Yesterday, Arkansas’ Mike Ross, an influential Blue Dog Democrat, stated that he was opposed to a public option in the Democrats’ health care reform package. “An overwhelming number of you oppose a government-run health insurance option, and it is your feedback that has led me to oppose the public option as well,” Ross asserted in a letter to his constituents.
Ross may well have gotten a significant number of letters and e-mails against the public option. He may have hosted a town hall forum before an audience who was skeptical of such a provision. But if Ross had actually polled his district, it’s unlikely he would have found overwhelming opposition to the public option. Instead, he might even have found a that a plurality or majority of his constituents supported the public plan.
[…]
While Arkansas-4 does not have a lot of Obama voters, it does have a lot of people in poverty: 20.5 percent of its population, which ranks it 50th out of the 435 Congressional Districts. It is basically like an exaggerated version of Kentucky where, according to the Research 2000 poll, 46 percent support the public option and 45 percent oppose it. That the public option is “overwhelmingly” unpopular in such a district is unlikely.
We can systematize these results by means of a regression analysis that accounts for the Obama vote share and the poverty level in each district. (Technically, we’ll be using a logistic regession, treating each of the voters included in one of these surveys as a separate data point.) This analysis finds that support for the public option nationwide is about 55 percent, against 36 percent opposed, similar results to what I believe to be the most reliable polls on the subject.
What’s more interesting, though, is where we project the public option in individual districts. We find that:
— The public option is estimated to have plurality support in 291 of the 435 Congressional Districts nationwide, or almost exactly two-thirds. — The public option is estimated to have plurality support in 235 of 257 Democratic-held districts. — The public option is estimated to have plurality support in 34 of 52 Blue Dog – held districts, and has overall popularity of 51 percent in these districts versus 39 percent opposed.
Mike Ross works for Blue Cross, like all Arkansas politicians. But while he may think because of that that nobody will ever bring up his probable vote against health care reform, I tend to think otherwise. It might not be a Republican, mind you (although don’t rule that out … they have no shame) but there are some people in politics these days who are kicking ass and taking names and who will very likely to be willing to run ads against them.
Most people are willing to be practical if somebody comes from a district that is truly conservative and demands that they vote a certain way. Democracy is democracy. But these corporate lackeys and village shills who refuse to represent their constituents and act like Republicans are another story.
“Triggers” seem to be the Goldilocks “compromise” de jour, something that can please everybody. I would like to introduce all these Democrats to a man named Gray Davis, who once ruled the Golden Land of California. He has a little story to tell about triggers:
California’s vehicle license fees, which are based on the value of the car or truck, tripled Friday as state officials allowed a controversial provision of a law which had been gradually lowering them to kick in.
That provision sends the fees up to previous levels in times of state budget difficulties.
[…]
The trigger for the increase had been a political hot potato as Gov. Gray Davis and some other elected officials tried to find a way to increase the fees without opening themselves up to voter backlash.
But state Sen. Tom McClintock, an opponent of the fee increase, on Friday filed paperwork with the state attorney general to collect signatures on two measures to lower or eliminate the fee.
McClintock and the rest of the California Republicans rode that horse all the way through the recall. And now we have a fiscal disaster of epic proportions because the whole government is paralyzed.
Granted, this particular trigger translated into increased fees for individuals, which can obviously cause a popular uprising. But if anyone thinks that the Republicans and the insurance companies are going to let the Democrats pull a Public Option Health Care trigger without having a world class hissy fit, they are living in an alternate universe.
The lesson is that triggers are bullshit, designed to make everyone feel ok about doing the irresponsible thing today by pretending that if it doesn’t work out they can always “fix it” later. (The corollary are tax breaks that are supposed to “sunset” but never do.) They won’t ever actually do it because the mechanism will depend on a bunch of complicated formulas that nobody can agree upon, the Republicans and the industry will claim it’s a socialistic plot to destroy the world and the fiscal scolds will come out of the woodwork to proclaim that the government will have to disband the armed forces if they hope to pay for it. Just like now.
It’s not going to get any easier to sell a public plan. The only thing the other side will ever go for is tax breaks and incentives to pay ever higher insurance company CEO bonusus. (That’s so they’ll keep being productive and make us all live forever.)
Putting off that argument isn’t going to buy the Democrats anything when the whole plan falls apart because the insurance companies (surprise) failed to behave like decent corporate citizens. The Dems will just look like jackasses who failed to properly reform health care. Then we’ll hear all about how we need to trust the free market do its magic and roll back all these onerous regulations so the insurance companies can truly “compete.”
