The truth is that opposition to this bill from the right is not inspired by or supported by the insurance industry, despite all of the accusations. It comes primarily from grassroots consumer groups and individuals who are as concerned about monopolies and corporate greed as they are about the inefficiency and corruption of government managed programs like Medicare and Medicaid. They realize that the source of the monopolization which unbalances and ultimately destroys free markets is almost always government regulation and government's desire to interfere with certain key industries and make the way that they operate more like government itself. The health care and insurance industries have been so heavily regulated on a state and federal level that they have ceased to exist in anything resembling a free market; market forces have been replaced with government mandates and bureaucratic procedures which they have been forced to rely on instead of good business practices because so much of their revenue is dependent on government authorization or direct payment from the government.
The core problem with the health care bill which ought to be enraging the left, but which they seem incapable of seeing, is the idea of mandated insurance, which has been in every version of the bill proposed because it is actively supported by President Obama. This mandate forces as many as 40 million people who are uninsured by choice to purchase health insurance which they can barely afford from private insurance companies under terms dictated by the government. Private insurers aren't opposing this, they're quietly cheering for it in the background and their allies in Big Pharma and their bought-and-paid-for shills in the American Medical Association are right there with them. These mandates will take more than $200 billion a year out of the pockets of the middle class and working poor and hand it with a bow on it directly to a small group of insurance companies who would rather work with government for a sure profit than operate in a free market which demands efficiency and quality service.
This takes choice and control away from consumers, makes the insurance companies answerable to the government instead of their customers, and will lead to less efficiency and even lower quality care, because the demands of government which has the deep pockets of deficits and raising taxes will never be as onerous for those companies as servicing the demands of customers in a free market would be.
Article comments
— go to most recent comments1 - Jeanne Browne
Dave, I agree with some although not all of what you say, and your question is a legitimate and important one.
My core disagreement is with the idea that The Market is the solution to almost any problem and that government involvement in nearly anything is, by nature, a bad idea.
However, I agree with you wholeheartedly when it comes to your central question: Why isn't the Left more angry? I'm a Leftie and I'm royally pissed off -- but it's become very difficult to explain what we're angry about and get that message across.
For example, I have no problem with the concept of "socialized medicine" as the Right defines it. But I have a HUGE problem with all of the actual legislation put forth to date. That original 1,000-page thing was a complete mess that almost nobody could read and even fewer understood. And this new Baucus bill is an outrage in the way it panders to the insurance companies and their related special interests.
Just today, I received a survey from Organizing for America/the DNC. The questions ask us to rate the President's "performance" on health care reform, energy policy, foreign policy. etc., and the answer options range from "excellent" to "undecided."
I'm not sure what to do with this survey, because it's asking the wrong questions and providing a selection of inadequate answers. What this survey doesn't allow us to express is that we approve overall of the President's "performance": his cool under pressure, his direct and ongoing communication with the media and the people, his willingness to move forward with difficult initiatives, his consistent civility and sincere efforts to achieve bipartisan cooperation, and many such aspects of manner, approach and leadership.
But I disagree, strongly, with many of his specific policies. I think we should be getting out of Iraq faster and more forcefully. I think we should get out of Afghanistan immediately and entirely; we can do no good there. I think the climate change bill was a useless joke. I think health care reform should be handled in stages, starting with the things that basically everyone can live with (no denial of coverage based on pre-existing conditions, no dumping sick people from their plans because they actually got sick, no punishment via increased premiums for employers or individuals who use the plans, a must for coverage of preventive care -- things like that).
Personally, I wish the President had just put forth a Medicare For All plan and demonstrated how Medicare would be cleaned up, cleaned out and streamlined to do the job well. I wish he'd put the useless, predatory, middle-men-insurance companies out of business and let health care be a direct matter between health care providers and patients. I do not believe that health should be a profit-making industry.
In general, I wish the President were more Left than Centrist, that he was not maintaining/repeating some of the worst aspects of the Bush administration. I wish he hadn't agreed to the original bailout before he was elected and that he hadn't compounded that act with further bailouts. I wish he'd give up on bipartisanship and just use the power he and the Congress have to put forth a new agenda. In short, I wish he'd do all the things that would probably make your head explode.
