Month: September 2009

Comment Of The Day

by digby

From Pseudonymous in NC:

Let’s talk about real costs. A 7% payroll tax and $120/month — that’s what gets your average French person his/her healthcare — copays, prescriptions, the works. No unexpected bills, no sticker-shock, no wrangling with insurers.

I’d pay that. I could afford that. I’m not going to pay for dogshit insurance from a corporate parasite, though.

I would guess that’s something a lot of people would agree with — if anyone would make the argument.

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The Good War Goes Bad

by digby

Apparently, the war is going so well that despite doubling the troop levels this year, we need even more. Huzzah:

The United States will probably need to deploy more troops to Afghanistan despite almost doubling the size of its force there this year, the top U.S. military officer said on Tuesday.

The assessment by Admiral Mike Mullen, chairman of the Joint Chiefs of Staff, was the clearest signal yet that commanders will tell President Barack Obama in the coming weeks that they need extra forces to defeat Taliban insurgents.

“A properly resourced counterinsurgency probably means more forces. And, without question, more time and more commitment to the protection of the Afghan people and to the development of good governance,” Mullen said.

Mullen did not say how many more forces would be required but he said he expected a request in the next couple of weeks from U.S. Army General Stanley McChrystal, the top U.S. and NATO commander in Afghanistan.

Testifying before the U.S. Senate’s Armed Services Committee, Mullen stressed the United States faced a race against the clock to reverse its fortunes in Afghanistan, where insurgent violence has reached its highest level since the Taliban was ousted from power in late 2001.

“I have a sense of urgency about this. I worry a great deal that the clock is moving very rapidly,” he said.

The United States currently has 62,000 troops in Afghanistan and that figure is expected to rise to 68,000 by the end of the year. There were around 32,000 U.S. troops in the country at the start of the year.

There are also some 38,000 troops from other nations — mainly NATO allies — in Afghanistan.

Unfortunately, this is likely to be a difficult sell:

The poll suggests that 23 percent of Democrats support the war. That number rises to 39 percent for independents and 62 percent for Republicans.

“Most of the recent erosion in support has come from within the GOP,” said Keating Holland, CNN’s polling director. “Unlike Democrats and independents, Republicans still favor the war, but their support has slipped eight points in just two weeks.”

Luckily for the Obama administration, the Republicans’ favorite son rallies to the cause:

Senator John McCain, the committee’s senior Republican, urged the Obama administration to learn from the Iraq war — where extra U.S. forces helped quell violence — and quickly deploy more troops to Afghanistan.

“Every day we delay in implementing this strategy and increasing the number of troops there — which we all know is vitally needed — puts more and more young Americans who are already there … in danger,” McCain said.

I know there are those who think that the Republicans will all vote with Obama on the war, but if the past is any guide, that’s not true. In fact, we have recent history to support the contention that Republicans will split on military action if it means supporting a Democratic president:

“You can support the troops but not the president.”
-Rep Tom Delay (R-TX)

“Well, I just think it’s a bad idea. What’s going to
happen is they’re going to be over there for 10, 15,
maybe 20 years.”
-Joe Scarborough (R-FL)

“Explain to the mothers and fathers of American
servicemen that may come home in body bags why their
son or daughter have to give up their life?”
-Sean Hannity, Fox News, 4/6/99

” President . . . is once again releasing
American military might on a foreign country with an
ill-defined objective and no exit strategy. He has
yet to tell the Congress how much this operation will
cost. And he has not informed our nation’s armed
forces about how long they will be away from home.
These strikes do not make for a sound foreign policy.”
-Sen Rick Santorum (R-PA)

“American foreign policy is now one huge big mystery.
Simply put, the administration is trying to lead the
world with a feel-good foreign policy.”
-Rep Tom Delay (R-TX)

“If we are going to commit American troops, we must be
certain they have a clear mission, an achievable goal
and an exit strategy.”
-Karen Hughes, speaking on behalf of George W Bush

“I had doubts about the bombing campaign from the
beginning . . . I didn’t think we had done enough in
the diplomatic area.”
-Senator Trent Lott (R-MS)

“I cannot support a failed foreign policy. History
teaches us that it is often easier to make war than
peace. This administration is just learning that
lesson right now. The President began this mission
with very vague objectives and lots of unanswered
questions. A month later, these questions are still
unanswered. There are no clarified rules of
engagement. There is no timetable. There is no
legitimate definition of victory. There is no
contingency plan for mission creep. There is no clear
funding program. There is no agenda to bolster our
over-extended military. There is no explanation
defining what vital national interests are at stake.
There was no strategic plan for war when the President
started this thing, and there still is no plan today”
-Rep Tom Delay (R-TX)

Many more quotes here.

