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Health Care Open Thread

(photo and caption from freedomofbleep.com)

The Administration is putting in another big push this week.  We should have a lot to talk about so let’s segregate discussion on this topic to this thread, which we’ll keep going until this thing is finally toast.

65 comments to Health Care Open Thread

  • Veruckt

    Oi. Not looking good healthcare vote wise. That crazy b*tch Pelosi is going to find a way to get this through rules be damned. The problem with our Congress etc is they simply have too much latitude to change the rules as they see fit. It looks like at this point we should be planning on how to go about repealling the abysmal mess. By the way as a nice bonus they have written in the Federal Government taking over student loans into the healthcare legislation.

    Rufus here; ignore the avatar. The above comment is from Veruckt. I copied it from the Tuesday Open Thread.

    • Rufus

      Veruckt,

      I’m hoping her, Axelrod and Obama’s rhetoric lately is simply a full court press strategy to try to get Representatives to flip. They themselves have been repeating the mantra that “Americans deserve an up or down vote on this issue.” Pushing it through without a vote would violate that principle.

      However, I don’t understand why they think this blindly aggressive strategy works. We know they don’t have the votes, otherwise Pelosi would have called for a vote and passed it. They know we know. Why do they think pretending that they do will get folks to flip? If anything it ought to make the hold outs even more resolute. I’m sure the hold outs would like nothing more than to be able to go back their constituents and say they didn’t vote for it, even if it does pass.

      These guys are really clueless.

      • Veruckt

        I think we’re seeing their true colors now. Most of us have always known this was not about political pragmatism but rather a mad power grab and a hellbent idealogical stab at capitalist principles. They are now looking at trying to force this with no vote like they did the raising of the debt ceiling. These people are corrupt beyond imagination and will find a way to do this I believe that to my very core, rules and principles mean nothing to them.

        Honestly I don’t know what it would take to get Americans mad enough to fight anymore.

  • Some of the back-room deals flipped a few key people the first time. Obama is making more back-room deals that are not even in the bill. Like he’s someone they can trust.

    • Veruckt

      My friend who knows things has told me a lot of the deals being made will not show up in this bill but will be showing up in a large appropriations bill within weeks of this turd being pinched out. He also says many blue dogs are being threatened with having Federal Contracts (ie local jobs) pulled from their districts and some Republican lawmakers are considering launching an investigation into some of the tactics being used after the 2010 elections.

      • Rufus

        I wish I had a friend who knows things. I have a friend who likes pie and another friend who collects back issues of the National Geographic.

        • I had a friend once. He seems to have disappeared.

          • V-
            If they had an investigation, what would really come out of it? They would find like Magnus says – Chicago thug politics – , pork spending, and people would roll their eyes and say how corrupt government officials are and wish things are different. Just like they do today, except it will be tomorrow.

            • Rufus

              Exactly. And they know that. Until the American people get serious this will never end. If this passes I think we will see sincere, organized efforts to finally stop this nonsense. People will get involved and work to amend the Constitution or pass legislation in their state that immunizes them from this crap sandwich. This has a good shot at galvanizing people to get serious about rooting out fraud and corruption in our government.

            • Veruckt

              Sadly you’re exactly right G-man. We’ve become so used to the knowledge that our politicians are hopelessly corrupt that it doesn’t even phase us when someone shines a light on it. My friend who knows things says the reason for the investigation is two fold; it will completely shut down this trainwreck Obama for the remainder of his Presidency since he will always be on the defensive and when Republicans reseize the White House in 2012 the illegality of the whole mess might make the possibility of repealing it easier.

          • My favorite song about a friend:
            by Stephen Lynch
            ————————————
            When I was
            A boy of ten
            I had a very best friend
            Ed was kind
            WIth good intent
            but just a little different

            O, special ed
            Momma dropped him on his head
            Now he’s not so bright, instead
            he’s a little bit special
            just a little bit special

            we played tag
            he’d get hurt
            i played ‘soldier’
            he’d eat dirt
            i like math
            and spelling bee
            ed liked to a tree

            O, special ed
            momma dropped him on his head
            now she keeps in the shed
            coz he’s a little bit special
            just a little bit special

            i ran track
            hang out in malls
            ed ran head first into walls
            i had girls
            lots of clothes
            ed had names for all his toes

            O, special ed
            momma dropped him on his head
            Now he thinks a peice of bread
            coz he’s a little bit special
            just a little bit special

            One day talking to special ed
            he grabbed a brick
            and he swung at my head
            and as he laughed at me thats when i knew
            that special ed just made me special too

            now i laugh as i count bugs
            i give strangers great big hugs
            next to me ed is fine
            yeah, he’s a f***in einstein

            O, special ed and me
            now we’re not bright in the head you see
            now we’re not so bright instead
            we’re a little bit special
            just a little bit special
            that f***er ed made me special
            just a little
            just a little bit…special

  • Magnus Caseus Formatis

    Chicago “thug-style” politics. Ya gotta love ‘em!

