Via Greg Sargent, quoting Senator Lincoln:

Health care reform must build upon what works and improve inefficiencies. Individuals should be able to choose from a range of quality health insurance plans. Options should include private plans as well as a quality, affordable public plan or non-profit plan that can accomplish the same goals as those of a public plan.

We’re pleased Senator Lincoln is moving in the right direction. With four out of the five committees in Congress supporting real health care reform, I know where the momentum is.

(also posted at the NOW! blog)

That’s basically the argument of the Wall Street Journal’s editorial board today:

Speaking to the American Medical Association last month, President Obama waxed enthusiastic about countries that “spend less” than the U.S. on health care. He’s right that many countries do, but what he doesn’t want to explain is how they ration care to do it.

Take the United Kingdom, which is often praised for spending as little as half as much per capita on health care as the U.S. Credit for this cost containment goes in large part to the National Institute for Health and Clinical Excellence, or NICE. Americans should understand how NICE works because under ObamaCare it will eventually be coming to a hospital near you.

…

The NICE precedent also undercuts the Obama Administration’s argument that vast health savings can be gleaned simply by automating health records or squeezing out “waste.” Britain has tried all of that but ultimately has concluded that it can only rein in costs by limiting care. The logic of a health-care system dominated by government is that it always ends up with some version of a NICE board that makes these life-or-death treatment decisions. The Administration’s new Council for Comparative Effectiveness Research currently lacks the authority of NICE. But over time, if the Obama plan passes and taxpayer costs inevitably soar, it could quickly gain it.

Mr. Obama and Democrats claim they can expand subsidies for tens of millions of Americans, while saving money and improving the quality of care. It can’t possibly be done. The inevitable result of their plan will be some version of a NICE board that will tell millions of Americans that they are too young, or too old, or too sick to be worth paying to care for.

So, because the Wall Street Journal thinks that at some point in the distant future the Obama health care plan could possibly start to look like England’s, Americans should have health care reform? Really?

What about the care that’s rationed in this country every day? What about Maureen’s story? Maureen’s insurance company intentionally delayed her care (rationed it) because it was too expensive. She almost died. Check out the video of her story:

Think of how many stories you hear in the media about people skipping their doctors visit because they can’t afford it. Or hospitals or insurance companies denying care because of some esoteric rule in a patient’s health care plan. The reality is we ration care in this country, and there is already a bureaucrat standing between you and your doctor - an insurance company employee who’s job it is to deny as much care as possible to save the company money.

These practices, right here in the USA, must stop. That’s why we need reform. Don’t let the fear-mongers scare you into losing sight of that.

After voluntary deals with the health insurers and the drug companies, Senators and the administration reportedly has a deal with hospitals:

With health care legislation at a crossroads, the nation’s hospitals are near agreement with a key lawmaker and the White House to pick up part of the cost of President Barack Obama’s plan for expanded coverage, officials said Monday.

The precise size of any deal was not available, although several days ago, talks were focused in the area $155 billion over a decade. These officials said under the emerging agreement, hospitals would accept lower-than-anticipated payments under Medicare and Medicaid, the federal health care programs for seniors and the poor.

To which I say, like I’ve said before, great! Now let’s just write all those deals into law to make sure we’re not hanging our hopes on voluntary measures that never come to pass.

But there’s more at work here than just the policy. Obama has clearly decided that he wants to keep these large industry players at the table, and he’s keeping them there by making these kinds of deals. It’s a high-stakes strategy, because these players would just as soon keep the status-quo if they could, but so far it seems to be paying off, seeing as they understand status-quo is dead. Hospitals, drug companies, and insurers are still saying they are pro-reform, and more importantly, they have not poured their huge coffers into paid media advertising against reform. Keeping them at the table means they can’t spend a lot of time or money attacking other elements of reform. That’s a big deal.

