In Private Meeting, Pelosi Floats Watered-Down Public Option, Frustrating Liberals
Just when things were looking good for the public option…
In a meeting today between House leaders and rank and file Dems in the capital, Nancy Pelosi frustrated many liberals by suggesting that they consider a watered-down public option as a way of getting health care through the House, a top House liberal says.
Pelosi’s suggestion prompted some aggressive pushback from some liberals, who demanded to know why the House leadership wasn’t throwing its weight behind the most robust form of the public option — one that reimburses providers at Medicare rates plus five percent — when a large majority of House Dems backs it.
In an interview with me, Dem Rep. Raul Grijalva described the scene in frustrated tones. He said House leaders acknowledged the popularity within the Dem caucus of the robust public option, but asked them to consider a public option where reimbursment rates are negotiated individually with providers. That’s a solution Blue Dogs favor but liberals reject.
“Unfortunately, the discussion was about negotiated rates,” Grijalva told me. “We continue to be very much opposed to that.”
Pelosi and House Majority Leader Steny Hoyer left the meeting, Grijalva said, but “frustrated” House liberals gave an earful to remaining Dem leaders, such as Jim Cyburn, Charlie Rangel and Henry Waxman.
“Why are we still in this discussion about negotiated rates? We went out and counted heads, and the vast majority supports Medicare plus five,” House liberals said to leadership, according to Grijalva. That’s a reference to the whip count by House progressives finding that 180 House Dems support of a robust public option.
When I pointed out to Grijalva that the robust public option doesn’t quite have the votes to pass a public option, he rejoined: “Neither do negotiated rates…This puts progressives in an untenable position.” Another meeting is set for tomorrow. Stay tuned…
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Greg,
What are the specifics of the:”watered down public option” that Speaker Pelosi proposed?
It would be helpful if you would obtain all the details of what that proposal would provide, and compare and contrast it to the “Robust Public Option” features.
We need more details, so we have a solid understanding of what is being proposed, and how it would affect a self sustaining Public Option, Insurance plan.
Liam, right now it appears to be the version that reimburses providers at rates individually negotiated with the providers. Trying to get more detail.
I’m thinking of being sedated until this over.
“It appears to be the version that reimburses providers at rates individually negotiated with the providers.”
That sounds like the Waxman/Blue Dogs compromise.
Why would she do this now, when the momentum has shifted toward the stronger PO? I need a nap, a really long nap. Any word from CBO yet on the watered down Baucus plan?
Tena, here’s a story that’ll brighten your day:
GOP backs corporate rape
In 2005, Jamie Leigh Jones was gang-raped by her co-workers while she was working for Halliburton/KBR in Baghdad. She was detained in a shipping container for at least 24 hours without food, water, or a bed, and “warned her that if she left Iraq for medical treatment, she’d be out of a job.” (Jones was not an isolated case.) Jones was prevented from bringing charges in court against KBR because her employment contract stipulated that sexual assault allegations would only be heard in private arbitration.
Sen. Al Franken (D-MN) proposed an amendment to the 2010 Defense Appropriations bill that would withhold defense contracts from companies like KBR “if they restrict their employees from taking workplace sexual assault, battery and discrimination cases to court.”
Easy call, right? Well, not if you’re a Republican, eager to protect a right of corporations to rape its employees.
Of the 40 Republicans in the Senate, only 10 voted for the Franken amendment, including all four women in the Senate GOP.
http://www.dailykos.com/storyonly/2009/10/7/790633/-GOP-backs-corporate-rape
Another……
I’m so glad we cut ACORN funding… Look what these commie socialists were doing:
The last FEMA grant received by ACORN was awarded on Aug. 23, totaling $450,000. The organization applied for, and received, five grants last year to improve fire safety in low income communities in five cities.
ACORN has been receiving fire safety improvement grants from FEMA since Hurricane Katrina ripped along the Gulf Coast in 2005.
http://www.politico.com/news/stories/1009/28041.html
SO glad we put an end to THAT disturbing practice. Fire safety is SOCIALIST PROPAGANDA.
Please excuse my extreme sarcasm on this post and the previous one….. It’s all I can do from impaling myself with a sharpie.