    • Rufus

      Yeah, but I think even they know this is too big to do without a vote. Even with a vote they’re risking mutiny. Passing something this big without a vote is tantamount to inciting an uprising. I’m not overly confident in my prediction, but I believe they will push hard, hard, hard this week to turn the Representativest they need to get the House to pass the Senate bill.

      I hear they are working on a House bill that “fixes” the things the Democrat House hold outs do not like in the Senate bill, so they can prove to them that they intend to keep their promises, if the hold outs vote “yeah” for reconciliation. That might be enough to flip those holding out in opposition of federally funding abortions.

      It will be interesting to see if Kucinich has flipped. The President spent a lot of time with him yesterday. I believe Kucinich is principled, and will not vote against his principles. Kucinich wants socialized medicine. If he flips I believe it will be because President Obama convinced him this bill is a slippery slope that will lead, inexorably, to socialized medicine. If Kucinich flips then I think that means Obama does believe this legislation can ultimately crush the private insurance companies.

      • Veruckt

        This goes back to my principal gripe with Americans right now. We simply take for granted what we have but so long as nothing interrupts our TV shows we won’t get worked up about it. No matter how despicable their actions are we simply have no fight in us. We are placated cattle waiting for the slaughter and our “leaders” have no fear of us.

        Since they don’t fear us upsetting us means nothing because they know we will never fight back. Sure we’ll gripe and carry signs and spend a couple of hours standing around in front of their offices but do you really think there is a chance of a mob of thousands kicking in the office doors and physically dragging these people into the streets? Most people get uncomfortable even hearing something like that but the fact is if the governing do not have that kind of fear of the governed then all bets are off.

        Also I’m pretty sure everyone knows this is an effort to crush private insurers and even hurt private banks by taking away student loans. I don’t think your people who want socialized medicine will be holdouts, this is down to anti-abortion and blue dog dems.

        • Rufus

          Veruckt,

          I think that’s what “they” are betting on. We’ll see. There are times in the past when I thought folks finally had their eyes open; Anderson’s 3rd party, Perot’s… But we all went back to watching our TVs. This time there really has been a lot of grassroots activity, and it has not lost pace. If this doesn’t do it, I’ll finally shed my optimism and become as cynical as you, Congress, Axelrod and Rahm.

          This is so brazen and ginormous it has to get people to wake up. Doesn’t it?

          • Veruckt

            You know I hate how cynical I’ve become but the more I know the harder it has become for me to be optimistic. By nature I’m a very happy go lucky person but when it comes to politics I can’t shake reality.

          • Maybe the day it passes (if it DOES pass) should be either: “National Flood The Emergency Rooms Day” or “National Support Your Local Rifle Range Day.”

        • JimmyC

          This goes back to my principal gripe with Americans right now. We simply take for granted what we have but so long as nothing interrupts our TV shows we won’t get worked up about it.

          Millions of Tea Party protesters say you’re wrong, V. :-)

  • Magnus Caseus Formatis

    I’ve all the pictures I’ve seen of Rahm’s nose, I never thought I’d see it in her ear! I thought I’d see it . . .well, you know.

  • Scott M.

    Blue dogs or lap dogs…we have two bellwether districts in Greater Memphis:John Tanner in the 8th Tennessee and Travis Childers in the 1st Mississippi.Childers is a solid Nay…Tanner is retiring,but I think that he is a Nay as well

  • I find it interesting how a President who claims to be a Constitutional Scholar can seemingly have such little knowledge of what the Constitution says.

    In fact, I have a very large hunch that he really wishes he could find a way to do away with the Constitution altogether, since it seems to be getting in the way of his plan for turning these United States into a socialist worker’s paradise.

    Probably why he drinks so much.

    • The College Widow

      Don’t forget that Obama sees the Bill of Rights and the Consitution negative. After all the Bill of Rights only addresses what gov’t can’t do to a citizen – not what gov’t must do for a citizen.

  • The College Widow

    The manipulation of the legislative process is making my head spin. Remember way back when Obama was pushing reform as a way to insure the uninsured? If this were truly about insuring the uninsured this could have been a done deal a long time ago. Getting insurance to those without who truly want it is relatively easy and cheaper than this quagmire of legislation.

