It's Aliiive, Sort Of

by publius

Max Baucus has finally circulated a health care plan.  That single fact is probably more important than any substantive provision the plan contains.  I just want the frickin' bill reported out of Finance, which has been holding up everything.

Some of the highlights include (1) subsidies at 300% of poverty (too low); (2) new fees on insurers' most expensive policies; and (3) no public option.  There are also various other provisions that the wonks will have to weigh in on (e.g., the size of out-of-pocket limits; the percentage of expenses covered).

On first read, though, my biggest fear is that the subsidies are too low.  The worst of all worlds, remember, is to require people (who can't afford it) to buy expensive but crappy coverage.  That's the type of thing that triggers landslide elections, pitchforked mobs, etc.  And that's precisely what will happen if Congress tries to do this on the cheap.

More to come.  And happy Labor Day!  Enjoy having weekends?  Thank a union.

Comments

[Hartmut]

The question is at whom the pitchforks will be pointed. It would be insane to aim them at the Dems but not the GOP or even to reward the GOP in the next elections (but that is sadly what is to be expected to happen).

[Hartmut]

That does not mean that there shouldn't be primary challengers to the lot of them or support for viable independents (i.e. people with a chance that are not scumbags or loonies).
Draft Rachel M.! ;-)

[Neil the Ethical Werewolf]

I just want the frickin' bill reported out of Finance, which has been holding up everything.

Right. A bad bill out of Finance can be fixed at several points in the process. It's not even that terrible if it gets reconciled badly with the HELP bill and Senate passes some crap with no public option and low subsidies. Everything will depend on whether Nancy and Henry can make a big power play in conference committee to make something very much like the House Bill into law. Of course, their job becomes easier with a better Senate bill, but I'm optimistic about their ability to improve a bad one.

[JanieM]

And happy Labor Day! Enjoy having weekends? Thank a union.

In this day and age (as my dad, a union guy himself, used to say), it might be more a propos to say:

"Wish you had weekends? Form a union."

But good luck with that. (Geez, I'm channeling someone here, or maybe it's just that I'm up too early.)

[liberal japonicus]

Here is Nate Silver's/538 blog take on the bill. If you can't trust a good baseball sabermetrician, who can you trust?

[liberal japonicus]

Whoops, that was from July, so it was about the speculative details for the bill, sorry about that. However, it might be interesting to see how much the AP got right.

[russell]

Mr. Baucus’s plan, expected to cost $850 billion to $900 billion over 10 years, would tax insurance companies on their most expensive health care policies. The hope is that employers would buy cheaper, less generous coverage for employees, thereby reducing the overuse of medical services.

Isn't $850 to $900B pretty close to the $1T estimate for HR 3200?

And our approach to cutting costs is going to be by reducing coverage??

Another section of Mr. Baucus’s proposal would help pay insurance premiums, co-payments and deductibles for people with incomes less than 300 percent of the poverty level ($66,150 for a family of four). .

The average annual premium for employer-provided health coverage for a family of four is about $13,000. If you are making, say, $70K rather than $66K, that's 18% of your *gross* annual income.

Mr. Baucus would impose limits on out-of-pocket medical costs — the co-payments, deductibles and similar charges for covered items and services. The limits would be $11,900 a year for a family and $5,950 for an individual.

For our family with household income of $70K that's 17% of annual gross income.

Median household income for a family of four in fiscal year 2008 was $67,019. As we all know, "median" means half the population earns less.

In other news, the top fifty profitable companies in the US include Johnson & Johnson, Pfizer, Merck, Bristol-Myers Squibb, Abbott Laboratories, Wyeth, CVS Caremark, and UnitedHealth Group.

My guess is that something close to Baucus' proposal is what we're going to end up with.

You tell me whose interests are being represented.

It's my sincere belief that the United States as a republican polity is kind of over. We are now officially living in something else. Plutocracy, kleptocracy, some kind of wealth-based aristocracy, call it whatever you like. It's no longer a representative republic.

One of the lenses by which you can view American political history over the last 150 years is as a sort of cage match between the broad public interest and the interests of speculative investment capital. There are others, including race and regional social differences, but broad public interest vs capital is one.

