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There was enough in President Obama's speech last night, but only barely. There was a bit of red meat and some tugged heartstrings, but I'll say this - his health plan is far too considerate of Big Insurance & Big Pharma and not nearly considerate enough of what is needed to truly reform the system.

In the President's proposal it would be illegal for people not to buy insurance from a private insurance company. In effect, he's adding a new tax, to be paid not to the government but to private, for-profit companies. Equating this mandate to the requirement to carry automobile insurance, as Obama did last night, is bogus because you can choose not to own a car but you can't simply choose not to get sick. This makes Aetna, Wellpoint, United Healthcare et al. into latter-day publicans, who've purchased the right to squeeze the populace for as much as they can. What the President laid out last night is a giveaway to insurance companies - the profits from the 30-50 million new, mandated "customers" will far outstrip any reduction in their profits due to restrictions on policy rescission and rejections for pre-existing conditions.

As the President described it, the public plan option will be there only for people who are otherwise unable to get insurance - i.e. only for those without an employer plan available to them. But what if the health insurance an employer provides sucks ass? Apparently it's "too bad, Charlie" because you can't opt out of employer insurance in favor of the public plan. It was not clear, but it appears that employers will be unable to choose the public plan when shopping for group health insurance for their employees - it will be for uninsured individuals only. This undercuts the raison d'etre of a public insurance option - to provide real, lower overhead/lower cost plans that will force insurers to keep internal costs down and innovate on the services they offer.

The health insurance "Exchanges" won't go into effect until 2013 (Why not? The Feds set up the Department of Homeland Security in mere months, and it has well over 100,000 employees) - leaving the uninsured still uninsured (except by a so-far-hypothetical assigned-risk pool that is likely to be very expensive to buy in to) for the next 4 years. In the meantime, insurers will almost certainly be raising premiums to cover the reduction in revenue from having to cover pre-existing conditions and rescinding the policies of sick people.

The President did not mention one of the most serious problems facing healthcare consumers today - the cost of prescription drugs. There's still no provision for negotiating lower prices. No re-visiting Medicare Part D to allow price negotiations. No elimination of the Part D "donut hole." And nothing that addresses the price disparity between what Americans pay for drugs and what the rest of the world pays (Canadian prescription drugs cost 35-90% less than they do here in the U.S.).

What also went completely unmentioned and unaddressed by the President was the massive waste of money on paper-pushing. Hospitals and physicians alike spend hundreds of billions each year on filing claims, requesting pre-certifications, issuing referrals - none of which add a single iota of value to the system. Health exchanges will only make that aspect worse.

The only viable solution for most of what really ails American healthcare is a single-payer plan. Despite his public support for it in the past, the President went out of his way last night to sneer at single-payer and its supporters, in what has lately become the Democratic Party modus vivendi - i.e. throw your most avid supporters under the bus while bending over backwards to try to satisfy your opposition, who will never support you anyway.

Originally posted to curmudgeon on Thu Sep 10, 2009 at 08:22 AM PDT.

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Comment Preferences

  •  Right on (8+ / 0-)

    The speech was indeed great for style, awful on substance.  He has surrendered on the gist of the plan.  But since the Rethugs oppose anything he does just because it's his plan, he rallies the troops with a speech that could just as well have been used to push a Democratic plan.

    But it made the Villagers happy.

  •  I disagree. (1+ / 0-)
    Recommended by:
    soms

    But I see the political necessity for your position.

    (I only disagree with the last observation, however: "throw your most avid supporters under the bus"...because we (the avid supporters) don't see how we MUST be thrown under the bus in order for him to get legit action accomplished. If we had been screaming single-payer from the beginning, this wouldn't be an issue.)

  •  Whew....thought you'd never come out with (10+ / 0-)

    the grades.

  •  I totally disagree. Only people like yourself (8+ / 0-)

    and the rest of the neocon world somehow "missed" the details the President outlined in his speech last night.  I don't think any amount of "content" would ever satisfy you and your party.

  •  I give this diary a C- for grading but a (8+ / 0-)

    B+ in angry discontent.

    What is this? Are you some kind of hypnotist? Waving your powers around...

    by Muskegon Critic on Thu Sep 10, 2009 at 08:31:45 AM PDT

  •  You are absolutely correct.... (11+ / 0-)

    Now get yourself ready for the insults from those who feel you are raining on their "Obama is back" parade.

