Schumer seeks to avoid filibuster on health care reform

by: Jay Stevens

Tue Aug 04, 2009 at 12:37:32 PM MST

Senate Democrats won't hesitate to forgo bipartisanship to pass a health-overhaul bill if negotiations fail in the next month, Sen. Charles Schumer said Monday.

The New York Democrat, on a conference call with reporters, indicated that Democratic leaders are actively exploring options to pass the health bill that wouldn't require Republican votes. He pointed specifically to budget reconciliation, a parliamentary tactic that would allow passage of a bill with a simple majority, rather than the 60 votes generally required in the Senate.

Reconciliation is "clearly one of the contingencies on the table," Mr. Schumer said. "We want to get a bipartisan agreement, but if we don't, it's not going to stop us from moving forward with health care."

It essentially signals to Baucus and his five Finance pals, that they have other plans, plans that don't involve a filibuster (especially difficult to avoid because the Democrats really have only 58 votes). Not only don't Senate Democrats need Baucus' bill, they don't need his vote either.

Schumer's (not Kennedy!) been one of the biggest adversaries of Baucus in the Senate on health care reform. I suspect the longer Baucus takes with his bill, the more support Schumer gathers. In fact, it may already be too late...

Would Tester and Baucus filibuster reform?

by: Jay Stevens

Tue Aug 04, 2009 at 12:23:45 PM MST

U.S. Sen. Jon Tester said Friday in Bozeman he could support a controversial public option insurance plan as part of health care reform.

"If it's designed right," the Montana Democrat said. "The devil's in the details."

Any reform bill, Tester said, would have to control costs, improve access and affordability, improve people's health, focus on wellness and prevention, and preserve choice.

Tester said he'd like to cover the 46 million Americans with no health insurance, but, "we need to do it without running up the national debt."

There you go. Tester's promising us everything and nothing at the same time.

I know a lot of folks want Max and Jon to spearhead real (single-payer?) health care reform, but state politics and Baucus-ian electoral strategy dictates something else entirely. I expect professional strategists are urging them to tack "moderately" with an eye to Montana's political middle.

Whether that strategy is good or not is a moot point. What's not moot is that there are a few other Democratic Senators in the same situation. (Conrad, Nelson, etc.) The question for those politicians isn't, "do you support a public option," but "would you support a filibuster of a Democratic bill that included a public option?"

Become lobbyists for the public option

by: Jay Stevens

Fri Jul 31, 2009 at 14:40:04 PM MST

Embarassing Max and Jon at their fundraiser is nuts. This could just as easily be a Conrad Burns fundraiser and then where would we be?

However, getting 1000 activists to politely pay their $50 and go to the events and then to wear nice stickers that support either the Public Option or Single Payer Health Care, while making nice, and talking to Jon and Max, and eating the excellent barbecue they always serve would make great sense.

Of course, the fact that about a thousand constituents made their fundraiser a roaring success because they supported a public option would certainly have an impact wouldn't it?

Oh, and I have stickers to distribute. They say,

"A Public Option Lets U.S. Work."

A nice reminder that there's another option besides confrontation that might sway or influence our Senators. (And I've argue that protests are often counter-productive.) After all, it's hard to argue with a 1,000 public-option supporters who show up for your fundraiser...

After all, if they're beholden to lobbyists as their critics maintain, wouldn't it make sense to become lobbyists?

You could probably still bring your stilts and puppet suits.

The political price of opposing a public option

by: Jay Stevens

Thu Jul 30, 2009 at 13:13:14 PM MST

In an apparent warning to Senate Finance Committee Chairman Max Baucus (D-Mont.), some liberal Democrats have suggested a secret-ballot vote every two years on whether or not to strip committee chairmen of their gavels.

Baucus, who is more conservative than most of the Democratic Conference, has frustrated many of his liberal colleagues by negotiating for weeks with Republicans over healthcare reform without producing a bill or even much detail about the policies he is considering.

