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Reid Confident He Has 60 Votes To Pass Health Care Reform

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Democratic Senators Harry Reid, Chris Dodd and Tom Harkin

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Senate Majority Leader Harry Reid seems confident that he has the 60 votes he'll need to pass health care reform. Asked by a reporter at a press conference moments ago whether his caucus is united to end a filibuster of his bill, Reid joked, "seems like it!"

In order to secure the support of all 58 Democrats, and both independents who caucus with his party, Reid had to make significant concessions to centrists, including eliminating the public option, and tightening the language restricting federal funds from paying for abortion.

He also apparently had to guarantee that the federal government would cover the entire cost of expanding Medicaid in the state of Nebraska--home to Sen. Ben Nelson. Reid insisted today that this Medicaid agreement, contained in the manager's amendment was a "small part" of winning Nelson's support for the legislation, but it's indicative of the sort of political trading that was necessary for Democratic leadership to win unanimous support for the legislation from the caucus.

And it seems to have worked. Reid will need his caucus to stay united for the next several days, and possibly into next month if a health care reform package is to become law. Sen. Olympia Snowe (R-ME) told reporters this afternoon that unless the timeline for passage is lengthened into January, she'll likely support a filibuster of the bill.

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December 19, 2009 11:52 AM   

Hey Snowe! Whatever happened to "when history calls, you have to answer?"

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December 19, 2009 12:28 PM    in reply to margaret

That was a one-time only offer. . .

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December 19, 2009 1:03 PM    in reply to margaret

"Will oppose it because it is being 'rushed'" sounds very much Liebersuckesque, doesn't it?

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December 19, 2009 3:19 PM    in reply to geofu54

Two Rushin' words: Patriot Act.

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December 20, 2009 7:02 PM    in reply to Doc Magnus

Two more: Bank Bailout.

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December 19, 2009 1:39 PM    in reply to margaret

Let's not "rush" to judge the Snowe of Olympia

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December 19, 2009 12:15 PM   

Oh happy day!

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bw

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December 19, 2009 12:15 PM   

The one thing in this health bill that needs to be fixed in conference with the house is the pre-existing condition. As it stands right now only children will be covered starting in 2010, but everyone else are not covered until 2014. This is just plain bullsh_t. We are being forced to pay for health insurance, yet if anyone and most people do, have a pre-existing condition will not be covered and are out of luck to be treated. The other things that need to be adjusted in this bill are any loopholes that insurance companies could use to deny coverage.

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December 19, 2009 12:49 PM    in reply to bw

The one thing in this health bill that needs to be fixed in conference with the house is the pre-existing condition.

The ONE thing? Really?

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December 19, 2009 1:01 PM    in reply to bw

Mandates don't start until 2014 either.

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December 19, 2009 2:57 PM    in reply to converse

But women can start dying from bad pregnancies right now!

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December 19, 2009 3:58 PM    in reply to converse

My premium is going up 10% in January.

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slb

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December 21, 2009 12:30 AM    in reply to JefferyK

The premium for mine only goes up 3%, but along with that increase, the co-pays, deductibles, and out of pocket caps are all going up considerably.

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December 20, 2009 7:04 PM    in reply to converse

This whole bill is like having sex today, but not getting to orgasm until four years from now.

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December 19, 2009 2:06 PM    in reply to bw

You're right on target, this is not for those needing coverage, but for their big money friends in the insurance business. Folks we've been taken for another ride and it sure is at no ones expense, but "We The People".

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December 19, 2009 3:52 PM    in reply to bw

Maybe Obama the genius shouldn't have handicapped Congress by coming up with an arbitrary $900 billion dollar number. The only way to do that is to push it back.

Another idiot move

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December 19, 2009 12:28 PM   

80 / 20 ‘Compromise’: 20 cents of every dollar - that’s 20 cents of every 
100 cents - by law (at least by the Senate ‘compromise’) can be retained by 
private sector insurers to pay their bonuses, lard their bottom line, expand their 
investments, etc. The Senate bill as now written provides that everyone in 
America pay for private sector health care, in short, wasting 20 cents of each 
health care dollar, piddling it off to middlers, who deliver no health care whatsoever, require mind numbing paper work, jerk you around with ‘co-pays’ and 
‘contributions’, etc, but do not ever in any shape or form deliver health care 
services to you. This is what the Senate has brought us. And here’s an added 
insult brought by the White House to everyone who is not a private sector health 
insurance corporate employee: Because both the right and the left think 
citizens should not be mandated by their government to provide corporate 
welfare for private sector health insurance companies with both taxes (paid to 
corporations as ‘subsidies’ to cover the poor who cannot afford to payoff the 
corporations) and premiums (20 percent of which are not used to provide health care services), they have persuaded themselves that independents will 
just love it! That’s a three- bagger: They have insulted virtually everyone. And who are these political masterminds? Like Bush, they were good at getting elected and, like Bush, very good at ignoring the American people.

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December 19, 2009 1:04 PM    in reply to bill

No, 80 percent has to be spent on medical reimbursement. The other 20 percent goes for overhead, etc. You know, insurance companies do need to hire at least a couple of people. And they usually like to have an office or something where they can work.

Please don't get carried away with the hyperbole and scare tactics coming from DK, et al. Most of it just isn't true.

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December 19, 2009 1:53 PM    in reply to converse

JUST the tip of the iceberg of the 'etc.':

CEO 2007 Compensation

* Aetna Ronald A. Williams: $23,045,834
* Cigna H. Edward Hanway: $25,839,777
* Coventry Dale B. Wolf : $14,869,823
* Health Net Jay M. Gellert: $3,686,230
* Humana Michael McCallister: $10,312,557
* U.Health Grp Stephen J. Hemsley: $13,164,529
* WellPoint Angela Braly (2007): $9,094,271
L. Glasscock (2006): $23,886,169
link

Not one of them saw one patient, diagnosed one illness, prescribed one medication or spent one minute comforting someone who was sick or debilitated.

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December 19, 2009 2:55 PM    in reply to NobleCommentDecider

BASTARDS!!!!!!

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December 19, 2009 5:27 PM    in reply to El Camino

They killed Kenny! (He had a pre-existing condition.)

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December 19, 2009 3:11 PM    in reply to converse

Seriously. Guys, take a deep breath and think about this. The fact that the 80:20 ratio is even in there is huge. Congress -- *this* Congress -- is about to pass sweeping legislation that *includes* a hard limit on expenses (and profits) for the health insurance industry.

That is huge. Simply huge. For those of us who have been gnashing our teeth over various compromises that we perceive as reducing the potential for moving to single payer in the future, I'm really surprised that no one is really paying attention to this -- or that they are drawing the wrong conclusion about what it means.

The only way we are going to get single payer is if we can get the return on capital down enough that it simply isn't attractive any more. And this puts us on the glide path. Seriously.

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December 19, 2009 3:25 PM    in reply to Cool Blue Reason

i agree

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December 19, 2009 5:56 PM    in reply to Cool Blue Reason

I also agree. It's a very tough pill to swallow for those who have emotionally invested for so much more, as we can see from the commentary in these threads, but hopefully people will cool down once they've had time to think about it. This may be the same reasoning behind the White House push to get this done by Christmas. Get this bill passed now to give time for those who are upset to feel better about it in time for the next elections.

