Pelosi Unveils House Health Care Bill

[kpete]

Source: Talking Points Memo

Pelosi Unveils House Health Care Bill
Ben Frumin | October 29, 2009, 10:42AM

Speaker of the House Nancy Pelosi is unveiling the House health care reform bill this morning. In her opening remarks, she said, "Today we are about to deliver on a promise of making affordable quality health care available for all Americans, laying a foundation for a brighter future for generations to come."

Pelosi said the bill will "insure 36 million more Americans" and "will not add one dime to the deficit" -- covering 96 percent of Americans and costing less than $900 billion. The bill includes a public option and will end "discrimination for preexisting medical conditions."

She said the plan will be put online "for all Americans to see."

Early in her remarks, a there was some loud off-camera noise -- apparently from protesters nearby.

Read more: http://tpmdc.talkingpointsmemo.com/2009/10/pelosi-to-unveil-health-care-bill-this-morning--to-crowd-of-tea-partiers.php?ref=fpa

---

FULL TEXT OF BILL:
http://health.burgess.house.gov/UploadedFiles/House_HCR_bill.pdf

[dipsydoodle]

1. Hopefully the loud noise

was the ground opening up and them falling into the abyss.

[ChiciB1]

18. Sounds Good To Me!!! Talk About "Watered Down" THIS IS IT!! n/t

[onehandle]

2. Great. Pass it and in a few years, make it single payer.

Progress.

[dnricci]

55. Bingo

I think that is the plan. Once they get any form of HCR passed the Dems can change it later. I think once the door for HCR is open, they can move to a single payer later. Think about Medicare, they have altered it over the years, and are up to part D.

[pattmarty]

84. Both of you are WRONG. Once ANY legislation is passed OR repealed..........

...............it is hard as hell to get it reinstated (Glass-Steagal) or repealed (the upcoming shitty healthcare bill). We fucked up after Obama was elected. ALL of us should have organized healthcare rallies (just like the "anti" rallies of the teabaggers) and demanded "Medicare for all". What's going to happen in my opinion on this crappy bill, is the Dems will get blamed (rightly so) for passing whatever abortion comes out of conference. Depending how actually fucked up the final bill is, Obama may get a primary opponent or two and in fact may lose the general election in 2012. Now, this depends how he handles Afghanistan, the economy and any other "problem" that arises too. But almost a year in on the Obama presidency, I really don't know how ANY liberal/progressive can be happy with "Bill" Obama at this point. Let's face it folks, he ain't gonna get more progressive in his 3 yrs left and may get worse (like Bill Clinton) if the Dems lose big in the House and Senate. So fucking much for "change we can believe in". I'm pretty much done with the "hope" thing too. In the famous words of our last great leader; "we got fooled again".

[placton]

139. patty - you are so right

this is a sell out. like we always knew it would be. just like Obama wants. Hey, if he loses in 2012, he's a multimillionaire - and free health care for life. I plan to make sure there is a primary challenger that beats him and then the next GOP candidate.

[AlbertCat]

144. Hey, if he loses in 2012, he's a multimillionaire - and free health care for life.

Yeah! That's why he ran for Prez in the 1st place!!!


Jesus.... you're as nutty as a Palin supporter!


Well, there are loopy whiny fruitcakes on both sides of everything I guess.

[Lagomorph]

197. So why it the bill ceremony closed to the public?

Open government is what we were promised and this isn't it.

http://www.youtube.com/watch?v=zPMUJ6PPHJg

[Go2Peace]

156. Yep, and it will be dogged and it is too weak to be defended.

This is too important to half ass it. This bill as written will not deliver in the way the American public expects. And when the huge holes start appearing the public will have no patience to hear a nuanced story of how this is not the fault of healthcare reform.

How in the world do we get the public to strengthen a bill that was innsufficient to begin with.

[Vidar]

226. Welcome to DU.

[JNelson6563]

72. Yes. "laying a foundation"

Sadly too many think not getting everything we want now means not getting it forever.

Julie

[zogofzorkon]

125. if your building a house you don't lay the foundation for a shed

[we_are_all_It]

159. If your goal is to have a house,

and you can't have one yet, you build the foundation for the house. Then you build a shed on it to live in while you continue to plan & build.

[Go2Peace]

162. This foundation IS NOT STRONG. It will be propaganda fodder and will hurt more than help in the end

Corporations and Republicans are smiling in glee, they got the Dems to pass something that is not strong and can be anhialated politically. We cannot do this in "small steps". One mistep and we are driven back 10 years!

[New Dawn]

223. In what way will they be "covered"? By forcing them to buy a service from a private company?

No thanks, that is fascism.

Edit: I was responding to the original post, not you.

[ooglymoogly]

81. Ahhh pie in the sky....thats the ticket to sooth the savage beast

whose pockets are being picked and the gold removed from his teeth.

[chimpymustgo]

108. Keep dreaming. We have been sold out. Again.

[totodeinhere]

134. We have no assurance that it will ever lead to single payer.

By then the political pendulum may well have swung back in the other direction, and if the pukes get back in power there is no way they would ever pass single payer.

Do you think they won't ever be back in power again? Think again. In 1964 LBJ won by a landslide, and the Dems had even more seats in Congress than they do now. Many people were ready to write off the GOP for good. But we all know what happened. Four years later Nixon was in the White House.

Or was it Viet Nam that ruined LBJ and allowed the GOP back in? Yes, that was part of it. But remember that some people are already calling Afghanistan Obama's Viet Nam.

President Barack Obama is considering sending large numbers of additional U.S. forces to Afghanistan next year...

http://www.google.com/hostednews/ap/article/ALeqM5iqyaFh_efr-brDq0rMLF1hkop0tgD9BKTHL80

It could happen again.

[swilton]

166. Well as far as I'm concerned

This proves that the Democrats (with extremely few exceptions - perhaps, Kucinich and a few others) and Republicans are cut from the same cloth anyway. When they put on their politician hats, they lost their hearts.

Somewhere it has been said that you can't serve two masters.

[No Elephants]

209. Bingo. We don't even have assurance that it will ever lead to a stronger public option.

[Umbral]

140. I wont be 'fixed' in my lifetime, I'll be dust before Congress revisits health care. nt

[BREMPRO]

143. agreed- an important step and progress. Here is a link to a summary of the bill:

http://energycommerce.house.gov/Press_111/20090714/hr3200_summary.pdf

[Go2Peace]

165. Nope, glad your on a fantasy cloud. It is an epic fail

It would have been better to strip out everything except a few provisions and make it a subsidy bill for the uninsured. As it exists it weakens long term efforts

[BREMPRO]

189. so, give up all the benefits we gain because you don't get exactly what you want.

that's just fukin stupid. sorry but i'm so tired of the lack of understanding of reality here. You and lots of other DUers here are living on a fantasy cloud if you think you'll get another chance to set in motion significant reform of health care. Give up all the hard work, stakeholder courting, weak democratic majority (because of the blue-dogs).

If the progressives join the republicans and kill this effort, we are going to be worse off. What do you think you'll get? single payer? that's a fantasy. This is reality. Please take off your blinders, read the bill, and stop siding with the republicans.

http://energycommerce.house.gov/Press_111/20090714/hr3200_summary.pdf

[No Elephants]

208. Are you expecting more than 60 Democratic Senators in a few years?

[mikelgb]

3. why 96%? who are these 4% (Millions) that won't be covered?

[BREMPRO]

14. we have nearly 15% uninsured now- reduced to 4% is a significant improvement n/t

[Raineyb]

29. Not if you're one of the 4%. Other countries cover ALL their citizens. n/t

[BREMPRO]

36. not true.

most european countries have between 1% and 2% who are not covered by insurance. Massachusetts is a better example to compare with because it's a mandate on American soil. 3% are now uninsured, but 97% are, the highest rate in the nation.

[liberation]

42. Which European countries don't have 100% coverage?

At least I can't think of any in Western Europe.

[BREMPRO]

54. they have universal coverage, but that does not mean some are still uninsured

just for example the dutch system has 1.5% uninsured, switzerland about 1%.

http://pnhp.org/blog/2009/01/21/commonwealth-on-the-swiss-and-dutch-systems/

[liberation]

64. Those are people who did not paid their premiums and are/were being penalized

Both the Netherlands and Switzerland don't have universal health care, they have hybrid public/private systems. The example you provided is not the same as being not covered from the get go.

[BREMPRO]

76. yes, but many people are under the impression that all of Western Europe and Canada

have ALL their citizens covered. I was just pointing out that there are some that don't have 100% coverage. The most natural evolution of our system would be closer to systems existing in switzerland/the netherlands, a public/private hybrid. This bill gets us much closer to their coverage percentage than we have now and should reduce costs over the long run. I'm particularly pleased to see the stripping of the anti-trust exemption and the inclusion of comparative effectiveness research. We can improve it each year, bill by bill, but we have to start somewhere that can actually pass congress.

[liberation]

78. Technically, both Switzerland and Holland have all of their citizens covered...

... your are listing the percentage of "dead beats" who did not pay their coverage and/or opted out completely and went purely private (which is an option in a lot of the EU countries). Which is something completely different than the current proposal in this bill... which leaves 5% of citizens out from the get go.

It is not the same to opt out of tourist class because you bought first class tickets, than not being allowed in tourist class because there are no more seats.

[BREMPRO]

90. The press indicates 96% will be covered, so which 4% are left out?

are these also expected opt-outs and so called "dead-beats"? or some other catagory? do you know who are we talking about?

[liberation]

98. I don't know who these people are, I also don't know how someone can be considered a deadbeat or...

... opt out of a system which does not exist yet.

That to me is why we can't use the canard of Holland and Switzerland to try to justify this clusterf*ck of a legislation.

[BREMPRO]

128. let me know when you find out, and then we can have a real discussion instead of engaging in

ignorant nay-saying.

[AlbertCat]

157. he dutch system has 1.5% uninsured, switzerland about 1%.

Well....both percentages are less than who got Bush tax cuts for the rich!


We just emerged from 8 years of no governing and the starting of 2 unnecessary wars... with the government still full of Bush/Cheney operatives.... with less than 1/4th the term over.... and people are up in arms that something is not 100%!

To me the most disheartening thing about this whole process is how the Dem leaders of the House and Senate are all content with "we can't get everything we want and blah blah blah" Did we hear such from Tom Delay????? And I don't just mean Health Care.... I mean everything they take up. Starting with lowered expectations may be the worst effect of the Bush Years. But it's also foolish to expect everything to change instantaneously after 8 years plus of Repug sabotage.

[No Elephants]

211. One percent of the population the size of Holland's is a lot different from 4% of a population the

size of ours.

[No Elephants]

212. By definition "universal" means everyone. If everyone is not covered, it is not "universal."

[pattmarty]

94. Not only did the "coverage" in Ma go up, but also premiums BIG TIME.

[BREMPRO]

129. because they neglected to include comparative effectiveness and cost controls

that come out of "fee for service" delivery. MA also didn't increase the number of primary care physicians. Comparative effectiveness research is included in this bill and the Sec of HHS has broad authority, especially in Medicare, to make binding recommendations that should reduce costs. Estimates up of 30% of our health care costs are from unnecessary procedures, and "fee for service" models that encourage doctors to do more tests and procedures.

[pattmarty]

154. What's in "this" particular bill (you do know that this IS NOT the final bill)...........

is crap and if you're honest will admit. Whatever "comparative effectiveness" is or IS NOT, ain't gonna help this piece of shit. It's awful already and it is only going to get worse before it reaches "Bill" Obama's desk.

[BREMPRO]

187. the fact that you don't know what "comparative effectiveness" is shows you aren't knowledgeable abou...

this health care debate. I would suggest before you call this "crap" before even reading the bill or understanding it, read the following:

The Cost Conundrum : http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande
The Dartmouth Atlas: http://www.dartmouthatlas.org/

once you've read them, then i'll consider your opinion.

or you can join the republicans who say that the bill "will ream the American people" and are unified against it. That should tell you something.

[pattmarty]

188. Uh, huh, sure.

[No Elephants]

213. A big reason for the cost in Massachusetts is lack of a public option.

[totodeinhere]

132. I am deeply disappointed.

Is this the best they could come up with? Those insurance company lobbyists did a good job protecting their insurance industry clients. No wonder the insurance industry donated so much money to Democrats. Now that investment is paying off for them.

Edit - This was meant to be a reply to the OP.

[No Elephants]

210. Massachusetts is an expensive failure because it lacks a public option.

And because Romney lied about the cost of "Romneycare." And because the overwhelmingly Democratic state legislature wimped out, in the name of the possible, much as the House seems to have done.

[Kokonoe]

152. The people who do not give $thousands$ to insurance companies..

I guess their saying millions willfully refuse to give money.

[bigdarryl]

4. The bill SUCKS!!!!

Health-care my ASS!!!!

[tridim]

5. It's not perfect, but it also doesn't "suck"

Why are you so pissed off?

[BREMPRO]

11. large group here doesn't understand compromise.

they'd rather have no health care reform because it's not single payer. Given the reflexive response, not much thought behind it. the perfect is the enemy of the good

[Raineyb]

30. We're talking about people not being able to see doctors due to lack of insurance

we're talking about the difference between life and death. Are going to volunteer to be one of the people who aren't covered at all?

I didn't think so.

[merh]

34. As an uninsured all I can say is - thanks for compromising

at the risk of my well being.

How big of the folks that represent "we, the people" - well we the 96%.

[Ms. Toad]

107. As an uninsured, you will be one of the FIRST covered. n/t

[merh]

115. What if my state opts out?

What happens then?

And how do you know I won't fall into the 4% that won't be insured?

[Ms. Toad]

123. In the versions I have read, the first eligible

are the uninsured and micro-employers. You have declared yourself uninsured - that puts you in the first wave.

If your state opts out of the public option, you will still be eligible for a policy from the exchange (mandatory issue, non-discrminatory premiums, etc.) - you just won't have the added choice of the public option.

[Raineyb]

141. I'm sorry? I'm not suggesting we compromise in such a manner at all

Frankly we need a single payer system that covers everyone. Barring that a public option that covers EVERYONE not one that only covers 96% of those who are currently uninsured and which also forces people to accept sub-par insurance because their cheap bastard employer offers it to them.

