The polls overwhelmingly supporting reform, notwithstanding...isn't the fact that we elected Obama by a large margin proof enough we want reform? Exactly why is he "taking this to the people!"? We already get it, we want it, and we voted FOR it when we voted for him and a vast majority in the House and Senate. That's how representative democracy is supposed to work.

All the serious Democratic candidates in the Primary strongly advocated for reform, specifically including a public option or better (in the case of Kucinich). They all ran on public options and universal coverage of some kind. Obama did this in the primary and in the general as well. A Democratic leader was elected. If this is essentially a party plank, where is the debate and why are we being courted?

Elections matter, and the elections are over.

The real problem is not getting the "people" on board...it's getting 6 Senators on board (or whatever the exact number is).

I almost think Obama does himself a disservice by acting like he still needs to convince us rather than just strong-arming the errant Senators who are putting politics and campaign $$$ ahead of sound policy and doing what's right.

The more he acts like there is a debate, the more he legitimizes those who are looking to delay, derail, or corrupt reform.

Personally, I think he should make back channel threats to the people standing in the way of saving lives. Either you vote with the President, or you are going to go down in the next primary to whoever Obama chooses to bless.

Consider me very disgusted at this point. With Bush, I was ashamed of my country, though I felt it got the bad governance it deserved. With Obama, I feel better about the avg American voter but I'm a lot more depressed about the Democratic Party that doesn't seem to know how to win, even when we hand the victory to them on silver near-filibuster proof platter.

What's wrong with these people?

Posted on March 5, 2009
Single-payer advocates win seats at White House health summit, remarks by Dr. Oliver Fein
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Dr. Oliver Fein releases prepared remarks

FOR IMMEDIATE RELEASE
March 5, 2009

Contact:
Oliver Fein, M.D.
Don McCanne, M.D.
Steffie Woolhandler, M.D.
David Himmelstein, M.D.
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

Two leading advocates of single-payer health reform, sometimes characterized as an improved Medicare for All, received last-minute invitations to attend the White House health care summit being held today. The invitations were greeted as a victory by single-payer supporters.

Rep. John Conyers Jr. (D-Mich.), chief sponsor of the single-payer U.S. National Health Care Act, H.R. 676, was invited to attend the meeting late in the day on Tuesday, and Dr. Oliver Fein, president of Physicians for a National Health Program, was invited on Wednesday afternoon.

The White House invitations were extended to the two leaders after intense grassroots lobbying efforts by single-payer supporters, who were concerned that no single-payer voices would be present at the meeting. The efforts included an outpouring of phone calls and e-mail messages to the White House, along with a threatened demonstration outside the White House gates by doctors and other health professionals wearing their white coats. The demonstration was called off when word arrived that Rep. Conyers and Dr. Fein had been invited.

In his prepared remarks, the full text of which follows, Dr. Fein says, “We are pleased to be here today and appreciate the implicit recognition of the majority support for single payer in our country. We hope this is the beginning of a serious dialogue on how to enact single-payer health reform and we look forward to working with and the Congress toward this end.”

Dr. Fein’s prepared remarks for the summit follow.
Prepared remarks by Dr. Oliver Fein

Mr. President, Physicians for a National Health Program agrees with your statement during your presidential campaign: health care should be a basic human right.

Physicians recommend an improved and expanded Medicare-for-All - that is, a single-payer national health insurance program, providing care that is publicly financed but largely privately delivered. This fundamental health reform - which enjoys solid majority support among physicians and the public - has become even more urgently needed in view of our severe economic recession.

Millions of people are losing their employer-sponsored health insurance, joining the 46 million who already lack coverage. Millions more, including those with insurance, are finding it harder to pay their co-pays and deductibles and are scrimping on their medications and doctor visits. Many go without care, risking their health and often their very lives.

Physicians find that private, for-profit health insurance companies add cost but no value to the health care system. The administrative waste associated with the private-insurance-based industry - enormous paperwork, marketing costs, and other costs that have nothing to do with delivering care - consumes 31 cents of every health care dollar.

As long as we rely on private health insurers, universal coverage will be unaffordable.

