Money Talks, the Rest Walk

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Henry Waxman has cut a deal with the conservative Blue Dog Democrats that moved the House version of the health care reform package out of the House Energy and Commerce Committee (of which Rep. Waxman is chair) so it can be voted on in September. But the deal is unlikely to satisfy the 57 liberal Democrats who have put it on record that they will vote against any bill that does not include a strong public option:

“This agreement will result in the public, both as insurance purchasers and taxpayers, paying ever higher rates to insurance companies,” the letter says. “We simply cannot vote for such a proposal.”

If Republicans oppose the healthcare bill on the floor en masse, 57 Democrats voting “no” would defeat the bill.

The agreement between four Blue Dogs and House leaders cut $100 billion off of the price tag of the bill. Under the proposal, reimbursement rates in the government-run “public plan” would not be linked to Medicare. It would also reduce subsidies to make a government-run “public plan” more affordable.

Liberals say those changes undermine the public plan by making it too expensive for people to join.

House liberals did manage to extract a concession from Waxman that has at least symbolic significance:

House liberals have struck a deal with Henry Waxman to bring legislation that would establish a single-payer health care system up for a floor vote this fall, a senior House Democratic staffer tells Mother Jones. H.R. 676, a bill that would create a national single-payer system—essentially Medicare for all—has been languishing in Waxman’s Energy and Commerce committee for months. “Waxman is saying our request will be honored,” the staffer says.

The Waxman-Blue Dog deal is a boon for the private health insurance industry — and why wouldn’t it be? Industry execs and lobbyists paid for that, and it seems they are getting their money’s worth. Ryan Powers points to a Washington Post article by Dan Eggen on how insurance companies’ campaign contributions affect health care legislation. Powers quotes from Eggen, as follows (bolds are Ryan’s):

[T]he [Blue Dogs] set a record pace for fundraising this year through its political action committee, surpassing other congressional leadership PACs in collecting more than $1.1 million through June. More than half the money came from the health-care, insurance and financial services industries, marking a notable surge in donations from those sectors compared with earlier years, according to an analysis by the Center for Public Integrity. […]

A look at career contribution patterns also shows that typical Blue Dogs receive significantly more money — about 25 percent — from the health-care and insurance sectors than other Democrats, putting them closer to Republicans in attracting industry support.

and comments that this kind of influence-peddling by various industries has more to do with bribe-ability than ideology:

The business of influence and access peddling in Washington is often thinly veiled in pseudo-respectable claims that industry groups donate to candidates who they believe are predisposed to agree with their public policy priorities. But I think it is more accurate to say that industries donate to individuals who they perceive as predisposed to being bought. Indeed, if the health insurance industry really based its contribution decisions on who they thought would be more likely sympathize with their desire to keep the health care system as it is, they would do well to always direct a majority of their cash to GOP candidates. But they don’t.

Apparently viewing House candidates as commodities to be bought, they appear to invest in the party that they believe will be in a position to most directly affect their industry’s future. The hope it seems is that their contributions will make their industry’s calls to stall reform a bit louder than the public’s calls for significant changes to the health care system in the U.S.

Powers follows this up with a chart that reveals a strong connection between campaign contributions and whichever party happened to be in power:

In every House campaign cycle in the last 20 years the health insurance industry has invested quite literally in the status quo — choosing to funnel a majority of their campaign funds to members of the ruling party in the House[.]

Matthew Yglesias points out the corollary:

This is why the very same members likely to be concerned that expanding coverage to the poor is too expensive also tend to be the same members who oppose saving money through the introduction of a robust public option embedded in a strong health insurance exchange. There are some visions of “health care reform” that are compatible with the interests of insurers, and the job of on-the-take Democrats is to try to steer legislation into that harbor.

In other words, it’s not truly about saving money — it’s about pleasing the insurance industry and using cost as a fig leaf.

It really isn’t subtle, either. Here are the opening paragraphs of that WaPo article by Dan Eggen:

On June 19, Rep. Mike Ross of Arkansas made clear that he and a group of other conservative Democrats known as the Blue Dogs were increasingly unhappy with the direction that health-care legislation was taking in the House.

