Thoughts on the President's "Health Care" Speech. I noticed three new things.

[Laelth]

My expectations were not high for the President's speech today on health care. I have argued for some time that Obama blew it by initially advocating a weak, complicated, hard-to-sell, and hard-to-understand plan. Of course the local cheer-leaders explained that Obama hadn't announced any plan yet, that five committees were working on different bills, and that the President wasn't ultimately responsible for any of them. If this speech did anything, it put that argument to rest. This is now Obama's plan. He owned it, he advocated it to Congress and the American people, and he laid out some specific policy positions for which he can now be held accountable.

It was a beautiful speech, of course. I do not deny that Obama is a brilliant orator, but I am more interested in the substance of the speech than its manner of delivery. On that score, let me tell you what I heard.

In his speech, the President recounted the problems with the current system. I heard nothing new there. We all know that the health insurance industry is motivated by profit and not the best interests of the American people. We know that insurance costs are skyrocketing. We know that the current system can not be sustained indefinitely. We know that change is needed. The President covered all of that.

The President also laid out, once again, the three insurance industry practices that he wanted to eliminate (pre-existing condition exclusions, rescission, and lifetime caps). He explained that his plan would eliminate all of those. Fine. Nothing new there.

He discussed the Public Option. He argued for it, and that was a relief, but he said it would be small. This is a problem. Either he was lying (because he believes it will be big, and it will need to be big to actually drive down insurance costs and "keep the insurance companies honest"), or he was telling the truth (in which case the Public Option will be meaningless because it won't be big enough to provide real competition). I have argued, and still believe, that a weak public option will prove that government doesn't work, and that enacting a weak public option would be worse than doing nothing. Ultimately, I hope the President was lying and that he believes the Public Option will be big and will actually do some good.

The President also said that he intends to be the last President to tackle the issue of health care. This comment stunned me. Really? Does he mean we will have a single payer system by 2016? Because we all know that this debate will not end until we have a single-payer system. Ultimately, I do not believe that Obama intends to enact single-payer before 2016. I wrote off this comment as flashy, but not meaningful, rhetoric. He's a politician. I can cut him some slack on this score, but he did raise my eyebrows with that comment.

I give the President credit for actually admitting that his plan will force everyone in the United States to buy health insurance. That took courage, even though it's not new (all five bills seriously under consideration in Congress contain the individual mandate), and even though I think this is a terrible idea. At least the President was willing to "own" it. Then, after explaining that everyone would have to buy it, he explained why, and it was at that point that I blew my top. Obama basically blamed the uninsured for the high cost of the insurance that those who have it have to pay. He even put a dollar figure on the cost increase that's attributable to those who lack insurance. I was astounded that the President, basically, resorted to Republican rhetoric and blamed the victims of this failed health care system for its failure. That was new. That was not good.

The second new thing I noticed was this. Whereas HR 3200 calls for subsidies for those who can not afford the mandated insurance, President Obama referred specifically to tax credits. Yes, tax credits, instead of subsidies, for those who can not afford insurance. This is new, and this is much, much worse than what the House proposed in HR 3200.

Finally, the third new proposal I heard was this. Obama threw a bone at the Republicans by promising to move forward on tort reform. This was also new, and this is both useless as a bargaining tool with Republicans who will continue to obstruct and harmful to the American people who are injured through malpractice. I simply do not understand what Obama hoped to accomplish with this offer, but it is doomed to fail, and it is an attack on one of the Democratic Party's most loyal constituencies--the Plaintiff's bar.

Other than the three things I listed above, this speech was more of the same. Very little was new, and what was new, in my opinion, was worse than what the House originally proposed in HR 3200. Many here are celebrating today. The President's a great speaker, but I am not at all pleased with the actual proposal he is now advocating. I suppose it could have been worse. He could have pushed for co-ops, but he did not. All the same, I hoped for much, much better.

:dem:

-Laelth

[moondust]

1. Wrong on this much.

He specifically said "subsidies" for those who cannot afford it.

[TCJ70]

4. I heard subsidies, too.

They would be based on how much of a need there was though. That part was a little vague to me.

[PHIMG]

28. subsidies for public option = bad, but for private insurance = good

did anyone catch that?

if we subsidized a government run plan, well that is HORRIBLE.

but it's okie-dokie to subsidize a private-run plan?

Obama pushes Reaganism. Clinton 2.0.

Bring on the primary challenger.

[JDPriestly]

99. He definitely spoke about tax credits.

Apparently some tax credits provide for refunds.

I just don't think that Congress has the authority under the Constitution to require a citizen to buy health insurance from a private company. Giving a direct tax credit for all insurance costs to people earning under a certain amount is the only way that Congress can give a strong incentive to cause people to buy health insurance. Congress cannot just require people to buy health insurance from private companies. This whole thing will be done by tax credits. It is the only way. A public option could be paid for through Congress's tax and appropriations authority. But the only way that Congress can force the American people to buy private insurance is to give tax credits for the cost of their premiums. The credit will decrease as income goes up. They won't really be requiring you to buy insurance. They will just make you pay for the cost of the insurance whether you buy it or not. Taxes will be raised for those who do not buy the insurance.

[jwirr]

29. Sliding fee scales?

[Laelth]

5. I could have sworn I heard "tax credits."

I'll look for the text and get back to you.

:dem:

-Laelth

[JDPriestly]

102. See my post 99. It will be done through tax credits because otherwise

it would not be constitutional. Congress has the power to tax and appropriate but not to order Americans to buy insurance from private companies. They will give Americans tax credits for money spent for the private insurance. Some of the credits will be refunds. Americans will have to front the money to the insurance companies and then get refunds for what they pay. That will be very unpopular and make insurance coverage impossible for poor Americans.

[Cronus Protagonist]

110. If they give me 100 percent tax credits for me to buy insurance, I won't get it

I'm too poor to pay taxes, so the "credit" would be hollow numbers.

[gorfle]

You'll just get EIC

Don't worry. You'll just get Earned Income Credit (EIC).

[Cronus Protagonist]

127. Oh, so I would have to file to get it. That'll cost me $300 a year then

Still, not good if I have to pay up front, because I won't and I can't.

[Cherchez la Femme]

135. Exactly

Which is more important: food, shelter, heat, utilities or health care?

Maslow's Hierarchy of Needs stipulates that one must have their basic necessities for life filled before they can advance to any other level.


And what can any administration do if, against law, a citizen doesn't (can't) purchase their for-profit health care?
Imprison them? Fine them?
It's totally ridiculous, imminently unworkable.

[Cronus Protagonist]

154. Luckily, I'm mostly healthy right now

And I do have a safety valve if I get really sick, but not catastrophically ill. I can go back to my home country which is civilized enough to not bankrupt its sick. However, I just don't have any spare cash lying around right now, so the burden of payment will not be borne by my financial situation. Will that make me a felon? I hope not.

[Cherchez la Femme]

158. You're luckier than most

I sincerely hope & pray you continue to keep your health.

May I ask, what is your home country?

[Cronus Protagonist]

161. Britain

Scotland, to be precise.

[Cherchez la Femme]

189. Ah, I adore your country!

I'm really an anglophile, especially loving the accents!

I was juso going all over Wikimaps looking at GB; Wales, Cornwall, Scotland, Hadrian's Wall, the cliffs of DOver, Manchester, the wreck sites surrounding the coastlines, trying to figure out exactly where the moors are (I know it's in Yorkshire, but by wikimaps it appears to be well-settled whereas I always thought it had a sparse population and was 'wild country', i.e. not farmed, left natural etc.)
Land's End is on the SW corner, right?

I really think I was a subject of the Queen/King in a former live LOL


Hopefully someday I'll be able to visit there. What I'd like to do is rent a motorcycle and just tour around the country with no especial route or itinerary beyond what cities/areas I'd eventually like to visit.
Two months may do it :D


Take care of yourself, & very nice to make your acquaintance!

[Cronus Protagonist]

200. If you go there, take sweaters and rubber boots

That's if it's summer. In the winter, add a lot more clothes and an oilskin coat! lol

[KoKo]

195. You would maybe qualify for a Medicaid or the assisted program for

those who are above Medicaid limits? I thought they were doing some kind of program to have folks who can't pay taxes be able to get on another program. It was statistical like 133 percent above a certain salary? :shrug:

[Laelth]

123. That makes sense. Thanks.

It's still a bad idea, and it does no good to those who don't file their taxes (a significant portion of the poor and working classes), but that does explain how the Federal Congress intends to get around the almost certain unconstitutionality of a law that forces people to buy a product from a private vendor.

:dem:

-Laelth

[shimmergal]

129. They should give vouchers.

Tax credits won't work for people who live from paycheck to paycheck already, with little extra room in their budgets and no savings. OTOH, if they give cash, even in the form of a refund, how can they make sure it's spent on insurance?

