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Norman Bernstein
07-06-2015, 01:20 PM
Obamacare did what it could... but Obamacare doesn't address the next real threat to American health care: mergers and consolidations that will put massive amounts of political power in the hands of a small number of health care giants:


The Supreme Court's recent blessing of Obamacare has precipitated a rush among the nation's biggest health insurers to consolidate into two or three behemoths.The result will be good for their shareholders and executives, but bad for the rest of us -- who will pay through the nose for the health insurance we need.

We have another choice, but before I get to it let me give you some background.

Last week, Aetna announced it would spend $35 billion to buy rival Humana in a deal that will create the second-largest (http://www.bloomberg.com/news/articles/2015-07-03/aetna-agrees-to-buy-humana-for-37-billion-in-cash-stock)health insurer in the nation, with 33 million (http://www.bloomberg.com/news/articles/2015-07-03/aetna-agrees-to-buy-humana-for-37-billion-in-cash-stock)members.

The combination will claim a large share of the insurance market in many states -- 88 percent (http://www.reuters.com/article/2015/07/03/us-humana-m-a-aetna-idUSKCN0PD04720150703)in Kansas and 58 percent (http://www.reuters.com/article/2015/07/03/us-humana-m-a-aetna-idUSKCN0PD04720150703)in Iowa, for example.

A week before Aetna's announcement, Anthem disclosed its $47 billion (http://www.bloomberg.com/news/articles/2015-06-21/biggest-u-s-health-insurers-to-get-even-bigger-under-obamacare)offer for giant insurer Cigna. If the deal goes through, the combined firm will become the largest health insurer in America.

Meanwhile, middle-sized and small insurers are being gobbled up. Centene just announced a $6.3 billion deal (http://www.reuters.com/article/2015/07/02/us-health-net-m-a-centene-idUSKCN0PC13V20150702)to acquire Health Net. Earlier this year Anthem bought Simply Healthcare Holdings for $800 million (http://www.businesswire.com/news/home/20150218005093/en/Anthem-Completes-Acquisition-Simply-Healthcare-Holdings#.VZnJPkbGpBk).

Executives say these combinations will make their companies more efficient, allowing them to gain economies of scale and squeeze waste out of the system.

This is what big companies always say when they acquire rivals.

Their real purpose is to give the giant health insurers more bargaining leverage over employees, consumers, state regulators and healthcare providers (which have also been consolidating).

The big health insurers have money to make these acquisitions because their Medicare businesses have been growing and Obamacare is bringing in hundreds of thousands of new customers. They've also been cutting payrolls and squeezing more work out of their employees.

This is also why their stock values have skyrocketed (http://www.fiercehealthpayer.com/story/health-insurance-stocks-hit-all-time-highs/2015-01-22). A few months ago the Standard & Poor's (S&P) 500 Managed Health Care Index hit its highest level (http://www.bloomberg.com/news/articles/2015-01-21/obamacare-pays-off-for-insurers-who-fought-it-as-stocks-hit-high)in more than twenty years. Since 2010, the biggest for-profit insurers have outperformed (http://www.fiercehealthpayer.com/story/health-insurance-stocks-hit-all-time-highs/2015-01-22) the entire S&P 500.

Insurers are seeking rate hikes of 20 to 40 percent (http://www.nytimes.com/2015/07/04/us/health-insurance-companies-seek-big-rate-increases-for-2016.html?_r=0)for next year because they think they already have enough economic and political clout to get them.
That's not what they're telling federal and state regulators, of course. They say (http://www.nytimes.com/2015/07/04/us/health-insurance-companies-seek-big-rate-increases-for-2016.html?_r=0) rate increases are necessary because people enrolling in Obamacare are sicker than they expected, and they're losing money.

Remember, this an industry with rising share values and wads of cash for mergers and acquisitions.

It also has enough dough to bestow huge pay packages on its top executives. The CEOs of the five largest for-profit health insurance companies each raked in $10 to $15 million (http://www.fiercehealthpayer.com/story/top-health-insurance-ceo-pay-exceeds-10-million-2014/2015-04-10)last year.

After the mergers, the biggest insurers will have even larger profits, higher share values, and fatter pay packages for their top brass.

There's abundant evidence that when health insurers merge, premiums rise. For example, Leemore Dafny, a professor at the Kellogg School of Management at Northwestern University, and his two co-authors, found (http://www.kellogg.northwestern.edu/faculty/dafny/personal/Documents/Working%20Papers/8_Dafny_Paying%20a%20Premium%20on%20Your%20Premium .pdf) that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The problem isn't Obamacare. The real problem is the current patchwork of state insurance regulations, insurance commissioners, and federal regulators can't stop the tidal wave of mergers, or limit the economic and political power of the emerging giants.

Which is why, ultimately, American will have to make a choice.

If we continue in the direction we're headed we'll soon have a health insurance system dominated by two or three mammoth for-profit corporations capable of squeezing employees and consumers for all they're worth -- and handing over the profits to their shareholders and executives.

The alternative is a government-run single payer system -- such as is in place in almost every other advanced economy -- dedicated to lower premiums and better care.

Which do you prefer?

Peerie Maa
07-06-2015, 01:24 PM
Aren't monopolies wonderful? Especially when they make their profits out of peoples misfortune.

You either need single payer or lots of regulation. Interesting choices for some on here. :D

RonW
07-06-2015, 01:38 PM
Obamacare did what it could... but Obamacare doesn't address the next real threat to American health care: mergers and consolidations that will put massive amounts of political power in the hands of a small number of health care giants:

Some people just don't get it, and others have to be told repeatedly before you can finally get it through their thick skulls.

When the competition is eliminated any reason for competitive pricing will also be eliminated. But that is exactly what nancy pelosi, hairy the reed and Obama knew up front. I wonder what their cut was for selling the american people into a non competitive government run health care program.

Oh and congratulations on your I bet the southern boys won't like this one, nothing like getting the crowd in a uproar just before the 4th with a thread on hate, prejudice and racism....good job norm....

Any how, glad to see you are wising up about berrycare and reading right wing websites to finally get informed about the reality of it all..

Curtism
07-06-2015, 02:48 PM
What was that about "the enemy of the good", Norman?

Flying Orca
07-06-2015, 02:54 PM
Just out of curiousity, are there any non-profit health care insurers in the USA? If so, how do they compare to the big for-profit players? And if not, why not?

Norman Bernstein
07-06-2015, 03:34 PM
When the competition is eliminated any reason for competitive pricing will also be eliminated. But that is exactly what nancy pelosi, hairy the reed and Obama knew up front. I wonder what their cut was for selling the american people into a non competitive government run health care program.

I don't know either, since Obamacare is not a government-run health care program. Health care is insured by commercial insurance companies, and administered by commercial health organizations.

