Progressive House members werent able to force a House vote on a national single-payer health care system or even hold onto an amendment allowing states to form their own single-payer plans because they didnt produce 14 members who would vote against the watered-down compromise bill, Rep. Dennis Kucinich (D-Ohio) said on Democracy Now! (11/9). Jane Hamsher of FireDogLake.com, also appearing on the program, noted that Rep. Bart Stupak (D-Mich.) forced the House to accept an amendment further restricting abortion coverage by private insurance companies because Stupak had lined up more than 39 Democrats who pledged to vote against the bill if they didnt get the abortion amendment. About 25 Democrats were pledged to vote against the bill anyway, she said, So, given the fact that there were  co-sponsors of [HR 676, the Medicare for All bill], was there any attempt to get 14 of them together to block any legislation from going through that didnt have a vote on single payer or your state legislation? she asked.
Kucinich, who voted against the bill (along with fellow single-payer advocate Eric Massa, D-N.Y.), replied, unfortunately, there were many people who just didnt want to fight that. They saw the administration had abandoned the state single-payer issue, and they didnt feel there was any support for it. I mean, theres this chemistry that happens, and people look around, and theres only a few people really taking a stand on something, they may not desire to join. He still hopes the state option will be inserted in the conference, but who knows?
Hamsher noted at FireDogLake.com (11/9) that 60 progressive reps pledged in July to oppose the bill if the cost control measures, such as a strong public option tied to Medicare, were taken out. They backed off when Pelosi promised they would get a floor vote on single-payer. Then she reneged on that promise.
A public option was never anything more than a stepping stone to Medicare for all, a foothold in what would have otherwise been nothing more than a huge transfer of wealth to the insurance industry (which it still by-and-large is), Hamsher wrote. But its going to take a lot more political organizing on the inside before any real headway can be made on that front, and were working on that now. The fact that even 14 of the 89 cosponsors wont exercise the power they have and stand together to force even a symbolic vote shows how much work has to be done.
HOUSE REFORMS WOULD START SOON. While much of the debate on health-care reform has concerned the creation of a government-run public option as part of an Insurance Exchange in 2013, the House bill approved 11/7 (HR 3962) would provide the following relief for working families in 2010:
A $5 bln insurance program to help get coverage for high-risk people who are turned down by private insurers.
Ending rescissions by which insurers nullify coverage when patients file claims except in case of fraud.
Ending the lifetime caps on how much insurers will cover.
Allowing young people to stay on their parents policies until age 27.
Allowing workers who have lost coverage because they lost their job to extend COBRA coverage until the Exchange is in place.
New incentive programs to increase the number of primary-care doctors, nurses and public health professionals.
Funding for community health centers to double the number of patients the centers can see.
A new $10 bln fund to help employers pay for coverage for early retirees.
For seniors, it eliminates co-payments for preventive services under Medicare and reduces the donut hole in Medicare prescription drug coverage by $500 and give seniors a 50% discount on brand-name drugs in the donut hole in 2010. Right now Medicare doesnt cover any drug costs between $2,700 and $4,050. The donut hole will be phased out by 2019.
IS A FLAWED HEALTH BILL BETTER THAN NO BILL? Dr. Marcia Angell, M.D., a single-payer supporter and former editor of the New England Journal of Medicine, is among those who believes that the House bill is not worth passing without a single-payer health plan. Writing at HuffingtonPost.com (11/9), Angell noted that two stalwarts of the single-payer movement split their votes: John Conyers voting for it and Dennis Kucinich voting against. Kucinich was right, she wrote.
Conservative rhetoric notwithstanding, the House bill is not a government takeover. I wish it were, Angell wrote. Instead, it enshrines and subsidizes the takeover by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesnt regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65s will be more likely to go without insurance, even if they have to pay fines. Thats OK with the industry, since these would be among their sickest customers. (Shouldnt age be considered a pre-existing condition?)
She said health costs will continue to skyrocket as taxpayer dollars are pumped into the private sector. The response of the government and employers will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
She concluded: Is the House bill better than nothing? I dont think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that weve tried health reform and it didnt work. But the real problem will be that we didnt really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
Ezra Klein, a progressive policy wonk, wrote at WashingtonPost.com (11/10) that he thinks Angell misreads the politics of this issue going forward as well as the history of health-care reform since Harry Truman originally proposed a single-payer plan. Failure does not bring with it a better chance for future success. It brings a trimming of future ambitions, Klein wrote. Obamas defeat will not mean that more ambitious reforms have a better chance of trying again. It will mean that less ambitious reformers have a better chance of trying next time.
