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Next entry: What a weird way to be smug Previous entry: Unfunny conservative rejects liberal women, liberal women rejoice

House bill released

To no one’s great surprise, the House bill for health care reform includes a public option.  When Nancy Pelosi says something is non-negotiable, you’d better believe her.  In general, the bill is exactly what most of us thought it would be.  The big thing is the Health Insurance Exchange that would allow people who aren’t covered for whatever reason to buy insurance through the exchange, which would increase competition and drive down prices.  There’s also a mandate, which is uncomfortable but should help drive down costs. 

One big thing the bill does that will help a lot of people out is it not only bans denials based on pre-existing conditions, but it also bans premium increases.  This was a major concern of mine, because simply mandating that insurance companies cover everyone doesn’t really help that much, if they just jack the rates up on the people with pre-existing conditions.  The elimination on caps will also help people with catastrophic illnesses. 

What makes reading this summary of the bill really exciting is that not only did the House make sure to get the minimum basic decency standards covered, but they threw in a bunch of goodies on top of the necessities:

# Guarantees that every child in America will have health care coverage that includes dental, hearing and vision benefits.

# Provides better preventive and wellness care. Every health care plan offered through the exchange and by employers after a grace period will cover preventive care at no cost to the patient.

# Increases the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.

If you think about it, moves like eliminating the co-pay on preventive care will save a lot of money over the long run, because it will encourage people to get that preventive care.  For instance, I got the flu shot yesterday and balked slightly when they said it was $25, because my insurance doesn’t cover it.  I did decide to get it, because I got the flu a couple years ago, and I was reminded of how bad it really is.  Plus, I missed SXSW, even with my wristband, because I didn’t feel up to going.  Imagine a world where the flu shot is free and available everywhere you go.  The enormous gains in productivity alone would make it worth it.

Of course, some things haven’t been hammered out yet, primarily because of this whiny fuckwad.  Representative Stupak has made it his life’s work to whine and whine until women who currently have abortion coverage with their insurance see that coverage disappear.  Stupak is either stupid or lying, because if his only concern is not using federal funds to pay for abortion, then the Capps amendment should satisfy him.  But he’s threatening to try to shut down the entire bill unless there’s a stiffer anti-choice amendment attached.  At which point, I have to assume that he wants to take away care, because the Capps amendment he objects so strenuously to doesn’t really affect abortion care one way or another.  I swear to god, his strategy for getting his way appears to be whining Pelosi to death.  This is where her status as the mother of five children really matters, I suppose, because I’m sure she’s learned to be strong in the face of all sorts of childish whining.

The irony in all this is that I think that a lot of Americans who have abortion coverage in their insurance plan don’t realize it.  As Amy Sullivan discovered, Focus on Family—-who is throwing a mega shit fit over “federal” funding of abortion under the Capps amendment, funding that doesn’t exist—-covers its employees through a company that, you guessed it, covers abortion.  I’ve joked to friends that most anti-choicers who are freaking out over this probably have insurance plans that cover abortion, but they probably just never thought about it.  The abortion freak-out is 100% red herring, an attempt to halt health care reform with bullshit tactics.  The result of all this coverage of the issue might be that a lot more people are made aware that insurance plans usually do cover abortion, and there might be an uptick in people billing their insurance companies for it.

 

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Posted by Amanda Marcotte on 12:34 PM • (68) Comments

Question:  Does it ban premium increases altogether, or does it just ban exorbidant increases?

Specifically, what I’m assuming is that there is some sort of mechanism that allows for increases based on inflation… $1,000 today isn’t going to be worth as much ten or twenty years from now.  I mean, it would be awesome if it was an outright ban, but I have a hard time beliving it doesn’t factor for general economic inflation.

Comment #1: DTG in STL  on  10/29  at  01:28 PM

Oh, one other question… is the rollout still 2013?

Strategically, and as a matter of basic real urgency, I think it sucks if that’s what we’re stuck with.  For starters, it would be probably yield more electoral dividends for Democrats next year and in 2012 if they can campaign on the results of this program.  If nobody can access it until 2013, it won’t be “real” to the everyday citizen when the next two election cycles come up.

But even more importantly, we need these changes sooner rather than later.  Yes, getting something in 2013 is much, much, much better than not getting anything at all, ever, but I just think that the 3 year window is gonna hurt a lot of people who could use this reform now.

Comment #2: DTG in STL  on  10/29  at  01:32 PM

My big question about the whole issue, both House and potential Senate versions, is what happens to people on Medicaid.  My partner is disabled and on Medicaid as a result, but Tennessee’s version of Medicaid is teh suxxor.  (Of course she can’t be on my insurance through my employer, that would make Jesus cry.)  Will she be eligible to participate in the exchange, or not?

Comment #3: elmo  on  10/29  at  01:36 PM

All in all, this bill makes me feel very hopeful.

Still, I am concerned with what the Senate is going to produce.  I don’t know whether Lieberdouche is just being an attention whore and bluffing, but the prospect that the Senate may be forced to kill the PO in their bill concerns me greatly right now - especially since Bayh, Nelson, and Landrieu all seem to be teetering on the edge of joining the asshole from Connecticut.

And I am concerned with how much of the House bill’s strongest assets the Senate will be willing to incorporate when the bill goes to reconciliation between the two chambers.

Comment #4: DTG in STL  on  10/29  at  01:38 PM

Plus, I missed SXSW, even with my wristband, because I didn’t feel up to going.

Horrific.  I have never been more for health care than I am today.  No one should miss SXSW, especially after scoring a wristband.

Comment #5: Zifnab  on  10/29  at  01:41 PM

The abortion freak-out is 100% red herring, an attempt to halt health care reform with bullshit tactics.

