Obama to Lay Out His Terms on Health Care Reform--Public Option Not Among Them

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Steve LaBonne

September 2, 2009 9:33 AM in reply to converse

Yeah, I'm keeping my powder dry on this one until the actual speech and/or reporting by somebody with more credibility than GOPolitico.

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converse

September 2, 2009 9:35 AM in reply to Steve LaBonne

Politico's source: "some administration officials". C'mon TPM!

The Commenter Formerly Known as NCSteve

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September 2, 2009 10:05 AM in reply to converse

Right there withya, guys.

But FWIW, Politico is sending "authorized leak" signals.

Problem is, our post-journalism political press is utterly and completely dominated by teh stoopid and the need to feed. To that end, they are fully capable of inflating a comparatively minor distinction between, say, the fully public option as conceived in the House bill and the endorsement of a public entity administered under contract by a private company floated by Harry Reid yesterday into a big deal in the hopes of provoking a liberal snitstorm and generating sweet, delicious, clickthrough generating conflict.

Before the Obama haters go all crazy claiming I'm apologizing for my Dear Leader, let me stress that I'm not saying that's what's happening. While it's possible, I am absolutely, totally, completely not saying that's what's happening.

Just saying that believing the anonymously sourced reports out of the useless, braindead Village MSM is a great way to embarass yourself regardless of whether their reports align with your own paranoia or your own delusional hopes.

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Obey

September 2, 2009 10:40 AM in reply to The Commenter Formerly Known as NCSteve

But, dude, why are you saying that's what is happening?!!

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September 2, 2009 10:48 AM in reply to Steve LaBonne

Exactly!! I will wait to hear it out of Obama's mouth. I don't believe after all this he will drop the public option. It makes no sense.

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jerryfatheart

September 2, 2009 12:46 PM in reply to lousgirl84

Exactly. He will not put anything new on the table. The public option is not new; in fact, he's said time and again that he believes the public option is the best way to strengthen competition. He's given people ample time to come up with ideas that are better. Enzi and Grassley, and by extension the entire GOP, have had their chance. That's over.
The only ideas that would be better is a public option available to all or single payer, and that ain't happening.

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ohyeathatsright

September 2, 2009 12:50 PM in reply to lousgirl84

Unfortunately I'm more pessimistic about that. When's Obama gonna start cracking heads in Congress? People want to see the type of leadership and command of the issues he demonstrated during the campaign. Even Republicans were supporting him in campaign commercials!

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Donald from Hawaii

September 2, 2009 1:06 PM in reply to ohyeathatsright

I'd settle for Obama cracking some heads in his own White House.

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3star2nr

September 2, 2009 1:29 PM in reply to lousgirl84

So lets look at the facts/

77% of americvans want and support the public option

60 reps in the house support the public option and will vote against any bill without one

The entire prgressive caucus and all the othe caucses, and most of te blue dogs support the publicvc option.

Nancy Pelosi supports the public option and will kill any bill with out it.

But Obama is not going for the public option?

Obama is going to stand up against his oown base, his own party, the american people. FOR WHAT REASON? to satisfy 7 republican wanna be senators?

seriously?

How much money did they pay him to end his political career

The Commenter Formerly Known as NCSteve

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September 2, 2009 2:38 PM in reply to 3star2nr

Yes, of course! Bribery. That must be it. Nothing else explains it. Can't possibly have anything to do with the Founders having deliberately designed the Senate to make it hard to get legislation passed. All that talk about silly Senate rules that give disproportionate power to the majority is just kool-ade talk. No, it must be that he's on the take. It's the only thing that makes sense.

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gharlane

September 2, 2009 11:55 PM in reply to The Commenter Formerly Known as NCSteve

Can't possibly have anything to do with the Founders having deliberately designed the Senate to make it hard to get legislation passed.

Despite re-reading Article I, Section 3, I fail to find Senate Rule 22 in it, or anything else deliberate that makes it hard to get legislation passed. How weird. I must be missing something. Are we reading the same Constitution? Do you have your own private copy with the Sekrit Passages in it?

http://digbysblog.blogspot.com/2009/08/and-thats-way-it-is-by-digby-bill.html

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gharlane

September 3, 2009 12:02 AM in reply to The Commenter Formerly Known as NCSteve

BARACK OBAMA: The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee who pushed the law through went to work for the pharmaceutical industry making $2 million a year. Imagine that. That's an example of the same old game-playing in Washington. I don't want to learn how to play the game better. I want to put an end to the game-playing.
BILL MOYERS: Now look at this recent story in the LOS ANGELES TIMES. Lo and behold, since the election, the pharmaceutical industry's $2 million dollars a year superstar lobbyist Billy Tauzin has morphed into President Obama's pal. Tauzin says the President has promised not to pressure the drug companies to negotiate with the government for lower drug prices and has agreed not to allow cheaper drugs to be imported from Canada or Europe - contrary to the position taken by candidate Obama…

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nobillary

September 2, 2009 2:55 PM in reply to converse

Or, as Bob Cesca calls it, "Drudge Trolling"! The "source that Drudge and Politico got this tidbit from was an "anonymous aide", and we all know, from past performances, there is no such person!

September 2, 2009 9:57 AM

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Stroszek

If it's going to work, this is how it's going to work:

A standard bill with new regulations will be passed in September.
In October, progressives in Congress will pass a public option through reconciliation.

Liberals will and should go apeshit to ensure this happens, but it's important to keep in mind that this is the only way to pass a comprehensive health insurance reform bill that achieves every goal.

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Chris

September 2, 2009 10:08 AM in reply to Stroszek

I can almost see that happening. Giving how effective the media has been at being ineffective, I can really see that happening.

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converse

September 2, 2009 10:51 AM in reply to Stroszek

You left out the weeks and weeks of stalling amendments and filibustering. And we don't have a clue where sixty votes will come from. Also.

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Stroszek

September 2, 2009 10:54 AM in reply to converse

Sixty votes for a "vanilla bill" without a public option will not be hard to come by, and you can't filibuster a reconciliation maneuver... so I don't see the problem.