The bottom line is this, there are a insufficient number of progressives in the Senate to pass more substantive bill. That's it. The good news is, assuming this bill passes, there are enough Senators--just barely--to pass a better than incremental improvement. An improvement that can be built on later.

Rather than play the victim (which we Democrats are very good at doing) and reward the Republicans for their obstructionism, we need to look at where we can pick up more seats for better legislation down the road. I also suspect some of the histrionics are paid shills trying to muddy the waters a bit. Why not? From the perspective of the opponents, they've made it clear that all's fair when it comes to derailing anything the Democrats want to do.

But, as many have pointed out, we can do better. Let's make that a objective for the next go round. It's ok to blame those who have obstructed the push for reform. However, blaming those few who have worked hard to get to where we are today is nonsensical. When the bill is final, and we know for sure what's in it, then we can push a Democratic Party platform that will address the more egregious problems.

Good luck to those pols who are really trying, I appreciate your hard work.

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December 19, 2009 6:59 PM    in reply to Homefries

I agree with you too homefries.

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December 20, 2009 12:00 AM    in reply to Homefries

God. THANK YOU for such a good post! Cheers! Someone who sees the reality of the situation.

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December 19, 2009 6:55 PM    in reply to Cool Blue Reason

I agree too.

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December 20, 2009 10:45 AM    in reply to Cool Blue Reason

And there will be NO loopholes? Somehow I find that hard to beleive.

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December 19, 2009 3:45 PM    in reply to converse

Overhead for Medicare is 3%.

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December 19, 2009 5:25 PM    in reply to JefferyK

These are notoriously slippery numbers. Medicare made about $24 billion in what OMB calls "improper payments". That's about 7% or so. Maybe they need to spend more on adminstration.

And how do we count the administrative costs of the supplemental policies most all Medicare beneficiaries buy or need (some get from medicaid and/or former employers) because Medicare lacks catastrophic care?


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December 19, 2009 6:51 PM    in reply to Economides

Are numbers only slippery when they are used to refute your points?

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December 20, 2009 7:10 PM    in reply to converse

In Minnesota the requirement is 90 percent spent on medical care, and that's what Franken pushed for in the Senate bill. Insurance companies here haven't gone bankrupt yet. In fact, they're pretty darn profitable.

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AJM

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December 19, 2009 8:22 PM    in reply to bill

Think of it as way to provide welfare by creating make work jobs at the insurance companies. Instead of having people dig holes and fill the up or something productive like that they can continue to shuffle paper and screw people's medical care up.

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December 19, 2009 8:28 PM    in reply to bill

That 20% (I saw 15%) includes all admin costs on the insurers side.

Their profits are fat and their executive compnsation extreme but it isn't any 20% of premiums.

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December 20, 2009 7:16 PM    in reply to bill

Far from being a political victory for Dems, this bill with individual mandates and no cost controls is going to kill them next November. Republicans are going to beat them silly with it.

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December 19, 2009 12:32 PM   

So much for Demint's plan to rename Constitution Ave. Ben Nelson Blvd

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December 19, 2009 12:40 PM    in reply to JohnMcCSF

Considering how thrilled the public is likely to be with their mandate to buy for profit insurance ridden with loopholes, the Republicans might put Ben up there on Mt. Rushmore next to Joe.

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December 19, 2009 12:42 PM   

You know, the bill may be terribly compromised. But the big question I ask is this: How will it be easier to further reform healthcare? Is it by killing this bill and starting from square one? Or is it by getting this beast passed and then coming back later?

My sense is that the latter may be the better route. If this bill fails I suspect that it will be years, if not decades, before we see this level of attention on healthcare again.

It's easy to say that the politicians are ignoring the American people -- and walk away. Unlike on TV, in the real world it takes time and effort to make any major policy change, particularly at the beginning of an era. As Josh has astutely pointed out, Washington has been wired for Republicans for years. You can't expect that system to shift radically in such a short time.

We need to pass the bill, carefully analyze where things went wrong, and figure out a political strategy to get around those obstacles. Part of that means getting more progressives elected.

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December 19, 2009 12:58 PM    in reply to Dr Lemming

There's been lots of spin about how easy it is to come back later and make legislation more progressive. That conveniently ignores the last 40 years when most legislation has made programs less progressive and certainly made the tax system less progressive.

Well, at least it's Christmas, the season of miracles. We're going to cover 30 million more people and it's going to cost the government less money. Hallelujah!

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December 19, 2009 2:04 PM    in reply to bluebell

Then what's your game plan for getting something better passed? Specifics, please.

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December 19, 2009 3:57 PM    in reply to Dr Lemming

What's your plan for getting the left to vote for Democrats again?

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December 19, 2009 4:44 PM    in reply to DA in LA

If you are a progressive (rather than a Republican troll) you know that's not a useful response. If you'd like the bill to die then what's your game plan for getting a real one passed in our lifetime?

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December 19, 2009 4:49 PM    in reply to Dr Lemming

I'm a liberal. All liberals aren't saying kill the bill, so quit listening to your masters and grow a brain. We aren't the Borg.

I really don't care whether or not the bill passes. I'm done with the Democrats. For good. Obama never had any interest in creating a public option - that's why he never fought for it and used the bully pulpit, also known as "Leading."

People like you will rue the day you left us behind. But you won't learn the lesson. Even 8 years of Bush and you still haven't learned the lesson.

Get ready for President Romney.

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December 19, 2009 5:29 PM    in reply to DA in LA

Oh, yeah. ALL us liberals will be SO much happier under the Mormon Overlords. Sheesh. Talk about cutting off your nose to spite your face.

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December 19, 2009 5:38 PM    in reply to Cal Gal

Um. My comment begins with what? What's the first part of the comment there?

Try brushing up on your reading skills.

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AJM

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December 19, 2009 8:33 PM    in reply to Cal Gal

Look at the history of how voters behave. Whether it is self-defeating or not, a base which has been kicked in the teeth stays home. Like it or not, it is a reality which these politicians in their rush for glory have failed to take into account. In their bubble world, their 'victory' is going to be celebrated by the voters. The available data -- the polls -- suggest that this is delusion.

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December 20, 2009 10:49 AM    in reply to Cal Gal

Mormon Overlords or Corporate overlords, which one more directly affect your life?

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December 20, 2009 6:44 AM    in reply to Dr Lemming

There are likely DNC astroturf trolls around, too...

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December 19, 2009 1:02 PM    in reply to Dr Lemming

gives us a scenario where "they" will come back later and improve this bill.

in case you didnt notice democrats have the largest majorities in congress they probably ever will have and yet you see how they do the bidding of their owners.

obama may be the only black president but he certainly isnt the only slave in congress.

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December 19, 2009 1:16 PM    in reply to JadeZ

obama may be the only black president but he certainly isnt the only slave in congress.

He isn't in Congress, goddammit!

