Studio8 - Uniting the Arts

Game On
by Mike Lux
Huffington Post, October 26, 2009

Okay, folks, we progressives got what we wanted. A comprehensive health care reform bill with a reasonably strong public option will be going to the floor as part of leadership bills in both the House and the Senate. We don't yet know whether we will get the best version of the public option in the House bill, and the Senate version is not as strong as progressives have been pushing for. But strengthening the form of the public option can be negotiated over in conference committee, once we get there.

For now, we can thank Harry Reid and Nancy Pelosi for their gutsy leadership, and fight like hungry dogs to win the floor fight and deliver on this hope. In the coming weeks we will have an all-hands-on-deck, all out public war with the insurance industry over whether we finally pass comprehensive health care reform or once again fall short at the bitter end after coming so far.

Here's where things are as we head into the floor fight:

1. White House staffers confirmed for me this afternoon that they are backing Harry Reid's decision "100 percent." Now that's not to say they aren't a little nervous about it. I suspect that there are still some feelings by some people working in that building that progressives should have given up and rolled over, and let them cut a deal with Olympia Snowe on her trigger-written-never-to-trigger. That would have been easier than sweating what will undoubtedly be a very tough battle to get all 60 Democrats to go along with the rest of the party. But us irritating progressive folk got in the way of doing that, and now Obama knows it's time to stand and deliver. I believe my friends at the White House when they say they will do an all-out fight for this bill. They know that starting down this path, and not being able to pull it off, would be a huge embarrassment and destroy all the momentum we've built by making it this far. They are all-in, and know how much is at stake. Rahm Emanuel and Jim Messina are famous for twisting arms and doing everything in their power to get the votes that are needed, and now is their time to deliver.

2. The entire progressive movement has to go all-in supporting an up or down vote on health care reform. We should try to strengthen this bill with an amendment strategy on the floor, and we should be prepared to fight for a strong, tough negotiation strategy in conference committee. But first, we should be putting every ounce of work, dollars, and muscle we can to convince all the Democrats in the Senate to support Reid on the cloture vote in the Senate. The White House and Reid are on the line to deliver, but so are we. This is a history- making fight, one of those huge moments in American history, and if we win, this progressive movement will be written about in the history books the way the big change movements of the 1960s, 1930s, 1900s, and 1860s are. This is our time to deliver, too.

3. Senate Democrats who are reluctant to support this need to be clear: there are plenty of things none of us like in this big, sprawling bill. Personally, I think the idea that states could opt out of the public option is a tragedy, and I will fight for a better bill in conference committee. There are plenty of other provisions I don't love as well. But to step on history, to stop the entire rest of the Democratic party from making history because you don't like one provision in a bill, is fundamentally wrong. Go ahead and vote against it on an up or down vote, but do not stop this incredibly important, incredibly historic bill with a filibuster. And as a loyal Democrat who wants all Democrats to win, I want you waverers to be very clear about the political consequences. There is a huge political upside to supporting Reid on cloture, and an even bigger downside to not doing so. I don't speak for the entire progressive movement at all, but I have spent my life working in it, and have a pretty good sense of it, and I will tell you this: this is of truly massive importance to progressives. If you think this is just another issue, you are dead wrong. You will be helping yourself an enormous amount with progressives by letting this vote happen, and letting the Democratic party and the president get a huge win. It would be harder to raise money for anyone running a primary against you and easier to get our help in any tough general election you might face. On the other hand, if you screw us on this issue, you are opening yourself up for enormous political problems. The odds of serious primaries, with a ton of funding, go up dramatically, just as the odds of ever getting help in a tough general election fight go steeply down. The likelihood of people and organizations trying to block anything politically you are trying to get for your state go up exponentially, from judges you are trying to get appointed to highway money you are trying to get. Look, I am not trying to make threats here at all, I am just a lowly consultant. What I am suggesting is that everyone in the progressive movement is going to have very, very long memories about this highest of high priorities for us.

This is the fight of our lives, and after all the preliminaries, we have made it to the finals. Reid and Pelosi have delivered. The White House is ready to roll. Now let's get this done.

Source: http://www.huffingtonpost.com/mike-lux/ ... 34571.html

Media's Credibility (Not Public Option) Is What Is Dead
by Chris Weigant
Huffington Post, October 26, 2009

Senate Majority Leader Harry Reid today announced that the public option (Charles Schumer's "opt out" plan, in particular) will be contained in the bill he moves to the Senate floor. This is an absolute shock to the media, since they have been obsessing over only one bill out of a total of five that congressional committees have passed to date -- the one produced by Max Baucus' Senate Finance Committee.

Baucus' bill (which took the longest to appear) is the only one of these five bills without a public option. But, in apparent widespread confusion as to how Congress actually works, the media has been pushing the "public option is dead" theme for so long, it's no wonder they're so astonished at today's news. Because it proves (yet again, I might add) that the media's credibility is really what should have been pronounced dead months ago, and not the public option.

A quick trip through Lexis/Nexis (searching on "public option is dead") proves this beyond any doubt. Republicans offered this up as a piece of "conventional wisdom," and the media swallowed the story hook, line, and sinker all summer long. While there were voices in the blogosphere's wilderness saying "there are bigger fights ahead, Baucus' committee is a minor skirmish," most of the mainstream media watched the hotheads yelling at town hall meetings, and took an enormous leap to reach the conclusion that the public option was deader than a doornail. Forgetting, I suppose, that a scattering of angry, vocal protesters are not who writes the actual legislation. Or something. At this point, it's hard to even fathom the depths of the media's distractibility on crucial issues facing our nation.

Here are just a few of the recurring instances of beating the particular "public option is dead" drum from the past few months (emphasis added by yours truly):

7/29/09 -- Fox News
MARTHA MACCULLUM: What we're hearing on the Senate side is that the public option is dead.

From the print media:

7/24/09 -- New York Daily News -- "Health Plan Stalls. Prez Concedes It May Not Get To Congress Till Fall"

Reid bent to reality as senators on the stalled Finance Committee met for hours hoping to clear the air, emerging to say their talks were "contentious."

Reform opponents cheered the delay, predicting it at least dooms the President's push for a government-run insurance option.

"I am very confident . . . that if Congress does not pass a health care bill with the public option before Labor Day, the public option is dead," conservative activist Rick Scott said in an e-mail to supporters.

Insiders say the delay would not land reform in the morgue. "Not fatal at all," said a Finance Committee aide.

Analysts agreed, but predicted the slowdown will prompt a barrage of attacks lasting through the summer.

That last sentence certainly appears prophetic in hindsight, I have to admit.

Kent Conrad began pushing his "co-op" plan pretty hard around this point, and with it served up more fodder for the "public option is dead" theme:

8/5/09 -- USA Today (with Reuters listed as source) -- "Health Co-ops Emerge As Weak Substitute"

Opposition in the Senate is so strong that some negotiators have concluded the public option is dead there. The co-op idea, championed by Sen. Kent Conrad, D-N.D., arose as an alternative free of the "government" stigma to provide competition for private insurers.

Fox News, of course, pronounced the public option dead repeatedly:

8/16/09 -- Fox -- Fox News Sunday

CHRIS WALLACE: Senator Conrad, as a practical matter, especially given what Secretary Sebelius says, is the public option dead?

SENATOR KENT CONRAD: Well, there are not the votes in the United States Senate for the public option. That's why I was asked to come up with an alternative. And I want to just make a tweak to what you've referred to as the cooperative plan.

. . .

WALLACE: And real quickly, Senator Conrad, because I want to move on to the next fact check, would the president be better off just taking the public option off the table right now?

CONRAD: Look, the fact of the matter is there are not the votes in the United States Senate for the public option. There never have been. So to continue to chase that rabbit, I think, is just a wasted effort.

