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Feinstein To Critics: It's Not The Public Option--It's The Mandate

Gil Duran, a spokesman for Sen. Dianne Feinstein, email's over the following statement in response to inquiries about her support for broad health reform.

I support:

1) Reducing costs and expanding coverage

2) Prohibiting the denial of insurance because of pre-existing conditions

3) Moving toward either a non-profit model of medical insurance or to one where premium costs can be controlled, either through competition in a public or cooperative model or through a regulated authority.

4) Assuring the financial survival of Medicare, because it is slated to run out of money in 2017.

5) Preventing the transfer of Medicaid costs to states, which could result in billions of dollars of additional loss to the State of California.

6) Establishing means testing for programs like Medicare Part D, which pays for prescription drugs

Clearly, the individual mandate - and how it is funded - is the critical, and as yet unanswered, question.

Though Democrats don't bandy about the term too often, the mandate is a provision that will require uninsured people to buy health insurance--private or public--on the individual market. Because many can't afford their own plans, though, it will require a great deal of subsidy and could, in the short term, impose a significant cost. Without the mandate, health care won't be universal. But supporters of the public plan note that without a government run option to root out waste and inefficiency, the choices available to consumers will suffer, and private insurance companies will reap windfall profits on the consumer dime.


44 Comments

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Sorry, her statement on the public option is totally meally-mouthed. She is not signalling support for it. She and others who are waffling must be put under pressure by Democrats if this is to happen.

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I know it's a little off-topic - Prof. Skocpol, what do you think about the Iranian situation and could you post something if you have the time and inclination?

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Couldn't she have just said:

I'm doing my best to squirm out of any commitment my constituents may want me to make. In other words, I don't really give a shit what you think. In short, FO&D!

Like I've said, Feinstein was a much better representative of the people before she was a member of the SF Board of Supervisors.

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More DiFi double talk

Californians are regrettably used to it

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1. Public health insurance at a reasonable price.
2. No mandates.
3. No means testing.

Pass it on.

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The notion that all these insurance companies who say they’re giving consumers the best possible deal, if they can’t compete against a public plan as one option, with consumers making the decision what’s the best deal, that defies logic, which is why I think you’ve seen in the polling data overwhelming support for a public plan.
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John, you didn't say who you were quoting. But here's a sweet little exchange from today's presser:

Q: Won't that drive private insurers out of business?

THE PRESIDENT: Why would it drive private insurers out of business? If private insurers say that the marketplace provides the best quality healthcare, if they tell us that they're offering a good deal, then why is it that the government -- which they say can't run anything -- suddenly is going to drive them out of business? That's not logical.

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Yup...that quote from the President!

I was waiting for someone to ask..hehe

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I love the quote from Obama's press conference.

Indeed, the reaction of the free-marketeers to the possibility of a public option proves, once and for all, that those who talk up the free market don't really believe in it.

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Diane,

I can get rid of your mandate problem. How about we change it thusly. Simply state that you will not stop until the bill guarantees healthcare to all Americans. A mandate to purchase insurance is something else entirely. That is merely insurance industry extortion. Now, if you'd like to add a little genuinely progressive taxation to the bill to fund the right of all Americans to have something that citizens of most all first world countries take for granted, that would be fine.

My Senator Amy and Senator Diane have something in common. They want to "expand access" to 5 people or 50 million they don't say.

Expand access is not good enough.

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I usually make an effort to be more eloquent, but honestly, Feinstein doesn't deserve it.

This is more of DiFi's typical middle-of-the-road, no commitment blather. What about the public option, Diane? What about single-payer? More, what about representing your constituents, lady? It would make for a nice change of pace.

Can we please be rid of her now?

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Please some progressive outfit like moveon, create a primary challenge fund to support challengers to any Dem who doesn't support a public option. Just give me an address to send my check.

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Could we also pin her down on what she means by "financial survival" of Medicare. Does that mean sticking a needle in your grandmother if it saves money or what?

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Hey Di-Fi: Fuck you.

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Seriously, Fuck you, DiFi!

I was wondering..if there is a public option, why are we allowing Medicare, Medicaid, Tricare (maybe the VA Med system needs to stay alive?), etc to continue to exist? The abolition of Medicaid alone would save the states a ton, not to mention the savings from the elimination of service duplication.

If we have a public option, move everyone on state and federal healthcare to that. If its already free for you, it continues to be.

I don't understand whats so fucking hard about this?

Or is this a stupid idea?

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Senator DiFi is, and always has been, a corporate whore.

Can't we do better, California?
~

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Single payer does all that. Is DiFi for a single payer plan then?

