I am bewildered by the difference in vote counting of key senators on this. Olympia Snowe, the most likely possible Republican swing vote says she won't vote for a bill with a public option and there's no way the votes are there to pass the bill if the public option is in it. Tom Harkin, the Democrat who took over the committee that oversees health care issues, guarantees they will pass a bill with a strong public option. I can't remember the last time the two sides guaranteed opposite outcomes and the media didn't even seem to know which to pick. Who's counting the votes here? I tend to think Snowe is more likely to be right than Harkin, but why would Harkin make this sort of proclamation without having counted the votes? Regardless of how this turns out, I am fascinated by the opposing predictions and by how this all gets "reconciled." (Just a pun; I'm not predicting reconciliation.) House Democrats say no bill without a public option; key senators say no bill with one. Obama pimps the public option but stops short of insisting on it. Who will be the power player that decides? Max Baucus? Kent Conrad? Olympia Snowe? Another crossover Republican like George Voinovich? Will Harkin assert his authority on the issue? Will Rahm step in? Or will Obama actually do his job, step to the front, get everything he can while still being able to pass the bill and take it to a vote? It's weird too that Harkin's making these sort of predictions without being in on the gang of six stuff, while Conrad and Baucus are saying their bill is the only one that could possibly pass -- and while the gang of six is clearly not including a public option in their bill. Meanwhile, Harkin's officially the ranking Democrat on the legislation. The last time I remember this sort of suspense was the Clarence Thomas vote. I mean, this time we don't even know how many votes it would take to get something through. Is it 51 or 60? Even though Snowe, Lieberman, Collins, etc. say they won't vote for a public option, would they help sustain a filibuster against one? None of them have said. Meanwhile, polls indicate that around 70% support a public option but only about 36% actually know what "public option" even means. What gives?
p.s. For those who might not know, Harkin took over Kennedy's chair on health care. Just mentioning that for perspective. Who is the Democratic party leader on this legislation? Harkin? Baucus? Obama? Nobody knows. That is really weird.
It is for this reason (no clear leadership and no communication with the public of what is being proposed) that the measure will likely fail. I, for one, am disappointed. I would like to think that if a bill of this magnitude were to fail, it would not be because the public has not been heavily informed on what it does and does not do.
I agree that leadership was badly lacking all summer long. The speech was powerful and I believe it saved the legislation at the last possible moment, but there is much, much more to do in the way of leading. A leader will have to emerge (Baucus is already acting like it's him) and a bill constituting real reform will pass. I doubt it will have a public option and it might not even have a trigger. That will be a real shame, if so, as it will constitute significantly less successful reform. But if a bill is passed that makes denial of coverage based on pre-existing conditions or lifetime caps illegal, one that makes every American insurable and 94% or so insured, that will be real, serious, incredible reform to a very messed up health care system. Why do I believe it will pass? Because it would pass tomorrow if he dropped the public option. And he is willing to do that. First he's going to try to see if he can get it included (though he doesn't seem to have decided how), but if he drops it he has the votes for the rest of the plan. I also believe it will pass because Obama's hanging his ass out on this issue. If real reform doesn't happen, his presidency is a failure before it's a year old. He will get something done. What fascinates me is how we're going to get there. Nobody knows. There are so many variables -- combined with so many bold, contradictory predictions -- that it's just a really fascinating time for political junkies. But
I disagree in part. Any meaningful reform will have to include the elimination of the high deductibles for labs needed upon illness or injury (X-rays, blood work, MRIs) and needed for preventative care (colonoscopies). As it stands now, because of absurdly high deductibles before the insurer will pay any of the cost for these procedures, the patient has to pay the entire cost themselves. Often they cannot afford it. If you have insurance and cannot obtain the tests that you need, are you really "covered?"
That's an excellent point and one that I'm sensitive to since my insurance has let me down since my injury. My insurance company doesn't give a **** about my health; they only care about making sure they don't lose money on me. I don't even feel like I have "insurance." I feel like I have a Gold Star Coupon Book for certain things and not for others, regardless of need. As I've said before, anyone that's happy with his insurance probably hasn't had much need to use it. I don't think the legislation is going to do everything it should. Not nearly. But if it does something as huge as ending discrimination towards people with pre-existing conditions, it will change the lives of millions of Americans. Think about how many people can't ever leave their jobs without losing coverage forever. And just think of how many lack coverage now and can never get it for this reason. I agree with you though. I'd go a lot farther though. I don't think concern about profits should have any place in our health care system. How to pay for care? Absolutely. How to make money off of it? Disgusting. It leads directly toward incentivizing denial of benefits, even in life and death situations and doing that in order to increase profits is as evil as anything in the world. Thanks to Republicans and Blue Dog Democrats, we're not going to get the reform we need. But we will still get some very, very serious reform.