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converse

September 2, 2009 10:58 AM in reply to Stroszek

"...so I don't see the problem..."

...said the Dem Rep on his way to the early August townhall meeting.

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Stroszek

September 2, 2009 11:08 AM in reply to converse

Do you have a point?

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CVille Dem

September 2, 2009 11:30 AM in reply to Stroszek

Can you explain the nuts & bolts of that? I don't understand the machinations, and if there is a shorthand way to walk me through it, I'd appreciate it.

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Darrius

September 2, 2009 12:27 PM in reply to Stroszek

In no way is that acceptable. If they pass anything I want the public option first.

If they pass some other crap bill first the political climate will change, the media will start to say that Dems bailed out on their promises, people will lose heart, and we may never get a public option.

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Darrius

September 2, 2009 12:46 PM in reply to Stroszek

That would not be acceptable. We have to get the public option first. If we don't then the other side will declare victory, the progressives will lose heart, and we may never get a public option. Progressives won't show up in 2010 and the conservative Dems will suffer a blood bath.

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Darrius

September 2, 2009 12:47 PM in reply to Darrius

Sorry for Double post. Computer did not show my post at first.

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Philv

September 2, 2009 3:31 PM in reply to Darrius

Why isn't this acceptable? If we get both the public option and the rest of the reform package? Or do you think it just isn't possible, that getting a public option through reconciliation isn't going to happen?

September 2, 2009 10:06 AM

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Beetlejuice

Well, the Big "O" thinks he can slip this one past the Progressives without a murmur of dissent, eh? The only way to kill single-payer/public option would be to include their attributes into the legislation without calling either out by name. Otherwise, there's gonna be a ruckus.

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VivaAmerica!

September 2, 2009 2:52 PM in reply to Beetlejuice

Oh please, you guys are so predictable. As if Obama actually thinks that he is slipping any thing by anyone.

September 2, 2009 10:09 AM

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Xantar

A public option is not a "goal" in and of itself. It is a means to an end. Obama has never said that the public option is an absolute requisite of health care reform, but he has said that whatever bill he signs must bend the cost curve. And he has also said that the only way he can see of doing that is including a public option or a really strong co-op. In that sense, if he says in his speech that his goal is to slow the growth of health care premiums by the most efficient means possible, he will be perfectly consistent. And I can live with that.

Incidentally, I'm glad he's back to making speeches. It's become clear to me that the press has no interest in letting him get a word in edgewise when communicating to the American public.

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Mimi katz

September 2, 2009 10:57 AM in reply to Xantar

It would be ok with me if it was a government-sponsored, not-for-profit alternative, like Kaiser Permanente for the whole country. I've had Kaiser in the Bay Area since the early 1950s when it started, and both of my parents were cared for by them as well. They are so big that they have good in-system information sharing and do a lot of good effectiveness and prevention research with the data they have. If the gov't contracted with a few not-for-profit companies like Kaiser as the option, that would be ok with me. I think it would do the trick.

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September 2, 2009 12:40 PM in reply to Mimi katz

Their are providers, such as Kaiser, that deliver care more efficiently (same or better outcomes at considerably lower cost). To change health care costs you will have to do far more than simply change who is paying the bills. You have to change they cost structure of delivering care. That is you have to find a way to make most health care providers like Kaiser, or Mayo, or Cleveland Clinic or a few dozen others. If not then Medicare, Medicaid and whatever other public plan you can think of will lead to ever escalating costs and all the hardships that will entail for consumers and taxpayers.

There is considerable confusion about co-ops being insurance cooperatives (think larger risk pool) or health care provider co-operatives (think multi-specialty group practices or integrated hospital systems) or some combo. The former are an alternative to a publicly administered plan, the latter are pretty much necessary to encourage no matter who the payers are.

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mcc

September 2, 2009 11:38 AM in reply to Xantar

The public option is the goal. Everything else is inessential.

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jerryfatheart

September 2, 2009 11:52 AM in reply to mcc

Is this snark?

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mcc

September 2, 2009 12:06 PM in reply to jerryfatheart

Nope. Everything else in the bill is either not useful without the public option (insurance exchanges), will not be enforceable in the absence of a public option (pre-existing conditions rule), actively deleterious (the personal mandate), or could be done better in a different way if we had tried to write a public-option-less bill from the beginning (private insurance subsidies rather than just expanding medicaid).

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jerryfatheart

September 2, 2009 12:16 PM in reply to mcc

I have to say, though, I wish everyone had the option to buy into the public plan. If anyone needs it, it's definitely the folks on the lower end of the income scale, but I wish the middle class would be able to get it on it.

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mcc

September 2, 2009 12:32 PM in reply to jerryfatheart

Yeah, agreed. But I think it would be easier to pass a public option now and patch in increased access later, than it would be to pass a public option later if any bill without one passes now.

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September 2, 2009 1:53 PM in reply to mcc

That is stupid. The goal is universal lifetime access to high quality medical care that everyone can afford, individually and collectively. In your response you explicitly refer to the public option as a means to an end.

What you are saying is that you can't imagine any other means to that end. I suggest that is a failure of both imagination and empirical knowledge on your part, but that's another issue.

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mcc

September 3, 2009 2:34 AM in reply to Economides

The goal is universal lifetime access to high quality medical care that everyone can afford

This is not an outcome of "the America's Affordable Health Choices Act", which was most recently projected to reduce the unemployment rate by something like 2/3 over ten years (that was the CBO score of the House bill with a public plan, mind you-- I'm unsure if there's a working estimate if inclusion or removal of the public plan alters that particular number). "Provide some health care access in 2019 to 70% of the people who otherwise would not have it" is a fine goal, but it's not really as all-encompassingly important as that other thing you mentioned. Kinda seems like just kicking the problem down the road.