“The committees’ draft falls short,” the former pharmacy owner said in a statement that day, citing, among other things, provisions that major health-care companies also strongly oppose.

Five days later, Ross was the guest of honor at a special “health-care industry reception,” one of at least seven fundraisers for the Arkansas lawmaker held by health-care companies or their lobbyists this year, according to publicly available invitations.

Now pair this with the mortality figures for Americans who do not have access to health care:

Let’s see, what’s the number of Americans who die every year because they lacked health care? Somewhere between 18,000 and 20,000, last I heard. I suspect that’s a low estimate. Money taken from the health insurance industry to block health care reform is blood money. There is no other way to look at it.

[Lots] of people are just plain being ground down for lack of decent health care. They don’t necessarily die prematurely, but they suffer more health care problems than they should.

Barbara also draws our attention to this article in Roll Call, which among other things points out that you can’t get a complete picture of the factors driving up health costs just by doing cost comparisons:

Why is it then that the health of citizens in these two [states] lags far behind the nation as a whole? Could it be that once given health insurance and other benefits — by way of reaching the dual entitlements of Medicare and Social Security — when they turn 65 years of age, Louisianans and Mississippians must eventually pay a heavier price for a lifetime of neglected health needs?

In Texas, 16 percent of the population lives in poverty, and per capita health care spending is far below the U.S. average ($4,601 vs. $5,283). Yet Medicare per capita spending in Texas is far greater ($8,292) than the U.S. average.

Babies in all three states have among the lowest life expectancy at birth — not because of what’s invested at the age of 65 and beyond, but rather because of what is not invested in children and young adults all of their lives.

States that have low poverty rates and relatively stable investments in health care throughout the lifetime of their citizens often show a very different picture. Vermont, smaller and far less diverse than its southern counterparts, has a poverty rate of 10 percent and spends about $6,000 a year on all patients, including Medicare beneficiaries.

Consider again how all of this matches up against the comparisons to other developed nations. On average, child poverty in OECD nations is 13 percent compared with more than 21 percent in the U.S. (and 5 percent in Norway). In single-parent households in the U.S., child poverty rates come close to 50 percent. While most discussions in the current debate have focused on the cost of clinical care, insurance rates and primary vs. specialty care, we may be missing the bigger picture.

But that is not what’s troubling House Republicans. No, they are upset about the inclusion of a “common ground” abortion provision in the Waxman-Blue Dog deal:

By a vote of 30 to 28, the committee approved an amendment setting forth abortion policy. The proposal, offered by Representative Lois Capps, Democrat of California, was supported by most Democrats and opposed by Republicans.

The amendment said abortion could not be included in the “essential benefits package” to be defined by the government. Further, it said insurers would not be required or forbidden to cover abortion. But, it says, in every part of the country, the government must ensure that there is at least one plan that covers abortion and at least one that does not.

Under the bill, health plans would receive federal subsidies to help pay premiums for low-income people. But under the amendment, subsidies could not be used to pay for abortions.

Democrats described the amendment as a compromise. But Representative Phil Gingrey, Republican of Georgia, who opposed the amendment, said, “We don’t compromise on the use of taxpayer funds for the destruction of human life.”

The cartoon by Adam Zyglis, The Buffalo News, is copyrighted and licensed to run on TMV. All Rights Reserved. Unauthorized reproduction prohibited.

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Author: KATHY KATTENBURG

  • DaGoat

    Isn't it possible the Blue Dogs are acting from the realization a public option may well be the precursor of a single-payer system as opposed to being bought off by insurance companies? Differing opinions within a party are a healthy thing – the GOP has shown the dangers of what happens when a party gets too monolithic. Compromise between these opinions may well lead to the optimal plan.

  • Father_Time

    I don't want insurance, I want Healthcare!

    We need full nationalized medicine. Why? Because no-where on the planet is healthcare more expensive than here. Supply and demand “free enterprise” fails us with medical needs because there is no viable competition. Therefore price of healthcare goes up according to “demand” which will never be less. Health insurance premiums are going up much faster than incomes. People are losing their homes and everything they have even WITH insurance! This is inhumane. It is also not necessary since every modern nation has already solved the healthcare problem with a national system. Why can we not do the same?

