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View Diary: Pew: Widespread Support For Insuring Everyone, Obama Approval Steady (144 comments)

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  •  A large part of the reason why is that the (5+ / 0-)

    system doesn't work for average patients. CNN had a good story about that a couple days ago--it was their lead story actually, but it got buried in Iran posts here. I decided to write a diary about it today. It can be found here:

    Realistically, we're going to have to compromise--something which this site has been bad about, as everybody wants a public option but fails to explain what they want to see in a public option beyond platitudes like "Medicare-like." To which I say, you want to expose 47 million Americans to the donut hole of part D? If not, how are you going to pay for that?

    The health care discussions here are becoming very disappointing to me. Ideally, people should be able to throw ideas out and see what sticks.

    I would favor a public option which has some sort of PPO structure and deductibles on prescription drugs and services. Or a co-op plan that functions like the German system, which by the way is quantifiably better than the American system according to the WHO. People should be able to keep their plans premium-free, or a set percentage of the unemployment check (2%, 4%, whatever) after being laid off.

    I think that's where we're headed anyway. What I want to be certain of is that co-ops are non-profit, do not pay bonuses to employees, and have limits on executive compensation.  

    •  The way this site is currently structured works (2+ / 0-)

      against the type of discussion you (and I) would dearly like to see. It currently serves to amplify the screamers and discourage the voices of reason.

      The reasons for that are fairly extensive, and I don't want to hijack this diary to discuss them.

      I'm hoping that is addressed in the new site design and architecture. In the meantime, though, all I know how to do is to try to push back on the screamers and not let them intimidate and bully reasonable people into silence.

      Just as we must not let the Fox/Limbaughs of the world dominate the public conversation, we must not let the strident thoughtless screamers dominate this community.

      The real problem is not which extreme one supports; the real problem is extremism itself, which inevitably elevates ends over means.

      Health care is an incredibly complex issue, and relatively obscure details can make the difference between a viable plan, and one that is not, as you clearly know. Unfortunately, this site, this community, and our entire national political and cultural system, doesn't do "complex" very well.

      One day posterity will remember, this strange era, these strange times, when ordinary common honesty was called courage. -- Yevgeny Yevtushenko

      by RandomActsOfReason on Thu Jun 18, 2009 at 10:44:17 AM PDT

      [ Parent ]

      •  Amen (1+ / 0-)
        Recommended by:

        I fear that, by having the screamers represent us in the minds of the media, we'll end up with nothing again. We have a very good chance to reform health care in a very positive way.

        But the problem is that people who would be willing to find a reasonable compromise on both sides are shouted down by the screamers, and we can't hear it other through the noise.

        Conrad's proposal in its current form isn't that great. That doesn't mean it can't be made better, and it doesn't mean it can't end up transforming our system into the German system (where everybody is insured and 95% of all insurance companies are nonprofits)...a system which spends 43% less of its GDP on health care than we do, and gets quantifiably better results than our system.

        If you free up 8% of GDP, which is what would happen if we adopted something akin to the German system, we'd end up with budget surpluses in no time.

        That's the thing that is being missed here. And there has to be some stuff liberals tend not to like for that to happen--the German system doesn't pay for life-prolonging care at the end of one's life, their is an individual mandate that is achieved through a flat income tax, the sickness funds operate as quasi-HMOs (we'd have to change that to PPOs in our system), etc.

        But if you free up 8% of GDP, then you A have a much better economy, B can use some of the surplus money on things like green jobs...  

      •  to take a contrary view (2+ / 0-)
        Recommended by:
        Livvy5, Book of Hearts

        we actually have moved beyond 'single payer and nothing else' in the discussion, and folks have come to terms with health care costs being important for the discussion.

        Is that true with everyone? No, but it never is.

        At this point we have three choices:

          public option, Cordad-Daschle co-op compromise, no  reform.

        in the Senate, and more of a public option push in the House. The August recess is when congress hears from constituents.

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Thu Jun 18, 2009 at 10:54:31 AM PDT

        [ Parent ]

        •  But my point is that, if done right, the co-ops (1+ / 0-)
          Recommended by:

          Can basically be nearly all of what the "Medicare-like option for all" crowd wants, actually better than what they want (Part D would be a total morass if we went of that cliff). But it would also free up GDP, balance the budget (and then some), and be privately administered. Because of those things, it would be less of a problem for the conservative Democrats, who the Medicare for All crowd bashes on a daily basis. Of course, they never note that no Democrat has yet said that they'd vote against cloture on a public option, even if they oppose the public option. In fact, Senator Nelson says he'll vote for cloture only to vote against the underlying bill on the floor.