Shouldn’t we be defunding KBR and Blackwatch? I know ACORN is pretty scary by comparison, but fair is fair. I’m having a little trouble not being cynical myself Ethan.
Here’s a little bit from The Hill. Should the President move farther left? Check out the last person they questioned. It’s a short survey, you can do it.
http://thehill.com/blogs/congress-blog/politics/62047-the-big-question-oct-7-should-obama-move-farther-left
Holy Schitt, Ethan – I know the Franken amendment passed.
I’m actually speechless over the Republicans’ response to that.
I’ve been pissed off about ACORN from the start – I know what they do – Dallas Co. used to have a terrible time with out and out voter intimidation in ethnic districts and ACORN put a stop to quite a bit of that.
I haven’t said this in a long time, but I just hate the damn Republicans. I tried hard not to but they make it impossible not to just despise them.
“Shouldn’t we be defunding KBR and Blackwatch? I know ACORN is pretty scary by comparison, but fair is fair. I’m having a little trouble not being cynical myself Ethan.”
I thought we were going to do that – I thought the Democrats turned the Defund ACORN legislation into a general Defund every group that is charged with corruption Bill.
Please tell me we are defunding KBR and Blackwater -
I know they want to, but as far as I know it hasn’t happened yet.
Tena, if I ever respond to Scott C. again would you hit me over the head with your keyboard.
# Greg Sargent | October 7th, 2009 at 03:34 pm
Liam, right now it appears to be the version that reimburses providers at rates individually negotiated with the providers. Trying to get more detail.
…………………………
Greg,
If that is correct, then it sounds like it would be an administrative nightmare, for those who would be managing the Public Option premium assessment rates. How could they possible set a fixed national premium rate, if they are going to have to reimburse the same medical procedures, at different rates, to many different providers. It would drive up the staffing overhead, and just bloat it, for no good reason.
Speaker Pelosi can not be proposing that approach, and if she is, then she is pushing a poison pill option, that will end up making a Public Option very inefficient, and unpopular.
Push them on this one Greg.
msinca | October 7th, 2009 at 03:57 pm
I know they want to, but as far as I know it hasn’t happened yet.
Tena, if I ever respond to Scott C. again would you hit me over the head with your keyboard.
………………..
I will.
Notice Scott C.’ M.O.
He is a comments parasite. He just pounces on other people’s comments, extracts, out of context bits, and pieces, prints them back in bold type, to set up his strawmen, and then sets fire to them.
That is pretty much all he does. If he did not have other people’s comments to distort, he would be a mute.
For everyone’s benefit, here is the GOP response to the Franken bill:
On the Senate floor, Sen. Jeff Sessions (R-AL) spoke against the amendment, calling it “a political attack directed at Halliburton.”
http://thinkprogress.org/2009/10/07/kbr-rape-franken-amendment/
I HATE the Republicans too. HATE them.
“Tena, if I ever respond to Scott C. again would you hit me over the head with your keyboard.”
LOL!!!
I will.
“On the Senate floor, Sen. Jeff Sessions (R-AL) spoke against the amendment, calling it “a political attack directed at Halliburton.””
O my god!
Who was just telling you that the “whip count” was bunk? Oh yeah, it was me. The momentum only shifted in your commie fantasies.
Republicans are Dyslexic Communists.
They take from The Have-Nots, to give to their Robber Baron Patrons.
“commie fantasies.”
That cracks my s*h*i*t up every time. You are one ancient, worn-out sock puppet, BabyHugo.
LOL!
Rape-ublicans – gotta love ‘em!
Well it all has a certain consistency to it. The Republicans are the party that enabled Halliburton to rape the Tax Payers.
This might be a good time to recycle my observation:
If Halle Berry had married Tim Burton, she would now be known as Halle Burton, and Dick Cheney would have funneled billions, and billions of no-bid defense contract toward her.
Maybe I just missed it, but I thought one of the advantages of the public option, in addition to no profit and reduced overhead costs, was to aggregate a large enough number of people to effectively negotiate reduced rates with health care providers.