"Every two years the caucus could have a secret ballot on whether a chairman should continue, yes or no," said Sen. Tom Harkin (D-Iowa), the chairman of the Senate Agriculture Committee. "If the 'no's win, [the chairman's] out.

"I've heard it talked about before," he added.

I'm absolutely, 100-percent with Kos when he writes that it's "time to end the tyranny of the long-serving chairmanships." Committees are the largely unseen roadblocks to good legislation that makes the already conservative essence of Congress all the more conservative. It's a kind of sinecure, where a chair can be sure to squeeze out legislation friendly to his backers for votes on the floor.

Will it happen? There's nothing more sacred in the Senate than seniority, where plum assignments are handed out purely on the basis of Senate longevity. I guess you could argue that this method discourages the doling out of pork and projects to fellow representatives to win committee chairs - like in the House - but on the other hand, it also discourages any accountability. And that's exactly why this isn't likely to happen. That's one of the goals of the Senate - to reach a point where they don't have to worry about elections anymore.

Still, one can dream, can't he? In any case, it's good to see Senate Democrats beginning to stir.

Taking the fight to Max Baucus; action alert!

by: Jacques

Thu Jul 30, 2009 at 02:33:39 AM MST

Remember: it's also not too late to protest "Camp Baucus," too... - promoted by Jay Stevens)

From Orange Satan diarist engine17

We are in a war and the other side just invited us to conduct highly effective offensive ground operations literally on their front lawn. We must evaluate if the resources necessary to conduct that operation are worth the likely benefits.

It's not the uninsured, stupid

by: Jay Stevens

Tue Jul 28, 2009 at 21:49:38 PM MST

But it's also worth offering a more general reality check here: The public option is not now, and has not ever, been the core of the argument for heath-care reform. It is the core of the fight in Washington, D.C. It is an important policy experiment. But it was not in Howard Dean or John Kerry or Dick Gephardt's plans, and reformers supported those. It was not in Bill Clinton's proposal, and most lament the death of that. It is not what politicians were using in their speeches five years ago. It is a recent addition to the debate, and a good one. But it is not the reason were are having this debate.

Rather, what has kept health-care reform at the forefront of liberal politics for decades is moral outrage that 47 million of our friends and neighbors are uninsured. That medical costs are one of the leading causes of bankruptcy in the United States. That an unemployed machinist gets screwed by fly-by-night insurance schemes while a comfortably employed banker need never worry. That the working class ends up in emergency rooms with crushing chest pains because they didn't have health insurance and didn't get prescribed cheap blood pressure medications five years before.

Klein's exactly right in saying that finding a way to insure the uninsured is the ultimate goal for health-care reform...in Congress.

So, in DC, we've got politicians figuring out how to insure the uninsured. Right now, it's essentially by subsidizing premiums for those that can't afford it. Unfortunately, most of those without insurance, and who want it, probably still wouldn't be able to buy insurance, even with subsidies. Most folks in that category have preexisting health conditions or are at or near poverty levels; no insurer would take them. So Congress is pushing a community rating - essentially prohibiting insurers to refuse to discriminate in pricing or coverage folks with preexisting medical conditions. Unfortunately instituting a community rating means that insurance premiums will go up - insurers will now have to pay claims for people who are sick. So Congress is pushing mandatory insurance, to compel those without insurance and who don't want it - the young and healthy - to buy it, thus having healthy folks essentially cover the costs of insuring the sick.

But is that what's really driving this latest push for health care? Is that what millions cheered for when Obama promised them health care reform? Health care for all? Or is there some deeper dissatisfaction - the denied claims, the high deductibles, the byzantine paperwork - behind the push, creating this dissonance between DC and the heartland over the issue? I'd argue yes. Americans hate the way they pay for their health care.

Basically I think Congress - and Ezra Klein? - has got the premise of health care reform all wrong.

An Idea for Max Baucus

by: Heartland1

Sun Jul 26, 2009 at 09:16:26 AM MST

Max,

Here's an idea for dealing with one of the vexing problems with the health insurance business:  Recision.