Reynard38
07-06-2015, 03:39 PM
Healthcare stocks went up after he SC decision.

$$ doesn't lie.

Norman Bernstein
07-06-2015, 03:42 PM
Healthcare stocks went up after he SC decision.

$$ doesn't lie.

Sure they did.... Obamacare did a number of things, including expanding the market. What Obamacare could NOT do was to prevent industry consolidation... and I think it can be reasonably argued that industry consolidation, no matter WHAT industry, rarely accrues to the benefit of consumers.

Jim Bow
07-06-2015, 04:00 PM
Just out of curiousity, are there any non-profit health care insurers in the USA? If so, how do they compare to the big for-profit players? And if not, why not?

http://chpw.org/about-us/who-we-are/

htom
07-06-2015, 09:02 PM
Just out of curiousity, are there any non-profit health care insurers in the USA? If so, how do they compare to the big for-profit players? And if not, why not?

Depends on how you define "insurer" (and where you live.) Kaiser-Permanente might be one, although some of it looks like an HMO. https://www.ehealthinsurance.com/health-insurance-companies/kaiser-permanente

I've been very happy with Medica for years; I don't understand the corporate structure. In some ways, it's non-profit, in others, it's for-profit.

Jim Mahan
07-06-2015, 09:42 PM
The CEOs of the five largest for-profit health insurance companies each raked in $10 to $15 million (http://www.fiercehealthpayer.com/story/top-health-insurance-ceo-pay-exceeds-10-million-2014/2015-04-10)last year.

I hope they spent a good chunk of that blood money on big tough gates where they live, and maybe some armour for the limo.

Paul Pless
07-07-2015, 05:11 AM
I'm confused Norman. You seem to have highlighted portions of your C&P which indicate that corporate greed and profit seeking are what is driving health care cost increases from insurance companies. This seems to be at odds with the ACA's 80/20 rule mandating that 80% of all revenue be spent directly on patient care.

KMacDonald
07-07-2015, 06:05 AM
I have said over and over that ACA did not fix anything. You libs drank the cool aid. Medicare to everyone is the quick and easy solution.

Paul, the 80/20 rule increases costs. Insurance companies profit by increasing medical costs-------20% of a larger medical bill is more than 20% of a small medical bill.

Norman Bernstein
07-07-2015, 07:40 AM
I'm confused Norman. You seem to have highlighted portions of your C&P which indicate that corporate greed and profit seeking are what is driving health care cost increases from insurance companies. This seems to be at odds with the ACA's 80/20 rule mandating that 80% of all revenue be spent directly on patient care.

There's no contradiction; the 80/20 rule limits overhead, but frankly, most corporations would be delighted to have a 20% gross margin, if their administrative costs are squeezed to the bone (ever wait on 'hold' to talk to an insurance adjuster?)... and price increases simply enlarge the pie. Furthermore, there's a ton of wiggle room in terms of what constitutes 'patient care' and the term 'spent directly on...', including lots of stuff that isn't directly going to actual medical services, but can include capital expenditures and other items. That which Man proposes, he also disposes, as they say.

On top of this, as the article mentions, health care providers are consolidating, as well... giving them more leverage. A price increase in services benefits both the provider, and the insurer.... the provider sees increased profits, and the insurer sees an increasing gross, which correlates to an increased bottom line.

John Smith
07-07-2015, 08:00 AM
I don't know either, since Obamacare is not a government-run health care program. Health care is insured by commercial insurance companies, and administered by commercial health organizations.

There is still that clause that requires 85% of total revenue to be spent on benefits.

As one who supports single payer, the way to get there, IMO, is to explain to people how our employer based system is an obstacle to more jobs and higher pay. Once the public understands that, single payer will have much more support.

KMacDonald
07-07-2015, 08:04 AM
There's no contradiction; the 80/20 rule limits overhead, but frankly, most corporations would be delighted to have a 20% gross margin, if their administrative costs are squeezed to the bone (ever wait on 'hold' to talk to an insurance adjuster?)... and price increases simply enlarge the pie. Furthermore, there's a ton of wiggle room in terms of what constitutes 'patient care' and the term 'spent directly on...', including lots of stuff that isn't directly going to actual medical services, but can include capital expenditures and other items. That which Man proposes, he also disposes, as they say.

On top of this, as the article mentions, health care providers are consolidating, as well... giving them more leverage. A price increase in services benefits both the provider, and the insurer.... the provider sees increased profits, and the insurer sees an increasing gross, which correlates to an increased bottom line.

Very good Norm. Now you understand what's been going on in healthcare.

John Smith
07-07-2015, 08:06 AM
Sure they did.... Obamacare did a number of things, including expanding the market. What Obamacare could NOT do was to prevent industry consolidation... and I think it can be reasonably argued that industry consolidation, no matter WHAT industry, rarely accrues to the benefit of consumers.

But sometimes it does. I just remembered ALL the different forms and insurance companies my doctors' offices have to deal with, and how easy it is to make a mistake. Perhaps fewer insurance providers still competing with each other will turn out to be a benefit.

John Smith
07-07-2015, 08:09 AM
I have said over and over that ACA did not fix anything. You libs drank the cool aid. Medicare to everyone is the quick and easy solution.

Paul, the 80/20 rule increases costs. Insurance companies profit by increasing medical costs-------20% of a larger medical bill is more than 20% of a small medical bill.

You misconstrue. the 80% is what they are mandated to spend OUT OF THEIR TOTAL REVENUE on benefits. They can only keep 20%, or, as I recall 15%, but either way, this is a cost containment.

John Smith
07-07-2015, 08:11 AM
One thing that drives up the cost of healthcare is progress. A new test is developed, and it requires a very expensive piece of equipment. That simply costs money.

Katherine
07-07-2015, 08:20 AM
Can we just go single payer and stop all this nonsense already?

Norman Bernstein
07-07-2015, 08:35 AM
Can we just go single payer and stop all this nonsense already?

If only.

Too bad that your hubby, and others, fail to understand political realities. Sure, most of us can easily see that single payer is the sensible solution... it might not fully resolve the increased costs which escalate above inflation, because newer medical advances tend to be more expensive.... but it would probably go a long way towards helping to limit those costs, while assuring equitable health care to the entire nation... a benefit that ALL other developed nations enjoy.

However, there the problem with political reality. It's almost a cliche to say, these days, that politics is the 'art of the possible', but nowhere is it more true than in healthcare. Obama's compromise might be unpalatable to some.... but anyone who thinks that he actually could have achieved 'single payer' is living in a pipe dream. Conservatives and their insurance company and health care company clients were NOT going to permit that... and hundreds of millions, if not billions, were available to prevent such a thing from ever happening.

So, what were the choices? Do nothing? Or try to achieve SOMETHING?

Obamacare falls way short of achieving a sensible solution.... but Obamacare is a dramatic improvement over 'doing nothing'.

