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Progressives Begin to Wobble on Public Option Commitment

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At least four signatories to a July letter drawing a line in the sand over a public option have suggested that they may be willing to support a compromise proposal to "trigger" a public option only as a fallback if other reforms don't produce results on their own.

"Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates...is unacceptable," the letter read. "We simply cannot vote for such a proposal."

Among the signatories were Reps. Mike Capuano (D-MA) Jim McGovern (D-MA), Bill Pascrell (D-NJ), and Sam Farr (D-CA), who now say that definitions of "public option" may vary.

"That's why we used words like 'robust' -- because it's in the eye of the beholder," Capuano told Roll Call. "We'll make our independent judgments."

"It depends on how strong that trigger is," Farr added. "The only way I could see it getting progressive votes is by making sure the public option is strong and goes into operation."

"This is a way to get a bill," Pascrell said of triggers. "I believe it's worth listening to because I want legislation that is going to, in some shape or form, expand coverage and bring down the cost of health care."

And McGovern noted "there may be a variety of ways of getting there than the one I originally formulated in my mind."

Four votes out of about sixty signatories isn't a ton--but it's not nothing either, especially as the trigger mechanism compromise seems to be gaining traction in the White House and Senate. McGovern is a pretty big hitter, for instance, and one House Democratic aide tells me his position "is where a lot of people are."

The shakiness, such as it is, comes at a time when Blue Dog Democrats are voicing stronger objections to House legislation than they were earlier this summer. Rep. Mike Ross (D-AR), leader of the Blue Dog's health care task force, has gone on the record with constituents saying he'll oppose any bill with a public option, and The Hill reports that up to 23 House Blue Dogs are suggesting they'll oppose the bill from the right.

Why would progressives wobble? There are a number of explanations. Perhaps chief among them is the fact that party leaders believe failure to pass a bill would be a political disaster--and that, hailing from safe districts, progressives can afford to vote against their constituents more easily than Blue Dogs can. Separately, many, like Capuano, believe that a half-loaf is better than no loaf at all--that spending hundreds of billions of dollars to expand health care access to the poor and uninsured, even in an inefficient way that redounds to the benefit of health insurers, is a step in the right direction.

That said, some key progressives--notably Rep. Jan Schakowsky (D-IL), who heads the Congressional Progressive Caucus' health care task force--still say they can't vote for a bill unless it creates a public option with no triggers. If House leaders decide that compromising further on the public option is the way to go, they'll have to chip away significantly at the progressive bloc. Assuming no GOP support, Democrats can only afford to lose 38 votes within their caucus, which means they'll need a lot more than four defectors to get a bill through.

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September 8, 2009 12:36 PM   

It is apparent that some Democrats are willing to throw those who can not afford insurance under the bus to give the President a win.

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September 8, 2009 12:45 PM    in reply to Indie Pro

let's be clear:

"that spending hundreds of billions of dollars to expand health care access to the poor and uninsured, even in an inefficient way that redounds to the benefit of health insurers, is a step in the right direction."

and still not cover the costs for many, forcing those who can not afford insurance to find a way to afford it anyway, as the costs continue to rise!!

Not everyone has money in their budgets for this. They'll have no one to blame but the Demcorats.

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September 8, 2009 1:54 PM    in reply to Indie Pro

Without a public option, any effort at health care reform will be as meaningful as a manicure for a gunshot victim. "The public option is the main thing on the table," says Michael Behan, an aide to Sen. Bernie Sanders of Vermont. "It's really coming down to that."

http://www.rollingstone.com/politics/story/29988909/sick_and_wrong/2

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September 8, 2009 12:38 PM   

And the list will keep growing.

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September 8, 2009 12:40 PM   

This is what you call "an emerging consensus."

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September 8, 2009 1:18 PM    in reply to Stroszek

Bingo. I think House liberals are coming to terms with the human consequences of their "public-option-or-bust" postion, and find it untenable. The other provisions in the bill -- the minimum benefits package, the subsidies, the community rating ratio, the Exchange, and the employer mandate -- are all far, far more important than whether or not the Exchange includes a public option.

