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Posted by on Sep 9, 2009 in Health, Politics | 22 comments

Sen. Baucus’ Health Care Proposal: ‘Not a Bad Bill’

So concludes Ezra Klein:

The legislation really would protect millions of Americans from medical bankruptcy. It really would insure tens of millions of people. It really will curb the worst practices of the private insurance industry. It really will expand Medicaid and transform it from a mish-mash of state regulation into a dependable benefit. It really will lay down out-of-pocket caps which are a lot better than anything people have today. It really will help primary care providers, and it really will make hospitals more transparent, and it really will be a step towards paying for quality rather than volume.

To put it more starkly, it really will be the most important progressive policy passed since Lyndon Johnson.

Klein goes on to outline what’s not-so-great about Baucus’ proposal, but his starting focus on that proposal’s merits — from a Progressive point-of-view — is noteworthy. Pending the impact (if any) of Obama’s much-anticipated speech tonight, Klein’s bottomline-read of Baucus’ proposal might be an early sign of a retrenchment among Progressives re: what’s acceptable.

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Copyright 2009 The Moderate Voice
  • redbus

    Thanks, Pete, for this excellent post. The more I’ve thought about health care, the less convincing GOP arguments against it have become. There is one argument, though, that resonates with all the fiscal conservatives out there, be they Ron Paul libertarians or Blue Dog Dems:

    What will this cost the taxpayer?

    This year alone, the budget deficit has surpassed $ 1.5 trillion. Any bill that doesn’t grapple with this fiscal reality is a dead letter. How does Sen. Baucus’ bill measure up on that score?

    • tidbits

      Redbus – You are correct. Cost containment is the 800 pound guerilla in the room. Everyone knows it’s there, but no one wants to deal with it. My guess is it’s politics as usual. Real cost containment would require taking on speical interests that the pols want on board, or at least not actively opposing reform. There are already reports of back room deals with drug companies and insurers. Other deals could include equipment manufacturers, hospital trade associations and unions afraid of losing jobs to cost cutting. But, at the end of the day, if you’re not willing to trim the fat, you can’t have a lean bill or a cost effective health care system.

      The current system has virtually no cost containment and the “reform” measures aren’t much better. The question, it seems to me, is whether we put the onus for government’s failure to address the key issue, cost containment, on individuals through bankruptcy proceedings (current system) or on the taxpayer (reform measures).

    • kathykattenburg

      How much do out-of-control and continually escalating health care costs affect the taxpayer now? How much do 47 million uninsured and underinsured Americans cost the taxpayer? What is the cost to the taxpayer of doing nothing or, arguably even worse, doing too little and embracing the wrong solutions? Very few people who complain about health care reform EVER ask those questions.

  • redbus

    And in the tradition of DLS (smile), here’s a piggy-back post:

    Does his bill allow for taxpayer funded abortions?

    That would also be a non-starter for social conservatives.

  • I don’t believe this can work. Not for a minute. Right now, and for at least the last decade, insurance premiums have risen at 7% a year. They doubled in the last 9 years, while wages were stagnant and cost of living generally went up about 1/4 that. At 7% rate of increase, insurance premiums will double again in 10 years. That means in a decade, insurance will cost four times what it did ten years ago. That’s $25,000 a year for family coverage. Median income is $45,000 a year. So OVER HALF of Americans make little enough to be subsidized by the Baucus plan. Their insurance (for anyone making < $65,000) can't cost over 13% of their income. So RIGHT NOW, we'd have to pick up half the private insurance cost (current average $13,000 a year) for over half of Americans. Within 10 years, we'd be paying 3/4 of it. Fat chance. No limits on age and condition, so insurance must pay for any treatment, any patient, any age. Those who don’t buy insurance are penalized, so the insurance companies get government mandated customers. We’d have “co-ops” small enough NOT to be able to negotiate lower prices for services.And, I’ll bet the plan STILL doesn’t have GOP support. Summary? Non-starter.

    • kathykattenburg

      If all that is accurate about the Baucus bill, then it would be a blessing if Republicans opposed it. We’d be better off w/o it.

  • DLS

    Red Bus: Note that I’m actually pro-abortion. (I view abortion the way I view contraception, something we’ve had in this world as long as child-bearing-age females have been able to get pregnant!) I’m simply one of those who isn’t ignorant or amoral and a psychotic militant absolutist on the issue (no parental involvement or even notification for minors, no acknowledgement of what “viability” implies, et cetera). My main view toward abortion as a political issue associated with government health care is that this will not be able to be avoided once government health care is extended to other than the elderly, and that those who deny this (or stupidly assume it should “automatically” [rolling eyes] be part of a set of new federal entitlements) are childishly self-centered if not deluding themselves. The facts are inescapable.

    * * *

    Baucus the Democrat’s “alternative” plan to that of the extremist non-thinking Pelosi-bots is the likely source of crafting a “compromise” by Obama and the Congress, and between the Senate and the House. (The Republicans have not been serious players with this, a federal expansion, and won’t be.)

    * * *

    “The question, it seems to me, is whether we put the onus for government’s failure to address the key issue, cost containment, on individuals through bankruptcy proceedings (current system) or on the taxpayer (reform measures).”

