A White House official, speaking on background, stressed that the meeting in no way signals a retreat from Obama's commitment to push ahead with comprehensive health care reform. He's interested in hearing out Republican ideas, the official said, but when the discussion is done he wants to see a bill move forward--and pass.Why? Is he seriously interested in changing the bill to include more Republican ideas. Seriously? If not then what is he doing? Trying to show the American people how broad-minded he is? I like how Obama has come out over the past week. But I can't escape the feeling that there is no real plan. One day Rahm is telling us that health care is fifth on the list of priorities, the next day Obama is telling us that it's still at the top--or some such.
I'm having a really hard time seeing how this is going to happen. They don't have the votes. And by Obama's lights, it doesn't seem to much that can be done to create them. If Democrats lose this, with the kind of majority they command right now, with a Democratic president, why should any voter trust them to do any of the heavy lifting that's needed in this country?
The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood 
I find it very hard to believe that Obama would actually think the GOP has even the slightest interest in cooperating with him. I just can't believe he'd be that naive, especially after seeing how skillful he was as a candidate. I have to believe that he knows the GOP wants to sink him and is just calculatedly going through the motions of bipartisanship.
I agree. The failure of HCR is on the Democrats. The Republicans' failure to show any sign of interest in governing is not as important as the failure of Democratic leadership to instill even the most basic discipline within the party. They allowed for a potentially very popular reform to be hijacked by less than a handful of petty, arrogant and self serving "moderates" in their party. The party leadership is toothless. And the only way it will improve is if Reid loses his Senate seat this year.
I've never wanted a Democrat to lose so badly.
The rest, TNC, I wholeheartedly agree with.
I agree about Harry Reid, I would loke to see him lose and he can take Arlen Specter with him......and John McCain. I am bipartisan.
yep, this is pretty disturbing. when this all started i heard concerns from some heavy hitters that this would be a test of whether or not our federal govt was still capable of making serious reforms on a national scale and the answer so far seems to be no. when the prez met with the house repubs and said that he had in fact read thru their ideas and done with them what he could i assumed that barring any new ideas from the right that this was the end of the conversation, so this just seems like more theatre as usual, so much for the new style govt.
In the end, this feels to me like it’s the president seeking the mandate to push something, anything, through. Democrats, always concerned with what polls well, have become so frightened by the numbers on health care, that they seem more or less ready to do nothing to ensure the reforms they’ve already voted on get signed into law. I think this summit is designed to be something of a bait and switch. Invite Republicans there to talk about what they want, ideally expose their ideas as being largely ineffective at combating either of the larger problems of cost and coverage, and show that many of the ideas (some form of tort reform and buying across state lines) are already in the senate plan.
I don’t know that it can work either. Republicans would have to be really stupid to walk into such a summit unprepared to discuss matters in a broad way. But Obama is hoping, I think, for something similar to a couple of weeks ago, where he could shoot down GOP talking points, and redirect focus to the object at hand. If it works the way I think he’s hoping it will work, it could be greatly impactful. But it could just as easily end up being another in a series of distractions that push a final bill further and further away from his desk. I think it’s what he has to do politically to attempt to give cover back to the cowards in the Democratic caucus.
TNC --
I think you've maybe missed the point. The point is not to engage with Republicans to come to a consensus on health care: that, as you've pointed out, is virtually impossible. Rather, the point is (a) to directly confront every Republican talking point on health care at once and win, and (b) rub the public's nose in Republican intransigence. Obama still believes that his repeated attempts at bipartisanship will result in a narrative that *he* (and not his opponents) is willing to be bipartisan. This is a fight that I feel confident Obama can win. I'm a little less confident that it'll be enough.
He's a brilliant and articulate advocate. And the health care bill needs one last push to get it over the edge; two weeks or so of rising favorability numbers on passing the bill is reasonably likely to be sufficient to get. the. bill. passed.
I'm also more optimistic than you on the chances of the bill being passed: there's been nothing that, to me, would indicate that a reconciliation fix would be impossible, other than the necessity of clearing the parliamentarian with an amendment to a law that hasn't been passed. My own back-of-the-envelope whip count leads me to believe that the number of votes in the Senate is somewhere quite near 50 now, considering that Baucus and Conrad (both Senators somewhat above the 50th-vote mark) are onboard with a reconciliation fix.
ACS: "I think you've maybe missed the point. The point is not to engage with Republicans to come to a consensus on health care: that, as you've pointed out, is virtually impossible. Rather, the point is (a) to directly confront every Republican talking point on health care at once and win, and (b) rub the public's nose in Republican intransigence. Obama still believes that his repeated attempts at bipartisanship will result in a narrative that *he* (and not his opponents) is willing to be bipartisan"
Exactly.
This. I think the Obama administration's unwillingness to broadcast their plans in public stems from experiences in which Republicans immediately move to counter with some bs obstructionist noise. The public may feel a little alienated right now, but if the WH can come through on this, I think the public is willing to forgive and forget.
This is what I would think is the main focus of this meeting - for Senate Democrats who are on the fence for the reconciliation fix. If Obama hammers home the fact that there is no bipartisan option, it may help them get the fact that there's no other option.