I'm calling that fight over. Capital won.

We'll get enough access to health care to keep people from rioting in the streets and no more. And we'll pay through the nose for it and be expected to say "thank you very much" for the privilege.

Fail.

[Nombrilisme Vide]

I wish I could add something more than "what Russell said", but I got nothin'.

Happy Labor Day, yinz!

[russell]

And happy Labor Day! Enjoy having weekends? Thank a union.

I'm a white collar professional. We don't need no stinking unions!

All of which is to say, I'm working today.

Cheers -

[Joe]

"Isn't $850 to $900B pretty close to the $1T estimate for HR 3200?"

The final stimulus number was close to the original plan too, but an arbitrary cut of this sort was deemed quite important to certain Blue Dog sorts then too.

Just to bring it up, I sort of recall another Senate Committee working on a bill too. Someone named Kennedy, I believe, had something to do with it. I might be wrong.

[freelunch]

No one has talked about the self-funded programs that companies have. Has this been addressed anywhere?

Do we really want cutbacks in benefits offered? There is good reason to work with the medical community to cut their profligate spending, but cutting actual, needed services is not the way. Anyway, this also seems to do nothing about the random limits that insurers impose after the contract is written.

[russell]

cutting actual, needed services is not the way.

It's certainly *a* way.

No service provided, no expenditure. Costs cut.

What could be simpler?

[TJ]

What russell said. When can we expect the House of Lords' official name change?

[Eric Martin]

Shorter Russell:

Your revolution is over, Mr. Lebowski. Condolences

[bedtimeforbonzo]

No, Janie, you weren't up too early.

I work in a non-union, commission-based job in a profession that gets away with just about anything it wants.

It's the last Wednesday of the month, say, and numbers are down, and suddely you're told that, "We're open on Sunday." Never mind that you are going to put in 50-plus hours without adding an extra work day to your plate.

Oh, yeah, you could protest and say you have family plans. But do that enough times, and you're a marked man when the next round of downsizing occurs.

Sure, unions reached a point where they gained too much power. But even working-class Americans forget how working conditions in this country were without them. Shame on them.

[RogueDem]

While I usually agree with Russell (like many here) I do think it is premature to label the healthcare reform effort a fail. I will withhold judgment until I see the final product which is still a ways off.

I do worry that our experiment in democracy is veering very close to plutocracy. When the Supreme Court says that money equals speech that is not a good sign. When our elections look more and more like auctions that is not a good sign. But in the end the onus is on us and I am not quite ready to throw in the towel.

[russell]

But in the end the onus is on us and I am not quite ready to throw in the towel.

You've named the SCOTUS and the election process as having gone over to the dark side, as it were. I think it's pretty clear that Congress has been there for quite a while now.

I agree that the onus is ultimately on us, but what's left in your toolbox?

[RogueDem]

Russell, I don't have any good answers but the first step must be to educate ourselves and our chldren. Converse, communicate, be open minded, blah blah blah. I do believe that the only way to convince other people is to have a dialog with them.

We need to elect people to represent us that are rational and are not primarily beholding to huge monied interests. I am no activist but we need to work harder and be smarter than those who want to prevent positive changes from occurring. Maybe it is too late for the whole 'of the people, by the people, for the people' thing to work out here in the US but I sure hope not.

[bob mcmanus]

Matt Taibibi ...all the "public options" are a disaster as written and will be worse than our current conditions

What russell said. Kill the bill dead. Support the House progresives. Demand single-payer. Don't listen to the frightened and complicit. Especially the dude playing golf with UBS. Sharpen pitchforks.

Not too late for social unrest. It could become so if we pass this bill.

[bob mcmanus]

On Labor Day Weep for Labor

"Really, everything else about Labor in America is just commentary on this graph"

[cleek]

Demand single-payer.

demand it of whom?

there is nobody in the Dem caucus who could or would fulfill such a demand.

