Senate Should Vote on a Public Option
An eminently reasonable request from Chris Bowers:
No matter what happens in the Finance committee, it is essential that there is a vote on health care reform with a robust public option on the floor of the Senate. If Democratic Senators can keep saying that their aren’t enough votes to pass a public option, and if they aren’t going to include on in their health care “reform” package, then at the very least they should have the decency to tell us which Democratic Senators were actually opposed to the public option.
Members of congress, and especially senators, have a very annoying habit of trying to avoid accepting responsibility for their own decisions. Instead of “I don’t want a public option” you get a lot of talk about vote counts and bipartisanship. And if the votes aren’t there, the votes aren’t there. But we should get a definitive view of who the people are who are making the decisions that are making it the case that the votes aren’t there.
37 Responses to “Senate Should Vote on a Public Option”
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September 15th, 2009 at 10:04 am
Yes, appealing to their sense of decency. That should work.
September 15th, 2009 at 10:14 am
Absolutely there needs to be an accounting. If any Democratic Senators are willing to stand up and actively prevent the fulfillment of 60+ years of promises from their party, then they need to face the consequences of their actions. If that is their position and they’re willing to stand up for it and stand by it, so be it. But no more hiding behind vague threats and pronouncements of “It won’t pass”.
September 15th, 2009 at 10:16 am
Two things. First, and this hardly needs saying, votes take on a very different character when the outcome is foregone. Look at EFCA. Everyone’s for it, until there’s some chance of it happening.
Second, your proposal is most unlikely. If there’s one thing that all Senators agree on, it’s the importance of maintaining plausible deniability, and Harry Reid’s job depends on making sure that no Senator’s feathers are ever ruffled. That’s why he’s so popular in the Democratic caucus: precisely because he’s a nonentity.
September 15th, 2009 at 10:20 am
Ah yes Matt, you and your Lefties should now be able to demand
Senate votes on whatever you want a vote on.
And you earned that right exactly how?
Your constant tantrums that the Senate and its rules are
impeding the March To A Glorious And Democratic Socialist State
Of North America really grows tedious and reveals you to be the peevish child your critics charge.
Go change your diapers.
Then have a long talk with Obama about voting “present” in our legislatures.
September 15th, 2009 at 10:23 am
Does anyone understand why the more histrionic trolls tend to write in free verse?
Are there a lot of poets manqué over at Redstate, or what’s the deal?
September 15th, 2009 at 10:23 am
Absolutely. Identify, then vilify.
Keep up the good work.
September 15th, 2009 at 10:30 am
Does anyone understand why the more histrionic trolls tend to write in free verse?
I was going to mention the same thing.
I think with a little tightening up, #4 might be a candidate for publication in the New Yorker. They’re one of the few outlets for poetry in a general circulation periodical.
Barring that, “Shouts and Murmurs” might be an option.
September 15th, 2009 at 10:32 am
I’m not sure it’ll matter. In the end, even with a public option, the individual mandate in this bill will probably destroy the Democratic party.
Even with subsidies up to the 400% level, these subsidies aren’t 100% or anything like it. You’re still going to cost people too much money at a time when 10% of them are unemployed, and another 6-8% are forced into part-time work. Americans just can’t afford this plan. It’s not about deficits, and it’s not about taxes. Actual individual Americans will not be able to afford this plan. Most of them will be people who usually vote for Democrats. All these efforts for future recriminations are just a waste of time. Most of these people won’t be with us at the end of the coming decade anyway. They will probably all be replaced by Republicans.
September 15th, 2009 at 10:40 am
You, Matt, and your Lefties should now demand
Senate votes on whatever issue’s in the hear and now.
And you earned that right exactly how?
Your constant tantrums that Senate’s rules stand
Impeding the March To A Socialist State
Of North America grows tedious and reveals you to be
the peevish child your critics see.
Go change your diapers. Then keep your dinner date
With The One, Barry O, that fool
And chat over overpriced metrosexual gruel
About voting “present” (in our legislatures)
til your passion cools.
September 15th, 2009 at 10:46 am
There once was a man from Nantucket . . .
September 15th, 2009 at 10:51 am
There only way to get a vote for a public option in the Senate is to ensure that it is in the final bill. Why Chris Bowers pretends there are other real possibilities is unknowable.
