Ted Kennedy Brings a Giant Stick To The Health Care Fight

It has been reported by the Washington Post and Bloomberg.com, that Ted Kennedy plans to release an outline of his health care reform legislation next week, with the bill to be marked up soon afterwards. If reports are correct, this is not a bipartisan bill negotiated behind closed doors. It is a very strong, progressive piece of legislation -- the kind of bill which fills the grassroots with hope and the for-profit insurance companies with fear.

It is a bill which would never overcome a filibuster in the Senate; a bill Obama might be able to force through using reconciliation if he is willing to spend a lot of political capital. It is a bold and clear warning to the health insurance industry. If you fight the compromise we offer, we will let the progressives write a bill you will hate.

From reporting I've seen, Kennedy's bill contains not one but two very strong progressives proposals, either of which the for-profit health insurance industry is sure to fight tooth and nail. Kennedy's bill is reported to contain a strong public health insurance option, based on Medicare, and a very large expansion of Medicaid. Families making up to 500% of the federal poverty level ($110,250 a year) would be eligible for Medicaid. Individuals would also be able to buy a public plan managed like Medicare.

The goal of many progressives is to allow Americans to free themselves from for-profit health insurance. Either proposal alone could do just that. It would take a lot of grassroot lobbying and pressure from the president to keep even one of them. I suspect both proposals will be heavily watered down to create a compromised bipartisan bill. This is not likely to be the final bill; this is the stick which Democrats will use to threaten anyone who is unwilling to play ball.

Myth That You Can't Compete With The Government: Colleges, Packages, and Water

The private health insurance companies are fighting hard to make sure that they don't face any competition from a new public health insurance plan. They claim that there is no way they can complete against the government. This argument is, of course, absurd. Any private company can easily compete against the government by simply providing a higher quality product or a better price.

Three classic examples of fields where private industry has managed to excel competing against the government are colleges, package delivery, and bottled water. State universities, public water utilities, and the United States' Postal Services are all highly effective government programs. Two are run primarily by local governments and the other by the federal government. All provide great services.

There are currently hundreds of public colleges and universities. Public colleges tend to be significantly cheaper than private universities yet private universities thrive. It is possible to receive an excellent education from either a public or a private university. Despite the fact that the government offers a cheaper “public option,” I don't think Harvard, Stanford, Brown, Yale, etc. think the competition will drive them out of business.
There are several package delivery companies competing directly against the USPS. They include UPS, Fedex, DHL, and thousands of smaller couriers. Fedex, UPS, and DHL have managed to compete directly with the USPS. Small private couriers and short distance runners don't compete directly but offer specialized package delivery services. They can offer delivery within hours instead of days.

Another example is bottled water. The vast majority of Americans receive public water on tap at home. The water is clean, safe, and cost pennies. One would think it would be impossible for a private company to sell a product that the government practically gives away for free. Of course, we know that is not the case. Bottled water is arguably a better quality product. Many believe it tastes better and is more convenient. Bottled water is now a multi-billion dollar industry in the United States.
I'm not surprised that private health insurance companies are fighting against competition. Competition lowers prices for consumers (all Americans) and reduces profits for sellers (the insurance companies). The idea that more competition would somehow drive all private health insurance companies out of business is a myth. Their fight against a public plan option is purely about maintaining high profits. Public policy should not be concerned with protecting profits but about what is best for society.

Washington Post Lies in Report

Today the Washington post published an article about Senator Max Baucus and his efforts to reform the health care system. They wrote:

His approach has been to pull together stakeholders and hold them as long as possible; no idea is ruled out, no policy change dismissed. In recent weeks, he has convened eight-hour sessions with Democrats and Republicans on the panel as part of his determination to craft a bipartisan solution. His mantra is always the same: "Suspend judgment, if only for a nanosecond."

This is not just bad journalism, this is an out right lie. It has been widely reported that Senator Baucus has activity excluded single payer (Medicare for all) advocates and refused to even consider the policy. (1, 2, 3) Dozens of countries and millions of people use single payer health care systems. Even if one feels that single payer is not politically possible it is still a legitimate policy proposal and ideal which Baucus has dismissed.