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December 19, 2009 3:14 PM    in reply to geofu54

Not only that, but some people here seem to think that he *is* Congress. Sadly, that is not the case.

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December 19, 2009 3:25 PM    in reply to Cool Blue Reason

some people here seem to think that he *is* Congress

Witty, and so true.

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AJM

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December 19, 2009 8:40 PM    in reply to geofu54

He is the last stop on legislation. He has a veto pen so hey, if he said it wouldn't fly, it wouldn't fly.

Any other excuses for his betrayal of choice?

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December 19, 2009 11:47 PM    in reply to AJM

He is the last stop in legislation. A veto threat wouldn't have worked, there were and are too many who oppose healthcare reform in any guise. They would have said it was Obama who was the radical uncompromising obstacle to reform and DONE NOTHING.

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December 20, 2009 10:52 AM    in reply to geofu54

Yes, the guy playing 11 demensional chess is not in Congress and has absolutely no power to effect what happens there. Hmmm...why did we elect a guy who was so impotent?

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December 19, 2009 2:06 PM    in reply to Dr Lemming

Its a toss up if this will delay or accelerate the crash of our non-existent health care 'system'.

Giving wheelbarrows full of money to Wall Street health care investors is not a solution to our dysfunctional medical care industry. This is like the TARP program, give money to the same greedy institutions whose only concern is their own pocketbook, and who use a lot of the money you give them to gain even more power and control in DC, to the detriment of the people.

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December 19, 2009 3:56 PM    in reply to Dr Lemming

What this bill does is eliminate a Democratic majority in the near future.

It also cements our health care system in the private market. Kiss single payer goodbye for good.

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AJM

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December 19, 2009 8:30 PM    in reply to Dr Lemming

Where this went wrong was in attempting to construct the bill before you had enough votes in hand for a decent version of it. This should not have been attempted in this session because it was apparent very rapidly that the votes for a decent version were not there.

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slb

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December 21, 2009 12:45 AM    in reply to AJM

They had to do it now; this was one of the top issues of the 2008 election. As elections cycles go, if it didn't get put in the hopper this year, it wasn't going to make it into the hopper at all, and Democrats could hardly go into 2012 without even having addressed one of their signature issues of 2008.

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December 19, 2009 10:21 PM    in reply to Dr Lemming

Medicare for all via reconciliation, 51 votes needed, Biden votes if stuck at 50; phase in alternative healing protocols that have a proven track record (and which are usually far more cost effective) as part of coverage.
Regards.

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December 19, 2009 12:48 PM   

Every single problem with today's health care system is caused by the for-profit health care insurance model: large number of uninsured, exorbitant rate increases, preexisting conditions, bureaucratic inefficiencies, etc., etc. Every single one of them. I do not understand how anyone can consider a Senate bill that reinforces this model progress.

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December 19, 2009 1:09 PM    in reply to JefferyK

Really?!? You seriously don't understand???

If you don't understand how 100 of the wealthiest people in our country refused to vote to do away with a for-profit insurance industry, then I'm afraid that someone has sadly neglected your education. You really need to forget what they taught you in 8th grade Social Studies class and wake up to the real world.

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December 19, 2009 1:12 PM    in reply to converse

Yes, I know. I need to get with the program and call my broker and invest all of my savings in health insurance company stock.

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December 19, 2009 3:59 PM    in reply to converse

How did you get to be such a jerk?

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AJM

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December 19, 2009 8:38 PM    in reply to shekissesfrogs

He read Open Secrets and looked at which industries donated to whom.

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December 19, 2009 1:11 PM    in reply to JefferyK

This is pure bullshit. The problems of the health care system are many and all segments of the system share in the blame for a badly broken system including consumers of health care who are suckered into bad decisions by direct to consumer Rx advertising and other needless consumption of medical products and services. To just point the finger of blame at the for profit health insurance companies is shallow, short sighted and intellectually dishonest. As part of the proof I point you to the state of Minnesota that has for years legally prohibited "for profit" insurance from being sold in the state. The system is not working in Minnesota either.

Let's at least think things through before holding forth sharing ignorance.

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December 19, 2009 2:13 PM    in reply to LeeJo

Does the socialized VA system work in Minnesota? Does Medicare work?

Do the Canadian, German, French, Australian, British, ...single payer systems work? And at half the price and with better health results than the US?

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December 20, 2009 11:09 AM    in reply to LeeJo

Once again Liberals are being asked to accept the "imperfect" and being scolded for not being happy about it and for raising legitimate concerns. Fine.

I suspect that when this turns bad, and it will, there will be a luandry list excuses and the concerns being expressed here will be forgotten or conviently left off the list, but on the off chance the our concerns are seen as legitimate, I wonder if all the scolds will come back and apologize for being so naive and in some cases nasty.

For my part I will gladly apologize if the citizens of this nation "love" this bill as someone said they would last night. I will also apologize if health care is taken up again next year as people are saying here. Of course if its to "fix" problems caused by this bill I will gloat.

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December 19, 2009 1:12 PM    in reply to JefferyK

Actually no you are wrong. The rising cost of health care is due to inefficient delivery of health care which is the fault of doctor's and hospital. Your premiums go up primarily because the cost of treatment goes up. It's true no matter who is paying. We tend to pay for health care-public and private sources-- in a way that makes those inefficiencies worse. And by the way, private insurance pays for less than 40% of care in the US. Government pays for almost half.

The failure to comprehend this point has led to much consternation, and too little pressure on policy makers to actually address the underlying problems.

Bad practices by insurers is the fault of weak regulation of insures and a lack of a universal system. Tightly regulated private insurers are part of several universal systems in Europe where the problems you cite do not exist. And of course, unless the insurers do not have to worry about adverse selection they will do their best to try to avoid selecting the most costly patients.

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December 19, 2009 1:58 PM    in reply to Economides

I think you're overlooking something here. Doctors, clinics, and hospitals have to hire staff just to deal with the insurance claims. Since the different insurance companies all use different codes for conditions and treatment, and since claims don't get paid unless the insurance companies are satisfied that they're covered, and since the doctors who are busy treating the patients don't have the time or the training to translate into 'insurance-ese', there has to be paid staff on hand just to process and submit (and often re-submit) claims. That's not the doctors' fault or the patients' fault or the government's fault. But, it definitely adds to the cost.

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December 19, 2009 4:01 PM    in reply to chimpale

Our OB told us insurance paper work took about 20% of her time.

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December 19, 2009 5:56 PM    in reply to chimpale

Yes there is no excuse for that sort of thing. Everyone should have electronic records that are compatible with everyone else's. I do think doctors are partly at fault for how they organize themselves. They should operate in much larger, more coordinated groups. Then it would be much easier to develop the kind of integrated systems that would make the practice of medicine better.

In any case I doubt doctors having more paperwork to do is a major cost driver. If I have 20% less time to see patients because of paperwork, I just see each one for 20% less time. YOu used to get 20 minutes, now you get 18. Also, it takes t the same for a prescription he same amount of time to order an xray or a CT scan, but the latter is much much more expensive, but not always necessary. You could say the same for prescription writing.

