Report: White House Drafting its Own Health Care Bill

jet

September 4, 2009 4:29 PM

This White House has gone completely tone deaf... it's unbelievable.

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DA in LA

September 4, 2009 4:32 PM

Thanks for getting around to coming up with your own plan. I would have done that in January, but what do I know?

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TaraV

September 4, 2009 5:17 PM in reply to DA in LA

Writing their own legislation is what the Clinton WH did and that was criticized. So the Obama team gave Congress the authority and that hasn't worked out either. Damned if you, damned if you don't.

There is no magic way to fight very powerful, entrenched corporate interests and their hacks on the Hill. This was never going to be easy and who wrote the legislation is only a small piece of it.

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mcc

September 4, 2009 6:06 PM in reply to TaraV

Damned if you do, damned if you don't

It seems like there are downsides to both options. However it also seems like suffering the long, slow attrition of an involved legislative process, THEN swooping in and expecting all that work to be replaced with your own bill after that process is almost completely done (seriously, what really remains of the conference process except stepping past Finance?)... that sounds like the worst of all possible worlds. I find it hard to imagine how this strategy change is any kind of improvement.

Another thing. Up until now the Obama administration's stance on the public option has been annoyingly wishy-washy, but to my mind reasonable: They say they support the public option, but they do not consider it a prerequisite for bill passage. I have found this defensible, since the White House doesn't write the bill and as such the most they can do is ask Congress to write in a public option-- the idea the White House could veto this particular bill has never seemed very credible. But if the Obama administration actually does write a bill? Then they alone will be responsible for that bill's text, and they will no longer be able to claim to "support" any particular legislative feature that isn't in the bill they wrote. It seems like they cannot write a bill without specifically taking sides against at least one wing of the party.

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Frex

September 4, 2009 6:19 PM in reply to TaraV

Tara, the problem with the Clinton proposal wasn't that he proposed legislation, it was that he made a proposal that had a snowballs chance in Hades of passing. So correcting Clinton's mistake isn't proposing nothing, it is proposing legislation that sets the framework for what's finally passed. Congress still needs to have input and go through the sausage making.

This WH says it has learned from the mistakes of its predecessors but the problem is that they learn the wrong lessons. This fractured flicker administration is just the kind of incompetent louts that convinced Saint Teddy of Hyannis, God bless his soul, to run against the peanut farmer.

Now let's see what they propose.

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agio

September 4, 2009 4:34 PM

I'm going to hold off lambasting this move until I see what they are coming up with.

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EastWest

September 4, 2009 4:53 PM in reply to agio

"...what they are coming up with."

Nothing. Nada. Zip. Zilch. Zero. Bupkis.

And the Dems are gonna get their asses handed to them in 2010.

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Stroszek

September 4, 2009 4:35 PM

I hate it.

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Jim H

September 4, 2009 4:36 PM

If there's a trigger, it needs to be something that can go off soon and almost sure to actually go off. Like, insurance companies need to hold premiums and benefits stable for 5 years (to make up for sky-rocketing rates the past several years). One increase - BAM! Public Option.

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HopefulPatriot

September 4, 2009 7:54 PM in reply to Jim H

Actually--I would not object to that.

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rj

September 4, 2009 11:09 PM in reply to HopefulPatriot

Yeah...as somebody who's written, called, emailed, signed petitions about the public option relentlessly but really is worried that there won't be the votes in the Senate, I've wondered whether the one conceivable type of "trigger" that MIGHT (only might) work could be one that: 1) is forever -- ie, the threat never goes away for the insurers; 2) is simply a buy-in to Medicare -- making real the ability to pull the trigger instantaneously rather than build an entity from scratch (with a higher payout to providers than for seniors, to address that issue); and 3) is closer to a hair-trigger than has been discussed -- ie, insurers must show real progress within, say, 3 months, with targets every quarter culminating in some definition of optimum within a year (or whatever minimum seems feasible). Really tough, with firm goals that would truly match what reform is meant to achieve.

I still don't like it, mostly because it's hard to see how the regulations could be made sufficiently firm and leakproof that they couldn't be gamed, especially in a future (FSM forbid) GOP administration. But I'd be curious to hear any actual substantive thoughts on this...and yeah, Jim H may be onto something, too.

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Economides

September 4, 2009 4:37 PM

Why is a public option that implements after a trigger incapable of being robust? Where by robust I assume we mean how many people it is available to, how much negotiating power it has, and how it sets payments, and how generous the benefits are. In fact, it's possible it could be even more robust since those who want a trigger are implicitly accepting it may be necessary.

