Dean Cheerleads Health Care Reform

In a letter to supporters yesterday, Gov. Howard Dean enthused:

We've worked together since the beginning of the healthcare debate to draw a line in the sand -- the choice of a public option must be included in any reform bill passed this year. And every time Republicans have tried to kill it or the insurance industry has claimed it's already dead, we've stood up and proven them wrong. The new line from opponents of reform is that Congress doesn't have the votes to pass a public option. Once again, thanks to you, we've proven them wrong. We've asked everyone in Congress where they stand. At least 218 House and 51 Senate Democrats have said they would vote for the final healthcare bill if it included the choice of a public option rather than vote against the bill and kill reform. That means Congress has the majority votes needed to pass a public option -- TODAY. Now is the season for action. The majority of Americans want it. Majority votes in Congress will pass it. Join President Obama in calling on Congress to get the job done this year.

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Private Medicare (DIS) Advantage Insurance

Private Medicare Advantage plans cover some 11 million patients, and are very profitable to the insurance industry. I think they're another example of corporate greed overwhelming decency. Republicans have protected privatized Medicare Advantage, and most progressives, seeing the abuses, have called for their elimination for years.

from Huffington Post

On average, the government pays about 14 percent more for a private insurance Medicare Advantage plan than regular Medicare. President Obama hopes to wring billions in savings by reducing that premium. He'll then reinvest the savings - an estimated $177 billion over ten years -- in his push for universal healthcare.

. . . [Peter ] Orszag, who's leading Obama's healthcare reform effort, [states] "Evidence suggests that each dollar provided under Medicare Advantage costs the government a dollar thirty in costs," he said. "I believe in competition. I don't believe in paying a dollar thirty to get a dollar."

The administration is not calling for an end to the plans, but rather that they be required to bid for the premium instead of simply being handed it. Reducing the premium could also reduce the fraud. Take the example of Curtis Smith: an elderly patient on a fixed income getting cancer treatments isn't any insurers idea of an ideal customer. But agents who sign patients up are generally paid a commission up front, so there's little incentive for them to do a longterm cost-benefit analysis. Once companies start doing that calculation under the new, reduced premium, tricking sick, old people into signing away their Medicare plan will be less profitable.

An example from Huffington Post

Curtis Smith is retired, 72, and not in the best of health. He lives with his wife in Washington DC. He rises early each day, and has difficulty finding safe things to do, as he does not live in the safest of neighborhoods. His story is an example of why health care reform, including limiting Medicare Advantage, is so necessary.

The tedium was broken one morning [last] summer when a young woman knocked on his door. His wife told him not to answer. Nothing good could come from it.

"Most time she's right, I have to give her credit," he says. "If I'd have listened to what she said, I wouldn't be in the predicament I'm in now."

The next time Smith went to his pharmacy, he was told he was no longer covered. When he went to Howard University Hospital for a colon cancer procedure, he was told the same thing. His wife sent him to the local Legal Aid Society of the District of Columbia.

The woman who'd knocked was a sales rep from EverCare ( "We care about healthcare" ), a company that sells Medicare Advantage plans, which are privately run and can be more expansive - with vision and dental coverage - but have a smaller network of providers that participate. In practice, the extra vision and dental coverage is often of negligible benefit and doesn't outweigh what's lost by leaving traditional Medicare - but it looks good at first.

The sales rep told him her plan would be cheaper and would provide vision coverage, something Smith, whose eyes are deteriorating, had wanted. "She told me to sign it. It was a piece of paper just like one of these right here," says Smith, who can't read well. "A big piece of paper. And she had read me something about the benefits being better and cheaper and I signed it." (An EverCare spokesman said he couldn't comment on any specific case.) . . .

[Whether the President's proposal to give relief to the victims of Medicare Advantage is] . . . .a moot point for Curtis Smith; he didn't stay on EverCare's rolls for long. Smith had two things most victims of such policy-switches don't: access to free legal help in his neighborhood and a wife smart enough to tell him to use it. His attorney at Legal Aid, Jennifer Hatton, pressed the Centers for Medicare and Medicaid Services (CMS) to rescind his enrollment in the Medicare Advantage plan, arguing that it was done fraudulently and was therefore illegitimate. CMS has long battled with shady marketing practices employed by Medicare Advantage companies. The agency has increasingly tightened what they're legally allowed to do, but policing against all situations like Smith's is a practical impossibility.

In late February, CMS apparently agreed that Smith had been enrolled under illegitimate circumstances. CMS, as a result, agreed to retroactively dis-enroll him from EverCare and re-enrolled him in traditional Medicare.

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Read more at: http://www.huffingtonpost.com/2009/03/16/medicare-advantage-seller_n_175324.html

Alan Greenspan Continues to Repent

In his long-awaited memoir released this week~

Photo © FreakingNews.com

'I am saddened that it is politically inconvenient
to acknowledge what everyone knows:

the Iraq war is largely about oil.'


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Stand Out Story of the Week

Geese and Ganders, Goofus and Gallant

© Tom Tomorrow @ Salon.com

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Bill Moyers' Advice to President Obama

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Stand Out Story of the Week

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Happy Labor Day: Thank A Liberal!

Day in the Life
of Joe Middle-Class Republican
By John Gray – originally Published by TvNewsLies.org – July, 2004

Joe gets up at 6:00am to prepare his morning coffee. He fills his pot full of good clean drinking water because some liberal fought for minimum water quality standards.