That’s all it’s ever been.

Whaa!  Abortion!  Give me tax cuts.
Whaa!  Abortion!  Increase military spending.
Whaa!  Abortion!  Cut government services.
Whaa!  Abortion!  Curtail civil rights.

It’s an excuse to pick through people’s medical records.  It’s an excuse to pillar good politicians.  It’s a great fund raising ploy.  And it is a completely neglected policy point whenever the Republicans aren’t in the minority.  Terri Shavio got more love from the GOP than any pile of embryos ever did.

Comment #6: Zifnab  on  10/29  at  01:47 PM

Bart Stupak used to be my grandmother’s rep.  She was really good at insulting politicians in two words or less.  She always voted for Stupak as the lesser of two evils, but she always said, “Well, Stupak’s no prize, but the alternative is worse.”

Comment #7: dopus dei  on  10/29  at  01:55 PM

I hope you Dirty Hippie, Left-of-Left, Ultra-Librul, SocialFascists are happy now…

America will go into slow agonizing decline as Freedom™ and Liberty™ are smothered under the soft, warm pillow of socialism, until we become just like those damn UroPeons.  I bet Tofu and Quiche sales will skyrocket as we all become homosexuals…

Comment #8: MikeEss  on  10/29  at  02:06 PM

I suppose I’ll take it (no room at all to water it down further, though.) But really, it’s a piece of crap that runs the risk of merely extending the life of a horrible system and fending off real reform yet longer. So please don’t expect me to get all enthusiastic.

Comment #9: Steve LaBonne  on  10/29  at  02:13 PM

MikeEss FTW!

Comment #10: jackspratt  on  10/29  at  02:17 PM

Even if they do realize their abortion is covered in their insurance policy, they may choose not to use it.  I was covered for mine, but I didn’t file for it.  It’s weird, I was only in my 20’s but something inside me balked at having a paper trail of my abortion.  I don’t know why.  But I didn’t use it.

Comment #11: JennyLI  on  10/29  at  02:21 PM

Mike I have been trying to become a homosexual all my life but it just hasn’t taken!  All I can say is, I hope you are right!

Comment #12: JennyLI  on  10/29  at  02:26 PM

It’s weird, I was only in my 20’s but something inside me balked at having a paper trail of my abortion.  I don’t know why.  But I didn’t use it.

I might have some insight here.

I suspect that you didn’t use it for the same reason anyone who has abortion coverage in her health insurance policy doesn’t use it:  The information is NOT secure.

That’s right.  I said it.  And I’ll say it again:  HIPAA is a farce.  It is of absolutely no effect when it comes to the decisions of private health insurance companies. Your health information is never secure so long as some bureaucrat at an insurance company (euphemistically named “actuarial”) can access it, analyze it, and base coverage decisions on it.  Never mind the fact that health insurance companies WILL report back to employers who make premium contributions to these plans.

So, not only did you have an abortion and everyone at your health insurance company knows about it, they will share that information with your employer’s HR department, and with any health insurance company that you should choose for future coverage if you ever leave the current insurance company.  This behind-the-insured’s-back reporting is what’s euphemistically termed “proof of insurability.”

Seeing as how the right to obtain an abortion is rooted in the first amendment principle of privacy, the only way a woman can avoid having her privacy violated is to pay for the abortion procedure out of her own pocket, such that there is no paper trail at an insurance company.

And we all know that making abortions unaffordable is just one of the ways that insurance companies and big pharma work with conservative political elements to limit access to abortion only to those who can afford to pay cash out of pocket. 

It’s essentially a form of de facto descrimination based on class, with abortions granted to relatively affluent women, while women from economically disadvantaged backgrounds are forced to carry unwanted pregnancies to term.  This discriminatory treatment of pregnant women functions to keep the market for adoptable infants up, and to enlarge the pool of economically disadvantaged young people who, in a couple of decades, will be shuttled off to the military as cannon fodder, or to the penitentiary, at great profit to the prison contractors.

Comment #13: Mezosub  on  10/29  at  02:48 PM

was Stupak the guy on hardball last night?

Tweety was busy being a concern troll when his other guest shot him down with “what? Medicaid is only supposed to pay Drs. Who work at Catholic hospitals?”

Comment #14: jefft452  on  10/29  at  02:49 PM

Back in the 80’s I knew a fellow who was in the insurance biz. He told me then that insurance companies used electronic means to keep track of people and their health care ostensibly to prevent fraud. I have no doubt that it was to have a running record of all of an individual’s medical care accessible to all insurers.

Also, abortion is a legal medical procedure. Too fuc&^%$ bad if someone doesn’t like it. I don’t much like the idea of organ transplants. I think that they are unethical but do I get to impose my will on people who don’t think as I do? Of course not. Why do the anti-choice screamers get to make any impact on what procedures will or won’t be covered? If they get to do so, will everyone get to prohibit their least favorite medical procedure? Taken to it’s illogical limit that could be pretty severe. What if Christian Scientists or Jehova’s Witnesses get to weigh in….the results well, you know.

Comment #15: Therealhellkitty  on  10/29  at  03:00 PM

I suppose I’ll take it (no room at all to water it down further, though.)

This is only the House bill.

The Senate has yet to produce their final bill, but when they do, rest assured that it will be less progressive than this.  And once both bills pass each house, they go to conference, and have to merge it into one final bill that can pass both houses of Congress.

I can virtually guaranfuckintee you that this will be watered down some more before all is said and done.  The question isn’t whether or not it gets watered down, but rather how much does it get watered down.

