It really shouldn’t be surprising that the Republican Party is focused right now on winning nothing, the biggest nothing in recent times.

The GOP’s goal, what they are campaigning full bore to provide to Americans, is absolutely nothing…in terms of health care reform. What is bewildering is how a party with 20% of the nation behind it thinks it’s a great idea to be the poster child for nothing (nothing for the public that is, except more expensive and worse medical coverage and greater wealth for health insurance companies).

There may be logic behind this. Since health care reform would give the 50 million without coverage health insurance, giving them nothing instead might contribute to more of them dying and everyone knows that people smart enough to know they need health insurance probably vote Democratic.

And those smart enough to recognize that the health insurance industry has itself become a cancer on this nation, eating away at the middle class’ financial stability and health, are also proving through their edjamucation that they too are Dems.

So maybe this is a very clever ploy by Republicans to reclaim power…in 30 or 40 years…by fighting for 30 million Americans to get sick and drop dead.

What else would one expect from the pro-life, family values party? A Marriage Appreciation Day march along the Appalachian Trail?

What a difference having the president in the country makes.

After a tumultuous and uneven week last week this week has been a major perhaps historic step forward on healthcare reform.

Two bills have advanced this week to the general assembly in each chamber of Congress.  The three committees working on healthcare reform have joined together to forward a bill for markup to the floor of the House.  While the Senate HELP committee in somewhat of a surprised outflanked the Fiance committee and passed a bill on a 13-10 partisan vote.

President Obama has certainly employed a full press at a crucial time in this healthcare battle.  The president’s major push this week included meetings with members of both chambers of Congress, meeting with citizens and doing several interviews and announcements in the media.  Republicans and conservative Democrats are pushing back but this has escalated from a mere skirmish to an all out war this last week.  The biggest development has been the presidents departure from a bipartisan approach to cramming the bill through with just the support of his party though he met with Senator Snowe (R-NH) and Senator Collins (R-NH) to see if they have any interest in signing onto Democratic efforts.

The president is even taking on his own party with recent ads to get healthcare reform passed.

The House and Senate Universal Healthcare Reform Bills

To simplify analyzes, both the House and Senate bills will be graded concurrently with proper denotation of notable disparities.

“A” Material.

There are a few outstanding components of these healthcare reform bills.

“A” -Fully funding and expansion of access to Medicaid is a great relief for thousands of working poor.  For many years Medicaid standards have left too many people who need healthcare and do not have enough income to purchase healthcare out of the loop.

“A” -Subsidies are very generous and supplied to families making up to 400% of the poverty level.  That is subsidies for families who make a little over $88,000/year.  This would be an “A+” save for the fact that the Senate bill has subsidies for families making up to 300% of the poverty level so this will need to be reconciled.

“A-” -The basic level of care spelled out in the healthcare reform bills are beyond basic and are quite robust with things like caps on out of pocket expenses and wellness care.   It does not look like anyone with the new plans will be under insured like millions of Americans are with their current private insurance.

“BBB” Rating for Bye Bye Bipartisanship.

The healthcare bills have progressives fingerprints all over it from a strong (while delayed) public option to increasing in the progressive tax code.  The healthcare reform bills hit on all cylinders of the presidents priorities being choice, reducing costs and increasing care.  However, the House bill is stronger than the Senate bill as expected.

“B+” -CBO estimates that the healthcare reform plans will cost a little over $1 trillion dollars over 10 years (Republicans and the right wing echo chamber are already lying calling it $1.5 trillion) and $600 billion over 10 years, respectively.  The CBO target is well within reach especially considering half of the cost can be recouped by cutting Medicare costs.

“B+” -The public plan once it kicks in both bills have a definitive public option.

“B” -Choice is a major part of both healthcare plans.  The positive aspect of delaying the public plan is that people who have health insurance now will see minimal impacts, save for lower costs.  A healthcare exchange will be established and a public plan will be part of that choice.

“B” -A little over half of the costs for the new healthcare plans will be paid for with taxing the wealthy in the House bill.  Those making more $350,000/year and more will pay 5.4% more in taxes.  While this will affect only 1.2% of the population it is far overdue to offset the huge break people who make over $115,000 get with the insanely low ceiling on the payroll taxes.  This tax increase faces a steeper climb in the Senate Finance committee because of the conservative Democrats on that committee.

