ObamaCare: The inevitable shrinking public option
[Posted by Karl]
Technically, the current proposal does not drop a “public option” from ObamaCare, but it is a ghost of its original form:
Democratic aides said that the group had tentatively agreed on a proposal that would replace a government-run health care plan with a menu of new national, privately-run insurance plans modeled after the Federal Employee Health Benefits Program, which covers more than eight million federal workers, including members of Congress, and their dependents.
A government-run plan would be retained as a fall-back option, the aides said, and would be triggered only if the new proposal failed to meet targets for providing affordable insurance coverage to a specified number of people.
Allahpundit asked how fiery will nutroots outrage at the Senate’s betrayal will be tomorrow, but the outrageous outrage is already building. FireDogLake’s Jon Walker lays out just how watered down this proposal may be: (1) the Medicaid expansion has completely been dropped; the Medicare buy-in may not really be a buy-in… or really Medicare; and (3) the non-Medicare non-buy-in may be a stopgap for three years only. At dKos, McJoan is less angry, or perhaps just more resigned. She and FDL’s Jane Hamsher are none too thrilled about the prospect of the Senate bill being forced on the House without a conference, either.
All of which makes for some nice schadenfreude, but it is no surprise, and a fleeting pleasure at best. The Obama administration (via Rahm Emanuel) has been open to neutering the public option with a trigger that won’t get pulled since January. The administration knows that ObamaCare’s mandates are sufficient to take over the US healthcare system. Joe Lieberman will likely not filibuster this latest proposal, so the GOP will have to decide whether they are really going to become the obstructionists the Democrats already claim they are.
–Karl
Will liberals oppose Obama with the same strength and effectiveness that conservatives managed when Bush nominated Harriet Miers? I doubt it.
Will conservatives oppose Obama with the same strength and effectiveness they promised their supporters? I doubt that, too.
DRJ (84a0c3) — 12/8/2009 @ 8:03 pmDRJ,
I think the fecklessness of pols attracts bipartisan consensus.
Karl (404c05) — 12/8/2009 @ 8:07 pmKarl – I agree that if the mandates are in there and strong enough, coupled with the faceless nonelected death panel standards boards, that’s equivalent to a takeover.
daleyrocks (718861) — 12/8/2009 @ 8:30 pmI need to puke in a boot. Any boot. Really.
sybilll (f7d1a0) — 12/8/2009 @ 8:47 pmIt’s establishing a right to health care is what they’re doing. That can’t be undone. Not without breaking an awful lot of stuff.
It’s like when they passed the lottery in Texas. It passed with the provision that monies would go to the General Fund, so no program would ever be directly tied to a volatile source of money. Not three years later the news whores are running stories about how polls show people are outraged that the money isn’t devoted to education and polls show most people had been under the impression that the lottery money was for education and why is the Legislature hijacking funds for schools?
Same think with dirty socialist health care. Wasn’t it supposed to do this the news whores will say. And wasn’t it supposed to do that? And why isn’t it doing more of this?
happyfeet (2c63dd) — 12/8/2009 @ 8:49 pmThe GOP should go to the mats against this, or else face the wrath of their constituents come election time. After all, they’re going to be crapped on no matter what they do, so why not?
Dmac (a964d5) — 12/8/2009 @ 8:53 pmThe FireDogLakers are talking about marching on Washington and voting for Republicans. Their contmpt for Reid and Obama and Rahm is blistering. At this point Republican obstructionism may be welcome by many on both sides of the issue.
elissa (6557fc) — 12/8/2009 @ 8:55 pmMonths ago, Karl Rove gave a one word, or rather two-number answer, when Bill O’Reilly asked him if reform would pass: “60-40.”
He didn’t pause, hesitate or blink. It was as simple as that to him.
O’Reilly strongly disagreed, and I never thought it was that simple, either. But the window for the GOP to kill reform closed shortly after the summer. The town halls, which the media was interested in, was their best shot. The media liked the screaming and drama.
But once reform got down to the details, the media shifted into the boring, “Both sides have good points” coverage, and the deal-making started. That’s the kind of environment where a political majority can exert its will in a number of ways that don’t attract mainstream attention.