I agree. I think since the Mass. election, conservadems have been on the fence, and this entire exercise is helping to bring them back into the fold.
I don't mean to be judgmental or essentialist, but there are few Atlantic readers (or political commentators) that quite understand the electoral incentives driving conservative Democratic politicians. I can fairly confidently say that many conservative Dems (or at least Western libertarian Dems) are firmer votes for a modified Senate bill than they would've been for a conference bill. In many ways, the problem here is less severe than most commentators think.
Which is not to say it's not dire. It is. But I don't see that the wholesale loss of the Blue Dog caucus on a modified Senate bill is quite on the table here.
I agree with this and all the above subreplies. All I can add is that this is about changing the narrative, from "why don't the Dems work with Reps?" and "why can't they get anything passed" to "those darn Republicans said they'd pass a bill if it included X, and 2 weeks later they're bailing--you just can't negotiate with those people, they aren't acting in good faith."
The president is visible enough to make this more evident on the national stage; Reid doesn't command enough camera and news time. Or cooperation--Reid can't dare them to show up or not in Congress, they'll be there. Obama can dare them to show up at a nationally televised venue to explain and defend their hcr ideas.
It's even mildly possible that some Rs will see that the party of no tactic has had its run and will start getting some accomplishments of their own up there--"we wouldn't vote for hcr until they put malpractice limits in."
Yep, exactly, ACS.
It's Republican intransigence that is the target of this TV event.
Their bet-the-farm electoral strategy of blocking any major policy bill, even if it would help their own constituents, in order to win one mid-term election - that is what I think will really be on display on Thursday.
It also gives Obama a great opportunity to toss Ben Nelson under the bus, which I would relish, since Obama only needs 51 votes in the Senate to do reconciliation and strip the Nebraska bribe.
At least Nelson has great Senate health care after bus bounces over him.
Yeah, as theater I don't think it's that smart, though. I just can't see the GOP walking into a punch again, the way they did last time. Likely they'll use the fact that Obama's committed to the bill on the table as a shield.
Moreover, I'm not convinced that the public so much believes that the Dems rammed this through, as they want a conversation about jobs and the economy. It's not like the Gang of Six didn't happen. I just don't believe that more health care process is going to change any minds.
It doesn't need to change minds on a grand scale, TNC. It just needs to change the minds of enough Senators on the fence that it makes the bill passable. Essentially, it needs to convince 10 of the 19 Senators least likely to support reconciliation that reconciliation is more likely than not to improve their electoral chances. Once that's done, the progressives will come on board: I have few doubts that Grijalva's (and the SEIU's) stance against the Senate bill is a negotiating position. They've wanted reconciliation all along -- and by pretending to be unreasonable, they make clear that they have reconciliation.
And if he can move the needle w/r/t healthcare reform at all, giving it that last bump over the edge into popular territory at all, I think it can drive home the point to the poll-watching lemmings that aren't inclined to support the bill.
-- ACS
P.S. I'm not convinced the conservative Dems are still a problem. I have it on reasonably good authority that the leadership has my representative (Walt Minnick, the most conservative Democrat in the House) in her pocket for a final vote on the Senate bill. Further, only five of the eleven Stupak votes are votes against. Given the math that implies, I suspect that the bigger problem is with the entire progressive voting bloc holding out for the House.
"I have to believe that he knows the GOP wants to sink him and is just calculatedly going through the motions of bipartisanship."
That's what I think too. And I have no problem with this. Bipartisanship doesn't mean it actually has to succeed you just have to try. He's giving them a fair chance, and I don't think this is for the GOP's benefit anyway. This is for the voters benefit to show that he is listening to both sides. I belive you can negotiatie around the details of a bill, but not give up on the core principles.
I think Obama is doing his part. He cannot force the senate to do his bidding all he can do is be a really strong cajoler. This is his style and I am in full support of it.
They don't have the votes for what they wanted to do before Brown true. But reconciliation is still an option. The way things are going I think there is a lot of backroom dealing right now, the public messages are going to be cryptic-seeming.
Unshitting the bed is never an easy process.
He has got to be playing a bit of chess here, I'm hoping against hope. He has to see that their whole purpose is to prevent passage of anything, because as bereft of ideas as they are, people just won't vote for democrats if they had this kind of power and didn't get it done (with student loans now appearing to be going the same way). It's the only way the Republicans can get power back: showing Democrats to be pathetically ineffectual.
The man is smart, smarter than me I have no doubt. He has to be working a game plan here.
He's definitely playing them.
The GOP either shows up and get smacked around or they boycott the summit and still get smacked around.
Of course, the problem still is the Congressional Democrats. And maybe this is the only way to convince them to PTDB, since they (and Congress in general) currently are incapable of legislating beyond random proclamations, non-binding resolutions, and quick adjournments for weather.
I'd basically refer everyone to Fallows on this one:
"Dem member response: 'If we put it in, will you vote for the bill?'
"GOP member: 'You know I can't vote for the bill.'
"Dem member: 'Then why should we put it in the bill?'
