Of course, for anyone actually involved in the negotiations to say something like this would be to guarantee that we get neither…

Of course.  And it’s still a strong possibility.  Hopefully, they’ll hold their cards close.

I would go with the public option as long as it includes contraception and pre-natal care.  Those two things would do more to prevent abortions than not funding abortions themselves.  But that wouldn’t make the forced birthers happy because you know, it’s alll about punishing teh sluts instead of the babeez.

Well, here’s the thing: the forced birthers are right wing nuts, at least 99% are.  This means two things: They are opposed to health care reform on the grounds that Other People will get to use it, and they have no compunction about lying.  This means that no matter what is in the bill, they will swear it’s a fetus-killing bill and tell their followers to mindlessly oppose it.  The bill could ban abortion outright, and they’d still say this, if there’s a chance that someone they put in the category of Other People gets their health care covered.

Remember how Stupak-Pitts made it into the bill in the first place?  Weiner agreed to withdraw his Medicare-for-all amendment if Stupak would withdraw his abortion amendment.  So Wiener withdrew his amendment, and Stupak got his amendment onto the floor and voted into the bill.

Just because Bart Stupak agrees to a deal, doesn’t mean there’s a deal.

At first it was healthcare reform.

Then it became health insurance reform.

Now the reform has been tossed, making it only mandatory health insurance.  Which may not cover much, if anything.  Which still costs too much.  Which you can still be denied or rescinded from.  With yearly and lifetime limits allowed.  And god help you if you have a vagina/uterus.

All this demonstrates the proles come last.  And poor female proles are the last of the last.

Outside of America, countries reform insurance.
In America, Big Insurance reforms the country…

Amanda - I have no idea what you, or Jeff Fecke, or Karoli is talking about.  The public option and medicare buy-in are dead.  They are not coming back.  There is not going to be any bargaining or trading off with respect to them.  That’s it.  They’re not going back into the bill.  If they do, Lieberman and Nelson vote to filibuster the conference report, and we get nothing.

As for Stupak, it seems incredibly likely to me that we’ll get the somewhat less egregious Casey-Nelson Senate version.  It seems highly unlikely that a bunch of mostly liberal-on-economics pro-life Democrats are going to kill the bill over the difference between the two, and, furthermore, the more conservative conference bill will probably win over some less liberal pro-choice Democrats who voted against the original, more liberal House bill, so you don’t need as many of the pro-lifers.  But if you give anything less than the Casey-Nelson version, Nelson is off the conference bill, so you basically have to give him at least that.

So, it seems to me pretty clear that abortion and the public option are pretty much the two things which are not up for grabs in the conference report.  Other things - national vs. state exchanges, level of subsidies, level of medicaid expansion, exact nature of regulations, funding, and so forth - may very well be up for grabs, but abortion and the public option just aren’t.

To pretend otherwise is just to court disappointment.  We’re getting the senate bill version for both of these.  We don’t get to choose.  Ben Nelson and Joe Lieberman have already chosen.

Amanda - What you are saying in comment #4 is true for Republicans, certainly.  But they’re all voting against the bill anyway because it kills grandma, or whatever other nonsense.  Pro-life Democrats are really a different animal entirely.  They’re generally from heavily Catholic districts, and they’re generally pretty liberal on non-abortion-related economic policy issues.  They’re still pretty awful on things relating to abortion, but they’re not just using abortion as an excuse to kill health care - it’s a genuine stumbling block.  Stupak is wackily pro-life, but he still voted for the house bill, as did many of the pro-life Democrats who helped pass the amendment.

jlk, we’re coming from the position that we have two houses of Congress.

I agree with you, and for the reasons you point out—access to affordable healthcare, including contraception, pre-natal care, and all that, means there will be fewer women needing abortions.  And then, for women who need abortions, they might have more money to pay for it, not having spent it all on expensive, useless health insurance, and other people will have more money to contribute to funds that help pay for those abortions, plus places like Planned Parenthood would less likely be in dire straights, since people wouldn’t need to come to them for non-abortion stuff as much. 

That doesn’t mean I’m particularly hopeful about this bill.  Just that, given a choice where one or the other would definitely happen, I’d go for public option, as long as it excluded only abortion, not women’s reproductive health in general.

i tend to agree with your position, for basically the reasons you iterated. as repellant as stupak-pitts is, it’s liveable (in the short-term) if the inclusion of a strong public option is the result. the next congress, with (hopefully) a veto-proof dem majority, can then drop-kick stupak-pitts.

for good measure, they could drop-kick the “gentlemen” themselves too.

Sorry to be glib, but look at it this way: progressives are being played by the mainstream media.  The MSM is pushing the notion that the House bill counts for nothing, because they know if they say it enough, it becomes true.  Progressives who help them out by repeating this belief are self-defeating.  Why should we join the mainstream media in killing the House bill?

I have very little faith that we will ever overturn Hyde.  The Beltway wisdom is that forced-gestationists have the moral high ground of wanting to protect baybeez, and that they can’t ever be hurt by slut-shaming.

While I’m always for all women having choice whenever, Stupak seriously fucks over women who want their babies and discover at the 20 week ultrasound that their fetus cannot live.  Terminating the pregnancy (and a woman is pregnant even if the baby fetus died) before it goes septic and endangers the woman’s life/health/ability to get pregnant again is the most responsible action, and most people think “health” provisions in laws protect that.

They do not.

Insurance companies will pay for a hysterectomy when a woman is septic, hemorrhaging, and dying.  They won’t pay before she is septic, b/c HER health is not actively in danger.  Women with Federal insurance already live this nightmare.

So it’s not a matter of getting $500.  It’s a matter of thousands.

I cannot support any bill that’s simply a mandate to buy insurance.  I’m pressuring Burris as hard as I can to filibuster Lieberman’s botched bill.  If Joe can have so much power by being an asshole, so can Roland.

Thank you, Amanda, for your thoughtful analysis of this really difficult issue.  Having spent the last week in really unpleasant e-mail discussions about whether or not this should pass, poor thing that it is, with me taking the pass it side because there are so many out there that it WILL help, and getting slammed for it, I appreciate your view a lot.  The people who were so upset with me were women, and supposedly progressives, but their take seemed to be “I have certain demands of this bill (in one case, a refusal to pay tax money to insurance companies, in the other, make my private non-group insurance bill go down right now and no restrictions on abortion coverage, period) and I will stop voting for Democrats if I don’t get it.”  Oh, yes, and “if you aren’t 100% with me, you are settling for less and a tap-dancer and if you don’t like my saying so, you should grow a thick skin like me.” 

We are trying to clean up the most enormous mess left by many years of right wing rule.  I figure since 1970 at least, and I am old enough to have seen a lot of this stuff happening.  I was born in 1943, and when I was a teenager and young woman contraception was illegal in my home state of Massachusetts, never mind getting an abortion.  The right has done all it could to increase poverty, decrease the middle-class, stop the women’s movement, etc.  And in my opinion made too many of the American people a rather ignorant bunch, no sense of history, no appreciation for diversity, and a thoroughly scared bunch of rabbits waiting for daddy to rescue them.

Thanks for a chance to rant.

I have very little faith that we will ever overturn Hyde.  The Beltway wisdom is that forced-gestationists have the moral high ground of wanting to protect baybeez, and that they can’t ever be hurt by slut-shaming.

Without trying, we will get nothing.  As has been demonstrated by Stupak-Pitts.

So it’s not a matter of getting $500.  It’s a matter of thousands.

For a few thousand women a year, compared to the millions who are facing serious financial pain if there’s a mandate with no real competition or price controls.  This, being a sheer numbers game, settles the question for me.  Thousands screwed versus millions screwed.  Thousands screwed over once, versus millions screwed over year after year. 

I’m not minimizing the issue of abortion rights.  I work for reproductive rights pretty tirelessly.  But if it comes down to this—-and there’s a strong reason to believe it will—-then we have to choose the many over the few.

Personally I see it as shit sandwiches all around. The idea of you guys getting anything less than what we get in Quebec, which I consider to be an improvable baseline, fills me with sadness.

But yeah, I guess that Amanda is mostly on point here. If you can get the public option this way it should be done.

Check out Stupak and McConnell working together with the Catholic Bishops over at Crooks and Liars.

http://crooksandliars.com/susie-madrak/stupak-working-mcconnell-stop-healthc

(Not trusting my html-fu)

the millions who are facing serious financial pain if there’s a mandate with no real competition or price controls.

There’s not going to be.

Obama has used Rahm and Joe to take the heat, but he signed a “secret” deal with Big Pharma months ago and has NEVER strongly supported the public option in any meaningful way.  They’ve backed off actively disparaging it when faced with liberal/progressive outrage, but they have never supported it (after the campaign, that is).

There’s no real competition without a public option, as many states are virtual monopolies now.  There’s not going to be a public option, b/c not enough people in DC give a shit about what the people want vs. the money they receive from the insurance companies.

There’s always been a majority of American citizens supporting the public option.  This should be a no-brainer if our representatives were representing us.  It’s taking so long b/c they are trying to give cover to themselves and pretend that they negotiated and that this mandated insurance with no public option was the best bill they could pass.

I’m not willing to say “Sure, let’s let Stupak in so we can pass the bill”.  I want fighting words the whole time.  I want a vote, and if Stupak shit is let in, I want people saying, “OK, for now.  But next session we’re fighting this again.”

Not. Gonna.  Happen.

I’m completely demoralized about healthcare right now, and think forcing them to continue covering abortion at the current rates is the best we can hope for because we’ve already lost the public option.  No one in DC takes the House bill seriously, just as it was always Max Baucus’ bill to write.

For profit insurance is a losing game, b/c they are already sucking too much money out of health care.  Left alone, the whole thing would probably fail in a decade as people wouldn’t be able to afford it and would negotiate on their own with medical providers. 

