Why we're celebrating the Supreme Court "Obamacare" Victory

It saves lives.

Who's really winning?

The Globe  had an article yesterday about the "ebbing clout" of labor, all the while business interests become increasingly more powerful. This is certainly a dangerous trend, particularly when labor was never as strong in this state (at least over the past few years) as the Globe likes to make out. While certainly labor is an interest, the only time it's really been able to flex its muscles in a 'special' kind of way is when its interests have lined up with Big Business. It's always been that way, and until We the People are working together to run things, it always will work that way.

The trend lines are certainly dangerous, but ever the more potent because business interests have become exceptionally talented in getting like-minded people to feud against themselves, instead of allowing those people to be focusing on Big Biz's creeping power base. When we have local progressive stalwarts like Charley-on-the-MTA sounding like the a Fox News liberal, then we know we've got a problem here.

Maybe the real problem here is that progressives just aren't the same kinds of people as members of the labor movement, and have no understanding for the struggles that movement has had to make to get where it is today. That much has always been obvious, but there was a lot of hope in the strategic alliances that formed between the progressive goo-goo types and labor in the 2006 and 2008 elections. Then again, maybe those alliances were only possible because there was a common enemy -- the GOP -- and now liberal interest groups are back to our usual bickering amongst each other. I hope not.

It's well past time anyone with even a single vertebrae of liberal-apologist spine take a calcium pill. This fight isn't for the weak and timid. We cannot sacrifice our friends in the labor movement because it's now suddenly convenient, and we cannot be so disrespectful and ignorant as to decide amongst our goo-goo liberal selves that, really, collective bargaining on health care rights isn't a big deal anyway, or worse, attempt to lash out at labor because they have something we don't. It's absurd and it's getting us no where -- and we don't have enough friends in this political fight for our lives as it is already.

Wisconsin, Here We Come? The Pledge, the Turn and the Prestige

With the Washington Post and other papers starting to pick up on the story, the Speaker's bash-the-teachers bill is finally catching national attention. The bill attempts to mask something almost universally detested -- ending collective bargaining -- under the guise of moving everyone on over to the GIC. The two issues, collective bargaining and the GIC, are not the same, and it's important for people to note that distinction.

The Globe drew on that distinction in its front-page story when news of the House's passage first broke, but unfortunately it was buried deep within. Here's the real meat-and-bones of the House bill -- or should I say hack saw?

Under the legislation, mayors and other local officials would be given unfettered authority to set copayments and deductibles for their employees, after the 30-day discussion period with unions. Only the share of premiums paid by employees would remain on the health care bargaining table.

Under the House bill, if your city or town wanted to create a $10,000 health care deductible for families, it could. And all unions could do is stamp their feet and complain bitterly for a few days. 

The key thing here is to ask why the Speaker & Co. want to move in this direction. It's not as if the unions aren't willing to do their part; they recognize the need for health care savings and have a proposal of their own, which would allow them to retain collective bargaining.

Unions proposed their own plan to cut health-care costs that did not hurt collective bargaining rights. “We’re willing to give the savings,” Haynes has said. “All we wanted was an arbitrator, some kind of neutral process that would determine what’s fair, and what was appropriate.”

Let's look at the details -- because it's good stuff, perhaps even better stuff than the House bill. It would save upwards of $120 million a year.

The union proposal would establish health care cost benchmarks that both municipalities and unions would have to meet at the end of the bargaining process. If an agreement can't be reached both sides would enter an expedited dispute-resolution process. 

While there has been a push to force municipal workers into the state's Group Insurance Commission to help rein in health spending, the union proposal would let municipalities and workers bargain either to enter the commission or make changes to existing health plans to lower costs as long as they meet the benchmark.

Only allowing the GIC (as opposed to giving the unions choice between collaboratives, the GIC or other ways of saving money), as the Speaker is trying to do, is a clear mistake -- and the motives are pretty obvious. But first, let's answer the question of why it's a mistake: There are other regional GIC-like entities and collaboratives in the state that consistently outperform the GIC, and there are cities and towns in Massachusetts that, for myriad reasons, don't want to be a part of the GIC -- some with Republican Mayors. 