"I witnessed this myself."
http://jamesfallows.theatlantic.com/archives/2010/02/why_bipartisanship_cant_work.php
Obama may be looking to rope some of the GOP into exactly that kind of exchange, except pointing out that [insert GOP demand here] is already in the bill. "So the American people can count on your vote, right?"
"Um, uh, uh, er. . . ." [Sits down]
I can totally see that happening. (Mike Pence, I'm lookin' at you. . . .)
Mike Pence looks disturbingly like Roger Sterling from Mad Men. Just sayin.
Heh. Yeah, I think it's the hair. But I don't go gooey, as I do for Roger. Pence is missing that je ne sais quoi.
Eh, wishful thinking man. This is a party whose stance was basically encapsulated in that famous sign: "Keep you're government hands off my medicare"
I think they got better coverage than they expected from the meeting with the House GOP -- you know it's a win when Fox News cuts away in the middle of it -- and they're trying to do the same thing here.
I don't think Obama believes he's going to win any GOP votes on this, nor do I think he's going to encourage the Dems to make any more concessions. I don't think this event will change the legislation in the slightest. What it may do is help frame the debate a little more rationally, and buoy the support for the bill among some wavering Dems. It's the Dems on both sides -- Blue Dogs on one side and progressives who can't stand the current bill on the other -- who need convincing, and who may yet be reachable, at least enough of them to pass the damned thing.
Maybe.
If Obama's on his game, like he was during the House GOP session, he may be able successfully to make the argument that the existing bill already has significant bipartisan elements, and that far from being something that's being "rammed down the throats" of the American public, it's only gotten as far as it has as a result good-faith efforts on one side of the aisle to accommodate the opposition, against virtually unanimous obstruction, obfuscation and outright lying on the other.
I have no idea if this will make a difference. I hope it does.
This does remind me too, and I'm surprised it hasn't come up more--why is Olympia Snowe any different than Joe Lieberman on this? She wanted the trigger, right? Well, now the public option isn't even in the bill...Of course I know the answer to this, but she should be getting more heat.
I'm a little surprised you don't see this for the political theater it clearly is.
The Democrats, and Obama, allowed the messaging on Healthcare Reform to be hijacked and abused by the Republicans and the media; they have to re-calibrate in order to get anywhere, because as you say, they don't have the votes currently.
Whether grounded in facts or not, the public perception of Obama and the Dems is that they weren't interested in Republican ideas and tried to jam through a backroom-crafted piece of legislation. The meme has taken hold and we can all agree that while this is mischaracterizing the way it went down, the Dems really should've played this differently at least when it came to the public face of it all. So they've got to now re-extend the olive branch, look a mite more sincere than they did last year, and in the process get the Republicans on camera rejecting ideas they in fact agree with, obstructing, and otherwise looking foolish.
I wish I could say that this was unnecessary, but the Dems have bungled their first year so badly when it comes to the message control and optics... I'm just hoping that this all makes it a little more clear who's really working in the best interests of the American people.
The meme, or winning narrative, matters. "They weren't interested in Republican ideas and tried to jam through a backroom-crafted piece of legislation" may be a story we're happy with in this blog, but it isn't what was winning in the press. The Dems need to change that narrative, not look backward and explain why it's the wrong narrative.
"happy" should be "not happy"
All power to the spam filter, blessings on its name.
"The Democrats, and Obama, allowed the messaging on Healthcare Reform to be hijacked and abused by the Republicans and the media"
On this, I think the abuse and hysteria, and the subsequent media coverage of such, was inevitable. I don't think the Dems could really exercise much control over this. And as always, hindsight is twenty/twenty.
I'm slow. Basically what several others have said above.
I'm not sure why you think this is a bad idea. The damage to Obama and the Democrats is done; they can lose nothing now by continuing to bring up the issue of health care. They already look bad. If, on the off chance, they can get something passed, their fortunes can only improve.
What the GOP want at this point is for the words "health care reform" to disappear from the political vocabulary until November when they can use the Democrats' failure against them. That would be a victory. But there are many months until November still...
Obama should say "health care" once every other day from now until it (hopefully) gets passed. The conventional wisdom might be that, unless you're sure you can pass a bill, you shouldn't bring it up. But I think that would be a major mistake. Stop running from the issue. The only people now who have anything to lose by continuing this debate are the Republicans because they've claimed in public that they want reform -- if only they'd been consulted. Now Obama is inviting them over to talk... and they're turning a cold shoulder to it. Obama needs to keep doing this until it becomes clear in the news cycle that Republicans aren't interested in working toward health care reform.
Even if many Americans disliked the way Democrats tried and failed to get the bill passed in 2009, most still believe health care reform is necessary. So, Obama should keep raising the issue, keep saying that here's a starting point, here's a way to deal at least with pre-existing conditions. And each time the Republicans say "no," they hurt themselves.
The last thing Republicans want to discuss is health care because they know they don't have a way forward on it. They want to talk deficit because that's code for "cut taxes" and pass no other substantial legislation.