My goal here-- yours might do something else-- is to alter the health care system, fundamentally, in some way such that we can have some reason to believe that maybe, somehow, eventually, we will actually move in the direction of creating a system where health care access can be a universal right instead of a privilege some are able to pay for. The bill with the public plan serves that goal; it changes the system in a fundamental way, by inserting the government into the health care system in a way that allows it to actively alter its dynamics rather than just passively regulating. There are lots of openings for positive change this would create. The bill without the public plan, in any form that has been yet proposed, doesn't serve that goal. It leaves the system in place, but makes it easier for some people to afford the privilege of health care. I guess the next step in that process is we wait another 40 years and break our backs again in order to, once again, pass legislation which shaves off another percentage of the uninsured at that time. Somehow doesn't seem worth all this hubbub. The goal of a percentage decrease in on-paper uninsured rates basically does not seem to me interesting or important enough to sacrifice the goal of fundamental change in the health care system, not when as far as I can tell we could have both.

September 2, 2009 10:32 AM

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nova voter

well, i don't know how you meaningfully bring down costs for consumers without the public option. then again, this really isn't my bailiwick.

what i want to see is this: everyone insured; costs to consumers brought down significantly; costs to the system reduced (preventative care); no more denials for preexisting conditions. in other words, access to good care for ALL. expensive access is not access.

if you can somehow accomplish that without a public option, fine. i just don't know how you do that.

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converse

September 2, 2009 10:56 AM in reply to nova voter

"...costs to consumers brought down significantly..."

We'll be lucky to see the rate of increase in costs to consumers brought down a little.

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September 2, 2009 12:53 PM in reply to nova voter

There seem to be two options:
1. You believe cost growth is primarily a result of insurance arrangements
or
2. You believe cost growth is a result of too costly (or too inefficient delivery of care (broadly defined to include stuff like using technology or drugs or any other device or procedure where is has little medical benefit).

There is of course some interaction. Payment policies create incentives for providers.

I contend that #2 is far more significant.
The evidence is:
(a) that both public and private insurers have rapidly escalating costs. It maters little which is faster they are both rising way too fast.
(b) That within Medicare, spending on similar patients varies widely and systematically depending on where you get your care (by state , region and hospital. If there is a greater difference in cost between the most and least efficient care deliverers under Medicare than there is between Medicare and private providers then that tells me it is much more important how we pay for care and what we get for it, than who pays.

If someone has evidence to the contrary let's hear it.

September 2, 2009 10:36 AM

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mans_best_friend

Good heavens. This has become a weekly event.

1. Obama or one of his surrogates makes some statement where they don't explicitly say a public option is absolutely, positively essential.

2. People go apeshit.

3. Gibbs or another official repeats that his position is the same as it's always been: he still believes a public option is the best way to go, but he's open to hearing other options that achieve the same goal.

4. Wait a week and repeat.

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nova voter

September 2, 2009 10:42 AM in reply to mans_best_friend

i typically go batshit over this stuff. i reserve the effort it takes to officially go apeshit for presidential elections.

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happycozy

September 2, 2009 1:52 PM in reply to mans_best_friend

Yep--it's like the primaries and general election all over again.

September 2, 2009 10:47 AM

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slinkypomo

Oh yippie, another speech! Just what we need, more stupid speeches!

Russ
www.anonymous-web.be.tc

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Mimi katz

September 2, 2009 11:03 AM in reply to slinkypomo

Obama does need to give a speech that outlines exactly what these terms mean.

"In this country we have the VA that provides health care for veterans. The hospitals are owned by the federal gov't and the doctors are government employees. That is "government-run health care" and no one, absolutely no one, is proposing that we expand that to the whole population. Then we have Medicare, where people enroll in different private health plans. The doctors and hospitals are private but they all send their bills to the federal government, and the gov't pays. That is a "single-payer" system. We have a similar program for low-income people (Medicaid). We are not proposing that for the rest of the population, although some people do advocate letting younger people buy into Medicare.

"The rest of the population has private health insurance, either through their employer or through an individual plan. The doctors and hospitals are private, and the bills are all sent to the different insurance companies. If the employer is the government, this is "government-funded" but not single-payer. This is the model we are proposing, not single-payer or government-run health care. The difference is that the insurance companies would be more regulated so that they couldn't deny coverage or treatment to make more money and there would be subsidies for people who didn't qualify for Medicaid but still couldn't afford insurance. We might also have a non-profit or publicly administered plan that still uses private doctors and hospitals but keeps costs down with lower administrative costs. And we will have various means to analyze which treatments work best in which situations and which don't so we don't waste money. But no one is proposing restricting or denying care for Medicare patients because of age or anything like that. Not going to happen. Period.

"But the point is, if we do nothing insurance premiums are going to rise, millions more are going to lose coverage because employers can't afford it and medical costs are going to rise as well. We could end up spending a huge amount of our GDP health care, leaving money for very little else, and have poorer health than we have now."

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Mimi katz

September 2, 2009 11:07 AM in reply to Mimi katz

And of course he needs to mention the 40 million with no insurance at all, people who don't get it through their emplioyer, do not qualify for subsidized care but can't afford individual plans because they are so much mnore expensive because they are the profit centers for insurance cos.

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September 2, 2009 11:07 AM in reply to Mimi katz

Excellent post. You should send this to the White House.

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CVille Dem

September 2, 2009 11:39 AM in reply to Mimi katz

MIMI, would you mind sending this to the Prez? If he would just say this it would be perfect. After hearing him at town halls, I have been very disappointed with his ability to get his point across (the Post Office vs Federal Express idiocy for example - like dissing the PO will make people want a public option!!!!).

You have concisely, and without hyperbole or lies, managed to explain a a relatively simple issue that has been stretched out of shape. Good for you!

Please send it everywhere! Can the rest of us copy it as well in order to get it out there? Thanks!

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714Day

September 2, 2009 12:52 PM in reply to Mimi katz

Uh...I think Obama has said all of this, in fact.

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Shrubbit

September 2, 2009 1:28 PM in reply to 714Day

I agree. He's said all that. It's time to move beyond the basics of health care and talk specifics about the plan, what he NEEDS in it in order to bend the cost curve down. Strong, specific, but brief and to-the-point. No more EXPLAINING.

