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Sunday, June 14, 2009

The "Debate"

by digby

This morning John King had Kathlen Sebelius on his show and she made a good case for the public plan option:

KING: The president tomorrow will speak to the American Medical Association. Doctors are skeptical about this public option. And let's look at -- we will show our viewers what our means. It's a government-owned health insurance plan, similar to Medicare and Medicaid. And it essentially would increase competition. And the goal is to lower prices by having competition with private insurers.

Those who argue against it say the subsidies from the government would be unfair competition, hurt private insurers, and perhaps drain the federal treasury, because, once you have a government option in place, you need to pay for it.

How will the president make the case to the skeptics, even in his own party, that this is too much government?

SEBELIUS: Well, I think that competition is a good thing, that most Americans understand that choice and competition is what we want. So, if you look at a health exchange, a marketplace, where people can have some options -- in many parts of the country, private insurers have no competitor, in -- in a state like my own home state of Kansas. There is a dominant insurance company in a lot of the states.

So, we created a public option for state employees, so they could choose side by side benefits and prices. Competition is good. You can write the rules for a level playing field.

The president does not want to dismantle privately-owned plans. He doesn't want the 180 million people who have employer coverage to lose that coverage. He wants to strengthen the marketplace.

But, you know, I -- I don't think it's a big surprise that a lot of insurers say, you know, what we would really like is, everybody who doesn't have insurance to be told they must buy it, and buy it only from us.

The president feels that having a public option side by side, same playing field, same rules, will give Americans choice and will help lower costs for everybody. And that's a good thing.

She went on to talk a bit about how the public plan is the best mechanism for cutting costs, (which is the reason for doing it!) And I like the fact that she pointed out that the insurers are all for a mandate that forces people to buy their insurance. Why wouldn't they be? There are 47 million+ new customers out there waiting to be screwed with lousy coverage, high deductibles, profit driven bureaucracy and eventual medical bankruptcy if they have the bad judgment to get sick. It's a bonanza for them.

So, that was good. Not so good was the fact that that was the last time we heard anything but nonsense on the subject from a parade of mushy MOR Senators, right wing flamethrowers and the Carville Matalin sideshow (which never fails to perfectly illustrate the fact that the Village sees all of this as some sort of a game.)They all pretty much predicted doom for anything but a "reform" that amounts to a mandate for the uninsured to buy insurance and maybe some phony, toothless non-profit hybrid that will do nothing to bring costs down, thus insuring long term failure. There were wingnuts a-plenty taking the far right position, which Matalin perfectly articulated, saying that "polls show" that people are far more worried about the deficit than anything else in the whole world. This means that not only shouldn't we be reforming health care, we should be cutting medicaid and medicare too. (Carville clowned and mugged and basically made little sense at all.) Sadly, there wasn't time to present any liberals who would argue from the other side for a rational single payer plan because well --- that's crazy talk.

And all this confusing chatter around the issue --- which started out with a pretty strong national consensus that the system was broken and that fundamental reform was needed --- plays perfectly into the hands of those who seek to preserve the worst aspects of the status quo and turn the crisis into yet another opportunity to profit at the taxpayers expense. Almost overnight the debate has become all about reassuring people that nothing's going to change.

And that leads to the public being completely incoherent on the issue --- all they have left is successful Republican bumper sticker propaganda to frame the issue:

So, we went to Junior's Diner. It's in Orlando, Florida. We sat down. Everyone at the table agreed on the urgency -- the urgency -- of doing something about health care. But getting them to agree on just what, that is a whole other matter.


KING: ... with the way we do health care in this country now, if anything?

BLANCHE DORMADY, ORLANDO, FLORIDA: I think that depends on the person. I -- I have -- I don't like the insurance. The insurances decide what you're going to have and what you're not going to have. And I certainly don't want the -- the government to have that ability. And I like it to be private.

KING: Well, are you -- are you -- are you worried, though, that they will make it worse, the politicians will make it worse?