This is a cold, political look at the mater. I hope, for the sake of the country, that some Republicans do take Obama up on his invitation. I'm willing to see a compromise bill go through; let's at least try to deal with pre-existing conditions (I ask this selfishly for my mother-in-law's sake; she's self employed, lost her health insurance after her divorce and now can't get insurance because she has diabetes... she'd pay for it if she could!).
You wrote, "But I can't escape the feeling that there is no real plan." I don't see how there can be a plan when you can't be sure of how people will respond. But there can be a strategy, and this invitation for a health care summit from Obama seems to fit clearly in his strategy of keeping the issue of health care alive and attempting (or at least appearing to attempt) bipartisanship.
why should any voter trust them to do any of the heavy lifting that's needed in this country?
I don't.
This was the litmus test, for me. If the Demos cannot reform the American health care "system" I'm totally disaffected.
You have to understand where I'm coming from.
Eighteen years ago I was so incautious as to send a college-age daughter for a "junior year abroad" in Scotland, at St. Andrew's. There she met a lovely young man, a Scot raised in the Netherlands, fell in love, and married the guy. They've always lived in Europe, first for twelve years in Scotland, and then, coming to their senses at last (the weather! the weather!) they moved to Amsterdam. I'm in Europe for two weeks twice a year; I've been doing this for seventeen years.
So I know European health care up close and personal. My daughter had her two children on Scottish National Health, a completely socialized system. They are now being raised in the Netherlands, which has an insurance-based system. My son-in-law's parents, grandparents, brother, sister-in-law, niece and nephew are all Europeans; some of them have never been here at all.
These people have always in every instance received excellent care, over a wide variety of health problems of people of every age. The same is true of me on the rare occasions that I've needed help while I'm over there. My son-in-law's aged grandmother received a hip replacement immediately when she needed one, as in, the same day. In Scotland. For example. My grandson was born by C-section at the Royal Infirmary in Scotland, probably THE premier obstetric facility on the globe.
The statistics, you can check them on google. The United States spends more, per capita (that's per person) on health care than anyone on the planet. Like, a lot more. Our next competitor for cost is Switzerland, which spends about 2/3 what we do.
And what are we getting for all this money? A vast population, now like 50 million people, who have no health insurance at all, and mortality and infant mortality statistics that place us below every single developed country on earth (and, quite a number of third world countries).
So, we're paying more, like on average over Europe, twice as much per person, and getting far less.
What's the hypothesis? We're dumber than the French, who have, by consensus, the best system in the world? No offense intended to the French, but really. Is that our national image? Our national aspiration?
Americans need to travel more. There's a great wide world out there, and there really are people there who can make this thing work. So.....what happened to Yankee ingenuity?
(Please not to tell me that Obama has opposition. Of course he has opposition. All democratically elected leaders have opposition, it's part of the game. So what? We need results, not excuses.)
The problem is not that Obama has opposition; the problem is that Obama has fundamentally dishonest, cynical opposition, and disgustingly spineless allies. More so, I think, that he realized when he started. Than ANY OF US realized when he started.
Actually, there are major problems comparing infant mortality statistics across countries. The US, for example, uses a more expansive definition of "live birth" than many other countries.
http://en.wikipedia.org/wiki/Infant_mortality#Comparing_infant_mortality_rates
As for the "50 million people who have no health insurance" (actually 46.6 million, circa 2006), 14 million are eligible for medicaid/SCHIP but have not signed up. 70% of the rest were simply people who were between jobs (uninsured for less than 4 months), and didn't bother to get COBRA. It is unknown how many are illegal immigrants.
Could we see some proof of your claims in the last paragraph, Inconvenient Truth? They certainly don't square with what a rather large people around the country seem to be saying about being priced out of health care.
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On your point about statistics: yes, statistics don't match up precisely. This is no doubt true for many things. What it does not mean is that an informed comparison cannot be made. Apples may not be the same thing as oranges, but we can compare their calorific value, their vitamin content and so forth. Why should health care be different? Note, by the way, that I said an "informed" comparison.
Here are a couple of sources.
http://www.washingtontimes.com/news/2009/jun/25/who-are-the-uninsured/
http://www.washingtonpost.com/wp-dyn/content/article/2008/04/25/AR2008042502855.html
As for an informed comparison on infant mortality, where can I find one? Such a comparison is theoretically possible. But I have yet to see one, and Juaquin did not cite one. The only such comparison I've ever seen is the naive one.
Inconvenient Truth, your first source is worthless. It just makes the same assertion, without any proof, that you did. The second source cites a reasonably reputable organization, and claims that about 12 million of those without healthcare haven't signed up, presumably because of limited literacy or the complexities of the system. This leaves you with about 34-35 million uninsured Americans to explain away. Would you like to try again with some actual evidence? Or will you admit that your claims are unsupported? Do you find 34 million unemployed people unimportant? Even if the obligations of decency and shared humanity don't matter in your view, surely you would agree that it's hardly in the national economic interest to have a large population lacking proper care, falling sick, losing work days, and costing more to treat than might have been achieved with preventative care?
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Secondly, you don't seem to have any response to the point that comparisons between different systems can be made, and made legitimately. Is there some reason why you find the idea distasteful?