Catherine, in comments, to my previous post, which mocked Robert Stacy McCain’s disgusting suggestion that American Jews be encouraged to move to the country to learn conservatism, wrote:
I read through the comments at the link. They weren’t talking about forced relocation of course. The thing that stood out to me is that no one at that site really has much understanding of what liberalism is and why a person would be drawn to it. Their attempts to describe what liberals believe or what motivates us are stilted and very wide of the mark. I know I don’t really get them, either. It would be nice to have a little real dialogue so we could stop viewing each other in such cartoonish ways.
Let me address this by first saying that I have the utmost respect for Catherine and her comments, here and on other posts, as I do for all our regular commenters. I hope my disagreements are respectful and if not, I hope she’ll point out where so I can learn. The internets is a harsh place and I have no interest in adding to it when highlighting a comment; I very much value our regular visitors.
When I first started blogging, I too was taken in by folks like McCain. I thought they were serious people interested in a genuine meeting of the minds. I was dying to have useful conversations with intelligent conservatives, who knew how to write and also knew how to debate.
It has never happened. It will never happen with the Robert Stacy McCains of the world, for they are not what we think of as conservatives. They are probably best described as part of the group that flirts with what David Neiwert calls eliminationists and eliminationist ideas, but the standard term, when being polite to them, is “movement conservative.” Whatever you call them, they hate liberalism with a passion. And by “liberalism” I mean liberalism as in the Englightenment and the American Founders such as the Jefferson of the Declaration and the letter to the Danbury Baptists. These are people who are still fighting the battles lost by the Federalists in the earliest days of the United States. These are very, very strange people and there is no common ground to be reached between liberals and them. They can only be defeated and their ideas relegated to the margins of modern American political discourse, where they belong. Fortunately, as powerful as they are, there are not too many of them. Unfortunately, they are extremely good at disguising their extremism; many decent Americans have been bamboozled. (One of the major reasons I started blogging was because, at the time, very few people other than Krugman seemed to be onto their game. Many more are now, but not enough.)
Among the most important ways to defeat movement conservatives is to refuse to take their bullshit seriously, even for a moment. In fact, when they are given undeserved influence and respect, as they were in the months before Bush/Iraq, innocent people die.
On the other hand, dialogue with conservatives, genuine conservatives, is not only possible, but something liberals are having right now, every day. A prime example is the intense argument many in the blogosphere are having with the current president of the United States. I’m not kidding or being a smarty-pants: Whatever his personal beliefs, Obama governs as a centrist and even, in some areas, like a conservative. Therefore, it is no surprise at all that it has been very, very difficult to introduce genuinely liberal ideas into this administration, and that Van Jones’ resignation is a genuine loss to liberals.
That said, the Obama administration has not heaped the kind of eliminationist scorn on us that McCain and his fellow brown shirt wannabes have. It is with Obama and other Democrats that you will find the discussions you want to have. You may not like what they’re doing, but they are not in the grip of a genuinely creepy ideology.
Indeed, most top Democrats adhere to what used to be called “conservatism,” including the Clintons, Reid, and of course the even-more-conservative blue dogs. It has been noted, often with amazement, that today’s Democrats are to the right of Nixon on many issues; needless to say, that is pretty damn far right.
With movement conservatives, however, there is not a chance of a real discussion. And yes, what that means is that to the (nearly complete) extent that Republicans have become synonymous with movement conservatism, they are, as Van Jones rightly said, simply assholes.
I’m sorry, Catherine, I understand your interest in listening and also in reaching out to other voices. It simply cannot be done with the extreme right. They do not hold “other views.” They’re simply irresponsible, malicious, and incompetent.
And that brings us to McCain’s “encouragement” of Podhoretz to get Jews to move to rural areas so they can embrace real conservative values. For reasons I hope I don’t have to explain to anyone on this blog, no one even remotely familiar with the ghastly result of worldwide anti-semitism would seriously suggest Jews move anywhere in order to change their politics. McCain claims this is a “perverse” reading of what he wrote but it is he who is being perverse. That he doesn’t understand this, or claims not to, is exactly what is so troublesome; Jews have heard this kind of “encouragement” many times before, and it never ends well. What he wrote is, by any normal standard, an outrageous thing to say and places him far beyond the pale of serious engagement.
