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Senate proceeds to health debate

by: Christopher

Sun Nov 22, 2009 at 13:02:18 PM EST


(Don't miss John Walsh's comment regarding the importance of having two Senators from Massachusetts.

Note to Christopher: the public option and the exchange are very different.  The exchange is very similar to the Connector that we have here in MA -- a centralized place where consumers can compare and purchase health insurance.  The public option is a government-operated health insurance plan, which presumably will be one option among those offered in the exchange.  So, when you go to the exchange, you can choose between (for instance) plans offered by Blue Cross, Aetna, Cigna, Tufts, Fallon, and the government (public option). - promoted by David)

Last night the Senate voted on straight party lines to open debate on the Democratic leadership's health reform bill.  All 60 members of the Democratic caucus voted for cloture on the motion; 39 Republicans (Voinovich of Ohio not voting) voted against.  As far as I'm concerned there's no reason in the world for this particular procedural vote to not have been unanimous.  All this was was a vote on whether to talk about it.  The Democrats should be hammering the GOP by saying we may have our disagreements, but the Republicans don't even want to talk about an issue affecting millions of Americans.  Ben Nelson of Nebraska asked rhetorically why he would vote against an opportunity to make the bill better.  I hope Reid stands fast for a public option though Lincoln's floor speech confused me because she sounded like she wanted an exchange, but not a public option which I thought were one in the same.

Christopher :: Senate proceeds to health debate
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Sixty - but just barely (6.00 / 10)
This vote and the closeness of it illustrates the importance of having Senator Paul Kirk's vote in the Senate last night.  It's not just the vote on the final bill - as important as that is.  If the Democrats didn't have Senator Kirk's vote, would this vote have occurred yet?  Maybe more importantly, what would have to have been sacrificed at this point to get that sixtieth vote somewhere else?

I am thankful for Senator Kirk's vote.  I am proud that Governor Patrick appointed an interim Senator that could cast that vote - and provide the Democrats that leverage as this process moves forward.  I am grateful to the legislators who voted to give him that authority.  It turns out it was needed.

Finally, Republicans in Washington - like their compatriots on Beacon Hill - continue to cement their reputation as the "Party of NO" on every issue.  Too bad.

Earlier today, I released a statement reflecting these sentiments:

"Today, because of the votes of 60 Democrats and Independents, we are closer than ever to historic health insurance reform. I'm sure there are some Republicans who know this opportunity to cut health insurance costs and provide coverage to the uninsured across our nation is important. There is still time for them to contribute to this debate, speak out and join us to help make national health insurance reform a reality like we have already started to do in Massachusetts.

"It is clear from last night's vote that the U.S. Senate would not have been able to open debate without the strong voice and vote of our own Senator, Paul Kirk. I commend him for his comments last night and for his vote.

"Without Governor Patrick's leadership and the effort of every Massachusetts legislator who voted to allow the change sending Sen. Kirk to the Senate, this issue would still be stymied by Republican efforts to just say, "No," to stop debate, to halt progress and to ruin once again the chance for historic change to our health insurance system. Democrats and independents across Massachusetts are proud of Governor Deval Patrick for his effort to allow us to send Sen. Kirk to stand alongside Sen. John Kerry for this vote."

John Walsh, Chair
Massachusetts Democratic Party


I'm honored... (0.00 / 0)
...that the party chairman would comment on one of my diaries - thank you!

[ Parent ]
no real movement here? (0.00 / 0)
This hardly even seems like a victory, given that Lincoln and Lieberman have both said they'll filibuster sending any bill with a public option to a vote. It's like they got a free vote to be able to say they supported a vigorous debate. What can change their position?

Big Insurance Is Working Blanche Lincoln Over in Arkansas (0.00 / 0)
My parents live 18 miles outside a 3,000-person town called Mountain View, and the big "Hands Off Healthcare" Tour Bus showed up this weekend for a rally against "socialism."  They passed around petitions saying "no healthcare for illegal aliens."  Now, if they have got the money and time to send a bus through Mountain View, Blue Cross must be covering every little hamlet in that state.

Blanche Lincoln's email and voicemail are full, btw.

This is far from decided.


[ Parent ]
And at what a price (0.00 / 0)
Ben Nelson of Nebraska asked rhetorically why he would vote against an opportunity to make the bill better.
Apparently he would vote against such an opportunity if it cost the insurance companies their antitrust exemption. That was his price. Not $100m like Lincoln; his sticking point was the antitrust exemption. Now we know how completely owned he is.

Shoe bomber, underwear bomber -- why aren't we waging war on clothes?

[ Parent ]
i worry we're in for (0.00 / 0)
months of debate with Democrats negotiating against Democrats to water down the bill to swill, good only for the health insurers.  

www.bit.ly/7Wousr - "Must include a public option"
www.bit.ly/7yaoMv - Coakley shifts, backs abortion curb
www.bit.ly/5f8CVb - John Kerry reporting for duty!
www.bit.ly/6rJnZU - Questions for Martha Coakley on Civil Rights  


[ Parent ]
Valid fear (0.00 / 0)
Sorry to say.