Insurance companies should stick to extras like private hospital rooms, non necessary cosmetic surgery and "platinum services" that are not necessary to keep healthy but are nice to have like they do in the countries that have universal coverage.

[BREMPRO]

40. I'd like to get everyone covered too, but look at the example in MA

they have had a mandate for 4 years and still have 3% uninsured. I'm just being realistic. we can reduce significantly the number of uninsured with this bill. That's a good step. Even western europe have on average 1% to 2% not covered by insurance. 100% is a good goal, but not going to happen under any circumstances. Many hospitals now provide free coverage for those below the poverty line- so even now they shouldn't die if they are sick. Those who don't have insurance by choice are taking a HUGE risk, that we all pay for. This bill "guarantees affordability"- now the devil is in the details on that, but again, its a good step. If we get more people covered, more will make a habit of regular doctor visits and screenings, and more people will NOT get too sick for early intervention and not die as a result, and costs will be reduced. This is a good thing. I keep saying here don't let the perfect be the enemy of the good.

[dflprincess]

52. Having insurance doesn't mean you can get care

not if you still can't afford a visit to the doctor or a procedure will cost because you haven't met your deductible.

Not only should the insurance companies like this bill, it will be a boon to the credit card companies as many people will have to continue to use plastic to pay medical bills.

[SandWalker1984]

69. Having insurance definitely doesn't mean you get health care - it's the loopholes

The premise is a mandate in which every American shall be forced to buy private insurance. Apparently that is uncontroversial, to our leaders, but the notion of providing a government-backed plan for those who do not want their health and welfare tied to the same companies that have been screwing them over for decades, now that is a bridge too far.

But absent a public option open to ALL Americans, and absent meaningful reform of the existing private system, it is nonsensical. It is worse than nonsensical, because it mandates a marketplace for a product that will not substantively assist people in actual need of healthcare.

Each company will price an insurance option to be whatever the subsidy turns out to be; that insurance will be provided to be as shoddy as possible, with massive deductibles, gigantic loopholes, and all the other tricks of the insurance trade rolled into whatever bottom-rung "package" is deemed the minimal necessary.

If someone were to actually get sick, an insurance policy with a $20,000, or $50,000, or $100,000 deductible -- so-called "junk" insurance, of the sort that is becoming more and more prevalent as insurance companies price their other products steadily out of reach of more and more consumers -- will not prevent bankruptcy. It will not provide preventative care, of the sort that would stop illnesses before they became catastrophic. It would do nothing to curtail costs.

IT WILL NOT FIX THE PROBLEMS WE ARE NOW FACING, IT WILL ONLY MAKE THEM WORSE!

THAT IS NOT THE MEANINGFUL HEALTHCARE REFORM WE WERE PROMISED!


This is more of Obama/Orwell's change we cannot believe in.

[chadmak09]

95. dead on!

I agree 100%

Mandating insurance on people is not going to get people healthier.
Its just going to make more people have money problems.

Most people that file for bankruptcy HAVE INSURANCE!!!

Its the deductibles and co-pays that get them.

And people die from lack of healthcare with insurance just like those without.

This bill is a total joke.

Some of you guys are wanting to claim a victory (any victory) for obama so bad that you cannot see this bill for what it really is.

And thats a gift to the insurance industry.

Forcing people to pay huge amounts for insurance is a HORRIBLE IDEA.


We need single payer!!!!

Not a public option that 90% cant join and states can opt out of.And on top of that, an insurance mandate without competition being provided.
Thats not reform.

Lets stand up and let obama know that we WANT REAL REFORM.

Not some watered down joke of a bill created just so they can claim an empty victory for political/election points.

[Ms. Toad]

113. Read the bills.

>>Each company will price an insurance option to be whatever the subsidy turns out to be; that insurance will be provided to be as shoddy as possible, with massive deductibles, gigantic loopholes, and all the other tricks of the insurance trade rolled into whatever bottom-rung "package" is deemed the minimal necessary.

If someone were to actually get sick, an insurance policy with a $20,000, or $50,000, or $100,000 deductible -- so-called "junk" insurance, of the sort that is becoming more and more prevalent as insurance companies price their other products steadily out of reach of more and more consumers -- will not prevent bankruptcy. It will not provide preventative care, of the sort that would stop illnesses before they became catastrophic. It would do nothing to curtail costs.<<

There are minimums that must be met to qualify - and they don't include $20,000-$100,000 deductibles, and prohibit many tricks of the insurance trade - such as lifetime caps, and most require preventative care.

The bills are far from perfect - but they also aren't the gloom and doom you are suggesting.

[swilton]

131. You Nailed It!

We have a public option that has more loop-holes than Swiss cheese......The first mistake was compromising from the get-go and taking Single Payer off the table.

THIS IS A BIG GIVE-AWAY TO CORPORATE INSURANCE AND BIG PHARMA.

[pattmarty]

110. EXCEPT for the 5000 dollar deductible plans that will surely be offered.............

..........by your friendly insurance company. Also, the "copays" can be juggled by the companies. For example instead of 80-20 (which is bad enough if you have a $20,000 bill) they are talking of "streamlined" plans of 65-35, whoopee, such a fucking deal. It's bullshit and dreaming of "change you can believe in" ain't gonna change that fact.

[liberation]

45. A fairly large group don't understand negotiation...

Hint you start high, and then you compromise. You most certainly don't start with a compromise, and then expect to negotiate your way back to where you wanted to be at the beginning.


I thought it may be useful for some of you... especially if you are planning on visiting countries where haggling is still used, and/or are planning on making a big purchase like a car.

[BREMPRO]

56. this is a good point, and in hindsight keeping single payer on the table

for negotiation might have improved our current position. However, you could also argue and imagine that having single payer on the table would have immediately pushed the heavy lobby and advertising guns of the insurance industry into full assault, and the single payer advocates not willing to compromise, that may have killed any attempt at reform. It was a political calculation and consistent with Obama's campaign platform.

[liberation]

68. In restrospect?

Some of us we've been saying that from the beginning, and then we were told things about ponies and what not...

It is starting to become more and more tiresome to be ALWAYS correct when it comes to matters of common sense, and being asked to subsume said common sense in the name of some weird voodoo double plus secret winning strategy by the DC politician d'jour.


The funny thing is that I have a great job, a great coverage, and I am married to a doctor. So as far as I am concerned I am A-OK, I don't even know why I give a rat's ass any more. Enjoy the shafting guys!

[Raineyb]

150. Thank you.

Retrospect? People have been saying this FROM DAY ONE. In fact people are saying it now. I've never stopped saying it. Taking single payer off the table guaranteed that we wouldn't get reform that would actually do us any good. But I'm sure the insurance companies are creaming their pants. They get us ordered to buy their shitty product without having to do a damn thing to fix their egregious business practices.

Insurance companies are leeches! They do NOTHING to improve access to health care. Quite the opposite actually, and if we had only ONE entity paying the doctors and hospitals we could use economies of scale to guarantee savings across the board without health care providers having to worry about getting paid! Economies of scale are perfectly fine for Walmart when it's undermining American manufacturing by forcing down prices to the point where the companies send their manufacturing and jobs overseas, in the service of getting cheaper plastic widgets but when it comes to something as our health and well being it's not worth looking into. This country is truly fucked up.

[No Elephants]

215. One could just as easily argue the opposite.

That, if single payer had not been removed from the table prematurely (AND the Democrats, up to and including OBama, had shown leadership and persuasion skilss), there would have been a groundswell from the publicc in favor of single payer.

[ooglymoogly]

97. A fairly large group understand we are talking

about life and death and that is something one cannot, in good conscience, compromise; And for what? A few beads and trinkets; Chew on that for a while and see if you can turn it into a malleable and nondescript, bland, lifeless gum that will assuage the crime bosses and their brainless zombie followers and the cheap whores they buy for a farthing .

[liberation]

104. I agree completelly...

... I am just tired of being told to shut up because the Dems are having some sort of double plus secret negotiation-fu to put the repugs right where they want it.

When all the indications point at the fact that their shitty negotiations... are just that: shitty negotiation. At this point, my visits to DU serve to get some comedic relief by reading the justifications and denial exercises by a lot of the perennial apologists. Might as well some lemonade from the lemons we seem to be getting, and will be getting in the foreseeable future it seems.

[Ms. Toad]

118. Current system: 15% or so uninsured and without access to care.

Bills: around 4% uninsured and without access to care.

Demand 100% coverage, and settle for no less - overwhelmingly probable result: The current system remains.

I'll take the improvement.

Those 11% are hardly a few beads and trinkets - especially when the realistic choice is 11% more covered or the current system.

[ooglymoogly]

135. I think you need to read the bill and listen to the credible rumors

and experts about what that bill really means and what is in the pipeline. I will bet a silk purse that this will turn out to be nothing more than an Orwellian smoke and mirror shell game, sows ear, trumpeted as a "good thing". Gee I have only the past dismal record to base this assumption; Need I list the shams trumpeted as a "good thing" of that record that has brought this country to its knees?

[Ms. Toad]

146. I have read every bill introduced, aside from the one linked to

in this thread which was just introduced.

Most of the "credible" rumors I have read (including the most recent one that the public option will be just another private insurance plan) perpetuated by people who either have not read the bill or do not understand how to read a bill.

Might I suggest you read the bills yourself - including the sections of the Medicare statutes (for example) which are incorporated by reference, and forget about listening to "credible" rumors unless those rumors are supported (or, at a minimum not contradicted by) the bills themselves.

[ooglymoogly]

168. It will not be too long before the proof of what is and what will be in

the bill and it will be far less than what is being now proposed. It is my position that we should be screaming as loud as possible that this is not enough and more has to be done to make this a good bill for the common man; Otherwise it will be negotiated down to next to meaningless. We have gotten this far by speaking loudly and carrying a big stick and we must ramp that up to make sure they continue paying attention to us. To be mollified at this juncture will mean failure in the end.

[Ms. Toad]

180. It is pointless to scream that it is not enough

if what you are screaming about is "credible" rumors, rather than what is actually in the bill.

Read the bill and scream intelligently.

[ooglymoogly]

219. If you think that there is nothing to scream about in this bill

you are on the wrong board.

[Ms. Toad]

225. I didn't say there was nothing to scream about

But random, uninformed screaming is pointless. That is what the teabaggers do.

Until you have read the bill, know what is in it, and know what is wrong with it, screaming just hurts the cause.

[ooglymoogly]

227. Nobody here is calling for pointless screaming....I am calling for screaming

at what is wrong with this bill. I like many here have skimmed the bill and have learned enough to scare me to the boiling point and that is the point at which I start screaming.

[Ms. Toad]

228. You could have said that several posts ago,

instead of just insisting that we need to scream. My entire point is that screaming without doing the necessary homework first is pointless - you repeatedly responded that we need to scream. All I ever suggested was that you needed to read the bill so you are doing informed screaming.

[chadmak09]

99. unless universal healthcare was never what you wanted

unless universal healthcare was never what you wanted in the first place.
I dont think obama and the gamg wanted single payer to begin with.
They never even gave it a chance.

Your not going to get lobbying dollars from those that benefit from single payer,
you get lobbying dollars for creating an insurance mandate to make insurance companies rich, and creating an illusion of a "public option" that noone will qualify for.

[ooglymoogly]

112. Exactly...snatching defeat from the jaws of victory.

Making a sows ear out of a golden purse. They are experts at this kind of flim flam. It is an Orwellian "victory" signifying just more of the same. Anything for the rich, sending the bill to the middle classes and the poor,

[pattmarty]

103. It's a piece of shit and if you're honest you would call it that................

...........Fuck compromise, this is 60 years fucking overdue. Medicare for all, or nothing. This "bill" will NOT hold costs down and exactly WHERE are the "reforms"???? The Dems are going to pass "shit" and call it victory AND they will pay at the polls in 2010 and 12.

[ooglymoogly]

114. When logic won't cut it, sophistry will just have to do. nt

[pattmarty]

116. I fucking DO understand compromise. This ain't compromise, it's................

...............taking a 4 ft broomstick in the ass. here's a small list of the happy campers if this piece of shit is passed; Insurance companies, Republicans (will be the largest beneficiary of the "compromise"), Banks (because people will be using the charge cards to pay for all the shit the bill DOESN'T cover), drug companies (no surprise there).

[BREMPRO]

190. SO if Republicans will be major beneficiaries of this bill as you suggest

why will not ONE SINGLE REPUBLICAN SAY THEY WILL VOTE FOR IT? Think about it. Your analysis is bunk.

[dflprincess]

195. Because the Republicans will oppose anything the Democrats come up with

even when it helps their pals. And, when the public wakes up and figures out what a POS this bill is, the Republicans will remind people it wasn't them who thought we should be forced to buy shoddy products from the crooks who broke the system in the first place.

[pattmarty]

200. Yep. I think that's referred to as "having your cake and eating it too".

The Dems are leaving themselves wide open here. Medicare is another good example of doing it right. It's been over 40 years now, and the Republicans are still trying to undermine it any way they can, but they definitely DON'T badmouth it. This bill they can sit on their hands and may come out looking like "heroes" to the voters.

[pattmarty]

199. If this "dogshit" bill is passed who in the fuck will get the credit OR blame?

If as I (and many others in the "know") suspect this bill will be a disaster, the Republicans will have to be really stupid NOT to capitalize on it. They can say that they didn't vote for it EXACTLY because it is crap. So where the fuck is the "bunk"?

[BREMPRO]

204. and how does it help democrat to craft and vote for a bill that will be a disaster?

Your reflexive assessment that this bill is going to be a total disaster suggests the Dem's know it will be a disaster and are selling out (rather than compromising to get a bill passed through a shaky majority) and are willing to sacrifice their political careers, reputation, and majority in congress for this bill to do the bidding of the insurance industry and republican friends. Not plausible.

