Booman Tribune

Serious Question

by BooMan
Wed Oct 28th, 2009 at 10:13:42 AM EST

My initial reaction on Monday to the White House endorsement of Harry Reid's opt-out plan was that it was aimed at helping Pelosi whip for a Medicare+5 robust public option. That idea has support in today's Hill.

Amid the continued vote-counting [in the House], there was widespread agreement among Democrats of all stripes that Reid’s move has helped Democratic leaders move far closer to getting 218 members to commit one way or another.

Rep. Anthony Weiner (D-N.Y.) said Reid has given comfort to members who felt they were being asked to take a controversial vote on something that might never become law. He said there might be 15 Democrats willing to support the “robust” option because of that.

Why would the White House, or Harry Reid for that matter, particularly care whether or not the House's public option is tied to Medicare reimbursement rates? Think about it.



Display:
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White House signaling it may compromise on a trigger or 'opt-in' option ...

'Put on a Good Show'

Oct. 28 (Bloomberg) -- U.S. Senate Democratic Leader Harry Reid doesn't have the 60 votes he needs to win approval of a government-run health-insurance program.

Connecticut Senator Joseph Lieberman, an independent who organizes with the Democrats, said he will oppose the so-called public option. At least four Senate Democrats criticized the idea and won't commit to backing their party, and the two Republicans who have signaled a willingness to support health- care legislation said they won't vote for the program ...

PUT ON A GOOD SHOW

Still, by simply bringing the public option to the floor, Reid may succeed in placating more liberal members of his party before compromising, said Ross Baker, who studies Congress at Rutgers University in New Brunswick, New Jersey.

"You put on a good show for certain elements of the electorate and say with all candor that you tried your hardest and you got it debated, but it's very difficult to corral 60 senators," he said, referring to the votes needed to prevent Republican stalling tactics. "That will satisfy most people."

Reid will likely be forced to accept a proposal by Senator Olympia Snowe, a Maine Republican, to trigger the public option on the failure of the private market to lower costs, Baker said.

When asked about the lack of solid Democratic support for the public option, Senator Kent Conrad, a North Dakota Democrat, told reporters "the trigger is not dead."

"I'm not going to make up my mind until I've actually seen the bill," said Senator Ben Nelson, a Nebraska Democrat. Arkansas Democrat Blanche Lincoln was also noncommittal.

The inclusion of the public option means losing the support of Snowe, the only Republican who has voted for health legislation so far. She said she can't see voting to let debate begin on a plan with a public option.

Fellow Maine Senator Susan Collins was also critical of Reid's plan. "It was a mistake and forecloses any real possibility of Republican support," said Collins.

TRIGGER AS COMPROMISE

The White House has signaled it would be willing to accept Snowe's proposal for a trigger mechanism, and moderate Democrats such as Nelson have praised it. An alternative is to allow states to decide whether to set up a public option, an opt-in plan that has also drawn kudos from Nelson.  

"But I will not let myself be reduced to silence."

by Oui on Wed Oct 28th, 2009 at 11:33:21 AM EST
Now, what exactly does the trigger trigger that makes it so attractive to Snowe?

It sounds more and more like the trigger triggers the entire bill and not just the public option.  In other words, it is all status quo until the mythical conditions of the trigger are triggered.

50 states, 210 media market, 435 Congressional Districts, 3080 counties, 192,480 precincts

by TarheelDem on Wed Oct 28th, 2009 at 12:39:49 PM EST
[ Parent ]
It's all about the trigger. Personally, I like this idea so long as the timeline is SHORT, because it's inevitable that the industry will not reform itself to the degree necessary, so, if created properly, the trigger WOULD kick in. I actually thought that was very smart of Snowe to suggest that.

Essentially it says (or should say) hey, insurance companies. You have x number of months to get your house in order. If (when) you fail to do that, we'll take over.

I would not object to that, unless the trigger conditions were too weak or the grace period too long.