This line (complete with its "rabbit metaphor") was widely quoted for the next two weeks, which I'll get to in a minute. But later on in the same show, A.B. Stoddard from The Hill newspaper, reinforced Conrad's words, by explaining why the president should just announce to the world that the public option is dead:

A.B. STODDARD: I think there's time if he wants to be a strong president and come in even behind the scenes -- if he doesn't declare the public option dead in public, come out and, behind the scenes, start speaking to the liberal members and say, "I want a bipartisan bill by September 15th. I want a reasonable incremental bill that will pass, that will not kill us in the next two elections. You need to stay with me on this." He needs to exert himself.

The problem is if they miss that deadline, as Ceci mentioned, then the Democrats -- the liberal wing is going to pile on and say, "Let's just go without them. Let's do a bill without the Republicans. Let's use reconciliation, have a public plan." And President Obama knows that's not -- it's politically just too perilous.

But it wasn't just Fox. CNN repeated the "public option is dead" discussion quite a few times. Here is a snippet of one of these, with Joe Klein of Time magazine and Patricia Murphy of PoliticsDaily.com debating the importance of the town hall protesters. Klein shows a rare moment of "gosh, the media is the one who determines what is 'news' so don't act so amazed" -- which is seldom heard from the media pack when marveling at "what is news" without taking responsibility:

8/17/09 -- CNN

JOE KLEIN: They're turning out handfuls of people who scream very loud.

(CROSSTALK)

PATRICIA MURPHY: And they're making the news.

(CROSSTALK)

KLEIN: They're making the news because we're letting them make the
news.

(CROSSTALK)

MURPHY: And it's working. And the public plan is off the table now.

KLEIN: Well, but the public plan was never going to be on the table.

Chris Matthews was an early proponent of the death of the public option, and has talked about it for months, both on his Hardball show and on his weekly Chris Matthews Show. An early example was Pat Buchanan saying "I think the public option's dead" on the Hardball that aired August 18, 2009. This show also amusingly had Matthews calling NBC's Chuck Todd "Chuckaroo" on the air, as well as Todd coming out with this frank admission (also rare for the media): "...we always say that the country has A.D.D., you know, and doesn't seem to remember what happened just five minutes ago."

Back on Fox, Dana Perino had this to say on Sean Hannity's show:

8/18/09 -- Fox News -- Sean Hannity

DANA PERINO: I think what this signaled this weekend is that the public option is dead. It's not coming back. ... They misread the American electorate. They absolutely misread on how seniors were going to feel about this. And they are walking down a road where they're going to not be able to unite the country on anything unless they can pull back.

On the show Inside Washington, they got into the "rabbit metaphor" from Kent Conrad's earlier statement. This led to an amusing mistranscription that I just had to include, because it's funny:

8/23/09 -- WJLA -- Inside Washington

After saying last weekend that the rabbit will probably be taken off the table, Health and Human Services Secretary Kathleen Sebelius this week gave the little fellow a newly sun life.

Um, perhaps you meant to type "a new lease on life"? Heh heh. Sorry, when you spend all day reading transcripts, you take your childish humor where you can find it...

But the real thing worth pointing out from this show was Charles Krauthammer, a little later on, following the same metaphor down the rabbit hole. Or, as he would put it, the wabbit hole:

CHARLES KRAUTHAMMER: The wascally wabbit is dead. It doesn't have a chance. In the end, the liberals are bluffing. Mara Liasson of NPR put it, I think, correctly. There's no left wing Democrat who's going to lose a seat if the option is left out of the bill. There're a lot of moderate Democrats who will lose a seat if the public option is in the bill. And that will determine how it goes. There'll be no public option. There might be a co-op idea, which is a Trojan horse, which will be a substitute.

Wait a minute, I thought it was a rabbit... now it's a horse? I'm confused.

Back on Fox, Bill O'Reilly and Karl Rove were betting on the imminent death of the public option. While no terms were actually discussed, Rove actually took the "public option is not dead" side of the bet, since he probably knows how Congress actually works, rather than the fantastical way it has been constantly viewed by the media throughout this debate. O'Reilly starts by airing a clip of the two talking the previous week.

9/14/09 -- Fox News -- The O'Reilly Factor

(BEGIN VIDEO CLIP)

BILL O'REILLY: I think the public option is gone. He threw it right out the window. So liberals aren't going to like that. It's gone. I think...

KARL ROVE: Bill, I don't agree with you. I think tonight he had a tougher tone on it than before.

O'REILLY: No. NO.

ROVE: I hope you're right. I thought his tone tonight was very tough.

O'REILLY: No, you heard him say, look, the progressives -- this is just the way to get their -- he's going to throw that out.

(END VIDEO CLIP)

O'REILLY: Well, yesterday, Republican Senator Lindsey Graham said this.

(BEGIN VIDEO CLIP)

LINDSEY GRAHAM: Well, I think the public option is dead. It's probably been dead a long time, because the public is very afraid. Eighty-five percent of the people with private health insurance like what they've got.

(END VIDEO CLIP)

O'REILLY: Here now, FOX News analyst Karl Rove. I don't understand this. It looks like I may have been right.

ROVE: I hope you're right. With you and Lindsey Graham saying it's gone, it is Bill Clinton, Nancy Pelosi, Harry Reid and new chairman of the Senate Health and Education and Labor Committee, Tom Harkin, saying...

O'REILLY: Olympia Snowe, the Republican senator from Maine.

ROVE: Forty -- 40/60, forty to sixty.

O'REILLY: But you know how much damage there will be if that gets in there.

ROVE: Absolutely.

O'REILLY: And so I...

ROVE: Which is why I'm hoping you're right.

O'REILLY: You're not going to bet me a lot of money.

ROVE: I will bet you.

O'REILLY: How much do you want to bet?

ROVE: Well, I'm not a gambler. I'm happy to make a modest bet with you. I hope you are right. Please.

O'REILLY: But you're still standing to your guns?

ROVE: Because look, it's a question of math. You have a huge Democrat majority in the House. And you have the speaker of the House.

O'REILLY: He that could get it done. One-termers.

ROVE: Sure. But you know what? If they got that done, that would be one term worth having from the perspective of a lot of progressives.

O'REILLY: I don't think Obama wants a one term.

ROVE: In the Senate Democrats, you've got people who are flaking out, because they're looking for a way to get a soft public option. That is to say, well, we're not for the public option.

O'REILLY: Yes, they'll work for guys...

ROVE: We are the trader or the co-opt.

O'REILLY: The big federal insurance apparatus isn't going to happen.

I said before we had all dodged a bullet because Tom Daschle had to withdraw from consideration for Secretary of Health and Human Resources. Here's why:

9/29/09 -- Bloomberg TC -- Peter Cook interviews Tom Daschle

PETER COOK: And right now, as you look at the votes in this committee so far, the underlying bill is basically intact, no major changes to it. If these public-option votes go down today, does that mean the public option's dead?

TOM DASCHLE: Well, it means that it's not dead, but that it's not necessarily -

COOK: Life support -

DASCHLE: Yes. It's probably on life support. It'll go to the Senate floor. There, they will have other votes. There may be other dynamics. There's another amendment on a public option that probably has a lot more possibility, and that is the so-called Snow amendment, which is a trigger for a public option over the course of several years. If we fail to accomplish everything we set out to do, the trigger sets in, maybe in about five years.

. . .

DASCHLE: I think it's possible, but it's not very probable. My guess is, at the end of the day, Democrats are going to coalesce. They're going to come up with an agreement on something that doesn't make them all that enthusiastic but, in large measure, addresses all of the concerns in cost, access and quality that we've been talking about all year.