Many progressives in congress including Anthony Weiner support this bill with the exception that they want a more robust public option. I'm all for that if they can convince their blue dog colleagues in the upcoming debate on the bill on the floor. If they can't get the votes, they will take what they can get and go on to fight another day. There are too many good things in this bill to sacrifice it for an attempt at perfect legislation. They will also have to reconcile the bill with the Senate bill where more compromises may have to be made to get the votes needed to avoid a filibuster. This is the way legislation works. Teddy Kennedy knew this and over his 40 year career accomplished more than any president for civil rights, health care, and progressive causes by fighting for ideals, and settling for steps towards those ideals. It took Canada 37 years to accomplish full single payer health care. I believe this bill puts in place the foundation for a trajectory towards that ultimate goal.

did you read the links I sent you yet?

[pattmarty]

205. You must have conveniently missed my reply. I believe you're wrong............

......about Canada. Tommy Douglas first proposed single payer in I believe Saskatchewan in the 40's and it was finally adopted in all of Canada in 1971. So even your 37 years is bullshit. "Most" European countries had some form of "government healthcare" by 1950. Truman tried to implement a similar plan in the US in 48 and failed. So yeah, it's been OVER 60 yrs since we SHOULD HAVE HAD some form of government health plan. And yes, I read your links. Did you read my reply? Simply stated, we should wait before passing something we all will be sorry for. This crap whoever you listen to won't be implemented until 2013 or 2109. What the fuck kind of "reform" is that? If you thought about the whole bill, you too would say "bullshit". If you want reform, then shitcan the bill and regulate the shit out of the healthcare industry. Oh, and the antitrust provision WON'T be in the final bill. You can take that to the fucking bank.

[BREMPRO]

220. I did read your response, apparently you ignored mine.

You did not address the point that Democrats (including many progressives) are supporting a bill that you suggest they know is a disaster and therefore would be undermining their political careers. Response? And no response to the links you say you read? Your point that its better to have no bill than this one is short sited. We will NOT have another chance at this- the Republicans are going to win seats in the next election cycle and it will be impossible to get any traction then. We need to take the positive changes in this bill and build on it in the future.

http://en.wikipedia.org/wiki/Health_care_in_Canada

The universal Canadian health care system was implemented over decades and depends on where you count. You are right about Tommy Douglas implementing the first province wide universal coverage plan in 1946, and that was eventually extended to all provinces through the "medical care act" in 1966, but not until 1985 with the "Canadian health act" was it fully implementation-preventing doctors and hospitals from charging extra fees. SO yes you're right not 37, but 39 years from a pilot program in Saskatchewan to full universal coverage. Keep in mind Canada has only 10 provinces, instead of 50 states, a much smaller population, less divided political fault lines, and a more socialized culture. We have a much more difficult task.


There are other who claim the Canadian system actually took over 50 years to implement and it was not without monumental efforts and political battles:

http://www.pnhp.org/facts/a_brief_history_universal_health_care_efforts_in_the_us.php?page=4

7.One Canadian lesson — the movement toward universal health care in Canada started in 1916 (depending on when you start counting), and took until 1962 for passage of both hospital and doctor care in a single province. It took another decade for the rest of the country to catch on. That is about 50 years all together. It wasn’t like we sat down over afternoon tea and crumpets and said please pass the health care bill so we can sign it and get on with the day. We fought, we threatened, the doctors went on strike, refused patients, people held rallies and signed petitions for and against it, burned effigies of government leaders, hissed, jeered, and booed at the doctors or the Premier depending on whose side they were on. In a nutshell, we weren’t the stereotypical nice polite Canadians. Although there was plenty of resistance, now you could more easily take away Christmas than health care, despite the rhetoric that you may hear to the contrary"

Your facts are correct about Truman introducing the idea of universal coverage, but it never got off the ground because it was vilified as "socialism" during the cold war when anything that smelled of communism was a non-starter. So, yes, there were efforts made for universal coverage 60 years ago and the same arguments used against it then are being used now, but nothing like the universal program in Saskatchewan was ever implemented as a model to be build on. Not an equivalent comparison since we enacted a mostly private system at that time for the majority of the population and a public welfare system for the poor - the seeds of medicaid and medicare.

http://www.pnhp.org/facts/a_brief_history_universal_health_care_efforts_in_the_us.php?page=3

"it was Truman who proposed a single egalitarian system that included all classes of society, not just the working class. He emphasized that this was not “socialized medicine.” He also dropped the funeral benefit that contributed to the defeat of national insurance in the Progressive Era. Congress had mixed reactions to Truman’s proposal. The chairman of the House Committee was an anti-union conservative and refused to hold hearings. Senior Republican Senator Taft declared, “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it.” Taft suggested that compulsory health insurance, like the Full Unemployment Act, came right out of the Soviet constitution and walked out of the hearings. The AMA, the American Hospital Association, the American Bar Association, and most of then nation’s press had no mixed feelings; they hated the plan. The AMA claimed it would make doctors slaves, even though Truman emphasized that doctors would be able to choose their method of payment.

In 1946, the Republicans took control of Congress and had no interest in enacting national health insurance. They charged that it was part of a large socialist scheme. Truman responded by focusing even more attention on a national health bill in the 1948 election. After Truman’s surprise victory in 1948, the AMA thought Armageddon had come. They assessed their members an extra $25 each to resist national health insurance, and in 1945 they spent $1.5 million on lobbying efforts which at the time was the most expensive lobbying effort in American history. They had one pamphlet that said, “Would socialized medicine lead to socialization of other phases of life? Lenin thought so. He declared socialized medicine is the keystone to the arch of the socialist state.” The AMA and its supporters were again very successful in linking socialism with national health insurance, and as anti-Communist sentiment rose in the late 1940’s and the Korean War began, national health insurance became vanishingly improbable. Truman’s plan died in a congressional committee. Compromises were proposed but none were successful. Instead of a single health insurance system for the entire population, America would have a system of private insurance for those who could afford it and public welfare services for the poor. Discouraged by yet another defeat, the advocates of health insurance now turned toward a more modest proposal they hoped the country would adopt: hospital insurance for the aged and the beginnings of Medicare."

Since our health insurance system and health care has historically been primarily private and employer based, and a majority polled say they are satisfied with their coverage, to modify the entire system to a single payer government run system in one legislative session is wildly unrealistic. A robust public option would be a good goal, but there are political obstacles to getting this. It's also wrong to focus so much on insurance, while ignoring the costs in the system involved in a "fee for service" model of delivery. If you read the Cost Conundrum, you already know that. The bill does have provisions for "comparative effectiveness" research to begin to lower costs and improve care. What we CAN also do and what the bills in congress begin to do, is reign in the unethical private insurance industry, enact a public option that can be expanded in the future, just as the Canadian system did.

As far as the 2013 timetable- All qualified experts who have evaluated the changes being proposed have said this time is necessary to allow for the adjustment to the new rules, regulations, and benifits by all parties involved. You can't turn an ocean liner on a dime.

[derby378]

119. Compromise = Capitulation

The bad is the enemy of the good. And the House version of the bill is, well, bad. No actual public option. That means fail.

[No Elephants]

214. Wroong. Single payer was the perfect. A strong public option is the good.

And it's time to put away that overworked cliche from this discussion. It never belonged in it in the first place because it was always a lie. Now it's a played out lie.

[SandWalker1984]

57. Why are we pissed off? This poster said it better than I can.

This was posted on dailykos in August and says it better than I can:

No More Faith: The Senate Topples Into Incompetence
by Hunter
Wed Aug 26, 2009

It seems absolutely assured that there is no American problem or catastrophe that will not be dealt with by our government by lavish, staggering public giveaways to the very corporations most directly responsible for the problem. We are currently mired in a Great Recession, to use the term that seems most commonplace at the moment; the result of which has been trillions of dollars in giveaways and subsidies to the banking and insurance giants whose foolish, outright stupid acts caused the very collapse we are saving them and us from.

They are Too Big To Fail, and you and I are not, and so you and I can suck eggs, from our elected leaders point of view. There is apparently no war too costly for us to fund indefinitely; there is no apparently stimulus package that can exist unless it funnels money only to the top of the economic chain, and not the bottom. We talk glowingly about putting Social Security in the hands of Wall Street tycoons, a new and immense treasure chest for them to play with, to collect fees on, and to gamble with at will. We provide lavish tax breaks to extraction companies, to oil companies that make record amounts of cash. America's auto industry has mismanaged themselves for decades, fighting every government request; we will come to their aid now, yet again, because they are also Too Big To Fail.

So it should have been transparently obvious from the outset that the only response our glorious and wizened Senate could come up with, when facing a failed healthcare system that has been steadily bankrupting the country, its businesses and its citizens for decades, would be to invent a solution in which the companies most responsible for the problem would be given cash hand over fist. And indeed, that seems to be the "solution" that is closer to fruition than any of the others.

The premise in this case is a mandate in which every American shall be forced to buy private insurance. Apparently that is uncontroversial, to our leaders, but the notion of providing a government-backed plan for those who do not want their health and welfare tied to the same companies that have been screwing them over for decades, now that is a bridge too far.

Let me be clear. To me, such a plan represents the very pinnacle of corruption, of corporate toadyism, and of the complete dissolution of effective government into merely being a legal framework for corporations to most efficiently extract wealth from the nation. And the day such a plan passes, I will no longer be a Democrat.


Max Baucus is a crook. There, I said it outright. Ben Nelson? A crook. Grassley, Boehner, McConnell, Hoyer and the others? Crooks. Not "conservative", not "fiscal watchdogs", not "representing their own peculiar constituents", none of that hogwash and drivel that churns up our airwaves on a daily basis. They join the long line of leaders that rake in more cash from health insurers, pharmaceutical companies and the like than you or I are likely to see in our lifetimes, and in exchange for that they are the unquestioned _kingmakers_ of reform, and all the nation must bow down to them and to those that have paid them more cash than any of their own constituents have been able to shell out. With regularity, every industry under the American spotlight will turn to "friendly" senators and representatives, where friendly means nothing more than plied with cash, and in them they will find regulatory salvation for a relative pittance. It does not represent corruption under our system of government simply because we have carefully designed our government to freely allow it. Corporations are people, after all, and people have freedom of speech, and dollars represent speech, and therefore the person with the most dollars is entitled to the most representation.

That, then, is the American way. Anything else you may have learned in school is a farce meant for children.

The current premise is that a public option -- that is, the government providing the same sort of insurance program as Medicare, but for all their citizens and not just the elderly -- is very nearly a nonstarter, because we Americans are apparently supposed to believe that our government providing insurance to a seventy year old is a noble service, but providing that same service to a fifty year old is socialism, and providing that same service to a twenty year old or a ten year old is something that only a goddamned Hitler would do. We can have public fire departments, public police departments, federal disaster relief, flood insurance and whatnot, but keeping you alive and out of bankruptcy if you get sick is an abomination. Never mind that we are alone among the most advanced countries in this regard; never mind that our current system is both among the most expensive and least effective. We are supposed to believe chaos will ensue if we follow the same path as other nations, because the industry that has the most profit to lose if a "public option" is available has sent phalanxes of lobbyists out to assert that everything is, in fact, Just Goddamned Fine, and a hellscape elsewhere. Because the lobbyists say it, the legislators say it. Because the legislators say it, the partisan press says it.

Doesn't matter that it's not true. Doesn't matter that there are no death panels, that there are no death booklets, that Stephen Hawking is not, in fact, dead from being British. We have yet to punish any politician or any news organization for baldly lying to us, so long as it is a lie that satisfies us to hear.

Fine; let us presume that we are too corrupt, as a nation, to consider promotion of the health and welfare of our citizens as being equal in importance to the health and welfare of, say, Goldman Sachs. Still, then, at the very least we ought to be able to come up with some solution that does not make the problem explicitly worse than it was when we first tackled it, some solution that does not take a solvable problem and turn it into nothing more than an excuse to funnel yet more money into the hands of corporations already sucking the well-being of their own nation dry. We should be able to, but given the basic structure of our Senate, which cannot pass any legislation that harms a corporate interest in any substantive way, so long as that interest has made the appropriate donations to the appropriate legislators, it seems evident that even that small request might be too much.


The so-called "private mandate" made sense in the context of a truly national solution: like Social Security, all Americans would pay into it, or opt out in favor of their own private insurance, and all Americans would in turn receive benefit from it, or from their own private insurance. It provides universal coverage. It does not rely on each American making a Vegas wager on whether or not they will be injured given a during year, and being reduced to destitution or death if they make the wrong guess.

But absent a public solution, and absent meaningful reform of the existing private system, it is nonsensical. It is worse than nonsensical, because it mandates a marketplace for a product that will not substantively assist people in actual need of healthcare. Each company will price an insurance option to be whatever the subsidy turns out to be; that insurance will be provided to be as shoddy as possible, with massive deductibles, gigantic loopholes, and all the other tricks of the insurance trade rolled into whatever bottom-rung "package" is deemed the minimal necessary.

If someone were to actually get sick, an insurance policy with a $20,000, or $50,000, or $100,000 deductible -- so-called "junk" insurance, of the sort that is becoming more and more prevalent as insurance companies price their other products steadily out of reach of more and more consumers -- will not prevent bankruptcy. It will not provide preventative care, of the sort that would stop illnesses before they became catastrophic. It would do nothing to curtail costs. It would do nothing to fix our broken emergency rooms.

It would act only as massive, all-encompassing national subsidy to the very insurance companies who have made healthcare so unaffordable in the first place. It would be exactly the same as placing Social Security in the hands of the private sector, bidding them farewell, and letting the retirement accounts of the entire nation be funneled into the same barely-regulated, never-accountable companies that have sent the economies of the entire world into a tailspin.

Enough is enough -- that is all I can think of to say. I know full well the underlying premise: the notion is that the insurance companies will, in exchange for having every single American in the country as captive consumers of their products, give up their policy of denying coverage to people who are actually sick. They will begrudgingly trade away their ability to deny "preexisting conditions", which at this point consist of every illness, proto-illness or maybe-illness you have ever had in your entire life, and will be more hesitant to retroactively revoke every cent of your coverage (but not refund your money) if you have the audacity to start costing them serious money.

