![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
cos[context, in case you need it] Obama has proposed including a "public option" which would basically be single-payer health care, but coexist with private for-profit insurance. People or employers could choose the public option, just as they could choose any existing private plan. If it turns out to be better than private insurers, they'll either get better to survive, or they'll get smaller and we'll have national single payer, more or less.
So, this post is for those of you who want this public option to happen.
First: We're winning. We're ahead. Press coverage has been very misleading, for several reasons, including:
Despite what it may seem from the news, a public option is >50% likely. On the other hand, it's not anywhere near 100% likely, so it can definitely use your help! And you can easily do some things that'll have a big effect on its chances.
If you're interested, here's what's happening in Congress, and why the actions I recommend below will matter. Or, you can skip the details, and just do them.
First, here are summaries of the four bills already out of committee:
As you can see, all four of these include a public health plan. Obama wants a public plan. So why is it even in question?
What I'm summarizing here is based not just on following the issue via the next over the past couple of months, and email from various advocacy groups and progressive organizer discussion lists I'm on, but also on informal conversations with several members of Congress at Netroots Nation last weekend, and a chat with Darcy Burner who organizes the Congressional Progressive Caucus.
First, and most important:
1. Democrats feel that they must pass some big health reform legislation. Some Democrats may not feel that the public option is important, and some may even prefer it not be there, but they all believe that if they fail to pass the legislation altogether, it will bite them hard in the 2010 elections.
2. Republicans agree that if Congress doesn't pass comprehensive health care reform, Democrats will lose a lot of seats in the 2010 election, so Republicans are nearly united in opposing anything, whether it has a public option or not.
Therefore: This is going to be decided by Democrats. What Republicans do won't be key here.
In the Senate, when multiple committees committees are working on the same legislation, the version that comes out of the committee that got the bill referred to them first, becomes the "base bill". What other committees produce can be substituted for the base bill as amendments, but amendments can be easily blocked by 40 votes, so the base bill is at a big advantage when it comes to "must pass something" at the end. And in this case, the Senate Finance Committee gets to produce the base bill.
Finance Committee members have said that what they produce, once it passes the Senate, will be what becomes law; basically, they've declared the House irrelevant. They believe that they can reject all the House versions and the House will be forced to accept the "compromise" they produce after it passes the Senate.
House leadership want the public option. Speaker Nancy Pelosi strongly wants it. Majority leader Steny Hoyer probably doesn't care that much, and would be willing to pass health care reform without it. But Steny Hoyer *does* care a lot about the power of the House vis-a-vis the Senate, and will stand up for it. If it turns into a pissing match between the two houses, Hoyer's hackles will be raised very high, and he'll stand on principle for the House version. This is the most important legislation this Congress will pass, and if the Senate gets to make the House irrelevant on this, then there will be no reason for President Obama to really care what the House wants on any other legislation.
House has a weapon to use against the Senate: An organized (finally!) Progressive Caucus. 65 Representatives have signed a letter saying they will vote "No" on any health care reform legislation that does not include a strong public option. With all Republicans voting no, no such bill can pass without these Representatives, so they're using their power as a block to show that the House will not pass the Senate version if it's the Finance Committee "compromise". Pelosi and Hoyer can use this to show Reid that he needs to get something out of the Senate that has a public option, otherwise it won't pass the House - and Senate Democrats can't let no bill pass at all. Even those Senate Dems who prefer no public option, would much rather have a public option than a 2010-Dem-killing lack of health care reform.
Meanwhile, in the Senate, Majority Leader Harry Reid is losing confidence in Max Baucus' Finance Committee. Dodd's HELP committee passed a good bill already, and Baucus' committee is still dickering and putting out all sorts of confusing and damaging statements and press coverage. Reid could try to say "enough is enough" and move the HELP committee bill to the floor as a base bill, rather than waiting for Finance to produce something.
Additionally, I'm told that there are actually a number of Democratic Senators also planning to vote No on any bill that doesn't include a public option. They haven't made their names public, due to the Senate's tradition of "comity" (outward friendliness), but there are more than 5 of them, and they're probably enough to kill a bill that would probably need every single Democrat voting for it to pass. So Reid is being pressured both from within the Senate and from the House, into passing a public option if he wants to pass anything.