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December 19, 2009 2:23 PM    in reply to Economides

The remaining 50-60% of people the government covers are the oldest, the poorest and the sickest in the country, and yet the government spends only 46% of health care dollars.
link

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December 19, 2009 4:12 PM    in reply to NobleCommentDecider

You are a little confused. Private insurers pay 40% of the health care costs. Govt pays about 50% of health care costs. We pay the rest out of pocket, and some is charity care and such. That is not the breakdown of how many people are covered by each system. I don;t have that off hand, but for example, people over 65 are about 12% of the population and account for about 35% of all the costs.

So yes, government insures disproportionately more expensive people. But the larger point is that it does not make sense that private insurers are responsible for all the cost escalation and yet they pay for less than half of care.

The truth is that it matter much less who pays than it does what how you pay (incentives) and what you pay for (quzlity versus quantity of care)


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December 19, 2009 8:35 PM    in reply to Economides

How do you explain the decline in MLR over the last decade? All the factors you point at would raise rather than lower MLR.

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December 20, 2009 7:22 PM    in reply to Bruce Webb

I believe premium increases at roughly 400% of inflation would explain that. More revenue, not more efficiency, is the driver.

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December 19, 2009 12:51 PM   

Congratulations Harry Reid! You did good!

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December 19, 2009 12:51 PM   

I admire Snowe's skill in finding an even morearbitrary yardstick than her Maine colleague's insistence that the stimulus come in under $800 million.

I predict neither will vote for the jobs package unless the draft circulates in a green folder, or for a climate bill unless the PDF of the bill uses only Caslon fonts.

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December 19, 2009 12:54 PM    in reply to Davis_X_Machina

Forget Snowe. We were NEVER going to get Snowe in the end folks.

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December 19, 2009 5:34 PM    in reply to Davis_X_Machina

LOL. I think Reid promised to rename Times New Roman to Times Nelson Roman.

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December 19, 2009 12:52 PM   

Who wants to bet that Lieberman's huge ego gets in the way and he signals he cannot support the bill? After all, his name has not come up on over 2 hours.

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December 19, 2009 12:55 PM   

Who wants to bet that Lieberman's huge ego gets in the way and he signals he cannot support the bill?
What happens to the internet progressive community when they have to thank Joe Lieberman for saving us all from a bad bill. Will they apologize for Lamont?

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December 19, 2009 3:19 PM    in reply to Davis_X_Machina

Let's hope that the progressive netroots community doesn't wake up to the fact that this is actually a good deal until after it is signed into law. Their shallow outrage right now is probably the only thing keeping that petty douchebag Lieberman on board.

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December 19, 2009 4:03 PM    in reply to Cool Blue Reason

Yes, the combination of regulation and market forces has not bitten us in the ass lately. Don't know what could go wrong with this reform, especially after Republicans take Congress back.

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December 19, 2009 4:47 PM    in reply to DA in LA

I'm not sure what you would really suggest. At least, I'm not sure what you would suggest we have *this* Congress do. I would be pleased if we could wipe away the whole private insurance industry, but it is truly not in the cards. So we regulate. This approach works elsewhere, and it *could* work here.

We have every reason to be skeptical, and we should -- and must -- be vigilant. But we shouldn't underestimate the power of framing the issue, and of putting in place institutional structures that are oriented toward the outcomes we want. This bill does that. It will provide a platform for improving the health care system over time, and I hope you will join me in that effort.

Progress is not and will never be easy, but future acts of incrementalism will in fact be somewhat easier to accomplish as a result of this broad framework / paradigm shift. Even if we do face Republican control in one or both houses, recent history should amply demonstrate the advantage accorded to those who are defending the status quo.

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December 19, 2009 4:53 PM    in reply to Cool Blue Reason

Um. How about putting anti-trust provision into the bill? How about getting rid of annual limits? How about getting rid of lifetime limits? How about only allowing them to spend 90% on profits and overhead.

I mean, seriously, wake the fuck up. None of that shit can't be attacked by the White House, or Reid or whoever the fuck is supposed to be in charge.

This bill is so flawed and ruined it's crazy.

It's an embarrassment to democracy.

You can guarantee Bush would have gotten what he wanted. Turns out he was actually a leader. A bad one, but a leader.

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December 19, 2009 5:20 PM    in reply to DA in LA

I would support each of the provisions you mention, if we can get them. Don't pretend that some of our representatives haven't been trying, or that the obstacles are not real.

Are you even aware that the current Senate compromise language caps private health insurers' overhead to 80% of premiums for individual plans, and 85% for employer plans? Want 90%? So do I. Lobby your state legislators, who can impose a higher standard under the putative federal law.

Go read the manager's amendment -- the PDF is on Harry Reid's senate web site.

And don't tell me to wake the fuck up. If you're paying any attention it is not hard to understand the dynamic in the Senate. We have a caucus of 60 "Democrats," and that is a very loose definition. With no margin for error, every single one of them effectively has a veto on major legislation. The incentives to defect are huge.

This legislation is the best we are going to get out of this Congress. The structural and political hurdles we are facing are not things that can simply be wished away. However, I truly believe that at the end of day, once our rage and frustration have faded, most of us will recognize this legislation as having been a good, difficult, and important step.

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December 19, 2009 5:23 PM    in reply to Cool Blue Reason

To be clear, that 80% requirement is for actual care -- limiting overhead/profits to the remaining 20% (or 15%).

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December 19, 2009 5:40 PM    in reply to Cool Blue Reason

Good luck with that.

Sometimes I enjoy a little delusion myself.

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December 20, 2009 11:25 AM    in reply to Cool Blue Reason

And minds have never been changed? Rahm is supposed to be the guy who plays hardball, Obama is the guy playing chess and these two can't get in there and get what they want? What is leadership all about?

I get so sick of the 60 vote crap. Where's the hardball? Directed at Liberals. Where's the chess? Deals with corporations (PhRma.) Either Obama and Rahm have been over sold or they are getting what they want.

You all seem to trust that the meager curbs that are put on Insurers are going to survive and get into the final bill or not come out looking like swiss cheese due to loopholes.

Apparently you are correct about this being the best that we can do given the Congress and the leadership, or lack there of, out of the Whitehouse, but please spare us the lectures on how great and historic it is. We have to accept this shit sandwich, we don't have to accept the PR bullshit.

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December 19, 2009 12:59 PM   

KILL THIS BILL!

its not reform.
it doesnt control costs.
it forces people under fines to buy insurance the ycant afford.

there is no PO.
no price controls

insurance makes 100s of billions of dollars FOR DOING NOTHING.

and it fools all the dumb bells that think it is good work.

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December 19, 2009 6:58 PM    in reply to JadeZ

You are nothing but a troll. You don't give a crap about health reform. Go back to the freeper sites and complain over there. They probably give a shit what you have to say.

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December 19, 2009 1:00 PM   

Is it even remotely realistic to hope that once the Senate passes any kind of health reform that the public option, medicare/medicaid expansions and other budget related provisions that emerge from conference can be re-introduced in both houses under the reconciliation process?