But a trade of mandated purchase of a for-profit, private product in exchange for a meager promise to not abuse customers is -- let's all say it together, for good measure -- goddamned asinine. The government of the United States should not have to bargain to get an abusive industry to be slightly less abusive. Especially when (1) the industry in question has a historical pattern of rampant customer abuse, and (2) when our Noble and Brilliant Goddamn Legislators have no recent history of being able to enforce corporate competence or fairness on any industry, at any point in the last several decades. The notion that suddenly, in exchange for a windfall of a trillion dollars or so, one of the most hated, manipulative, dishonest industries in America will suddenly become worthy of nationally mandated fealty is so preposterous that it could only be dreamed up by someone as crooked as a politician.


So count me against, without reservation, the Worst Possible Goddamn Outcome Yet Devised. I have to believe that a mandate for all Americans to buy private, for profit health insurance, absent a public option, absent serious regulation, is not going to happen. Yes, it looks like there are members of the Senate willing to go for it, but I have to believe that more sensible heads would gut such a moronic plan, such an obvious and transparent corporate giveaway on such a massive scale, as being a ridiculous and humiliating premise even by recent piss-poor standards.

But I am probably wrong, because underestimating the willful cronyism, the absolute craven crookedness in favor of corporate giveaways by both Republicans and Democrats alike is at this point little more than a parlor game: no matter how cynical you may be, you can bet that the reality is worse. You can bet that the outcome will be worse than you thought, that the regulation will be pathetic than you could have imagined, that the oversight after the fact will be totally non-existent.

It is not even about the so-called "public option", at this point. It is not, narrowly, even about the so-called "private mandate" itself. It is about how the Senate can take absolutely any national crisis and turn it into a corporate giveaway. None of these people deserve to be trusted any farther than they can jump to snatch a dollar from your hand; the whole institution seems bent on proving itself irrelevant at best, and devoutly crooked at worst.

So yes, I am spitting mad that such asinine proposals are even being considered. The Senate has totally lost any pretense of being able to effectively govern, and there seems little left to do about it short of running every last one of them out of town on a rail. The notion of forcing every American, by law, to purchase a crappy, barely-regulated, for-profit product that won't actually do them anything but a bare trickle of goddamn good if they do get sick is proof enough that the jury is unabashedly rigged, and the notion of repairing our American healthcare system because it is the right thing to do is a distant and despised thought.


I do not know what the outcome of this legislative dance will be, but all the players have made their intents absolutely clear. If once again, the only outcome acceptable to our senate, our representatives or our president is, yet again, after all this, after every other fight, yet another corporate giveaway piled high on the backs of every last American, I will not support even one of the goddamn politicians that vote for such a thing.

We have been more than patient; we have been more than accommodating. But no more. Our parties are kept properties of those that finance them; our politicians are so intent on not biting the hands of the most powerful one percent that the needs of the other ninety-nine percent are continually reduced to begrudging afterthought. The Republican Party has joyfully reduced themselves to a band of bigots, of know-nothings and nihilists, who to a person would rather peddle the most absurd, fear-mongering lies than engage in actual governance of the sort they were elected to -- they stand for nothing, at this point, and can hardly be called a political movement at all. The Democratic Party continues to be at war with itself, trying to toe the line between being bought and remaining in power, knowing that there is only so many corporate fanfares that can be blared out from Capitol Hill before the public comes to the conclusion that they, too, represent no one but themselves.

Yes, it is a harsh pronouncement, but there are only so many years that a nation can be patient, and only so many crises that can be resolved by funneling cash to America's corporate behemoths. We are either a nation or we are a subsidiary.

So I am done. It is this fight, or nothing. We have been asked to put up with war crimes, because "moving forward" is the more conciliatory path. We have been asked to stomach the politicization of the highest offices in our system of justice, because investigating it would be divisive. Time and time again we have asked for nothing more than our government to enforce its own goddamned laws, or to take action against the worst and most corrupt abusers of its citizens, whether done by government or by balance sheet, and we have gotten between nothing and jack-squat in return. We have gotten worse than nothing: we have gotten corporate immunity for lawbreakers, we have gotten tacit approval of the methods of murdering thugs, we have set in stone the notion that there is absolutely no corporate fuckup so damaging to the economy of the entire nation that it would result in substantive regulatory restraints.

No more. This fight is the last and final test; whether or not our leaders are so corrupt as to be irredeemable should be easily gleanable by whether or not they are able to bring themselves to even try on this, the one fight that every last one of them has supposedly been saving their strength for. It is this or nothing, and I will be damn proud, at the end of it, to abandon those who have so completely abandoned us.

[pattmarty]

100. I'll second the "sucks" part. Only, I'll call the final bill (yes even before any .........

.........of us know what the "final" bill will be) a big piece of shit. It will be a bill ANY Republican would be proud to call their own. Except that NO Republican will "sign on" to it AND the Dems will get the blame (rightly so) for a complete steenkin turd. Progressive/Liberal, my fucking ass.

[shraby]

7. You've read it already???

[ChiciB1]

181. You Know... Reading IT ALL Might Be Something We Should Do... BUT

even then, I have a sneaky feeling it's only going to GET WORSE!

To say it's watered down isn't enough, but it may just get MORE WATERED DOWN before it's all over!

For months now people have been saying Obama is playing some sort of chess game, but I think the game wasn't chess... it was GAMBLING! And on people's lives who never got close to the SLOT MACHINES!!

NOW IT'S ON TO MORE WAR... OR NOT!! Place your bets now, I just wish I could get a pay out on what I WOULD BET!!

[kpete]

9. Full text:

http://health.burgess.house.gov/UploadedFiles/House_HCR_bill.pdf

[Ms. Toad]

121. Darn. More homework. n/t

[BREMPRO]

17. The bill contains significant improvements to our health care system, including:

a public option,
competitive health insurance exchange,
subsidies for low income,
repeal of anti-trust exemption,
guaranteed access to affordable coverage and essential benefits,
consumer protections, including no denials of insurance for pre-existing conditions, or cancelling policies because of illness.
comparative effectiveness research,
credit for small businesses health care expenses,
medicare reforms, including reduction of waste, fraud and abuse
improvements to medicare part D,
nursing home transparency.

among other provisions. It also appears to be still budget neutral.

This is a VERY GOOD BILL. WE ARE NOT GETTING SINGLE PAYER- GET OVER IT!!!





DIVISION A—AFFORDABLE HEALTH CARE CHOICES
TITLE I—IMMEDIATE REFORMS
TITLE II—PROTECTIONS AND STANDARDS FOR QUALIFIED
HEALTH BENEFITS PLANS
Subtitle A—General Standards
Subtitle B—Standards Guaranteeing Access to Affordable Coverage
Subtitle C—Standards Guaranteeing Access to Essential Benefits
Subtitle D—Additional Consumer Protections
Subtitle E—Governance
Subtitle F—Relation to Other Requirements; Miscellaneous
TITLE III—HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS
Subtitle A—Health Insurance Exchange
Subtitle B—Public Health Insurance Option
Subtitle C—Individual Affordability Credits
TITLE IV—SHARED RESPONSIBILITY
Subtitle A—Individual Responsibility
Subtitle B—Employer Responsibility
TITLE V—AMENDMENTS TO INTERNAL REVENUE CODE OF 1986
Subtitle A—Shared Responsibility
Subtitle B—Credit for Small Business Employee Health Coverage Expenses
Subtitle C—Disclosures To Carry Out Health Insurance Exchange Subsidies
Subtitle D—Other Revenue Provisions
DIVISION B—MEDICARE AND MEDICAID IMPROVEMENTS
TITLE I—IMPROVING HEALTH CARE VALUE
Subtitle A—Provisions related to Medicare part A
Subtitle B—Provisions Related to Part B
Subtitle C—Provisions Related to Medicare Parts A and B
Subtitle D—Medicare Advantage Reforms
Subtitle E—Improvements to Medicare Part D
Subtitle F—Medicare Rural Access Protections
TITLE II—MEDICARE BENEFICIARY IMPROVEMENTS
Subtitle A—Improving and Simplifying Financial Assistance for Low Income
Medicare Beneficiaries
Subtitle B—Reducing Health Disparities
Subtitle C—Miscellaneous Improvements
TITLE III—PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES,
AND COORDINATED CARE
TITLE IV—QUALITY
Subtitle A—Comparative Effectiveness Research
Subtitle B—Nursing Home Transparency
Subtitle C—Quality Measurements
Subtitle D—Physician Payments Sunshine Provision
Subtitle E—Public Reporting on Health Care-Associated Infections
TITLE V—MEDICARE GRADUATE MEDICAL EDUCATION
TITLE VI—PROGRAM INTEGRITY
Subtitle A—Increased funding to fight waste, fraud, and abuse
Subtitle B—Enhanced penalties for fraud and abuse
Subtitle C—Enhanced Program and Provider Protections
Subtitle D—Access to Information Needed to Prevent Fraud, Waste, and Abuse
TITLE VII—MEDICAID AND CHIP
Subtitle A—Medicaid and Health Reform
Subtitle B—Prevention
Subtitle C—Access
Subtitle D—Coverage
Subtitle E—Financing
Subtitle F—Waste, Fraud, and Abuse
Subtitle G—Puerto Rico and the Territories
Subtitle H—Miscellaneous
TITLE VIII—REVENUE-RELATED PROVISIONS
TITLE IX—MISCELLANEOUS PROVISIONS
DIVISION C—PUBLIC HEALTH AND WORKFORCE DEVELOPMENT
TITLE I—COMMUNITY HEALTH CENTERS
TITLE II—WORKFORCE
Subtitle A—Primary Care Workforce
Subtitle B—Nursing Workforce
Subtitle C—Public Health Workforce
Subtitle D—Adapting Workforce to Evolving Health System Needs
TITLE III—PREVENTION AND WELLNESS
TITLE IV—QUALITY AND SURVEILLANCE
TITLE V—OTHER PROVISIONS
Subtitle A—Drug Discount for Rural and Other Hospitals; 340B Program Integrity
Subtitle B—Programs
Subtitle C—Food and Drug Administration
Subtitle D—Community Living Assistance Services and Supports
Subtitle E—Miscellaneous
DIVISION D—INDIAN HEALTH CARE IMPROVEMENT
TITLE I—AMENDMENTS TO INDIAN LAWS
TITLE II—IMPROVEMENT OF INDIAN HEALTH CARE PROVIDED
UNDER THE SOCIAL SECURITY ACT

[ixion]

19. it contains a mandate

which negates any good it might have done.

[BREMPRO]

23. none of the consumer protections work without a mandate

then only the sick will sign up and make it impossible to include the consumer protection provisions to prevent insurance companies to deny coverage for pre-existing conditions and denial of care. There are provisions for subsidies adjusted to income, a public option and competitive exchanges to lower costs- the bill claims will "guaranteed affordability". I'd like to see the calculations on affordability before full support of the bill.

[chadmak09]

105. oh!

oh!
so those of us who are being screwed by our insurance companies and have huge co-pays can come join the public option??
Or do 90% of americans get the shaft on the public option???
And do the insurance companies get thier golden mandate?

If the insurance companies cannot reject me for pre-existing conditions, can they just raise the rates so high I cant afford it anyway??

This bill is a joke.
It helps the average american who is going bankrupt from co-pays and deductibles NONE!!!
WHERES THE COMPETITION IF 90% OF US CANNOT JOIN THE PUBLIC OPTION.

[BREMPRO]

142. if it is a joke, and a giveaway to the insurance industry, why are the republicans vehemently

opposed to it? They work for corporations and the insurance industry.

according to the summary "Over time, the Exchange will be opened to additional employers as another choice for covering their employees"

if what you have now from your employer is significantly more expensive than what you can get from the exchange and public option, public pressure will ensue and employers will begin (after a transition period where they will be prevented from dropping private insurance) to either make rates more competitive or opt out of providing insurance so you can take advantage of a public option. Then you would be able to choose among options that allow subsidies and limits on out of pocket based on income.

The other factor is that with more people covered, and the requirement of insurance companies to make a case for raising rates through the sec. of HHS, comparative effectiveness and moving away from "fee for service" delivery, average rates should eventually go down. This is all addressed and implicit in this bill.

summary here:http://energycommerce.house.gov/Press_111/20090714/hr3200_summary.pdf

[Posteritatis]

182. Simple - a Democratic president wants it. (nt)

[TorchTheWitch]

198. Because big campaign money from Big Ins. will go to Dems

A givaway by Dems to Big Ins. insures big campaign money from Big Ins. will go to Dems rather than Repubs. That's the only reason that Repubs hate it. They're pissed that they didn't come up with this health "reform" scam themselves.

[ChiciB1]

183. Do YOU Work For The Insurance Companies Or Something?? You Seem

to be so comfortable with all this, makes a person wonder! I'm just wondering, not looking for a fight... but for SURE I'm not seeing as much of an UP SIDE as you are! Actually, I don't see MUCH of an up side!

Maybe it's because I watched Alan Grayson read about the names of the dead recently. Perhaps you might want to link to it! www.NamesOfTheDead.com it's depressing, but unfortunately TRUE!!

[BREMPRO]

192. HA, that's a good one. I'm a self employed artist- I hate insurance companies!!

I'm just being realistic and have done lots of reading on this subject, enough to realize that this mono-focus on insurance is misplaced- many other important issues like "fee for service" delivery which adds costs are just as important to address (read The Cost Conundrum article)

We have a weak democratic coalition because of the blue-dogs, so i believe this is for the most part the best we can do right now. The reason i'm supportive of this bill to this point is that it meets many of the goals set out by the president that i agree with. I watched the Grayson names of the dead too- very powerful and heartbreaking. THis bill reduces the uninsured from 15% to 4%, eliminates the anti-trust exemptions for the health insurance industry, adds a public option (that can be expanded later), eliminates denials for pre-existing conditions, make illegal dropping people when they get sick, reforms medicare with more enforcement of waste,fraud and abuse, includes comparative effectiveness research to lower costs, and will end up REDUCING the deficit over 10 years. It's NOT perfect, and I have some problems with it, but it's a good step forward.