Comment #16: DTG in STL  on  10/29  at  03:07 PM

“Why do the anti-choice screamers get to make any impact on what procedures will or won’t be covered? If they get to do so, will everyone get to prohibit their least favorite medical procedure? Taken to it’s illogical limit that could be pretty severe. What if Christian Scientists or Jehova’s Witnesses get to weigh in….the results well, you know.”

...this is why we can’t have nice medical care in America — some people just ruin things for everyone else by getting abortions, blood-transfusions, and depending on mortal doctors for care instead of the all-mighty power of prayer to a Christian God…

Comment #17: MikeEss  on  10/29  at  03:10 PM

I don’t much like the idea of organ transplants. I think that they are unethical but do I get to impose my will on people who don’t think as I do?

Just out of curiosity, why do you believe them to be unethical, if both donor and recipient are willing participants in the procedure?

I don’t really have any strong opinion on the issue, just not sure I understand the reasoning for viewing it as unethical.

Comment #18: DTG in STL  on  10/29  at  03:13 PM

There’s also a mandate, which is uncomfortable but should help drive down costs.
One big thing the bill does that will help a lot of people out is it not only bans denials based on pre-existing conditions, but it also bans premium increases.

If you’re going to have a law that gets rid of the troubles with pre-existing conditions and rate increases as methods for forcing insurees to continuously pay into the pool in times of health, then you need a mandate else people could just not carry insurance until they got sick, injured, etc., and could then get the benefits without ever having to pay premiums for longer than it took to treat their issue.  It just wouldn’t work.

Comment #19: Tim P.  on  10/29  at  03:41 PM

The mandate will be found unconstitutional. The other provisions will bankrupt insurance companies, and everyone will lose their coverage and be forced into the public system. Which is probably what many want to see happen, anyway.

Seems a dishonest way of getting it, though.

Comment #20: Alkaloid  on  10/29  at  03:46 PM

“Just out of curiosity, why do you believe them to be unethical, if both donor and recipient are willing participants in the procedure?”

The current system tends to save the rich at the expense of the poor, though I don’t know if that’s Therealhellkitty’s objection.  The obvious remedy to that one is universal health care, more aggressive pro-donation campaigns, and knocking it off with the hand-wringing and pearl-clutching about stem cells, though, not “No more organ donations!”.

Comment #21: preying mantis  on  10/29  at  04:03 PM

The mandate will be found unconstitutional.

I have an honest question, because I’m not a constitutional scholar, and I’m particularly clueless when it comes to the constitutionality of commerce-type issues such as this.

I’ve heard a lot of people make the claim that the mandate will be deemed unconstitutional.  And I am certain that if this bill passes and is signed with a mandate, somebody will immediately file suit testing its constitutionality.  On what specific grounds will SCOTUS find the mandate to be unconstitutional?

I’m not thrilled about the mandate, but at the same time, I realize that if you remove pre-existing conditions clauses, cap premiums, and uncap coverage limits, it will create a financially untenable situation for the health insurance industry if they aren’t given a much bigger pool to work with.  Otherwise, everyone would only sign up for insurance when they get sick, and then drop it once they get healthy again, and this would go on ad infinitum.

Comment #22: DTG in STL  on  10/29  at  04:08 PM

The current system tends to save the rich at the expense of the poor, though I don’t know if that’s Therealhellkitty’s objection.

Yeah, I certainly find that to be unethical… but as you said, I kinda got the impression that TRHK’s objection was to the actual procedure itself, not the socioeconomic circumstances surrounding it.

Comment #23: DTG in STL  on  10/29  at  04:12 PM

”The current system tends to save the rich at the expense of the poor”

Not as much as you might think, which is why libertarians want to legalize organ buying

A few high profile cases like Gov Casey give that impression but overall its at least as equitable as anything else in this country
Your wait time is more dependent on what organ you need then how much money you have
For example kidney/pancreas from the some donor most donated pancreas’ will do
But a pancreas from a different donor they have to be really picky about the quality of the pancreas

(unless that’s changed in the last 5 yrs)

Comment #24: jefft452  on  10/29  at  04:54 PM

I kinda got the impression that TRHK’s objection was to the actual procedure itself,

How is it so important if it is? She doesn’t have to explain herself to us, particularly when the whole gist of her argument is that personal moral compunctions should not policy decisions make.

Some people consider any non-reconstructive plastic surgery immoral. Talk to a white woman without kids who wants to get sterilized and you’ll find out how many people consider *that* immoral. I’m an organ donor (most of us who ride motorcycles are, I think it’s a superstitious thing), and she’s totally welcome to her opinions. It’s not like I’m going to lose sleep tonight because TRHK doesn’t want my kidneys.

Comment #25: Mighty Ponygirl  on  10/29  at  04:59 PM

“This discriminatory treatment of pregnant women functions to keep the market for adoptable infants up, and to enlarge the pool of economically disadvantaged young people who, in a couple of decades, will be shuttled off to the military as cannon fodder, or to the penitentiary, at great profit to the prison contractors.”
Comment #13: Mezosub on 10/29 at 01:48 PM

Twenty years ago—maybe even just ten—I would have considered this the raving of a schizophrenic.
Now it’s likely that this is actually underrepresenting the reality.  (Mezo, you left out breaking the unions, and allowing corporations to undercut minimum wage and other labor protections for everyone, but especially for women and people of color, and to trash the environment without obstacle or consequence, among others.)
If that’s the case, then the question becomes:  is this just the way things are, and certain powers—politicians, investors, corporate management—have learned how to exploit it?  Or is there conscious design and cooperation in creating the situation—ie, an actual conspiracy.
It’s terrifying to realize that this question is even worth asking.