September 15th, 2009 at 10:55 am
1) We don’t have the specifics of healthcare reform yet — but I’m bothered that the backroom nature of the Baucus discussions didn’t really address the real problems. That’s the problem with horsetrading among a few Senators.
2) This nation is in major financial difficulty — we can no longer afford our incompetent and blandly corrupt Congress.
3) Where are the measures to increase SUPPLY to handle the huge aging baby boomer cohort?
a) Many more doctors. Scrapping of our ridiculous AMA union shop and replacing it with a medical education that can be done in 4 or 5 years — including undergraduate school, medical school, internship and residency?
b) There are many people who would happy to be doctors at $70,000 per year if they didn’t have to waste 12 years of their lives in unpaid or low-paid poverty and didn’t have to run up huge medical loans.
c) Do drug patents need to have such a long life? The government funds much of the basic research anyway.
d) Can’t the FDA adminstrative process be streamlined to reduce delays and expenses?
e) Medical Tort reform would bring huge savings. All these fucking ambulance chasers do NOTHING to help provide healthcare and yet they rake in big bucks. Pennsylvania is losing doctors by the truckloads because of its stupid shit malpractice fund that assess doctors for huge annual fees (up to $200,000 per year, i believe.)
4) Our Primary Problem is that we just need to scrap the fucking US Congress via Constitutional Convention.
I’m really getting tired of these treacherous, two-faced whoring cocksuckers. They are what’s destroying this country.
September 15th, 2009 at 10:55 am
Even with subsidies up to the 400% level, these subsidies aren’t 100% or anything like it. You’re still going to cost people too much money at a time when 10% of them are unemployed, and another 6-8% are forced into part-time work.
Keep in mind that under the House tri-committee bill, Medicaid coverage is expanded and asset tests removed, so households with no or low income due to employment issues wouldn’t necessarily be in the subsidized exchanges at all.
September 15th, 2009 at 11:02 am
There’s more to a vote than just determining responsibility. A vote is necessary to determine the strength of a public option position in conference. A narrow loss makes it easier for Senate conferees to accept the House position without having to demand much in return and vice-versa.
September 15th, 2009 at 11:05 am
Ibc- definitely no flow there. How ’bout something a little catchier, like this little ditty…
Jingo Balls!
Jingo Balls!
Joe McCarthy had his day!
Now it’s time to say good-bye
To wingnuts on parade!
September 15th, 2009 at 11:15 am
e) Medical Tort reform would bring huge savings. All these fucking ambulance chasers do NOTHING to help provide healthcare and yet they rake in big bucks. Pennsylvania is losing doctors by the truckloads because of its stupid shit malpractice fund that assess doctors for huge annual fees (up to $200,000 per year, i believe.)
You can get me on board with 1, 2, 4, and 3, parts a through d, but part e) I must take issue with.
AFAIK, there’s no evidence of any significant cost savings in “tort reform”. Mostly just a lot of potential to leave people who have been genuinely wronged without any redress.
To the extent that there’s a problem somewhere in that area, it’s not that there are lawsuits after people get hurt, it’s that there are so many injuries and errors in the first place. Hopefully, reforms that rethink medical training and staffing, and things like electronic record standards can reduce those.
September 15th, 2009 at 11:24 am
This is simply false. Not only have numerous studies shown that malpractice premiums and defensive medicine contribute only a relatively small portion of health care costs in the US, we have experimental laboratories available which have tested this in the form of the states which have sharply limited malpractice claims. Texas is one such state and there have been almost no cost reductions as a result.
That’s not what this kind of whinging is about. What it’s about is solidly middle-class healthy people who have chosen to forgo health insurance (or who don’t mind that their employer doesn’t offer it) and just plain don’t like having to pay for it. Forget all those truly needy people who would be able to have health insurance—if it means not getting the new big-screen television then it’s a terrible injustice.
I agree that the subsidy should be 400% of the poverty level, but let’s get some perspective here. I think these people simply aren’t aware of how much every variety of health insurance really is. They don’t know that Medicare premiums are at least $100 a month, and they don’t know just how much many times that are the total monthly premiums of employer group policy health insurance when the employer’s portion is included. Or even just the employee’s. A lot of these folk are twentysomething college graduates who make 30K-40K and have never had health insurance since they left college. And they’re healthy: if they weren’t, they’d know that paying 10% of their income for health insurance is a bargain compared to the alternative.
