by publius
Ezra Klein found a relatively new fundraising letter from Chuck Grassley, the Democrats' point man on health care. Note the classy dig at Ted Kennedy (who was alive at the time, but close to death). Ezra posted the pdf, but I've provided an excerpt below.
Despicable pig is despicable.
Posted by: chmood | August 31, 2009 at 03:33 PM
the GOP lying about the Dems' proposals? that can't be true. if it were, i'd have heard about it on the news.
Posted by: cleek | August 31, 2009 at 04:11 PM
Alex, I'll take the category "Blue Dogs doing the bidding of the insurance industry and using for political cover their GOP colleagues who have no intention of compromising or negotiating in good faith, ever", for $500.
Posted by: ThatLeftTurnInABQ | August 31, 2009 at 04:47 PM
Weird how Grassley has done just about everything possible to assure us that he, and by extension his party, will have no role in reforming our nation's health care.
And, if any viable Democratic opponent emerges, he likely won't have a chance in getting re-elected.
Posted by: Point | August 31, 2009 at 05:00 PM
So he is against the public option, why did you not think it was reasonable to include this paragraph in your excerpts?
"I am working in the Senate to develop a viable alternative that is free-market based and rejects the pitfalls of government–run insurance. As a result, the public is being given time to
See the reality of what has been rushed through by Speaker Pelosi's House committees and Senator Kennedy's committee."
Isn't that exactly what he is doing?
Posted by: Marty | August 31, 2009 at 08:06 PM
Marty: No, it's not. This is shown by the lies in the earlier part of his letter, as excerpted above.
Posted by: Nate | August 31, 2009 at 08:21 PM
Isn't that exactly what he is doing?
no.
he's attacking a whole army of strawmen designed to allow him to slander the Democrats' plan. he's a shameless liar for The Cause.
which is what Republicans do these days. apparently. ahem.
Posted by: cleek | August 31, 2009 at 08:22 PM
Well, there is nothing there that is a lie. The public option certainly turns it into a government bureaucracy,it certainly rations healthcare. The rest is an opinion on how that would turn out. Perhaps it would be good to recognize that others don't have the undying (pun intended) faith in government that progressives seem to have gained in the last nine months.
What the real issue with this memo is that others might agree with it.
Posted by: Marty | August 31, 2009 at 08:30 PM
Well, there is nothing there that is a lie.
first para: there is no "government run health care" proposed, in debate, or under discussion, no matter how many times you say there is. try to remember we're not all as stupid as the average tea-bagger.
second para: there is no such thing as Obama-care. all the bills in question came from Congress, not from Obama. calling it "ObamaCare" is a ploy transparently intended to weaken Obama by tying your lies about Congress' health care to Obama himself.
third para: the "government takeover" stuff is nonsense. there is no takeover. neither is that anything which says such a thing is inevitable. this is total fear-mongering bullshit.
fourth para: given that everybody who has health insurance today is already faced with bureaucratic rationing in the name of controlling costs. Grassley's shoveling-out big piles of bullshit.
fifth para: quality of life will certainly suffer? bullshit baseless fear-mongering designed to scare the ignorant.
sixth para: what has Grassley done to demonstrate his desire to bring "meaningful change" ? bullshit.
seventh para: bullshit. the MO of his whole party is to defeat Obama for transparently political reasons.
it's all bullshit, lies and fear-mongering.
Posted by: cleek | August 31, 2009 at 08:54 PM
"it's all bullshit, lies and fear-mongering."
Well we agree on one thing, just not who is doing it.
And what gets lost in all your crude rhetoric?
47M people who should get insured and may not because people like you would rather get it your way or not at all.
Posted by: Marty | August 31, 2009 at 09:05 PM
If the 47M folks who aren't insured now are still not insured by the end of Obama's time in office, it ain't gonna be because of cleek.
Posted by: russell | August 31, 2009 at 09:51 PM
Well we agree on one thing, just not who is doing it.
go ahead, prove the validity of those statements.
Posted by: cleek | August 31, 2009 at 10:02 PM
"go ahead, prove the validity of those statements."
Cite:
"Posted by: cleek | August 31, 2009 at 08:54 PM"
Posted by: Marty | August 31, 2009 at 10:10 PM
Ah, come on, Marty...that's kinda disappointing. cleek said what he thought were lies...ya gotta match.
Posted by: gwangung | August 31, 2009 at 10:13 PM
just so we're clear: he insists that Grassley in no way lied, but instead of trying to prove it when challenged, Marty's going to play games.
gotcha.
ladies and gentlemen: your modern day GOP in a nutshell.
maybe now he'll tell us again how the GOP's lies are all Obama's fault. that's my favorite story, evah.
Posted by: cleek | August 31, 2009 at 10:16 PM
"go ahead, prove the validity of those statements."
Longer version
Certainly this is covered in the bill in multiple areas by new panels to evaluate treatment and cost options, mak ercommendations, some of which require Congress to do nothing to go into effect
Obama having no plan doesn't mean he gets to distance himself from the Democratic proposals he has spent several weeks on the road supporting. This is an egregious falsehood.
This is just opinion on both sides as to the long term effects of the proposal. Reinforced by the crudeness of the epithets.
I waas married once before, I like this one better. Some people may prefer the bureaucracy they have. It doesn't mean the government won't be rationing.
So you have the crystal ball that says this is false?
Well, at least he is still negotiating.
So what does this have to do with him, even it were true rather than a favorite lie of the Dems to highlight a few political memos to score political points.
Posted by: Marty | August 31, 2009 at 10:27 PM
I'm so proud of my Senator from Iowa. Blech.
Posted by: Jim SIegel | August 31, 2009 at 10:27 PM
I don't want this to get into personal attacks on Marty, seriously - we need to avoid that - but I would ask you, Marty, to think through what you're saying here.
"47M people who should get insured and may not because people like you would rather get it your way or not at all."
That's just as much a corollary answer that could be just as well given by anyone who is aware that market-based health insurance and care as a whole would rather have people...well, have health insurance and care the market-based way, or not at all.
Cleeks's rhetoric might seem crude to you, but frankly, it's understandable given that the histrionics of the right have been far more crude, and based in reaction and fear-mongering rather than fact. You have to be honest and face the fact that the GOP is making no serious attempt at any policy-making on this issue at all - if anybody's making such an attempt at squarely facing facts about the catastrophic state of health care and delivery in the U.S., it's Obama and the Dems, as flawed as aspects of their bills may be. It's the GOP that isn't facing facts.
If in fact any government-based health delivery was as horrific as it's been made out to be, we would've seriously gotten rid of Medicare and Medicaid a long time ago, and perhaps abolished the VA to boot. Gingrich's minions had the opportunity to do it and didn't.
The problems of health care in terms of cost and lack of effort to make insurance more affordable are the doings of the market, not government. If government is culpable in any of it, it's been in its willingness to allow the market to abuse its remit. No-one is suggesting that government take over health care. No-one is suggesting that private insurance companies should be run out of business for good. All the Dems are saying, as imperfectly as they are, is that those 47 million Americans who don't have health insurance should be covered. What they don't say outright for fear of being pounced upon is that, gulp, maybe those people actually have a right to be covered. What is so awful about that?
Marty, I'm an American who lives in Japan, yet I am covered under its horribly warped, government-regulated, rottenly Bismarckian system of national health insurance. Under this terrible system, I can choose any doctor or hospital I want. Under this liberty-sapping scheme, if I move to another city or town or prefecture, I can simply go to a hospital or clinic in the area, and I can ask a former doctor to write a letter and even forward the chart to the new hospital or clinic. Any physician is happy to do it - and it'd be done at no charge.
By contrast, under managed care in the States, how many people get their choice of physicians, and how easy would it be to change your physician if you don't like or trust him/her, or even if you had to because you had to move to a new city or state? The Japanese system is not perfect - no system is - and Japanese and foreigners alike here complain about aspects of it. Yet the right to access of care isn't even discussed here, because it's so fundamental to be common sense. And it hasn't run private insurance into the dirt - I have a supplemental private plan specifically for cancer that I get at a very affordable rate per month.