Back at CNN, Gloria Borger weighed in on the issue:

9/29/09 -- CNN -- Campbell Brown

CAMPBELL BROWN: After today's vote, is public option dead or alive?

GLORIA BORGER: I think it's pretty dead, Campbell. I think it's safe to say that right now it looks like it's a goner.

Alex Castellanos, over at The Situation Room on the same network, agreed, with an Hallowe'eny mental image for us all to enjoy:

9/29/09 -- CNN -- The Situation Room

ALEX CASTELLANOS: Look, the president and the Democratic Party, Wolf, for a long time have been very clear. They would like government-run health care. They can't get it now, so they will take what they call a public option, a step toward that. In the short term, the public option is dead. They don't have the votes in the Senate. It's like when you die your hair and your fingernails keep growing for a few days. Well, the public option... it will still keep growing for a few days, but it's dead. It's not going to happen.

The Wall Street Journal was also quite convinced:

9/30/09 -- Wall Street Journal -- Greg Hitt

Bipartisan vote in Senate Finance Committee defeats proposal for government-run health insurance plan to help those who cannot get affordable insurance; defeat suggests so-called public option is dead in Senate, though it clings to life in House; public option could be revived if Obama administration weighs in strongly; alternative could be 'trigger' option that takes effect only if other steps fail to expand coverage and lower costs

The Washington Times agreed (note: the number five is apparently a "large number" to the folks a the Times):

9/30/09 -- Washington Times -- "Public Option Rejected Twice By Senate Panel; Democrats Defect In Large Numbers, Complicating Reform"

In a long-awaited fight that pitted Democrats against one another, liberal lawmakers failed twice Tuesday to insert a government-run health insurance program into the emerging Senate health care reform bill but vowed that the battle for a public option is far from over.

Republicans immediately hailed the Senate Finance Committee showdown votes as proof that the public option was dead.

These obituaries came as recently as yesterday, in case you were wondering. But, tellingly, they're starting to confuse the "journalists" who believed the hype, because the storyline is beginning to change on them.

10/25/09 -- NBC -- Meet The Press

JOE SCARBOROUGH: Well, I, I can, I can tell you it's been very confusing. Headlines on Tuesday said public option's dead; headlines on Wednesday, public option's alive. Headline--headlines this morning, The New York Times, public option, dead. And Dan Balz, Washington Post, says public option alive. This is where we're at: Harry Reid this morning has 57 votes. He's got 57 votes for the opt-out, the state opt-out. The president, at the White House right now, wants to go with the trigger. Huffington Post this morning had, had, had an article and they've got some great insights on, on some other areas, about how liberals are angry because the Obama White House is moving toward the trigger. And, and what does a trigger do? A trigger says, "We're not going to have a public option unless health care--insurance companies don't step forward."

But I saved my favorite one for last, since it wins the award for best "Are you still beating your wife, Senator?" way of framing the question so it is only answerable one particular way. From last week's Chris Matthews Show, here is the host:

10/18/09 -- NBC -- Chris Matthews Show

CHRIS MATTHEWS: OK. Let's take a look at the bottom line. We asked The Matthews Meter, 12 of our regulars, do the Democratic leaders who are pushing the public option now really deep down know that it's dead, that it can't be part of a solution that gets 60 votes, 218 in the House? Our meter's got a canny bunch here. Look, seven say the leaders already know there's not going to be a public option, five say they honestly still believe they can win it and get it part of this package.

In other words, Chris is not really asking whether the public option is dead or not, but he's actually asking "Do Democrats know that the public option's dead?" He presents it as a fait accompli, leaving only the question of whether Democrats are too dense to see reality or not.

Meanwhile, back in the real world, the headline today: "Harry Reid Says Senate Bill Will Have Public Option" is being written (in various variations) across the media. Don't ask me how I know this, but "We, The Media, Got It Totally And Utterly Wrong For Months On End; Sorry About That" will likely not be the subheading to many of these stories.

Watching the media fall all over themselves to pretend the last three months never happened will be interesting, though. It's like watching some Medieval drama being played out, with that old inherently contradictory statement being shouted by the town crier:

"The public option is dead! Long live the public option!"

Source: http://www.huffingtonpost.com/chris-wei ... 34767.html

Reid’s Opt-Out: The Devil is In the Details
By: Jane Hamsher
Huffington Post, October 26, 2009

In his presser, Harry Reid said very little about what kind of an “opt-out” he’ll put in the final bill.

The good news: Pressure on Reid from progressives when his poll numbers are flagging made him defy the White House. More importantly, he ratted them out to the press. Rahm thought he could continue to push for triggers in the background and satisfy the base by mouthing gibberish about “the President supports a public option” until it was too late. It didn’t work out so well.

The bad news: Having a state opt-out that will make corporatist Democrats happy is quite likely not to be “available nationwide from day one,” and thus does not meet the the definition of a “robust public option” by anyone’s terms.

Depending on how an opt-out was written, it could potentially disenfranchise large parts of the population:

State legislature and governor’s approval required for opt-out The following ten state legislatures are fully controlled by Republicans and the state also has a Republican governor: AZ, FL, GA, ID, NE, ND, SC, SD, TX, UT. If the opt out required approval by both the legislature and governor roughly 71 million people (23% of the population) live in state where they would be denied the public option.

State legislature’s approval required for opt-out Fourteen states legislatures (AZ, FL, GA, ID, NE, ND, SC, SD, TX, UT, WY, OK, MO, KS) are fully controlled by Republicans. If the opt out only required an act of the legislature, roughly 84 million people (28% of the population) would be in a state without the choice of a public option.

Governor’s decree required for opt-out There are 22 states with Republicans governors (AL, AK, AZ, CA, CT, FL, GA, HI, ID, IN, LA, MN, MS, NE, NV, ND, RI, SC, SD, TX, UT, VT). One hundred and forty-one million people (46% of the population) live in states where the Republican governor could opt the state out by decree.

Either state legislature or governor can opt-out the state A combined total of 154 million people (51% of the population) live in states where Republicans control the governor’s mansion or the state legislature.

Providing health care for the nation is a moral issue, it’s not about getting a “political win.” And Reid has many procedural moves at his disposal to make the opt-out easy to accomplish, or even drag triggers back into the picture.

Anyone remember the time Reid had the Seargent-at-Arms set up cots for the all-nighter on forcing troop withdrawal in Iraq? It was very theatrical, but ultimately accomplished nothing.

Short answer: no chicken counting going on here yet.

Source: http://fdlaction.firedoglake.com/2009/1 ... e-details/

House Bill Will Lack Robust Public Option
by Ryan Grim
Huffington Post, October 28, 2009

The Congressional Progressive Caucus has been furiously rounding up support for a "robust" public insurance option to be included in the health care bill that Speaker Nancy Pelosi (D-Calif.) is scheduled to unveil Thursday. House Democratic leadership has been part of the effort, whipping the caucus in an effort to find 218 votes to back it.

Leadership isn't confirming that a decision has been made, but all indications are that the progressives have lost this round and that Pelosi will include a public option that is required to negotiate rates with providers. Progressives prefer the robust version -- Capitol Hill code for a public plan that reimburses providers using Medicare rates plus five percent. [UPDATE: Leadership is now confirming they are indeed going with the negotiated-rate option.]

Rep. Raul Grijalva (D-Ariz.) has been pushing strenuously for a robust public option, arguing that tying it to Medicare rates gives it the best chance of competing against private insurers. The public option's intellectual father, Yale Professor Jacob Hacker, makes the same case.
Grijalva, in a statement to HuffPost, insists that he is not being rolled by leadership.