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rj

September 4, 2009 11:33 PM in reply to Economides

To me the main problem is designing a trigger that absolutely can't be gamed by the insurers -- clearly defining tough standards for them to meet, and a no-wiggle-room point (in time and results) for the trigger to be pulled. And then having designed it, to keep the same "centrists" who've blocked the public option (which offers cost control and choice: the moderate ideal) from blocking the trigger as well, or weakening it so it's almost meaningless. But see my comment above (and Jim H's) for thoughts...bottom line, I'm skeptical that it's possible in practice. But in fact, since reform wouldn't fully kick until 2013 anyway, I'd be willing to have a firm, tough trigger waiting to kick in on that date. Emphasis on "firm" and "tough"...dunno...

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rj

September 4, 2009 11:41 PM in reply to rj

Ooops, make that *might* be willing...

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Indie Pro

September 4, 2009 4:40 PM

From campaigning against a mandate, when Hillary offered it.

From constantly proclaiming, cost reduction is a vital part of reform.

I sincerely hope, if this post is true, that Obama's plan includes robust cost reduction to attach to the mandates.

With different committees all ready working to lower the subsidy, cost saving measures are vital to legislation.

If we don't have strong cost saving measures(like the public option brings), and we force middle america (the ones all ready uninsured, mainly because they can't afford it) to buy from the insurance industry, it won't matter who the democratic party runs, this reform kill the party.

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Texar

September 4, 2009 4:49 PM

Saw this on Kos -- a trigger we can all get behind:

"If Obama fails to get a meaningful health care bill passed, then my support for a primary challenger will automatically trigger in 2012."

Change even the President can understand.

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Stroszek

September 4, 2009 4:51 PM in reply to Texar

I'm sure Kucinich will be able to pull it off this time.

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agio

September 4, 2009 4:53 PM in reply to Texar

It depends on HOW he fails. If he goes all in for a public option and it gets shot down by the Ben Nelsons of the world, I'll still support him.

If he goes milquetoast and signs a piece of shit bill that does little to reign in actual costs, trigger away.

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jeffgee

September 4, 2009 4:51 PM

Unless it's some rope-a-dope tactic, it doesn't help when anonymous WH people leak that Obama's desperate for any deal he can get.

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John Shreffler

September 4, 2009 4:54 PM

If we don't get a public option, then by all means let's drop the individual mandate, which is a bonanza for the Health Insurers and will leave the individual insured completley at their mercy, and rather focus in on regulating them, which will make them bleed while helping everyone else.

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jpearson

September 4, 2009 5:02 PM

What am I missing here? Instead of a public option, why not just let those who would qualify for a public option buy into Medicare? It's not "Medicare for All," those choosing it would still have to pay premiums (but lower than on the private market), and there would be no need for a new (scary!) government bureaucracy. In fact, it's a program that has already proven to be both very popular and very effective.

Why isn't anyone suggesting this? As far as I'm concerned, it's actually better than a public option because the infrastructure is already there and because we wouldn't have to worry about a public option that turns out to be emasculated by not being allowed to negotiate low enough rates.

It also seems like a much easier sell to those who still need to be convinced -- i.e., feeble minded Democratic congresscritters and the public. (Not to the Rethuglicans, of course, who don't want ANY reform...but they are irrelevant at this point.)

So, again, why isn't anyone proposing this?

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Indie Pro

September 4, 2009 5:04 PM in reply to jpearson

my guess is, the lobby, the industry, would rather have the bill, as it is, without a public option, or any other significant cost controls.

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steady

September 5, 2009 11:58 AM in reply to jpearson

I completely agree, this seems almost a no-brainer. My Dad went through 4 months of tests, hospitalization, etc. this past spring/summer before he died in July. The stress of that would have become unbearable if it had been exacerbated by worry over bills. Medicare was a DREAM. Ask any senior, they are thrilled with it. In one swoop, the Deather argument is wiped out once you say the word Medicare.

I am hoping that the Obama has come to his senses and will state unequivocally on Wed night that we have engaged in a "dialogue" and screaming doesn't work, so i will now jam a reasonable plan down the naysayers throats for the good of the citizens and the future of our economy. The right obviously is not interested in compromise, so don't give them any. We have the majority, USE IT.

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IndyEllen

September 4, 2009 5:10 PM

If Snowe is involved in President Obama's proposed plan, how "robust" could it possibly be?

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theone718

September 4, 2009 5:22 PM

This is what I don't get. Why does he find the path of convincing 80 some odd members to vote for something BAD easier than convincing what 4 or 5 senators to vote for cloture on something GOOD.

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Philv

September 4, 2009 6:30 PM in reply to theone718

You're assuming that it's equally difficult (or easy) to convince one person on each side. The 80 odd members care passionately about this issue, the four or five don't. The 80 odd members are used to operating in an environment that is more conducive to making people fall into line, the four or five are used to doing whatever they please with no consequences.