Here’s just one example of what they actually did on the Balkans (which McCain — before he became an embarrassment to the Republoicans — also backed.)

In a sharp challenge to President Clinton, the House voted Wednesday to bar the President from sending ground troops to Yugoslavia without Congressional approval and then on a tie vote refused to support NATO air strikes against Serbia.

The votes came during a day of heated and sometimes anguished speeches that showcased deep divisions in Congress over the escalating conflict in the Balkans. The all-day session marked the first formal Congressional debate since NATO began its bombing campaign on March 24 to drive the forces of the Yugoslav President, Slobodan Milosevic, out of Kosovo. The Senate had voted on March 23 to approve the air strikes.

The House voted 249 to 180 to require the President to seek Congressional approval for ground forces. Forty-five Democrats and an independent joined 203 Republicans to support the measure. Sixteen Republicans and 164 Democrats opposed the bill.

But the surprise came when the House finished its deliberations this evening by failing to pass a Democratic resolution intended to give symbolic support to the President’s air campaign. The measure failed in a tie vote of 213 to 213 even though Speaker J. Dennis Hastert threw his support behind it. In all, 31 Republicans broke with their party to back the air campaign and 26 Democrats voted against it.

If you think the Republican Party is less partisan today, you are dreaming. If you think they are less hypocritical, think again. They have no principles, on the military or anything else. They are purely partisan animals whose thuggish insistence that every military adventure must be supported in lock-step was only in effect during a Republican presidency.

Don’t think they can’t make a perfectly hypocritical argument to their minions and gain their support. They already have almost 40% of Republicans against the war right now. There is every reason to believe another 20% could be easily persuaded that Obama is wrong on the war. With John McCain arguing for more troops, it’s almost a shoo-in that a good portion of them will be against it.

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If Nobody Can Afford It, Does It Make A Difference?

by dday

I mentioned below that there are other major concerns with the Baucus draft, which is really the blueprint for what the President laid out last week in a variety of ways. Jon Cohn found a document from the Senate Finance Committee showing the impact of the bill on the middle class:

Total medical expenses, including premiums and out-of-pocket expenses, would be no more than 20 percent of annual income for most of the people profiled in the document. For the poor, it’d be dramatically less. That’s the (relatively) good news.

And the bad news? These figures are all for people in average health. But people end up paying a lot more in out-of-pocket expenses when they have a serious medical issue–whether it’s because of an accident, an acute illness, or a chronic disease. According to my back-of-the-envelope calculations, a family of four making $42,000 a year could owe $9,000 a year in medical expenses if it hit the maximum in out-of-pocket expenses–which is pegged, in the Finance legislation, to deductible levels in Health Savings Accounts. That’s easy to do when one family member gets in an accident, has an acute medical problem, or is dealing with a chronic disease.

A family of four making $78,000 a year could owe $23,000–nearly a third of its income–if it had a member with high medical bills.

The committee analysis (and mine) includes a ton of assumptions–chief among them, that the families are buying the “silver” option, the benchmark plan on which federal subsidies are based. In other words, these figures are not precise, particularly since we don’t even have an actual bill yet. And, in case you were wondering, families staring at such huge medical expenses would probably fall under the “hardship” waiver, exempting them from the requirement to purchase insurance. (In other words, neither Baucus nor any other sane member of Congress is going to force people to shell out money for insurance that leaves them so exposed to costs.)

On that last point, if families are exempted from buying insurance under the hardship waiver, then 1) the program will be far less universal than needed, 2) the smaller risk pool will lead to higher premium prices from insurers, 3) most people WANT to be covered by insurance, and under this plan their only option would be to purchase unaffordable insurance that would still not shield them from potential bankruptcy in the event of an illness.

All of this is to say that the real problem here is the final cost of the bill. Already we’ve seen it drop from $1.3 trillion over ten years to $880 billion, with some Senators agitating for less. And not for any reason, mind you, other than to make the bill more “moderate,” just like on the stimulus. But that lowered cost means a cap on subsidies which will be insufficient for most. “Moderate” in this case being another word for “ineffective.”