Now people are going to be forced to purchase for-profit insurance, propping up a failed strategy and continuing the pain.

What’s interesting to me is that is evidence that Stupak might not actually be, as I suspect he is, a covert agent working to kill health care reform.  Not that I ever doubted for a minute that his misogyny is sincere, but it’s been clear to me from the get-go that his Republican friends are using him a cover for their attempts to use abortion to kill health care reform.  And it seemed hard for me to believe he could be so dumb as to not see that he’s being used, and therefore, he must agree with their goals. 

But the Catholic Bishops actually want the bill to pass, if it’s got all these abortion restrictions, because Catholic hospitals stand to make a lot of money.  Working closely with them might mean that Stupak is closer to them in his opinions.

What savvy politickers need to get is this: if the Republicans are willing to use abortion to derail the conversation, then we need to ju-jitsu them with this, and turn it around so that’s the thing that we use to compromise and not the public option.  And I think that could work, because the Republican base is far more likely to be frustrated on the abortion thing than making their health care cheaper, after it’s all said and done.  Or, to be more clear, Republican voters are more likely to stay home because they’re pissed about abortion than because they’re pissed that the Republicans were unable to keep their insurance premiums nice and high.  So Republicans could, if they’re smart, be more motivated to choose the public option over abortion, too.

It pains me like a motherfucker to see women’s rights kicked around like this, but unfortunately, we can’t change that simply by being pissed at the politicians, who are responsive to issues they think move the voters.  To really get our way on this, and to have women’s rights stop being a political football, we need to change the public’s attitudes.  And refusing to admit this, and putting all our focus on politicians, strikes me as another example of how liberals are often short-sighted, impatient, and lazy.

Caren, if the public option wasn’t a threat to insurance companies’ profits, they wouldn’t have spent untold millions of dollars trying to defeat it.

I’m as pissed about Stupak-Pitts as anyone, but I’m not willing to convince myself that other concerns are not worth fighting for.

Amanda, I agree with Caren—Obama is hiding behind Holy Joe, but he’s made his priorities clear.

Do you think he’d veto a bill that undermines insurance profits?  Really?

Hey BlackBloc,

Where’s the 7$-a-day daycare for the rest of Canada?!* Minimum standards, my ass!

But the universal health-care and covered abortions are a good starting point. For us, the problems are more to do with access than will. I think that if it were possible to introduce a single-payer system in America, after a generation or two it would be impossible to imagine how you did without it. Private insurance still has a place here too; it funds dental care, counselling, physiotherapy and private/semi-private hospital rooms during stays.

*for those in the States, Québec’s position in the country is a point of contention, as the other provinces have been funneling money there for decades as an incentive to keep the province a part of Canada, resulting in Québec’s ability to massively subsidise daycare and provide large baby bonuses for growing families, which are not as generous elsewhere. Daycare for an infant in Ontario without subsidy is about $1400 a month. The federal one-year maternity leave (which I’m currently enjoying) at 55% of pay is fantastic, though.

“If they do, Lieberman and Nelson vote to filibuster the conference report, and we get nothing”

Then there is no mandate either, I’m with Dean, the Senate bill is worse then status quo, put the public option back in conferance and if Lieberman kills it then he kills it
but witout it I dont want it to pass

What about including easily accessible birth-control options, free pregnancy care and infant medical care?

That’s not really how it works, though there is some stuff in one version of the bill that includes free home visits to low income women for your first baby, to discuss basic baby care.  I think there’s clearly a lot of confusion about how this works.  What they’re going to do is set up a health care exchange that will set the basic minimum of coverage for insurance companies to participate.  It’s mostly good that it’s not hard written into the bill, and instead handled by bureaucrats, because health care is always changing.  So, say the FDA approves the upcoming herpes vaccine.  If it’s hard written what’s covered, then that wouldn’t be covered.  Under the health care exchange, it will be.

So yes, prenatal care is covered.  Because insurance covers prenatal care, and the bill is about expanding who can buy insurance.  Contraception is a little more iffy, but since the board will be composed of Democrats, I think that’s a shoo-in.  Whether or not a Republican administration will fight that remains to be seen.

And of course infant care is covered.  Last time I checked, people generally insure their infants.  There’s also a great deal of money still spent on S-CHIP. 

I’m not sure where the idea that the health care bill will provide anything but standard insurance coverage came from.  The only form of medical care being openly excluded is abortion.

Also, it’s already federal law that if an insurance company covers Viagra, it has to cover contraception.  Subsequently, if Viagra is set by the health care exchange as a minimum—-and history suggests to me that it will—-then contraception will have to be covered.  Even under Republicans.  Of course, that’s only prescription contraception.  Condoms are funded through other channels, basically family planning money that largely goes to organizations like Planned Parenthood.  If we want more funding for over the counter contraception, and we should, we need to go through other channels.  But simply spending more isn’t enough.  The idea should be to get condoms into the hands of people who have an immediate use for them, much like they provide free condoms in a lot of bars in New York.

Yes, the House is an equal branch of congress.  And there are areas, probably, where the bill can be improved in conference because of that.

The public option just isn’t one of them.  It’s dead, because it can’t pass the Senate.  Putting it back in in conference would be doing what Kos, et al, want - killing the bill.  Because Joe Lieberman and Olympia Snowe and Ben Nelson are happy to kill the bill rather than allow the creation of a public option.

If you don’t realize this, you are living in a dream world.

What’s worse, I remain unconvinced that we are faced with it, for the reason that jlk7e notes: I still think it’s more likely that we’ll end up with the worst of both worlds.

I think that’s more likely than any option which involves getting the public option back.  What’s most likely is we get the slightly more palatable Senate abortion language along with no public option.  At any rate, what the conference should focus on is making sure we get the somewhat more palatable abortion option and making improvements elsewhere.  Any effort towards the public option is a waste of time, because it can’t pass the Senate, and we want the conference report to be something that can get 60 votes there.

It’s impractical to choose the pragmatic stance. If you always choose the pragmatic option, it gives your opposition greater leverage over you. By taking an extreme stance, it allows your opposition to limit the gain you can make pragmatically. A scorched-earth, ideological stance allows you to obstruct any progress.

“Without a public option, there is a strong possibility that a lot of people are going to be financially ruined by this bill.”

I am a completely healthy 26 y.o., lost my job, and I have a little bit of savings (cannot qualify for Medicaid). Now, I will be mandated to buy expensive health insurance (premiums for younger people will go up to compensate for the low premiums for sick old people and for people with pre-existing chronic conditions).

We younger people (who have not accumulated any wealth yet) will have to subsidize the low premiums of the elderly (many have accumulated a lot wealth over the years).

This is not fair at all.

“So yes, prenatal care is covered.  Because insurance covers prenatal care, and the bill is about expanding who can buy insurance. “

“And of course infant care is covered.  Last time I checked, people generally insure their infants.  There’s also a great deal of money still spent on S-CHIP. “

Amanda, insurance does NOT always cover prenatal and infant care. In my state, South Dakota, insurance companies aren’t required to include prenatal like they are in some other states. So when people have to enter the individual insurance market, like we did, they don’t necessarily get that coverage. We could only afford a high-deductible policy ($5,200 family deductible then, currently it’s $7,500) that did not include prenatal or delivery. That meant we paid out-of-pocket for every last cent of my prenatal plus labor & delivery, because they didn’t count toward our deductible. That total was a bit over $7,000. Then baby was born with pneumonia and had to spend three days in the NICU. Insurance kicked in once we met the deductible, so our total out-of-pocket for our baby’s birth was over $12,000, which we paid off over three years.

Yes, we’re one of those families that makes ever-so-slightly too much to qualify for S-CHIP but too little to buy a good insurance policy and doesn’t have access to employer-based insurance at the moment.

I’m not at all optimistic on this. I’m pretty sure that the bill will have no PO(not even a trigger)and that we’ll be stuck with some sort of Stu-Pit. This stopped being about HCR and started being about getting support for the next election from the insurance companies and big Pharma the minute Obama took the oath of office. 
The only decent thing I’ve seen in the bill so far is an amendment from Al Franken requiring the insurance companies to spend 85% of your premiums on healthcare. But even that is weak because the next HHS secretary can nullify it if he/she desires.

Remember, Obama will sign any piece of shit called HCR and call it a big victory.

I am a completely healthy 26 y.o., lost my job, and I have a little bit of savings (cannot qualify for Medicaid). Now, I will be mandated to buy expensive health insurance (premiums for younger people will go up to compensate for the low premiums for sick old people and for people with pre-existing chronic conditions).

We younger people (who have not accumulated any wealth yet) will have to subsidize the low premiums of the elderly (many have accumulated a lot wealth over the years).

Okay, a couple of points.  Firstly, you will not have to buy health insurance.  If it would cost more than 8% (I think) of your income to buy insurance, you are exempted from the mandate.  If you have no income, I think that would qualify, no?  Even if not, you merely have to pay a fine which, I think, would cost considerably less than insurance (although obviously you get nothing for your trouble).  And there’s also the possibility that you would qualify for subsidies (even if you don’t for medicaid).

The basic premise of the sob story is kind of offensive, though, and is exactly the kind of thing that Republicans say.  “Oh no, I’m forced to spend my hard earned cash to help other people.”  I don’t see how that cuts it.  Everyone should have health care.  If that means some wealth transfer from young healthy people to older, unhealthy people, well, that’s the price of it.

Ben - perhaps I was hyperbolic.  I do think that a bill without a mandate is probably worse than the bill before us, in that it’s totally unsustainable.  And I think Kos’s understanding of the legislative procedures here is unrealistic.  But maybe your interpretation of his motives are correct.  I certainly will concede that Kos really does want a health care bill.  But I’ll stand by my main point, though, which is adding the public option back in in conference will kill the bill.  Which is why it’s absolutely not going to happen.  The public option is dead.