Of course, keeping these people at the table carries the risk that the final product will be influenced by their interests, which makes it more likely the final product won’t actually provide quality, affordable health care to everyone. (And indeed, there is an understanding in this deal that the new public option would pay higher than Medicare and Medicaid rates - a win in that hospitals are tacitly agreeing to a public option, but with a caveat.) But, while the industry is spending $1.4 million a day, that money is just barely keeping them in the game. Reform is moving forward, and four of the five committees with control over health care in Congress are supporting a strong public health insurance option, the thing these interests fear most.

I’d agree with Jon Cohn about the big picture:

[Congressional and administration staff] suggested the political upside of these deals was considerable: “The more people are making deals,” one Hill staffer told me, “the greater the sense of inevitability that this will happen and the greater the momentum.” And while these sources understood the groups could simply walk away from the deals anytime–and declare, in effect, that their pledges of support were null and void–these sources noted that reformers, starting with the president, could do the very same thing.

Keep in mind these are deals with Baucus and, via his proxy, the Senate Finance Committee. But whatever comes out of Senate Finance will eventually have to be combined with the Senate Health, Education, Labor, and Pensions Committee bill. The combination, in turn, will have to be reconciled with whatever comes out of the House. That creates quite a few opportunities for modification–and improvement.

Keeping these people at the table makes reform more likely, and if you can keep them at the table while still writing legislation that lowers cost and gives good health care to everyone - something these groups don’t really want to do - more power to you.

(also posted at the NOW! blog)

On June 25th, Maureen came to Washington, DC from Pennsylvania to lobby her Members of Congress on health care. The Campaign for America’s Future documented the trip, and her story.

The insurance company literally tried to kill her, delaying her routine care because they didn’t want to pay. She suffered permanent harm as a result. But she survived, and thrived, and was able to tell a crowd of thousands why health care can’t wait anymore.

Watch:

Maureen Kurtek Goes to Washington from AmericasFuture on Vimeo.

Last week, I wrote about workers who were fighting back against Wells Fargo after the bank cut off credit to Quad City Die Casting factory on Moline, Ill., causing the factory to close. This week Wells Fargo has cut off health care benefits to the workers, which the workers say violates federal labor laws.

The United Electrical, Radio and Machine Workers of America (UE) Local 1174, which represents the workers, has responded by filing charges today with the National Labor Relations Board. The company also informed employees that Wells Fargo would not approve the expenditure of owed vacation pay, and the company has refused to pay a 2 percent wage increase due the employees under their legally binding collective bargaining agreement.

As Wells Fargo cuts off credit to Quad City and forces it to break its collective bargaining agreement with its workers, the bank has $25 billion in federal bailout funds that were intended in part to make credit more available to businesses.

“Wells Fargo first ends financing, forcing our company to close, and now they won’t pay us what we are owed by law. To us, our vacation, insurance and wages mean everything to our families. But to Wells Fargo it’s pennies, not even a blip in their billions. Yet they choose to cheat us out of what we have earned.” said Deb Johann, a union member employed at the factory.

According to management officials, Wells Fargo approves all expenditures by the company on a weekly basis. Workers are calling upon federal officials to investigate the practices of Wells Fargo.

The UE that represents workers at the plant is the same union that occupied Republic Windows and Doors last summer. Its members are engaging in direct action against Wells Fargo, calling on the bank to keep the plant open. Workers continue to demand that Wells Fargo do what is necessary to keep the company in business until a sale of the company is finalized. According to parties familiar with the discussions, there are currently several interested parties looking to make a bid to purchase Quad City Die Casting.

The union says that after having received $25 billion in bailout money, Wells Fargo has an obligation to promote economic recovery by keeping the plant open. UE Director of Organization Bob Kingsley said, “We can’t let this giant bank default on its obligation to the American people and the people of the Quad Cities. Wells Fargo is a roadblock to economic recovery.”

Growing up the son of a union organizer in Pittsburgh, PA, Mike Elk has been a part of the labor movement for nearly his entire life. Currently, he works on the health care reform team at Campaign for America’s Future. He has worked as a union organizer for the United Electrical, Radio, and Machine Workers (UE) and the Obama-Biden Campaign. Mike served as a research fellow at the Instituto Marques de Salamanca in Rio de Janeiro, Brazil helping to set up worker run cooperatives. When Mike is not scanning a twenty blogs at a time, he enjoys jazz, golden retrievers, and making friends of stranger. He blogs at Yinzer Solidarity.