    You will be called a purist, an idealogue, and things like that.

    But reality will eventually hit very hard.

    If Obama is determined to be the last president to deal with health care reform, and this is the "reform" we get, we are in deep, deep trouble.

    Any party that would lie to start a war would also steal an election.

    by landrew on Thu Sep 10, 2009 at 08:32:13 AM PDT

  •  At first, I was ready to discard this diary as (2+ / 0-)
    Recommended by:
    Chi, lgcap

    "whiny."  Upon further review its logic is undeniable.  The cost of prescription drugs is an enormous problem in this country.  

  •  Where is the (6+ / 0-)
    American Hugo Chavez we are all looking for??

    snark.

    From Neocon to sane- thanks to Obama- and Kos.

    by satrap on Thu Sep 10, 2009 at 08:37:14 AM PDT

  •  As as there is a public option -- (2+ / 0-)
    Recommended by:
    The Raven, Maimonides

    It's absolutely untrue to say he's forcing people to buy private insurance. Right, or am I missing something?

    My feeling about this are simple: Any way that can be figured out to provide truly affordable quality health care for all is the goal. If doing so makes the wrong people rich, that would be a shame but probably well worth the price.

    Forward to Yesterday -- Reactionary aesthetics and liberal politics (in that order)

    by LABobsterofAnaheim on Thu Sep 10, 2009 at 08:37:27 AM PDT

  •  Single Payer Purity Trolls (9+ / 0-)

    They need to knock off wasting air yammering for single payer. It isn't on the table, isn't going to happen, and talking about it is on a par with throwing a petulant tantrum.

    Every day's another chance to stick it to The Man. - dls.

    by The Raven on Thu Sep 10, 2009 at 08:38:52 AM PDT

  •  they can barely pass the public option (8+ / 0-)

    wtf are your ideas? executive order?

    the hand ringing is ridiculous. this is what we're getting. and that's if we fight for it.

    the congress just isn't as blue as you'd like it to be.

  •  Waaaaaaaaaaah. eom (4+ / 0-)
    Recommended by:
    Maimonides, soms, aggie98, satrap
  •  Want the reason? (2+ / 0-)
    Recommended by:
    soms, FightingRegistrar

    The health insurance "Exchanges" won't go into effect until 2013 (Why not?...)

    Money.

    Is that a real poncho, or is that a Sears' poncho? - Frank Zappa

    by JoesGarage on Thu Sep 10, 2009 at 08:39:21 AM PDT

  •  Politics is the art (2+ / 0-)
    Recommended by:
    soms, nickrud

    of compromise....

    We are not going to get all we want. We need to establish the idea that health care is a right. The expanded coverage that these proposals will lead to will start that idea growing.

    Its kinda how Social Security and Medicare started.

    A journey of a thousands miles starts with one step. Stop bitching just because the first step isn't to board a jet plane.

    You usually get what you paid for.

    by IowaMike on Thu Sep 10, 2009 at 08:43:22 AM PDT

  •  Jesus Christ! Don't you realize that it took (8+ / 0-)

    decades for Canada to get to their system? We cannot afford to go to single payer suddenly. First, we have no money to set it up. Second the industry is enormous and to put all those people out of work suddenly in this recession would bankrupt us immediately. The reforms mentioned in his speech are substantial changes that will benefit people immediately. The exchange will be able to insure people at low rates. You see, it's the exchange (with the PO as a choice) that will bring down costs. Obama is right in downplaying the PO as a choice, because it does not apply to the majority of Americans with health care. He's already hearing from the people who can't buy insurance. He needs support from people with insurance and show them that the regulations going into effect will benefit them. If they are behind it then the Congress will be pressured to get it passed.

    •  bbbbbut...i thought Canada got it overnight. (2+ / 0-)
      Recommended by:
      aggie98, Amayi
    •  How will the exchange insure low rates? (3+ / 0-)
      Recommended by:
      DarkestHour, gustynpip, Nisi Prius

      The PO will be very expensive if only the otherwise uninsurable are using it, if that's what you're suggesting.

      How will a mandate that people buy shity insurance be beneficial? People know that the industry will not tolerate real regulation. This very process proves congress is powerless over corporate interests.

      •  The exchange will have different companies (1+ / 0-)
        Recommended by:
        soms

        competing for customers and will have to offer good insurance for a low rate or the people will take the public option.