Another 5.6 million admitted to being illegals and 9 million are not citizens.
17.7 million earned at least $50k/year and 9.7 million earned at least $75k/year. Some middle class people choose to go without insurance (I've been one of them myself). Why is this a problem?
http://www.census.gov/hhes/www/cpstables/032009/health/toc.htm
I wouldn't agree with this without seeing some compelling evidence of it. Do you have any? Also, do you have any evidence that lacking insurance is the same thing as lacking proper care? And do you have evidence that the procedures you describe as "preventative care" are actually cost effective?
Let me repeat what I said: "...*where can I find one*? Such a comparison is theoretically possible."
Yes; the Institute of Medicine found several years ago that being uninsured had adverse health consequences and confirmed those findings in a more recent study.
The source you linked to does not state any conclusions or explain their methodology.
All they do is claim that some committees made some reports. The "for more information" link is broken.
Hi there, Inconvenient.
1. Medicaid is one of the least efficient, least comprehensive medical care "systems" on the planet. It pays for almost nothing, and requires very high organizational skills to sign up and to claim coverage. They don't pay for ordinary, down the line antibiotics for an ear infection, just for one example. No dental coverage. And so forth. I know this because I have a disabled son on Medicaid, so don't get me started on Medicaid for the love of God. It takes the combined skills of two high-earning attorneys to figure out the paperwork. Sometimes it seems deliberate.....would someone who really needed this service be able to access it? No, probably not. Is this an accident...? Ah, how cheap to exclude them!!
2. "Didn't bother to get COBRA." Do you know what COBRA costs? Have any idea how many unemployed people could afford it? Could manage the bureaucratic inroads?
You sound like someone who has no pre-existing conditions who has not (yet!) been laid off. Mazeltof. Hope your good luck continues, or that you're independently wealthy. And/or die suddenly in a car crash and don't need medical help.
OK, you win. I guess. Let's suppose, in defiance of the numbers, that the mortality and infant mortality results in the United States equaled the same numbers for western Europe. (They don't, but whatever.)
So, why are we paying twice as much per person as Europe does for this??
Regarding 1: this is probably why many people don't bother to sign up for medicaid. Nevertheless, they are de-facto insured, since medicaid can not reject them if they get sick first and then sign up.
Regarding COBRA, I've used it. It costs, if I recall correctly, 102% of what your employer was previously paying for your health insurance. And you can't be rejected from COBRA for a pre-existing condition. This means that a big chunk of the uninsured (the ones uninsured for 4 months or less) could have been insured had they dipped into their savings. Instead, they simply decided to take their chances.
Regarding why we pay twice as much, the main reason is Baumol's cost disease. The US is richer than the EU (per capita); 40% richer than France and 50% richer than the EU as a whole. The skew is even worse at higher income levels. Since medicine is labor intensive, the cost of medicine is proportional to prevailing wages (at a given skill level). Since prevailing wages are higher in the US, particularly for high skill people such as doctors, medicine costs more.
This is true for other labor intensive services as well, e.g. haircuts, education or prostitution.
There are other reasons, for instance in the US we practice a lot of lawsuit-preventing medicine (e.g., C-sections, which don't help patients, but ward off crooks like John Edwards). In fact, in the US, we really like the latest and greatest medical techniques, even though they don't have any statistically significant health benefits.
Inconvenient:
This is why many people don't bother to sign up for medicaid
Emphasis on "bother to."
The implication is that the process is easy, and the persons involved are just lazy or something. This is shockingly unaware of the real situation.
Moving right along, COBRA covers you for a very limited period. Then, you're on your own, and God forbid that you have a hangnail or something and then want to apply for private insurance. Hey, OK if you go to work for some Megacorporation, but is that an accident? Isn't that what the system wants? You're on your own, you're on your own, get it?
Prevailing wages are higher in the US than in Europe?
Earth to Inconvenient, come in, Inconvenient!
Been to Europe lately??? You think European doctors are out grubbing in the turnip patch or something??? Wow. You really need to get out more. Like, at all. European physicians are doing very well, very well indeed when you consider that they don't have gigantic educational expenses to repay.
Oh God I don't know where to start. Meet me in Amsterdam on May 7 and stay for a couple of weeks, as I will. Even better, I'll break your arm while we're there, and you can figure all this out for yourself.
At a certain level, I just can't talk to people who have this little experience. I'm rapidly developing sympathy for our host, who is continually saying that if you haven't experienced racism you cannot possibly know what you're talking about.
Incredible.
Inconvenient Truth, you really are remarkably cavalier with social . You assume that everyone has savings, even though you never offer any explanation as to why lower income groups should suddenly acquire them out of thin air. As for the idea that people without insurance really have insurance, I can only wonder whether you've resided on planet earth recently.
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Baumol's cost disease simply isn't a key factor here (and your explanation of it is rather confused, incidentally). The major reason for higher medical costs vis a vis France or Britain is simple: we have a layer of unneeded free market companies and bureaucrats between patients and medical treatment. They contribute nothing to the national health, but add substantially to its costs.
