From David Waldman in a Comment at Daily Kos
If the bill comes to the floor with no public option in it, and the "deal" is that opponents are to be allowed a vote on an amendment that would add it in, here's what will happen:
- The "deal" will be a unanimous consent agreement that the public option amendment (and possibly other amendments) will require 60 votes to pass
- The public option amendment will garner majority support on the Senate floor -- say, around 55 votes -- but because Senators agreed unanimously that 60 would be needed, the amendment would fail
- The Senate would pass a bill with no public option, and would go to conference with the House to settle that difference (and all others)
- The House and Senate would vote on whatever settlement they reach in conference, and the fate of the public option would be in the hands of the conferees
Now, why would there be such a unanimous consent agreement?
- Opponents of the public option will threaten to filibuster an amendment to add it
- leadership on both sides will know that the filibuster will be useless if there are 60 votes to end it
- leadership also knows that ending a filibuster means:
- the trouble of conducting that filibuster
- filing a cloture motion which takes one day plus one hour (at minimum) to become eligible for a vote on it.
- the trouble of running out the clock on the 30 hours of post-cloture debate permitted by the rules
- So instead of going through all of that, they agree ahead of time to transfer the 60 vote threshold onto the vote on the amendment itself
Transferring the 60 vote threshold directly onto the amendment itself puts the amendment at no disadvantage relative to the hurdle of overcoming an actual filibuster, so in that sense it's not a concession at all. But it does relieve opponents of the public option amendment of the burden of having to go on record as opposing cloture on that amendment. Instead, all they have to do to require 60 votes to pass it is silently assent to a unanimous consent agreement.
Read the diary this was posted to, also by David Waldman: Remember the "Painless Filibuster?" See also: Is there a (scary looking) deal that can help the public option survive the Senate?
Must watch, if you missed this segment. Women who vote for these 30 Republican jerks really need to take a hard look in the mirror, or maybe their daughters' faces.
In The Nation, Emily Douglas provides some background info if you need it, along with a reminder of the bravery it takes for rape victims to speak out:
Upon hearing the amendment passed, Jamie Leigh Jones told the Minnesota Post: "It means the world to me...It means that every tear shed to go public and repeat my story over and over again to make a difference for other women was worth it." It's a reminder that rape survivors go public with their stories at a serious emotional cost, and the onus is on political leaders and advocates to make it worth what could be only in the most euphemistic sense be referred to as their while.
At the end of his segment on the bill, John Stewart tied it all up with a bow. Now we get it! Comparing this move to regulate government contractors to ACORN's frozen funding, he says, "You don't want to waste taxpayer money on someone who advises fake prostitute how to make imaginary crimes. You want to give it to Halliburton, because they're committing real gang rape. You cut out the middleman! And they say government doesn't work."
Peggy Robertson was denied insurance coverage because she had a c-section. She was later told that if she was sterilized, she would be able to gain coverage.
From Daily Kos a report on a Washington Post story:
Congressional budget analysts have given House leaders cost estimates for two competing versions of their plan to overhaul the health-care system, concluding that one comes within striking distance of the $900 billion limit set by President Obama and the other falls below it.
House leaders have been working to lower the cost of the $1.2 trillion health-care package they offered in July. The report from the Congressional Budget Office, a copy of which was obtained by The Washington Post, puts the cost of one plan at $859 billion over the next decade and the other at $905 billion.
....
Both packages are based on the original House framework, which proposes to extend coverage to more than 30 million Americans by expanding Medicaid eligibility and subsidizing private insurance for people who lack access to affordable coverage through an employer. Each would expand the ranks of the insured to more than 95 percent of Americans by 2019, and each would create a government-run insurance plan to compete with private insurance companies.
A frightening new climate change study says the United States must eliminate its enormous rate of carbon emission within ten years. Read it all at AlterNet
1. Google has built a site where you “explore the potential impacts of climate change on our planet Earth and find out about possible solutions for adaptation and mitigation, ahead of the UN’s climate conference in Copenhagen in December.” They’ve got a Google Earth mashup, a introductory video featuring Al Gore, and more. Visit: Climate change in Google Earth
2. Climate change is a human issue. It isn’t just about saving the planet and communities around the world face serious threats from the climate crisis. The TckTckTck campaign has created a great tool for learning the stories behind the human face of climate change. It’s called the Climate Orb and it is an animated interactive tool housing first-hand stories searchable by country, keyword and timeframe. Explore the Climate Orb.