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She lost my vote when she voted for Mukasey. The only thing left for me to do is to get my friends actively involved in defeating her for Governor in 2010 or reelection in 2012.

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I'd be cool with DiFi going for governor in 2010. It'd get her out of the Senate. Let her struggle with the 2/3 majority needed in the state legislature to enact a budget.

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She's not exactly leading the way for Americans. And this is a time when we need our Senators to act like leaders.

Lead or get out of the way, Senator Feinstein.

Her statement just barely meets the definition of due diligence. Maybe for an issue that wasn't as much of a crisis, like opening or closing a post office, or naming a library, this kind of generic carefully moderated statement would suffice.

But this issue is a crisis. Americans are dying every day or going bankrupt at an alarming rate.

And the best she can come up with is "I support reducing costs and expanding coverage"?

To be fair, she was definitive about moving to prohibit the denial of health insurance because of pre-existing conditions.

But how can she not say anything about rescission?

Personally, I'm insulted by her statement. Maybe because I've learned so much about the issue that I feel she's either just not up to speed or just not up to the task of participating in an honest debate.

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"3) Moving toward either a non-profit model of medical insurance or to one where premium costs can be controlled, either through competition in a public or cooperative model or through a regulated authority.":

Humph! The idea that premium costs could be controlled by some type of co-operative model is ridiculous: are we talking about some kind of baby Blue?

Why does she claim to think that this might work?

If there is not a full fledged public option, the plan ought to fail.

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Feinstein will support any health care plan which is acceptable to her health insurance and pharmaceutical company donors.

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I haven't seen any info that shows specific pharmaceutical or health insurance companies that have donated to Senator Feinstein.

Could you provide the link?

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She's accepted about $19,500 over the years from Health Net Inc, which is a California HMO. Eli Lilly gave $5k to her PAC last cycle; in 2007, her PAC received donations from:

Affymetrix Inc $2,300
Allergan Inc $2,500
Amgen Inc $2,000
Genentech Inc $5,000

I imagine there's more if you want to look closer:

http://www.opensecrets.org/politicians/contrib.php?type=C&cid=N00007364&newMem=N&cycle=2010

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Feinstein... De Facto Republican.

I am pushing the eject button on the ballot in 2010. Hopefully a couple of million Californians will push the same "Feinstein Eject" button with me.

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Pure BS. The only important is providing affordable healthcare for everyone and that can only be done with a public plan. Her self-serving statement will ring hollow to everyone in her state.

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She REALLY needs to retire, we should have a mandatory retirement in the Senate. Good luck getting them to vote on that though.

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every person i know can give you a horror story when it comes to their health insurance company,

this statement of hers is total BS.

she will never support a true public option because anyone who says a co-op is a good deal is signaling their corruption.

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Remember Mukasey!

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Also, ANY mandate will not work. How is anyone going to force the schizophrenic living on the street to buy insurance? Or the unemployed carpenter? Or the single mom working two jobs to support 3 kids? It's a stupid idea and it's hard to believe anyone could be so stupid as to think it would work. It's because they have never had to decide whether or not to buy good wheat bread instead of the cheapo white bread because you only have ten bucks to last until Friday. They never had to put $3 in the tank and save the other $2 for a quart of milk for the kids. They never had to choose between paying the car insurance and paying the gas bill to keep the heat on for another month in the middle of winter. They never had to roll pennies to buy groceries. I am not a hater but if I was I would have to say I hate them all, Democrats, Republicans, and Independents. It's a damn disgrace that we can't get good health care for everyone in the richest nation in the history of civilization.

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DINO DiFi. The last time she did anything truly progressive, Harvey Milk was still alive.

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She is responsable, with the help of her little friend Boxer for the failure of Californis. Billions in Ethynol that cost more to produce ( 2 unit of oil for 1 unit of eythnol ) and it did not run well in combustion engines. Now tax on Diesel has has distroyed Cali.

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I especially love how Feinstein speaks of "the mandate" (not "a mandate"), as if it's a done deal, and the only option on the table.

Fuck the mandate, Feinstein. We want a real public option. THE public option, in case you need reminding, is ALREADY a waffling compromise; it's a back-off position from single-payer, which is what we really need.

There is no need to waffle and back off further, and a lot of Americans will not tolerate it. Which means, to be plain, that we will try to get you booted out of office if you stand in the way of a real health care plan. Capisce, Diane?