[chadmak09]

101. +1

+1

[Fire1sKid]

173. Really???

mandate-An order from the federal government that requires state governments to take a certain action.
So please feel free to enlighten me on how this negates any good it might have done.

[dflprincess]

24. Labeling something that most of us will not have access to a "public option"

does not make it so.

The insurance companies and all those "contributions" they make will be fine, us, not so much.

[BREMPRO]

28. my position is that a public option, even if it's not now available to everyone

is a good step forward. If it works and can be quantified to have lowered costs and efficiently administered, there will be demands and justification to expand it. You can't expand something you don't have. This how the S-Chip program evolved. This is how Canada's single payer system evolved (took 37 years to fully implement) I did notice in the bill it appears that the administration of the PO can be contracted out to a private (non-profit) firm. That provision i'm not so excited about.

[Raineyb]

31. If it's not available to everyone it's not a public option.

Do we need to start with the definition of everyone, public and option now?

[Ms. Toad]

153. We needed to start with it a long time before now.

For months, people demanding a public option, and making it the litmus test, have failed to understand that a public option just means an insurance plan run by the government.

The rest of what was attributed to it (like "everyone" "affordable" etc.) are the details I have been insisting be in any petition calling for a "public option" (or opposing any bill without one) before I would sign it.

The devil is in the details - which were lacking far too long while the rhetoric piled up.

[dflprincess]

41. It's being set up to fail

Limiting the pool to those who don't have insurance now - many of whom have a preexisting condition which may (depending on the condition) make them costilier to insure and excluding a lot of individuals who are healthier means the public "option" will be running at a disadvantage from the start.

[BREMPRO]

53. true, but many who don't have insurance now are young and healthy

who think they are invincible and would choose to spend the money on starbucks and martinis instead. There are many young adults who also can't afford it. That is why the public option and exchanges have subsidies tied to income. 11% maximum is not unreasonable.

[dflprincess]

61. A premium of 11% for someone making $43,000/year

is nearly $400/month. I'd have trouble finding that much more money a month and I'm making more than $43K (and I'm not spending it on martinis or Starbucks - of course, I'm not young either).

Also, the deductibles and premiums may go up every year even if your income doesn't.

It all sounds a lot like the same crappy system we have now.

[bamacrat]

67. When my wife an I were covered in my last job I was paying way more than 11%.

I made 35-40,000 and was paying $451/month in a commission based job. For two people, we have no children. 11% would have been great. I worked for a small business in Alabama that has only one insurer so I understand not everyone has such a shitty rate.

[liberation]

70. Hey, let's set our expectations real low...

... now that is the ticket!

[bamacrat]

80. It's not great but what I was saying is 11% would have saved me $130/month.

Now for those who have the luxury of being in a big pool and paying way less it would suck for them but it would have helped me. And people who work for small businesses are usually the ones that have healthcare but cant afford to use it, so $130 extra a month would have helped alot.

[liberation]

109. that was not my point at all...

I am sure a guy who gets shot twice could have appreciated greatly just a single shot. I tend to believe not getting shot at all would have been the minimum expectation of acceptability.

[pattmarty]

127. Yeah, maybe you're right. I guess I'd eat shit if I were hungry enough.

[dflprincess]

82. A married couple with an income of $40,000 would be eligible for some subsidy

as the cut off for a 2 person family would be about $58,000.

The figure I was using was the coverage for a single person who is at the income cut off for subsidies.

For a family of 4 the income cut off is just about $88,200 and 11% of that comes to a premium of $800/month. These are the amounts someone without employer based coverage may be forced to pay out of their own pockets if this scam is passed.

It should also be noted that at one point in this debate Pelosi did say that the 400% of the poverty level (originally laid out in HR3200) was negotiable and she could see it drop to 300%. That would mean a single making $32,500; a couple at $43,700 & a family of 4 making $66,100 would be ineligible for subsidies.

[Lydia Leftcoast]

106. This is another scam in which the Dems PRETEND to be helpful

Unfortunately, I have to oppose it.

As a self-employed person, I would love to see TRUE reform, but nothing without a short choker collar on the insurance companies, if they are to be allowed to sell health insurance at all.

[Ms. Toad]

155. ALL new policies, private or public,

are required to operate under the same restrictions.

Accept all applicants, non-discriminatory premiums, no lifetime caps, etc.

The public option is merely one of several policies that will be available in the exchange.

[vanbean]

172. Get over it? No one should profit from health insurance. It should be illegal.

Get over it? I can't. Insurance is sharing risk. An entity that profits from sharing health care risk is absurd. Health insurance should be non-profit by definition. Lately, I have become ashamed of my country to a degree I would never have believed possible 20 years ago. "Single Payer" is a bad term. We all pay for our health costs and the most cost-effective way is to exclude anyone or anything from making money from the process. It is so simple I can't believe that we can't all (meanning all Americans) agree on it. The only people who disagree are the ones who are cashing in on the profit. Get over it, my ass. I can't. I won't. Neither should any other Americans.

[Demonaut]

35. it covers Proctologists...yeah!!!

it's an improvement, give it time once it's implemented

[Joanne98]

6. We got a mandate without a robust public option.

This SUX!

[ixion]

12. exactly... the worst of both worlds for the taxpayers

and a win only for insurance companies.

[BREMPRO]

8. the house bill strips anti-trust exemption!

"Pelosi has also said the bill would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price fixing and bid rigging. Democratic officials said the bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative."


edit. house bill ALSO has Public Option!

[nyc 4 Biden]

25. p.150 - RESTORING APPLICATION OF ANTITRUST LAWS...

SEC. 262. RESTORING APPLICATION OF ANTITRUST LAWS TO HEALTH SECTOR INSURERS.

(a) AMENDMENT TO MCCARRAN-FERGUSON ACT.—
Section 3 of the Act of March 9, 1945 (15 U.S.C. 1013), commonly known as the McCarran-Ferguson Act, is amended by adding at the end the following:

‘‘(c)(1) Except as provided in paragraph (2), nothing contained in this Act shall modify, impair, or supersede the operation of any of the antitrust laws with respect to price fixing, market allocation, or monopolization (or attempting to monopolize) by—

‘‘(A) a person engaged in the business of health insurance, in connection with providing health insurance; or

‘‘(B) a person engaged in the business of medical malpractice insurance, in connection with providing medical malpractice insurance.

‘‘(2) Paragraph (1) shall not apply to—

‘‘(A) collecting, compiling, classifying, or disseminating historical loss data;

‘‘(B) determining a loss development factor applicable to historical loss data;

‘‘(C) performing actuarial services if doing so does not involve a restraint of trade; or

‘‘(D) information gathering and rate setting activities of a State insurance commission or other State regulatory entity with authority to set insurance rates.

‘‘(3) For purposes of this subsection—

‘‘(A) the term ‘antitrust laws’ has the meaning given it in subsection (a) of the first section of the Clayton Act, except that such term includes section 5 of the Federal Trade Commission Act to the extent that such section 5 applies to unfair methods of competition;

‘‘(B) the term ‘historical loss data’ means information respecting claims paid, or reserves held for claims reported, by any person engaged in the business of insurance; and

‘‘(C) the term ‘loss development factor’ means an adjustment to be made to the aggregate of losses incurred during a prior period of time that have been paid, or for which claims have been received and reserves are being held, in order to estimate the aggregate of the losses incurred during such period that will ultimately be paid.

’’(b) RELATED PROVISION.—For purposes of section 5 of the Federal Trade Commission Act (15 U.S.C. 45) to the extent such section applies to unfair methods of competition, section 3(c) of the McCarran-Ferguson Act shall apply with respect to the business of health insurance, and with respect to the business of medical malpractice insurance, without regard to whether such business is carried on for profit, notwithstanding the definition of ‘‘Corporation’’ contained in section 4 of the Federal Trade Commission Act.

(c) RELATED PRESERVATION OF ANTITRUST LAWS.—Except as provided in subsections (a) and (b), nothing in this Act, or in the amendments made by this Act, shall be construed to modify, impair, or supersede the operation of any of the antitrust laws. For purposes of the preceding sentence, the term ‘‘antitrust laws’’ has the meaning given it in subsection (a) of the first section of the Clayton Act, except that it includes section 5 of the Federal Trade Commission Act to the extent that such section 5 applies to unfair methods of competition.

[Raineyb]

32. So if company a charges 5000 a month we can go to company B which charges

4000 a month for its service. Neither company is affordable but you've got choice! Some choice!

[pattmarty]

130. ALERT, ALERT, ALERT!!!!!! This ain't the final bill. Do I even hafta say fucking more?

[placton]

145. patty - you are so right

again! The final bill, as we have predicted again and again, will be even worse. But of course, if OBAMA likes it,, and he is after all playing a chess game we dumabasses dont begin to understand, why that's good enough. "We made a wasteland and called it peace," a Roman general said. Here, Obama shits a turd and calls it healthcare reform.

[nyc 4 Biden]

10. The Public Option portion starts on page 211. n/t

[dflprincess]

20. A quick persusal starting on page 252

looks like it allows the same big out of pocket expenses that HR3200 did. If you're single and making more than $42,999 you do not qualify for any subsidy; your premium may be as high as 11% of your income (nearly $400/month) and additional out of pockets (aka "cost sharing" - a term nearly as obnoxious as "consumer driven" that the insurance companies are using) can go up to $5,000/year for covered services. Premiums do not count toward out of pocket max and in addition to the $5K you will also be on the hook for anythng not covered.

This bill is only about "coverage" it has nothing to do with improving access to care as large deductibles tend to discourage people from getting care.

If they were going to keep the private insurers involved, they should have looked at the way Hawaii does it and expanded that system to the rest of the country.

[barbtries]

43. thank you!

i've scanned to page 25, but this could take a hella lot of time, and i'm supposed to be working! eek

[nyc 4 Biden]

74. no problem!

"and i'm supposed to be working!"

me too! :)

[nyc 4 Biden]

13. Interesting Parts of the Public Option Portion of the Bill...

ADMINISTRATIVE CONTRACTING.—
The Secretary may enter into contracts for the purpose of performing administrative functions (including functions described in subsection (a)(4) of section 1874A of the Social Security Act) with respect to the public health insurance option in the same manner as the Secretary may enter into contracts under subsection (a)(1) of such section. The Secretary has the same authority with respect to the public health insurance option as the Secretary has under subsections (a)(1) and (b) of section 1874A of the Social Security Act with respect to title XVIII of such Act. Contracts under this subsection shall not involve the transfer of insurance risk to such entity.

NO BAILOUTS.—
In no case shall the public health insurance option receive any Federal funds for purposes of insolvency in any manner similar to the manner in which entities receive Federal funding under the Troubled Assets Relief Program of the Secretary of the Treasury.

NEGOTIATION OF PAYMENT RATES.—
21 (1) IN GENERAL.—The Secretary shall negotiate payment for the public health insurance option for health care providers and items and services, including prescription drugs, consistent with this section and section 324.

MANNER OF NEGOTIATION.—
The Secretary shall negotiate such rates in a manner that results in payment rates that are not lower, in the aggregate, than rates under title XVIII of the Social Security Act, and not higher, in the aggregate, than the average rates paid by other QHBP offering entities for services and health care providers.

[mvd]

47. Oh, so no bailouts for the public option

But bailouts for the banks are ok. I don't like that.

I think the bill could be a slight improvement and could be improved more later, but we really need that public option available to all to break through.

[bkkyosemite]

15. The lines are hot today. I am furious and said so to the WH to Pelosi's office and Hoyer's. What a

bunch of bribed legislators. They are caving to the corruption and bribes of the insurance industry. Only those without insurance will have a plan. The ghetto plan. No competition. They think we are stupid. Ole Hoyer said we left up the bill for comment and heard from the constituents and they all clapped! LOL....he heard from one today.......I am so mad... everyone call if you can get through. They are not listening to us. They are not listening to us. They are gonna allow insurance companies to control we must let them know we will not stand for this legislator bribe...We pay their wage and they are not listening. HELLO listen up........all they care about is the money they get from the bribes of the insurance industry and their butts at election time!!!!!!! We want ALL americans to have choice...all Americans to choose a public option. No more insurance companies telling us to live or die.

WH
202 456-1111

Pelosi
[phone] -
Washington, D.C. Office - 235 Cannon HOB - Washington, DC 20515 - [phone]

Hoyer

1705 Longworth House Office Building
Washington, D.C. 20515
Phone - [phone]
Fax - [phone]
E-mail Congressman Hoyer

[bkkyosemite]

22. My email to Pres. Obama:

PRESIDENT OBAMA WE ARE NOT STUPID OUT HERE!!! WE WANT CHOICE FOR EVERYONE...NOT JUST 35 MIL.. EVERYONE..TO HELL WITH INSURANCE COMPANY BRIBING OF OUR LEGISLATORS. WE WANT A ROBUST PUBLIC OPTION FOR EVERYONE EVERYONE EVERYONE..MEDICARE FOR ALL. WE DO NOT WANT THE INSURANCE COMPANIES DECIDING WHETHER WE LIVE OR DIE. NO MORE BRIBES NO MORE CORRUPTION NO MORE TREATING US OUT HERE AS IF WE ARE STUPID! WE WANT CHOICE FOR EVERYONE. WE DO NOT WANT THE INSURANCE INDUSTRY TO CONTROL OUR LIVES ANY LONGER..UNDERSTAND WE ARE VERY ANGRY OUT HERE...WE WANT WHAT YOU PROMISED COVERAGE FOR ALL ..END THE EMPLOYER INSURANCE SCAM NOW! END THE INSURANCE COMPENSATION NOW!!! WE WANT CHOICE FOR EVERYONE NOT JUST A GHETTO COVERAGE FOR A FEW WITH NO COMPETITION..HOYER IS AN IDIOT TO THINK WE ARE STUPID AND WILL FALL FOR WE DID A GOOD JOB HERE! HE SAID THEY LISTENED TO US LIARS LIARS LIARS...THEY LISTENED TO THE CHA CHING OF THE INSURANCE LOBBY DANGLING MONEY IN FRONT OF THEIR CAMPAIGN COFFERS. WE WANT CHOICE FOR EVERYONE. WE WANT A ROBUST PUBLIC OPTION. BETTER YET MEDICARE FOR ALL, SINGLE PAYER FOR ALL, AS YOU HAVE SAID PRESIDENT OBAMA .ENOUGH! ENOUGH! ENOUGH! I WORKED MY BUTT OFF FOR YOU VOLUNTEERED, CANVASSED AND FOR WHAT ...THERE IS NO CHANGE JUST THE SAME BRIBED LEGISLATORS LOOKING OUT FOR THEIR OWN BUTTS. LISTEN TO YOUR PEOPLE. LISTEN WE ARE VERY ANGRY!!!