    We all know that THEY know the majority of citizens in the US don’t want this mystery bill to pass. The sad thing is they don’t care. Not even threats of being thrown out of office matter. Pelosi is willing to lose control of the house in order to gain long term control of all of those tax dollars in the guise of insurance premiums.

    May God help us and I mean that with all the sincerity and reverence I can muster.

  • Veruckt

    It’s funny of the hundreds of articles and studies I’ve read on healthcare, yes sadly I have read hundreds, none address what is probably the most basic problem. Us.

    Out of control consumerism in healthcare is ultimately what put us here and no legislation will ever fix it. Strangely all proposed reforms stand to only make it worse by making it easier and cheaper to go to the doctor. While on the surface this sounds like a good thing the problem we have now is people are going to the doctor too much and often for idiotic reasons. Over the years working in various clinics and hospitals over the I don’t know how many people I’ve seen come in with stomach viruses, colds, cold sores, and other nonsense that doctors can’t do anything about except to tell you to rest and drink plenty of fluids which you hopefully were smart enough to do anyway. Fact is nothing would fix healthcare faster than a little consumer education that made sure we were only going to the doctor when it was necessary rather than just because we “don’t feel good.”

    • The College Widow

      Good point. Let’s face it, not every malady requires a prescription or a visit to the doctor.

      Remember when Obama was ranting about people going to the ER for asthma attacks, etc? What in the world will happen when suddenly we all have the ‘right’ to see our GP for every illness or hangnail? There won’t be enough physicians to meet the demand and we’ll quickly see rationing.

  • Mr. Sideous

    In the meantime, those who really need health insurance – those with pre conditions – are screwed every which way. Either insurance turns them down, or the medicare will turn them down – nice.

    • The College Widow

      Hey, Mr. S! Good to see you!

    • Veruckt

      You know there is a lot of misunderstanding about “pre-conditions” I’d like to clear up. Actually I intend on doing a full article about this very subject because politicians have it so jacked up.

      Insurance companies don’t care how sick you are and actually have really strict “cherry picking” guidelines already that prevent them from only picking people they know they can make money off of. Fact is no matter how sick you are you can get insurance…if you already had insurance.

      Using myself as an example. I have a horrible back and have since a weightlifting accident back in 2001. It has hospitalized me 6 times in the last 9 years but has resulted in honestly probably closer to 50 doctor visits and tens of thousands in medical cost. Yet in this 9 years I have had no difficulty getting insurance to cover my chronically injured back in spite of being with 4 different insurers in that time. Why did United Healthcare in 2003 cover my back injury from 2001? Afterall it was clearly a pre-existing condition.

      They covered me because I had always stayed insured so they were able to more accurately assess the risk I provided to them as an insured person. You see the exact same thing in auto insurance. If you go for a year or two without auto insurance then suddenly sign up for it they will charge you more regardless of your driving record because they have less insurance history to assess your risk from. Health insurance functions the exact same way. It’s not your illness that is the risk to them, it’s the unpredictability.

      If a person comes to a health insurance carrier with no or minimal insurance history and a chronic illness then yes there are insurance carriers who will turn them down because they’re risk profile is too high. Aetna is notoriously bad about this. There are however many nationwide insurers who will not turn anyone down regardless of their condition such as Great West Life HMO, they are a high risk carrier who are built around high risk patients. Will you pay more? Yes initially. Is it “cadillac coverage”? No but it will get better with time.

      The thing with these high risk insured (people with pre-existing conditions) is once they are insured and build up a 6 month to a year history with that carrier they can generally go to any insurance they like because there is now predictability to their risk.

      Conversely if you become very ill while you are uninsured and then get insurance to cover that illness then yes they can, and probably should, deny coverage to you for that illness. This is done to keep the insured from exploiting the insurance carrier, sort of the example you have heard Rufus and I use before and this is a person calling an insurance carrier to sign up while they are in an ambulance on their way to the hospital. Obviously it wouldn’t make sense for that insurance company to cover whatever put him in the ambulance since he wasn’t their insured (ie their responsibility) when he was injured.

      Hope this makes some sense.

      • Rufus

        “weightlifting accident back in 2001″ He conveniently left out the fact that the lifting occured in a Motel 6 outside of Southaven and the “weight” was named Raul.

        • Veruckt

          Southaven? Are you breaking out cities in MS?

          The injury acutally occurred while doing deadlifts at 405, a very manageable weight for me at the time. Now of course if I tried it someone would have to stand behind me and try to catch my pancreas when it fired out of me.