"If you look for the social economic motive, you will not have to wait for history to tell you what was propaganda and what was truth." - George Seldes

by Real History Lisa (lpeaseRemoveThis@gte.net) on Wed Oct 28th, 2009 at 02:34:16 PM EST
[ Parent ]
Who's going to decide whether they're providing adequate service? All the trigger would do is spark another round of grandstanding and obfuscation with no good result. You seem to have forgotten for the moment that results in this country are not based on facts or reason. That's what Snowe and her masters are counting on, and they're quite correct.

FDR's response to progressive demands: "I agree. Now go out and make me do it."
by DaveW on Wed Oct 28th, 2009 at 03:01:39 PM EST
[ Parent ]
a multiple choice question, is it:

a multiple choice question, is it:

    A. roy rogers horse
    B. a really bad idea
    C. all of the above

if you want a preview of the snowe queens' trigger, revisit  Medicare Part D:

The legislation had a "trigger" built in to supposedly protect consumers and taxpayers against huge cost increases in the program. If the bills became too large, a "public option" would kick in and tell Big Pharma what's what. Unsurprisingly, that threshold has not yet been reached.

As a result, Big Pharma got a big windfall (a whopping $3.7 billion in the first two years alone) from Medicare Part D. But hey, that's what happens when you let lobbyists for the industry you're trying to reform write the legislation that does the reforming.

du

substitute the insurance co.s for big pharma, and it's déjà vu all over again.

the revolution will not be televised...

by dada on Wed Oct 28th, 2009 at 03:22:41 PM EST
[ Parent ]
  "Why would the White House, or Harry Reid for that matter, particularly care whether or not the House's public option is tied to Medicare reimbursement rates? Think about it."

   Following your monotonous emphasis on the Conference committee's work, it can only be because, it's supposed to provide encouragement to "grumpy [Senate] liberals" and thereby be reassured of their support, I guess---oh! wait, there's another possibility: by the provision being an element of a House bill, it can be argued for in Conference. Maybe that's the reason, or, why not both of these?  

  Then again, we're free to speculate as to whether or not this is part of a sincere strategy to actually get those Medicare reimbursement rate provisions in the end, or, conversely, merely have them available as bargaining chips, intended from the start to be "given away" as inducements to arriving at an eventual deal.

   You see, in the system as it now operates (I almost wrote "works", but I had a second thought about using that word) a congress member can speak in support of a measure which he flatly opposes (because he's confident it's going to fail anyway) or he can speak against a measure he actually supports (because, again, while doing may provide needed "cover", he's confident that the measure is going to pass anyway) and he's giving something up later for the current "leeway" to stand up and state (what some of his colleagues will have been made to understand is)  an insincere opposition, and so on and so forth.

    In such a realm, where apparent support or opposition can be used, traded, dealed over, when in actual fact, the reality is just the opposite of the appearance, unless one is actually privy to the most intimate details during off-the-record meetings and discussions, the "why would such-and-such a thing happen" is really a matter of pure conjecture.

   We can hear all day long of any number of possible explanations, each one more or less plausible.  But as for really knowing what is in fact going on, we don't and can't since the system is opaque---by mutually-agreed design, and, of course, you'll be quick to remind us that fortunately or unfortunately, that's just the way it has to be.

 

by proximity1 (timesreader@free.fr) on Wed Oct 28th, 2009 at 11:36:04 AM EST
you are definitely catching on.
by BooMan on Wed Oct 28th, 2009 at 11:49:57 AM EST
[ Parent ]
   These "insights" aren't new to me.

   What we have now as a legislative process came about as the replacement (however gradually, and fitfully) of a system which once upon a time "ran-like-clockwork" because, unlike today, there was such a well-organized party system with such awesome and thorough control over who was to be a House or Senate candidate, that, very few if any members --and certainly no members who could be described as "ordinary rank-and-file") ever came to hold office without the blessing of the leadership to whom they were completely beholden.