Soda Tax Just For Show, According To GOP Senator

On Monday, Senator Baucus and Senator Grassley released a paper outlining possible sources of revenue to pay for health care reform. Among the several proposals was the idea of imposing new “lifestyle taxes.” One possible “lifestyle tax” would be a new excise tax on sugar-sweetened beverages. Some in the media have dubbed this the “soda tax."

Several news outlets (1, 2, 3, 4) have jumped on the story of a possible “soda tax,” even though there is almost no chance that it will ever be enacted. When Grassley was asked last week if there would be a new tax on soda, he responded with an unequivocal “No.” He explained that the soda tax is only being brought up to “get it shot down early so it doesn't become part of the debate. I don't think it's going to have any legs at all.”

While talk of a “soda tax” might make for good headlines, it is not really news. Its inclusion as one of many possibilities is more about window dressing and less about serious policy debate.

Torture, Like Rape, Is All About The Lack Of Consent

Visit msnbc.com for Breaking News, World News, and News about the Economy

Several conservative defenders of waterboarding have recently made the argument that waterboarding is not torture because we do it to Navy Seals as part of their training. Most recently, Liz Cheney used this argument on Morning Joe. They seem to ignore that we waterboard Navy Seals to teach them how to resist torture. The biggest problem with this line of argument is that it ignores the value of consent. Actions--even painful actions--that you consent to are not torture. Navy Seals are not forcibly waterboarded. They agreed to this treatment and know that the people doing it are not planning to kill them.

This argument in support of waterboarding is the same as an argument in support of rape. Just because some people voluntarily allow themselves to be sexually penetrated, does not mean you can legally sexually penetrate anyone you want against their will. Chemotherapy is another good example of the value of consent. Chemotherapy can be incredibly painful, but people consent to it as a way to treat cancer. For that reason it is not torture. If you tied someone down and injected them with these same drugs against their will, it would be torture.

There are plenty of activities that do inflict intense pain (bondage, pro-fighting, skin branding, medical treatments), but some people choose to take part in them. Just because someone, somewhere, previously consented to an action does not mean it is not torture.

The More AHIP Concedes, The More Proof A Public Plan Is Needed

Ever since Barack Obama took office, the America's Health Insurance Plans have been steadily conceding ground in hopes of killing off a public health insurance option. For years the cost of health insurance has been growing dramatically, the number of uninsured has skyrocketed, and out-of-pocket costs are going ever upwards. While all this has been happening, the private health insurance companies have done nothing to slow the explosion in cost. They did not put forward a serious plan to address the number of uninsured. And they refused to stop cherry picking customers, overcharging women, and fighting claims.

All this changed when it appeared that they might face real competition from a public plan. They first promised to accept all comers. Then they promised to stop charging sick people more. Recently, they promised to stop charging women more than men. And today, they promised to slow the increase in cost by introducing reforms that should have happened years ago.

As long as the health insurance companies fear facing real competition, they will continue to concede. That is how competition works: it forces companies to cut costs and/or increase the quality of their product. Once the public health insurance plan is officially killed, they will stop conceding. Companies only change when they know not changing will hurt their bottom line.

The public plan is already working and is needed so it can continue to improve health care for everyone. If there is no public option, the health insurance companies will soon return to their old tricks. They are still claiming that they should be able to set rates based on “geography.” Being able to charge people more based on “geography” will allow health insurance companies to redline low income, African-American, and/or Hispanic neighborhoods.

This needs to be clear: The only reason the health insurance companies are playing nice is because they fear real competition for the first time. They will only play nice as long as they face real competition from a public health insurance option. If there is no public plan, in the long run, there will be no meaningful reform.

Can Protectionism Pay for Health Care Reform?

Today, Josh Gerstein at Politico, reported that the White House updated budget calls for a massive increase in “user fees” charged by the U.S. Custom and Border Protection. The new budget calls for collecting a total of $124 billion in CBP inspection user fees every year starting in 2010. In 2007, the CBP collect only $33 billion in revenue. The new increased user fees would be quadruple what they were in the past.

This increase in CBP inspection user fees will have strong protectionist implications. Somebody will need to pay this extra $91 billion in fees. The cost of imported goods will rise as a result.