What savvy politickers need to get is this: if the Republicans are willing to use abortion to derail the conversation, then we need to ju-jitsu them with this, and turn it around so that’s the thing that we use to compromise and not the public option.

I’ll repeat myself: We’ve already given up the public option, and it’s already gone.  You seem to be basically saying that given the choice, you’d rather the Senate pass the House bill than the House pass the senate bill.  But how is that a practical possibility? how do you possibly get the senate to pass the house bill?  Having the public option loses you Lieberman definitely, and probably Nelson, Landrieu and Lincoln.  Who do you get in exchange?  So far as I can tell, nobody at all.  But not only that, you might lose other people as well.  The Senate, you’ll recall, rejected the Stupak language by a pretty convincing vote.  Mightn’t there be some pro-choice senator who would filibuster the thing with that language?  I don’t know, but it seems a lot more likely than that you win anybody over.

There’s just no practical path for your proposed compromise to pass the Senate.  Including the public option guarantees the opposition of every Republican, plus Lieberman, plus probably Nelson, Landrieu, and Lincoln.  Maybe the latter two will be reluctant to join a Republican filibuster to kill health care.  Lieberman and Nelson would be happy to do so, especially the former.  No bill with a public option can pass the Senate through regular order, and they aren’t going to do reconciliation at this point.

On the other hand, it seems perfectly plausible that a bill like the Senate bill can pass the House.  The House bill passed narrowly, but that’s because on controversial matters like that, the leadership gets as many votes as it needs, and lets everyone else vote against it if they think it will be politically advantageous to do so.

Taking out the public option might lose you a few members of the progressive caucus, and the Senate’s abortion compromise might lose you Stupak and a few other hard-core Democratic pro-lifers.  But Pelosi should be able to round up enough people who she let vote “no” the first time around to get the thing passed in the house.

There’s just much more flexibility in the House, which means that the house is the one that has to give way.  Your proposed compromise would simply prevent any bill from passing.  We don’t get to choose between the house bill and the senate bill.  We get to choose between the Senate bill and something even worse that has no public option and the Stupak language (although I think the latter is unlikely).

There’s no point in directing political activity towards impossibilities.  The public option is now as dead as single payer.  Progressive attention on the conference activity should be focused on keeping Stupak out and making improvements to other parts of the bill, not to a hopeless effort to get the public option back in.

Private insurance still has a place here too; it funds dental care, counselling, physiotherapy and private/semi-private hospital rooms during stays.

Hey tiktik, if you don’t mind, can you please not be so glib at seeing dental care as something that can be covered by private insurance.  Let me give you a couple of examples:

Young child needs braces - debilitating and worsening headaches, as well as loss of appetite and depression from jaw pain are symptoms..  Employer has an “optional” dental coverage. for @$800, one can get twice a year cleanings for self and children and orthodontics - braces covered at 50% - sounds good, right - until one reads the fine print of $500 max on braces coverage - while the going rate for braces is $5000-$7000.  In other words, one can pay $800 for @ $900 in needed coverage- and then “find” another $4500-$6500 to cover the needed braces.
The option is to wait until the teeth are impacted (and probably infected) at which point, the kid can have oral surgery which under some plans is covered as medical and under some as dental for thousands more and the complications of anesthesia in children.

There is no reason that dental and minimum vision care (no, not designer frames) are not considered a part of health insurance.

Why are liberals & Progressives ALWAYS the ones who have to give up so much in order to get back so little?

The insurance companies cannot discriminate - ie, refuse coverage - for pre-existing conditions, but they can raise rates by, IIRC, 3 times the going rate, which will put insurance in the cannot-afford-it level for many people.  I don’t see how that’s much of an improvement.

Firstly, you will not have to buy health insurance.  If it would cost more than 8% (I think) of your income to buy insurance, you are exempted from the mandate.  If you have no income, I think that would qualify, no?  Even if not, you merely have to pay a fine which, I think, would cost considerably less than insurance (although obviously you get nothing for your trouble).  And there’s also the possibility that you would qualify for subsidies (even if you don’t for medicaid).

I’m not the person you were responding to, but I’m going to stick my nose in a little bit.

Ok, lets say there’s no mandate for me (another unemployed person with no income and very little saved up).  So I have no health insurance, because I can’t afford it, and they didn’t make me buy it, so I didn’t.  Of course, if someone’s willing to sell me a policy for 8% of $0, I’d totally buy it (like when I used to live in Massachusetts and had a very lox income.  Anyone have thoughts on what will happen to their newish universal coverage under a federal bill?).  Anyway, now I still don’t have health insurance, and I don’t really have money for anything beyond a yearly physical and teeth cleaning, so trips to the emergency room, follow-up appointments, and treatment of long-standing sports injuries are out.  Maybe I’ll be able to keep paying for a birth control prescription.  And I might have to pay a fine—meaning I have less money to spend on that prescription, or the possible trip to the emergency room should I fall off my bike and break an arm or something. 

There’s a possibility of a subsidy to help me buy insurance.  Well, it had better be a big one, and a little more likely than a possibility. 

So unless that big fat subsidy comes through, I still can’t get health care.  A bill like that does me and people like me diddle-squat.

Rowmyboat - I’m sure there are people whom the bill doesn’t help.  I don’t really know enough about the details of the subsidies to know if you are in that group (it’s also worth noting that none of this goes into effect until 2014, so we’re kind of all in a bit of a veil of ignorance about whether it will help us personally or not).

The point is, though, that the hypothetical person who can’t afford insurance after the bill is passed isn’t any worse off than they are now.  But the existence of the medicaid expansion, of the insurance reform, and of the subsidies, means that many people will be helped by it.  The flaws in the bill can perhaps be ameliorated in the future.

I don’t think you’ll find much argument with the idea that the bill is inadequate and could, in an ideal world, be much better.  It seems clear, though, that this is the best we can get in 2009 (or 2010, I guess), and that, flawed as it may be, it’s still much, much better than doing nothing.  The argument that the bill will make things worse seems to be based on faulty premises about insurance premiums rising for no apparent reason (except, I guess, that insurance companies are evil, which is a necessary, but not sufficient, cause).

Is this health care bill much worse than a single payer system?  Of course it is.  Is it worse than a bill with a robust public option?  Yes.  Is it worse than the status quo?  No.  It is much better than the status quo, even if it’s still inadequate.

When Stupak-Pitts was first placed into the House Bill, I thought to myself, “Good God, this bill is quickly turning into utter crap.”  And I genuinely believed that it couldn’t really get any worse.

I was proven wrong the day Rahm Emmanuel was dispatched to tell Senate Majority Leader Harry Reid that he had to give Joe Lieberman whatever he needed to give him to get the bill passed.

A comprehensive bill with a good public option that includes the poison pill of Stupak-Pitts is a poor form of healthcare reform; BUT… it still serves the purpose of doing more good than harm in the big picture.

The watered-down Senate Bill that completely stripped both the Medicare buy-in and the public option, while including the poison pill of having to purchase essentially unregulated for-profit health insurance is no reform at all.  It’s actually worse than doing nothing.

I’ve been willing to accept compromises throughout the process.  Like most progressives, I know that the most just, best possible reform would be a true universal single-payer system - Medicare for all.  I also knew on day one that such a proposal was DOA, and while wishing it would happen is nice, it was always just a pipe dream with the Congress and White House that we have.  It was never even on the table (which is criminal, but hardly surprising).  So I didn’t dwell too long on what should have been but never would be… I focused on “the possible”.  A good bill that both introduced tougher regulations to the private health insurance industry and provided a government-run public option to force the for-profit sector to compete seemed to be the best option available.

Stupak-Pitts angered me, as it angered progressives everywhere, and justifiably so.  Still for me, as bad as that amendment is and was… it wasn’t quite enough to move me from being in favor of passing the bill to opposing its passage.

What happened last week in which entire control over the shape of this bill was cowardly ceded to Joe Lieberman by a frightened White House and a spineless Senate was a line that I could not cross.  From the moment President Obama took office until the week of December 13th, I supported passage of the bill throughout as it morphed from decent, to poor but adequate, to terrible but still an improvement over the status quo.  Last week, the invisible line of minimum acceptability was crossed for me, and a significant number of progressives everywhere… as evidenced by numerous polls indicating that the current legislation is only supported by 1/3 of the country at this point.  From this past summer when polls showed nearly 75% support for a public option to today, where 2 out of every 3 Americans think the bill has morphed into utter shit, and think that doing absolutely nothing would be preferable to allowing this bill to pass.

I’m with Amanda… Stupak-Pitts is an unconscionably bad trade-off.  But a good bill with a public option in which we must accept Stupak-Pitts is still a better bill than a bill with no public option and no meaningful regulation in which Stupak-Pitts has been removed.  One is arguably an improvement over the status quo as whole (even though it clearly harms reproductive justice specifically), the other is clearly a step backwards entirely - we’ll be even worse off if we were to pass the bill with no public option plus a mandate to make insurance companies richer than if we were to do nothing at all.

Believe it or not, the Washington Post has a good chart up explaining the differences between the House and Senate plans.  Subsidies in both plans cover people up to 400% of the poverty rate.

Also, can someone please explain to me the difference between the House’s public option and the Senate’s national plans run by the government’s Office of Personnel Management?  The details are different but, frankly, the outcome sounds like it’s exactly the same:  people get to buy affordable health insurance at rates negotiated by the government.

Amanda, insurance does NOT always cover prenatal and infant care.

That’s what the exchange board is set up for.  I’m extremely skeptical of the idea that they won’t cover this.  It may not always be covered, but it’s pretty standard.  And I’m pretty sure there’s additional language protecting it in the bill, because god forbid anyone be accused of not wanting more babies.

No Amanda, this bill is not that innocuous—else why would the forced birth brigade be fighting so hard for it?