    Well, there are other things, some of which may merely satisfy emotional needs without costing that much more to the taxpayers, but which could be sought in addition to more expensive things — such as a special “medical bankruptcy” set of laws that aids those suffering that situation and which would be an inducement to more substantial government measures later (the real reason for seeking the measures).

  • DLS

    “This year alone, the budget deficit has surpassed $ 1.5 trillion. Any bill that doesn’t grapple with this fiscal reality is a dead letter.”

    That’s what Obama is saying, in advance of his speech tonight. However, it’s hard to believe his words.

    Is it any surprise, today, to learn that GM and Chrysler are unlikely to repay all the money given to them?

  • JSpencer

    I’d love to believe the upside of Ezra’s take on this, but my reaction is more along the lines of GreenDream’s. Of course the height of irony here (beyond irony actually) is that however meager a “reform” this might turn out to be, the party of no will resist it. Meanwhile, my monthly health insurance premium with AETNA (a very high deductable policy to begin with) has just risen again, without any corresponding change in my wages of course. And yes, the deficit IS the 800 # gorilla, but ignoring the need for change won’t make the gorilla go away either.

  • DLS

    “Those who don’t buy insurance are penalized, so the insurance companies get government mandated customers.”

    What do you expect to happen if we have openly public health care? Someone Else pays for it all?

  • DLS

    “And, I’ll bet the plan STILL doesn’t have GOP support.”

    The Dems don’t care. And with the Baucus bill as an alternative to Pelosi-bot idiocy that also is being pushed without GOP support, the Dems can have something all of their own to ram through Congress, and if it’s different than Obama had led the Herd to expect originally, then Baucus is another of Obama’s lightning rods to deflect criticism. It’s no wonder he’s thinking about this bill in addition to discussing health care with GOP-who-actually-should-be-Dem members of the Senate like Olympia Snowe.

  • Leonidas

    Isn’t this the same bill that will fine people for not buying health insurance?

    http://apnews.myway.com/article/20090908/D9AJCL500.html

    As lons as that provision is in it I don’t think it has any chance of passing.

  • DLS, I’ve been very clear. Here’s what I want to slice from health care cost: 14% of the 17% “overhead+profit” for insurers. Does nothing to improve health care. 19-25% overpayment of doctors and hospitals due to inability of private insurance to negotiate the best rates, 12 of the 16% drug company profit for drugs. I’m tired of subsidizing Canada, Europe and the rest of the world’s drug prices through excessive profit.

    You keep characterizing a public option or single payer as some kind of fringe idea. Wrong. Your ideas are the fringe. Every single country on Earth except ours has single payer. 71% of Americans favor it. By definition, those who oppose it are a minority of THIS country and a HUGE minority worldwide.

    • redbus

      “Every single country on Earth except ours has single payer.”

      Funny, I know lots of African countries that can’t feed their people. Health care means going to the witch doctor. I haven’t researched it, but I suspect the number of countries on earth that provide health insurance via tax revenues would be quite small compared to those that provide nothing. This doesn’t mean the U.S.A. shouldn’t have single-payer health care provided, but I can’t let this bit of hyperbole pass, Greendreams.

      • Uh, redbus, “witch doctor” is a pejorative term. It’s “traditional healer”.

        We are largely to blame for the devastation of African health care and other government services, as we crammed “economic liberalization” down their throats. The Milton Friedman / Ronald Reagan / Margaret Thatcher / Donald Rumsfeld mantra “Privatize, Deregulate, Cut social spending” has produced exactly the same results in every country in which it has been implemented: transfer of public property to private hands, transfer of private debt to public hands, increasing wealth gap. Here’s how it worked in Africa:

        “The Onset of Structural Adjustment Programmes in Africa

        In the 1980s, a combination of natural and manmade factors as well as general worldwide economic depression left many African countries reeling towards decline. The increasing burden of debts prevented countries from allocating national budgets to health, education and other public services. Many countries resorted to external borrowing to finance debt repayments as well as government services.

        Countries in crisis turned to the World Bank and the International Monetary Fund (IMF). These two institutions demanded reforms in return for loans which could be used to deal with the crisis. However, curtailing government expenditure even further only reinforced the negative impact of the economic crisis. These reforms, referred to as structural adjustment programmes (SAPs), attached a number of stringent conditions to funding, and these gave the World Bank and the IMF stronger influence over the economies of debt-strapped governments in the South, with devastating consequences on the economies of sub-Saharan Africa. New loans and aid were given only if the debtor nation implemented the reforms. In order to continue receiving funds, countries already devastated by debt obligations had virtually no choice but to follow these mandates. In addition, most donor countries and bilateral agencies gave assistance based on developing nations’ compliance with the World Bank and IMF structural adjustment programmes.