In response to the hubbub today:

Richard Kirsch, National Campaign Manager, Health Care for America Now:

“Today, President Obama unequivocally reaffirmed his commitment to a public health insurance option as part of comprehensive health care reform this year. We believe too that a national robust public health insurance plan that is ready on day one is central to lowering costs, injecting competition into the health insurance market, ensuring access to care in every corner of the country, and keeping the insurance companies honest. We look forward to working with the President and Congressional leadership to accomplish these goals.”

Just so you know what kind of public option we’re supporting…

(also posted at the NOW! blog)

As I noted last week, the overwhelming majority of Americans favor substantial change to the health care system, including the public option.  Even though Republicans are taking the unpopular position of opposing the public option, even though Republicans have no plan of their own to fix the problems millions of Americans are dealing with, they do have a few things going for them.  First, drug and insurance companies are spending millions of dollars on lobbying aimed at scuttling the public option and influencing members of Congress.  Second, the traditional media is failing to report fairly and accurately on debate.

I noticed one more problem tonight: even supporters of reform who favor a public option don’t know how to play the rhetoric game.  Republicans are masters of this–they have made phrases like “tax and spend liberals”, the “war on terror”, and “socialized medicine” into effective rhetorical tools in the health care context and beyond.  Supporters of reform need to stop accepting the Republicans’ terms of debate.  On tonight’s “The Ed Show”, Ed Schultz and Katrina vanden Heuvel, two supporters of the public option, lost a rhetorical battle with Republican Sen. John Barrasso, who opposes the public option.  Several times, Sen. Barrasso charged that health care reform promises a “government takeover” of the health care system, even suggesting that a single payer system is in the offing.  Pure fantasy.    No one on the Democratic side has managed to make single payer part of the debate.  The question is whether reform will include a public option, which would allow Americans to choose a government plan, but would not require it.  If people are happy with their current health insurance, they can keep it–whether it is provided by a private or public insurer.

Schultz and vanden Heuvel failed to make this point.  Schultz debated Sen. Barrasso directly, and simply failed to point out that Barrasso was creating a straw man by insisting that reform is about single payer and “government takeover” of health care.  Vanden Heuvel came on just after Sen. Barrasso finished his rhetorical sleight of hand and she too failed to point out that the senator’s argument depended on a red herring.

I’m no expert on health care reform, but I know that if supporters of the public option allow opponents of the idea to frame the debate in terms of a threatened government takeover aimed at socialized medicine, they have given up ground unnecessarily.  It’s time to call opponents of reform out and insist that debate is based on facts, not fantasies about proposed reforms that are simply not on the table.

Fake health reform opponents, meet real health reform opponents. It’s hard to decide which is funnier.

It’s pretty clear that despite Frank Luntz’s best efforts, conservatives aren’t getting the talking points. Watch tea party goers in New York talk about how great our health care system is, then readily admit the Republicans have no plan for health care, either. This is priceless:

Paul Krugman gets it:

But last week the budget office scored the full proposed legislation from the Senate committee on Health, Education, Labor and Pensions (HELP). And the news — which got far less play in the media than the downbeat earlier analysis — was very, very good. Yes, we can reform health care.

…

Now, about those specifics: The HELP plan achieves near-universal coverage through a combination of regulation and subsidies. Insurance companies would be required to offer the same coverage to everyone, regardless of medical history; on the other side, everyone except the poor and near-poor would be obliged to buy insurance, with the aid of subsidies that would limit premiums as a share of income.

Employers would also have to chip in, with all firms employing more than 25 people required to offer their workers insurance or pay a penalty. By the way, the absence of such an “employer mandate” was the big problem with the earlier, incomplete version of the plan.

And those who prefer not to buy insurance from the private sector would be able to choose a public plan instead. This would, among other things, bring some real competition to the health insurance market, which is currently a collection of local monopolies and cartels.