Since cost is a factor in the discussion, I'll say that no-one who is seriously discussing this issue believes that it would come for free. The real choice is this - would you rather pay a market-based instrument for no legal guarantee of payout, or pay into an alternative instrument through - gasp - taxation, or into a competitive public option, where in either case, you might actually have guarantee of access? If the question of public money is at stake, I'll also say this - Americans are the only people who think they can have civilization without taxation. We're already paying for this big-time - I'm at a loss as to why people keep shilling for a system where legal disclaimers and capriciousness are rampant, where there is no guarantee of access, and that is costing us, as a whole, really even more than what it would with legal and civil safeguards built into it.
Posted by: sekaijin | August 31, 2009 at 10:42 PM
"You have to be honest and face the fact that the GOP is making no serious attempt at any policy-making on this issue at all - if anybody's making such an attempt at squarely facing facts about the catastrophic state of health care and delivery in the U.S., it's Obama and the Dems, as flawed as aspects of their bills may be. It's the GOP that isn't facing facts."
Basically I disagree with all of this. The state of affairs in the US isn't catastrophic. 85% of people have healthcare they are reasonably satisfied with. The costs are controllable by reforming healthcare delivery.
The government will need to provide some money to ensure coverage of the uninsured, probably mostly taxes, and no Americans believe we shouldn't pay taxes, we just want our moneys worth.
In general, most of this is just about not wanting the government to make things worse for 85% while fixing things for the 15%. A reasonable request.
Posted by: Marty | August 31, 2009 at 11:00 PM
I don't see cleek making any unsupported claims that something certainly will happen. That'd be the Amazing Grassnac. He does have a crystal ball that says this is true, right? Because otherwise it's just unsupported rhetoric meant to induce fear... baseless fear-mongering, one could say.
Posted by: Nombrilisme Vide | August 31, 2009 at 11:00 PM
A national health insurance system in which you have to buy supplemental private coverage for cancer definitely seems to be missing the point somewhere, though I guess it's still not as crazy as what we're dealing with in the US.
Posted by: KCinDC | August 31, 2009 at 11:02 PM
"baseless fear-mongering, one could say"
See, here's the rub with me, cleek says no it won't, Grassley says yes it will, neither has a fact, they are just divergent opinions. Grassley has a right to his, cleek has a right to his. Neither has a right to call the other a name, or question his character, for having it.
Sorry, we can play "yes it will", "no it won't" forever and that won't justify the name calling.
Posted by: Marty | August 31, 2009 at 11:09 PM
Certainly this is covered in the bill in multiple areas by new panels to evaluate treatment and cost options, mak ercommendations, some of which require Congress to do nothing to go into effect
bzzt.
"government provided healthcare", by normal understanding of the words, implies something like the VA or the NHS, where the government owns the facilities and employs the doctors. nothing like that is proposed. to even talk about opposing such a thing is a clear strawman argument.
there is no "government provided healthcare" in there.
Obama having no plan doesn't mean he gets to distance himself from the Democratic proposals he has spent several weeks on the road supporting. This is an egregious falsehood.
so by virtue of his promotion of some of the things contained in these bills, Obama gets his name on whatever comes of them? that seems a bit gratuitous.
i hereby proposed that all opposition to the bill be named after Marty.
This is just opinion on both sides as to the long term effects of the proposal.
oh come now. it's fear-mongering. just admit it.
Reinforced by the crudeness of the epithets.
oh noes. my crudity hath offended poor Marty. if only he was as upset by lies. i mean, we know he's not, but if only... oh dear me.
Some people may prefer the bureaucracy they have. It doesn't mean the government won't be rationing.
given finite resources, there is no way in the universe to not ration. complaining that the government will ration is like complaining the sun will set tomorrow, a few hours past noon, thus cruelly limiting our hours of daylight - blame Obama! (also, shots might sting a bit, and Gen. Tso's Chicken will no longer be recommended for indigestion, all thanks to the new ObamaCare)
and to complain about the dread specter of impending rationing as a way of opposing a proposal to reduce rationing (by offering care to the 45M who are currently rationed out of decent health care entirely) is not just stupid, and cruel, it's as good an example of fear-mongering as one will ever see.
to claim that decisions in health care are between you and your physician is a laughable lie. most people who have experience with our current system should be able to recall insurance companies denying drugs, treatment or payment for medical decisions.
everything Grassley and is defenders and fellow liars are claiming about rationing is already here. the bills in consideration would actually reduce such rationing.
but Grassley can't very well tell anybody that, can he?
So you have the crystal ball that says this is false?
the onus is on Grassley (or his defenders, ahem) to prove his assertion, not on those who point out that he has no basis to make such a claim. if i challenge a tarot card reader to prove his prediction, he doesn't get off the hook by asking me to disprove the wisdom of the tarot.
besides:
a: there is still no proposal for "government run health care"
b: but if you really want to talk about such a thing: go ahead, demonstrate that Medicare or the VA has lead to a decline in health care. and be sure to compare it to plausible alternatives.
if you choose to defend his claim, not only do you have to find a plausible way for us to inevitably get to that "government run health care" (which again, isn't even proposed), you then have to show (with some meaningful statistics, i hope?) that we'd be worse off. show your work.
So what does this have to do with him
err, well. he wrote it. and given his position, he has a unique opportunity to win one for his party.
even it were true rather than a favorite lie of the Dems to highlight a few political memos
wow. now that's rich.
ignore what the GOP says, ignore what it does - focus on what they want you to think they're doing ?
look, if the GOP was doing anything but opposing this in bad faith, we'd have ample evidence. but the vast majority of what we see is lies, misrepresentation and bullshit. they don't have any competing legislation to show how they'd handle HCR, because they don't actually want to reform anything. they just want to defeat Obama.
this really couldn't be clearer.
Posted by: cleek | August 31, 2009 at 11:11 PM
Because the vast majority of them have been lucky enough not to really need it, so far. Those who are less lucky in the future may find that their insurance is not so satisfactory as they thought, since much of the industry is essentially a scam.
Posted by: KCinDC | August 31, 2009 at 11:11 PM
"i hereby proposed that all opposition to the bill be named after Marty."
Only if I can write the bill we should pass.
Posted by: Marty | August 31, 2009 at 11:15 PM
"they don't have any competing legislation to show how they'd handle HCR,"
They have had HCR proposals on the table since 2007. Some of them have a bipartisan proposal in the mix. This another of those dastardly misrepresentations.
Posted by: Marty | August 31, 2009 at 11:18 PM
They have had HCR proposals on the table since 2007
well, they've had a few ten-page had "conservative" boilerplate HCR proposals on the table.
but, here's a rather amusing bit from the "Patients Choice Act of 2009". i'll go ahead and highlight the funny parts.
Affordable premiums. Under the status quo, plans offering coverage to individuals often charge exorbitant premiums. The Patients’ Choice Act solves this very real problem through a model that works in several European countries: independent risk‐adjustment among insurance companies. 21 A non‐profit, independent board would penalize insurance companies that cherry pick healthy patients while rewarding companies that seek patients with pre‐‐existing conditions. This solution would ensure health insurers compete based on superior products and the lowest price.
and then it's more of the same-ol GOP BS: HSAs and tax cuts.
but let's imagine that this was a Democratic proposal. why, the lies practically write themselves, eh?
Posted by: cleek | August 31, 2009 at 11:30 PM
Um, no. Grassley's comment is a policy prediction claiming certain knowledge of future events, while conveniently neglecting to establish a basis whereby said certainty would be derived. Cleek's comment is identifying this rhetorical strategy as such.
To claim that these two statements are equivalent is, to understate things a bit, grossly unreasonable. One is a prediction of the future on the basis of wholly unstated reasoning. The other is an observation of the present on the basis of a proffered opinion. Judging the validity of one requires (omitted) speculation and/or analysis of probable outcomes of legislation. Judging the validity of the other requires the ability to read the first comment, as it is written. These two comments are by no means equivalently valid absent additional support. Pretending they are does your credibility no favors.