"I am not rolling over. I will insist on a Medicare+5 amendment on the Floor so that the full Caucus can vote on it. We are hopeful that the Rules Committee will allow this amendment, which has tremendous public support, to at the very least be voted on for the record," he said.
Grijalva, in pushing for an amendment rather than including the provision in the bill itself, is in conceding defeat in this round, while vowing to press forward.

Demanding an amendment, however, comes with its own set of problems, because conservative Democrats could then demand their own amendments related to abortion and other issues that would garner enough GOP support to pass.

On a policy level, the negotiated public option will cost taxpayers an extra $85 billion and is the favored choice of Blue Dogs and other conservative Democrats. Observers have noted the irony of the Blue Dogs -- who champion fiscal conservatism -- backing the the more costly public option. But such confusion misreads the Blue Dog Coalition, which is more properly understood as a bloc of Democrats who favor business interests. In the case of the public option, requiring it to negotiate rates means higher payments to providers -- hospitals, doctors and drug makers -- and less competition for insurance companies.

Leadership paved the way for negotiated rates on Tuesday evening, leaking Congressional Budget Office numbers showing that the bill including negotiated rates will cover as many people -- in fact, slightly more -- than the plan with a robust option.

House Speaker Nancy Pelosi (D-Calif.) will unveil the bill that will hit the House floor on Thursday morning.

Source: http://www.huffingtonpost.com/2009/10/2 ... 37574.html

The House Health Care Bill: Read It
by Ryan Grim
Huffington Post, October 29, 2009

Speaker Nancy Pelosi (D-Calif.) officially unveiled the House health care reform bill that is headed to the House floor. The ceremony, held on the West steps of the Capitol, marks the greatest progress toward the Democratic Party's top domestic priority goal in more than half a century.

The bill, the Affordable Health Care for America Act -- H.R. 3962 -- includes a public health insurance option that would be required to negotiate with providers -- the top choice of centrist and conservative Democrats.

Coming in at just under $900 billion over ten years, the plan would cover 36 million uninsured Americans.

House Democrats have posted the bill online.
A summary can be read here: http://edlabor.house.gov/blog/2009/10/a ... care.shtml
and the full version is here:
http://docs.house.gov/rules/health/111_ahcaa.pdf

The Congressional Progressive Caucus had pushed hard for a "robust" public option that would have reimbursed providers using Medicare rates. Blue Dog Democrats beat back that effort, costing taxpayers $85 billion over ten years -- money that will go to hospitals, doctors and drug makers, increasing the cost of health care.

The bill also prevents insurers from discriminating against people with preexisting conditions, caps the financial responsibility that insured individuals will face when medical emergencies strike, bans insurers for dropping folks because they get sick, and proposes a host of other insurance industry reforms.

Meanwhile, congressional Republicans are hoping that the historic push will give them an advantage in the 2010 midterm elections. "The lasting image coming out of today's press conference is one of dozens of House Democrats standing proudly behind an incredibly unpopular Nancy Pelosi as she prepares to lead them off a political cliff," said Ken Spain, spokesman for the National Republican Congressional Committee.

If anything jumps out at you, let me know at ryan@huffingtonpost.com. The SEIU notes that the bill bans the practice of using domestic violence as a pre-existing condition.

SEC. 2754. PROHIBITION ON DOMESTIC VIOLENCE AS PRE-EXISTING CONDITION.
A health insurance issuer offering health insurance coverage in the individual market may not, on the basis of domestic violence, impose any preexisting condition exclusion (as defined in section 2701(b)(1)(A)) with respect to such coverage.

UPDATE: In what could be seen as a boost for the bill, the insurance industry says they don't like it. Karen Ignagni, President and CEO of America's Health Insurance Plans (AHIP), put out this statement:

"The promise of health care reform has been that if you like your current coverage, you can keep it. We are concerned that this proposal will break this promise by increasing health care costs for families and employers across the country and significantly disrupting the quality coverage on which millions of Americans rely today.

"The lack of system-wide cost containment is a missed opportunity. Without a greater focus on health care costs, families and employers will not be able to afford coverage and health care costs will rise at a rate much faster than the overall economy is able to sustain.

"We share the concerns that doctors, hospitals, employers, and patients have all raised about the significant disruption a new government-run plan would have on the current health care system. A new government-run plan would bankrupt hospitals, dismantle employer coverage, exacerbate cost-shifting from Medicare and Medicaid, and ultimately increase the federal deficit.

"Estimates show that a government-run plan would cause millions of people to lose their current coverage. Moreover, massive Medicare Advantage cuts would cause millions of seniors to lose their Medicare Advantage coverage altogether, while millions more would face benefit cuts and higher out-of-pocket costs.

"Health plans strongly support comprehensive, bipartisan health care reform and have proposed sweeping insurance market reforms and new consumer protections to ensure that every American has guaranteed access to affordable health care coverage. Experience in the states has shown that insurance market reforms must be paired with an effective personal coverage requirement for these reforms to work. While this legislation recognizes the key linkage of market reforms and a personal coverage requirement, more needs to be done to ensure coverage is affordable and our health care system is sustainable.

"As the process progresses, health plans will continue to work to advance bipartisan legislation this year that will cover all Americans, make coverage more affordable, and improve quality."

Source: http://www.huffingtonpost.com/2009/10/2 ... 38438.html

Final House Health Care Bill Unveiled
by Ryan Grim
Huffington Post, November 4, 2009

Read more at: http://www.huffingtonpost.com/2009/11/0 ... 44596.html

House Speaker Nancy Pelosi (D-Calif.) unveiled a revised health care reform bill -- known as a manager's amendment -- Tuesday evening after taking the concerns of her caucus into account.

Pelosi said late last week that she was leaning against allowing individual floor amendments, so what you see here is likely what you get.

If it passes the House, it'll be merged with the Senate version in conference committee and then will come back for one final vote before heading to the president's desk.

Rival factions within the party still differ on how far the bill should go to prevent any money that has somehow come into contact with federal money from then funding abortions, whether undocumented workers can somehow participate in the health care system short of getting treated for free in hospital emergency rooms, and whether states should be allowed to choose to move to a single-payer system if they decide to, among other differences.

The House health care bill unveiled Thursday was stripped of a provision that would allow individual states to implement single-payer health care if they elected to. HuffPost readers read through it and found that it also requires chain restaurants with more than 20 locations to post calorie information on the menu. It bars the federal government from bailing out the public option and adds that there "shall be no administrative or judicial review of a payment rate or methodology" established by the head of the public insurance plan. And it addresses health disparities while making specific reference to protecting populations discriminated against due to sexual orientation or gender identity.

The stripping of the single-payer provision, which Rep. Dennis Kucinich (D-Ohio) originally moved through the Education and Labor Committee, particularly galled HuffPost readers as well as Kucinich himself. Kucinich tells HuffPost that the Congressional Budget Office scored his amendment as having zero effect on the federal budget, a sign that it was at least considered to be included in the manager's amendment.

Kevin McKeown, a city councilmember from Santa Monica, California, wrote in to protest the removal, arguing that if California passes single-payer legislation, it ought to be allowed to become law. "This year I had our city finance department calculate how much money single-payer would save just our city, just on health care for our own employees," said McKeown. "States poised to enact their own single-payer should not be disempowered by this bill."

Another reader, Jake Orlando, noted that the bill specifically mentions gay, lesbian, bisexual and transgender people in a section dedicated to addressing health disparities. "It's a quite small mention, but at least worth noting in the LGBT community," Orlando writes. "We know the Republicans would have gone out of their way to exclude us from mention of existence."

Fernando Castro noticed that the bill will require chain restaurants to publish calorie content on the menus. It'll be tough to reduce health care costs, after all, if the obesity epidemic continues apace.

