11th Hour of U.S. Health Care Reform

WASHINGTON — After a frenzied push to nail down final commitments and resolve lingering disputes in their ranks, House Democrats today are poised to pass the most sweeping change to the nation’s health care system since the creation of Medicare nearly half a century ago.

President Obama has at long last starting stumping for health care reform and started speaking the truth to the power of the health insurance companies strangling American families worse and worse every year. Whatever strategic issues I have with Democratic Health Care Reform, the bottom line is the party and the president have stepped up to do the right thing and put forward the agenda of the American people instead of the agenda of Corporate America being placed in the highest priority. Whatever enhancements I myself would add to this bill (Public Option) it is nonetheless a step in the right direction and beyond that point, if we failed to complete at the bare minimum of this reform in the system there will be dire consequences on the overall national economic stability in years to come.

This is the eleventh-hour of health care reform in the U.S., and this political blogger is predicting we will see these reforms pass.

Good news, to be sure.

After more than forty years of inaction and failures to address this most important issue we shall at long last see moral standards in our health care system and some limit placed on the corrupt practices of the insurance companies.

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Urban Institute Overviews The Public Option

Ezra Klein of The Washington Post has called this the “best overview of the public option” he has read so far, and I concur:

Getting to a Public Option that Contains Costs: Negotiations, Opt-Outs and Triggers

The debate over a public option has essentially become a debate over the size and role of government in the health care system. The central argument, as we see it, should be one of fiscal conservatism—that a public option should play a role in addressing the very serious problem of health care cost containment. The current debate between the left and the right on this issue is obscuring the fact that consolidation in both the insurance and provider markets is propelling a higher rate of growth in health care costs. The consolidation of power, particularly in provider markets, makes it extremely difficult for insurers to negotiate rates for their services and contributes to rapid growth in health care costs. A strong public option is one that ties provider rates in some way to Medicare rates (though set at likely higher levels), and that is open to any individual or firm regardless of firm size. It would thus provide countervailing power to providers and help control cost growth.

We argue that a strong version is necessary because there is little else in health reform that can be counted on to contribute significantly to cost containment in the short term. Capping tax-exempt employer contributions to health insurance has great support among many analysts (including us), but it faces considerable political opposition. Proposals such as comparative effectiveness research, new payment approaches, medical homes and accountable care organizations, all offer promise but could take years to provide savings. Thus, the use of a strong public option to reduce government subsidy costs and as a cost containment device should be an essential part of the health reform debate.

We recognize that there is opposition to a strong public option. Both the House and Senate proposals are considering relatively weak versions to make the public option more acceptable. Both proposals would have the public option negotiate rates with physicians and hospitals. We see two problems with this. One is that negotiating rates is not simple and it raises difficult implementation issues; for example, with whom would the government negotiate? Further, negotiations are most likely to be unsuccessful with providers who have substantial market power. Since this is at the heart of the cost problem, a strategy of negotiations seems unlikely to be effective, as has been affirmed by cost estimates from the Congressional Budget Office.

The Senate has proposed a public option with an opt-out provision. This has the advantage of recognizing regional diversity in political philosophy by allowing states to pass legislation to keep it from being offered in their states. A disadvantage of this proposal is that it would exclude many who would potentially benefit from a public option. The states likely to opt out are likely to be those with high shares of low-income people and many uninsured.

The other alternative is to establish a strong public option but not implement it unless a triggering event occurred. The goal would be to allow the private insurance system to prove that it can control costs with a new set of insurance rules and state exchanges. The triggering events could be the level of premiums exceeding a certain percentage of family incomes or the growth in health care spending exceeding certain benchmarks. Since the public option would only be triggered because of excessive costs, however measured, we assume that a relatively strong version of a public option would come into play.

We recognize that taking a strong public option off the table may be necessary to enact reform legislation. But this will mean, at a minimum, higher government subsidy costs by not permitting a payer with substantial market power to bring cost containment pressure on the system. The outcome is likely to be that costs will continue to spiral upward. In effect, the nation would be relying on the range of promising pilot approaches to cost containment that would take some time to be successful. If they are not, we may be left with increasingly regulatory approaches, such as rate setting or utilization controls that apply to all payers. This would mean much more government involvement than giving people a choice of a low-cost public option that would be required to compete with private insurers.

(Read entire paper in PDF)

Obama is Not Perfect

Obama

Well everyone has to make mistakes, right?

So this is what we got going on that nobody cares enough about you to tell you in the newsmedia:

Obama has dropped the ball on this round of health care reform.

This is not the say he is now failing as president, or anything else the hate-mongers on the rightwing are sure to say.

But this is the first major misstep of The 44th US President.

There are a whole multitude of reasons, most of which very technical and are not coming to mind right now, (and very boring to cover) but as I prefer to ‘cut to the chase’ I’ll just say it like this:

Obama and The Democrats have failed, and failed utterly, to properly sell good health care reform to be proposed in the Congress.

I’m going to give you all a brief lesson in sales … pay attention:

The first thing you do is explain the value. Is this highly valuable or moderately valuable or barely valuable? Are we talking about a gold-plated coffee maker, or a plastic one? Is this car made for the long haul, or just for going to the store and back?

The second thing you do is explain the benefits. Are these the greatest benefits you could possibly have or just fine benefits or perhaps no benefit exists at all? Will you be better off in a few seconds after owning this or will you be better off in two months or will you never be better for owning this?

All the Democrats and President Obama have succeeded in doing at this stage is explaining what this bill won’t do.

Not one of them has succeeded in properly conveying the value and benefit of public health care options, nor have they properly conveyed the value and benefit of saving money in a exasperated system.