        They will have to deal with these new regulations and they won't be able to hide from them. If people get dropped or denied coverage it will be blatantly obvious and illegal. Right now people don't have recourse because their policies are not illegal.

        •  What prevents insurance companies in the exchange (1+ / 0-)
          Recommended by:
          lgcap

          from colluding?  (Please don't tell me that you hope the government will actually enforce price-fixing laws.)

          On a slightly more serious note, what happens when the inevitable market consolidation (big fish eats the little fish) occurs, and we're down to very few major players in the health insurance market?

          •  If that happens, people will go to the PO (1+ / 0-)
            Recommended by:
            soms

            one of the choices in the exchange - which will make it stronger.

            •  People will go to the PO (2+ / 0-)
              Recommended by:
              itsbenj, lgcap

              only if they are allowed to - which eliminates 80-90% of the possible PO's market.

              Don't anthropomorphize computers. They hate it when you do that.

              by curmudgeon on Thu Sep 10, 2009 at 09:06:32 AM PDT

              [ Parent ]

              •  Where is that written? (0+ / 0-)
                •  its in the House bill (0+ / 0-)

                  the most 'liberal' version of the legislation, which will inevitably become more conservative as the bills merge. companies will be mandated to provide insurance coverage, with some limited exceptions. people will be mandated to accept that coverage.

                  people who get no insurance through employers will be eligible, and it is a nearly negligible number of people. the HELP bill is similar, and the finance bill will, of course, contain no PO.

                  What carpet-man doesn't understand is; if carpet-man don't dance, carpet-man don't eat! - Bob Fossel (The Mighty Boosh)

                  by itsbenj on Thu Sep 10, 2009 at 09:16:22 AM PDT

                  [ Parent ]

                •  The president said the plan would (0+ / 0-)

                  have a limited PO available for only about 5% of the population.

                  Do you dispute that?

                  •  He's trying to lowball it because it has been (1+ / 0-)
                    Recommended by:
                    lgcap

                    such a lightening rod. I'm listening to Boehner and Cantor running their ignorant mouths right now about it.

                    Look, it's easier to fix a plan that is already in place than it is to throw everything away and fighting something that is unattainable right now.

                    You might want to check out Slinkerwink's rec list diary.

                    •  The speech was vague (1+ / 0-)
                      Recommended by:
                      DarkestHour

                      Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. (Applause.) And the insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. (Applause.) Now, let me be clear. Let me be clear. It would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.

                  •  He said only 5% would choose the PO (2+ / 0-)
                    Recommended by:
                    lgcap, beaky

                    Not that it would be limited to 5%.  At least that is the way I heard it.

              •  right (2+ / 0-)

                that's the basic point people keep missing.

                the "strongest" PO on the table is in the House bill. almost NO ONE is eligible for it, and it doesn't take effect until 2013. it will not, as is, introduce any meaningful competition into the market.

                and I say this as someone who currently would be eligible for it. just because it would work for me, doesn't mean it's OK to exclude nearly everyone from it. and mandating people to buy insurance from the monopolies is a terrible idea without a proper PO.

                hopefully one day, many years down the line, somehow it will be improved upon. but people saying it's 'whining' to point out these obvious weaknesses, well, I don't have much use for y'all. reality is reality. if you don't want to face it, feel free to keep that head in the sand, and keep that USA!!! foam finger a-wavin in the air.

                What carpet-man doesn't understand is; if carpet-man don't dance, carpet-man don't eat! - Bob Fossel (The Mighty Boosh)

                by itsbenj on Thu Sep 10, 2009 at 09:13:51 AM PDT

                [ Parent ]

                •  I'm not saying people are whining. (0+ / 0-)

                  I don't have my head in the sand and am not waving a fucking foam finger. YOUR attitude sure doesn't help in this process. I have been completely polite and tried to point out things realistically. I am still pushing for a strong PO and have been. I will not however just give up on HCR and call the President a sellout and go pout in the corner because I can't get EXACTLY what i want RIGHT now. I will fight to make this the best plan we can get in this Congress and continue after it's passed to make it better.

                  There's no reason to throw away real change because we're not getting single-payer.

                •  And I'll point out to you that if all you do (1+ / 0-)
                  Recommended by:
                  beaky

                  is whine about how the PO isn't ice cream and cake then you won't even get the pudding.

                  The US does have a pretty good record of improving programs once they finally get one started. Examine the starting points and history of SS and Medicare. Based on your comments about the PO, you'd be willing to go to war over the original implementations of each.