At least some Democrats are aware of the deficiencies, and the fact that Baucus tailored his bill to attend to all of the concerns of a GOP who won’t vote for it, instead of a Democratic Party who may. Even at this point, the Axis of Grassley and Enzi aren’t satisfied, and are offering wildly contradictory proposals, like asking the Feds to bear the full cost of Medicaid expansion instead of part going to the states (I don’t disagree) and also wanting to eliminate the tax on insurance companies that would pay for, among other things, Medicaid expansion. By contrast, a few Democrats are extremely concerned about the subsidies, which would lead to a package that people would either hate or not be able to use. And The Hill reports that Democrats on the Senate Finance Committee will push this with amendments.

Near the top of the list for the panel’s Democrats is worry that health insurance subsidies will not be sufficiently generous nor available to enough people despite the fact that the bill would legally require most people to obtain coverage. Beyond premiums, some Democrats are concerned that Baucus’s proposal would not do enough to protect middle-class families from high healthcare expenses.

“It’s very clear, at this point in the debate, the flashpoint is all about affordability,” said Sen. Ron Wyden (D-Ore.). “I personally think there’s a lot of heavy lifting left to do on the affordability issue.”

The healthcare bills already approved by three House committees and another Senate committee offer more generous subsidies – but at a higher cost to taxpayers.

“We’re doing our very best to make an insurance requirement as affordable as we possibly can, recognizing that we’re trying to get this bill under $900 billion total,” said Baucus, who has been courting Republican support for his measure in an attempt to guarantee that a healthcare bill can achieve the 60 votes or more needed to avoid a Senate filibuster.

“I’m going to work even harder to address any legitimate affordability concerns. I knew they were there,” Baucus said.

I just don’t believe that the guy who created a bill which represents a gift to the insurance industry is all that concerned about “legitimate” affordability concerns. But in the end, the bill can’t work unless people can afford coverage. That would obliterate everything it’s trying to do.

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Your Dr. Will Give You A Public Option Now

by dday

As we know, the Baucus draft to be released today will not include a public option, making it the only bill out of the five in the Congress not to have one. On this basis Olympia Snowe wants it off the table. On her side are Republicans, a few ConservaDems without the courage to admit their opposition and prefer to say “it doesn’t have the votes,” insurance companies and teabaggers. On the side of the public option are Tom Harkin, a majority of the House, a majority of the Senate, the President, four committees in the Congress, the wide majority of Americans, states as conservative as Arkansas, and doctors (h/t):

A RWJF survey summarized in the September 14, 2009 edition of the New England Journal of Medicine shows that 62.9 percent of physicians nationwide support proposals to expand health care coverage that include both public and private insurance options—where people under the age of 65 would have the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans. The survey shows that just 27.3 percent of physicians support a new program that does not include a public option and instead provides subsidies for low-income people to purchase private insurance. Only 9.6 percent of doctors nationwide support a system where a Medicare-like public program is created in lieu of any private insurance. A majority of physicians (58%) also support expanding Medicare eligibility to those between the ages of 55 and 64.

In every region of the country, a majority of physicians supported a combination of public and private options, as did physicians who identified themselves as primary care providers, surgeons, or other medical subspecialists. Among those who identified themselves as members of the American Medical Association, 62.2 percent favored both the public and private options.

What’s so interesting about this is that the doctors broadly prefer private plans to Medicare on the basis of adequacy of payment, because private plans reimburse them more generously, but they STILL prefer a public option for their patients, because they have a frickin’ heart.

There are other, perhaps more despicable elements of the Baucus bill, but it’s important to understand how out of step with public opinion it is on this point.

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Xtreme Politics

by digby

Joe Sudbay has this right. President Obama dismissing the Wilson flap as a “circus” is weak. I don’t personally think what Wilson said was that big of a deal, but this has taken on a life of its own and the political implications are now bigger than the act itself.

Joe writes:

Last night, on 60 Minutes, President Obama, as he did in his speech on Wednesday night, took a jab at “the extremists” on both sides of the partisan spectrum:

I think we’re debating something that has always been a source of controversy, and that’s not just health care, but also the structure, and the size, and the role of government. That’s something that basically defines the left and the right in this country. And so, extremes on both sides get very agitated about that issue.

We know who the “extremes” on the GOP side are. A lot of them were in DC protesting on Saturday, but it also includes Republican members of Congress who heckle Obama and question his citizenship. And, there’s Rush and FOX News. Their message is that they want Obama to fail (and many of them don’t think he’s legitimately the President.)