DRJ: You are right about the liberals at least. They’ll fold in the end, b/c of all constituencies in the Democratic Party they want reform most, so will compromise the most to get it. That is the cold calculation Obama and his team have made, and they’re probably right. There’s something cruel in that, but that’s politics. You have doubtlessly heard that the president didn’t even mention the public option during his pep talk on Sunday. He knew then it was very likely dead. (I like to be right, but this is one area where I’d love to be wrong.)
Both parties abuse their respective bases. It’s just that the conservatives are officially sick of it. I expect the liberals will one day get there, too.
This day is likely the high-water mark for Republicans who are opposed to a bill, in that losing the public option is a blow to supporters of real reform. I’m sure many promises are being made about what kind of tweaking can be done down the road.
Myron (6a93dd) — 12/8/2009 @ 9:01 pmThe people of this country need an option to purchase public health insurance. It is the right thing to do. Congress should focus on doing that for a change!
Marly (a7a362) — 12/8/2009 @ 9:20 pmThis is really funny because the availability of plans for federal employees varies dramatically not only from state to state, but from county to county within a state. When I was working in California, I had probably 2 dozen plans to choose from. But workers in other parts of California had an even wider selection since there were more plans offered in major metro areas like LA and SF.
But, where I live now, there are only 2 choices available to federal workers — Kaiser and Blue Cross. Both have their rates regulated by the state insurance commissioner, and what they are required to offer is dictated by state law.
So, these new plans, will their contents be dictated by state law? What if the state requirements are not generous enough? What if the state requirements are too generous, making the plans prohibitively expensive to currently uninsured persons? Will the insurance companies be able to offer plans that don’t comply with the requirements of state law because to do so would make them non-competitive under this program?
This is a trainwreck in progress. The interest groups are going to cripple this idea before it gets passed.
WLS Shipwrecked (3d3fb8) — 12/8/2009 @ 9:25 pmComment by Myron — 12/8/2009 @ 9:01 pm
On BOTH sides of the aisle. And $50 will get you $100 that the Republicans get their tweaks in first. Regardless of whether or not (unlikely, IMHO) they get the House back in ’10.
And as far as establishing this “right to healthcare,” please see Fleming v Nestor (1960) on the topic of establishing property and other rights to certain government benefits.
Brad S (d566f4) — 12/8/2009 @ 10:45 pmI suspect something will get passed and called reform. This is politics, folks.
Mike K (2cf494) — 12/8/2009 @ 10:58 pmA couple of comments:
1. I see that the Senate also declined to adopt the tough standards against using public money for abortions that the House set in place (the Stupak Amendment). I am interested in seeing the reaction of two groups to this: pro-life House Democrats, and the Catholic Bishops. Opposition from either one has a reasonably good chance of sinking the bill.
2. To follow up on the points made by Myron at (9:01 pm) and Brad S (at 10:45), I wonder if by winning this battle the Dems will lose the war. They will get a watered-down healthcare bill, but liberals will decide that Obama, Pelosi, and Reid are not going to fight for the left’s principles and will be very blase about the 2010 midterms. If that gets countered by energized and angry Republicans, this could be a repeat of 1994 and 2006 and the Democrat Moment might end up lasting only two years. It will be interesting to see.
JVW (0fe413) — 12/8/2009 @ 11:44 pmBrad, it’s early yet, but I think it’s going to be very hard for the democrats to keep the house. Can’t say that with any more authority than you can say otherwise, but we’ll see.
While you’re right that the supreme court will not rule that I have a right to the government paying for my healthcare, that’s not the same as voters realizing they rely on some government handout, and must elect a democrat to keep it.
That’s what this healthcare bill is meant to do: create a problem so severe that the government will have to step in and take over with single payer. Then, the entitlement will become a crucial part of how moms care for their babies, how we take care of our old parents, etc. And the evil GOP will keep trying to decrease taxes while the valient Democrats are committed to increasing funding and fixing this and that problem (with money), and just need your continued eternal support.