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December 19, 2009 1:06 PM   

RAM IT THROUGH!

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December 19, 2009 1:10 PM   

If you read some of the changes in the bill one of them is an increase in the individual mandate penalty.

They raised the fucking penalty.

Kill this piece of shit bill.

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December 19, 2009 1:16 PM   

I don't understand how we get to 60. Have we heard any hints that Lieberman is supporting this? Last I heard it was a no.

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December 19, 2009 1:16 PM   

This is Romney-care writ large.

I feel betrayed by both my US Senators.

Chuck Grassley for proving that Republican obstructionism and lying works.

And Tom Harkin who promised at his annual steak fry in Indianola, IA last September that he would never vote for a health care reform bill without a strong public option!

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slb

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December 21, 2009 1:03 AM    in reply to ETSpoon

And yet--for all its faults, aren't the people of Massachusetts reasonably happy with what they have? Are they more inclined to scrap it than to try to improve it?

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December 19, 2009 1:20 PM   

but Senator Reid, I'm Pagliacci!

It seems the US is continuing it's dubious tradition of incremental, rather than transformational change. Of course, given the polarization of the American political landscape, this is best we can probably attain. American is not a land of clear majorities, only pluralities and partisans.

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slb

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December 21, 2009 1:00 AM    in reply to pagliacci

It seems the US is continuing it's dubious tradition of incremental, rather than transformational change.

Well, duh -- that's the way the whole system is structured. The founders weren't all that anxious for any transformational change beyond what they had already forced.

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December 19, 2009 1:23 PM   

This is Romney-care writ large.

Meh. You can do worse. You weren't going to do better with this Congress.

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December 19, 2009 1:33 PM   

So now I suppose that after we gave up the farm, we're supposed to be grateful to Nelson. Well, I guess I'm not.

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December 19, 2009 1:39 PM   

These Senators are not human beings. They have no conscience. What does Senator Snowe meant by delaying this reform. There are people dying because they do not have health care. These people are just inhumane and they do not care about other people. They are just selfish and I am not sure what they are trying to prove. They can have money for wars and spend billions on our so called Department of Defense but not Health Care. What is the difference between bribes and lobbyists? NONE!!!!!!

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December 19, 2009 10:49 PM    in reply to Sode

I'm really picking up the negative vibe stuff with Snowe. All over this site. FYI: I'm not a troll. I voted for Obama and Franken this year (after having stayed out of the process for over 20 years). And a different perspective:
1. Your concern over no more delays: Do you realize the pre-existing condition stuff doesn't kick in for adults until 2014?? In fact, most of the bill's "benefits" don't kick in until then. (Which is why Howard Dean said portions of the bill - those least controversial - could be tweaked and passed now, then do the grit stuff next year...even take it to reconcilation...and...whatever is worked out then could be implemented immediately. And...that means it could actually get kicked into gear 2010 or 2011 rather than 2014.)
2. Honestly...this is a 2,000 plus page bill, with how many hundreds of pages of amendments that keep getting changed, and changed, and changed... Even now, with what we got tonight, isn't it hundreds of pages more? And the original bill - have you read every page? Or understood even half of it? I know I haven't, and even people "in the know" stutter and stammer about certain questions because they really don't have a clue. Yet we're gonna pass this thing under those conditions? All because "we can't delay any further?"
Kindly reminder: We did that with TARP. As a result, no one bothered questioning the fine print, the thousand or more pages on that one, and again, we were told it had to be done "Now"...or else...everything will fall apart. Interesting Barack comes out this week and says, if we don't pass this bill, the country will - oh no! oh no! - go bankrupt.
See a pattern here?
So for what it's worth...I don't think Snowe is off. Why not break down the main components of the bill, have our reps come back to their home states and spend some time actually explaining it, in detail, and in language we can understand, taking questions and answering...and then see where it lands.
This is a monumental bill. Yet we never got the CSPAN meeting coverage that was promised. And were there ever meetings. Backroom meetings all over the place. And the public was left out. Major promise reneged.
What we got instead...lots of broad language, a few details that change by the day, and sweeping generalizations about how great this thing is.
If it take a month or two longer...I believe a great investment of my time.

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December 19, 2009 1:52 PM   

Does that include the cap on payouts? The House version came in with a similar score and it is superior. The House represents the people, who gives a rat's ass what the Senate thinks. They represent the states. This is health care, not commerce care.

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December 19, 2009 2:19 PM   

It seems like only yesterday that people were abuzz with talk of Sen. Snowe switching parties and becoming a Democrat. Anyone who still thinks she'd be a great catch for the party, please raise your hand.

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December 19, 2009 3:23 PM    in reply to screaminmeme

Actually, I think if she switched parties she would likely move to the left, not unlike Specter. And having 61 in the caucus would be light years better than 60. Having every last Senator in your "big tent" effectively hold veto power over big legislation increases the incentives for defection tenfold. And the result is what we have seen in the past several weeks.

Even the tiniest bit of wiggle room would have made a big difference in reducing their individual leverage.

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December 19, 2009 2:39 PM   

New wine, old wineskin, but Lieberman promises plenty of water.

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December 19, 2009 3:20 PM    in reply to Official A

more like yellow water.

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December 19, 2009 3:29 PM   

Now I'm lost. Snowe's reason for delaying the vote into January to get her support is ?

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December 19, 2009 5:38 PM    in reply to rbe1

Something about Tea Baggers shouting at people over the "Christmas" break, I betcha.

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December 19, 2009 3:38 PM   

please yank the Nebraska pay-off in conference

other creepy things in the bill: allows states to ban any abortion insurance coverage whatsoever AND abstinence-only sex ed ended up in there

this bill is shit, and I have no patience for any milquetoast, pusillanimous, pretend-friend-to-humanity "liberals" who get behind it. this bill is 5 steps backwards in too many areas to support, and it will be the end of Democratic majorities for a generation once people start paying fines for the mandates

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December 20, 2009 7:31 AM    in reply to twirling fartknocker

I'd be all for it if they'd strip it of the mandate, as jon walker advises, hold that hostage for various 'fixes'.

This is a loophole ridden version of Romneycare. MA now has the most expensive health care in the world.

I'd really be interested to see some hypothetical political scenarios and legislative prioritizing that explain how we improve on this bill with a smaller majority.

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December 19, 2009 3:56 PM   

ok, i have several questions about these bills
1. how many are there besides the house and congressional one? i thought there were 5 total but i could be wrong.
2. since the bills have to all be merge into one, doesn't this make the public option still in play since the house has the po?
3. if the bill lowers cost, provides healthcare and gives the insurance companies competition, why do you still need a public option
4. why is abortion being considered. that is not a health issue for the woman. it is for the baby, but not her.
4. how is this being paid for

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December 19, 2009 4:05 PM   

If this hasn't been linked yet, read this article in The New Yorker. Overhauling a major portion of our economy cannot and will not happen overnight but there are some historical parallels in agriculture/USDA and the current economics of health care.

http://www.newyorker.com/reporting/2009/12/14/091214fa_fact_gawande

There is no master plan for all of this but, we have to start NOW in trying to bring down the costs. Nuking the Senate Bill is ridiculous.