Posted by: Nombrilisme Vide | August 31, 2009 at 11:31 PM
Marty, you're excluding the middle. Our problem is with the word "certainly". Grassley says "Certainly will happen", against that cleek only says "may not happen". He doesn't say (or need to say) "certainly won't happen", and that's why it isn't just a "Yes it will / No it won't".
Posted by: Shane | August 31, 2009 at 11:32 PM
"Our problem is with the word "certainly". Grassley says "Certainly will happen", against that cleek only says "may not happen"."
Yes and in another place he says that:
"the "government takeover" stuff is nonsense. there is no takeover. neither is that anything which says such a thing is inevitable.'
Note that it isn't INEVITABLE. That makes me feel so much better. I won't worry about that anymore.....
Posted by: Marty | August 31, 2009 at 11:38 PM
KCinDC - point taken, and here is where the J. system is at its limitations. But without being mealy or make any special pleadings, and without pushing anything on to you - yes, as much as it is missing the point somewhere (in your words), you're right - it definitely still isn't as crazy as what's going on in the U.S.
As for Marty:
Basically I disagree with all of this. The state of affairs in the US isn't catastrophic. 85% of people have healthcare they are reasonably satisfied with. The costs are controllable by reforming healthcare delivery.
"The government will need to provide some money to ensure coverage of the uninsured, probably mostly taxes, and no Americans believe we shouldn't pay taxes, we just want our moneys worth."
Point taken here too - except that with your last statement about 'your money's worth'...sorry, but Americans are not getting their money's worth. Is it possible that costs are being driven up because of the market's failure to reach out to the 15% who don't have insurance? Is it even possible that costs might end up flattening out, at least to a degree, if there were more access because administrative costs might get spread out better to handle the load?
As for your earlier statement about reform of delivery - there is no reform of delivery without a serious discussion of reform of the practices of market-based health care delivery. Unreasonably high co-pays? No discussion there. Caps on payouts? Nope, none there either. Clauses precluding pre-existing conditions? Not even a whisper. The private insurance industry has never once, in this whole issue, ever offered to reform its practices from within. There isn't a single major insuror that has ever once attempted to craft any kind of plan that is affordable to those without coverage. And as for the 85% who are smoothly sailing along - that's great, but for the 15% who don't have it, it is a catastrophe, and a health care delivery system in which you have 15% of your population that isn't covered, and where, in a good number of that population, there isn't anything appreciably different about them from the other 85%, well...definitely something seems to be missing the point somewhere, though I guess it's still not as crazy as a system that, flaws and all, guarantees you access.
The fact is, Marty, that the 85% you're trumpeting really has no assurance that the insuror will fully follow the terms of even a standard policy, and has no legal recourse should an insuror renege on it, conspicuously when it comes to money. There seems to be this subtext (and I'm not accusing you of saying this, only pointing out what is there in the rhetoric of some others) that the remaining 15% are a bunch of indigent bums who haven't done a stroke of honest work and therefore aren't entitled to access. But a good number of those in this group ARE employed, and given what the system doesn't guarantee, there is nothing stopping you or anyone else in that 85% from going over into the 15%.
(note to KCinDC - I'm not making fun of you, as I do take your point...it's just that your words were the best at that moment)
Posted by: sekaijin | August 31, 2009 at 11:42 PM
"to claim that decisions in health care are between you and your physician is a laughable lie. most people who have experience with our current system should be able to recall insurance companies denying drugs, treatment or payment for medical decisions."
I have a little experience with this for myself, and Medicare with my Dad, I'll take mine thanks.
Posted by: Marty | August 31, 2009 at 11:43 PM
Marty, while I sympathize with the conservative ideology, you must admit that it's unbecoming of a man who's supposed to be the point man for middle-of-the-road compromise to use inflammatory language that simply assumes the worst conclusions, with no better proof than pessimism.
This is particularly foul because, as has been stated ad nauseum, the program is not designed to create a "health care monopoly" (quite the opposite), and is no more rationed or absurd than the current system, which includes ludicrous provisions such as the dreaded "pre-existing condition."
If the Republicans were the least bit interested in fixing health care, they should have done it years ago. There was nothing stopping them. I would LOVE a really good, conservative solution! But they have done nothing but actively block needed reforms since the '90s. And please don't tell me about the 2007 proposals. They've had majorities on and off for two decades, and this has been a known problem since at latest H.W. Bush's term.
So, bereft of serious conservative solutions, I have two options: The Democrats' way, or the status quo.
The Democrats' way may bankrupt the country. Could be. The status quo WILL bankrupt the country (and do so while insuring fewer people).
Until the tinfoil hats come off the Republicans, and I have some good-faith negotiations with actual policy proposals, I as a voter have to go with the Democrats.
[As an aside, it's not like there are no good conservative ideas; I thought the Whole Foods op ed was awesome. The problem is that there aren't any conservatives in Congress, only Republicans.]
Posted by: Steve | August 31, 2009 at 11:46 PM
"There seems to be this subtext (and I'm not accusing you of saying this, only pointing out what is there in the rhetoric of some others) that the remaining 15% are a bunch of indigent bums who haven't done a stroke of honest work and therefore aren't entitled to access"
That subtext must exist somewhere else. I have brothers and sisters, and a son who fall into the working uninsured category. I want those people (all 47M) covered. None of the vitriol helps make that happen.
Posted by: Marty | August 31, 2009 at 11:48 PM
Note that it isn't INEVITABLE. That makes me feel so much better. I won't worry about that anymore.....
if i had said "THIS WILL NOT HAPPEN", i'd be committing the same fallacy Grassley did (but without his apparently-malicious intent). instead, i chose to point out that there is nothing on the table which compels, mandates or requires the conclusion he claims. you and Grassley seem to think there is some kind of reason thing will inevitably end up in his worst-case state. neither of you have said what that is, but you seem to be talking as if it's a given.
so... present your evidence.
or quit pretending you have it.
Posted by: cleek | August 31, 2009 at 11:53 PM
Thank you, Steve.
Posted by: sekaijin | September 01, 2009 at 12:01 AM
"..faith in government that progressives seem to have gained in the last nine months."
We've always had that belief in government - well done, and watched carefully. Conservatives used to, too. Seriously, it seems to me our biggest complaints throughout Bush's eight years were where government wasn't done well ("Heckuva job, Brownie", airport security, maybe count tax cuts) or where he actively prevented proper monitoring (Iraq War justifications, wiretapping, TSA, Gitmo, and so on).
Posted by: Shane | September 01, 2009 at 12:06 AM
So by Marty's definition, the Republicans are proposing government-run health care. (Of course, as has been discussed here previously, if anything the government regulates is "government-run", then practically the entire US economy is government-run, so I'm not sure why we're worrying about "socialism" at this point.)
Posted by: KCinDC | September 01, 2009 at 12:07 AM
As one of the majority of people with health insurance, and the minority of people with a cadillac insurance plan, I gotta say that I'm NOT "reasonably satisfied" with it. I'm not satisfied at the cost of it; I'm not satisfied with its waste, or its exclusions, or with the fact that my neighbor may have nothing based on an unfortunate career choice or a lost job. I'm also not satisfied with the fact that I can't take it with me if I change jobs, or lose my job.
I just wanted to point out the majority of people having health insurance does not equal satisfaction with the status quo. Even those of us with extremely generous employer-provided health insurance know that the systems broken, and the Democrats are the only one offering a possible solution.
Posted by: leon | September 01, 2009 at 12:08 AM
Should've put this in my previous post, so my apologies here.
Marty again: "(s)ee, here's the rub with me, cleek says no it won't, Grassley says yes it will, neither has a fact, they are just divergent opinions. Grassley has a right to his, cleek has a right to his. Neither has a right to call the other a name, or question his character, for having it."
This again is all good and fine, but the relevant difference here is that Grassley is in a position to craft legislation that Cleek isn't.
Sorry, but are opinions all you want out of your elected officials? Guess I'm funny this way, but I don't want them to just go around "offering opinions" - I want them to face facts and do something about them, and he's conspicuously not doing either.