I’ll leave it to others to come to their own conclusions about the motives behind McCain’s “encouragement” for urban Jews to relocate to the country for political reasons. I’ll simply conclude by repeating what so many of us have said: our political discourse is deeply askew. Norman Podhoretz’s and Robert Stacy McCain’s ideas would have only a marginal impact and distribution in a healthy discourse. Instead, NoPod, a truly troubled soul, is thought a serious intellectual, and the likes of McCain are heard everyday in the drooling rants of Beck and other clowns. They can’t be ignored, but they also can’t be engaged. Believe me, I tried. I learned.
Finally, don’t be fooled if, like Huckabee or Gingrich, they seem personable. They have a long history of acting on their hate and rage. These are ugly, ugly people.
I had forgotten about the modern-day equivalent of the Project for a New American Century, called the “Foreign Policy Initiative” (can you get more anodyne?). They exist solely to pressure Barack Obama on foreign policy from the neocon right, and to pat him on the forehead when he performs in ways aligned with their beliefs. They did a little of both of this with this letter asking for a “properly resourced” war effort in Afghanistan (that means a massive escalation):
The letter’s signatories write: “The situation in Afghanistan is grave and deteriorating…Since the announcement of your administration’s new strategy, we have been troubled by calls for a drawdown of American forces in Afghanistan and a growing sense of defeatism about the war. With General McChrystal expected to request additional troops later this month, we urge you to continue on the path you have taken thus far and give our commanders on the ground the forces they need to implement a successful counterinsurgency strategy. There is no middle course. Incrementally committing fewer troops than required would be a grave mistake and may well lead to American defeat. We will not support half-measures that repeat the errors of the past.”
In addition to the usual suspects, the Kristols, Cliff Mays, Peter Wehners and Randy Scheunemanns of the world, Sarah Palin has signed on, clearly signaling her alignment with the neocon crowd.
As Jeremy Scahill notes, this is exactly analogous to what the PNAC types did to Bill Clinton in the 1990s.
The neoconservative Project for a New American Century laid much of the groundwork for the foreign policy of the Bush administration. Its members received important postings in the White House, Department of Defense and other institutions. But what is seldom mentioned is that PNAC achieved its first great political victory during the Clinton administration when PNAC pushed Clinton to sign the Iraq Liberation Act of 1998. In January 1998, the group wrote to Clinton: “[Y]ou have an opportunity to chart a clear and determined course for meeting this threat. We urge you to seize that opportunity, and to enunciate a new strategy that would secure the interests of the U.S. and our friends and allies around the world. That strategy should aim, above all, at the removal of Saddam Hussein’s regime from power.” The Iraq Liberation Act, backed overwhelmingly by Democrats and Republicans and signed by Clinton, made regime change in Iraq official US policy and set the course for the eventual invasion and occupation.
And we all remember one of the responses from neocons to the war in Iraq, saying at every opportunity that “Democrats agreed to and Clinton signed the Iraq Liberation Act in 1998!”
This is exactly the pincer movement that FPI is attempting with Obama. His Afghanistan policy has shrinking support among liberals, and so the neocons are increasingly among his only supporters. And of course, those neocons will only be pleased with a full escalation of the kind we had in Vietnam. So if Obama continues with involvement in Afghanistan, his most vocal supporters are pushing the debate severely to the right.
Neocons always do this. Under a Republican President, they waltz into the White House and make a complete mess of things. Under a Democrat, they head underground, prod and push from the right, and support the President when he accedes to their views, aloowing that President to claim bipartisan support (along with partisan Obama defenders) and allowing the neocons to control policy even when out of power. As Steve Hynd notes, the FPI letter urges Obama to “reverse the errors of previous years,” when they were responsible for those errors.
If you lay down with dogs, you’ll get up with fleas. It’s time to begin drawing bright lines in the Af/Pak debate. The Obama administration and its neoliberal interventionist supporters have aligned themselves with the neocons, the instigators of so much atrocious American foreign policy. That bipartisan consensus of hawks is opposed by another bipartisan consensus of progressives and realist conservatives who oppose escalation, and by the bulk of the American public.
Progressives need to start asking themselves if they’re at all comfortable with Obama’s allies.
I hope Glenn Beck’s “9/12” events are going to be a big bust. But just in case they aren’t, people should probably be prepared. Go to this website, Resistnet, which is one of the main teabagger organizers, along with Beck’s 9/12 group, and see what they are up to.