Comment #26: smartalek  on  10/29  at  05:09 PM

I echo DTG in STL’s question: Why would the mandates be found unconstitutional? I could see an as-applied challenge possibly, mayber succeeding where a religious plaintiff claims s/he is forced to pay for coverage of medical services that are against his or her religious beliefs. But how would the mandate be unconstitutional on its face?

Comment #27: Luke  on  10/29  at  05:26 PM

Comment #1: DTG in STL on 10/29 at 12:28 PM

Question:  Does it ban premium increases altogether, or does it just ban exorbidant increases?

Specifically, what I’m assuming is that there is some sort of mechanism that allows for increases based on inflation… $1,000 today isn’t going to be worth as much ten or twenty years from now.  I mean, it would be awesome if it was an outright ban, but I have a hard time beliving it doesn’t factor for general economic inflation.

My guess is that what’s meant by “banning premium increases” is to ban the insurers from bumping up your rate when they learn new information about your health.  For example, forbid them from bumping up your rate once they discover that you have a congenital illness that wasn’t known when you signed up.

Comment #28: sacundim  on  10/29  at  05:34 PM

I kinda got the impression that TRHK’s objection was to the actual procedure itself

How is it so important if it is? She doesn’t have to explain herself to us, particularly when the whole gist of her argument is that personal moral compunctions should not policy decisions make.

Just curiosity, that’s all.

I have never heard of anyone having ethical issues with organ donation before.  It doesn’t make sense to me… not that I think she’s a bad person for having an ethical disagreement with it, it’s just nothing I’ve ever heard of before.  I mean, I’ve heard of people having ethical objections to abortion and vaccinations, and while I don’t agree with those positions, I understand why people have them.  Or even certain Christian denominations who are opposed to all medical treatments… I understand why they object, even though I find their reasoning silly.

But I’ve never heard of someone having ethical objections to organ transplants (except for people who are opposed to all modern Western medical procedures), and I was wondering how one arrived at a place of ethical disagreement about a seemingly non-controversial procedure.  Not looking for a fight or trying to prove someone wrong, just wanting to understand the thinking, seriously.  And it was out of sheer curiosity, honest… the same curiosity I would have if somebody said that they were ethically opposed to defibrillator machines.

Anyway, you’re right, she has no obligation to answer, and if she doesn’t want to, that’s fine.  Just wondering about a viewpoint I have never heard of before, that’s all.

Comment #29: DTG in STL  on  10/29  at  06:00 PM

DTG, for what it’s worth, I was curious too.

Comment #30: elmo  on  10/29  at  06:05 PM

SmartAlek, I think it’s more that the pattern was designed during feudalism and colonial slavery, and it has remarkable staying power even though the law’s no longer completely on its side.  The corporation’s the descendant of the feudal lord, and for-profit prisons the descendant of the workhouse.

Comment #31: Maureen  on  10/29  at  06:18 PM

If that’s the case, then the question becomes:  is this just the way things are, and certain powers—politicians, investors, corporate management—have learned how to exploit it?  Or is there conscious design and cooperation in creating the situation—ie, an actual conspiracy.
It’s terrifying to realize that this question is even worth asking.

I’m glad you asked, smartalek.

I tend to favor concious design and cooperation in creating the situation.  Conflict Theory gives us a pretty decent explaination of why, which is that the bourgeoisie (mostly capitalists, investors, corporate management) NEED a captive pool of cheap labor if they are to show increased profits each quarter and keep firms from going out of business. 

Conflict theory is basically an examination of the social struggle between those who have control of the means of production attempting to realize maximum exploitation of those who must sell their labor in the market because they have no capital (the proletariat).  It creates a situation where management must violate labor regulations and operate production facilities in an unsafe/inefficient manner because following the rules is just too expensive.  In practice, it’s the difference between CEOs who get paid 400 times the average workers’ compensation, and those who only get paid 200 times as much. 

Of course, the bourgeoisie purchase politicians, via campaign contributions, who will make, amend, and maintain laws that favor corporate interests.  The immigration code is a perfect example:  Instead of punishing the firms who offer employment to undocumented workers and thereby violate minimum wage laws and employment verification regulations, law enforcement agencies are authorized to round up the workers and deport them.  As any fool can see, the workers wouldn’t have been working there but for the firm violating the labor laws in the first place.  Still, the firm is never held accountable for its lawlessness.  The proletariat workers are the ones who must bear the punishment for the bourgeoisie firm’s wrongdoings.

Why?  Because the firm had the laws written that way. 

Because the firm went to the expense of having the politicians write the laws to punish workers for the firm’s lawbreaking, the firm has demonstrated intent.  If prosecuted criminally, this could also be evidence of “malice aforethought,” meaning, the chips didn’t just fall where they did via legislative processes.  The firm actively planned the outcome (conspiracy), then instructed their lobbyists to pay the politicians (bribery) to ensure that particular outcome.

In my post above, I’m basically saying the same thing about controlling abortion via eliminating coverage for it.

Comment #32: Mezosub  on  10/29  at  06:20 PM

marx and hegel are clapping madly in their graves!

Comment #33: cpinva  on  10/29  at  06:25 PM

cpinva: Are you saying that you exhumed their bodies, had sex with them, and gave them gonorrhea?

You sick fuck!

Comment #34: Mighty Ponygirl  on  10/29  at  06:27 PM

Mezosub: I don’t consider that a demonstration of intent or design. Complex systems evolve all the time in nature without a designer. The prole vs bourgeoisie inevitable conflict is inscribed in the system of capitalism itself, and how plusvalue is divided. Wages and Profit are taken from the same pool. Sure, you can make the pie bigger, but you still need to cut it, and both factions want to have the largest share.

