The Presser and the Public Option

by publius

All in all, a pretty solid performance.  There were lots of things I liked:  (1) the gentle smackdown of Preening John McCain on Iran; (2) the recognition of Nico Pitney's outstanding work; and (3) the strong words in support of the public option. 

On #3, I've been wondering lately why exactly so many otherwise decent Democratic Senators have been so wankerous on this.  I mean, I assume that people like Blanche Lincoln didn't go into public office to make the nation safe for health insurance companies.  And it's also hard to believe that the good people of Arkansas (wealthy as they are) are ready to throw Lincoln out of office unless she protects one of America's most hated industries.

Paul Krugman (via Kevin Drum) has the best theory I've heard -- basically, these Senators are simply protecting dominant home-state insurance companies who throw around more money than, say, Arkansas's uninsured.  But even if that's a bit off, it's hard to believe that the Democratic opposition is based on anything other than kissing up to industry.

But that's where public pressure -- and particularly pressure from Obama -- can help.  Again, I'm assuming there isn't much actual ideological opposition to the public option among Dems.  What they presumably need is a face-saving way to support it in their meetings with the health insurance companies.  In short, they need an excuse to support the public option.  And Obama helped provide it today.

It would obviously be too much to expect that Blanche Lincoln might stand on principle.  But she could say, "Hey, you know I'm with you but I can't risk the wrath of the White House on this."  Or maybe even, "Hey, you know I'm with you, but they're killing me on TV on this." 

Thankfully, electoral self-interest still trumps even industry donations.  I'm not saying that sustained pressure will make people like Lincoln fear getting thrown out of office.  But people don't like to be criticized -- and a sufficient amount of pressure can make things uncomfortable enough to give her a pretext to change her mind.  This pressure has at least sort of worked for Nelson... for the time being.

Comments

[Pithlord]

The problem with a public option, as opposed to some non-profit option, is that no one can really ensure it won't be subsidized by the overall Treasury, with its power to tax.

So the result is inevitably a lopsided competition. If the public plan on its own has greater costs than benefits, the people choosing it won't have to pay those extra costs because they can be offloaded onto the taxpayer.

Moderate Democratic Senators have some understanding of this. Argue with them if you wish, but calling them wankers is (a) infantile and (b) British.

[Older]

Who the hell cares if it's (oh the horror!!) subsidized. It should be supported by taxes!! In the long run, that will be cheaper. Trust me, I worked it out years ago. Cheaper, and that's even with keeping the current system where FEHB and Medicare subcontract to private insurance companies. (They do, you know. Look at your Medicare statement if you have one. FEHB users, you already know this, but you're calling it something else.)

Under that plan the insurance companies would still get a cut, but they don't like it, because it would deprive them of the opportunity to really gouge some categories of health care users.

[Pithlord]

I'm not saying there is anything necessarily wrong with public subsidies to health care. But if you want to keep a competitive system (and the median Senator thinks that's a good idea), then the subsidies have to be given out on an even-handed basis.

[A.J.]

You know, it would be helpful to have a script which automatically substitutes "hello, I'm a clueless n00b" for "First!"

So the result is inevitably a lopsided competition.

So what? The goal is to make sure that everyone has adequate health care. We've got overwhelming evidence now that competition among insurance companies is not an effective means of achieving this.

[Gary Farber]

"Paul Krugman (via Kevin Drum) has the best theory I've heard -- basically, these Senators are simply protecting dominant home-state insurance companies who throw around more money than, say, Arkansas's uninsured."

I kinda thought little could be more obvious.

"You know, it would be helpful to have a script which automatically substitutes 'hello, I'm a clueless n00b' for 'First!'"

I thought everyone who isn't a clueless idiot has one of those in their head.

[Gary Farber]

Without being so dumb as to click on the tinyurl, my assumption is that its presence, and the accompanying statements, mean our 4chan troll is back.

[Sebastian]

"Who the hell cares if it's (oh the horror!!) subsidized. It should be supported by taxes!! In the long run, that will be cheaper."

Maybe, maybe not. The US government already spends more money than the UK government and doesn't have universal health care.

In any case there are at least two things to wrangle over: how to cover the uninsured, and whether or not the US government ought to be deeply involved in everyone's health care.

They are two different issues, they shouldn't be treated as all the same thing.

