The Feinstein 1200 Newsletter: December 11, 2009
1. Your Comments: On The Demise of the Public Option
2. Anthony Weiner’s Enthusiastic Support of the Senate Compromise
3. Robert Reich: Not So Much
4. Maggie Mahar’s Not Biting, Either
5. Your Comments: This Isn’t Working for Paula and S.
6. Lieberman Increasingly Troubled by Medicare Buy-In
7. F1200’er Rob Increasingly Troubled by Lieberman
8. Al Franken and Rocky Take Feinstein’s Idea and Run With It
9. Your Comments: Pat takes note of co-sponsors of Franken-Rocky
10. Warning: Side Effects of Extended Release HCR May Include Pre-Election Anxiety
11. Restrictions on Abortion Are, Well, Aborted
12. Your Comments: Root Canal Prompts Lawyer’s Meditation on NHI
13. Your Events: Meet the Legendary Don Bechler
14. Saving the Best for Last
1. Your Comments: I Never Liked That Public Option Thing, Anyway.
M. writes: “Despite all of the wailing, gnashing of teeth, and tearing of hair,”(Editor’s Note: What? No rending of clothing?) “it seems to me that trading off the public option (whatever it now is, in its form that is diminishing by the day) for Medicare at 55 and Medicaid at 300% of poverty is a good thing. I think that expanding Medicare is the only hope we have of getting to single payer (unless, of course, everything collapses). I am less optimistic about Medicaid, where physicians have been treating patients on an essentially pro bono basis for at least 30 years that I know of. But both of them will expand the public sector. I also think that Medicare will be less expensive than the private alternatives over time.
“Have you received anything on this issue from your informed sources? If so, I would appreciate your sharing. As you know, MoveOn and FireDogLake and probably others believe that the sky is falling, so any perspective on the issue would be helpful.”
My “informed sources” appear to be too involved in gnashing of teeth to respond right now. But you’re right – the public option was looking less than “robust” which has caused many to ask what value it has at this point, other than symbolic. This was the point made by Ken Jacobs, Chair of the Labor Center at UCB at our seminar - that we were all too fixated on the public option, and that affordability was really the more important issue.
But this new Senate compromise (and the details have been sparse) is something else entirely. Anthony Weiner gave it a big thumbs-up, but others I respect as much were far more skeptical. I’ll admit to an increasingly state of being perpetually non-plussed. But here’s a look at what the non-nonplussed are saying.
2. Anthony Weiner’s Enthusiastic Support:
Yesterday on public radio station WNYC, single-payer-“playa” RepresentativeAnthony Weiner strongly embraced the Senate compromise in a 12-minute interview. Reporter/host Brian Lehrer opened the interview by roughly defining the Senate compromise as allowing anyone 55+ or older who is uninsured to buy into Medicare (eventually with subsidies based on income.) It would reportedly also include a non-profit alternative to the corporate health insurance plans for people younger than fifty-five. (Or so we think, since Harry Reid ain’t talking.) Here’s a very stripped-down out-take of Weiner’s remarks on the senate compromise:
“It basically takes us away from our compromise position which was the public option and goes to more our original position. We have Medicare, which is a full single payer system for those 65 and over. Why not make it 64 or 54 or 34? Well, we finally came back to the same place we should have started – Medicare. Popular, successful, barely more than 1 percent overhead rate, and now we’re going to expand it to the people who have the most difficulty getting insurance. We had this big debate, we decided we’re going to expand something that works. So much of the opposition was based on confusion. But everyone understands Medicare. It has one final benefit – it takes a program that is a progressive, Democratic, bedrock success story, and it builds on it.”
(He also had a bold answer for the GOP members who took him on, and he briefly addressed the financing problems in both Medicare and private insurance.)
The radio host asked: Why would Senator Lieberman find this more acceptable?
Weiner answered: “Because some of my colleagues have tied themselves in a knot, saying they don’t want any new government programs. It became such a bugaboo to a handful of senators, that they were perfectly willing to take the same outcome with an existing program.”
Weiner continued: “(The senate compromise) is the public option on steroids. It uses this rhetorical jab that’s been used against us and turns it around. The public option was never our opening bid – single payer was. We ought not fall in love with the idea that our compromise is falling away when we’re getting our opening bid.