Kennedy said she has been meeting with union leaders in the hopes of coming to an agreement on concessions that would put the brakes on a possible 8.5 percent increase and keep the city out of the state's healthcare program, the Group Insurance Commission. Kennedy said the unions do not want to join the GIC and neither does she. 

"I'm in the minority of Massachusetts mayors," she said. "I'm trying to stay out of the program."

If there are other options to save money, why not let unions and municipalities come to the table and bargain about how best to do it? This drives straight at the Speaker's motives. On what level does this make sense? While stripping collective bargaining rights on deductibles and co-pays is pure travesty, the Speaker's forced march on GIC, not giving unions and municipalities time enough to at least look at other options is, more than anything, illuminating.

Perhaps there's a much more logical explanation to all this? Right now, while state employees are in the GIC, the vast majority of municipal employees aren't -- and there are far more of the latter than there are the former. Why's that important? Well, the GIC can be changed, without union or employee consent, at the whim of the state.

Get everyone on the state's program, and suddenly you can change everyone's health insurance right from within the doors of Beacon Hill (and those doors are usually the closed ones). The state needs to ax a billion this year? Suddenly, if everyone's all-in, there's a very easy and rather convenient place to do it. The Speaker's bill could ultimately serve to be one of the biggest power grabs we've ever seen in this state, and could have disastrous longterm consequences for cities and towns and their employees. Moreover, if this isn't the real explanation, then it's pure spite -- because the House bill is neither the best nor the fairest solution to the problem.

[Update: The other motive I forgot to mention is this plan will be able to lock in the maximum savings on health care away from the actual employees -- so the savings goes to the state and towns, and isn't shared with employees trying to pay for their health care.]

It's looking more and more likely that while money may be the motivation to do something about municpal health insurance, it's not the real motivation for this particular bill. At the end of the day, the budget shortfall is the bait, and all we have left to do is wait and see if the Senate will allow the House's switch to stand. Or, maybe we can all take a step back and ask ourselves what the hell we're doing here.

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As a bonus, Christopher Nolan eloquently explained what's going on right now on Beacon Hilll years ago in The Prestige. 

Every great magic trick consists of three parts or acts. The first part is called "The Pledge". The magician shows you something ordinary: a deck of cards, a bird or a man. He shows you this object. Perhaps he asks you to inspect it to see if it is indeed real, unaltered, normal. But of course... it probably isn't. The second act is called "The Turn". The magician takes the ordinary something and makes it do something extraordinary. Now you're looking for the secret... but you won't find it, because of course you're not really looking. You don't really want to know. You want to be fooled. But you wouldn't clap yet. Because making something disappear isn't enough; you have to bring it back. That's why every magic trick has a third act, the hardest part, the part we call "The Prestige".

Holy Jeebus, Brown Okay with Dismantling Medicare?

More evidence that Scott Brown is out of touch with the Massachusetts voter.

House Budget Chairman Paul Ryan's plan to end Medicare and Medicaid as we know them might be slow to accrue supporters within his own party, but Sen. Scott Brown (R-MA), a key swing vote in the Senate, indicated to TPM on Tuesday he was at least open to the idea. 

"Listen, everything is on the table right now and the people understand everything is on the table," he said when asked by TPM if he had concerns about privatizing and cutting Medicare. "People recognize that we're in a financial emergency and as a result of that to say that something is not on the table is really irresponsible and I'm thankful that we have people like Congressman Ryan working and coming up with a plan."

I'm sorry, Senator, but the destruction of Medicare should not be on the table. The most ironic thing about this statement is the fact that Congressman Ryan's plan is essentially "Obamacare" for seniors, hypocrisy extreme for both Brown, who railed against Obama's health care bill, and the entire Republican Party (aka "The Party of No.").