Posted by: sekaijin | September 01, 2009 at 12:13 AM
Without beating myself into the dirt, one more time to Marty - I did not mean to imply that you were making that subtext in my 11:42 comment, which you referred to in your 11:48 reply. I was only referring to the fact that there have been those that have tried to paint the 15% without health insurance as such.
I thought my note in parentheses explained that, but if it didn't, my apologies to you.
Posted by: sekaijin | September 01, 2009 at 12:21 AM
With some of the arguments one could also demand the abolition of firefighting services since the vast majority will never need it. So why should tax dollars subsidize those irresponsible enough to have their houses burn down? Now imagine a firefighting system similar to the US healthcare insurance system...
Posted by: Hartmut | September 01, 2009 at 12:26 AM
85% of people have healthcare they are reasonably satisfied with.
In fact, this is false.
About 85% of the population has health care *at all*.
Among the folks who have health care but are not particularly likely to be "reasonably satisfied" with it are people who have been denied necessary care due to recission, people who can only make use of their insurance after paying thousands of dollars out of pocket, and people who, despite having health insurance, have been bankrupted by medical expenses.
I don't have a cite, but my guess is that the vast majority, by far, of the folks I've just described receive their insurance from a private source.
And, of course, of the remaining percentage who are happy with their coverage, those who receive it through their employer could lose it immediately if they lose their jobs. Which something like a half-million Americans continue to do each month.
The system we have now is not functional. It does not provide anything like a reasonable level of care or coverage for anything approaching the entire population.
It's great that you're happy with your coverage. Lots of people aren't, and it's not because the government is getting in the way.
I've read a handful of analyses of HR 3200. As far as I can see, there is nothing in the bill that will interfere in the private relationship between patients and their health care providers in any significant way. The only forms of "rationing" that appear to be on the table are more or less equivalent to what private vendors do now, and will no doubt continue to do.
Lots of people in this country think the government sucks at what it does. In fact, the government does not, and is actually quite often quite competent. Especially at naturally bureaucratic, bean-counter tasks like running a health insurance program. The government runs several at least as successfully as private for-profit vendors, and more efficiently and at lower overall cost.
But Grassley's agin it. That's fine, everyone's entitled to their opinion. But to be honest, I kind of expect members of Congress, especially ranking members of Senate Finance, to do better than just spout ill-informed opinions.
There is no basis in fact for any of the claims he makes. None. The strongest case you could make would be of the "it might..." variety, and the simple reply to that is "then again, it might not". And whether it does, or not, is not something that's out of our control.
I'm with cleek, I think Grassley is a dissembling SOB. If he had a factual case to make, he'd make it. And he doesn't.
To be frank, I also don't see you putting much on the table here other than an animus toward a public solution and a personal dislike for cleek's tone.
A claim that "85% of the population is reasonably satisfied" with their health coverage is baldly and laughably false. And the folks who aren't reasonably satisfied have damned good reason to not be so.
Posted by: russell | September 01, 2009 at 12:49 AM
What Leon said. I have an extremely generous insurance plan through my employer which covers my entire family. I pay somewhere in the neighborhood of $200 out of every biweekly paycheck for it. It has yet, knock on wood, to fail us.
That's not to say that it couldn't. All it takes is one bad day to put you in the realm of the uninsured or the uninsurable. A place more than a few of my friends inhabit.
So no, I really don't have a problem paying a bit extra in taxes to have proper universal health care, even if I never end up needing it.
Posted by: Catsy | September 01, 2009 at 12:55 AM
I've spoke to hard-core market worshipers, and they love the idea of free-market compitition solving the monopoly the statists' have over fire-fighting.
__________________
However the United States did not have professional firefighters in the sense of government-run fire departments until around the time of the American Civil War. Prior to this time, amateur fire brigades would compete with one another to be the first to respond to a fire because insurance companies paid brigades to save buildings. Underwriters also employed their own Salvage Corps in some cities. The first known female firefighter Molly Williams took her place with the men on the dragropes during the blizzard of 1818 and pulled the pumper to the fire through the deep snow.
Fire houses were a sort of social gathering place rather than a place where professionals would meet, and the money paid to the brigade went into the house's fund rather than to individual members. It was not all that uncommon to see someone "squatting" on a fire hydrant by placing a barrel over it so other fire brigades could not use it. However, paid professional firefighting services were eventually established.
From:
History of Firefighting
Posted by: someotherdude | September 01, 2009 at 01:08 AM
I think it was last year that I read that California already begins to witness such a de facto privatized firefighting system. Public expenditures have been cut in many (especially well-to-do, GOP leaning) areas despite greater demand for the services. As a result public firefighters lacked the capacity to 'service' all areas. The well-to-do (s.o.) hired private services instead that would (try to) protect their houses (but not those of others that could not afford it).
There is a 1979 (German) http://de.oleo.tv/songtext/otto-waalkes/freiwillige-feuerwehr/>sketch by Otto Waalkes that would fit almost perfectly.
Posted by: Hartmut | September 01, 2009 at 09:12 AM
@ someotherdude - I wonder how many homes / lives / furnishings were lost during the jockeying for profit during that period? Certainly, it was insufficiently beloved of the public or we'd still do it that way.
Or was it...GOVERNMENT??? Rearing its head up there next to Putin?
Posted by: chmood | September 01, 2009 at 09:16 AM
Well, private health insurance doesn't work like the private fire brigades before the Civil War.
If it did, insurers would compete and rush to cover the sickest among us before we burned to the ground, but instead they gather up the hook and ladder and the dalmation and run the other way. They compete to be the last to insure the sick.
So, the private marketplace can find one way to f--- up firefighting and a completely different way to f--- up medical insurance coverage.
The nice thing about the private marketplace over government-run-just-about-anything in America is the wide range of choice we have in how things get f----- up in the former, while in the latter, according to the conservative mind, things are f---ed up for only one reason.
Posted by: John Thullen | September 01, 2009 at 09:32 AM
Further, the situation Catsy describes, in which people can be left without insurance coverage, shows the creativity of the private marketplace.
Our government run death panels will kill you, but they can't seem to find a way to bankrupt you while they kill you.
On the other hand, the death panels in the private marketplace will kill you and bankrupt you simultaneously, thus delivering two services at once with little cost to shareholders.
Posted by: John Thullen | September 01, 2009 at 09:38 AM
"Without beating myself into the dirt, one more time to Marty - I did not mean to imply that you were making that subtext in my 11:42 comment, which you referred to in your 11:48 reply. I was only referring to the fact that there have been those that have tried to paint the 15% without health insurance as such.
I thought my note in parentheses explained that, but if it didn't, my apologies to you."
No need to apologize, I did get your note in parenthesis, I was just clarifying for everyone else. Thanks for the thought.
Posted by: Marty | September 01, 2009 at 09:39 AM
And we haven't yet come to the topic of service providers 'creating demand' (and there were iirc historic precedents of arsonist firemen*). Popular culture is full of it (e.g. Vincent Price in The Comedy of Terrors, The (banned) Ankh-Morpork fire brigade...).
*and, more locally, car repair shop operators placing caltrops on roads in the vicinity
Posted by: Hartmut | September 01, 2009 at 09:45 AM
Bob Bennett, friend of Ron Wyden's granny, sat next to Karl Rove yesterday and said "The Number one assignment in 2009 is to kill Obamacare."
I look forward to the elevated rhetoric we'll enjoy when our legislators take up Wyden-Bennett.
Personally, I hope Republican townhall meetings next August look like baseball in Quentin Tarentino's "Inglorious Basterds". and I want to be the lead-off hitter.
Posted by: John Thullen | September 01, 2009 at 09:49 AM
It also wasn't unheard of for private fire companies to, uh, create business for themselves. Or to use the prospect of such business being created as an incentive to purchase their services.
At least the health insurance companies manage to make enough money to keep them happy without going around to the uninsired and saying, "Buy our policy or we'll make you sick." For now anyway.
