Archive for http://rorap.net The Roanoke Valley's Most Reliable Forum
 



       http://rorap.net Forum Index -> Roanoke Valley News, Events, Politics
THE CURE

Public option

The Senate will add a public option to the health care bill.

http://www.latimes.com/news/natio...-reid27-2009oct27,0,7425185.story
Cap'n Slappy

Harry Reid finally made the decision he should have made a long time ago. It's much more important to have true competition than a bipartisan bill.
coastie

Maybe, maybe not.  We'll see.

http://www.cbsnews.com/stories/2009/10/27/politics/main5424267.shtml


Special Report

Health Care

The latest news and analysis on the continuing battle over Barack Obama's health care reform plans.
Stories
Obama: Health Care Reform Closer than Ever
(AP)  The focus of the health overhaul debate now shifts to whether Senate Majority Leader Harry Reid can persuade a handful of moderate senators to get behind his new proposal for a government-sponsored insurance plan.

That's no sure bet. Even Reid, D-Nev., didn't claim to have the 60 votes needed to pass his proposal when he ended weeks of speculation by announcing that the Senate version of sweeping health care legislation would include a provision for the government to sell health insurance in competition with private insurers.
coastie

Just saw where Joe Lieberman will filibuster with Republicans against any public option.  Other moderate Dems are undecided.  The nuclear option might be Reids only option if he's unwilling to drop it.  I don't think the Dems want that.

so much for the transparency that Obama promised.

http://www.politico.com/news/stories/1009/28750.html
THE CURE

Why wouldn't the Dems want that coastie? George Bush used it with both of his big tax cut bills.
coastie

Read this article from the NY Times:

http://www.nytimes.com/2009/08/02/us/politics/02hulse.html

Quote:
WASHINGTON — With bipartisan health care negotiations teetering, Democrats are talking reluctantly — and very, very quietly — about exploiting a procedural loophole they planted in this year’s budget to skirt Republican filibusters against a health care overhaul.

They are talking reluctantly because using the tactic, officially known as reconciliation, would present a variety of serious procedural and substantive obstacles that could result in a piecemeal health bill. And they are whispering because the mere mention of reconciliation touches partisan nerves and could be viewed as a threat by the three Republicans still engaged in the delicate talks, causing them to collapse.

Yet with the discussions so far failing to produce an agreement, Democrats are exploring whether they could use the tactic as a last resort to secure a health care victory if they have to go it alone. The answer: It would not be pretty and it would not be preferable, but it could be doable.

“This is tough stuff,” said Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee, “but, yes, it is more than theoretically possible.”

Mr. Conrad, who is one of the Democrats bargaining with Republicans, has been advising that fashioning a health care plan under byzantine reconciliation rules is a bad idea. From his perspective, a major impediment is the fact that the plans devised by the Senate finance and health panels would have to produce $2 billion in savings over five years and not add to the deficit after that.

Considering the upfront costs of trying to bring all Americans under the health insurance umbrella, and the fact that some of the structural health care changes that lawmakers are eyeing might not produce immediate savings, the deficit rules could severely limit the scope of a bill.

“You would have a very difficult time getting universal coverage in reconciliation,” Mr. Conrad said.

And that is just the beginning. Under the Congressional Budget Act of 1974, reconciliation bills were given special Senate protection and allowed to pass by simple majority votes, after limited debate, to give senators the ability to make the kinds of tough decisions required to cut the deficit.
At the same time, Senator Robert C. Byrd, Democrat of West Virginia and longtime protector of the prerogatives of the Senate, created a complex set of rules intended to impede those who would dare to use reconciliation to rewrite federal policy rather than produce budget savings.

Under the Byrd Rule, provisions where the fiscal consequences are “merely incidental” to the true intent of the legislation can be struck from the bill unless 60 senators vote to waive the rule. Reconciliation measures are traditionally scoured for such provisions, in what is known around the Senate as giving the bill a “Byrd bath.”

Because Republicans would most likely be so incensed that Democrats were trying to force through a sweeping health plan by simple majority vote, they would no doubt challenge many elements of the bill and could strip them out.

“Most of the big public policy stuff, which is really important, would not survive the Byrd Rule,” said Senator Judd Gregg of New Hampshire, the senior Republican on the Budget Committee and someone who could be counted on to use his expertise to make reconciliation as difficult as possible for Democrats.