    Why is our healthcare so expensive? Our healthcare s no better than other nations, and, worse than most. We are 39th with medical accidents, (number one being the best) and something like 75th in public availability. I believe it is so expensive simply because that is what those in the industry choose to charge us. They charge as much as they can get not because that is the cost required, but because that is what they can get it! From big pharma to Jill the nurse, you get charged way to much. Extremely few people can afford to pay on their own for any significant medical need ,so in comes the insurance crooks. The insurance crooks merely play the odds for profit and WOW what a profit it is. Insurance only makes the cost of medical care much higher and not surprisingly their cost of operations and profit just about equals what it would cost for those without insurance to have healthcare coverage. It’s clearly a sham.

    Unfortunately the cost of healthcare will not be reduced unless forced. I realize that a gradual change from a capitalist system, to nationalized medicine rather than sudden change, is prudent. However it is the only viable option. Even if the government attempts to subsidies the patient costs or insurance premiums or whatever, the cost of healthcare will eventually out price even that and the only competition healthcare providers will have, is for those few than can pay. The rest will be discarded or billed directly to the state or federal government anyway.

    It is stupid not to start moving toward national healthcare.

  • AustinRoth

    I want a free house and a free car, free food, a guaranteed paycheck, 6 weeks of vacation a year, free cable and cell phone service, and free college degree of my choice.

  • GeorgeSorwell

    I want a free house and a free car, free food, a guaranteed paycheck, 6 weeks of vacation a year, free cable and cell phone service, and free college degree of my choice.

    Austin Roth is a communist!! ;)

  • JSpencer

    Anyone who continues to believe this is strictly a democrat or republican thing, a “liberal” or “conservative” thing, is following exactly the story line the insurance companies want them to… legislators not exempted.

  • Rudi

    AR – Start a conservative PAC. It will also allow you to cheat on your wife while living on C Street…

  • kathykattenburg

    Isn't it possible the Blue Dogs are acting from the realization a public option may well be the precursor of a single-payer system as opposed to being bought off by insurance companies?

    Well yes, of course, DaGoat, but why would you think that argues against Blue Dogs having been bought off by insurance companies?

  • Lit3Bolt

    AR-what does healthcare have anything to do with hard work and “free markets”? I hate that meme. Do you expect “hard work” to build a road for you? Clean your sewage? Provide clean drinking water? Protect you from criminals? Protect you from terrorists? Educate your children? Provide a fair banking system? Provide a system of justice and courts for you?

    This is not a “deserving” vs. “undeserving” issue. Do you really believe so many people are uninsured in the US because they don't want or deserve it? Besides, this is giving people the OPPORTUNITY to take advantage of it, where beforehand they had none. This is about fair shakes, nothing more. It'll still be up to people to haul their ass to the doctor when needed.

    What's funny is we already have Medicare, and many many people would give that up after you pried it from their cold, dead hands. But I bet they're all socialist commies as well, and freeloaders, because they don't work. They should die.

    Healthcare is like justice. Everyone should get a chance at it. And it's not something you can do by “living right,” unless you expect to go through life without injuries or accidents or illness. We ALREADY provide government healthcare to elderly and poor people, the ones that use it the most and are costing us the most money.

    I mean, honestly…you don't expect a free market military, or a free market justice system, do you? And taxes pay for these and more. You get BENEFITS for your money. Or are you against state owned anything, including your local university? Do you hate that as well?

    In fact, raising taxes is the easiest way to weed out the freeloaders that are scaring you. It's just that your health, your life, and that of your family, should not be tied to your employment status, which is fluid. Or would you prefer that when the cops arrested you, you were only provided a lawyer if you were employed? Or that firefighters checked your employment status before turning the water on? Or that the military and national guard was dispatched only to highly employed areas that were hit by disasters and hurricanes?

  • Jim_Satterfield

    AR shows how little the health care debate really means to the American conservative, except how important it is to stay as close to the status quo as possible.

  • richg

    For all of his TALK to the contrary, supposedly “conservative” Blue Dog Mike Ross and others voted in favor of the final bill which includes the government-run “public option” which will use tax dollars to pay not only for late-term abortions, but also sex change operations.