To be perfectly blunt, any chance of getting a *more* progressive bill will be lost after 2010 if the Democrats lose seats. But, if we can solidify or at l least hold on to our numbers in Congress, we can strengthen the legislation. This *will not* likely happen if we lose too many seats. This is a start-imperfect as it is. Carpe diem.

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December 19, 2009 4:23 PM    in reply to LBJs Brain

The current Senate bill isn't remotely progressive, and that's thanks to Democrats -- no one else. If you think Democrats are suddenly going to stand up to the health care insurance lobby if they retain a majority in the Senate in 2010, you're in for a big surprise.

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December 19, 2009 4:49 PM    in reply to JefferyK

No, thats thanks to conservative Democrats from conservative states. As soon as folks from those states elect more liberal Democrats...

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December 19, 2009 5:40 PM    in reply to LBJs Brain

...Satan will be wearing a fur coat?

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December 19, 2009 6:16 PM    in reply to Cal Gal

Bingo.

The Filibuster is a double edged sword. And, this Congress is obviously extremely partisan. You can't trade a liberal northern Republican for Southern conservative Democrat the way you could in the '60s.

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December 19, 2009 6:58 PM    in reply to LBJs Brain

What the hell? What kind of party can't keep its people on the same page?

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December 19, 2009 7:37 PM    in reply to JefferyK

Any party other than a soon-to-come teabagger party...

I mean seriously. When you have the filibuster-free line of 60 votes, and you have exactly 60 in your caucus, quite a few of which comes from goddamn ruby-reddish states and one of which whereas from a blue state is personally an idiot, then it is structurally inevitable each one of the votes exerts a tremendous leverage. It's not a matter of leaders-should-strike-a-fear-of-god-in-them or something like that, it's the current political dynamic and actual institutional obstacles getting in the way. I know it sucks. I see the frustration. But that's the reality we have to deal with now.

Walking away is not an option. What we need to do is to dilute the leverage by electing additional liberal votes, as LBJs Brain said.

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December 19, 2009 7:43 PM    in reply to geofu54

Word.

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December 19, 2009 5:12 PM    in reply to LBJs Brain

Um. The "losing seats because we didn't pass the bill" is a myth. Guess what? Your going to lose seats because the bill PASSES.

You'll lose liberals and independents.

Toast. Liberals won the debate over the public option being important months ago. The lack of understanding of Obama and Reid and Pelosi to realize this and scare the life out of Lieberman and Nelson is amazing.

So, you lose by winning. Nice work.

Already lost me.

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December 19, 2009 5:21 PM    in reply to DA in LA

Lost you to what? The GOP?

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December 19, 2009 5:41 PM    in reply to LBJs Brain

Nader Part Deux.

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December 19, 2009 5:51 PM    in reply to Cal Gal

Maybe people should have learned their lesson.

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December 19, 2009 5:49 PM    in reply to LBJs Brain

Why would I go to the GOP? I'm a liberal. The two main parties don't represent me, so I'll find the one that best does. Or I'll vote independent. But I won't be voting for a Dem for a long, long time, if ever.

Here's what they've lost: Someone who has, since the age of 16, walked precincts for candidates (now 42). Someone who has donated thousands of dollars. Someone who flew to battleground states on election days, rented cars and helped Democrats who have a hard time getting to the polls get there. Someone who traveled to Las Vegas last election three times to walk precincts. I'm one of the one's you don't want to lose.

But now I'm done. There is no reason to support corporations. If I want to do that, I can just cut out the middle man and buy their products.

And there are a lot more like me. Head over to Reddit and Digg and you'll see how done people really are. Go Google the story about how Obama's troops in Florida responded to his last email asking for phone calls and donations. Es no bueno. The conventional wisdom seems to be that if the Dems don't pass this bill, they'll lose. It seems more obvious to me, with a 33% approval rating, the bill passing will lead to a massive loss in 2010 and 2012.

It's called not paying attention to your base. It leads to 1994. I thought the DLC was dead, but I was wrong. So goes life.

I'm out.

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December 19, 2009 6:10 PM    in reply to DA in LA

Sounds to me like you should stay exactly where you are and *keep* the pressure on Obama and the Democrats. What do you think you will gain by dropping out. Never voting for a Dem for a long, long time but you're a liberal? That leaves Democrats, Sanders-esque Independents and few Greens. You'll have better luck advancing your ideals by staying with the Democrats.

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December 19, 2009 6:30 PM    in reply to LBJs Brain

There's always a liberal on the ticket. I'll be voting in my best interest and working for a 3rd party or ind. from here on out.

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December 19, 2009 6:38 PM    in reply to DA in LA

Listen-I feel you. I really do, but if that third party makes it to Congress, they will have to caucus with someone which will be the Democrats which will in turn require compromise. Why go to the trouble of starting a new party when you already *have* a party?

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December 20, 2009 3:01 AM    in reply to LBJs Brain

Maybe you're not getting it. I clearly do not have a party. Liberals do not. How many times does one have to get kicked in the teeth before they realize that?

I'm done. Many of us are. Dems have blown it.

You guys might want to suck it up and figure out how not to screw so many people over.

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December 20, 2009 11:48 AM    in reply to DA in LA

Oy. The Democratic Party isn't going anywhere so who are your leftist/third party candidates going to caucus with? Democrats. You seem to be waaaay too hung up on the name "Democrat", as if that signifies some kind of sellout. Your purity test *will fail* the first time your third rail candidate has to compromise to get something done. Are you going to dump them, as well? My advice? Elect better Democrats. The Rayburns, Humphreys and Kennedys are still out there-elect *them*.

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December 20, 2009 2:40 PM    in reply to LBJs Brain

And as for "how not to screw so many people over", one of the most critical things we absolutely must make sure about is to keep wingnut loons like DeMint and Co. from power. The eight years under Bush should never so quickly be forgotten; we WERE screwed.

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December 19, 2009 11:06 PM    in reply to DA in LA

Responses like yours...well, this is why I actually feel pretty calm about how things are going.
I sense it'll take a major, major "OMG" moment for people to really wake up to the depth of corruption that runs rampant throughout our political system. To wake up, and change it. Big time. Not the little bit here, little bit there stuff. Because that doesn't work. But I have a feeling...we may be entering a tipping point.
The cool news? A lot of us are indeed waking up. And I couldn't be happier.
The system...is choosing not to reform itself. Very stuck. So...perhaps a nationwide progressive third party will begin to organize.
Count me in.
P.S. I currently live in MN, and not too long ago a man, an outsider who was given ZIPPO chance of winning the governorship, won as an independent. Jesse Ventura. And he beat two very well-known, well-established party leaders who had lots of money behind them. Why? Tipping point. And wanna bet how shocked everyone was when the results came in that night?
Translate: It IS possible. The challenge: Has to be a nationwide movement, or anyone voted in will get sucked into the disease which is now Washington. Need to get larger numbers of progressives, unaffilated with either party, in.
It CAN be done.
Yippee, everyone!