This is an important point, just as coverage of pre-existing conditions and elimination of a lifetime cap are to bringing real reform to healthcare in this country. There are a relatively few number of measures that could come out in a bill that would have an enormous impact on millions of Americans. What concerns me is how premiums are affected. If you have a reasonable deductable for tests as well as for doctor visits, hospitalization, meds, etc., but your monthly premiums are outrageous, what real purpose is served? A friend of mine moved back to Austin after several years living in Boston with the excellent, inexpensive healthcare that state has. He almost couldn't get insured in Texas due to pre-existing conditions. It's not like he has some terrible illness or anything. He just has a couple of problems controlled by medications. The state of Texas is supposed to have "insurance of last resort" to cover people that can't get insurance from the industry. His premiums were going to be well over a thousand dollars a month. Closer to two thousand. In other words, this "coverage" is a joke, something the pols can run on (I'll leave it to the reader to figure out the political leanings of the creators of this little jewel) that in reality does nothing. There's a reason Texas breaks records for the number of uninsured. So how do you control premiums? If you propose a "cap" the industry and its paid buddies will scream bloody murder. So what do you do. The industry has to have some outside mechanism to make it keep premiums reasonable. Otherwise, they are going to go for the money, as they always have. That's great as capitalism, but sucks if you believe government should insure that all its citizens are insured. That's why so many support a public option, the folks who understand why you need one, or another mechanism that does the same thing. Provide a reason for insurance companies to keep rates reasonable.
This is why the approach to healthcare is completely wrong. We want to complain that insurance companies do not want to cover pre-existing conditions, and we expect them to offer reasonable rates. Insurance companies are intended to make a profit, just as you would go to a horse race and intend to placing a bet on a winning horse. You wouldn't bet on a horse with a broken leg. So you surely can't expect an insurance company to willingly insure someone who is a guarantee loss. And the same applies to the public option; someone is going to have to pick up that guaranteed loss. I am health conscience and i don't make stupid and foolish risks on my life. My premiums should not be the same as the person next to me, who refuses to put down the fork and develops diabetes or other major and costly medical issues.
Dude. Not every serious "pre-existing" condition is avoidable. Lord knows I agree with you regarding health decisions and personal accountability, but I think you're being extremely callous here. My brother has epilepsy. It's no fault of his. It's really not even that expensive to treat (it can be, but I digress). But I am really worried about how his health care coverage will work without reform. I'm beginning to think that you may be misunderstanding the entire concept of "insurance".
as someone who has diabetes because of heredity i wish people would stop using it as an example because you don't know what the **** you're tallking about.
Space Ghost claimed in a different thread that he doesn't have health insurance. That's a potential ER appointment waiting to happen.
There are at least three different issues here w/ pre-existing conditions - one is the issue referred to by you of coverage of a pre-existing condition. The others are a bigger issue - the use of pre-existing conditions to deny unrelated coverage. This works in two ways: 1. Use of a pre-existing condition (say, past cancer) to deny someone insurance at all. So, because of cancer, that person can't get coverage for a broken leg, for example. 2. Use of a non-reported pre-existing minor condition to deny payment on an unrelated procedure. Because a patient didn't report a broken foot in the past, the insurance company now denies their cancer payments.
"I've been in this town a long time. I think this is the year we're gonna get health care done. But I guarantee you this will be pronounced dead at least four or five times before we finally get a bill passed." -- President Obama
MRIs, CAT scans, etc. are expensive to the member because the hospitals/clinics charge a lot for them. Most insurance plans cover things like bloodwork and x-rays at a copay, but hospitals can bill over $1,000 for an MRI. The idea that insurance should pay this at 100% without you kicking in anything is crazy. The plan some of you guys want can't work. You want a plan that is cheap, covers everything for everyone, AND covers expensive things at 100%. You want that plan and it will bankrupt whatever institution is responsible for funding it. PPOs are set up the way they are (deductibles/co-insurance) because cost-sharing helps insurance companies reduce their costs which allows them to reduce premiums, increase payouts and increase the coverage under the in-network side.
And I believe he's right. But that doesn't say anything about yea or nay on the public option. Harkin and a lot of House members guarantee yea - and a "strong" one at that; Snowe, Baucus and Conrad guarantee nay. Who's right?
In Europe, it happens every day. The difference? They're not trying to make people rich on health care.