[Suzii]

No, dear, it is not true that everyone already has adequate access to health care.

It is true that my sister-in-law could, after living for years with untreated diabetes, go to the emergency room if her heart failed, or her kidneys failed. But catastrophic care is not health care, and the nation does not benefit from the fact that diabetes' effects on brain function reduce her productivity for all the intervening years.

[Tony P.]

Why the hell should a public option cost the taxpayers money? Health insurance appears to be a profitable business. A government-run health insurance plan could charge what private-sector insurance plans charge and make a profit for the Treasury. Or it could charge less and come out revenue-neutral. Or it could use its profit to subsidize premiums for poor people who cannot afford insurance at all.

Note that we're arguing about insurance, not medicine. Insurance "covers"; medicine heals, or cures, or palliates. I pay for health insurance to protect my wealth, not my health. Blue Cross has collected much more money from me over the years than it has paid to doctors on my behalf. It's a year-to-year gamble for Blue Cross, and so far Blue Cross is way ahead. In principle, Blue Cross will keep playing when I go the way of all flesh and start costing them money. My main worry is that they won't. I would gladly pay the exact same premium for the exact same coverage to a government-run insurance plan that is guaranteed to keep accepting my bets even when I start "winning".

--TP

[rweaver]

Isn't this the project for which Organizing for America was intended? Let loose the hounds!

[publius]

pith - on a side note, "wanker" may be juvenile. But... it has become a term of art of sorts on the internet. it basically is directed at people who are ideologically similar but are seen to pander, cave unnecessarily, or generally care too much about centrism or looking acceptable to conservatives.

[Johnny Canuck]

As I think Pithlord knows, Canada has had experience with public entities competing against private- we call them "crown corporations". They are run like a business and are somewhat insulated from day to day politics. For about 60 years Canadian National Railway (crown corporation) competed against Canadian Pacific, as far as I can make out it worked OK. I don't remember CP bleating about unfair competition. And in fact the Canadian Broadcasting Corporation is publicly owned and has to compete with private broadcasters at a competitive disadvantage.
Whether the public option is unfairly subsidized, competes from a level playing field, or is unfairly disadvantaged (eg has to take a greater percentage of high cost people)is a political decision to be determined.

[Anderson]

I assume that people like Blanche Lincoln didn't go into public office to make the nation safe for health insurance companies.

Why, I wonder, do you assume that?

[Woody]

No nation that holds the health of its people hostage to the wealth of its elites can justly call itself even remotely 'civilized.'

[Bernard Yomtov]

Uh, oh, I'm a clueless n00b.

Well, at least you've learned how to spell "Triandos." And associating Gus Triandos with quickness does indicate a certain cluelessness

[stonetools]

Twentieth! (or thereabouts)

Hey, its just as moronic as "First!"

I'm in touch with one of the Obama grassroots groups and they are mobilizing for this big time. There will be constituent pressure.

[Jeff]

So the result is inevitably a lopsided competition.

Too fleeping bad. The "insurance" companies have said that fraud is built into their system (they call it "recission", I call it what it is). They don't want to compete; they want to keep raking in blood money.

---------------

Everyone already has adequate access to health care.

That is so far from true, I wonder how you arrived at this conclusion. Just for starters, see above re recission.

[bedtimeforbonzo]

During his presser, President Obama patted himself on the back for the new financial reform package his administration proposed last week.

Tells me he is still living in an alternate universe -- certainly not the real economy -- since he has missed an opportunity to use the financial crisis as a point of real change and hope for the future.

Obama patted himself on the back for reforms that coddle Wall Street, change very little -- Moody's and the other ratings agencies that were in the tank with the banks and investment firms emerge as powerful and independent as ever -- and amount to window dressing.

In the real economy, as the above link mentions:

"One in eight mortgages is now either in foreclosure or delinquent, with the share of new mortgages going into foreclosure reaching a record high in the first quarter of 2009. Credit card debt delinquencies are up 11 percent from last year in that same quarter."

My mortgage falls into the delinquency category.

Luckily, I will be able to pay what is owed just before becoming 30 days past due. Otherwise, I would be headed for foreclosure since an active bankruptcy affords me no more leeway than that.

Obama was a giant FAIL in addressing the mortgage crisis. He put banks and Wall Street ahead of homes and families, a giant disappointment, and something I find unforgivable.