“B” -Private healthcare insurers will be regulated.  Not talked about much but this is very important because to establish raise healthcare standards in this country healthcare reform not only needs to be universal but uniform.  Private insurers and the public plan will have to adhere to uniform levels of coverage where these standards need to be established but the minimum requirements for both the public and the private plans with caps on out of pocket expenses is a major start listed above.

“B” -In the Senate bill payments to primary care providers (PCPs) will rise. Payments to other providers will not be cut across the board.  This is a good part of the Senate bill because of the way private insurance companies squeeze PCPs now too many med students chose to specialize when many more PCPs are desperately needed.  One purpose of universal healthcare is to promote preventative medicine and the only way to do that is for people to have regular medical checkups which will obviously required an influx of PCPs.

“B” -Where the two bills have a significant split is on cutting provider costs.  The House bill will reimburse providers at or close to Medicare rates which will provide the greates cost savings of the two bills for the public plan.

“B” -There is shared sacrifice in the mandates in these bills as well.  Large employers will have to offer coverage to all it’s employees and contribute 4% more in payroll taxes per employee based on the House plan.  Coverage is mandated for individuals who can afford it.  Government has to do it’s part to cut fraud and wast especially with Medicare and the new public plan.

“C” is for Compromises and Cutting Costs not up to the level of single payer.

There were obviously compromises in the bill.  Senator Dodd (D-CT) pointed out that there was 160 Republican amendments in the bill.  It is doubtful that those amendments made the bill stronger and were most likely put in there as political cover for conservative Democrats.  Evaluating costs reductions you must evaluate these bills to the lowest cost alternative which is a single payer system.

“C+” -One of the major compromises is that even after a delay this is still virtual universal healthcare.  97% of Americans will be covered but many will opt out because it will be cheaper to take that risk and pay the penalty.  For a 2.5% penalty on income mostly young healthy people will take their chances and opt out of the program.  The more that opt out the more expensive insurance will be for everyone else like it is today with the uninsured.  Because some percentage of people that do take the risk and opt out of the system will get sick or injured and not be able to pay for the care themselves.  Also this 97% does not include undocumented immigrants who will raise healthcare costs for the rest of the population.

“C” -Cutting Medicare is necessary but the over $500 billion dollars of cuts expected over the next 10 years if not conducted properly could hurt struggling not for profit hospitals that take many Medicare patients.  Some of this is offset by fully funding Medicaid where not for profit hospitals and clinics get many of their patients.  There is waste and fraud in Medicare especially but if too much is summary cut it is like taking a hand saw to the problem rather than a scalpel.

“C” -Cutting provider costs in the House bill public plan goes deeper (near Medicare rates) than the Senate bill making the House bill the cheaper and stronger public option in that regard.  Again this is something that would have to be reconciled depending on what bills pass.

“D” if for Delays and conservative Democrat Dunces.

“D” -The delay in the bills, especially outlined in the House bill are excessive because the best parts of the bill including the public plan and health insurance exchange do not kick in for four years.  There are some practical reason for some delay but it should be much closer to 1-2 years than 4 years.  It will take some time to develop and implement the plans with input from Congress and implementation with the Administration.  No one expected this level of modification to our system to happen overnight but 4 years is too long.

“D” -One inherent weakness in the public option has always been the unintended but prognosticated effect that private insurance companies through businesses gaming the system will be able to cherry pick healthy people leaving most sick people in the public system.  This would result in higher costs for the government.  The delay actually helps a little here but there still has not been an adequate answer to prevent this from occurring.

“D” -The conservative Democrat dunces like Senator Baucus (D-SD) and Senator Nelson (D-NE) that still want to gum up the works.  The HELP committees bill is incomplete because it’s up to Baucus’ Finance committee to approve ways to raise revenue to pay for healthcare reform.  The longer they drag their feet the momentum that has been gained can dissipate.  As Ezra Klein points out in his article some delay is necessary to keep employers from dumping costs by letting private insurance companies cherry pick healthy customers leaving all others for a public plan.  Amendments to the bill in the “Free Choice Act” proposed by Senator Wyden (D-OR) may be a good way to mitigate this effect.

