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It's hard to get truly excited about the fair-to-middlin' health care reform package now pending final debate and a vote later today, because it really stood just a few cruel Blue Dog votes away from producing an ironically cheaper (and more effective) bill they couldn't support. Kurt Schrader in the OR 5th echoed the refrain from other Western/rural Democrats who complained that Medicare +5% provider reimbursements under the public plan would penalize the more efficient Oregon providers, who get much less than doctors in other states for the same services.

It's a fair argument--but it's also something that can be dealt with; Congressman Blumenauer (OR-3) last month reached an agreement to insert into the current bill a call for study of Medicare rates prior to 2013, with its recommendations to be taken by the developers of the public plan, the idea being to geographically adjust provider rates more fairly, and begin rewarding efficiencies rather than paying less as a "reward." 

{more, below}

So it's fixable, and even if it's not let's be honest--Oregon providers are not showing up at soup kitchens; they'll continue to get by on Med+5, and for that generous gesture the reward will be nearly $100 billion in savings for the entire nation, plus a much better potential reach for the public plan and an easier path to immediate stability and success. In short, it's not really a good reason to oppose the more robust plan...but out Med+5 went to appease the Coalition of the Fiscally Ironic, and Schrader appears to be nominally on board this weekend for the final vote.

Not so the Coalition of the Indignantly Inappropriate, led by Bart Stupak and a small group of other pro-life Democrats who are almost literally holding the entire health reform bill hostage in order to indeed literally strip women of their prior health care rights. If you can believe it--and really, I still can't almost--what they are demanding be voted on would not only bar the public plan from covering abortion, it would bar any PRIVATE provider that wanted to participate in the exchange from doing so as well. Women who are covered today, may not be covered tomorrow if Stupak gets his way.

And why did he get his way, exactly? That part may burn me up the most: the whole idea was that the bill would hit the floor clean, without amendments. Anthony Weiner had to graciously fall on his sword for the Speaker, agreeing not to have the single payer amendment heard on the floor--explicitly so that poison pill amendments like Stupak's could be blocked out of fairness.

Single payer proponents--progressives--once again are told to suck it up for the team...and then the very same leadership turns around and gently cups the balls of the Blue Dogs, giving them whatever they want to get their votes. It's disgusting, and it Makes. The Base. Stay. Home.

Blumenauer, for his part, is not going to let that happen:

I am deeply troubled by any Congressional action that restricts a woman’s right to choose. This amendment is an unfortunate shift from the status quo on federal abortion policy that will disproportionately impact low-income women. There is no room for government involvement in the personal and difficult decisions around women’s reproductive choices. To force insurance companies to deny a woman access to a legal procedure would be a very disturbing step backwards.

 

Good for you. As I said, I think all four Democrats in Oregon are on board with the bill at this point, and in any case the only waffler has a filled voice mail box in DC and no answer at the state offices. So about the best you can do is sit back and hope that Stupak's gambit with fire (remember all 177 GOP Reps will happily vote for his amendment) falls short, and then they'll be able to wipe their diapers and vote for the bill. Heaven help us for the small favors we desire. 

Crossposted at Loaded Orygun...

Originally posted to torridjoe on Sat Nov 07, 2009 at 11:47 AM PST.

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