I'm much more comfortable with the policy than the politics, but I know that at the end of the day, this bill's political debate will be determined by whether or not the investment was worth the benefits. The less the bill costs, the greater portion people who don't get employer-based health insurance will be have to spend out of their own pocket on health care. If this portion is too high, then there will be political backlash.

Which is why I feel that whatever your position on the public option -- for or against -- it shouldn't be a make-or-break issue. The provisions that prevent medical bankruptcies should be.

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September 8, 2009 2:14 PM    in reply to jimbomoron

Your logic makes no sense.

It's not OK for a progressive to have a make it or break it position on the public option but it os OK for the Blue Dogs to have the same position and get their way.

Again, it makes no sense.

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September 8, 2009 3:27 PM    in reply to politicjock

I don't agree the inclusion or exclusion of the public option should be a make-or-break issue -- period. I am upset when Mike Ross says he would vote against any bill that had the public option, and I am upset that Lynn Woolsey won't vote for any bill that excludes a public option.

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September 8, 2009 3:30 PM    in reply to politicjock

I see someone with a reading comprehension problem. Please read my last line again:

Which is why I feel that whatever your position on the public option -- for or against -- it shouldn't be a make-or-break issue. The provisions that prevent medical bankruptcies should be.

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September 8, 2009 3:42 PM    in reply to jimbomoron

then keep the provisions that prevent medical bankruptcies

but if the public option is dropped, then the mandates should be dropped.

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September 8, 2009 5:19 PM    in reply to Indie Pro

Then if insurers are required to cover everyone, are prohibited from varying premiums by health status, and you drop the individual mandate, how do you prevent people from waiting until the get sick to sign up for health insurance? How will insurance be affordable if only sick people sign up?

And I don't just want to keep the provisions that prevent medical bankruptcies -- I want to strengthen them. And if that means having to gut the public option, I'm willing to make that trade.

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September 8, 2009 5:35 PM    in reply to jimbomoron

Without a public option, what you are advocating is another massive wealth transfer from the public to the private sector. Same thing of what happened under Bush's Medicare Advantage, only bigger. Also, every serious analyst has agreed that without a public option, there is no way to exercise a downward pressure on costs. The Baucus fees proposal will be passed directly to consumers in the form of higher premiums.

The question is, who in their right mind, would want to subsidize private health insurance CEO multi million dollar bonuses?

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September 8, 2009 12:42 PM   

Triggers are a big copout, and if passed will never materialize. I hope that the progressives in these districts let these guys know starting today how unacceptable triggers are to them. Triggers are like whimpy parents telling their kid for the 10th time that if the kid does something bad one more time there will be consequences. The insurance companies have been abusing us over and over and over for years and congress is saying "one more time" knowing there is no teeth in the threat. We want the teeth of a good public option. We have been battered ENOUGH!

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September 8, 2009 12:51 PM   

Horse manure.

that spending hundreds of billions of dollars to expand health care access to the poor and uninsured, even in an inefficient way that redounds to the benefit of health insurers, is a step in the right direction.

It's another step in the wrong direction.

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September 8, 2009 12:58 PM    in reply to 714Day

absolutely!


who knew that healthcare reform would be a big boon to the insurance industry?!?!?!

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September 8, 2009 1:15 PM    in reply to Indie Pro

now now were not republicans

But I think voting them out is a good plan.

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September 8, 2009 1:04 PM   

Fucking whores. It may be time to point a trigger at them.

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September 8, 2009 1:13 PM    in reply to CranialRectalLoopback

I like this idea. Public option or you're dead.

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September 8, 2009 1:14 PM    in reply to SqueakyRat

Oh, politically, of course. that's what I meant.

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September 8, 2009 1:18 PM    in reply to SqueakyRat

Oh, politically, of course. that's what I meant.