B. DORMADY: It will make it worse. But I'm not a worrier.


MARGARET DORMADY, ORLANDO, FLORIDA: I'm against health -- national health care. I personally don't have health insurance, because it is too expensive.

But I want to get for myself what I need. I -- I don't want to be told what I can have and when I can have it. And I sure as hell -- excuse me -- don't want...


M. DORMADY: ... the government having my medical records running throughout the U.S.

KING: One of the things in the proposal put forward by Senator Kennedy, and most likely in the House by the Democrats as well, would be a mandate that would require you to get health insurance. That's the way they do it in the state of Massachusetts now. And you would have to get health insurance. If you had a job, and you were able to afford it, you would be -- you would have to get it, and you would be penalized if you didn't?

Is that right?

M. DORMADY: Just like the car insurance. I understand that. And I don't like that either.

STAFFORD EZZARD, WINTER PARK, FLORIDA: I trust the government more than many people do. I'm a Democrat. And I think the Democratic Party, at heart, has the people's interests in mind. I'm somewhat skeptical of our ability, politically speaking, to reach a -- maybe a conclusion at all.

KING: You don't want the government involved, but do you think they will pass something? The Democrats have big majorities.

M. DORMADY: I'm a Democrat. I vote open ticket. And I'm afraid they will. And I just feel more power, control by the government, so that I no longer have ambition to be able to go out and strive and do what I want to do in life and have the life that I want. I have to be under someone's thumb.

KING: You think they will do something?

B. DORMADY: Oh, I hope not.


B. DORMADY: I'm sorry, but if they put it back in the hands of the doctors to do what the doctors want, maybe it will be done. But to have government getting involved....

M. DORMADY: And I think that's a good point. Doctors need to be more involved in this, and not be pushed around.

KING: Well, do you think they're pushed around by -- by the insurance companies?

M. DORMADY: I think they're pushed around by insurance companies. I really do.

EZZARD: Yes, I think we are agreed on that.

I just had an experience with -- with my primary provider, who joined a -- a private -- I don't know what you would call it, but it's a -- but it's a group of doctors who have banded together.

And, in order to stay with him, I was going to have to pay him $1,500 cash, and my wife would have had to pay $1,500. My son would have had to pay $1,500. That's in addition to our health insurance.

KING: Paying for it is the big question mark, where many think this could collapse. One of the things on the table is to tax the health benefits you get from your employer.

Is that a fair way to do it?

B. DORMADY: I don't think the government ought to get into it.

M. DORMADY: Well, I see what you're saying.

And even McCain was trying to say we should back...

KING: Right.

M. DORMADY: ... we should tax...

KING: Right.

M. DORMADY: ... everything. So, you would have to pay more taxes on what your benefits are.

But you know what? Why not. I don't have a problem with that. (END VIDEOTAPE)

KING: A fun discussion and great oatmeal with raisins at Junior's Diner. You can see we brought the CNN Express along, and took up most of the parking lot there.

John King fed them the conservative straight lines and they delivered the propaganda punch lines, one right after the other. If anyone stepped in with something provocative, like the guy who said that his doctor was making him pay $1500.00 per family member, on top of his insurance premiums, just to stay with him. King just blathered on about taxes as if that's this fellows biggest financial problem rather than the fact that he's getting it coming and going from the health care industry.

I don't blame them really. Nobody is helping them make sense of this. If you watch Democrats on television explaining their plans, they sound as if they are just as scared of a socialized, government takeover of health care as the Republicans are. And seeing as most of them take massive sums of money from insurance companies, it isn't exactly surprising, is it?

This is just beginning and a lot can happen, but I can't say that it's going very well so far. They took single payer off the table before they even began, so they are starting this negotiation with this public plan option as the leftward position to be bargained away in the inevitable "compromise." The way they're going we'll be lucky if we don't end up with "reforming" Medicare into a private, for profit insurance company.

Update: Good stuff on this subject from Scarecrow at FDL


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