Resistnet is a right wing frontgroup, as is most of the Freedomworks teabag nexus:
ResistNet is a Web site, that says it is “the online community for patriotic citizens who are opposing the Obama-led socialist agenda with a patriotic, idea-based, conservative resistance.” It’s “About Us” page is not a valid URL (as of August 13, 2009). The site contains no contact information (phone, address, or email) for ResistNet but does provide a way to donate and the site sells “resistance gear” (tote bags, etc.). Its home page constantly refers to Congressmembers’ recess town hall discussions about health care reform as “Obamacare town hall” meetings, and calls health care reform proposals “Obamacare.” The site is created by a group called Grassfire.org,[1], a conservative issues advocacy group set up by Shirley & Banister Public Affairs. The president of Shirley & Bannister Public Affairs is Craig Shirley, a long-time Republican PR operative
The site is very slick, as is Beck’s.
It’s hard to know how many people are going to attend the Washington event or others around the country. But if this list of buses coming to DC is true, there could be a decent turnout.
And unlike the huge global protest marches against the Iraq war, I think we can expect these events to get a ton of play on television. The good news is that the protesters are teabaggers and will likely say many ridiculous things. The bad news is that because it’s on TV it’s going to convince a lot of people that these ridiculous things have merit. It would be really nice if the designated Democrats were prepared instead of sputtering stupidly as usual.
let’s hope this isn’t a big story, but it could be. The media loves these guys.
There’s a lot of talk today about the Baucus plan, and some serious sturm and drang over whether or not it actually presents an improvement in people’s lives. Matt Yglesias and Marcy Wheeler take on the question and both make good points although they come to different conclusions. The details on all this are, surprisingly, just being looked at, and it’s revealed that health care will still be expensive for the average, middle class person like me who has to buy insurance on the private market.
To that, I can only say, yup. And anyone over 45 who is self employed is fucked in the current system and not a whole lot better off under the proposed new one. For us, just being allowed to buy into Medicare at any price would be a dream come true since it covers everything and can’t be taken away. At my age, my friends are starting to drop with cancer, heart disease etc (which I’m sure they all deserve for having eaten fried snickers bars and everything, but still …) And my husband and I can’t buy even a crappy policy with gigantic deductibles and ridiculous out of pocket expenses for less than $550.00 a month. That’s a big bill, particularly for the self-employed whose income is often unpredictable. The Baucus plan isn’t going to improve much of anything for me. I’m an older,self-employed middle class American and I basically have to just keep my fingers crossed that I stay very healthy for the next 13 years or I’ll lose whatever sad retirement savings I have.
But we’re stuck with what is, not with what works, and the fact is that there will be some material improvements for people other than me and my useless middle aged loser cohort, and that’s something. The Baucus plan does provide some rather substantial help for the poor, caps out of pocket expenses (at a pretty high rate, but it’s better than most private insurance which pays out a total of about $3.72 when you add up all the exclusions.) But I’m very skeptical of the plan actually bringing improvement over the long haul for reasons that have little to do with the actual policies they contain (the final mix of which we can’t know yet.)
The problem is the politics. Any plan that forces the uninsured to pay their hard earned money to wealthy private insurance companies under penalty of law is a huge political risk. These are the same companies that have brought us to this place where people are routinely denied the care they were promised, lied to about what was covered, scammed into paying huge sums of money for no security and no guarantee. Health insurance companies have dealt with their customers in bad faith for years and years and now we are being told that everyone must pony up and pay them even more. For all the talk of reform, when you whittle this down, that one fact comes roaring back at you and it sticks hard in the craw of anyone who considers themselves progressive.
The Democrats simply do not understand that as much as many people mistrust the government and believe it is inept and malevolent, just as many mistrust the private sector and believe it is greedy and malevolent — and those beliefs don’t break down as neatly between right and left as one might think. What they are going to do is force the currently uninsured to write a check to a private company for a large sum of money every month, the subsidies for which will show up as some kind of “credit” on their tax returns. How do you think most people are going to mentally and emotionally process that expense? As a good deal or a bad one?