It’s truly a desperate situation. People will indeed die if this bill is passed. It’s not hyperbole to say so. It’s creating a mess in our healthcare system, and just as people die in Canada and the UK waiting for treatment they’d get under a free system, Americans will die thanks to this bill. It’s uncouth to say it, I suppose.
Dustin (44f8cb) — 12/8/2009 @ 11:57 pmIt’ll be bad enough for us, but just think of the poor Brits and Canucks. With passage of Obamacare, they’ll have no where to go to (continue to) live.
AD - RtR/OS! (e93189) — 12/9/2009 @ 1:38 amHow can we be so insensitive to the fates of our (metaphorical) cousins?
But, on the bright side, all of the illegals from Latin America will be covered – and for them, Obamacare will be a step up.
Comment by Dustin — 12/8/2009 @ 11:57 pm
Dustin, voters may realize that they rely on a government handout, but that is not the same as having a property or other right to that government handout. Don’t EVER underestimate the ability of the American public to know this basic fact. The adults in my Great Plains community when I was growing up made sure that I understood that there was no guarantee to Social Security, to name a prominent benefit.
Brad S (9f6740) — 12/9/2009 @ 5:37 amHe didn’t pause, hesitate or blink. It was as simple as that to him.
No wonder our little Boy Wonder loved that quote. And it’s hilarious that he suddenly finds that Rovian analysis is a thing of not only certainty, but remarkably prescient as well. Alphabetist.
Dmac (a964d5) — 12/9/2009 @ 7:07 amThe public option is obviously as dead as a doornail. My advice to the progressives is to take what they can get now.
I don’t know what kind of health care reform will come out of this session, but I strongly suspect it won’t be much. There is, however a silver lining behind this very dark cloud. I am reminded of the Civil Rights Act of 1957. Don’t be embarrassed if you’ve never heard of it, there really isn’t a hell of a lot to remember about it; a mere pittance, really – a scrap of leftovers tossed out to “American Negros” (in the parlance of the age) in order to appease them. But it made the passing of the Civil Rights Act of 1964 – the one we remember – all the more easier seven years later.
We’ll live to fight another day.
http://www.tomdegan.blogspot.com
Tom Degan
Tom Degan (4ca04d) — 12/9/2009 @ 7:55 amNeo
Besides tort reform, the one subject that seems to have fallen through the cracks is capacity of the system.
There is nothing here to add doctors at a rate that will cover demand .. and this is before many of the current doctors retire early when they are given the option of “slave labor” or retirement. Officially adding 20 to 30 million Americans, who previously only went to an emergency room in dire conditions, to the normal doctors’ roles is going to make it bad for everyone.
Also missing is anything to cover the “displaced” workers. Insurance and other medical workers will have to be displaced when the feds effectively cap the amount of money going into the system. Call them “waste, fraud and abuse” if it makes you feel better, but these folks are still displaced.
Neo (7830e6) — 12/9/2009 @ 9:48 amLieberman seems to be laying the groundwork to support a filibuster. He knows he’s going to get attacked from the left in any Dem primary, and will have to run for reelection as an independent or a Repub.
And, after a night of thinking about this, and reading some commentary, it seems clear that this really is a “Hail Mary” effort by Reid to create some sense of “inevitability” to keep the entire effort from collapsing.
What he suggests he will produce is going to be very unpopular with both the right and left flanks of the Dem caucus in the House — the Blue Dogs won’t like it because it has no Stupak langugage, and the Progressives won’t like it because it has no public option. I think that makes the “ping pong” strategy unlikely, and I don’t think the old guard liberals and progressives in the House will be willing, in the end, to simply cave in to what the moderate Dems in the Senate are proposing.
Shipwreckedcrew (6178ee) — 12/9/2009 @ 12:14 pmAnd, after a night of thinking about this, and reading some commentary, it seems clear that this really is a “Hail Mary” effort by Reid to create some sense of “inevitability” to keep the entire effort from collapsing.
If this is what you came up with after a night of thinking, shipwrecked, you need to do some more thinking, or else get some sleep and only then, think some more. Dems are not the ones who need a “Hail Mary.” This bill is passing, though I agree with Tom Degan, it may not be much of a bill.
