25,000,000 more people served -- another $10-billion on-site, $4-billion personnel.
Sanders-Cardin makes the Kennedy CHC program the single best thing to happen for America's working poor since food stamps:
-- 14,000 total Community Health Clinics nationwide
-- Expanding capabilities
-- 45,000,000 people served
-- $$$$$ to attract 20,000 more primary care physicians
-- Drugs at VHA prices
-- Dental care
-- Patient billing scaled to income
-- 1/5th the cost of Emergency Room treatment
The Public Option was a tactical distraction, never doable.
Senate rules and Federal abortion law constrain what Harry Reid can move to the floor. Alan Frumin, the Senate Parliamentarian, showed last April that for a P.O., the Senate's Byrd Rule would force a split pair of bills.
Non-budgetary insurance sections do not qualify for reconciliation. A half-dozen filibusters were unavoidable.
Scheduled to the very last moment for HCR, Harry Reid appended this fully developed Sanders-Cardin section.
S1ngle-Pay3r medical care is enabled directly.
America will become a rather larger Vermont. And yes, dental care.
Details BTF :::
Netroots support for public option plans has reached something of a crescendo. Here at DKOS, the situation has turned to blaming President Obama for WEAK LEADERSHIP and other forms of flaccidity.
What. A. Hoot.
Here's a dose of real world Tamiflu from a political genius, Bernie Sanders:
Bernie Sanders and Ben Cardin CHC Press Briefing -- from C-SPAN. 7 minutes.
Heaven help you with this if you have a dial-up/molasses connection. A minute to change colors. Its own player.... Long time to get a download. You can also get "This video is temporarily unavailable due to system maintenance...." Hopefully this hits YouTube ASAP.
A Must See, especially for those who wanted the its-what-I-think-it-is Public Option more than life itself.......... ;^)
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Monday Civics Class: Reconciliation
There is no mystery. HERE for a .pdf of The Budget Reconciliation Process: The Senate’s "Byrd Rule" as of March, 2008.
There's a complete text of the Byrd Rule as Appendix A. Feel free to skip reading it. Everybody else does.
The Legislative History section is worth a scan.
This fellow Alan Frumin is not a shy person. He did not cover up his resolution system for what Democrats need to do to invoke reconciliation. Problem is, every Public Option lay-out depends on setting up insurance conditions that do not meet the budget boundaries of the Byrd Rule.
Slate has nice fluff piece, getting the facts backward, titled
Romancing the Parliamentarian. There is a lot of nonsense in it. Tim Noah did get one part right:
Frumin's susceptibility to influence, or lack thereof, is a matter of growing interest because it's increasingly likely he'll play a significant role in health care reform. With the prospect of bipartisan agreement fading rapidly, it's becoming more likely that Senate Democrats will break health reform down into two bills. The uncontroversial parts (for example, tighter regulations on health insurers, which nearly everyone seems to favor) would be considered under normal Senate rules. The controversial parts (for example, taxes to pay for new subsidies to help low-income people purchase health insurance) would be considered under a budget procedure known as "reconciliation" that is exempt from the filibuster, allowing this portion of health reform to pass on a simple majority vote rather than the 60 votes required to break a filibuster.
Do believe it, folks -- the GOPers and their shill allies would filibuster to stop any bill that enables a Public Option.
Once Mr. Frumin identified what fit within the Byrd Rule bounds for reconciliation and what did not, the arguments over the Public Option became moot.
It was all over for a P.O. before the summer started.
Barack Obama ??? The One could walk on water and make Oprah a 27-year old again... and it wouldn't matter to the basics of Senate rules. Public Option talk was a distraction to mislead the GOPers, at most.
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The Sander press release hits the main points:
A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today.
-- The provision... would provide primary care for 25 million more Americans.... (with language broadening coverage in response to rural needs where the clinics can be the sole local health resource for communities.)
-- (This) will help bring about a revolution in primary health care in America and create new or expanded health centers in an additional 10,000 communities.
-- The provision would also provide loan repayments and scholarships through the National Health Service Corps to create an additional 20,000 primary care doctors, dentists, nurse practitioners, physician assistants and mental health professionals.
-- Very importantly, Sanders also said the provision would save Medicaid tens of billions of dollars by keeping patients out of emergency rooms and hospitals by providing primary care when then needed it.
The investment would more than pay for itself by saving Medicaid $23 billion over five years on reduced emergency room use and hospital costs, according to a study conducted by George Washington University.