“D-” -Or I should say DINO- minuse with Senator Nelson (D-NE) might as well have read the right wing playbook on this quote.  “Tax is a four-letter word” with voters, said  Sen. Ben Nelson (D-Neb.). Even families not ranking in the top 1 percent of earners “hope they’re going to be there someday,” he said. “So they don’t necessarily think it’s fair.”

“F” Troop a.k.a The Grand Obstructionist Party.

As expected even though their are 160 amendments in the healthcare bill added by Republicans they are claiming they were part of the process.

“F” -Fearmongering continues based on Republican comments about both bills.  Following are a few quotes by the party of NO:

“This supposed health care fix is a health care failure and a disaster for the American people,” Sen. Judd Gregg, R-N.H., said. “We still have time to turn this process around instead of steamrolling our country into a sub-par government-run plan, but it will require serious action from Democrats and Republicans and a pledge to put politics aside.”

“You can’t tax the job creators and expect them to create jobs,” said House  Minority Leader John A. Boehner (Ohio)

Rep. Boener goes as far to parrot Frank Lutz notorious anti-healthcare reform memo.

Rep. John Boehner: “The forthcoming plan from Democratic leaders will make health care more expensive, limit treatments, ration care, and put bureaucrats in charge of medical decisions rather than patients and doctors. That amounts to a government takeover of health care, and it will hurt, rather than help, middle-class families across our country.”

Midterm Grade “B-” The bills would earn a solid “B” but the delays bring it down half a notch.

Of course what bills finally pass if any and are reconciled is yet to be determined.

So far the bills have got the mixed reviews expected with more progressive sources lauding the bill and conservative sources claiming it is the start of Armageddon.  The disingenuous and intellectually dishonest right wing reviews are omitted on purpose.

The New York Times declares that the House bill is “A Strong Health Reform Bill”

Earlier Economist Paul Krugman endorsed many components of the Senate HELP committee bill claiming “HELP Is on the Way”

Ezra Klein of the Washington Post says at first glance the House Universal bill looks good

Healthbeatblog.org gives the universal healthcare bills a thumbs up

By far the most unexpected endorsment of the House bill came late this afternoon when the AMA endorsed the bill

For the reading challenged right wing the GOP has revisited it’s infamous healthcare bureaucracy chart.  But in response “The New Republic” has released a chart of our current failed healthcare system.

Make no mistakes universal healthcare reform has advanced further than it ever has before but the battles are far from over.

Holder’s trial balloon describes a course of inquiry worse than no investigation at all.

While what little we know we know due to carefully leaked comments, the fact that the leaks were coordinated to several newspapers simultaneously and that the story was consistent indicates that this is a course of inquiry that Holder is considering:

To investigate only if some interrogators went past the barbarous limits offered by Yoo and Co from the Office of Legal Counsel.   There currently is no indication that there would be any discussion of the formulation of the torture memos by Yoo and his fellow deviates, nor any discussion of the fact that Cheney decided what sort of torture he wanted to conduct, and then directed the lackeys at Office of Legal Counsel to write memos to permit said torture.

The terribly clever Liberals continue to insist that Obama is playing three dimensional chess while the Rethugs play checkers.  This audience of terribly clever Liberals are playing tiddly winks all the while, and not terribly well.

Obama wants desperately to have no investigations.   The absolute last thing his presidency could tolerate would be the raging victimization of the Reactionaries should a serious effort be made to determine who actually ordered that hundreds of prisoners be tortured, with perhaps a hundered tortured to death.

His is a rational concern.   I have colleagues on this very blog who are certain that such investigations would derail any opportunity to pass health care reform.   I believe they may well be correct, Obama and those begging their nation to finally pull its collective thumb out of its collective ass and get heath care reform enacted.    Why is America determined to be last and worst in Heath Care among industrialized nations?

But the necessity of bringing  justice in this case is absolute.    Cheney is a hold-over from Nixon, and he was furious that the absolute power of Rethug presidents could be thwarted.   Cheney was delighted to steal two presidential elections, and commit tens or hundreds of thousands of felonies while in office.   Our civil democracy cannot tolerate another such assualt on our liberties.  BushCo must be tried.