Mandates to buy private insurance are not the answer. Experience with mandate plans in Washington state (1993), Oregon (1992) and Massachusetts (1988 and today), shows they simply don’t work, achieving neither universal health care nor cost containment.

Some of these plans offer a Medicare-like, public option that people could buy into, but experience with Medicare shows that the private plans refuse to compete on a level playing field. They cherry-pick healthier patients and insist on more than their share of payment.

In contrast, single payer guarantees everyone access to comprehensive, quality health care and choice of their own doctor and hospital.

Single-payer health reform, an improved Medicare for All, is the only reform model that offers $400 billion in annual savings in administrative costs. It is the only approach that contains effective cost-containment provisions such as bulk purchasing and global budgeting.

Such economies would allow for expanding health coverage to everyone - with no co-pays or deductibles - with no overall increase in health care spending. In other words, it’s the only health reform proposal that pays for itself.

The single-payer model is the only fiscally prudent proposal available, an especially important consideration at a time of economic distress. And we know from our experience with Medicare and other single-payer systems that it will work.

With a single-payer national health insurance program we can assure lifelong, high quality, comprehensive and affordable coverage for everyone. Such a program will lift the heavy burden of crushing medical expenses off the shoulders of our population, expenses that often lead to personal bankruptcy. And we can save lives: the Institute of Medicine estimated in 2002 that more than 18,000 Americans die each year from lack of health insurance. That number is certainly higher today.

From the standpoint of what benefits our patients, single payer is the health policy model that best reflects their needs and values.

Support for single payer is extensive. In a peer-reviewed statistical study in the Annals of Internal Medicine, 59 percent of U.S. physicians said they would support government action to establish national health insurance. In a recent Associated Press poll, 65 percent of the respondents said, “The United State should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxes.”

Single-payer health reform is embodied in the U.S. National Health Care Act, H.R. 676, sponsored by Rep. John Conyers (D-Mich.). It had 93 co-sponsors in the 110th Congress, the most of any health reform legislation.

We are pleased to be here today and appreciate the implicit recognition of the majority support for single payer in our country. We hope this is the beginning of a serious dialogue on how to enact single-payer health reform and we look forward to working with you and the Congress toward this end.

****

A short biography of Dr. Fein is available here: http://www.pnhp.org/stateactions/new_york /

Physicians for a National Health Program (www.pnhp.org ), a membership organization of over 15,000 physicians, supports a single-payer national health insurance program. To contact a physician-spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

However the goals have to be modest. We cannot be there to "control" or pacify the region but rather to destabilize our adversaries there. Additionally, if we are going to have some troops there, it is not ethical or moral to have them in country without enough support to ensure their relative safety or enough means to let them complete the mission they are sent there to do. I don't hold the view that if we just left Afghanistan and Pakistan to their own devices that it would defuse enough anti-American sentiment that their cause would go away. On the other hand, I think having a standing force there is legitimate. We never really finished what we started after 9/11 because we literally dropped the ball when we went to Iraq. Just because we made that blunder doesn't mean the original problem went away.

Honestly, I hate Al Qaeda and the Taliban. I hate everything they stand for. Just because they are Bush's enemy does not make them the friend of liberals, anywhere. If you think George Bush violated your human rights, living under the Taliban would be like that to an other wordly extreme. I couldn't imagine for a second being a father in that country of my two beautiful daughters knowing they would be deprived of dignity, self-worth, and an education. If anything, Al Qaeda is organized crime fueled by a sick interpretation of religion. It is not in anyone's interest, anywhere, to allow them to foment their oppression through brutality and fear. They have been allowed to re-organize and re-empower themself in Pakistan because of Bush's policies. This is not acceptable.

But further drawing down in Afghanistan will further allow the Taliban to consolidate their position in Pakistan and Afghanistan. Do we really want a Taliban run nuclear Pakistan? We don't have to kill all the Taliban, nor do we have to "rebuild" Afghanistan or democratize it. We just need to keep constant pressure on them so that they can't have open and free reign of the villages and cities there in order to subjugate and rule by terror meanwhile gathering resources to strike again.