"Perseverance is a great element of success. If you knock long enough and loud enough at the gate, you are sure to wake up somebody." -Longfellow

[ Parent ]
I think what he's saying... (0.00 / 0)
...is he DOES want reform and realizes we won't get it at all if we can't even discuss it, including whatever in his mind might improve the proposal.

[ Parent ]
Yes, that's what he's saying (0.00 / 0)
What he's doing is something else - he's protecting the insurance companies' exemption from antitrust laws. He could have gone for some traditional pork, which would have at least benefited his constituents. That's what Lincoln did. He could also have insisted on some change that actually made the bill better. Instead, he chose to benefit his corporate sponsors.

Shoe bomber, underwear bomber -- why aren't we waging war on clothes?

[ Parent ]
weeks of awful grandstanding ahead! (0.00 / 0)
By the way, can we all agree that "world's greatest deliberative body" is among the most hideous pieces of empty, meaningless, self-serving bullshit in the history of the English language?

LOL. (6.00 / 1)
I like that.  I'm sort of partial to the Wonkette headline, "Senate Votes to Allow Itself to Discuss Health Care For the Next Several Months."

You'd think they'd just figured out that the Answer to Life, the Universe, and Everything is 42.  

Honestly, if it weren't so Hitchhikeresque it might be Kafkaesque--or some hideous hybrid.


[ Parent ]
Thank you, David (0.00 / 0)
for both the promotion and the clarification.  Is really all the exchange does is make research easier since presumably if you need to self-purchase now you can shop around?  How (if at all) do prices go down without a public option?  Is it just the idea that people are more likely to notice price differences with all the information in one place and thus the providers will be encouraged to lower them?  An exchange sounds like a travel agent which you can use or just do your own planning.  Any further clarification would be appreciated.

The exchanges (0.00 / 0)
would be a huge help.  I don't know if you ever had the misfortune of trying to buy health insurance as an individual pre-reform.  I have; it was a truly horrible experience.  Then I had to do it again when the Connector was in place.  No comparison.  The Connector works really well, and I'm sure the exchanges will too.  Prices will go down because on exchanges (as on the Connector) it's actually possible for consumers to comparison-shop, hence there is better information, which is a prerequisite for effective competition.

[ Parent ]
Does that also require... (0.00 / 0)
...that all the plans will offer the same coverage so we can truly compare apples to apples?  I'm still not sure what's stopping me right now from doing my own homework and going to the websites of each provider separately to see what they are offering and choosing accordingly.

[ Parent ]
Heh. (0.00 / 0)
Well why don't you give that a try and see how it works out.

[ Parent ]
One thing I would say about cost... (0.00 / 0)
...and I would love for this to be THE message on this factor.  If we can find money for wars, money for bailouts, and money for stimulus, we can find money for this.  We should always try to be efficient with public spending, but we should not cower in the face of collective sticker-shock.

Whoa, not so fast though... (0.00 / 0)
As I understand it, the achilles heel of the exchange is that it results in a slew of small and fragmented exchanges, none of whom contain enough subscribers to provide effective cost competition to the established providers. Consumers end up with just another way to throw away their money on over-priced private health insurance plans.

The public option, on the other hand, provides a huge base of subscribers that allows it to offer a compelling cost advantage. This is why the insurance companies want exchanges, especially if they can kill the public option along the way.

The aspect of the public option that strikes fear in the hearts of private insurers is the possibility of a huge nationwide pool of subscribers -- allowing the costs (and therefore premiums) to be dramatically lower than anything the private insurers can offer.

I am under the impression that our early experience with the Connector supports this analysis.

"If the Republicans will stop lying about the Democrats, the Democrats will stop telling the truth about the Republicans" -- Adlai Stevenson


I'm not sure (6.00 / 1)
how the Connector relates to that hypothesis, since we have nothing like a public option here in MA.  The Connector is an easy way to buy any of several private health insurance plans.  Can you elaborate?

[ Parent ]
The Connector functions as an "exchange" (0.00 / 0)
It offers consumers a choice, yes, but it doesn't allow them to join a larger pool. Thus, it doesn't change the cost structure that keeps premiums high.

Competition among insurers is only one aspect of reducing consumer costs, and apparently (based on the early results from the Connector) a relatively  minor one.

A far more effective way to lower consumer costs is to allow each to be part of a much larger pool, with far more attractive loss payout ratios -- thus dramatically lowering the costs and therefore the price.

It's the large base of subscribers (with the correspondingly more attractive loss payout ratio) that makes the public option so threatening to private insurers. That's why they are working so feverishly to kill it any way they can.

"If the Republicans will stop lying about the Democrats, the Democrats will stop telling the truth about the Republicans" -- Adlai Stevenson


[ Parent ]
Oh I see. (0.00 / 0)
Yes, I agree with that.  I misunderstood your earlier comment.  Carry on.

[ Parent ]



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