Because it “will effectively make abortion coverage unavailable in health insurance exchanges and, ultimately, in private insurance policies as well.”

http://www.politico.com/livepulse/1209/Abortion_rights_groups_oppose_compromise.html?showall

Which will in turn, increase number of self-induced abortions and maimed women, and God forbid—but if we go by history—dead women.

And no, that’s not hyperbolic, either. I was in my early ‘20s when Roe V. Wade was passed, and am old enough to have lived that history.

When abortion was illegal, I knew a woman forced to carry her dead baby to term, her system so poisoned by that, she was never able to carry a live child to term after.

The Hyde Amendment is already endangering women with high-risk pregnancies, such as this Federal Employee presented a bill for $9,000 for the unelective abortion she was forced to have to save her health. (although Hyde stipulates coverage for “health and life” of mother, the insurance company refused to acknowledge that.)

http://www.huffingtonpost.com/2009/12/01/federal-employee-forced-t_n_375072.html

What will happen to the desperate women and girls who don’t have a spare $9,000 (or the $500, or whatever bill presented to them, access to affordable abortion)? We don’t have to go back 40 years for the answer: Some will self-induce, such this American woman in our military:

http://www.religiondispatches.org/archive/religiousright/2111/military_abortion_ban:_female_soldiers_not_protected_by_constitution_they_defend

This is no small thing, this “compromise” Forced Birth Brigade is calling for.

This is a roll-back on Roe V. Wade, which in part was passed by the Supreme Court, because of the evidence that illegal abortion was an unequal situation: wealthy women could afford to get safe abortions by flying to Puerto Rico and countries where abortion was legal, and in those leafy, upper-class suburban hospitals where D&Cs;were approved at a rate not seen in urban or lower-middle class hospitals.

In other words, illegal abortion was an unequal situation: more poor women, women of color, lower-middle class women died of illegal abortions, or were forced to come to term in unwanted pregnancies or high-risk pregnancies.

I was born in 1950, and personally experienced that inequality.

I knew a 14-year old girl, forced to continue her pregnancy, although it was unhealthy in her immature body.

I read the newspapers, which contained reports of women who died from self-induced or illegal abortions.

As evidenced by the articles above, Nelson and his ilk who “just” want to make abortion expensive will be overturning Roe and returning us to the days of women whose life and health will be threatened because they won’t be able to afford safe, legal abortions.

Abortions will continue, but in an unequal fashion, that threaten the life and health American women, and yes, an important intent of Roe V. Wade will be overturned.

They can’t refuse you for pre-existing conditions. They can’t charge you higher rates for pre-existing conditions.

From what I understand, that’s not true.  There’s a restriction on preventing people with pre-existing conditions, but the Senate version still has language about “fraud” (which is used to deny care to people who did the best they could) and as far as I know, they can still charge much higher rates if you have a pre-existing condition, which is functionally keeping you off the rolls.

But I may be wrong.

judy, where did I say it was innocuous?  Please point to that.  Please point to where I said it was no big deal.

I said that between two evils, the one that bankrupts more people and leaves more dead is the more evil one. That’s the no public option one.  Numbers game, that’s all.  No one is suggesting that abortion isn’t a big deal.  No one.

According to that link Mnem provided, both bills have a ban on premium disparity based on health status.  If that’s true, then that will be significant.  It means they can’t only not keep you off because of a pre-existing condition, but that they can’t charge you more.

I still think Stupak-Pitts is evil, and that not having a public option is evil.  Just in case there was doubt.  That hasn’t changed in the past minute.  I still think abortion should be free to anyone who wants one, honestly.  But believing that won’t happen /= thinking that’s right.

Well, here’s the thing: the forced birthers are right wing nuts, at least 99% are.  This means two things: They are opposed to health care reform on the grounds that Other People will get to use it, and they have no compunction about lying.  This means that no matter what is in the bill, they will swear it’s a fetus-killing bill and tell their followers to mindlessly oppose it.  The bill could ban abortion outright, and they’d still say this, if there’s a chance that someone they put in the category of Other People gets their health care covered.

True enough.

Even though Stupak-Pitts has been introduced into the House Bill and marginally less odious similar provisions have been added to the Senate Bill (thanks, Ben Nelson), the forced birth crowd isn’t outwardly treating these things as victories.

Not only that, they continue to falsely portray the current legislation as a program filled with government-funded abortion provisions.  It all makes me wonder if Bart Stupak and Ben Nelson are happy with the evil that they have done - because not only have they completely alienated 51% of the U.S. population by behaving like misogynist pricks, they aren’t even being given credit for it by the fundie wingnuts who pushed them to do this.

I got a robocall poll from the Family Research Council (I have no idea how that happened), and one of the questions was, “Do you want your taxpayer dollars being used to pay for the murder of innocent babies through abortion, as Barack Obama’s current healthcare reform legislation will do?”

I wanted to put my fist through the phone and knock the teeth out of every single fundnut douchenozzle at FRC, because this call went out AFTER Stupak-Pitts had long since been included in the House Bill and AFTER Ben Nelson’s anti-choice requests were placated.  They are telling their constituents that abortions will be funded by the CURRENT legislation, when there is nothing further from the truth.

This all reveals one thing… this is not now, nor was it ever, really about abortion for these folks.  Sure, they wanted to get those restrictions put in on the chance that the bill might get passed, but what they really want, and what they have wanted from Day One, is to destroy healthcare reform altogether.  First and foremost, because they don’t want “undeserving” (mostly brown) poor people benifitting in any way from their precious tax dollars.  Second, they want to protect the for-profit insurance cabal.  Third, they want to hurt President Obama specifically.  Fourth, they want to create an atmosphere like 1994 all over again, so they can retake Congress next November.

It’s sort of like they told Stupak and Nelson that they would get behind the bill if it made sure to fuck women over by restricting the hell out of abortions.  And then, once they got precisely what they wanted, it’s as if they are now sitting back and laughing, “Haha, just kidding.  We still aren’t gonna support this bill, but thanks for playing along, suckers.”

This idea of caving in to people who are never going to be allies is assanine, and it has backfired royally on the Democratic Party, because now, in addition to not gaining any support from the opposition in spite of caving in to their every desire, they’ve managed to alienate progressives so much that huge defeats at the polls next November appear to be an inevitability no matter what happens at this point.  Pass no bill, they’ll certainly get their asses kicked.  Pass the current Senate Bill and they’ll still get their asses kicked, and quite possibly even worse.  But what do they care?  Even if they lose their seat because a pissed-off base doesn’t bother voting next fall (and all signs indicate a huge number of us won’t), they’ve probably got a cushy 6 or 7 figure lobbying job waiting for them on the other side of Congressional ouster.

Whatever.

Pro-life Democrats are really a different animal entirely.  They’re generally from heavily Catholic districts, and they’re generally pretty liberal on non-abortion-related economic policy issues.

The irony of this statement is this: the principal driver of anti-choice provisions in the Senate Bill is Ben Nelson.  Oh, but since he’s pro-life, that must mean he’s economically more liberal, right?

Wrong.  Nelson was quoted last week as saying that even if he got anti-choice restrictions as tough as Stupak-Pitts added to the bill, he might STILL vote to filibuster unless the subsidies for poor people were reduced.

Pro-life and economic liberal my ass.

How do we trade Stupak for a public option? Ben Nelson is the 60th vote. He has indicated that he will settle for giving states the option to restrict abortion funding under health reform. Nelson also threatened to filibuster over the public option, as has Joe Lieberman.

After the Senate bill passes, the next step is to put the House bill and the Senate bill together in conference. The combined version is what the House and the Senate will ultimately vote on for final passage. Right now, the House bill has an okay public option and the Stupak amendment. The Senate bill will have no public option and Stupak-lite.

I don’t see a scenario where we could trade Stupak for the public option. If Nelson is willing to settle for Stupak-lite, we’re not going to pick up any additional senate votes by putting Stupak into the final bill. It’s not like Susan Collins or Olympia Snowe or Joe Lieberman will swallow their objections to the public option in exchange for more draconian abortion funding. IIRC, they’re all more or less pro-choice. I doubt Nelson would be willing to vote for a bill with a public option in exchange for putting the full Stupak back in.

On the House side, we’ve got more votes to spare and the bill can pass with a simple majority (i.e., no filibuster). How would a quid pro quo, Stupak for Public Option, work in the House? Who’s going to change their vote? Do we even need such a deal in the House, given the larger majority and the fact that a lot of the Stupak set are Blue Dogs who know they’re politically fucked if health care falls through?

I think the idea is that behind the scenes, a lot of negotiating is being done, in sum.  Unfortunately, I think that the end result will be abortion left in, but restricted, and no public option.  Because you’re right; Nelson is the roadblock, and he’s economically conservative.  But the bargaining chips are abortion and the public option, from what I understand.

the next congress, with (hopefully) a veto-proof dem majority, can then drop-kick stupak-pitts.

You are kidding, right?

There isn’t a single poll analyst even talking about something like that happening.  Even the most electorally optimistic progressives are conceding that a loss of Senate seats is virtually inevitable.  The only real deabte taking place is not whether or not we’re going to lose seats in 2010, but just how many we will lose.

As for a veto-proof majority, well that would be 67 Senators on our side.  Filibuster-proof is 60… veto-proof is 67.

Now, that must take into consideration that we don’t really have 60 Senators on our side as it currently stands.  Lieberman is definitely not a part of 60 solid votes, as he has proven.  Nelson is slightly less bad, but he’s not a part of that 60, either.  Landrieu is a little improvement, but her vote has to be bought with huge amounts of cash ($300 Million to Louisiana to buy her vote on this bill).  There’s also Baucus, Lincoln, and Bayh… not great allies.

So let’s be honest here… we really only have about 55-57 Senate votes currently.  To get to 67 solid votes on our side, we really need to get to about 70-72 votes if you are gonna include Lieberman, Nelson, Lincoln, etc. in the count.

