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Death of a Public Plan? Or: The Problem With the Revenge-Against-the-Morons Strategy
There's still a chance that health reform could pass with a public plan. But, despite the muffled squeaks of "I'm not dead yet!", the liberal commentariat seems ready to toss their beloved government-run insurance plan onto the death wagon with the rest of the corpses that have succumbed to the plague of politics.
In Salon, Thomas Schaller asks "what went wrong?" and suggests that, horror of horrors, Obama might have negotiated the public option away because of politics. Paul Krugman is claiming that the public option was killed by Washington's zombie Reaganism (which I desperately hope to someday find as a plot element in a Michael Moore/George Romero crossover film). Matt Yglesias says that criticisms of the reformers' strategy miss the point, which is that lots of liberal presidents have tried and failed before, and thus what we really need to understand is that health-care reform, like the final round in Guitar Hero, is just really stinkin' hard.
Yglesias lays part of the blame on the Senate, which seems like the sort of "problem" that's not likely to be fixed any time soon. But he's right about the fundamental difficulty of these sorts of reforms. And if liberals want to take from all this the lesson that, for liberal presidents, attempting health-care reform is like doing the drink-a-gallon-of-milk-in-an-hour challenge—endlessly tempting, but equally guaranteed to end in a mess—that's fine by me. But I think it's more likely that the view expressed in the Guardian by Michael Tomasky will prevail: Sure, major reforms are hard, but that just means that progressives need to fight harder, even if swallowing a public-planless bill ends up less savory than three-day-old Taco Bell:
A health bill will likely have a very weak public option or it won't have one at all. But liberals will have to battle for that bill as if it's life and death (which in fact it will be for thousands of Americans), because its defeat would constitute a historic victory for the birthers and the gun-toters and the Hitler analogists.
So we've moved from the moral case to the fiscal case to the "the-other-side-is-made-up-of-crazed-and-despicable-idiots" case. Republicans don't deserve any sympathy for their numerous distortions, exaggerations, and forays into hysterical nonsense. But Tomasky's revenge-against-the-morons strategy seems like an awfully convenient way of both avoiding addressing the substantive problems with liberal reform and ignoring the significant role moderate Democrats have played in making reform difficult. And it reveals, I think, a bigger—and ongoing—problem for a lot of diehard liberal activists currently seeking reform: As satisfying as rallying against the other side's lunacy might be to the left's feisty base, it's not much of an outreach strategy.
Read Reason's health-care archive here.
|8.24.09 @ 12:49PM|#
because its defeat would constitute a historic victory for
the birthers and the gun-toters and the Hitler
analogists.
Mmmmm, I love the smell of hyperbole in the morning.
|8.24.09 @ 12:52PM|#
They should've tried to get it passed before the trillion dollar giveaways to the banking elite.
|8.24.09 @ 12:53PM|#
"Republicans don't deserve any sympathy for their numerous
distortions, exaggerations, and forays into hysterical
nonsense."
Really? What would those be? Oh yes death panels. Is it your
position that one facebook post by a former governor who you no
doubt think is insane killed the public option?
What else? Pointing out that you can't cover 47 million uninsured
people and cut costs without cutting care to someone who is getting
it now? Pointing that the government can't run the DMV yet they are
supposed to run healthcare? Pointing out that a public option with
the ability to print its own money would run private insurance out
of business? Pointing out the Obama was an ardent advocate for a
single payer system for his entire career? What?
Suderman has become the new Weigel. Any post where he has to admit
fault among the Democrats must be accompanied by a sentence or
clause mentioning that Republicans are worse.
|8.24.09 @ 12:55PM|#
"But Tomasky's revenge-against-the-morons strategy seems like an
awfully convenient way of both avoiding addressing the substantive
problems with liberal reform and ignoring the significant role
moderate Democrats have played in making reform difficult."
So is anyone who objects to the plan besides the moderate
Democrats, a birther and a gun toating hate monger? Suderman you
really never respond to the slam. It is like you agree with it and
think that anyone who is not a Democrat is a birther and a
moron.
|8.24.09 @ 12:59PM|#
"As satisfying as rallying against the other side's lunacy might
be to the left's feisty base, it's not much of an outreach
strategy."
And we all know the other side are just lunatics right? No one
could ever have a principled objection to Obamacare. We are all
just a bunch of gun clinging birthers.
Joe M|8.24.09 @ 1:04PM|#
John, you're being way too defensive. I don't think Peter is saying all Republicans are loonies, and he's not saying they're worse than Democrats. I think he's saying focusing on the more embarrassing elements of right wing opposition and ignoring intra-party difficulties isn't going to accomplish much.
Elemenope|8.24.09 @ 1:05PM|#
Any post where he has to admit fault among the Democrats
must be accompanied by a sentence or clause mentioning that
Republicans are worse.
It helps a lot that they are.
Joe M|8.24.09 @ 1:06PM|#
And that's a good thing, by the way. Not getting anything done is about the best we can hope for these days.
|8.24.09 @ 1:08PM|#
"It helps a lot that they are."
Becuase GW Bush had trillion dollar deficits and plans to take over
the healthcare system.
|8.24.09 @ 1:09PM|#
Republicans don't deserve any sympathy for their numerous distortions, exaggerations, and forays into hysterical nonsense.
I think that the post would be better if this part, like the rest,
had links, no?
Some of the "distortions" appear to be more of less correct; some
of them are quite difficult to determine, like, say, abortion
or the related illegal immigrant issue.
In both, amendments to prevent public money being used have been
rejected along party lines. At the same time, most bills don't
mandate full coverage of abortion or of illegal immigrants, but
leave that decision up to HHS. (And, of course, to judges.) It's
entirely reasonable to think that abortion and/or illegal
immigrants might end up being covered in actual application, just
as it's reasonable to suspect that drug price controls would
eventually happen even if not in the bill initially thanks to
PhRMA's deal.
There are, of course, lunatics on both sides, and the side out of
power tends to have more visible lunatics, all things being equal.
And, as always, actual elected officials are less loony than
activists. Yet somehow Rep. Paul Ryan's
reasonable criticism gets ignored.