I fear you may technically be right; however if there are only profit-making insurance plans to choose from, in my opinion it will still be unconstitutional.

[wildflower]

131. But how does that work for auto insurance?

[Laelth]

7. Here's the quote from the text.

"Now, for those individuals and small businesses who still can't afford the lower-priced insurance available in the exchange, we'll provide tax credits, the size of which will be based on your need."

http://www.whitehouse.gov/the_press_office/Remarks-by-the-President-to-a-Joint-Session-of-Congress-on-Health-Care/

Tax credits. Not subsidies.

:dem:

-Laelth

[TCJ70]

8. Yeah, I went back through...

...and found that as well. Tax credits = not helpful to individuals really.

[lumberjack_jeff]

17. Why not?

The only bad thing about the child tax credit, for instance, is that you only get it once per year.

The house bill calls them "affordability credits", not subsidies.

[TCJ70]

22. Unless I'm not understanding taxes right...

...as it's late and my mind is winding down, heh...

Too date, I've never owed the government taxes, I've always gotten money back. A tax credit for me, as far as know, yields no benefits, and I'm sure there are tons of people out there in my same situation. I guess I don't see how this kind of policy would actually help someone who can't afford insurance on a month to month basis get coverage. Maybe someone more knowledgeable could clear that up for me.

[FrenchieCat]

30. There are different types of tax credits.....

There are credits that are before taxes to reduce your adjusted gross income,
credits that are after exemptions and deductions, but before the tax is calculated, as well as others that are only given to the extent of reducing your tax liability to zero but not below, and there are after-tax credits that actually calculates additional monies to be refunded, even if you don't owe anything like earned income credits. There are also credits that can be advanced via their employer throughout the year instead of waiting till the end of the year.

The President was talking about after tax credit in where you actually get money, even if you didn't pay any in.

[TCJ70]

33. Looks like I have some research to do...

...oh the things I have yet to learn...

[Statistical]

74. deductions reduce income, credits offset taxes, virtually all credits are fully refundable.

[JDPriestly]

103. I've never heard of a tax credit that is advanced throughout the year.

Could you give an example please? Because I understand the tax credit and how that would work, but I am concerned that people with low incomes will be excluded because they won't be able to pay for insurance up front. Also, does this mean that insurance premium costs will be uniform. How will the amount of the tax credit be figured if companies charge different amounts? People with low incomes cannot benefit from this unless the tax credit pays their entire bill?

Obama's speech was very unclear on this. Clearly Congress does not really have the authority under the Constitution to require Americans to buy insurance from private companies. This tax credit business sounds like a bigger bureaucratic nightmare than single payer would have been.

How can the government insure that people are really getting the insurance coverage they pay for and are promised? Sounds like this is going to create a lot of jobs for the tax accountants and lawyers. Single payer would be much more efficient and economical than this.

[lumberjack_jeff]

121. HR 3200 describes "affordability credits"

... that are administered by the exchange. Effectively, the subscriber only has to write a check each month for the difference between the premium and the subsidy.

I suspect Obama was using the term "tax credits" as shorthand for this process.

[JDPriestly]

126. That is interesting.

[Statistical]

172. Earned Income Credit is one example.

The govt will calculate your aproximate EIC. Then pay your employer who increases your payroll check by the amount of the EIC.

So say you get paid 26 times a year and you qualify for an EIC of $2600 you employer will add a $100 EIC to each of your paychecks.

Think of it as a "reverse tax".

Single payer is obviously much better for a variety of reasons but that has been pushed under the bus.

[Statistical]

73. Most tax credits are FULLY refundable.

Take for example the housing $8K tax credit.

If you owed $0.00 in taxes and qualified for the $8K tax credit the govt would pay you $8,000 PLUS return all taxes collected.

Virtually all tax credits are fully refundable now.

[Laelth]

148. If you file your taxes.

A lot of poor and working-classed people don't.

Tax credits will do them no good. A fully socialized system would.

:dem:

-Laelth

[Statistical]

169. Most very poor don't file tax returns because they are able to...

except payroll deductions. They have no return coming back when they file the return.

I find it hard to believe someone making say $12K a year would not file a tax return even if it means an extra $2K in "income" via credits. They would opt to decline a 18% pay raise on principle?

Of course anyone making $17,900 or more is REQUIRED to file a tax return under penalty of law.

I agree single payer would be the best and only logical solution.
Given that is not going to happen I see little issue between a subsidy and a tax credit.
tax credit is more "PC" and easier to vote yes on.

[noiretextatique]

134. many people can't afford to put out the cash

the reap the benefit of a tax credit.

[barbtries]

162. do your own taxes

it's free

[quiller4]

84. Refundable tax credits are very helpful to individuals. It allows

you to adjust your withholding so that you have less taken out of each check thus more to purchase what you need-same principle as EITC which has been a tremendous boon to low income wage earners.

[JDPriestly]

104. Does it affect the amounts deducted for Medicare and Social Security?

That's about all that really low income people pay. They don't generally pay other federal taxes.

[lumberjack_jeff]

122. Tax credits can exceed taxes actually paid.

Republicans call it "a tax break for people who don't pay taxes"

The "refund" that poor families get offsets social security and medicare taxes.

[moondust]

9. He said subsidies.

No question.

[moondust]

51. My error.

He mentioned "subsidizing" in another context. Sorry.

[NMDemDist2]

12. that's what the website says too.....

http://my.barackobama.com/page/content/hcsignon/?district=NM2&returnlink=false

[hfojvt]

23. I am hoping that that is just framing

"subsidies" having a bad implication, but 'tax credits' are something Republicans will always support. If the tax credits are refundable, then they are the same as subsidies. I believe Obama and Congressional dems know they have to be refundable. Even Republicans are proposing refundable tax credits and that is something new for them.

[CTyankee]

57. I think Reagan support the Earned Income Tax Credit, didn't he?

Isn't that a refundable tax credit?

[quiller4]

85. You are right.

[hfojvt]

96. well I was not thinking about ancient history

through the 1990s, Republicans proposed taking away the EIC from people who don't have children. They constantly are proposing tax credits as the solution to every problem and those credits are typically NOT refundable. They complained about Obama's $500 per person credit. They didn't like the fact that it IS refundable. 'It goes to people who do not pay taxes' they squawked.

During the primary, one of my complaints about Hillary was her tax credit proposals, none of which were refundable
http://journals.democraticunderground.com/hfojvt/62

[Raineyb]

15. Subsidies is a bit vague. If the ceiling is so low that you have to be

destitute to qualify for it then it's really not going to do much good. And our government tends to underestimate what constitutes what should be considered poverty levels.

[laughingliberal]

48. The bills out of committee now include subsidies

Most of the bills provide some subsidies for those at 400% of the poverty level. The current blueprint out of Baucus' Gang of Six Thugs lowers that to those at 300% of FPL.

[Raineyb]

89. The poverty level has been artificially low for decades. Not to mention

they don't take regional differences into consideration. 300% of poverty level for a single person in NYC isn't going to cut it.

[CTyankee]

115. But aren't subsidies tax payer supported? I thought Obama said taxpayers money

would not be required or used.

[JDPriestly]

105. What constitutes poverty in Alabama is very different from what

constitutes poverty in New York City or Los Angeles or Silicon Valley. Life is incredibly expensive in Silicon Valley or New York City or Los Angeles.

[Cherchez la Femme]

141. Life can be as 'incredibly expensive' anywhere

in just the same proportion -- it would depend on one's income vs. their ability to afford local expenses.

Mind you. I'm not naysaying how expensive it is to live in the areas you mention,
I'm just pointing out proportions.

[JDPriestly]

196. In terms of dollars, life is more expensive here -- dollars for rent, transportation,

etc.

We therefore are paid more and pay more than our share of taxes. That's the issue I was talking about. $50,000 a year in L.A. does not go as far as it does in a small town in the U.S. Housing is out of proportion expensive here, and more so in Silicon Valley and New York City. Therefore the paychecks are larger, but so is the tax burden. We don't really live that much better than elsewhere although we do have warmer weather and save a little on heating bills. That is about the only thing that is cheaper here. Food in my neighborhood is cheaper than in my mother's small town in the midwest, but it is also of lower quality. That is because I live in a relatively low-income area (for L.A.).

[dysfunctional press]

75. nope- he specifically said "tax credits".

i know, because it hurt my ears.

[kath]

147. But what our bought-and-paid-for "representatives" call "affordable" and what any normal person

would call "affordable" are UNIVERSES apart.