Dustin: In your doomsday scenarios, you neglect to point out that life expectancies in both the U.K. and Canada exceed life expectancies here. That’s what they call, I believe, an “inconvenient truth.”
Dmac: Kiss my grits. Where are you getting your “suddenly” regarding my views on Rove? Do you have evidence where I’ve questioned his ability as an analyst? Or are you one of those who is fighting against an image of me you created in your pretty little head?
Unlike dittoheads such as yourself, I can acknowledge talent on the other side, even when said talent is in the service of the wrong goals.
Myron (6a93dd) — 12/9/2009 @ 12:30 pmThere’s a direct correlation between life expectancy and quality of life, is there? There aren’t mitigating factors such as murder & suicide & accident rates?
And don’t you think that the extra 6 months you would be expected to live if you were in the UK would just be spent waiting for a doctor to see you, anyway?
Icy Texan (648a94) — 12/9/2009 @ 12:40 pm“Dustin: In your doomsday scenarios, you neglect to point out that life expectancies in both the U.K. and Canada exceed life expectancies here. That’s what they call, I believe, an “inconvenient truth”
No, that’s not truth.
It’s well established that the US health care system is dramatically superior to the Canadian and UK ones. We have a large immigrant population because we are such a kickass place, and we have a large number of genetically disadvantaged peoples, and when you account for that, you come up with a real truth: the US health care system leads to Japanese people living longer than they would in Japan (despite Japan’s racially homogenous population living longer than the US mixed population). This applies down the line.
You are exposed to these arguments, and I know they have not been debunked… they are respected as accurate. So it’s hard not to call you dishonest.
Dustin (44f8cb) — 12/9/2009 @ 12:44 pmgenetically disadvantaged?
imdw (01dd72) — 12/9/2009 @ 1:17 pmNo, that’s not truth.
Why, because you said so, Dustin? That’s schoolyard stuff. I prefer to deal in hard facts, chucker.
Check this out. The figures are from the CIA World Factbook.
Canada is 8. The UK is 36. The U.S. is 50. (ranked by entity, which includes some non-sovereign regions.)
So, I think Brits and Canadians will be fine, whether they stay here or move home.
“Oh God, we don’t want a system like the Canadians!”
Please.
Myron (6a93dd) — 12/9/2009 @ 2:34 pmThere aren’t mitigating factors such as murder & suicide & accident rates?
I’ll answer your question, Icy Texan, with a question: Is mental health care a part of health care?
Myron (6a93dd) — 12/9/2009 @ 2:36 pmU.S. infant mortality is lower for several reasons other than the availability of health care:
Thus, even those who are covered by government health care programs can’t get health care if they don’t have doctors and hospitals in their areas. In addition, there also appear to be genetic or behavioral factors that affect mortality despite access to health care.
In all likelihood, these same factors are involved in adult mortality statistics as well.
DRJ (84a0c3) — 12/9/2009 @ 3:04 pmMyron, I gave my argument why it’s not the truth. You dismiss the argument, quote the conclusion, and say this is schoolyard stuff?
That’s damn unconvincing. It’s very well known that the statistics are not calculated in the same way, and that race plays a role in lifespan. A black man lives much longer in the US than elsewhere, a Japanese does too, but in a nation with all Japanese and few blacks, the general population will live longer.
It’s like a Honda Mechanic bragging that he’s a better mechanic because his cars barely ever break, while a Chrysler Mechanic’s cars break all the time. In reality, it’s not the health care system your statistics measured, as I proved and you dismissed. Of course, you dismissed it because you already know you’re trolling. You refuse to argue back while projecting your childish partisan and Unamerican attitude onto me.
Dustin (44f8cb) — 12/9/2009 @ 3:12 pmMegan Mcardle shows how the polling is spelling doom for Democrats’ big centerpiece.
SPQR (26be8b) — 12/9/2009 @ 4:19 pmThe Art Of War…
…A post I read a while ago over at…
The Art Of War (e57ed5) — 12/14/2010 @ 3:01 am