Posted by: Hogan | September 01, 2009 at 09:59 AM
"And whether it does, or not, is not something that's out of our control."
See, buried in a long comment, (most of which is fairly reasoned) is this statement. It seems to me that it is the heart of the issue. People either believe they have that control, once reform is passed, or they don't.
Many of us, note including myself, have watched government programs become more expensive and ingrained in our society over the years, while their effectiveness diminished. It seems the larger the program the more we hear that it is going bankrupt and something must be done about it. Many of us have no confidence that SS will be there for us after paying into it for (for me) over 35 years. Medicare the same. Something will exist, but probably not what I thought I was paying for.
I don't care about the USPS or the DMV, those entities don't begin to match the complexity of this endeavor.
So, if you want my support of any proposal, keep it simple and have the right, and obvious, checks and restraints in place.
Don't tell me how it is not inevitable it will become single payer system or a bloated, ineffective government program or government run health care delivery. Don't tell me those things aren't spelled out in the current proposal.
Tell me what you are putting in the law so they definitely won't happen. Then if you won't, then all the denials in the world are meaningless, because that signals your intent to leave that door open.
Then who is being deceptive in this debate?
Posted by: Marty | September 01, 2009 at 10:06 AM
Tell me about it. We keep spending more and more on "defense", but the damned military can't even successfully pacify a couple of pissant middle eastern countries. That is what you meant, right?
Okay, I won't, but maybe you could tell us how they are? Otherwise it seems a bit like fear-mongering.
The problem is that many of us don't fear government as you obviously do. If conservatives are so concerned about the possible consequences, maybe they should try to actually craft a bipartisan bill that contains such provisions, rather than simply opposing reform in order to hand Obama and the Dems a defeat?Posted by: Larv | September 01, 2009 at 10:23 AM
I have nothing to add to the firefighting theme - sorry - but without trying to get the last word in or trump anyone else, something that Marty has said has been especially bothering me, though not for the predictable reasons. It's for the fact that he has admitted that he has (I'm partially quoting him) brothers and sisters, and a son who all are among the working uninsured.
Marty - if you don't feel thoroughly beaten up on by now and are still hanging on with this blog, I truly mean it when I say that it is tragic that they aren't covered, and I'm not piddling on you or anyone else from a great height, because I'm not on that great a height and I'm not about to piddle on anyone. When I lived in the States, I too went without health coverage for some time, and it stank, truly. And for Americans who lack insurance in their own country - you're right, vitriol isn't going to get them covered, and I'm with you all the way when you say you want them covered. Living in another country for the time I've had doesn't stop me from caring about what happens in our country any less than not being a Japanese national doesn't stop me from caring about what happens where I'm living.
The thing is, though, that if there's any vitroil, or whizzing from so-called great heights, it's primarily coming from the right, both from the media rant machine and from reactionary GOP lawmakers and fence-sitting Dems who either don't fully grasp the magnitude of this problem, or who do but find it ideologically inexpedient to deal with it, or for the true fruitbats, further their own political agendas and private vendettas to defeat political forces they don't like but that when and if they find themselves back in the majority, this issue will still be there and they'll have to face because this isn't going away, has been festering for some time, and will get worse. Steve's post at 11:46 on 8/31 summed it up better than what I could - the GOP, at various times over the last 25 years or so, had Pennsylvania Avenue and both houses of Congress and at one point had each of them, and did nothing about this when it would've been a comparitively more manageable problem than what it's allowed to become now. It is they who are upholding a system that has rationed your family members out of health care, and they expect your vote for it.
If a public option is still too unpalatable for you, then I would suggest that you demand your lawmakers, whether they are GOP or Dem, to craft legislation that would regulate, and even criminalize, the most onerous practices of the health care industry. As I see no-one even daring to brook these waters (talk about something really ideologically inexpedient), chances of reform would pretty much be dead in the water as so much of what real reform would entail has been pruned away by the rank and file GOP, sold out by Dems who still don't realize they're in the majority now, shouted down by Beck, Rush, Fox and any one of a number of rightist bloggers, pundits and self-styled experts, and laughed off by spokespeople and lobbyists for the industry.
There's no question that reform will entail hard choices. But when we consider the alternative, which is to continue to do nothing, then the hard choices will simply keep getting deferred until we get around to facing them when it's too late. What the right wants us to believe is that the hard choices can simply be wished away. There's a name for that - it's called the status quo.
Posted by: sekaijin | September 01, 2009 at 10:25 AM
Tell me what you are putting in the law so they definitely won't happen.
Laws can't be written to say that some other laws can't be written later.
To put it a different way, today's legislature can't bind tomorrow's. Only an amendment to the Constitution could do something like that.
If the Dems tried to write something like that into this bill, you'd jump all over it for the dishonesty that it would indeed be.
Posted by: JanieM | September 01, 2009 at 10:30 AM
Hmm. So you pointedly refuse to make the case that such eventualities are inevitable, or even probable. You instead shift the burden of proof to us to mollify your every fear in this regard, without bothering to establish the credibility of said fears.
For the sake of argument, I'll let that slide for the moment in order to address what you are doing, rather than what you aren't.
Care to spell out what measures you would consider sufficient to ensure the degree of certainty you call for here? A failure to do so makes your call for exhaustive, ill-defined "sensible precautions" a near cousin to concern trolling.
Posted by: Nombrilisme Vide | September 01, 2009 at 10:31 AM
"the GOP, at various times over the last 25 years or so, had Pennsylvania Avenue and both houses of Congress and at one point had each of them, and did nothing about this when it would've been a comparitively more manageable problem than what it's allowed to become now"
Thanks for the overall post, much of it I agree with. This part, however, is just fantasy. The Republicans have not held a veto proof majority in all that time. Every time this subject has come up it hass been clear that a Republican solution wouldn't get through the Senate. If we haad implemented even Bushes proposal we would be better off.
One of our Canadiana friends said in an earlier post that it seemed best to define the requirements and leave it to the states to implement. In some ways that was the Bush proposal.
In the last few years in particular the Democrats were not going to give Bush or any Republican any wins, the goal was to ensure they took control.
The discussions now are no more palatable to me from either side. I would like the government to govern, that only happens in 5 month long stretches now and the House (and 1/3 of the Senate) is back on the campaign trail. We are talking about people losing seats over this debate, because the campaigns have already started.
The concept that anyone has had control of the government in the last thirty years is just not accurate. When the Dems were doing everything to ensure they gained power the progressives and liberals cheered them on. Now, in the opposite circumstance, being political is a bad thing.
Posted by: Marty | September 01, 2009 at 10:39 AM
"Care to spell out what measures you would consider sufficient to ensure the degree of certainty you call for here? A failure to do so makes your call for exhaustive, ill-defined "sensible precautions" a near cousin to concern trolling."
Sure, no one expects that future Congresses can't pass laws. The construct of the program can require Congressional oversight and approval of any number of the panel recommendations, for example.
This is one example, and i am not there, but what I would be looking for is the assurance that in bureaucratic process the program couldn't change significantly without Congress doing something.
The bureaucracy, once created, is not responsive to the voter.
Posted by: Marty | September 01, 2009 at 10:46 AM
Marty, you call for reformers to "keep it simple", but any reform that passes is going to be complicated precisely because people like you make it impossible to pass anything that might disrupt any aspect of people's current insurance, so we've got to keep the existing deadwood while adding on alternatives. A single-payer system would clearly be much, much simpler than whatever reform we might actually get, and much, much simpler than the complicated mess of interacting entities we have now in the unreformed system, but we're not going to get that.
Posted by: KCinDC | September 01, 2009 at 10:51 AM
"Tell me about it. We keep spending more and more on "defense", but the damned military can't even successfully pacify a couple of pissant middle eastern countries. That is what you meant, right?"
I missed this the first time through.
Actually, yes that is one place I think we should be getting some of the money to pay for HCR. The money we shouldn't spend escalating in Afghanistan would probably help a lot.