These folks aren’t worth listening to, they’re Republicans-lite. They’re all about what’s in it for them, and they’d better not have to pay for it.
September 15th, 2009 at 11:27 am
@13: Good point. But in any case, would anyone be nuts enough to turn to the *Republican* party because the Democratic solution wasn’t favorable enough to the working class?
It *might* split the Democratic party with a true liberal party arising to its left, and where that would lead in the medium and long terms, I don’t know. But I wouldn’t necessarily consider that future apocalyptic.
September 15th, 2009 at 11:36 am
DTM, why? I don’t even really think the subsidies are going to be 400% of poverty. I’d imagine we’ll end up between 200-300%. If the Senate passes a bill, I expect it to look like the Baucaus bill. I expect that, if it emerges from conference, it will have only minor tweaks.
To be honest, at this point I’n not even sure a bill should be passed. Nothing this major anyway, not with congress this corrupt. Something MORE incrementalist than an individual mandate would probably be a good idea. The system they are creating won’t be flawed in a minor way, like excluding this group or that one. Flaws like that are easy to fix later. How on earth do you fix the massive structural flaws of the system Obama is setting up right now? It’s the product of too much corruption, of too many industries being bought off.
We should look for ways to cripple these industries and decrease their power. THEN we should try for something better.
September 15th, 2009 at 11:44 am
Chris, a combination of the innate human reaction to frustration (Repition, variation, violence) and the innate rules of a zero-sum game.
When upset, frustrated, angry or stressed; human beings will first attempt to be more emphatic. They may start yelling their arguments, or repeatedly pushing the same button in the hopes this will be more effective.
If that fails, they will turn to variation. This will consist of going to other people, and trying to get them to understad or pushing different buttons in the hopes one of them will work.
If nobody will help them, a small percentage will simply give up. The rest will become violent in the hopes of getting the attention they need or venting their frustration. The level of this violence varies in correlation to multiple factors (closeness to goal, level of need, etc). This is basic human psychology.
In a zero sum game, in order for one group to gain support the other MUST lose it. In order for Democrats to be punished, Republicans MUST be rewarded. This is standard game-theory. I’d imagine your was a rhetorical question. It did, however, have an answer.
September 15th, 2009 at 11:49 am
Both politics and justice
combine to require
that subsidies for mandates
be raised up much higher.
This represents a windfall
for private insurance,
whose overhead won’t shrivel:
I give you assurance.
The thing that will make the
insurers efficient
is an option that’s public:
Necessary, sufficient.
September 15th, 2009 at 11:49 am
How would this work in practice, though? Any parliamentarians know? I’m all for the approach suggested by Bowers if we’re talking about an amendment for a public option to the bill, but if it’s a straight up or down vote on the bill as a whole on the Senate floor, doesn’t that risk the bill going down to defeat?
September 15th, 2009 at 12:15 pm
File this in the same place you put the “Force those fuckers to actually filibuster” file.
September 15th, 2009 at 12:29 pm
DTM, why? I don’t even really think the subsidies are going to be 400% of poverty. I’d imagine we’ll end up between 200-300%. If the Senate passes a bill, I expect it to look like the Baucaus bill. I expect that, if it emerges from conference, it will have only minor tweaks.
I’m not sure what you are asking me “why” about–I was just pointing out that households without much income due to disemployment aren’t really who we are talking about when it comes to subsidies in the national exchange.
As for the basically-healthy, younger, middle-class people with good jobs, who might be screwed a bit if the subsidies are not generous enough . . . that is a real issue, particularly from a partisan political standpoint. But that isn’t a big enough issue for me to think it is a good idea to hit the reset button and hope that some day Congress won’t be corrupted by business interests, partisans won’t be acting against their own self-interest for basically tribal reasons, and generally for human nature to have somehow perfected itself.