Oh, and just to give you a taste of the mendacious horseshit that flies around at a moment like this, on this morning’s Beltway Bullshit Confab, ABC style, George Will spoke darkly about the risks to security if an Independent Counsel were to be appointed to investigate TortureGate.

What low grade drivel.    The Independent Counsel law expired ten years ago.    Holder could appoint a Special Prosecutor, al la Fitzgerald.   Said prosecutor would not be allowed to discuss any part of the case that did not involve bringing charges.    Much as Fitzgerald has never discussed the “testimony” of Rove, Cheney or his sock puppet W.

No, if this is a serious offer on the part of Holder, then this is the consensus least the Admin can do, with Emmanuel and Obama signing off.    None of this came as a surprise in the WH.

It seems a substantial portion of Americans live by the phrase, “Don’t pee on my leg and tell me it’s raining…unless you’re really, really convincing.”

Many WANT to be “sold” happy or comforting delusions, those folks don’t like thinking about things that make them feel bad or insecure and welcome any and all attempts to re-label reality. This is endemic in politics but just as intertwined in most other parts of society.

We could compose a long list of the bullshit in politics since the majority of political campaigns are molded out of it. In fact, the now-crumbling facade of the Republican Party is maybe the most obvious example.

The GOP claimed aggressively to be THE party of family and family values, protecting and respecting marriage, for those who believe strongly in being good Christians, fiscal conservationism, caring about our troops and on and on.

Over the past eight years and due to very recent events, Republicans repeating any of those claims now would result in chuckles or shoes whizzing through the air.

And yet, it was only four and a half short years ago that a majority of Americans voted for Bush to continue his reign of terror. It was no secret to many of us that he and the Repubs were just as full of shit then, exploiting 9/11 and “keeping you safe” to maintain power and continue their corrupt ways.

Why did so many buy it back in 2004? If there was another attack on the U.S. as Dick Cheney prays for, would he be right in thinking that it would flip a switch in people’s heads and make them once again open to believing the bullshit shoveled by Republicans?

I wouldn’t bet against it. The only solution to people’s fear of what could happen “next” is the lie that someone or some group can protect you from the unknown. This is an acute problem with a section of our population, many out there willingly remain open and available to being manipulated because of what they want to hear and believe. Having their their fears comforted trumps truth or the pursuit of truth, once they’ve embraced a calming solution, they can hold it in a death grip and be very unavailable to changing their views.

Now…I have a very presumptuous and sweeping theory about this…

People prefer feeling good to feeling bad, even if it means consciously ignoring the truth. In recent history, at one time or another, people have bought into the following:

1. America doesn’t torture.
2. America’s government doesn’t spy on its citizens.
3. Al Qaeda attacked us on 9/11 because they hate us for our freedoms.
4. If we give up some of our freedoms, we will be safer.
5. Bush was a good president because he kept us safe (as long as you forget about 9/11, the anthrax attacks, the destruction of the global economy, etc.).

When most people are young, they are told the primal concepts that God is watching over and protecting them, that all things happen for a reason, that if you’re good, good things will happen for you and that America is a place where you can have or be anything that you can imagine. In general, we grow up believing that life should be fair and that good wins out over evil.  We can surely work towards those goals but they certainly are not a given and haven’t been throughout world history.

For some, reality is sometimes an undesired weight to carry around and they welcome the opportunity to put it down. It’s a sensibility also connected to our consumer culture. Americans want to be convinced to believe things…even if in some cases they know deep down that it clashes with their experience of reality (easy answers to big problems…where would the diet book industry be without it?).  Or if it is too good to be true (dot com boom or housing bubble anyone?).

It is part of human nature, people like being sold on positive thoughts and to be that way, one must sometimes disconnect from one’s reasoning. Shouldn’t it have been a bit more obvious to a bit more people that houses just can’t go up in value so fast and so much forever, didn’t it look so obviously like an inflating bubble and scam? Why did so few reason that out? Because the gratification of the belief overrode their desire to reason.

As a society, this makes us very vulnerable to those with power and control in the world of media. They know far too well that people are like this and whether they’re trying to convince people to vote or protest against their own interests (against the stimulus, public plan for health care, saving the environment) or trying to delude the public to support their pursuit of profit (Iraq War, Stock market and housing prices, privatization) or simply trying to separate them from more of their money by convincing them that they NEED to buy more unnecessary “stuff” (Hannah Montana, Transformers, Snug-Wow), they have and continue to use this trait against the public.