He noted that Medicare and Medicaid began as fairly limited programs. But once they were passed into law, they were slowly but continually improved. They became more expansive, with Medicaid growing to cover not only poor families but also poor adults, and the federal government giving states the option, and matching dollars, to include more people under the programs umbrella. Medicare was charged with covering people with long-term disabilities, and it was eventually strengthened with a drug benefit, more preventive coverage, the option of supplementary plans and much more.
It is not hard to imagine health-care reform following a similar path. The exchanges can be opened to all employers and all individuals, creating a competitive insurance market virtually overnight. The public plan could be strengthened, or the government could begin to set payment rates for insurers who participate in the exchange (as is common in other countries). Subsidies could expand, and new funds could be used to encourage the development of integrated care organizations rather than simple insurance companies. The public option could be strengthened and the employer tax exclusion converted, as Ron Wyden has long advocated, into a standard deduction, which would strike at the heart of the employer-based market.
But all that is predicated on the creation of this new, flawed, insufficient system. As any scientist will tell you, its much easier to encourage something to evolve in a certain direction than it is to create it anew. The idea that a high-profile failure in a moment where a liberal Democrat occupies the White House and Democrats hold 60 seats in the Senate for the first time since the 1970s will encourage a more ambitious success later does not track with the history of this issue, nor with the political incentives that future actors are likely to face. If even Obamas modest effort proves too ambitious for the political system, the result is likely to be a retreat towards even more modest efforts in the future, as has happened in the past.
DONT MAKE LIKE TEXAS. Perhaps the most unusual proposal for health-care reform was an op-ed column in the Washington Post (11/6) written by Texas Gov. Rick Perry (R) and former House Speaker Newt Gingrich (R) proposing Texas as an example of how to control health care costs while improving choice. Texas in 2003 limited the amount of damages injured patients can recover from health-care providers, effectively closing off state courts to medical malpractice lawsuits. That resulted in malpractice insurance premiums dropping 30%, but it didnt stop health insurance premiums from rising 86.8% from 2000 to 2007, according to Families USA. And Texas currently leads the nation in the rate of uninsured, with more than 25% of the states residents lacking health-care coverage. Jon Perr at CrooksAndLiars.com (11/7) noted that the state still ranks 48th in physicians per capita. Jim Landers reported in the Dallas Morning News (4/21) that Medicare spending in Texas rose 24% in the three years after the state capped malpractice awards.
DEM GAINS IN GOP SPLIT. National conservative ideologues showed New York Republicans what for in the special election for New Yorks 23rd Congressional District (11/3). Local GOP officials nominated moderate state Assemblywoman Dede Scozzafava for the seat that Rep. John McHugh (R) gave up to become secretary of the Army. The seat had been a virtual lock for Republicans since the Civil War. But conservative leaders such as Sarah Palin, Glenn Beck, Richard Viguerie, the anti-tax Club for Growth and Dick Armeys FreedomWorks, which specializes in astroturf organizing such as the Tea Parties, condemned Scozzafava for her support for gay rights, abortion and organized labor. They instead endorsed Doug Hoffman, a right-winger who didnt live in the district and was unfamiliar with local issues but was nominated by New Yorks Conservative Party. Scozzafava was demonized as a radical leftist, a child killer, a lesbian lover and a homo. Even former Gov. George Pataki (R), who had encouraged her to run, switched his support to Hoffman. After that betrayal coincided with dwindling campaign funds and polls showing her in third place behind Bill Owens (D) and Hoffman, Scozzafava decided to withdraw from the race (10/31). Conservatives issued triumphant press releases and Hoffman didnt bother to place a condolence call, but Democrats consoled her, including Owens, whom she ended up endorsing. Owens ended up winning the race with 49%, 3 percentage points ahead of Hoffman, to become the first Democrat to represent the district since 1871. Scozzafava, who got 5%, was stripped of her Republican leadership position at the Assembly (11/9) but she told the Watertown Daily News she had no regrets. Neither did Dick Armey, who told the Washington Post, She was a Republican as long as it enhanced her electability. He added, My guess is she made a deal with Chuck Schumer or the White House that will eventually show itself to us.
LESSONS FROM OFF-OFF-YEAR ELECTION. Pundits declared the election (11/3) a blow to President Obama, largely on the basis of Republican wins in governor races in Virginia and New Jersey while ignoring Democratic victories in the two open congressional races.