THE CURE

Just because it would be difficult doesn't mean it won't happen or that Harry Reid won't make it happen. Reform IS coming one way or another. Another consequence of last years election.
coastie

cure wrote:

Quote:
Reform IS coming one way or another.


Much needed reform too.  It just probably won't include a government option.
Roostercogburn

coastie wrote:
cure wrote:

Quote:
Reform IS coming one way or another.


Much needed reform too.  It just probably won't include a government option.



You know, nowhere is the dysfunction of congress more clear than in the discussion of the "opt out" Public Option. Lets go back in history: We have, until recently, had a system of largely private insurer based healthcare in which large and larger for profit private insurance companies offer group plans to large "groups"--generally employer based--and individual plans for individuals and families who don't get employer sponsored group membership. That has been "state based" because, as I understand it, when you allow for profit insurance companies to sell policies across state lines state AG's discovered that they were even more likely to rip off the consumer than when you simply let them gouge people within state lines.

Surrounding this basically for profit system, in which individuals and companies pay into the plans while they can/while they are employed and then attempt to handle their health care needs through insurance is a not for profit, government run, safety net for 1) the elderly and 2) the chronically sick and poor, and 3) people who need dialysis and kidney transplants. In other words, for a very long time, the government and the tax payer have acted as a kind of safety valve for the neediest--the elderly who have chronic "pre-existing" conditions like, say, life and the the very sick and very poor. This is precisely what hurt the Post Office, of course. We allowed the growth of for profit Federal Express and UPS to cream off high paying business mail services and left the Post Office to handle the more costly and difficult task of providing low cost delivery to everyone else. In effect the government has stepped in and saved Private Business from the actual cost of carrying through on their promise to insure workers/citizens and to guarantee health care coverage by saying "if you want to refuse coverage to an elderly person, or raise premiums beyond reason, we'll catch some number of the people you throw overboard."

But of course people don't need insurance, or health care coverage, only for the portion of their lives when they are employed. In fact, as it turns out, they really need it especially when they are unemployed and unable to pay the premiums. In states where very few people are covered during their working life times and their early youth to middle age (*cough* red states, union busting red states *cough* ) people routinely get to the age of medicare coverage much sicker than they do in blue states with good health benefits through employment. The cost of lifetime coverage simply gets shifted towards the latter end of life when the government steps in and picks up the tab.

Well, that's basically what is going to happen, geographically speaking rather than temporally, with the opt out provision for states. This was an integral part of discussions, as I remember them, about Welfare back in the day. We always heard about how people from low welfare states would move to get welfare in high welfare states. We hear about women going across state lines to get abortions. We hear about citizens travelling to Canada to get treatment and drugs. We hear about "high tax" citizens going across state lines to get the cost benefit of "low sales tax" states. But suddenly we hear nothing about the individuals whose state's opt out of the public option? I'd suggest we hear nothing about it because a) fears of mass population movement for welfare purposes were wildly overstated by anti welfare people, and b) people just don't have the luxury of moving on a whim.

People need health care coverage regardless of their income level, regardless of their employment situation, and regardless of the profit margins of their insurers. In fact, generally speaking, people need more health care as they get progressively less profitable for insurance company coverage. They need more health care as they take on "risks" like getting raped, or assaulted in domestic violence, or while living sexually, or having children, or getting older. Sometimes, as we now know, they need more health care when they take on the "risk" of being "fat" as a breast fed four month old. Individuals and families in low coverage states will continue to get low coverage and continue to need high coverage regardless of the compromises that Harry Reid and the Democrats are willing to make on their behalf. This is going to be a regional "compromise".



Its time for congress to grasp that national initiatives must be national in scope. Health care choice is the perfect place for that argument to be made. Individuals require health care coverage regardless of their age, station, or location. They need progressively more health care coverage as they age, or the sicker they get. Allowing some states to "opt out" of the struggle to cover all citizens is identical to allowing private, for profit, insurance companies to cherry pick high paying/low cost, healthy people and while shoving the sickest off onto Medicare and Medicaid. Just as we are trying to prevent a situation in which the neediest have to go to expensive emergency rooms we should be actively working to prevent the situation in which the neediest drive across state lines to establish residency to get more generous benefits than their own states will cover. Not because we don't want to see everyone covered but because we don't want red states to free ride on the rest of us. This is so obvious a point that you can expect no one in congress to mention it.
coastie

to me, the logical  way to provide coverage for the poor and low-income folks would be to expand medicaid.  Set new criteria on household income, number of people living in the household etc, etc.