This is not a call for cynicism, just a request for realism and reason.

We can hate Al Qaeda and see them as 100% responsible for 9/11 while still recognizing how our oil-centric policies in the Middle East have fed these flames.

We can support capitalism while still recognizing that some critical things such as health care and saving lives should not be subservient to profitability.

We can live in the real world and when we do, we have real decision making power in our own lives and greater control over our own destiny.

There have been numerous developments on the healthcare reform front since congress has returned from July 4th recess.  The biggest development is that the Democrats now have a so called “super majority” since they now have 60 seats in the Senate thanks to the addition of progressive Senator Al Franken of Minnesota.

Senator Bernie Sanders (I-VT) in a couple interviews this week described what 60 seats mean the best.  There is a big difference than voting against a final healthcare bill and supporting a Republican filibuster.  If conservative Democrats want political cover in their more conservative states they can simply not vote for the final bill but if they refuse to vote for cloture it opens them to more severe repercussions.  In essence passage of the final healthcare bill will only require 50 votes in the Senate, that’s assuming that Vice President Biden would be willing to break a tie.

This “super majority” has spurred on one Democratic leader already.  Testicular challenged, Senate majority leader Reid (D-NV) is using his new found “super majority” muscles to firmly order Senator Baucus (D-MT) to stop chasing after Republican votes on his Finance committee in crafting a healthcare bill.

“According to Democratic sources, Reid told Baucus that taxing health benefits and failing to include a strong government-run insurance option of some sort in his bill would cost 10 to 15 Democratic votes; Reid told Baucus it wasn’t worth securing the support of Grassley and at best a few additional Republicans.

By Tuesday afternoon, the Finance Committee began looking at ways other than taxing health benefits to deliver a health care overhaul that costs less than $1 trillion and is deficit-neutral, as Baucus wants.”

Since taxing medicare benefits is off the table that will please progressive members of congress however it does make it more difficult to find ways to fund the final bill.   It is ironic that to get more Republicans on board increasing taxes on benefits was a selling point.  It just goes to show that raising taxes is fine with the GOP when these increases do not affect the rich or big business.  Based on an article put out late today these conditions could delay healthcare bills being introduced to the general assemblies in congress though some Democrats say progress is still on target.  Of course Republicans reiterated their NO for any real healthcare reform in the article. 

“Sen. Judd Gregg, R-N.H., who did not attend the meeting in Reid’s office, later told reporters a so-called public option “can only have one purposes … to lead to a single-payer program” under which all policies are issued by the government.”

“That is a non-starter,” he said.

The president’s chief of staff Rahm Emanuel made a major blunder this week talking to the WSJ he left the door open for alternate ways to keep insurance companies honest like the highly incredulous “trigger” plan and co-ops.  Private insurance has already pulled the trigger on the American people by refusing to cover people with pre-existing conditions or at affordable rates, refusing treatments and refusing to pay claims while adding massive costs increases to our failed healthcare system.

President Obama attempted to control the damage by issuing a statement from Moscow to reiterate his support for a public plan saying it is the best way to keep insurance companies honest.  In fact a strong public option is the only way to keep private healthcare insurance honest.   A resent study by the Commonwealth Fund shows a stong public option is the best way to cut costs based on the bills now being considered in congress.

Following is a summary of the cost projections from the study.

With no universal healthcare costs will rise 6.5%
With only private universal healthcare costs will rise 5.8%
With universal healthcare with public option costs will rise 5.6%
With universal healthcare with public option and Medicare limits costs will rise 5.2%

A 1.3% reduction in cost increases amounts to about $2 trillion dollars over 10 years.  Unfortunaly the glide slope predicted by these projections still indicates that even a strong public option will need to be tweaked or morph into a virtual single payer system to be sustainable over time.

Probably the most encouraging findings from the study shows how a strong public option would cut premiums in the following graph.

Move on and other progressive groups have rightfully pulled the trigger on Rahm for the shit storm he created.  Reportedly Emanuel has backed off his comment when speaking to congressional Democrats.  Rep. Charlie Rangel (D-NY) probably summed up Emanuel’s untimely and inappropriate PVJs (personal value judgments) the best.

