Why The Health Care Debate Is So Contentious

Even prior to the abortion issue being pointlessly dragged into the debate over health care reform the issue has been one of the most contentious debates I have ever seen in politics.

The question quickly becomes: Why?

I feel I have an answer, and it mirrors the matter of the abortion debate as well.

It is simple:

Both sides view the other as disingenuous and downright evil.

From the perspective of the anti-reformists all support for this bill is a disguised effort to destroy capitalism and / or expand the federal government to an unreasonable size.

From the perspective of the pro-reformists all rejection of this bill is a disguised effort to spread hatred, intolerance, racism and violence under the banner of a “tea party” and / or purely strategic politics of conservatives seeking to undermine all bills proposed under President Obama.

(There is, of course, a great deal more complexity at play here in both positions.)

In a situation where both groups view the other as “liars” there is no debate to be had. No discussion that will bare fruits. None.

The fear and lies surrounding this health bill entirely native to the rightwing has no bartering point from which to start from. There is no common ground to find with a person who lies about the record and rejects all evidence that does not compliment their existing preconceptions.

Throughout this year long national debate I have strived to pull the emotions out and put the facts in their place, but such actions only serve a purpose when there remains holdouts on both sides. In the course of this I have seen new levels of hostility directed at me personally more so then ever before in my experience.

I have never “unfriended” and “blocked” so many people in my entire ten-plus years on the Internet.

The incitement toward violence, the death threats, the partisan hate; all existed prior to the matter becoming national in the death threats against Democrats post-HCR. All of this existed in the venom directed at health reform advocates on a daily basis from individuals of a very low moral fiber and very poor understanding of democracy.

In matters discussing life and death, I’d rather not see so many and myself give in to fear; but it truly doesn’t surprise me in the least to see this country explode in mindless paranoia. Big changes equates to big fears, bad economy equates to paranoia on the rise.

In the solid matter of facts, this health bill is a net-positive for America.

But this issue will not lose any of it’s contentious nature no matter how many facts are interjected in the mass spreading of paranoid myths. For too many Americans it is simply easier to believe the worst, and the biased conservative media is sure to provide them endless piles of red meat.

Yes We Can Have Health Care!

We have talked about it.

We have fought about it.

We have gotten upset about it.

But now it’s over, and I called this shot from months back.

Some said I was counting my chickens before they hatched, others believed in my crystal ball.

But here we have it! Health Care Reform in the U.S. has passed!

And not a moment too soon.

The Truth Before The Summit

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Rep. Anthony Weiner (D-NY) brought forth the truth to power that has been so lacking in the liberal progressive movement as of late.

The Bush Tax Cuts, COBRA, & S-CHIP, were all passed by the same tactic these Republicans are now calling the “nuclear option.”

Anyone watching the plays on health care reform knows that it is nothing less than the simple truth that the Republicans are wholly owned by the insurance companies.

And their partisan conservative media with them.

Obamacare Revealed!

We have heard a right-wing meme that some in the middle or left have been mistakenly using since to first days of the U.S. Health Care Debate: “Obamacare

No such thing existed, until today.

Perhaps under pressure by the grassroots push for Senate reconciliation, the president has moved in the direction that I and others urged him toward near to the beginning of the health care debate surrounding the congressional reform bills.

If there is a bipartisan support for the president’s proposal then Senate reconciliation measures may prove ultimately avoidable. As all rational people advocating for reconciliation understand the underlying drawback to using the process.

Still reading…

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Image: Alan.com

Senate Reconciliation Now!

The Republican obstructionism on the health care reform agenda is not “principled objections” as Senate minority leader Eric Cantor suggests. It is non-principled, pure nihilistic policy of poisoning the well and deception on behalf of conservatives.

The liberal majority that elected Democrats to office in 2008 has spoken.

The Public Option must survive in a final health care bill, and the process of reconciliation between House and Senate bills is the only avenue by which Democratic representatives can claim to have made any “meaningful reform” come reelection time.

Make it clear that this will not go away, and we the liberal progressives will not be silent.

This push did not come from the White House, or the Progressive Caucus, or from the desk of Sen. Harry Reid. This push for a strong public option through reconciliation came from the people who understand that health care is a moral issue, not merely a budgetary issue.

Both President Obama and Senator Reid remain open to the pursuit of Senate reconciliation, but I believe it important to state that this in itself is the “failure to sell health care reform to the American people” I spoke of before.

Instead, we will have to make perfectly clear that the public option must go forward and does not continue to be the “public optional.”

Sen. Majority Leader Harry Reid (D-Nev.) announced on Friday afternoon that he would work with other Democrats and the White House to pass a public option through reconciliation if that’s the legislative path the party chooses.

The party has spoken. The ball is their court now in congress, but we must not allow this to fade into the night.

Just as Paul Krugman recently closed an op-ed with, “Health Care Reform Now!” I would say the as he except in different words given the changing of the situation but holding the same meaning:

Senate Reconciliation Now!

U.S. History in the Making (Health Care)

(Big3News)

My political predictions have once again proven true.

I predicted at the onset of the national and Congressional debate over health care coverage in the US that we would see a bill pass both House and Senate but that it would a “watered-down” bill that addressed preexisting conditions and state-to-state plan probability more than it addressed the larger problem of controlling costs.

This Senate bill hardly resembles what I would call “sweeping reform.”

In the course of the debate over the past few months I was in the “incrementalism-reform camp” that was frustrating my fellow Democrats advocating for single-payer, but in the end this bill will fall into indeed too small a step. I was only saying along with others that we have studied government and nothing this big is done all at once. However, like I have heard many say, I would have liked to get a lot more out this process.

The last time I spoke of this I was urging Harry Reid for “reconciliation” in the Senate; without the civics lesson needed here it is quicker to say that once the public option was removed from the table, the process of reconciliation was removed as well.

To encapsulate what is going on this country: we are a constipated nation when it comes to social programs.

There is the very real ideological constipation against positive social reforms dating back to the days of FDR and further still. Then there is the constipation specific to this issue of the monopolistic health insurance companies spreading public disinformation like the stuff is on sale. This, and other factors like Sara “Death Panels” Palin and Glenn “Fearmonger-in-Chief” Beck, make this one of the most hostile environments one could possibly hope to create against pro-reform activities.

The entire experience feels like we pro-reformists have fallen flat on our face and bloodied our nose, which would be correct. But I remind everyone sharing with me in this feeling that we did just run head-first into a brick wall of highly funded anti-reformism.

We have made history in the US Congress in that we have finally cracked the brick wall against fixing a system that every informed person agrees desperately needs reform. To shatter this brick wall is a much larger task and the true importance of these recent national debates over health care coverage has been the value of flushing the wolves out into the open more than it was about the larger picture.

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)