We have two points of pressure to apply:
One: Support the House Progressives who have signed the letter saying they will vote No on any bill without a public option, so they stick to what they've pledged despite all the pressure they're likely to be under to back off.
Two: Try to get the Sneate Finance committee to stall and not pass a bad bill.
A word about supporting the Reps who signed the letter... here's Darcy Burner's plea, paraphrased: "When they do something lobbyists want, they get a big fat check, and a thank-you visit. when they do something we (progressives) want, sometimes they don't even get a single phone call!!" Darcy told me about one Representative who, when he voted against the FISA bill last year with immunity for warrantless wiretapping, got something like 50 thank you phone calls, and about $1200 in small donations. That seems like very little, yet she says he was so excited about it he's still bringing it up now. Remember, these are Reps who want to do that things we want them to do. We don't need to give them more money than the lobbyists do, we just need to validate them in doing what they're already doing because they want to. We need to make them feel that it really is appreciated, so they'll feel confident when under pressure. It only takes a few phone calls, and a few small donations (100 people giving $12 each, for example).
If you want this to happen, do these things this week:
Edit: To find a Senator or Representative's phone number:
- Google their name
- Go to their house.gov or senate.gov web site, and click "contact"
- Call their DC office, the one with a 202 area code. Local offices usually focus on constituent services, DC offices handle legislation.
So, this post is for those of you who want this public option to happen.
First: We're winning. We're ahead. Press coverage has been very misleading, for several reasons, including:
- Angry protesters at legislator's town hall meetings have some effect on the legislators, but have a lot more effect on news coverage, by far.
- Our mainstream press hasn't gotten used to the expanded power of the new progressive movement, because it's so new. That's why they were so shocked that Obama won the Democratic nomination, for example. In fact the press was so badly caught off guard by that that they didn't even report that Obama had basically won until about three months after everyone who was looking at the numbers already knew it. They just couldn't believe it. If we win on health care, much of the press won't believe it until after it has really happened.
- Three committees in the US House, and one committee in the Senate, have already completed health care legislation that includes a public option. Only one committee, the Senate Finance Committee, is still arguing out their version of health care reform, and they're the only ones working on a bill that doesn't have a public option. But because they're the only committee still actively working on it, they're getting all the press coverage.
Despite what it may seem from the news, a public option is >50% likely. On the other hand, it's not anywhere near 100% likely, so it can definitely use your help! And you can easily do some things that'll have a big effect on its chances.
If you're interested, here's what's happening in Congress, and why the actions I recommend below will matter. Or, you can skip the details, and just do them.
First, here are summaries of the four bills already out of committee:
- Senate HELP (Health, Education, Labor, and Pensions) committee bill summary [PDF]
- House Ways and Means committee bill text, summaries, & other info
- House Education & Labor committee press release (link to summary near bottom)
- House Energy & Commerce committee press release and bill text, summaries, & other info
As you can see, all four of these include a public health plan. Obama wants a public plan. So why is it even in question?
What I'm summarizing here is based not just on following the issue via the next over the past couple of months, and email from various advocacy groups and progressive organizer discussion lists I'm on, but also on informal conversations with several members of Congress at Netroots Nation last weekend, and a chat with Darcy Burner who organizes the Congressional Progressive Caucus.
First, and most important:
1. Democrats feel that they must pass some big health reform legislation. Some Democrats may not feel that the public option is important, and some may even prefer it not be there, but they all believe that if they fail to pass the legislation altogether, it will bite them hard in the 2010 elections.
2. Republicans agree that if Congress doesn't pass comprehensive health care reform, Democrats will lose a lot of seats in the 2010 election, so Republicans are nearly united in opposing anything, whether it has a public option or not.
Therefore: This is going to be decided by Democrats. What Republicans do won't be key here.
In the Senate, when multiple committees committees are working on the same legislation, the version that comes out of the committee that got the bill referred to them first, becomes the "base bill". What other committees produce can be substituted for the base bill as amendments, but amendments can be easily blocked by 40 votes, so the base bill is at a big advantage when it comes to "must pass something" at the end. And in this case, the Senate Finance Committee gets to produce the base bill.