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Tom Betz

September 2, 2009 1:17 PM in reply to Mimi katz

"[A]nd no one, absolutely no one, is proposing that we expand that to the whole population"?

I am.

ALl over the country, public and private hospitals (especially those operated by the cash-strapped Catholic church) are closing for lack of money. This means that the often-impoverished populations they serve are having to travel further for health care, if they can get it at all.

I propose that the VA should take over the management of these hospitals and run them using the procedures that are so successful in providing quality service while holding down costs in the existing VA system. They should be dual-use -- to expand provision of quality care primarily to veterans (as we are adding tens of thousands of disabled vets as a result of the Iraq and Afghanistan wars, we need the added capacity) and secondarily to Medicare and Medicaid patients, and thirdly to provide emergency and trauma care.

Eventually, the whole VA hospital system could be made available to all, but it should start here.

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September 2, 2009 1:50 PM in reply to Tom Betz

You and I pay for the VA not the patients ( I am not sure what their out-of-pocket exposure is). I have no problem with that-- You volunteer to fight for your country and you deserve it. But who is gonna pay for taking over the Catholic hospitals. What is the business model?

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Tom Betz

September 2, 2009 2:17 PM in reply to Economides

Start by shutting down half of the Pentagon's acquisition offices, and the gold-plated weapons projects they are acquiring. Then we'll only be spending half as much as the rest of the world combined does on the military, and three times as much as our nearest competitor instead of six times as much -- and we can use the savings to pay for a gold-plated national health service.

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September 2, 2009 3:24 PM in reply to Tom Betz

I think you are missing the point. In the VA the patients are not paying for their care the taxpayers are (yes, most veterans also pay the taxes that support their own care). In Medicare, enrollees pay a a share and the taxpayers pay the rest. In employer sponsered plans, the employees pay for their care out of their compensation (they are getting a tax subsidy but the employer is not gifting them anything.)

In your scheme you would have the taxpayers take over a limited number of hospitals and apparently provide care to certain geographical areas. I don't get it.

If you are proposing full-blown national health service a la the UK then yeah, everyone gets it. Taxpayers pay for their own care and for those who can;t afford it. Is that all you are saying?

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September 2, 2009 1:47 PM in reply to Mimi katz

Heroic attempt but even you got tripped up by the inherent complexity of our system. Even our public systems are remarkably complex.

In traditional Medicare, people do not sign up for private plans. They can go to the providers of their choice (assuming they accept Medicare payment) and Medicare is their health plan. Under Medicare Advantage, enrollees choose a particular private plan (an HMO plan) and Medicare still pays the bill.

Most Medicare enrollees have/buy SUPPLEMENTAL insurance coverage as well to cover their out-of pocket exposure. There is no catastrophic coverage in Medicare. I other there is not upper limit on what your out-of pocket costs will be. Some of those providers are former employers plans, other s have private Medigap. Others get it through Medicaid.

Simple enough?

Also if I work for the Federal government then my employer-sponsored health care plan is indeed "single payer", just as IBM is the single payer for it's employees. Of course the tax dollars that are used to pay the employer side of the Federal employees premiums come from exactly the same place as the taxes used to pay for Medicaid and Medicare Parts B&D (part A or hospital Insurance is from your payroll taxes, until those are not sufficient, then they'll need some general revenue too).

Your description of the "non-profit or publicly administered plan" contains an interesting ambivalence. Public plans of course don't make a profit (although the question of whether they would have reserves and then would they be allowed to invest their reserves is interesting). There are private non-profit plans as well. Incidentally, the payment processing under the publicly administered plan called Medicare is contracted out to private companies. Such an arrangement made Ross Perot into a billionaire, by the way.

That public plans would have significantly lower administrative costs I guess is debatable. since the proposed regulations--no denial for pre-existing conditions, community rating, etc...--effectively eliminate much of the outrageous administrative practices of insurers. There are also the administrative costs to the providers, and it is unclear that one more plan makes things any better for them unless it has a very large participant base (that is, there's no reason single payer and public option have the same administrative environment).

The issue of how the publicl administered plan will crete incentives for high quality, less costly care using will depend on numerous factors although the knowledge gained from comparative effectiveness research should be entirely in the public domain not the sole province of the public plan

September 2, 2009 10:50 AM

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LuxVeritas

Well the public option isn't anything new, so it would obviously be fair game. I'm not going to assume he is going to throw it under the bus until he actually does. Screw anonymous aides.

September 2, 2009 10:51 AM

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hsr0601

Faced with unsustainable insurance premiums, the auto industry has little chance to roll out affordable products as the premium inflation plunged it into insolvency before.

With this promising reform that comes in with a balancing function for price in operation, Chevy Volt, too, could earn competitive edge in price along the way, together with Nissan Leaf.

September 2, 2009 11:11 AM

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davidfarrar

Look, if a speech from Obama was going to change anything, or even stop his downward slide, it would have done so by now. Yet another speech by Obama on what he wants in a plan he doesn't have, isn't going to change anything.

My advise to Obama on a major speech on health care reform later this month: Go head. Knock youself out.

ex animo
davidfarrar

September 2, 2009 11:19 AM

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wbgonne

It will a DISASTER if Obama abandons the public option. And by "abandon" I mean everything other that pronouncing that the public option MUST be in any health care reform bill that he signs. Triangulation may have been the way forward during Clinton's tenure because the country was so conservative then; but things are different now. The country is more progressive and that is exactly how Obama got nominated and elected. If Obama abandons the public option, he will have abandoned progressives and they, in turn, will abandon him. This isn't some silly Sister Souljah PR stunt; reforming the health care system is vital to the nation's economy. And reform includes a public plan which people can opt into so that we may learn whether the government or private industry most fairly and efficiently provides health care to Americans.

I hope the rumors are false and that Obama will announce his commitment to the public option. If not, Obama and the entire Demoratic party will suffer grievously. And they will have earned it.