Paul Pless
07-07-2015, 08:37 AM
Too bad that your hubby, and others, fail to understand political realities.

The basic truths of Obamacare:


It benefits some small percentage people who prior to its passage could not obtain insurance due to pre - existing conditions. We should assume that these people want(ed) insurance.
It benefits some small percentage of people who wanted insurance prior to its passage but who could not afford it and now can because they receive tax payer funded assistance.
It probably has a small negative impact on people who had and continue to have employer based insurance.
There is a small percentage of people who for perhaps legitimate reason perhaps not are hurt financially because they are now required to purchase health insurance.
Its reasonable to think it has a negative impact on small firms that may be required to insure its workforce. Surely it has impacted some of these firms hiring decisions.
Obamacare has been a boon for insurance companies. This will quite likely make it even more difficult in the future to move away from the private insurance model. (are there any notable socialized health care models used by other first world nations that use a private insurer model?) This is the large stumbling block to single payer in this nation.
Obamacare did nothing to control costs and especially differentiated pricing for non generics and manipulation of the generics market (through patent tweaks) for pharmaceuticals. No other nation pays what we do for medications.
Obamacare did nothing to control for, or even to educate, on the very high cost of end of life care in the United States.
Its probably safe to assume that there will be fewer challenges to Obamacare in the courts.
Obamacare remains a deeply divisive issue (unnecessarily so) and its unlikely under the current and foreseeable Congresses that it will be tweaked to perform better, no matter who gets elected to the White House next.
Reality says we should not view Obamacare as revolutionary.


So what next?

I can easily foresee a decade or more of the status quo. If democrats in the future are somehow able to gain majorities in both chambers of Congress and to control the White House they may be able to make some small incremental positive changes to Obamacare. On the other hand I believe despite the bluster on the right, big business and Wall Street lobbying would most likely prevent Republicans from instituting a complete repeal should they gain enough power to do so - business does not like instability and unpredictability in the economy.

btw, more disturbing than a consolidation of insurance companies is a consolidation of health care providers, doctors, and hospitals.

Norman Bernstein
07-07-2015, 08:38 AM
I have said over and over that ACA did not fix anything.

It didn't fix anything?

It didn't make it possible for perhaps 10 million people to get health care coverage, which heretofore they couldn't possible afford?

It didn't guarantee acceptance, despite pre-existing conditions, thereby shutting out millions from getting care?

It didn't prevent insurance companies from simply dropping subscribers, when they got expensively sick?

That's 'nothing'?

Norman Bernstein
07-07-2015, 08:41 AM
The basic truths of Obamacare:

Congratulations: you have just described something called 'compromise'.... an essential element to getting ANYTHING done in Congress, because insisting on 'my way or the highway' doesn't work. If Obama had held out for single payer, it would have been the defining failure of his presidency... his 'Bay of Pigs'.


btw, more disturbing than a consolidation of insurance companies is a consolidation of health care providers, doctors, and hospitals.

I'm not sure which is worse... but I think the insurer consolidation is probably worse.

Canoez
07-07-2015, 08:58 AM
I'd like to see more of the following. My health care provider must provide a certain ratio of health care provide to profit/administrative expenses. If they don't provide that ratio, they must return a share of profit until that ratio is reached. It's a good check and balance between profit and administrative expenses. Facilities and equipment costs are limited in what is considered "health care provided".

htom
07-07-2015, 09:12 AM
You misconstrue. the 80% is what they are mandated to spend OUT OF THEIR TOTAL REVENUE on benefits. They can only keep 20%, or, as I recall 15%, but either way, this is a cost containment.

? So if they increase what they charge (say from $100 to $120) this limits their share from ($20 to $24). How is this containing costs? If they want $30, increase charges to $150.

Norman Bernstein
07-07-2015, 09:41 AM
? So if they increase what they charge (say from $100 to $120) this limits their share from ($20 to $24). How is this containing costs? If they want $30, increase charges to $150.

You are more or less right... but they do have SOME constraints. Medicare reimbursements are controlled, so there's a limit to just how much the vendors can charge, without it being obvious that they are gouging. Admittedly, it's not all that much of a control, but it DOES constrain them a bit. If Medicare reimburses, say, $33, for a standard blood test (even though the lab's 'nominal' charge is $175), then a charge of $90 by the lab, to a private insurer, is decidedly suspect in the eyes of the regulators, even if they've negotiated the rate.

There's a reason why I always insist that capitalism is the best economic system on the planet... but unregulated capitalism is a guaranteed disaster. There's a purpose behind regulation, and a value to it. The 'invisible hand' of the marketplace is a myth; businesses don't mind competition, but they much prefer cartels and monopolies.

htom
07-07-2015, 10:53 AM
Norm, what's the difference between a cartel and a government- regulated market?

Norman Bernstein
07-07-2015, 11:02 AM
Norm, what's the difference between a cartel and a government- regulated market?

Presuming that the government is not corrupt, then the government-regulated market seeks to insure fair and equal access to goods and services, and fair competition, with the welfare of the general public in mind. The cartel is concerned only with its own profits, and doesn't care if the general welfare of the populace is considered. Cartels specifically want to avoid competition, in order to be unconstrained in terms of profitability. When a cartel exists, the mythical 'invisible hand' of the marketplace doesn't exist.... it's been amputated.

There are exceptions: government sanctioned monopolies are sometimes necessary, for things like public utilities... in which case, regulation is absolutely critical.

RonW
07-07-2015, 11:10 AM
Norman Bernstein says -----

-
Presuming that the government is not corrupt,


The cartel is concerned only with its own profits, and doesn't care if the general welfare of the populace is considered.


Cartels specifically want to avoid competition, in order to be unconstrained in terms of profitability.


When a cartel exists, the mythical 'invisible hand' of the marketplace doesn't exist.... it's been amputated.

I think you slipped and might want to correct the above true statements....

With the knowledge above, why wouldn't a rational, logical thinking person want to create a system of competitiveness to reduce cost and improve service and quality.

KMacDonald
07-07-2015, 11:57 AM
? So if they increase what they charge (say from $100 to $120) this limits their share from ($20 to $24). How is this containing costs? If they want $30, increase charges to $150.
Yep, you got it. If they want to increase their profit by $1.00 they have to charge you $5.00.

RonW
07-07-2015, 12:43 PM
What is Single-Payer Healthcare?
Adapted from PNHP’s website.

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of healthcare, a single-payer system would be setup such that one entity—a government run organization—would collect all healthcare fees, and pay out all healthcare costs.

In the current US system, there are literally tens of thousands of different healthcare organizations—HMOs, billing agencies, etc. By having so many different payers of healthcare fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.)

