The tidetime folklorist wonders in this age of endless summiteering when the era of bipartisanship will end and the era of leadership will begin.
The Platter: Undecided by Django Reinhardt with Beryl Davis (the suits in the room or the voters we need?)
The Bait: The Gotcha Cedar Plug Daisy Chain (for two houses with abundant pox)
Next proposal: a federal regulator for insurance premiums!
And so it’s on to this week’s pointless health care summit, where we will again see:
Republicans will not propose anything of substance.
In today’s New York Times, 5 “conservative proposals” were:
1) pay providers based on “value”, whatever that means, rather than “fee for service”, which is what actually happens;
2) pay more money to those who provide better value, whatever that means and whoever they are;
3) cure more diseases and provide more health care so we don’t spend money on things we no longer need to, although we’ll be spending ever more money on doing these things until the cures arrive;
4) introduce more “regional” competition, although in most states the vast majority of insurance coverage comes from 2 or fewer providers, thus insurers will just have a greater incentive to cherry pick across state lines; and
5) limit malpractice awards, although the cost of malpractice in total amounts to a little more than 1% of total health care spending.
Republicans will not vote for any bill endorsed by the President or the Democratic majority in the Congress.
Neither party will consider a single payer system, bringing everyone into Medicare, or eliminating the link between health care and employment, or eliminating the anti-trust exemption for insurance companies, or eliminating the tax deductibility of employer-provided health care, all of which would drastically reduce health care spending and improve health care outcomes.
Americans will continue to pay 50% more annually for health care than any other nation on earth so as to achieve a life expectancy that’s less than that of Portugal (which spends less than a third as much as we do!).
Gorilla thinks: “The rhetoric is willing, but the leaders are weak!”
If some insurance premiums in California will rise by 25% or more, isn’t it about time for single payer?
No, it’s time for more endless bullshitting from our leaders in Washington, who are shocked, shocked to find that insurance companies engage in cherry picking the healthy and those who are less successful at it (only $2.7 billion in profits last quarter!) pass the costs of the sick onto (wait for it!) the sick!!!
Gorilla thinks: “Chronic leadership failure disease starts with anti-trust exemptions, develops more full blown as PAC donations increase, and continues along its merry way to bankrupting the country!”
Another day, another summit on an issue that no one wants to lead on!
Over the weekend, the G-7 boys and girls tried to reassure each other that the PIIGS of Europe aren’t going to be a problem.
Today, it’s President Obama, calling on Republican leaders to join him for yet another pointless summit on health care reform.
The facts are these:
1) Republicans will not vote for any Administration proposal on health care reform, or any other major issue, in 2010.
2) Democrats have not yet decided whether they will abandon health care reform, thus guaranteeing they will lose big time in 2010.
So, the President could say to House Democrats: Vote for the Senate bill and we’ll fix it later using reconciliation.
Or he could engage in a time wasting exercise in hopes that Americans will blame a minority opposition party for the failures of this President and his party to tackle major issues.
Gorilla says: “Good luck with that!”
Or it will by next year, as the government’s share of health care expenditures tops 50%!
So, why not proceed ahead with health care reform?
Or, even better, why not just bring the remaining 50% of health care costs into Medicare/Medicaid and cut these costs dramatically?
After all, the US spends more than anyone else on health care, but health care outcomes are certainly not as good as in socialized medicine countries like the UK, Spain, or (gasp!) Canada…
In fact, we spend nearly $3,000/year more per capita than the number two spender Switzerland, i.e. 67% more, and guess what? The Swiss live nearly 4 years longer!!!
Here’s the famous Ezra Klein graphic:
Gorilla says: “Single payer anyone?”
Which comes first, health care reform or reform of health care reform?
According to House Speaker Nancy Pelosi, the House won’t pass health care reform until the Senate passes a “sidecar” bill that reforms the already passed Senate version of the bill.
Presumably, the calculus is: you can only pass health care once, you can’t come back a few weeks later and amend it, so you have to get it right the first time.