Section 2572 requires that restaurants with more than 20 locations "shall disclose in a clear and conspicuous manner in a nutrient content disclosure statement adjacent to the name of the standard menu item, so as to be clearly associated with the standard menu item, on the menu listing the item for sale, the number of calories contained in the standard menu item, as usually prepared and offered for sale."

Reader Zen Tiger noted that while the government freely bails out Wall Street when it runs into trouble, no such help would be forthcoming for the public health insurance option.

"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," reads the bill.

A high number of readers wrote in surprised that the public option was as limited as it is in the bill. That surprise is partly the fault of reporters - including myself - who haven't been clear that only certain people would be eligible for it. If you have employer coverage, for instance, you're not eligible. However, this FDL post from Jon Walker explains how the number of people eligible for it is liable to expand over time.

Thanks to the many people who read parts of the nearly 2,000 word health care bill last week. If you give this one a look and find anything interesting, let me know at ryan@huffingtonpost.com. If you don't want your name published, please say so. We'll post the bill as soon as it's out.

UPDATE: It's out. The manager's amendment is a scant 42 pages long and amends the bill as introduced.

Source: http://www.huffingtonpost.com/2009/11/0 ... 44596.html

Joseph Cao: Voting For Health Reform Was "A Decision Of Conscience" (VIDEO)
by Sam Stein
Huffington Post, November 8, 2009

The one House Republican to support health care reform said on Sunday that his decision to back the bill was driven by his conscience and the needs of his district and not back-room dealing with the White House or Democrats.

Rep. Joseph Cao (R-La), appearing on CNN, said that he cast his vote in favor of reform only after an amendment greatly restricting the coverage of abortions was allowed to come to a vote. Once that hurdle was clear, Cao said, "I called the White House and said I could possibly support the bill."

The subject of a fierce, late-in-the-game, lobbying effort between Democrats and Republicans, Cao ultimately voted yea because, as he put it, "I had to make a decision of conscience based on the needs of the people in my district."

"I had to make a decision and I felt that last night's decision was the right decision for my district," he added. "Even though it was not the popular decision for my party."

The first-term Republican, who hails from a very Democratic district in New Orleans, insisted that he did not consider possible electoral ramifications before casting his votes. Asked whether he had offered his support to the White House in exchange for additional help in Hurricane Katrina reconstruction, he similarly dismissed the charge.

"The president and I, we have had a very good relationship, and I thank him and his administration for their hard work in helping me to rebuild my district after the devastation of Hurricane Katrina," Cao said.

"I'm pretty sure that if I were to vote no against the bill the president would still continue to work with me to address the needs of my district. But I felt it was important of me to support the president in this matter because, like I said before, based on my own conscience, it was the right decision for my district."

Source: http://www.huffingtonpost.com/2009/11/0 ... 49929.html

Obama on Abortion Amendment: Don't Want to Change "Status Quo"
by Sam Stein
Huffington Post, November 9, 2009

UPDATE: In an interview with ABC News's Jake Tapper, President Obama said he did not support any change in current abortion laws through the health care bill -- an implicit rebuke to the House for passing an amendment that could considerably restrict women's access to abortions. The president said that he doesn't want to change "the status quo" one way or another.

TAPPER: Here's a question a lot of Senate Democrats want to know. You said, when you gave your joint address to Congress, that under our plan, no federal dollars will be used to fund abortions. This amendment passed Saturday night which not only prohibits abortion coverage in the public option, but also prohibits women who receive subsidies from taking out plans that -- that provide abortion coverage. Does that meet the promise that you set out or does it over reach, does it go too far?

OBAMA: You know, I laid out a very simple principle, which is this is a health care bill, not an abortion bill. And we're not looking to change what is the principle that has been in place for a very long time, which is federal dollars are not used to subsidize abortions. And I want to make sure that the provision that emerges meets that test -- that we are not in some way sneaking in funding for abortions, but, on the other hand, that we're not restricting women's insurance choices, because one of the pledges I made in that same speech was to say that if you're happy and satisfied with the insurance that you have, that it's not going to change. So, you know, this is going to be a complex set of negotiations. I'm confident that we can actually arrive at this place where neither side feels that it's being betrayed. But it's going to take some time.

TAPPER: Do you think that amendment is status quo or does it lean a little bit in one direction or the other?

OBAMA: I think that there are strong feelings on both sides. And what that tells me is that there needs to be some more work before we get to the point where we're not changing the status quo. And that's the goal. The goal here is to make sure that people who have health insurance have greater stability and security, people who don't have health insurance get the ability to buy it affordably and that we're driving down costs.

And, you know, I think everybody understands that there's going to be work to be done on the Senate side. It's not going to match up perfectly with the House side. But obviously, it was a historic night for the House. We've never been this far. And I'm very confident that my colleagues in the Senate are going to say to themselves that we've got to get this done.

Source (with Video of interview): http://www.huffingtonpost.com/2009/11/0 ... 51064.html

Ben Nelson Wants Anti-Abortion Measures In Senate Health Bill
Huffington Post, November 9, 2009

WASHINGTON — Abortion opponents in the Senate want tough restrictions in the health care overhaul bill, similar to the limits passed by the House this past weekend.

The issue could roil an already shaky Democratic effort to pass a health care bill by year's end for President Barack Obama.

Democratic Sen. Ben Nelson of Nebraska said Monday it's highly unlikely he would support a bill that doesn't clearly prohibit federal dollars from going to pay for abortions. His spokesman said Nelson is weighing options, including offering an amendment similar to the one passed by the House.

The limits in the House bill have angered liberals, some of whom are now threatening to vote against health care legislation if the curbs stay in.

Source: http://www.huffingtonpost.com/2009/11/0 ... 51340.html

McCaskill Opposes Adding Stupak Amendment To Senate Bill
by Sam Stein
Huffington Post, November 9, 2009

Less than a day after saying the Senate could live with a health care amendment that greatly restricted a woman's access to abortion in the private insurance market, Sen. Claire McCaskill, (D-MO) announced she opposed such an amendment.

The Senator, on her twitter page, said that she objected to the language offered to the House health care bill by Sen. Bart Stupak (D-Mich). " Don't think we should change current law which is no public $ for abortions, but amndmt goes too far limitng [sic] private funds too," her tweet read.

McCaskill is a pro-choice lawmaker from a generally toss-up political state. So her support for a Senate variation to the Stupak amendment would have given it a major boost. Already, other socially conservative Democratic lawmakers have hinted that they would back such a provision or even introduce it themselves.

During an appearance on MSNBC's Morning Joe on Monday, McCaskill said she didn't think such an effort would be a bitter pill in the health care reform debate.

"I am not sure that it is," she said. "Obviously, I have been a pro-choice candidate for my entire political career, and obviously there is controversy always surrounding this issue. But we are talking about whether or not people that get public money can buy an insurance policy that has a coverage for abortion. And that is not the majority of America. The majority of America is not going to be getting subsidies from the government...."

That remark, of course, didn't approach the question of whether McCaskill herself would support the amendment if introduced. So her tweet isn't, necessarily, contradictory. It just suggests that adding Stupak-like language to the Senate bill is more of an uphill climb than it seemed.

Source: http://www.huffingtonpost.com/2009/11/0 ... 51642.html

Why the Stupak Amendment Is a Monumental Setback for Abortion Access
by Jessica Arons
Huffington Post, November 9, 2009

If you thought that just because abortion is a constitutional right and part of basic reproductive health care it would be available in the reformed health insurance market known as the Exchange, think again. The Stupak Amendment, passed Saturday night by the House of Representatives after a compromise deal fell apart, potentially goes farther than any other federal law to restrict women's access to abortion.