“Rep. Charlie Rangel (D-NY), chair of the powerful Ways and Means Committee, said the Chief of Staff “”made a hell of a mistake. He made a hell of a mistake and he knows it.”"

Vice President Biden announce a deal that would cut reimbursements to hospitals about $155 billion over 10 years.  It is common practice to negotiate reimbursements for Medicare and Medicaid but this goes further than Bush’s tepid approach to leverage public healthcare to reduce costs.  These cost reductions are necessary to help a final healthcare bill cover the uninsured and create a public plan.  The downside is that some struggling non profit hospitals will need additional funds to stay open.  Some of the money is already supplied in budget increases but further funding or exceptions may be necessary.

The HELP committee scored a bill last week with a public option that would cost about $600 billion over 10 years but the projections are on an incomplete bill while details are being hashed out.  The final bill will be much closer to $1 trillion over 10 years which is still within targets.  The HELP committee met on the healthcare bill yesterday.  I watched the committee meeting on C-SPAN last night and of course the leading Republican on the committee Senator Gregg (R-NH) pointed out some flaws in the bill but offered no constructive alternatives.

Economist Paul Krugman had some good things to say about the HELP committee bill.

“HELP Is on the Way

Now, about those specifics: The HELP plan achieves near-universal coverage through a combination of regulation and subsidies. Insurance companies would be required to offer the same coverage to everyone, regardless of medical history; on the other side, everyone except the poor and near-poor would be obliged to buy insurance, with the aid of subsidies that would limit premiums as a share of income.

Employers would also have to chip in, with all firms employing more than 25 people required to offer their workers insurance or pay a penalty. By the way, the absence of such an “employer mandate” was the big problem with the earlier, incomplete version of the plan.

And those who prefer not to buy insurance from the private sector would be able to choose a public plan instead. This would, among other things, bring some real competition to the health insurance market, which is currently a collection of local monopolies and cartels.”

The HELP committee bill still contains compromises with the public plan like adopting provider rates somewhat higher than Medicare but it’s still a work in progress.  Senator Sanders is trying to add an amendment to the HELP committee bill to leave it up to states if they want to institute mandatory single payer healthcare insurance systems.  This approach would only strengthen public healthcare and would be excellent for large states like CA that have large enough populations to give a single payer system enough leverage to lower provider costs and improve their financial situation in the long run.

Three House committees are working on healthcare reform bills in committee and are committed to strong public options in each bill appearing to draw a line in the sand according to some reports.

In a late development even President Clinton showed much optimism that healthcare reform will happen under President Obama.

Senator Rockefeller announced on The Ed Show that he had just released a study detailing rampant fraud perpetrated by private healthcare insurers so look for more updates on that developing story.

Overall the healthcare fight is still moving forward and the outcry over Emanuel’s comments seems to have revitalized the progressive base’s and Democrats’ willingness to fight harder for a strong public option.  There is a palatable change in the urgency and dedication to including a public plan in the healthcare bills in congress.  Hopefully the president and other Democratic leaders can use this renewed momentum to push conservative Democrats into action.  We know Rahm Emanuel’s job is to push legislation but the president and his administration along with Senate Democrats need to learn the lesson that Americans do not want any healthcare reform which may have been true at one time.  Americans want real healthcare reform with a strong public plan as a major component.

Feel free to post any comments on any topic here. Also, this is where you’ll find any off topic comments that have been moved from other posts, those conversations can continue here.

This week’s latest installment in the soap opera of Sarah Palin has given again the opportuinity to reactionaries (the people who detest Bill Clinton or Barack Obama) to again ask in a plaintive voice: “Why are Liberals so hateful toward (whoever) Sarah Palin?    (Next week there will be a new victim.)

This one is not difficult.   During her campaign to bamboozle America into electing her as VP, she repeatedly divided America between “real” (patriotic) America, and that part of the nation that was not outraged that William Ayers walked the earth unmolested and intended to vote for Obama.

No apologies.   Call me a traitor?   Impugn my patriotism?   Declare yourself a more real American than me?

Fuck You.   Fuck you and all that ride in your vile little boat.