Medicare+5 seems to be, if I may coin a term, a lobbied rate. IIRC, there is an annual fight in Congress regarding increasing / decreasing payment rates for all kinds of health care services.
The model then is to set Medicare+5 as the payout rate, and then the insurance premiums paid by people would be based on level of payment to providers, plus the small expected overhead to operate the public option function.
This would seem to drive the private insurance companies to do 2 things. One, be as efficient and low cost as the public option. Two, set a their payment to providers to equal what the public options pays.
Thus, we get defacto prices controls (Medicare+5) for all health care goods an services paid for by either the public option or private plans.
Is this the right way to understand this?
I hate Republicans, the medical insurance industry, Sarah Palin, Glenn Beck, Rushbo, and Scott C.
Mr. Tena spent over 2 years in courts in more than one district with Haliburton over an arbitration agreement.
He beat them like a drum in every court.
“and Scott C.”
Now I’m going to have to go read the thread and find out what happened. lol
I hate Rush and I hate Rupert Murdoch.
The Defense Department has confirmed that the eight soldiers killed in an attack on an U.S. outpost in Afghanistan were all from Fort Carson [Colorado].
The military identified them as:
_ Staff Sgt. Vernon W. Martin, 25, of Savannah, Ga.
_ Sgt. Justin T. Gallegos, 27, of Tucson, Ariz.
_ Sgt. Joshua M. Hardt, 24, of Applegate, Calif.
_ Sgt. Joshua J. Kirk, 30, of South Portland, Maine.
_ Sgt. Michael P. Scusa, 22, of Villas, N.J.
_ Spc. Christopher T. Griffin, 24, of Kincheloe, Mich.
_ Spc. Stephan L. Mace, 21, of Lovettsville, Va.
_ Pfc. Kevin C. Thomson, 22, of Reno, Nev.
God Bless our Troops. Bring them home.
lmsinca:
Tena, if I ever respond to Scott C. again would you hit me over the head with your keyboard.
I see that you too, like so many others here, just can’t stand to have your ideological preconceptions and prejudices challenged with logic and unemotional reason. That’s too bad.
Liam:
He just pounces on other people’s comments, extracts, out of context bits, and pieces…
False. I’ve never taken anything out of context.
If he did not have other people’s comments to distort, he would be a mute.
Let’s test your theory. Stop posting and see if I stop.
Must-watch vid over at Kos:
Sale after sale after sale where private dealers being told point blank that their buyer probably couldn’t pass a background check, but the cash changes hands, and the buyers are scooted out the door. Often by sellers who themselves say they couldn’t pass background checks, either.
You can see more at GunShowUndercover.org, plus video of “straw purchases,” where a presumably prohibited buyer makes the deal, then brings in someone totally different to fill out the paperwork and become the “owner,” right in front of the eyes of federally licensed dealers.
Fake pimps. Fake “hos.” Fake “brothels.”
Real guns. Real crimes.
http://www.dailykos.com/storyonly/2009/10/7/790568/-Hello.-I-am-a-pimp-and-this-is-my-ho.-We-want-to-buy-guns.
Scott C, you are human refuse. Go sulk in a corner.
lmsinca:
I hate…Scott C.
Wow.
War is man’s most futile endeavor. It almost never solves the original problem or reaches the original goal without creating 10 worse problems in its wake.
Viz. The British Empire and WWII – we’re still cleaning up after both.
Gee, wouldn’t it be just a crying shame, if Private Insurance had to become more efficient, and had to settle for a reasonable take for just passing money through their hands. O the horror of it all. Pardon me, while I shed an ocean of tears for the poor Private Insurance Moguls
“Wow.”
If you start posting that enough, you’ll reveal your sock-puppetry.
The Comments Parasite is back, and true to form, all he can come up with is bits and pieces of other people’s comments.
If he ever farts, he will be declared brain dead.
A-HAAAAAAA!!!!!
Baucus Bill REDUCES DEFICIT BY $80B; COVERS 94% OF AMERICANS
Politico:
The CBO report (.pdf), just released, is good news for the Baucus bill:
The Congressional Budget Office said health-care legislation being considered by the Senate Finance Committee would cut the U.S. budget deficit, a decision that may clear the way for a vote by the panel.