  • DLS

    The reality is that the Dems' health care effort is so bad that it even has some Dems now objecting to the worst of it (because the growing public opposition to it, which is natural and obvious, affects at least some Dems' re-election prospects). At least some Dems are being grown-up and intelligent to some extent. The childish left Dems are simply disgracing themselves and their party as they have been notably since the Dems got their latest chance to exercise power without restraint, and have done so horribly wrongly, as are their ignorant and childish hard-core Dem voters, whose silly demands aren't being met fast enough.

  • DLS

    “the final bill which includes the government-run 'public option'”

    The “public option” is the current form of incrementalism of federal health care provision chosen by the Democrats all along. It's like being blatantly liberal (as many Dems are this year) while still avoiding the use of the word “liberal” (which has been so very discredited, and so, avoided, and why is that, again?), but in the case of health care (or anything else Austin Roth correctly can note, someday afterward) lends itself to incrementalism as an alternative to avoiding “government” nomenclature _and_ action altogether.

    As for abortion, I've warned people for ages that this subject would be introduced (and promptly and militantly politicized by the anarchic and amoral militant extremists on the far Left, who will be surrounding this like fruit flies at a fruit and vegetable market area, or like fleas or ticks) once federal health care were extended en masse to child-bearing-age females. Abortion, particularly with its extremist baggage, is guaranteed to materialize with government health care incrementalism. If the Dems were actually to take the initiative, though, and to promote abortion explicitly (and encourage the scummy militants), that would be especially bad, though this health care effort has been especially bad among the Dem efforts this year so far that it wouldn't be surprising at all (and obviously shouldn't be).

  • DLS

    “In fact, raising taxes is the easiest way to weed out the freeloaders that are scaring you.”

    Not when the taxes are deliberately distorted and engineered in fact to the contrary, by liberal politicians!

    * * *

    “Do you really believe so many people are uninsured in the US because they don't want or deserve it? Besides, this is giving people the OPPORTUNITY to take advantage of it, where beforehand they had none.”

    Many are foregoing insurance because they are young and don't want to pay for it, often because they don't believe they need it, or they'd rather spend the money on other things. In fact, the honest kind of stereotypical uninsured person that intelligent critics of ridiculously-rushed stuff like the Dems tried this time (outdoing themselves and failing in the process so far) can provide is a college sophomore with no cares about health care whatsoever.

    In any case, intelligent critics rolled their eyes at the screeching about the number of uninsured during the Clinton health care fiasco and they and so much of the rest of the public really doesn't care what number is being used now. (The issue currently on most minds is what kind of incrementalist moves the federal government is going to make toward provision of health care to how much more of the public, and how it will be paid for. Nobody grown-up is swayed now by ridiculous howling about the number of uninsured. We've all encountered people by now who are uninsured for all kinds of different reasons. [sigh] Not only that, but that alone is not the only reason to seek government health care — the safety net — because the current system is begging for this or that reform in addition to any new public health care provision.)

  • Duopoly_Spoiler

    Do you honestly believe that the right to healthcare and education are the same as the right to “free cable and cell phone service”? This is the way the right wing always argues. It's called the logical fallacy of the “slippery slope”. The argument would go something like this “if were going to use tax dollars to pay for healthcare, the next thing you know people will want tax dollars to pay for their cell phone”.

    Of course anyone using such an illogical argument would be bounced out of any serious debate but then the right wing never engages in serious debate.

    Every other nation in the world considers healthcare and education to be human rights guaranteed by government. If we were to use tax dollars to provide universal single-payer health care we would pay about half as much in taxes as we are paying to the insurance companies to provide us with a health care system that is ranked 37th in the world in terms of quality!

    These goofballs on the right have turned the slimy authors of the United States Constitution — the landed aristocracy of the 18th century — into some kind of saints. These numb skulls can be heard saying things like “there is nothing in the Bill of Rights that says a citizen has a right to be alive, let alone be healthy, and since the first ten amendments to the Constitution were written by God, anyone who wants to propose a bill that changes any rights hates Jesus.”

    It's really amusing to hear them call Obama a socialist when he has been opposed to universal single-payer healthcare. Obama, in fact, is following the same economic, foreign and domestic policies as George Bush! Well I guess that's why they're called ditto heads!