The claim that it only bars federal funding for abortions is simply false. Here's what the Stupak Amendment does:

1. It effectively bans coverage for most abortions from all public and private health plans in the Exchange: In addition to prohibiting direct government funding for abortion, it also prohibits public money from being spent on any plan that covers abortion even if paid for entirely with private premiums. Therefore, no plan that covers abortion services can operate in the Exchange unless its subscribers can afford to pay 100% of their premiums with no assistance from government "affordability credits." As the vast majority of Americans in the Exchange will need to use some of these credits, it is highly unlikely any plan will want to offer abortion coverage (unless they decide to use it as a convenient proxy to discriminate against low- and moderate-income Americans who tend to have more health care needs and incur higher costs).

2. It includes only extremely narrow exceptions: Plans in the Exchange can only cover abortions in the case of rape or incest or "where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death." Given insurance companies' dexterity in denying claims, we can predict what they'll do with that language. Cases that are excluded: where the health but not the life of the woman is threatened by the pregnancy, severe fetal abnormalities, mental illness or anguish that will lead to suicide or self-harm, and the numerous other reasons women need to have an abortion.

3. It allows for a useless abortion "rider": Stupak and his allies claim his Amendment doesn't ban abortion from the Exchange because it allows plans to offer and women to purchase extra, stand-alone insurance known as a rider to cover abortion services. Hopefully the irony of this is immediately apparent: Stupak wants women to plan for a completely unexpected event.

4. It allows for discrimination against abortion providers: Previously, the health care bill included an evenhanded provision that prohibited discrimination against any health care provider or facility "because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions." Now, it only protects those who are unwilling to provide such services.

One in three women will have an abortion in their lifetime. Eighty-seven percent of employer plans offer abortion coverage. None of that will matter if the Senate takes its cues from the House. In every other way, this bill will expand access to health care. But for millions of women, they are about to lose coverage they currently have and often need.

Source: http://www.huffingtonpost.com/jessica-a ... 50748.html

Abortion in Health Care Reform: The Fight is Far From Over
by Eleanor Smeal
Huffington Post, November 9, 2009

How quickly joy can turn to outrage.

Women had a lot to cheer about Saturday night when the House passed the historic Affordable Health Care Act. Among other major strides in health-insurance reform, it would eliminate "gender rating" in insurance pricing and unequal taxation of domestic partner benefits, ban discrimination based on preexisting conditions and stop the practice of dropping or capping coverage for sick people.

But our celebration was quickly dampened by an ugly amendment to the bill. The so-called Stupak amendment, named for one of its cosponsors, Bart Stupak (D-Mic.), bans abortion coverage not only in the public health-insurance option but in private plans participating in a new national health-insurance exchange.

This is an outrageous denial of choice to women, dictated behind the scenes by the National Conference of Catholic Bishops and their army of lobbyists. Millions of poor and middle-class women would be denied abortion coverage and millions more would lose the coverage they already have, since 85 percent of private plans now cover abortion. Far from being abortion-neutral, the Stupak amendment is a giant step backward for women. It's unacceptable. In the compromise to get the bill passed, women and their health-care rights were thrown under the bus.

Fortunately, the fight is far from over. Many pro-choice legislators and groups are now determined to strip the amendment from the bill before it is finally approved by Congress and signed by the president. As the legislation proceeds to the Senate and then to a House/Senate conference committee to iron out differences, pressure will be stepped up. There are many more pro-choice than anti-abortion Democrats; the question Democrats must now answer is if they're more willing to dance to the tune of the Catholic bishops or instead listen to their overwhelming constituency of pro-choice women.

We must stop federal legislation from being used as a vehicle to cut back reproductive rights. Young women's lives cannot continue to be a political football. We must free this historic Act of abortion politics--and then we can begin to celebrate anew.

Source: http://www.huffingtonpost.com/eleanor-s ... 51098.html

Excerpt ...

Make no mistake about it: the Stupak Amendment will deny millions of women access to safe, affordable reproductive health care. It puts an expensive price tag on women's ability to act on their reproductive rights. This outrageous provision must be stricken from the legislation before health care reform becomes law.

In 2008 the country elected a pro-choice Congress and a pro-choice president. The president has repeatedly told the country that health care reform would not take away benefits from those who currently have insurance. Now it's up to the President and the Congress to make certain that women do not lose their benefits or rights as a result of health care reform. There's no point in passing a health care reform bill that makes women less healthy, less safe and less able to exercise their constitutional rights.

Source/full story: http://www.huffingtonpost.com/ellen-mal ... 49623.html

A Short Guide to the Public Option Fight, and the 75-Year Battle Over Universal Health Care
by Robert Reich
Huffington Post, September 8, 2009

With Congress returning from recess to consider health care legislation and the President set to deliver a major address on the subject to both chambers tomorrow, it's more important than ever to get word out on why a public option is so important and what can be done to push for it. Here's a short video that may be helpful:

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In addition, it's useful to know how long America has been wrestling with universal health care, and how hard the battle has been, so a bit of history may be in order. An excellent starting place is David Blumenthal's and James Marone's The Heart of Power, which I reviewed for the New York Times this past weekend. Here are the major points:

Universal health care has bedeviled, eluded or defeated every president for the last 75 years. Franklin Roosevelt left it out of Social Security because he was afraid it would be too complicated and attract fierce resistance. Harry Truman fought like hell for it but ultimately lost. Dwight Eisenhower reshaped the public debate over it. John Kennedy was passionate about it. Lyndon Johnson scored the first and last major victory on the road toward achieving it. Richard Nixon devised the essential elements of all future designs for it. Jimmy Carter tried in vain to re-engineer it. The first George Bush toyed with it. Bill Clinton lost it and then never mentioned it again. George W. expanded it significantly, but only for retirees.

All the while, the ideal of universal care has revolved around two poles. In the 1930s, liberals imagined a universal right to health care tied to compulsory insurance, like Social Security. Johnson based Medicare on this idea, and it survives today as the "single-payer model" of universal health care, or "Medicare for all." The alternative proposal, starting with Eisenhower, was to create a market for health care based on private insurers and employers; he locked in the tax break for employee health benefits. Nixon came up with notions of prepaid, competing H.M.O.'s and urged a requirement that employers cover their employees. Everything since has been a variation on one or both of these competing visions. The plan now emerging from the White House and the Democratic Congress combines an aspect of the first (the public health care option) with several of the second (competing plans and an employer requirement to "pay or play").

Devising a plan is easy compared with the politics of getting it enacted. Mere mention of national health insurance has always prompted a vigorous response from the ever-vigilant American Medical Association; in the 1930s, the editor of its journal equated national health care with "socialism, communism, inciting to revolution." Bill Clinton's plan was buried under an avalanche of hostility that included the now legendary ad featuring the couple Harry and Louise voicing their fears that the Clinton plan would substitute government for individual choice -- "they choose, we lose."

One lesson is that a new president must move quickly, before opponents have time to stoke public fears. After his 1964 landslide, Johnson warned his staff to push Medicare immediately because "every day while I'm in office, I'm going to lose votes. I'm going to alienate somebody. We've got to get this legislation fast." George W. Bush started planning what became the Medicare drug benefit months before he was elected.

Clinton, by contrast, suffered from delay. Right after his election, national health insurance looked so likely that even some Republicans began lining up behind various plans. A year later, it was dead. In the interim, battles over Clinton's budget and NAFTA drained his political capital, gave his opponents ample time to rouse public concerns about government-sponsored health care and soured key allies like organized labor and the AARP.

Congress can be just as much of an obstacle: one lesson from history is that a president must set broad health reform goals and allow legislators to fill in the details, but be ready to knock heads together to forge a consensus. "I'm not trying to go into the details," Johnson repeatedly said of his Medicare bill, yet he flattered, cajoled, intimidated and bluffed recalcitrant members until they agreed. "The only way to deal with Congress is continuously, incessantly and without interruption," he quipped.