The measure, an amended version of a proposal put forth by panel Chairman Max Baucus, would reduce the budget deficit by $81 billion over 10 years, according to an analysis released today by the nonpartisan agency. It would also increase the share of the population with health insurance to 94 percent from the current 83 percent, the CBO said.
That’s right Freehold, Medi-care plus 5%. A true public option with price controls. If they don’t like it maybe they could sell flood insurance in New Orleans.
“Gee, wouldn’t it be just a crying shame, if Private Insurance had to become more efficient, and had to settle for a reasonable take for just passing money through their hands. O the horror of it all. Pardon me, while I shed an ocean of tears for the poor Private Insurance Moguls”
You can say the same about all the giant industries. They’ve had a decade of ramped up all out full scale racking up unheard of and honestly obscene profits.
I don’t see a crying need in the country for anymore billionaires. In fact, I don’t see any need on god’s green earth for billionaires to begin with.
Tena,
You have no heart. I lose sleep every night, worrying about the plight of all our struggling billionaires. You must be a commie, just like Huge Diaper Rash claims.
I’m confused – do we support the Baucus bill now? It doesn’t have any PO.
Liam – I must be.
I’m fine up to millionaires – that I can see. But these multi-billionaires – that’s just overkill to the nth degree and I’d like to see a system of regulation that levels things back out so that we don’t have people making multi-billions like that. It’s not warranted. It’s one of the things driving the widening of the chasm the middle class has fallen into.
By 2019:
…about 25 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). [illegal immigrants NOT covered, YOU LIE Joe Wilson]
…the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent
…Roughly 23 million people would purchase their own coverage through the new insurance exchanges, and there would be roughly 14 million more enrollees in Medicaid and CHIP than is projected under current law. Relative to currently projected levels, the number of people either purchasing individual coverage outside the exchanges or obtaining coverage through employers would decline by several million.
AFTER 2019:
…the added revenues and cost savings are projected to grow more rapidly than the cost of the coverage expansion.
http://cboblog.cbo.gov/?p=387
sbj
Support whichever bill you want. The Dems will get it right in the end.
sbj | October 7th, 2009 at 04:51 pm
I’m confused
…………………….
Yes you are, always, and terminally bewildered too!!!
Tena:
If you start posting that enough, you’ll reveal your sock-puppetry.
Huh?
And Liam has the gall to accuse others of taking words out of context.
“The Dems will get it right in the end.”
I certainly (and sincerely) hope so!
I am serious, though – are y’all moving the goalposts back to the Baucus bill now?
Ethan | October 7th, 2009 at 04:44 pm
Baucus Bill REDUCES DEFICIT BY $80B; COVERS 94% OF AMERICANS
…………………….
OK. Now let us “Irish it up” as Bart Simpson said on Sunday’s show, when he came up with the idea to put booze in Edna Krabappel’s coffee.
http://upload.wikimedia.org/wikipedia/en/7/76/Edna_Krabappel.png
We should cut out the $500 billion in federal subsidies, for Private Insurance, that is currently in the Baucus Bill. That would allow us to reduce the deficit by a massive amount.
Since a Public Option will not be given any Federal revenues, why should we give away $500 billions to the Insurance Moguls to increase their already huge compensation packages, and swell their profit margins.
The comments Parasite can never changes it’s ways. It just keeps gnawing away at tasty bits off of other people’s comments.
That’s right Freehold, Medi-care plus 5%. A true public option with price controls. If they don’t like it maybe they could sell flood insurance in New Orleans.
What got my attention, and what I was asking about, was the price controls for health care providers. I think that is a pretty major change, and hasn’t been much discussed thus for in the debate.
I had expected that to show up as soon as the government achieved a monopsony, but wasn’t thinking that would happen until the public option was replace by single payer, a few years out.
Its clever on the part of the Medicare+5 proponents. Give it a couple of years, and it will be Medicare+0, which will then be merged into Medicare for “efficiency”, which will be consolidated with Medicaid, yielding MedicareForAll.
You’ll get what you want.
“are y’all moving the goalposts back to the Baucus bill now?”
I’m serious – you’re the only one making that claim over and over and over.