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Finally, I see you've decided that the latest medical techniques just don't matter. When do you plan to campaign for cutting off limbs without anesthetic and then dipping the stump in boiling tar?
But at least you won't go bankrupt, right?
No, I'm assuming people don't bother to do it *until they actually need insurance*. If you aren't sick, there is no reason to go through the hassle. Medicaid will not turn you down just for being sick.
It would have taken you about 5 seconds with google or wikipedia to realize that I'm correct.
I also wasn't aware that 33% poorer than the US average means 'grubbing in the turnip patch'. Incidentally, when you bring up Amsterdam, you are describing the expensive part of one of the richer EU countries. The Netherlands are only 12% poorer than the US.
Further, you need to compare the *top* of the income distribution. The US is far more unequal than most of europe (Gini index 47 vs 31), which means that there is a bigger gap at the top of the distribution (i.e., US highly skilled labor vs EU highly skilled labor).
Seriously, it would only take you a few seconds with google to check this out. Why not do that before boldly asserting that my numbers are incorrect?
For the record, I was not lumping anesthesia (invented in 1779) in with the "latest medical techniques". Nor did I intend "latest medical techniques" to refer to cauterization (invented around 1000AD) or boiled bandages (1870's or so).
In fact, I think it's quite dishonest of you to bring it up. Why are you trying to derail the conversation? Are you simply unable to argue on facts?
I just want to make my position clear.
I'm a relatively wealthy attorney, as is my spouse. We have Cadillac medical coverage (at astronomical cost). I'm nearing Medicare. We don't have an employer, and we can't be laid off.
I don't have a personal horse in this race. No matter what happens, I will get first chair medical care, so not to worry about me. What public programs don't provide, I'll pay out of my own pocket. I've got lots.
So, end of discussion, right?
But not. What kind of a country do I want to live in anyway? Is the medical fate of a newborn baby to be decided on the basis of how much money her parents have, or, which sometimes amounts to the same thing, on the color of her skin? Where is the justice here? Where is the accounting? Even if we produced the same results as Europe (which we do NOT) why is it costing us twice as much money per person? Where is all that money going?
I don't have a personal horse in this race. No matter what happens, I will get first chair medical care, so not to worry about me.
This is why I want to smack the "what's the matter with Kansas" people. Liberals can support programs they don't expect to need and higher taxes they will have to pay, and it's good because they're thinking big picture. Conservatives vote against their economic interests--for the same thinking big picture goal--and its proof to the left they're morons.
Deborah, I'm probably not understanding your post.
You want to "smack" me? Whyever? I can "support programs [I] don't expect to need and higher taxes [I] will have to pay"? Why would I "dismiss higher taxes" that come out of my pocket? Do you want to "smack" me for trying to see that everyone, not just me, gets adequate health care, even though it will cost me more money (in the form of higher taxes)?
@Inconvenient Truth
People have torn apart you statements, but I'll just focus on this claim.
70% of the rest were simply people who were between jobs (uninsured for less than 4 months), and didn't bother to get COBRA.
I went through a jobless spell. Do you know what my COBRA payments were? $1000 a month (and I paid it, because I'm deathly afraid of being without healthcare in the U.S). At the end of my few months of joblessness, it had almost come to a decision between rent/etc and the COBRA payment. I have a hard time taking anyone seriously when they think that the reason that people don't go on COBRA is because they're lazy or forgetful. When I was jobless, my burn rate was $3000 a month (meaning I was burning through my savings at that rate). So fully a third of my emergency funds were going towards healthcare.
Inconvenient sounds like a person who
1. hasn't lost his/her job (with benefits) and doesn't expect to (good luck, Inconvenient!); or
2. has a huge bank account; or
3. thinks he/she won't get sick (again, best of luck!); or
4. has no knowledge whatever of what public health benefits offer (or, as is more relevant, don't offer); or
4. can't read; or
5. doesn't care much whether he/she gets medical treatment if he/she needs it.
Since Inconvenient can not only read, but also, apparently, write, that's out of court. We're left with ignorance or malice (the notion that Inconvenient, like me, will get whatever medical care is necessary by whatever means necessary, and the devil take the hindmost).
An admirable position. All who are so inclined should definitely join.
Medicaid is not guaranteed at least not in VA. Yes they can turn you down. My mom got renal failure and then was fired (totally unrelated). She thought she had paid into the system and that of course she was so sick that this great country would help her through this time. She went to apply for medicaid (remember she is unemployed and has no money and is on dialysis). The lady told her she was not qualified. My mother sat crying because of course this could not be America. It was not until my mother mentioned that she was taking care of my nephew who was on FAMIS (insurance for kids) that the lady said that she qualified.
I think a lot of this gamble depends on whether Republicans have serious proposals that they can sell to the public.
I think Obama was buoyed by his success at the Republican retreat. But he also is probably encouraged by the release of the Ryan plan to balance the budget. The Ryan plan calls for privatizing social security and replacing Medicare for people 55 and under (when they reach the age of eligibility) with subsidies of decreasing value. This is a serious idea in that it would balance the budget (eventually, but not quickly because of the proposed tax cuts) but it is such an obvious political loser that Republicans are trying to avoid talking about the specifics while Democrats are thinking about how to have votes on its contents.