Under RomneyCare, $1400/month premium, w/ co-pays and deductibles ON TOP of that, for a family of 3 making $70K/year is considered "affordable"! Bull-fucking-shit!

[Laelth]

155. Hear, hear!

I am currently not insured because I can't afford it. I will deeply resent it if Congress tells me I can afford an extra tax that I must pay directly to the health insurance industry, and a lot of other people will resent it too.

This plan is a disaster waiting to happen. It will drive new, young voters away from the Democratic Party by the millions.

:dem:

-Laelth

[kath]

160. Spread it far and wide -- WHEN THEY SAY "AFFORDABLE", THEY SPEAK WITH FORKED TONGUE

(or as if they're from some other freakin' planet)

[Laelth]

165. +1

The constant use of that word makes me very nervous. It's as if they have to remind us it's "affordable," because they know, deep down, that they're forcing us to buy it, and it's not affordable at all.

But, if the uninsured are forced to pay, it will become more affordable for everyone else.

Health insurance reform isn't something the Democratic Party wants to do FOR the uninsured. It's what the Democratic Party wants to do TO the uninsured.

:dem:

-Laelth

[Time for change]

187. Isn't a tax credit, targeted for a specific purpose, a subsidy?

[aquart]

2. Yep. It wasn't out of the park. It wasn't even to first base.

[Laelth]

130. A bunt, at best.

A this point, I am wishing he had not even taken a swing at the ball (to continue your analogy).

I am convinced we'd be better of abandoning this project, for the moment, rather than pass the legislation the President described.

:dem:

-Laelth

[omega minimo]

3. Yeah but What about JOE Wilson!!!!!! 11111!1 11 11

Beautiful, thoughtful, clear, concise, informative OP. Thank you. Thank you. Thank you.

I predicted the Dem win would provide another Clinton administration. Here we are. The solutions/red flags you have pointed out certainly don't help those who don't have JOBS with which to pay for the health insurance they are now required to buy or benefit from the TAX credits......................

:thumbsdown: Corporate government sucks.

[Laelth]

40. Thank you, o. m.

Part of me still can't believe that the Democratic Party is as controlled by corporate interests as the Republican Party. Let's hope the Progressive Caucus can bail us out. I am now convinced that I want no "health insurance reform" bill to pass this year ... not if this is the best we can do. I hope the Progressive Caucus has the strength and the courage to block this disaster waiting to happen.

:dem:

-Laelth

[gtar100]

80. It was clear that the one thing not sacrificed would be the health "care" companies.

When I heard that part - that health care industry represents 1/6th of our economy and therefore cannot be messed with - I realized we are being fed to the same industries that are the very heart of the problem in the first place. That your and my premiums go to subsidize a for-profit industry is truly offensive to me.

Great post. I think you hit on a lot of very important points.

[Laelth]

136. Exactly. Obama made it clear that the insurance companies would be protected at all costs.

Sickening.

That speech was obviously not designed to appeal to the base.

Thanks for the kind words.

:dem:

-Laelth

[Cherchez la Femme]

144. OMG, another industry "too big to fail"

Mind you, I realize that the health care industry incorporates more than the health "care", as you so rightly put it :), companies; but to even phrase it in that way is a gift to insurance companies who only "care" to profit off its subscribers, not truly help them

and it sickens me.

[katandmoon]

6. K&R

[Laelth]

150. Thanks. n/t

:toast:

:dem:

-Laelth

[Sheri]

10. that's about what i heard.

plus, i wasn't too happy about the fact that the public option has to play on a level playing field. why? what good does that do? isn't the point to drive down costs for everyone? how will this work if the public option isn't backed by the government? why does it have to be self-sufficient?

[Laelth]

50. He has been saying that all along. That's not new, either.

But it is irritating. It was nice to hear the President ridicule the Republicans for their irresponsible deficit spending (on massive tax cuts for the rich and blank checks for two wars), but then he turned around and acted like a true Republican by saying he wanted to Public Option to be deficit neutral.

Why is it perfectly fine to spend money bailing out banks and on cash for clunkers, but yet it's not O.K. to spend more money on health care? If I wanted a Republican government, I would have voted for one. Personally, I think that if we have enough money to kill Iraqis, we have enough money to provide health care (not health insurance) to all Americans, and I could care less about the deficit.

:dem:

-Laelth

[Ms. Toad]

58. A level playing field is actually a good thing

Public option has never been a government subsidized option - it is merely a government sponsored insurance plan. Far too many people were throwing around the term with no understanding of its limited meaning. The subsidies available are to individuals, who can choose to spend them to purchase the public plan or a private one.

The only thing that keeps the public option from being a dumping ground is requiring the insurance companies to operate under the same rules. (Accept all applicants, cover all pre-existing conditions, and don't set premiums based on health status being the three primary ones.) Without a level playing field, anyone rejected by private insurance would end up in the public option pool - and would drive up the premium costs for the public option since all the people the insurance companies believe are too costly to treat would end up there, causing those who could get insurance elsewhere to leave, driving the costs up even further since the loss of cheap patients drives up the average cost.

With a level playing field, both private and public have the same mixed customer pool. Theoretically, without the need to make a profit the public option can charge lower premiums, which will drive down private insurance because it must compete with the public option for the same customer set. If you go back and read either Dean's or Obama's statements from the beginning of this debate you will see that they were touting public options as a way of controlling costs by competition, not by government subsidy of the plan.

[slipslidingaway]

11. knr...

and thanks for your courageous knr earlier this evening.

I hope the President was lying as well.

:)

[Laelth]

14. Smile. My pleasure. n/t

:toast:

:dem:

-Laelth

[TransitJohn]

13. Well your review was a lot more reasoned than mine.

:hi:

[Laelth]

47. Smile. Trust me. It took a couple hours for me to get "reasonable" on this speech. n/t

:hi:

:dem:

-Laelth

[Ms. Toad]

16. This is the other new thing he said:

>>Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. For those Americans who cannot get insurance coverage today because of a pre-existing condition, the President’s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.<<

My biggest complaint about HR 3200 is that, essentially, nothing changes for the uninsurable until 2013. Far too many people don't have until 2013 to wait for change without risking a major health or financial catastrophe. Although far from perfect, that addition combined with the rest of HR 3200 would make it tolerable and a significant step towards reforming health care.

[lumberjack_jeff]

18. That's a good addition.

I wish I had been available to see the speech.

[TCJ70]

24. You can read the text at the c-span website. n/t

[Ms. Toad]

26. or at whitehouse.gov along with a bullet point summary of the plan. n/t

[Ms. Toad]

25. I was still working - so I went to read it online

after reading over and over on DU how disappointed people (who apparently hadn't previously read the bill) were to find out they had to wait four years for any change. I was looking to confirm that my daughter (who can't wait) was still stuck with a 4 year wait it before I sent off an "I am so disappointed" e-mail to Obama. I was so glad to find that change that I have not seen mentioned on DU. I had written letters to my congress critters and Obama suggesting that even if it took time to implement the full plan, at a minimum, they needed to immediately open up Medicare or otherwise make affordable coverage to individuals with costly chronic illnesses.

[Laelth]

27. That is definitely new and positive.

I can give the President credit for that.

:dem:

-Laelth

[Zhade]

46. One of my best friends almost died this year from lack of health insurance.

I am infuriated with this sellout.

[Ms. Toad]

55. This particular change goes beyond HB 3200

There are certainly portions of the bill I am less than thrilled with, but overall it is a significant improvement that will permit my daughter (whose medical expenses are about $50,000 a year) to have some flexibility to follow her dreams of being an artist - rather than being forced to spend her college years preparing for work that either comes with insurance or pays enough that she can afford to buy into the high risk pool every year until she reaches Medicare age. This new change will at least ensure that insurance will be available to her at some price for the one year after college before the rest of the changes kick in, and a year later the price will drop significantly. She will not have to wait four years for access to insurance, and she will not be stuck forever at high risk rates.

I would love single payer. Health care should be treated as a right, not a privilege in this country. Unfortunately, the current political reality is that we're not there yet. If you don't realize that, particularly after the reaction to the significant - but nowhere near single payer - changes proposed in HB 3200, then you are living in a fantasy world. I'm not willing to sacrifice my daughter's access to health care - and her life - for the microscopic chance that we could hold out and get single payer.

[treestar]

67. I don't know what to say about this kind of attitude

This is political, it involves everyone.

People died in 1994 for the same reason. People died during the Bush Adminstration for the same reason.

This is bigger than just one person. Everyone knows people die or suffer due to lack of health care. The Republicans just say too bad, the Democrats left of the Blue Dogs want to do something, but it has to pass Congress.

How can it be a sellout then, if it saves some people, even if not everyone? It's an improvement on the previous situation.