3. There’s a lot more to solving the climate crisis than just sitting back and leaving it to world leaders and policy wonks to figure everything out. Need inspiration? Meet Alec Loorz, the creator of Kids vs. Global Warming. He describes it as “group of kids that educate other kids about the science of global warming and empower them to take action.” The site shows that everyone really can play a role in tackling climate change.
4. Just the facts, that’s what some people want—as long as there are lots of cool charts, graphs and clear explanations of course. That’s what’s great about the Pew Center for Global Climate Change’s "Facts and Figures" site, it is filled with all the charts and graphs you need to get a much clearer picture of what causes climate change and what effects it has. If you want even more information you can also check out their entire Climate Change 101 series.
5. At this point you’ve probably heard of “carbon footprints” and you might have even used an online calculator to figure out what yours is (and thus what your impact is on climate change). The problem is that there are just so many calculators out there now it can be hard to figure out which one to use. Thankfully you can learn about your options from MNN’s 15 Best Carbon Calulators survey.
6. OK, but how will climate change affect you? What are the consquences that are mostly likely to impact your day-to-day life? Take a look at this list of The Top 100 Effects of Climate Change. From “Say Goodbye to Pinot Noir” to “More Bear Attacks” to “Malaria Spreading in South America” to “More Stray Kitties” it seems like climate change is going to have a lot of consequences, some big, some not so big.
7. On the other side of the coin, you might want to be a little more optimistic and review the science behind “10 Solutions for Climate Change” which details what we can actually do to solve these problems personally and as a larger society.
8. Finally, don’t forget that people all around the world are getting involved and taking action.
Next week, on October 24, 350.org is organizing the International Day of Climate Action. You can visit their site and see what people all around the world are planning to do next week to demonstrate their commitment to stopping climate change.
Learn More at Blog Action Day 2009: Climate Change
From Chris Bowers at Open Left
# In the House, the public option tied to Medicare rates has 200 confirmed supporters. However, that appears to include the leadership at this point. Further, the count will drop to 199 when Robert Wexler leaves Congress, and his replacement will not be sworn in before the health care vote. The CA-10 and NY-23 special elections will both take place on November 3rd, with the former guaranteed to send another public option supporter to Congress and the latter guaranteed to send a public option opponent.
Worth noting: Of the four dozen undecided and "lean no" members the Progressive Caucus is targeting at this point, half were first elected in 2004, 2006 or 2008. As such, it really shouldn't be difficult for the overall House leadership to pass a public option with Medicare +5% rates if they wanted to. If they want access to the party treasury for re-election, then they better not sink the policy aims of the overwhelming majority of the party.
# In the Senate, despite Lieberman's recent grumblings, everything I hear still points to Evan Bayh, Mary Landrieu, Blanche Lincoln and Ben Nelson as the main obstacles to passing a public option. As leader of the Conservadems (looking in to increase power), as someone who voted against the budget (appears to oppose even the principle of universal health care), and as a scorned Vice-Presidential short-lister who shifted sharply to the right in 2009, Evan Bayh strikes me as particularly problematic. Check out this quote of his in the Politico, where he basically says he will join in a Republican filibuster against virtually any health care bill:
"It's not fair to ask people to facilitate the enactment of policies with which we ultimately disagree," said moderate Sen. Evan Bayh (D-Ind.). "So the closer we get to the end of the process, the more, for me, the process and policy will be one and the same." It isn't fair, eh? How about the fairness of the Senate elevating itself to unicameral status through its culture of 60-votes? Is it "fair" to use the filibuster to destroy the branch of Congress that actually has equal representation for the American people?
Now that the primary responsibility for health reform has shifted to Senate Majority Leader Harry Reid, progressives are pushing him to get tough with conservative Democrats looking to delay progress of a unified Senate reform bill.
Progressive Caucus member Rep. Alan Grayson (D-Fla.) and representatives from the Progressive Change Campaign Committee delivered their respective petitions to Reid's office Wednesday afternoon. With some 87,000 signatures collected in the past week, the PCCC urged Reid to strip leadership powers from members of the Democratic Caucus who do not vote for cloture to prevent a Republican filibuster -- a clear shot at Sen. Joseph Lieberman (I-Conn.), who chairs the Homeland Security committee and said Monday he "wouldn't rule out" allowing a filibuster to proceed.
Reiterating the urgent need for reform outside the Hart Senate office building Wednesday afternoon, Grayson didn't single out any congressmen or senators, but said he was baffled by continued delays given the Democratic supermajority and the cost of delay.
"Every single day in America, 122 more Americans die for lack of health insurance. That means that as we stand here in front of you right now, one or two or three more Americans have died because we have not acted yet," Grayson said. "I apologized to the dead and their loved ones for our inaction. Now it's time to move beyond that and get the job done."