The economy and jobs were the chief concern for voters in both Virginia and New Jersey, a CNN poll showed. Health care was the next most important issue in Virginia, with 24% of the voters, while 56% of voters said the president was not a factor. In New Jersey, 26% said property taxes were a major issue, and Obama was not a factor for 60%.
Republican Bob McDonnell took an easy win in Virginia, after conservative Democrat Creigh Deeds distanced himself from Obama, opposed health reform, clean energy legislation and the Employee Free Choice Act, organize labors top priority. He reversed course only after it became apparent that the strategy was going spectacularly wrong. Deeds failed to convey a consistent message and excited neither the Democratic base nor independents and ended up losing to McDonnells jobs-focused campaign.
In New Jersey, Gov. Jon Corzine tried to take advantage of Obamas popularity in the state, but Chris Christie, a former US Attorney, apparently convinced voters he was more of a reformer than the former Goldman Sachs executive who, as the incumbent, failed to cut property taxes as he had promised.
In races that actually will have an impact on Obamas programs, Bill Owens (D) narrowly won a special election in New Yorks 23rd Congressional District after Republicans split over a moderate and a right-winger, putting a Dem in that seat for the first time since 1871. In Californias 10th CD, John Garamendi, a progressive Dem, former insurance commissioner and lieutenant governor, won by 10 points in the race to succeed Rep. Ellen Tauscher, a centrist Dem who had unseated a Republican in 1996 but quit to join the State Department. Owens and Garamendis votes gave the Democratic health reform bill the margin of victory (11/7).
Markos Moulitsas wrote at DailyKos.com of the lessons on election night:
If you abandon Democratic principles in a bid for unnecessary bipartisanship, you will lose votes.
If you water down reform in favor of Blue Dogs and their corporate benefactors, you will lose votes.
If you forget why you were elected health care, financial services, energy policy and immigration reform you will lose votes.
Tonight proved conclusively that were not going to turn out just because you have a (D) next to your name, or because Obama tells us to, Moulitsas wrote. Well turn out if we feel its worth our time and effort to vote, and well work hard to make sure others turn out if you inspire us with bold and decisive action. The choice is yours. Give us a reason to vote for you, or we sit home. And you arent going to make up the margins with conservative voters. They already know exactly who theyre voting for, and it aint you.
CONS STILL HUNTING RINOS. Undeterred by the experience in New York, conservatives are moving ahead with plans to purge moderate Republicans derided as Republican in Name Only (RINOs) from their ranks. The Hartford Courant reported (11/2) that Dick Armey of FreedomWorks planned to meet in Connecticut with conservative activists and expects to be involved in Senate contests in Connecticut, Florida and Pennsylvania.
The New York congressional race was the tip of the spear, Armey told Politico.com (11/3). We are the biggest source of energy in American politics today. But those spears may be destined for the backs of ideologically straying GOP officeholders.
Right-wingers may challenge a dozen Republican candidates in key House and Senate races in 2010, including Florida Gov. Charlie Crist, who is popular and running for the Senate but hes too moderate for the wingers; former Rep. Rob Simmons, a moderate planning a Connecticut Senate race; and Rep. Mark Kirk, a moderate who has tried to veer right as he prepares an Illinois Senate run. Were going to work hard as hell to make sure Mark Kirk doesnt win, Evert Evertsen, an Illinois Tea Party organizer told Politico.com. Mark Kirk is about as liberal as Arlen Specter was.
Incumbents are fair game, too. Rep. Rob Inglis (R-S.C.) faces a primary challenge for re-election. Potential future targets who have strayed from rigid party-line positions include Olympia Snowe (Maine), whose seat is up in 2012, and Sen. Lindsey Graham (R-S.C.), whose seat is up in 2014. A Maine poll by Public Policy Polling (11/10) showed Snowe trailing a generic conservative challenger 59%-31% among likely GOP primary voters.
The Club for Growth has marked the Florida Senate race as a new priority, endorsing former state House Speaker Marco Rubio over Crist, Eric Kleefelt noted at TalkingPointsMemo.com (11/9). Crist is now revising history, saying he didnt endorse the stimulus despite footage of him campaigning for it beside President Obama. He says he was simply working to get the best deal for Florida.
Club for Growth also is considering putting up a challenger to Sen. Robert Bennett (R-Utah), who upset conservatives by sponsoring health-care legislation, supporting the Wall Street bailout and supporting appropriations bills that implemented the Obama budget.