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mcc

September 2, 2009 11:39 AM in reply to wbgonne

It will a DISASTER if Obama abandons the public option. And by "abandon" I mean everything other that pronouncing that the public option MUST be in any health care reform bill that he signs.
He has never done that. He will never do that.

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wbgonne

September 2, 2009 1:36 PM in reply to mcc

Well, what is the point of the speech other than to clarify what he will and will not insist upon? I can understand Obama not having declared himself so far; consider it a negotiating tactic (albeit, IMO, a poor one). The biggest problem w HCR right now is that there is no bill to sell because nobody knows what it will contain. That allows the oligarchists and their toy crazies to spew lunacy, which is how the thing has spun out of control.

The public option isn't going to magically appear. It must be insisted upon by the president and then sold by the president. If Obama signals that the public option isn't vital then there will not be a public option. Simple as that. If you are correct that he will never say it then it won't happen.

Enough with the coyness; it's time to step up. The rest is BS.

September 2, 2009 11:19 AM

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Xantar

Boy, the trolls are out in force this morning. I wonder what set them off?

September 2, 2009 11:37 AM

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Marie Burns

Here's something you can do if you've got two broken arms. Raise your hand if you think another long-winded Obama speech is going to provide clarity to the 2/3rds of the public who admit they don't understand the problem & the other 33% (that leaves .3%) who don't understand it but don't know it.

The Constant Weader at www.RealityChex.com

September 2, 2009 12:45 PM

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traitorjoe

Does anyone believe there will be any significant reform without the public option?

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3star2nr

September 2, 2009 1:34 PM in reply to traitorjoe

yes, we will all be forced to buy private insurance, and insuranc e companies will have an excuse to raise costs astronomically because they are being "forced" to accept more risks and potentially more losses.

The public option is the cost containment part of the bill, dont do that and the insurance companies iwill just jack rates up.

I thought the point of the bill was that costs and cost growth is too high.

So thats why it makes perfect sense to kill the ONLY part of the bill that addresses cost.

We have some real Geniuses in Washington

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September 2, 2009 3:29 PM in reply to 3star2nr

You really don't understand what is happening do you?

Try this experiment: what is going to control cost growth in the Medicare program? No evil insurers to put it on. How does it happen? Alternatively why are costs rising so fast in Medicare and Medicaid? Why does Medicare pay way more for patients who are cared for in McAllen than in El Paso?

The reason costs are going up is not because of the insurance companies and we will not slow down cost growth just by changing who pays? You have to change HOW you pay and what you are paying for , and how you go about delivering care. The public option in and of itslef does nothing to change that.

September 2, 2009 12:52 PM

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Avvocato

Probably too little ...
perhaps too late.
Health INSURANCE reform was handled poorly!

September 2, 2009 1:01 PM

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Acewrap

I'm laying out my choices for who I will be voting for in the next presidential election. Obama is not among them.

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September 2, 2009 1:07 PM in reply to Acewrap

You are obviously a troll because if you won't vote for Obama who are you going to vote for. No dem or progressive will vote for a republican and no dem is going to oppose Obama.

So troll, GTFOOH

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Acewrap

September 2, 2009 1:13 PM in reply to lousgirl84

Giving up on comprehensive health care reform is a deal breaker for me. You can go fuck yourself.

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happycozy

September 2, 2009 1:58 PM in reply to Acewrap

Fine--say hello to President Pawlenty and VP Jindal. They will fuck us all.

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Acewrap

September 2, 2009 2:04 PM in reply to happycozy

Will do.

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jeffgee

September 2, 2009 1:12 PM in reply to Acewrap

There aren't any Dems gunning for Obama's job yet.
So, what choices are you laying out? Gingrich? Palin? Huckabee? Romney? Maybe Michelle Bachmann will get a sign from God. Maybe Cheney can be drafted.

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Acewrap

September 2, 2009 1:14 PM in reply to jeffgee

Anyone but the coward who sold us out on comprehensive health care reform.

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September 2, 2009 2:00 PM in reply to Acewrap

Give me a fucking break.
You're basing your decision on reading into an unsubstantiated report from an unreliable source.

Good thing people like you weren't at Yorktown, or we'd be singing "God Save the Queen" as our national anthem.

Good thing people like you weren't at Gettysburg, or we'd be singing "Dixie" as our national anthem.

Good thing people like you weren't at Normandy Beach, or we'd be singing "Deutschland Uber Alles" as our national anthem.

Now that the fight is on, you're quitting.

Goodbye pussy troll.

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Acewrap

September 2, 2009 2:06 PM in reply to Buckeye Terrorist Fist Jab Nation

I just donated to the RNC because of your post. At least they have the balls to stick up for what they believe.

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kfreed

September 2, 2009 2:34 PM in reply to Acewrap

Good for you. Bye now.

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September 2, 2009 2:43 PM in reply to Acewrap

Good riddance troll.

Go suck on the GOP since they have the "balls" you so desperately need and yearn for.

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happycozy

September 2, 2009 2:45 PM in reply to Buckeye Terrorist Fist Jab Nation

good one...

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EastWest

September 2, 2009 2:26 PM in reply to Buckeye Terrorist Fist Jab Nation

And another silly Democan't kook-aid drinker resorts to obscenities in place of actual thought.

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EastWest

September 2, 2009 2:27 PM in reply to EastWest

Heh. I meant "kool-aid" but "kook-aid" may be more accurate.

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September 2, 2009 2:40 PM in reply to EastWest

Want to see a REAL kook?

Look in a mirror sometime.

Begone troll.

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happycozy

September 2, 2009 2:01 PM in reply to Acewrap

People like you are the reason we were stuck with GWB for eight years. Take your ball and go home.

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Acewrap

September 2, 2009 2:08 PM in reply to happycozy

Ok. I will. One thing I will not do is fight for a fucking coward.

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EastWest

September 2, 2009 2:29 PM in reply to happycozy

No. People like Barack Obama are the reason we were stuck with W and his evil administration. Spineless, sniveling, scared, wishy-washy cowards.

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September 2, 2009 2:47 PM in reply to EastWest

Go fuck yourself troll.