[OhioBlue]

33. it is completely unreadable.

lay off the caps locks.

[bkkyosemite]

44. This is how I wrote my email to the President in CAPS so that is what I copied for here.

If you cannot read it well.. it's what I was feeling when I typed it. It's honest, may not be readable or correct in it's format but it's how I felt at the moment. If anyone at the WH reads it (which I highly doubt) they will get the gist of it. And yes I was yelling at the President!

[drm604]

16. Useless without the Senate.

And Lieberman's taking care of that.

[JaneFordA]

21. Okay, I checked out pp. 200 and following...

... and that Public Option doesn't seem very "public" to me. If I read it remotely correctly, it doesn't look like I'm going to be in a position to get rid of the outrageous plan I have and pick up what Kucinich and Weiner have been working so hard to provide!

WHAT A MESS!

[SandWalker1984]

49. They are deliberately setting up a Public Option to fail.

What I am getting from this bill is that Congress is giving us a Public Option in name only.

The public option will be very limited in who can enroll.
If the plan is limited to only those who don't now have insurance, many of whom have health issues (that's why they were kicked off their inidividual health insurance plans), that will make for a very expensive insurance pool.

It will not receive any start-up money from Congress.
Everything I've read to date states you cannot get a large program like this up and running without substantial funding.



If I can figure this out, members of Congress can too. We are getting lip service from the Democrats instead of health care reform.


Not only that, they want to MANDATE we buy insurance from the thieves and thugs that are already destroying our health care system in the name of greed.

Where's the regulation? Cost controls? Price gouging protection?
It's not there!


Passing this crap and calling it reform is a big fat lie and I refuse to drink the corporate wealthfare for insurance companies kool-aid.

[bkkyosemite]

26. Just called Dingle's office. They said he is for a much robust option. I said why did he allow Hoyer

to announce his name as the person who authored this bill that they are hoping to pass. I said he is gonna get the anger because of it.

We need to call Pelosi, Hoyer, Dingle, Obama, etc. This is NOT a good bill. This is not a Robust Option for ALL. A single payer is not what this is about either. It is about a lousy bill that they want to shove down our throats. They are not listening and the calls are mounting and the voicemails are clogged and people are yelling and angry today. This is not going to go away.

[bkkyosemite]

27. If everyone that could would drop their monthly premiums ...the insurance industry would fry...

[SandWalker1984]

37. Call the bill what it really is -- Wealthcare for Insurance Corporations

The 2 so called health care bills in Congress are nothing more than a corporate jackpot.

Before we can have any meaningful reform of the health care industry (and it has become too big of a business), we must face the harsh, cold facts of what we are up against.

PROFITS - the focus of these companies is PROFITS, not people and not health care. What kind of profits? Huge, excessive profits, achieved by rationing health care.


HEALTH INSURANCE COMPANY PROFITS IN 2007:

1. UnitedHealth Group—$ 4.654 BILLION. UnitedHealth Group owns Oxford, PacifiCare, IBA, AmeriChoice, Evercare, Ovations, MAMSI and Ingenix, a healthcare data company

2. WellPoint—$ 3.345 BILLION. Wellpoint owns BLUES across the US, including Anthem Blue Cross Blue Shield, Blue Cross Blue Shield of Georgia, Blue Cross Blue Shield of Wisconsin, Empire HealthChoice Assurance, Healthy Alliance, and many others

3. Aetna Inc.—$ 1.831 BILLION

4. CIGNA Corp—$ 1.115 BILLION

5. Humana Inc.—$ 834 million

6. Coventry Health Care—$626 million. Coventry owns Altius, Carelink, Group Health Plan, HealthAmerica, OmniCare, WellPath, others

7. Health Net—$ 194 million

****************

EXCESSIVE SALARIES AND COMPENSATION - the CEO's that run these corporations are compensated well for denying and rationing YOUR health care. How much do they make?

(from dailykos.com)
2008 Salaries & Compensation - the top 10 in Health Care

Ron Williams - Aetna
Total Compensation: $24,300,112
Details: Williams earned $24,300,112 in total compensation for 2008, with more than half of that ($13,537,365) coming from option awards. He also received an additional $6,456,630 in stock awards to go along with his base salary of $1,091,764.
Personal use of a corporate aircraft and vehicle, as well as financial planning and 401(k) company matches added up to $101,487 for Williams.


H. Edward Hanway - CIGNA
Total Compensation: $12,236,740
Details: Hanway took a significant pay cut from 2007 to 2008, due mainly to a drop off of more than $11 million in his non-equity incentive plan compensation. Still, his base salary of $1,142,885 surpasses that of Aetna's Williams, and is supplemented by just over $3.6 million in option awards, and just over $820,000 in non-qualified deferred compensation earnings.
Also, nearly $21,800 in "other compensation" included the use of a company car with a driver, in-office meals, and emergency assistance services relating to medical exams.


Angela Braly - WellPoint
Total Compensation: $9,844,212
Details: Braly, like Williams, earned more money in 2008 ($9,844,212) than in 2007 (9,094,271), increasing her option rewards by nearly $1.5 million, and also receiving a $200,000-plus bump in base salary, from $922,269 to $1,135,538. Braly's stock awards dropped from $2,160,159 to $1,750,015 because, according to the SEC, "performance-based restricted stock units awarded in 2008 were cancelled because our ROE target for 2008 was not met."
Braly's "other compensation" comprised use of a private jet for her and her family on business trips, just under $10,000 for legal services relating to her employment agreement and cash credits.


Dale Wolf - Coventry Health Care
Total Compensation: $9,047,469
Details: Wolf is the only CEO on this list who is no longer employed with his associated health plan; he retired from his position on Jan. 30 of this year after serving in that role since Jan. 1, 2005, and was replaced by former CEO Allen Wise.
Wolf, whose total compensation dipped quite a bit from 2007 ($14,869,823) to 2008 ($9,047,469), was pleased with the direction the company was headed in at the time of his departure.

"I am proud of what a talented group of people have accomplished over the past 13 years of my association with the company," Wolf said, "and I am confident that the fundamentals which are in place today will carry the company forward to continued success."

Wolf carried a base salary of $965,000 in 2008, and earned just over $1.9 million in stock awards. His "other compensation," which amounted to $486,447, included transportation on the company's airplane, a company match retirement savings plan and a company match 401(k) plan.


Michael Neidorff - Centene
Total Compensation: $8,774,483
Details: Neidorff, who's base salary remained at $1 million, received increases in both his bonus ($1.25 million, up from $1 million) and his stock awards ($4.7 million, from $3.98 million) in 2008. According to the SEC, "Neidorff's agreement was amended twice in the past twelve months; (1) to eliminate the non-compete and non-solicitation requirements if there was a ‘hostile change in control' as defined in his agreement and (2) to add language to the agreement to make it compliant with Internal Revenue Section 409A."
Neidorff's "other compensation" of just over $418,000 comprised of use of the company airplane "for all travel," life insurance benefits, security services, and tax preparation services, among other things.


James Carlson - AMERIGROUP
Total Compensation: $5,292,546
Details: Despite a lawsuit regarding Medicaid fraud that cost the Illinois plan $225 million, Carlson himself earned roughly $2 million more than he did in 2007. All aspects of his compensation increased in 2008, from his base salary (up from $608,000 to just over $761,000) to his non-equity incentive plan compensation (up to about $2.8 million from $1.98 million a year ago). Carlson's bonus also grew quite a bit, going from $225,000 in 2007 to $520,312 in 2008; much of that amount was based on long term incentive program goals being met.
Carlson's "other compensation," which nearly tripled (going from about $7,000 to just over $20,000), included his employer 401(k) contribution, life insurance premiums, an executive health screening, flight services and a medical insurance stipend.


Michael McCallister - Humana
Total Compensation: $4,764,309
Details: Despite its pick ups of two smaller health plans (OSF Health Plans of Peoria, IL and Cos/Cariten Healthcare of Knoxville, TN), Humana's McCallister earned roughly $5.5 million less in 2008 than in 2007. While his base salary ($1,017,308), option awards ($3,078,897) and "other compensation" ($668,104) all increased, his non-equity incentive plan compensation and his nonqualified deferred compensation earnings totaled zero dollars. The latter represents a discontinuation of the Officers' Target Retirement Plan, according to the SEC.

McCallister's "other compensation" included personal use of the company aircraft for him, and sometimes his family; company contributions to the Supplemental Executive Retirement & Savings Plan and the Humana Retirement & Savings Plan; a once-a-year physical, financial planning assistance, and more.


Jay Gellert - Health Net
Total Compensation: $4,425,355
Details: Gellert, whose company is considering selling off divisions in at least four states, earned nearly $740,000 in additional compensation for 2008. His overall base salary increased to a little more than $1.2 million from about $1.18 million in 2007, and his stock awards also rose (from about $1.4 million to more than $1.8 million).
Gellert's "other compensation," which totaled $131,526, included, but were not limited to, a $53,000 housing allowance, a corporate car and tax reimbursements of nearly $41,000.


Richard Barasch - Universal American
Total Compensation: $3,503,702
Details: After taking a pay cut from 2006 to 2007, Barasch more than doubled his total compensation for 2008, jumping up from $1,564,293 in 2007. Barasch's base salary jumped up to $857,851 from $798,340 in 2007; his stock and option awards also increased, as did his "other compensation," which reflected a car allowance, relocation benefits and a matching contribution to his 401(k).
Also of note for Barasch was the fact that his non-equity incentive plan compensation earnings totaled $1,195,147; in 2007, he did not receive any money in 2007 for such compensation, but took home $1.1 million in 2006.


Stephen Hemsley - UnitedHealth Group
Total Compensation: $3,241,042
Details: An $895 million class-action lawsuit over stock-option back dating aside, Hemsley still manages to make the cut for this list at No. 10. The UHG CEO's base salary was $1.3 million in 2008, to go along with a non-equity incentive plan compensation worth just over $1.8 million and "other compensation" amounting to slightly more than $119,000.

Hemsley's other compensation was a combination of the company matching his contributions under the 401(k) plan and the company matching contributions under his executive savings plan. According to the SEC, "in May 2006, the amount of Hemsley's supplemental retirement benefit was frozen based on his current age and average base salary and converted into a lump sum of $10,703,229." Because of this, "there was no increase in the benefit payable to Mr. Hemsley under his supplemental retirement benefit" in 2008.

***********

I've reached the following conclusions regarding Congress & health care reform:

(1) The profits are too large, the pay scales too excessive for the health care industry to willingly allow meaningful reform that benefits us, the people.

(2) Many, if not most, members of Congress, along with Obama, are recipients of large donations from these health industry corporations. Donations they do not wish to see stopped or given to opponents in the next election cycle.

(3) Therefore, Congress is attempting to make the so called health care reform into TOKEN REFORM to try to appease us, the voters, while in reality they are planning the BIGGEST GIVEAWAY(500 billion dollars or more, according to Jay Rockefeller) to that industry ever. They also plan to MANDATE WE PURCHASE PRIVATE, overpriced and under delivering INSURANCE from this industry to keep their donations rolling in WITHOUT ANY MEANINGFUL COST CONTROLS. EVEN LAS VEGAS LIMITS THE ALLOWED GAMBLING PROFITS.

(4) No meaningful regulation of the health care industry will take place as long as the industry is calling the shots with Congress.


What are they offering us?
The insurance companies will have the power to force you by law to buy what they decide they want to sell you. That's how big the loopholes are in the House bill. Remember, the income tax started out at only 1% of your income - where is it now?

Unless some more Democrats suddenly get religion regarding true health care reform, it is better to defeat the Democrats and this sham legislation. It is better to defeat it now rather than hand the health care industry more customers, more money, more power so they can buy even more members of Congress.

I disagree with some that post here. NO legislation is better than bad legislation that forces us by law to buy insurance from the very corporations that are destroying our health care system.

Better to end this battle now and fight again later than to surrender our well being to these mega, profit generating, out of control machines.


No wonder the Republicans have been sitting this one out - do the math, it's far more advantageous politically for them to let the Democrats hang themselves.

[vanbean]

174. Great post, Sandwalker. Thanks.

[barbtries]

38. 1,990 pages

i may not be able to finish reading this in a couple minutes. myGAWD.

[bkkyosemite]

48. Yes ridiculous and they are gonna put it up for us to read for three days or whatever..HR676 has

only 27 easy to read pages. Especially pages 4-6 (coverage). That will never happen.

[T Wolf]

39. Is there ANYTHING that says that insurance corps must over (PAY FOR) individual events?

It is obvious what this "reform" does...

1) everyone must buy a policy from the corporations.
2) the corps must sell a policy to anyone who applies (which you must do because of the mandate).
3) the corps can still refuse to pay for any event they want, or charge a co-pay or deductible making the event unaffordable.
4) the corps get richer and no one gets better healthcare.
5) the corporate donations to the paid-for minions in Congress and the WH continue.

Is any of this incorrect?

[dflprincess]

46. A couple adjustments

Item #1 there are a few people who will be eligible for the public option, but most of us will be required to continue buying shoddy products from the insurance crooks.

With item #3, the public "option" may also have "cost-sharing" (out of pockets) amounts that are so high that even the people who are able to buy into that may still not be able to afford care.

[T Wolf]

51. Further evidence that this "reform" is not worth a damn. It keeps most of us at the

lack of mercy of the insurance corps and screws over the millions who have no health care at all.

Does it do ANYTHING good except make the Dems feel good about themselves? And that is not really good, by any rational account.

[freddie mertz]

50. A gross disappointment.

The Democrats in Washington have failed us.