We couldn’t win 10-12 Senate seats in 2008 when EVERYTHING was going our way electorally.  It is absolute lunacy to think there is any chance in hell of us doing such a thing in 2010, when everyone agrees that we most likely aren’t going to gain a single seat, and will probably lose a few.

My odds of winning Powerball are higher than are the odds that we’ll get a veto-proof Democratic majority in the 112th Congress.

I’m not willing to say “Sure, let’s let Stupak in so we can pass the bill”.  I want fighting words the whole time.  I want a vote, and if Stupak shit is let in, I want people saying, “OK, for now.  But next session we’re fighting this again.”

My impression wasn’t that Amanda was willing to allow Stupak to slide just to get the bill passed… she pretty specifically tied it to putting the public option back in the bill.

You are arguing that there isn’t going to be a public option, and that since there won’t be, we shouldn’t be OK with allowing Stupak-Pitts to remain in the bill.

I think we all agree.  No public option + Stupak-Pitts is an unacceptable bill to all parties here, as far as I am aware.  Amanda was saying, “You give us back the public option, and we’ll let you keep Stupak-Pitts.”  And I agree with that position.  But no public option, no Stupak-Pitts.

And truthfully, no public option plus no meaningful cost control, no support for this bill from me.

The status quo is a lousy, craptacular, unnacceptable situation.  But it is still preferable to the current Senate Bill.  I would rather HCR die entirely than allow it to be passed in the current form, which would actually be regressive to the cause of true healthcare reform.  We would be worse off with the Senate Bill than no bill at all.

Amanda, I said, “not as innocuous” since you didn’t recognize that this bill could eventually kill ALL insurance coverage for abortion.

It’s also a false trade: 35,000 covered vs. losing abortion insurance coverage. Or the Public Option vs. abortion coverage.

They’re not either/or. (For one thing, I’ve read that the Progressive revolt, with finally, finally enough saying “Kill the bill,” has actually improved it. Backed off some of the worst provisions Nelson, for one, was asking for. Wish I could find the link.)

Rolling over and accepting a reversal of Roe v. Wade in exchange for what you may not get is a bad trade, bad negotiation. No less more dead women and maimed girls.

It’s not something to horsetrade, because every restriction on abortion has created more suffering.

Forty years ago, many hospitals had what they privately termed their “abortion wards.”

In other words, a segregated area where the women maimed or dying from illegal abortions were kept away from the maternity and other cases.

A couple years ago I read an article (and unfortunately didn’t save the link) quoting nurses and doctors across country who said that the “abortion wards” are returning, especially in states that severely restricted access to abortion.

Privacy rights hamstrung medical personnel from speaking out, as they will when the abortion wards are more well-stocked if this bill is enacted.

Parental notification laws have already killed teenage girls, and I’ve read more than one article qouting parents lamenting those laws because their daughters died through self-induced or illegal abortions as a result.

http://www.encyclopedia.com/doc/1P2-1141309.html

Okay, maybe I’m preaching to the choir here, but statisically, more women will die under this bill.

We’ve had the statistics drummed into our dear little ears for months on end: 45,000 Americans a year die because they lack health insurance.

Oh, but there’s more:

Hospitalized Children Without Insurance Are More Likely to Die, a Study Finds

http://prescriptions.blogs.nytimes.com/2009/10/30/lacking-insurance-hospitalized-children-more-likely-to-die/

The risk of dying from traumatic injuries is 80% higher for those without any insurance, a study says.ER physicians say they’re surprised by the findings.

http://www.latimes.com/news/nationworld/nation/la-sci-trauma-uninsured17-2009nov17,0,4308260.story

So we can’t be surprised that more women will die without health insurance that covers abortion—it’s plain, bald, statistically so.

When abortion was illegal in this country, more poor, lower-middle class and women of color died simply because they weren’t able to afford a safe abortion.

And this bill is returning us to an all-too-similar situation.

Statiscally, more women will die if they lose insurance coverage for abortion.

Something I’m not willing to horse trade for.

I agree with (4) in Amanda’s post and hence am confused as to why this bill has any support at all among truly Liberal voters: Mandates without a public option = give-away to the insurance companies and the screwing of consumers. Why hasn’t more been made of the mandates in the rhetoric on this bill? I hear a lot of clucking about how more people will now be covered: well, yes, because they’re now forced to buy this product they can’t afford and which, without competition and quality control, will still be crap for them anyway.

And truthfully, no public option plus no meaningful cost control, no support for this bill from me.

So I’ll ask my question again:  what is the functional difference between a public option administered by HHS and a national insurance program administered by OPM?  I still haven’t been able to get anyone to articulate why it’s great to have the HHS administer insurance but a shit sandwich to have OPM do it, particularly since OPM currently administers health insurance for all federal employees.

Any effort towards the public option is a waste of time, because it can’t pass the Senate, and we want the conference report to be something that can get 60 votes there.

Who exactly is “we”?

I’m not “we”.  Neither is a pretty sizeable chunk of the progressive base.  This current bill is utter crap, and 2/3 of Americans have said so.

My top priority is and always has been to push for legislation that fundamentally reforms our fucked-up healthcare system in a meaningful way.  I accept that compromise is part of the deal.  I want single-payer universal coverage, but I’m more than happy to compromise and accept a decent public option to introduce real competition and meaningful regulation being imposed on the for-profit industry.

The current Senate Bill does neither thing.  Just because the bill says that insurance companies have to accept the jacked-up premiums of patients with pre-existing conditions doesn’t mean they actually have to pay for their treatments - denial of claims are still fully allowed.

So if the Senate Bill is more or less what will come out of the conference report, then count me out as a supporter.

I don’t support “killing the ill” just for the sake of killing the bill.  But I refuse to buy into the premise that passing a craptacular bill that will actually do more harm than good is a better option than passing no bill at all.

Not passing legislation that makes healthcare more affordable and accessible for all Americans is unacceptable.  Passing a bill that legally forces all Americans to buy a for-profit shitty product which may or may not pay for their healthcare needs and makes the health insurance lobby ten times stronger by forcing 30 Million more people to consume their product is not only not good healthcare reform, it’s a literal step backwards.

We will be worse off if this bill passes than if we do nothing at all.  And while the argument that the Democrats will get trounced next year if HCR dies entirely are probably true, I’m fairly sure that they’ll also get trounced if they do something that 2 out of 3 Americans are clearly telling them not to do.

This bill isn’t “barely acceptable”... it is entirely unacceptable as currently written.  Better for it to die entirely than for it to pass in its current form.  Either get it right or let it die.

However, the national insurance program ministered by the OPM, but it’s not the same coverage or protections that federal employees on the hill are receiving. Considerably shittier, from what I’ve read.

That’s one big difference I’ve read about, but don’t have time to look up the link.

However, the national insurance program ministered by the OPM, but it’s not the same coverage or protections that federal employees on the hill are receiving. Considerably shittier, from what I’ve read.

Read where?  If you can at least give me a lead, that would help, but I keep seeing these vague references with absolutely no information.  I realize that part of the problem is that the proposed OPM insurance doesn’t actually exist yet so people are able to project “it’s awesome!” or “it sucks!” onto it with no information, but it would be nice to have some actual information since, on the surface, it doesn’t look much different than the public option.

I agree with (4) in Amanda’s post and hence am confused as to why this bill has any support at all among truly Liberal voters: Mandates without a public option = give-away to the insurance companies and the screwing of consumers.

That’s not a bug - that’s a feature

The fundamental problem was that healthcare in America ccompared to that in other Western nations:

i, delivered worse results
ii for more money
iii, and the cost was rising way faster than the general cost of livig.

As far as I can see it, the proposed bills have been so compromised that they will not affect these factors, especially the third. They are, in fact, more shit for the great shit sandwich of American life - and if you don’t have much bread, you’re going to wind up eating these faeces.

Since I’m now recovering slowly from a major illness, I am unutterably glad I do not live in the USA.

The insurance companies cannot discriminate - ie, refuse coverage - for pre-existing conditions, but they can raise rates by, IIRC, 3 times the going rate, which will put insurance in the cannot-afford-it level for many people.  I don’t see how that’s much of an improvement.

Not to mention the fact that the bill does nothing to substantively regulate their ability to deny claims on a whim.  The language of the bill states that minimum standard of treatment have to be paid for, and that denial of claims has to be based on “misrepresentation” and “fraud”.  Well, that’s pretty much what most state insurance commissions currently mandate, and yet insurance companies deny claims all the time, and the only recourse the patient has is to go through a lengthy appeals process first with the insurer, and then, if they still believe they have had their claim wrongfully denied, they can file a lawsuit.  That is, if they can afford to get lawyered up, and they can make sure not to die before they get their day in court.

That right there is why the provision that they must cover people with pre-existing conditions means nothing functionally.  Sure, they are forced to give sick people a piece of paper saying they now have insurance… but that doesn’t mean they actually have to pay for any treatment if they don’t want to.

And lawsuits really don’t scare multi-billion dollar corporations who can afford the top defense attorneys in the country and who have the time and money to drag the legal process out for years and years.  They know most people who they wrong by speciously denying claims will never even bother to sue, because the average person just doesn’t have the time or money to undertake the effort.

It isn’t just the lack of a public option and the mandates that are the problem for “people like Kos et al”... it’s also the toothlessness of the bill such that the insurance companies aren’t going to be substantively required to change the way they do business in a meaningful way, but they are going to be handed 30 Million new customers and have their coffers filled without really changing much of anything.

I don’t know where this meme among some liberals got built that giving a bunch of people private for-profit health insurance was automatically a great thing… if they are going to be given the same kind of shitty health insurance that is still trying to deny a $20,000 hospital claim I have from last summer (UnitedHealthCare), they aren’t being done any favors.

It seems clear, though, that this is the best we can get in 2009 (or 2010, I guess), and that, flawed as it may be, it’s still much, much better than doing nothing.