Finance Committee members have said that what they produce, once it passes the Senate, will be what becomes law; basically, they've declared the House irrelevant. They believe that they can reject all the House versions and the House will be forced to accept the "compromise" they produce after it passes the Senate.
House leadership want the public option. Speaker Nancy Pelosi strongly wants it. Majority leader Steny Hoyer probably doesn't care that much, and would be willing to pass health care reform without it. But Steny Hoyer *does* care a lot about the power of the House vis-a-vis the Senate, and will stand up for it. If it turns into a pissing match between the two houses, Hoyer's hackles will be raised very high, and he'll stand on principle for the House version. This is the most important legislation this Congress will pass, and if the Senate gets to make the House irrelevant on this, then there will be no reason for President Obama to really care what the House wants on any other legislation.
House has a weapon to use against the Senate: An organized (finally!) Progressive Caucus. 65 Representatives have signed a letter saying they will vote "No" on any health care reform legislation that does not include a strong public option. With all Republicans voting no, no such bill can pass without these Representatives, so they're using their power as a block to show that the House will not pass the Senate version if it's the Finance Committee "compromise". Pelosi and Hoyer can use this to show Reid that he needs to get something out of the Senate that has a public option, otherwise it won't pass the House - and Senate Democrats can't let no bill pass at all. Even those Senate Dems who prefer no public option, would much rather have a public option than a 2010-Dem-killing lack of health care reform.
Meanwhile, in the Senate, Majority Leader Harry Reid is losing confidence in Max Baucus' Finance Committee. Dodd's HELP committee passed a good bill already, and Baucus' committee is still dickering and putting out all sorts of confusing and damaging statements and press coverage. Reid could try to say "enough is enough" and move the HELP committee bill to the floor as a base bill, rather than waiting for Finance to produce something.
Additionally, I'm told that there are actually a number of Democratic Senators also planning to vote No on any bill that doesn't include a public option. They haven't made their names public, due to the Senate's tradition of "comity" (outward friendliness), but there are more than 5 of them, and they're probably enough to kill a bill that would probably need every single Democrat voting for it to pass. So Reid is being pressured both from within the Senate and from the House, into passing a public option if he wants to pass anything.
We have two points of pressure to apply:
One: Support the House Progressives who have signed the letter saying they will vote No on any bill without a public option, so they stick to what they've pledged despite all the pressure they're likely to be under to back off.
Two: Try to get the Sneate Finance committee to stall and not pass a bad bill.
A word about supporting the Reps who signed the letter... here's Darcy Burner's plea, paraphrased: "When they do something lobbyists want, they get a big fat check, and a thank-you visit. when they do something we (progressives) want, sometimes they don't even get a single phone call!!" Darcy told me about one Representative who, when he voted against the FISA bill last year with immunity for warrantless wiretapping, got something like 50 thank you phone calls, and about $1200 in small donations. That seems like very little, yet she says he was so excited about it he's still bringing it up now. Remember, these are Reps who want to do that things we want them to do. We don't need to give them more money than the lobbyists do, we just need to validate them in doing what they're already doing because they want to. We need to make them feel that it really is appreciated, so they'll feel confident when under pressure. It only takes a few phone calls, and a few small donations (100 people giving $12 each, for example).
If you want this to happen, do these things this week:
- Look at this list of House members who signed the letter and if yours is on it, make a quick phone call to say thank you.
- Even better, if you can, make a small donation - even if it's just $10. And then - this is key - call the Representative to not only thank him/her, but also to say "I just made a small donation to you because you committed to vote No on health care reform if it doesn't have a strong public option." Imagine the effect it'd have on someone, who wants a public option, to know that people gave them money specifically because they said they'd vote this way. How can they back down now?
- Is your rep not on the list? Donate to some others, and call them and tell them you gave money because of this.
- Your rep not on the list? Find a Rep on the list whose district has someone you know in it, and get that someone you know to call them and say thank you. Find another, and another, and repeat.
- Massachusetts people: John Kerry is on the Senate Finance Committee. He wants a public option. Call him and urge him to pledge to vote no in committee on any bill without a strong public option. Literally that: vote no in committee. It'd only take a few Senators to block the compromise from passing, and if the Finance Committee can't produce a bill, then the much better HELP committee bill will become the base bill on the Senate floor. Then theres no need for a fight between the Senate and the House, and we win.