Instead, I think many of these possible flaws are naturally going to lead to their own correction: for example, if the future problem is insufficient subsidies for politically-potent middle-class voters, well then the future solution isn’t going to be to take their health insurance away and give up, it will be to make their subsidies more generous. And if then the future problem is lack of effective cost controls in the subsidized national exchange due to the lack of a public option, then the future solution again won’t be to remove their subsidized health insurance, but rather to add a public option (or even more draconian cost controls, like Japan-style price-setting).
And so on. Once this snowball is rolling downhill, pulling it back uphill isn’t going to be possible. So I see no point in waiting an indefinite amount of time as people suffer for the ball be a certain ideal size before we push it. And that is because if necessary, it will pick up more size on the way down.
September 15th, 2009 at 12:31 pm
If you want medical malpractice tort reform, you need to reform medical care in the US. In pretty much every other developed country with a strong social safety net (but I repeat myself), someone who is incapacitated via a medical procedure gone wrong is taken care of for the rest of their life by the society through government programs.
Here, the doctor’s insurer pays.
This has nothing to do with some sort of ingrained American litigiousness, trial lawyers, or anything else. Someone has to pay for that person’s care for the rest of their life. If doctors have a problem with that, they should be fighting to strengthen the safety net.
September 15th, 2009 at 12:46 pm
And so on. Once this snowball is rolling downhill, pulling it back uphill isn’t going to be possible. So I see no point in waiting an indefinite amount of time as people suffer for the ball be a certain ideal size before we push it. And that is because if necessary, it will pick up more size on the way down.
The slippery unstoppable snowball of SOCIALISM. Better put on your ushanka’s now, everybody. And learn how to make snow Lenins. They’re coming to take your guns!
September 15th, 2009 at 12:56 pm
Re jack at 16 and Keith at 17: “This is simply false. Not only have numerous studies shown that malpractice premiums and defensive medicine contribute only a relatively small portion of health care costs in the US, we have experimental laboratories available which have tested this in the form of the states which have sharply limited malpractice claims.”
—————–
This is bullshit — although I am biased because I live in one of the most fucked states in the country when it comes to medical liability — Pennsylvania.
We had people DYING here a few years ago due to the departure of needed specialists. Democratic Governor Ed Rendall adopted emergency measures –including state support of malpractice insurance for doctors — and limits on lawsuits that partially abated the problem.
The state subsidy costs taxpayers over $100 Million per year.
I think it has about $3 Billion in unfunded liability that will have to be paid in the future by assessments on doctures.
See http://www.mainlinehealth.org/wtn/Page.asp?PageID=WTN000451
The malign effects of high insurance premiums — some of which are as much the fault of greedy insurance companies
as of lawyers — include:
a) Loss of doctors in low-revenue areas (rural areas, low income urban areas)
b) Loss of needed specialists
c) large costs from defensive medicine
d)Denial of needed care because doctors are deterred from doing needed but high risk procedures that leave them open to lawsuits
September 15th, 2009 at 1:03 pm
The slippery unstoppable snowball of SOCIALISM.
Yep–even Hayek recognized that providing basic health coverage is ultimately a proper task for the state. So the end result is inevitable, and the only question is how many resources and lives we waste before we get there.
September 15th, 2009 at 1:11 pm
I don’t know what’s going on in Pennsylvania – but the fact that it seems to be specifically a Pennsylvania crisis suggests to me that it’s some kind of issue with the way insurance is regulated there, or some other quirk of Pennsylvania law, rather than some more general problem with medical malpractice lawsuits nationwide.
In general, there’s zero evidence for things like excessive defensive medicine, or the shortage of general practioners being primarily (or at all) traceable to medical malpractice costs. There are a lot of factors at work.
September 15th, 2009 at 1:40 pm
By beating the living snot out of you people at the ballot box, twice in a row, in a manner reminiscent of Mike Tyson circa 1989.
That’s how.
September 15th, 2009 at 1:43 pm
That isn’t going to heighten the contradictions of capitalism and bring the workers into the streets. Booooo-ring.
There are some people who want to help their fellow Americans get medical care. There are others who want to exploit their economic insecurity, and when the chips are down, will oppose anything that will help them.