[ThatLeftTurnInABQ]

I too am not ready to write "American experiment, RIP" per russell's critique, until the final bill is signed into law. But there certainly are a lot of storm clouds hovering. I think this really comes down to a fight both within the Democratic Party and within Congress. The House progressives are going to have to stand up to the Senate and say: "Senator. You have done enough. Have you no sense of decency sir, at long last? Have you left no sense of decency?"

Otherwise the Dems will get the worst of both worlds - a "reform" bill passed which will be hung around their necks like a millstone by the GOP and which makes the situation of far too many middle class voters worse than it was before; and once the smoke clears it will be seen as a transparent give away to the insurance industry.

As for the plutocracy, we've been thru such dark times before. The 1890s were if anything, worse than today. But back then there were threats (Anarchists and Reds) which prompted reform lest capitalism itself be threatened from below. Today our Masters of the Universe appear to be operating out of a sense of complete and total invulnerability.

Speaking of which.

[russell]

The 1890s were if anything, worse than today.

I agree. But, as you note, there was also a meaningful opposition to the interests of capital, both within and without the political establishment.

Where is it now?

[bob mcmanus]

there is nobody in the Dem caucus who could or would fulfill such a demand

IIRC, there are 163 house votes for HR 676, or were before Nancy and Rahm/Obama started threatening.

"could or would fulfill?"

Just say no. If we can get 50 House members to say no to anything but single-payer, as FDL, again IIRC, has gotten 30+ to say no to anything without a "public option", the system will further erode and s-p may have a chance. It won't if we don't fight for it.

Politics is played at the cliff, the edge of chaos. The railroad, steel, air-traffic controller unions were willing to take a chance on bringing the entire country down, and were usually hated for it. It would be good to remember that on Labor Day.

It should be obvious by now that incremental liberalism is a horrendous fail.

[wonkie]

There's always Canada. If we get no public option my faily will have to immigrate after the demiswe of my mother-in-law. I cannot work at my job until I am old enough for Medicare and I have a pre-existing condition which puts imsurance out of reach even if I could afford it which I can't.

Fortunatley I love the BC coast and would very much enjoy living in Nanaimo and having a flag with a maple leaf on it.

ANother thing to thank unions for: I get insurance with my current job.

[Nombrilisme Vide]

Speaking of which.

-----

Ethics for Everyman

Throwing a bomb is bad,
Dropping a bomb is good;
Terror, no need to add,
Depends on who's wearing the hood.

Kangaroo courts are wrong.
Specialist courts are right;
Discipline by the strong
Is fair if your collar is white.

Company profit 'soars',
Wages, of course 'explode';
Profits deserve applause,
Pay claims, the criminal code.

Daily the Church declares
Betting shops are a curse;
Gambling with stocks and shares
Enlarges the national purse.

Workers are absentees,
Businessmen relax,
Different as chalk and cheese;
Social morality
Has a duality-
One for each side of the tracks.

--Roger Woddis

[russell]

We have friends who just moved to the Canadian maritimes from upstate NY.

He's a carpenter/general contractor. She's an artist and has a pretty good business making hats.

That equals either no health insurance, or health insurance paid 100% out of pocket.

They have a five year old son.

She was born in Canada, so citizenship and emigration were a non-issue.

It was a no-brainer.

[Don SinFalta]

That's the type of thing that triggers landslide elections, pitchforked mobs, etc. And that's precisely what will happen if Congress tries to do this on the cheap.

So what? If that's what the Dems end up passing as "health care reform", they deserve to get thrown out of office en masse.

[hairshirthedonist]

She was born in Canada, so citizenship and emigration were a non-issue.

We're all Mexicans now.

[JakeInDk]

Gotta love 'thank a union'! Been living in Denmark for 15 years now, and I'm regularly shocked by how little Danes under 50 recognize the importance of (mixed metaphor ahead - danger) squeaky wheels at the bottom of the ladder. Here it's 'Enjoy having weekends? enjoy free medical care? enjoy 5 weeks paid vacation? enjoy free higher education with a monthly stipend? enjoy full-pay maternity AND paternity leave? thank a union!'.

Also here 'we won't raise your taxes' is a winning campaign strategy, and also here the free-marketers and the xenophobes seem to have fallen naturally together.

All of which is to say thanks for keeping us educated O'Wingers!