Nobody else has said: Hot damn! I’m there! Ethan just reported it.
sbj
I’m not, I’m still pushing and hoping for a strong PO. The insurance industry likes his bill a whole lot more than I do. It’s just a really good thing we got a good CBO score, with wiggle room. Now they can reconcile, if it gets past Wyden and Rockefeller, with the HELP bill and make it better for us and worse for industry.
Remember, I hate the medical insuarance industry and I’ll throw in Halliburton also.
Freehold
Sounds like a good plan to me.
Tena,
You have to spell it out for SBJ. He is among the terminally bewildered.
What Ethan was pointing out was that CBO found that the Baucus proposal would reduce the deficit, by about 80 Billion. I know that is actually over ten years, but still a reduction. Why Ethan stressed that point was because the Republicans have been claiming that the Government can not afford to reform health care now.
Either SBJ is thick as a brick, for not grasping that simple fact, or he is being deliberately obtuse. I think it is the latter, because that is his usual methodology. He is FUDmaster, SBJ. He has a blackbelt in obfuscation.
Yeah, I could go with Freehold’s view of the thing – sounds like a plan to me, too -
G-O-Politico:
Bob Dole, 86, was supposed to make news today as another GOP lion predicting the passage of health care reform — and he did, saying reforms would pass within the next six months or so.
Thanks, Lmsinca – I understand what you are saying – a good CBO score gets the Baucus bill out of committee.
What I don’t understand is how the CBO score of a bill that y’all want to change – significantly – even matters beyond that one detail (out of cmte)? The Baucus bill will have to be remain largely unchanged to survive the legislative hurdles set before h/c reform. In that sense I am wondering about the level of support for the Baucus bill as presently written?
He is still at it. Like I said, he thinks that he is being very clever with his little FUD and obfuscation tricks.
Again.
What Ethan was pointing out was that CBO found that the Baucus proposal would reduce the deficit, by about 80 Billion. I know that is actually over ten years, but still a reduction. Why Ethan stressed that point was because the Republicans have been claiming that the Government can not afford to reform health care now.
Either SBJ is thick as a brick, for not grasping that simple fact, or he is being deliberately obtuse. I think it is the latter, because that is his usual methodology. He is FUDmaster, SBJ. He has a blackbelt in obfuscation.
@Imsinca
Yea, I know.
Putting wage and price controls on 17% of the economy is likely to have some fairly profound effects.
I would expect that some will start this year, but many won’t show up for a decade or two or three. I’d be reluctant to advise a kid to go to medical school now, for example.
I’ve been having a discussion recently with a young relative who sometimes asks me for career advice. Bright kid, good education. I’ve been telling them, somewhat reluctantly, to strongly consider a Federal government job. More money, less work, much better benefits, much better job security. Do your 40 hours a week and invest your life energy elsewhere. I suspect there are a lot of discussions like that going on now.
It would bring down cost, and provide care for all. That would allow small businesses and not so small ones to get a huge monkey of their backs.
Private health Insurance is a huge drag on the nation’s ability to create jobs. They contribute nothing that would justify the massive amounts that they suck out of the pockets of corporations, and individuals each year.
“I’d be reluctant to advise a kid to go to medical school now, for example.”
Aw Freehold – Jeez. That presupposes that the reason to go to med school is to get rich. I thought the idea was that those people have a skill that helps people – not that they have a skill they can make millions off of.
Furthermore – national health care in Britain, France, Italy, Germany, Australia and Switzerland has not had that affect on the medical profession.
Maybe it’s just American med students who in it for the money. And maybe that’s what the hell is wrong with our health care system and the whole damn country.
SG, where are you? We need you to get on the messaging here. Nobody liked the name public option, but robust public option is a whole lot worse. It sounds like a huffing politician ready to burst out of his suit.
@Tena
Its not that simple. And its not about getting rich. I wouldn’t advise someone to do it for the money in the first place.
To begin with we are talking here about the top 10% cohort, IQ 125+, etc. They could do a lot of things, and succeed at most of them. But these are the folks that make the wheels turn. (I was counting the staff the other day at the surgery clinic where my wife had outpatient surgery – one surgeon, three nurses, one lab tech, two front desk clerical folks. One surgeon clinic – at least 6 other direct jobs.)