[Raineyb]

97. Tell that to the people who aren't saved. Seriously this is what you want to tell them?

Sorry we couldn't save you but hey look at all the others. You're just an acceptable tragedy. Forget how we could have gone for a single payer system and saved you too.

Health insurance reform really isn't health care reform. It's too bad that too many don't seem to understand that.

[eridani]

52. HIgh risk pools are ALWAYS way more expensive than real shared risks

This proposal sucks.

[Ms. Toad]

54. True, as to the cost

but guaranteed issue is better than continuing to permit insurance companies to completely reject individuals for another four years which is what many of us are stuck with now, and what HB 3200 permitted. It is a stopgap measure for four years until the rest of the changes kick in. It isn't perfect, but it is a step in the right direction, and we'll see what "low cost" and "without markup" means. It will likely be better than what is currently available in places where there are high risk pools.

[lumberjack_jeff]

77. The alternative is that the high-risk uninsured will just go to the ER.

At least this proposal prevents bankruptcies.

[Raineyb]

93. Assuming that those in the high risk pool can afford the premiums.

Considering the economy that's a hell of an assumption.

[eridani]

145. Not really. The premiums bleed you dry before you ever incur health care expenses

This is just another bullshit war on the sick proposal.

[AllyCat]

152. That's what I thought Rainey! Why not just reform insurance so they have to take these folks?

Now we have a high risk pool to have high risk to fail by 2013 and then the 'cons can say "see? it doesn't work!"

What is up with this wait until 2013 anyway?

[KoKo]

197. That does sound positive, if it kicks in immediately for the pre-existing.

I had a hard time understanding why so much wasn't kicking in for four years and public option (if it get's through in some form) not until 2019. Anything could happen between now and then. Repugs could take over and gut the bill passed by Dems in 2010.

[Name removed]

19. Deleted sub-thread

Sub-thread removed by moderator. Click here to review the message board rules.

[inna]

20. great post, rec#9.

:kick:

[Laelth]

128. Thanks.

:toast:

:dem:

-Laelth

[Thickasabrick]

21. I specifically heard him mention co-ops at the end in talking about

the details that needed to be worked out. Here's the quote - he said co-ops should be explored.

For example -- for example, some have suggested that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others have proposed a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring.

[Laelth]

34. Yikes! I missed that, obviously.

Thanks for bringing it to my attention. Needless to say, I am not happy about it. Regional co-ops would not be big enough or strong enough to actually compete with private insurance and drive down insurance costs.

:dem:

-Laelth

[AllyCat]

153. So did he only listen to the 'cons to draft this plan?

[Dragonfli]

31. K&R The mandate alone is going to hurt me badly.

I had to give up my "insurance" last year because I couldn't afford the premiums and could not afford to use it anyway (very high deductible).

Even with that sacrifice I am running a slight household deficit each month and am hoping to get extra money somehow to get even again.

With the mandate, I will have to pay money I literally don't have for coverage that is almost non-existent. In that speech I heard also that I can not choose better coverage than what is offered for what I already can't afford, No public option for me! just a mandated cash cow for an insurance company that will not cover much any way. Why? because my employer likes the plan he got us, it saves him money as he pays 20%. (he doesn't use it himself, he deserves better of course)

Thank you Mr Romney 2.0! You have just turned me into a criminal that will face fines collected by the IRS.

Why no choice with the mandate? That is just evil.

[inna]

36. thank you for the illustration, this proposed reform is simply atrocious.

:(

[Swamp Rat]

39. Dragonfli!

:hi::hug:

[Dragonfli]

42. Swampy!! (Back in the North America again?)

Nice to see you man!

:hi:

If you haven't been there in a while, the other place we posted has gotten weird, They even pushed Keith out because he is a "useless RW hippy" or something (pretty weird huh?). :shrug:

That dude is further left than me and that is saying allot!
Most of the original cast has been purged now. New ownership or something.

Good to see you again tho.

[Laelth]

56. The mandate will hurt a lot of us in the struggling middle class.

And it will bite the party hard in 2010 and 2012. It will be deeply resented, and it will drive voters away from the Democratic Party in droves.

I fear that the President is sticking his neck out supporting a very bad plan.

:dem:

-Laelth

[Dragonfli]

143. The good news is there will be no fines for anyone "according to frenchie"

Also no one will be mandated to buy insurance according to NonSense.
They like to bullshit a guy that reads the bills and listens to the speeches, I guess that makes the BS true.

Also I have it on good authority from NonSense that there is no such thing as Romney care!
All those reports from the state are apparently made up.

It must be nice to live in a world that is not real.

[Laelth]

156. LOL. It must be nice to live in a world like that.

i.e. mostly blind to reality, completely loyal to their team, and always thankful for the crumbs that are occasionally thrown their way.

Sadly, you and I live in a different, less cheerful reality. At least that gives us the ability to argue and fight to change the world we see when it clearly needs major change and a strong "dose of reality."

:toast:

:dem:

-Laelth

[Dragonfli]

190. Thank You for all you do and for facing a harsh reality without giving up.

:toast:
I really mean that, it would be so easy to take a few tabs of hope and trip on the electric kool aid while the people die and are ignored for profit and bribes.

Laughing and fawning over a picture of an idol while I die in a burning house is something that is very tempting sometimes. The truth is I have seen too much in life to still have that sort of capacity to delude myself with false hope, no matter how tempting it may sometimes be.

[Laelth]

192. Thank you for the kind words.

And thank you for fighting the good fight too.

:toast:

:dem:

-Laelth

[ProSense]

86. "I couldn't afford the premiums " If you can't afford the premiums

you will be eligible for a public option if you opt out of your employer plan, and if you don't you will be eligible for credits and subsidies.

People seem to forget that big companies also employ low-income workers. The credits and subsidies are not tied solely to the public option.

Firms offer health insurance if their workers demand it, but the evidence makes clear that many low-income workers cannot afford to demand health insurance today," concludes Nichols, a health policy expert. "Increasing their purchasing power through targeted subsidies is the surest way to expand coverage. If such subsidies are structured properly, the share of firms that offer health insurance and the share of workers who enroll would both increase."

[JDPriestly]

107. If my understanding is correct, you won't actually be fined for not buying the insurance,

you just won't get the tax credit which might mean you would not get a refund if your income is low enough to qualify you for the refund. The government does not have the authority to force you to buy private insurance in my view. I could be wrong, but that is why they are talking about subsidies when they really mean tax credits. Frenchie Cat thinks that the tax credit could not only be refundable at the end of the year but also on a paycheck by paycheck basis. I have never heard of tax credit refunds being paid in paychecks. Check with Frenchie Cat on that. I asked her to give me an example.

[TheKentuckian]

32. As far as the number that is an expectation based on the plan working

The pitch is that prices will go down and access will improve to the point that private offerings will become attractive. Keep in mind that we don't need our fears of a government takeover soothed. He simply painted the picture that most would continue with what they have under better regulation that makes terms rational and the payout reasonable.

[Laelth]

163. Only a "robust" public option can do what you describe.

I define that as a plan with 50+ million members, open to the general public and corporations, with pay-out rates hopefully pegged to Medicare. HR 3200 calls for Medicare +5%. That would force real competition and drive down costs.

I have no faith that the puny public option described by the President last night will be able to control enough of the market to actually drive down prices and "keep the insurance companies honest."

Thanks for the response.

:dem:

-Laelth

[Hatchling]

35. K&R I didn't hear the speech, but I read it.

And you are spot on with your analysis. I don't know why everybody is high fiving around here.
Maybe because they heard the speech instead of reading it?

This part of the speech really ticked me off:

"....a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated - by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end - and we should remain open to other ideas that accomplish our ultimate goal.

The words in bold are bullshit. The drive behind reform has NOT been insurance reform. It has been Health Care Reform! Revisionism at it's best. :mad:

[Laelth]

38. Hear, hear. I don't need insurance. I need health care. n/t

:dem:

-Laelth

[sybylla]

63. I agree!

Laelth put into words the trouble I was having with various speech points but couldn't quite express.

And you, Hatchling, have nailed the core issue I have with the speech as a whole.

We need healthcare reform, not health insurance reform.

[Bluenorthwest]

69. I never listen to his speeches anymore, I only read them

His use of theatrical devices is annoying to me, as he uses them to distract from, rather than shine light on, the issue at hand. The 'no drama' nickname is laughable, as his speeches are all about drama and dynamics and too often, the seeking of personal adulation, ie the applause lines.
I have no need for flourish, show me the content.
And he is engaging in huge revisionism there. The Insurance Companies have always been the problem. They have always been the enemy of actual health care.