The budget office says that all this would cost $597 billion over the next decade. But that doesn’t include the cost of insuring the poor and near-poor, whom HELP suggests covering via an expansion of Medicaid (which is outside the committee’s jurisdiction). Add in the cost of this expansion, and we’re probably looking at between $1 trillion and $1.3 trillion.

There are a number of ways to look at this number, but maybe the best is to point out that it’s less than 4 percent of the $33 trillion the U.S. government predicts we’ll spend on health care over the next decade. And that in turn means that much of the expense can be offset with straightforward cost-saving measures, like ending Medicare overpayments to private health insurers and reining in spending on medical procedures with no demonstrated health benefits.

The verdict is clear - if we do reform right, it doesn’t cost much, and the benefits, both economically and socially, are enormous. People get coverage, costs go down, and medical bankruptcies stop.

But this only works if you’ve got all the elements. A public option, shared responsibility where employer contribute, decent benefits, and subsidies to make it affordable. If you’re missing those elements, the costs go up, and on top of that, you don’t get real reform that meaningfully affects everyday Americans.

Will the Finance Committee follow suit here? If Chuck Schumer has anything to say about it, yes:

“If you did a consensus within the Democratic Party, you would find the level-playing-field public option to be the answer,” said Sen. Chuck Schumer, D-N.Y. “And now that we have 60 votes, it seems to me like we don’t have to turn it inside out for something we don’t like.”

…

“[Sen. Chuck] Grassley hasn’t closed the door, but it seems in general that his model of co-op is little co-ops popping up like they do in farm country,” he said. “And the model that we are saying we need is they have to be strong, national and available everywhere from the first day. And I think we are very far apart on this.”

“So I don’t think the co-op way can work,” Schumer added. “So let’s go back and do what we should be doing: a public option.”

And they should. It’s better for the country, it’s better for consumers, and it’s better for America’s bank account. Just about the only people who don’t like it are ideological conservatives, and they just lost the election.

(also posted at the NOW! blog)

That the rest of the world is able to do something that the U.S. can’t seems an odd principle for the entrepreneurship advocates to espouse. While holding that regulation destroys innovation, our wingers claim that we are going to give up our advantages by providing health care to everyone. Regulation of our health care system is the danger they predict; freedom to be sick doesn’t seem like much of an argument, but it’s the best they’ve got.

Dr. Krugman has already pointed out that this country spent its way into the present crisis with tax breaks for business that did not produce the employment they were claimed to. Today, he provides some specifics of the health plan proposed for the U.S. public.

Let me start by pointing out something serious health economists have known all along: on general principles, universal health insurance should be eminently affordable.

After all, every other advanced country offers universal coverage, while spending much less on health care than we do. For example, the French health care system covers everyone, offers excellent care and costs barely more than half as much per person as our system.

And even if we didn’t have this international evidence to reassure us, a look at the U.S. numbers makes it clear that insuring the uninsured shouldn’t cost all that much, for two reasons.

First, the uninsured are disproportionately young adults, whose medical costs tend to be relatively low. The big spending is mainly on the elderly, who are already covered by Medicare.

Second, even now the uninsured receive a considerable (though inadequate) amount of “uncompensated” care, whose costs are passed on to the rest of the population. So the net cost of giving the uninsured explicit coverage is substantially less than it might seem.

Putting these observations together, what sounds at first like a daunting prospect — extending coverage to most or all of the 45 million people in America without health insurance — should, in the end, add only a few percent to our overall national health bill. And that’s exactly what the budget office found when scoring the HELP proposal.

The wingers appear to have nothing but opposition to public interest as a basis for existence. It’s not surprising that their arguments are creative,but lack substance, as they are not the true story.

The right wing is against the left, and that is its attraction. Unreasoning obstruction isn’t a tactic, it’s the character of the movement. Sadly, there is still a faction of the voting public that identifies with mindless opposition to anything progressive and in the public interest.

Hopefully, the wingnuts can be cured by rational behavior over time.

(This post also at http://cabdrollery.blogspot.com/ )