One lesson, of course, is that yelling and screaming
works, on all sides. Sensible measured criticism
doesn't.
|8.24.09 @ 1:09PM|#
"John, you're being way too defensive. I don't think Peter is
saying all Republicans are loonies, and he's not saying they're
worse than Democrats. I think he's saying focusing on the more
embarrassing elements of right wing opposition and ignoring
intra-party difficulties isn't going to accomplish much."
We will see if Peter comments. But it doesn't appear that way to
me.
|8.24.09 @ 1:10PM|#
Pointing that the government can't run the DMV yet they are
supposed to run healthcare?
Then why do we trust them with a nuclear arsenal?
|8.24.09 @ 1:11PM|#
I'm I the only one thinking maybe a Rovian 50%+1 strategy isn't such a bad thing after all? A smaller majority is much easier to control, it would seem.
|8.24.09 @ 1:14PM|#
Johns,
Some distortions off the top of my head, death panel, the death
book, covering illegal immigrants and fears that government will
run Medicare*. And that's off the top of my head as an Obamacare
opponent.
* As opposed to the current, unicorn run Medicare.
|8.24.09 @ 1:15PM|#
"Pointing that the government can't run the DMV yet they are
supposed to run healthcare?
Then why do we trust them with a nuclear arsenal?"
Bacuse that is a lot easier and a completely different sort of task
than providing healthcare.
|8.24.09 @ 1:16PM|#
Peter, what if you, as you seem to do, find substantive problems with the chosen liberal reform, but you can only get a small minority of people to agree with your objections? Would you prefer that it pass, or would you prefer, e.g,. alliances with pro-lifers, anti-immigrant forces, and seniors who don't want their Medicare subsidy cut in order to stop it?
|8.24.09 @ 1:17PM|#
Suderman you really never respond to the slam. It is like
you agree with it and think that anyone who is not a Democrat is a
birther and a moron.
John, he never said that you were a birther.
PC|8.24.09 @ 1:19PM|#
"Then why do we trust them with a nuclear arsenal?"
Because reducing costs really isn't a priority, that and the
Constitution.
|8.24.09 @ 1:19PM|#
They're both talking about a $10-billion provision tucked deep inside thousands of pages of health care overhaul bills that could help the UAW's retiree health-care plan and other union-backed plans.
It would see the government -- at least temporarily -- pay 80 cents on the dollar to corporate and union insurance plans for claims between $15,000 and $90,000 for retirees age 55 to 64.
...
"It is not enough money," said former U.S. Rep. David Bonior, a Mt. Clemens Democrat who chairs the board at Washington, D.C.-based American Rights at Work, a labor advocacy group. "That will have to be supplemented to fill the gap."
|8.24.09 @ 1:20PM|#
Some distortions off the top of my head, death panel, the death book, covering illegal immigrants and fears that government will run Medicare*. And that's off the top of my head as an Obamacare opponent.
The illegal immigrants one is not exactly a distortion. It's a
distortion to say that the bill right now covers illegal
immigrants, but it's entirely reasonable to expect that unless the
bill specifically has measures to prevent it from covering illegal
immigrants, that illegal immigrants will be covered. Especially
when some people (like Yglesias) admit that they'd prefer illegal
immigrants be covered.
If that's a distortion, then the libertarian complaining that a
subsidized public option will lead to single-payer is also a
distortion, for exactly the same reasons. Indeed, supporters of
Obamacare make exactly that claim.
The "death panel" and "death book" are intemperate terms and
exaggerations of things with a kernel of fact. Nasty tactics, but
nothing new from either side (or from libertarians, for that
matter.)
A statement of "keep the government's hands off my Medicare" from a
senior sounds dumb, but their concerns that the reform will alter
their Medicare for the worse, making them pay for expanding
coverage to others are entirely justified.
PC|8.24.09 @ 1:20PM|#
"I thought living Reagan was Zombie Reagan."
It's hard to tell. Alzheimers Reagan muddies up the waters.
|8.24.09 @ 1:21PM|#
(Re: illegal immigrants, especially when amendments to that effect are continually rejected on party-line votes.)
|8.24.09 @ 1:21PM|#
"Some distortions off the top of my head, death panel, the death
book, covering illegal immigrants and fears that government will
run Medicare*. And that's off the top of my head as an Obamacare
opponent."
I don't think the death panel was a distortion. Obama himself said
that 80% of medical costs were for end of life care and that
"people were going to have to stop taking treatments that didn't
make them better." You combine that with Dr. Emmanual's writings
about evaluating care based on life years and life quality and the
reality of the claims of cutting costs while expanding coverage, it
there is a pretty good circumstantial case that they are going to
have to have some kind of death panel. It is not an unreasonable
argument. And it is an argument that deserves a better response
than the ad hominim attacks it has gotten.
Second, I don't think it is an unreasonable fear that once you have
a public option, liberals will want to cover illegals. It may not
be in the plan right now, but it is a pretty good bet a lot of
liberals would like it to be and that it could very well end up
there eventually. In the end, the only response to the charge is
"trust us we would never do that". Sorry I don't find that very
convincing.
I am not sure what you mean by "the government will run Medicare".
I think people were afraid that the government will no longer
support medicare in the same way and provide the same dumbed down
crappy service to everyone.
|8.24.09 @ 1:22PM|#
Bacuse that is a lot easier and a completely different sort
of task than providing healthcare.
Managing a $650 billion/year military in over 100 countries, with
over 1.5 million personnel and crazy amounts of equipment is easier
than providing health care? Are you on crack?
BTW, I think the military is a huge waste of taxpayer money and is
inefficient to boot, but easy to run is not how I would describe
it.
Elemenope|8.24.09 @ 1:22PM|#
You have to admit Zombie Reagan is a lot cooler than living
Reagan was.
Way totally cooler.
|8.24.09 @ 1:24PM|#
"Managing a $650 billion/year military in over 100 countries,
with over 1.5 million personnel and crazy amounts of equipment is
easier than providing health care? Are you on crack?"
As opposed to managing the healthcare of 300 million people? Are
you on crack? Also, the military has the luxury of throwing anyone
wearing a uniform in jail if they don't do what they are told. That
makes a huge difference.
|8.24.09 @ 1:24PM|#
As far as distortions go, one of the ones that as a mathematician annoys me the most is President Obama repeatedly claiming that a $800 billion dollar bill over ten years would be $80 billion a year. That's extremely misleading and distorts the long-term picture; all the bills before Congress spend nothing in the first three or four years and them ramp up to full effect by year six. It ends up being $202B in the tenth year, not $80B or $100B.
|8.24.09 @ 1:26PM|#
Managing a $650 billion/year military in over 100 countries,
with over 1.5 million personnel and crazy amounts of equipment is
easier than providing health care?
It certainly calls for totally different skill sets.
|8.24.09 @ 1:26PM|#
Also, the military has the luxury of throwing anyone wearing
a uniform in jail if they don't do what they are told.
Umm, and the government doesn't?
|8.24.09 @ 1:29PM|#
"Umm, and the government doesn't?"
As it currently stands no. There is something called the SIEU that
keeps that from happening.
Anonymous|8.24.09 @ 1:29PM|#
Then why do we trust them with a nuclear arsenal?
To their credit they mostly take that seriously, and they know it's
their own asses that will be burned off (if they can't get to the
bunker in time) if something goes really bad.
But personally, I still don't. If I had my way, I'd split them
between Ron Paul and Zombie Reagan.
|8.24.09 @ 1:29PM|#
I have a difficult time distinguishing these slippery
slope public
option means inevitable single-payer health care articles from
the claims about illegal immigrants or abortion made by the actual
organizations
involved.
True, people who only half-comprehend arguments get misled and
aren't coherent in protests, but that's equally true of the public
option leading the a single health care plan or Megan McArdle's
argument about inevitable price controls and innovation.
|8.24.09 @ 1:31PM|#
Also, the military has the luxury of throwing anyone wearing a uniform in jail if they don't do what they are told.
Umm, and the government doesn't?
They can throw the ruled in jail, sure. They can't throw the
"public servants" themselves in jail; well, unless they have
security clearances or are one of those nasty contractors.
Rich|8.24.09 @ 1:37PM|#
As far as distortions go, one of the ones that as a
mathematician annoys me the most is President Obama repeatedly
claiming that a $800 billion dollar bill over ten years would be
$80 billion a year.
John, I agree with you. But FTL: "Each billion matters." That's the
distortion/kicker -- as far as these guys are concerned, each
billion does *not* matter.
creech|8.24.09 @ 1:39PM|#
I like Daniel Henninger's views in the WSJ (Thursday). He believes, with reason, that the American people (or most of them anyway) no longer trust the government or politicians. The people see Cal. and NY "the two most economically important and famous of the 50 states" with incompetent legislatures. They saw the housing bubble burst. They see Medicaid "wrecking state budgets," Medicare going broke in eight years and Social Security "flatlining" soon after. Then the Obamessiah writes, in the NYT, "We'll cut hundreds of billions in waste and inefficiency in federal health programs like Medicare and Medicaid." Say Henninger: "Hundreds of billions? Just like that? This is nothing but an assertion by one man. It's close to Peter Pan telling the children that thinking lovely thoughts will make them fly."
Peter Suderman|8.24.09 @ 1:40PM|#
John,
I'd invite you to search my archives. I've been consistently been
skeptical of reform, and I've written far more about the left than
the right, and spent far more time criticizing liberals and
Democrats than Republicans (because the left is where the important
players are).
Still, a short list of Republican distortions:
-The death panels, most obviously: The provision in question just
isn't a "death panel." It's a voluntary doctor consultation. IMAC
might be closer, and I wonder why it hasn't attracted more
criticism. But the phrase is still totally over-the-top.
-Republicans have consistently gotten the numbers wrong --
confusing cost, debt, and deficit, talking about the costs of a
public plan before there was any cost attached to it, etc.
-The Nazi talk. Yes, a lot of it comes from La Rouchies. But not
all of it.
-The talk of a "government takeover" of medicine. It would mean
giving the government more control than the roughly 50% stake it
currently has in our medical system, but a menacing overthrow isn't
what's being proposed. Again, some of the Republican rhetoric is
needlessly hysterical and over the top.
But as I've written before, I think Republicans are mostly botching
their opposition efforts, and reform is flailing because of liberal
infighting and because of systemic issues with the political
process that are bound to infuriate those on the left who think
that Obama ought to be able to just wish away opposition and
dissent.
|8.24.09 @ 1:45PM|#
So Thacker, you are essentially saying that the first year is
base spending (nothing) and adding more money each year to a sum
total of "800 billion dollars" for that ten year period?
So why the incremental spending, unless someone is expecting the
the other shoe to drop during that first three or four years, like
Medicare/Caid/SocSec reaching insolvency?
Assuming this Akira-sized mutation of the current system is voted
in before 2010, those three or four years would be the time I would
least like to be a senior or an invalid/total care patient.
|8.24.09 @ 1:48PM|#
In theory, the Obama plan to have a public option compete against private insurers seems no different to me than having the social security system compete against an opt out program like the one Chile started in the 1980s. By all accounts, the vast majority of Chileans opted out of government social security in favor of the private plans. Why would this be any different under the Obama health care plan? Shouldn't we expect that most people would still go for the private options (after some initial flurry of interest in the government plan)? And over time, if free market theory is correct, private health plans would gradually attract more and more people away from the public option.
|8.24.09 @ 1:49PM|#
"-The death panels, most obviously: The provision in question
just isn't a "death panel." It's a voluntary doctor
consultation."
Peter considered within the context of the program being run by the
government with all of its coercive power and the actual statements
of Obama and his chief healthcare policy advisor, your statement is
laughable. Truly laughable if not Orwellian.
"Republicans have consistently gotten the numbers wrong --
confusing cost, debt, and deficit, talking about the costs of a
public plan before there was any cost attached to it, etc."
Considering that no government program has ever come in on budget,
I would say everyone has gotten the numbers wrong. Further, the
inflated numbers are much more likely, considering history, to be
true.
"The Nazi talk. Yes, a lot of it comes from La Rouchies. But not
all of it."
Links? Exapmles?
"The talk of a "government takeover" of medicine. It would mean
giving the government more control than the roughly 50% stake it
currently has in our medical system, but a menacing overthrow isn't
what's being proposed. Again, some of the Republican rhetoric is
needlessly hysterical and over the top. "
Bullshit. That is exactly what the President's stated goal was
right up until he started to be held accountable for it.
Additionally, when you have a public option that is backed by the
government's ability to tax and coerce combined with the creation
of an incentive for businesses to dump people on the public plan,
it is a pretty rational assumption that the public option will end
up becoming a complete takeover. Further, between Medicare and the
public option, the government would become a monopsony able to
effectively control healthcare the way Texas and California control
high school textbook production.
Why can't you just admit the Dems have a horrible plan that is
going to cost a fortune and is designed to produce a single payer
system?
Mad Max|8.24.09 @ 1:53PM|#
from the Website of Compassion & Choices (formerly known as the
Hemlock Society), a pro-euthanasia organization:
'As Congress debates health insurance reform, Compassion &
Choices is leading the charge to make end-of-life choice a
centerpiece of any program that emerges.
'We are working hard to reach our goal to make end-of-life choice a
centerpiece of national health insurance reform. The technical term
for our goal is "Physician Order for Life Sustaining Treatment"
(POLST). In practical terms, it's a new requirement for Medicare to
provide coverage for the "conversation" - the dialog between doctor
and patient about a patient's wishes and options for end-of-life
treatment.
'POLST is one way to get these conversations started. POLST forms
allow patients to document with their physician their end-of-life
treatment wishes. A decade of research has demonstrated that orders
for life-sustaining treatment effectively convey treatment
preferences and guide medical personnel to provide or withhold
interventions. These orders contain the individual's treatment
decisions, signed by a physician, and follow the patient through
all end-of-life health care settings. Without these medical orders,
emergency medical personnel may be required to provide treatments
that aren't consistent with the individual's preferences.
'Right now, Medicare does not cover this pivotal conversation. As a
result, most doctors don't suggest it. And most elderly patients
don't get the opportunity to talk about their questions, values and
decisions about the kind of care they want at life's end.
'Winning Medicare coverage to fund the discussion will be
transformational. It will lay the groundwork for coverage in the
other plans that will be part of health care reform, secure a
valuable right for every American, and keep millions of people from
being trapped in agonizing and futile medical interventions in
their final weeks of life.
'HR 1898, the Life Sustaining Treatment Preferences Act of 2009,
introduced by Congressman Earl Blumenauer (D-OR) and Charles
Boustany (R-LA), would provide coverage under the Medicare Program
for consultations regarding POLST.
'. . . HR 1898 will lay the groundwork so all seriously ill
Americans have the tools to make informed medical care decisions.
The bill will also help patients convey their care plans as clearly
as possible and feel confident their wishes will be known and
respected by health care personnel. These tools will help the dying
choose between acute care and hospice care, avoid unwanted medical
interventions and do a much better job of explaining why and when
to choose hospice care.'
Fawning Betty|8.24.09 @ 1:56PM|#
" (which I desperately hope to someday find as a plot element in
a Michael Moore/George Romero crossover film)."
You are so cool!
Fawning Betty|8.24.09 @ 1:58PM|#
"Suderman has become the new Weigel."
No, Weigel-Lite. At least Weigel had a good education.
|8.24.09 @ 1:59PM|#
"Right now, Medicare does not cover this pivotal conversation.
As a result, most doctors don't suggest it. And most elderly
patients don't get the opportunity to talk about their questions,
values and decisions about the kind of care they want at life's
end."
That is just complete horseshit. Everyone who has ever lost a close
relative knows very well the conversation about DNRs. Why do you
need to go to a pannel of experts when you have one with your
doctor? I can see no other reason than the government wanting to
pressure people into ending their lives earlier.
kinnath|8.24.09 @ 2:03PM|#
The comments over at Salon last weekend have been really sweet. The "liberals" are already starting to talk about throwing Obama under a bus in 2012.
Mad Max|8.24.09 @ 2:03PM|#
John,
I think you have managed to see into the Hemlock Society mentality.
Not particularly pleasant, is it?
Alabam Getaway.|8.24.09 @ 2:04PM|#
"Some of the "distortions" appear to be more of less correct;
some of them are quite difficult to determine, like, say, abortion
or the related illegal immigrant issue."
Here's what I find funny. The Administration has said that illegal
immigrants WILL NOT BE covered by the healthcare bill. So my
question is, what will happen to them then? Will I be seeing them
coughing up blood in the streets on my way into work?
It's all just lies.
(discosure: I'm fine with covering illegal imigrants)
Alabam Getaway.|8.24.09 @ 2:05PM|#
"Then why do we trust them with a nuclear arsenal?"
Just try taking it away...
|8.24.09 @ 2:05PM|#
Consider the "public choice option" as analogous to Amtrak; what
private operator is going to try to offer a passenger rail service
which directly competes with Amtrak? Amtrak, because of their
ability to get the Congress to make up their operating losses, can
set prices at a level which will prevent anybody from making money;
it could conceivably be possible to compete on quality, but it
would be extremely difficult.
If the public "competitor" doesn't have to worry about covering
claims with their own money, who will be able to compete with them
over the long term?
|8.24.09 @ 2:07PM|#
The "liberals" are already starting to talk about throwing
Obama under a bus in 2012.
Waters/Waxman 2012!
Wheee!
Alabama Getaway.|8.24.09 @ 2:09PM|#
"Managing a $650 billion/year military in over 100 countries,
with over 1.5 million personnel and crazy amounts of equipment is
easier than providing health care? Are you on crack?"
Heathcare - $1T
Patients - 300 million
|8.24.09 @ 2:09PM|#
P Brooks,
No kidding. But according to Sudderman, there is no public takeover
being proposed and anyone who says otherwise is a birther or a nut.
People are not stupid. They can see the second order effects of the
public option and revolted against it.
Surely Suderman sees it to. That means he either wants single
payer, in which case I can't see how he can call himself a
Libertarian, or he is so hung up on how much he can't stand the
people who also see through the Obama plan, he is willing to deny
the obvious to avoid having to admit they are right.
|8.24.09 @ 2:09PM|#
P Brooks,
Didn't Northern Pacific, which competed against the other lines
(government funded), actually do better than the government rail
lines and services?
|8.24.09 @ 2:09PM|#
Malto Dextrin | August 24, 2009, 12:52pm | #
They should've tried to get it passed before the trillion dollar
giveaways to the banking elite.
Bingo!!
or considering the reccession they should have simply run the
county well for a couple of years then done the reforms. Now it
looks like they will lose seats in congress.
Crazed Gun Nut|8.24.09 @ 2:18PM|#
Woohoo!!! Think I'll go to the range tonight and let loose a few mags in opposition to the pubic option.
Mad Max|8.24.09 @ 2:18PM|#
'Some of the "distortions" appear to be more of less correct;
some of them are quite difficult to determine, like, say, abortion
. . .'
Difficult to determine? When the administration isn't even *trying*
to deny that the bill will cover abortion?
the White House's
(taxpayer financed) Web page dedicated to refuting supposed
right-wing falsehoods about the health-care proposal does not
(as of 2:17 PM August 27) even bother to refute the claim that the
proposal would cover abortions. (This omission has been duly noted by
pro-lifers).
Alabama Getaway.|8.24.09 @ 2:20PM|#
"Bingo!!
or considering the reccession they should have simply run the
county well for a couple of years then done the reforms. Now it
looks like they will lose seats in congress."
What I find funny is that after 9/11 we set up an allegedly
bipartisian commision to determine what went wrong and how to
improve things.
Obama errored greivously by failing to follow that model.
|8.24.09 @ 2:23PM|#
I doubt even the Northern Pacific could profitably compete (today) head-to-head with Amtrak, particularly on passenger service.
|8.24.09 @ 2:23PM|#
Suderman has become the new Weigel. Any post where he has to
admit fault among the Democrats must be accompanied by a sentence
or clause mentioning that Republicans are worse.
I think they all do that...or at least make an effort to point out
how they both suck.
In the case of Weigle i think you would be hard pressed to find an
article that actaully does critisize the Demecrats and you will
find quite a few that critisizes big L Libertarians.
kinnath|8.24.09 @ 2:27PM|#
I've been watching the coverage over at Salon. Various articles
have stated that the "public option" was used to placate the rabid
liberal wing of the Democratic party who were demading a
single-payer sytem. "Everyone" on the left recognized that the
public option was a Trojan horse to bring in single-payer.
Of course, in public, the administration says that the
public-option was never intended to be a gateway to
single-payer.
Then Obama spills his guts on TV and says private insurers
shouldn't fear the public option -- just look at the post
office.
Now we're seeing analysis that says the public option was never
important to the administration, it was only a bargaining chip to
get the opposition to accept the "real" objectives of the
reformers.
What a bunch of clueless amateurs.
|8.24.09 @ 2:30PM|#
How is having the "conversation", or more specifically, having the "conversation" covered by insurance inconsistent with libertarian philosophy? I would think that libertarians would support the right of a person to make his/her own decision about how to end their life. Indeed, how is the Hemlock Society not a libertarian organization?
Mad Max|8.24.09 @ 2:33PM|#
Socrates, you ignorant slut,
Taxpayer subsidies and government incentives for doctors to nudge
patients towards death? Yes, indeed, a worthy libertarian
cause!
Joe M|8.24.09 @ 2:35PM|#
Ray,
The difference is that Social Security would have to provide good
financial returns and exercise sound money management to compete
against a private option, while public health care can spend as
much money as it wants and operate with a deficit, undercutting
private companies that must profit to survive.
robc|8.24.09 @ 2:38PM|#
In theory, the Obama plan to have a public option compete
against private insurers seems no different to me than having the
social security system compete against an opt out program like the
one Chile started in the 1980s.
The bill in no way followed your theory.
1. The public plan was subsidized (to be cheaper than private
plans)
2. Private plans only lasted as long as you didnt change anything -
there was no switching between private plans or back and forth from
public to private. Pure mathematics shows that everyone would have
eventually ended up in the public plan.
Anonymous|8.24.09 @ 2:39PM|#
If end of life isn't death, what is it?
The beginning of society to live without the drain of resources
needed to keep up your feeble existence.
|8.24.09 @ 2:39PM|#
I have a difficult time distinguishing these slippery slope
public option means inevitable single-payer health care
What slippery slope? Obama has said publicly he prefers and desires
single-payer. Whether he gets there in pieces or in one fell swoop
is irrelevant. Should we not take him at his word?
|8.24.09 @ 3:07PM|#
'"Right now, Medicare does not cover this pivotal conversation.
As a result, most doctors don't suggest it. And most elderly
patients don't get the opportunity to talk about their questions,
values and decisions about the kind of care they want at life's
end."
That is just complete horseshit. Everyone who has ever lost a close
relative knows very well the conversation about DNRs. Why do you
need to go to a pannel of experts when you have one with your
doctor? I can see no other reason than the government wanting to
pressure people into ending their lives earlier.'
Very true John, not only regarding end of life issues, but also
standard protocol during a surgical consult and discussed before an
operative consent is signed. Other DX where AD/DNR are discussed is
(and can be very touchy) is when dementia/Alzheimer's, especially
when the patient requires LTC/Alzhiemer's care. This is germane as
neurological deficits can occur before end of life is discussed
with the patient while he or she is is still 'compus mentus'.
There is no need for a bill like this under the current
system.
Here's an article written by Charles Krauthammer highlighting
AD/DNR's.
http://article.nationalreview.com/?q=ZTk3ODM3MWFjNDQyMTFiOWI5ZTAwYWY5ZmIwZmUzMzY=
|8.24.09 @ 3:08PM|#
Mad Max, show me again where it says the government will be nudging people towards "death"? If the government is going to be in the insurance business (which it is and will be) should it not be offering people the widest array of choices possible to empower them to make their OWN end of life decisions? I for one would like to have the OPTION of selecting to discuss such issues with my health care provider and having that option covered by my free government run insurance. Choosing when to die is a laudable libertarian ideal even if being made in the context of a big government run insurance program. Bitch.
Mike M.|8.24.09 @ 3:08PM|#
And we all know the other side are just lunatics right? No
one could ever have a principled objection to Obamacare. We are all
just a bunch of gun clinging birthers.
I have no doubt at all that SOME of the town hall participants are
total loonies and nuts, but most of them are just deeply concerned
and angry citizens. And they aren't all Republicans either; any
implication that they are is B.S.
Here's the deal: being nice, polite, and respectful got the TARP
bailout and the stimulus package rammed down our throats, so those
days are pretty much over now.
If you give a guy the middle finger enough times, I guarantee that
eventually he's going to respond back to you in an extremely
hostile manner.
Tony|8.24.09 @ 3:21PM|#
Jesus Christ John could you suck GOP cock any harder? You do know they prefer their boys young?
|8.24.09 @ 3:27PM|#
I believe I speak for all here when I say, if this bill passes, I hope to be on Tony's death panel.
Tomcat1066|8.24.09 @ 3:28PM|#
Once again, Tony shows that he can't grasp that this isn't a GOP website. Nice job!
mark|8.24.09 @ 3:30PM|#
-The death panels, most obviously: The provision in question
just isn't a "death panel." It's a voluntary doctor consultation.
IMAC might be closer, and I wonder why it hasn't attracted more
criticism. But the phrase is still totally over-the-top.
Am I correct that the president has already signed legislation
authorizing the creation of a "comparative effectiveness research"
council, which will have some level of authority in offering
"incentives" and possibly "penalties" to doctors who prescribe
treatment that is/is not "cost effective"? If so, then Sarah
Palin's 'death panels' are a bit of a misnomer; a more accurate
description would be a 'death council'. But who knows how long it
would be before the council becomes a panel?
The provision in question was a reimbursement for voluntary
'end-of-life' counseling (there's that word again) sessions.
Unclear in a casual reading of the law was who exactly was supposed
to initiate said sessions, or who would be charged with initiating
a communication to the patient that such a session is available.
Perhaps the CER council could incentivize such sessions? Does the
law say they can't?
The law prescribed what was to be discussed in such sessions, so it
was already way out of line. But the "voluntariness" of the
provision was also in question.
Libertarian|8.24.09 @ 3:31PM|#
Once again, Tony shows that he can't grasp that this isn't a GOP website. Nice job!
Then what is John doing here?
|8.24.09 @ 3:33PM|#
How is having the "conversation", or more specifically,
having the "conversation" covered by insurance inconsistent with
libertarian philosophy?
Well, first off, we're talking about having a conversation paid for
by the government, so there's a libertarian problem right
there.
Second, libertarians aren't so naive as to believe that the
government won't apply pressure to (a) make sure this conversation
gets held and (b) make sure it includes certain content. More
libertarian problems.
Finally, those of us who have actually dealt with Medicare know how
it works, and you can be sure that there will be financial
incentives, first, to get living wills or whatnot signed and,
second, to get the "right kind" of living wills signed, those that
abjure heroic measures. Big libertarian problems.
|8.24.09 @ 3:34PM|#
Peter,
John's H&R commenting m.o.:
1) If it is negative post about the Democrats, pile on.
2) If it is negative post about the Republicans, point out that the
Democrats did the same thing, or at least something equivalently
bad.
3) If it is a negative post about both parties, question the
negativity about Republicans, and accuse the poster of being soft
on the Democrats.
4) Argue over the irrelevant, never cop to a mistake, take
conversations down elusive tangents, and win by attrition.
Engage in dialogue at your own risk. Even if I am on his side of an
issue, I typically don't want to read his comments.
Tomcat1066|8.24.09 @ 3:35PM|#
All these libertarian commenters, but John makes it a GOP
site?
Yeah. OK. Aren't you late to eat paint chips or something?
Tony|8.24.09 @ 3:36PM|#
It's been explained to you time and again Tom. If you don't like being mistaken for GOP cocksuckers then stop sucking GOP cock.
|8.24.09 @ 3:41PM|#
"Engage in dialogue at your own risk. Even if I am on his side
of an issue, I typically don't want to read his comments."
Then don't.
Tomcat1066|8.24.09 @ 3:42PM|#
Tony, you ignorant slut.
You see GOP cock so much you must have been born kneeling in front
of Karl Rove.
So why don't you go take a flying fuck. The GOP is about as useful
as an escape hatch on a football, just like the democrats, and
plenty have told you the exact same thing. You're just to fucking
stupid to comprehend it.
|8.24.09 @ 3:43PM|#
"It's been explained to you time and again Tom. If you don't
like being mistaken for GOP cocksuckers then stop sucking GOP
cock."
Because God forbid we wouldn't want that reputuation among the
Obama cocksuckers.
If you don't like what I have to say, then engage me the way
Suderman did. If all you can do is scream "GOP cocksucker" then you
are an idiot unworthy of responding to and you can go fuck
yourself.
Tony|8.24.09 @ 3:48PM|#
I just expect anyone with half a brain to dismiss the GOP for the corrupt, theocratic, budget-busting, bill of rights dismantling, phony warmongering nutjobs they are. Once you do that, bash the Dems all you want. But don't whine to me about being mistaken for a rightwing hack when that's exactly how you present yourself.
Tomcat1066|8.24.09 @ 3:50PM|#
Right. Because all the stupid being done currently is all on
Republicans. Plenty of us have argued against distortions on health
care from the GOP...we just haven't been in favor of the public
option.
Tony, do you stay awake at night looking for ways to look
stupid?
|8.24.09 @ 3:51PM|#
Yes Tony just scream that anyone who doesn't 100% agree with you is stupid and crazy. I am sure among the crowd you run in that counts as serious, reasoned argument. But, it really doesn't cut it around here.
Tony|8.24.09 @ 3:53PM|#
John,
I am perfectly aware that eye-rollingly stupid GOP propaganda shat
directly from the flabby jowls of Sean Hannity is treated with more
respect here than even mainstream factual information. My question
the entire time I've been posting here is why the fuck is this the
case.
|8.24.09 @ 3:53PM|#
mark, Nat Hentoff, in a column this past Saturday, pointed out
that the Center for Health Outcomes Research and Evaluation is
already signed into law in the stimulus bill.
I haven't taken the time to find it and verify his claim.
Queen Gertrude|8.24.09 @ 3:53PM|#
"Tony | August 24, 2009, 3:36pm | #
It's been explained to you time and again Tom. If you don't like
being mistaken for GOP cocksuckers then stop sucking GOP
cock."
Methinks the lady doth protest too much.
Xeones|8.24.09 @ 3:58PM|#
Tony, you passed the point of self-parody long, long ago, and now you're just embarrassing yourself. Quit acting stupidly, for your own sake.
|8.24.09 @ 4:00PM|#
"I am perfectly aware that eye-rollingly stupid GOP propaganda
shat directly from the flabby jowls of Sean Hannity is treated with
more respect here than even mainstream factual information. My
question the entire time I've been posting here is why the fuck is
this the case."
You just don't get it because you are a narrow minded moron. No one
treats anything with any respect. It is just that people actually
look at the facts and arguments and disagree with them based on
their merits rather than engaging in ad homonym attacks based on
the source. Idiots like you, who can't grasp the subtleties of
arguments, have to rely on attacking the source of things. Thinking
people, since they can understand the arguments, don't have to
obsess about that as much. I dare say no one on this board watches
Hannity or listens to Rush Limbaugh. You just think they do because
you have convinced yourself that anyone who disagrees with you does
so because they are listening to unapproved news sources.
|8.24.09 @ 4:03PM|#
Will this public option work like the public option in primary
education? We are all perfectly welcome to purchase a private
education for our kids using whatever money is left over after
being forced to pay for the inferior public option.
That's where I see this heading. What we see today will not be what
we could end up with tomorrow. Well, maybe tomorrow, but a few
tomorrows later things could look just like what we were promised
wouldn't happen yesterday. This is why Obama wants to pass
something, anything, doesn't matter what - just pass it.
|8.24.09 @ 4:06PM|#
"That's where I see this heading. What we see today will not be
what we could end up with tomorrow. Well, maybe tomorrow, but a few
tomorrows later things could look just like what we were promised
wouldn't happen yesterday. This is why Obama wants to pass
something, anything, doesn't matter what - just pass it."
Medicare was supposed to be small state program overseen by the
Feds and costing only $12 Billion by 1989. Liberals just have to
get the nose in the tent. But remember according to Suderman anyone
who thinks this is a Trojan Horse is a birther gun clinging
nut.
Joe M|8.24.09 @ 4:21PM|#
John, Peter says:
So we've moved from the moral case to the fiscal case to the
"the-other-side-is-made-up-of-crazed-and-despicable-idiots"
case.
That's clearly a statement deriding that way of thinking. Note the
scare quotes.
Mike M.|8.24.09 @ 4:24PM|#
Medicare was supposed to be small state program overseen by
the Feds and costing only $12 Billion by 1989.
Given that these government programs that already exist have put us
right at the cusp of national bankrupcty, this whole debate has a
surreal Alice-in-Wonderland quality to it all, like doubling down
on pure insanity.
For goodness sakes, the government can't even reimburse the auto
dealers on time for the relatively small-potatoes "Cash for
Clunkers" program that is mercifully ending in a few hours.
Furthermore, they just came out and announced that there won't be a
COLA increase in Medicare for the first time ever!
|8.24.09 @ 4:28PM|#
So we've moved from the moral case to the fiscal case to the
"the-other-side-is-made-up-of-crazed-and-despicable-idiots"
case.
That's clearly a statement deriding that way of thinking. Note the
scare quotes."
I agreee. I think he is saying that. But he also seems to be saying
that everyone, beyond the moderate Democrats (whoever they are) who
is objecting to Obamacare are crazies or saying untrue things.
Suderman seems to be saying, stop blaming the crazies even though
all your opponents really are crazy.
Anonymous|8.24.09 @ 4:29PM|#
Idiots like you, who can't grasp the subtleties of
arguments, have to rely on attacking the source of
things.
So Tony is Barry
Soetoro?
|8.24.09 @ 4:29PM|#
"Given that these government programs that already exist have
put us right at the cusp of national bankrupcty, this whole debate
has a surreal Alice-in-Wonderland quality to it all, like doubling
down on pure insanity."
Maybe someone should just say, "we can't afford for the government
to pay for everyone's healthcare."
Barack Obama|8.24.09 @ 4:33PM|#
But we CAN afford to "bend the curve" of cost inflation. You can trust me on that because only I understand the root causes of health care cost inflation.
|8.24.09 @ 7:06PM|#
Anonymous | August 24, 2009, 2:39pm | #
If end of life isn't death, what is it?
The beginning of society to live without the drain of resources
needed to keep up your feeble existence.
Yeah cuz we all know that research and development implicit in the
massive spending we put out toward keeping old people alive and
healthy will have no effect in keeping people productive at ever
older ages in the future.
Hogwash.
|8.24.09 @ 7:13PM|#
Yes Tony just scream that anyone who doesn't 100% agree with
you is stupid and crazy. I am sure among the crowd you run in that
counts as serious, reasoned argument.
to be fair as a semi-regular consumer of the comments i prefer the
sceams of "everyone-is-a-fucking-idiot" mixed in with the serious
reasoned argument.
But yeah the serious reasoned argument is the meat...the sceams
just add spice.
|8.24.09 @ 8:48PM|#
Tony, you seem to believe that anything emanating from a "right-wing" source should be automatically regarded as discredited, prior to any evaluation of the arguments. How about evaluating each side's arguments in good faith, without regard to the source?
|8.24.09 @ 9:19PM|#
"I just expect anyone with half a brain to dismiss [Obama &
the Dems] for the corrupt, theocratic, budget-busting, bill of
rights dismantling, phony warmongering nutjobs they are. Once you
do that, bash [the gubmint] all you want.
FTFY
anonymous|8.24.09 @ 10:32PM|#
"Mad Max, show me again where it says the government will be
nudging people towards "death"? If the government is going to be in
the insurance business (which it is and will be) should it not be
offering people the widest array of choices possible to empower
them to make their OWN end of life decisions?"
Well, nudging people toward death is helpful toward achieving
government cost-saving objectives (not important or productive
people, mind you -- just the elderly, the disabled, criminals,
political dissidents, and other social undesirables).
When there's a will, there's a way. And when's there's a will
backed up by police, soldiers, a cult of zealous believers, and a
limitless credit card, there's a very powerful way.
"
Yeah cuz we all know that research and development implicit in the
massive spending we put out toward keeping old people alive and
healthy will have no effect in keeping people productive at ever
older ages in the future."
The problem is that we haven't changed our idea of when people
should be supported by society from the time when most people were
broken down and at the end of their lives in their 7th decade.
Their health only contributes to productivity if they're actually
using that healthy time being productive.
The Libertarian Guy|8.24.09 @ 11:48PM|#
"It's been explained to you time and again Tom. If you don't
like being mistaken for GOP cocksuckers then stop sucking GOP
cock."