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September 8, 2009 1:11 PM   

I have not heard any thing of the sort from the President or any of the progressive liberals in the House. Mr. Obama has been emphatic in his support for a public option. His speech tomorrow only further solidifies the importance of universal health care. A public option would be nothing short.

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September 8, 2009 1:12 PM   

When this non-reform bill passes, I think the so-called President should make the announcement while standing in front of a private hospital draped with a huge banner that reads, "Mission Accomplished."

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September 8, 2009 1:16 PM    in reply to Winston Smith

hilarious

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September 8, 2009 1:39 PM    in reply to Winston Smith

ABSOLUTELY PERFECT STATED ....

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September 8, 2009 4:09 PM    in reply to Winston Smith

Strong public option
no one representing me
trigger was a horse

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September 8, 2009 1:13 PM   

sigh just when I thought they had some balls.

HOLD THE LINE. fight to the end. let them kill the bill. but dont backdown.

worse before the speech come on man thats immensely weak

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September 8, 2009 1:18 PM   

Another day of hour-by-hour "now you see it, now you don't" public option statement parsing and froth-whipping by Mr. Beutler.

See this post of mine (in particular the final headline): http://tpmcafe.talkingpointsmemo.com/talk/blogs/ttarleton/2009/09/headlines-on-tpmdc.php

"Ferris" Beutler needs a day off!

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September 8, 2009 1:27 PM   

McGovern is my rep. I spoke to his office a few minutes ago. The Congressmen mentioned here, according to an office member, 'are trying to stack the deck so that the public option will take effect' (my words, not hers). I guess I could live with that.

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rwc

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September 8, 2009 2:41 PM    in reply to VictorShaw

I could, too, if the tigger had any real teeth and a chance of being triggered. My guess is it won't on both counts.

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AJM

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September 8, 2009 3:37 PM    in reply to VictorShaw

If MCGovern folds on his commitment to vote against any bill without a public option, what makes you think his commitment to a trigger with teeth will hold?

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September 8, 2009 1:29 PM   

Clueless lemmings.

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September 8, 2009 1:37 PM   

If Pres. Obama folds on his promise that he would not sign any bill not including a PUBLIC OPTION when it reached his desk he may as well pack up and leave. He will have then demonstrated he does not have the spine to stand up and fight ... he allows the Republicans and Corporations to continue to control the White House. First remedy is to get rid of Harry Reid and replace him with a senator that has the ability to create a driving force among the senate that would back the president and his agenda. The CHANGE promised needs to be evident now!

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wyt

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September 8, 2009 1:49 PM    in reply to kmac

The problem isn't read. It's Max Ballkiss. Did you see the NY Times article today that was based on his POV about how now, under pressure of Obama's speech, the Gang of Six will come through? Anything put forward with Grassley's stamp of approval at this point is total poison with the Democratic core. And Ballkiss - with the help of the Times and continued nods from the administration - is still working to sugarcoat that poison.

Not good. Not smart. Not a winning formula.

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September 8, 2009 1:49 PM   

Timing is everything and these comments are very poorly timed. Although, as I think about it a little further, I guess I wouldn't be entirely opposed to a trigger mechanism myself, as long as the trigger was tied to strong insurance industry reform measures and went into effect immediately upon insurance industry malfeasance of any sort (improperly denied claims, denial of coverage, unwarranted price increases, etc.). But I have a feeling that's not what the trigger option will do.

So in the meantime, I hope everyone has signed the HCAN petition to President Obama, which says:

"President Obama, we're counting on you to fight for bold change on health care. We need quality, affordable health care we all can count on, including a strong public health insurance option."

http://healthcareforamericanow.org/page/s/change

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September 8, 2009 1:55 PM   

We must have a public option, NOW....no triggers

I can already hear the republican ad machine saying, "First they wanted to pull the plug on Grandma, now they want to pull the trigger."

With no republican's supporting regardless of any health bill, why the continued appeasement?