                  •  Well that's always been the problem (0+ / 0-)

                    with health care reform.  All the pieces are interdependent - and without one piece, the others are somewhat useless.

                    Pre-existing conditions requires mandates.  Mandates require affordable premiums.  Affordable premiums requires real competition among insurers.  Real competition is a strong public option.  Strong public option means....

                    So if I can't have the ice cream and cake, the pudding doesn't do much good.

                  •  OK (0+ / 0-)

                    except that you could not, in fact, point that out about me, because it wouldn't be true. but have fun with that!

                    What carpet-man doesn't understand is; if carpet-man don't dance, carpet-man don't eat! - Bob Fossel (The Mighty Boosh)

                    by itsbenj on Thu Sep 10, 2009 at 10:59:04 AM PDT

                    [ Parent ]

            •  That's what I was hoping to hear. (0+ / 0-)

              And why I've been telling people all morning to keep their focus on a strong public option.

              The goals here are universal, affordable coverage.  And affordable health insurance means health insurance premium containment through real competition.  A watered down public option may be just as ineffective at encouraging competition as not having any public option at all!

              •  Which is why it is important to keep fighting (0+ / 0-)

                for it and not throw hands up in the air, call Obama a sellout and do nothing. He has to deal with Congress to get this done and appealing to Americans with coverage and showing us (I have insurance) that HCR benefits ALL OF US is the right way to go about it.

          •  that's exactly where we are now - (1+ / 0-)
            Recommended by:
            beaky

            you remember his mention of 90% of insurance in Alabama is issued by one company? The PO provides guaranteed competition in those markets.

            •  How? (0+ / 0-)

              If the market is small, companies may decide not to compete in it.

              Does the proposed legislation supersede state regulations?

              •  Why wouldn't it? Federal laws do. (0+ / 0-)
              •  What are you talking about? (1+ / 0-)
                Recommended by:
                beaky

                The PO is not a private company operation. It might be the only competition against that company but it'll be there.

                •  I'm not getting the proposed PO (0+ / 0-)

                  From the speech I understood that the PO would only be available to those who don't have insurance, those people typically are uninsulated in today's environment.

                  But what others understand is that the PO insurance company will be available everywhere to compete for the same customers as the private companies. Presumably, the private companies would be required to take customers regardless of their health, but will they be required to cover all conditions?

                  Blue cross could just decide there are certain conditions it won't pay for universally, forcing someone with an expensive illness to turn to the PO. T

                  There is no way the PO will be self-sustaining if it is the insurer of last resort.

                  Now, let me be clear. Let me be clear. It would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up

                  .

                  •  He's fighting the Republican lie that (1+ / 0-)
                    Recommended by:
                    lgcap

                    the PO is a government takeover of health care. People with insurance don't want to lose their insurance for something unknown. I'm not saying this is rational but it's true. Obama needs these people to understand the government is not going to take over.

                  •  It's neither. (0+ / 0-)

                    The PO only competes with individual insurance polices, or policies that are directed at companies with 10 or fewer employees to begin with. It does not compete with the policies held by, for example, the autoworkers' union. If you're covered by one of those, you can't drop it and go for the public option. It's also predicted that major companies who offer insurance aren't going to suddenly drop it and force it's employees to go to the exchange, and choose a policy from a company or the PO.

                    The law will institute minimum coverage standards. As Obama said, there's still a lot of details to be worked out. What is in and what isn't convered specifically in those minimums is one of those things.

          •  This is up and running in Massachusetts (0+ / 0-)

            And rates are skyrocketing.  My rate of $1338 last year went to >1720, before I switched to a cheaper plan.  The exchange (MA Health Connector)?  It would be around $2000 for something comparable.  After all, it's really the assigned risk pool, for those unable to get better deals, and the prices charged by the handful of companies there are unregulated.  As are provider rates charged to them.

            After all, the free market "choice" of the Health Industry is what counts, not actually taking care of the peoples' health.

        •  The PO will (0+ / 0-)

          compete directly with private insurers, and the private insurers will not be able to vet their clients? And the government will regulate the private insurers?

          That's what Obama suggested last night?

          Any system that requires regulation is doomed, because the government got out of that business at least 15 years ago, but even assuming there is the slim possibility that could happen, I'm not sure the PO was on the list as an alternative.