Your reform proposal should stipulate that:  (A) If an H.I. Company opts to rescind a policy, then that company needs to return premiums paid, with the prevailing rate of interest for as long as the consumer paid  premiums, back to a maximum period of 5 years from the date of the proposed recision. (B)  Claims paid over that period are not deductible from the recision penalty .

This stipulation will make the company think twice about the short term profit they can make using this process, at the expense of a consumer who's paid premium in good faith for any number of years.

It will also prevent H.I. Companies from fraudulently accepting payments from consumers they may flag for recision from day one.

It will give consumers a pot of cash to deal with the catastrophic health care needs that usually prompt an H.I. company to rescind a policy.

And finally, the policy must remain fully in effect until the recision penalty is paid in full.

It's just a good idea.

But an even better idea is a government-run public option that takes the profit incentive away from those H.I. companies standing between me and my doctor.  I need health care, NOT health "Insurance".  Health insurance doesn't buy a dime's worth of health care .  I would hope you would structure the public option in a way that will eventually steer the country toward single-payer health care over, say, a ten-year transition period.  H. I. companies are not an "industry".  Building cars, trains, farming, and creative endeavours are industries.  H.I. is an anchor that produces nothing.

Sincerely,

Jeff Shelden

Read It, Congressman. Or Don't Vote.

by: Matt Singer

Thu Jul 23, 2009 at 10:35:26 AM MST

Pogie asks a good question: is Congressman Rehberg comfortable voting against the bill if he hasn't read it in its entirety?

Here's what I want to see: a video of our Congressman personally reading the complete bill.

Even better would be some kind of statement from the Congressman of what he will vote for. Montanans want to see health care reformed. Unlike our Representative, who is one of the richest members of Congress, a lot of folks here can't afford more delay and denial of fixing this system.

So put up, Congressman, and either pledge to read the full bill before voting either way or just come out and be honest with us -- you're with Senator DeMint's strategy of opposing reform at all costs.

Why take the money, Senator?

by: Jay Stevens

Tue Jul 21, 2009 at 09:43:25 AM MST

Imagine that Baucus is, at best, bemused by the lobbyists and corporate chieftains autographing checks in a futile effort to purchase his affections. Why let them? Baucus is from Montana. It's one of the smallest states in the country. It has a cheap media market. And Baucus -- who faced no serious competition in his last campaign -- isn't up for reelection until 2014.

Baucus could have shut off his fundraising operation and avoided the appearance of any and all impropriety. Instead, on June 10, he held his "annual fly-fishing and golfing weekend in Big Sky, Mont., for a minimum donation of $2,500." Sometime this month he'll preside over "Camp Baucus," a "trip for the whole family" that touts horseback riding and hiking on the list of activities. The problem with this is not that it necessarily influences Baucus's thinking on health-care reform. It's that all this industry money reduces his credibility to make necessary concessions and hard decisions. And there's no reason for it. He doesn't need the money.

I will say that Klein is asking this completely out of context, as if Baucus hadn't been in office since 1978 and survived several close challenges and a long, dark conservative shift in state politics.

The Choices We Face

by: Matt Singer

Mon Jul 20, 2009 at 19:42:37 PM MST

I mean, I'll take it as granted that Pat Williams might be, like me, a malleable sell-out scoundrel. He might also be Montana's most progressive lawmaker of the modern era. Potato, potahto.

Since writing about the forest bill, I've gotten a couple notes and had conversations with people very familiar with the forest bill's content and the process behind it. My understanding is that the "talkers" of the critics are either deeply misleading or, in some cases, just not true.

I've been struck during this process how amazingly similar the health care, global warming, and forest debates are. With health care, the question is private/public or single-payer. With global warming, the question is cap-and-trade or carbon tax. With forest, the question is Tester bill or complete wilderness protection.

