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45,000,000 get CHC-single-payer care =vs.= 3,000,000 P.O. tickets ??? -- Cummon folks.


Ted Kennedy's existing CHC program expands along lines developed by Bernie Sanders and Ben Cardin.

The single best thing to happen for America's working poor since food stamps:

-- 14,000 nationwide Community Health Clinics

-- Expand CHC capabilities to match VHA technology

-- 45,000,000 people served

-- $$$$$ to attract 20,000 primary care physicians, nurses, etc.

-- Drugs at VHA prices

-- Dental care

-- Patient billing scaled to income

-- No profit motive.

-- 40% saving for chronic care, 1/5th the cost for ER.

Find A CHC Health Center.

Alan Frumin, the Senate Parliamentarian, showed last April that non-budgetary insurance sections would not qualify for reconciliation. Filibusters would doom any Senate P.O.

Harry Reid concealed Sanders-Cardin till the last hour, then popped it into the Senate HCR Managers Amendment.

America will become a rather larger Vermont.

MBTF :::

Netroots support for public option plans continues at a crescendo. The House P.O. might reach all of 3,000,000 while doing nothing to push back costs.

Here at DKOS, the situation has turned to such as blaming President Obama for WEAK LEADERSHIP and other forms of flaccidity.

Silly geese.

Technically, this is not Single-Payer. But 80% of CHC operating funds come from government transfer payments, which is close enough in practice.

Insured and uninsured patients get access to what is a non-profit, fully socialized, no-bill-padding system.

What happens at the clinics is that the health care is paid from one source. Billing is separated and even uninsured individuals (7% of total) are then billed with installments.

Anyone can use the CHC clinics.

At point of delivery, from the point of view of the care provider, its Single-Payer.

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.

Must See, especially for those who wanted the its-what-I-think-it-is Public Option.......... ;^)

And then there's YouTube link from valadon:



Good if you can use it, sure thing. But it turns out that reco was not available for P.O. enablement sections.

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 good scan through.

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.

Simple fact is that a P.O. could not avoid filibusters.

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 political talk after April 2009 was a distraction to mislead the GOPers, at most. Democrats outside the leadership loop ??? Likely not told what was coming.

Security was essential to minimize GOPer counterattacks. It worked.


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-payer system.

-- Sanders has worked with House Majority Whip James Clyburn (D-S.C.) to include $14 billion in the House version of the legislation. (Which had already been done.)

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 for dedicated KOSSACKS: compare/contrast Bernie Sanders's take on this with recent DKOS Diaries on these subjects. Take note of how long you can go without ROFL. ]


Vermont has all of 500,000 people plus the head count from one goodly Fourth of July picnic at Boston harbor. They get along with 8 CHC full centers and 40 satellite clinics.

The current national CHC system has 4,000 sites for the whole country. This upgrade makes for a total of 14,000 national sites.

-- A minimum of 35 clinics for every Congressional District except where there really is no need. One site for every 25,000 Americans overall -- concentrated to low-service areas.

-- 300 service days per resource -- makes for one massive impact on American health care.

Bernie just got us to this level of CHC-Vermont medicine for 45,000,000 Americans total.

For rural America, this change will be remembered. Big time.

Kennedy, Sanders, Cardin -- a Democratic Party trinity any o' youse folks can believe in.


There are 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 0.03% with the VHA hospitals.

Amazing what getting away from profit-motive greed can do for quality control systems.


So, despite not including a 3,000,000 ticket P.O., and NO DENTAL, this Bill moves America to Vermont-style single-payer for 45,000,000 people.

More than doubling the Kennedy CHCs.

Provide at least 2,000 rural areas with currently nonexistent medical resources. Go after the primary care crisis. Enable states to run their own systems as straight up S1ngle-Payer operations immediately.

Altogether, Sanders-Cardin as an option to any P.O. Option is better.

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 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.


The $14-billion got pumped into the House Bill. Nobody noticed. Nobody said a word. Not one drop of press.

The GOPers were drunk ??? Too lost in whining about P.O. ? Quite possibly, the House GOPers didn't read their Bill at all.

The GOPers went for All Or Nothing.

Break the Obama presidency..... dontcha know.

What they are getting is nothing.

Anyway, you're likely to see a half-dozen states go pure single-payer for these clinics. We'll tell the GOPers about that, how high-quality socialized medicine came to America. How their brand of immoral greed is taking one in the neck.

Majority Leader Harry Reid and Speaker Pelosi: Hip! Hip! Hoo-ray !!!!!

Damn, you two are brilliant !!


Thanks for the REC list. Glad people got to look at it, despite crappy writing. (Of course, complainers can wotch du videos.)

Originally posted to vets74 on Tue Dec 22, 2009 at 01:52 PM PST.

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