What will the Obama administration use this extra $91 billion a year for? Universal health care legislation is estimated to cost roughly $1 trillion over the next decade or roughly $100 billion a year. Interestingly, $91 billion a year from CBP user fees should be enough to pay for a new health care reform bill.

The GOP Demographics Problem: Whiter Than Maine

The Republican party's demographics problem is increasingly becoming clear. While the rest of the country becomes more multi-racial, the GOP remains overwhelmingly white. The numbers are telling. Below is a chart showing the ethnic breakdown of the United States Congress:


From the numbers we can see that minorities are still underrepresented in Congress. While the Democratic caucus is much more diverse than the Republican party, it still has a ways to go if it wants to reflect the racial makeup of the country.

For the Republican party, the numbers are damning. Congressional Republican membership is 96.33% non-Hispanic white. That is very white. To give you an idea of how white that is, if the congressional Republicans were a state, they would be the whitest state in the union. In contrast, Maine, the whitest state in the country, is only 95.5% non-Hispanic white.

The raw numbers for Republicans are even worse than they appear. Cubans make up fully half of all the ethnic minority members in the Republican congressional caucus. While older Cubans are still loyal to the Republican party, younger Cubans are increasingly voting for Democrats. If the Republican party cares about their long term viability, they need to start better representing the country.

*Demographic data from the U.S. Census Bureau

Ted Kennedy Abandons Liberals on Health Care Reform

This is probably the worst sign yet for the public health insurance plan. Ted Kennedy has abandoned liberals on the issue of his career. On his senate website, Ted Kennedy no longer publicly supports providing all Americans with the choice of a public health insurance option. He continues the trend started by the Obama administration of trying to whitewash over support for a public plan.

Only a week ago, Ted Kennedy's website still promoted giving all Americans the choice of signing up for Medicare. Now, under the issue of “health care” there is no longer any reference to offering people the choice of a public health insurance plan.

I highly respect Ted Kennedy and his long career of fighting for what he believes in. But now is the time for health care reform. Important health care reform legislation is being written as we speak. To see Kennedy quietly abandon a core principle of the progressive agenda is very disappointing.

See what Ted Kennedy's website said about health care reform last week and now.

Progressive's Ultimatum for Specter

The Democrats had a very good chance of electing a moderate-to-progressive Democrat from Pennsylvania in 2010. Pennsylvania is a blue state which has only move further into the Democratic column in the past few years. Senator Arlen Specter was either going to lose his primary or come out of it in terrible shape.

The Democratic leadership encouraged Specter to switch parties. They decided that having a very conservative Democrat now was more important than waiting 2 years and electing a progressive Democrat who would probably hold that seat for a few decades. After a week of doing everything possible to piss off his new Democratic base many are questioning the wisdom of welcoming Specter with open arms.

Specter claims that as a Democrat he is still against the Employee Free Choice Act, even though he supported it only 2 years ago. He recently said he opposes creating a public health insurance option. The public plan was the core principle of Obama's health care plan and would save the average American 30% of their cost of health care. Specter even “mistakingly” said he was still routing for Norm Coleman in his unethical attempt to subvert democracy.

The progressives need to give Specter a strong ultimatum. You may not supporting a single filibuster. Specter can be free to vote against any bill he wants, what he can't do is stand in the way of a bill getting an up or down vote. His vote is not needed to pass important legislation, only to stop Republican obstructionism. If Specter block a public plan and the rest of Obama's campaign promises, he will face a strong primary challenger. Clearly, Specter is a man who responds to election threats.

The progressives should be careful not to fall into the same trap that conservatives did over the last 8 years. The conservatives were so willing to blindly follow their presidential leadership that they ended up selling out their values and crippling their movement. If the Democratic leadership is unwilling to put pressure on Specter, than the grassroots progressives need to.

Barack Obama Whitewashes Support for the Public Insurance Plan

There are many ominous signs that indicate the Obama administration will not even try to include the public plan option in this year's health care reform. During the campaign, Barack Obama promised that his health care plan would include a public plan option in his health care reform, but it looks like the plan may die without a fight.

The Obama administration's websites have essential no indications that he supports a public plan option. Not only is the public plan not mentioned on Whitehouse.gov, but there is only a few indirect reference to it on his website dedicated to health care reform, healthreform.gov. Neither site states Obama supports a public plan.