Weiner concluded that, “if this is successful, we can expand Medicare even further.”
The host responded: That’s what the GOP will attack you for.
Weiner’s response: “Well, that’s why we’re in charge, and they’re in the minority, and we hope to keep it that way.”
Listen to the last two minutes to hear Weiner’s answer on what the buy-in will be – he points out that “once this program is up and running, we’ll look around and ask, why does a 56-year-old have to pay, but a 65-year-old doesn’t? And that’s going to get us down the road to where a single-payer advocate like myself likes to be.”
3. Robert Reich Doesn’t Share Anthony’s Enthusiasm:
Read the entire article here.
Excerpt:
“To provide political cover to senators who want to tell their constituents that the intent behind a robust public option lives on, the emerging Senate bill makes Medicare available to younger folk (age 55), and lets people who aren't covered by their employers buy in to a system that's similar to the plan that federal employees now have, where the federal government's Office of Personnel Management selects from among private insurers.
“But we still end up with a system that's based on private insurers that have no incentive whatsoever to control their costs or the costs of pharmaceutical companies and medical providers. If you think the federal employee benefit plan is an answer to this, think again. Its premiums increased nearly 9 percent this year. And if you think an expanded Medicare is the answer, you're smoking medical marijuana. The Senate bill allows an independent commission to hold back Medicare costs only if Medicare spending is rising faster than total health spending. So if health spending is soaring because private insurers have no incentive to control it, we're all out of luck. Medicare explodes as well.
“A system based on private insurers won't control costs because private insurers barely compete against each other. According to data from the American Medical Association, only a handful of insurers dominate most states. In 9 states, 2 insurance companies control 85 percent or more of the market. In Arkansas, home to Senator Blanche Lincoln, who doesn't dare cross Big Insurance, the Blue Cross plan controls almost 70 percent of the market; most of the rest is United Healthcare. These data, by the way, are from 2005 and 2006. Since then, private insurers have been consolidating like mad across the country. At this rate by 2014, when the new health bill kicks in and 30 million more Americans buy health insurance, Big Insurance will be really Big.
4. Maggie Mahar Isn’t Biting, Either
I shared Congressman Weiner’s enthusiasm, but Maggie’s dissent gave me real pause.
5. Your Comments: It’s not working for Paula and S,.
Paula sends this from Credo.
And S. sends this from FDL,
Don't just go with Credo and FDL - this debate on the Times blog lays out some of the merits and pitfalls. Weirdly, the guy from the Heritage Foundation is in agreement with the PNHP guys. But obviously for different reasons.
6. Lieberman “Increasingly Troubled” by Medicare Buy-In
http://www.politico.com/news/
7. F-1200’er Rob is “Increasingly Troubled” by Lieberman
One of our own F1200’ers sent a letter to Senator Joe Lieberman, and got a canned response saying that his letter doesn’t count because Rob doesn’t live in Connecticut. Rob wasn’t taking that lying down.
“Senator,
I am sorry to hear that you limit your answers to Connecticut residents. Considering that you have the power, and willingness, to hold the entire US Senate Democratic Caucus hostage to your interests, I firmly believe that you owe an answer to the entire Nation.
I once again request that you support President Obama's efforts to pass a comprehensive Health Care reform, including a strong public option.
Respectfully,
Rob”
8. Franken and Rockefeller take Feinstein’s idea and run with it:
I promised that I would call Feinstein’s office and get back to you on her three-point plan (rate authority + capping of medical loss ratio + elimination of anti-trust exemption for insurers.), but it turns out that Franken and Rockefeller are already working on one of Feinstein’s three points.
Washington, D.C. [Dec 4, 2009] – Today, U.S. Sens. Al Franken (D-Minn.) and Jay Rockefeller (W.Va.) introduced the Ensuring Value for Premiums amendment to the Patient Protection and Affordable Care Act. The amendment proposes that the Senate health care reform bill include a provision to require that 90 percent of each health insurance premium dollar go toward health care services. Right now, on average, only 70 cents of every dollar paid toward health care premiums are spent on actual health care services. The Patient Protection and Affordable Care Act raises that ratio to 80 percent. Currently, Minnesota’s non-profit plans lead the nation in keeping administrative costs low, spending 91 cents of every premium dollar on actual health services. This amendment would set a 90 percent standard on insurance companies nationwide, allowing only the remaining portion to be spent on administrative costs, marketing campaigns, and profits.