I sent my request last Friday to Wells Fargo for a loan modification -- faxing a hardship letter, a letter of consent from my bankruptcy attorney, a month of paychecks and a financial worksheet -- and was told today that it would take up to 45 days before it was reviewed, and then the process of review itself could take another 90 days.

Meanwhile, in those four months -- while car sales remain down in what used to be a buying season and my paycheck grows smaller and smaller -- I must avoid foreclosure proceedings and hope for a modification, something my lawyer scoffed at me for even trying, explaining she has yet to see any granted. (Ironically, the No. 1 thing keeping car sales down from what I am experiencing -- verified by other local dealers -- is tightening lending by the greedy bastards that run the banks whom Obama has shown so much generosity.)

Under Obama, TARP money got to AIG and the rest of the bad apples on Wall Street quickly: There was no such four-month wait because, heaven forbid, we were told, the economy was fncked without getting the Too Big To Fails back on their feet in a hurry.

Well, I am fncked right now.

I do not regret voting for President Obama after supporting his opponent in the primaries because God only knows how many wars we'd be in now under John McCain.

But I will again be seeking Democratic alternatives when the next presidential campaign cycle begins. I will not support a candidate who kisses Wall Street's ass while regular workers lose their jobs and homes in the millions.

[Gary Farber]

"Everyone already has adequate access to health care."

Sorry, what?

[liberal japonicus]

pithlord, for your reference

[Justin]

"I do not regret voting for President Obama after supporting his opponent in the primaries because God only knows how many wars we'd be in now under John McCain"

After laundry listing several ways that Obama has shown where his loyalties lie in a thread about Democrats in general sucking off insurance companies, you fall back on the hypothetical. God bless you democratic voters, with this kind of positive thinking we are sure to have a long line of politicians who keep on working us over. I'm sure we'd be in at least 7 wars with McCain as president.

[bedtimeforbonzo]

Justin: You'd be OK with McCain amping things up with Iran?

You'd be OK with him declaring "all options are on the table," some crazy sh!t like that, while the war going on in the streets over there is between themsevles, not the United States of America?

On the other hand, McCain does have a spare home or two he might be willing to share to a troubled soul like myself.

[Ben Alpers]

Be sure to check out Nate Silver's analysis of the effect of industry lobbying on the willingness of Senators to support the public option. His conclusion: it makes a big difference, especially for "moderate" Dems.

Everyone already has adequate access to health care.

Absolutely, in the same sense that everyone already has access to Rolls Royces and mansions in the Hamptons, just as the law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread.

As for the question of voting for Obama last November: I did and I'm glad I did for the same reason that bedtimeforbonzo is. Voting for the lesser evil is, unfortunately, a necessary short-term tactic. Justin is correct, however, that it is a deadly long-term strategy.

[russell]

"Everyone already has adequate access to health care."

I'm thinking pithlord is posting from the UK.

"The goal is to reduce costs."

If we do not reduce costs, neither public nor private health insurance options will suffice. Both will be expensive enough to make a useful level of health care coverage somewhere between a hardship and right out of reach for anyone but wealthy folks.

"Obama was a giant FAIL in addressing the mortgage crisis. He put banks and Wall Street ahead of homes and families, a giant disappointment"

Agreed. I'm amazed, in a bad way, at Obama's deference to Wall St.

[...now I try to be amused]

"...a sufficient amount of pressure can make things uncomfortable enough to give her a pretext to change her mind."

There are politicians who will not do it, and there are politicians who will do it if we make them do it (h/t FDR). If Lincoln is one of the latter then there is hope.

"I pay for health insurance to protect my wealth, not my health. Blue Cross has collected much more money from me over the years than it has paid to doctors on my behalf. It's a year-to-year gamble for Blue Cross, and so far Blue Cross is way ahead. In principle, Blue Cross will keep playing when I go the way of all flesh and start costing them money. My main worry is that they won't. I would gladly pay the exact same premium for the exact same coverage to a government-run insurance plan that is guaranteed to keep accepting my bets even when I start "winning"."

Brilliant metaphor!

[hello]

And how exactly are you NOT a shill for this administration publius?

What a bankrupt blogger.

[Gary Farber]

"What a bankrupt blogger."

Says someone who makes a drive-by comment with no content.