You're just a GOP apologists who has been infecting this board with bullshit,
over the past year or so pretending you're a progressive.

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plan69

September 2, 2009 3:07 PM in reply to Acewrap

Um...nothing has HAPPENED yet. No bill has been signed. If you had the minimum of an elementary grade school knowledge of the legislative process, you'd realize it's too early to give up .

September 2, 2009 1:03 PM

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Doofus

"That means that Obama will, again, not be insisting on a public option--a development (or a non-development) that's sure to give his progressive base some heartburn."

No problem, Barack. I hope that you enjoy the huge -- and unnecessary -- loss of Dem seats that will almost certainly occur in the upcoming mid-terms because of your equivocation, fecklessness, and triangulation on this critical issue. This is what happens when you stiff your base, the people who after all got you elected.

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September 2, 2009 1:08 PM in reply to Doofus

Another troll heard from. What's the matter trolls, you got tired of lurking under the rocks you crawled out from under?

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EastWest

September 2, 2009 1:15 PM in reply to lousgirl84

Don't be an ass, Lousqirl. Doofus is telling it like it is. Obama is selling out. He got elected by convincing chumps like you that he is something different. He isn't. He's just another spineless, gutless, nutless Democan't.

The only trolls around here are those who think Obama really meant that "Change We Can Believe In" nonsense.

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Rich in NJ

September 2, 2009 1:18 PM in reply to lousgirl84

lousgirl8

How important is a public option to you?

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gharlane

September 3, 2009 12:22 AM in reply to lousgirl84

Just to clarify definitions, to lousgirl84, a "troll" is someone with an opposing viewpoint. It does make the world so much less complicated that way.

September 2, 2009 1:12 PM

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Doofus

What's your definition of "troll"? Because you've got the wrong person. I've been posting here as a progressive Dem for several years now. You?

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gharlane

September 3, 2009 12:25 AM in reply to Doofus

You do not understand, Grasshopper. As I noted above, a "troll" to lousgirl84 is someone with an opposing viewpoint. Nothing else matters.

September 2, 2009 1:24 PM

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DurianJoe

If Obama does not insist on a public option, he has lost my vote in 2012. Guaranteed.

Let's hope this report is erroneous.

The Commenter Formerly Known as NCSteve

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September 2, 2009 2:42 PM in reply to DurianJoe

Even if it turned out the plan works great without it?

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Philv

September 2, 2009 3:27 PM in reply to The Commenter Formerly Known as NCSteve

I think you're barking up the wrong tree, Durian would seem to me to be a "process" person, that is how we do something is the most important, whereas you would seem to be a "results" person, that is whatever gets the best results is the way to go. Process people don't like half a loaf and see some things as inviolate (for HCR, it's the public option) and it's better to have nothing than to set aside whatever the inviolate thing is. Results people tend to first try to figure out what is possible and go from there and prefer half a loaf to no loaf at all. Both types are absolutely essential for an effective party, but they tend to not get along so well...

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gharlane

September 3, 2009 12:11 AM in reply to The Commenter Formerly Known as NCSteve

Even if it turned out the plan works great without it?

Please explain how that would occur.

Tell you what, NCSteve: Here's my bill. It's very short. Simple. Easy to explain. Every American citizen must purchase health insurance from a private insurance company. There. Done. End of bill. It's the mandate without the regulations and of course without a public option. Sure it's not perfect -- no cost control measures (except those realized by broadening the risk pool, although no guarantees that those cost controls will be passed along to consumers), no regulations on insurers, no restrictions on denying coverage due to pre-existing conditions, no restrictions on post-claim underwriting or rescission, but hey, you know, we are broadening the risk pool, and that should, theoretically, bring down costs, right?

Maybe we'll throw in a subsidy to help people afford it. And they'll need it, of course. Pretty much a direct infusion of cash, right in the vein, from the taxpayers to Big Insurance.

Call it "Health Care Reform", declare victory and go home.

Close enough for government work. Not perfect, but it's something we can call reform. Certainly the health insurers will call it reform.

Oh, you don't like that bill, you say? Pray tell, why not? After all, we's gotta take what we can get, right? In five or ten or fifteen years we can revisit the issue.

And if you tell me you don't like the bill, that it's unacceptable, that it's not enough -- well, then, your position is really no different than those Ideological Purists among the Democratic Left you so love to mock and vilify. It's just a matter of where you draw the line between acceptable and not.

September 2, 2009 1:25 PM

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Fighting Bill

Progressives (myself included) are just going to have to endure this process as it continues to play out. Who is the audience for such a speech? It's not us, GET IT? I've been saying this for a long time now: Obama's strategy is reality-based; he has to finesse the Senate, and, until now, he has had to defend policy proposals that don't really exist yet. I happen to believe that everything the White House has done since the spring has been calculated to result in the most progressive bill possible. Publicly saying things that warm the hearts of progressives, such as trashing Grassley and the rest of the fools in the Republican Party, or insisting in every public utterance that the "public option" (which, after all, can mean a lot of things) is essential to any bill, these things would have made us feel good in the moment but would not have served his long-terms goals one bit--quite the contrary. Yes, he has taken a hit in public opinion, which is what happens to any President when they are defending a bill that hasn't been written yet, but he has also maneuvered the Republicans into a position where they stand for literally nothing except the unworkable status quo. He also has now given Blue Dogs the cover they needed to reluctantly support him as needed. Don't expect him to call out ANYONE publicly, but rest assured that behind the scenes there is and will continue to be enormous pressure exerted on individual Democrats, whose futures will be in the balance.

An Obama White House, like an Obama Campaign machine, is not stupid, blind or passive. They are playing the hand the way they analyzed things way back at the beginning of the summer, and I, for one, see how this could work out very well for us and for all Democrats.

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wbgonne

September 2, 2009 1:41 PM in reply to Fighting Bill

"Who is the audience for such a speech? It's not us, GET IT?"

That is PRECISELY THE PROBLEM. Obama is trying to triangulate and seems willing to betray the progressives who nomnated and elected him. It is past time he started talking to us!