I'm not a MIHOP but I'd buy LIHOP if truth be told. I'm that distrusting and suspicious of the Bush/Cheney regime. However, I do think Al Qaeda had a hand to play and I think its leaders are just as blood thirsty and destructive as groups like the Khmer Rouge. Their intentions aren't just for self-rule and peace but rather a large scale showdown between their extreme version of Islam vs. moderate forces in the middle east. If anything the US is just a tool and a foil to this end.

We will have to engage Al Qaeda somewhere in the world. To me, Afghanistan is the only logical choice right now. We can't just ignore the issue away.

I know this doesn't sound very liberal or progressive. However, I just don't have a lot of compassion for Al Qaeda, their vision for the world, or their means of political and social expression. I do however have a lot of compassion for the innocents caught in the crossfire. Whatever methods we employ, the least amount of collateral damage is imperitave even though it is unavoidable.

Nonetheless, if we suffer another major attack under Obama, liberalism will be the biggest casualty of all. We are at the precipice of climate change cataclysm as well as a peak oil calamity of epic proportions. With a successful Obama Presidency, there's a possibility we might head into the next 30 years with policies in place that will be better off for the world when we face those two monumental transformations. On the other hand, an unsuccessful Obama Presidency means we will likely embrace much of the failed policies of the oil-backed right wing and head us back to pseudo-fascism. That's the last place in the world we want to head when they finally admit, "hey folks, we are half through our oil and we can no longer support the world's population, we've kind of been lying all along...get ready for mass starvation and large scale open war". Let there be no doubt, a large scale terrorist attack on our country, if following a large reduction of forces in Iraq and Afghanistan, will raise the odds of one term for Obama and then you will be hailing to President Palin or some other representative of the American-Taliban. In other words, if you are gay, a minority, or female, pray that we kill Osama Bin Laden and skullfuck the Taliban.

Obama is not dumb. In fact, he's really kind of smart. And strategic. And steady. And shrewd. And insightful. He wasn't supposed to be President, and yet there he is. To a certain extent, you have to lend him some trust. I said lend, not give. He deserves the loan. But if over time, he does not live up to the bargain, I think everyone is well within their rights to withdraw that trust. But until then, a good leader needs good followers. There's no reason to go this far only to turn our backs on him.

People have every right to be skeptical. We've been lead down the primrose path ever since Carter was shot down while warning us that the end of the age-of-oil was within our grandchildren's lifetimes. You see, the US had it's experience of domestic peak oil in the 1970's. It was at that time we doubled-down on the doctrine which meant more war for more oil. This has obviously been our modus operandi ever since, peaking with the pure fantasy also known as Bush foreign policy. But I believe Obama is a real change. Even though he means to extend some of the mechanics of what was in place from Bush, doesn't mean his intentions, goals, or endpoints are the same.

As for Afghanistan itself, the place where "empires go to die". I'm sorry but the Taliban and Al Qaeda there are just people. They don't have adamantium skeletons or keep kryptonite in their pockets. The mountains may be steep and the cultural traditions may be prohibitive to any sort of colonial conquest but as long as conquest is not our aim, our hurdles for success won't be nearly as high as they were in Iraq.

The fantasy of Iraq, as it evolved, was to create a permanent safe military and oil producing haven for the United States in order to stave off the effects of peak oil as well as conquer the middle east. The scope of what the neoconservatives originally wanted to do was on an imperial scale hearkening back to Stalin and Hitler. That's not what Obama is doing in Afghanistan. This will make the job immensely easier. It's one thing to try to break and rebuild a whole country, it's another to hunt down and kill a bunch of criminals. As long as we give more money and security to the people of the region than the Taliban does, the Taliban will have a much harder time than we will. Clean water, electricity, food, and safety will be our keys to success. Although the Taliban and Al Qaeda have redundant resources throughout the Arab world, we can dry some of that up with good will made elsewhere (hopefully in places like Palestine). Also, we will always have deeper pockets, better weapons, and better trained armed forces.