Health Care in Massachusetts

If a tree falls in the woods, but nobody can hear it, does it make a sound? If people pay for health insurance, but they can't use it when they need it, are they really insured? That's the context we must look at Health Care Reform as a country and in Massachusetts, with our own 2006 effort.

The story about Massachusetts's 2006 Health Care Reform shouldn't be the 98% of our population that has health insurance. After all, health insurance is not health care and shouldn't be confused or treated as such. The story has to be how successful we are at truly expanding access to quality health care in this state -- how successful we've been at ensuring those of us who are in need of medical treatment can get good care at a rate they can reasonably afford.

On that end, we aren't nearly as successful -- 1 in 5 people in this state with insurance, as of 2009, didn't get treatment they thought they needed because they couldn't afford it. Outside of the population of kids and seniors, populations of this state that get extra federal help to afford coverage, that number jumps to a full 40% of the population. 

When allowable deductibles in this state are $2000 or $4000 for families, and co-pays can be so high that they'll eat half a paycheck for some people, such a statistic becomes very understandable -- if not excusable. These are people who already pay a hefty price for the plastic card that says they have health insurance, but they can't use it. In many cases, the premiums may be so high that it's the reason why they can't use it. Is it insurance if, when we're sick, we can't cash it in? People used to make Matt-Damon movies about these kind of frauds. 

Massachusetts does considerably better than most states in terms of the percent of the population who's insured, but there's little evidence we do much better in terms of making sure people can get care when they need it. We aren't the healthiest, we don't live longer and we don't have the lowest medical bankruptcy rates. While we may be better off with 2006's effort -- and the country may be better off with this past year's federal Health Care Reform -- we may not be as better off as we think. Health insurance reform that fails to make quality health care affordable to at least 20% of the population is less reform than it is a smokescreen. We have problems that no one seems to want to talk about, and meanwhile we're still patting ourselves on the back as if it's a job well done. 

Wow

It's amazing...

Candidate Obama's health care plan was pretty damn good.

Essentially . . we're going to set up a public plan that all persons and all women can access if they don't have health http://www.blogger.com/post-create.g?blogID=15133926insurance. It will be a plan that will provide all essential services, including reproductive services." (7/17/07)

Even more interesting (from the same link):

For starters, Obama's proposal would require that all children have coverage. He would expand the tax-funded children's health-insurance program to make sure that those unable to join private plans were covered. Although Obama would not require adults to have insurance, he would mandate that large businesses either provide coverage to their employees or pay into a new public plan through which anyone without coverage could buy it. Small-business owners would be exempt and would get a 50 percent health-care tax credit to help ease their cost of employee coverage. People without coverage could buy insurance through new public and private plans. Key to Obama's plan is creation of a National Health Insurance Exchange in which private insurers would offer coverage as generous as the government's plan, with new regulations requiring them to accept and not penalize anyone regardless of pre-existing conditions, Tanden said. [Columbus Dispatch, 9/23/08, via Lexis]

It's too bad President Obama decided to sell out and lie about all that transformational/courageous/stand up to the special interest crap.

Primary challenge, anyone?

Ben Nelson's Demand List

According to my super secret sources in Washington, D.C., these are the new additional demands Nelson's made after lying about his agreement to the medicare buy-in compromise.

• To reach a compromise with pro-choice senators, instead of allowing women to purchase insurance from the national exchange which would include abortion coverage, everyone gets a free coat hanger.
• MangerCare: In order to reach the goal of cutting costs from this country's health care system, instead of going to the hospital to deliver a baby, a network of mangers will be established across the country. If it was good enough for Jesus...
• Ban Lollipops at Doctors Offices. Given that those are expenses for medical offices which would increase the cost of health care, lollipops will now be banned at the doctor's office.
• Recycle, Reuse. Why throw out those dirty needles when they can be used again and again and again? It would be good for the environment, too.
  

This is the Bill Obama Wants

Lest anyone think the health care debacles of the past week or two were merely due to Senate centrists gone amuck, and the poor POTUS was just some innocent bystander, think again. This is the health care bill Barack Obama wanted all along.