   For Republicans, this was nothing other than simply political business as usual.  For Democrats, in, for example the heydays of New York's Tammany Hall, it was distinguished from the Republican brand of graft as being "honest graft", in a feat of moral and intellectual acrobatics which is not very different in its base from what some today do to explain, excuse and apologize for the system that prevails.  In  William Riordan's classic text, Plunkitt of Tammany Hall [Plunkitt of Tammany Hall: A Series of Plain Talks on Very Practical Politics (New York: E.P. Dutton, 1963) ], referring to George Washington Plunkitt (1842 - 1924), famous for having said, "I seen my opportunities and I took 'em" (as any Mafia hit-man could as easily claim), we're told of an occasion in which it's admitted that the forces for reform should actually prevail, but that it has to be understood that the time is not yet right and ripe for such reform.  Such a explanation may have been made entirely unselfconsciously.  In the time---unlike in our advanced day---everyone took these things for granted.

 

 e.g.

  as present-day casebook example of a politician offering a rationale:

  "We're trying to do too much at once," Lieberman said. "To put this government-created, government-run insurance company on top of everything else is just asking for trouble for the taxpayer, for the premium payer and for the national debt. I don't think we need it now."

  http://thehill.com/homenews/senate/65105-reid-doesnt-have-health-votes-yet

 

by proximity1 (timesreader@free.fr) on Wed Oct 28th, 2009 at 12:30:49 PM EST
[ Parent ]
I still don't really understand your point.  

I am writing about a legislative process.  You are writing about the great shame that our legislative process operates the way it does.  They are similar topics, but it's not like criticizing me for discussing the process makes a whole lot of sense.  I do occasionally pause to note the insanity or regrettable nature of the process, but that can't be the sole focus of what I'm writing.  

If you don't want to read about the process, then try a different blog that focuses more on the corrupt nature of our system.

by BooMan on Wed Oct 28th, 2009 at 12:37:47 PM EST
[ Parent ]

  " I do occasionally pause to note the insanity or regrettable nature of the process, but that can't be the sole focus of what I'm writing."

    I wouldn't expect it to be; there should be "room" (time) for both, it seems to me.

   My point is better understanding through a larger context taken into account than is typical when the minutae of legislative deal-making are the bulk of the discussion.

by proximity1 (timesreader@free.fr) on Wed Oct 28th, 2009 at 12:53:25 PM EST
[ Parent ]

  I meant to go on, but got lost in the process---

  That former system was eventually replaced when, in processes which unfolded in a generally similar way in each house of congress---members rebelled against the existing system (which, it has to be admitted, was still one which afforded a certain amount of give-and-take even in its most authoritarian forms), and won for themselves greater freedom to support or oppose their party's leadership as they saw fit.

   In days of tight party control, as I wanted to point out above, House and Senate leaders could literally sit down together (with the President when it was useful) and decide personally the character and details of legislation, trading favors and settling differences then and there--or over a time, depending on how contentious the issues were.  That power was immense, of course.  It meant that the leaders could promise and deliver what they promised.  This situation is one part of the horns of a dilemma, however.  The wonderful controlling power didn't by any means lead to a better representation and advance of the general public's best interests; instead, as you'd guess, those in power got what they paid for and the rest of the people got what the powerful chose to allow them to have---which could include a certain measure of peace and prosperity.

   We're now on the other side of the horns of the dilemma: much greater independence on the part of individual House and Senate members, on one hand, with, on the other, a corresponding weakness in the ability to craft and pass legislation ---except by passing it through the process of bargaining with members one by one.  In each scenario, the interests of the public are easily lost, or sold out to higher bidders in the process.

   Which is better is a quite debatable matter.  Both have evident positive and negative aspects.  I would like a better party discipline and with it, reliable and faithful representation of the general public's best or better interests, without, in the process, reducing House and Senate members to abject slavery.

by proximity1 (timesreader@free.fr) on Wed Oct 28th, 2009 at 12:45:12 PM EST
[ Parent ]
if lieberman doesn't care about anyone but lieberman, and he loses his committee chair and committee assignments, and he's not running again in 2012, and he's lined up a cushy lobbyist job with Aetna following his exit at the end of this term, what is there to manipulate him with?  His cred as a lobbyist will be in the toilet?  

If Harry Reid has totally f---ed this up, what is plan B?  How late in the session can HCR be put into budget reconciliation?

by maye on Wed Oct 28th, 2009 at 12:03:39 PM EST
.
Lieberman Twists the Knife

(TruthDig) - Is there a more hypocritical figure in American politics than Joe Lieberman? The Connecticut senator declared Tuesday that he would support a filibuster of any health care reform bill that has a public option--even the version with the "trigger" compromise accepted by Republican Sen. Olympia Snowe--because it might cost money.