Reid's deputy, Sen. Dick Durbin (D-Ill.), said the PCCC and Grayson ought to "count to 60 and understand we need to be together, and there are times when we need to work out our differences."
Grayson wasn't sympathetic to that argument Wednesday, noting that other Americans are paying the price while the Senate tries to work out its differences. Pulling a large American Journal of Public Health study from his jacket pocket, he said, paraphrasing the study authors, "You take two Americans who are otherwise identical in every single way -- same age, same gender, same race, same smoking habits, same weight -- you put them side by side, if one has insurance and one does not, the one without insurance is 40 percent more likely to die."
Read it all at Huffington Post
Update:
Reid pushed back Wednesday afternoon against the consensus that health reform is on him -- after Sen. Chuck Schumer (D-N.Y.), laid the fate of the public option in the Majority Leader's hands Tuesday night. "He would rather say anything so it wasn't up to him," Reid snapped Wednesday, en route to a meeting with White House Chief of Staff Rahm Emanuel and Sens. Chris Dodd (D-Conn.) and Max Baucus (D-Mont.).
Dodd said he expects the Senate finance and health bills to be reconciled by the end of next week. "The Leader will set the agenda," he said.
Here is Schumer with the best plan:
SCHUMER: "Well, first, Leader Reid has the option of putting it in the final bill. If he puts it in the final bill, in the combined bill, then you would need 60 votes to remove it. And there clearly are not 60 votes against the public option."
On Monday October 5th, Drs. Margaret Flowers and Paul Hochfeld led a delegation of 15 physicians and nurses to the White House gate. The occasion was a Rose Garden ceremony with over 100 physicians in white coats invited, a photo-op to showcase support among doctors for the President’s effort at health reform.
Dr. Margaret Flowers, Congressional Fellow of Physicians for a National Health Program, was later contacted by one of the doctors allowed in the gates. The following is her response:
Don’t let the good be the enemy of the perfect
Thank you for inviting me to this conversation. I understand your concern to get some type of reform now. I hear your desperation. I have felt it myself. There is so much suffering that it is tempting to say – we must get something even if we know it is not the solution.
At some point we have to look at the facts that incremental change and compromise when it comes to health reform in this nation have not gotten us anywhere. While SCHIP is great, it has merely held the level of uninsured children at bay, not decreased it. Medicaid expansions have similarly not been able to keep up with the rising uninsured or been able to provide a financially sustainable and high quality solution. Why is this?
It is because the greatest impediment to health reform in this country is that the for profit (and not for profit in some cases, such as BCBS) health industries control the political process. No amount of incremental reform will change that. Regulation of the industry is expensive and has been ineffective. The industry can do an end-run around regulation so fast that it would make your head spin. With the proposed legislation, we will be throwing more money into an already overpriced and dysfunctional situation. We will delay enactment of better reform while we wait to see if this reform works, all the time knowing that it won’t. In the meantime, thousands of people will die unnecessarily, thousands of people will suffer, families will continue to go bankrupt and lose their homes, physicians will continue to leave practice.
Single payer was not supposed to be on the table this year, yet despite having little in the way of funding and no paid organizers (like HCAN has), we were able to move it forward and break through some of the media blackout through perseverance and dedication.
We must ask ourselves, how long are we willing to play the incremental game (knowing that while a few more get access to healthcare, many more continue to be left out)? When will we decide that we’ve reached the tipping point, and like other social justice movements, dig in and do the necessary work to enact change?
I am tired of hearing that we can’t have single payer or that it is not on the table. It will never be on the table and we will never get it until we do the work to put it there. We, as physicians (and the other health professionals), hold a unique position in society. For the most part we are seen as advocates for our patients and acting in the best interest of our patients (although sadly this vision is truer for nurses than for doctors). We are seen as "experts." Thus, I believe that it is our professional responsibility to educate and advocate for effective reform. If we work together we can create real change. But it is harder than showing up for a photo shoot. It takes a lot of time and travel and writing and speaking and money and a willingness to put our bodies on the line.
Until more of us are willng to do this, we will have to continue to settle for crumbs. I am not willing to settle for crumbs. My part in this drama is to be a strong voice for single payer. And I won’t give in until we get there. The stories that I hear from patients and docs keep me going. Nobody should be left out. Everybody should have the same level of care. It is our responsibility to fight for this. Anything less is unacceptable.
My two cents, for what it’s worth.
Respectfully,
Margaret
Additional comments from Dr. Andrew Coates:
Single-payer advocates should take note. Dr. Hochfeld was allowed to attend the ceremony, uninvited and at the last minute, because single payer cannot be ignored. Our persistence has proven effective. The goal of the mainstream discussion, orderly consensus for incremental change, with nary a ripple of discord, as remained elusive. Yet experience proves again and again that single payer swims just below the surface.