Posted by: Marty | September 01, 2009 at 11:00 AM
"Marty, you call for reformers to "keep it simple", but any reform that passes is going to be complicated precisely because people like you make it impossible to pass anything that might disrupt any aspect of people's current insurance, so we've got to keep the existing deadwood while adding on alternatives......"
The simplest CHANGE to cover the 47M uninsured is what I am looking for here.
Posted by: Marty | September 01, 2009 at 11:05 AM
The bureaucracy, once created, is not responsive to the voter.
While insurance companies are so very responsive to the voter.
Posted by: JanieM | September 01, 2009 at 11:11 AM
The simplest CHANGE to cover the 47M uninsured is what I am looking for here.
But that's exactly what KC is referring to. You call for reform that will insure the uninsured without altering coverage for the 85% of the population who "are satisfied" with their existing coverage, while also neither noticeably expanding nor entrenching bureaucracy, nor even allowing the possibility of future expansion of said new coverage. And give us all a pony.
Posted by: Nombrilisme Vide | September 01, 2009 at 11:13 AM
"The bureaucracy, once created, is not responsive to the voter.
While insurance companies are so very responsive to the voter."
I am so very tired of this argument, there are several things in every version of the bills that add protections for consumers of insurance.
So why should I want to trade the bureaucracy that I have negotiated with all of my life for the completely unknown bureaucracy that is envisioned?
I would rather government provide oversight than have government provide the bureaucracy with no oversight.
Posted by: Marty | September 01, 2009 at 11:24 AM
You can't possibly be more tired of my argument than I am of yours.
Posted by: JanieM | September 01, 2009 at 11:33 AM
So why should I want to trade the bureaucracy that I have negotiated with all of my life for the completely unknown bureaucracy that is envisioned?
And, as has been pointed out numerous times in this very thread, nothing in any of the bills says you would have to make such a trade. But you keep insisting on a slippery slope, which no one can disprove to your satisfaction, because it's logically impossible to disprove a negative.
Thus rendering this possibly the most pointless "discussion" I've ever read on the Internet.
We get it, Marty. Your fear of the unknown trumps all other concerns. If those uninsured family members of yours have to go another 15-20 years before somebody in Washington takes another serious stab at universal coverage...hey, them's the breaks.
Posted by: Uncle Kvetch | September 01, 2009 at 11:40 AM
I would rather government provide oversight than have government provide the bureaucracy with no oversight.
...because that's just how it must be when you create a bureaucracy from scratch, no? It has to be byzantine, unresponsive, and wholly free from oversight. There is no other way. It's simply not possible, when creating a new structure, to design it so as to avoid such pitfalls... whereas existing byzantine, unresponsive entities can easily have oversight and responsiveness forced upon them in the eleventh hour.
Uh-huh. Right. Color me convinced. I'll second Uncle Kvetch's comments in toto.
Posted by: Nombrilisme Vide | September 01, 2009 at 12:02 PM
"We get it, Marty. Your fear of the unknown trumps all other concerns. If those uninsured family members of yours have to go another 15-20 years before somebody in Washington takes another serious stab at universal coverage...hey, them's the breaks."
No, see, you don't get it.
I never said I would have to do that. I was responding to someone who said this:
All of which reinforces my point, we have made this into a bunch of lines in the sand. Your response could be interpreted that if we don't get a public option then we shouldn't do anything. Grassleys is that any public option means we shouldn't pass it. None of this rhetoric on either side is productive.
I want something passed and would like the DEMOCRATS to understand how to get it done. The Republicans are not likely to get 60 votes for any plan they write.
See I AM FOR THIS, yet we can't have an honest back and forth about the concerns.
And, just in case ya'll missed it in past threads, I am for a completely public option for the uninsured, paid for from current revenues by cutting both defense and domestic spending to pay for it. Essentially an extension of Medicare type coverage with needs based payments.
Posted by: Marty | September 01, 2009 at 12:02 PM
Hey, at least Marty and Sebastian are arguing in good faith and from the real world . I've been arguing health care over at Megan Mcardle and believe me, its like through the looking glass and down the rabbit hole over there. One of the commenters has one answer fits all with every health care reform issue: " Government always screws up" . Another actually believes in Sarah Palin's death panels. Unfortunately, they are the rule, not the exception, among the Republican voters.
Posted by: stonetools | September 01, 2009 at 12:07 PM
No, see, you don't get it.
You're right, I don't.
And, just in case ya'll missed it in past threads, I am for a completely public option for the uninsured
I surrender.
Posted by: Uncle Kvetch | September 01, 2009 at 12:14 PM
Many of us, note including myself, have watched government programs become more expensive and ingrained in our society over the years, while their effectiveness diminished.
My general impression over the last 30 years is that an enormous number of very useful government programs have had their influence trimmed back considerably.
That's just me.
The programs that you're referring to -- SS, Medicare, Medicaid -- are growing in expense because the cost of health care is growing at an unsustainable rate.
If that isn't addressed it won't matter much who provides health care, or health insurance. We just won't be able to afford it, period.
I am so very tired of this argument
I think if you want to participate in this particular debate, you need to get beyond that, because it's an important argument, and one that your comment doesn't really do a good job of addressing.
We have lots of regulation of the health care industry *now*, and lots of protections for consumers *now*, and executives of health insurance companies can still stand in the halls of Congress and say they have no intention of ending the practice of recission.
To turn your anti-government argument on its head, *why should we have any confidence that the private sector will do any different, or any better, than they do now*?
How has, frex, Humana demonstrated that they are a more responsible and reliable provider of insurance than HHS? You have to show me that, because I'm not seeing it.
As far as I can tell, the entire argument here is about whether you trust government to act effectively in your interest. I think it is clear that private entities are *not* obliged to act in your interest, and in fact many conservatives bitterly fight any attempts to constrain them to do so.
So it seems (to me) like the issue is whether you see government as an institution that either acts in some vested interest of its own, or that is demonstrably incompetent, or not.
I don't, and I don't really see strong evidence to change my mind. Particularly when I compare government, as an institution, to the private sector, at least in this particular area of the economy.
In particular, the objections Grassley raises to HR 2300 seem, to me, to be pandering to paranoia.
Posted by: russell | September 01, 2009 at 12:15 PM
Not to pile on, but this is bugging me. Marty maybe you could provide some cites on those Republican plans to reform health care over the past 30 years? 'Cause... I don't remember any of them. Especially not a "Bush's plan".
And given the seriousness (well, complete lack thereof) of their recent proposals, I don't think their earlier ones would be much more effective, like the "give a tax credit and make everybody buy individual insurance!" nonsense that would require a lot more regulation of the insurance companies than Republicans would find palatable to work at all.
And what, exactly, is so terrifying about single payer health care? It works well in many other countries, more cheaply, and without "death panels" or other nonsense.
Posted by: Nate | September 01, 2009 at 12:27 PM
I just want to chime in and say that every time I see a post from an ex-pat American regarding the universal healthcare they're getting in another country, it's very positive (this is obviously in reference to Sekaijin's posts). I have relatives in Canada and the UK and, despite my Republican mother's firm belief that their systems suck, I've followed their situations and what I see is my relatives getting solid healthcare.
Yet all we get from the GOP is "OMG, gummint bad! Look at the UK, it's horrible! Run for the hills!"
Christ. If you have substantive issues with the Dem proposal, write 'em up and suggest amendments, by all means. And don't give me Wyden-Bennett (look @ Bennett latetly, since the Club For Growth starting pounding on him for his support of that EEEEEVIL bill). I too am worried about the price tag (especially since it seems obvious that nobody will touch military spending in the foreseable future), so if you have some good ideas for bending that cost curve, have at it (it would be pretty funny to see the GOP tackle that after all the effort they put into lying about "death panels").
But the vast majority of us watching this play out know the reality is that the GOP is fine with the status quo, and just want to kill whatever plan the Dems put up. It's clear as day. The GOP announces this over and over... and yet some folks can't seem to figure it out.
Posted by: Rob in CT | September 01, 2009 at 12:54 PM
Okay, now "Warren Terra" has posted on each of publius's last three articles, with essentially the same "publius sucks" message. Any mods able to make sure that's the real deal?