But who does Obama think the “extremes” are on the Democratic side of the aisle? He’s made the analogy numerous times, so clearly he has someone, or some group, in mind. A few weeks ago, the White House castigated the “left of the left” for pushing Obama to keep his promise on the public option. Is that the standard for “extreme” on the left – supporting the public option, or expecting the president to keep, at the very least, his major campaign promises?

Ok, let’s do a different equivalence test and consider how our previous president handled a similar situation which happened at a pivotal moment in the congressional debate about the Iraq war “surge:”

Q What is your reaction to the MoveOn.org ad that mocked General Petraeus as General “Betrayus,” and said that he cooked the books on Iraq? And secondly, would you like to see Democrats, including presidential candidates, repudiate that ad?

THE PRESIDENT: I thought the ad was disgusting. I felt like the ad was an attack not only on General Petraeus, but on the U.S. military. And I was disappointed that not more leaders in the Democrat Party spoke out strongly against that kind of ad. And that leads me to come to this conclusion: that most Democrats are afraid of irritating a left-wing group like MoveOn.org — or more afraid of irritating them than they are of irritating the United States military. That was a sorry deal.

It worked too. The Democrats came to heel like well trained German Shepherds and Petraeus was treated like a God by both parties. And that hissy fit, one of the biggest we saw during the Bush years, succeeded in quelling the growing protest against the surge.

Dismissing these things when Republican congressmen do them and capitulating when the shoe is on the other foot is one of the things that makes people mistrust the Democrats and make them look weak. These Republican politicians are throwing down the gauntlet, taunting the president, calling him a liar to his face, saying he is going to kill old people and winking at those who are calling him Hitler. He should not be afraid to at least allude to that craziness as a problem in our politics and refrain from claiming that “extremes” on both sides are equal in the lunacy.

It’s politically useful to drive that wedge between the Republicans and their base (as well as a good many of their elected officials) even deeper than it is. I know Obama doesn’t like such things — and nobody says he should be a crude as Bush — but it is part of politics, particularly now, and he shouldn’t shirk it. It’s part of the job.

Update: Oh hell. Forget all that. Just read this:

Attn Barack Obama: A guide to dealing with kindergarten bullies

Big bad Beck is a bully through and through. His rocky childhood gave rise to deep paranoia, a bipolar personality, delusions of grandeur, and deep-seated anger at people he perceives to be different than him. He consciously and repeatedly attempts to cause psychological harm to little Obama, mostly by spreading false rumors, making threats, using put-downs and encouraging his base to take up arms. Big bad Beck’s attacks are not just criticisms of little Obama’s pet projects. His attacks are meant to destroy Obama’s spirit, self-esteem, and popularity and to get back at him for winning the elections by a wide margin. It must be said that, as Dr. Gary Namie (author of “The Bully at Work”) says, “Good employers purge bullies, bad ones promote them”. Fox News and talk radio stations are complicit in big bad Beck’s “bullyism” by providing him a bullhorn to spread his slanderous and deranged rumors.

It must be said that big bad Beck’s behavior is perfectly normal for a bully, especially one in the kindergarten playground spanning from New York’s media rooms to Washington D.C.’s halls of power. The unusual aspect of this bullying dynamic is that little Obama is passively taking all the blows. As Kidshealth.com states, “Bullies tend to bully kids who don’t stick up for themselves.”

There are two things you absolutely do not want to do when a bully tries to make your life a living hell: you do not want to ignore them and you do not want to give in to their demands.

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Deal Of The Century

by dday

So Max Baucus will reveal his long-awaited wet kiss of a bill tomorrow, with subsequent votes in committee in the coming week. We’ve already seen an outline of it, so we know that it would still cripple people financially who have the temerity to get sick, it would criminalize people who do not buy inadequate private coverage from the insurance industry, it would incentivize employers to offer crappy coverage and discriminate in hiring against people who have no coverage from a family member, and it would not include a public insurance option to compete with private plans. It won’t even include a trigger, because the original trigger backer, Olympia Snowe, has decreed that it’s a dead letter. Those weak state-based co-ops designed to allow nonprofits like Blue Cross, some of which control 90% of the insurance market, to access billions in government seed money, will be as close as we get in the Finance Committee to a public option. Seemingly, the only reason for the death of the trigger is that Susan Collins said they might lead to a (horrors!) public option, and Snowe probably wants her along as cover for a final bill.