- Non-MA people: see if your Senator is on the Finance Committee.
- Sign Democracy for America's petition and DFA/PCCC's advertisement for the public option. DFA is Howard Dean's organization, and his top focus these days is getting a public option passed.
Edit: To find a Senator or Representative's phone number:
- Google their name
- Go to their house.gov or senate.gov web site, and click "contact"
- Call their DC office, the one with a 202 area code. Local offices usually focus on constituent services, DC offices handle legislation.
Tags:
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
Re: wording & framing
One question about your letter; you write:
he's proposing to put a public health insurance on the market with the private companies, to let people choose and see what works better
However, according to the summary of the SELF plan, Title I Subtitle D, "All individuals will be required to obtain health insurance coverage." It further states, "The minimum penalty to accomplish the goal of enhancing participation in qualifying coverage will be no more than $750 per year."
I respectfully submit that this is not the same as "putting a public health insurance on the market with the private companies, to let people choose and see what works better", because under this plan, people no longer have the ability to choose not to carry health insurance. I know a few people who genuinely prefer just to pay their doctors directly; there are also people who prefer alternative therapies to allopathic medicine, and their preferred treatments will almost certainly not be covered. The plans on the table take away their option not to participate in a health insurance plan, and in fact penalise them for not doing so. How is this fair?
Also: I am a U.S. citizen who no longer lives in the United States. I haven't been able to find out how this is going to affect me and other expats; since we're still U.S. taxpayers, will we have to purchase coverage that we won't ever use or else pay a fine? I already pay for coverage in the country where I live; however, my insurer does not do business in the U.S. and thus my health plan would not be a qualified health plan. What happens to me and the other ~4 million expats out there?
Re: wording & framing
You may recall that during the Democratic primaries, one of the main points of contention between Clinton and Obama was this requirement. Obama thought it was necessary, Clinton said some of the same things you're saying. Obama was right, though.
Before I get into why he was right, I'll address "is this fair?" You, with your taxes, have contributed to the maintenance of the sidewalk in front of my house, even though you may never ever visit here. All of us have "crime insurance" - if we're attacked, the police will respond. None of us have the "option" of choosing not to pay for it. Anyone who has a car is *required* to get a certain level of insurance in exchange for permission to put that car on any public roads. Yes, it's fair. Some things just work better when we all pool our money together, and we make decisions about how to do that through a democratic process. Just as it's important that all the cars sharing the road with you are insured, it's important that all the people sharing air space and economic activity with you are insured against injury and disease, and all of us need to pay for it. It'd be much simpler to just lump it in with the taxes we already pay, and have the government administer it, as most developed countries do, but apparently the USA isn't quite ready for that "socialized medicine" they have in such socialist countries as England. Okay, so we can have an individual mandate, with subsidies for people whose income is low. It works out to the same thing, and it's just as fair as forcing all of us to pay for roads, police, and the court system.
Now, why is it needed? Why was Obama right, and Clinton wrong? Because currently, in a private market, insurance companies have to protect themselves from the dynamic that comes out of exactly what you describe: people who are on balance healthy, deciding they don't need health insurance. Unlike many other kinds of insurance, health insurance doesn't just cover the expense of a single catastrophic event at a point in time, it covers all of the treatment afterward. Imagine if you could choose not to insure your car, until it got totalled in an accident, and *then* you could get insurance that would pay you to fix it? Either the insurance companies would all go broke, or they'd have to charge so much that lots of people couldn't afford it, or they'd have to have rules in place to deny you coverage if you tried to get it after an accident.
What we have in health insurance is a combination of the latter two. Lots of healthy young people do indeed go without insurance for years (I did for a few years, before Massachusetts health reform both made it affordable and instituted an individual mandate). Insurance rates are way too high. And they deny coverage to anyone with a "pre-existing condition". However, it's not really like cars, and "pre-existing conditions" actually include a lot of what we do need the system to cover. Overall, it's a mess.
If we're going to keep private insurance, and force them to cover everybody and every condition, we *have* to spread the risk, and the cost, across the whole population. In exchange for ending a system of rules that denies many of us coverage when we realize that we do need it, all of us have to get coverage even when we think we may not need it. It's only fair.