Income taxes which nobody particularly enjoys paying, are at least taken out of your paychecks before you see the money and are theoretically going to pay for things which go to the common good: defense, police, air traffic control, roads, “volcano monitoring” etc. The payroll tax goes into the pool for disability, medicare and social security — the safety net. But the for-profit health insurance business is in business to make money for its shareholders, period. And everybody knows that you simply can’t expect Wellpoint to not act like a capitalistic enterprise and try to make as much profit as they can from that transaction. We’ve just witnessed the Masters of the Universe thumb their noses at any call to decent human behavior even immediately after they nearly destroyed the financial system. Corporations are not designed to give a damn about anything but profits and they have the political system so wired that regulation is just another bargaining chip.
In any case, the insurance companies may be regulated under the law, but the remedy for the average person is to hire a lawyer and take them through the legal system all the way to that wholly owned industry subsidiary they call the Roberts Court. That’s a rather inefficient way to ensure that costs come down and people are covered. Especially since the people who are suing are probably dead by the time they get there.
Aside from its (dubious) merits as a cost control measure (which relies on that notorious commie concept of competition!)the public plan at least ensures that the people who object to being forced by law to contribute to obscene CEO salaries could choose instead to pay their money to a highly regulated non-profit government program. That program, rather than putting profits into the pockets of executives and shareholders, would put it back into the system to pay for more health care and would be structurally in place for future improvements. Since the party took Medicare for all Americans off the table before we even got here, it’s not too much to ask for at least that one paltry choice, especially since it actually solidifies the compact between the people and their government, something that Democrats should always be trying to do.
As for whether or not it’s a deal breaker, well that isn’t really up to me or you. It’s up to Barack Obama. I’m afraid that as much as we like to think we can “hold the progressives’ feet to the fire” on health care reform, it’s always been highly unlikely that at the end of the day progressive Democrats would vote against their new president on his signature piece of domestic legislation (which also happens to have been the Liberal Holy Grail for the past 60 years) no matter how much we might scream and yell and issue threats. Health care is not going to be the issue on which the left defies Barack Obama and bands together with Republicans to defeat him. If Obama wants to pass a Health Care reform bill that opens up Medicaid to more poor people, ostensibly regulates the insurance industry and provides some modest subsidies to the uninsured middle class, even if its a rube Goldberg set-up that is unlikely to be sustained, progressives are not going to be the ones to stop it. I’m sorry, they just aren’t. Obama himself must be persuaded that the public option is in his own and the country’s best interest for it to pass. And even then it might fail at the hands of the “centrist” corporate shills for whom this paltry effort goes too far.
The price that’s paid for a compromised Obama plan with meager subsidies and big mandates which line the pockets of insurance companies is likely to be very high indeed for the Democratic Party and its relationship to the middle class. Maybe they think they can finesse it, but the economy is likely to be in distress for some long time to come, more and more people are going to be thrown into the private insurance market and what they find is going to be far less than promised.
The riskiest thing Obama can do is to put in place a plan from which a majority of people will not see the benefit and many will see something worse. The beauty of social security was that every citizen had a stake in it. On health care, the only people anyone refers to as “stakeholders” are members of the medical industry. I think that tells you exactly where things went wrong.
Update: Here’s a nice headline: Fines proposed for going without health insurance
AP – Tuesday, September 08, 2009 6:04:53 AM By RICARDO ALONSO-ZALDIVAR
Americans who don’t get health insurance once the system is overhauled would be fined up to $3,800 under a proposal that circulated in Congress on Tuesday as Democratic leaders cast doubt on prospects for creating a government-run insurance plan.
Update II: Via dday below, I see that Baucus has provided for state level ombudsmen, which presumably would have to be accessed before any lawsuit could commence. So I feel pretty confident that they will work out the kinks in the regulatory scheme by 2109.
Update III: Belay that opinion that Baucus will be an improvement for the poor. Some working poor are likely to be worse off — because they can’t get a job:
The proposal has serious flaws, including the following:
Biasing Hiring and Firing Decisions Against Low-Income Workers
* The proposal would make it considerably more expensive for employers to hire workers from lower-income families than workers from higher-income backgrounds to do the same job. As a result, it would distort hiring decisions. Employers would have strong incentives to tilt hiring toward people who have a spouse with a good income (or have health coverage through a family member), teenagers whose parents make a decent living, and people without children (since the eligibility limit for the subsidies in the new health insurance exchanges will increase with family size). Low-income women with children in one-earner families would be particularly disadvantaged.