You can pretty much tell what a steaming pile of garbage the Baucus bill would be by the fact that the drugmakers are going all in to support it.

The drug industry’s trade group plans to roll out a series of television advertisements in coming weeks specifically to support Senator Max Baucus’s health care overhaul proposal, according to an industry official involved in the planning.

The move would be a follow-up to the deal that drug makers struck in June with Mr. Baucus and the White House. Under that pact, the industry agreed to various givebacks and discounts meant to reduce the nation’s pharmaceutical spending by $80 billion over 10 years.

Shortly after striking that agreement, the trade group — the Pharmaceutical Research and Manufacturers of America, or PhRMA — also set aside $150 million for advertising to support health care legislation.

President Obama has cited the deal with the group as signifying a new era of cooperation. But some critics say the advertising fund could be wielded against alternative approaches to health care legislation. Some House Democrats, including Henry A. Waxman of California, are seeking drug industry givebacks not covered in the deal with Mr. Baucus and the White House.

You rarely see bribes like this spelled out so succinctly and directly. $150 million is certainly more money than has been spent on health care advertising to date. And it’s all going toward the Baucus plan, based on a quid pro quo agreement. Other committee chairs like Henry Waxman want to find more savings that what Big Pharma agreed to by letting the government to bargain for lower drug prices, like many other industrialized nations. But Baucus dutifully abided by the deal, and so his plan will get the ad backing. Matt Taibbi further explains.

The $150 million it committed to support Obama’s bill is now being rolled out in pro-reform ads, which are being aired mostly in the districts of freshman congressmen. The ads are cheesy, half-hearted tripe blandly supporting the weak-as-fuck remnants of Obama’s health care plan, an example being this “Eight Ways Health Reform Matters To You” ad that salutes the end of coverage denials for those with pre-existing conditions.

Now we’re also seeing pressure from a group of freshmen and Blue Dogs, who have composed a letter to a quartet of House Committee chairs requesting that the Waxman language be removed from the health care bill and replaced with the PhRMA language, which happens to be the language the White House is pushing and which will appear in the Baucus bill in the Senate. The pro-PhRMA language retains the preposterous government subsidy to the pharmaceutical industry in the form of laws banning Medicare from negotiating market rates. It is completely useless and of no possible social benefit to anyone except pharmaceutical companies, but this group still managed to get 60 people to sign this bill.

What does this letter say? Does it argue that the PhRMA language is better for America than the Waxman language? Does it say it will cost taxpayers less and provide cheaper drugs to more people? Hilariously, no. What it says is that this PhRMA language, while worse than the Waxman language, is not quite so bad as you think (it doesn’t save as much as the Waxman language, but it still has a 50 percent price reduction, which isn’t terrible!). Moreover, the letter says, substituting this language will help the bill get passed! Here’s the actual language, addressed primarily to Waxman:

“Your efforts to remove this onerous burden on Medicare beneficiaries… are to be greatly commended. However the commitment by President Obama and the AARP to support legislation that would provide a 50 percent reduction is a dramatic step forward in helping fill the doughnut hole. Equally important, it moves us toward our goal of health care legislation.”

In other words, your attempt to put in a real reform is cool and all, but PhRMA has us by the balls, so help us out.

At the same time, the drug industry is employing scumbag from way back Tony Coelho, who may be single-handedly responsible for Democratic silence in the face of the decimation of American manufacturing in the 1970s and 1980s, to attack comparative effectiveness research, another part of the Obama plan. I guess there’s nothing two-way about that loyalty.

While we were going back and forth on a public option, this backroom deal to fund future Democratic campaigns (I don’t believe for a second that the $150 million will be spent now, but on protecting conservative Democratic incumbents who protected drug industry profits next year) in exchange for backing off a huge subsidy to giant corporations was put into motion. Baucus’ delay actually may have crimped this and forced Big Pharma to start spending now. With industry out in front, however, a bill will probably pass.

Just don’t read it so closely.

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More Dispatches From Mars

by digby

From Foser:

The Washington Independent‘s David Weigel catches Politico‘s Jim VandeHei and Mike Allen calling Republican Rep. Brian Bilbray “a centrist Republican.” Weigel explains:

Bilbray was a member of the class of 1994 who lost his old House seat in 2000, then stayed in Washington as a lobbyist for the Federation for American Immigration Reform, which advocates “a temporary moratorium on all immigration except spouses and minor children of U.S. citizens and a limited number of refugees.” Bilbray returned to Congress in a 2006 special election, which he won in part by accusing his Democratic opponent of soliciting votes from illegal aliens. Since then, Bilbray has maintained a 92% rating from the American Conservative Union, which makes him an “ACU Conservative” in their ranking system. He voted against increasing the minimum wage, voted to repeal the Washington, D.C. gun ban, voted against a ban on anti-gay job discrimination, and voted against expanding SCHIP.