-- Sanders is also working with Sen. Ron Wyden (D-Ore.) to improve language already in the bill to provide waivers for states that want to provide comprehensive, affordable health care and curb rapidly-rising costs for money-making private health insurance companies. The waivers could clear the way for a state-run, s1ngle-pay3r system.
-- Sanders has worked with House Majority Whip James Clyburn (D-S.C.) to include $14 billion in the House version of the legislation.
The system of Federally Qualified Health Centers began four decades ago under pioneering legislation by the late Sen. Edward M. Kennedy. Community health centers now provide primary health care, dental care, mental health counseling and low-cost prescription drugs for about 20 million Americans. Open to everyone, the centers care for patients covered by Medicaid, Medicare and private insurance as well as those who have no insurance.
In Vermont, eight (FQHC) health centers and 40 satellite offices provide primary health care to more than 100,000 patients regardless of their ability to pay. Sanders said that with the additional health care funding it was very likely that new centers would be established in Addison County, Bennington County and perhaps Windham County VT.
[ Exercise assignment: compare/contrast with recent DKOS Diaries on these subjects. Take note of how long you can go without ROFL. ]
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Vermont has all of 500,000 people plus the head count from one goodly Fourth of July picnic at Boston harbor.
Round all this up to a dozen seemingly/might-as-well-be S1ngle-Pay3r health centers and 50 satellite offices. That gives you one site for every 10,000 people or so, to the odd power of ten.
The current CHC system has 4,000 sites. This makes a total of 14,000 sites.
350-million Americans. One site for every 25,000 people overall.
300 service days per resource -- makes for one massive impact on American health care.
Bernie just got this level of Vermont medicine for 25,000,000 new Americans -- up to a 45,000,000 total -- mostly new people to clinic and health center systems.
For rural America, this will be remembered. Big time.
Kennedy, Sanders, Cardin -- a Democratic Party trinity any o' youse folks can believe in.
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There were also indications that technology from VHA will be used to save money. Computerized records and controls on medicine doses will be upgraded with investment to the standard we see now at VHA and TriCare.
Background In the mid-1990s, the Department of Veterans Affairs (VA) health care system initiated a systemwide reengineering to, among other things, improve its quality of care. We sought to determine the subsequent change in the quality of health care and to compare the quality with that of the [private service] Medicare fee-for-service program.
Using data from an ongoing performance-evaluation program in the VA, we evaluated the quality of preventive, acute, and chronic care. ...
... In 2000, the VA outperformed Medicare on 12 of 13 indicators.
Conclusions: The quality of care in the VA health care system substantially improved after the implementation of a systemwide reengineering and, during the period from 1997 through 2000, was significantly better than that in the [private service] Medicare fee-for-service program. These data suggest that the quality-improvement initiatives adopted by the VA were effective.
New England Journal of Medicine -- Veterans Affairs and quality of care, statistical and qualitative analysis as of 2000.
VHA has gotten better steadily from the mid-1990s to today.
One big ticket is getting 100% of prescriptions and doses into a computer system. Mistakes with medicine are a 20% risk with complications for each patient entering the private so-called "Managed Care" uncomputerized meat grinders. That goes down to 0.01% with the VHA hospitals.
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More than doubling Kennedy's CHC, providing at least 2,000 rural areas with currently nonexistent medical resources, going after the primary care crisis, enabling states to run their own systems as straight up S1ngle-Pay3r operations immediately -- altogether, Sanders-Cardin Option is better than what any Public Option would have provided.
The cutest part of this is that Bernie Sanders, Ben Cardin, and Harry Reid got all this built out at the skunk works. Nobody but these guys and Nancy Pelosi and Dick Durbin and their inner circles and likely the White House seem to have known what was coming.
Quiet. Well crafted. Done in secrecy. No press. No amateurs. No drama. No chance for GOPer sabotage.
Brilliant.
The $14-billion got pumped into the House Bill. Nobody noticed. Nobody said a word. Not one drop of press.
The GOPers were too drunk. Too lost in whining about P.O. infamy to figure out what was happening. Or, quite possibly, the House GOPers didn't read the Bill at all.
Too hungover.
Anyway, you're likely to see a half-dozen states go S1ngle-Pay3r for these clinics. We'll tell the GOPers about all that, come Christmas of 2020.
Majority Leader Harry Reid: Hip! Hip! Hoo-ray !!!!!
Damn, guy. You're good.