September 15th, 2009 at 2:06 pm
Re Jack at 29: “the fact that it seems to be specifically a Pennsylvania crisis suggests to me that it’s some kind of issue with the way insurance is regulated there, or some other quirk of Pennsylvania law, ”
————–
1) The words you are looking for are “Pennsylvania Trial Lawyers Association”. Sucks more blood than ticks on a dog. But spreads money around Harrisburg (state capital).
2) The Rendell measures that alleviated the problem were:
a) Banning venue-shopping by the lawyers — in which doctors in western PA counties were being tried before juries in Philadelphia by Philadelphia lawyers.
b) Banning coercion via hundreds of frivolous lawsuits –by requiring a statement from another doctor that malpractice had occurred as an initial requirement for filing suit.
3) To help pay for the initial insurance relief, Rendell also seized a bunch of “reserves” from the insurance companies via “fees”. The crooks were dismayed to discover that they could be robbed. ha ha Ed deserves another term just for that.
September 15th, 2009 at 3:49 pm
2) The Rendell measures that alleviated the problem were:…
Okay, I’ll take your word for it. Those all sound like basically good ideas. None of them are “tort reform” as it’s understood on the national level, which usually involves (among other things) hard caps on damages.
Again, it sounds like PA maybe had an acute, PA specific dysfunction, but there isn’t any analogous national crisis in malpractice premiums. They’re probably more costly than they need to be – but those premiums alone just aren’t a particularly significant piece of the health care cost puzzle. So proponents of tort reform usually claim that they’re somehow just the tip of the iceberg. That doctors are engaging in trillions of dollars worth of “defensive medicine” that will magically all go away if patients can’t sue them. The support for that is thin, to say the least. (Like Keith Ellis, I’d say the experiment in Texas should have disproved the notion entirely.)
September 15th, 2009 at 4:28 pm
Trolls: 34 states have enacted the tort reform being discussed in this legislation. The passage would effect only 16 states (and they ain’t the red ‘uns) and would not lower costs, since health care is probably more expensive in those 34 states!
As far as a vote goes, if Reid puts the public plan in a merged bill, there will have to be votes to change it. Anything making it weaker can be voted down; anything improving it is open to filibuster (right?) but that filibuster will require a cloture vote. If the amendment improving it fails, it’s still in the bill.
So the merged bill will contain the Senate’s best-case PO. It’s almost entirely up to Reid how the merged bill looks.
Also, Reid can make break-out bills (a Reconciliation Bill and a Non-Rec Bill) such that the Rec Bill gets dropped if the full bill is filibustered. We’ll already know whether or not the Rec Bill has 50 votes, so it’ll pass easily (in whatever form).
All of this is exclusively at the whim of Harry Reid. If he doesn’t do it, he’ll lose his seat next year and we’ll get a new majority leader.
September 15th, 2009 at 5:36 pm
DTM, you support the Baucaus bill and do not support the Public option. Well, you claim you do. But you don’t support trying to have it included in any actual bill, so you don’t really actually support it.
September 15th, 2009 at 5:37 pm
Joe, Red Bating? What fucking century do you think this is? Go lay down old man, you’re losing it.
September 15th, 2009 at 6:24 pm
That’s absolutely untrue. DTM has said repeatedly that he supports the public option and efforts to include it in the actual bill. I certainly do—I strongly support the public option with the only limit being that I refuse to accept the status quo as preferable to reform without it. For some reason, you insist on wrongly equating this position with opposing the public option (or failing to support it) directly. It is absolutely bad-faith to argue what you’re arguing because you know good and well that the two things aren’t equivalent.
Why can’t you simply assert that we’re wrong in thinking that a bill without a public option is nevertheless better than nothing and leave it at that? Why is it necessary for you to do as the Republicans do and make this into some moral battle where a technical disagreement becomes the equivalent of an essential ideological opposition?
I have a lot of difficulty comprehending how you or anyone else can truly believe that the status quo is preferable to a bill without the public option—and I think it results from a sort of selective blindness about the urgency and reality of the problems the rest of reform will correct combined with an over-zealous fixation on the public option as a panacea—but one thing I don’t think or have the bad-faith to accuse you of is that your position is really just a smokescreen for an opposition to reform entirely. Yet, unless I’ve confused you with someone else, in the past you have repeatedly proven that you are willing to make such accusations about people like DTM, Yglesias, and myself.