In a single-payer system, all hospitals, doctors, and other healthcare providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

Access and Benefits

Everyone would receive comprehensive medical benefits under single-payer. Coverage would include all medically necessary services, including rehabilitative, long-term, and home care; mental healthcare, prescription drugs, and medical supplies; and preventive and public health measures.
Care would be based on need, not on ability to pay.

Payment

Hospital billing would be virtually eliminated. Instead, hospitals would receive an annual lump-sum payment from the government to cover operating expenses—a “global budget.” A separate budget would cover such expenses as hospital expansion, the purchase of technology, marketing, etc.
Doctors would have three options for payment: fee-for-service, salaried positions in hospitals, and salaried positions within group practices or HMOs. Fees would be negotiated between a representative of the fee-for-service practitioners (such as the state medical society) and a state payment board. Government would serve as administrator, not employer.

Aren't they the ones that are running the postal system, and the ones that stole all the money from the social security system, oh yea and the ones who are running yearly deficits and has a debt of over $18 trillion dollars.......

I don't know if I would trust these people with my health care..

Too Little Time
07-07-2015, 02:10 PM
What is Single-Payer Healthcare?
Adapted from PNHP’s website.

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of healthcare, a single-payer system would be setup such that one entity—a government run organization—would collect all healthcare fees, and pay out all healthcare costs.

]In the current US system, there are literally tens of thousands of different healthcare organizations—HMOs, billing agencies, etc. By having so many different payers of healthcare fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.)

In a single-payer system, all hospitals, doctors, and other healthcare providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

Access and Benefits

Everyone would receive comprehensive medical benefits under single-payer. Coverage would include all medically necessary services, including rehabilitative, long-term, and home care; mental healthcare, prescription drugs, and medical supplies; and preventive and public health measures.
Care would be based on need, not on ability to pay.

Payment

Hospital billing would be virtually eliminated. Instead, hospitals would receive an annual lump-sum payment from the government to cover operating expenses—a “global budget.” A separate budget would cover such expenses as hospital expansion, the purchase of technology, marketing, etc.
Doctors would have three options for payment: fee-for-service, salaried positions in hospitals, and salaried positions within group practices or HMOs. Fees would be negotiated between a representative of the fee-for-service practitioners (such as the state medical society) and a state payment board. Government would serve as administrator, not employer.

Such comments are misleading.

Most doctors offices deal with a limited number of payers. Not tens of thousands.

There is no reason why a single payer could not provide appropriate health care policies for each individual. There is no reason for all people to get the same coverage.

The most misleading is the omission of who pays the single payer. Most likely it is the poor who will have to pay more than they did in the past. The rich will pay less.

Norman Bernstein
07-07-2015, 02:12 PM
Most doctors offices deal with a limited number of payers. Not tens of thousands.

Most 'payers' (HMO's, insurance companies, etc) deal with tens of thousands of 'vendors' (doctors, labs, pharmacies, etc).

The payers have the upper hand, of course... by imposing sometimes ridiculous requirements from vendors, like rejecting forms filled out in blue pen, accepting only black, and so on.

Todd D
07-07-2015, 03:03 PM
Such comments are misleading.

Most doctors offices deal with a limited number of payers. Not tens of thousands.

There is no reason why a single payer could not provide appropriate health care policies for each individual. There is no reason for all people to get the same coverage.

The most misleading is the omission of who pays the single payer. Most likely it is the poor who will have to pay more than they did in the past. The rich will pay less.

Having spent the bulk of my adult life under a single payer system (Canada) I can address a few of your comments. In Canada health care is paid from income tax revenues which are transferred to the provinces.. each province runs its own health care system. Everyone is covered for all medical treatment (certain cosmetic and voluntary procedures are excluded). All billing is sent to the provincial health care program. The patient never sees a bill. Everyone is covered all the time independent of employment.. There are no monthly premiums (at times there have been small premiums - I recall paying about $6.50 per month in Alberta back in the 70s).

In my experience, the system works very well.

SullivanB
07-07-2015, 03:22 PM
If only.

Too bad that your hubby, and others, fail to understand political realities. Sure, most of us can easily see that single payer is the sensible solution... it might not fully resolve the increased costs which escalate above inflation, because newer medical advances tend to be more expensive.... but it would probably go a long way towards helping to limit those costs, while assuring equitable health care to the entire nation... a benefit that ALL other developed nations enjoy.

However, there the problem with political reality. It's almost a cliche to say, these days, that politics is the 'art of the possible', but nowhere is it more true than in healthcare. Obama's compromise might be unpalatable to some.... but anyone who thinks that he actually could have achieved 'single payer' is living in a pipe dream. Conservatives and their insurance company and health care company clients were NOT going to permit that... and hundreds of millions, if not billions, were available to prevent such a thing from ever happening.

So, what were the choices? Do nothing? Or try to achieve SOMETHING?

Obamacare falls way short of achieving a sensible solution.... but Obamacare is a dramatic improvement over 'doing nothing'.

Obamacare was not really a compromise. It was an outright sellout of the American people in favor of corporate America and all that big money you speak of. Obama never intended to make good on his campaign rhetoric touting single payor, instead, coming right out of the chute with his personal version of corporate welfare served up on the backs of the American taxpayer. And that was the first clear indication that Obama was a fraud. The suggestion that he couldn't have pulled off single payor is rank speculation. At that time, the man had genuine political capital. It was quite clear that the country was waiting to get behind him in his push for Medicare for all. They expected it, and he disappointed. Obama could have mustered tremendous heat from the masses, had he fought for it. Pelosi and her merry band served it up for Obama on a platter. The potential 60 Senate votes were there and it might well have been doable had Obama been willing to do whatever it took to get them. We'll never know for sure but it's a fair bet that, at that time, an aggressive public campaign for single payor and behind-the-scenes wielding of "carrots and sticks", LBJ style, would have got it done. The real crime is that Obama never tried, never even intended to try. And that ugly fact still ought to make a Liberaltarian sick to his stomach. It may be that Obamacare is better for the country than what existed before but it was probably Obama's most disgraceful moment, for it's the closest this county's ever been to single payor or will be for decades and it was cast aside, from even before the start, without a fight. Truth is, Obama's "legacy" is a crying shame.

Norman Bernstein
07-07-2015, 03:42 PM
Obamacare was not really a compromise. It was an outright sellout of the American people in favor of corporate America and all that big money you speak of. Obama never intended to make good on his campaign rhetoric touting single payor, instead, coming right out of the chute with his personal version of corporate welfare served up on the backs of the American taxpayer. And that was the first clear indication that Obama was a fraud. The suggestion that he couldn't have pulled off single payor is rank speculation. At that time, the man had genuine political capital. It was quite clear that the country was waiting to get behind him in his push for Medicare for all. They expected it, and he disappointed. Obama could have mustered tremendous heat from the masses, had he fought for it. Pelosi and her merry band served it up for Obama on a platter. The potential 60 Senate votes were there and it might well have been doable had Obama been willing to do whatever it took to get them. We'll never know for sure but it's a fair bet that, at that time, an aggressive public campaign for single payor and behind-the-scenes wielding of "carrots and sticks", LBJ style, would have got it done. The real crime is that Obama never tried, never even intended to try. And that ugly fact still ought to make a Liberaltarian sick to his stomach. It may be that Obamacare is better for the country than what existed before but it was probably Obama's most disgraceful moment, for it's the closest this county's ever been to single payor or will be for decades and it was cast aside, from even before the start, without a fight. Truth is, Obama's "legacy" is a crying shame.