Except those really are all fake choices that really say that the choice is private/public or nothing, cap-and-trade or nothing, the Tester bill or nothing.

Perfect: enemy of the good.

Again, this isn't to say that there aren't devils in the details to focus on, but the question at this point for much of the left is whether we're ever going to take yes for an answer.

The health care bills under consideration institute important insurance regulations like community rating and guaranteed issue, subsidize coverage for low-income families, ease purchasing through exchanges, and (hopefully) bend the cost curve over the long-term.

Cap and trade actually worked better than anticipated when instituted for sulfur dioxide and, while imperfect, will reduce carbon output in this country. Action by the U.S. will help stoke other nations to take steps as well, creating a positive feedback loop.

I still know less about this forest bill, but so far the voices I trust on lands management and conservation are increasingly telling me thumbs up on the bill.

While reading up on Steve Kelly's, let's say quixotic, run against Pat Williams in '94, I came across this piece. Interestingly, the piece basically recounts how efforts to shore up Williams' left flank also resulted in Williams moving to the right to prove his independence from the Clinton White House. Some of the quotes are marvelous, though:

With progressive
congressmen like this, Kelly asked, who misses the likes of Ron Marlenee?

[...]

"The Clinton administration was retreating from its campaign pledges to protect our public lands and Pat Williams played a key role in pushing them in that direction," Kelly told me. "Williams repeatedly voted against mining reform, grazing reform and measures to end subsidies to multinational timber companies. Worst of all, from my point of view here in Bozeman, Williams sponsored anti-wilderness legislation that condemns 4 million acres in Montana to logging and mining. Cy Jaminson's record spoke for itself. He never pretended to be anything but what he was: a voice for pillage."

[...]

"If these independent political campaigns cause some conservative Republicans to get elected, well at least we don't have to guess where they are on an issue," said Larry Tuttle, director of the Portland-based Center for Environmental Equity. "Frankly, when it comes to changing the incentives that lead to environmental destruction, evironmentalists often have more in common with the National Taxpayers Union than with many incumbent Democrats."

I'm not interested in walking down that path. So, yeah, call me malleable.

A (Mostly) Meaningless Post on Health Care

by: Matt Singer

Sat Jul 18, 2009 at 12:02:07 PM MST

If we're serious over the long-term about health, cost reduction, and financial security, some mix of

1. universally provided (and heavily pushed) primary care through a NHS model
2. HSAs funded through refundable tax credits with auto-deposits into retirement accounts if money is unused and
3. a single-payer high deductible insurance system that insures everyone against financial ruin in the face of accidents.

Of course, I haven't really thought through how this system would integrate with the ideas of health homes and other innovations beyond the fee-for-service structure that we're now discussing. It is possible (and quite believable) that the bills being discussed in Congress are better than this little system that I dreamed up at the age of 22.

As noted above, my opinion doesn't mean much, so I'll keep advocating for the Baucus/Obama/Kennedy/House framework that also strikes me as pretty smart, just as I would probably be advocating for single-payer if it had the momentum right now. Mark T called me malleable in comments as though it was an insult. I'm taking it as a compliment.

Scoring the House health care bill

by: Jay Stevens

Fri Jul 17, 2009 at 16:22:42 PM MST

Here's the shorter version: the CBO found there'd be no net cost savings from the legislation, but that's in part a result of not making the public option available to many, as well as some other measures, including not capping tax credits for those holding employer-based health insurance.

Of the two points, guess which one Senator Baucus seized upon?

Curiously, Ezra Klein brings up Senator Ron Wyden's "Free Choice Act" as the possible savior of health care reform, which would essentially throw open the health insurance exchange - and access to a public option - to everybody.

I've spoken out against the cap on health insurance benefits before, but I'd gladly trade it for what Wyden's offering.

Thoughts?

The CBO scores the public option...

by: Jay Stevens

Sat Jul 11, 2009 at 06:49:20 AM MST

According to a pair of Capitol Hill sources, preliminary estimates from the Congressional Budget Office suggest that a strong public option--the kind that the House of Representatives is putting in its reform bill--should net somewhere in the neighborhood of $150 billion in savings over ten years.