We may be bound by this system, but so are they. If a CEO refuses to cut corners to maximize profits, he is disposed of. According to his fiduciary responsabilities to the shareholders, he might even get sued for it. If a company refuses to send lobbyists in Washington, its competitors won’t make that mistake. This complex system of incentives results in certain behavior being favored. I don’t think the greedy created this system. I think the system created the greed.

Like Jack London wrote in the Iron Hell, “they are so tied up to the machine that they sit on top of it”.

Comment #35: BlackBloc  on  10/29  at  06:47 PM

<ot>
@Mighty Ponygirl
No, THRK doesn’t ‘have to explain herself’ - that doesn’t mean it’s somehow taboo to ask someone who’s expressed a novel viewpoint to expand upon it (in which case, it matters what her objection is, obvs). I would also be interested to hear what moral objections someone has to the procedure - I’m open to the idea that I may have overlooked something, and I’m also just curious what other people think about things. However, since it’s kind of a tangent, I would also understand if people wanted this discussion to happen someplace else.
</ot>

Comment #36: jalmondale  on  10/29  at  06:48 PM

Of course, the reality is that it’s probably more of a feedback loop, with it feeding on itself ad nauseam, and we’re both right. wink

Comment #37: BlackBloc  on  10/29  at  06:49 PM

BlackBloc:

Just because the capitalist system evolved without a designer per se does not mean that rational actors should allow the exploitation and corruption to proceed unabated without complaint.

The point I’m getting at here is that our economic and political systems are specifically designed to enrich firms via the exploitation of workers, but that doesn’t mean we should continue in this vein.

There are plenty of areas for improvement, and a veritable laundry list of regulation and oversight adjustments that could ease some of these disparities between rich and poor, for the greater good of the whole society. 

What I’m suggesting is that we attempt to leverage those adjustments such that a greater number of individuals see a greater percentage of their own efforts come back to them in the form of social benefits, rather than being leached off by government bureaucrats and turned into corporate welfare.

After all, Exxon Mobil has been posting record profits the last few years.  Their CEOs make so much money (and pay such a small percentage in taxes) that they certainly don’t need any of my piddly little compensation.  They already got theirs.  I’m asking when the rest of us workers are going to get ours.

Comment #38: Mezosub  on  10/29  at  07:04 PM

Mighty Ponygirl ftw!

Comment #39: Caren-Sun-blocking Creator of Animorphic Pancakes  on  10/29  at  07:07 PM

Maureen, I would argue that corporations are WORSE than a feudal lord.  Milord wants his peasants submissive and hardworking, but he also wants them healthy and contented and fully committed to their place in the world, not wandering around disaffected and surly.  The Man wants a large body of the unemployed and desperate that he can hire and fire at will, without needing to look after the idle population.

Milord wants low unemployment and gives to the Church so it can look after the poor.  The Man wants high unemployment and for the poor to suffer badly.

Comment #40: Dr. Psycho  on  10/29  at  07:18 PM

BlackBloc, are you and I the only ones here today who have read “The Iron Heel”...?

Comment #41: Dr. Psycho  on  10/29  at  07:20 PM

On what specific grounds will SCOTUS find the mandate to be unconstitutional?

I’m not any kind of lawyer and my knowledge of the Constitution pretty much is what I got out of civics class, so this isn’t definitive, but I’ve heard from much more knowledgeable friends that there are a couple of basic ways that it could fall apart in court. I suspect those friends were mostly going off of this WaPost article.

10th amendment would be one possibility. There’s nothing in the constitution about health care, and nothing in there that gives the impression that the federal government is empowered to require the purchase of a consumer good. But 10th amendment suits don’t have a great history of success from my understanding.

Inapplicability of the commerce clause would be another possibility. Basically most economically-related bills these days say something about how this law is pursuant to Congress’ exercise of its powers to regulate commerce among the states, blah blah. The Court has booted a number of laws where the connection to interstate commerce was weak; this seems like a pretty good example of that.

Comment #42: Alkaloid  on  10/29  at  07:21 PM

“they will share that information with your employer’s HR department”

Mezo, at the time I didn’t know much, and yet I still worried about exactly this.

You’re right.

Comment #43: JennyLI  on  10/29  at  07:46 PM

Dr. Psycho - the “keep peasants healthy” idea may have been motivated by the fact that between the Black Death and the eighteenth century Agricultural Revolution there simply weren’t that many peasants.  If you worked your peasants to death it was hard to find new ones; additionally, many peasants died of whatever disease was going around Europe at the time.  The eighteenth century’s increase in population (which scared the hell out of Malthus) and the nineteenth century’s improvements in medicine, sanitation, and autonomization created a huge labor surplus - and when you think about all the crap we’re encouraged to buy just to reduce unemployment we’ve still got a huge labor surplus.  I’m fairly certain that our country could produce enough goods and services for a comfortable middle-class lifestyle for all inhabitants of America, with sufficient tradegoods for items it’s inefficient to produce here (coffee, tea, etc.), for 75% or less of the workhours we do now.

Comment #44: Maureen  on  10/29  at  07:49 PM

“I’m fairly certain that our country could produce enough goods and services for a comfortable middle-class lifestyle for all inhabitants of America, with sufficient tradegoods for items it’s inefficient to produce here (coffee, tea, etc.), for 75% or less of the workhours we do now.”

But what about the builders and staff of immense mansions, limousine makers and drivers, private jet makers and pilots, and the makers of exotic Italian, German, and British supercars?  If we don’t have an overclass in America <strike>stealing from all of us</strike> working hard to earn their fabulous wealth and then spend it frivolously, how will those people survive?

Won’t somebody consider the plight of the extremely wealthy in America if we become economically fair?...

Comment #45: MikeEss  on  10/29  at  08:19 PM

Yeah, at least a lord needs a healthy population in order to get his men-at-arms from.

