2701

Meanwhile, from the outposts of reality, Paul Krugman has a funny line this morning in his NYT column:

On the eve of the big vote, Republican members of Congress warned that “freedom dies a little bit today” and accused Democrats of “totalitarian tactics,” which I believe means the process known as “voting.”

2702

Yeah, I had to go back and clarify since it can be difficult to sort the fake crazy from the true crazy.

2703

So, how is this being seen over there? Massive defeat for the repubs after they tried every trick in the book? What does this mean for the repubs? Are the democrats emboldened?

2704

Media Matters doesn’t have anything on that and they’re posting quotes from today’s show already, including his comment that he was just funnin’ with you about the leaving the country thing.

Everything’s anecdotal at this point obviously, but Democrats have +4 morale and Republicans have +10 insanity scores this morning. Admittedly the right-wing talk shows haven’t finished yet so the right wing doesn’t know what to think yet. Give it a few more hours. As for actual Republican law makers, they are threatening to get states to refuse to comply with the HCR bill. I kind of wish Republicans think we could do that with other federal laws we don’t like. Some might think that exhorting the states to tell the Federal government to piss off might be reminiscent of earlier troubles, which Republicans have not gone to great lengths to conceal.

2705

Glenn Greenwald highlights a new CNN poll the Republicans would rather ignore:

Thus, a majority of Americans either support the plan or believe it should be more liberal (52%), while only a minority (43%) oppose the plan on the ground that it is too liberal.

2706

Sort of a revitalization for Dems and some independents that government can actually accomplish something. A lot of us are concerned that mandated health insurance without cost controls is dangerous, but it’s certainly better than no reform at all. The removal of the pre-existing condition check alone is an enormous step.

Personally, I pretty much agree with Frum on the GOP.

2707

I do not believe that running on a “repeal the bill” platform is going to be a winning strategy for Republicans. In seven months there will be a lot less concern about a law already passed (hell, it’ll probably die in 60 days), and people really don’t like their politicians taking stuff away from them.

If the economy is improving, and jobs are starting to come back, the all-or-nothing Republican strategy could end up being a gigantic mistake.

2708

Does the bill really have any realistic chance of controlling costs? It sure seems to me that the approach it pushes forward (Go buy insurance! If you can’t afford it, we’ll pay for part of it for you!) is a ridiculous way to go about this. (It’s a sad, sad statement that we’re probably still better off with this way of going about reform than not doing anything.)
Any credible theories that somehow incorporating the previously uninsurable and financially insolvent into the equation isn’t going to just drive up costs across the board?

(Note that I’m not arguing it shouldn’t have happened. It probably should have. It just looks to me from my vantage point like it really ought to be advertised as “Those of you who have insurance and make a nice living have been getting more than you’ve been giving, and we need to change that.” rather than “No, really, in happymagicfairyhealthcareland having the insurance companies never able to deny insurance to anyone will lead to cost cuts!”)

Any backend wording on, say, standardizing billing processes or fee schedules or the like which isn’t getting much airtime but really may have a material effect on the pricing of health care? Maybe something like, say, requiring insurance companies to pay claims in a viable time period so that by the time you end up with your portion of the bill, you’re not also owing additional percentages for 90+ day late payments because the interest has been accruing since billing while the insurance company haggled to pay as little as possible?

2709

This needs to be underscored. Link to the full poll.

Any Republicans who continue to harp about how public opinion is against the bill should remember that before the public option was taken out, public opinion was overwhelmingly in favor of the bill and even now public opinion is pulling left rather than right.

2710

Well, for one thing, not all uninsured people are expensive or financially incapable of buying it. I don’t feel like looking up the numbers, but there are lots of young adults who just don’t think it’s important for them to have insurance because they’re young and invincible.

I understand and share your concerns, though. I hope there is enough in this bill to control costs. I don’t have a lot of confidence in a health insurance industry that has the primary goal of increasing profit margins.

2711

Here’s a right-wing article that lists some factual aspects of the bill, particularly all the little places that it will collect more money. Breathless and angry, but it seems to be real research:

http://blogs.investors.com/capitalhill/index.php/home/35-politicsinvesting/1563-20-ways-obamacare-will-take-away-our-freedoms

If anyone can address any of the points (in particular I didn’t know that the bill prevents lower cost plans for lower risk people, assuming the article isn’t a flat-out lie) please do.

H.

2712

The more people you have in the insurance pool the greater the risk distribution.

2713

Any bill that is at all workable would have to do this (left as an exercise for the reader), so I’m sure this one does.