Let's see. A strong public option is wildly popular...and it would actually raise revenue? Something tells me though that Republicans and conservative Democrats will still oppose it...

Will Walmart live up to their PR on Health Care this time?

by: WakeUpWalmart

Fri Jul 10, 2009 at 12:11:52 PM MST

There has been a lot of talk this week about the surprising move by Walmart to publically support President Obama’s health care reform plan, supposedly positioning themselves as a leader in the fight to bring health care to all Americans. As we mentioned in a post on our blog yesterday, this might be easier to swallow if Walmart had any history of leading by example. Instead, they usually do just the opposite.

Given Walmart’s long record of trying to build a positive reputation on ineffective work-arounds to health care coverage for employee, the recent revelations about sacrificing quality for cheap perescription drugs, and their deceptive PR campaign that severely overstated their workers’ health care coverage, it’s not hard to understand our skepticism. [get the details in the extended entry]

Win by winning

by: Jay Stevens

Thu Jul 09, 2009 at 12:27:17 PM MST

Reporting from Waukon, Iowa -- One is a thrifty soybean farmer from Iowa with a penchant for righteous speeches about government waste. The other is a Stanford-educated lawyer from a Montana ranching family who looks uncomfortable leading a debate.

Despite more than 60 years in Congress between them, Charles E. Grassley, the Iowa Republican, and Max Baucus, the Montana Democrat, are outsiders -- loners whose independent streaks make colleagues wary, sometimes even mistrustful.

But unlikely as it may seem, the partnership between these two slightly eccentric men may hold the key to overhauling the nation's sprawling healthcare system -- a legislative grail that has eluded the giants of the Senate for more than half a century.

In the face of strident criticism from colleagues in both parties, Baucus (chairman of the Senate Finance Committee) and Grassley (the panel's senior Republican) are laboring to fashion a series of compromises on healthcare that might win the support of a bipartisan majority on Capitol Hill.

(A) There will be no bipartisanship on health care reform, because the Republican party's goal is to sabotage any and all reform. I'm am completely flabbergasted by Baucus' continued attempts to rope Grassley into the process. It...will...not...happen.

(B) The report kept mentioning the "middle ground" in health care. Let's be frank. A fully accessible and robust public option for health insurance is the "middle ground" - among the American people. The "middle ground" batted so casually around here is the ground between right-wing Republicans and pro-corporate Democrats.

When this happens -

Senate Majority Leader Harry Reid (D-Nev.) on Tuesday ordered Finance Chairman Max Baucus (D-Mont.) to drop a proposal to tax health benefits and stop chasing Republican votes on a massive health care reform bill.

- you know you're really banging your head against a brick wall. I mean, it's not as if Harry Reid has been aggressively progressive on this issue...or any other issue for that matter.

A lot of folks who dislike Max Baucus' stance on health care often cite the amount of money our Senator receives from health care industries. I don't think it's the money. I think Baucus was being honest during his interview with John Adams when he said, "Money means nothing to me. I pay no attention to campaign contributions. Nothing. Makes no difference." I think it's who he talks to.

From the Sunlight Foundation:

Lobbying disclosure filings for the first quarter of 2009 reveal that five of Baucus' former staffers currently work for a total of twenty-seven different organizations that are either in the health care or insurance sector or have a noted interest in the outcome. The organizations represented include some of the top lobbying organizations in the health sector: Pharmaceutical Manufacturers and Researchers of America (PhRMA), America's Health Insurance Plans (AHIP), Amgen, and GE Health Care.

The former staffers turned lobbyists include two former chiefs of staff, David Castagnetti and Jeff Forbes, and one former legislative assistant, Scott Olsen. Other former staffers working with health care portfolios include Angela Hoffman and Roger Blauwet.