...Not that I support feudalism in any way, mind you.

Comment #46: Crissa  on  10/29  at  08:20 PM

I’m fairly certain that our country could produce enough goods and services for a comfortable middle-class lifestyle for all inhabitants of America, with sufficient tradegoods for items it’s inefficient to produce here (coffee, tea, etc.), for 75% or less of the workhours we do now.

And you’re basing this on what economic analysis exactly?

Even the soshulisticic Europeans can’t manage that.  Yes, they can mandate sick leave and one-month vacations and can just generally have more laid back attitudes toward work.  Many of them have also greatly reduced the gap between rich and poor, but they still have to work roughly 40 hours a week.  And I can assure you that they don’t buy nearly as much of the worthless crap that we do.

you think about all the crap we’re encouraged to buy just to reduce unemployment we’ve still got a huge labor surplus.

What huge labor surplus is that?  Even in the best of times, 6 percent is well within range of people who are marginally employable or are between jobs.  The lowest unemployment this country has ever seen was 3 percent.  I’m not seeing a “huge” surplus.

Comment #47: keshmeshi  on  10/29  at  08:39 PM

Glad y’all mentioned labor surpluses, work hours, and consumption.  I never pass up an opportunity to encourage people to read The Gospel Of Consumption:  http://www.orionmagazine.org/index.php/articles/article/2962/ 

It’s a long article but well worth it.  People are working themselves to the bone because the titans of industry decided it needed to be that way and put the kibosh on business concepts that would increase leisure time and provide full employment for everyone over 70 years ago.

Comment #48: DonnaDiva  on  10/29  at  08:39 PM

“A few high profile cases like Gov Casey give that impression but overall its at least as equitable as anything else in this country “

In other words, it’s not really terribly equitable at all?

Comment #49: preying mantis  on  10/29  at  09:22 PM

What huge labor surplus is that?  Even in the best of times, 6 percent is well within range of people who are marginally employable or are between jobs.  The lowest unemployment this country has ever seen was 3 percent.  I’m not seeing a “huge” surplus.

I’m confused.

Right now, unemployment in California is hovering around 10%.  And those are just the ones who are actually filing for benefits.  For everyone that is getting a UI check, there are two or three unemployed people who aren’t.  That’s a HUGE labor surplus.

Also, you have to take into account corporate policies like discrimination against felons who have successfully completed parole.  Whether they’re qualified or not, nobody has to ever hire them, because it’s not unlawful to discriminate against them in employment.

Comment #50: Mezosub  on  10/29  at  09:31 PM

What huge labor surplus is that?  Even in the best of times, 6 percent is well within range of people who are marginally employable or are between jobs.  The lowest unemployment this country has ever seen was 3 percent.  I’m not seeing a “huge” surplus.

Are you asking about surplus available labor (i.e. the people unemployed, available to work), as your points about the unemployment rate suggest, or surplus labor available (i.e. the amount of work that is available to be done), which is what I think the point was about in the first place?

I’m reading the original assertion as “if we streamlined things to get rid of all the labor (work) that doesn’t need doing or doesn’t need doing by humans, including the production of various types of crap that have nothing to reccommend their existance, we could produce enough with drastically fewer man-hours of labor, and divide these man-hours among the labor force so that each person works fifteen or twenty hours a week (or whatever) to produce enough goods and services for us to maintain our current quality of life.”

Comment #51: Kyra  on  10/29  at  09:39 PM

Wait, cancel that, on rereading I think I read it wrong.  Both, however, are technically true—-we have a whole lot of people producing worthless shit which people consume without really thinking about it, and we have a whole lot of people who need work to make money.

The ideal solution is to divide the work fairly among the people who need work, and fuss with the compensation system so that people don’t need to work 40 hours and more a week to provide themselves with decent quality of life.

Comment #52: Kyra  on  10/29  at  09:47 PM

Inapplicability of the commerce clause would be another possibility. Basically most economically-related bills these days say something about how this law is pursuant to Congress’ exercise of its powers to regulate commerce among the states, blah blah. The Court has booted a number of laws where the connection to interstate commerce was weak; this seems like a pretty good example of that.

Why would it be inapplicable to regulate companies that operate in multiple states like Blue Cross, HealthNet, Cigna, Aetna, etc.?  If that were the case, then Safeway wouldn’t have to submit to any federal regulation for their grocery stores because they operate under different names in different states.

Of course, it was apparently perfectly legal for Pacific Gas & Electric to transfer all of their profits to their parent company and then claim they were on the verge of bankruptcy because they had no money, so you may be right that Blue Cross would be able to argue that since they have separate Blue Cross offices in different states, they should all be treated as separate companies.

Comment #53: Mnemosyne  on  10/29  at  10:00 PM

If this is unconstitutional, it seems pretty clear that social security and medicare have to go too. So I wouldn’t worry much.

Comment #54: paul  on  10/29  at  10:21 PM

America will go into slow agonizing decline as Freedom™ and Liberty™ are smothered under the soft, warm pillow of socialism, until we become just like those damn UroPeons.  I bet Tofu and Quiche sales will skyrocket as we all become homosexuals…

Yup - you’re buggered now.

Um, let me rephrase that…

Comment #55: Phoenician in a time of Romans  on  10/29  at  10:39 PM

“If this is unconstitutional, it seems pretty clear that social security and medicare have to go too. So I wouldn’t worry much.”

The main sticking point I see with that is that SS and Medicare are government-administered.  You pay your taxes to the government, and the government administers a program with them.  That’s a bit different than the government decreeing that you have to go enter into an individual, private contract and give a load of money to a private company with nebulous guarantees that you’ll get what you pay for but absolute guarantees that the government will bust your ass if you don’t pay.  I don’t know of any similar situation, really.  Even in states that mandate car insurance, that’s not a universal; it’s a condition for driving—which is still considered a privilege rather than a right—not a condition for living in that state.