Wow... you really DO lay it on thick!

Well, I guess all I can say is that I can't agree. You say that the presumption that Obama couldn't pull off single-payer is rank speculation... is, itself, rank speculation. We DO know that virtually every Republican was dead set against a single payer solution.... hell, they're STILL against Social Security, after 75 years!

If you're going to raise the spirit of LBJ as someone who could 'get things done', you might want to be careful.... because for every grand and noble thing LBJ did, he also doled out pork, all sorts of political favors, and more, in exchange for those votes. LBJ certainly compromised.... it's just that the compromises he had to make were not talked about in public, back in 1968. The days of politicians like that are long over.

George Jung
07-07-2015, 04:01 PM
Pretty outspoken for a 'newbie'. Of course - it's mostly fabrication, Sullivan. I watched the politicking and votes closely - the support wasn't there for Single Payer, and don't recall Medicare for All ever mentioned (though essentially single payer) - nor do I recall anyone lined up to support that. Maybe you got something, more substantive?

RonW
07-07-2015, 04:14 PM
Norman -
Wow... you really DO lay it on thick!

Well, I guess all I can say is that I can't agree. You say that the presumption that Obama couldn't pull off single-payer is rank speculation... is, itself, rank speculation. We DO know that virtually every Republican was dead set against a single payer solution..


George Jung -
Pretty outspoken for a 'newbie'. Of course - it's mostly fabrication, Sullivan. I watched the politicking and votes closely - the support wasn't there for Single Payer, and don't recall Medicare for All ever mentioned (though essentially single payer)

Got a little lapse of memory there? Or just liberal deception..........There was not One (1) republican vote from the congress or from the senate.

Obamacare is 100% a left wing liberal bill.......and that is why they no longer control congress or the senate and soon to be presidency....

The left owns it.........and yes it was a sell out to corporate america, otherwise known as treason,...

RonW
07-07-2015, 04:39 PM
Well maybe we should just finish the story, after Obama and his crony friends (we got to pass this to see what is in it Pelosi ) and dirty dingy hairy the reed sold out america to corporate insurance companies, they had every intention of the following year placing a large tax on the american people in the disguise of a carbon tax for the purpose of saving the planet. But in comes the tea party and snatched the unbridled control of the government out from under neath the corrupt politicians.

Which was the last thing berry expected, and why he was so pissed over losing the congress in nov. 2010 and the payday he would have received from corporate america for his dirty deeds. Obama had every intention of cashing in after leaving office just like the Clintons did, I guess he is going to have to make it on half pay now.

RonW
07-07-2015, 05:02 PM
Well Berry's right hand man, actually woman is vallerie Jarret a born and bred Iranian, so what does that say, and she was the one who lit the whitehouse up into multi colors.

Jung's remarks of watching the votes closely and not enough votes, is just too funny...........

bobbys
07-07-2015, 05:08 PM
Obamacare was not really a compromise. It was an outright sellout of the American people in favor of corporate America and all that big money you speak of. Obama never intended to make good on his campaign rhetoric touting single payor, instead, coming right out of the chute with his personal version of corporate welfare served up on the backs of the American taxpayer. And that was the first clear indication that Obama was a fraud. The suggestion that he couldn't have pulled off single payor is rank speculation. At that time, the man had genuine political capital. It was quite clear that the country was waiting to get behind him in his push for Medicare for all. They expected it, and he disappointed. Obama could have mustered tremendous heat from the masses, had he fought for it. Pelosi and her merry band served it up for Obama on a platter. The potential 60 Senate votes were there and it might well have been doable had Obama been willing to do whatever it took to get them. We'll never know for sure but it's a fair bet that, at that time, an aggressive public campaign for single payor and behind-the-scenes wielding of "carrots and sticks", LBJ style, would have got it done. The real crime is that Obama never tried, never even intended to try. And that ugly fact still ought to make a Liberaltarian sick to his stomach. It may be that Obamacare is better for the country than what existed before but it was probably Obama's most disgraceful moment, for it's the closest this county's ever been to single payor or will be for decades and it was cast aside, from even before the start, without a fight. Truth is, Obama's "legacy" is a crying shame..

Well said.

SullivanB
07-07-2015, 05:22 PM
Norman, I admit that I laid it on thick and, just between you and me, I'll admit to still having a pretty big chip on my shoulder when it comes to Obama's handling of healthcare. I still say he failed the American people. My statement that the man had genuine political capital at that time is spot on and that's important (or was) because might have been very influential in making single payor happen. He's the candidate who touted it over and over again during his campaign. It's largely why I fell for his spiel. I agree that no one could have reasonably expected Obama to get help from the Republicans, though it's conceivable that he might have sprung a vote or two, by way of political bribery or meaningful threat. But there's was much better chance of reeling in the 58 Dems and the 2 independents, especially with heat laid on by a riled up citizenry. Hey, shouldn't the man at least have tried? No, I don't offer the ghost of LBJ as a saint but, as you well know, the man proved that he could get the job done, even passing "impossible" legislation, when it was for his legacy. I just think it's not at all clear that it was impossible. What is clear is that the possibilites were never explored, that he never even tried and, worse, that he never intended to. That, my friend, was a travesty of the first order, especially at that time.

George, I also listened very carefully to what the man said. Of course, you're absolutely right in saying that Obama never promised to fight for Medicare (single payor) for all, at least a mandate for all. That was poorly/inaccurately stated on my part. As you know, what he campaigned on, repeatedly, was single payor for all who wanted it and that's what I really intended to convey there. Of course, had he been serious about passing single payor as an option, he would have (or at least should have) started the sausage making from the position of single payor mandated for everyone. Neither you nor I know for sure if he could have lined up the votes. I don't deny that it would have been hard fought (though it might have been easier than we guess) and that it might have failed. But the man never tried and it's a damned shame because Medicare for all or even only those who wanted is what this country has so badly needed for decades. As for your concern about a newbie offering up an opinion, hey, I'm sorry to cause newbie heartburn. I readily admit that my knowledge of boats and sailing is distinctly limited (albeit, growing everyday, thanks to reading suggestions from forum members) and I'm working on learning not to jump in with both feet on that thin ice. As for subjects such as this one, I'm as knowledgeable as most posting here and believe I can bring something to the conversation. I do appreciate you and Norman taking the time to respond.

bobbys
07-07-2015, 07:38 PM
born with a lie and completly partisan it's a perfect obama idea.