But my comrades on the so-called Left are tired, and they're confused. They want to be supportive of a President they admire, even though they're definitely unhappy with the specifics of many policies. And while he's being so vehemently attacked by the Right, they don't want to create a demoralizing climate by attacking him from the other side. Besides -- and this is most important -- the nuanced objections of the Left are hard to condense on demonstration placards and 30-second media sound bites.
President Obama has been at the helm for a mere nine months. But because we live in a high-tech age where his every move is noted in real time, he has a thankless task. How can anyone lead in a 24-hour news cycle? And in a media environment with a blood-thirst for controversy, how do supporters voice their concerns without being portrayed as disloyal?
It's all very complicated and there are no easy answers to any of today's difficult and very legitimate questions -- including yours.
2 - handyguy
Amid the customary distortions, fact-twisting, and carefully masked half-truths, all very typical of Mr. Nalle's propaganda, is this gem:
Excessive regulation always leads to a reduction in competition and the creation of monopolies.
Oh indeed? Do tell. Are you inventing a new economics theory imported from Planet Pluto?
At any rate, the Baucus bill is a starting point for debate, not a finished product. There will be more subsidies and lower penalties to reduce the mandate's burden on the middle class. The mandate could catch some folks in a dilemma, but many [liberal and moderate] senators are already making a lot of noise about that possibility and demanding changes. [This will make the bill more expensive, which may be inevitable.]
And the largest group of people will continue to get insurance through their employer, just like now.
The point of the much abused 'public option' was to compete with private insurers on price as a brake on costs. You may expect to see Olympia Snowe's adaptation of this, a public option trigger that goes into effect only if insurers fail to meet affordability and coverage targets, in the final bill.
The 'giveaway' to the insurance industry comes with a big consequence for them: it is virtually certain that 'pre-existing conditions,' lifetime coverage caps, and insurers dropping people when they get 'too sick' will all become a part of the past.
Leftists and liberals and progressives don't all want exactly the same thing, and we want the president to succeed; that has muted some disappointed reaction to some policies.
And most of us find Obama a highly intelligent, highly honorable man with a very sharp set of advisers. His policies have been caricatured to an extent beyond belief. Some of the public may have bought into these caricatures, but I believe that is leveling off. Even Rasmussen now finds Obama's favorable rating higher than his disapproval rating. The Real Clear Politics average is 52% approval and 42% disapproval, about the same for more than a month now.
Yet as recently as this evening, Rush Limbaugh was saying on Jay Leno [!] that Obama's numbers are 'plummeting.'
3 - Dave Nalle
Excessive regulation always leads to a reduction in competition and the creation of monopolies.
Oh indeed? Do tell. Are you inventing a new economics theory imported from Planet Pluto?
Actually, from Planet Friedman and Planet Laffer, but I'm sure they're as far away from you as Pluto which you still seem to think is a planet.
At any rate, the Baucus bill is a starting point for debate, not a finished product. There will be more subsidies and lower penalties to reduce the mandate's burden on the middle class. The mandate could catch some folks in a dilemma, but many [liberal and moderate] senators are already making a lot of noise about that possibility and demanding changes. [This will make the bill more expensive, which may be inevitable.]
Listen. While the cost of the mandates is onerous, it is the idea of the mandate which is the problem. It is the massive subsidy to monopolistic fat cats which it creates which ought to have you up in arms. Does the charm of Obama just turn off your rational faculties altogether?
And the largest group of people will continue to get insurance through their employer, just like now.
Which is the other side of the coin of bad policy which no one is addressing. Forcing people into group plans through their employers is one of the things which has led to monopolization, inflated prices and poor service.
The point of the much abused 'public option' was to compete with private insurers on price as a brake on costs. You may expect to see Olympia Snowe's adaptation of this, a public option trigger that goes into effect only if insurers fail to meet affordability and coverage targets, in the final bill.