Voting against a minimum wage increase, expanding health insurance for kids, and against banning workplace discrimination puts Bilbray far out of the mainstream of the American people. And in the last Congress, Bilbray’s voting record put him far to the right of most of his colleagues, too — he was the 79th most conservative member of the House of Representatives, out of a total of 435. That means Bilbray’s voting record was more conservative than more than 80 percent of all members of Congress.

Right. Bilbray, like the teabaggers, is a “moderate,” mainstream centrist. Therefore, it make sense that Obama is a socialist/fascist/communist.

It’s hard to believe that these people are all just falling right back into their comfortable old narrative, but we should have known that all it would take is a big hissy fit to convince them that the far right freakshow somehow represents the whole country. They really believe in their hearts that Real America is a bunch of right wing cranks. Even electing a black president from Illinois with a huge Democratic congressional majority didn’t convince them otherwise. In fact, it’s as if it never happened.

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Owning It

by dday

On 60 Minutes last night, the President vowed to take ownership of the health care legislation and its consequences.

Mr. Obama said he would take responsibility for any health-care legislation passed. “You know, I intend to be president for a while and once this bill passes, I own it,” he said. “And if people look and say, ‘You know what? This hasn’t reduced my costs. My premiums are still going up 25%, insurance companies are still jerkin’ me around,’ I’m the one who’s going to be held responsible.”

But there are more possibilities than just increased costs and insurance company-created pain. There’s a very real cost to women, many of whom will not be able to access legal medical services through their insurance plans.

HHS Secretary Kathleen Sebelius told me on ‘This Week’ the President will go beyond language in a House bill to make sure no public money goes to pay for abortions under health care reform.

Abortion foes argue language in the House bill has too many holes and that taxpayers could potentially subsidize abortions. Sebelius told me there will be no uncertainty with the President’s plan.

“In fact recently the Catholic bishops came out, after the President’s statement saying that his statement about what he intends in the plan that no public fund would go to fund abortion and the fact that he has come out firmly for insuring all Americans and saying that it’s a moral issue as well as an economic issue and they endorsed moving forward. I think the legislative language will reflect what the President has just said.”

GEORGE: “So you are saying that he will go beyond what we have seen in the House and explicitly rule out any public funding for abortion?”

SEBELIUS: “Well that’s exactly what the President said and that’s what he intends that the bill he signs will do.”

The only way to go beyond the House bill is to restrict private insurers from offering reproductive services in any plans they offer in the insurance exchange. Which means that nobody in the individual market will have those legal medical services covered, in effect extending the Hyde Amendment ban from Medicaid to the entire individual insurance market. Meaning that health care “reform” would actually make it harder for millions of people to access reproductive choice services.

You see a similar dynamic with the arguments over the immigration provisions in the bill. The President was not wrong when he said any bill would not insure undocumented immigrants – he’s just wrong to carry out such a spiteful, shortsighted threat.

Consider a few statistics. According to a July article in the American Journal of Public Health, immigrants typically arrive in America during their prime working years and tend to be younger and healthier than the rest of the U.S. population. As a result, health-care expenditures for the average immigrant are 55 percent lower than for a native-born American citizen with similar characteristics. With the ratio of seniors to workers projected to increase by 67 percent between 2010 and 2030, it stands to reason that including the relatively healthy, relatively employable and largely uninsured illegal population in some sort of universal health-care system would be a boon rather than a burden. “Insurance in principle has to cover the average medical cost of all the people it’s serving,” explains Leighton Ku, a professor of health policy at George Washington University. “So if you add cheaper people to the pool, like immigrants, you reduce the average cost.” More undocumented workers, in other words, means lower premiums for everyone.