Re: wording & framing
Re: wording & framing
On the contrary, Clinton insisted on the mandate, and Obama preferred the scheme where participation is voluntary. And that was one of the reasons for his popularity in the primaries.
I am not sure how to interpret this phenomenon, where their respective positions get somehow exchanged in people's memories. But it does make me feel quite uneasy..
Re: wording & framing
I googled and found something about Obama explaining why he had changed his mind on the individual mandate, so that is probably why I got it backward: I remembered that it was a subject of debate back in March/April/May last year, and knew that he proposed an individual mandate when he asked Congress for health care reform legislation this year, so that got me to think he'd favored it, since I didn't notice him talking about changing his mind about it. But that also suggests how unimportant it was as an issue in making up my mind about the candidates; Obama's overall outline for health care reform is mainly John Edwards' plan anyway, and that was the best one of the three of them during the primaries.
Re: wording & framing
I certainly made a point of quoting this to people as yet another reason why he was better than Clinton. All that was quite early in the primary season (I was still campaigning for Obama actively at that point).
It was quite late in the game when he suggested he might be open to a mandate. I still remember my disappointment. Yet, at that moment he still was preferring the voluntary scheme, he was just "open to a mandate".
I think I am starting to better understand the current opposition to the reform. No wonder if quite a few voters feel cheated because of Obama's shifting position on the mandate. I, somehow, have not considered this aspect until now. But I can see it: they voted for a guy who was saying something different, and that looked attractive, and now they feel they've been manipulated..
Re: wording & framing
I definitely heard activists referring to policy differences like this when talking to people about their choice of candidate, but as far as I can tell these were rarely the points which convinced anyone to pick one candidate over another. Everyone who picked a candidate still preferred at least some policy positions from some of the others; they picked based on an overall sense of who was best, in terms of things like strategy, overall depth, the direction of the candidate's overall campaign, etc. Then they might tell people about specific policy details, but that was an ineffective campaigning method (which isn't to say it wasn't a useful thing to do - it was useful - it just wasn't the thing that moved people in their decisions of who to support).
Personally, I felt that Edwards had the best health care proposals, and even though I supported Obama, I was hoping that whoever won (either he or Clinton) could be gotten to propose something like Edwards'. I also figured that the real details of health care reform would be more up to Ted Kennedy than any of the candidates, so I was counting on him to write good legislation, and on the president to provide the leadership to make sure Congress actually did something. Although unfortunately Kennedy hasn't been able to do the hard work due to his cancer, it's still true that the details are mostly up to Congress, and I'm also quite glad that Obama mostly adopted Edwards' outline in what he asked Congress to do.
P.S. In case it's not clear, I very strongly disagree with your assessment that this disagreement on the mandate had much to do with how much support each candidate got. However early you may have noticed it, hardly any voters were likely to be aware of it before Super Tuesday, and even in March when they would've been aware of it, I'm quite confident that it had a small, probably negligible, effect on voting patterns. Though it might've been something more people used to explain their voting preferences, by then.
Re: wording & framing
Perhaps. But, at least at the early stages of the campaign, there was still some coherence in the positions of the candidates.
And Obama's no-mandate position from that period is in coherence with the general perception that he was the most "libertarian-friendly" and "independent-friendly" of the democrats. And that perception certainly had a lot to do with how much support each candidate got.
So I don't know whether this particular item was important, but the overall "libertarian-friendly" and "independent-friendly" stance (of which this item was an integral part) definitely was.
Re: wording & framing
I'm actually quite pleased that a mandate is on the table now, since this way I get Obama and the mandate.
My one concern is to be sure that the mandate doesn't force lots of people to pour money into the Insurance Companies profit centers, but that we actually get better health care for our mandate.
Re: wording & framing
... which is a good reason to
- start with a public option
- try to make it good
- encourage people to choose it, and put their money into it
- indirectly also forcing the private companies to get better or fail
Re: wording & framing
out of the country
no subject
I would prefer a single-payer option and I don't give a damn if insurance companies die, but I also know that it's completely untenable for completely reasonable reasons to reform one side of the equation without reforming the other.