worst-case scenarios ruining reform, then those same problems would plague the Public Option.

BTW, did you miss the part about the OPM getting into these exchanges, and how at least one non-profit plan needed to be included? You read that link better than I did, yet seem to have missed all the parts that didn't fit your argument.

"And no, I'm not an expert on this. And neither are you. But at least I had a vague idea of what the exchanges were, while you had no clue about them."

No actually as it turned out we both had about the same understanding.

"You wanted to know what the enforcement mechanism was for these regulations and now you know. "

Indeed, I know now that it's a joke. Of course I knew that before, too.

"And even if people could get insurance outside an exchange, they wouldn't"

Right, and people would never choose to take up smoking, or buy extended service warranties, or get lottery tickets. Or shop at walmart. Because people never do things that ultimately hurt them. Like in response to advertising. No that never happens.

Your understanding of humanity is practically non-existent, Dr.

"And honestly, are you now pinning your argument on the assumption that NO insurers will enter the exchanges? That's ridiculous."

Why? Look two options- either the exchanges are rigorously regulated, in which case the insurers will be very happy to leave, or they won't be well regulated. Either way your argument falls apart.

"Or...you can imagine horrible scenarios in which the government is incompent and/or corrupt"

Imagine? Again you understanding of reality is childlike. The government is definitively incompetent and corrupt. That said it is a lot more incompetent and corrupt when someone is paying it to be. Like say the insurance companies which lobby for what they want.

"And so you're wanting us to stop the only chance you've got of getting reasonable insurance, because a non-expert named "Doctor Biobrain" can't explain it better for you. Yeah, THAT'S rational."

No I want to stop this atrocity because its supporters clearly don;t understand a damn thing about the bill. And when those of us who do point this out they close their eyes and ears and start humming so as not to hear it. That scares the shit out of me. You guys are clueless but absolutely convinced you can do no wrong. That's a recipe for a disaster of epic proportions.

But you're too busy humming to hear me.

Your understanding of humanity is practically non-existent, Dr.

So you're understanding of humanity is that people will choose to have crappy insurance that the government won't help pay for, when they could have GOOD insurance that WILL be subsidized? Please. I believe in the selfishness of the average person, myself included, and think that selfishness will dictate that people prefer good insurance that's cheap over bad insurance that's expensive. Any Walmart shopper would agree.

And again, if the insurers are so powerful and the government so corrupt/incompetent, why would the Public Option work? Why wouldn't they ruin that too? Please explain how this is a magic bullet.

And again, this is all based upon one small part of an analysis you read of the Senate bill last night, which you might be wrong about and might not even be in the final bill. And what if you're wrong about this? Why, you'd be denying yourself good insurance because of a misunderstanding.

Please, read more. I'm not an expert. Find someone who is and discuss it with them. Send Ezra an email to explain it to you. Stop pretending to have knowledge of this when it's obvious you just learned it from me last night.

Hmmmmm, Bruce Webb's body of posts here vs. Tlaloc's body of posts here. Who's more credible?

I can't stop laughing.

The government will support the formation of two kinds of non-profits in the exchanges, a national non-profit negotiated by the Office of Personnel Management that runs the current Federal employee program, and state-level or multi-state level customer-owned co-ops. They are generally not considered to be equal to the public option in competing against private for-profit insurers, but they will be non-profit alternatives.

Urban Legend - Can you explain why they non-profits wouldn't be the same as the public option? I only read about the non-profit thing last night and know nothing about it.

And your name doesn't instill the most confidence in what you're saying. This better not be a myth.

"So you're understanding of humanity is that people will choose to have crappy insurance that the government won't help pay for, when they could have GOOD insurance that WILL be subsidized?"

Again there are two possibilities- eithe the exchange will be heavily regilated and insurers will not play or it won't in which case the difference between non-exchange insurance and exchange insurance is trivial. Either way your argument falls apart.

You are relying on the insurance companies to voluntarily choose to be ethical, when all their history shows they will not be.

"And again, if the insurers are so powerful and the government so corrupt/incompetent, why would the Public Option work? Why wouldn't they ruin that too? Please explain how this is a magic bullet."

It's not a magic bullet, but it is VERY much harder to gut a popular program than it is to subvert regulations. The GOP has worked for decades to kill SS and medicare and while they have at times hurt it they haven't been able to kill it. A public option could work the same way. Regulating businesses won't. Regulation tends to be arcane and behind the scenes so that people don't really know if and when it is working, much less working well. But they damn well know that they get their SS check each month.

"nd again, this is all based upon one small part of an analysis you read of the Senate bill last night, which you might be wrong about and might not even be in the final bill."

IT WAS YOUR RESOURCE! I love how you criticize me for not being an expert on the exchange then admit you aren't an expert and when i ask you to provide a reference and then read it and base arguments off of it you want to attack me for that to. If you really didn't trust the source why the hell did you want me to read it?

Jeebus.

"Please, read more. I'm not an expert. Find someone who is and discuss it with them. Send Ezra an email to explain it to you. Stop pretending to have knowledge of this when it's obvious you just learned it from me last night."