So, I have to conclude this with saying I'm glad we are drawing down in Iraq and satisfied with an end goal of honoring the SOFA by 2011. I'm also satisfied that we are going to apply more pressure directly to Al Qaeda and the Taliban in Afghanistan as well as Pakistan for the reasons I listed above. Expect us to be there throughout Obama's first term, and possibly his second. This has been a generational struggle and will continue to be so until they smolder out. The latter will only happen when we are a fair broker of peace between Palestine and Israel, have more honest intentions in Iraq (which we are now seeing), and when the whole region is less vital to the world's energy supply (hence, another reason to go Green).

Let's be honest, it was an inane question asked at the wrong time. I really thought the fellow who asked the question didn't do himself a favor by wasting his valuable question time.

However, Obama took what was inappropriate and irrelevant and turned it into a bit of magic. His response was pure beauty both for its pure political value but more importantly the message it conveyed. "There are no short cuts". This seizes upon the zeitgeist of what is currently wrong with our economic system, our health care system, our educational system, and our political system in general. "There are no short cuts" is another way of saying "there are no easy answers... there is no free lunch... and you can't expect to get something from doing nothing". Part of the economic malaise that grips the financial sector of America is the notion that they are the "masters of their own reality" and that through paperwork tricks they can somehow create wealth. Really all they've done is Rob Peter (mainly, the people) to pay Paul (mainly, themselves).

On the other layer of this, it goes directly to parents, children, and self reliance. It undercuts the heart of the criticism of liberalism. The critique is that liberalism is somehow an enabler (via the "nanny state") of the cycle of poverty. But here stands the most powerful man in the world, a liberal by any reasonable definition, who basically says that a culture of success starts with parents, children, educational opportunity, and HARD WORK. This is a stake through Reaganism's heart. Reaganism cannot live without the false notion that the goal of liberalism is to perpetuate poverty and redistribute working class tax dollars to those who don't want to help themselves. Obama, as our highest elected liberal, dispels that by saying a core tenet of his philosophy is that we need to provide equality of opportunity but that people have to take advantage of that and earn their success.

I'd say the rest of the presser was a total grand slam for Obama. But as for everything else he said I expected or already heard. It was this inane left field question that really made reminded of me of what an amazing thinker and leader Obama really is. He turned what was a waste of time and turned it into a way to demonstrate a core foundational tenet of liberalism.

Like many of you, I've noticed John McCain eking up ever so slightly these past few days without Obama slipping. My sense is that McCain is coming up to his natural steady state and that his numbers were "artificially" low for a while based on a couple things. One, McCain bottomed out due to the hyperacute sense of economic crisis when the banks were crashing and two, John McCain did and said a lot of really dumb things right around then. The point is that when McCain was polling at 40% it's a basement for him, he had no where to go but up.

I think the polls for the past several weeks indicate true and solid support for Barack and soft support for McCain which fell away with the hyperacute phase of the crisis and is now only returning because there's a bit of distance between McCain and some of his most embarrassing moments.

All of this is also colored by the Palin effect which I think has had an overall action of hardening the electorate into their respective camps. She is polarizing to say the least. Overall, I think she has had a negative effect for McCain, because unlike a Romney, there's no way you can somehow spin her as "being right for these times".

My expectation is that McCain will likely halt around 45 to 48% support and Obama will hold at around 49 to 51% while retaining a large solid and real lead in the key battleground states. The gestalt I get is that Obama supporters aren't flipping to McCain but rather we are seeing McCain supporters who were too ashamed to declare before are now "coming home".

Barring outright election theft by the Republicans, via Diebold, voter suppression/purging, and trashcanning votes, Obama is highly likely going to win next Tuesday.

Bottom line: McCain is recovering a bit of his base but he's not gaining momentum at the expense of Obama's support.

Why this matters: The bandwagon effect and voter turnout.

People like winners and it is important to be seen as a winner going into tuesday. The RW media apparatus is going into overdrive to make this look like McCain is coming back and will overtake Obama by election day to galvanize the meme that Obama is just not ready and just "not like us". It's not working and as long as Obama continues to do what he did last night, which was to own the airwaves, Obama will continue to hold off the horde at the gates. I think the 30 minute ad will help to solidify the bandwagon firmly in Obama's court but he needs to keep possession of the news cycle right up until the polls close.