The public option is meaningless. Insurance companies are already so tied in to government regulation that they are the public option, and they certainly will be after this goes through.
The 'giveaway' to the insurance industry comes with a big consequence for them: it is virtually certain that 'pre-existing conditions,' lifetime coverage caps, and insurers dropping people when they get 'too sick' will all become a part of the past.
Which, again, will limit choice, limit competition and raise costs. Only the insurers willing to make a set profit under the terms set by government will remain in the business, and government will set costs based on the demands of those few monopolies not on real world considerations.
Leftists and liberals and progressives don't all want exactly the same thing, and we want the president to succeed; that has muted some disappointed reaction to some policies.
But what you are supporting in this case out of blind partisanship is inherently extremely illiberal and a disaster for the nation.
And most of us find Obama a highly intelligent, highly honorable man with a very sharp set of advisers.
Who are resigning over amateurish gaffes and issues in their background which should ahve disqualified them from any public office.
His policies have been caricatured to an extent beyond belief.
There is no caricaturing in this article. Obama has unequivocally suppoted and even demanded the mandates, end of story.
Some of the public may have bought into these caricatures, but I believe that is leveling off. Even Rasmussen now finds Obama's favorable rating higher than his disapproval rating. The Real Clear Politics average is 52% approval and 42% disapproval, about the same for more than a month now.
Yes, Obama remains personally popular, but the popularity of his policies, especially healthcare, is dropping fast, because people who are not blinded by partisanship can see through this plan to the disaster it represents for our future.
Yet as recently as this evening, Rush Limbaugh was saying on Jay Leno [!] that Obama's numbers are 'plummeting.'
Why do you think that anything Rush Limbaugh says is relevant?
Dave
4 - Cindy
None of it makes any sense, Dave. But what people want to see is insurance for those who can't afford it. That is the bottom line. If it is insurance with plenty of issues that are distasteful or no insurance--there's pretty much only one choice. Sort of like the presidential choices...or any other supposed 'choice' people have about anything.
5 - Clavos
If the only real issue is insurance for those who can't afford it, all that has to happen is for the Medicaid threshold to be lowered to whatever point satisfies every faction and we're done.
6 - Baritone
Dave's last comment first: Regarding Limbaugh - Sadly, a huge number of people DO believe everything Limbaugh spews.
Both handy and Jeanne have very good points.
Dave, of course, is wrong about most of what he writes.
As it happens, I am the supposed "deluded" lefty he chose to quote early in his piece.
He also chose to ignore my next rebuttal. (All this happened on Facebook - BTW.)
I pointed out that his charge that the insurance companies will make out like a hog in slop would not happen if a robust public option is included in the bill.
He also states that the left is firmly behind the Senate version coming out from the "gang of six," which isn't remotely true. It is recognized by both moderates and liberals as a meaningless, watered down nothing of a bill. It only barely will serve as a starting point.
It is unfortunate that Obama had compromised away from his campaign position, which generally supported a single payer system, so early in the game. He gave away far too much from the gitgo.
It goes without saying that Congress would not support a single payer system even though a majority of Americans would welcome it. But, had Obama led a charge for single payer, he could have, little by little, meted out compromises that might well have culminated in the public option. This miscalculation on his part left him with few bargaining chips.
Dave, and most conservatives are over-estimating the strength of the anti-Obama movement. It has been loud, and rude thereby garnering a lot of press. But it's core backing and financing comes primarily from Dick Armey's Freedom Works working in tandem with pharma and many of the insurance companies who together have fed the flames of most of these tea parties and the disruptions at townhall meetings AND the traveling protest gatherings.
Sure some grassroots people have jumped on the bandwagon probably thinking that it was their idea. The fearmongering by the Reps and those working for and on behalf of Freedom Works has succeeded in galvanizing many who were on the right and have hated the left and, in particular, Obama for a variety of reasons. People tend to forget that the right lost last November by a rather large margin. The shine may not be as glossy now as then, but there still remains a majority of people who are behind Obama. They just haven't been as loud as the anti-Obama throng.