Posted by: Nate | September 01, 2009 at 12:59 PM
"We have lots of regulation of the health care industry *now*, and lots of protections for consumers *now*, and executives of health insurance companies can still stand in the halls of Congress and say they have no intention of ending the practice of recission."
Of course they have no intention of doing so. So the government makes recission after an initial 90 day period against the law. Then they make sure uninsurable people have access to baseline insurance if rescinded during that time or rejected initially.
The real challenge with recission is they don't investigate or reject until there is a big claim, so don't let them take our money and not provide insurance.
These are actually what I consider the simple concepts that government can contribute to in a positive way.
Then:
I agree with entirely. My basic stance is get the simplest solution for insuring the uninsured and then fix delivery. None of the proposals do that so it will be unsustainably expensive no matter which one is chosen.
Finally:
is a great idea, it uncouples insurance from employment, addresses all citizens and, in his proposal, encouraged innovation at the state level to find the best ways to provide for the uninsured.
Posted by: Marty | September 01, 2009 at 12:59 PM
The Republicans have not held a veto proof majority in all that time. Every time this subject has come up it hass been clear that a Republican solution wouldn't get through the Senate.
This is either insane or dishonest, but I honestly can't think of a third possibility that would explain making a statement that is so clearly false. (OK, I can think of more possibilities: maybe you wrote so incoherently that what you wrote bears no relation to what you meant, or maybe you just are completely ignorant of very basic facts about our government.)
A veto-proof majority doesn't matter when the Republicans have the White House. Getting through the Senate isn't hard when the Republicans had a majority. The Republicans had the White House and both houses of Congress for the four middle years of Bush's time in office, and for the first two years Republicans had the House of Representatives and had the Senate for part of that time as well.
And a simple majority would have been enough. The de facto requirement for a 60-vote majority is new; more procedural filibusters have been filed in the last session of Congress than in almost any two previous sessions combined. The 2003-2004 session of Congress was a nadir of cloture votes going back more than 10 years.
If the Republicans had wanted to pass health care reform, they could have during half to three-quarters of Bush's time in office. They didn't, ergo, they didn't want to, and if it's not dishonest or insane to claim otherwise then I can't think of any other explanation.
Posted by: Cyrus | September 01, 2009 at 01:16 PM
Marty: No, it didn't. It threw people into the wilds of the individual insurance market, where people would have to choose between many, often more expensive, individual insurance plans. Which the companies could then turn down, or mark up, or whatever, as they do now. Individual citizens do not have the same level of information, or of time, as a giant company with a marketing and legal department both dedicated to making sure they can make as much money as possible by paying out as little as possible.
To make the "tax credit and individual insurance" idea work, you'd need to require the insurance companies to take all comers, regulate recission, preexisting conditions, rates, contracts, etc. Which would all be things Republicans would oppose. You would also probably have to raise taxes to give a massive tax subsidy to those who can't afford insurance now, which would ALSO be opposed by Republicans. And most people would probably end up paying quite a bit more for insurance than they do now, if they have it.
So the "free market" tax credit idea would require massive government regulation, effectiveness panels, tax increases, get rid of everyone's current insurance, give huge profits to the insurance companies, and be a lot more confusing and a hassle than it is now, even WITH the extra regulations involved. Much of which would be opposed by Republicans, so either the Republicans wouldn't support it, or it'd be a disaster. In case of b, it'd be a bad idea, and in case of a, if you're looking at something with all the disruption it'd cause and the Republican opposition to it, why not just go for single payer, which we know can be made to work, and would get the same amount of Republican support, for LESS disruption and probably similar costs?
Posted by: Nate | September 01, 2009 at 01:17 PM
Can you explain how this is consistent with your defense of Grassley's claim that a public option will lead to a "government takeover" of the health care system? I'm about ready to surrender like Uncle Kvetch.
Posted by: KCinDC | September 01, 2009 at 01:53 PM
I'm about ready to surrender like Uncle Kvetch.
the only way to win is to not play the game.
Posted by: cleek | September 01, 2009 at 02:00 PM
Marty,
Uncoupling health insurance from employment is a goal you and I share. How exactly do you propose to discourage, or prevent, or forbid, employers from offering health insurance as part of their compensation package?
I know, I know: change the tax rules. But which ones? It's not businesses who get a tax break for paying their workers' health insurance premiums. It's the workers. So if I understand you right, you would: a)tax the workers on the extra cash pay they would get in lieu of insurance; and b)give them a tax credit if they use the cash to buy health insurance. Frankly, that seems like more fuss and bother for more people than the current proposals would inflict.
I'm also with you on this: insurance must not be a one-sided gamble. If an insurance company takes your money every year that you're healthy, it cannot be allowed to stop taking your money after you get sick.
So we make a law: no rescissions, period. That makes insurance companies less inclined to sell you insurance in the first place. So we add another law: health insurance can only be sold on a MUST ISSUE basis, with community ratings. Well, no consumer in his right mind would then buy insurance UNTIL he gets sick. So we add yet another law: an INDIVIDUAL MANDATE to carry insurance.
Now, I don't object to an individual mandate, oppressive and tyrannical though it may seem to freedom-lovers everywhere. But some people will not be able to afford the premiums. So we set up a government program to subsidize them. Naturally, such a program will need masses of bureaucrats to verify that every person who pleads poverty is in fact poor.
We cannot seem to avoid complexity in our quest for simplicity. Once we set foot over the edge of the status quo, we are on the slippery slope of regulations, mandates, and growing bureaucracy.
But sliding down slippery slopes is another name for skiing. It can be challenging, but it doesn't HAVE to result in a disastrous tumble all the way to the bottom.
We are now at an almost-unbearably high level of "health care spending". We are hanging on to the pommel lift which is the current "system". We can see that it's dragging us ever higher up the mountain of cost. The slope back down to lower levels is indeed slippery. We can let go of the tow-rope NOW, and trust our ability to ski down the slippery slope somewhat gracefully. Or we can hang on. But that will only bring us even higher up the mountain, where the slopes are even more slippery.
If you're afraid of how slippery the bunny slope is, wait til you see the diamond trails.
--TP
Posted by: Tony P. | September 01, 2009 at 02:08 PM
When you folks are done negotiating the healthcare legislation with each other, run it by Grassley, Palin, Gingrich, Limbaugh, the entire Republican caucus, the RNC, FOX, the militia groups, the NRA, Grover Norquist, and the cast of tens of millions of the republican base and let me know what they say.
Posted by: John Thullen | September 01, 2009 at 02:21 PM
So the government makes recission after an initial 90 day period against the law.
Yes, but can you promise that after we've done health reform and everyone is getting on with their lives, the insurance lobbyists won't come back and get that repealed? Because I really need an ironclad guarantee.
Posted by: Hogan | September 01, 2009 at 02:40 PM
"We cannot seem to avoid complexity in our quest for simplicity. Once we set foot over the edge of the status quo, we are on the slippery slope of regulations, mandates, and growing bureaucracy."
Thinking about this, we've changed tax laws pretty regularly over the years, doesn't seem too complex. The IRS is pretty good at vetting taxable income for credits. Proof of insurance certainly becomes another form to have, but I need it today to actually get medical care.
As for requiring insurance, most states do that today at some level for auto insurance. Seems you could leave the administration of that to the states.
I don't see a new bureaucracy here.
Posted by: Marty | September 01, 2009 at 02:46 PM
Well, Marty, how does it feel to be in the belly of the progressive beast. To use an Obamaism, I'm empathetic.
You should have long ago figured out that here every person who substantially disagrees with or totally discounts the progressive agenda, including federal government dominating matters related to healthcare, education, energy and the environment, will be a lying, fear-mongering, bullsh*tter. The progressives have all the facts and the rest of us don't have any. Any democrat in the Congress who has a conservative bone in his body needs a primary challenge. Republicans have no integrity but little is said about democrats who obviously have such problems, (Reid, Rangel, Dodd, Jefferson, Franks).