At the Democratic retreat, Republicans got to say they have ideas, but did not have to share them. Obama has seen them, and I suspect he thinks bringing them out in public helps the Democratic health care reform cause.
And if they don't come or don't participate that helps the Democrats too. The Democrats only lose if the Republicans can come off as having substanative responses that people don't hate. That would seem to be the gamble here. It does not seem to be a big gamble.
At my very worst, my most pessimistic, I actually want the Republicans to win so they're left holding the bag when everything goes to shit. I think "Four years of President Palin? That'll teach em'!" and we can all hold hands and sing because everyone will realize the error of their ways and America will put adults in charge again
And then I realize there are real people who get hurt by this stuff and force myself to start caring again. Crap
Worse we already did this with 4 (and then 8) years of President Bush. So there is no reason to think that it will teach em.
"Four years of President Palin? That'll teach 'em!"
You're right to be worried about people getting hurt, Jack. From her Sat night speech (and adding it to her earlier nuttynesses already aired), I get the sense that she's pretty convinced that she needs to gain the White House so she can nuke her some Muslims. And bring about that new Christian reign via a nice mideast Armageddon.
Just worryin, just sayin', Jack.
Considering the inevitable continuation of the recession and the long-term global economic realignment, it's more like that trick was just played on the Democrats: the 2008 electoral victories now seem a bit Pyrrhic.
Forgive me for not taking the time to quote specific cases, but I still hear some of the faith that Obama's got a stealth maneuver that will make it all OK any time now. I think it's nonsense. The real question is, why do the Democrats have so much trouble producing a narrative that gets things done? Considering how deep the fundamental contradiction in the Republican party is - essentially secular neo-conservatives (and economic neoliberals) at the helm of an essentially religious, populist movement of ressentiment - why are they now deftly gumming up the works? (The Dems have worse than a contradiction to deal with - they don't really have a narrative at all, except "wouldn't it be nice to be a little bit more like Europe?" A sentiment I agree with, but not one that's going to go far. Maybe that's the problem.)
The real problem is that even without public health care, the bulk of America isn't really suffering. Even a medical bankruptcy is quite survivable. There is little that can eclipse the purchase of so many voters - especially white, rural and lower-middle class voters - into the cultural politics that have become the chosen landscape for political narratives.
You guys have no sense of strategy.
The GOP has been lying through their teeth with the complicity of the MSM for a year now. Obama is sick of it and he's making the GOP back their shit up now. On camera.
It's like a poser b-boy in a club (this is one area I know about). There are the real dancers, the ones with a real style and groove who you can watch for hours in the circle, and then there are the posers who talk a good game and where the right clothes and are always ready to throw some hate but never step into the circle to show any skills.
Obama is making the GOP step into the circle and dance, and they're going to look like fools. You can't learn groove in 3 weeks, and they've painted themselves into a corner by saying "we've got all these ideas but he won't listen" so they can't say "no".
Obama trouncing the GOP once is fun; him doing it over and over and over again is a narrative, and if there's one thing the GOP understands it's narratives. They can see what Obama is doing, and they don't know how to stop him. Just watch — he's got this.
The GOP has two "ideas": tort reform (which has been proven in several states to have no effect on health care costs), and allowing insurance companies to offer policies across state lines. This should be a short summit.
Ha ha! Since when does the GOP and their MSM lapdogs need any proof to support stoopid ideas? Just because "tort reform" has been proven to have no effect doesn't mean they won't continue to flog this dead horse. Remember, tax cuts always create jobs - especially when multimillionaires get them!
I think the intended strategy is pretty clear, I don't think anyone's missing it. But it's pretty easy to make one side's strategy turn out brilliant when you get to write the actions of both teams when you game it out. I worry that the real life of this is going to be a whole lot messier, as it almost always is. I tend to think TNC's right that they aren't going to be dumb enough to walk into the same punch twice, and that few are looking for more talk at this point. But hey, maybe this will work. We'll all get to find out.
It's not about being dumb enough to walk into the same punch twice: the fact is you can't come up with substantial policies overnight. And they don't HAVE substantial policies, they have talking points.
I heard NPR's Mara Liasson on the radio the other day, reporting from the New Hampshire Town Hall. She expressed great surprise and amazement(!) at the crowd's strong response to Obama's comments on health care reform. Her whole thing was, "I thought this issue was dead." Yes, in Washington, where all the pundits and politicians and lobbyists have excellent health care coverage and can easily afford the yearly out-of-pocket cost increases, it is easy to declare HCR "dead" and move blithely on to the next flavor of the month topic. Not so easy for the rest of us.
Obama needs to flog this issue until congress passes the bill out of sheer exhaustion. Don't have the votes? Get them! Pass out favors! Twist arms? Horse trade! Threaten! Bribe! Force a filibuster, pass it in reconciliation, pass it in pieces, whatever, I don't care. Politically, there is no other path for the Democrats than to pass the health care reform. And the rest of us cannot afford their failure.