All year long it has become more and more clear – to more and more people – that single payer national health insurance is in fact the very least we need when it comes to health care reform that will work to improve our lives. As Dr. Flowers explains, "Anything less is unacceptable."
This just-below-the-surface dynamic, combined with clear and persistent advocacy, that has taken single payer from "off the table" to "on the floor" this year. We now learn that the vote on HR 3200 – and with it, the Weiner amendment that would substitute single payer legislation for the text of the bill – may be imminent. Activists around the nation are pulling out all the stops.
So the single payer presence within the beltway continues, even now, to increase, not diminish. We also recognize that soon we will begin a new chapter in our efforts to educate and advocate for a single-payer national health program.
Source: PNHP's Blog
From PNHP
Fifty-nine members of the Harvard Medical School Class of 1959 are convinced that reform of the American health care system is essential, must be substantial and carefully designed, and must include a public health insurance option. Each of the signers has 50 years of experience and leadership in clinical practice, medical education, administration, and/or research. Our collective careers cover a wide variety of primary care and specialty fields in a range of organizational settings, in both private practice and academia, across the United States. Excluding a public option would throw away a vital opportunity to test different ways to provide quality care for all. A public plan would help develop and evaluate new standards of practice, malpractice reform, and reimbursement of physicians, and would emphasize preventive care. To be affordable, it would have to avoid financial incentives for unnecessary services and contain measures that curb financial abuse and waste by some hospitals and, unfortunately, by some of our medical colleagues.
A public option would also identify and encourage use of demonstrated best practices shown to be effective at less cost, offer greater access, and provide higher quality of care. Administrative overhead, as now in Medicare, would be significantly lower without for-profit intermediaries. These innovations could help lift the competitive burden that health care places on American employers in the global marketplace, while also offering portability and continuity of coverage during job changes and illness.
Common sense demands a planned, full comparison of the relative benefits of public vs. private options. At the outset, there must be clear and uniform ground rules for measuring, reporting, and evaluating cost, access, and quality of care for all plans.
We urge Congress and the President to take this courageous step at a vital time in our nation’s history.
From Bloomberg.com
Twenty-seven U.S. labor unions defied White House Chief of Staff Rahm Emanuel and announced their opposition to the $829 billion health-care measure passed yesterday by the Senate Finance Committee.
The unions say in a full-page newspaper advertisement today that lawmakers need to make "substantial" changes to the bill or they will urge their members to seek its defeat on the Senate floor. Emanuel asked organized labor not to go public in opposition, said Gerald McEntee, president of the American Federation of State, County and Municipal Employees.
"He told us that we really don't want to be looked upon as the group that stopped meaningful health-care reform," McEntee said in an interview yesterday. "We would love to be on the exact same page as the White House, but we see ourselves as fighting for our members."
From John Nichols at The Nation
So it is in the U.S. Senate, where the Finance Committee finally got around to finishing its health care reform assignment.
The vote on the measure -- which does not include a public option to hold insurance companies to account -- was 14-9, with all Democrats on the committee and Maine Republican Olympia Snowe voting Tuesday to toss the measure into the legislative sausage-grinder that will eventually produce final legislation for the Senate to consider.
The important thing to remember is that for all of Tuesday's attention to the finance committee vote, the full Senate will never vote on this particular measure.
Senate Health, Education, Labor and Pensions Committee chair Tom Harkin, D-Iowa, has said throughout the process that "the bill that (the Finance Committee) proposes is just that – a proposal."
Harkin is too polite to state the obvious: The Finance Committee proposal is no more likely to become law than the slacker student's last-to-be-handed-in homework assignment is to be awarded academic honors.
That's a good thing because the Finance Committee bill falls far short of real health care reform. It steers billions of taxpayer dollars into the accounts of insurance companies while failing to provide a realistic, humane or fiscally-responsible alternative to their profiteering. The problems with the Finance Committee's proposal extend far beyond the fact that it fails to establish a government-run alternative to compete with the private insurers that will be ridiculously enriched by it.
But the lack of a "public option" should make the Baucus bill a nonstarter. As insurance-industry insider turned whistleblower Wendell Potter explained in an advertisement produced by MoveOn.org, the Baucus bill would, if enacted effectively, "kill health reform."