Conservatives also are split over the California Senate primary race between former Hewlett-Packard CEO Carly Fiorina and state Rep. Chuck DeVore. Sen. Jim DeMint (R-S.C.) has endorsed the more conservative DeVore, while Fiorina has the backing of Minority Leader Mitch McConnell (R-Ky.), Whip Jon Kyl (R-Ariz.) and Sen. John McCain (R-Ariz.).
In Ohio, Cleveland car dealer Tom Ganley hopes Teabagger support will help him defeat former US Rep. Rob Portman in the GOP primary for the open Senate seat. Lt. Gov. Lee Fisher and Secretary of State Jennifer Brunner are facing off in the Democratic primary.
The Club for Growth already has run Sen. Arlen Specter out of the GOP, as a potential primary race with former right-wing Rep. Pat Toomey (R) caused Specter to switch to the Democrats in April. Now Specter faces a primary challenge from Rep. Joe Sestak (D).
Conservatives would like to punish Rep. Joseph Cao (R-La.), the only Repub to vote for the Dems health care bill, but Cao narrowly defeated indicted US Rep. William Jefferson (D) in 2008 and the New Orleans-based district is so Democratic that conservatives probably will let nature take its course.
Teabaggers arent letting Dems off the hook, of course. A leading Tea Party activist, Eric Odom, is setting up the Liberty First PAC which he hopes will raise $1 mln to defeat incumbents who support health-care reform and elect a new crop of lawmakers committed to small-government principles in 2010, Zachary Roth reported at TalkingPointsMemo.com (11/10). But Odom rejects assumptions that the Tea Party is a GOP proxy. He said the PAC would not support incumbents of either party, and he had harsh words for the GOPers currently in Washington. Republicans had eight years to step up to the plate and push through a conservative agenda, he said. Most of the Tea Party activists dont see a difference between most of the Republicans and the Democrats.
He added that he hadnt been in touch with the RNC or any organized Republican group in connection to the new PAC. Roth noted that a Tea Party activist, David Smith, plans to challenge Rep. Pete Sessions (R-Texas), chairman of the National Republican Congressional Committee, citing the budget deficit, federal spending and Sessions votes for the Wall Street bailout as his main issues.
SWEATSHOP INSURANCE FAILS. House Republicans produced a health reform bill on 11/3 that proposed the virtual deregulation of health insurance industry. The bill, which was offered as an amendment to the Democratic bill, would allow insurers to sell policies across state lines. But Ezra Klein noted (11/6) that the GOP bill not only would allow insurers to cluster in whichever state has the loosest regulation and sell policies that accord with those minimal standards (which is the dynamic that brought you a credit card industry based almost entirely out of South Dakota). It also allows the insurance companies to use the Virgin Islands, Guam, American Samoa and the Northern Marianas for the same purpose. All those territories are poorer, and would have even more incentive to give insurers whatever regulatory concessions they wanted in return for the jobs and tax revenue that would come from WellPoint opening offices in Guam, Klein wrote. Bruce Webb at MyDD.com (11/4) called the provision Sweatshop Insurance. The GOP bill was rejected on a nearly party-line vote of 258-176, with Rep. Timothy Johnson (R-Ill.) voting with the Dems. He also voted agains the Dem bill.
GOP TURNABOUT ON JUDICIAL FILIBUSTER. Senate Majority Leader Harry Reid said (11/4) he plans to force a confirmation vote on the nomination of US District Judge David Hamilton to a seat on the US Court of Appeals for the 7th Circuit. President Obama nominated Hamilton in March and he won Judiciary Committee approval on a party line vote in June but Sen. Jeff Sessions (R-Ala.) has been blocking the confirmation vote ever since. In 2005 Sessions was one of many Republicans who objected to Democratic use of the filibuster against judicial nominees, Steve Benen noted at WashingtonMonthly.com (11/9). I would object and fight against any filibuster on a judge, whether it is somebody I opposed or supported; that I felt the Senate should do its duty, Sessions said in 2005. If we dont like somebody the President nominates, vote him or her up or down. But dont hold them in this anonymous unconscionable limbo.
Doug Kendall, founder of the Constitutional Accountability Center, noted at HuffingtonPost.com (11/9) that Republicans sent Obama a letter in March before Obama had nominated a single judicial nominee threatening to filibuster anyone who didnt come with bipartisan support. Obama tried to put the confirmation wars to rest with the nomination of Hamilton, a moderate with the strong support of Sen. Richard Lugar (R-Ind.) and the president of the Indiana Federalist Society. But thats not enough for Senate Republicans.