Call me vastly arrogant, but I feel they need to put my over-the-top with conviction self on this issue. I am a Progressive Reformist to the bone, and I think perhaps that is exactly what is lacking in the Democratic Party these days.

It seems to me the political will to get this done is floating away from the Democrats now that we are faced with actually doing it. After years of campaigning on health care reform, specifically what we are talking about as to medical insurance reform, these same people seem to lost their thunder as the moment in upon them to roar.

I chalk this up to the nature of people and nature of the real world.

President Obama has done an excellent job in terms of foreign affairs and the national security agenda, but seems to have some trouble working toward this particular domestic policy agenda at this time.

In the end, we the people cannot rely on any one political figure or any one group to get what we need from our government.

The fight goes on, and if they fail to achieve meaningful reform then we will pick up this battle once more in days yet to come.

And perhaps in those days yet to be before us, someone can explain clearly and passionately why we need health care reform in the US.

One can only hope….

Republican Obstructionism in Health Care Reform

I see these God-forsaken ads running on my blog about how people are supposed to “Stop Obama-care Now!” and I would like to metaphorically spit on this nonsense once and for all. Anyone attaching the misnomer of “socialized medicine” or using the phrase “Obama-care” at this stage has already labeled themselves as part of the partisan agenda weakening this country from within everyday.

I contend that if we witnessed these same bills moving through Congress proposed by Republicans instead of Democrats that many of the same harsh opponents of reform would flip-flop their stance entirely. Almost anyone questioned on their position in the media or otherwise states that they think there should be “some kind” of reform.

I am left to think that a vast majority of the resistance to the passage of these measures is simply playing politics on behalf of Republicans, in that if President Obama passes a successful humanitarian bill that enhances the lives of so many American families the political consequences to their party will be too severe to manage.

At least the televised and media punditry are motivated by this end, if noting else.

This Party of No” mentality is dangerous to us all. If anyone has a valid objection or concern by all means they should make themselves known. But when a person simply stands on the legs of right wing talking points and shaky numbers I tend to think they would be a strong advocate for “McCain-care” if the universe where all flipped upside down.

Marble-Cake Federalism And Health Care Reform

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In the midst of civil and uncivil protests against any type of reformist action on the medical insurance corporations and their stranglehold over health care options in the United States there has been a proposed amendment to the bill that I feel best represents the embodiment of liberty and American Values.

The Kucinich Amendment proposes that the federal option remains intact but each state would be allowed to elect into a single-payer system if they chose to do so.

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We live in a system of government called Marble-cake Federalism where the federal government and state governments share powers over specific matters.

The best example being the issue of Gay-Marriage and the nature of how each state can decide for itself at this point if it is a legal practice or not, but if a federal law were to pass that either granted or denied the right to all citizens of the nation that would be nationwide legal practice from that point forward.

By granting a public option and in the same motion granting the state’s powers to establish a single-payer model is the best representation of Progressive Reformist action.

I would grant a lot more credit to the protestors of recent days to their commit to their cause and their willingness to do what it takes to heard, except for the facts that the values of non-violent protest seems to lost on far too many of their numbers and that the outright falsehoods coming from their mouths.

If there is a complete absence of logic and desired direction in any movement then ultimately there is one course in it’s direction: violence.

I understand a person if they speak about their fears about over reaching government powers into our lives. But I’m more interested to talk about The Patriot Act and The Homeland Security Department than I am to talk about a bill moving through Congress.

When the same group of people remained mute or even in support of expanding federalism when George W. Bush did it and then shout down their own representatives when they come to speak it becomes clear that some certain number of these people are just the most perverse of political partisans.

We the people do indeed need to find a way to take back the massive expanses in federal and executive powers but lacking a clear message beyond obstructionism of any government action regarding health care reform I am left to question the very motives of these protestors at their very core.

I also believe it to be true that a certain number of these people are paid-provocateurs working for the for-profit insurance agencies in order to make it appear that a vast majority of people support monopolies over the availability of health care in America.

Judge Andrew Napolitano & Alan Colmes

There Will Be No Radio Fairness Doctrine

PresidentBillClintonMay282003Disk2074Former President Bill Clinton can now be added to the list of big name Democrats that have eluded to or outright mentioned the Fairness Doctrine in radio-media.

I will boldly speak out turn and say now that there shall not a return to the arcane legislation of the Fairness Doctrine where an opposing opinion must be made time for after any political opinion is expressed.

Though John Kerry, Bill Clinton and other figures speak of a need for media regulation I think the issue was already addressed by President Obama when he requested that conservatives stray away from partisanship like that of The Radio Comedian Rush Limbaugh.

This is the clear stance of this administration that partisanship is any form is counter productive in politics. The partisanship found on FOX Network airwaves and conservative-talk radio was challenged thusly by the Executive Branch. I see no moves from this office toward this matter beyond what we have already witnessed.

This issue simply doesn’t rate high enough on the presidential ‘to do list.’ The outcries from the far right wing that this inane legislation from days gone by are paranoid delusions created to fabricate the image of ’persecuted’ conservatives.

The right to Freedom of Speech has always challenged Americans in terms of what they will accept in terms of their politics and their news media. Those like myself who have educated themselves on some aspects of modern media know about the Radio Fair and Equal Rule.

In the Fair and Equal Rule a political campaign that receives airtime must have due consideration and / or equal airtime.

I foresee no threat to the talk radio medium spreading further into FM, satellite and internet formats.

Though I also would not predict any ‘explosions’ of talk radio, but rather just a gradual integration. The Politic-Talk Medium will always remain, no matter what paranoid conservative pundits say.