The murky world of Washington is filled with enemies and lunatics, and I suspect those our lawmakers trust most are those people who have worked with them down in the trenches of political warfare, during their toughest times. The staffers. And these people are very bright, and they know a lot about issues, probably more than Baucus himself does. So when they come a-knockin', Baucus listens.

And I suspect that's why the "middle ground" is staked out on some barren turf, far, far from where everyday Americans stand on the issue.

Ironically, one of the reasons politicians like Baucus listen to these lobbyists and pursue the "middle ground" is that they're constantly running scared, looking over their shoulders at critics and always anticipating the next election. In Baucus' case - who's been in office since the 1970s and survived the long, long Republican infestation of Montana - that's doubly so. Staking out the "middle," thwarting progressives and appeasing business has been a staple in the Senator's electioneering playbook. And to be fair to his political strategists, it's been a winning formula.

But now there's health care. And Baucus is suddenly a prominent national figure for reform. He's getting a lot of attention, and he's setting himself up to be the one held responsible for whatever comes out of reform. He has a couple of options, as I see it, before him:

- He can fight for the kind of reform most Americans want. That is a public/private model of insurance with a robust public option available to all. Call this, "giving us what we want."

- He can compromise with private insurers, and create a system that accounts for the uninsured, has some minor progressive reforms that dull the edge of the current system, and implement policies to reduce, or slow, health care costs, and ensure that Americans don't feel much bite in the form of higher taxes. Call this, "fixing leaks without pain."

Based on this Ezra Klein post, and what I know about Baucus' plan, I'm guessing he's trying for the latter. No surprise: it's cautious and "moderate."

But the thing is, we're in a crisis. People are miserable. They hate the way they pay for health care. If most people are untouched by reform, reform will be seen as a bust. If you're cautious and "moderate" on this issue, you will be seen as a failure.

This is one of the rare political issues where you can't win by not losing.

The public option has to be available

by: Jay Stevens

Tue Jul 07, 2009 at 07:59:06 AM MST

Mr. Emanuel said one of several ways to meet President Barack Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.

Mr. Obama has pushed hard for a vigorous public option. But he has also said he won't draw a "line in the sand" over this point.

Obviously, the trigger option is just another way of denying a public option. No one here believes the legislation for the trigger won't include the usual language and loopholes that will allow the insurance industry to essentially continue to operate as usual and indefinitely. Worse still, if legislation containing a trigger were combined with mandatory coverage, it'll be a boondoggle for private insurers.

Senator Schumer, on the other hand, said, "Make no mistake about it, the president is for this strongly. There will be a public option in the final bill." Of course, as to what form a public option will take is of paramount importance...

In response to the outrage over the threat to the public opion, Ezra Klein opines that the public option may be a distraction:

But [the public option] has captured the process. Its existence, or lack thereof, is how the left and right are both benchmarking their success. The only problem is that it's not necessarily a very good benchmark. The left may win a political victory by including it in the policy but find that it hasn't won a particularly large substantive victory at all. The right could give up a lot to block the public plan only to find their concessions worth more than their triumph.

In the post (which you should read), Klein identifies five elements of reform that "deserve a lot more specific attention than they're receiving." Among them is the "health insurance exchange." Klein explained it in an earlier post:

The central problem facing health reformers is a simple one: America's health-care system is a mess. But a lot of people rely on it very heavily. But how do you merge the need for root-and-branch reform with the public's fear of rapid change?

The answer, put simply, is that you don't institute rapid change. You don't take what people have. But you give them the option to trade up to something better. As the theory goes, if the current system really is so inefficient, and your alternative really is so much better, then the lure of lower costs and better quality will persuade Americans to switch to the new system of their own accord.

This was a little-noticed wrinkle in President Obama's speech to the American Medical Association yesterday. Traditionally, reformers promise that if you like what you have, you'll be able to keep it. Obama echoed that vow. But he also said that "if you don't like your health coverage or don't have any insurance, you will have a chance to take part in what we're calling a Health Insurance Exchange." That is, in effect, the opposite promise: If you don't like what you have, you'll be able to change it.