Yes. I too was really caught by Mara's inside the beltway surprise in her coverage. Just because the bill looked/looks endangered for a few weeks doesn't mean that people aren't still loosing their coverage or seeing family members have to fight tooth and nail for their insurer to cover a prescription or procedure.
Their lives & their financial security are at stake and one Massachusetts by-election is not changing reality on the street. I shudder at how easily the insiders think "the narrative" has changed. Uhh, only for the chatterers, dear Mara.
For the first time in over 6 months I believe that Obama actually has a plan and I hope that all roads lead to reconciliation (HCR). Publicly engaging the Republicans on HCR is good for Obama and will give him an opportunity to dispel some of the rumors about death panels, abortion coverage, medicare and it will force the democrats to show leadership and some ability to govern.
Why don't they have the votes? If you want healthcare reform, it could easily be done - now. All that has to happen is for the House to pass the Senate bill as is and, presto, it's all done. Why isn't that happening? I think it is not happening for the reason that Emanuel said: Liberals are, well, foolish (I'll avoid using Emanuel's term). Liberals in the House won't vote for the Senate bill as is, primarily because of union opposition to the Cadillac tax. So House liberals are insisting on Senate modifications to the bill, and obviously, that's not going to happen. If you couldn't get bipartisan support for the Senate bill as it is now, how on earth are you going to get any support for a more liberal bill? Liberals should acknowledge that the existing Senate bill is the best we're going to get, pass it now, and move on. Anything else is a long, slow, painful death for healthcare reform.
the reason is that a lot of people - conservative, liberal, moderate - don't want to pass it. And those who do, or even those who realize they already voted "yay" once and can't re-cast that vote, just need some cover. Obama knows this, and he's giving some people the cover to vote for it all over again, some to vote for it for the first time, and others still some cover to vote against it. And all this has to be done because unfortunately the bill is not popular and the Republicans have won almost all of the media cycles on it.
I think a lot of liberals are having to get over their disappointment that single payer is a pipe dream, that the government option is something that may take 5 years, and that corporate insurers are being perceived as the winners.
The current polling does not differentiate, mostly anyway, between conservatives who oppose it, and liberals who don't support it because it doesn't go far enough.
I think Obama is (finally) getting out on the hustings and dancing because the left has to be persuaded, and the middle has to be shown that things they want really are in the bill.
The right, eh they get to keep complaining.
The problem is that you don't have the luxury of a lot of time. The closer we get to November, the greater the likelihood of nothing happening. Politicians know that somebody is going to be against just about anything they do, so their general preference is either to do nothing or do something that has all upside and no downside. The Republicans have made that sort of thing into an art form - huge tax cuts, huge increases in Medicare prescription benefits without paying for them, etc. - all upside, no downside. However, if you are going to get something like real healthcare reform, bullet-biting is inevitable. Remarkably, both Houses did it and passed reform bills. That this happened at all was a phenomenal occurrence. If we start going back to the beginning, you guarantee that nothing is going to get done. The only hope for reform is to pass the Senate bill.
I agree with this sentiment. As much as Democrats accuse Republicans as too stupid to govern, I'm starting to come to the realization that the Democrats are too timid or too stubborn to govern. From my understanding, the White House worked out a deal with labor regarding the cadillac tax issue the weekend before the Mass. election. Then the election happened and some Dems started to waive the white flag basically while Brown was giving his victory speech. People can dismiss this summit as theater, but it gives the Dems an opportunity to a) work out any issues that can be worked out with regards to the differences between the two bills; and b) give the appearance of bipartisanship by hearing Republican proposals (which we have already heard before). There is no need to start from scratch -- it would be foolish to do so. The legislation is right there. If, after this summit, the Dems choose to walk away from healthcare, that tells me all I need to know. These people are not grownups. These people are not serious about governing this country. It doesn't matter if you elect Democrats as the most sane choice when faced with voting for a Republican because they will retreat at the first sign of difficulty. That's really all it comes down to for me at least. I don't want to hear any sob stories about the bill not having single payer, the public option, or unicorns for children as a basis to walk away. After going through this process, it is clear that what's in the two bills is the best that we are going to get for right now. The bill is not going to become more liberal, more progressive, as the time clock ticks on. This is it. So the Dems can either take this opportunity and run with it, or lose their credibility.
I think this is about Obama calling the Republican's bluff. You've got ideas? Bring 'em out.
You want to explain why you won't vote for anything? Do it with the cameras rolling.
BHO is doing everything in his power to validate campaign critiques that HRC and the Republicans leveled against him: he's all talk and is incapable of closing the deal on anything. Although the healthcare summit can rhetorically engage the Republicans and potentially paint them as obstructionists, the summit will also reinforce the above campaign critiques of BHO. If an Obama loyalist like THC cannot see the end game in this exercise, it's hard to expect a disengaged public to. The perception gaining the most traction among liberals and independents alike is that Obama is an opener and not a closer. In contrast, the tea-party right have always held two contradictory views on Obama: he is a rhetorically gifted lightweight and he's an effective totalitarian socialist.