The most articulate spokesman from the left is New York Congressman Anthony Weiner. He is an ardent supporter of a single payer system, but is also pragmatic enough to know that that is a remote - virtually non-existent - possibility at this juncture.
I don't agree that the health care legislation should have been approached piecemeal. That would have far too many repeated opportunities for opponents to throw a wrench in the entire effort. I say - all or nothing.
I personally think that Republicans - other than perhaps, Olympia Snowe - are irrelevant and should be completely shut out of the health care reform effort. They clearly want none of it.
The real trouble comes from the damn Blue Dogs, who, frankly are essentially Republicans in sheep's clothing. Indiana's Evan Bayh is one of them. It was noted last Sunday on one of the talking head shows that it's possible Richard Lugar would be more likely to support health care reform than Bayh.
I'd love to see the Dems succeed in enticing Lugar into their camp for health reform. That'd be great.
B
7 - Baritone
Oh, one more thing I take issue with is Dave's repeated notion that 30 million people are uninsured in this country "by choice." That is rot. His numbers don't hold up to any scrutiny. The great majority of the uninsured in this country WANT health insurance, but for a variety of reasons cannot afford it. In the event they need care, their only alternatives are to either go into debt or depend on emergency rooms which are mandated to provide care to all, the cost of which winds up being borne either by the government or in the form of higher premiums for everyone else. The insurance companies absorb little or nothing. Anything that could diminish their bottom line is passed onto their policy holders - not their stock holders.
B
8 - Dave Nalle
Dave, and most conservatives are over-estimating the strength of the anti-Obama movement. It has been loud, and rude thereby garnering a lot of press.
There's really nothing about this in the article we're discussing.
But it's core backing and financing comes primarily from Dick Armey's Freedom Works working in tandem with pharma and many of the insurance companies who together have fed the flames of most of these tea parties and the disruptions at townhall meetings AND the traveling protest gatherings.
This is just pure and utter bullshit, taken from Democratic Party talking points which bear little or no relation to reality. FreedomWorks is playing almost no role at all in the protests, except to claim credit they don't deserve and issue a lot of press releases to make themselves look good. As for Pharma and insurance companies, even less of a role because they are all on Obama's side.
Incrasingly the protesters include people like the 60,000 doctors who have quit the AMA because of its support for the health care bill and many other health care workers who believe they will not be able to do their jobs and serve their patients if this bill goes through.
Sure some grassroots people have jumped on the bandwagon probably thinking that it was their idea.
The grassroots people were there first and dominate the protests. Why do you think you can get away with lying about this to people who know better?
The great majority of the uninsured in this country WANT health insurance, but for a variety of reasons cannot afford it.
Those reasons are outlined in this article. As the article says clearly, they face the choice between overpriced monopolized health insurance and no insurance at all and they DO choose the latter.
Dave
9 - Dave Nalle
The insurance companies absorb little or nothing. Anything that could diminish their bottom line is passed onto their policy holders - not their stock holders.
This is because the absence of competition and the protection of a government facilitated monopoly takes away any incentive to provide good customer service or any service at all to marginal customers when they can focus on the most profitable. Open up real competition and companies will find ways to serve higher risk customers.
Dave
10 - Dave Nalle
Oh, and sorry for not quoting your addendum, but it came in after the article was submitted and Clavos has had it locked until now. I'll see if I can work it in somehow.
Dave
11 - Arch Conservative
The left isn't angry now because they're a plethora of pathetic, patronizing hypocrites(if anyone knows a synonym for hypocrites that starts with p please let me know...i find alliterations so entertaining)
The left spent the last two months demonizing those at the town halls who raised their voices in the presence of Democrat congressmen/women but now we have the left wing loons at the g20 throwing rocks at property and police and generally causing a threat to public safety but the left isn't saying shit. No long winded rants from Olbermann or Maddow......
No........ granny tearing up her aarp card because she doesn't buy into Obamacare is much more of a threat than some 20 year old masked punk chucking rocks at the heads of Pittsburgh's finest.