        Conditionalities of Structural Adjustment Programmes

        Structural adjustment programmes were designed to improve a country’s foreign investment by eliminating restrictive trade and investment regulations, boosting foreign exchange earnings and reducing government deficits. Although SAPs differed from country to country, they forced indebted countries to adopt a series of harsh economic measures. These included:

        * a shift from growing diverse food crops for domestic consumption to producing cash crops or other commodities for export;
        * abolishing food and agricultural subsidies to reduce government expenditures;
        * severe cuts to health, education and housing programmes as well as massive layoffs in the civil service;
        * currency devaluation to make exports cheaper but imports more expensive;
        * liberalization of trade and investment, and increases in real interest rates to attract foreign investment;
        * privatization of government-held enterprises. “

  • DLS

    “You keep characterizing a public option or single payer as some kind of fringe idea. Wrong.”

    “Every single country on Earth except ours has single payer.”

    Wrong? Oh, the irony again. (“Raising the FICA cap ‘will save’ Social Security” still amuses me.)

    The public is against a prompt or rapid imposition of “single-payer,” such as extending Medicare to everybody, which is why once again it is incrementalism that is being attempted, and the existing private insurers retained and utilized(!) as well. The public has never been wholeheardly in favor of the public option, either, and support for it is diminishing, as is support overall for “reform” in general, in large part due to increasing public alienation by the Dems’ increasingly worse misconduct this year.

    Look again, here, at the poll I linked to earlier this month:

    Health care “reform”:

    Favor, 48%
    Oppose, 51%
    No Opinion, 2%

    PUBLIC OPTION:

    Favor, 55%
    Oppose, 41%
    No opinion, 4%

    Favor strongly, 27%
    Favor moderately, 28%
    Oppose moderately, 11%
    Oppose strongly, 30%
    No opinion, 4%

    http://i2.cdn.turner.com/cnn/2009/images/09/02/rel12d.pdf

    This is far from the “83% love the public option” nonsense (five out of every six Americans) claimed in the silly signs that the true fringists have been depicted holding aloft (along with similar silliness such as “health care is a right,” etc. — do they really expect people to believe this or take them seriously?).

  • Father_Time

    Every MODERN country on earth has Socialized medicine. Period. We compare there “redbus” because we are a Modern nation. Many not so modern have it also. Socialized Medicine is much cheaper than capitalist medicine and capitalist medicine has not proven better that Socilized Medicine, in fact its much worse. It’s rather suspicious to me that these republican corkers that are supposed to be “cost concious” are not asking why healthcare costs under Socialized Medicine is but a fraction of healthcare costs in the United States. Gee that should perk their little ears up, but no they would rather use their goofy logic to spred the “commies coming over the hill lusting for grandma’s blood” horror crap. I say forget Senator Baucus’s plan and fight the issue as a Midterm reelection issue. Double what private industry is spending on ads to spred lies against reform, with federal money ads to spred the truth. I believe that the longer we pound away exposing these desperate republican propaganda tactics the sooner the confussion will be over. Drag it out to the Midterms and get some more of these wacko’s kicked out of office.

  • DLS

    “Health care means going to the witch doctor.”

    http://www.hesperian.org/publications_download_dnhd.php

  • DLS

    “Very few people who complain about health care reform EVER ask those questions.”

    Smarter people aren’t going to be fooled or panicked into witless rushing to approve whatever their lib and Dem handlers tell them, and aren’t so dense they’ll fixate on “We can’t afford to wait” or “we can’t afford NOT to do something NOW!” [rolling eyes] They’ve long directed their attention instead to what counts, which is what is being sought, and to how that may likely make things not better, but worse. (Also relevent is the disturbing history of misconduct by these people, even if some may not grasp it.)

    The foregoing applies to “single-payer” [sic; WHO’S THE PAYER?] as well.

    http://www.rasmussenreports.com/public_content/politics/toplines/pt_survey_toplines/august_2009/toplines_health_care_august_7_8_2009

  • Oooooh. I stand corrected. I didn’t realize we aspired to match the most impoverished nations. Yeah, I did mean advanced nations. My point stands though. There is NOTHING fringe about believing that caring for our citizen’s health is a part of what society should do.

  • DLS, you can deny it all you want. The orgy of greed that has paraded as free market theory for the last 30 years–Reaganomics–has created the biggest wealth gap in our history, the biggest in the (developed) world. Tax breaks since 1980 have wildly enriched the already rich at the expense of the rest of the nation. This has strangled the income side of the federal budget, while the right’s incessant fear-based spending has ballooned the cost side. Medicare and Social Security are hugely popular programs, but I fully support the GOP’s continued attempts to dismantle them, as it dismantles only the GOP. These programs WILL be funded and will outlast every one of your desperate arguments and nasty insults. They will outlast you and me.

    Deal with it.

  • DLS

    “DLS, you can deny it all you want.”

    I’ve refuted the false statements you’ve made on a number of topics.

    “The orgy of greed that has paraded as free market theory for the last 30 years–Reaganomics”

    I prefer Thom Hartmann’s ravings and true hatred and loathing about this (and nostalgia for the paradise of the 1960s, Detroit-UAW model, etc.).

    Social Security and Medicare (which are unsustainable in their current form, and which will wreck federal finance eventually) form the Godzilla of the federal budget, a budget made worse this year than ever before by the Dems (generating an increasing concern and opposition from the intelligent public).

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