    •  Don't you realize we've already been fighting (1+ / 0-)
      Recommended by:
      gleniris

      for decades.  And mandates for putting more profit into insurance companies' pockets without giving alll of us the option on whether to get the insurance through public or private means is not headway in the right direction.  It's moving backwards.

      "If you trust you are not critical; if you are critical you do not trust" by our own Dauphin

      by gustynpip on Thu Sep 10, 2009 at 08:53:59 AM PDT

      [ Parent ]

      •  But we have not been working towards a (1+ / 0-)
        Recommended by:
        soms

        single payer system continuously. Our system was set up differently and we have more to overcome. The Canadian system grew out of provinces adopting single payer incrementally. They only have 13 provinces and a smaller population. Our population is spread out and 50 states makes statewide reform piecemeal if we had gone about it the same way.

        This reform plan is a huge step in the right direction, the details have not been decided, and the things that don't work will be fixed. We have to work within the system we have right now, not what we wish it could be. We will get to single payer - it just won't happen overnight.

        •  This isn't movement toward single payer, IMO. (0+ / 0-)

          Not even close.  A strong public option might have been.  The public option included in this plan is so weak, it will have little impact on anything.  The best that can be said is that it will provide a safety net for the most needy - eventually.  I'm hoping I'm wrong, but I don't think so.  

          "If you trust you are not critical; if you are critical you do not trust" by our own Dauphin

          by gustynpip on Thu Sep 10, 2009 at 11:12:12 AM PDT

          [ Parent ]

  •  All morning I'll be asking this question (5+ / 0-)

    What is going to prevent health insurance companies from jacking up premiums once they are required to cover pre-existing conditions?

    What good does it do us to force insurance companies to provide coverage to the sick, if they'll be allowed to price the sick out of coverage by raising their premiums?

    Haven't heard an answer yet - especially not among those who are telling us to "stop focusing on the public option".

    •  A country (2+ / 0-)
      Recommended by:
      soms, nickrud

      COULD set price controls (which seems to be what you are asking for) but those tend to have very bad side effects of reducing innovation,etc.  

      So rates WILL go up, forever probably, no matter who is in charge.

      If they price the sick out of coverage, though, the PO will get kicked in or stronger, depending on whether it exists yet or is just a trigger.

      From Neocon to sane- thanks to Obama- and Kos.

      by satrap on Thu Sep 10, 2009 at 09:04:08 AM PDT

      [ Parent ]

      •  Look at Japan (0+ / 0-)

        There's a country that has strict price controls on providers.  A book lists exactly what any doctor or hospital is allowed to charge for anything.  Nobody gets filthy rich but they all make a nice living.  The rates are probably far below what some specialists make in the US.

        But Japan is hardly starved for innovation.

  •  Thank you for posting this. I feel the same way. (1+ / 0-)
    Recommended by:
    DarkestHour

    There's a carrot for private insurance to offer a plan on the exchange, but they've already got carrot cake- they don't want the people who will be using the exchange.

    Meanwhile, there's a stick to use on us taxpayers.

    He's using both the carrot and the stick on the wrong people.

    I'm not saying that the regulation that will get passed isn't a good thing- we need more regulation in the health insurance industry. But without effective cost controls, mandating private insurance is nothing but a handout to the health insurance companies.

    I own half a house- it's a duo.

    by EsnRedshirt on Thu Sep 10, 2009 at 08:58:41 AM PDT

  •  Perhaps you should read a transcript (4+ / 0-)
    Recommended by:
    soms, Inkin, Mistral Wind, beaky

    of the Presidents speech, cause you missed some stuff.

    the public plan option will be there only for people who are otherwise unable to get insurance - i.e. only for those without an employer plan available to them. But what if the health insurance an employer provides sucks ass?

    The President also said that all insurance companies will be required by law to provide a basic level of coverage, including no life-time coverage caps, limits on out of pocket expenses for patients, and preventative care. So, legislatively a base line of care will be mandated from insurance companies, i.e. no suck ass coverage. Homeland Security combined already existing intelligence operations; the government did not run out and hire 100,000 people. The President again spoke of eliminating the corporate subsidies in Medicaid Part D and using some of those funds to plug the donut hole. I could go on.
    I am sure there will still be plenty of the President's speech you disagree with, but until you get your facts straight you will not persuade me to agree with you.