"I think that a lot of people may think that the public option is free," said Lieberman, one of the Senate's big spenders, in a suddenly frugal mood. "It's not. It's going to cost the taxpayers and people that have health insurance now, and if it doesn't, it's going to add terribly to our national debt."

This from a senator who, as much as anyone, helped run up the national debt since 9/11 by pushing to raise the military budget to its highest level since World War II.

Health Insurance Company CEOs Total Compensation in 2008

  • Aetna's Ron Williams - CEO Compensation

    "But I will not let myself be reduced to silence."

  • by Oui on Wed Oct 28th, 2009 at 12:20:53 PM EST
    [ Parent ]
    Assuming the Dems hold power for some time to come, as is nearly certain, Lieberman will have absolutely no value as a lobbyist. Aetna already has all the lackeys it needs among the Reps, and Lieberman will be toxic waste to the Dems. So where would he fit in?

    FDR's response to progressive demands: "I agree. Now go out and make me do it."
    by DaveW on Wed Oct 28th, 2009 at 01:52:40 PM EST
    [ Parent ]
    There is a slightly nauseating twist to what you say.

    Maybe Lieberman's reward is a million dollar salary for doing nothing. Just for having made sure no bill is passed in the Senate.

    Gross but that's what I'd do if I were the health insurance industry. Cross his palms with platinum.

    by richrichthanki on Wed Oct 28th, 2009 at 02:25:46 PM EST
    [ Parent ]
    I almost hope you're right. A criminal prosecution for bribery would make my day.

    FDR's response to progressive demands: "I agree. Now go out and make me do it."
    by DaveW on Wed Oct 28th, 2009 at 03:05:07 PM EST
    [ Parent ]
    I give up.  What's the answer?
    by maye on Wed Oct 28th, 2009 at 11:09:10 AM EST
    Isn't it obvious? To push the ultimate reconciled bill to the left. Might also put pressure on Lieberman et. al. to get on board. That's my best guess.
    by Parallax on Wed Oct 28th, 2009 at 11:23:19 AM EST
    [ Parent ]
    IMO, lieberman won't respond to pressure for a variety of reasons.
    1. although he promised to caucus with the democrats, it should be clear by now that Lieberman has taken the words "hold your friends close and your enemies closer" to heart. he hates the democrats.
    2. lieberman knows the GOP is the one that saved his ass. he owes them a lot more than he owes the democrats.
    3. lieberman knows he can't win with connecticut democrats, and i suspect he won't run for re-election.
    4. Connecticut is home to several large insurance companies, all of who pay good money to keep lieberman on their side.

    he has literally no reason to play ball. the best we can  hope for, IMO, is that he suffers a massive heart attack or a stroke, and is replaced via special election.

    John Mccain Called his wife WHAT??
    by brendan on Wed Oct 28th, 2009 at 11:49:39 AM EST
    [ Parent ]
    Ergo the brag that he's the most important man in the Senate.

    Iirc, no one else represents such dead weight that we hope for a natural extension of the metaphor.

    by wilderness wench on Wed Oct 28th, 2009 at 12:17:30 PM EST
    [ Parent ]
    Perhaps because it is an existing and popular program of long-standing duration.  

    Oh, there you are, Perry. -Phineas -SLB-
    by boran2 (blogistan@yahoo.com) on Wed Oct 28th, 2009 at 11:31:37 AM EST
    This game is far from over. This is the stage the White House has prepared for over many months, and I suspect that the environment is, if anything, more conducive to the sort of maneuvering that could result in a bill with some real bite to it than they had imagined. The trick is timing, to get the dominoes to begin to fall towards a sense of inevitability at the right moment, making it next to impossible for scum-Dems to obstruct or resist.
    by Fighting Bill on Wed Oct 28th, 2009 at 11:38:59 AM EST
     
      "This game is far from over"...