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Some "Centrist" Senate Democrats, unfortunately, do appear to be playing games with the language, hoping supporters of real reform will somehow be fooled. These Democrats forget that we just went nine rounds with the Bush administration in America. Due to the dense network of smoke and mirrors games that were afoot from 2000 to 2008, people who came of political age during the era are going to be harder to fool. Frank Luntz's "pick the right buzz word" strategy may not be as likely to hit the mark. The political brain circuitry changed at some point, and people have possibly learned to look behind the words.

Feinstein's comments on Sunday were strange. What was it she said again? Something like, "I don't think he has the votes right now." The votes for what? The plans are being kicked around and it's not time to vote yet, not even close. It has been made clear that "the vote" probably won't happen until fall. That means Senators Feinstein and Conrad have plenty of time this summer to actually get to work and come up with a plan that serves all Americans, not just those who have the money to show up at fundraisers with high-rolling Washington politicians. No, Feinstein seems to have gone on TV to throw ice water on this thing. It was apparently fun going on TV during the campaign and talking about reforming the system, and all, but now that Obama actually intends to follow up on it, all of a sudden we need about a hundred more years for "research."

Finally, in this thread, the Senator mentioned "expanding coverage." Sorry, but this is nowhere near specific enough.

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The woman has spent the past 30 years coasting on the fact that she was the one who made the tearful announcement to the press the night Harvey Milk and George Moscone were murdered by Twinkie man.

If she was from any other city but San Francisco, and any other state but California, she would long since have been seen as the pseudo-Republican fat cat that she really is.

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As I've said to both the Cantwell campaign and the local media, the lack of commitment on this issue speaks volumes more than the commitment to the wrong plan.

I would love to see people take a hard stance on an alternative, much like how Obama chided the GOP to do earlier this year on the stimulus bill. Within the Democratic party, there seems to be a vacuum of both unified vision and varied viewpoints. What we have, sadly, is a party plan with a minority dissent. The public debate, which I'm sure the elected officials are trying to delay at all costs, would definitively benefit from a rollcall on various options. With only one solution in the chute, there's a community of supporters with a single view, but the community of dissenters fraying in several different directions.

The way to attack the issue is to stem the waffling at the top of the pyramids. Start with Reid and committee members, and follow the threads down to the junior senators.

Phone calls, people! Phone calls to senators and phone calls to local media to have senators on TV. Eventually, local media will note that the refusal of invitations to senators is a news story by itself.

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In Praise of Senator Diane Feinstein (D-CA)

Perhaps it's time we all take a deep breath, step back, and remember all of the great things Diane Feinstein has done for the nation, in general, and California, in particular, during her 24 illustrious years in the U.S. Senate, especially now that she's truly wise, august and powerful.

Here's my list:
1. (note to self: fill in after her death when history is rewritten by the MSM ala Reagan.)

OK, so I got crickets.

Still, it's just cruel for anyone (jzap) to suggest that she become governor of California at this point in time. In addition to a shortage of jobs, water, the endless-list, California could suffer an acute shortage of extra-hold, all-weather, helmet-in-a-can hairspray, potentially crippling Hollywood. Should Lady DiFi actually visit the state for more than 10 days running, rationing would no doubt ensue. The errant vapors released from her cases of Spray O' Wonder® alone could, conceivably, asphyxiate the entire state. (Thankfully, her taking office as governor would be delayed upon completion of a coiffure-related EPA Impact Report, which would take a few years. It's likely, however, that the FCC would fast-track a dispensation for her hair; DiFi's 'do does WiFi, you know. I understand it has to do with collection, analysis, transcription, routing to appropriate agencies, and such. In a nutshell, her 'do screws it up, slows it down, frustrates the user. It's DiFi.) Combined with her unnaturally innate ability to suck ... my gawd, what am I gonna do? Quit smoking? Move to Missouri? Go back to wearing my rubber Devo JFK Hair? It's too damn hot!!! ... God, I can't breathe! "Cool moss, cool moss." Oh damn, that's for firewalking. C-c-can't breathe.

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Feinstein's statement deserves to get deconstructed up the ying-yang. Mostly, it's deceptive, shallow mush.

Except for the following, which is the worse kind of corporate whoredom:


Clearly, the individual mandate - and how it is funded - is the critical, and as yet unanswered, question.

Without a strong public option that any American can choose, a mandate to buy insurance is a pure increase for the demand for health care without any commensurate increase in supply: in effect the price of insurance rises, and the insurance rackets will simply pocket the profits. It turns what is currently a protected oligopoly in to an even better protected, even more profitable oligopoly. It's why the "reform" in Massachusetts has turned out to be such a clusterfuck.