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tosh

September 4, 2009 5:38 PM

We're utterly fucked.

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matyra

September 4, 2009 5:45 PM

with what, crayons? I'm getting sick of these kid gloves that the WH is trying to box with.

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Gooner

September 4, 2009 5:50 PM

I'm going to give Obama a chance to make this happen.

Like everyone else here, I want Obama to ensure a good public option and heavy regulations, but I recognize he is fighting against interests that can and will spend far more money than all of his supporters did in getting him elected.

I'm not giving him a pass, but I trust the man and I hope he'll do well by us.

I remember the first 31 years of my life (and was reminded by Rachel Maddow of the 70 years which preceded it) during which no real health care reform was done. I'm no fan of Edmund Burke, but things take time, and I want to give my guy some of that time to make it happen.

If the legislation is bad, then we can disapprove. Until then, I'm trusting the man I elected.

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Frex

September 4, 2009 6:09 PM

It's about time.

The problem with the Clinton plan wasn't that he presented a plan, but that it was unintelligible and was zinged to death. Yes, having a proposal gives your opponents something to criticize, but is also gives your supporters something to support and probably more importantly something for Congressional reform proponents to rally around rather wheeling and dealing of the corrupt committee chairmen.

To the guillotine with the Gang of Six!!

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drmoore

September 4, 2009 6:10 PM

Check this out. VERY relevant. It was a Minnesota Public Radio Sept 3 Midday Program with T.R. Reid. Very good insights, especially comparing us (US) to them (other countries). One of the most interesting points is the opinion of how the US has more socialized medicine (Medicare) than the other countries with national health plans (run by private companies). Also, MRI in US, $1500, MRI in Japan $98. Check it out.

http://minnesota.publicradio.org/display/web/2009/09/03/midday1/

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Viva!America!

September 4, 2009 6:33 PM

Why is anyone upset about the WH writing it's own bill? And yes, I see that TPM said presumably they are working on the uncertain plan together that will presumably lack a robust public option. Notice how many times this article screams "I'm Guessing Here" and still some of you act like the words came straight from Obama's mouth.

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Mathew Johnson - Harlem

September 4, 2009 6:46 PM

I wish the Democrats and Obama would really stand up for what they believe in and what Obama campaigned on; A public option. Not a watered down "trigger" public option. I am so sick and tired of Obama trying to get one Snowe vote and bending over backwards to placate Republicans. Fight and set the agenda Obama. I'm fearing I voted for hope I could believe in and have gotten hope I can't believe in. Hope that gets sold out to the industry big wigs that visited Obama. I will wait to see what he says in his speech. After that if there is no public option this life long Dem will leave the democratic party as they are too weak to fight for what's right and no longer represent my view. If they can't fight for health care then what will they fight for?

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Mathew Johnson - Harlem

September 4, 2009 6:46 PM

I wish the Democrats and Obama would really stand up for what they believe in and what Obama campaigned on; A public option. Not a watered down "trigger" public option. I am so sick and tired of Obama trying to get one Snowe vote and bending over backwards to placate Republicans. Fight and set the agenda Obama. I'm fearing I voted for hope I could believe in and have gotten hope I can't believe in. Hope that gets sold out to the industry big wigs that visited Obama. I will wait to see what he says in his speech. After that if there is no public option this life long Dem will leave the democratic party as they are too weak to fight for what's right and no longer represent my view. If they can't fight for health care then what will they fight for?

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Philv

September 4, 2009 7:13 PM in reply to Mathew Johnson - Harlem

This might interest you:

http://firstread.msnbc.msn.com/archive/2009/09/04/2053400.aspx

He didn't campaign on a public option. I'm sure that won't make you feel any better, but it's the truth.

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Mathew Johnson - Harlem

September 4, 2009 7:45 PM in reply to Philv

Actually in Albuquerque NM on August 18, 2008 he gave his thoughts on health care which included a new marketplace with a new government-run plan, like Medicare, to compete against the private plans. He spoke about this plan during a round table meeting on equal pay for women. Also since being president he has campaigned on the public option on more than one occasion and then backed off the plan. Again, he needs to fight for what he believes in and set the agenda and stop giving in to the ideal of bipartisan-ship with republicans that won't support health care reform. From the Wall Street Journal 8/19/08

"Obama’s health-care plan aims for universal coverage by offering a new government-run marketplace where Americans could buy insurance, mostly from private plans. He would offer subsidies to individuals and to small business owners that offer their workers coverage. His plan also would require that parents get insurance for their kids. And he aims to lower health-care costs to make coverage more affordable. His plan includes one small step toward single payer. His new marketplace would create a new government-run plan, like Medicare, to compete against the private plans."

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