The actuarial advantages don’t end there. As it is now, undocumented workers (and others) who can’t pay their way receive free emergency and charitable care—a service that costs those of us with health insurance an additional $1,000 per year, as Obama noted. But if illegals were covered, this hidden tax would decrease, further lowering our premiums and “relieving some of the financial burden on state and local governments,” says Harold Pollack, a University of Chicago professor who specializes in poverty and public health. What’s more, employers currently have a clear economic incentive to hire undocumented immigrants: they don’t require coverage. A plan that mandates insurance for native workers but not their illegal counterparts actually makes life harder on the blue-collar Americans competing for jobs (and railing against immigrants) because it means that hiring them will cost more than hiring a recent transplant from Mexico City. As The Washington Post’s Ezra Klein recently explained, “If you’re really worried about the native-born workforce, what you want to do is minimize the differences in labor costs between different types of workers. A health care policy that enlarges those differences—that makes documented workers more expensive compared to undocumented workers—is actually worse for the documented workers.”

I’d add to this that blunt enforcement mechanisms like what is used in Medicaid cost millions of dollars for almost no material benefit, which even George Stephanopoulos was inclined to point out this weekend. Such systems also tend to weed out legal US citizens without proper documentation. And not letting immigrants participate in the exchanges with their own money, as was floated by the White House over the weekend, completely cuts them off from the individual market and further strains emergency rooms, who will be the doctors of last resort, making this whole spite-based policy grossly more expensive.

(By the way, when some legal resident gets denied coverage because of immigration enforcement provisions, I fully expect Republicans to be the first in line to usher him to a press conference as proof of how government doesn’t work.)

Meanwhile, Amanda Marcotte notes that the entire wasteful enterprise to make sure that some alien other never ever gets one dime of the hardworking Murcan taxpayer money ever is a totally moot point:

Mexican migrants working in the United States may soon have their own affordable health insurance program. According to Mexico’s Health Department, it is launching a pilot program designed to encourage migrants who work in the states to sign up for the Mexican government’s Seguro Popular health insurance plan.

In 2003, Mexico set out to achieve universal health care, and from what I understand, they’re on track to reach their goal of doing so by 2012. They’ve done such a remarkable job because they have—you guessed it—a public option that everyone who has a job can buy into. (Except public sector workers, who are covered by a separate insurance system.) They also have a system of federally run clinics to administer to basic health care needs, regardless of employment status. It would be this public insurance that would reach out to migrant workers in the U.S. and encourage them to buy in. Of course, covering bills incurred by Mexican citizens who go to U.S. providers will be very expensive for Mexico, especially since they’ve kept internal health care costs so low. (About 1/3 of what the same procedures cost in the U.S.) Still, it’s both the humane and fair thing for Mexico to do, because migrant workers in the U.S. are good for the Mexican economy, putting billions of dollars into their economy every year. Unfortunately, the economic crisis in America has significantly reduced the average income levels of migrant workers in the U.S., which has impacted the remittance income tremendously. So the Mexican government is starting this pilot program even as immigration is making them less money.

Mexican health care is not an optimal model for the US, but the philosophy behind it is light years beyond what our brigade of idiots in Washington can fathom. Instead, we’re jumping through hoops and implementing costly verification systems when Mexican workers can sign up for their home country’s public option and never touch any American system to begin with.

If the President wants to “own” these stupid and petty political compromises which benefit his opponents but make no sense from the standpoint of economics or human decency, he’d better be prepared with some good arguments about them. From what I see, naked fear of Republican extremism is leading him to act against the interests of the public.

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Teabaggers R Us

by digby

I’m feeling like it’s 1994 again for the first time since Obama took over. The conventional wisdom has set in. From MSNBC this morning:

Chris Cilizza: I think President Obama’s speech today will dominate for the next 24 hours. He talked about regulatory reform, but if you read carefully in there, that speech is aimed at lots of people, a lot of his critics who say that the Obama administration is simply interested in growing government. He’s basically saying that the government stepped in out of necessity to help these financial firms get back on their feet. now that they are, they have to take over because the government’s job is not to control the financial institutions. It’s sort of a subtle jab at people who are saying that all the Obama administration wants to do is take over government.

Mitchell: How does he thread this needle? We’ve been wrestling with this throughout the hour. Not bring the government more into people’s lives, because people are pushing back so hard and that’s been one of the problems in selling health care.

Cilizza: You know I think that’s the central problem. I think you’ve nailed it. On health care there is so much skepticism from the 700 billion dollar stimulus package to some of the other things that have been put in place by the Obama administration.

What’s hard is that people’s perceptions are set in their ways. People have decided, many people, not everyone, but many people have decided that government is too involved in their lives, the debt is getting too big. It’s crippling what the president is trying to do on health care, which is a difficult proposition in and of itself.