"Take it from me," argues Potter, "the Senate Finance bill is a dream come true of the health insurance industry. If there is no public option insurance companies aren't going to change. The choice of a public health insurance option is the only way to keep insurance companies honest." Perhaps that is why the other four congressional committees that produced health-care reform bills – three in the House and the Senate Health, Education, Labor and Pensions (HELP) Committee -- have included far more robust language with regard to alternatives to for-profit insurance companies. It is Harkin, not Baucus, who is the serious health-care reformer in the Senate.
It is Harkin, not Baucus, who has consistently promoted the public option and who continues to argue that it can and will be a part of any final legislation. "Look," says Harkin, "five committees have reported a bill out on healthcare. Four of them have a public option. One doesn't. So you would think the weight would be on the side of having a public option in the bill – and that's where it is."
And it is Harkin, the chairman who gets his work done on time and right, that we should be paying attention to now that Baucus has finally finished his silly sideshow.
AHIP - the insurance industry, has funded a new study attacking the Senate Finance Committee health reform bill, claiming it will hike family premiums.
- The White House to then issued new talking points attacking the study as a “self serving” effort to defend its “profits."
- While the study seems to help reform foes, it actually makes a good case for Single-Payer or a Medicare like Public Option and should make it easier for Dems to cast opposition to reform as orchestrated by the insurance companies.
- Even some GOP aides are worried about this.
- Ezra Klein shreds the report on the facts, as does Jonathan Cohn who got MIT economist Jonathan Gruber to review AHIP's PriceWaterhouseCoopers report and says that the AHIP Claim on Benefits Tax is "Implausible".
msnbc.com reports:
The health insurance industry has been working until recently to help draft legislation, while publicly endorsing President Barack Obama's goal of affordable coverage for all Americans. The alliance has grown strained as legislation advances toward votes in Congress.
Late Sunday, the industry trade group America's Health Insurance Plans sent its member companies a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect. I think they make an excellent case for Single-Payer... Medicare For All:
Study: Premium increase
Premiums for a single person would go up by $600 more than would be the case without the legislation, the PricewaterhouseCoopers analysis concluded in the study commissioned by the insurance group.
"Several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company CEOs.
The study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.
But the PricewaterhouseCoopers analysis attempted to get at a different issue — costs for privately insured individuals.
It concluded that a combination of factors in the bill — and decisions by lawmakers as they amended it — would raise costs.
The chief reason, said the report, is a decision by lawmakers to weaken proposed penalties for failing to get health insurance. The bill would require insurers to take all applicants, doing away with denials for pre-existing health problems. In return, all Americans would be required to carry coverage, either through an employer or a government program, or by buying it themselves. Other factors leading to higher costs include a new tax on high-cost health insurance plans, cuts in Medicare payments to hospitals and doctors, and a series of new taxes on insurers and other health care industries, the report said. While I do believe the Insurance Industry through AHIP is being disingenuous with this report, it does still demonstrate how current plans under review are far more complicated and expensive than they need to be. We have a historic opportunity for members of Congress to go on the record in support of single-payer legislation and we should push for those votes. A significant of YES votes helps establish a benchmark so with healthcare reform returns for debate again - as it will given the plans offered - we won't have single payer taken off the table before then negotiations begin.
Note that the text in the above forms will need a bit of revising - which you are free to do and should do. I would also urge you to ask them to request that the Congressional Budget Office score HR-676. Let Congress and the public see where the real efficiencies are.
More Info on upcoming Single Payer votes here.
Industry representatives put Congress and the Obama administration on notice that if health-reform legislation doesn’t send even more new customers the industry’s way or if a windfall profits tax is included, the industry would hit businesses, individuals and the government with higher premiums, effectively defeating one of the initiative’s top goals, reining in ever-rising costs.
The industry’s chief complaint, which was raised in connection with an already-industry-friendly bill cobbled together by Senate Finance Committee chairman Max Baucus, is that the legislation would push 29 million more Americans into the insurance market, but that they might be the sickest and thus costliest people.
The industry wants more of the estimated 25 million still uninsured – especially healthy, young people – to be compelled to buy policies, too. Without more healthy customers added to the mix, the industry says it will have no choice but to raise rates. Read it all at Truthout
BILL MOYERS: You know from the news that early next week the Senate Finance Committee is expected to vote on its version of health care reform. And therein lies another story of money and politics.
Polls show the overwhelming majority of Americans favor a non-profit alternative -- like Medicare -- that would give the private health insurance industry some competition. But if so many Americans and the President himself want that public option, how come we're not getting one?
Because, the medicine has been poisoned from day one, in part because of that same revolving door that Congresswoman Kaptur and Simon Johnson were just talking about. Movers and shakers rotate between government and the lucrative private sector at a speed so dizzying they forget who they're working for.
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