You are wrong.  Period.  And no, it does not regulate insurance in any meaningful way.

Regulating insurance in a meaningful way would include a provision that stipulates that claims cannot be denied unless an independent government auditor determines that there is reasonable grounds upon which to deny the claims.

So long as the insurance companies still essentially get to pick and choose what they will or will not pay for on a whim, this bill does nothing to regulate the industry.  They will continue to deny claims they have no business denying, and people will still needlessly die and be bankrupted by medical calamities because the insurance company didn’t want to pay up.

I also don’t think it will be possible to repeal either Hyde or Stupak/Pitts.

For one, notice that Hyde is still in place after decades, and I rather think that abortion rights activists have been working toward that appeal in all those decades.

Neither Clinton—when he had a Democratic Congress—nor Obama have successfully worked for that repeal.

All of the various abortion restrictions set in place have remained, and the Democrats have no will to overturn them.

Which is another reason not to agree to give a major restriction up in trade for anything.

By the by, nearly 90% of insurance policies now cover abortion.

http://www.time.com/time/politics/article/0,8599,1909178,00.html

And experts believe this bill could create the domino effect of wiping out all that coverage.

There’s a lot of negotiating going on, but the issue is whether the final bill will be Stupak or Stupak-lite. The public option is dead, regardless. The only way to revive it would be to pass a different Senate bill through budget reconciliation, and Harry Reid and the Democratic establishment have demonstrated that they’d rather lick an icy DC mailbox than go the reconciliation route.

There are good and bad reasons for their reluctance. The bad reason is that most of them don’t really want a public option or serious cost control anyway and even if they did they’d be too scared of what the GOP and the Serious Villagers would say about them. The good reason not to do reconciliation is that it would take too long. Public support for reform is dwindling by the day and the longer it hangs in limbo, the more time the GOP has to sow fear, uncertainty and doubt. Also, the rest of the administration’s agenda is on hold pending health care reform and there are a few other things they’d like to get done before their majorities get slashed in 2010.

Here’s my take.  I can’t speculate what will come of these bills.  It’s not up to me and the representatives in both houses clearly couldn’t give a fuck what most Americans think.  So I think it’s pointless to try to outguess congress or the white house here.

All of which comes down to the very simple point that if the majority party in two branches of government doesn’t understand that a strong HCR benefits them both politically and fiscally (as well as the nation as a whole), I think they’ll pay the price for the continued patronage they are obviously so eagerly seeking.

In other words, “compromise” is fine.  In 2010 and 2012, rather than give the dems my money, my time and my vote, I’ll compromise with them and can have something less than each of those.  What that is exactly I leave as exercise to the pols involved.

Jake McIntyre at Daily Kos wrote an excellent piece analyzing the split in the healthcare debate between the wonkish pragmatists and the impassioned activists in the left blogosphere a few days ago:

Has anyone else noticed that the split in the progressive blogosphere between those who are saying “it’s a good bill in spite of everything” (Kevin Drum, Matt Yglesias, Ezra Klein, Josh Marshall, to name a few) and those who just can’t bring themselves to support Liebercare (Markos and Digby come to mind, among bloggers who have been at it since 2003*) is eerily similar to the split between those who grudgingly backed the invasion of Iraq and those who fought against the war seven years ago?

To a large degree, it’s the same cast of characters, with the same tone to the arguments. It’s the policy wonks versus the activists. On the wonky side, there is (and was, in 2003) a resigned sense that this isn’t an ideal action, but that we don’t live in an ideal world, and that consequently we should suck it up and support an imperfect initiative. On the other, there is (and was, in 2003) a resistance born of an awareness that Congressional Democrats will more often than not—and often unintentionally—screw themselves and the country, out of a misguided belief that powerful forces with agendas very different from that of the Democratic Party can be managed and trusted.

I agree 100%.  Many of the same people who are telling us that we must eat this shit sandwich because it’s the best shit sandwich we’re gonna get and better than not eating shit at all were also telling us that the party would be better off accepting and capitulating to the rush to war in Iraq in 2003 than facing political blowback if we didn’t fall in line.

I disagreed then and I disagree now.  I get it… if HCR dies and nothing gets passed, the Republicans are going to have a field day campaigning on it, and will steamroll us in the midterm elections.

But passing a terribly regressive piece of legislation just to improve our electoral odds in November 2010 doesn’t make passing it any better of an idea.  And besides that, I question whether or not passing it will mitigate the fallout we’re going to see next November - I believe that it’s entirely possible that it could turn a 30-40 seat loss into a 40-50 seat loss.  The American public HATES this current bill, and I believe it to be directly as a result of abandoning the most important progressive elements.  The right was never on board, moderates were wavering, and progressives were pretty staunchly in support of passing a bill with a good public option.  Now, in addition to still not having anybody on the right getting behind this bill, you’ve lost pretty much all of the moderates, and the left has been split in half in support of the bill.  Nobody on the right + virtually nobody in the middle + only half of people on the left does not equal good legislation.  It’s bad not only policy-wise, it’s also bad from a sheer cynical political perspective.  We won’t just happily “fall in line” once it is passed, if it is passed.  Many of us will not vote in the next election.  Many, many, many of us.  I would say that includes the vast majority of the first-time voters in 2008.  Those who were so hopeful last November are now collectively saying, “We worked our asses off for this?  Are you fucking kidding?  Fuck it, I’m done with politics.  They all suck.”

No, I don’t buy the notion that the consequences of not passing this bill will be worse than passing it in its current form.  Neither in the political realm nor in the practical realm in which it affects real people.

If this bill is not radically improved after conference, I will work tirelessly to see that it gets defeated.

Also, can someone please explain to me the difference between the House’s public option and the Senate’s national plans run by the government’s Office of Personnel Management?

A government-run public option acts as its own insurance company, independent of the private health insurance industry.

The Office of Personnel Management is essentially a benefits administrator, similar to those operated by large private corporations.  OPM does not actually insure anyone, they manage the relationship between the insured parties and the insurance companies.  Federal employees still utilize private health insurance like everyone else, but OPM serves as their benefits administrator.

Suggesting that the offerings from OPM for the general public will be anything like the offerings for members of Congress ignores one important distinction.

We aren’t members of Congress.  There is one group of people in America who will never, ever, ever experience the heartache of getting screwed over by a private for-profit insurance company.  A member of Congress.  So while Johnny Nobody from Alabama may have Blue Cross through the OPM, he’s not gonna be getting the same quality of Blue Cross coverage as his representative Jimmy Congressman gets.  The Congressman’s insurance policy will never, ever be rescinded, nor will the insurer ever deny any of his claims… it wouldn’t be worth the likely fallout to them.  You don’t want to piss off the people who have the power to take your company down.  That incentive to not screw over the customer doesn’t exist with the average schlub.

Here’s an anology… if Congress is getting ready to focus on a major piece of legislation that will deal with commercial airlines, and a key Congressman suddenly needs to catch a flight back to his district on a commercial jet but no flights are available, what do you think the odds are that someone is gonna get bumped so that the Congressman can get to where he needs to be right away?  I’d say about 100%.

Similarly, if a Congressman needs an expensive medical procedure done, a procedure that a private insurer would normally be inclined to deny coverage for, what do you think the odds are that the insurance company will make an exception for the Congressman?  I’d say about 100%.

Simply by virtue of having the word “Congressman/Congresswoman” or “Senator” affixed to their name GUARANTEES that they will get better coverage through their health insurance provider.  The notion that an average working class anonymous citizen will ever truly have the same guarantee of good health coverage through private insurance as a Congressman does through the same company is fallacious… Blue Cross knows that denying a Congressman’s healthcare claim could be suicidal for their business… they don’t have the same pressure on them when the patient is a non-influential nobody.

I’m still not sure that the Stupak amendment in the end actually does anything more than speed things along. Meaning I’m pretty sure that even without the Stupak amendment, eventually you’d see a lawsuit saying that government funding of the exchange is considered material support, and as such abortion can not be paid for by participating companies. And they’d win, I think (unfortunately, of course)

It’s the Hyde amendment that’s the problem. And yes, overturning that is difficult, and it won’t be done without a complete change in the way people view abortion, and in turn parenthood in our culture.

DTG:The political consequences I think of a shitty bill won’t come into play until at least 2014, as most of it is delayed until then. At the very least it’ll be after the midterms so I really don’t think that a bad bill will make all that much of a difference for the average person. But yes, eventually passing a bill that hates the poor will have a huge political blowback

The bigger problem is that laws that really have teeth are simply not politically viable right now. Not because politicians are corrupt, although that doesn’t help things, but because the electorate really does care about stock prices, retirement funds and property values more than most other concerns, or at least a significant chunk of it.

In order to maintain private insurance, you’d need a regulatory structure where systematic fraud by the insurance company could result in profits for the company either being zeroed out for a matter of time, or even more, for the company to be nationalized, and yes, the shareholders being told, sorry, you made a bad investment. Better luck next time! But that’s never going to happen because it’ll destabilize the fortunes…or the perceived fortunes of the middle class.

In the end, people believe for one reason or another that the poor are losers and thusly should be punished as such. Because if they are not punished, then there’s no reward for winning.

Similarly, if a Congressman needs an expensive medical procedure done, a procedure that a private insurer would normally be inclined to deny coverage for, what do you think the odds are that the insurance company will make an exception for the Congressman?  I’d say about 100%.

We have a guy at work right now who’s about to take a 9-month leave of absence to get a bone marrow transplant.  You know what the odds are of him getting dropped by our insurance?  Approximately zero.  That’s because I work for one of the biggest corporations in the country and no matter how expensive he is, there’s no way that Cigna is going to risk their contract for our 50,000 US employees over one guy.  They’re going to pay for his treatment and suck it up because otherwise they lose an enormous chunk of their business that far outweighs the cost of his treatment.  I pay about $200 a month for insurance through my company, and that includes medical, dental, eye care and chiropractic.  That’s because my company insures enough people that they have a huge amount of bargaining power, and they’re willing to go to the mat for their employees.