The only way to prevent the insurance companies from doing exactly the same paper-pushing, health care denying shenanigans they currently do now is to build real competition into the system, where the competitor competes by giving better care, rather than competing on how effectively you can fuck the public. That doesn't mean warmed-over HMOs, which is what Conrad's "health care co-ops" really are. It means a plan that anyone can choose over a private plan, that will actually pay for health care people need, when they need it.

A private plan can compete, by actually giving real health care coverage, and by actually reimbursing doctors for needed care, rather than forcing doctors to hire two or three clerical people to try to ungame what the insurance companies currently game on physicians. It won't be as profitable as the current racket. But that's exactly the reason real competition is essential: competitive markets are just profitable enough to cover costs and a reasonable return. Any "health care" insurer that needs more than reasonable market returns should be forced out of the business, for the good of the public and for the good of health providers like doctors and hospitals.

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C'mon. Stop making sense. Lady DiFi has a plan.

Just because "the plan" excludes you and everyone you might know doesn't make it unacceptable. Never get sick and you'll come out ahead.

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The sad truth is that DiFi, like so many of her colleagues, is simply ill-suited to leadership. Her "response" is clear evidence that she lacks the personal courage to fight for those that she in theory represents.

More and BETTER Democrats.

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Here's something else to watch out for on the mandate front. I heard a Republican rep say last week (can't remember where or when) that one possible way to mandate "affordable" insurance is with a high-deductible plan. What good is insurance if out-of-pocket costs were still untenable?

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Dianne Feinstein should divorce her husband and marry Ben Nelson.

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Reading through these comments it's easy to see why this is such a hard issue to tackle. I see lots of folks complaining about the "mandate", but the bottom line is that you can't have "universal coverage" unless you make everyone participate in one way or another. Without it, you've still got too many people going without and showing up at the ER for treatment that costs 8 or 10 times more when rather minor conditions become acute health issues, with those costs continuing to be offloaded onto everyone else and continuing to put upward pressure on prices. Under any solution there will be some of this; as someone else mentioned upthread, you aren't going to get the homeless to enroll in any kind of insurance plan, public or private, and you aren't going to be able to increase withholding taxes on the unemployed to fund their coverage or get money for premiums out of them in any other way - but it's important to limit the pool of those outside the system as much as possible. Sure, a nationalized single-payer system funded via taxes would accomplish this, but we need to accept that no matter how much sense it makes, we aren't going to get it at this time. And not because our new president is a wimpy-wimp who just isn't willing to deplete his political capital on doing the right thing, but because of a whole combination of factors including the financial power of the existing players, the 50 years of brainwashing people to fear "socialized medicine" and so on.

So we really shouldn't have an issue with the "mandate" - unless it's a mandate that we must all buy insurance from the private insurers at their current bloated-by-profit rate, without any regulation or restrictions being placed upon them. If what we ended up with was a law that said private insurers weren't allowed to profit on basic care coverage (or profit very little, like 2% or something), weren't allowed to deny coverage to any applicant, weren't allowed to practice recission, weren't allowed to jack us around when it comes time to pay our bills, we'd essentially have a system like the Swiss have which is working pretty well for them - although it's the second most expensive health care system in the world, it still costs something like 40 - 50% less than ours. The amount of regulation on insurers required to get there isn't going to be accepted by the private insurers any more than a straight government funded single-payer system would be, though, and as we've already seen, they have the financial muscle to kill any attempt to regulate them in this manner.

Which leaves us with the public option. And really, it's not all that bad of a solution, given what we're up against. Over the course of just a few years, it will either force the private insurers into a Swiss-type model or they will cease to exist, as consumers fleeing the practices of recission, etc. flock to the public plan. Private insurers will end up either having to impose "regulation" upon themselves with regard to these practices, or go out of business.

All that having been said, we need to be prepared to hit the streets if they come up with any reform-in-name-only that's more watered-down than either of the two options above, because anything less won't address any of the problems with the current system, which is exactly where DiFi is wavering. So, national public insurance for everyone who isn't otherwise covered, with everyone else having free access to choose it over their current insurer, or a complete regulatory overhaul of the existing private insurance industry forcing them to accept all comers, drop abusive practices, and offer basic care coverage to all at no-or-very-low profit - those are the only options we should be willing to accept, and we need to let them know this.

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They could have simply funded this through progressive taxation and covered everyone - but that would be progressive.

Now, fine if people reject that idea as long as you realize that you were never given the option to debate that idea or many others. We're not getting small "d" democratic debate on this. We're getting a narrow debate on options that suit establishment interests and the devil is going to be in the details of what they are NOT going to tell us.

So you are so right to warn of reform-in-name-only.

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