There you have it. According to the Cilizza and Mitchell, the country is all up in arms about government spending and it’s destroying Obama’s chances of getting health care reform through. Is this true?

I don’t think that’s clear at all:

Leading Pollsters to Discuss Results of New Poll Showing Strong Momentum for President Obama’s Health Insurance Reform Proposal, Including a Public Option, Following Address to Congress

Washington D.C. – Americans United for Change will host a press conference call today, September 14th at 3PM EDT with leading pollsters to discuss a new poll today showing strong momentum for health insurance reform following President Obama’s address to Congress last week. On behalf of Americans United, Anzalone Liszt Research conducted n=801 live telephone interviews nationwide with likely 2010 general election voters between September 10-11. Among the key findings:

Ø 60% of likely 2010 voters say they watched at least part of the President’s speech, and a majority of those who did (54%) are now more likely to support his plan

Ø By a 10-point margin, voters are more likely to re-elect a Member of Congress who votes for healthcare reform

Ø By a 62% to 28% margin, voters support a public option regardless of whether they watched the speech.

Unless this poll is rigged, the entire discussion by Mitchell and Cilizza is cracked. People still want health care reform and they still want the public plan. Just because a couple of loudmouthed GOP gasbags shouted in the chamber and some teabaggers came to town doesn’t mean that everyone in the country is suddenly channeling Glenn Beck.

Update: According to CNNs new poll (not online yet) the president’s approval rating is up five points from two weeks ago — to 58%.

Naturally Gloria Borger characterizes this as bad news because while he is popular, his policies are “polarizing.” She uses this to illustrate her point:

Effect of Obama Health Care Plan On Your Family

Better off: 21%
Worse off: 35 %
About The Same: 43%
No Opinion: 1%

So, 64% of the people thinking their families will not be affected or will improve under health care reform, (which the president explicitly promises) is evidence of polarization. Ok.

She said:

“This is such a polarizing issue. They are worried about the deficit. Two thirds of them are worried that it’s going to grow. And they’re worried about how it’s going to affect them. When asked if they would be better or worse off with health care reform, only 21 percent said they would be better off! 35 percent said worse and about the same, 43 percent.[that’s exactly how she said it —ed]

And what’s really interesting is that when you break down these numbers, only 5 percent of Republicans thinks they’re going to be better off and only 15 percent of Independent voters think they’ll be better off. So that gives you a sense of how divided the country is.

This woman is called a “senior political analyst.”

What you are seeing is consensus in Broderville that the teabaggers represent some silent (and unpolled) majority and that the president is being “polarizing” by pushing an agenda of which they don’t approve. The numbers don’t matter. It’s the simple fact that conservatives always represent the mythical Real America that Gloria and her pals all feel they represent.

Hopefully the numbers coming in over the next few days will be obvious enough that nobody but Gloria Borger will have the nerve to skew the analysis quite this egregiously. But be prepared.

Update II:

Here’s more from the Washington Post sent in by reader Jeff Z:

“But it is the public option that has become the major point of contention, with support for the government creation of an insurance plan that would compete with private insurers stabilizing in the survey after dipping last month. Now, 55 percent say they like the idea, but the notion continues to attract intense objection: If that single provision were removed, opposition to the overall package drops by six percentage points, according to the poll.

Without the public option, 50 percent back the rest of the proposed changes; a still sizable 42 percent are opposed. Independents divide 45-45 on a package without the government-sponsored insurance option, while they are largely negative on the entire set of proposals (40 percent support and 52 percent oppose). Republican opposition also fades 20 points under this scenario.”

Here’s the poll

Here are questions 22 and 23 in that poll:

22. Would you support or oppose having the government create a new health insurance plan to compete with private health insurance plans?

Support Oppose

Net Strongly Somewhat Strongly/Net Strongly Somewhat Strongly
9/12/09 —–55 33 22 ———–42 11 31 3

8/17/09 —– 52 33 19 ———–46 11 35 2

6/21/09 —– 62 NA NA———- 33 NA NA 5

23. Say health care reform does NOT include the option of a government-sponsored health plan – in that case would you support or oppose the rest of the proposed changes to the health care system being developed by (Congress) and (the Obama administration)?

Support Oppose No opinion

9/12/09 —- 50 42 8

This 5% drop in support w/o the public option and rock steady 42%opposition produces a conclusion that there is more support if the public option is dropped.

Unbelievable!!!!!

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Viruses

by digby

Valtin at Daily Kos writes: