So Much for Bipartisanship

Politico is reporting that it's likely no Republicans will support the Baucus health-care plan. There's some question as to whether super-squish Olympia Snowe, long considered the Democrats' best hope for a Republican vote, might still go along. But The Hill, at least, is already counting Snowe out, putting Democrats in a tough spot. From Politico:

Despite deep divisions within their own ranks, Senate Democratic leaders are confident that they'll come together when it's time for a vote on health care reform. But without the late Sen. Ted Kennedy, the Democrats have just 59 votes—one shy of the filibuster-busting 60 they're likely to need.

Comments

[Fist of Etiquette]

Wow, Snowe lifts her skirt for virtually any "bipartisan" bill to come sniffing around, so for her to snap shut means the public must really have them spooked.

[Gabe]

Medicare Would Rather Buy $8000 Computer than $150 iPhone App'

Say that, all things equal, you could fix a problem for $8000 or fix the same problem for $150. Which would you choose? Clearly, you are not Medicare. Proloquo2Go is a text-to-speech iPhone app that's meant to aid those with autism, cerebral palsy, ALS, Down Syndrome-pretty much anyone who has a disability that makes speaking a difficult venture. It costs $150.

But Medicare/Medicaid restrictions won't pay for this software or the accompanying iPhone because the iPhone is not a uni-functional device. (A person with autism might play games on it, after all! Or call a doctor!) One family's alternative, as documented by the NYTimes, is a government-funded $8000 desktop computer that can have no other function than text-to-speech. No emailing doctors. No browsing the web for medical research. So, this pricey clunker sits at home while the family pays out of pocket for the iPhone app that can operate in their real, mobile life.

Medicare acknowledges the situation. They have heard of the iPhone, as they explain in their official statement on the matter: "We would not cover the iPhones and netbooks with speech-generating software capabilities because they are useful in the absence of an illness or injury."

[Attorney]

But without the late Sen. Ted Kennedy, the Democrats have just 59 votes -- one shy of the filibuster-busting 60 they're likely to need.

Woohoo!

[SCOTUS]

Senate Democratic leaders are confident that they'll come together

Not if we ban dildoes.

[Nick]

Gabe's post is exhibit A why no one trusts the government to keep health-care-for-all at a remotely reasonable price. The current government insurance programs are so amazingly inefficient, no one wants to find out how ridiculous they will be when everyone is covered. Not to mention the fact that no one pushing for reform has even suggested fixing the inefficiencies in Medicare and Medicaid first as a trial example. No one's even trying.

[!]

Politico is reporting that it's likely no Republicans will support the Baucus health-care plan.

[sarcasm]
Darn!
[/sarcasm]

[Gilbert Martin]

"But without the late Sen. Ted Kennedy, the Democrats have just 59 votes -- one shy of the filibuster-busting 60 they're likely to need."

They should have buried him in Chicago.

Then he could still vote just like all the rest of the graveyard residents there.

[P Brooks]

Politico is reporting that it's likely no Republicans will support the Baucus health-care plan.

I don't understand; the pharmaceutical companies say it's a terrific plan.

[Gilbert Martin]

Also of this health care "reform" is so whiz-bang terrific and vitally needed to solve a "crisis", as the Dems claim why should they care if any Republicans vote for or not?

It's your bill, Dems - own it.

And own the consequences of it.

[Sal Paradise]

"But without the late Sen. Ted Kennedy, the Democrats have just 59 votes-one shy of the filibuster-busting 60 they're likely to need. "

Oh dear, what a shame. Well Teddy, you finally did something right.

[Nephilium]

So... am I the only one who thinks that the Democrats will push for the vote before Kennedy's replacement gets seated? That way they have the cover of blaming the mean-spirited, racist, filibustering Republicans for the bill failing. Instead of just admitting that the bill is far too unpopular to pass.

Nephilium

[smartass sob]

But Medicare/Medicaid restrictions won't pay for this software or the accompanying iPhone because the iPhone is not a uni-functional device. (A person with autism might play games on it, after all! Or call a doctor!) One family's alternative, as documented by the NYTimes, is a government-funded $8000 desktop computer that can have no other function than text-to-speech. No emailing doctors. No browsing the web for medical research. So, this pricey clunker sits at home while the family pays out of pocket for the iPhone app that can operate in their real, mobile life.

Eight thousand dollars for a computer? Sounds like someone has a nice lucrative government contract being protected.

[John]

What some call partisianship, I call clarity. The last thing the country needs is for either side to avoid responsibility for this crap via bi-partisianship.

[Colin]

Don't forget that Byrd is very sick. There's no guarantee he'll show up for the vote.

And I read today that Rockefeller won't support the Baucus either because it doesn't go far enough.

[Gilbert Martin]

"So... am I the only one who thinks that the Democrats will push for the vote before Kennedy's replacement gets seated? That way they have the cover of blaming the mean-spirited, racist, filibustering Republicans for the bill failing. Instead of just admitting that the bill is far too unpopular to pass."

The reply to that excuse is that the bill doesn't go into effect until 2013 so the Dems have plenty of time to try again after the swimmer's replacement has parked his but in the Senate chamber.

And an added bonus zinger to follow that up with is the following question: If we have such a GD healthcare "emergency" that we need to HURRY UP AND PASS SOMETHING RIGHT NOW, then why does the bill not go into effect until 2013? Which just coincedently happens to be after the next presidential election cycle.

[T]

I don't understand; the pharmaceutical companies say it's a terrific plan.

Gee, I wonder why? $8000 dedicated text-to-speech converters don't give you a hint?

[Pro Libertate]

Surely some Democrats will oppose the bill, too.

[Johnny Longtorso]

And an added bonus zinger to follow that up with is the following question: If we have such a GD healthcare "emergency" that we need to HURRY UP AND PASS SOMETHING RIGHT NOW, then why does the bill not go into effect until 2013? Which just coincedently happens to be after the next presidential election cycle.

They did that to add a few years of 0 spending up front, to lower the "first 10 years" estimate. This lowers the projected cost, by making the first 10 years of the program not really the first 10 years of the program.

In other words, Obama, you lie.

[Gilbert Martin]

"his lowers the projected cost, by making the first 10 years of the program not really the first 10 years of the program."

And even that projection is guaranteed to be far short of actual - just like Medicare.

"In other words, Obama, you lie."

Obama is behaving just like a used car salesmen trying to hurry up and close the deal on a lemon that he needs to move off the lot to meet his sales quota for the month.

[sage]

Obama is behaving just like a used car salesmen

Racist.

[Ken Shultz]

"Politico is reporting that it's likely no Republicans will support the Baucus health-care plan."

Awesome! I freakin' hate bipartisanship!

So which party's advocating rolling back the prescription drug burden Bush and his cronies inflicted?

Oh. Keeping that, they're bipartisan on?

See, I told you bipartisanship sucks!

And I just got this off the WSJ website...

"The Senate Finance Committee chairman proposed a 10-year, $856 billion health-care bill that doesn't include a provision for a government-run option to compete with private insurers. The bill would expand coverage by creating a network of nonprofit co-ops."

http://online.wsj.com/home-page

The good news is that there's no public option in the Baucus Bill. The bad news is that it's going to cost us $856 billion over ten years. ...and I'm guessin' that's a low ball figure.

Here's your shit pizza, this time with no anchovies! Bon appetit!

[Tomcat1066]

I think everyone has missed the boat on what bipartisanship really means.

Bipartisanship - the state of everyone shutting the hell up and going along with whatever the president asks for.

Every call for bipartisanship has really been a call to tell the opposition to shut up and go along. No matter the issue, no matter the parties involved, it's the same fucking thing. They don't give a shit if Republicans are opposed to this or not. They really just want them to shut the fuck up and go along with the bill anyways.

[Gilbert Martin]

The public option part was always thowaway piece anyway.

All the mandates on private insurance about pre existing conditions, paying for preventative care and individual mandates to buy insurance is the main show. THAT constitutes a government takeover of healthcare every bit as much as a full blown mandatory participation single payer system does.

[Mr. Snark]

Obama is behaving just like a used car salesmen

Racist.

Used car salesmen do not constitute a "race".

Really, people.

[Ken Shultz]

"Used car salesmen do not constitute a "race".

And you call yourself "Mr. Snark"?

[?]

"People?!"

Racist.

[Gilbert Martin]

"And you call yourself "Mr. Snark"?"

Maybe he's a double secret snark undercover agent.

[Joe M]

Easiest way to filibuster: just read the entire bill out loud. That should keep you going for a solid week or two.

[ed]

without the late Sen. Ted Kennedy, the Democrats have just 59 votes

If Kennedy had resigned his seat at the beginning of the year (certainly being replaced by another Democrat) the Dems would not be in this position. I'm surprised no one has mentioned this fact. Did anyone discuss this with Teddy? Or did they believe that the mighty Kennedys can battle brain cancer and win? Talk about hubris.

[Ken Shultz]

"All the mandates on private insurance about pre existing conditions, paying for preventative care and individual mandates to buy insurance is the main show. THAT constitutes a government takeover of healthcare every bit as much as a full blown mandatory participation single payer system does."

My biggest problem with Medicare/Medicaid is that it only pays for a fraction of the hospital and other costs it covers. ...it only covers a fraction of the costs to the hospitals and other providers, hence, leaving the rest of those providers costs to be covered by private insurance, cash patients, et. al. ...which is really easy to see if you do the sources and uses analysis.

It's that distortion that causes most of the problems associated with outrageous costs in the health care system. That's why insurers often try to control which providers you go to--because they already have contracts with those providers. If you end up in a hospital that has a large proportion of Medicare/Medicaid patients, and your insurer doesn't already have a preexisting contract with that provider, they're going to charge your insurance company through the nose...

I have some prescription drugs I have to use for a chronic "preexisting" condition--paying cash for those drugs costs me about $1,100 a month in the U.S., but the same medication only costs $150 dollars a month cash in Mexico.

There's no difference in the quality, it's just that in Mexico, I don't have to subsidize all the Medicare/Medicaid patients who, essentially, freeload. It's like shoplifting. The stores have to charge more to cover the costs of lost inventory to theft--but in the case of the health care system, the shoplifters have a much bigger impact, 'cause they make up a majority of the shoppers!

To end that absurd distortion, it might actually be better if all those Medicare/Medicaid people went to government sponsored co-ops...so long as the co-ops actually par for the full price of care. I don't support this expansion of government into healthcare one iota, but if this were being offered as an alternative to Medicare/Medicaid, it might actually be worth it.

...of course, this is being offered in addition to, rather than as an alternative to, so Baucus, the Democrats and the Republicans can all line up and kiss my ass.

[Gabe]

any outrage from the obama supporters??

The Obama administration supports extending three key provisions of the Patriot Act that are due to expire at the end of the year, the Justice Department told Congress in a letter made public Tuesday.

Lawmakers and civil rights groups had been pressing the Democratic administration to say whether it wants to preserve the post-Sept. 11 law's authority to access business records, as well as monitor so-called "lone wolf" terrorists and conduct roving wiretaps.

As a presidential candidate, Barack Obama said he would take a close look at the law, based on his past expertise in constitutional law. Back in May, President Obama said legal institutions must be updated to deal with the threat of terrorism, but in a way that preserves the rule of law and accountability.

Extending the Bush war in Afghanistan. Expanding on the Bush corporate welfare bailouts. Keeping in place Bush's Fascist "PATRIOT" law. I just don't know how much more of this Obama "change" I can handle.

[Mike M.]

Also if this health care "reform" is so whiz-bang terrific and vitally needed to solve a "crisis", as the Dems claim why should they care if any Republicans vote for or not?

Also, if it's so terrific, why wouldn't it go into effect for about four years, and why is all of Congress exempting itself from the requirements?

[Ken Shultz]

I don't have current numbers, but baby boomers being the age they are, there's reason to assume it's gotten worse... If anybody has current numbers, I'd love to see 'em.

But it used to be that the majority of the health care resources in this country were going to patients on Medicare and Medicaid. ...older people tend to be sicker and sick more often. Meanwhile, Medicare used to pay approximately 25 cents on average for every dollar billed, and Medicaid would pay 15 cents on average for every dollar billed.

So the healthcare providers were getting 40 cents on the dollar, what were they supposed to do? Make it up in volume?!

No! Look at the sources and uses analysis...they make it up from their other customers--private insurers and cash patients.

So, yeah, you're screwed as a tax payer for having to cover the costs of Medicare and Medicaid, but you're even more screwed as a consumer of healthcare. It's sick people that are the butt of the joke. It's a sick joke.

...and I think the poor suffer from this too. It isn't the hospitals in North County San Diego or South Orange County that get in trouble. It's County USC, Harbor UCLA, King Drew... If your hospital serves a demographic that has a small percentage of privately insured patients to gouge, then you're goin' out of business. 'cause they gotta see you in the ER, and if you're really bad off, they can't just let you go.

[Clockwork Persimmon]

"Obama is behaving just like a used car salesmen trying to hurry up and close the deal on a lemon that he needs to move off the lot to meet his sales quota for the month."

Fuck you. That's my name. You know why, mister? You drove a Hyundai to get here. I drove an eighty-thousand dollar BMW. THAT'S my name. And your name is you're wanting. You can't play in the man's game, you can't close them - go home and tell your wife your troubles. Because only one thing counts in this life: Get them to sign on the line which is dotted. You hear me you fucking faggots? A-B-C. A-Always, B-Be, C-Closing. Always be closing. ALWAYS BE CLOSING. A-I-D-A. Attention, Interest, Decision, Action. Attention - Do I have you attention? Interest - Are you interested? I know you are, because it's fuck or walk. You close or you hit the bricks. Decision - Have you made your decision, for Christ? And Action. A-I-D-A. Get out there - you got the prospects coming in. You think they came in to get out of the rain? A guy don't walk on the lot lest he wants to buy. They're sitting out there waiting to give you their money. Are you gonna take it? Are you man enough to take it? What's the problem, pal?

[Groovus Maximus]

Bi-partisanship/Bi-partisan needs to be tossed in the dustbin of meaningless politcal "buzz word" rhetoric.

Current occupants include: "racist"; "liberal/progressive"; "lifer"; "truther"; "birther"; "fascist/socialist/communist"; "American values"; "Let me be clear..."; anything containing the word "Fair".

All of these terms are arguably useless and have been bastardized far from their true meaning.

[Clockwork Persimmon]

@ Groovus Maximus

That's a lot of worsd. Why not just burn books?

[Clockwork Persimmon]

words

[R C Dean]

Meanwhile, Medicare used to pay approximately 25 cents on average for every dollar billed, and Medicaid would pay 15 cents on average for every dollar billed.

Dollars billed is a meaningless number. The real number is actual cost.

Of course, Medicare pays somewhat less than cost (at least in hospitals). Medicaid pays a hell of a lot less than cost, across the board.

So a "cross-subsidy" from private payers or local taxpayers is still needed, but its not really 60 cents on the dollar.

[Groovus Maximus]

That's a lot of worsd. Why not just burn books?

Steeempy, you EEEEEDIOT. Don't give Dear Leader any more ideas!!!!!

Seriously, I was merely suggesting retiring these terms in the context of political discourse would improve the truth value and cogency of said discourse.

[Syd Henderson]

May I point out that Senators who are against the plan may not necessarily support a filibuster?

[Ken Shultz]

"Dollars billed is a meaningless number. The real number is actual cost."

And like I said, the actual cost is in the sources and uses analysis...

I don't have the current number, but assuming that old people still use more health care than the rest of us, and with baby boomers getting older and older every year, Medicare and Medicaid pay nowhere near enough to account for the healthcare resources their beneficiaries consume. And consumers with private insurance, or those who pay cash, are paying way more than their proportionate share.

It used to be that average acute care hosptiatls needed about a 1 private pay patient for every 7 Medicare/Medical patients to break even, and given the demographic trends, I can't image that number's improved.

So, anyway, dollars billed isn't a meaningless cost to Aetna. ...particularly if you were admitted through the ER into a hospital they don't have a contract with. Whether dollars billed is a meaningless term to Medicare and Medical, despite so many payor rates being influenced by those numbers...hell, even that's beside the point.