Works great, assuming there are 51 votes in the Senate for whatever amendments you want.
Kills health care reform altogether if the votes aren’t there.
Either way, the Democrats will be blamed.
For that reason, it’s astonishing that the House doesn’t simply pass the Senate version of the bill and move on.
Health care will need lots of tweaking and reforming in the next 10 years.
It’s difficult to believe that Democrats will not vote for their central campaign issue in 2008, thus demonstrating conclusively that they cannot govern.
Gorilla thinks: “Why do these chickens always insist their eggs are square? They’re merely soft and yellow!”
Virginia once again leads the nation on a downward spiral!
This time it’s a bill in the Virginia Senate exempting Virginians from being required to buy health insurance should the current version of health care reform ever pass.
And of course, this bill really should be called “The Insurance Company Cherry Picking Subsidy Act”.
Without a mandate, insurance companies will either offload the sick to government or charge vastly higher premiums to the healthy. It’s a surefire formula for keeping health care costs rising forever.
What’s even more ridiculous is that Democrats made this possible: 5 Democratic senators joined with all the Know Nothings to pass the bill.
Of course, the bill’s an exercise in political pandering and has no chance of being made law.
But the message is clear: Democrats are not willing to lead on health care reform and they will be punished for it in November.
Gorilla says: “Insurance companies get the cherry, the rest of us get the pits!”
As Krugman notes, the choice for the House of Representatives on health care reform is very simple:
1) Pass the Senate bill as is, come back and fix it later.
2) Pass nothing, forget about passing anything in the forseeable future, and be punished in November.
The Senate bill is lousy in many respects, but it’s the only bill on offer.
Now that the Republicans have a veto-enabling minority in the Senate, there’s absolutely no chance they’ll back any legislation of any kind for the rest of Obama’s term.
So, if you’re a Congressperson, you can run away and hide, wait for a diffident President to decide to lead, or hold your nose and vote for the first step towards comprehensive, universal health care.
Go to the polls, and you’ll find that most Americans support universal health care and are willing to make the sacrifices necessary to see it happen.
Are House Democrats ready to join them?
Gorilla says: “They’re all a load of cobblers, but 218 may decide to stick their neck out and gobble up a surefire vote winner!”
It’s clear now that health care reform is finished.
The Democrats don’t have the votes in the House to pass the Senate version of the bill.
Absent a firm commitment to use reconciliation, the White House has effectively signalled that it’s giving up; starting over as they now suggest means more time wasting and more defeats at the polls in 2010.
It’s a shameful performance and a failure of leadership that guarantees President Obama will serve only one term.
And now that the Supreme Court has enabled America’s plutocracy to control the campaign finance process, the middle class can look forward to another 35 years of nothing.
Gorilla sums it up: “No hope, no change, all bullshit, it’s business and politics as usual!”
Well, the Democrats and their feckless cowardice now stand for?
Health care reform is dead in the water unless the House votes to accept entirely the Senate version of the bill.
And there’s no certainty that Pelosi has the votes. The Blue Dogs and other centrists may just abandon the whole thing, and the liberals are very angry that the House version of the bill is now dead.
Who’s to blame?
1) The President of the United States: As with the stimulus, he woefully underestimated both how badly the economy was doing and how uninterested the Republicans were in any kind of bipartisanship. The time to pass health care was in the first 100 days, the fact that he couldn’t get this done is a failure of leadership, nothing more and nothing less.
2) The Senate of the United States: Harry Reid is without question the worst majority leader of the past 50 years. He could have used reconciliation to get health care reform passed, which is exactly what the Republicans did with the Bush tax cuts and any other piece of legislation they really wanted. Instead, Reid turned it over to Max Baucus, who wasted 9 months trying to seduce Olympia Snowe.
3) The American people: They elect these clowns, and the clowns reflect the electorate very well. A pig ignorant society when it comes to basic economics is a society that’s easily gamed by plutocrats who know what they want and buy the Congress that will deliver the goods.
Gorilla says: “In a land of mythological denial, the one eyed middle man remains king!”