2714

Not when the risk statistics of the people being used to increase the size of the pool are disproportionately skewed. That’s just not how the statistics work. No matter what size group of people you add to the mix, for example, if they all have aggressive cancer requiring radical and expensive treatment, your insurance rates aren’t going down.

I haven’t really been keeping up, but I don’t recall anyone making the argument that the un- or under-insured out there currently represent the same type of risk distribution as the population that’s currently insured. In fact I’d tend to believe the opposite, since many of the causative factors for being unable to afford insurance would seem to line up pretty well with many of the causative factors for having health problems in the first place.

(We can go round and round about whether it’s a lack of opportunity that serves as the fundamental issue; certainly it’s a valid argument that disproportionate health problems among the poor and downtrodden are probably because they can’t afford to look after themselves and take care of themselves as well due to being, y’know, poor and downtrodden. Hopefully that viewpoint is right; if so then over time this will equalize and in a generation or so things will look better all around.)

2715

I’m impressed by this opinion piece by conservative David Frum. Hell, I can even agree with some of it!

  1. We should quit defending employment-based health care. The leading Republican spokesman in the House on these issues, Rep. Paul Ryan, repeatedly complained during floor debate that the Obama plan would “dump” people out of employer-provided care into the exchanges. He said that as if it were a bad thing.
    Yet free-market economists from Milton Friedman onward have identified employer-provided care as the original sin of American health care. Employers choose different policies for employees than those employees would choose for themselves. The cost is concealed.
    Wages are depressed without employees understanding why. The day when every employee in America gets his or her insurance through an exchange will be a good day for market economics. It’s true that the exchanges are subsidized. So is employer-provided care, to the tune of almost $200 billion a year.

  2. We should call for reducing regulation of the policies sold inside the health care exchanges. The Democrats’ plans require every policy sold within the exchanges to meet certain strict conditions.
    American workers will lose the option of buying more basic but cheaper plans. It will be as if the only cable packages available were those that include all the premium channels. No bargains in that case. Republicans should press for more scope for insurers to cut prices if they think they can offer an attractive product that way.

I agree with both of these, hopefully more choice will be offered in the future.

I’ve been on a soapbox for months now about the harm that our overheated talk is doing to us. Yes, it mobilizes supporters – but by mobilizing them with hysterical accusations and pseudo-information, overheated talk has made it impossible for representatives to represent and elected leaders to lead.
Now the overheated talk is about to get worse. Over the past 48 hours, I’ve heard conservatives compare the House bill to the Kansas-Nebraska Act of 1854 – a decisive step on the path to the Civil War. Conservatives have whipped themselves into spasms of outrage and despair that block all strategic thinking.
Or almost all. The vitriolic talking heads on conservative talk radio and shock TV have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination.

When Rush Limbaugh said that he wanted Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail.

If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less and hear fewer ads for Sleep Number beds.

So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished.

For the cause they purport to represent, however, the “Waterloo” threatened by GOP Sen. Jim DeMint last year regarding Obama and health care has finally arrived all right: Only it turns out to be our own.

I’m glad somebody within the Republican party recognizes Limbaugh and his ilk for what they are…purely entertainers. Too bad some people get their ‘facts’ from these blow hards.

2716

To be fair, if you think we should end employer based health care by (almost) the same logic we should end employer contributions to FICA.

2717

Isn’t FICA a state program? And doesn’t the government actually pay out on FICA (at least it did for me)? FICA is therefore very different from employee based insurance choices. I don’t see them the same at all. FICA also has a very limited payout; you only get paid if you are injured and can’t work. This is very different from a full on healthcare plan.

2718

FICA is the Federal Insurance Contributions Act tax, a payroll tax that is deducted from salaried or hourly employees and paid to the IRS by the employer. Most employees never know this tax is being levied against their take home pay. So, no, it’s (almost) exactly the same logic; hiding the cost of employment from the employee.

Almost, because FICA funds Social Security, so it’s not competing with a hypothetically more efficient market solution.

2719

From Wikipedia:

2720

FICA is the Federal Insurance Contribution ACT .It’s the payroll tax that pays SS and Medicare so it’s definitely NOT a state program.

that said, I don’t see the connection between heatlh/FICA. Employer based health care is an untaxed benefits where employees often don’t realize what the employer contribution level is. EDIT: AHh,I see the argument that the untaxed value of FICA is another compensation that employees don’t realize. And most economists believe that the employer share of FICA is passed to employees (which is why the argument that the excise tax will boost wages and hence SS tak reciepts). So yeah, I understand this logic and I think that the employer share of FICa should be on the payroll stub as well. I’m all about tax transparency.

I think the destruction of the employer based system to be a positive, which is one of the reasons I back the excise tax.