[JDPriestly]

108. Obama is trying to sell those of us slightly to his left on this issue on the

idea of co-ops rather than a government public option. That's how I read it. And you are right. The drive has not been insurance reform. It has been health care reform. It will take another couple of hundred years before we get that. Americans are neanderthals -- primitive compared to other developed countries. We need to get out and see the world more. And we need to learn foreign languages so we know what is going on outside of the English-speaking world.

[Laelth]

112. Sadly, I must agree with you. Well said.

I had such hopes, though, that we were ready for change. I also had hope that the Democratic Party would not sell us out to corporate interests.

:dem:

-Laelth

[leftstreet]

37. K&R

[Laelth]

157. Thanks. n/t

:toast:

:dem:

-Laelth

[cui bono]

41. He also said the public option is only for the uninsured.

"But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up."

Sounds to me like if you have bad health insurance from your job you can't choose public option. So that is saving the insurance companies from losing people to the public option.

[Laelth]

43. Agreed. But in HR 3200 the exchange wouldn't kick in until 2013.

So, there would be no way to change insurance until then, in either case. Perhaps the plan is to give the insurance companies four more years of obscene profits before making the public option available to all. Then, we would hope, most employers would drop private insurance for the cheaper and better public option.

But I am really not certain about this.

:shrug:

:dem:

-Laelth

[Zhade]

44. "Ultimately, I hope the President was lying" -- don't worry, with this guy that's a certainty.

And isn't it just insane that you have to HOPE our president is a LIAR?

[moondust]

45. And Joe "The Ho" Wilson finally shows up.

Where ya been, Joe?

[Zhade]

49. Restoring the rule of law, universal health care, getting us out of Iraq...

Should I continue? Ah, no point, you can't even hear me through all that fucking sand.

[ima_sinnic]

53. +1

to counter the predictable snark

[Laelth]

65. It is tragic that I have to hope that the President is lying.

Sadly, this is not the first time I have had this feeling regarding Obama.

:dem:

-Laelth

[SammyWinstonJack]

70. +1000 nt

[ArcticFox]

59. Tort reform

The speech was already disappointing enough without this shocker. The thing that really irks me is that he's planning on waiting 4 years to introduce the public option (and is sounds pretty weak at that), but says he'll begin tort reform efforts immediately.

The one good thing I can say about that speech is that now I don't have to wonder anymore. I know: Obama is a sellout.

[Laelth]

164. I am not ready to believe that Obama, himself, has sold us out.

But I understand why you feel that way. I am slowly coming to the same conclusion, but I remain hopeful that Obama can find his conscience, boot out all his DLC cabinet members, and actually work for the American people.

I hope it happens sooner rather than later.

:dem:

-Laelth

[ArcticFox]

201. I'm glad you understand me

Am I totally wrong about this situation?

Public option in four years simply means he wants four years to figure out how to tell us we're not going to get it. It's a reverse trigger. I'm sure the insurance companies will play nice for a few years and politicians will say: "I guess we don't need a public option." Then, when we've all forgotten how close we came, four years will pass with nothing and nobody will say a word.

IF the democrats are ACTUALLY serious, then does anyone REALLY THINK that the insurance companies won't just throw billions of dollars to the republicans in order to change the law before those four years are up?

The alternatives are therefore:

EITHER Obama and Pelosi, et al. sold out

OR Obama and Pelosa, et al. have ensured a republican rout in 2012.

This could have been used to energize the democratic base. Instead, the dems have lost all the momentum they had after the election. I do believe it will end in utter failure. For the democratic party and, even worse, for the country.

[Laelth]

202. No, I do not think you are totally wrong.

In fact, most of the evidence supports the conclusion that you have reached.

For the moment, I am in willful denial ... but it won't be long before I will have to face the probable truth that you have described.

This makes me very sad.

:dem:

-Laelth

[Statistical]

60. Why are tax credits worse than subsidies? It is a PC name for the exact same thing.

[Bluenorthwest]

71. For one thing, the tax law is discriminatory

and treats GLBT families and partners as strangers to each other. People who have been together for decades are forced to file as single people. In some cases, that means we pay more.
So my gay household is not a household under tax law. Although we've been together longer than say, Michelle and Barack, we are also considered single by the discriminatory law.
So. just to be very blunt, I do not know if we might benefit from this, or if we might wind up destroyed by it. "We" as a couple have decent income. He, as an individual, has not that much, especially this year and last. So. Will 'he' get virtually free insurance, because he is poor, or will we wind up paying lots for him, because 'we' are not poor?
The tax law is filled with discrimination. The 'reform' thus far has specifically disallowed even legally registered domestic partners from being treated equally. It is for 'spouses' only, and of course, they are also defending DOMA and letting it sit there. So gee. We'd just like to have an idea of what our legal responsibilities will be, and when. How much more will we have to pay than the real, full citizens? Or will it be less? He's poor, if he's not we. You see? And the bottom line kicker is that he would already have insurance under mine, if it were not for the discriminatory nature of the majority and the dogma they worship in lieu of being good people.
So your tax law and ours are not equal. And so using the tax law for new reasons just makes things less equal, more unfair, and ties it all up under the deep powers of the IRS. The power to take without permission.

[Statistical]

72. I hadn't considered that. Unequal protection under the law is not justice.

Tax credit vs. subsidies is just a symptom of the larger problem which is violation of 14th amendment.

"nor deny to any person within its jurisdiction the equal protection of the laws"

[demmiblue]

61. K&R

[Laelth]

166. Thanks. n/t

:toast:

:dem:

-Laelth

[HughBeaumont]

62. So . . from what I'm reading from your synopsis and a lot of others . . .

. . . is that mere survival as far as your health is concerned is STILL going to be almost completely tethered to how gainfully you're employed and how much you'll be able to afford.

That there is no way out, not any progressive-like bone whatsoever being tossed, that you'll still be paying some insurance conglomerate through the nose whether you can afford it or not (likely to increase since insurance conglomerates view this as a slap to their collective faces, which behooves them to shoot back), only now you'll be forced to be covered whether or not you can afford the premiums, and if you're unemployed and absolutely cannot afford to pay, you'll still be forced to pay out of a pocket you don't have.

In other words, there will not be a public option which lets the impoverished completely off the hook for out-of-pocket costs they absolutely cannot afford.

:wtf:

I'm not getting how this fixes anything for anyone other than the well-monied. This just sounds like the same old bullshit. I'm not convinced at all that if I or someone from my family gets a catastrophic illness I'm not going to lose everything I worked so hard for.

[Laelth]

167. Well, yes and no.

I was relieved that the President described and argued for a public option. But he said it would be small. If it is, it won't be strong enough to actually drive down insurance prices and "keep the insurance companies honest."

All in all, though, I agree with your overall assessment. That speech was not designed to appeal to the base, and there's very little in the President's proposal that progressives should celebrate.

On the other hand, I saw in another thread that insurance company stocks all went up today. Evidently, they're very happy about the President's proposal.

:dem:

-Laelth

[Myrina]

64. Perfect assessment, thank you.

He intends to be 'the last' president to deal with Health Care?
And I'm sure, if another Repub is ever elected, Obama will have been the last, because the GOP ain't gonna touch it.

That comment made me go :wtf:

[Laelth]

168. Thanks for the kind words.

If we could just enact a single-payer system, we'd be set. No country that has ever adopted a single-payer system has ever gotten rid of it. That's because the people love it, and even conservatives are afraid to touch it.

Alas, it seems we don't currently have the votes to do this right. That's why I advocate waiting. Passing a bad bill now will only make it harder for us to get a good bill later.

:dem:

-Laelth

[LibDemAlways]

66. The best we can hope for at this point is that the progressives step up and

shoot this thing down. What's being proposed here isn't even close to health care reform. At best it's tweaking the private insurance system a little. The mandate, however, sucks and could sink this Presidency if it goes through. All in all this seems like a huge case of bait and switch.

[Laelth]

91. That's certainly what I am hoping.

I am sending out my letters today, urging them to reject this massive Federal bail-out of the health insurance cabal.

Doing nothing would be better than adopting the plan the President outlined last night.

:dem:

-Laelth

[blueworld]

68. Beautiful synopsis, but I am disappointed

I heard subsidies for catastrophic health insurance. Catastrophic coverage as it stands today has no wellness care or preventative care provisions. The deductibles are high & it only kicks in after hospitalization or something huge. In combination with mandated insurance coverage, I believe this is true abuse of taxpayers.

As I snarkily noted elsewhere, if I develop a serious boil on my butt I can pay several hundred dollars to have it lanced, medicated & get antibiotics. Or, if I can't afford that (high deductibles, catastrophic coverage whatever) and I develop blood poisoning, the catastrophic coverage will pay PART of my bill. I consider this a complete sellout.