The vehicle for that promise is the Health Insurance Exchange.

Basically, it's in the exchange where we'd be able to purchase public insurance. Then it follows that the qualification for participating in the exchange is important. Allowing everybody to participate seems logical, and would no doubt be politically popular. After all, you'd be simply giving everyone more options for health insurance: a no-brainer, right?

But the numbers I've heard so far - and sorry, I can't find a link - imply that not so many folks will qualify for the exchange. You have to unemployed or have your employer-based coverage cost a certain percentage of your pay. (Twelve percent?) Which means that most of us would be stuck with the "coverage" we already have.

So not only do we need a robust public option, we need it to be available to all...

Franken's victory means no more excuses

by: Jay Stevens

Thu Jul 02, 2009 at 09:59:36 AM MST

Not so fast:

The persistent absences of two veteran Democratic senators because of serious illness, the varied ideological makeup of the Democratic caucus and the willingness of individual senators to break with the party if they do not get their legislative way make the new mathematical might of the Democrats a bit illusory.

"We have 60 votes on paper," Senator Harry Reid, the majority leader, said Wednesday in an interview. "But we cannot bulldoze anybody; it doesn't work that way. My caucus doesn't allow it. And we have a very diverse group of senators philosophically. I am not this morning suddenly flexing my muscles."

I call bullsh*t! Kos:

But for a party and a majority leader that has been whining that it can't get anything done because it doesn't have 60 votes -- well, now it does. In other words, that excuse is now laid bare. I mean, remember how we had to be nice to Joe Lieberman because he got us closer to 60? We laughed at that logic because he didn't get us closer to shit. He would still vote with Republicans half the time, whether inside our caucus or outside it.

So yeah, I know that the "60" mark is arbitrary, and like I said in that MSNBC appearance, a new invention since it didn't exist in the Bush years. In fact, no one has promoted that notion more than Harry Reid himself, afraid to be held accountable for the actions of his caucus. Well, he's no longer got cover. Any failures from here on out will be at his feet, and his feet alone.

Right now, of course, Democrats own health-care reform. If it fails, they lose. If it passes, but it's watered down, and it doesn't fix at least some of the problems everyday Americans are experiencing with their health care insurance, they lose.

Kevin Drum:

The key to healthcare reform is that it be popular with the public. The Medicare prescription bill, for example, was generally popular because it provided a clear and concrete benefit. Broader healthcare reform, however, is going to have a harder time. If there's no public option, for example, and most people simply keep the employer-based healthcare they already have, then what's the selling point? Most people will just see higher taxes funding better coverage for the poor, and you don't have to be the world's biggest cynic to understand that this isn't going to be overwhelmingly popular. Helping the poor is all well and good, but like it or not, most of us want to know what's in it for ourselves if our taxes are going up. That's just life.

Right now, we're running the risk that the answer is "not much." Healthcare reform needs a little more obvious sizzle if it's going to survive the coming tsunami of conservative agitprop, and the bills wending their way through Congress don't have much of that left...

Just a reminder to Democrats everywhere. Yes, it's sporting to find a "bipartisan" solution - but then the Republican party's strategy to make you fail. Yes, it's quite popular with newspapers to appear as a "moderate" by working with major institutions, like the health-insurance and health-care industries. Yes, I know you're always running scared, thinking about the next election, thinking about what your Republican opponent is going to say about you. But the bottom line is, you must pass health-care reform that's effective and meaningful for everybody.

Or else you'll lose.

You've now got the means. Use it, even if you have to bloody your knuckles to do so.

We need health care coverage, not more insurance

by: Jay Stevens

Wed Jul 01, 2009 at 07:44:31 AM MST

Health insurance is supposed to offer protection - both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.

And so, even as Washington tries to cover the tens of millions of Americans without medical insurance, many health policy experts say simply giving everyone an insurance card will not be enough to fix what is wrong with the system.