          More on what specifically a good co-op plan would look like in this comment:

          •  look forward to reading your diary... (1+ / 0-)

            Without seeing it, I wonder how coops could stand up to PHARMA if the US congress cannot.

            I wonder how coops could guarantee equal rights to care, if the US congress cannot.

            State level programs have been a favorite of the Blue Dog southern states for many decades - because once out of the national eye, they can discriminate wily-nily against people of color. That's why they like those state level programs so much.

            For recent history, look at post-Katrina rebuilding in the Gulf states.

            •  Thanks (0+ / 0-)

              simply put, a co-op can be everything a public option would be, just administered by a non-profit, if it's written correctly. There's a way for co-ops to end up like the German plan, which insures every citizen and provides access to quality health care--judged better than ours in terms of outcomes by the WHO--for 43% less GDP (we currently spend 17% of GDP on health care, they spend 9.7% of GDP on health care). If you reduce free up 8% of GDP, then the budget problems solve themselves.

        •  Basically agree, just to point out (1+ / 0-)

          that, as noted by Bagof, above, the most effective option for activism is often to push to modify existing proposals, not an all or nothing attitude that shoots down things that can be improved, while promoting preferable options that don't have the votes to become law.

          This is supposed to be a site all about effective political activism, not about noble, doomed gestures.

          I increasingly see the latter dominate this site over the former. We like to pat ourselves on the back and point to our raw numbers and think we are making such a big difference. But I wonder how much more all of us could do if we stopped spending so much energy shooting each other down.

          One day posterity will remember, this strange era, these strange times, when ordinary common honesty was called courage. -- Yevgeny Yevtushenko

          by RandomActsOfReason on Thu Jun 18, 2009 at 11:07:33 AM PDT

          [ Parent ]

          •  I agree (1+ / 0-)
            Recommended by:

            I remember the way this site went all gaga over AIG's press secretary coming here. I mean he had a nice shiny title and a big office, and he was talking to us!

            Then we found out that pushing for all or nothing, or being awed by people's titles, means that you end up with nothing more than half the time.

            I wonder how much his bonus was? He certainly deserved it for the way he forestalled the backlash by posting here.

            Conrad's proposal can be good. What I think is important is for people to contact their House members--you heard that right, their House members--and make sure the House, which is a co-equal branch, passes a very strong public option. Then when it comes to negotiating with the Senate, the House might be willing to give up government administration for whatever is contained within the House public option being the co-op (plus nonprofit status, executive compensation limits, and a ban on stock options). But that is apparently too complex for some to understand.  

            •  you two are talking to each other and agreeing (0+ / 0-)

              but I don't really know if your are referring to the diaries or the front page.

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Thu Jun 18, 2009 at 11:46:37 AM PDT

              [ Parent ]

          •  Make a proposal that competes... please. (0+ / 0-)

            Moaning will not make it so. Neither will what the health insurance companies are proposing.

            If we haven't learned from the experience of Medicare Part D, then...

        •  I haven't seen the numbers yet (0+ / 0-)

          that demonstrate how anything but single payer can be accommodated fiscally.

          Tweaking the insurance companies around the edges will not provide cost-effective reform and universal care.

          German insurance companies are highly regulated, and equalize proceeds at the end of the year. That is not a credible outcome for American companies.

          Much more likely is what has been discussed before Congress recently. The American scenario is more likely to be a collusion between BlueCross (or whatever it's called now) and HealthNet (or whatever it's called) to maximize profits and minimize costs by allowing insurance companies to mine our health records to find rescission points for every pre-existing condition whenever someone needs care. Common Dreams

          A free hand for PHARMA produced Medicare Part D, a huge subsidy for PHARMA at the cost to people who really need medicine. A free hand for insurance companies will produce the equivalent. I see no evidence that Congress will choose a path that benefits us at the expense of insurance companies. Never have, never will.

          Obama could lead the effort, but he appears to value bipartisanship more. It's true that "something is better than nothing" when it comes to exercise, but it's not true when it comes to legislation for something as important as health care.

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