It remained unclear if enough Democrats would support the nomination to reach the 60-vote threshold to end a filibuster, as two conservative senators, Ben Nelson (D-Neb.) and Joe Lieberman (I-Conn.) have expressed reservations about Hamilton, CQ Today reported (11/4). So far, Obama has made nominations for 12 openings on federal appellate courts. Only one of the 12 nominations has been confirmed by the Senate.
BILL WOULD BREAK UP TOO BIG BANKS. Sen. Bernie Sanders (I-Vt.) introduced a bill (11/6) that would make the Treasury Department identify and break up financial institutions that are too big to fail. Sanders commented, If an institution is too big to fail, it is too big to exist. We should break them up so they are no longer in a position to bring down the entire economy. We should end the concentration of ownership that has resulted in just four huge financial institutions holding half the mortgages in America, controlling two-thirds of the credit cards, and amassing 40% of all deposits.
Sanders legislation would give Treasury Secretary Timothy F. Geithner 90 days to compile a list of commercial banks, investment banks, hedge funds and insurance companies that he deems too big to fail. The affected financial institutions would include any entity that has grown so large that its failure would have a catastrophic effect on the stability of either the financial system or the United States economy without substantial Government assistance.
Within one year after the legislation became law, the Treasury Department would be required to break up those banks, insurance companies and other financial institutions identified by the secretary.
Sanders noted that the perilous condition of financial institutions deemed too big to fail played a major role last year in undermining the American economy and driving the country into a severe recession. As Wall Street cratered, taxpayers were put on the hook for a $700 bln bank bailout. Teetering banks also were propped up by at least $2 tln more from the Federal Reserve in secret loans at virtually no interest.
Since then, the four largest banks in America (JPMorgan Chase, Bank of America, Wells Fargo, and Citigroup) now have strengthened their domination of the home mortgage and credit card industries. Just five American banks (JP Morgan Chase, Bank of America, Citigroup, Goldman Sachs and Morgan Stanley) own a staggering 95% of the $290 tln in risky derivatives held at commercial banks. One result of the burgeoning concentration of ownership has been outrageously high bank fees and interest rates for credit cards, mortgages and other financial products, Sanders said.
CONLIN EYES POPULIST CAMPAIGN. Roxanne Conlin hopes to tap voter anger in her campaign against Sen. Charles Grassley (R-Iowa). The plaintiff lawyer who ran unsuccessfully for governor in 1982 said she was furious about bonuses given to Wall Street firms that were bailed out in the past year. How have banks, to whom we as taxpayers have given billions of dollars, increased their profits? They have fired people. We gave them the money so we could have them lend it to small businesses to create jobs, and instead they gave it out in bonuses. Kathie Obradovich wrote in the Des Moines Register (11/8) that Conlin continues for a bit about Wall Streets arrogance and sense of entitlement and finishes with what sounds a lot like a campaign slogan: Iowa needs a good lawyer. Get your money back for ya! Conlins philosophy as a candidate is similar to the conviction she brings to her legal work: People before profits, Obradovich noted. She doesnt back down when asked whether some might interpret the slogan as anti-business. Her concern, she said, is for Main Street businesses, which needed bailout money to go into loans instead of bankers pockets.
In contrast, Charles Grassley is a laconic and low-key farmer who takes pride in his status as a non-lawyer on the Judiciary Committee. He knows that even people who need lawyers often dont like them very much, Obradovich noted.
SOCIALIST HEALTH CARE SAVES TEABAGGERS. Thousands of protesters came to Capitol Hill (11/5) for Rep. Michele Bachmanns (R-Minn.) protest against health care reform, capping months of fear-mongering about the dangers of so-called socialized medicine. However, the Washington Posts Dana Milbank noted that at one point, one of the protesters had a heart attack. Luckily, federally-employed medical personnel were able to quickly attend to him even though they were part of government-run health care, which is supposedly quite dangerous. They rushed over, attaching electrodes to his chest and giving him oxygen and an IV drip. Then a D.C. ambulance and fire truck, lights flashing, pulled in behind the lawmakers and the patient, attended to by about 10 government medical personnel, was being wheeled away on a stretcher just as House Minority Leader John Boehner (R-Ohio) stepped to the microphone. Join us in defeating Pelosi care! he exhorted. A few members stole a glance at the stretcher. By the end of the day, medics had administered government-run health care to at least five people in the crowd who were stricken as they denounced government-run health care.
From The Progressive Populist, December 1, 2009
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