      And, don't forget--- speaking of lives in the balance---such is the grand cause for which thousands (considering only American lives, of course)  of lives have been risked and sacrificed in Iraq and Afghanistan, the sacred cause of democracy, the very thing our missions there are supposed to bring to those unfortunate peoples.

    by proximity1 (timesreader@free.fr) on Wed Oct 28th, 2009 at 11:43:39 AM EST
    [ Parent ]
    I tend to agree with you guys on this point. There are still lots of cards for Obama, Reid and Pelosi to play. We don't know what Liberman wants. We don't know if he can be pressured effectively. Even if he can't, I'm not convinced his games will hurt reconciliation as an option or using it to include a strong public option.

    Perhaps it's dangerous to be more optimistic than Booman, but on this one I am.

    by Parallax on Wed Oct 28th, 2009 at 03:58:39 PM EST
    [ Parent ]
    Medicare reimbursement rates is the issue for senate dems from rural states - gives Conrad, Baucus, Nelson, Lincoln an excuse to support it? wondering, since Reid's career is on the line with this now, if he's pressuring some with respect to chairmanships of committees.

    Viva Obama
    by Errol on Wed Oct 28th, 2009 at 11:49:48 AM EST
    Medicare reimbursement rates are a cover for these folks.  If you jigger the rates to deal with their situation, it causes the cost to go up and then these same folks are worried, oh so worried, about the deficit.

    50 states, 210 media market, 435 Congressional Districts, 3080 counties, 192,480 precincts
    by TarheelDem on Wed Oct 28th, 2009 at 12:42:17 PM EST
    [ Parent ]
    This is the preferred compromise.  If we make the public option less efficient by giving providers more money in rural states it can be changed later.

    The important thing is getting the system in place so that it is hard to take away.  Then make it more efficient later (yes, some Dr.'s payments will have to come down).

    I think this would be Weiner's argument.  He would say let's just expand Medicare first and then worry about cost controls.

    I would like to hear Feingold's argument why he would not compromise on this (based on his recent vote).  If it's for budgetary reasons, I agree with him on principle.  Democrats have ignored the fact that no matter what system we have we will have to ration and cut costs.

    by SFHawkguy on Wed Oct 28th, 2009 at 12:01:44 PM EST
    [ Parent ]
    Anyone here read the book Touching the Void? (the book is far more terrifying than the doc, because with the book you never really believe the guy will survive) we're now at the point where the guy is lying on a ledge in a crevasse at night with a broken leg. my 2 cents.

    Viva Obama
    by Errol on Wed Oct 28th, 2009 at 11:56:37 AM EST
    Nutter Butter cookies are the best cookie ever!

    nalbar

    by nalbar (nalbarsatgmaildotcom) on Wed Oct 28th, 2009 at 12:19:53 PM EST
    according to the nyt, the medicare + 5, robust plan is doa: Pelosi Retreats on Having U.S. Set Rates for a Public Option

    Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals, rather than using prices set by the government, aides said Wednesday.

    Ms. Pelosi said the public plan, which she prefers to call a "consumer option," would compete with private insurers. But the speaker was apparently unable to muster the votes needed for the "robust" liberal version of a public plan, which she has repeatedly said would save more money for consumers and the government.
    ...

    House Democratic leaders will hold a rally at the Capitol on Thursday to promote the legislation. They hope to take it to the House floor next week, with a final vote before Veterans Day, Nov. 11.

    Scores of lobbyists were "cordially invited" to attend the rally in e-mail messages sent Wednesday by Ms. Pelosi. The Senate majority leader, Harry Reid, Democrat of Nevada, announced Monday that he too had decided to include a government plan, with negotiated rates, in the bill he intends to take to the Senate floor for weeks of debate....

    at this point, my skepticism and cynicism is telling me that by the time the sausage machine finishes grinding hcr, the resulting bill is going to be yet another taxpayer funded welfare program for the insurance industry.

    f*cking lovely development, eh. you feeling used yet?

    and an aside, since the massachusetts health care reform law has become the latest whipping boy for the "false claims of ideologues, academics and politicians", l would encourage you to read this post in the wsj: A Great Success

    the revolution will not be televised...

    by dada on Wed Oct 28th, 2009 at 09:09:56 PM EST


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