    Now, I like the idea of a single payer too. However, I do not see the majority of the country supporting a complete change in the way health care is delivered in the middle of a recession. I think people are too economically scared. That is why I support the public option and will be working for its inclusion in the final bill. I do not know what the outcome will be on this. But I am going to grab the arc of Justice and start bending it.

    •  Make no mistake... (4+ / 0-)
      Recommended by:
      itsbenj, DarkestHour, lgcap, Nisi Prius

      ...I support the public option too - but what the President described is not really a public option, it's an option of last resort.

      And I did say that I thought there was enough in there to support - just not enough to be at all enthused about it.

      So far we have no idea what that basic minimum might be.

      Don't anthropomorphize computers. They hate it when you do that.

      by curmudgeon on Thu Sep 10, 2009 at 09:04:06 AM PDT

      [ Parent ]

      •  And it begs the question (0+ / 0-)

        if the insurers are required to take everyone, why would the pubic option be necessary for the uninsuable.

        It sounds very much like the insurance companies will not be required to accept very sick patients, but the government will be stuck with the most expensive patients. It's the insurance companies' dream come true.

        •  Stop making things up. (0+ / 0-)

          There are explicit provisions about pre-existing conditions not being a reason for denying coverage. Being sick is a pre-existing condition.

          You remind me of Hannity, making up scarecrows out of straw.

          •  It would be helpful (0+ / 0-)

            if you avoided the personal attacks. They are not persuasive in the least.

            The president said the PO would be available only to people without insurance, that group is almost certainly the most expensive subset.

            •  It would be helpful if you did not make stuff up (0+ / 0-)

              the president said it would be available to people that did not have health insurance under the new rules. Since the health insurance companies couldn't discriminate against those with pre-existing conditions they would be eligible under other aspects of the insurance industry: their parent's, or spouses's insurer, or even their own company insurance. Again, these are going to be, by far, the largest sources of new insurance availability.

              This is why every reputable evaluation of the public option, including the insurance companies, say the public option will be cheaper than what the insurance companies will offer.

          •  don't be so insulting (0+ / 0-)

            just because somebody disagrees with you.

            The private insurance company might offer you insurance for, say, $5000/month.  There are no price controls in the plan, after all.

            The PO's job is to be reasonable, to keep the "market" in check.  But as proposed, it is very, very weak, and even that has been proposed as a throwaway.

      •  And that makes it a start (2+ / 0-)
        Recommended by:
        fivefouranonymous, Inkin

        for those who currently have nothing. They will have coverage. And, if the administration takes the time to set it up properly, larger segments of the population will want it, because it works and is affordable.  

        Don't get me wrong. I think you should keep pushing for what you believe in. OK. It makes me look reasonable. (Ya know, MLK was called a communist, until Malcom X came along.) What I object to is your mischaracterization of the President's position.

        I'll keep an eye out for your future postings. It's been an interesting morning.

    •  How will he achieve these goals (1+ / 0-)
      Recommended by:
      DarkestHour

      and create affordability.

      His tort reform is nothing more than a bone for the conservatives who believe rich doctors shouldn't be responsible for their mistakes, it will save close to nothing.

      The people who are uninsured now have health problems. But in theory they should be able to buy insurance once the preexisting condition clauses are prohibited, so the PO would be unnecessary then?

      Taxing benefits is the same as penalizing those with good insurance. Employers with expensive plans also have older workers, who are necessarily more expensive. Rather than punish the fortunate, perhaps a credit for those on the open market would accomplish some of their goals.

      The bottom line is that the private insurers are inefficient and greedy. There purpose is not to insure people have adequate health care, but to be sure the company is as profitable as possible.

      The enforcement of the limitations is unspecified in the presidents speech, maybe because the insurance companies haven't approved the plan yet.

  •  Our choices are limited (5+ / 0-)
    Recommended by:
    soms, nickrud, Inkin, Mistral Wind, satrap

    Choice A:
    Do nothing, status quo, people get upset, system fails some more and we lose part of, if not all  of democratic majorities in congress.

    Choice B:
    Pass what Obama wants which sounds pretty good to most people in the cuontry, improve things a bit, maybe quell the masses, and either maintain or improve the democratic majorities (especially in the Senate...would love to win NH, OH, MO, KY, etc.).

    Choice C:
    Work harder for even more, maybe even single payer.  Nothing gets done for a long time, the system gets worse, and we probably also lose majorities in congress.

    I choose option B.

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