I have long enjoyed Ezra Klein’s brilliant reporting on the healthcare legislation. He has always looked at the issue with laser-like precision, just sticking to the facts and without ever seeming to be pushing his own personal agenda. Ezra has frequently been a guest on Mr. Olbermann’s MSNBC’s Countdown program, offering according to Olbermann, "cogent analysis" on the progression of the healthcare bill. Well, Mr. Olbermann, one of the persons you rely on for insight on this matter, one of the people you have complemented frequently for his knowledge on the subject, disagrees with your martyr-like clarion call to kill the healthcare bill.
It is interesting that as Keith Olbermann promotes his effort to provide free health clinics to the poor, and others who might not be as poor, but who are unable to afford healthcare, he is joining the ranks of those who are trying to kill the bill. As it relates to the poor, here is what Ezra Klein had to say about the bill:
I want to be very clear on this: I think this bill will do more to help the poor and underserved than anything since the Great Society. I think it will do more to control costs, and create an infrastructure to control costs and a politics able to control costs, than anything we've ever done, full stop.
In listening to the debate over this issue over the past few days, it occurred to me that everybody wants to tell the President what to do or ELSE! Everyone is grasping their ego with a firm grip and stepping up to the President with their own individual threats: "I’m going to blow this, and the hopes of so many who are dying at the rate of 45,000 a year, to kingdom come, unless you do what I say, Mr. President," or "I campaigned for you, worked hard for you, so if I say jump, you better sure as hell jump!"
According to Klein in an article yesterday:
These days, it seems everyone wants to take hostage and everyone thinks they can. In 1994, the bar was a bit higher. Famously, Bill Clinton vowed to veto the legislation if it didn't achieve full universality. This year, Republicans and some conservative Democrats vowed to kill the bill if it contained a small public plan for the 10 percent of the population using the exchanges. This week, Joe Lieberman vowed to kill the bill if it allowed people between 55 and 64 who didn't have access to employer-based insurance to buy into Medicare. This morning, Howard Dean vowed to oppose the bill unless the state-based exchanges "act as prudent purchasers and select only the most efficient insurers." (If that was included, he said, a "stripped-down" version of the bill would be acceptable, though it's not clear what that means.)
In considering Dean’s promotion of the killing of the bill, Klein considered the Doctor’s specific objection:
What's so strange about Dean's objection is that the exchanges in the Senate bill (pdf) do act as "prudent purchasers," that is to say, they set limits on the plans that can enter in the exchange to ensure that people are getting good choices. The relevant section begins on page 131 of the Senate bill. "The Secretary shall, by regulation, establish criteria for the certification of health plans as qualified health plans." A couple of pages of relevant criteria follow, including marketing requirements (plans can be disqualified for focusing their marketing in outlets that would bring them uncommonly healthy enrollees), broad provider networks, coverage of options used by low-income folks community health centers, say), quality measures, quality improvement strategies, consumer ratings, standardized benefit packages, etc.
For those harboring doubt to Klein’s reading of the bill, according to Klein, Dean singles out John Kerry as the Senator who has been working the hardest on this issue. He contacted Kerry’s staff which afforded him with a comment from Kerry himself which said:
"The prudent purchasing provisions in the Senate health bill will lower costs and increase affordable options for consumers," Kerry says. "It’s strong language that will allow the exchange to deliver competitive prices and offer high quality care, and I’m thrilled to see national reform honor the best innovations already succeeding in Massachusetts."
If we just listen to the voices who want to kill this bill, we will come away with the impression that this bill is worst than any personal illness that could ever befall us, but is this correct? They have control of the media and the blogosphere and can spin this in any way they wish. But is what they are spinning the ultimate truth? Yes, this bill could be far far better; everyone agrees with that, even Mr. Klein. But is it so bad that it cannot be improved over the years, as Social Security and other legislation in the past have been improved? Perhaps not, perhaps, as I speculated, this might just be a case of "Do as I say or ELSE!"
An additional point from Klein is this:
I'm sure there's some theoretical way in which the language could be stronger. Dean doesn't say what it is, but I don't doubt it exists. But now we're talking about killing the Senate health-care bill -- with its $900 billion in subsidies and its delivery system reforms and its Medicare Commission and its Medicaid expansion and its exchanges and its regulations on insurers -- unless we make the exchanges slightly stronger prudent purchasers, when they're already strong enough to "thrill" the original sponsor of the prudent purchaser amendment? I guess this is the logical outcome of a system in which the greatest gains accrue to those making the most credible and severe threats. But it's not healthy.
I know that many will now vociferously disagree with Klein and even suggest that he is bereft of the facts, when they have enjoyed his analysis so many times before. Still, as far as I'm concerned, all I really want to say is, thank you.
Those wishing to see the preliminary Senate bill effort that was referenced in the diary will find links to it in Ezra's article, which is provided below.
Ezra Klein
http://voices.washingtonpost.com/...
http://www.washingtonpost.com/...