Comment #56: preying mantis  on  10/29  at  10:43 PM

Mantis:

Medicare contracts with HMOs. And no one was saying that privatizing social security (handing the money over to brokers) could be unconstitutional. And finally, you don’t have to pay an insurance company if you really don’t want to; you can just kick in a surtax…

Comment #57: paul  on  10/29  at  10:50 PM

“And no one was saying that privatizing social security (handing the money over to brokers) could be unconstitutional.”

Which is unfortunate, because if there’s anything that should have gotten somebody tarred and feathered….Again, though, that’s the government going and contracting with someone.  The government is assuming responsibility.  If that someone doesn’t perform, presumably they’re answering to the government, which is a rather greater force to be reckoned with than Josephine Blow of 123 Fake St., Boise.

I suppose we’ll find out for sure when the inevitable lawsuit is filed.  Honestly, it seems like it would be a lot simpler to institute a real universal healthcare system, levy a general tax to support it, and then let the private insurers sort themselves out in the face of a legitimate alternative.

Comment #58: preying mantis  on  10/29  at  11:03 PM

“But even more importantly, we need these changes sooner rather than later.  Yes, getting something in 2013 is much, much, much better than not getting anything at all, ever, but I just think that the 3 year window is gonna hurt a lot of people who could use this reform now.
—Comment #2: DTG in STL on 10/29 at 12:32 PM”

Unfortunately for us, the Teabaggers have already said exactly what they’re going to do. They know that stuff like this will make the public happy, so they’re banking on that delay. If they can make gains, &/or recapture the majority in the next two election before 2013 (due to a perceived inability of the Dems to do anything helpfull), the ‘Baggers game plan is REPEAL, REPEAL, REPEAL.

They want to reverse and destroy any progressive gains, like Hate Crimes and Health Reform, preferably before anyone actually sees any real benefits from it. The Conserva-trolls oh the blogs like to brag about just that outcome.

Comment #59: KMac  on  10/30  at  12:42 AM

The main sticking point I see with that is that SS and Medicare are government-administered.  You pay your taxes to the government, and the government administers a program with them.  That’s a bit different than the government decreeing that you have to go enter into an individual, private contract and give a load of money to a private company with nebulous guarantees that you’ll get what you pay for but absolute guarantees that the government will bust your ass if you don’t pay.  I don’t know of any similar situation, really.  Even in states that mandate car insurance, that’s not a universal; it’s a condition for driving—which is still considered a privilege rather than a right—not a condition for living in that state.

Yeah, that appears to be the sticking point with the constitutionality issue.

Although, the argument they’ll make is that they aren’t forcing anybody to buy insurance… if you don’t buy it, you can just pay the extra 2.5% income tax (I believe that’s the figure in the bill).

Further, rather than calling it a tax penalty for not buying insurance, they could just say that they are raising everyone’s taxes, but those who purchase insurance will be elegible for a deduction.  And that would be perfectly constitutional.  Think of it this way… the government doesn’t penalize anyone for not buying a hybrid automobile, but they DO reward people who buy them, in the form of tax deductions.  And just the same here, if they frame it correctly, they could set it up as a deduction for those who purchase insurance rather than a penalty for those who don’t.  That would, however, require that they raise everybody’s taxes in the beginning to get to the necessary baseline - those who buy insurance get the deduction, which effectively nullifies the tax increase.

It’s sneaky as hell, but I think that would possibly work in terms of constitutional muster.  But I don’t think that’s what they have in mind in regard to implemetation of the mandate.

Comment #60: DTG in STL  on  10/30  at  03:24 AM

#53 - there’s nothing unconstitutional about regulating insurance companies. It’s the requirement for private citizens that are problematic.

#56 - exactly, and in many states you can even get out of the insurance requirement by putting up a bond the same size as the minimum insurance liability amount.

#58 - yep, me too. We’d probably end up with a healthy insurance industry that would be significantly smaller and that focused on providing additional benefits in areas where the public system wasn’t world-class, or in covering things like mental health that are only very sketchily covered.

#60 - maybe that would get past the Court but it would make selling the plan in Congress nearly impossible, and it would also raise a lot of questions in many voters’ minds. (“Wait, so you knew what you were trying to do is unconstitutional, so you tried legal trickery to get around that…I’m not sure that’s really cool, man.”)

This issue is why many people started off with saying that a health care reform that left things mainly being done by private industry wouldn’t work. If we’re going to socialize medicine, then let’s get some damn socialized medicine up in here. This public-private bastard hybrid looks to me like it’s going to make things worse, and much more confused, not better and easier.

Comment #61: Alkaloid  on  10/30  at  03:36 AM

Honestly, it seems like it would be a lot simpler to institute a real universal healthcare system, levy a general tax to support it, and then let the private insurers sort themselves out in the face of a legitimate alternative.

Absolutely that would be the simplest, best, and most logical plan.

But until we get MASSIVE campaign finance reform in place, that will never happen.  The insurance companies will always have a rather large seat at the Congressional table - and they are benefactors to politicians in both parties - and as long as they get a behind-the-scenes voice in the debate, state-funded universal healthcare isn’t happening.

I know a lot of the progressive base was infuriated when it was made clear early on that universal healthcare was never going to be considered an option.  I was too.  But there’s a reason for why that happened.  More specifically, 535 reasons.  Most of them are beholden to the industry to varying degrees - the insurance lobby donates to practically EVERYONE, even some of your favorite progressive congresscritters.  Many of those who aren’t on the insurance lobby’s payroll still have to deal with the fact that the insurance lobby will pump zillions into an opponent’s campaign if the kind and decent progresive congresscritter gets too far out of line or becomes a threat to them.  Sure, there are a few good folks in the chamber who genuinely want universal healthcare and aren’t afraid to push for it, but they are very few and far between.