Although I am angry that we currently have a man destined to be one of the worst presidents in history I, [Gratuitous vulgarity deleted by Comments Editor], (you know who you are) can at least attempt to be objective.
Here are three things I think Obama has gotten right since taking office. They will probably be the only three in his four years.
1. He gave the OK to take out the Somali pirates. It took him longer than it should have but he made the right calla nd captian whatever his name is alive because of it. Kudos Barry!
2. Calling Kanye West a jackass. Who could argue with this one?
3. The last is definitely the most significant. It is obama's hesitancy to send more troops to Afghanistan. Sadly I believe the GOP is playing politics with Afghanistan and not approaching the situation objectively. It is a lost cause if we continue to fight in Afghanistan with the idea that somehow we can make the place anything other than what it was destined to be for all time, a mountainous 10th century shithole full of ungrateful, helpless, cavemen. It is not worth any more American blood or money. If Obama's intent is to withdraw the troops or scale back to some type of covert intel operation then I cannot help but commend him because I believe that would be the right thing to do in Afghnistan. It's very sad that the Dems played politics with Iraq and the GOP is now using Afghanistan as a political football.
12 - Andy Marsh
I must say that I like the fact that Facebook is letting me know the names of a lot of you that have been hiding for years behind these silly screen names...
And I still don't hear or see anyone talking about the number one cost to doctors...their own malpractice insurance. As long as you leave the lawyers alone the price of health care will never go down. Think about it, average insurance cost for an OB/GYN is $200K a year! That's almost $4 grand a month!
Whose pockets are the those trial lawyers in? Come on liberals...you know the answer...you can say it...come on...wanna hint? Starts with a D...
I honestly thought you were smarter than that...damn!
13 - Dave Nalle
No........ granny tearing up her aarp card because she doesn't buy into Obamacare is much more of a threat than some 20 year old masked punk chucking rocks at the heads of Pittsburgh's finest.
Actually, I'd argue that they're right about this. Tens of thousands of grannies tearing up their AARP cards are a much more significant and effective form of protest than some braindead anarchists throwing rocks at the police. The angry grannies vote and have money to spend, so they have real influence beyond just posting a video of police in riot gear dragging your dreadlocked boyfriend off for a night in jail.
Dave
14 - Mark
Beware of Anarchist Grannies...and Aunties! Shouldn't be allowed to handle those cards with their sharp edges anyway.
15 - Cindy
11- Arch
phonies, pretenders, or posers
16 - Cindy
the left wing loons at the g20 throwing rocks at property and police and generally causing a threat to public safety
Ah, Pittsburgh. I was sorry I couldn't make it. It's so close and yet so far.
17 - Cindy
G20 is a trending topic on twitter. (like that alliteration Arch?) I will at least be able to participate (in some modest way) from home. (I'm not much of a rock-thrower anyway.)
18 - Clavos
One more time: enroll everyone who doesn't have and really can't afford health insurance in Medicaid. Leave the 20-somethings who choose not to have insurance and the rest of us happy with what we've got, the hell alone.
The only really viable argument for "reform" is the people (whatever their number) who don't have and do want insurance.
All the rest is pure bullshit.
Note to Andy: I have brought up the issue of tort reform a number of times in the past, but it's a sacred cow to the dems because they get the majority of their funds (both at individual and party levels) from the trial scumbags, er, lawyers, and their lobbyists.
19 - Baritone
After these 3 or so years that I've been posting and commenting here, I don't know how or why I forget what a right-wing haven BC is. You guys love nothing so much as stroking each other's - uh - egos.
You sit upon your high chairs banging your spoons in protest and pontificating from your self-serving and limited perspective while truly understanding virtually nothing.
I haven't the time to make a point by point rebuttal of all the garbage (spoken with a soft "g" to give it some class which it sorely needs.) spewed above. I will note, however, that Freedom Works has provided the money and the venues for most of the protests, but has actually charged other, lesser groups thousands of dollars to participate.
Pharma in particular is NOT on board with Obama and the insurers and HMO's are only willing participants as long as the public option is off the table. They are ready and willing to pick up their toys and go home if it winds up in the final bill.