While language could be included to try to ban such discriminatory effects, it would be virtually impossible to enforce effectively. It would be extremely difficult to prove in court that an employer has passed over one applicant and hired another because of the health surcharge that employers would face if they hired people receiving health insurance subsidies. Moreover, most low-income job applicants who do not get hired could not afford to hire attorneys to initiate legal proceedings. For the tiny number that might be able to institute proceedings, the legal complaint likely would take months and, more likely, years to adjudicate. In short, the fact that low-income workers would cost an employer up to several thousand dollars more to perform the same job could not easily be overcome.
* This differential treatment of workers based on their family income also would likely influence employer decisions about which of their employees to let go when they trim their workforces to cut costs, such as during a recession. Workers from low-income families would cost the firm significantly more to retain than other workers who are paid the same wage to do the same job.
* Although this clearly is not intended, the proposal likely would have discriminatory racial effects on hiring and firing. As noted, it would discourage the hiring of lower-income people. And since minorities are more likely to have low family incomes than non-minorities, a larger share of prospective minority workers would likely be harmed.
The Washington Post today becomes yet another media outlet to detail the practice of rescission, whereby insurance companies go through your application form with a fine-toothed comb and look for any excuse to drop you from your coverage – but only after you try to use it to get treatment. They’re perfectly fine with what they call “medical fraud” as long as you’re just paying them your premiums. It’s when you want to receive health care that fraud becomes the greatest threat facing the Republic.
The problem is that rescission just isn’t a snappy enough description of the actual circumstance. I prefer “insurer-assisted suicide”:
The untimely disappearance of Sally Marrari’s medical coverage goes a long way toward explaining why insurance companies are cast as the villain in the health-care reform drama.
“They said I never mentioned I had a back problem,” said Marrari, 52, whose coverage with Blue Cross was abruptly canceled in 2006 after a thyroid disorder, fluid in the heart and lupus were diagnosed. That left the Los Angeles woman with $25,000 in medical bills and the stigma of the company’s claim that she had committed fraud by not listing on a health questionnaire “preexisting conditions” Marrari said she did not know she had.
By the time she filed a lawsuit in 2008, she also got a diagnosis of pancreatic cancer and her debts had swelled beyond $200,000. She was able to see a specialist by trading office visits for work on the doctor’s 1969 Porsche at the garage she owns with her husband.
“I’ve had about 10 visits,” Marrari said of the barter arrangement that has proved more reliable than her insurance. “The car needs a lot of work.”
And where would Mrs. Marrari be if she didn’t have a garage that could work on Porsches?
Nobody knows how much money has been saved through insurer-assisted suicide; three insurance companies admitted in a hearing this summer that they’ve cancelled 20,000 over five years at a savings of $300 million dollars. Given that amount of money, the fact that California’s five largest insurers have paid around $19 million to deal with rescissions seems like a drop in the ocean. Here’s something that’s not in the article: when Anthem Blue Cross challenged the fine placed on them for rescinding policies, state regulators never even tried to file suit because they figured they would be outgunned in court.
“This is probably the most egregious of examples of health insurers using their power and their resources to deny benefits to people who are most in need of care,” said Gerald Kominski, associate director of the Center for Health Policy Research at the University of California at Los Angeles. “It’s really a horrendous activity on the part of the insurers.” […]
In the only case to go to trial in California, an arbitration judge awarded $9 million to a beautician who had to stop chemotherapy for her breast cancer after Health Net dropped her policy. Company officials declined to comment.
In a pending case, Blue Shield searched in vain for an inconsistency in the health records of the wife of a dairy farmer after she filed a claim for emergency gallbladder surgery, according to attorneys for the family. Turning to her husband’s questionnaire, the company discovered he had not mentioned his high cholesterol and dropped them both. Blue Shield officials said they would not comment on a pending case.
You might be wondering whether there’s a mechanism to stop rescission in the current plans on the table. The President and Democratic leaders would certainly tell you that’s the case, if only by banning the refusal of coverage for pre-existing conditions. However, as seen from the paragraph above, the fines they may incur as a result will either be seen as the cost of doing business or a fine that will never be enforced. In addition, there are plenty of additional ways to evade responsibility.
If federal health-care reform bars companies from screening for preexisting conditions, insurers note that cancellations will no longer be an issue. But Melinda Beeuwkes Buntin, an economist at the Rand Corp., said that unless for-profit companies are compensated for taking higher-risk patients, the firms will continue to look for ways to unload them.