I also don't understand why Congress believes they have the right & the ability to mandate internal insurance company procedures & rules, yet they get hysterical over a Public Option as government interference.

What the Public Option would offer is real marketplace competition, the only tool I believe will adequately modify insurer practices that they CAN'T get around later.

I see all glitz, no substance. More corporate shilling. The President is a talented orator, but none of this is the change I voted for. Although the President can guide, it is Congress that must deliver and they are failing miserably.

I remain disappointed, but personally, refuse to give up hope.

PS - I consider the "better something than nothing" attitude absurd on it's face. I want to see SERIOUS debate on a robust Public Option.

[Laelth]

92. Hear, hear. I fully agree. n/t

:dem:

-Laelth

[berni_mccoy]

76. This is about as honest as the GOP is on HCR.

[Laelth]

171. Dishonest?

Come on, now. Was that really necessary? Is there anything truly dishonest in the OP? If so, I'd like you to spell it out.

:shrug:

:dem:

-Laelth

[debbierlus]

78. Eloquent sales pitch for the selling out to big insurance & pharm.

I am disgusted.

[AllyCat]

111. Wish I could rec your reply

I am horrified that he has sold us out to the insurance companies. We all know who controls the government now, even if we didn't get it before. Aetna, BC/BS, and United Healthcare must be hiring the corporate jets to fly everyone to Tahiti for vacation before they give them their bonus checks.

[Laelth]

173. All we can do now is pressure the Progressive Caucus to vote "NO."

That's what I intend to do, in any event. My blue dog congressperson has already vowed to vote "NO," for very bad reasons, but I might send him a reminder letter just in case.

:dem:

-Laelth

[fascisthunter]

79. I Have to Say, all these posts, pro and con are helpful

they really are...(no, that was not sarcasm)

[Laelth]

106. Thanks. It's a complicated matter. Multiple perspectives are always useful.

:toast:

:dem:

-Laelth

[Prism]

81. Did you notice the tone as well?

I can't quite put my finger on it, and perhaps I need to skim through the text to really nail it, but it seemed as if the President was constantly scolding people for being sick. I can't quite articulate it, but especially during the parts about the uninsured, there was a kind of odd disapproval in his tone and word choice that kept laying the responsibility on people who get ill. An almost "How dare you burden the rest of us with your accidents and illness?" quality to it.

I know he was talking about people who choose to be uninsured, but the same tone kept hitting up against those who do not choose to be uninsured, a kind of condescending disdain for the sick and uninsured. It really almost felt like I was listening to a Republican at points.

I know he and his administration have been walking down from the public option for months. It's amazing to have watched this reality since May, and yet someone see, every single day, the endless accusations that's we're hallucinating what is staring everyone plain in the face.

But this tone thing was new, and I did not care for it in the slightest.

[Laelth]

118. I definitely noticed the tone you describe.

It was, to be honest, insulting. My wife and I both lack health insurance at the moment--not because we "choose" not to have it, but because we can not afford it. My wife was furious. She felt that she was being blamed for the problems in our health care system and being accused of being a burden on society, despite the fact that, in truth, she's hard-working and under-compensated.

Perhaps the President was feeding the resentment of the people who have insurance already and trying to score some points with them, but, if you ask me, it was a bad move.

:dem:

-Laelth

[glitch]

82. Excellent OP and thread, thanks for informing rather than simply cheering or sneering. K & R nt

[Laelth]

170. My pleasure. Glad you found the thread useful. n/t

:dem:

-Laelth

[ProSense]

83. "Very little was new" is the new "public option is dead." Seriously,

some people spent the last few weeks lambasting Obama for not stating his support for a public option with conviction, claiming he sold out and declaring the public option dead.

Now that he stood up for the public option and put it in writing, the claim is that "very little was new"?

This is called moving the goal post.

[Laelth]

174. I gave him credit in the OP for advocating for the public option.

He has for some time said that he "liked" the idea, but this time he explained it and explained how it was supposed to work. That was good. But then he tells me it's going to be small. If so, it's useless, and the Progressive Caucus has promised to vote against it. What Obama may have signaled is his willingness to abandon the public option, as a couple of pundits have noted. Ultimately, that's not new. He has repeatedly said he would consider other options (and abandon the public option) if his goals could be met another way. Again, that's not new.

There were some new things, however, and I noted them above. Regrettably, all of them are bad.

:dem:

-Laelth

[Proud Liberal Dem]

87. I definitely agree with you on a couple of points

1.) I HOPE Obama isn't the LAST President to takle the health care issue. It may not be dramatically changing in the near future but I hope that our country eventually joins the rest of the civilized world at some point and adopt universal government-run health care at some point in the not-so-distant future. However, until we're able to "re-sell" the benefits (and sometimes necessity) of government intervention to the American public (which has been brainwashed by a LOT of anti-government rhetoric over the past 30 years), we're pretty much stuck with the private health insurance vultures for the time being. The best thing that can happen right now is that they will have government breathing down their necks a WHOLE lot more than do now.

2.) I didn't like the section about mandates and him appearing to blame people whom don't have insurance- for whatever reason- for increasing costs on everybody else. I can see how more people buying insurance can theoretically *help* bring down the costs but I thought it was unnecessary to try and assign blame for high costs on people whom don't have it, particularly when insurance company CEOs are getting such massive salaries, bonuses, and other perks and there is a lot of other waste, fraud, and abuse in the industry that is contributing to that particular problem. THAT is what he should've really been talking about. I also don't honestly believe that most people whom don't have it simply refuse to purchase health insurance coverage because they are reckless and/or irresponsible. I would reckon THAT has more to do with not being able to afford insurance and/or being unable to find a suitable policy that meets their needs. Also, I have no idea how the government is going to enforce this *mandate*. Will hospitals file a report if an individual comes into a hospital/ER without an insurance card and then what will happen? :shrug:

[Laelth]

175. My wife and I (both uninsured) were really furious about #2.

My wife felt that she was being blamed for the problems in our health care system and being accused of being a burden on society, despite the fact that, in truth, she's hard-working and under-compensated. If we could afford decent health insurance, we would have bought it already.

Perhaps the President was feeding the resentment of the people who have insurance already and trying to score some points with them, but, if you ask me, it was a bad move. That speech was not designed to appeal to the base.

Remarkably, lots of people around here loved it anyway. As an orator, the President is brilliant, and it looks like he may actually be able to sell this awful legislation.

:shrug:

:dem:

-Laelth

[Proud Liberal Dem]

186. Overall I thought it was a good speech

I think that he could've tried to sell mandates without using RW talking points that blame people whom don't carry insurance for being part of the problem. That was a real :wtf: moment for me. I think that he perhaps tried to put too fine a point on the subject.

Of course, mandates are only part of his overall proposal and it may get drastically changed in Congress. I think that a mandate would be o.k. as long there are a variety of private AND public health insurance options to choose from but the fate of the PO and who exactly would qualify for it is uncertain at best right now. Massachusetts "Romneycare" hasn't been particularly *successful* and I'm very concerned about what kind of effect a similar plan might have nationally. We'll see what happens.

BTW sorry to hear about your situation and hope that it improves. :hug: We have been priced out of HMO coverage through my job and are now stuck with an HSA with a $2900 deductible, which is practically like having no real coverage.

[branders seine]

88. good rhetorical defense of liberalism--right on President Obama!

good rhetorical putdown of the naysayer republicans--right on President Obama!

truly, perhaps epically, awful policy--WTF President Obama?

it looks to me like an almost complete surrender to the medical insurance industry

just as he negotiated away single payer before debate ever began (but after his then secret meetings with health care executives), he now seems to have at least signalled a willingness, if not a desire, to negotiate away any real public option. His "plan" (if something as undefined as what he sketched out last night can be called a "plan") offers a huge windfall to medical insurance companies, with litte interruption of business as usual. What little help he offers to ordinary citizens will not even happen for four years. If United Healthcare had written the plan, they could not have done better for themselves.

In 2003, Obama was asked what it would take to get single payer enacted. He said, “First, we have to take back the White House, the Senate and the House.”

Now, we have the White House, the Senate and the House, but Obama is more interested in further rewarding the insurance companies than in helping the people.

[Laelth]

94. Welcome to DU.

I agree. It was a beautiful speech. The President is a brilliant orator.

But the plan he outlined? An absolute disaster waiting to happen, and undoubtedly a massive, Federal bail-out of the health insurance cabal paid for, principally, on the backs of the struggling middle class.

Your assessment is spot on. Thanks for the response.

:dem:

-Laelth

[branders seine]

119. thank you for the welcome

I did not watch the speech live; I was working.