Economies of scale.  If there are conservatively 50,000 people on the OPM plan, whatever insurance company takes them on is not going to dick around the government and start dropping those people, because it will put their contract with OPM to cover 1.8 million government employees at risk.

Many of the same people who are telling us that we must eat this shit sandwich because it’s the best shit sandwich we’re gonna get and better than not eating shit at all were also telling us that the party would be better off accepting and capitulating to the rush to war in Iraq in 2003 than facing political blowback if we didn’t fall in line.

Oh, FFS.  Yes, that’s right, if I support this bill after reading it and comparing it to the House bill, that means I supported the war in Iraq because, after all, it’s not possible that I looked at the evidence for Iraq and came up with one conclusion and looked at the evidence for these bills and came to a different conclusion.

I’m done.  The level of stupid has just gotten too high again.  Jesus fucking Christ.

Why did Congress try to throw all the changes that needed to happen all together in a single bill in the first place? I mean, I’m sure there’s a good reason, but I can’t figure out what it was.

It seems to me like it would be more effective to pass what progressive pieces of legislation related to health care could be passed, in bits and pieces, rather than try to force through a sweeping bill which has been negotiated down to nothing and nobody even likes. Smaller chunks would also maybe be less susceptible to special snowflakes like Lieberman killing good stuff.

And maybe the latter approach isn’t even possible anymore, after all this drama, but if the choice is between a handful of raisins, or two handfuls of raisins plus a shit sandwich. . . .

If we could get the public option, Stupak would be a worthy price. It’s a damn shame there’d be a big gap in coverage, but better all the other medical conditions become affordable and just one requires a payday loan or fundraising party or whatever than that we don’t get the public option.

OTOH, I’m not banking on the public option being restored. But Krugman’s column has made me more optimistic a half-ass reform is a start.

It’s a hard choice, but you’re right… The lack of the public option is more of an imposition than the Stupak Amendment, since the stupak amend is just like not haveing the public option.

Still, I’m worried what the public option+stupak (and the option itself) means for other plans…

There’s also a big philosophical gain if this bill passes.  It’s a start on the road to seeing healthcare as a right or at least healthcare insurance as less than a commodity, or, put still another way, an acknowledgment that government has a right to ensure the health welfare of its citizens.  Anything more is (though it may not seem like it) gravy.  Anything flawed can be fixed later once that basic role of government has been established.

Sorry phylosopher, I am not trying to be glib at all. Dental care is a vital part of overall health, but back when universal health care was created in Canada, it wasn’t known to be so, and thus isn’t something our provincial plans cover. Employer-based insurances still provide coverage for this, and other non-covered needs. My experiences with our personal dental plans have been positive so far, but my children aren’t old enough to be getting into the heavy expenses yet, so we’ll see.

I would love it if OHIP and other provincial plans could cover dental care also; it would benefit everyone, as if your job has no benefits (or they suck), you will be paying out of pocket, and not everyone can. We likely pay for it anyway in increased healthcare costs in the long run. I was trying to say that private health-insurance companies still exist in Canada, despite universal coverage but are not competing for the same services. This isn’t ideal, nor meant to be promoted as such, it’s just the way we do things here at this time.

for those in the States, Québec’s position in the country is a point of contention, as the other provinces have been funneling money there for decades as an incentive to keep the province a part of Canada

That’s just bullshit. When the Maritimes receive hefty transfer payments nobody has conspiracy theories about how it’s all just a bribe to keep them in the Confederation.

We get these programs because our government in the 70s had the political will to raise the taxe revenues to get them. Nothing more.

The only money that’s been funneled is into the coffers of Liberal party friends who took a huge cut out of the propaganda campaigns. If that’s the money you’re worried about, you can keep it, we don’t need it.

Or shorter: if we were really a net drain, wouldn’t they have cut us loose a long time ago? In reality the reason we’re in is because we’re basically a colony of the federal government, and they can get cheap lumber and other natural ressources out of our colonial-style primary sector economy.

There’s also a big philosophical gain if this bill passes.  It’s a start on the road to seeing healthcare as a right or at least healthcare insurance as less than a commodity, or, put still another way, an acknowledgment that government has a right to ensure the health welfare of its citizens.  Anything more is (though it may not seem like it) gravy.  Anything flawed can be fixed later once that basic role of government has been established.

If it did those things, sure.

What it does is force people to buy a crappy product from a relatively unregulated for-profit greedy industry.

Considering the hundreds of millions that AHIP has sunk into trying to thwart real healthcare reform (And guess what?  They’ve succeeded at doing just that) from being enacted, all this bill does is give them even more money in the form of 30 Million new customers to fight real HCR even harder next time.

There will be no “fixing” this legislation.  If this passes, we’ll have made the for-profit health insurance industry’s wildest dreams come true, and we’ll literally be financing their even more strong-armed efforts at blocking any future attempts to “fix” this.  You’re gonna see all of the big health insurance companies’ stock prices skyrocket the day this monstrosity becomes law.

Thinking this is a step forward to real reform is akin to thinking that it would have been a great idea to nuke the entire city of New Orleans (with all of its poorest citizens in it) after Katrina to try to rebuild the city.

The only way HCR will be revisited anytime soon (as in, anytime in the next decade) is if we hold hostage something that the health insurance industry wants - like the mandate.

Now some will make the argument, “But, but ,but… this can’t work without the mandate!”  Exactly.  That’s the point.

We need to incentivize the need to “fix” the legislation later if we are going to pass it now without a public option or strict cost controls… so we hold the mandate hostage.  No public option, no mandate. 

That is the only possible way that HCR will actually be addressed again anytime in the near future.  You give them the mandate and no cost controls, and they will have absolutely no incentive to “fix” this craptastic bill anytime soon.  Because it will be working perfectly… for the insurance industry and the members of Congress that they have bought and paid for.

If the obstructionists agree to work with us to actually “fix” this bill down the road, they won’t mind holding off on implementing the mandate until after we have some assurance that the health insurance industry will actually have to compete for their business and end their disgusting profit-driven practices which kill people.

You really have to be Charlie Brown to naively believe that these shitbags have any intention whatsoever of revisiting HCR to “fix” the things we want fixed anytime soon after they foist this steaming shitpile upon us.

Once Obama’s pen hits that bill and it becomes law, that’s it.  We’re all slaves to their corporate masters then, and there’s no turning back until the situation becomes so untenable that health insurance CEOs start getting taken out by angry snipers.

I seem to remember a thing called “single payer” being discussed not so many months ago.  And the public option was distant, and disliked, compromise option.  Now that public option, with a shitty, woman-killing amendment, is the best that can be got.  Are you sure you want to keep on giving in?

Now that public option, with a shitty, woman-killing amendment, is the best that can be got.

Actually, that would probably be an improvement over what it looks like we’re going to get.

The Senate Bill passed the motion for cloture last night just after midnight - 60-40.  Not one Republican on board, and at least three very bought and paid for members of the Democratic Caucus (Lieberman, Nelson, and Landrieu).

The Senate Bill will be officially passed on Christmas Eve immediately before the Senate takes recess - it’s passage in that vote will only require 50 votes + Biden.

Once they return from break, the House and Senate Bills go to conference to get merged into one bill, which President Obama wants to be able to sign before he delivers the State of the Union at the end of January.

It looks very much like we’re going to get no public option + woman-killing amendment.

And while it most certainly should have been talked about, universal single-payer was never once discussed seriously in Congress - the progressive blogosphere talked a lot about it, but Congress essentially took it off the table last spring right when they first started putting committee reports together.

That was NEVER going to happen.  Not with this bunch.  Unfortunately.

BlackBloc, if you think that billions of dollars in federal equalization payments every year headed Québec’s way don’t make any difference in the social programs your provincial govt can pay for, then carry on. I don’t grudge the Maritimes their share, especially after the fisheries collapse; Newfoundland is of the equalization dole as of this year, thanks to the offshore oil refining. Hell, Ontario’s getting a few hundred million this year, too. I’m not saying that the Québecois shouldn’t have affordable daycare, I’m saying the rest of Canadian families deserve it too. So do American families, and they deserve the kind of healthcare we take for granted at a bare minimum. 

Also, I think the James Bay Cree have had a few things to say regarding Québec’s natural resource management…

Once Obama’s pen hits that bill and it becomes law, that’s it.  We’re all slaves to their corporate masters then, and there’s no turning back until the situation becomes so untenable that health insurance CEOs start getting taken out by angry snipers.

Sometimes I wonder why I haven’t been very active in discussions on HCR. You’ve reminded me that it’s because people are insane<>, and I prefer to limit my exposure to people with such a crippling lack of perspective.

I think the wonks are basically right on this. We’re not getting a public option (and even if we could get one, it would be extremely weak and not make a whole lot of impact, sadly). But we are getting a major improvement over the status quo. Need I remind anyone that the insurance companies don’t want ANY change to current policy. There’s a fucking <i>reason for that. They are exerting all the leverage they can to make a weaker bill, but they are not exactly steepling their fingers and cackling with glee; they would much rather kill it altogether.

And before the shit starts flying, let me make it clear that I am bitterly disappointed. The huge improvement that we get with this bill still leaves us with the worst healthcare in the developed world by a wide margin. It still leaves millions of people unprotected. The White House fucked this one up badly, so I’m pissed at them, too. Being less aggressive than Clinton was the right idea, but the over-the-top caution (cowardice, you might say) from the administration has been killing us all year, and this is just the icing on a shit cake. Good work, guys.

With all that said, I’ll take what we’re going to get out of this over change at all. The big thing for me, now, is keeping Stupak out of the bill.