The problem you run into is you shift the burden to the states.

from DMA:
Quote:
Medicaid
Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid serves low-income parents, children, seniors, and people with disabilities.

In 2006-2007, Medicaid served approximately 1.7 million children, aged, blind and/or disabled individuals.

The budget for the 2007-08 Medicaid program is $11,345,677,668 – which is supported by $8,425,318,396 in revenue (predominately federal Medicaid funds) and $2,920,359,272 in state appropriations.  Medicaid's budget is one of the largest in NC government – second only to the overall budget for primary and secondary education.


In these tight budgetary times, the States are not going to want to expand their responsibilities (the only way to pay for it would be to increase State income taxes).  So, it's the old shell game - the Feds, in theory are running on a basis of "no increase to the Federal deficiit"  - and the States are unwilling to pay more of the costs.

Interesting, we'll see how it all works out.
coastie

Quote:
Moveon.org issued a warning Tuesday to any Democrat who might join Republicans to filibuster a government-run insurance option -- if you oppose the government option you will lose support from the organization's 5 million members

Senate Majority Leader Harry Reid announced Monday that the Senate's version of a health care reform bill will include a so-called public option. Moveon.org issued its e-mail to its supporters threatening revolt one day later.

The group said it surveyed its members over the weekend and found that "93 percent of MoveOn members agreed that any senator who helps block an up-or-down vote on a health care bill with the public option should lose the support of all five million of us -- no donations, no volunteering, and no help getting out the vote."

To ensure conservative Democrats will not oppose the public option, the group is launching an "emergency campaign" to urge them to support an up-or-down vote.

Despite its support, the group added that Reid's bill is still problematic.

"The 'opt-out' version of the public option has real problems," the e-mail said, adding that "the most conservative states in the country would likely opt out, potentially leaving millions of uninsured folks without access to the affordable health care a public option would provide."



then you have the good guys at moveon.org
THE CURE

The people that rode the coattails of Obama into office owe him a vote when it's time for cloture. They don't owe him a vote on the bill but they should let the American people have an up or down vote. You disagree coastie?
Outsider

coastie wrote:
Quote:
Moveon.org issued a warning Tuesday to any Democrat who might join Republicans to filibuster a government-run insurance option -- if you oppose the government option you will lose support from the organization's 5 million members

Senate Majority Leader Harry Reid announced Monday that the Senate's version of a health care reform bill will include a so-called public option. Moveon.org issued its e-mail to its supporters threatening revolt one day later.

The group said it surveyed its members over the weekend and found that "93 percent of MoveOn members agreed that any senator who helps block an up-or-down vote on a health care bill with the public option should lose the support of all five million of us -- no donations, no volunteering, and no help getting out the vote."

To ensure conservative Democrats will not oppose the public option, the group is launching an "emergency campaign" to urge them to support an up-or-down vote.

Despite its support, the group added that Reid's bill is still problematic.

"The 'opt-out' version of the public option has real problems," the e-mail said, adding that "the most conservative states in the country would likely opt out, potentially leaving millions of uninsured folks without access to the affordable health care a public option would provide."



then you have the good guys at moveon.org


Nothing new here.  Moveon.org is operating under the rules just like the big oil, financial and health insurance industry giants are doing.  If big corps. can pay them off, then big numbers at the polls can kick them out.
Just politics as usual.
coastie

These guys "careers" come first, CURE.  If they think they're going to be hammered next election if they vote for cloiture, then they won't.

If they go nuclear it will get messy and I don't think anyone (including Obama and the Dems) will get anything close to what they want.

ousider wrote

"Just politics as usual."

exactly.  It will be interesting.

       http://rorap.net Forum Index -> Roanoke Valley News, Events, Politics
Page 1 of 1
Create your own free forum | Buy a domain to use with your forum
map it!
Arts and Entertainment Articles
Arts and Entertainment Articles
Online advertising
Online directory provides free and full featured advertising services.