I watched the video a couple of times and read the transcript thoroughly. The policy really is bad. It is pretty weasely in most areas, and leaves plenty of wiggle room. BUT, if--and it's a HUGE if--all the vague areas are filled in as progressively as possible, we could end up with Mitt Romney's health care plan. :puke:

[Laelth]

159. Exactly.

And that would be the best-case scenario. That's entirely unacceptable, imho.

The individual mandate will be deeply resented by millions of Americans, many of them young, new voters. Alienating them now would be a disaster for the Democratic Party. The meager reforms outlined in the President's plan are not worth the costs--the grotesque enrichment of the health insurance industry that the President's plan will create and the alienation of millions of voters.

For me, this is a no-brainier. I feel compelled to do everything in my power to make sure that this bill does not pass.

:dem:

-Laelth

Edit:Laelth--clarity.

[Lydia Leftcoast]

90. I didn't hear the speech (I was at choir practice), but I read the transcript

What it looks like is that most of us will be required to buy private insurance, with not enough restriction on what the insurance companies can do to us, and that only people who can't get insurance on the private market will be allowed to go with the public option.

I don't care how brilliant Obama SOUNDED. Look at the substance instead of the style.

This is a weak compromise, close to a total cave-in to the insurance companies.

[Love Bug]

120. That would explain why insurance co.'s stocks went up this morning

This is very disturbing and frankly, I'd almost rather they did nothing than go ahead with this plan. This will be a financial boon for the insurance companies and a real hardship on those who can't afford to buy insurance outright or can't afford to front the money now and wait for a "tax credit" later.

Question: Will big Ed, Obermann, Maddow, etc., see this tonight or will they be too busy gushing over Obama's speechifying ability?

Don't get me wrong. I like Obama and I voted for him but the more I hear about this plan, the less I like it. It's looking more and more like glorified lip service to me.

Disclaimer: Personally, I get my health care through the VA so no matter what Congress does, it won't affect me. However, my 32 year old daughter and her fiance work the kind of jobs that don't have benefits and they've been unable to afford coverage on their own, even though they are both young and healthy. My concern is really for them and my two grandsons.

I'm also concerned about the continued burden on small businesses, especially, who, in this shitty economy, are often forced to drop coverage or lay off workers to stay in business. I don't believe we'll have a true economic recovery in this country that includes rehiring the millions of unemployed until we stop linking coverage to employment. We are all being crushed under the burden of supporting an unfair, bloated system that benefits no one except the insurance companies. We need universal, single-payer health coverage and until we get it, we're going to continue to limp along economically in fits and starts and many who've lost their jobs over the past year will continue to remain unemployed.

[scarletwoman]

142. Linking coverage to employment is one of the MAJOR flaws in the U.S. healthcare system.

It made some sense when we had a more sound economic policy of tariffs to protect domestic industry, but now that Free Trade and corporate globalization has destroyed our domestic economic sovereignty, it's just another cruel joke on both the working class and the small business owner.

sw

[Love Bug]

146. Exactly right. Linking coverage to employment is one of the main

reasons why the auto industry is in the dire straits it is. When you have a retiree population drawing benefits that is larger than the worker population producing goods, sooner or later the whole top-heavy thing will topple over, which is what has happened. I think I read an estimate that some $1,500-$2,000 of the wholesale price of every new car just goes to pay health care benefits.

[scarletwoman]

151. It's such an excellent and straightforward argument for single payer.

If Obama were any kind of real progressive, he'd be making THAT argument instead of all the convoluted justifications for keeping the status quo with just few tweaks here and there.

But he WON'T make that argument because his heart is with the neo-liberal globalists. The same way he won't fight to bring our outsourced jobs back.

Bah!

sw

[Laelth]

176. Hear, hear. It's a very weak compromise.

And it's likely to get weaker still before a bill reaches the President's desk. I am more convinced than ever that doing nothing (at this time) would be preferable to passing a law that resembles the proposals the President made in his "health care" speech.

Thanks for the response.

:dem:

-Laelth

[WeCanWorkItOut]

95. Excellent synopsis and discussion. The "waste and abuse" issue worries me, though

That's where the savings are supposed to come from.
But we need examples. I'm concerned that
where there are public health ways of saving money,
and for-profit ways, Obama's advisors will go with
the ways that benefit their donors.
And if the choice is between lowering the price of
a service, and just telling some people to do without,
they will not want to lower the price. We've already
seen too much of that in these hard times:
people at the top of the hierarchy get their raises
while people lower down get furloughs.

[Laelth]

177. Welcome to DU.

As I understand it, savings are supposed to come from preventative medicine and elimination of redundant testing and procedures, primarily. Those should both improve care and lower costs. Doctors do a lot of tests, for example, not because they are medically necessary but because they know Medicare will pay for them. The President hopes to eliminate this practice (and other near-fraudulent abuses of Medicare) in order to save some taxpayer money.

I hear your concerns, but I have very different reasons for opposing the President's plan. On this, I think he is right. Reform is needed. The question is what price are we willing to pay for these needed reforms. I am not willing to pay the price that the President is demanding.

:dem:

-Laelth

[Name removed]

98. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Skittles]

113. it's YOU'RE

[Laelth]

114. That's really quite rude.

But in an attempt to be civil and constructive, let me say this. You have a choice, here. You can either listen to and try to respect the opinions of the progressives in the Democratic Party, or you can continue to try to push us right out. Which is it going to be?

:shrug:

:dem:

-Laelth

[paulkienitz]

100. the last president to tackle it

"The President also said that he intends to be the last President to tackle the issue of health care."

By the time he got to the end, I knew that this was going to be a forlorn hope. We'll have to revisit it just as soon as we find out that health care hasn't gotten cheaper like we hoped.

And I agree that an individual mandate is a terrible idea. That's a piece of total bigbrotherism.

[Laelth]

178. The Republicans already claim that Democrats want to take away their freedoms.

Imagine how "big-brothered," to use your term, the Republicans and many other people will feel when the government forces them to buy insurance.

The individual mandate is a disaster waiting to happen. It will be deeply resented by millions of Americans, and it will drive voters away from the Democratic Party by the millions.

Thanks for the response.

:dem:

-Laelth

[Individualist]

101. K&R

[Laelth]

180. Thanks. n/t

:toast:

:dem:

-Laelth

[dem mba]

109. he wasn't refering to people without insurance who couldn't afford

it, he was talking about people without insurance who could but chose not too. Basically this refers to people between the ages of 18-24 who think they are invincible and want to save a few bucks a month. I know because when I was that age I went without health insurance. I was living on ramen noodles at the time but I could have asked my parents to cover me. I didn't. I was irresponsible and had some accident happened I would have been screwed. Fortunately I got wiser with age (I think) and am now fully covered.

As for Tort reform, this is not a waste of time. It deflates the argument that Obama is a "tyrant". Even though he will be called this anyway, at least there is a valid, reasonable argument to make against that line of attack. In any event, something needs to happen. Doctors can't order 17 different tests on a patient just to avoid getting sued because they missed something. The costs are unnecessary and insanely expensive. Conversely, a doctor must be held accountable if they botch a diagnosis or procedure. A happy medium will probably never be reached, but the status quo is not helping anybody.

[VLC98]

116. Speak for yourself.

I don't agree that most 18-24 year olds think they are invincible; that sounds like a RW talking point. My 21 year old daughter is uninsured and extremely worried about having an accident or illness. If insurance really did cost "a few bucks a month", as you say, she would be covered...try $500 a month for Cobra.

[dem mba]

193. a RW talking point regards a perceived flaw in a system

and then advocates totally removing the system as opposed to just fixing the problem. i'm just pointing out that some people will game the system. that isn't me being a RW kook, it's just common sense and pragmatism.

if they are republican, if they are democratic, if they don't follow politics, it doesn't matter - people will game the system. it benefits us all to mandate health coverage and subsidize those who can't afford it.

and paying $500 a month for health insurance is criminal. who is that plan even for? if you are unemployed and eligible for COBRA you sure as hell can't afford that...

[Laelth]

179. Yikes!

Most people who are 18-24 aren't saving a dime. They have no disposable income, and they can not afford health insurance. They will resent it if we force them to buy it, and they will be driven away from the Democratic Party by the millions.

Doctors perform a bunch of tests only because they know they will get paid for them. Tort reform will solve nothing there, and it's not wise for the Democratic Party to attack one of its single, largest contributors.

-Laelth

[dem mba]

194. so whats the solution then?

to the 18-24 year olds who are working full or part time and don't have health insurance? when they get into a serious accident or suffer a major illness they won't be covered and we all pay for the ER trip. mandating coverage seems like the best way to cover everyone and distribute costs evenly. you can't have "universal" health care unless everyone is covered, right? (i assume no single payer system for this)

as for their savings, well the health insurance fees would be deducted out of their paychecks just like SSI, Medicare, state tax and all the rest, right? in theory, since employers would no longer pay as much for health insurance(right?) they would pay their employees more to compensate. in theory...

tort reform isn't even worth debating because both sides have very real and legit points to make. if we weaken patients ability to sue negligent doctors, serious and even fatal medical errors will inevitably rise. if we strengthen patients ability to sue, malpractice costs both direct and indirect skyrocket. its a tough nut to crack.