Perception also affects voter turnout and I'm convinced that McCain has more to lose in this. Though we need to be mindful of complacency and its ill effect, the GOP has to worry about widespread demoralization. If people "know" McCain is going to lose and they don't really like him in the first place, they aren't going to suffer long lines at the polls. On the other hand, even if we "know" Obama is going to win, we will still "want to vote for the next POTUS!" and will gladly suffer those long lines as a badge of pride.

So, anyway, I think all things considered and knock on wood, this is looking like it might happen but Obama has to retain control of the news cycle from here on out.

I just want to put it out there that Obama, despite being liberal and progressive in many ways, is still the kind of guy to take a lot of different viewpoints into account. Furthermore, he doesn't seem to keen on carrying out grudges and vindictive behavior. If anything, I expect him to reach out in many different directions, including "across the isle". Now is not the time for "payback".

This might create a lot of disaffection here on DU. It shouldn't. Obama has got our backs and will try to carry through on his campaign promises, filibuster proof senate or not. However, he will govern by consensus, and this will involve a degree of compromise. And though there will be much gnashing of teeth over this it will be a good thing because this will be the key to moving the ball forward and consolidating a center left politics power structure in this country.

No one needs to look any further than Bush to see how it shouldn't be done, and it was his lack of being President "of all the people" that ultimately did him in. His unilateral, brash, and vindictive politics created the climate of division and cronyism. This created the crisis of incompetence from the top down. And when that house of cards fell, having no good will to fall back on, the entire Party and "brand" fell apart.

Nothing will maintain Obama's brand and the brand of the Democratic Party like success, real success. We will need to be better off in 4 years, or else. Not only that, there will need to be a new spirit in America of inclusiveness and unity. The latter will not come without an approach to politics that does not include respect and fairness to the opposition.

But if we move to the left with both success and a renewed political spirit, it will bode well for a long term future that might just bring us universal single payer care, some semblance of energy independence, better trade balances, better jobs, less poverty, better educational opportunities, and a reduced budget deficit/national debt.

MCCAIN'S HEALTH CARE PLAN: HEALTH INSURANCE YOU CAN'T BELIEVE IN, OR RELY ON.

(sorry about all caps, it's this way in the original article).

http://www.prospect.org/csnc/blogs/ezrakle...

...snip...

The big mover here is is the tax increase on employer-based health care, which is achieved by ending its deductability. There are two things worth knowing about the way the exclusion works now: First, it makes health care much cheaper for employers. Second, to qualify for the tax exclusion, you can't discriminate among sick and healthy workers, nor among young and old workers. In general, you might expect this to drive out the young and healthy. But it doesn't, because the savings from deductability still make employer-based insurance cheaper and more comprehensive than what they could purchase on the individual market.

"Eliminating the tax exclusion would greatly reduce the number of people who obtain health insurance through their employers," write the authors. "This decline would be driven by three factors: the effective price of employer-sponsored coverage would increase, the nondiscrimination rules would no longer apply, and low-risk employees would have less incentive to remain in employer-sponsored groups...the elimination of the income tax preference for employer-sponsored insurance would cause twenty million Americans to lose such coverage."

Italics, as you might imagine, are mine. But this is the main fact worth knowing, and repeating, about John McCain's health care plan: Its first-order effect would be to take employer health insurance away from 20 million Americans who currently have it. And this estimate is on the low-end. The authors write that it only looks at what employers would do in response to the new tax rules. It does not examine "the number of low-wage workers who might lose employer-sponsored insurance when employers are no longer bound by the nondiscrimination rules, nor do they capture the impact of breaking up existing risk pools." In other words, 20 million plus will lose their employer-based health insurance.

...snip...

And this is examining healthy applicants. The ill are simply denied coverage outright. "A recent survey looks at the experience of people who are less healthy in nongroup markets.21 One-third of such people buying or looking into nongroup coverage were denied coverage or charged more because of a pre-existing condition. Nearly half found it difficult or impossible to find the coverage they needed, and more than two-thirds found it difficult or impossible to find affordable coverage."

Bottom line: Even if you pay exactly as much as your employer did, your plan will still be worse. The authors estimate that most people will choose health care plans that are far less comprehensive than what their employers offered, and also feature premiums that are about a 1/3rd cheaper. In comparison to what they had before, this will barely count as health insurance. But for about 21 million people, it will be exactly what they can afford.