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happycozy

September 2, 2009 2:05 PM in reply to wbgonne

Sorry to bust your little pot-induced bubble, but there aren't enough progressives in this country to get Obama elected. He had to appeal to other people. I know--it's a shock that other people live in this country besides progressives.

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wbgonne

September 2, 2009 2:20 PM in reply to happycozy

It isn't a shock to me that there are Americans who aren't progressives. What seems to be a shock to many others is that progressives exist and matter. There are many more progressives than there were 10 or 20 years ago. The Democrats appear incapable of updating their thinking. The conservative revolution is over and the progressive counter-revolution has begun (with or without the Democratic party). Agreed that many people don't want to participate in any revolutions but that is how it always is. Nevertheless, it is the revolutionaries that make things happen. While there may not be enough progressives to alone elect Obama, there are enough to un-elect him. And the Democratic party will suffer greatly if it abandons the public option and thereby adandons progressives.

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Fighting Bill

September 2, 2009 2:10 PM in reply to wbgonne

Did you even read what I wrote before you responded?

He needs to convince those who need convincing, not those (like you) who already want the public option.

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wbgonne

September 2, 2009 2:24 PM in reply to Fighting Bill

Honestly, I didn't read your entire post and I apologize for that. However, now that I have, I have a question for you? Do you think a public option is essential? And do you think Pres Obama should say whether he thinks it is essential? If not, why not?

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Fighting Bill

September 2, 2009 2:59 PM in reply to wbgonne

Yes, I think the public option in a good form is essential and I think as difficult as it will be given the shaky Democratic caucus, there will be no better time than now to get it, for the forseeable future. It comes down, then, to who does Obama need to convince, and how to go about doing it. He has chosen to hold back to some degree, as he did many times in the campaign, and his patience served him very, very well back then. Everyone yelled at him then too. I think he will pick the time, place and method of getting behind something progressives will be happy to support--but it will most certainly NOT be timed for OUR benefit. He is goal-oriented and has demonstrated on many occasions that he doesn't grandstand for the momentary applause and adulation.

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wbgonne

September 2, 2009 3:59 PM in reply to Fighting Bill

If you are right -- and I sincerely hope you are -- then I will be perfectly content notwithstanding the present consternation. And I also agree that, over the course of the campaign, Obama proved himself a master tactician. There were times when I thought he was letting Hillary and later McCain walk all over him, only to see him bounce back stronger than before. To be perfectly honest, I have doubts about him right now based upon how he's governed since the election. Believe me: I don't care HOW we get a public option as long as we get it. Obama can proselytize Rush Limbaugh if he wants to as long as it happens. And if it does, I will tip my cap and re-double my commitment. But if Obama doesn't even fight or a public option -- really fight, not some mealy-mouthed, gee, I'd like to see the public option but, you know, life is tough BS, well that is a different story. The chess game is over. Checkmate.

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Xantar

September 2, 2009 1:54 PM in reply to Fighting Bill

Why? So that we can feel better? We're already in favor of comprehensive health care reform, and he knows it. What would be the point in talking to us other than buttering us up and making us feel important? I for one am more interested in Obama trying to convince Middle America because that's how anything actually gets done.

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Xantar

September 2, 2009 1:55 PM in reply to Xantar

Whoops. Meant to write that as a reply to wbgonne

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wbgonne

September 2, 2009 2:05 PM in reply to Xantar

First thing first. Announce the requisite parameters of the HCR legislation. Only then can the bill be sold to anybody, progressives and Middle America included. Once Obama declares for the public option I couldn't care less how he sells it. He's really good at that stuff so I wouldn't presume to advise him anyhow. Middle America WILL support a public option IF Obama explains why it is crucial, which it absolutely is.

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Xantar

September 2, 2009 2:34 PM in reply to wbgonne

Ok, but I ask again: why does he need to "talk to us"?

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wbgonne

September 2, 2009 2:37 PM in reply to Xantar

OK. It seems we agree. That's good.

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trblmkr

September 2, 2009 2:37 PM in reply to Fighting Bill

OK. But whatever does pass has to include something that is strong enough(opponents will try to undermine/sabotage it) and large enough (member population) to be a real bain to the private insurers, eventually forcing them out of business.
The 'profit motive' is a preexisting condition that needs to be excised. That won't happen with a voluntary private co-op with 1 or 2 million memebers.

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September 2, 2009 3:39 PM in reply to Fighting Bill

I don't think the goal is as progressive a bill as possible. I think the goal is to cover everyone and put very serious cost containment strategies onto place so we can actually afford it now and well into the long-term. Most progressives have no idea what those strategies are or should be. Not because they are stupid, but they don't care. They have fixated on the "public option" as the cure-all even as Medicare stand as a monument to the shortsightedness of that proposition, and ignored the importance of delivery system reform.

Here's a quick quiz: name a state that effectively used the *threat* of a public option to control cost growth in markets with no competition among insurers without having to actually to put the plan in place. How can you run around making claims about the sine qua non for a public option when you don't even know how this works in real life.

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wbgonne

September 2, 2009 4:02 PM in reply to Economides

Ah, the reassuring voice of the health care industrial complex.

September 2, 2009 1:28 PM

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MyMy

Both the AP and Politico are untrustworthy. I do know Obama has played the left, but perhaps not quite as we think. I have the feeling that he keeps dodging on the PO to keep the left engaged and contacting Congress. Maybe I'm wrong, but we can dream, can't we?

September 2, 2009 1:43 PM

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JadeZ

no public option means the end of Obama.

but I have predicted this long ago.
(still hope I am wrong)

not only will Obama lose for good the real progressives and most of the independants, but the battle cry of the republicans will be "we brought down Obama".

so, the rest of his 3 years will see more weakness and cave ins from Obama as even the dems wont support him.

expect total cave ins on the middle east and escalation of war to resemble Vietnam.