Howard Dean 2012.

Obama has lost it

Thanking Joe Lieberman, when he held a gun to health insurance reform, but lashing out against Howard Dean -- who's only trying to help the American people and get the President to adhere to his promises? I'm done with Obama. If he loses reelection, I may not be all that sad.

Musings: Stupak, Star Trek and Hulu

• The thing about Stupak: If it's okay to discriminate against women for one medical choice, why shouldn't it be okay to discriminate against men for ED? Or come up with other stupid ideas like "no tax credits for fat people." There are thousands of ways we could legislate morality into health care. What ever happened to coming up with legislation that lets doctors and patients decide what treatments are necessary together?
• I hate the new Hulu trend where you have to wait up to a week for an episode to go up. I realize it's not profitable yet, but I don't think it will become so by trying to get fewer people to use it. Ads may not get them to the promised land yet, but will eventually -- and probably soon. When it comes to media, companies always take a hit when starting out. Even in the good times, it used to take any publication 5+ years to to turn a profit. Hulu will get there... if they don't drive away their users first. Hello, Amazon.com.
• One of my hobbies is gaming -- yes, I am a geek -- so I was very excited today that the devs of an upcoming game I'm really excited about, Star Trek Online, took one of my questions - and actually gave an answer I found satisfactory.
  

The Hypocrisy of Republicans

No group in America has fought against the "government take-over" of health care harder than Republicans. Though what they have to say has absolutely no merit, they spread the lie that this effort to reform the health insurance industry is nothing less than government deciding each and every individual's health care choices. Yes, what do Republicans decide to do in the new house health care bill? Allow government to decide what choices women will and won't have when it comes to their own personal health. This is nothing but hypocrisy.

People must stand up to the Senate and demand that their version of the health care bill does not include a provision banning a women's right to have an abortion - then demanding that any bill that goes through conference committee is free from such provisions, too. The House bill will ban the funding of the right to choose to any health insurance plan that accepts people who take any public subsidies. I ask readers: What health insurance company in Massachusetts doesn't accept any individuals who are subsidized? Doubtfully even one. The end result is millions of people who receive no health care subsidies at all will end up unable to afford their right to choose. Without that crucial ability to decide, they are not free and equal citizens of this country.

Health Insurance Reform: The Human Cost

Big Bad news today in the health insurance reform effort -- Joe Lieberman's threatening to be the one person in the Democratic Caucus to kill health care reform. As far as I'm concerned, I hold him complicit in the deaths of the 45,000 people in America who die every year for lack of quality, affordable health insurance.

Someone accused me over on Facebook of being too "emotional" about my argument. Damn straight. People forget the human cost. I have a second cousin, who I think more of as a niece, who's father died when she was around the age of 2. I remember that fateful day like it was yesterday. My mother and some of my family members, including my then-toddler cousin, were visiting the old Christmas house in Peabody -- a former local tourist destination in the holiday season.

I can't remember exactly how, but word came in that my much-older cousin's husband died, while we were walking back to the car. I think an aunt may have come to meet us there, to tell my aunt who was the mother of the at-that-point widow. He had died for something that would have been easily found if he had been given a test he had requested, but his insurance company denied.

It was a very tough period for the entire family. My older cousin was not the same for a very long time. My second cousin/niece had to grow up without a father. My older cousin took the insurance company to court, but it was fought and fought for so long, that my cousin couldn't take it anymore, so she just dropped it, to move on with her life.

On the other hand, my older brother, who had insurance through my dad, a teacher with a strong union, suffered through a heart valve transplant after battling strep in his heart for the better part of a year. It was in the early 90s, when the surgery he had was exceptionally expiramental. A lot of insurance companies at the time never would have covered it, but my dad had exceptional coverage.