Carter, on the other hand, pored endlessly over his incipient health care plan, scribbling opinions in the margins about every detail, and dealt with Congress at arm's length. And Clinton delivered a plan so vast and complex that even a Democratic Congress chose simply to ignore it. Republicans, meanwhile, decided that a defeat of Clinton's health care bill would be seen as a repudiation of the new administration and might give them a shot at retaking the House and Senate.

Presidents who have been most successful in moving the country toward universal health coverage have disregarded or overruled their economic advisers. Plans to expand coverage have consistently drawn cautions or condemnations from economic teams in every administration, from Harry Truman's down to George W. Bush's. An exasperated Lyndon Johnson groused to Ted Kennedy that "the fools had to go to projecting" Medicare costs "down the road five or six years." Such long-term projections meant political headaches. "The first thing, Senator Dick Russell comes running in, says, 'My God, you've got a one billion dollar [estimate] for next year on health. Therefore I'm against any of it now." Johnson rejected his advisers' estimates and intentionally lowballed the cost. "I'll spend the goddamn money." An honest economic forecast would most likely have sunk Medicare.

It's not so much that presidential economic advisers have been wrong -- in fact, Medicare is well on its way to bankrupting the nation -- but that they are typically in the business of thinking small and trying to minimize risk, while the herculean task of expanding health coverage entails great vision and large risk. Economic advice is important, but it's only one source of wisdom.

Yet since Johnson, presidents have found it increasingly difficult to keep their economists at bay, mainly as a result of the growth of Washington's economic policy infrastructure. Cost estimates and projections emanating from the White House's Office of Management and Budget and the Congressional Budget Office, both created during the Nixon administration, have bound presidents within webs of technical arguments, arcane rules and budget limits. To date, Democratic presidents have felt more constrained by this apparatus than Republicans, perhaps because they have felt more of a need to prove their cost-cutting chops.

President Obama seems to have anticipated many of these lessons. He's moved as quickly on the issue as this terrible economy has let him, and he has not been too rattled by naysaying economists (although the cost estimates of the Congressional Budget Office set him back). But although he outlined his goals but left most details to Congress, the lesson from history is that he may have waited too long to force a deal on that disorderly body (especially disorderly when Democrats are in charge). The question remains whether, in the weeks and months ahead, he can knock Congressional heads together to clinch it, and overcome those who inevitably feed public fears about a "government takeover" of health care and of budget-busting future expenditures. He needs to work fast, and be tough as nails.

But even if Obama fails, there is an art to losing, too -- in a way that can tee up the issue for future presidents. Truman lost but nonetheless redefined the terms of debate, setting the stage for Medicare (which is why Johnson honored Truman when he signed it into law). Compare him with Clinton, who walked away from the wreckage of his health care plan and rarely mentioned the subject again. This allowed opponents to gain control over the spin and history, so that the Democrats' signature cause slipped out of political sight for a decade.

Any history of the fight for universal care in America contains a subplot with a supporting actor who, although he never became president, is repeatedly heard from offstage -- goading, pushing, threatening and pulling presidents of both parties toward universal coverage. Ted Kennedy first introduced his ambitious national health insurance proposal 40 years ago, and he never stopped promoting the cause. A deal he reached with President Nixon was the closest this country has ever come to universal care. Even before Kennedy's death last month, his illness had tragically sidelined him just when his powerful voice was most needed. Yet when and if America ever achieves universal coverage, it will be due in no small measure to the tenacity and perseverance of this one remarkable man.

Source: http://www.huffingtonpost.com/robert-re ... 79389.html

Lack of health care killed 2,266 US veterans last year: study
Yahoo! News
November 11, 2009

WASHINGTON (AFP) – The number of US veterans who died in 2008 because they lacked health insurance was 14 times higher than the US military death toll in Afghanistan that year, according to a new study. The analysis produced by two Harvard medical researchers estimates that 2,266 US military veterans under the age of 65 died in 2008 because they lacked health coverage and had reduced access to medical care.

That figure is more than 14 times higher than the 155 US troop deaths in Afghanistan in 2008, the study says.

Released as the United States commemorates fallen soldiers on Veterans Day, the study warns that even health care provided by the Veterans Health Administration (VA) leaves many veterans without coverage.

The analysis uses census data to isolate the number of US veterans who lack both private health coverage and care offered by the VA.
"That's a group that's about 1.5 million people," said David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program who co-authored the study.

Himmelstein and co-author Stephanie Woolhandler, also a Harvard medical professor, overlaid that figure with another study examining the mortality rate associated with lack of health insurance.

"The uninsured have about a 40 percent higher risk of dying each year than otherwise comparable insured individuals," Himmelstein told AFP.

"Putting that all together you get an estimate of almost 2,300 -- 2,266 veterans who die each year from lack of health insurance."

Only some US veterans have access to medical care through the VA and coverage is apportioned on the basis of eight "priority groups."

"They range from things like people who were prisoners of war, who have coverage for life, or who have battle injuries and therefore have coverage for their injuries for life," said Himmelstein.

Veterans who fall below an income threshold that is determined on a county-by-county basis can qualify for care, but many veterans are "working poor" and fall just above the bracket.

"The priority eight group, the lowest priority, are veterans above the very poor group who have no other reason to be eligible and that group is essentially shut out of the VA," according to Himmelstein.

The study comes as the US Senate weighs health care reform legislation and whether to offer government health insurance.

Himmelstein warns that congressional proposals could still leave veterans uncovered and favors a national health care program similar to those in Britain and Canada.

Source: http://news.yahoo.com/s/afp/healthusinsurancemilitary

GOP's Coburn Blocks Disabled Vets Bill
NPR, November 11, 2009

The Senate wants to provide $4 billion to help homecare providers for 6,800 disabled veterans of Iraq and Afghanistan. Leaders hoped the measure would sail through on the eve of Veterans Day by unanimous consent, but they got one no vote: Republican Tom Coburn. He says there is no budgeted money for the bill and that other programs should be cut to pay for it, and he isn't backing down.

Click here to get link to listen to audio of NPR's report:
http://www.npr.org/templates/story/stor ... h-20091111

Is the House Health Care Bill Better than Nothing?
by Marcia Angell, M.D.
Huffington Post, November 8, 2009

Well, the House health reform bill -- known to Republicans as the Government Takeover -- finally passed after one of Congress's longer, less enlightening debates. Two stalwarts of the single-payer movement split their votes; John Conyers voted for it; Dennis Kucinich against. Kucinich was right.

Conservative rhetoric notwithstanding, the House bill is not a "government takeover." I wish it were. Instead, it enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.

What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)

Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.

If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?

First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.

But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.

Here is my program for real reform:

Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it's a better program, because it ensures that everyone has access to a uniform package of benefits.

Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.

Recommendation #3: Medicare should monitor doctors' practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.

Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.

Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.

Is the House bill better than nothing? I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.

Source: http://www.huffingtonpost.com/marcia-an ... 50190.html

The Big Fights and the Big Benefits in the Bill
by Mike Lux
Huffington Post, November 12, 2009

I thought it might be useful to summarize the big battles ahead, as well as the list of things that are good policy changes that seem likely to be in the final legislation. The battles still ahead include:

1. The shape of the public option. The House public option, while not everything we had hoped for, is still pretty solid. It is national in scope so that it can compete with the big insurers, will cover more people over time, and can be a platform to build on and expand in the future. The Senate version is worse because of the state opt-out, but still has some strong features. Most of the other alternatives -- Snowe's trigger, Conrad's co-ops, Carper's opt-in -- are extremely weak and completely unacceptable.

2. Affordability. The House bill is far better than what is rumored will be in the merged Senate bill on middle-class affordability. This is an absolutely critical issue for middle-class families mandated to buy insurance.