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rwc

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September 8, 2009 2:45 PM    in reply to Shanenon

The appeasement is for the corporate dems, who are legion in the Senate and common in the House. My guess is that right now there are 40-45 votes in the Senate for a bill that would really provide a stong public option and really attempt to rein in the insurance industry. As you can see from those numbers, even reconciliation won't fly.

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September 8, 2009 1:58 PM   

As a Democrat, I must say these fellows aren't. They are representatives of the Losers Party.

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September 8, 2009 2:15 PM   

We need more people like Bernie Sanders.

Split the Party.

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September 8, 2009 2:20 PM   

From Daily Kos:

Dem Rep. Raul Grijalva, the co-chair of the Congressional Progressive Caucus, is issuing a strong rebuke to fellow liberals who may be inclined to accept a compromise involving a public option "trigger," saying it would amount to waving a "white flag" and "a surrender."

...Grijalva said that most House progressives would in fact stand firm and still vote against a bill with a trigger:

"The vast majority of CPC is not prepared to wave a white flag on public option. A trigger would be a surrender."

If the "vast majority" of the five dozen or so House progressives did vote against the bill, as Grijalva vows they would, it wouldn’t pass.

Also noteworthy: Grijalva’s description of a trigger as "surrender" leaves liberals no wiggle room to support it. When it comes to the trigger, House progressive leaders are refusing to budge.

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September 8, 2009 2:29 PM   

We've got the majority. We've got the votes. We've got the public support. We just don't have the courage.

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September 8, 2009 2:44 PM   

We got the votes to pass health care with a "robust" public option? Where?

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rwc

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September 8, 2009 2:48 PM    in reply to VivaAmerica!

exactly

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September 8, 2009 2:52 PM    in reply to VivaAmerica!

Drop the public option

but drop the personal mandates as well (these things are tied together)

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September 8, 2009 2:49 PM   

In the Senate. In the House. Maybe not robust, but for God's sake, we've got 60 seats in the Senate and more than enough in the House.

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September 8, 2009 3:11 PM    in reply to traitorjoe

Who is "we"?

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September 8, 2009 3:15 PM    in reply to traitorjoe

You don't even have 50 votes for a PO in the senate. Not even 50.

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AJM

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September 8, 2009 3:41 PM    in reply to impik

You don't have 50% plus one for a bill without PO in the House if the Progressives hold firm. Plus the progressives have the backing of the public on this and the President's number are dropping in part because he looks weak because he keeps backing away from his stated positions.

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September 8, 2009 3:45 PM    in reply to AJM

AJM, agreed, Obama looks weak. But 10 senators have already 100% backed off the public option? They can't be convinced? If that's true we are screwed. And by "we" I mean progressives.

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AJM

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September 8, 2009 3:49 PM    in reply to traitorjoe

So Obama needs to figure out if arm-twisting the progressive from safe districts who are doing what their districts want is easier than arm twising 10 Senators who aren't doing what their states want.(Or would want if someone bothered to set them straight on the facts -- McCaskill took a dive -- just said I hear you.)

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September 8, 2009 2:56 PM   

If the Democrats don't pass a bill with the public option they will pay a steep penalty, as will OBama.

Millions of supporters will desert them by not voting and not king for them in the next election, and losing public option will just give the Republicans more balls to continue their intransigent behavior.

Obama and the Democrats must not allow the Republican minority to stymie them, it simply emboldens them and makes the Dems seem weak.

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September 8, 2009 3:10 PM    in reply to JohnW1141

What is worse is a bad bill that is seen to be strictly a democratic initiative. With the additional regulations on the private insurance, every time the insurance rates go up the new regulations will get the blame. Rightly or wrongly the democrats are going to get the blame for future insurance price increases. If they don't implement strong methods to keep the costs contained they will deservedly get the blame.

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September 8, 2009 3:19 PM   

The Democrats are proving themselves to be one of the absolute worst group of politicians in U.S. history. They are either too incompetent,too corrupt or both to advance the agenda of the people who voted for them. As long as people continue supporting them the Democrats will continue screwing them. Just look at Obama's actions.