...the point being that Medicare and Medicaid only pay for a fraction of the resources their beneficiaries consume, and that if these new programs do the same thing, the pressure all those new...um...sorry, "shoplifters" put on the system will only exacerbate affordability problems of private pay.

It's funny, too, 'cause everyone looks to the north for comparison purposes on the social side, and I guess people sometimes cite the increasing affordability of cosmetic surgery for comparison purposes, but if you want to see what a private pay plus free care for poor people looks like, we should be lookin' to the south...

My doctor here in Merida graduated from Harvard Med. I've been under the care of doctor's in his specialty, and I worked in an acute care hospital for years--he's as good a specialist as I've ever known. When I go to the ER in the middle of the night, my doctor gets out of bed at 2:00 in the morning, just because I'm his patient and in the ER.

...that's not unusual here. In fact, not getting your doctor's home phone number? That's unusual!

I spent a night in the hospital, private room, state of the art care, $697 US, all included.

I spent four nights in a hospital in San Diego, yeah, there was a $2,000 US procedure in there, but the total costs were in the neighborhood of $24,000. To some extent, the difference in costs can be attributed to the difference in salaries--radiotechs make a hell of a lot more in the U.S. ...but I still think the main difference is that in Mexico, I don't have to pay for all the Medicare and Medicaid patients, effectively, but in the U.S. I do.

If a proposal doesn't address the deadbeat system that is Medicare and Medicaid, then it isn't going to do anything to improve the affordability of private insurance for the average business or average American, and any proposal that exacerbates that problem, by putting even more people into new deadbeat programs? Those should all be non-starters...

...regardless of the statistical significance of "dollars billed".

[prolefeed]

Easiest way to filibuster: just read the entire bill out loud. That should keep you going for a solid week or two.

With frequent forays into asking someone -- anyone -- in the chamber to explain what a particularly complicated passage means, thus exposing that not only have they not read the bill, they are not capable of reading and understanding the bill.

[R C Dean]

I agree with just about everything you post, there, Ken.

I work in a hospital, and have been in the hospital biz for years, so I know that the charges are meaningless. Billed charges have somewhat more meaning (which is I think what you are saying).

But the blizzard of numbers should not obscure this fundamental fact:

Medicare and Medicaid pay nowhere near enough to account for the healthcare resources their beneficiaries consume

And as the state goes about destroying the private payors, the ability to cross subsidize the state-paid services will erode.

[Hobo Chang Ba]

I just watched Baucus's press conference. I get this uncomfortable feeling sometimes known as cognitive dissonance when I see a politician in front of a sign saying "lower costs" talking about how his plan would increase taxes on insurers, medical providers and medical supply companies.

I really think cognitive dissonance is fueling the anger we're seeing towards this administration far more than racism. People with the most primitive grasp of economics know that we can't cut taxes for 95% of people, increase spending by trillions of dollars, and not raise the deficit by a "dime," and the more Obama insists this is possible, the more people recognize that it just flat isn't. Overexposure is going to crush his presidency unless he figures out someway to make the math work in a remotely realistic fashion.

[R C Dean]

I really think cognitive dissonance is fueling the anger we're seeing towards this administration far more than racism.

Obviously, then, you, sir, are a racist yourself. Covering up for racists is racism, you know.

[Pro Libertate]

Drastically cut spending. Deregulate any number of industries. Stop subsidies. End the War on Drugs and other useless, costly, and morally bankrupt policies. Cut taxes.

Do all that, and I'll be happy if you're an intelligent bicycle.

[Hobo Chang Ba]

An intelligent (or unintellegent) bicycle as president could not sign enforcement/spending bills. Therefore, by electing an inanimate object, these things would be almost guaranteed to happen.

[Pro Libertate]

Say, that's a good point. Instead of postulating and electing an intelligent bicycle, why not just elect a regular bicycle? Nothing would ever get signed!

[Hobo Chang Ba]

I voted for the Flying Spaghetti Monster last time. Originally I was planning to vote for a fish head - maybe next time.