Not every one of them, but enough to show how little our victories have actually amounted to.

Vote OUT insurance-company-owned DINO Dems. :thumbsdown: :wtf: :puke:

[ChiciB1]

58. Good Luck Voting ANY Of Them Out.... It Ain't So Easy!! The Reason We Got

THIS kind of Health Care Reform is BECAUSE those in office NOW get big BUCKS from LOBBYISTS just like Big Pharma AND Insurance Companies!

And they will keep getting it, they have NAME recognition and they have Friends in HIGH PLACES to keep in touch with all those FRIENDS to tell OTHER FRIENDS how WONDERFUL these people are!

Kicking them out, is liking "breaking up is hard to do!!" Keep trying, I know down here in Florida, it's ALMOST impossible!!

Bill Nelson ain't going NOW WHERE, and he probably knows it!!

All THIS TIME, ALL THIS TALK, ALL OUR WORK... calling, pleading & begging... and FOR WHAT??

Clap your hands everyone, WE DONE IT!! HEALTH CARE REFORM!!

:puke: -- :nuke: -- :grr:

[freddie mertz]

65. I know.. it just seems futile at this point.

Our system is hopelessly corrupted, I fear.

Hope?

Not much basis for it these days....

[ChiciB1]

177. I Used The Word HOPE For A Little While During The Presidential

campaign, but before that it had been about EIGHT years that I didn't use the word! Now I DON'T use the word anymore... AGAIN!!

I REALLY did want to, I REALLY wanted to BELIEVE when "we the people" worked for and voted for DEMOCRATS, and DID give them the WH, The Senate AND The House that we would get something more than what we seem to be getting now. I realize it takes time to get things done, and I won't say "some" things haven't been done... BUT the REALLY BIG things, the things that will affect MOST of us MORE... not so much!

I think I knew we couldn't get SINGLE PAYER, but real HEALTH CARE REFORM of some sort seemed like it was possible. Now, THE WAR & HEALTH CARE don't seem all that important to them, I'm so very disappointed and don't really know what to do!

I have seen polling that MORE & MORE people want a third party, so that may be the way to go. New blood is needed and the only way to rid ourselves of all the BIG MONEY and CORPORATIONS and INSURANCES, & all the rest is to perhaps try to SPLIT it up! Still, that seems almost IMPOSSIBLE too!

I commented on people and friends I have that are really hurting these days at another post, but I'm sure many here have the same story to tell! It's just a shame that this is what it's come to.

[freddie mertz]

185. It is truly, truly sad.

I am more sad than angry.

I've been an active, dedicated Democrat my entire adult life, since before my first vote (for McGovern) in 1972.

I think I'm petty much done with it, now.

But I have no idea where to turn.

Drink? Drugs? Despair?

Is that all thats left?

Maybe a retreat into the persona realm, concentrating on family and friends.

This politics thing has betrayed me one too many times.

[ChiciB1]

194. Before I Moved To This Ruby Red District, I Lived In Texas... A Military Brat

from Ft. Hood. Said I would NEVER marry anyone in the military and didn't. He too was an Army brat and we met there when I was 14, but my father had already indoctrinated me into politics at 11. A LIFELONG Democrat when Texas was a Democratic state, I have learned through the years the art of losing gracefully!

Not long after moving to Florida because my husband was born in Tampa, even then Florida seemed much more Democratic. I think Reuben Askew was the Governor then. A few years after moving here the shift began and I too worked for McGovern when I first learned about how "mean" some people could be. I had bumper stickers torn from my car, and I think there were only a handful of us working for George. It was my foray into many lost Presidential elections. My first vote was for McGovern too! I lived in a very small town at the time and I thought it was because I moved to Florida that things had changed.

Of course, you must know the same stories I do, the upheaval of the times, the protests against the war and the excitement that when we MARCHED we got heard! Working in the trenches these many years I realize things change, but in my heart I always believed in the Democratic Party and was always active because I felt it was the correct thing to do.

But I, like you now feel useless and alone. I yearn for the days when the citizens of this country were listened too. I recall one time writing to Bob Graham about an issue and he wrote back right away telling me why he felt as he did. Now, because where I live there has NEVER been a Democratic Representative that I know of. I've written, contacted and phoned these people, but I know they don't hear me. Katherine Harris was my Representative for two terms and that was when I began to have serious doubts about my effectiveness. After 2000 it's been gloomy at best.

I think I've worked my last election now, but as an addicted addict of politics I come here just to communicate. While Obama was never my first choice I did go out in the HOT Florida sun and do all the usual things you do. Many, many hours volunteered, and many hours standing on sidewalks holding signs and going to rallies. It was heady at times and even fun, but my light is going out. I felt I needed to be an example to my kids so they too could pass it on to theirs. It just doesn't work that way these days. People get pumped for short periods and then it's over.

Those of us who are dedicated know issues fairly well, but many around me don't even know whose on the Supreme Court. What can you do?

Drink, Drugs, Despair? Sounds like something I've said myself one too many times! I'm the go-to person when others want to know about politics. That's very SAD and says a lot too!

Now, I'm becoming more cynical and I don't like feeling this way! Unfortunately many of our efforts go un-noticed and we seem to be people who just get in the way of those who are much more POWERFUL!

Remember that old saying "you can't fight city hall?" Well now it seems any fight you have left means very little or nothing at all!

End of my tirade... much too long winded! I'm just venting because I feel lost and alone!

[mvd]

59. If this is what passes, my grade for..

President Obama will stay at a B+. An A is reserved for times he goes beyond what I expect. Unlike that Senate Finance bill, this would be an improvement - but not something that would provide as good a care as they have in France, Canada, etc. It should be a first step only and needs to be be built upon.

[dflprincess]

62. If it passes it won't only be the first step, it will be the last one

If this crap passes Congress and the president will happily pat each other on the back and ignore any cries from the public for real reform.

And the insurance companies will make a show of hating while they cry all the way to the bank.

[mvd]

63. I don't know; let's keep trying to elect more progressive members

Progress is often not all in one step.

[liberation]

71. Given that health care reform has been stalled ever since Teddy Roosevelt made an initial attempt

at it... yeah, progress in the US takes over a century to do what it took a couple of decades in the rest of the industrialized world.

With that long development, our final reform will be such a masterpiece! Too bad none of us will be around to see it, but I hear it will be awesome!

[mvd]

87. I agree; it may be after my time by the time we get single payer

But anything that helps now, I'll take.

[liberation]

111. ... and that right there is one of the reasons why we have had reform stalled for a century.

Let's try to have some minimum level of expectations for what we want as a society.

If you take any thing you can get, and all you get is crumbs.... you end up with a pile of stale bread. You most definitively don't end up with a steak dinner.

[dflprincess]

91. The bill that came out today is not progress

it's status quo protection.

We have to elect more progressives but to do so we have to be prepared to take on the party structure including the DNC, DSCC and the DCCC and, probably a good many of the state organizations. We're also up against the money the corporate stooges currently in Congress will get from their masters to continue doing such a fine job protecting the plutocracy.

[mvd]

126. I'm going to keep on the optimistic side

Not doing so won't change the current Congress. I'm not saying we should like it, but no one has told me how we get much better at this point.

And the current health care state is so bad that to me, it is some progress.

[Vinca]

60. Won't the bill go to the floor for amendments before passage?

I'm getting so confused over this.

[Posteritatis]

66. Yeah, I still think they need to rider a bunch of unrelated things into it first

I imagine the GOP will try to slip an abortion ban or English-only clause or criminalization of homosexuality or something into it.

[liberation]

73. And the dems have to water it further down...

... lest it offend the sensitivities of their fellow blue dogs.

[Posteritatis]

75. They're already working on it

A bunch of the senators are fighting against health coverage for the disabled for fear of their feeling "entitled".

[liberation]

79. You gotta be sh*tting me...

I weep for this country, I really do.

[KamaAina]

96. How the hell would it increase deficits?

The CLASS Act (Communtiy Living Assistance, Services and Supports) creates an insurance fund that you pay into through payroll deductions, like Social Security or Medicare. And unlike those programs, it's voluntary.

Figures LIEberman would be in there. :eyes:

[Raineyb]

160. :facepalm:

Health care SHOULD BE an entitlement.

Of course those fuckers don't give a shit. They have their coverage and they don't have to worry about being dumped do they?

Assholes every one of those flea bitten blue dogs. They can all go to hell!

[dana_b]

167. and then STILL not vote for it n/t

[dflprincess]

138. Yes

but the House has more limits on what can be done to it once it's on the floor than does the Senate.

So, the House will pass their piece of crap. The Senate appears to be on track to come up with something that's even worse than the House bill. A conference committee will be convened to hammer out differences between the two bills so that there is only one bad bill. The conference committee bill will be voted on by both chambers and all the members will be so proud of themselves and expect us to not only be dumb enough to fall for this scam, but to be greatful for it and reelect them.

[ooglymoogly]

77. The "robust public option" was just flushed down the toilet.

for no other purpose than to assuage the insurance crooks and the Wall st. crime bosses. A "public option" in name only is no public option. After the smoke dissipates and mirrors are broken we will again have nothing but ever increasing medical costs with a drug costing $4 being sold for $250, while being stripped or any bargaining power. Flim Flam has reached stratospheric levels of insanity.

[Lagomorph]

203. I'm starting to think it's a shell game.

By nationalizing health care, all the money is removed from the private sector. An entire trillion dollar plus industry would simply vanish from the free market economy. Profitless, government run programs don't look good on the balance sheet.

The numbers would indict a much smaller free market economy and fewer employment opportunities within the free market.

Our foreign financial overlords would interpret this as an indication that we can't afford any more foreign credit because of our alarmingly smaller free market economy and would insist on accelerated repayment.

If they keep it in the free market, our economy would appear to be larger and generating the revenues our foreign financial overlords want to see.

[dflprincess]

206. You forget that other areas of the U.S. economy are less competitive

because of health insurance costs. Our current "system" already results in lower wages and fewer jobs because of these costs. The House bill will do nothing to help other areas of the economy. The bill is designed only as a bail out for the insurance companies which will collapse if they aren't given a captive customer base.

[Lagomorph]

224. If the Insurance companies collapse...

...it will be because the economy collapses.

There is no way the government option could support health insurance for those kind of numbers.

When energy costs and taxes sky rocket, wealthy people will bail on the country, as well.

The unemployed middle class won't be able to feed itself, let alone pick up the bill for health insurance.

The golden goose is already in intensive care.

I'm all for solutions, but I'm not looking offshore for them.

[BluinTX]

83. Well, I've read most of the pertinent portions of the Bill

and I think it's pretty darn good from what I can see so far. The cost sharing of up to $5,000 for an individual and $10,000 for a family troubled me at first, but it apperas that it will only be applied through co-pays and not deductibles. Thus, if there is an 80/20 co-pay, a hospital visit that would cost $10,000 if you were uninsured may be negotiated down to about $3,000, of which you would be responsible for $600. Not perfect, but not terrible.

The public option is available to anyone without current basic coverage, or anyone who loses coverage. Again, not perfect, but not bad. And this way the mandate cannot force anyone to buy a policy from a for-profit insurer, since you will always have the public option instead.

Moreover, there is no longer an antitrust exemption for the insurers, no pre-existing coverage exclusions, no recission, some level of price controls on premiums, maternity care, mental health parity, free well care and baby care, dependents covered up to age 27, no blanket prohibition on abortion services being covered.

The one part I'm not yet clear on is how affordable the premiums will be -- which of course is paramount.

[pattmarty]

137. You do know that this "masterpiece" is NOT the final bill, don't you???

I also like Mothers, Baseball AND fucking apple pie, But my Mom is dead, Baseball nowadays sucks and the apple pie is made from frankenfood.

[BluinTX]

147. WTF?

My mom is alive, baseball is pretty great if you live in Philly, and apple pie is still made from apples!

What on Earth is your point?

And of course this isn't the final bill, but it isn't a complete POS that some here make it out to be, at least not in my opinion. Single payer, or Medicare for all would certainly be preferable, but this is much better than the Baucus tripe that passed out of the Finance Committee. I am just hopeful that this is what the House insists on as a MINIMUM level HCR.

[pattmarty]

158. It's a fucking piece of shit already, and it's only going to get................

.............worse before it reaches "Bill" Obama's desk for signature.

[ooglymoogly]

149. This is the stage of the bill where everybody grandstands on their great success

and how warm and fuzzy they feel about what a wonderful thing they have done. I am, however, very skeptical of what the final bill will be if this is the position they are negotiating from; What will be stripped from it to supposedly satisfy blue dogs and traitors like Droopy Joe. It is up to us, in my opinion, that we should scream as loud as possible to let them know this is not good enough and force them to go more robust than weaker; Which is rumored to be what is in the pipeline and since the Snow job fell flat to raucous laughter, they need a new point man to make the bill meaningless and Droopy Joe is that point man. If I am right on this, it will be proven if Joe, who has made these threats to sell out his party, keeps his powerful chairs, who's very existence has been very suspect from the beginning; That clue to me at least is a window into what is really going on in the "Democratic Leadership" and it aint about making this a better place for, or helping out the common man.

[dflprincess]

175. I think you may be reading that wrong

On page 9 "cost-sharing" (what a cute term) is defined as including "deductibles, copays, coinsurance and similar charges but does not include premiums, balance billing amounts for non-network providers or spending for non-covered services."

On page 122 deductibles, copays and coinsurance are all listed again as cost-sharing items.

So it sounds like the bill still allows deductbles (as did HR3200) - and deductibles that are high enough to keep some people from being able to afford care.

If you found something different in another section, please provide the page number(s).

[Libertas1776]

85. Great

so now our President and the eminent representatives can have a multitude of photo ops and pat each other on the back and say mission accomplished, while the majority of Americans continue to get the royal health insurance screw job...and this time ITS MANDATED!!! Don't expect my vote in '10 or '12 you corporate whores.

[riskpeace]

86. The section on continuation of COBRA is interesting and a significant change.

It looks like it discontinues the 18-month limit on COBRA coverage. You'd get to remain on COBRA until you got covered by an employer-based plan or through the public option plan.