He takes his daily medication with his first swallow of coffee. His medications are safe to take because some liberal fought to insure their safety and work as advertised. All but $10.00 of his medications are paid for by his employers medical plan because some liberal union workers fought their employers for paid medical insurance, now Joe gets it too.

He prepares his morning breakfast, bacon and eggs this day. Joe’s bacon is safe to eat because some liberal fought for laws to regulate the meat packing industry.

Joe takes his morning shower reaching for his shampoo. His bottle is properly labeled with every ingredient and the amount of its contents because some liberal fought for his right to know what he was putting on his body and how much it contained.

Joe dresses, walks outside and takes a deep breath. The air he breathes is clean because some tree hugging liberal fought for laws to stop industries from polluting our air.

He walks to the subway station for his government subsidized ride to work; it saves him considerable money in parking and transportation fees. You see, some liberal fought for affordable public transportation, which gives everyone the opportunity to be a contributor.

Joe begins his work day; he has a good job with excellent pay, medicals benefits, retirement, paid holidays and vacation because some liberal union members fought and died for these working standards. Joe’s employer pays these standards because Joe’s employer doesn’t want his employees to call the union.

If Joe is hurt on the job or becomes unemployed he’ll get a worker compensation or unemployment check because some liberal didn’t think he should loose his home because of his temporary misfortune.

Its noon time, Joe needs to make a Bank Deposit so he can pay some bills. Joe’s deposit is federally insured by the FSLIC because some liberal wanted to protect Joe’s money from unscrupulous bankers who ruined the banking system before the depression. Joe has to pay his Fannie Mae underwritten Mortgage and his below market federal student loan because some stupid liberal decided that Joe and the government would be better off if he was educated and earned more money over his life-time.

Joe is home from work, he plans to visit his father this evening at his farm home in the country. He gets in his car for the drive to dads; his car is among the safest in the world because some liberal fought for car safety standards. He arrives at his boyhood home. He was the third generation to live in the house financed by Farmers Home Administration because bankers didn’t want to make rural loans.

The house didn’t have electric until some big government liberal stuck his nose where it didn’t belong and demanded rural electrification. (Those rural Republican’s would still be sitting in the dark)

He is happy to see his dad who is now retired. His dad lives on Social Security and his union pension because some liberal made sure he could take care of himself so Joe wouldn’t have to.

After his visit with dad he gets back in his car for the ride home. He turns on a radio talk show, the host’s keeps saying that liberals are bad and conservatives are good. (He doesn’t tell Joe that his beloved Republicans have fought against every protection and benefit Joe enjoys throughout his day) Joe agrees, “We don’t need those big government liberals ruining our lives; after all, I’m a self made man who believes everyone should take care of hemselves, just like I have”.

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Here Come the Nuremburg Defences, Again

Nuremberg Principle IV, states that "defense of superior orders" is not a defense for war crimes, although it might influence a sentencing authority to lessen the penalty.

Nuremberg Principle IV states:

"The fact that a person acted pursuant to order of his Government or of a superior does not relieve him from responsibility under international law, provided a moral choice was in fact possible to him."

The Reconciliation Process and Health Care Reform

The most cogent explanation I've found of the much-talked-about (but less understood) congressional budget reconciliation process is from TalkingPointsMemo. TPM's Brian Beutler explains:

Each year, Congress passes a budget, but sometimes it has to enact a separate bill to raise or reroute funds in order to meet the budget's demands. That's the reconciliation bill--and it's so important that Senate rules exempt it from a filibuster. But they also prevent it from being a vessel for any old provision that the majority party wants enacted.

The specifics of these limits (enshrined in the so-called Byrd rule) are complex, but the overarching rule of thumb is that provisions passed through this process must have a significant budgetary component (i.e. involve the moving around of federal money) and that the legislation should not, in the long run, increase the federal deficit. (A recent historical example: the 2001 Bush tax cuts were passed via the reconciliation process. They survived the Byrd rule because they had a huge budgetary impact, but since they vastly increased the federal deficit, they sunsetted, and had to be renewed after five years.)

Thanks to Mimi @ Wounded Bird for blogging about the TPM post first and thus educating my formerly clueless self about reconciliation on so many fronts.
As Mimi points out:

[quoting from TPM]

. . . According to Martin Paone, a legislative expert who's helping Democrats map out legislative strategy, a more robust public option--one that sets low prices, and provides cheap, subsidized insurance to low- and middle-class consumers--would have an easier time surviving the procedural demands of the so-called reconciliation process. However, he cautions that the cost of subsidies "will have to be offset and if [the health care plan] loses money beyond 2014...it will have to be sunsetted."

And there the irony continues: Some experts, including on Capitol Hill, believe that a more robust public option will generate crucial savings needed to keep health care reform in the black--and thus prevent it from expiring. But though that may solve the procedural problems, conservative Democrats have balked at the idea creating such a momentous government program, and if they defected in great numbers, they could imperil the entire reform package.

[Mimi then comments]

Let's see if I have this straight. If Democrats choose the more robust public option, they are more likely to be able to overcome the procedural hurdles and pass the bill on 51 votes without the threat of filibuster by the Republicans. The bill would also save money and perhaps pay for itself.

But the conservative Democrats may not stay on board, because they don't like the idea of a "momentous government program"? On what grounds? Read on. Because the Republicans in their pushback say that the public option would have to be "very aggressive in setting rates, price controls and rationing,". Ah, those are scary words to conservative Democrats.

On the other hand, those with no health insurance know rationing quite well.

So. As the author of the article, Brian Beutler says:

The path of least political resistance is beset by procedural obstacles; and the path of least procedural resistance is beset by political ones.

Got that everyone?

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