It’s pretty clear to me from the commentary I’ve read that Obama has displayed a disappointing lack of leadership and commitment, yes.  I don’t think that makes me an idiot.  I think it makes me disappointed that the US isn’t going to get a system more worthy of its wealth because of the consistent bending to corporate power.

As predicted:

<ASSOCIATED PRESS - 12/21/09 (Updated 34 minutes ago)

NEW YORK — Shares of health insurance providers leaped Monday after a key Senate vote on the country’s health care overhaul put legislation on track for passage before Christmas.

Shortly after 1 a.m. on Monday, 60 senators voted to shut down a threatened Republican filibuster on a health care reform bill. The Senate bill would make health insurance mandatory for nearly everyone, covering 30 million currently uninsured Americans. A final vote in the Senate is expected by Christmas Eve.

The House passed health-care legislation in November. The two bills must still be merged into one before President Barack Obama can sign it into law.

The Senate bill does not contain a provision for a government-run insurance plan, which managed-care companies have contested. The House bill, however, does include that option.

Investors have been worried for months that a public option would provide unfair competition to private insurers in part because it would receive government financial backing and could set reimbursement at artificially low levels.

On Monday, a Credit Suisse analyst boosted his price targets on seven insurance providers.

“The ultimate passage of health care reform, expected early next year, will serve as a positive catalyst for the managed care universe,” said Gregory Nersessian in a note to investors.

He raised his price targets on Aetna Inc., Amerigroup Corp., Cigna Corp., Humana Inc., Molina Healthcare Inc., UnitedHealth Group Inc. and Wellcare Health Plans Inc. He also boosted his profit estimates for Health Net Inc.

Shares of Aetna rose $1.81, or 5.6 percent, to $34.32; Cigna gained $2.15, or 6 percent, to $37.95; Humana added $1.71, or 3.9 percent, to $45.24; UnitedHealth traded up $1.35, or 4.3 percent, to $32.89; Wellpoint Inc. jumped $2.19, or 3.8 percent, to $60.51. All hit 52-week highs, except for Humana, which was a little more than a dime short of its 12-month high.

Wellcare also rose $1.47, or 4 percent, to $38.41; Health Net rose 73 cents, or 3.1 percent, to $24.28; Molina rose 61 cents, or 2.7 percent, to $23.02; and Amerigroup rose 49 cents to $26.28. Wellcare and Health Net hit 52-week highs as well.

Gee, just about every single major health insurance company in America has hit 52-week record highs today as the huge corporate monopoly giveaway moved one step closer to reality this weekend.

Nobody could have possibly seen this one coming.

Need I remind anyone that the insurance companies don’t want ANY change to current policy.

Right.  I’m sure they are all infuriated about all of the money they made today, and the even bigger pile of money that they’ll be making if this abomination passes after conference.

Just infuriated, because they just hate making billions of dollars.

DTG, you’re welcome to believe that a similar rise in stocks would not have occurred with the inclusion of a wimpy public option that would have covered almost no one (which is the only thing that might have been remotely possible in this fucked-up country), but believing it wouldn’t make it true. As for me, I remain shocked - shocked! - that increased enrollment will lead to increased profit to insurance companies. Even a bill with a robust public option would increase private insurance enrollment. So, what, exactly, is your point? The big question is margins. Do they stay the same, or go up? A robust public option might shrink margins, but it would still be a money-maker. Not that insurance companies want such a thing (rationally, since a public option would probably lead to further reform as citizens realize how much better the service is and demand it for everyone), but they net more revenue under it.

The only HCR option that would probably NOT lead to an increase in private insurance enrollment, and therefore to an increase in their profits, would be single-payer or a near cousin to it. Which was never going to happen, unfortunately.

So I can’t get too worked up about a bunch of stockbrokers thinking that Aetna is going to make more money in 2014 than in 2009. It certainly does herald the coming of our New Age of Corporate Slavery.

ARGH. “Does NOT herald the coming…”

@ #89 It’s actually a testament to how much progressives HAVE wanted HCR and how hard they have pushed for progressive reform that we’ve even gotten a bill as good as the crappy, compromise-filled one it looks like we’ll get, in the face of such tepid leadership from Obama. It makes the anger even more dissonant; if it feels like you’ve been betrayed, maybe you should consider that without all that work, there wouldn’t have been anything at all. The netroots have had to fight all the bullshit thrown out by the anti-HCR noise machine essentially all by themselves.

Of course, that assumes that you think that the current bill is better than nothing; personally, I think that from a Utilitarian perspective, you’d have to be crazy not to see this as an improvement. We’re talking about covering something to the tune of 17 million more people in this country. That’s a win in a health care industry as sick as the one we’ve got.

What’s funny about this is that what we’re going to end up with is basically what Hillary Clinton proposed in 1993. Subsidies so people can afford insurance, a mandate (with hardship exemptions) and a big expansion of Medicaid and SCHIP.

If this were 1999 instead of 2009 and this bill were about to pass, progressives would be thrilled. We’ve just raised our expectations. Nothing wrong with that, just something to think about. There’s been progress.

So, yeah, in case I’m not clear, pass the bill. Even with the insurance companies making more money from this it will STILL do a lot of good, more good than the status quo. And it will change the framing of healthcare—it will be seen as a RIGHT after this bill passes. The 30 million who are covered will not have health insurance taken away from them again.

Even with the insurance companies making more money from this it will STILL do a lot of good, more good than the status quo.

i, It does not address the basic problem of the ubsustainability of health care costs in America

ii, It makes attempts to address this in the future that much harder.

You’ll be paying for this bill for decades to come, in some quite unexpected ways.

i, It does not address the basic problem of the ubsustainability of health care costs in America

http://www.dailykos.com/story/2009/12/19/816837/-The-Public-Option-Distraction-(Or,-Why-This-Bill-Should-Pass)

It actually does a hell of a lot to address that problem. And it will make attempts to address it in the future easier.

Oh, and you might want to check out this chart:

http://www.fivethirtyeight.com/2009/12/why-progressives-are-batshit-crazy-to.html

I disagree, mostly because I disagree with the last point.  It will be much more difficult to repeal Stupak than it will be to pass a public option.

As I understand it, the public option is eligible for reconciliation, so if the Democrats were so inclined, they could pass the public option separately with a simple majority in the Senate.  Majorities of both houses support the public option, so in theory, they could pass this bill with 60 and the public option with 50 and be done with it.

Stupak repeal, on the other hand, could be filibustered.  And we don’t have 60 Senators opposed to Stupak, which means that once it passes, it will be far, far harder to repeal.

So pass health care without a public option and without Stupak, then pass the public option (or Medicare expansion, or whatever form of public insurance is desirable), and everyone is happy.

Thank you, Chet.

I’m sure this “idiot” insult that you are flinging around is intended to sting.  However, I’m not going to get bothered by insults thrown by someone who knows next to nothing about me, my situation, or my views.  If you can’t be bothered to address the debate without being personally insulting, that’s your problem.

I don’t think Obama could get any deal just by wanting it hard enough, no.  I don’t believe I ever said that.  I do however think it is clear that a better deal might have been possible if a bit more backbone had been on display.  Your anger at the situation is understandable, but directing it at me is misplaced.

And people keep going on about the 60th Senator when, as I understand it, 50 votes is what is needed to pass.  Oh I know, the filibuster boogeyman.  Which, alas, just displays how much bending over backwards to the tactics of the Republicans leads to the goalposts being constantly pushed back and back and back.

My point, should you care to actually listen, is that no major changes can ever be made without leadership and commitment to a principle.  This may not be a sufficient condition, but it is a necessary one.  If Bevan had given up in the face of opposition from the doctors in the UK, we would never have got the NHS, for example.

And people keep going on about the 60th Senator when, as I understand it, 50 votes is what is needed to pass.

Your understanding wrong.

Reconciliation only works with budget items. It won’t work with regulations. And it has to be re-visited every five years.

Okay, reallly dumb question here and I apologize, but here goes: so, in worse case sitch where fetus is dead/brain-dead/not-viable-after-“birth” and abortion is the obvious solution to guard a woman’s health and reproductive potential, could a c-section be performed and paid for via the insurance proposals (which is more dangerous than an abortion, certainly and not medically indicated, but also wouldn’t leave woman financially ruined)???? Of course, NICU would be used to keep a fetus at 25 weeks “alive” for 30 seconds and all—and a medical team for said dead-fetus would need to be utilized/billed at the same time—so this would all be ridiculously expensive and unnecessary, but still…is this what might happen?

This is not to erase the legitimate concerns of lack of coverage of abortion at all stages and to a woman in poverty, a $500 abortion bill may look as daunting as a $15,000 2nd/3rd trimester abortion to a middle-class woman in above scenerio.

Regarding the public option, I do think that there’s serious possibility for 60 votes with a public option, if it comes about as a “trigger” option, meaning that if premiums are not down to level X by 2014, the public option comes into effect. This will allow Liberman and Snow to pretend like that’s all they wanted all along, the public option is not all evil if there’s the “trigger” that proves…well, that they were wrong to oppose the public option. I think that face saving language like that could result in essentially the same thing initially proposed, since we did have such big wait-times in the reforms for banning discrimination, etc.

First, the reason why we receive billions: we get less per person than the other have-not provinces, but we have a much larger population. This has absolutly nothing to do with bribes, though yes, the federalists have used it as an argument against separation… the way the USA might say to the Bible Belt states that it would be pretty stupid of them to split since they’re net recipients of federal aid. A simple statement of fact.

http://network.nationalpost.com/np/blogs/posted/archive/2009/02/04/what-the-is-the-deal-with-quebec-receiving-8-billion-in-equalization-payments.aspx

I’m not saying that the Québecois shouldn’t have affordable daycare, I’m saying the rest of Canadian families deserve it too.

Well the rest of Canada should get cracking on getting Conservatives out of power and getting the NDP in. Maybe get unionized on the same level as Quebec, too. That might help.