...snip...

Then there's McCain's plan to bulldoze state regulations and create a truly national market. "The main effect of establishing a national market would be to undo state laws designed to establish minimum levels of coverage and protect consumers. In a national market where state licenses are not required, insurers will charter in places where regulations are scarce--much like credit card companies do today. As a result, people guaranteed basic benefits today would find those benefits eliminated under the McCain plan...People also would lose access to many benefit protections. For example, forty-seven states now require mental health parity, forty-nine states require coverage of breast cancer reconstructive surgery, and twenty-nine require coverage of cervical cancer screening. All of these requirements--as well as regulations in several states that limit the rates that can be charged to higher-cost consumers and that limit who can be excluded from a health plan--would be eliminated under the McCain plan."

The 2008 Presidential Candidates' Health Reform Proposals: Choices For America

http://www.commonwealthfund.org/publicatio...

The 2008 Presidential Candidates' Health Reform Proposals: Choices For America

October 2, 2008 | Volume 100

Authors: Sara R. Collins,Ph.D., Jennifer L. Nicholson, Sheila D. Rustgi, and Karen Davis, Ph.D.
Contact: src@cmwf.org
Editor(s): Martha Hostetter




...snip...

Which Proposal Holds the Greatest Promise?

To evaluate the candidates' proposals, the Commonwealth Fund Commission on a High Performance Health System identified several key principles for moving the health system toward high performance. They include:

* provision of equitable and comprehensive insurance for all;
* provision of benefits that cover essential services with appropriate financial protection;
* premiums, deductibles, and out-of-pocket costs are affordable relative to family income;
* health risks are broadly pooled;
* the proposals should be simple to administer, with coverage that is automatic and continuous;
* dislocation should be kept to a minimum—people could choose to keep the coverage they have; and
* financing should be adequate, fair, and shared across stakeholders.

Measured against these broad principles, Obama's proposal for mixed private–public group insurance with a shared responsibility for financing has greater potential to move the health care system toward high performance than does McCain's proposal to encourage individual market coverage through the use of tax incentives and deregulation (Figure ES-4). Compared with McCain's approach, Obama's approach could provide more people with affordable health insurance that covers essential services, achieve greater equity in access to care, realize efficiencies and cost savings in the provision of coverage and delivery of care, and redirect incentives to improve quality. In the absence of a requirement that everyone has affordable coverage, however, the proposal is likely to fall short of achieving universal coverage.

http://www.pnhp.org/news/2008/september/lo...

Look before you leap into McCain's idea of health coverage

By James C. Mitchiner
Other Voices
The Ann Arbor News
September 11, 2008

...snip...

Let’s look first at the income tax credits. The idea is for individuals and families to use these credits to purchase health insurance plans in the non-group market, i.e., from a private insurer not sponsored by your employer. Premiums would be kept reasonable because plans would compete with each other to sell health insurance to those who valued it, or at least to individuals deemed “good risks” (read: healthy people).

And what level of credits are we talking about? Senator McCain proposes credits of just $2,500 per individual, or $5,000 per family.

Given that the average annual family health insurance premium in 2007 was over $12,000, it seems to me that $5,000 is woefully inadequate. Some, in fact, have compared the effect of these tax credits to that of throwing a 10-foot rope to a man stuck in a 40-foot hole. Just to make up the difference between the credit and the premium cost, a middle class family of four with a household income of $70,000 would have to fork over 10 percent of that income, a commitment that would seriously impact the family budget.

Let us suppose, however, that a worker could find and purchase a policy for only $5,000 per year. What would it look like? My guess is that it would have either multiple coverage restrictions (non-coverage for pre-existing conditions, a prolonged waiting period before insurance became effective) or significant financial limitations (high deductibles or co-pays, puny lifetime maximums), which defeat the purpose of having insurance in the first place. Clearly, private insurers cannot make a profit by selling comprehensive insurance at premiums the average individual can afford.

Perhaps the most significant objection to tax credits, however, is that they don’t address the serious flaws inherent in for-profit insurance.