Most people aren't in that situation, especially in this day in age, after decades of serious cost increases and benefit cuts. However, we easily have the resources to have affordable, universal coverage for every person in America. We spend 5% more of our GDP per capita than any other country in the world for our health care, yet have results for that great expense that are middling at best. There is absolutely no reason why we can't cover everyone with quality care and do so at a smaller cost, but that's not going to happen with the private insurance industry we have now.

The public option is key to getting there over the long haul -- and we should be arguing passionately for it, as well as other key aspects to insurance reform, with the exact furor we've felt when we lost a loved one who should have lived, if not for their lousy insurance, or the total lack of it; We must hold those who vote against a public option and health reform accountable, for they are then complicit in those 45,000 needless and inhumane deaths that happen every year.

The Public Option Will Save You Money and the Government

There's tons of focus on government costs associated with the health care bill. However, lost in the argument is cost to individuals, which is probably the more relevant question to most Americans. There's good news on both fronts: According to the nonpartisan Congressional Budget Office, the Public Option will save you 10% over private options and the government $110 billion over 10 years (more than 10% of the likely cost).

However, there's also bad news: If Congress passes the watered-down public option, it only saves $25 billion for the government and nothing for you. In fact, it very likely will cost you more -- up to $1,000 a year more. To make up that $85 million in lost savings, the government would likely be forced to reduce subsidies for those who would need help affording coverage -- a figure that would average out to $1,000 more per person, especially for those who are at the margins of being subsidized.

The Case for the Insurance Industry

Link.

Would You Shop Here?

I've been thinking of creating a website to sell airline tickets at reduced prices. We're going to call it Club Ryan. I'll sell tickets to LA for $150 round trip, tickets to Florida for $100 round trip and tickets to NYC for $50 round trip. These are amazing prices, right?

To fuel my profit margin, though, I'm going to have to adopt certain business practices. For example, I'm not going to send any tickets to people who change address, phone number or credit card information between when the purchase has been made and flight takes place. In addition, I won't advertise how many stops certain trips will make. Anyone who wants to get to LA will first have to stop in NY, then stop in DC, then stop in Orlando, then in Houston, then Las Vegas, upon which they'll have a quick flight to LA. Each stop will only have roughly 10 minutes between flight, so it won't be so bad, right? Of course, anyone who misses a flight along the way will have a prexisting condition and will have to pay through pocket to finish the trip.

Additionally, anyone who uses the service too much will reach their lifetime limit. We'll keep close watch over those who purchase tickets -- those who've been known to miss a lot of flights will almost always get their tickets. Those who buy coach tickets will only get their tickets half the time. Anyone who buys first class will probably get their tickets, but those tickets will cost a pretty premium, and they'll probably only get coach anyway.

This is a great business model that will provide a cheap flights to a lot of people. Anyone want to join my ticket club?

Talked to Senator Kerry's Office on Health Care

Just called Senator Kerry's office, describing myself as a constituent and blogger. I was shipped between three different people, but I got some answers. I was particularly concerned after reading this article, which I found over at Americablog, in which Senator Kerry says he "would not throw the baby out with the bathwater," should he not think the public option could pass.

I came to ask three basic questions. Christopher Benner, an aide, said he has absolutely "no comment" on Max Baucus's 'strategy' to get health insurance reform passed -- ignoring our large majority and instead focusing on three republicans and three democrats. Then I asked about the public option, to which Benner said Senator Kerry "absolutely" supports the public option. I followed that up, alluding to the Reuters article, asking whether Senator Kerry would support getting rid of the public option if he thought that was the only way it could pass. Benner dodged the question and re-quoted his (I think) prepared statement that Senator Kerry supports the public option.

I ended my questions asking if Senator Kerry would support Kennedy and Dodd's HELP bill, to which Kerry's aide said he does. That was the bright spot of the interview. I said I was finished with my questions, at which point Benner wanted to forward me to another aide, Megan Thompson, who I think is Kerry's head health care aide (though not sure on that). I got Thompson's voicemail, but didn't really have any further questions, so I didn't leave a message.