The ends justify the means..

And people think Democrats can "fix" it.

LOL.

SullivanB
07-07-2015, 08:05 PM
Of course, bobby, as I'm sure you'll agree, it was "partisan" as you put it only because the Republicans offered absolutely no alternative to the nation's healthcare crisis, choosing instead as their official policy, to do whatever they could to obstruct and cause the Obama administration to fail, whatever the consequences and however harmful to the nation that policy might be. And it's good to know that you, too, feel that a single payor system like Medicare for all would be best for the country. If only you could get the folks on the right to see it your way.

Norman Bernstein
07-08-2015, 02:56 PM
Norman, I admit that I laid it on thick and, just between you and me, I'll admit to still having a pretty big chip on my shoulder when it comes to Obama's handling of healthcare. I still say he failed the American people.

SullivanB (is that what we call ya?), I saw your post last night but was unable to respond at the time... but you provided a very passionate argument, and seem like a decent guy to have a spirited disagreement with... so here goes :)


My statement that the man had genuine political capital at that time is spot on and that's important (or was) because might have been very influential in making single payor happen. He's the candidate who touted it over and over again during his campaign. It's largely why I fell for his spiel.

Look, it's an age-old problem, when it comes to the distinctions between campaign promises, and what a President can actually accomplish in office.

You are arguing that you were 'hoodwinked', so to speak, but those campaign promises, buying into them, and then becoming disappointed when they weren't realized. It's an argument which is, in a sense, out of context, as I'll try to illustrate.

Let us consider ANY past President you'd care to choose.... Democrat or Republican. Which one, would you say, delivered on campaign promises more or less faithfully, when in office? Hint: it NEVER happens. Politicians, so they say, campaign in poetry, and serve in prose... and especially for the less experienced ones, get a bucket of cold water thrown in their face in the first month they occupy the Oval Office. The campaigns consist of lofty goals and noble aspirations... before the mud-flinging between the executive and legislative branches begin to fly.

If you can't name a President whose actions in office mirrored his campaign promises, then wouldn't expecting such a thing be an innocent error of naivete?

Let's suppose he had held true to those campaign promises, but failed... and failed miserably (which would have been the most likely outcome, considering just how opposed the Republicans are to ANYTHING that smacks of an 'entitlement' program). Do we applaud Presidents for trying valiantly and failing? Would the effort have been meaningful, if the outcome was poor?


What is clear is that the possibilites were never explored, that he never even tried and, worse, that he never intended to. That, my friend, was a travesty of the first order, especially at that time.

I don't believe, with all due respect, that you have a basis to make that claim. For every 100,000 words related in the popular press, there were probably 10,000,000 words exchanged among Obama's political aides, staffers, and the Democratic leadership in the House and Senate. You have no basis to say that he didn't explore the possibilities... and then come to the realization that is simply wasn't going to happen....

....and if he had gone ahead like Don Quixote, tilted at the windmills, and got bloodied in failure, how do you thing the rest of his Presidency would have gone?

This is all part of the calculus of political leadership.

Admittedly, a failure might not have hurt him... perhaps. I think often about JFK, whose brief Presidential career basically included one significant accomplishment (the Cuban Missile Crisis), and one abject failure (the Bay of Pigs fiasco).... yet his name is on thousands of school buildings and government office, etc.Most interestingly, at the time, few people realized that his 'victory' in the Cuban Missile Crisis was actually a serious national security compromise, because as part of the 'deal', he was forced to withdraw missiles stationed in Turkey.

But more likely, the failure would be disastrous, especially for a guy barely into his first term. The failure would mark him as ineffectual for the remainder of his presidency.


George, I also listened very carefully to what the man said. Of course, you're absolutely right in saying that Obama never promised to fight for Medicare (single payor) for all, at least a mandate for all. That was poorly/inaccurately stated on my part. As you know, what he campaigned on, repeatedly, was single payor for all who wanted it and that's what I really intended to convey there. Of course, had he been serious about passing single payor as an option, he would have (or at least should have) started the sausage making from the position of single payor mandated for everyone. Neither you nor I know for sure if he could have lined up the votes.

I suspect that Obama was in the best position of ANYONE (including us armchair politicians here in the bilge) to determine whether he had the votes or not. You seem to be arguing that even if he clearly DIDN'T have the votes, he should have gone down fighting.

What good would THAT have done anyone?


As for your concern about a newbie offering up an opinion, hey, I'm sorry to cause newbie heartburn.

Newbie or not, a passionately argued position is a good thing... glad you came around.


I do appreciate you and Norman taking the time to respond.

You'll always get a response from me. It might come with lightening bolts, a sword, and pointed sticks, though :)

SullivanB
07-09-2015, 09:54 AM
Norman,

clearly, the nation had hoped that Obama would try to change course from the disastrous policies of the Cheney/Bush regime and business as usual in Washington, not just because they were sick to death of greed and corruption trumping what was best for the nation's future and because they desperately wanted change, but because this man, in particular, was telling them that's exactly what he intended to do, that he would fight for them and that change every day he was in office. No one expects a politician to win on every issue he campaigns on but to suggest that one is naive and doesn't really understand the nature of politics, because one expects him to at least fight for the big issues he campaigned on, the very ones that got the voters to vote for him in the first place, only serves to relieve the politician from accountability. The ever predictable efforts of the Obama ( the name of any politician could be plugged in here) apologists to "educate" the unwashed about how politics really works, the suggestions that one really isn't entitled to expect the man to at least try to make good on the big campaign promises, that one is simply naive to expect, let alone insist on, honest commitment to the promises of the public official for whom they've cast their vote, well, that's all just another way of letting the politician off the hook and not holding them accountable. Problem is, it's unhealthy for a political party and/or a people to buy into such suggestions, for it simply enables more business as usual rather than accomplishing change so badly needed.

The suggestion that had Obama fought meaningfully for the PO, rather than jettisoning the PO and closing out any possibility of the healthcare relief the country so badly needed, would have been considered a failure is misguided. Fighting for what's right for the country, even if the goal is not achieved, is anything but a failure. It's his not making the fight, his jettisoning the PO right out of the chute, even before he's out of the chute, that's Obama's failure of the American people. Polling showed that a solid majority of the country was ready for single payor, the PO that Obama had repeatedly campaigned on. He traveled around the country explaining, quite clearly, why the PO was so necessary. It was why many voted for him. To fail to at least fight for it, to not even start with it if only as a bargaining chip in what were touted as real negotiations, was a sellout of the first order. And it probably was worse than that.

http://www.huffingtonpost.com/miles-mogulescu/the-real-reason-obamas-pl_b_473924.html

The best thing Obama could have done, in terms of solidifying his position with those who put him in office was to fight tooth and nail for the PO. The time was right, the people were primed and ready to join in, and it just might have worked. To pass up the chance was a travesty.