Obama has sealed his doom and the democratic party as well will now self-implode.
you think black and latino voters will now support the dems?

so, there it is.

the end.

p.s.....if you think this story cant be trusted, where are the denials

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September 2, 2009 3:50 PM in reply to JadeZ

To quote Barney Frank: what planet are you living on.

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gharlane

September 3, 2009 12:40 AM in reply to Economides

Earth.

Allow Bob Cesca to explain it to you:

But tossed into the mix ... is the necessity for individual and employer mandates which, like car insurance, would require everyone to buy health insurance. Simply put, mandates will spread out the risk and help to control costs by making sure everyone can pay for medical treatment. ...
[W]ithout the public option, such mandates would be nothing less than an ongoing financial endorsement of corporate crime....

Without a public plan, mandates would transform what would otherwise be a landmark reform bill into a massive and perpetual handout to the healthcare industry. You and I would have no choice but to pay a monthly tribute to the worthless bastards at UnitedHealth, CIGNA, Aetna and Blue Cross every month until we died, went broke or reached the age of 65.

Put another way: either we're forced to financially support an industry that has knowingly allowed thousands of Americans to die by denying them healthcare when they need it most, or we operate without a safety net while also paying a hefty annual penalty to the federal government. Nice. I'm not sure which is more punitive. A solid public option, on the other hand, solves this wicked catch-22. It will allow many of us to both purchase affordable, portable and reliable health insurance, while also serving as an expression of our disgust with the Mafioso-style business practices of the private insurers.

The former scenario -- the mandates but no public option scenario -- is practically unthinkable (with or without Senator Kennedy's name). Wrapping my conscience around a being legally forced to buy private health insurance, regardless of new regulations and knowing everything I know about how the private insurance industry has operated all these years, would be almost impossible for me. I honestly don't know what I'd do. In a political sense, the president and the Democratic Party will have succeeded in authoring and passing a bill that would boil down to nothing less than a massive, almost unprecedented subsidy to the private health insurance oligarchy.

And we'd have no way out. In fact, you and I would've spent years of our lives mobilizing and activating for healthcare reform only to wind up with a bill that sanctions us to subsidize the very enemy we've been fighting all this time. Senator Kennedy would've spent his career fighting for what will have devolved into an enormous corporate giveaway disguised as "universal healthcare."

That's what a sucky bill looks like.

Clear now?

Shorter Bob Cesca: Individual mandates - public plan = revolt.

September 2, 2009 1:43 PM

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plan69

The last time I heard him speak, which was the OFA online/telephone town hall 2 weeks ago, he said there must be a public option and unless he says specifically otherwise I have no reason to not believe him. Maybe we should wait until we hear what he actually says before we freak the fuck out? My CT is that the AP and Politico reports are being thrown out there to get Dems to fight amongst themselves. Divide and Conquer......

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happycozy

September 2, 2009 2:20 PM in reply to plan69

I've decided to take a break from progressive sites for a day or so because I know people are going to lose their minds over this Politico piece.

It's like the movie Ground Hog Day. Someone writes an article with tons of anonymous sources about how the Admin is abandoning the public option. The progressive blogosphere goes apeshit. The Admins comes out and says nothing has changed. The progressive blogosphere calms down and finds some other shiny object to fixate on. Then someone writes an article with tons of anonymous sources about how the Admin is abandoning the public option, and we start the whole process over again.

It's exhausting, and I need to get a fucking life.

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Philv

September 2, 2009 3:39 PM in reply to happycozy

Rinse and repeat with every issue, this isn't going to end with HCR, we're going to see it again and again over the next 7 years. What's the next "public option" line in the sand going to be?

September 2, 2009 1:54 PM

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Mateo123

He's fast becoming irrelevant to the debate. The House should demand a public option and the Senate should see whether it has 50 votes to pass the HELP bill. The two should then be reconciled and Harry Reid would be able to move on.

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Philv

September 2, 2009 3:29 PM in reply to Mateo123

And if there aren't 50 votes in the Senate (or really, 60, in your scenario since you need to overcome a fillibuster), then what?

September 2, 2009 1:56 PM

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MNPundit

Huh. How about that.

Well what can I to him except FU? Really there is no conversation possible.

September 2, 2009 1:56 PM

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synchronicity

If this is true, I'd rather he said nothing.

September 2, 2009 2:18 PM

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rb6

Maybe Obama should outline what his alternative plan for bending the cost curve is because mandated private insurance won't do anything. In this matter, at least, I don't really think he understands how the pieces fit together. If insurers could reduce costs, they would. I'm not being pie in the sky: insurers know that rising costs ultimately affect their bottom line because it makes their whole market contract.

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September 2, 2009 3:48 PM in reply to rb6

If food prices go up, why don't you blame the grocery store first? Just because you pay the insurance company, and they also do a lot of nasty shit like rescission, does not mean they are the ones driving up costs.

Prices are going up for private insurers and for government insurers.

Private insurers pay for about 37% of health care in this country. Government pays for close to 50% and we pay roughly 12% out of our pockets. Yet the whole issue is private payments?

There are more and less expensive hospital in this country. MAyo Clinic provides the same quality care for Medicare patients as UCLA medical Center for far lower costs. Why? What does that have to do with insurance companies? What will the public plan do to change the situation that Medicare hasn;'t or could not?

The one area where private payers raise prices for reasons totally unrelated to their costs is when they lose reserves because of steep declines in the market.

September 2, 2009 2:24 PM

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kfreed

Here we go again... somebody somewhere said something about Obama wanting to make a speech about something having to do with health care reform... which, in Newspeak, translates to "no public option" and the crowd goes wild... again. TPM, may I say that you are truly sucking. Quoting "Politico" is really scraping the bottom and this wouldn't be the first time you've thrown Obama under the bus for no reason. Do you not get that you are undermining your own "progressivism"? Is there NOT an actual News outlet left in this entire friggin' country?????????????????

September 2, 2009 3:35 PM

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annieratna

real progressives will not abandon obama over this. sorry. down with hmo's monopoly over america's health

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wbgonne

September 2, 2009 4:00 PM in reply to annieratna

This real progressive will.