What about you? You're just going to assume you were right all long, huh? No running off to discuss the matter with "experts" for you, because well the PTDB guys don;t need facts or anything.

I'd love to discuss the issue with Klein or Benen or Drum but if you haven't noticed they refuse to discuss the critics concerns except to baldly say they have no validity with no proof whatsoever. Pretty similar to what you are giving me, actually.

Tlaloc - Again, the provision you're complaining about might not even be in the bill we're discussing.

Look, I'm not criticizing you for not being an expert. I'm telling you to go become an expert. Learn this stuff. Do research. You're basing everything on one sentence in one link I found and I don't even know who the hell those people are. I was just trying to find something that gave an explanation of exchanges and hadn't even read most of it when I posted the link.

Send an email to Ezra to get him to explain it to you. It couldn't hurt. But be nice and don't pretend that you know about this stuff, because you don't. Just write a brief message that you're someone with a medical condition who needs insurance and wanted to learn how the exchanges will work and whether insurers will be able to avoid the system, and therefore ignore the regulations. It's an important topic that he might not have discussed, so it'd be helpful to get this info out.

If you sound nice and willing to listen, he'll help. But if you attack him, he'll ignore you, just like all of us ignored you when you attacked us. If you think calling us lying douchebags is a good way of getting people to listen to you, you clearly don't have a good understanding of human nature. Again, if this is your main sticking point, you need to stop arguing with me and start learning if you're right. You might be getting good insurance soon and you don't even know it.

And your name doesn't instill the most confidence in what you're saying. This better not be a myth.

urban legend has been posting here since long before you showed up.

"Tlaloc - Again, the provision you're complaining about might not even be in the bill we're discussing."

Well since the exchange thing was your big argument why don't you find out exactly what is in there and get back to me? You're the one whose argument critically depends on how the exchanges work, but you want me to take it on faith that they'll work how you imagine them working.

Not good enough.

" I'm telling you to go become an expert. Learn this stuff. Do research."

Why should I have to research YOUR argument? I make a point- "there's no enforcement inthe bill." You counter- "sure there is because we'll kick offending insurers out of the exchange." I reply- "that's not sounding like much of a threat given the resource you directed me to." And your response- "well why don;t you keep reading until you find something that supports my conclusion, and then let me know what that was, okay?"

Uh, no. You can damn well back up your own argument or admit you have no counter argument to mine. And why the hell are you so convinced the exchanges will work right when you admit you don't know much about them?

"If you sound nice and willing to listen, he'll help."

no, they won't. Look I didn;t start off this bitter and disgusted. 6 months ago I was a big fan of Klein, and Drum, and Benen. I've got blog posts I can point you to to prove it. but the fact is they've utterly refused to talk about the critics complaints in any way besides flat denial. I did try, back when I thought maybe there was something I was missing.

Steve, you claim that you are a "supporter" of a public option.

But you have been demanding loud and long that the House "pass the damn bill" -- meaning the Senate bill, which contains NO public option.

And you have been accusing the progressive House Democrats who insist on a public option of being fools, cowards and traitors.

How does that make you a "supporter" of the public option?

As far as I can tell, you are a "supporter" of passing something, anything, that can be labeled "health reform" so that Obama and the Democratic Party leadership can claim victory -- even if it is nothing more than a package of modest, likely ineffective regulations of the for-profit insurance corporations, at the price of requiring the taxpayers to guarantee and subsidize their profits.

urban legend has been posting here since long before you showed up.

I came here from Carpetbagger's and had been posting there for many years, and I consider this to be HIS blog, no matter what the masthead says. And I used to comment here even before that, but got bored with Drum and left. I was doing this shit before blogs were invented, so I don't know what you're talking about.

Secondly, I was just making a joke, as if he was posting an urban legend. I guess I could have worded it better.

Doc B.,

For the record, there's a difference between

a) gov't supplied services agencies such as the USPS and Medicare
b) gov't regulatory enforcement agencies such as the SEC or EPA.

The historical record shows it's relatively easy for Republicans to intentionally screw up B type agencies rather than A type agencies.

The PO is an instance of A. The exchange idea is an instance of B.

You're being obtuse to claim otherwise.

Dr. Biobrain, the difference between the non-profits referenced in the bill and the public option is that the non-profits would be run by private, non-profit entities -- either the national non-profit set up by the agency that negotiates insurance plans for Federal employees, or the state-level (or multi-state level by compact) non-profit cooperative plans owned by the customers -- while the public option would be run by the Federal government. I'm not sure "quasi-public option plans" would not be an accurate description, but while they put the lie to the hyper-progressives' hyperventilating claim that the legislation forces people into the hands of private, profit-grubbing insurance companies, these "quasi-public options," while non-profit, would not have the pool size or bargaining power of a true public option. It's still a valuable idea, but the best way to get it in place and give it the robustness it should have is to give it time to build its public support as a standalone bill. Progressive politicians will never let the public option die, and it will continue to build support. It will become harder and harder for the so-called "centrist Democrats" -- they aren't -- to oppose it if they want to survive future primaries.