Obama, while spitting on his base supporters and breaking campaign promise after campaign promise has certainly taken care of the banking, pharmcutical and insurance industry intersts.

He hasn't found an issue yet where he won't capitulate to the minority GOP. Not even the reagular nitwit GOP, but their lunatic, idiot base who despise him.

He's a perfect example of how little regard the leadership of the Democratic Party has for it's rank and file members.


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September 8, 2009 3:28 PM   

I think that without SOME form of public option, it's not really reform at all. The public option is the most powerful tool to keep the insurance companies in line.

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September 8, 2009 3:42 PM   

IF they are wobbling, then they are NOT progressives.

You could call them PINOs (in name only).

Or, to borrow from a Terry Gilliam movie, you could call them "pathetically ineffectual and pusillanimous pretend friend to people."


And so do we wait another 20 years until Dems regain control of Congress and the White House before we try again, or do we finally start voting Green and pressuring these ninnies to do right or hit the road?

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September 8, 2009 3:54 PM   

I still have a hard time believing we can't get a majority of the House and 51 senators (assuming reconciliation) to vote for a bill with a strong public option. But IF this really does become impossible, what's most critical is that any compromise come with real concessions from the other side, especially on three fronts: 1) subsidies up to four times the poverty line in a way that will make insurance truly affordable; 2) much tougher regulations on insurance companies, not only to prevent the use of preexisting conditions and rescissions but also to stop all the other bullshit they do in denying coverage for treatments authorized by doctors; 3) A trigger that would actually kick in the moment it becomes clear the private sector can't or won't provide affordable, universal, genuine coverage.

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September 8, 2009 5:16 PM    in reply to Moose49

As TPM has reported, reconciliation is no sure thing.

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Ted

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September 8, 2009 3:55 PM   

We already pulled the trigger. We elected Obama. We don't need another trigger. How have the 15 years since Clinton's plan was prevented NOT already pulled any conceivable trigger?

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September 8, 2009 3:58 PM   

No public option, no mandates. Anything else is just a huge government giveaway to the insurance industry.

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September 8, 2009 4:10 PM   

Strong public option
no one representing me
trigger was a horse

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September 8, 2009 4:16 PM   

I'm a MD in Massachusetts, where we have mandatory heath care insurance-everyone must have insurance or incur a fine. What has happened is that people are forced to buy insurance from private companies at high market rates with maybe some government subsidies if poor. When ill or the insurance company feels someone is too expensive, they raise rate, or even more catastrophically, lose their insurance in the middle of treatment of a medical condition. The result is decline, premature death or bankruptcy, or all three. These Democratic measures of mandating citizens to give money to profit-seeking companies will be extremely expensive and in the end, not improve our nation's health. I feel health financing reform without a public option will be a disaster. Public option or nothing! Get angry America, you are being taken for suckers.

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September 8, 2009 4:40 PM    in reply to capeJoe

Dr. capeJoe, if public policy results in the transfer of wealth from the least of us to those who already have the most, then our political system will wholeheartedly support that policy. Therefore, we can rest assured that the final bill will replicate the MA experiment since it has already been proven to work for the corporatocracy.

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September 8, 2009 5:18 PM    in reply to capeJoe

This is not how the system works in Massachusetts:

"When ill or the insurance company feels someone is too expensive, they raise rate, or even more catastrophically, lose their insurance in the middle of treatment of a medical condition."

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September 8, 2009 9:17 PM    in reply to ohiomeister

I disagree. I've seen it happen in some of my patients. I think those who are in employer based groups cannot be dropped, but certainly those who buy as individuals can be dropped at any time and their rates can be changed at any time.

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September 9, 2009 12:04 AM   

Step One: Pass Health Reform with a Public Option Trigger.

Step Two: Tell the yokels you HAVE to vote for us or the Republicans will remove the trigger.

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September 9, 2009 6:28 AM   

Surely these people know the wheels are coming off the health care reform bus. Is Washington really that insulated from the rest of the country?

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