      • The College Widow

        Thanks for that explanation, V. The Spouse, Mr. TCW, was once an independent insurance agent. The agency was the family and they sold property, casualty and health insurance. He often talks about the fallacies surrounding pre-existing conditions and you really explained it well in this comment. Cheers and huzzah!

        • blackhawk12151

          Off topic but have you ever watched Scrubs? Your reference to Mr. TCW reminded me of a character whose husband was in a coma. She was hot, so they called her “Tasty Coma Wife” aka TCW. Just thought you’d like to know that you share your initials.

          • The College Widow

            No, I’ve not seen Scrubs. Glad to know TCW can also mean Tasty Coma Wife…well, other than the spouse being comatose. Heard from a few that Scrubs is good.

            • Avoid, avoid, avoid what they’re calling Scrubs in its current season, but all the preceding ones are golden. The first 5 seasons couldn’t be touched for sitcom greatness, except maybe by Arrested Development.

              Of course, it doesn’t hurt the first episode I saw (season 2 premiere) featured one of my favorite songs ever.

            • Rufus

              This, coupled with Floyd’s rebus on today’s open thread is a nice segue to this:

              Who can tell me the meaning of “The College Widow’s” moniker? Threedonians and The College Widow are not eligible to play, of course.

      • Mr. Sideous

        I’ll keep Great West Life in mind.
        As for me: 11 years ago I had aortic valve replacement at the tender age of 34. Now insurance will not touch me, except through HIPPAA.(If not for HIPPAA I would be sent to the insurance titan of Diddle & Squat). And when they do offer me something, prices are so high I just sit in my chair and laugh. Oh yeah, and with the leftover change I can buy a six pack of Ensure, because that’s the only food I’ll be able to afford. the deductibles are high, and the pharmacy prices are the same if I didn’t have insurance. So this is what I can look forward to. The only thing missing is a large Sicilian gentleman cracking his knuckles while I sign on the dotted line.

        On a separate note: Hi all!

        • Veruckt

          It does suck when that sort of thing happens and honestly you are looking at a year of maintaining coverage with a reasonably clean bill of health before those rates improve. People in your situation are the people who most benefit from some sort of group coverage and are the absolute best argument available for allowing people to form groups for coverage. Let me put my ear to the ground and find out some other high risk carriers for you. If you don’t mind my asking what state are you in? Also is employer coverage an option for you?

          One thing though. HIPAA is not doing you any favors. HIPAA does not protect your medical records from insurance carriers as they are considered to be an “authorized entity”. That law is a train wreck and has done untold damage to the patient doctor relationship.

          To me the most feasible solution to any kind of intervention in the pre-existing condition issue is to provide incentive for insurance carriers to take on high risk patients. The government has already put this in practice in the Medicare Advantage industry where they simply offered us a 20% higher reimbursement rate for insuring high risk patients. As a result of this insurance carriers went from not wanting to insure high risk members to creating plans for and openly advertising for people with; Diabetes, heart failure, psychological disorders, etc.

          What they’re doing now by trying to force carriers to take everyone regardless will do nothing more than drive up the rates so high that everyone regardless of health will be priced out of the market.

          • Mr. Sideous

            I’m in California. right now I’m on COBRA, the zombie version kept alive by the stimulus jolts. Its stopped suddenly for awhile, and that’s when I discovered really how screwed I am. I’m sure this COBRA coverage isn’t going to last much longer, and I’d rather have my own coverage I can take with me wherever.

            • Rufus

              Mr. Sideous. Sorry to hear of your troubles. For the record, I am not against your state, or any state, providing measures like this. I hope to cover this soon in a post. I’m just agin’ the Fed sticking their noses in it. It’s their noses that are keeping you from porting insurance across state lines.

            • Veruckt

              Ouch. California is a tough area to get reasonable insurance of any kind in because they have so many seperate taxes, fees, and penalties on carriers and since you can’t go across state lines you’re kind of stuck. You of course already know insurance rates are out of control there from your health insurance and I’m sure your auto insurance as well.

              Here is what you are going to run into in California that makes your rates so high. You may have heard of MediCal before, it’s the California Medicaid program and is mostly used to insure illegal aliens, right now MediCal occupies just shy of 40% of California’s state budget and has caused over 15 hospital closures in the last 5 years. Most recently Downing Memorial had to shutter it’s doors because of abuses of the MediCal program. You may be wondering what MediCal has to do with you, afterall you aren’t on Medicaid. Here is the brief explanation:

              * Since California has such a high number of Medicaid (MediCal) recipients who have to pay nothing when they get medical care California has the highest utilization rate in the nation. What that means is on average Californians seek medical care more than any other Americans. Utilization is a cost determining factor for insurance carriers when they try to assess risk. The higher the average utilization the higher the premiums.