Its a life trade-off – a number of years of fairly intense post-graduate education and training, with the prospect of making a probably OK (but to be determined by some future Congress) income, as what is to all intents and purposes a government employee. In the large, a projected environment where they have many fewer choices than today.
If you really have a vocation for it, fine. I think for most people its a combination of vocation, social status (and all the things that come with that), and materially better than average income. Probably not so different than the motivations for many to go to law school.
I may be being overly fey – been looking at too much macro economic data. But there is a huge, huge problem coming with paying for providing health care for boomers, and I suspect that the government is going to be under incredible pressure to constrain costs.
Then why hasn’t it worked like that in any other country on earth with national health, freehold?
Makes no sense.
Maybe you haven’t thoroughly checked all the bills yet
Freehold. They’ve put incentives for General Practitioners and school financing to sweeten the kitty for those inclined to go into medicine. I recommend anyone looking for both a rewarding career and financial stability to go into any kind of science, well except for biology, unless you want to be a doctor.
You’re being way too pesimistic, things change and we have to change with them especially when we are on an unsustainable path. It’s time to move into the 21st. Century and bring new fields of green technology into the forefront and any scientist who wants a job can get one in the environmental field right now and probably for years to come. It’s a good field for engineers as well.
I would stay away from financing however.
The real truth is, and Freehold can not bring himself to admit it, is that the Republicans have destroyed the jobs market once more. That is why he is advising his young relative to find a government job.
The Republicans, and their Robber Baron Patrons have looted the country, and shipped all the good blue collar jobs to China, so college graduates can either look for jobs in Government, or starve.
That is the reality of what the Republicans have wrought.
# AllButCertain | October 7th, 2009 at 06:01 pm
SG, where are you? We need you to get on the messaging here. Nobody liked the name public option, but robust public option is a whole lot worse. It sounds like a huffing politician ready to burst out of his suit.
Since Sg is not around, let me *** up the Option name for you.
From now on it shall be known as The Robust Scarlett Johansson Option.
Who could refuse to vote for that, or stand up for it, for that matter.
The blog censored; S*ex up.
That is what happens when you get your software from Ned Flanders.
In theory, negotiated rates could work. (I’m not saying they would, just they could. My preference is Medicare plus.)
If the public option has enough members the “negotiation” could be more like making an offer they can’t refuse. They can say, we’re paying Medicare plus 5. Sign up at that rate or you lose access to all our members. If the membership is high enough, providers will have to sign up.
That last if is a big if. It will take a fairly large chunk of members to constitute such a critical mass.
Where it will face particular difficulty is with large specialty practices that often represent a practical monopoly in many areas. If 80% of the cardiologists in an area are part of one group, they can dictate prices in any negotiation. That’s a big part of the reason why specialty costs are such a big driver of runaway health costs. (The other major factor is how RVRVU’s are set but that is a very complex subject.)
I was in a meeting the other day when someone asked the speaker, a cardiologist, what he thought of the possibility that a public option without negotiated rates could restrict doctors’ income. He said said it was likely that exhorbitant physician income – a relatively new (i.e., mid 20th century) phenomena – had distorted the profession. He opined that medicine now attracted many people more interested in making money than healing and, in marvelously understated sarcasm, noted he wasn’t sure they made the best care givers.
Pelosi and Reid must not be reelected. The pathetic leadership during the last administration was somewhat understandable; however, they have both demonstrated the lact of resolve and commitment for Democratic Party principles far beyond the worse of any party leaders on both sides. It is astonishing how capitulating these cowards are. Not one ounce of fortitude. PLEASE, PLEASE, vote Pelosi and Reid out of office; start a grassroot movement, lets raise money for formidable primary candidates against Pelosi and Reid and also the blue dog GOP plants. If Obama doesn’t muster his resolve and quit this partisan love fest; he should be a one term president and take the equally ineffective Holder with him. Vote for change; all we got was Bush blue dog light. Its disheartening; Obama is weak, ineffective, and full on nothing but words with no action.
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