Making good on big commitments to the American people are just not very high on Obama's to do list. Remember that other promise he repeated at all the whistle stops about holding the Wall Street criminals accountable, another promise neither accomplished not even attempted. Now, Obama's main man, the one who should have been prosecuting them what pulled off the biggest heist ever perpetrated against the American people, well, that guy's now working for a law firm that's best buds with the same big financial institutions that pulled off the heist.

Now, you're right that we ought not be surprised that our politicians lie to us and that they sell out, even on the big stuff they commit to to get us to vote for them. And truth is, we're not surprised. It's just that some of us are not prepared to settle for that kind of sellout, for business as usual. Respectfully submitted, it's settling for business as usual that's naive and the most harmful.

BTW, that thing about presidents making good on campaign promises, like him or not, look no further than LBJ. Even having sold out the old south and promising to do more with his Great Society, he was elected and he made good on it. See the Voting Rights Act, big immigration reform and others I can't even remember at the moment. Again, LBJ is the perfect demonstration of how the hardest of legislative fights really can be won by a president who's sufficiently committed and, I submit, of why Obama dropped the ball, big time.

Thanks, Norman. Sullivan

John Smith
07-09-2015, 10:01 AM
Times are different. Once Obama got elected, he faced a GOP committed to obstructing him. Senator Byrd was ill. Time was short for having 60 votes. I think that put pressure on to put together a bill while 60 votes were available. Don't forget Byrd had to be transported in medically to vote for the bill.

What irks me isn't that the Public Option got dropped, but that single payer never had a seat at the table, and NO ONE that I've heard has pointed out that our employer based healthcare system is a huge obstacle to job creation.

DMillet
07-09-2015, 10:04 AM
^Excellent post Sullivan. I think you hit the nail on the head regarding the disappointment many of us Obama supporters feel. He ran on and accepted a nearly impossible task but he fell short in execution. We all know the opposition was relentless but he caved too soon and too often.

Norman Bernstein
07-09-2015, 10:59 AM
BTW, that thing about presidents making good on campaign promises, like him or not, look no further than LBJ. Even having sold out the old south and promising to do more with his Great Society, he was elected and he made good on it. See the Voting Rights Act, big immigration reform and others I can't even remember at the moment. Again, LBJ is the perfect demonstration of how the hardest of legislative fights really can be won by a president who's sufficiently committed and, I submit, of why Obama dropped the ball, big time.

Thanks, Norman. Sullivan

I understand the points you make, and I have to respectfully disagree.

However, I do think that the invocation of LBJ as the prototype for what you believe is a President who delivers on his promises might be, if not out of context, then certainly out of the times. Politics in DC were overwhelmingly different, at the time, then they are now. LBJ had the benefit of a certain comity in relations between the parties that is completely dead now... it's a very different era.

DMillet
07-09-2015, 11:21 AM
I think President Obama suffered from a lack of experience. Easily the intellectual superior to most all of his opponents, I think he failed to consider the utter lack of integrity those same opponents possessed. It took him way too long to figure that out.

George Jung
07-09-2015, 01:29 PM
I'm enjoying the exchange - but gotta ask; you sure you're from Texas, SullivanB? :p

So far you've been reasonable, even liberal.... all highly suspect...

My recollection is Obama not only had no Republican support - he also didn't have entire Democrat backing - some of those folks had been bought and paid for, and Single Payer wasn't an option. I'd also echo Normans point - this is a dramatically different Congress than LBJ had to face. I don't recall such rabid partisanship in the past.

Norman Bernstein
07-09-2015, 01:51 PM
I
My recollection is Obama not only had no Republican support - he also didn't have entire Democrat backing - some of those folks had been bought and paid for, and Single Payer wasn't an option. I'd also echo Normans point - this is a dramatically different Congress than LBJ had to face. I don't recall such rabid partisanship in the past.

That's a point worth amplifying. In 1963-1968, there were still 'Dixiecrats'....and there was a now-extinct species of political animal, sorely missed: the 'moderate Republican', as dead today as the dodo bird. Massachusetts had a black REPUBLICAN senator. Legislators routinely traded pork for votes, back and forth, from one side to the other, without any outrage from the voting population. They treated one another as colleagues, despite being on opposite sides of the political fence. Lyndon Johnson wasn't the least bit reticent about telling a Republican senator to fall in line on some issue, or risk some military installation in his state being closed down. Nor was he reluctant to award some congressman with a federal project, grant, or other bonus, for voting in Johnson's favor.

Today's Congress looks NOTHING like it did in 1968... for better, or for worse. A president, these days, can't really get away from blatantly holding some federal project hostage over some recalcitrant congressman, for the sake of their vote... at least, he certainly can't do it more or less openly, like in the old days. Consider the stats on filibusters; it was a relatively rare thing in those days, not the most common method of opposition to the other party, when it can be pulled off. Inter-party hostility, which, if it existed at all back then, was largely hidden from the public, is now how one party operates, as a matter of course.

SullivanB
07-09-2015, 02:44 PM
Hi, George. Yep, I'm in Texas, been here long enough, now, to claim it as home. Truth is, there are plenty of liberally thinking folks here in Texas and, if the Democratic Party would get off its behind and decide to spend some real money down this way, instead of just paying lip service to the Party faithful here, the Party's ranks and political clout might just grow exponentially.

I certainly agree that Obama was going to get precious little and, most likely, no help from the Republicans, especially with something like single payor, even if it was to be made optional as opposed to a mandate for all. It may be that he could have sprung a vote or two out of them by applying some sort of political blackmail or dangling a rich enough enticement under someone's nose. That's why I mentioned LBJ and the Civil Rights Act, since he was able to muster what would have been considered "impossible" votes. It does happen.

I'm sure there are differences, maybe big differences, between the LBJ and Obama situations, though I suspect things got pretty partisan back then with the folks in the south thinking LBJ was stabbing them in the back and the Republican Party taking advantage of that situation. I was around back then but was young, had just joined the service and really wasn't paying much attention to it all.