3. Who pays, middle-class workers or millionaires? The House bill pays for much of health care reform with a surtax on wealthy Americans, while Senate Finance taxes middle-class workers who have better than average health benefits. The Senate Finance version is a terrible way to go.

4. Do businesses have any responsibility? The House bill makes most business (exempting the smallest businesses) pay a fair share for covering their employees, while the Senate Finance bill exempts businesses from responsibility. Everyone needs to take responsibility for health care.

5. Are immigrants totally screwed over? There is still a fight over how immigrants, both legal and undocumented, will be treated in the final health care bill, with various amendments constructing terrible ways to treat them -- such as immigrants being mandated to have insurance but not being allowed into the new health insurance pools. The Senate Finance language in this area is much worse than the House language. Any good bill has to treat immigrants fairly.

6. Abortion. The Stupak amendment is designed to decimate abortion coverage in the country. It is completely unacceptable and has to be taken out of the bill in conference committee.

7. The individual mandate. This is one place where I think the Senate Finance committee actually got it better than the House, with much lighter penalties if you don't get insurance. There are downsides to that, but given the cheapness of the subsidies for the middle class, and the weakening of the public option in even the House bill, I think having too harsh penalties on the individual mandate would be wrong.

Some pretty big stuff, huh? Lots of intense work to do. The good news is that under all the hullabaloo of the public option fight and the horrendous Stupak amendment, there is actually a lot of good things that are pretty well-settled assuming a bill gets passed. These items don't have the drama of some of the other fights, but none of them are insignificant policy changes, all will improve a lot of people's lives. Included in this list are:

1. The ability of insurers to destroy people's lives over pre-existing condition clauses, recissions, and lifetime caps on their coverage will end.

2. Everyone will finally be covered, with subsidies for low and middle income people. That is a very big deal, something that a lot of us have been fighting for our entire lives.

3. The "doughnut hole" screwing over senior citizens on their prescription coverage will be fixed.

4. Community rating is incredibly important, means older and sicker people, and women, won't face the same kinds of discrimination.

5. Creating the insurance exchange will provide lower prices and more choices for many people.

6. It does provide immediate help for the un-insured, even before the public option and insurance exchanges are in place.

7. It extends coverage for young people wanting to stay under their parents' coverage up to 27 years old.

8. Strengthens Medicare in several modest but important ways- no co-pays for prevention services, more help for low-income seniors, stops Medicare Advantage from screwing seniors.

9. Provides more disclosure of insurance rate increases.

10. Allows people to keep their COBRA until the exchange is in place.

11. Creates a new long term care insurance program.

12. Makes it easier for early retirees (55-64 years old) to get health care coverage.

13. Doubles the number of patients Community Health Services can treat.

14. More money for education/training of primary care providers.

I do think these kinds of modest less visible things really do matter in people's lives, and we should be proud if we can get them done. The big fights left, though, are incredibly important to whether this is a good bill overall.

Source: http://www.huffingtonpost.com/mike-lux/ ... 55279.html

Joe Lieberman Filibusters Health Care While Americans Suffer
by Bob Cesca
Huffington Post, November 12, 2009

One of many classic episodes of Seinfeld was "The Opposite" -- the finale of season five. While George decides to ignore his instincts and behave in the exact opposite way he normally would, the B-story involves Elaine's boyfriend, Jake Jarmel, being hit by a cab. And instead of rushing to the hospital, Elaine stops at a movie theater concession stand and buys a box of Jujyfruits -- completely unfazed by the gravity of the situation.

When it comes to health care reform, Joe Lieberman is Elaine times a thousand.

So are Ben Nelson, Tom Carper, Blanche Lincoln and Evan Bayh. But let's focus on Lieberman since his emergence in this situation was dropped like a ton of bricks -- rubbery, fruity bricks -- seemingly out of nowhere, whereas the rest of these conservative Democrats have more or less been enemies of real reform since the process began.

With every month that goes by without health care reform, another 3,600 Americans die due to a lack of insurance. More deaths than 9/11 every 30 days. Every 30 seconds, another family slips into medical bankruptcy, potentially losing everything simply because they were unlucky enough to become sick or injured in a for-profit system that's gamed in favor of the house. There are nearly 300,000 uninsured American adults in Lieberman's home state of Connecticut alone, not to mention 53,000 uninsured children.

And Joe Lieberman, along with his conservadem friends, are stopping off for Jujyfruits. Political favors. Attention. Spotlight. Concessions -- literally and figuratively.

By shamelessly seeking attention via a filibuster threat against health care reform, Joe Lieberman is putting his own political ambitions ahead of American lives. This selfish acting out -- this pathetic, insufferable emergence of The Lieberman at reform's eleventh hour ought to further seal his legacy as one of the U.S. Senate's most greedy, self-serving political hacks.

Make no mistake. By merely threatening a filibuster, Joe Lieberman is, in effect, filibustering health care reform. It's not a threat. He's doing it right now. He's delaying reform and creating another unnecessary obstruction in a process that surely doesn't suffer from a lack of delays imposed by everyone from lobbyists to careerist political bastards.

So what's his gripe?

Lieberman's first, only and most ridiculous gripe with health care reform (so far) is that, somehow, reform with a public option will increase the deficit. This is, naturally, a lie. He's making it up because, as we're well aware, the CBO reported that the House bill, featuring a "level playing field" public option and no opt-out language, will reduce the federal budget deficit by more than $100 billion over ten years, with further deficit reduction in the subsequent ten years.

What makes this whole thing even more insane is that Lieberman actually supported the public option when he ran for president in 2004.

To date, he really doesn't have any substantive reason to be filibustering the public option other than this lie about the deficit. And so we're left with no other justification other than to peg his obstructionism as sheer hubris and drama queen posturing.

Elaine inappropriately delayed her rush to the hospital in order to stop off for Jujyfruits. Why? Because she likes Jujyfruits, and so Jujyfruits took precedent over her injured friend. It was about self-indulgence, and that explains everything Lieberman has done since 2006.

He's clearly a man who's grappling with irrelevance, so he needs to be needed -- as long as his vote becomes necessary for passing reform, he's viewed relevant. For the wrong reasons, but relevant nonetheless. He's obstructing because he can. Meanwhile, Lieberman seems to have made it his mission to take a piss on the left whenever possible. And in doing so, he also believes he'll win friends on the right -- he's also attempting to out-flank Republican Olympia Snowe on the public option. Though beyond his comfy McCain-Graham orbit, he's trying to win acceptance in a Republican Party that's rapidly purging its ranks of anyone in the middle. So it seems like that path is a dead end as well.

He's admired by neither the left nor the right. He's that weasely kid from recess who would constantly pit one clique of friends against the other -- making friends with neither.

Meanwhile, every second that Lieberman performs this infuriating filibuster routine is another second without reform. Every second spent ameliorating the Lieberman filibuster -- massaging his ego with kid gloves and determining exactly what it is he wants -- is another second without reform. Instead of a comprehensive health care bill, we're getting a lot of unnecessary drama circulating around Joe Lieberman's masturbatory ego trip. He wins some press attention and lots of urgent calls from the White House and Harry Reid's office, while the rest of us are jammed with the medical bills.

All in all, there's no other way to peg Lieberman other than as a desperate hack who will thoughtlessly hurl thousands of Americans overboard for the sake of his unquenchable lust for attention, and his childish, vengeful goal of tweaking of the left.

Help us unseat this guy next time around, Connecticut. After all, he's playing politics with your lives. He's stopping off for Jujyfruits when he should be, you know, helping you. And there's no excuse.

Source: http://www.huffingtonpost.com/bob-cesca ... 55870.html