“They wouldn’t be able to overtly kick you out, but that doesn’t mean that they might not put, for example, more onerous preauthorization requirements on services that people who are at risk might need, and that might discourage you from re-enrolling next year,” Buntin said.
As long as insurers’ incentive to make a profit diverges from caring for their customers, insurer-assisted suicide will always be a reality. And as we’ve seen, balkanizing the enforcement to the state level instead of having a federal regulator cracking down on this will put the enforcement at the mercy of fragile state budgets and haphazard state regulators. Here is the entire enforcement mechanism, as far as I see it, in the Baucus draft plan from the Senate Finance Committee:
Ombudsman. In 2010, states would be required to establish an ombudsman office to act as a consumer advocate for those with private coverage in the individual and small group markets. Policyholders whose health insurers have rejected claims and who have exhausted internal appeals would be able to access the ombudsman office for assistance.
Yay, the states get an ombudsman! And he or she can only be tapped if individuals “exhaust internal appeals”; that is, beg their insurers to stop cheating them. And since the states will be establishing the office themselves, they’ll set the budgets and choose the staff – meaning that we’ll potentially be leaving enforcement of insurance regulations in Texas and South Carolina, for example, to Rick Perry and Mark Sanford.
Ultimately, those fighting for a public option are fighting for some way out of this Chinese box, where insurers have control over the health care you receive, and can just as easily deny your coveage as they can allow it. All of the regulations in the world won’t mean a thing without proper enforcement, and this won’t cut it.
Here’s Robert Stacy McCain riffing on some reflections from Commentary on a new masterpiece from Norman “World War IV” Podhoretz entitled, and I’m not making this up, “Why are Jews Liberals?”:
If Messrs. Podhorhetz, et al., wish to promote conservatism among American Jews, let them find some way to encourage Jewish families to move to small towns in the Heartland, where their kids can grow up hunting, fishing and hot-rodding the backroads. A guy with a gun rack in the back window of his four-wheel drive truck may occasionally vote Democrat, but he’s extremely unlikely to be an out-and-out liberal.
Now it’s true: What Mr. McCain is suggesting can’t help but remind one of what Cambodia’s Pol Pot did. But, and I want to be fair here, Pol Pot didn’t ask very politely when he encouraged all the city slicker intellectuals to move to the country. I’m sure Mr. McCain and friends would handle the relocation of the Jews from the Upper West Side to Wedowee, Alabama with tremendous finesse and circumspection. The real question is, how will the good citizens of Wedowee greet all them Jews, ‘specially when their kids start to date?
Oh, one more thing: the sane, reasonable, Newt Gingrich does not approve of relocating America’s Jews… At least I think he doesn’t. Sometimes, like when he called Sotomayor a racist and then he didn’t, he takes both sides of a controversy. And this is, no doubt, an important controversy.
We should be deeply concerned that our public discourse has become so degraded and the American right so consumed by paranoia and conspiracy theories that Newt Gingrich has released remarks (via Twitter) on the president’s school day speech that appear remarkably sane.
Maybe so, maybe Gingrich does “appear remarkably sane,” but it is vitally important to underscore dday’s earlier post: Newt Gingrich is a rightwing extremist with genuinely batshit ideas and no moral compass whatsoever.
Among the non-crazy reasons that the GOP pushed the delusional Obama’s-gonna-commify-Little-Johnny meme was to adjust the view through the famous Overton window, so we’d perceive thugs and nutjobs like Gingrich as fine, upright American citizens. You’d never guess that Gingrich, a world-class hypocrite actually is a classic sociopath who, in The Economist no less, accused the President of the United States of being “pro-terrorist-rights”. (To get his meaning, be sure to say that phrase “pro-terrorist-rights” with a huge pause between the last two words; that’s the way Phyllis Schafly used to call her opponents: “pro-abortion…rights”). And exactly like Glenn Beck – a fellow so deranged that to label him a “paranoid” would be like calling a stinking town dump a “transfer station” – Gingrich thinks Obama is creating an American “political dictatorship”.
As Connie Bruck said back in 1995, Gingrich is the consummate con artist. Make no mistake: he wants to be president. Badly. As Josh surely knows, his “reasonableness” is simply positioning for a run in ’12. Let’s never forget what this man is. If you think Bush was bad, you ain’t seen nothing ’til Newt’s in charge. And given how godawful all the other Republicans are, Gingrich has a chance at a nomination, especially if he can fool everyone into thinking him a sane man.