  • AustinRoth

    Do you honestly believe that the right to healthcare and education are the same as the right to “free cable and cell phone service”?

    No, of course not. But you make a false assumption. I do not believe health care OR education are a 'right', either.

  • AustinRoth

    Rudi -

    I would rather start a Democratic PAC so I can stop paying my taxes, get VIP home loans, and have Murtha and Dodd funnel unnecessary federal funds into my coffers.

  • AustinRoth

    Jim – the health care debate means a LOT to me. I am just on the opposite side of the fence than you. I opposite it in any form.

  • AustinRoth

    Lit3 – where did the words 'hard work' or 'free markets' , and 'deserving' or 'undeserving' appear in my post?

  • Dr J

    “This is the way the right wing always argues. It's called the logical fallacy of the “slippery slope”.”

    I hear you, Duopoly. It's a logical fallacy only when the slope isn't actually slippery, though, and this one may very well be. People don't perceive much of a gap between “federal entitlement program” and “civil right,” so plenty of people will enumerate education, welfare, jobs, unemployment insurance, school lunches, and pensions among their civil rights.

    It's certainly no surprise that health care is creeping onto the list, but did you know good parking spots for the handicapped are now a civil right? I had thought they were a courtesy cast in law until a few years ago, when I discovered their recipients have come to regard them as something closer to an owed tribute.

    And perhaps you're unaware, but phone service has been a civil right for decades. The FCC set its sights on providing universal access back in the '30s. Their lifeline program is already catching up with cell phones.

  • Jim_Satterfield

    I mis-spoke. The debate means something to people like you. What happens to those who the American non-system fails means nothing to them.

  • AustinRoth

    Jim – if it helps you justify yourself somehow, then make up any story you want. However, to say what happens to others means nothing is not the truth, and you, I truly think, do know that.

    Conservatives believe that government programs are about the worst, most inefficient means possible of delivering aid to the needy. Liberals believe the opposite, which is why Conservatives, across ALL income levels, give significantly more to charity than Liberals, and Liberals support higher taxes and higher government spending.

    The funny thing is, overall I am way more liberal in my social views than my fiscal views, but it is the certainty of the fiscal unwiseness of nationalized health care, which make no mistake is the end-game of the current efforts, in conjunction with the associated reduction in the quality of medical care that will accompany it, that flat out prevents me from supporting it in any form.

  • Jim_Satterfield

    And those conservatives refuse to recognize that something different needs to be tried when their corporate system fails millions of people. There is no private charity capable of fixing this problem. In fact private charities are no longer capable of meeting the demands that our collapsing middle class is putting on them. Conservatives come up with excuses and accusations that they cannot support to blame the government for it all, completely ignoring numerous changes in our economic and social environment that contribute to that situation. As I said in another thread and it applies here too, the conservative attitude is ideology uber alles.

  • Dr J

    Jim, how would you characterize the attitude you're putting out in comments like that?

    You're right that the middle class is struggling, which is why conservatives–and an increasing number of liberals–are thinking twice about saddling them with yet another ill-conceived public burden. If that's ideology, I'm fine with it.

  • AustinRoth

    Jim – when the middle class is being squeezed by an national average of 9.7% of their income to state and local taxes, 6.2% for social security, 1.45% for medicare, on top of an average effective federal income tax rate of 10% – 15% (for the middle class), then you are talking about the various government entities already taking 27% – 32% of the their income. No wonder they are squeezed.

    Even given THAT, 'flint-hearted' Conservatives STILL give WAY more to charity than 'compassionate' Liberals, who will not be happy until they tax 100% of income, and put us all on the government dole.

  • Dr J

    Austin, I don't think you understand. The middle class has been getting squeezed harder and harder for the past century. You can't be suggesting funding the public sector might have something to do with it?

  • bradhick

    I find the debate interesting. If National Health Care is so important, then please simply answer this: Why does Congress have a different plan for themselves (and are specifically expemted from the proposal)?

    Why isn't that front page news?

    There should be a constitutional amendment that says people in government must live under the same laws they pass. I GUARANTEE we'd get offered a different plan.

    Forget “Conservative v Liberal”, “Right v Left”, “Democrat v Republican”. It's “them v. us” and your God given rights are slipping away with every law that gets passed.