Lenin's been dead too long, Tony. Sucking his cock, alas, isn't
going to happen for you.
another another anonymous|8.24.09 @ 11:53PM|#
Tony, why do you hang out here? You hate the private sector, and likely your only concerns re: choice are abortion and gay issues.
daveinboca|8.25.09 @ 12:21AM|#
Suderman you really never respond to the slam. It is like
you agree with it and think that anyone who is not a Democrat is a
birther and a moron. Yes, another libertarian who is a libtard
in disguise. I think Suderman agrees with Michael Tomasky, who is
probably a Maoist death cult Pol Pot wannabe like most Guardian
hacks.
The "public option" is the camel's nose under the tent for single
payer. Everyone with an IQ over room temp has figured that out, and
Barney Frank admitted it a while ago in a unique moment of candor.
Pubic [!?!] Option drives insurance companies into the ground by
undercutting private sector companies with taxpayer dollars, then
single payer comes in to finish off the corpse of the Republic. And
we have a socialist autarky in the White House, with a bicameral
peanut gallery applauding Dear Leader when he make a State of
Disunion appearance.
Hahaha|8.25.09 @ 12:50AM|#
So, when did Tony start copying Episiarch? The verbiage is there, but it does not seems correct somehow.
Tony|8.25.09 @ 12:50PM|#
Tony, why do you hang out here? You hate the private sector, and likely your only concerns re: choice are abortion and gay issues.
Call me a left wing libertarian. I do think libertarian economic
ideas are simplistic, anti-human, outdated, and generally nothing
but a collection of euphemisms for corporate feudalism, but I'm
very strong on civil liberties. I hang out here because I like
arguing with people who disagree with me.
Anonymous|8.25.09 @ 3:52PM|#
Free choice is anti-human, therefore "civil liberties" exist at the behest of a dictator.
The Libertarian Guy|8.25.09 @ 8:14PM|#
Let's see:
"simplistic" = "doesn't tax the bat-fuck out of rich people"
"anti-human" = "doesn't tax the bat-fuc out of rich people"
"outdated" = "taxing the bat-fuck out of rich people isn't an
oudated, simplistic, or anti-human idea"
"corporate feudalism" = "people are allowed to own their own means
of production, as in small-business entrepreneuers who clearly step
on the necks of their ten or fifteen employees just like Big
[insert evil corporation] does"
"I'm very strong on civil liberties" = "except when it comes to
people over an arbitrary income level, keep more than fifty percent
of said income, and I'm only concerned about civil liberties when
it comes to gay marriage and abortion, because I want government to
dictate what kinds of cars people drive, ban them from eating
trans-fat-soaked fried food, where they can smoke, and make it
illegal for radio-show hosts to use 'the public airwaves' to
dissent against the current sitting government"
Y'know, Tony, thirty years ago, I actually raised eyebrows in
junior high when I told a career counselor I wanted to learn
Russian so I could help spread the good news of the Soviet Union
way of life.
Then I grew the fuck up, and stopped hating the rich folks who
lived in the swanky neighborhoods, even though I will likely never
live in one myself.
Get over it, man. That's my advice.
Tony|8.25.09 @ 9:39PM|#
TLG,
That's a lot of psychoanalysis to explain a lot of views I don't
hold.
Also, it's not a civil liberty not to be taxed! There wouldn't be
any liberties without taxes funding an apparatus to "secure"
them.
The Libertarian Guy|8.26.09 @ 12:19AM|#
Well, if you're not like virtually every other Democrat who's
crossed my path, color me surprised.
We have to have SOME way to pay for what gets done, I'll admit -
it's just that we're paying for shit we don't need.
We could shitcan half of the Alphabet Agencies, and America would
be just fine. Good start, anyway.
THAT'S a goddamn civil liberty for ya.
Why isn't 34 cents on the dollar, not enough? Why do you morons
want to punish anyone with a half-decent paycheck?
Wait, I know this... it's because you're in the party that openly
despises the private sector, and can't wait to administer the rest
of the Death of a Thousand Cuts to bleed it dry and let the
vultures pick at the bones.
The Libertarian Guy|8.26.09 @ 12:34AM|#
The gist is: While you, Tony, may not hold all of those views
described a few posts back... YOUR PARTY DOES.
Republicans suck cock, too, mind you. But at least some of them are
capitalists who aren't in the business of micromanaging our lives
in or out of the bedroom. MAYBE a few Democrats fit that bill, but
they're probably so few I could count them on one hand and have a
finger left to hoist at the rest.
Same for the right, same finger, different hand.
I watch a friend of mine make out a monthly check to the IRS for a
back-taxes plus interest and penalties, that he will NEVER get
caught up with because the IRS won't settle for a lump-sum payoff.
He's not alone - I know three other people in the same boat.
Is that "civil liberties", for our own tax-collection agency to act
like fucking loan sharks?
I watched a former colleague have everything he owns taken because
he grew a few pot plants in a closet. Forfeiture, endorsed by
Republicans AND Democrats who are so fucking hot-to-trot Drug
Warriors that they'll stand by and let a jar full of loose change
be counted as "drug sale proceeds".
My boss and I - the sole employees of a local delivery company -
are scrounging for business because our clients are scrimping,
worrying that Obamacare is gonna fuck them, that cap and trade is
gonna fuck gas prices, electric bills to run the presses at the
print shops we deliver for, offices are scrimping on toner and
office supplies because they don't know if the other proverbial
boot is going to drop on their bottom lines.
Get the picture? It's a trickle-everywhere effect - the more
uncertain the private sector is that Obama won't stick another
fondue fork in the eye of the thing that keeps this country running
- business, big and small - the longer it takes for our economy to
finally turn the corner. Cause/effect.
This country spends billions complying with a tax code that even
Einstein couldn't figure out in HIS day. That's billions that could
be spent on real things, tangible items, services, EMPLOY people
that don't push fucking tax forms for a living.
But, hey, by all means... let's keep the current system. Hell,
let's ADD to it. Just to poke a broom handle in the ass of "rich
people".
Y'damn right I'm pissed. I can't get a side gig because the economy
is still screwed - no thanks to the gang of criminals that replaced
the PREVIOUS gang of criminals.
Fuck 'em all.
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