But couldn't the insurance companies just continue to raise premiums to make up the difference without a rate authority a la Feinstein’s proposal?
9. Your Comments: Pat notes Franken-Rocky co-sponsors:
“I'm fascinated by co-sponsors of some amendments - specifically Blanche Lincoln on the Franken-Rockefeller amendment. (The amendment is co-sponsored by Sens. Blanche Lincoln (D-Ark.), Sheldon Whitehouse (D-R.I.), Patrick Leahy (D-VT), Bernie Sanders (I-VT), Sherrod Brown (D-Oh.), and Mark Begich (D-Alaska).”
10. Warning: Side Effects May Include Headaches, Nausea and Pre-Election Anxiety
This is the kind of thing UCB’s Ken Jacobs was warning about at our seminar – wherein the biggest loss wouldn’t be a weak public option, but a combination of unaffordability and, in this case, timing.
http://tpmdc.
11: Abortion Amendment Is, Well, Aborted:
As many had predicted, the Stupak Amendment in the Senate (Ben Nelson's version) didn’t have a hope-in-Hades of passing. And so it didn’t, (but not before hijacking the health care discussion and allowing both sides of the abortion debate to do some serious fund-raising.) Don’t count on NARAL to send Bart Stupak and Ben Nelson a thank-you letter. For the same reason, I never sent a thank-you to Sarah Palin for getting our Democratic base so motivated to fight last summer. But sister, I was grateful.
12. Root Canal Inspires Nostalgic Meditation for an F1200 Lawyer:
One of our F1200’ers, Bruce Cahan, endured a particularly expensive root canal recently, which prompted this meditation.
“I have a nostalgic view of NHI. Thirty years ago – 1979 – I wrote a Temple Law Quarterly article entitled National Health Insurance: How would the courts take it? The article was reprinted by BNA, and on August 12th of this year, I hand delivered a copy of the faded (but shockingly still timely) article to Senator Feinstein’s staffers. The article makes the U.S. Constitutional argument that there is a natural right to health care. While I’m not opining on that argument under today’s jurisprudence, the history of that argument may be worthwhile for Constitutional scholars to take up today.
While I’ve been a bystander in the current health insurance saga, there are many non sequiturs that seem worth reconsidering. Take dental care. I recently paid $3,000+ for a second root canal and new crown on an upper left molar, second due to the fact that the first root canal and crown let a cavity grow underneath. Where was it written that the mouth and its teeth are some out of body experience? Why should dentists, oral surgeons and related dental specialists be permitted to charge a la carte prices, while their physician friends have fees regulated by insurers or under the public option, a government regulatory agency? Why should the working family whose child, parent or grandparent needs orthodontia or other oral care have protection from cardiac surgery bankrupting them, but remain exposed to dental charges? It’s time to reattach the mouth to the rest of the body, and to include it and its care in the national health insurance debate.
I just came across this anomaly: http://www.ada.org/prof/
So if a family is required to have medical health insurance and can’t afford it due to uncovered dental costs, their 2.5% of AGI isn’t reduced by the amount of uncovered dental costs!"
13. Your Events: Meet the Legendary Don Bechler
Now that San Francisco’s become tame, you have to look pretty hard to find any old school activists in the mold of Depression-era Harry Bridges and the legendary activist/runner Walt Stack. But the ever-gracious Don Bechler, of “Single Payer Now”, is one of the old-school “true believers” – and that’s a compliment. You can meet Bechler and his merry band at the Single Payer Now Annual Potluck Dinner on December 19 at 3:00 p.m. at St. Mary’s Cathedral (Geary and Gough). Speakers will include Tom Ammiano – and New York’s Eric Massa, the congressman who co-sponsored HR 676. Check ‘em out at www.singlepayernow.net
14. Saving the Best for Last
This one’s deserves a burlesque rimshot – or at least a laugh track. Alas, we have none!
Please contact me with any questions or comments.
Many thanks,
Eva Chrysanthe
The Feinstein 1200
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