As anyone who's ever held an insurance policy knows, having insurance isn't the same thing as having coverage.

There are those that don't realize this, like our state's only representative, Dennis Rehberg, who believes the problem with health care is limited to about 8 million Americans who don't have insurance. But then, if you're a multi-millionaire real estate developer with a nifty government-provided health insurance plan, your ignorance isn't all that surprising.

Me, then:

In essence, those that repeat the mantra, "single-payer, single-payer," are aware there's a difference between universal health care insurance and universal health care coverage, that a solution that gives the private insurance and pharmaceutical industries a leading role may not solve the problems we experience with health care. Will we still be bombarded with denial-of-claim slips every time we see a doctor? Will "pre-existing conditions" follow us to our graves? Will general practitioners still be driven out of business by the byzantine administrative requirements of insurers? Will we still have to work that crap desk job for that multinational corporation to keep our insurance? Will the insurers continue to abandon their promises in our times of greatest need?

Yes, it's fine that Congress is seeking to extend health care coverage to the uninsured. Yes, it's fine we're talking about health care exchanges that would allow consumers to buy the best coverage available at the best price. Yes, it's swell that Congress is looking at ways to reduce the cost of health care. But a health-care reform bill that doesn't directly address the pitfalls of private insurance and guarantees that insurance translates into coverage is a bill that doesn't address our nation's health-care crisis.

McDonald backs single-payer health insurance

by: Jay Stevens

Mon Jun 29, 2009 at 18:32:56 PM MST

US Congressional candidate Dennis McDonald is today announcing his support for a single-payer health care plan. Over 100 million Americans are uninsured or underinsured, and when coupled with the high costs of health care it is clear that we can delay no longer in enacting comprehensive health care reform.

There is overwhelming public support for a single payer plan here in America. And as families continue to struggle financially across Montana, providing relief from high health care costs is a priority for McDonald.

One of the complaints (and rightfully so) of single-payer advocates is that single-payer health care is popular among Americans. Well, here's their chance to put that idea to the test: a single-payer candidate.

That position, of course, is in stark contrast to the incumbent, Dennis Rehberg's, who not only opposes any meaningful health care reform, but thinks the health care crisis is limited to about 1 in 50 Americans. (Maybe it is limited to 1 in 50 multi-millionaire real estate developers.)

I'm curious to see Tyler Gernant's reaction to this news. If Germant plays it cool, and doesn't endorse single-payer health care, this could be the big issue in the primary...

The Real Bipartisanship of Healthcare Reform

by: Matt Singer

Mon Jun 29, 2009 at 06:13:36 AM MST

Fortunately, there are indications that at least here in Montana, some of that beltway partisanship can be put aside. Look no further than Bob Brown's op-ed this morning for proof. I've tried excerpting it, but it just doesn't work that way. Go read the whole piece.

The statewide town hall that is being co-sponsored by a bunch of groups tonight, including Forward Montana, American Cancer Society Cancer Action Network, SEIU, and others, has Republican Sen. John Brueggeman as Master of Ceremonies.

And here's the thing -- I am nearly positive John and Bob and I don't see eye-to-eye on all of the elements of what should happen. But there's a fundamental reasonableness still present that makes quite a bit of difference.

The other bit of difference is life experience. Bob Brown relates a story of his perspective as a teacher watching hard-working independent contractors who lacked his employer and his union. John Brueggeman is someone who has worked union and also squeezed out a living self-employed. They're also not stupid. And, at some point, if you've seen how radically different the system treats two similarly hard-working people in different lines of work, you start to wonder just who created such absurdities.

I'm rambling now, but I want to applaud Bob Brown for standing up on this issue. Bucking your own party involves inviting some criticism (something Max Baucus knows well himself). But there is a time and place for political courage. And if ever there was a fight where we needed some courageous Republicans to buck their party in high-profile ways, it is in this fight for health care reform.

So a big thanks, Bob -- this kid from Billings thinks you done good.