              * To prop up MediCal and keep people on the program California has created an endless number of excise taxes on insurance carriers. It’s a three fold tax system where insurance carriers are forced to pay taxes on each insured, the insured pays a tax (rolled into the premium as a stealth tax), and the hospital pays a usage tax for accepting insurance. All of these taxes and fees are simply passed on to the insured and on average add an additional 20 to 25% to California premiums.

              * MediCal pays medical providers well below market value and even below Medicare fee schedule but all hopsitals are forced to accept Medical. In real world terms this means since hospitals are getting less money from MediCal they are increasing their charges well above US average (thus Obama liking to use examples of increases from California)to all non MediCal or Medicare customers, the privately insured, and since insurance carriers pay based off Medicare fee schedule the additional charges get passed on to you to patient instead of your insurance carrier.

              Those are three determining factors that make getting insurance in California much higher than they are anywhere else in the US.

  • blackhawk12151

    Rush offered up this bit of brilliance a couple of minutes ago:

    “This has ceased to be about doctors or hospitals or insurance companies. This is now about saving the Obama presidency.”

    The irony here is, at this point, which is worse for Obama? Failure of the bill means defeat on his key issue, an emboldened resistance, and the overall look of being ineffectual. Passage of the bill means foisting unpopular legislation on the American people. Talk about a rock and a hard place.

    • Rufus

      “which is worse for Obama” The guy is in way over his head. That’s almost a meaningless question. He was destined to be a failure the day he took the oath of office. I guess his only chance would have been to lay real low, and try to have a sort-of “do nothing” Presidency, hoping for some luck with the economy, like Clinton had with the dot com bubble. Sort of like Obama did when he was in the Senate; lay low, try to miss the controversial votes, make some nice speeches…

      • blackhawk12151

        “He was destined to be a failure the day he took the oath of office.”

        Well that’s the truth. I guess it then becomes which course is easier to spin into a success and dupe the people who are not paying attention into thinking something good was accomplished? I think passage of the bill is marginally better for Obama’s image, because he can at least spin it as a success on some level. However, passage of the bill is bad for Congress, and will mean the defeat of many dems and possibly more defections.

        • JohnFN

          Democrats believe they lost in 1994 because they didn’t pass health care – that their base abandoned them, like what happened to Republicans in 2006. As long as they operate under that fantasy, they’ll continue to keep pushing this off the cliff. Apparently they forget gays in the military, the abortion push, the tax increases, congressional malfeasance and corruption, and the assault weapons ban.

          Problem for Obama, the base has already abandoned them and there isn’t getting them back with this bill. Take away his 96-percent popularity among African Americans, Obama’s approval is more around 30-percent – Bush numbers. There is no single-payer, not even a public option. The rule changes don’t mean much to the progressive base, because it all amounts to a huge corporate pay off with the individual mandate.

          Not to mention, I don’t see planes full of soldiers flying out of Iraq or Afghanistan at the moment …

  • We better hope that this bill is rejected. If it passed and handed to “The One,” who will certainly make an event of its signing on par with the crowning of the King at the end of The Return of the King, then we will be stuck with it.

    Repeal? Don’t count on it.

    If Republicans take Congress and pass a bill repealing the legislation, it would have to be signed by Obama, which would never happen. Therefore, there would have to be enough votes to overcome a veto, and I don’t see that kind of landslide happening in November.

    That means the bill remains into the 2012 election. And after two years of divided government, the majority of people will forget all this hullabaloo. Republicans will run on how they can manage government better than Democrats, and Democrats will run on how Republicans want to take away your health care.

    And most voters will be motivated by fear of the latter, than believe the former.

    In short, this needs to end now. Or else we’re stuck with it.

  • JohnFN

    The joke is, we’ll be paying taxes on this disaster for years before its implemented, and maybe even further. The individual mandate is bound to face court challenges from here to eternity, and that’s the central portion of the bill, and Congress has to know that. This is all about saving face. Right now, they are lame duck.

    My question – if this is passed through reconciliation, why can’t a Republican Congress and Senate de-fund it through reconciliation? Just take the money and tax hikes out of it, it renders it moot.

  • Nobody even believs that Rahm has a copy of The Constitution, let alone carries it in his pocket.

  • Scott M.

    Or as Eric Massa would call him,Ram Emmanuel

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