[Laelth]

198. I do not oppose payroll taxes to pay for health care for all.

That's how several countries do it. It's fair. If you're working, you pay, based upon how much you make. If you're not working, you don't pay, because you can not afford it, but you still have complete access to health care. I would completely support that.

That is not, as far as I know, what the President's plan is designed to do.

As for tort reform, I have written on that topic, if you are interested, here:

http://journals.democraticunderground.com/Laelth/34

:dem:

-Laelth

[Cleita]

117. Thanks Laelth for a good analysis. Also, I want to know

why he feels that he has to preserve that one-sixth of the economy that has failed sick and dying people up until now. IMHO access to health care for everyone regardless of their ability to pay shouldn't even be a part of the economy, anymore that our firefighters, and our legitimate military are.

[branders seine]

125. money is undoubtely the reason

lots and lots of money

[Laelth]

182. He said it would be "too disruptive" to not preserve the current system.

Frankly, I think we could all benefit from some major disruption.

Thanks for the response and for the kind words.

:dem:

-Laelth

[gorfle]

124. My comments on your comments.

He discussed the Public Option. He argued for it, and that was a relief, but he said it would be small. This is a problem. Either he was lying (because he believes it will be big, and it will need to be big to actually drive down insurance costs and "keep the insurance companies honest"), or he was telling the truth (in which case the Public Option will be meaningless because it won't be big enough to provide real competition). I have argued, and still believe, that a weak public option will prove that government doesn't work, and that enacting a weak public option would be worse than doing nothing. Ultimately, I hope the President was lying and that he believes the Public Option will be big and will actually do some good.

I believe there will be a subsidized Public Option for poor people, but it will be priced to be unattractive to anyone non-subsidized, so thus to not be a threat to private insurance. Basically, it will become a new welfare project paid for by people unable to use it.

I give the President credit for actually admitting that his plan will force everyone in the United States to buy health insurance. That took courage, even though it's not new (all five bills seriously under consideration in Congress contain the individual mandate), and even though I think this is a terrible idea. At least the President was willing to "own" it. Then, after explaining that everyone would have to buy it, he explained why, and it was at that point that I blew my top. Obama basically blamed the uninsured for the high cost of the insurance that those who have it have to pay. He even put a dollar figure on the cost increase that's attributable to those who lack insurance. I was astounded that the President, basically, resorted to Republican rhetoric and blamed the victims of this failed health care system for its failure. That was new. That was not good.

What you are missing is this: Yes, they are "mandating" that people without insurance buy it. But for all the people who don't have it presently because they can't afford it, they'll be getting it for free, or heavily subsidized.

The second new thing I noticed was this. Whereas HR 3200 calls for subsidies for those who can not afford the mandated insurance, President Obama referred specifically to tax credits. Yes, tax credits, instead of subsidies, for those who can not afford insurance. This is new, and this is much, much worse than what the House proposed in HR 3200.

No worries. For those who don't make enough money to benefit from tax credits on their income, they will simply get more EIC (Earned Income Credit) to make up for it.

[shimmergal]

132. About "it will be small" being a problem.

I'm not worried about that. It WON'T STAY small. Whether Obama knows it or not, if there's any public option allowed, even if it's supposedly confined to the uninsured, it'll grow tremendously, as the for-profit insurance companies aren't able to control their greed.

We just need to make sure it's IN the final version, and that membership in the public option is grandfathered in. In other words, once you have it you can keep it, even if you later find yourself in a situation where another plan is offered. So many people end up uninsured for a while, that I can envision an enrollment of 30 million or more within a year or two after it kicks in.

At that point, half the U.S. population will be included in some form of govt. health coverage. And the momentum will pick up from there...

And since the "temporary" coverage till 2013 is new--at least not mentioned in the public dialogue before now -- maybe we can shape it better. Demand it not be limited to catastrophic coverage, but also could be used as a lab for trying out vatrious ideas. Even single payer on a statewide basis, perhaps? Obama DID say he'd welcome all ideas made in good faith, didn't he?

[gorfle]

191. They will make sure it stays small.

Look, as President Obama said in his speech, he is not going to destroy the health insurance industry. He can't. I bet the market cap of the health insurance industry dwarfs the auto industry, and they wouldn't let the auto industry fail because the loss in investments and jobs would be disastrous.

So they will make sure that the Public Option ALWAYS costs more than buying equivalent health insurance in the private sector - UNLESS you are getting a government subsidy because you are poor.

This will keep the Public Option program small, because no one paying for their own insurance would sign up for it.

[cornermouse]

140. And are they also subsidizing co-pay?

Tax credits? IF you don't have money tax credits or EIC is useless because you may need money later but you need it more now when you're sick. This whole thing is stupid and doesn't indicate any knowledge of the economics of the poor.

[mistertrickster]

133. What's with the obsession on "single-payer?"

France, ranked best in the world on health care, doesn't have it.

Neither does Germany-Switzerland-Austria and a number of other European countries.

In fact, they don't even have a "government option." They just have tightly-regulated private NOT-for-profit health care, subsidized for the poor.

There're a lot of good health care models out there that don't look like Canada and England.

[Cleita]

137. Mistaken notions being spread as facts again. Just because

France allows private insurance in addition to their basic plan doesn't mean they don't have it. Single payer has been studied in depth by doctors and economists who are smarter than the rest of us and they have come to the conclusion it works the best of all the other systems. Frankly, even if Canada's system isn't the best system in the world, it's 90% better than what we have and that we are going to get because nobody is impoverished because of health care and no businesses are destroyed because of health care costs wherein they can't compete on the global market. Those are facts that are as plain as the nose on your face.

[Greyhound]

138. As today's market evidences, the unspoken yet completely clear message he delivered was,

"Don't worry, the American People will subsidize your obscene profits".
:kick: & R

[kath]

181. Ding, ding, ding, ding!!

A winnah!

[Laelth]

185. You nailed it.

The health insurance industry was very pleased with the President's speech.

I fail to understand why so many people here are celebrating.

:shrug:

:dem:

-Laelth

[hay rick]

139. A couple thoughts.

Agree that a "small" public option could be a problem. Promising that it will be small is another way of saying to those who oppose any public option that it won't be large enough to be harmful. Unfortunately, it's also a way station on the road to ditching the public option entirely- the flip side of not-large-enough-to-be-harmful is too-small-to-have-done-much-good-anyway. I also agree that a weak public option would create the self-fulfilling prophecy of "government that doesn't work."

I'm more sanguine about Obama raising the fact that charity care drives up insurance costs. One of the important arguments in favor of extending insurance coverage is that a substantial portion of the costs of expansion will be recovered by reducing the expense of charity care. This is money we are ALREADY SPENDING that can be redirected in a more humane and efficient way.

The compromising Obama was on full display in his remarks on tort reform. He suggested small demonstration projects a la GWB. Small demonstration projects would be too-small-to-do-much-harm... I think half the point of that sally was to drag 43's name into his bipartisan stew.

One more point on tort reform- though not particularly relevant to Obama's speech. I see tort reform as a counter-argument from people who want to preserve fee-for-service. It is an alternate explanation for the reality that a lot of our excessive medical costs are related to unnecessary tests and procedures. Doctors who can increase their income by providing additional borderline-useless services can claim they are just practicing "defensive medicine." The devil made me do it.

[Laelth]

184. I agree totally with your assessment of doctors' practices.

They get to bill for all of that allegedly "defensive" medicine, so they do it whenever they can, often when it's unnecessary. It greatly increases their bottom line.

Thanks for a thoughtful response.

:dem:

-Laelth

[scarletwoman]

149. Thank you for your well-stated OP, as well as for the thoughtful & informative thread

that your OP has inspired.

I must admit, I find any "reform" predicated on preserving the health insurance industry to be utterly distasteful. Therefore, my own experience of listening to Obama's speech last night was much like that of Ginger the dog in the old Gary Larson cartoon.

"Blah blah blah Healthcare blah blah blah blah Healthcare blah blah blah..."

sw

[Laelth]

183. LOL. I listened to every word. I might have been happier taking your approach.

Thanks for the response and for the kind words.

:dem:

-Laelth

[Mithreal]

188. Too late to rec, enjoyed the op and discussions. nt

[Laelth]

199. I am glad you did. Thanks for the kind words. n/t

:dem:

-Laelth