It’s not a strictly Republican thing, as we’re learning with our supposed 60 Senate votes.  Sure, the GOP legislators typically get a bigger piece of the insurance industry campaign finance pie, but many, many Democrats are getting fed from that pie as well - including both Barack Obama and Hillary Clinton in their past campaigns.

And really, it isn’t even about people in Congress all all being horrible human beings… it’s about the system that they have to work with.  Wanna be a good, solid progressive and get elected to Congress but not sell out your soul?  Go find a district so completely blue that you can take the heat of a well-funded Republican opponent.  Oh, but wait… you still have to deal with the primaries.  Oops.

Case in point - Madame Speaker.  I actually really like Nancy Pelosi, but she isn’t the most progressive candidate available to her constituents.  Cindy Sheehan, as eccentric as she may be, seems to have much stronger core progressive principles than Nancy Pelosi.  But she had no chance of winning that seat, and never will.  Why?  Because she can’t be bought by anyone.  And if you can’t be bought, you can’t win.  Because your opponent will have a lot more money to work with.  Yes, the best-funded campaigns don’t always win, but when they lose, it’s typically to a challenger who is at least in the same ballpark in campaign fundraising.  Staunch progressives can’t build up that kind of warchest, because nobody but plebes donate to them.

So that’s it.  Until there is earth-moving campaign finance reform (sorry, McCain-Feingold was helpful, but not nearly enough), don’t ever expect to see the most progressive pro-people options getting through Congress.  Because the most radically pro-people candidates don’t get elected.  Ever.  They can’t.  Not in this system, which is designed to keep that from happening.

Even the very bill that we’re discussing here is more progressive than what we’ll actually get when all is said and done.  Somebody said upthread that this bill would be passably acceptable, provided it isn’t watered down any further.  Too late.  It WILL BE watered down further, especially when it has to be reconciled with whatever garbage the Senate brings to the table.

Comment #62: DTG in STL  on  10/30  at  03:58 AM

“In other words, it’s not really terribly equitable at all?”

ouch
I walked right into that one didnt I?

Comment #63: jefft452  on  10/30  at  04:09 AM

cpinva: Are you saying that you exhumed their bodies, had sex with them, and gave them gonorrhea?

You sick fuck!
Comment #34: Mighty Ponygirl on 10/29 at 05:27 PM

Simultaneously or serially?

Comment #64: phylosopher  on  10/30  at  04:09 AM

#56 - exactly, and in many states you can even get out of the insurance requirement by putting up a bond the same size as the minimum insurance liability amount.

I believe that’s the case in every state.  Most millionaires and billionaires don’t have auto insurance (though they do frequently carry blanket umbrella policies which cover them for just about any sort of financial liability - lawsuit insurance, esentially).

The federal law which ties highway funding to driver financial responsibility only mandates that any licensed driver must have the financial ability to cover the state minimum coverage amounts while they are driving - not that they have to have auto insurance specifically.  If I have ten million dollars, I can just set aside $100,000 or whatever the minimum is and say, “that’s my insurance policy”.  You don’t have to be insured.  You just have to be able to cough up the minimum required coverage amount on the spot.

And minimum coverage policies don’t protect you from all liability, which you’ll likely find out if you crash into someone else’s very expensive automobile.  If your policy has a $10,000 limit for property damage and you total someone’s $60,000 sports car… they can sue you personally for the other $50,000 that your insurance won’t cover, and if the accident was clearly your fault, you’ll lose and have to cough up $50K.

Comment #65: DTG in STL  on  10/30  at  04:17 AM

@Maureen (#31) & Mezosub (#32), thank you very much.
I’ve just started Naomi Klein’s “Shock Doctrine,” and figure to give Zinn’s “People’s History of the US” another try next (couldn’t get thru it while in school, but I’m more patient, diligent, and engaged now).
Couple posters above referenced London’s “Iron Heel,” which is free from Project Gutenberg (yay).  I imagine Sinclair Lewis has something to say on this too.
And I clearly need to read Marx, or at least a “Marx for Dummies” knock-off, and Adam Smith (read enough citations of “Wealth of Nations” from both sides to conclude that the wingnuts are probably about as complete, accurate, and respectful of authorial intent in their appreciations of that work as they are with the New Testament—which is to say, a Kelvin zero).
Can anyone suggest any other reading you think might provide a good introduction to these issues?
tia, everyone, and happy hallowe’en.

Comment #66: smartalek  on  10/30  at  05:37 AM

Just because the capitalist system evolved without a designer per se does not mean that rational actors should allow the exploitation and corruption to proceed unabated without complaint.

Erm, guy, my *nickname* IS BlackBloc. I don’t think ‘without complaint’ applies to me. raspberry

I’m asking when the rest of us workers are going to get ours.

I got an answer for you but unless you’re a revolutionary you’re not going to like it.

Comment #67: BlackBloc  on  10/30  at  09:46 AM

Anyway, you’re right, she has no obligation to answer, and if she doesn’t want to, that’s fine.  Just wondering about a viewpoint I have never heard of before, that’s all.

I respect that and totally understand. I’m curious as well but I could definitely see how the reactions she was getting could be interpreted as the beginnings of a gangpile and didn’t want her to feel like she had stepped in a hornet’s nest by trying to use her own dislike of organ donation as an arguing point about why abortion should be covered.

Comment #68: Mighty Ponygirl  on  10/30  at  12:39 PM
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