But Obama was able to line up the 60 votes for the ACA and with little apparent effort. Though some will disagree, I think it's clear that he didn't make the effort re the PO, that he was never serious about it and, in fact, that he sold out on it well before the sausage making commenced. I think you use the phrase "bought and paid for" correctly with regards to the so called Dems who might have been the roadblock. Maybe Baucus and some of the others might well have been brought over with sufficient enticement and other pressure brought to bear. Recall that the public was polling at 60% in favor of the PO. I think your state's Nelson would have been the hardest case. But it wasn't attempted. My complaint is that we really don't know how it might have played out since the president let it drop, instead of taking the issue to the people and applying a full court press to the holdouts. What's I think is clear and what I believe is an even worse offense is that he tossed it aside even before the real negotiations started. The best opportunity for single payor we've seen, or may see for decades to come, was never even a serious consideration. Shameful.

mikefrommontana
07-09-2015, 03:06 PM
I think to claim inexperience against Mr. Obama is not out of line. I would be more inclined to think he was naieve to think that Congress operated on a rational and positive basis. You know, for the good of the Nation and its people.

The Public Option died at the hands of (D) Sen. Max Baucus, and that was that. Perhaps the President could have gotten more done, but it would have required a full court press of the Presidency to effect it, and once that political capital was spent, he would have been mercilessly pounded (moreso than what we have seen) for the remainder of his term. And still with no guarantee of success.

Norman Bernstein
07-09-2015, 03:14 PM
But Obama was able to line up the 60 votes for the ACA and with little apparent effort.

'Apparent' is the right word... because none of us know whether it was easy or not, to get even those 60 votes. Liberal and progressive Democratic legislators need wealthy donors to their campaigns, just like conservative Republicans... so it might have required significant effort.


Though some will disagree, I think it's clear that he didn't make the effort re the PO, that he was never serious about it and, in fact, that he sold out on it well before the sausage making commenced.

I'm one of those who will disagree... not because I have any inside knowledge... but because NOBODY has any inside knowledge of just what factors might have led him to give up on the PO. The 'outside' factors, however, are pretty obvious, most notably, the fact that a PO looked, to the Republicans, like yet another huge entitlement program... or, at least, a foot in the door. We're talking about a party and ideology who STILL thinks that Social Security was a bad idea!


Recall that the public was polling at 60% in favor of the PO.

Smart politicians know that an adverse poll may have nothing to do with what happens at the ballot box in the next election cycle.


My complaint is that we really don't know how it might have played out since the president let it drop, instead of taking the issue to the people and applying a full court press to the holdouts.

You don't consider the possibility that, by doing that, he might have jeopardized the entire ACA legislation? If he failed on the entire thing, what exactly would you be criticizing him for? Failing to get the PO?


What's I think is clear and what I believe is an even worse offense is that he tossed it aside even before the real negotiations started. The best opportunity for single payor we've seen, or may see for decades to come, was never even a serious consideration. Shameful.

I appreciate the sentiment.... but I'm a pragmatist. I don't believe ANYONE knows whether it would have been possible to get the PO as part of the deal... and I also appreciate that, at the time this was being negotiated, SOMEONE had to make a judgment as to how big of a bite of the apple should be taken, cognizant that too big a bite might have turned the entire thing to crap.

On issues where there's a judgment involved, I'm more inclined to give the participants the benefit of the doubt. Maybe 20 years from now, we'll have better insight into what went on... and maybe our view will be changed by that insight.

Curtism
07-10-2015, 05:32 AM
For giggles I googled 'who killed the public option'. There's a ton of finger pointing as to who-done-it and it appears no one wanted that dirty little deed made public. Those involved (on either side) seem to have done a good job of spreading the blame and Norman's right, nobody, outside the inner circles really knows who torpedoed that part of the bill.

Imagine now, had the public option passed into law, (miraculously, as some here would have us believe) would Aetna, Cigna and the other remaining behemoths have been gobbling up the market the way they are, further limiting our choices and gouging us even more than they were prior to the ACA?

Or would people be opting for the govt run system in efforts to get their families out from under the boot of these thieving giants? I'm inclined to think they'd be leaving the for-profit vendors in droves.

Too Little Time
07-10-2015, 08:31 AM
For giggles I googled 'who killed the public option'. There's a ton of finger pointing as to who-done-it and it appears no one wanted that dirty little deed made public.

http://www.publicintegrity.org/2015/02/16/16766/elimination-public-option-threw-consumers-insurance-wolves


Although a majority of Senate Democrats supported the public option, the industry knew it only needed one senator who caucused with the Dems to change his mind and kill it.


The Democrats needed Lieberman’s vote to get reform passed, and insurers knew it. Shortly before the Senate was set to vote on the bill, Lieberman said he would vote for the bill only if the public option was stripped out.

Curtism
07-11-2015, 05:13 AM
Thanks, TLT. Who can forget ol' Joe.

Wendel Potter does about as good a job as we're likely to see answering the questions in my previous post.


Would a public option have kept insurers more honest? Thanks to Big Money from Big Insurance—and Joe Lieberman—we’ll never know.

George Jung
07-11-2015, 08:40 AM
Wonder if the next Democrat President will have the horses to get this through. The way Insurance is gouging us, public support will be there. Or maybe we're gonna have to break out the ropes, tar and pitchforks.

SullivanB
07-11-2015, 10:58 AM
Only time will tell, IMO. The ACA will likely prove to be better than what we had, at least in the short run, and in many respects is already there for the moment. But the ACA, instead of single payor even only in the form of the PO, has probably and significantly prolonged the struggle. There's not likely to be a situation any time soon where it's so "front and center" and so obviously wanted by the public as it was during the first 2 years of the Obama presidency. Rememebt, that was all because of that big campaign promise. To miss such an opportunity, especially if it was a sellout instead of absolutely unavoidable, would be a travesty.

Since TLT kindly served up that Wendell Potter article just above, be sure to note Potter's comments in the middle of the article. After reminding us that President Obama had continued, as late as July, to say that the PO was going to be part of the law, he then "began to waffle". He then says that he believed the industry lobby "has gotten to him". Let's not confuse the issue of whether or not Obama sold out and made a deal with big healthcare with holdouts Lieberman and Nelson.

Here's another article, written by a fella we can all agree is as objective as the day is long. :ycool:

http://www.salon.com/2010/10/05/public_option_24/

And we all know the NYTimes always gets it right. :)

Lieberman and Nelson have well demonstrated that they were subject to being influenced by the right kind of inducement and they may well have come along. But it seems the deal was really already dead because this president and his "team" agreed to its death. The matter of not enough votes is just another "straw man". Certainly, this was not the only instance in the Obama record that big business came out the winner, at the expense of the little guy and gal.

John Smith
07-11-2015, 11:07 AM
Wonder if the next Democrat President will have the horses to get this through. The way Insurance is gouging us, public support will be there. Or maybe we're gonna have to break out the ropes, tar and pitchforks.

This depends entirely on the make up of congress. If we have a Democrat in the White House, a Democratic majority in the house, and a filibuster proof majority in the senate, all kinds of good things can happen. We may well get universal, single payer healthcare. We may get our infrastructure worked on. We may get college cost reduced. We may get immigration reform. We may get minimum wage increased.

Depends on congress. President can't do any of these things alone.