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AJM

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December 19, 2009 8:46 PM    in reply to LBJs Brain

Name one politician I can trust to uphold the rights of women after this debacle?

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December 19, 2009 4:06 PM   

Healthcare Reform Part D

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December 19, 2009 4:36 PM   

Welcome to Blackwater Healthcare.

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December 19, 2009 4:40 PM    in reply to DA in LA

Yup.

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December 19, 2009 4:36 PM   

While I sincerely hate the republican platform, at least they stick togther in their hypocrisy and bull shyt, unlike the wussy Democrats.

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des

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December 19, 2009 6:02 PM   

If I understand correctly, this bill will go to a Senate/House conference where the differences will be "ironed out"; ie, anything "liberal" will be dumped. Why that assertion? Because the bill will have to be passed again by the Senate and 60 votes will be needed again for cloture. So forget about any of the more liberal ideas from the House bill being included.
The most that can be hoped for at this time is that the portions of the House bill concerning recissions and denials of coverage are included since they are stronger than the Senate's version.
But don't hold your breath...

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December 19, 2009 6:20 PM   

shit!shit!shit! Will we ever be able to buy ourselves away from the corporate government now?

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December 19, 2009 6:53 PM    in reply to conniptionfit

Probably not. Not unless the young people organize a revolution - otherwise no.

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December 19, 2009 6:59 PM   

Now I can add Nebraska to my list of states I never need visit again. And I am proud to say that neither of my senators wears a really cheap wig.

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December 19, 2009 7:54 PM   

What a mess!

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December 19, 2009 10:12 PM   

So, who is doing the betting pool on when Lieberman will say something new to derail the process in order to get more "concessions"? (Perhaps a straight-up payment of $1 billion, no strings attached, to Aetna would be enough?) My money is on 11am Eastern, tomorrow. How about you all?

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December 19, 2009 11:14 PM    in reply to dougom

belly laugh...!!! :)

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December 19, 2009 10:47 PM   

As I understand it, this bill forces people, under penalty of the law, to purchase health insurance. If that is the case, you can count me as a former Democrat. It's insane for the federal government to force anyone to purchase anything. If I find myself out of work, I'll be damned if I spend any money to buy health insurance. It's insane.

I'll bet there will be a court challenge, as well. It is unprecedented.

LBJ is reported to have said that the civil rights legislation would lose the south for the democrats for a generation. This will lose a lot more than that - and for a lot longer. Americans don't want to be forced to buy insurance. Give them a Medicare type system, fine.


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December 19, 2009 11:21 PM    in reply to eric the red

And in this latest version unveiled today...the fines were increased.
Me thinks it's called: tone deaf.

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December 19, 2009 11:36 PM   

This bill is a complete and utter failure on the part of Democrats and a rousing success for the GOP and insurance companies. Democrats failed to include either a public option (the stress being on "option", meaning "optional" and "voluntary") or anything resembling single payer. Both of which the Democrats, and Obama in particular, promised. Both of which had widespread public support. As has been the case for 3 decades now, Republicans have won again -- making the Dems look like boys in a mans game.

Passing this bill into law will set back any chance of true health reform for decades to come. Look back at history and try and find any program that has improved incrementally to benefit average Americans. It doesn't happen. Once the folks in DC say "Phew, it's not exactly what we wanted, but at least it's done," they mean it's done. Not until it's clear that the bandaid failed to cure the disease does the subject get revisited -- and by that time, it's too late. The only way real reform ever sees the light of day is if it's done in one moment of, well, reform.

The Democrats are done. Jeanne Shaheen has surely lost my vote. And, frankly, if this is the type of leadership that is Obama, we're better off if he's done in 2012 as well.

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December 19, 2009 11:59 PM    in reply to Mad Man Moon

No, what looks like "boys at a man's game" is not realizing where the real power lies-money. Who has it, who wields it and how to get it. Thats not to say you can't make positive change but you have to do it incrementally.

So many of the comments I read here and elsewhere are so shocking in their naivete about how the system works. I don't know whether or to laugh or cry at how many so-called "progressives' are ready to dump Obama (are they truly Democrats or just folks posting anonymously?) because they didn't what THEY thought he promised.

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December 20, 2009 2:37 AM    in reply to LBJs Brain

Agree. What's disturbing is those who say they'll vote Republican now out of spite. Not rational. Obama may not be very good at dealing with the power brokers, but until somebody better comes along - and it won't be a Republican - we just keep pushing him and other Dems as hard as possible till the debate ends and take the gains we got. Then push again if that's what it takes.

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December 20, 2009 3:19 AM    in reply to LBJs Brain

Aside from being an amazingly arrogant, this comment is laughable. Your naive if you don't think we understand what you seem to think is some amazing knowledge. It's shockingly obvious knowledge. You're not onto anything special there, champ.

We get it. And we're still done.

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December 20, 2009 12:04 PM    in reply to DA in LA

Well, if you are so dead set on "leaving" the Democratic Party, thats a shame because obviously your passion is an asset.

Let's game your third party out a couple decades:
You start grassroots with a few thousand across the country but you still need to figure out a platform-which I *guarantee you* will resemble the Democratic Party for the most part. You manage to get a few state seats in places like Portland, S.F. Mass, etc., where in order to pass any kind of legislation you will have to caucus with Democrats. If you eventually want to surpass the Democrats nationally, they will have had to have imploded. Maybe you can bet on that-maybe not. If they do, then maybe left-leaning folks will vote for your candidates. If the Democrats don't implode, you will still need their support.

But, the question underlying all of this is: what happens when you have helped elect another G.W. Bush because you have split the Left?

A united front *on basic issues* has a better chance of beating the Right, as I'm sure you know.

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December 20, 2009 3:49 PM    in reply to LBJs Brain

Sure, another GW Bush gets elected. Maybe after another eight years Dems will understand not to ignore the people who got them there.

Get it?

No, you don't.

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December 20, 2009 10:12 PM    in reply to LBJs Brain

The one big mistake you're making is assuming I'm a Democrat. I am an Independent. Picking a party and supporting it like one would a favorite football team is for the weak minded. These things are far too important to approach as if all that matters is that your "team" wins -- particularly when "winning" means that average Americans lose.

Don't kid yourself into thinking that independents somehow have less passion for issues than their partisan counterparts. Unlike partisans on both sides, independents demand results -- expecting elected leaders to actually deliver on what they promised as candidates.

Neither the legislative nor the executive branch has shown leadership on this issue of health care. To the contrary, they've been played by the Republicans the whole way.

I can say with confidence that Obama and the Democrats as a whole have lost independent minded voters -- who consciously chose to give them the reigns believing we would see real leadership with tangible, positive changes aimed at improving the lot of middle America and the country as a whole.

Think I'm full of it? Well, there's a reason why Obama's and Democrat's poll numbers have slipped dramatically. They've lost the people that put them where they are.

The bottom line being, while compromise is necessary in all negotiations, once things reach the stage where the objective itself has been fully compromised -- you've failed.

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December 21, 2009 12:35 AM    in reply to Mad Man Moon

Bravo!