[KamaAina]

88. This is news I can use. I'm meeting with a congressional staffer later today.

Any suggestions (particularly relating to people with disabilities)?

[Posteritatis]

89. Check my link in #79

Bring it up, preferably with a question along the lines of "are you fucking kidding me?!" and let us know how they react.

[Andronex]

92. what's ironic

is that it's the republicans who will be looking good by voting against this giveaway to the insurance companys.

[SandWalker1984]

93. State level single-payer healthcare stripped out of House bill

Healthcare Hoax from Hell
AfterDowningStreet.org
http://www.afterdowningstreet.org/node/47375
By David Swanson

Lies, damn lies, and promises from Democrats. An amendment allowing states to create state-level single-payer healthcare has been stripped out of the House healthcare bill, after having passed in committee back in July by a vote of 27 to 19. And rumor has it that a vote on national single-payer that was promised in July in exchange for skipping a committee vote on it will now be denied.

First, the state single-payer amendment.

Back in July, the House Committee on Education and Labor did something right, something that could have made all the difference in the world to millions of Americans. Congressman Dennis Kucinich introduced in the committee an amendment that would have effectively allowed states to improve on our healthcare system if they chose to, allowed them to create state-level single-payer healthcare. There are bills to do this in several state legislatures already. Such a bill has passed and been vetoed in California twice, where a change in governor is imminent.

President Obama told the committee chairman, George Miller, to oppose Kucinich's amendment, and he did so, leading off the voting with a resounding "No." But the Democrats voted 14 to 14 with one member passing and two failing to vote. And the Republicans voted 13 to 5 with one member failing to vote. That added up to 27 yes votes and 19 no votes. Some Republicans may have voted yes simply because the chairman voted no, but they said they were voting yes for states' rights. And that would be a sensible, decent, and constitutional position. Why shouldn't states be permitted to do better, as well as worse, than Washington, even if the insurance companies bring in less blood money?

Canada got its healthcare system in one province first. If California or Pennsylvania joins the civilized world and treats healthcare as a right, and eliminates the waste and bureaucracy of the health insurance companies, our whole nation may just be forced to come along, or watch half the population migrate to California and Pennsylvania.

Ah, but it's not to be. Unless Americans behave as a civilized people and raise holy hell over this immediately. Sadly, a huge chunk of Americans opposes being provided with healthcare, and another huge chunk is drunk with a teenage crush on the guy who no doubt told Pelosi to strip out the amendment.

In the healthcare advocacy world, a big group has focused on the godforsaken bastard policy known as "public option" which at best will offer a token mitigating element in some states for a disastrous healthcare policy imposed on all states. But the states that choose to do right by their residents will not be able to choose a real solution like single-payer, not without a drawn-out legal battle with the insurance companies over the federal laws that Kucinich's amendment would have waived.

Another big group of healthcare advocates has been so obsessed with getting national single-payer immediately, rather than state-by-state, that they've barely lifted a finger for the Kucinich amendment, which I predicted in July would be stripped out.

Which brings us to the Weiner Amendment. The deal cut with Congressman Anthony Weiner was cut in committee. It's on video. Chairman Henry Waxman told Weiner that Pelosi would allow a floor vote if he skipped a committee vote. Weiner agreed. Weiner may have been lied to. But whether his amendment gets a vote or not, it has served as a big glaring distraction from the Kucinich Amendment.

A conversation I had with Congresswoman Betty Sutton is typical. She told me that the Kucinich Amendment was no big deal and shouldn't be paid any attention to. She said she wanted everyone to focus on the Weiner Amendment on which she planned to vote yes. Asked if there was any chance the Weiner Amendment would pass, she replied of course not.

From Congresswoman Sutton's point of view, a bill that will fail is far more important than a life-saving measure in a bill that might pass, because she planned to vote right on the former and brag about it to her constituents. "See, I tried. I really tried." But if Sutton's state, Ohio, passes the bill currently making its way through the state legislature and establishes single-payer for all Ohioans, the death panels, aka health insurance companies, will sue. And without the Kucinich Amendment they will win or at least hold things up for several years and several thousand deaths.

Will Sutton or any other members of Congress fight for either of these amendments? Will any of them call out Pelosi? Forcing the Kucinich amendment back into the bill and forcing a floor vote on the Weiner amendment are admirable immediate goals (as of now Pelosi will be allowing no floor amendments of any sort), but healthcare is very complex with the devil in the details, and the details are being written by devils, blood-soaked devils. The central demand of members of Congress must be: Vote No. The reason they should have to listen must be: We will occupy your offices and prevent you from working unless you commit to voting No, but if you commit to voting No and vote No, we will consider possibly not throwing your sorry ass in the street in next year's elections.

[dflprincess]

151. Well, isn't that just ducky?

My last hope for reform was that several DFL state legislators were posed to push a state single payer bill if the law changed.

This bill needs to be defeated.

[dana_b]

169. they never had any intention

of giving any credence to either amendment. Fuck her, fuck Pelosi and most of the rest of them.

[Lydia Leftcoast]

102. A 2000-page bill?--NO! NO! NO!

I'm against on on those grounds alone.

It means it's full of special favors and overly picky regulations. Did you know that the bill establishing Canada's health care system is only 16 pages long and that HR676 is only 13 pages long, since it doesn't require translation into French?

I'd rather have NO reform than one that makes ANY concessions to the insurance industries.

This bill is a Trojan horse designed to FOOL the public into believing that the Dems are doing something.

Until the Dems have the guts to tell the insurance industry whereto stuff their pre-existing conditions, their age-based premiums, their deductibles, their exclusions, and their lavish executive pay, whatever results from "reform" efforts will be seen as a burden and no help by the general public.

Please don't be so eager for "reform" that you'll accept stale, chemically tainted crumbs instead of freshly baked bread.

Please don't be such a partisan cheerleader that you'll applaud anything the Dems come up with.

We deserve better--or maybe we don't, because we keep electing people who fool us with fancy words.

[Posteritatis]

117. Some problems there

The bill establishing "Canada's health care system" - we have thirteen, not just one, and that's leaving aside federal or military ones - wouldn't need to be that long since it's just a "start doing this" sort of thing. Canadian health law isn't as Byzantine as US law, but Nova Scotia's got a big pile of cross-referenced health-related laws and regulations that can easily get into the hundreds of pages or more (even before getting into clauses like "(insert hospital here) shall have a set of bylaws," which obviously wouldn't show up in the act. It isn't that different from a single major comprehensive bill like what the US is working on in theory.

I like my health care system for the most part, but the mechanisms underlying it are vastly longer than sixteen pages and can get quite complex. I'm looking at a longer one right now that's just pertaining to mental health care in one of the smallest provinces in the country, and largely consists of modifications to other laws.

[tjwash]

120. There are some people on this thread that seriously need to grow the fuck up

Seriously...grow up.

This pervasive, infantile attitude, of "fix everything at once or don't fix a damn thing and drop it" is, quite frankly, embarrassing to be around or associated with.

If you want to ever see a society that has actually starting to act as if all of its members are entitled to the same consideration and access to basic rights for all, after DECADES of rot, and abuse at the hands of the lobbyist-led corporate propaganda machine, it is going to take steps ...actually a HELL of a lots of steps ... over lots of time. And guess what, it may take the same amount of decades to fix it. Some more bad news sunshine--it is most likely, going to take more time than you or I have left in our lives.

So get the fuck over yourselves.

On the other hand, if your attitude is just that "they're including all the wrong people, they should only be putting the stuff in the bill that I believe should be in the bill, otherwise it is shit fuck 'em anyway I voting against them next term no matter what now" ...well then, you are a major part of the problem.


Either way, you're not contributing anything useful, except cheap entertainment while you stamp your feet, and hold your breath till you turn blue.

[Psephos]

124. Translation: do not criticize this bill. Merge with the hive. n/t

[BluinTX]

148. what tjwash said!

+1,000

[Lydia Leftcoast]

184. It's not bratty to oppose a bill that will make things worse for many people

such as keeping them stuck with their crappy insurance companies and forced to pay whatever the insurance companies feel like charging.

[BREMPRO]

191. Thank you for helping with the adult reality check on this thread

i feel like i'm fighting a losing battle against the "my way or the highway" "all or nothing" rabble that is determined to side with the Republicans and kill this effort at health care reform. They exhibit a stunning misunderstanding of how legislation and reform works. Again, thank you for adding your voice.

[fascisthunter]

122. well, there goes my vote

I won't waste my vote again....


and to those of you telling others to accept this piece of shit, fuck you too. I know too many around me who are suffering while you bastards live comfortably. You grow the fuck up!

[dana_b]

170. +1

[riskpeace]

133. This excerpt from NYT article shows why public option scares insurance companies.

http://www.nytimes.com/2009/10/30/health/policy/30health.html?hp

The new House bill would expand Medicaid to cover childless adults, parents and others with incomes less than 150 percent of the poverty level, or $33,075 for a family of four. This goes beyond the earlier House bill and a companion measure in the Senate, which would extend Medicaid to people with incomes less than 133 percent of the poverty level ($29,327 for a family of four).

This change saves money. It is less expensive for the federal government to cover low-income people under Medicaid than to provide them with subsidies to buy private insurance.

[Ms. Toad]

161. Well...except that Medicaid actually pays the premiums

for private insurance policies in many states. When my daughter was on Healthy Start she was actually enrolled in a BC/BS plan.

[riskpeace]

176. The state got a lower premium and likely better coverage

The state negotiated an annual payment with the MCO per individual that was most likely less than the premium would have been for coverage in the private market. The contract with the MCO will include stop loss provisions that are usually better than exclusions in individual or group coverage in the private market.

[Ms. Toad]

179. I was responding to the assertion that

private insurance companies were afraid of the public option because more people would be moving to Medicaid, rather than private insurance. Going on to Medicaid does not necessarily remove customers from private insurance, and even at lower negotiated rates, private insurers still reap the benefits of paying customers (with guaranteed payments). Not much to fear.

[riskpeace]

193. I did not assert that people would move to Medicaid.

I thought it was interesting that the federal government could save money by expanding Medicaid and covering more people at higher income levels that way rather than subsidize the same individual to buy insurance in the private market. That seems to me like a confirmation of many of the arguments for a single-payer system.

[Ms. Toad]

196. Expanding Medicaid is moving more people to Medicaid.

which, in turn, means more people for whom premiums are paid to private insurers (under the current Medicaid structure). As I said - I can't imagine that scares them much at all. Under the proposed scheme, it might even means a larger group of people who are not eligible to choose the public option, unless the exchange is made open to everyone on Medicaid.

[toocoolforschool]

136. im fired up! Fired up! ready to go! ready to go!

[earth mom]

163. I knew Pelosi would sell us all out. Told ya all so!

:puke:

[placton]

171. gee mom

the Obama worshippers don't wanna hear that sort of talk - especially since you were right and they were wrong

[earth mom]

186. You know what? I wish I wasn't right. I wish Obama & Pelosi & Congress would do the right thing

for the majority of the people.

[fascisthunter]

202. some people just don't give a shit

We the People are being raped by this government and their corporate constituents, and yet some fools on this site have the gaul to suggest we accept whatever is proposed. Some live in a very strange World where they think accepting whatever is somehow good. Sick, sad and pathetic.

[ramapo]

164. This %&*%*&%* POS Bill doesn't even end pre-existing condx until 2013!!!

This is unbelievable.

I never imagined these scumbags would stoop so low.

My intense interest in this has been driven by the fact that my son had a brain tumor seven years ago at age 16.

Today he doesn't have a brain tumor, hasn't had it, and is perfectly healthy.

Yet he has been denied insurance. He doesn't have a condition! Yet medical underwriting wins the day.

This bill does NEXT TO NOTHING about this situation.

WHY 2013?????

Fuck these gutless, useless bastards

[marshall]

178. There's my reading for the weekend

Have to keep the porch light off so the trick or treaters won't interrupt me.

[mstinamotorcity]

201. Looks like dog house has been renovated

I don't care how they package the health care bill it still is the same old dog house with some new paint. Public option yea right the option is that lawmakers said f--k the public our option is to corporate insurance giants. Maybe we should have a lawmaker option in 2012. And a push to revoke their government run healthcare. Because i really don't see paying for something that is not available to the people who pay their wages. and their healthcare. If the president has a rabbit under his hat now would be a good time to see it.

[dflprincess]

207. Actually they don't have government run health care

they do chose from private plans. However, as their employers, we do subsidize their insurance with our taxes. I think it's time they be offered one of those crappy high deductible, "consumer driven" health plans (CDHP) that are becoming so popular and that should be the only option they're given.

CDHPs come with the option of having a Health Savings account that, once it reaches $2,000, can be invested in a mutual fund. Good luck with your health if you put your health care dollars in the stock market).

[No Elephants]

216. Government run health care is very different from single payer. With government run

health care, the government owns the hospitals and clinics, hirea and fires the doctors, etc. That was never on the table, even with those who want single payer.

Single payer would mean that the government would be paying the bills, much as insurance companies do now, only without the garbage about pre-existing conditions, getting cut off when you are sick, etc.

What Congress has is health care coverage paid for by the taxpayer, albeit indirectly. That is what the poster meant.

[dflprincess]

221. I know the difference between government run and single payer

the poster I responded to refered to Congress as having government run health care - also very different from the taxpayer (employer) subsidized insurance they have. I don't know where you get your interpretation of what the poster meant. One of the incorrect charges that continues to surface is that Congress has a plan that is unique to them when, if fact, they have the same options other federal employees have.

However, I don't have a problem with Congress having a plan that's different from other government employess. Providd that, if they're going to stick us with high deductible plans, they should be forced to have the same kind of crap and they should start paying 11% of their incomes for it - just like they think we can do.

[No Elephants]

217. What the hell happened to the Progressive Caucus and "The Pledge?"

[No Elephants]

218. And the Senate will water down even this and the House knows it.

And Obama will sign whatever lands on his desk and declare victory.

[dflprincess]

222. And expect us to happy and greatful for it

and not bring up the health care issue again because Obama "wants to be the last president to deal with it."