The most recent indication that Obama is planning to abandon one of his core campaign promises came today with the launch of “Doctors for America” (DrsforAmerica.org). Senator Baucus and the Center for America Progress Action Fund today announced the rebranding of the campaign organization “Doctors for Obama” (DoctorsForObama.org) as “Doctors for America”.

Doctors For Obama was an organization which promoted Obama's health care plan and his candidacy. It previously actively endorsed the public plan on its website. In its newest incarnation DrsforAmerica.org the phrase “public plan” does not appear once.

Almost all Republicans, a few Democrats, and the whole health insurance industry is opposed to the public plan option. On the other hand, the public plan option is one of the core issues for the progressive movement and is supported by the vast majority of Americans in most polling. Many Democrats believe a public plan option is the cornerstone of reform and the only way to dramatically reduce the cost of health care while expanding coverage. Barack Obama could never have won the Democratic presidential primary without fully backing a public plan option.

It would be highly disappointing, but understandable, if the public plan had to be sacrificed as literally the only way to implement important health care reforms. What is happening, though, is completely different. Not only is the Obama administration not openly fighting for the public plan, it appears that they are also trying to whitewash history and pretend that he never supported it in the first place. If this critical campaign promise dies a quiet death behind closed doors, it will be a very worrying sign about the type of president Obama will be.

A Public Plan is the End All, Be All of Health Care Reform

The goal of health care reform is to provide universal access to affordable, quality health care to every American. There are two ways to achieve this goal. One is through the use of a public health insurance plan. There other is through a very highly regulated health insurance market.

It is technically possible to achieve real health care reform without a public plan. We can call this the Dutch or Swiss model. Switzerland pays a lot less for health care than the United States but still much more than most of the first world. What is required is a very highly regulated health care market. There would need to be a list of all conditions and procedures that must be covered; a limit on co-pays, out-of-network charges, out-of-pocket expenses, etc.; and rules preventing customer shopping and dropping. Premiums must be based on community risk. Hopefully there would be a special board or court to deal with insurance companies which refuse to pay for procedures.

The other way to achieve real health care reform is to simply offer a public plan option. All that is needed is to provide all Americans with the option to purchase a plan offered by the government. The plan would be affordable, low hassle, and wouldn't turn down anyone based on pre-existing conditions. The public plan could be modeled after Medicare or the health care plan that members of Congress have. Very little regulation would be needed for the private health insurance market. For-profit health insurance companies would need to offer plans as good as the public plan or they would slowly lose customers and market share.

Given the Republican party's nearly religious devotion to de-regulation, I fear for the longer term success of a highly regulated private-only health care market. The chance that a decade from now Republicans would start stripping many of the health care regulations that make the system work is very real. A popular public plan would be much more politically difficult to modify or eliminate.

Women's Liberation, Senate GOP Style

Arlen Specter's abandonment of the Republican Party should make it easier for three female GOP senators to make tough decisions. When the Senate Republicans had just enough senators to filibuster any Democratic piece of legislation, there was a strong sense of pressure to remain united. Now the Republican senators can't stop a united Democratic Caucus. There is no longer a practical reason for the GOP to form a fully united opposition.

The Senate Republicans will soon be feeling the freedom of irrelevancy. This new-found freedom should make life easier (although maybe not more enjoyable) for Susan Collins, Olympia Snowe, and Kay Bailey Hutchison. Senator Collins and Snowe are now the two remaining moderate Republican senators. Since the Republicans no longer have the numbers to maintain a filibuster, they should dramatically ratchet down their pressure on these two to toe the party line. Collins and Snowe should be able to vote based on their conscience instead party considerations.

Senator Hutchison is not a moderate, but Specter's defection should give her greater freedom of action. Hutchison has been considering a run against Texas Governor Rick Perry. She would need to resign from the Senate to dedicate her time to a state-wide campaign. If she resigns there is a small but real possibility that a Democrat could win her seat in a special election. There was an argument that she should not give the Democrats a chance at getting to 60 in the Senate. Since the Democrats will now get 60 anyway, there is little reason for Hutchinson not to run.