I agree with your point that Grassley is not a liar but a politician expressing a political view, as are most republicans and democrats, for that matter. I don't consider progressives liars or lacking integrity, but only that they have political views that are essentially collectivist or tribal or some other word that expresses a view that is against the concept of an individual's personal liberty. There will never be a way to reach common ground between those who believe in individual liberty and those who believe in the power of the collective.
Posted by: GoodOleBoy | September 01, 2009 at 03:21 PM
Thinking about this, we've changed tax laws pretty regularly over the years, doesn't seem too complex.
Seriously? Why are accountants so busy mid-February through mid-April?
The IRS is pretty good at vetting taxable income for credits.
Isn't the IRS a large, existing bureaucracy?
Proof of insurance certainly becomes another form to have, but I need it today to actually get medical care.
As for requiring insurance, most states do that today at some level for auto insurance. Seems you could leave the administration of that to the states.
I don't see a new bureaucracy here.
For what? Verifying that people carry insurance under a mandate? It seemed to me that there was a bit more to Tony P.'s comment than having to check people's proof of insurance.
Posted by: hairshirthedonist | September 01, 2009 at 03:27 PM
Really? Last I heard Marty was extremely concerned about not changing anything for the people who already have insurance. Maybe there's more than one Marty in the comments here? That would explain a lot.
Posted by: KCinDC | September 01, 2009 at 03:32 PM
You should have long ago figured out that here every person who substantially disagrees with or totally discounts the progressive agenda, including federal government dominating matters related to healthcare, education, energy and the environment, will be a lying, fear-mongering, bullsh*tter.
This statement is bullsh*t. What happens when the progressives disagree about what the "progressive agenda" is? Inquiring hive-minds want to know.
Republicans have no integrity but little is said about democrats who obviously have such problems, (Reid, Rangel, Dodd, Jefferson, Franks).
This is utterly false. I can't count how many times Reid's been criticized on this blog, and I'm pretty sure Hilzoy wrote an entire post about Jefferson's failings.
I agree with your point that Grassley is not a liar but a politician expressing a political view, as are most republicans and democrats, for that matter. I don't consider progressives liars or lacking integrity, but only that they have political views that are essentially collectivist or tribal or some other word that expresses a view that is against the concept of an individual's personal liberty. There will never be a way to reach common ground between those who believe in individual liberty and those who believe in the power of the collective.
This is very conveniently vague. Why is it that a specific discussion about specific things gets addressed with this sort of meaninglessly general, quasi-meta baloney that has nothing to do with anything? Seriously...
Posted by: hairshirthedonist | September 01, 2009 at 03:38 PM
Grassley is not a liar but a politician expressing a political view
then the word "lie" has no meaning.
Posted by: cleek | September 01, 2009 at 04:02 PM
'This is very conveniently vague. Why is it that a specific discussion about specific things gets addressed with this sort of meaninglessly general, quasi-meta baloney that has nothing to do with anything? Seriously...'
Why not affirm that you consider individual liberty to be one of the foremost rights protected by our Constitution and that an individual's right to personal property and those things acquired through an individual's legitimate efforts belong to that individual and any portion taken by the federal government should be used for limited purposes as delineated in the Constitution?
If you do so affirm, then we can have a valid discussion about whether healthcare legislation proposed in this session of Congress makes sense. If not, then tell why this is vague.
Posted by: GoodOleBoy | September 01, 2009 at 04:09 PM
"There will never be a way to reach common ground between those who believe in individual liberty and those who believe in the power of the collective."
Marty's fine, but .......
I'll be happy when just one --- just one --- dumb, bullet-headed 68 year-old f--- who shows up at townhall meetings (after listening to lying scum like Grassley and any number of bullsh#tters on the Right) to protest against socialism in healthcare AND to protest AGAINST taking his Medicare away, can tell me what the flying f--- he believes in, or knows, or thinks he knows, or who he thinks he's fooling, or how deeply he must reach up his own posterior to find the courage to open his ignorant, demogagogic, lying, scum mouth about anything, let alone individual liberty and/or the collective, in a democracy.
Other than that, GOB, I agree with you.
However, if in fact Obsidian Wings is the belly of the progressive beast where things are settled in the progressive world, why do lovers of individual liberty send their little guys over here (no offense, Marty) instead of sending Rush, or Grassley, or Erick Erickson, or Glenn Feck over here so the beast can eat them alive.
Well, we know why.
They can only lie in one-way forums.
Posted by: John Thullen | September 01, 2009 at 04:29 PM
GOB, by what possible interpretation of the Constitution would Medicare be constitutional but the proposed reforms not be? If you're for abolishing Medicare, then let's hear it. We can note that your views are far outside the political mainstream for either party and have little to do with what's likely to happen in Congress any time soon, but we can have a discussion, I suppose. If not, then what is your point?
Posted by: KCinDC | September 01, 2009 at 04:29 PM
Why not affirm that you consider individual liberty to be one of the foremost rights protected by our Constitution and that an individual's right to personal property and those things acquired through an individual's legitimate efforts belong to that individual and any portion taken by the federal government should be used for limited purposes as delineated in the Constitution?
Absolutely, though I'd leave it to the Supreme Court to decide what is outside the federal governement's limited purposes as delineated in the Constitution once some legislation has been passed. And I'd consider it a greater individual liberty not to drop dead from something reasonably easily preventable than to avoid paying some marginal amount of taxes.
Posted by: hairshirthedonist | September 01, 2009 at 04:39 PM
"Why not affirm that you consider individual liberty to be one of the foremost rights protected by our Constitution and that an individual's right to personal property and those things acquired through an individual's legitimate efforts belong to that individual and any portion taken by the federal government should be used for limited purposes as delineated in the Constitution?"
By which you mean to say that we must first agree with your views on taxation and scope of government. Only then will you deign to discuss healthcare reform?
Wow. The arrogance of the 28%...
Posted by: Rob in CT | September 01, 2009 at 04:41 PM
"I don't consider progressives liars or lacking integrity, but only that they have political views that are essentially collectivist or tribal or some other word that expresses a view that is against the concept of an individual's personal liberty."
Tribal would best describe the current rump of the GOP. They've actually gone well past the Dems when it comes to identity politics.
Collectivist works better for Progressives, though mostly in an economic sense, IMO. Progressives are generally in favor of helping the poor at the expense of the rich. However, they tend to resist governmental power when it's used to, for instance, spy on Americans, invade other countries on dubious pretexts, torture prisoners, etc. Flipside: Libertarians and Conservatives tend to hate progressive taxation and wealth redistribution, but many of them are just fine with spying on Americans, military adventures in nationbuilding and, of course, "enhanced interrogation." Most people actually want the government to do things. They just want it to do things they want.
Posted by: Rob in CT | September 01, 2009 at 04:51 PM
Since when is individual liberty just another word for the stuff you own? Is this another "freedom from" versus "freedom to" type thing?
Posted by: Nate | September 01, 2009 at 04:59 PM
one should not expect coherence from a party that celebrates torture, open-ended war, indefinite detention and domestic surveillance while complaining that the government is enslaving us with taxes.
Posted by: cleek | September 01, 2009 at 05:28 PM
"I'll be happy when just one --- just one --- dumb, bullet-headed 68 year-old f--- who shows up at townhall meetings (after listening to lying scum like Grassley and any number of bullsh#tters on the Right) to protest against socialism in healthcare AND to protest AGAINST taking his Medicare away,"
There is a difference, all us old geezers have been paying for the privilege of Medicare all our (working) lives. We don't see that as socialism, we see it as buying insurance. Then we get old enough for it to pay and get told it might not be there, it's going broke.
Posted by: Marty | September 01, 2009 at 05:33 PM
"Really? Last I heard Marty was extremely concerned about not changing anything for the people who already have insurance. Maybe there's more than one Marty in the comments here? That would explain a lot."
No only one marty, did see a Martin thats not me. However, I am capable of seeing more than one way to solve the problem we face. Some I prefer, some i prefer out of what I think is possible.
Posted by: Marty | September 01, 2009 at 05:49 PM