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slb

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December 21, 2009 1:22 AM    in reply to LBJs Brain

No, what looks like "boys at a man's game" is not realizing where the real power lies-money.

Not to mention that the more liberal Democrats have the structural disadvantage of actually caring about governance. Health care reform is not just good governance, it is necessary governance. So the Democrats want it, and the more liberal the Democrat, the greater the want. And when you want a deal badly and the other guy doesn't give a rat's ass about good governance and would just as soon see the entire thing tanked, it's the guy who doesn't care whether or not there is a deal who has the clear advantage in the negotiation.

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December 20, 2009 2:57 AM   

I love the smell of bullshit in the night...
Kill, this piece of shit bill.

Kill it!

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December 20, 2009 2:59 AM   

The Senate contributed little in the way of non-lobbyist inspired thinking throughout this discussion. In the big picture, it seems time for the United States to consider a more unicameral legislative approach, that only leaves the Senate with advice and veto powers. The millionaires club could still act lordy, but without making the general population suffer the consequences.

There is also an issue of whether the two-party system is the most appropriate for a country facing a diminished role in global policy-setting. My great uncle, for example, is a Rockefeller Republican of the old school. He says he has no party any more as the current Republicans have let the Tea Bag People into the Big Tent.

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December 20, 2009 1:27 PM   

I'm just shaking my head over the insurance mandate, but I guess I shouldn't be surprised. The Dem base hasn't been important to the party since the 1980's. The cure for the party's deafness is to start a revolution by terminating party affiliations at the courthouse or wherever it's done in your state, and then sending a copy to your Representatives and Senators. As long as there are enough wussies willing to "settle", the party will never change its ways. Tell them we've had enough talking the talk. Force them walk the walk, even if it means making them walk the plank.

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December 20, 2009 1:31 PM   

It's time to stir the pot, because the base is getting burned.

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December 20, 2009 1:54 PM   

So, is it possible to get a medicare buy-in or a public option via reconciliation? (I think a medicare buy-in for anyone wants it is the way to go, because apparently medicare is a sacred cow for the repugs these days, and a widespread buy-in would also fund the system for years to come. But, it can't be just for poor and older people; healthy, young folks are the ones who will keep it solvent.) However, if this is done, will it spell doom for all the other legislation that Reid needs centrist support for, such as a climate bill, etc? Meaning if they feel betrayed, will they be willing to take chances on other legislation they have concerns about (meaning for which some powerful lobby has bought their souls)? My sense is to wait until some of the other major legislation is passed, and then fix it all with reconciliation right before the elections. However, if we cannot fix the healthcare legislation, it will definitely make things worse for many people (those who already cannot afford healthcare) while (perhaps) making it better in the short term for those who can. If it is not fixed before the mandate begins, I hope congress has the sense to drop the mandate.

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December 20, 2009 2:12 PM   

The mandate is pure evil. The Dems are REALLY shooting themselves in the foot with that one, which will probably cost them for the next three, four, five elections. I bet the Repuglies are sniggering up their sleeves about what they're about to pull off.

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December 20, 2009 4:13 PM   

Oh, those regulations! Costs are coming down!

http://bit.ly/6EPvxI

Possibly coming soon to a doctor's office near you: a little something extra on your bill, not covered by insurance -- a nifty number known as a "facility fee." What is it exactly? Here's a fun experiment: Ask five medical professionals. Most likely, you will get a variety of explanations, all guaranteed to make you respond, "Huh?"

"Healthcare billing is complex enough without throwing another factor into the mix," writes the website FierceHealthFinance. "Increasingly, however, it seems that consumers are being caught off guard by a new bill -- a 'facility fee' for visiting doctors based in a hospital-owned building -- which these days they're usually expected to pay on their own."

I definitely was caught off guard when I checked in to see a specialist in a Cedars-Sinai Medical Center building in Los Angeles and was told to pay a $75 facility fee. When I asked what that meant, the receptionist explained that this was a fee being levied to cover the wear-and-tear I would inflict on the office.

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December 20, 2009 11:37 PM   

This is not a 'liberal' bill. This is a corporate bailout of a magnitude second only to Obama's first corporate bailout shortly after taking office. Here it is again (Im sorry to do this, but i think it's getting lost, and, in my opinion, at least, deserves to be right at the top). From the Washington Post's summary of the 'Compromise' written by Shailagh Murray and Lori Montgomery and posted December 19, 2009:

“And all insurance companies would be required to spend at least 80 cents of every dollar they collect in premiums on delivering care to their customers.” The 80/20 ‘Compromise’ is by far the most blatant admission that Reid et al have crafted yet another corporate bailout at the citizens’ expense. Now, get this: 20 cents of every dollar - that’s 20 cents of every 100 cents - by law (at least by the Senate ‘compromise’) can be retained by private sector insurers to pay their bonuses,marketing and advertising, lard their bottom lines, expand their 
investments, fight sick people's appeals to the ‘independent insurance panels’, contribute to candidates ‘sympathetic’ to insurance companies, etc.

The Senate bill as now written provides that everyone in 
America pay for private sector health care, in short, wasting 20 cents of every health care dollar, piddling it off to middlers, who deliver no health care whatsoever, require mind numbing paper work, jerk you around with ‘co-pays’ and 
‘contributions’, etc, but do not ever in any shape or form deliver health care services to you. This is what the Senate has brought us.

Medicare operates at about 3% administrative costs; the alleged 'fraud' (of 7%) is difficult to believe, if you've ever been on or known someone on medicare (as fraud would involve a host of folks from the doctors, patients, pharmacists, etc - large cabal - all staying quite about it). But, let's give 'em half the 'fraud'; is there not that much 'fraud' in the current insurance industry operation (denying coverage, denying treatment, closing off insurance when it's most needed, capping coverages, etc)? If this is not 'fraud', isnt it on par with 'fraud' - only it's stealing from people, not the government? So, let's say the 'fraud' factor is about equal.

That still leaves us with a health care dollar. In the Senate bill, 80% of our health care dollar goes to health care. In a single payer or government option, 97% of our health care dollar goes to health care. Under the Senate bill, 20% of our premiums (the ones we're going to be 'mandated' to pay) are going to private sector overhead and profits. Under a single payer or government option, 3% of our health care dollar goes to overhead.

This a simple way to provide more health care for the same money. You can gain efficiencies in the neighborhood of 20% by limiting insurers to the rate maintained by the public sector (cut private sector overhead to 3%). Or, said another way, for every 100 dollars spent, you could have 17 more dollars going directly to provide health care to people. (It's easy to see here why the right and the 'Tea Party-ers' yell at meetings; they want any thing but an 'honest debate' about this.) The mystery is why the left does not speak up.

This is not a liberal bill; it is purely and simply another corporate bailout.

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December 21, 2009 12:42 AM   

Here's an article about how to change your party affiliation. Looks like progressives who want to change their party affiliation from Democrat should do it soon:

http://www.examiner.com/x-3747-Louisville-City-Hall-Examiner~y2009m12d17-Time-running-out-to-change-your-political-party-affiliation

I'll be switching to Independent ASAP.

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