Mass Stands to Gain Most from Health Insurance Reform?

With the most expensive health insurance premiums in the country, despite the fact we're the only state that forces (nearly) everyone into 'the pool,' it certainly looks plausible. Given the revolutionary choice -- and competition -- public insurance would provide, it's going to drive the cost of insurance down, even for those who don't sign up. Well, that's assuming a robust, strong plan.

Have you called your congressperson yet?
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In other health-care related news, the Globe needs to seriously rethink this sentence from Saturday's health care editorial.

If all states had an insurance market like Massachusetts’, no one would be talking about including a public plan in national legislation.

Perhaps the Globe editorial board needs to reread its own pages, again. None of the Partners stuff would be possible without a complicit Blue Cross, Blue Shield. Heck, the very same day this is printed, the Globe's headline was about how Massachusetts's premiums are the highest in the country. We are not a model for this country in anyway other than access -- and without serious cost reform, there's only so much longer we'll even be able to keep our other reforms up.

More than 75% of people support public option

Great news. Here's the Q.

Question: In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance--extremely important, quite important, not that important, or not at all important?

Extremely important....58%
Quite important........19%
Not that important..... 7%
Not at all important...15%
Not sure............... 1%

So, 79% think the choice of having a public option is either "extremely important" or "quite important." That's gotta be everyone but the birthers, deathers, teabaggers and LaRoushians, right?

Obama's "Nazi" Health Care Plan

Seriously, that's the shit a very, very small & crazy minority are peddling on the streets. Some goofy, off-balanced prick asked me if I wanted to know more about Obama's "Nazi" health care plan when I was walking into one of the state house office buildings today to file some paperwork. I wanted to ask if he was "fucking stupid," but I figured I should just ignore him. I'm 99% sure he was a LeRoushian nutjob. Those people make the birthers and teabaggers look sane.

Tangently related, I'm going to let Rachel Maddow's words echo here in regards to the teabaggers at Town Halls acting like freaking lunatics because corporate Republicans know how to push all their buttons in pure astroturf politics.

Curious Choice by Globe

The President had a prime-time speech on health care, perhaps the most important issue facing this country, and that gets second billing to the President's relatively brief comments at the presser about the Gates situation in Cambridge. If you just looked at the Globe's front-page briefly today, you'd think the press conference was about "Gatesgate" (and they can't even manage to get that story right, making the same mistake Maddow did the night before).

Question for the Globe: Were these three minutes and thirty three seconds really more important than the rest of the entire press conference or the issue of health care? No doubt, there's a local interest to the Gates story. However, contrary to whatever the gatekeeper editors at the Globe think, there's an even bigger local interest in health care.

What kind of a local interest? We're getting new windows put in my house today. The window guy just lost his home recently, one that he built himself. Why? He got sick. It put him out of work for a while. There were also fewer jobs. Deductibles and co-pays added up. He had health insurance and still went bankrupt. Now he's better -- and lost his home. There's literally hundreds or thousands of people like him in Massachusetts today, just in the past few years, due to our country's sorry state in health care and economy. The Globe chose not to cover that kind of local interest.

David, along with others, almost blames Obama for this hiccup. Obama chose to answer the Gates question. He could have - and probably should have - skipped the question, since it didn't reinforce the night's health care message. However, the Globe (and other media outlets) have decided to play race over health care. They've decided to ignore the more important story over the sensational one -- that will no doubt be well handled by Gates and Harvard Law. It was the media's choice to pounce on that 3 minutes and 33 seconds, not Obama's.

If and when the Globe goes under, it's going to go because it became a newspaper of the high-end condos and retailers - and not of the middle-class workers who struggle every day. While the Globe publishes stories that belittle second-hand stores in JP, they ignore the thousands of people who are crying out for major reforms in health care -- and the President who's actually working on their behalf. Sadly, the Globe's forgotten who their readers are -- which, in the newspaper biz, is worse than being obsolete. The dead trees could live on if what was printed on them actually interested readers.