I live at the home of Eli Lilly and their public position is wholly against the reforms. If they are negotiating privately in any other direction, it would be news to most everyone here.
B
20 - Glenn Contrarian
Baritone -
Don't you know that Dave has stated that BC has a reputation as a 'left-leaning website'?
21 - Glenn Contrarian
Dave -
You know why most of the left isn't enraged?
Because we know that this is merely a first step, a foot in the door, the first pebble giving way on that slippery slope to forcing all of that Last Bastion of Corporate Personhood - the United States of America - to join the Socialists of the Dark Side in the Land of Socialized Medicine: MorCare!
Really, Dave - you've got to Learn How to Stop Worrying and Love the Obama!
22 - roger nowosielski
Like your post, B-man. The Reps don't want to have anything to do with it. So they may as well be left out of the debate. And I think you're also right about the Blue Dogs: they're nothing but "Dinos," to use Limbaugh's terminology.
I agree with Jeannie, however. This bill doesn't go far enough. There's already been too much compromise. The only good thing about it, if it passes, it's the first step - like breaking the barrier.
23 - handyguy
Re: Clavos, #18:
Your simplistic solution has a few holes in it:
The fact that medical costs have been rising at several times the price of inflation.
The resulting increase in premiums is pricing more and more employers and individuals out of the health insurance market.
Pre-existing conditions and other disgusting insurance practices
People who face personal bankruptcy because of medical bills; they often have insurance, just not enough when the bills get very high
20-somethings who don't want to buy insurance...until they get in an auto accident or come down with leukemia or AIDS or diabetes
The latter group should at least be required to buy catastrophic insurance. But the reason for the larger mandate is to enlarge the risk pool -- not because the government craves more power over you.
And regarding tort reform: David Leonhardt, the excellent NY Times economics columnist covered it earlier this week. His conclusion: doctors do prescribe unnecessary treatments to cover their asses, but it amounts to $30 billion a year or less, not insignificant, but not the primary cost driver either.
And...only 3-5% of significant errors result in malpractice suits. The actual costs of lawsuits and damage awards amount to a rounding error in the universe of total healthcare spending.
24 - Clavos
The fact that medical costs have been rising at several times the price of inflation.
Due in large part to the increasing sophistication and scope of modern medical care, an increase which will not be ameliorated by the government paying for and regulating health care, unless we're willing to settle for less of it. Due also to the costs of defensive medicine which increase as above.
Pre-existing conditions and other disgusting insurance practices
Medicaid doesn't do that, and the private insurers have already agreed to stop it in exchange for continuing to be able to sell private insurance -- now a non-issue.
People who face personal bankruptcy because of medical bills; they often have insurance, just not enough when the bills get very high.
Give Medicaid (and I DO mean give -- no charge) to supplement their inadequate private insurance, if the inadequacy is due to their inability to pay the premiums for a good policy.
20-somethings who don't want to buy insurance...until they get in an auto accident or come down with leukemia or AIDS or diabetes
Not a factor -- most don't suffer catastrophes. I'm willing to pay the taxes to take care of those who do -- we're already doing that.
David Leonhardt's opinion is only one of many. Plenty of conservatives argue that the bill is higher, but accepting Mr. Leonhardt's $30 billion figure, that's probably enough to cover the 50 million uninsured who WANT insurance.
And...only 3-5% of significant errors result in malpractice suits. The actual costs of lawsuits and damage awards amount to a rounding error in the universe of total health care spending.
No argument, but the REAL cost is in the coverage (premiums) and especially in the cost of unnecessary defensive medicine.
25 - handyguy
[Me:] Pre-existing conditions and other disgusting insurance practices
[Clavos:] Medicaid doesn't do that, and the private insurers have already agreed to stop it in exchange for continuing to be able to sell private insurance -- now a non-issue.
Yes, assuming the bill passes. But I was responding to your comment suggesting expanding Medicaid instead of the rest of the bill. The insurers want a tit-for-tat, more customers for fewer restrictions.